Social Support Among Women Veterans

ABSTRACT

The beneficial effects of social support on well-being have been shown in various studies. Less is known about factors which constrain or enhance the availability of social support. The present study profiles social support among women veterans and attempts to identify factors which enhance or constrain perceptions of support and social integration for women of different military eras. Data are derived from a national sample of women veterans who had at least one VA out-patient visit during a one year time period. Twenty percent of women veterans report having no one to depend on. Social support is lowest among Vietnam and Post-Vietnam era women. Chronic strains (such as having problems with relatives, housing, and paying bills) are important factors which are associated with levels of perceived support. Factors related to loneliness/alone status appear to be associated with constraints in group activities and perceived support. This research illustrates the importance of examining factors which constrain and enhance supportive activities and relationships.     

Responding to social service and health care needs of aging women veterans

This is a study about aging women veterans who served in the military during the 1940s, 1950s and 1960s. The Veterans Administration (VA) represents a formal network of health and support services that offers a wide range of benefits for veterans. However, older women veterans may not be aware of, or benefit from, all that may be available to them. The purpose of this study was to learn about aging women veterans' knowledge and utilization of services and benefits available through the VA. Telephone interviews were conducted in April 1998 with 220 women veterans in Massachusetts who were age 60 + years. There was generally strong identification with veterans' organizations among the women surveyed. These women veterans were likely to receive medical care-a major benefit available through the VA. The benefits veterans were least likely to know about included services that may be particularly relevant and helpful to an aging veteran, such as long-term care and home adaptation services. Strategies are suggested to enhance outreach efforts to aging veterans.     

Responding to Social Service and Health Care Needs of Aging Women Veterans

ABSTRACT

This is a study about aging women veterans who served in the military during the 1940s, 1950s and 1960s. The Veterans Administration (VA) represents a formal network of health and support services that offers a wide range of benefits for veterans. However, older women veterans may not be aware of, or benefit from, all that may be available to them. The purpose of this study was to learn about aging women veterans' knowledge and utilization of services and benefits available through the VA. Telephone interviews were conducted in April 1998 with 220 women veterans in Massachusetts who were age 60 + years.

There was generally strong identification with veterans' organizations among the women surveyed. These women veterans were likely to receive medical care—a major benefit available through the VA. The benefits veterans were least likely to know about included services that may be particularly relevant and helpful to an aging veteran, such as long-term care and home adaptation services. Strategies are suggested to enhance outreach efforts to aging veterans.     

Perceived social support and prenatal wellbeing; The mediating effects of loneliness and repetitive negative thinking on anxiety and depression during the COVID-19 pandemic

ProblemPrenatal depression and anxiety are linked to poor maternal and infant outcomes. We need to understand predictors of poor mental health to identify at-risk women, and targets for support.BackgroundPrevious research has demonstrated a relationship between low levels of perceived social support, and depression and anxiety in pregnant women. However, there is a lack of research into the factors that may mediate this relationship.AimAs social distancing measures (e.g., lockdown) are likely to negatively affect women’s perceived support in the prenatal period, we investigated the relationship between perceived social support and both anxiety and depression in UK-based pregnant women during the COVID-19 pandemic. Further, we examined two potential mediators that may contribute to psychological symptoms: repetitive negative thinking and loneliness.MethodsWe administered a battery of online measures to a sample of pregnant women (N = 205) between May-June 2020, during the first peak of the pandemic in the UK, when perceived social support was likely to be low.ResultsConsistent with predictions, perceived social support was significantly negatively related to depression, anxiety, loneliness and repetitive negative thinking. Furthermore, repetitive negative thinking and loneliness mediated the relationship between perceived social support and both depression and anxiety. Moreover, perceived social support and loneliness were associated with specific types of online behaviours.ConclusionsTaken together, the findings shed light on the processes through which social support may exert its effects on depression and anxiety and highlight potential therapeutic targets for interventions which aim to prevent and treat mood disorders in perinatal cohorts.     

When lesbians aren't gay: factors affecting depression among lesbians

Research on women and depression has neglected to explore how the factors that put women at risk for depression apply to lesbians. The present study examined four of the risk factors consistently cited in the women and depression literature (relationship status, relationship satisfaction, social support from friends, and social support from family), and two unique factors (outness and relationship status satisfaction), to determine their ability to predict depression among lesbians. Data were collected from 167 lesbians between the ages of 20 and 60. Perceived social support from friends, relationship status satisfaction, and perceived social support from family, were found to be significant predictors, accounting for 17.8% of the variance in depression, as measured by the Center for Epidemiologic Study Depression Scale (CES-D). A second multiple regression equation focused on the 110 lesbians who were in committed relationships, using the variables relationship satisfaction, perceived social support from friends, perceived social support from family, and outness, to determine if relationship satisfaction added to the amount of variance which could be predicted in depression. Social support from friends was the only significant predictor in this equation, accounting for 5.8% of the variance in depression scores.     

Correlates of Quality of Life in New Migrants to Hong Kong from Mainland China

The concept of Quality of life (QOL) has received considerable attention from different disciplines. The aim of this study was to identify what are the correlates of QOL among Chinese new immigrants in Hong Kong. Data were collected through a cross-sectional survey among 449 Hong Kong new immigrants from Mainland China. Bivariate and multiple regression analyses were performed to examine the association between immigrants’ QOL and their demographic characteristics, socio-economic factors, optimism, sense of control, perceived social support, perceived neighborhood disorder, collective efficacy, pre-migration planning, depressive symptoms and acculturation stress. Our findings demonstrated that depressive symptom is the most prominent factor in reducing immigrants’ level of QOL, perceived social support and optimism are the two important factors that enhance the QOL of these depressed immigrants. Our results indicate that preventive measures must be developed, and professional counseling and psychological support services must be provided to new immigrants in Hong Kong, especially those who have depressive symptoms.     

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.     

Loneliness and Mistreatment of Older Chinese Women: Does Social Support Matter?

The objectives of this study are to: (a) examine the association of loneliness and mistreatment of older Chinese women, and (b) examine the potential modifying effect of social support on these associations. We conducted a cross-sectional study of 141 elderly women presented to an urban medical center. After adjusting for confounders, every 1-point increase in the loneliness score was associated with 44% increased risk for mistreatment. After adding the interaction of social support (social support x loneliness), loneliness was no longer associated with increased risk for mistreatment. Loneliness is a significant risk factor for mistreatment of older Chinese women. Greater social support, particularly perceived social support, may modify loneliness as a risk factor for the mistreatment of older Chinese women.     

Association of late childbearing with healthy longevity among the oldest-old in China

Statistical analysis of a large and unique longitudinal data-set demonstrates that childbearing after age 35 or 40 is associated with survival and healthy survival among very old Chinese women and men. The association is stronger for women than for men. The estimates are adjusted for a variety of confounding factors: demographic characteristics, family support, social connections, health practices, and health conditions. Further analysis based on an extension of the Fixed-Attributes Dynamics method shows that late childbearing is positively associated with long-term survival and healthy survival from ages 80-85 to 90-95 and 100-105. This association exists among oldest-old women and men, but, again, the effects are substantially stronger for women than for men. We discuss four possible factors that may explain why late childbearing affects healthy longevity at advanced ages: (1) social factors; (2) biological changes caused by late pregnancy and delivery; (3) genetic and other biological characteristics; and (4) selection.     

Facilitators and barriers to substance-free pregnancies in high-income countries: A meta-synthesis of qualitative research

BackgroundPrevious studies have associated substance use (alcohol, illicit drugs and smoking) to negative pregnancy outcomes, including higher risk of stillbirth.AimThis study aims to identify facilitators and barriers reported by women to remain substance free during pregnancy.MethodsA systematic search was conducted in six databases from inception to March 2019 and updated in November 2020. Qualitative studies involving pregnant or post-partum women, from high-income countries, examining women’s experiences of substance use during pregnancy were eligible. Meta-ethnography was used to facilitate this meta-synthesis.FindingsTwenty-two studies were included for analysis. Internal barriers included the perceived emotional and social benefits of using substances such as stress coping, and the associated feelings of shame and guilt. Finding insensitive professionals, the lack of information and discussion about risks, and lack of social support were identified as external barriers. Furthermore, the social stigma and fear of prosecution associated with substance use led some women to conceal their use. Facilitators included awareness of the health risks of substance use, having intrinsic incentives and finding support in family, friends and professionals.DiscussionPerceived benefits, knowledge, experiences in health care settings, and social factors all play important roles in women’s behaviours. These factors can co-occur and must be considered together to be able to understand the complexity of prenatal substance use.ConclusionIncreased clinical and community awareness of the modifiable risk factors associated with substance use during pregnancy presented in this study, is necessary to inform future prevention efforts.     

Economic Stress, Quality of Life, and Mortality for the Oldest-Old in China

China??s oldest old population is estimated to quadruple by 2050. Yet, poverty rate for the oldest old has been the highest among all age groups in China. This paper investigates the relationship between economic stress, quality of life, and mortality among the oldest-old in China. Both objective economic hardships and perceived economic strain are examined. We base our investigation on data drawn from the Chinese Longitudinal Healthy Longevity Survey conducted between 2000 and 2005. Our sample includes 10,972 men and women between the ages of 80 and 105 in 2000. The data show that about 16% of these oldest-old lived under economic stress in 2000. The risk factors that make one vulnerable to economic stress include age, being male, being widowed or never married, being a minority member, having no education, having no living children, and not having children as main source of income, and having no pension. Economic stress is negatively associated with indicators of quality of life, such as the quality of medical care and mental well-being. The poor quality of life contributes to the higher mortality rate for the oldest old who are under economic stress. Results also show that perceived economic strain increases the risk of mortality by 42% in rural areas, even after controlling for basic demographic characteristics, life style factors, and major health events.?For the rural oldest-old, having children as a main source of income and having access to pension alleviates the negative impact of economic hardship on mortality hazard by 23 and 66% respectively. However, in urban areas, economic stress has no direct impact on the hazard of mortality.     

Factors that positively influence in-hospital exclusive breastfeeding among women with gestational diabetes: An integrative review

ProblemWomen with gestational diabetes have higher rates of introducing infant formula before leaving hospital.BackgroundDespite health professional support, less women with gestational diabetes exclusively breastfeed in hospital.AimTo find factors that positively influence in-hospital exclusive breastfeeding practices among women with gestational diabetes.MethodsAn online search was performed in Medline, Scopus, Pubmed, CINAHL and Cochrane databases. Studies containing the keywords gestational diabetes and breastfeeding were retrieved.FindingsAuthors identified 1935 papers from search criteria. Twenty-six papers with no restrictions on research design met inclusion criteria and were included in the review. Factors were divided into personal, antenatal, intrapartum and postnatal factors. The main modifiable factors that were associated with improved in-hospital exclusive breastfeeding rates were having a strong intention to breastfeed, being confident, feeling supported and having continuity of education and support. Women’s main reasons to introduce formula were related to baby’s hypoglycaemia, delayed lactogenesis II and perceived low milk supply. Skin-to-skin contact after birth combined with frequent breastfeeds were effective ways to improve in-hospital exclusive breastfeeding rates.ConclusionInfluencing factors such as women’s breastfeeding intention, confidence and ongoing support are no different to the general population of women. However, promoting skin-to-skin contact after birth combined with frequent feeds are crucial for women with gestational diabetes who are more likely to introduce formula due to delayed lactogenesis II and fear of neonatal hypoglycaemia. There is a need for developing educational and supportive interventions that are tailored specifically for women who have gestational diabetes.     

Treatment decision-making among older women with breast cancer

This study examined breast cancer treatment decision-making among older adults, including professional and lay involvement. Thirty respondents were interviewed for this study; cancer survivors (70%) and newly diagnosed (30%) women with breast cancer. Respondents reported making treatment decisions in consultation with their oncologists. However, women differed on the extent to which they perceived their participation in the treatment process. Respondents' oncologists appear to be the primary factor associated with older women's breast cancer surveillance decision-making and adherence. The influence of women's support systems on their treatment decisions and surveillance activities appears to be minimal. Informal support systems, however, likely enhance women's ability to be active participants in their care. The growing need for interventions which target older women has been indicated. Interventions, however, cannot be adequately developed without first identifying the physical and psychosocial phenomena which affect decision-making.     

Social Networks and Support,Gender, and Racial/Ethnic Disparities in Hypertension Among Older Adults

Using data from the 2001 NHIS and the 2005–2006 and 2007–2008 NHANES, we examine how self-reporting a previous diagnosis of hypertension among adults aged 65+ differs by race/ethnicity for men and women; we explore the extent to which disparities are driven by group differences in social risk factors, particularly social support and integration; and last, whether these relationships mimic patterns seen for measured hypertension at interview. Findings indicate that rates of ever-diagnosed hypertension in both samples are highest among black seniors and older women and lowest among Mexican-American men, with the gender gap lowest among whites and substantially higher among blacks and Mexican-Americans. However, replication analyses of NHANES models using measured hypertension, instead of a self-report of having ever been diagnosed with hypertension, suggests that reporting bias and measurement error contribute to observed disparities, as racial/ethnic differences in hypertension rates are smaller when measured hypertension is examined, especially among women. Logistic regression models also show that while adjusting for group differences in measures of support and integration mediates some of the disparity in measured hypertension between Mexican-American and white seniors, adjusting for support and integration amplifies black-white disparities in both ever diagnosed and measured hypertension—driven primarily by adjustment for attendance at religious services, which reduces hypertension risk for all older adults but is more commonly reported among black seniors, especially women.     

HIV Risk Among Men Who Have Sex with Men Only (MSMO) and Men Who Have Sex with Men and Women (MSMW) in Baltimore

Men who have sex with men and women (MSMW) are at high risk for HIV. However, the majority of research on populations of men who have sex with men (MSM) combines MSMW and men who have sex with men only (MSMO) samples, which limits our understanding of HIV risk behaviors and factors associated with HIV risk among MSMW populations. We used the BESURE-MSM2, a venue-based cross-sectional study of HIV risk behaviors among MSM in Baltimore, MD, to examine HIV risk among MSMW. MSMW were less likely to report unprotected receptive anal intercourse than MSMO (6.8% vs. 19.6%, p = .0024). Among MSMW, 43.0% reported unprotected sex with a woman in the past year, but only 19.4% reported unprotected sex with both men and women, representing only 5.0% of the total MSM sample. In multivariate analyses, we found that among MSMW having unprotected sex with women in the past year, disclosing same sex behavior and having a main female partner were associated with unprotected anal intercourse with male partners. HIV prevention programs for MSMW are needed that address the complex partnerships of MSMW and the social contextual factors within which relationships and behaviors are embedded.     

Factors associated with breastfeeding initiation and maintenance for Aboriginal and Torres Strait Islander women in Australia: A systematic review and narrative analysis.

BackgroundAustralian Aboriginal and Torres Strait Islander (hereafter referred to as Aboriginal) women breastfeed at lower rates than non-Aboriginal women. Little is known about factors associated with breastfeeding specific to Aboriginal women and infants.AimDetermine the protective and risk factors associated with breastfeeding for Aboriginal women in Australia.MethodsCINAHL, Medline, EMBASE, SCOPUS, PsycINFO, and the Cochrane library were searched for peer-reviewed literature published between 1995 and 2021. Quantitative studies written in English reporting protective and risk factors associated with breastfeeding for Aboriginal women or women having an Aboriginal infant were included. Ten percent of papers were co-screened, and two reviewers completed data extraction. Narrative data synthesis was used.FindingsThe initial search identified 12,091 records, with 31 full text studies retrieved, and 17 reports from 14 studies met inclusion criteria. Protective factors included living in a remote area, attending an Aboriginal-specific service, attending a regional service, higher levels of education attainment, increased maternal age, living in larger households, being partnered, and having a higher reported number of stressful events and social health issues. The identified risk factors were smoking in pregnancy, admission to SCN or NICU, and being multiparous.ConclusionThis review identified factors associated with breastfeeding for Aboriginal women. Government focus, support, and consistent funding are required to plan and implement evidence-based interventions and services for Aboriginal women and infants in urban, rural, remote, and very remote locations. Rigorous research is required to understand the Aboriginal-specific factors associated with breastfeeding to improve rates and health outcomes for Aboriginal women and infants.     

Advance Care Planning by Unmarried Women of Different Sexual Orientations: The Importance of Social Support

We examined social support as a facilitator of advance care planning in unmarried women of different sexual orientations. Survey participants consisted of 215 women, 90 who reported a preference for partnering with women (WPW) and 125 for partnering with men (WPM). Our findings indicate that the association between social support and advance care planning was mixed. Specifically, social support had no significant impact on executing a will for either WPW or WPM. Among WPW, naming a health-care proxy was associated with reporting a partner who provided social support. For WPM, having a partner for social support was not associated with naming a health-care proxy. These insights help in the understanding of women's advance care planning.     

Conditional Solidarity: Social Class,Experiences of the Economic Crisis,and Welfare Attitudes in Europe

The aftermath of the Global Financial and Economic Crisis of 2007/2008 turned out as a veritable “stress test” for European welfare states. Aiming to stabilize citizens’ living conditions and mitigate socio-economic hardship, European governments have engaged in active crisis management. Yet, the protective capacities of European welfare states vary, as does individuals’ exposure to crisis-induced social risks. Hence, the crisis has impacted countries and the members of different social classes unequally. Against this backdrop, this paper asks how Europeans’ perceptions of the personal impact of the crisis are associated with their welfare attitudes, focusing on variations between social classes and across nations. Using cross-sectional Eurobarometer survey data from 2010 for 27 European countries, I find that perceived crisis impact is associated with greater support for welfare state responsibility and redistribution. However, this association is not homogeneous but moderated by an individual’s class position as well as national economic conditions and social spending levels. More specifically, on the individual level, perceived crisis impact is associated with more favourable welfare attitudes not only among its traditional supporters—such as the working class or the unemployed—but also among its traditional opponents, notably the self-employed. Furthermore, where social spending is higher, welfare state support is less strongly related to perceived crisis impact, suggesting that more encompassing welfare states mitigate the subjective impacts of the crisis. However, redistribution appears to be slightly more contested between those affected and those not affected by the crisis under better economic conditions. Given the challenges facing welfare states across Europe, it remains to be seen how stable a basis of popular support can be formed on these grounds.     

Advance care planning by unmarried women of different sexual orientations: the importance of social support

We examined social support as a facilitator of advance care planning in unmarried women of different sexual orientations. Survey participants consisted of 215 women, 90 who reported a preference for partnering with women (WPW) and 125 for partnering with men (WPM). Our findings indicate that the association between social support and advance care planning was mixed. Specifically, social support had no significant impact on executing a will for either WPW or WPM. Among WPW, naming a health-care proxy was associated with reporting a partner who provided social support. For WPM, having a partner for social support was not associated with naming a health-care proxy. These insights help in the understanding of women's advance care planning.     

Older Unemployed Women and Job Search Activity:

Thirty unemployed female workers over the age of fifty were interviewed in order to examine the relationship between the quality of social support provided by family and friends for their job search efforts and their job search intensity. The fmdings indicate that receiving positive social support for job search activities was significantly related to job search intensity. In addition, these workers perceived the supportive messages provided by unemployed friends as more positive than the support messages provided by employed and retired family or friends. Implications of these fmdings for assessing the presence of positive social supports and for developing successful job search assistance programs for older unemployed women are discussed.