Enhancing Women's Partnership with Health Providers in Hormone Replacement Therapy Decision-Making:

In the next two decades nearly 40 million women will reach menopause. The women now approaching menopause are different in a variety of ways from previous cohorts of women. More women are surviving to this age with better health and functioning. They are better educated and the first cohort of women to have been employed outside the home throughout most their adult years. This cohort of women expect more from the health care system. They want far more information, involvement, control and choice regarding their care. The pressures of this most educated, consumer-oriented cohort will soon be felt in the services women seek related to menopause. This cohort of women is reaching menopause at a time where there are still no definitive answers about the long-term safety and efficacy of hormone replacement therapy (HRT). The task is not to convince women to use HRT, but to help women make informed choices in the face of uncertainty. The purpose of this paper is to explore some of the unique problems associated with delivering services to this growing population and to consider the research and practice changes which may be required to meet this challenge.     

"Why can't you control this?" How women's interactions with intimate partners define menopause and family

In this article I explore women's discussions of the interactions that families have about menopause and, thus, attempt to broaden feminist knowledge of women's experiences of menopause within families. Data on which this article is based were collected in 61 in-depth interviews with menopausal women in a midwest state in 2001. Findings suggest that biomedical definitions of menopause are often reaffirmed within interactions between intimate partners. Thus, women reported negative familial interactions about menopause, as they were encouraged to define symptoms as problematic and seek medical treatment. Alternatively, some interviewees reported positive interactions about menopause, as a few partners helped them soothe symptoms and follow health regimens. Women interpreted these latter interactions as support or care, rather than surveillance or monitoring. The author concludes that familial interactions bolster dominant constructions of both menopause and family because, as menopause is discussed between intimate partners, definitions of gendered familial roles and responsibilities are cemented.     

Women at Midlife: Women's Perceptions,Physicians' Perceptions

Research and assessment of the well-being of women at midlife, for the most part, focuses on assumptions based on stereotypes and myths that hinder our ability to realistically appraise women's experiences. Women's reproductive role, manifested in the centrality of menopause, predominates in the health literature. This paper looks at how physicians and midlife women view the experiences of midlife women. Attribution theory is used to offer explanations for different perceptions that may hinder appropriate health care. Suggestions to mitigate these differences in the future are offered.     

Best practices for online Canadian prenatal health promotion: A public health approach

Background

Prenatal health promotion provides information regarding pregnancy risks, protective behaviours and clinical and community resources. Typically, women obtain prenatal health information from health care providers, prenatal classes, peers/family, media and increasingly, Internet sites and mobile apps. Barriers to prenatal health promotion and related services include language, rural/remote location, citizenship and disability. Online public health platforms represent the capacity to reach underserved women and can be customised to address the needs of a heterogeneous population of pregnant women.

我国农村地区老年人群体的健康状况研究

今天,健康已经成为人们生活质量的重要组成部分。中国作为世界上老龄化速度最快的国家之一．人口老龄化是本世纪我国遇到的一个重要社会问题。随着老年人口的增加,不仅仅是城市地区,农村老年人群体的健康条件也越来越引起人们的重视。为此,本文使用2005年4月进行的全国性抽样跟踪调查数据。对我国五个省份地区的八百多个五十岁以上的老年人健康进行了调查分析。研究表明。农村地区老年人的身体健康存在明显的性别差异和地区差异,尤其是老年女性的身体健康状况较男性明显落后。     

Preliminary Evaluation of the Validity and Reliability of the Spanish Version of the Therapeutic Alliance with Clinician (TAC) Questionnaire

As part of a broader study aimed at evaluating perceived alliance with service providers and level of satisfaction with services received, 103 monolingual Spanish speaking Hispanic women were interviewed. Participants were receiving ongoing behavioral health treatment at three different community service provider sites located in the greater New Haven area in Connecticut. These sites included a community health center (n = 40), a community behavioral health center (n = 40), and a faith-based agency (n = 23). As part of this study, the English version of the Therapeutic Alliance with Clinician (TAC) questionnaire was translated into Spanish and administered to our sample of Hispanic women. Results on the psychometric properties of the Spanish version of the TAC are presented in this article.     

Effects of the COVID-19 pandemic on perinatal mental health in Spain: Positive and negative outcomes

BackgroundPrevious studies have shown that perinatal distress has a negative influence on pregnancy outcome and the physiological development of the baby.ObjectiveThe aim of this study was to describe the effects of the COVID-19 pandemic on maternal perinatal mental health in Spain.MethodsSeven hundred and twenty-four women (N = 450 pregnancy, N = 274 postpartum) were recruited online during the pandemic. The Edinburgh Postnatal Depression Scale, the Positive and Negative Affect Schedule, and the Satisfaction With Life Scale were administered. Variables related to sociodemographic information, the COVID-19 pandemic, and perinatal care were also assessed.FindingsThe results showed that 58% of women reported depressive symptoms. Moreover, 51% of women reported anxiety symptoms. On the other hand, a regression analysis for life satisfaction showed that besides the perception about their own health, marital status or being a health practitioner were also significant predictors during pregnancy. However, perception about baby’s health and sleep, perception about their own health, and marital status were significant predictors of life satisfaction during the postpartum stage.DiscussionWomen assessed during the COVID-19 pandemic reported high rates of psychological distress.ConclusionThese results highlight the need of clinical support during this period. Knowing the routes to both distress and well-being may help maternity services to effectively cope with the pandemic.     

Afghan families and health professionals’ access to health information during and after pregnancy

BackgroundHaving a baby in a new country can be challenging, especially if unable to communicate in a preferred language. The aim of this paper is to explore the provision of health information for Afghan women and men during pregnancy, childbirth and the first year after birth in Melbourne, Australia.MethodsCommunity engagement underpinned the study design. Qualitative study with bicultural researchers conducting semi-structured interviews. Interviews and focus groups were also conducted with health professionals.ResultsSixteen Afghan women and 14 Afghan men with a baby aged 4–12 months participated. Thirty four health professionals also participated. Verbal information provided by a health professional with an interpreter was the most common way in which information was exchanged, and was generally viewed favourably by Afghan women and men. Families had limited access to an interpreter during labour and some families reported difficulty accessing an interpreter fluent in their dialect. Availability of translated information was inconsistent and health professionals occasionally used pictures to support explanations. Women and men were unsure of the role of health professionals in providing information about issues other than pregnancy and infant wellbeing.ConclusionBoth individual and health system issues hinder and enable the availability and use of information. Consistent, understandable and ‘actionable’ information is required to meet the needs of diverse families. Health professionals need to be supported with adequate alternatives to written information and access to appropriate interpreters. Inconsistent provision of information is likely to contribute to low health literacy and poor maternal and child health outcomes.     

After Menopause

Women of 50 today have roughly the same number of years to look forward to as they have already lived as reproductive women. Many women will live 30,40 or even 50 years post menopause. This very important period in women's lives has been studied little and viewed negatively by the medical profession and society at large. The purpose of this paper is to examine the psychological and physiological concerns of women at menopause. Self-help measures that are effective in managing the physical and psychological aspects of menopause are discussed. Hormone replacement therapy as a method of managing menopause is examined. Women are challenged to sort out the myths surrounding menopause, to take charge of their health and to move into this second season of their lives filled with vitality and joy.     

Older women and the internet

This study was designed to explore the effects that training had on older adults' willingness to use the Internet to manage their health care. The most interesting result was that out of 70 self-volunteers, 58 were women. Results show that highly educated women who either own a computer or have access to one, and have low levels of anxiety toward computers, with strong feelings of self-efficacy toward computers and the Internet, and an internal locus of control, are more willing than men to use the Internet to find medical information to manage a chronic health problem.     

An alternative sampling strategy for obtaining child health data in a reproductive health survey

Retrospective demographic surveys typically collect substantial information about child health. This information is often collected for all children born during a specified period. For women with several young children, the interview can become quite long. To shorten the interview, some surveys have asked child health questions only for the last child born. However, data on the last birth may be biased because last children have a younger age distribution and have longer subsequent birth intervals than does the average child. In this paper, we propose an alternative approach to collecting child health data - that child health questions be asked only for a child chosen randomly from among the respondent's children younger than age five. This alternative has the advantage of keeping the interview shorter but does not lead to biased information.Abbreviations DHS Demographic and Health Surveys     

“Whatsapping” the continuity of postpartum care in Switzerland: A socio-anthropological study

BackgroundDigital media such as Apps, Internet and social networks have become integral parts of the maternity experience for more than a decade. These media can support or undermine women’s experiences as has been shown in digital sociology research. Using Immediate Messaging Applications to provide information and support to women during the perinatal period is an emerging practice.AimThis article analyses how health and social care professionals – with a focus on community midwives – and women communicate between postpartum home visits through Immediate Message Applications in Switzerland.MethodsA socio-anthropological study that relied on qualitative methods including semi-directed interviews with midwives and health and social care professionals (n = 30) and immigrant women (n = 20).FindingsSince the introduction of Immediate Messaging Applications, women and their carer converse more regularly between post-partum home visits. Women send questions, pictures and videos to them, often allowing swift responses to their concerns. Midwives encounter difficulties answering women’s questions when they cannot be solved through quick communication (e.g. infant crying). To them, texting frequency forms a clinical clue to women’s mental health. Not all women contact their carer through digital messages; immigrant women are less likely to know and use this service.Discussion and conclusionImmediate Messaging Applications form a promising communication tool, complementary to home visits, and contribute to woman-centered care and continuity of care. As an emergent practice, it has not been framed by a guideline yet. Policy makers and practitioners should ensure that its use does not contribute to unequal access to care.     

Good mothers never wane: mothering at menopause

Due to recent feminist scholarship, we know a considerable amount about women's mothering identities and activities, as well as the impact of mothering ideology on individual women. Nonetheless there are gaps in our knowledge about motherhood. For instance, we know mostly about experiences of mothers with young children, and an implicit assumption is that mothers are also fairly young themselves. Yet, what about mothers at midlife and beyond? What about menopausal mothers? This paper represents an initial attempt to explore motherhood experiences of middle-aged menopausal women. Findings presented in this article are based on 45 in-depth interviews with middle-class, heterosexual menopausal women in a midwestern state in 2001. Findings suggest that motherwork and the maintenance of "good" mothering ideology are still primary activities of women at menopause despite assumptions that menopausal women have completed mothering experiences and are now grandmothers (if caregivers at all). In analyzing menopausal mothers, I encourage broader explorations of women's experiences of both motherhood and menopause.     

Self-Care Strategies of Menopausal Women

ABSTRACT

The purpose of this study was to describe the self-care strategies related to natural menopause used by menopausal women. The Self Care Responses Questionnaire (SCR) was completed by a convenience sample of 99 middle class, mostly Caucasian, married, employed women. The women used many self-care responses, on average, 32 of the 39 possible. The frequently used strategies, “accept changes in my body,” “have faith,” “keep busy,” “educate myself,” and “accept as legitimate,” suggest that these women are successful in their self care related to menopause. Consistent with a women's health perspective, they seemed to view menopause as a developmental phase which they have integrated into their lives.     

Seeking and Processing Information for Health Decisions among Elderly Chinese Singaporean Women

Information behavior includes activities of active information seeking, passive acquisition of information, and information use. Guided by the Elaboration Likelihood Model, this study explored elderly Singaporean women’s health information behavior to understand how they sought, evaluated, and used health information in everyday lives. Twenty-two in-depth interviews were conducted with elderly Chinese women aged 61 to 79. Qualitative analysis of the interview data yielded three meta-themes: information-seeking patterns, trustworthiness of health information, and peripheral route of decision making. Results revealed that elderly women took both systematic and heuristic approaches to processing information but relied on interpersonal networks to negotiate health choices.     

Good Mothers Never Wane: Mothering at Menopause

ABSTRACT

Due to recent feminist scholarship, we know a considerable amount about women's mothering identities and activities, as well as the impact of mothering ideology on individual women. Nonetheless there are gaps in our knowledge about motherhood. For instance, we know mostly about experiences of mothers with young children, and an implicit assumption is that mothers are also fairly young themselves. Yet, what about mothers at midlife and beyond? What about menopausal mothers? This paper represents an initial attempt to explore motherhood experiences of middle-aged menopausal women. Findings presented in this article are based on 45 in-depth interviews with middle-class, heterosexual menopausal women in a midwestern state in 2001. Findings suggest that motherwork and the maintenance of “good” mothering ideology are still primary activities of women at menopause despite assumptions that menopausal women have completed mothering experiences and are now grandmothers (if caregivers at all). In analyzing menopausal mothers, I encourage broader explorations of women's experiences of both motherhood and menopause.     

Perinatal mental healthcare: Developing skills in midwifery students

Midwives have a pivotal role in screening for risk factors for mental illness and psychosocial vulnerabilities in women during the perinatal period. They also have a key responsibility to provide women with the appropriate resources to support their mental wellbeing. Midwives can lack confidence and/or feelings of competence regarding these skills.Care of women in the context of their perinatal mental health is a core midwifery skill that deserves practical learning during pre-registration education, just as the more ‘hands on’ skills such as abdominal palpation, labour and birth support or newborn examination. However, there is limited opportunity for students to gain clinical placement experiences that are specific to perinatal mental health (PMH).This discussion paper describes an innovative teaching and learning project that aimed to improve confidence in students’ ability to conduct screening, support, and referral of women experiencing mental ill health. The project involved the development of an Objective Structured Clinical Examination (OSCE) and audio visual resources to support learning and teaching and clinical placement. Feedback was collected to inform the refinement of the first OSCE, and to assist in the design of the audio visual resources that are now displayed publicly on the Australian College of Midwives website at https://www.midwives.org.au/Web/Web/Professional-Development/Resources.aspx?hkey=12c2360e-d8b9-4286-8d0a-50aeaeca9702.