Self-management of a chronic illness: An exploratory study on the role of spirituality among older African American women

Living with a chronic illness is an experience characterized by changes in self-management behavior. Few studies have addressed the role of spirituality in the self-management of a chronic illness among older African American women. The purpose of this exploratory study was to understand the role of spirituality in the self-management of chronic illness. Data from a sample of 10 African American women were collected from semi-structured interviews and analyzed for common themes through narrative analysis. Four themes emerge from the linkage of spirituality and self-management. Understanding this experience will assist public health providers in creating culturally appropriate health education interventions.     

Self-Management of a Chronic Illness: An Exploratory Study on the Role of Spirituality Among Older African American Women

ABSTRACT

Living with a chronic illness is an experience characterized by changes in self-management behavior. Few studies have addressed the role of spirituality in the self-management of a chronic illness among older African American women. The purpose of this exploratory study was to understand the role of spirituality in the self-management of chronic illness. Data from a sample of 10 African American women were collected from semi-structured interviews and analyzed for common themes through narrative analysis. Four themes emerge from the linkage of spirituality and self-management. Understanding this experience will assist public health providers in creating culturally appropriate health education interventions.     

Taking charge of self: breast health practices of older rural women

The purpose of this grounded theory study was to explore breast health practices of older Vermont women residing in rural communities. Although the three components of breast health-mammography, clinical breast exam, and self-breast exam-are recommended for women 40 years and over, minimal research has empirically analyzed the breast health practices of healthy women to ascertain if, in fact, these procedures are followed, and if so, what the motivation is for doing so. Twelve women, 50-64 years, participated in face-to-face, audiotaped interviews. Data analysis, including line-by-line and constant comparative approaches, occurred concurrently with data collection. Taking Charge of Self, the generated theory, describes participants' engagement in a process of learning how to take charge of their lives. The analysis indicates that health care providers have a powerful role in the lives of women in this age group. With an increasing emphasis on health promotion and disease prevention, health care providers are positioned to cultivate and support women's development of the personal or internal motivation for health and well-being.     

Patterns of pain and well-being in older women: a 10-year longitudinal study

The relationships among pain, health, and psychological well-being were examined in a secondary analysis of a ten-year study of community-dwelling older women. Over time, there was an increase in the percentage of women reporting pain and a significant increase in the mean level of pain, although 24% of the women never reported pain. Subjective health declined as pain increased. Psychological well-being did not differ between women whose pain increased over time compared to women whose pain did not increase. Future research needs to examine how women maintain psychological well-being as they age in spite of increased pain.     

Women, aging, and schizophrenia

Schizophrenia is a psychiatric disorder of unknown etiology that typically has an onset in early adulthood and persists for the remainder of the lifespan. For most affected individuals, the illness is recurrent with psychotic symptoms that tend to be episodic in nature. The illness has pervasive and disruptive effects on many life domains; for example, women with schizophrenia are less likely to marry, bear children, and raise their own children than are women in the general population. The age of onset of schizophrenia is later on average in women then men, and women are over-represented among those who develop the illness after the age of 45. Among younger patients with schizophrenia, women tend to have less severe symptoms than men and better outcomes; however, there are fewer gender differences among older patients with schizophrenia. Older women with schizophrenia are vulnerable to problems of both schizophrenia and aging. Schizophrenia symptoms typically continue in later years and include ongoing psychotic symptoms. Problems of aging such as cognitive decline and chronic medical conditions may be exacerbated by schizophrenia and the disorder is associated with premature mortality. Older women with schizophrenia are at risk for neglect of psychiatric and other health needs that are further compounded by limited social support and low socioeconomic status. More research and clinical attention is needed to the problems of older women with schizophrenia.     

Social support promoting health in older women

Given the aging of women and their increased risk for health problems, it is important to explicate factors that may foster health promotion. While social support has been a concept of interest in predicting health promotion in women, the concept has been inconsistently defined and poorly explicated. A qualitative study was conducted to describe the types and processes of social support for health promotion in older women. Focus group interviews with 51 women, aged 55-93, were held. Data were analyzed using open coding to categorize data with attention to consistency and variance. Data explicated aspects of social support unique to health promotion in community-dwelling older women. Broad categories identified included connectedness and collectivism. Findings validate existing conceptualizations and provide an expanded perspective of social support by demonstrating aspects of support unique to the social context of older, community-dwelling women. Findings also provide a basis for development of socially relevant interventions designed to promote health and optimize health outcomes in older women.     

Promoting Older Women's Health and Well-Being Through Social Leisure Environments: What We Have Learned from the Red Hat Society®

ABSTRACT

The purpose of this study was to describe the ways that participation in a leisure organization contributed to the health and well-being of middle-aged and older women. We analyzed 1,693 members' responses to a query about meaningful experiences garnered through participation in the Red Hat Society®. Results suggested that older women's lives have been enriched and changed by their experiences, with the women in this study citing multiple psychosocial health benefits from their participation in the Red Hat Society®. Main themes encapsulating these health benefits were creating happy moments, responding to transitions and negative events, and enhancing the self. These findings are related to research on positive psychology, social support and coping, transformative leisure processes, and social identity formation. We conclude by providing suggestions for applying these findings to leisure and health promotion programming to enhance women's health and well-being in later life.     

Taking Charge of Self: Breast Health Practices of Older Rural Women

ABSTRACT

The purpose of this grounded theory study was to explore breast health practices of older Vermont women residing in rural communities. Although the three components of breast health-mammography, clinical breast exam, and self-breast exam-are recommended for women 40 years and over, minimal research has empirically analyzed the breast health practices of healthy women to ascertain if, in fact, these procedures are followed, and if so, what the motivation is for doing so. Twelve women, 50–64 years, participated in face-to-face, audiotaped interviews. Data analysis, including line-by-line and constant comparative approaches, occurred concurrently with data collection. Taking Charge of Self, the generated theory, describes participants' engagement in a process of learning how to take charge of their lives. The analysis indicates that health care providers have a powerful role in the lives of women in this age group. With an increasing emphasis on health promotion and disease prevention, health care providers are positioned to cultivate and support women's development of the personal or internal motivation for health and well-being.     

Women,Aging, and Schizophrenia

SUMMARY

Schizophrenia is a psychiatric disorder of unknown etiology that typically has an onset in early adulthood and persists for the remainder of the life span. For most affected individuals, the illness is recurrent with psychotic symptoms that tend to be episodic in nature. The illness has pervasive and disruptive effects on many life domains; for example, women with schizophrenia are less likely to marry, bear children, and raise their own children than are women in the general population. The age of onset of schizophrenia is later on average in women than men, and women are overrepresented among those who develop the illness after the age of 45. Among younger patients with schizophrenia, women tend to have less severe symptoms than men and better outcomes; however, there are fewer gender differences among older patients with schizophrenia. Older women with schizophrenia are vulnerable to problems of both schizophrenia and aging. Schizophrenia symptoms typically continue in later years and include ongoing psychotic symptoms. Problems of aging such as cognitive decline and chronic medical conditions may be exacerbated by schizophrenia and the disorder is associated with premature mortality. Older women with schizophrenia are at risk for neglect of psychiatric and other health needs that are further compounded by limited social support and low socioeconomic status. More research and clinical attention is needed for the problems of older women with schizophrenia.     

Quality of Life Among Older Women with Rheumatoid Arthritis

The purpose of this study was twofold: (1) to identify perceptions of quality of life among a sample of 35 older women with rheumatoid arthritis; and, (2) to describe the strategies they employ to improve the quality of their lives. The responses of these women were consistent with other studies examining dimensions of quality of life; however, these participants also revealed specific self-care actions that were planned and deliberate, aimed at making their lives more enjoyable. This study also underscored the impact of chronic illness on the economic well-being of oIder women.     

Family structure and well-being at older ages in Japan

The family structure of older Japanese is projected to change dramatically as a result of very low fertility, increasing levels of non-marriage, childlessness, and divorce, and declining intergenerational co-residence. To provide an empirical basis for speculation about the implications of projected increases in single-person and couple-only households, we use two sources of data to describe relationships between family structure and the physical and emotional well-being of Japanese men and women aged 60 and above. We find that marriage is positively associated with self-rated health and emotional well-being among older men but not women. In contrast to expectations, however, we find only limited evidence that the presence of children contributes to well-being. Taken as a whole, our results suggest that declines in marriage may have negative implications for the well-being of older Japanese men while the implications of declines in fertility and intergenerational co-residence may be less than popularly believed.     

Promoting older women's health and well-being through social leisure environments: what we have learned from the Red Hat Society

The purpose of this study was to describe the ways that participation in a leisure organization contributed to the health and wellbeing of middle-aged and older women. We analyzed 1,693 members' responses to a query about meaningful experiences garnered through participation in the Red Hat Society. Results suggested that older women's lives have been enriched and changed by their experiences, with the women in this study citing multiple psychosocial health benefits from their participation in the Red Hat Society. Main themes encapsulating these health benefits were creating happy moments, responding to transitions and negative events, and enhancing the self. These findings are related to research on positive psychology, social support and coping, transformative leisure processes, and social identity formation. We conclude by providing suggestions for applying these findings to leisure and health promotion programming to enhance women's health and well-being in later life.     

Healthy,Wealthy, Wise,and Happy? Assessing Age Differences in Evaluative and Emotional Well-Being Among Mature Adults from Five Low- and Middle-Income Countries

This study assesses the relationship between age and two dimensions of subjective well-being—evaluative and emotional—among mature adults from five low-and middle-income countries. We use data from the World Health Organization’s Study on Global AGEing and Adult Health to contrast the associations of age with subjective well-being when controlling only for gender with the corresponding partial associations when including a richer set of covariates. Adjusting only for gender, we find negative associations of age with evaluative well-being, while the corresponding age gradients for emotional well-being are relatively flat. By contrast, adjusting for further socio-demographic factors results in positive associations of age with both evaluative and emotional well-being. Oaxaca-Blinder decompositions allow us to explore the roles of two factors to account for any unadjusted age differences in subjective well-being: age-group differences in individual characteristics and life circumstances, and age-specific associations of individual characteristics and life circumstances with subjective well-being. While adverse circumstances such as poor health and low income contribute to lower levels of evaluative well-being among older adults, age per se is—ceteris paribus—positively associated with subjective well-being. Even in poorer countries, older age does not need to be a time of low subjective well-being. Policies aimed at preserving income and limiting or compensating old-age disability appear to be key for maintaining subjective well-being among older adults.

     

Economics and Well-Being of Older Divorced Persons

The purpose of this research was to compare gender differences in postdivorce cconomic factors and in the well-being of older persons who were in long-term marital relationships. Although more women were depressed, overall there were no significant gender differences in postdivorce adjustment. Data suggest present income is the best predictor of well-being for both genders, and reliance on types of gender related income have a negative impact on women. Findings are discussed in terms of implications for structural changes, policy modifications, and direct practice issues.     

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.     

Trends in health of older adults in the United States: Past,present, future

The decline in late-life disability prevalence in the United States was one of the most important developments in the well-being of older Americans in the 1980s and 1990s, but there is no guarantee that it will continue into the future. We review the past literature on trends in disability and other health indicators and then estimate the most recent trends in biomarkers and limitations for both the population aged 65 and older and those aged 40 to 64, the future elderly. We then investigate the extent to which trends in education, smoking, and obesity can account for recent trends in limitations and discuss how these three factors might influence future prospects for late-life health. We find that improvements in the health of the older population generally have continued into the first decade of the twenty-first century. The recent increase in the proportion of the younger population needing help with activities of daily living is concerning, as is the doubling of obesity in the last few decades. However, the increase in obesity has recently paused, and favorable trends in education and smoking are encouraging.     

Unpacking Self-Rated Health and Quality of Life in Older Adults and Elderly in India: A Structural Equation Modelling Approach

The Study on global AGEing and adult health (SAGE) aims at improving empirical understanding of the health and well-being of older adults in low- and middle-income countries. A total of 321 adults aged 50 years and older were interviewed in rural Pune district, India, in 2007. We used Structural Equation Modelling (SEM) to examine the pathways through which social factors, functional disability, risk behaviours, and chronic disease experience influence self-rated health (SRH) and quality of life (QOL) amongst older adults in India. Both SRH and QOL worsened with increased age (indirect effect) and limitations in functional ability (direct effect). QOL, socio-economic status (SES), and social networking had no significant effect on SRH. Smoking was associated with the presence of at least one chronic illness, but this did not have a statistically significant effect on SRH. Higher social networking was seen amongst the better educated and those with regular income, which in turn positively affected the QOL rating. QOL had a direct, but statistically not significant, effect on SRH. In conclusion, the indirect effects of age on SRH mediated through functional ability, and the effects of SES on QOL mediated through social networking, provide new understanding of how age and socio-economic status affect SRH and QOL. By allowing for measurement errors, solving for collinearity in predictor variables by integrating them into measurement models, and specifying causal dependencies between the underlying latent constructs, SEM provides a strong link between theory and empirics.     

Unanticipated consequences: a comparison of expected and actual retirement timing among older women

The present study adds to the growing body of literature on women and retirement by means of a comparative analysis of the factors associated with anticipated retirement timing (among pre-retirees) and actual retirement timing (among retirees). Adopting a political economy of aging perspective, we argue that socially-structured patterns of gender inequality related to women's multiple roles across the life course affect patterns of retirement timing. Specifically, we hypothesize that the gendered nature of women's work-retirement decision-making is unanticipated during pre-retirement years. Logistic regression analyses are performed on data drawn from a sample of 275 women aged 45 and older living in the Vancouver area of British Columbia. A central finding is that while actual timing of retirement is affected by family caregiving responsibilities and by health/stress factors, pre-retirees do not perceive these to be important in their own expected retirement timing. Implications for social policy, education, and women's financial and psychological well-being in old age are elaborated.     

Social support and the quality of life following myocardial infarction

A serious illness is a severe threat to the assumptive world, sense of mastery and self-concept of the individual. The quality of life of the person with a chronic disease depends upon the degree to which the patient is able to cope with these and other major adaptive tasks confronting him. The influence of the social environment on successful adaptation and well-being has been investigated in a longitudinal study with a representative sample of male German cardiac patients (N=980). The quality of interpersonal relationships and experienced socio-emotional support were found to affect both the positive and negative dimensions of psychological well-being as defined by Bradburn (1969). Perceived health status, a pivotal variable in the adaptation process, and physical disability mainly influenced the negative dimension.     

Access to Health Care: Social Determinants of Preventive Cancer Screening Use in Northern British Columbia

The purpose of this study was to examine theextent to which social factors are influentialin determining women's access to cancerscreening services in Prince George, BritishColumbia. Specifically, this study evaluatedthe association of age, income, education, workstatus, disability, marital status, andimmigrant status with previous use of screeningmammography and Pap tests. Data was obtainedfrom the 1994 National Population HealthSurvey, which contains a sample of 416 womenfrom the Prince George area. A series oflogistic regression analyses were used todistinguish ever versus never beenscreened as well as recency of previousscreening. Participation rates in screeningmammography in Prince George are comparativelyhigh; however, no association was found betweensocial factors and previous mammography use.This suggests women in Prince George areparticipating in mammography servicesregardless of social background. Participationrates in Pap test screening in Prince Georgeare high and are similar to provincialaverages; however, while a large percentage ofwomen have been screened, this percentagevaries across social groups. Immigrant women,single women, and women with less education areover represented among women who have never hada Pap test. In addition, older women are lesslikely to obtain a recent Pap test whencompared to younger women. This study suggeststhat certain groups of women in northernBritish Columbia experience low participationin health services, resulting in a higher riskfor poor health and a poor quality of life.