Worry and Bother: Factors in Rural Women’s Health Decision Making

This exploratory study examined older rural women’s health decision making. Thirty-three rural women were recruited to participate in semistructured qualitative interviews. Major themes emerged that focused on rural women’s comments regarding their concerns about not worrying or bothering their children with personal health matters. Themes were discussed in the context of an ethic of care. Results suggest that it is important for mental health professionals, family physicians, social workers, and other practitioners to be aware of the sense of worry and concern for others that older rural women bring to bear in decision making about personal health issues.     

Mothers’ Sexual Identity and Children’s Health

Sexual minority women face a plethora of structural, socioeconomic, and interpersonal disadvantages and stressors. Research has established negative associations between women’s sexual minority identities and both their own health and their infants’ birth outcomes. Yet a separate body of scholarship has documented similarities in the development and well-being of children living with same-sex couples relative to those living with similarly situated different-sex couples. This study sought to reconcile these literatures by examining the association between maternal sexual identity and child health at ages 5–18 using a US sample from the full population of children of sexual minority women, including those who identify as mostly heterosexual, bisexual, or lesbian, regardless of partner sex or gender. Analyses using data from the National Longitudinal Study of Adolescent to Adult Health (N?=?8978) followed women longitudinally and examined several measures of their children’s health, including general health and specific developmental and physical health conditions. Analyses found that children of mostly heterosexual and bisexual women experienced health disadvantages relative to children of heterosexual women, whereas the few children of lesbian women in our sample evidenced a mixture of advantages and disadvantages. These findings underscore that to understand sexual orientation disparities and the intergenerational transmission of health, it is important to incorporate broad measurement of sexual orientation that can capture variation in family forms and in sexual minority identities.

     

Self-Perceived Parental Role and Mental Health Concomitants Among Israeli Gay and Heterosexual Fathers

ABSTRACT

In this study we examined the association between self-perceived parental role and adverse mental health (indicated by depressive symptoms, neuroticism, and negative affect) in a sample of 82 Israeli gay fathers (Mean age = 39.57, SD = 6.70) that were individually matched with 82 heterosexual fathers (Mean age = 39.11, SD = 7.88). Results showed that although self-perceived parental role was associated with adverse mental health, this association was moderated by sexual orientation, such that a significant negative association between self-perceived parental role and adverse mental health was evident only among gay fathers. The findings are understood by features of gay fatherhood, which is intentional and purposeful, and usually achieved after contending with particular difficulties in the journey to fatherhood. These features presumably shape the perceived parental role, and thus may link more strongly with lower levels of adverse mental health among gay fathers, compared to heterosexual fathers.     

Neuroticism, Education and Self-Assessed Health in the General Population of the United States. Can Smoking Behaviour Explain the Associations?

In this study we investigate the interrelation between neuroticism, education, smoking and health. Two lines of research are brought together: one studying the relationship between neuroticism and health and the other studying the association between education and health. As lower educated people more often score high on neuroticism, we study the relationships of education and neuroticism with health simultaneously. Moreover, we hypothesize that smoking behaviour is a common explanatory factor in these associations. A 1996 US general population sample is employed to test the hypotheses. The associations between education and neuroticism on the one hand and self-assessed health on the other hand proved to be substantially smaller when education and neuroticism are mutually controlled for. Yet, the hypothesis that smoking behaviour provides an explanation for educational differences in health was only supported for men.     

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.     

Validation of the Childbirth Attitudes Questionnaire in Greek and psychosocial characteristics of pregnant women with fear of childbirth

BackgroundFear of childbirth has been found to be a factor that influences women's decision about their choice of delivery. The investigation of psychological factors that relate to fear of childbirth as well as the validation of the Childbirth Attitudes Questionnaire (CAQ) can help identify pregnant women with high fear of childbirth.AimThis study aimed to (a) translate and validate the Childbirth Attitude Questionnaire in Greek and (b) explore how fear of childbirth was related to childbirth self-efficacy, state anxiety, depression, neuroticism, self-esteem and optimism.Methods145 nulliparous pregnant women, in late pregnancy, attending routine antenatal visit in a private maternity clinic participated. All participants completed the CAQ (fear of childbirth) and other self-report questionnaires that measured childbirth self-efficacy, self-esteem, optimism, neuroticism, state anxiety and depressive symptomatology. Factor structure was investigated using principal axis factoring. Cronbach's α was used to measure internal consistency reliability. Pearson's correlation coefficients were calculated between all study variables, followed by multiple linear regression.FindingsThe factor analysis suggested the existence of one-factor structure. Construct validity was confirmed by computing correlations between the CAQ and childbirth self-efficacy, self-esteem and optimism. Multivariate analysis showed that childbirth self-efficacy, self-esteem and optimism were negatively and significantly associated with fear of childbirth.Conclusion and implications for practiceThe Greek version of the CAQ is a reliable and valid measure. The clinical use of CAQ may enable midwives and other health care professionals to identify pregnant women with low childbirth confidence and to provide information and support.     

Personality Traits and Subjective Well-Being: Moderating Role of Optimism in University Employees

The present study examined the moderating impact of optimism on the relationship between personality traits (neuroticism and conscientiousness) and subjective well-being (distress and satisfaction with life) among university employees. Participants were 251 (age 25–60) employees at COMSATS University, who completed demographic information sheet, two subscales (neuroticism and conscientiousness) of NEO Personality Inventory (Costa et al. in Br J Psychol 78:299–306, 1987), Life Orientation Test-Revised (Scheier et al. in J Pers Soc Psychol 67:1063–1078, 1994), Satisfaction with Life Scale (Dienere et al. in J Persy Assess 49:71–75, 1985), and two subscales (depression and anxiety) of Brief Symptom Inventory (Derogatis and Melisaratos in Psychol Med 13:595–605, 1983). On a final sample of 251 university employees, a series of moderated hierarchical regression analyses were performed separately for positive and negative health outcomes. Results indicated that optimism moderated between neuroticism and distress and neuroticism and satisfaction with life. Further, optimism moderated between conscientiousness and distress and conscientiousness and satisfaction with life. The current findings have implications for clinicians, researchers, and policy makers for the identification of resource factors that may help to understand the resistant power of non clinical sample to maintain positive functioning.     

Paperbark and pinard: A historical account of maternity care in one remote Australian Aboriginal town

Background and aimMaternity care in remote areas of the Australian Northern Territory is restricted to antenatal and postnatal care only, with women routinely evacuated to give birth in hospital. Using one remote Aboriginal community as a case study, our aim with this research was to document and explore the major changes to the provision of remote maternity care over the period spanning pre-European colonisation to 1996.MethodsOur research methods included historical ethnographic fieldwork (2007–2013); interviews with Aboriginal women, Aboriginal health workers, religious and non-religious non-Aboriginal health workers and past residents; and archival review of historical documents.FindingsWe identified four distinct eras of maternity care. Maternity care staffed by nuns who were trained in nursing and midwifery serviced childbirth in the local community. Support for community childbirth was incrementally withdrawn over a period, until the government eventually assumed responsibility for all health care.ConclusionsThe introduction of Western maternity care colonised Aboriginal birth practices and midwifery practice. Historical population statistics suggest that access to local Western maternity care may have contributed to a significant population increase. Despite population growth and higher demand for maternity services, local maternity services declined significantly. The rationale for removing childbirth services from the community was never explicitly addressed in any known written policy directive. Declining maternity services led to the de-skilling of many Aboriginal health workers and the significant community loss of future career pathways for Aboriginal midwives. This has contributed to the current status quo, with very few female Aboriginal health workers actively providing remote maternity care.     

Gender differences in retirement decisions in Hong Kong

The study of labor force participation at older ages and the process of retirement do not have a long tradition in Asia's newly developed societies. This study, based on telephone survey of 950 respondents, examines various socio-economic factors that would influence retirement decision among older workers in Hong Kong. The findings show that older men were more likely to participate in the labor force than older women. Interestingly, older workers, in particular older women, with pension were less likely to retire. Having a working spouse decreased the likelihood of retirement and older workers, in particular older women, living with married children were more likely to retire. Poor health also discourages the propensity to continue working at old age. These findings confirm that retirement entails much more than just a decision to stop work, and that there were gender differences in retirement decision. Finally, several policy challenges, with reference to elderly women, concerning older workers' labor force participation were discussed.     

Coffee intake,health-related quality of life,and associated factors of overactive bladder in older Korean women living in rural South Korea

ABSTRACT

Overactive bladder (OAB) is a common health problem in older women. The aim of the study was to investigate coffee consumption, health-related quality of life (HRQOL), and associated factors of OAB in older Korean women living in rural South Korea. A total of 248 women aged 65 years and older participated in this study. Chi-square tests, t-tests, and multivariable logistic regressions were performed. The means of coffee consumption between OAB and non-OAB groups were not significantly different. Women with OAB showed significantly lower HRQOL than women with stress urinary incontinence only. OAB was associated with high body mass index and poor health status.     

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.     

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.     

Elderly Women Show Neither a Shortage of Strategies nor an Overreliance on Drugs in Handling Aging and in Dealing with Minor Health Problems

ABSTRACT

Women 65 years old and over make up the fastest growing population segment in North America. They are, particularly among the underprivileged, known to be heavy consumers of prescribed and over-the-counter drugs. The objective of this study was to identify the role of medication in underprivileged elderly women's strategies for aging well and dealing with minor health problems. A qualitative study was conducted among 40 women aged 65 to 75. Results show that elderly women seldom mention resorting to medication to “age well” although they report using this strategy to deal with minor health problems. Overall, the elderly women mentioned a wide range of strategies to cope with aging and minor health problems, which suggests that they are well equipped to face the challenges of aging.     

Depressive Symptoms of Caregiving Women in Midlife: The Role of Physical Health

ABSTRACT

This research examined the relationships between providing assistance to aging family members, caregivers' age, caregivers' perceptions of their physical health, and caregivers' depressive symptoms. Several alternative hypotheses were examined. Longitudinal data from 1, 898 women from the 1992 and 2000 waves of the Health and Retirement Study (HRS) were used. Results indicate a reciprocal relationship between depression and physical health. These processes were examined using a path analysis. Although the evidence only supported one of the hypotheses, this study clearly demonstrated the importance of physical health for the psychological well-being of women in midlife.     

Working Conditions and Health Among Italian Ageing Workers

In many European countries requirements for retirement have been tightened, causing an increase in work participation of older workers, in spite their potentially poorer health may limit their work ability. This study aimed at assessing the diffusion of health problems and exposure to unfavorable working conditions among ageing workers in two Italian surveys, as well as comparing them with those observed in the same surveys conducted before the 2011 Italian pension reform tightening the normal retirement age. The 2013 National Health Survey (NHS) and Labour Force Survey (LFS) were employed to assess the prevalence of poor perceived health, health conditions and functional limitations, and of exposure to physical, psychosocial and organization factors at work, among 60–64 years workers. Poisson regression models were used to estimate Prevalence Ratios of health outcomes and unfavorable working conditions in the two surveys, compared to data from the 2005 (NHS) and 2007 (LFS) corresponding surveys, respectively. Among both men and women, approximately one quarter had at least one physical disorder or functional limitations and 15% poor mental health. Exposure to different ergonomic factors (15–30%) and working during unsocial hours (19%) were particularly diffused. A significant increase in the prevalence of functional limitations and of working at night or during unsocial hours was found in 2013, compared to corresponding data from 2005 and 2007, respectively. Our results indicate that exposure to ergonomic and organizational hazards should be reduced among ageing workers, to avoid decreased work ability, health damage or early exit from the labour market.

     

Sleep Behaviors in Older African American Females Reporting Nonmalignant Chronic Pain: Understanding the Psychosocial Implications of General Sleep Disturbance

This study examined factors that influence sleep quality in older African American women (N = 181) reporting chronic pain. Participants completed a series of questions assessing demographic and behavioral characteristics, health status, pain intensity, and sleep disturbance. Findings indicated that younger participants and those experiencing poorer physical functioning reported more difficulty sleeping due to pain. Similarly, participants who reported being awakened from sleep due to pain were younger and experienced greater pain intensity. Understanding the relationship between sleep and pain in this group of women may be useful in promoting effective disease management and sleep awareness among patients, caregivers, and healthcare professionals.     

Health worker pilot project

In a survey conducted by the Kavar Village Health Worker Project in Iran, among married women, aged 15-44, residing in 16 villages served by project trained, auxillary rural health workers, 28% used oral contraceptives, while only 13% of the women who resided in 16 control villages served by untrained rural midwives used oral contraceptives. Among women in the 25-35 age bracket, the % of oral contraceptive users in the project villages was twice as great as in the control villages. Surprisingly, despite the strong Muslim tradition extant in these villages, no significant differences in usage were found between those villages served by male auxillary health workers and those served by female workers. The auxillary health workers had been trained to provide a wide variety of preventive and curative medical services, in addition to providing family planning and contraceptive distribution. At the time of the survey, these workers had been serving the 16 villages for 21 months. In the 16 control villages the nonresident midwives had received no training but had been provided with oral contraceptives for distribution.     

Effects of chronic illness on daily life and barriers to self-care for older women: A mixed-methods exploration

This mixed-methods study examined the subjective experience of living with chronic illness and identified barriers to self-care. Community-dwelling older women with chronic illness completed an initial (N = 138) and follow-up mailed survey 6 months later (N = 130). On average, participants reported four comorbid health conditions and the corresponding physical pain, activities curtailed or relinquished, and time and energy focused on managing health. Only 34% of participants practiced all 10 key self-care behaviors. Reported barriers to self-management included pain, lack of financial resources, and worry. In the regression analysis, having more depressive symptoms was a significant predictor of challenges with self-care behaviors.