Factors Associated with Advance Care Planning Among Older Women in Southwest Florida

ABSTRACT

As the nation's population continues to age, many older women will face care needs that can be anticipated in advance. However, little is known about the advance care plans of older women and the characteristics of those who plan. This study utilized a stratified random sampling design to survey older women (n = 124) in the state of Florida regarding their attitudes toward future care and planning behavior in social-environmental, health, and financial domains. Regression analyses were conducted to determine factors most predictive of attitudes toward future care and planning behavior by domain. Results suggest that advanced age predicts greater planning behavior, while living alone is associated with less advance care planning behavior. Other factors associated with less planning by domains of care needs include income status, chronic health conditions, educational attainment, and religious status. Nonaccepting attitudes toward planning were associated with a decreased likelihood to have advance care planning documents.     

Self-perceived health status,gender, and work status

ABSTRACT

This study analyzes the relationship between gender and self-perceived health status in Spanish retirees and housewives from a sample of 1,106 community-dwelling older adults. A multivariate linear regression model was used in which self-perceived health status was measured by the EQ-5D visual analogue scale and gender according to work status (retired men and women and housewives). Retired males reported a significantly better health status than housewives. Self-perceived health status was closely associated with physical, mental, and functional health and leisure activities. Finally, being a woman with complete dedication to domestic work is associated with a worse state of self-perceived health.     

A mixed methods study: Midlife African American women’s knowledge,beliefs, and barriers to well-woman visit,flu vaccine,and mammogram use

ABSTRACT

African American women (AAW) are particularly at risk for deleterious health outcomes that might be mitigated through increased preventive care use. A mixed methods study that examined relationships between knowledge of, beliefs about, and barriers to well-woman visits, flu vaccines, and mammograms was conducted with midlife AAW who participated in an online survey (n = 124) and in-depth interviews (n = 19). Findings showed that greater knowledge of preventive service recommendations and positive patient-provider relationships were associated with greater preventive service use. Flu vaccines were significantly underused. Study implications inform strategies to increase preventive care utilization among AAW and increase capacities to improve health disparities.     

The Psychosocial Context of Bereavement for Older Women Who Were Caregivers for a Spouse With Advanced Cancer

The psychosocial context of bereavement for older women who were caregivers for a spouse with advanced cancer was explored qualitatively with 13 older women. Interviews and diaries were analyzed using constant comparison. The psychosocial context emerged as the intrapersonal : exhaustion, loneliness, pain, and recovering physical health; the interpersonal: finding a new way through both supportive and difficult relationships; and the community/societal: a loss of identity, pressure to move on, financial concerns, and relying on formal supports. The psychosocial context of bereavement for older women who were caregivers is uniquely challenging and must be considered when providing care and programs of support.     

The Influence of the Built Environment and Other Factors on the Physical Activity of Older Women from Different Ethnic Communities

ABSTRACT

Inactivity has been identified as a major contributor to the burden of disease in older women. Study aims were: (a) to assess the personal, social, and environmental facilitators and impediments to physical activity in older women from ethnic communities; and (b) to determine the factors associated with physical activity participation. Older women (aged 60–84 years) were recruited from the local Italian (n = 20), Vietnamese (n = 26) and Anglo-Celtic (n = 26) communities. A survey questionnaire was administered in the participants' preferred language. The most common barriers were: “I am not in good health,” “I am self-conscious about my looks,” “I am too tired,” “I don't have time,” and “The weather is bad.” When comparing the ethnic groups, the Vietnamese women reported fewer barriers than the Italian women (2.6 vs. 5.9). While the Vietnamese women were much more likely to report being “self-conscious about my looks,” the Italian women more commonly reported poor health, being too tired, and not liking exercise as barriers. Overall, those living alone were more likely to be active and those who reported fear of injury, less active. Recognizing ethnospecific differences in the prevalence of barriers may be important when devising strategies to increase activity levels of older women.     

Older Women on the U.S.-México Border: Exploring the Health of Hispanics and Non-Hispanic Whites

ABSTRACT

Research on ethnicity and socioeconomic status (SES) suggests that Hispanics are more likely than non-Hispanic Whites to experience poverty and low levels of education, which may relate to poorer health status. This study used a health survey to examine income, education, ethnicity, birthplace, and age on self-reported health factors of women age 60 and older on the U.S.-México border. Results show that income, age, and education were significantly associated with several health factors (Physical Health, Emotional Health, General Health, Energy Level, and Activity Potential). Older women with lower SES, regardless of ethnicity, reported poorer health than younger-old women with higher SES.     

“If you can have one glass of wine now and then,why are you denying that to a woman with no evidence”: Knowledge and practices of health professionals concerning alcohol consumption during pregnancy

BackgroundAlcohol consumption during pregnancy has the potential to cause significant harm to the foetus and the current Australian guidelines state that it is safest not to drink alcohol while pregnant. However, conflicting messages often appear in the media and it is unclear if the message to avoid alcohol is being effectively conveyed to pregnant women.AimsThis research aims to explore the advice that health professionals provide to pregnant women about alcohol consumption; the knowledge of health professionals regarding the effects of alcohol consumption; and their consistency with following the Australian guidelines.MethodsTen semi-structured face to face interviews were conducted with health professionals who regularly provide antenatal care. These include midwives, obstetricians, and shared care general practitioners. A six-stage thematic analysis framework was used to analyse the interview data in a systematic way to ensure rigour and transparency. The analysis involved coding data extracts, followed by identifying the major themes.FindingsHealth professionals displayed adequate knowledge that alcohol can cause physical and mental difficulties that are lifelong; however, knowledge of the term FASD and the broad spectrum of difficulties associated with alcohol consumption during pregnancy was limited. Although health professionals were willing to discuss alcohol with pregnant women, many did not make this a routine part of practice, and several concerning judgements were noted.ConclusionCommunication between health professionals and pregnant women needs to be improved to ensure that accurate information about alcohol use in pregnancy is being provided. Further, it is important to ensure that the national guidelines are being supported by health professionals.     

Social Support for Exercise by Experts in Older Women Post–Hip Fracture

ABSTRACT

Using the data of the Baltimore Hip Study 5 (a home-based exercise intervention), this study examined how social support for exercise by experts (SSE-E) affected the self-efficacy, outcome expectations, and exercise behavior among older women following a hip fracture. The total sample included 164 females aged 65 years (M = 81.0; SD = 6.9) who had surgical repair of a nonpathologic hip fracture. Model testing showed a direct relationship between SSE-E and outcome expectations for exercise. There was, however, no direct or indirect relationship between SSE-E and self-efficacy or exercise behavior. The positive effect of SSE-E on the outcome expectations for exercise in older women recovering from a hip fracture provides an opportunity for health care providers in improving physical activity in this population.     

Women's frequency of alcohol consumption prior to pregnancy and at their pregnancy-booking visit 2001–2006: A cohort study

BackgroundWith evidence of offspring harms and concern for younger women's drinking behaviours, this study uses a hospital cohort to trend the use and changes in women's reported alcohol consumption.AimsTo examine (i) the trend of women's reported alcohol consumption over time, (ii) whether any increases in the frequency of alcohol consumption prior to a pregnancy are accompanied by increases in the frequency of alcohol consumption in pregnancy and (iii) the characteristics of women consuming alcohol at these times.MethodsMidwives collected routine data on 19,699 women between 2001 and 2006. Data on women's alcohol use prior to pregnancy and at their pregnancy-booking visit were analysed using a non-parametric test for trend and with bivariate and multivariate tests adjusting for possible confounders.FindingsThe proportion of women reporting at-least weekly alcohol use prior to pregnancy was 25.4% and 5.9% at their pregnancy-booking visit. A significant linear increase over time (p < 0.001) was found in the rate of women aged 20 years and older reporting at-least weekly alcohol use prior to pregnancy. Tertiary-educated women were more likely to consume alcohol at-least weekly prior to pregnancy. Women aged less than 20 years were less likely to report at-least weekly alcohol use at both time points. Having more children and Asian ethnicity were associated with a lower risk of at-least weekly alcohol use at these times.ConclusionThe majority of women reduce their alcohol consumption once they learn they are pregnant, with some evidence this trend may have increased in recent years.     

Exploring First Sexual Intercourse,Sexual Orientation,and Sexual Health in Men

In this study the characteristics of the sexual debut of men who have sex with men (MSM) and men who have sex with women (MSW) age 35 or younger (N = 1,201) were compared with one another. We investigated whether these characteristics were associated with sexual health and behavior, and to what extent. Compared to MSW, MSM tended to be older when they had their first sexual intercourse; their first sex partner was older, they felt less ready, and they experienced more pain. We also found that they reported a higher number of lifetime sexual partners and less condom use compared to MSW. Similarities were also ascertained, such as the fact that individuals from both groups do not differ significantly regarding how they experienced their first sexual intercourse emotionally. Many differences between these groups should not always be seen as problematic, whereas others still indicate a need for targeted interventions.     

Self-regulation in older Thai women with self-reported knee osteoarthritis: A path analysis

Abstract

This study aimed at testing factors influencing coping behavior and health status among older women with knee osteoarthritis. A total of 274 participants completed questionnaires. Model testing revealed that self-efficacy was the most powerful predictor of coping behavior. Illness representation had a significant direct and indirect effect on health status and was a better predictor of health status than were the other variables. Understanding the complex relationships among study variables should help to tailor future interventions to better address the symptoms of osteoarthritis and to promote optimal health in older Thai women who report knee osteoarthritis.     

Increased Hospitalization Risk for Recently Widowed Older Women and Protective Effects of Social Contacts

SUMMARY

This study examines effects of recent widowhood on health for a nationally representative sample of older women in the United States. Mediating effects of social connectedness on the health of recently widowed women are also explored. Using data from the 1984–1990 Longitudinal Study of Aging and Medicare claims, discrete-time hazard models estimate the risk of hospitalization for any 30-day period for women who were married at the time of the baseline survey (n = 1,138). Compared to women who are not recently widowed, those recently widowed have a 40% higher risk of hospitalization. Social connectedness, measured by having phoned a friend/neighbor or family member in the period prior to the baseline survey, significantly decreases hospitalization risk for the recently widowed. The findings indicate that recent widowhood has a large adverse effect on the health of older women. Results highlight the need to provide additional support to recently widowed older women.     

Perceived neighborhood social disorder as a predictor of depressive symptoms among unmarried older women and the stress-buffering effect of friends support

ABSTRACT

The current study examined whether perceived neighborhood social disorder predicted depressive symptoms among unmarried older women (N = 823) drawn from the 2016 Health and Retirement Study. This study also tested the stress-buffering effect of friends support. A negative binomial regression model showed that higher perceived neighborhood social disorder was associated with higher depressive symptoms. The number of close friends was a significant factor, but no stress-buffering effect of friends support was identified. This study highlights the adverse effect of negative perceptions of the neighborhood social environment on unmarried older women’s depressive symptoms.     

A pilot study combining Go4Life® materials with an interactive voice response system to promote physical activity in older women

ABSTRACT

Telephone-based interactive voice response (IVR) systems could be an effective tool for promotion of physical activity among older women. To test IVR feasibility, we enrolled 30 older women in a 10-week physical activity intervention designed around National Institute on Aging (NIA) Go4Life® educational materials with IVR coaching. Participants (mean age = 76 years) significantly increased physical activity by a mean 79 ± 116 (SD) minutes/week (p < .001). Participants reported that the Go4Life® materials, pedometer, and IVR coaching (70% reported easy technology) were useful tools for change. This pilot study demonstrates IVR acceptability as an evidence-based physical activity program for older women.     

Gender differences in the experience of loneliness in U.S. Chinese older adults

This study aimed to explore the gender differences in the experiences of loneliness in the U.S. Chinese older population. The data were drawn from the PINE study, a population-based study of U.S. Chinese adults aged 60 years and older. The Revised–University of California at Los Angeles Loneliness Scale (R-UCLA) was used to measure loneliness. Overall, older Chinese women (28.3%) had a higher rate of loneliness than older men (23.3%, p < .001). In particular, women were more likely to sometimes or often experience a lack of companionship than men (22.9% vs. 17.3%, p < .001). Older women living with fewer people, with lower health status, poorer quality of life, and worsening health changes over the past year were more likely than men to experience any loneliness. This study indicates that gender differences exist in the prevalence, symptoms, and correlates of loneliness. Longitudinal studies should be undertaken to understand gender differences in risk factors and outcomes of loneliness.     

Explaining age differences in women’s emotional well-being: The role of subjective experiences of aging

ABSTRACT

Our study examines explanations for the “paradox” of older women’s better emotional well-being compared with younger women. We consider the role of subjective experiences of aging in a society that devalues older women. Using a sample of women (n = 872) from the National Survey of Midlife Development in the United States (1995–1996 and 2004–2006), we examine the role of five components of the subjective experience of aging in explaining older women’s better emotional well-being compared with younger women: age identity, conceptions of the timing of middle age, aging attitudes, aging anxieties, and self-assessed physiological changes. We find that, compared with women 50–54 years old, those 35–39 years old report lower positive affect, and those 25–49 report higher negative affect. These patterns are partially explained by younger women’s greater anxiety about declines in health and attractiveness and older women’s more youthful identities. Our study underscores the value of considering the implications of our ageist and sexist society for women’s emotional well-being across adulthood.     

Perceptions of Aging Among Rural,Midwestern Senior Citizens: Signs of Women's Resiliency

ABSTRACT

This study utilized both quantitative and qualitative approaches to examine perceptions of aging among rural-dwelling senior citizens (203 women and 112 men), ages 65 and older. Quantitative results revealed that, despite no significant gender differences in the total number of medical conditions reported, women were less likely than men to report that health problems interfered with their daily functioning. Qualitative analyses revealed that women were particularly like to identify relationships, frame of mind, participating in activities, and religion/spirituality as important contributors to successful aging.     

Mental health differences between men and women caregivers,BRFSS 2009

This study uses data from the 2009 Behavioral Risk Factors Surveillance System (BRFSS) to examine differences between male and female caregivers by demographics, health-related quality of life (HRQOL), and the effect of social support on HRQOL. Roughly two-thirds of caregivers were women, and demographic characteristics differed among men and women caregivers. Women caregivers reported significantly more mentally and physically unhealthy days than men, but there were no differences between men and women in general health or life satisfaction. Men were significantly more likely to report that they rarely or never received social support. Despite this, the effect of social support on HRQOL was stronger in men than in women. Implications of these findings for caregiver support programs are discussed.