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.     

On Growing Old in America: Perceptions of the Okinawan War Bride

ABSTRACT

The unique perceptions of aging of Okinawan war brides are presented through interviews with 15 subjects. They voiced their thoughts about a range of topics, including available support systems, effects of acculturation, and their sense of security as they approach old age. Pride in culture and fears of lost family connections are expressed as these women speculate about the demands of aging in America.     

Why do I dread looking old?: A test of social identity theory,terror management theory,and the double standard of aging

ABSTRACT

Outward appearance is one of the means by which age is determined, and fear of looking old may stem from fears about social identity and death. This study explored how social identity theory and terror management theory may help to explain the dread of looking old. University students from the United States, England, and Australia (N = 1,042) completed a questionnaire regarding their attitudes about aging and older adults. Results indicated that sex, age, beliefs about personal aging, and death anxiety explained 30.4% of the variance for participants’ dread of looking old. Theoretical hypotheses were supported by our findings.     

Women and Retirement Planning: Towards the “Feminization of Poverty” in an Aging Hong Kong

ABSTRACT

Hong Kong's population is aging but retirement research is largely missing from the research agenda in Hong Kong. This study, based on a telephone survey of 1,078 respondents, examines middle-aged adult's retirement planning activities in Hong Kong. The findings show men are more likely to be involved in financial planning, while women are more likely to take part in some forms of health, living arrangement and psychological planning for retirement. Further, there are age, education and income differences in the various forms of retirement planning activities within genders. Women are living longer; because of their lack of financial retirement planning, they are prime candidates for poverty. The discussion concludes with policy implications related to assisting midlife individuals, in particular women, in planning for retirement.     

From alternative,to complementary to integrative medicine: Supporting Australian midwives in an increasingly pluralistic maternity environment

BackgroundThe use of complementary and alternative medicine during pregnancy has become increasingly popular over the past decade in Australia.AimThe purpose of this discussion paper to make recommendations and foster a constructive debate regarding the appropriate response by the midwifery profession.DiscussionMidwives should receive basic education regarding the use of complementary and alternative medicine. All women should be routinely question women about their use and this should be documented. While a few therapies could be safely integrated, in most situations interested women should be referred to a qualified practitioner. Referral frameworks and flexible clinical guidelines should be investigated.ConclusionWith the appropriate education and support, midwives are in an excellent position to engage women in open dialogue and raise awareness of the benefits and risks of CAM practices. The way forwards for midwifery profession is to focus on self-governance, education and flexible clinical guidelines.     

Breastfeeding practices in women with type 1 diabetes: A discussion of the psychosocial factors and policies in Sweden and Australia

BackgroundWomen with type 1 diabetes (T1DM) face many challenges during their pregnancy, birth and in the postnatal period, including breastfeeding initiation and continuation while maintaining stable glycaemic control. In both Sweden and Australia the rates of breastfeeding initiation are high. However, overall there is limited information about the breastfeeding practices of women with T1DM and the factors affecting them. Similarities in demographics, birth rates and health systems create bases for discussion.AimThe aim of this paper is to discuss psychosocial factors, policies and practices that impact on the breastfeeding practices of women with T1DM.FindingsSwedish research indicates that the overall breastfeeding rate in women with T1DM remains significantly lower than in women without diabetes in the first 2 and 6 months after childbirth with no differences in exclusive breastfeeding. Breastfeeding initiation and continuation among women with T1DM in Sweden has been shown to be influenced by health services delivery, supportive breastfeeding polices and socio-economic factors, particular perceived support from social networks and health professionals.ConclusionThere is limited research on the impact of attitudes towards breastfeeding, emotional and social well-being and diabetes-related stress on the decision of women with T1DM to initiate and continue to breastfeed for at least 6 months. A more comprehensive understanding of the breastfeeding practices and psychosocial factors operating during the first 6 months after birth for women with T1DM will be instrumental in the future design of interventions promoting initiation and continuation of breastfeeding in Sweden, Australia and elsewhere.     

Working with Terminally Ill Older Women: Can a Feminist Perspective Add New Insight and Direction?

SUMMARY

While sexism and ageism in the health care system have been systematically documented, nowhere is the treatment of aging women more androcentric than in the care for the terminally ill. In fact, a terminally ill older woman is too often disadvantaged by a health care system which excludes her from decision-making and renders her powerless. In response, we propose a feminist approach to health care for terminally ill older women and argue that it is this approach which will not only put knowledge and power into the hands of women, but will change the fundamental ways in which women approach death.     

Spirituality and spiritual care in and around childbirth

BackgroundEmerging evidence points to childbirth as a spiritually felt meaningful occasion. Although growing literature and development of guidelines charge the midwife to provide spiritual care felt spiritual experiences are not addressed. There is need to revisit contemporary approaches to spiritual care in midwifery lest something of significance becomes lost in policy rhetoric.AimThe aim of this discussion paper is to bring to the surface what is meant by spiritual care and spiritual experiences, to increase awareness about spirituality in childbirth and midwifery and move beyond the constraints of structured defined protocols.MethodsThe authors’ own studies and other's research that focuses on the complex contextual experiences of childbirth related to spirituality are discussed in relation to the growing interest in spiritual care assessments and guidelines.FindingsThere is a growing presence in the literature about how spirituality is a concern to the wellbeing of human beings. Although spirituality remains on the peripheral of current discourse about childbirth. Spiritual care guidelines are now being developed. However spiritual care guidelines do not appear to acknowledge the lived-experience of childbirth as spiritually meaningful.ConclusionIntroduction of spiritual care guidelines into midwifery practice do not address the spiritual meaningful significance of childbirth. If childbirth spirituality is relegated to a spiritual care tick box culture this would be a travesty. The depth of spirituality that inheres uniquely in the experience of childbirth would remain silenced and hidden. Spiritual experiences are felt and beckon sensitive and tactful practice beyond words and formulaic questions.     

Perceived Sexual Orientation of Men and Women with Eating Disorders and Obesity

ABSTRACT

The present study explores the perceived sexual orientation of hypothetical men and women with various eating disorders and obesity. Undergraduates were randomly provided with one vignette describing a male or female with anorexia nervosa (AN), bulimia nervosa (BN), binge-eating disorder, or obesity and were asked about the target’s likely sexual orientation. Significant differences emerged between male and female targets with AN and BN on the forced-choice question, with a greater percentage of participants indicating that the male targets were probably non-heterosexual. On continuous items, participants rated the female targets as significantly more likely to be heterosexual and significantly less likely to be homosexual than male targets. The general public may be more likely to perceive men with eating disorders as gay or bisexual relative to females with eating disorders. Perceived sexual orientation might be an important factor to consider when exploring the potentially unique perspectives of men with eating disorders.     

Conflicting contexts: Midwives’ interpretation of childbirth through photo elicitation

IntroductionThis study seeks to explore midwives’ perceptions about childbirth and in particular their beliefs about normality and risk. In the current climate of increasing interventions during labour, it is important to understand the thought processes that impact on midwifery care in order to examine whether these beliefs influence midwifery clinical decision-making.Method12 Midwives who worked in a variety of metropolitan hospitals in Sydney, Australia were interviewed about how they care for women during labour. The study utilised an inductive qualitative design using photo elicitation during the interview process.ResultsSix themes emerged from the data that clearly indicated midwives felt challenged by working in a system dominated by an obstetric model of care that undermined midwifery autonomy in maintaining normal birth. These themes were: desiring normal, scanning the environment, constructing the context, navigating the way, relinquishing desire and reflecting on reality. Most midwives felt they were unable to practice in the manner they were philosophically aligned to, that is, promoting normal birth, as the medical model restricted their practice.DiscussionThe polarised views of childbirth held by midwives and obstetricians do little to enhance normal birth outcomes. Midwives in this study expressed frustration that they were unable to practice midwifery in a way that reflected their belief in normal birth. This, they cite is a result of the oppressive obstetric model prevalent in maternity care facilities in Sydney and the over use of technological interventions during childbirth.     

The return of weighing in pregnancy: A discussion of evidence and practice

BackgroundInadequate or excessive gestational weight gain is associated with both short and long-term adverse maternal and infant health outcomes. The practice of routine maternal weight monitoring has been suggested as an effective health promotion intervention, both as a screening tool for adverse maternal and infant outcomes and as a weight management strategy for addressing gestational weight gain.DiscussionThe effectiveness of routine maternal weighing as part of maternity care has been debated for more than 30 years. The National Health and Medical Research Council of Australia have recently revised their pregnancy care clinical practice guidelines recommending maternal weight monitoring (clinician and/or self-weighing) be reintroduced into clinical practice. This paper presents a timely discussion of the topic that will contribute new insights to the debate.ConclusionWeight gain in pregnancy is complex. Evaluation of the translation, implementation, acceptability and uptake of the newly revised guidelines is warranted, given that evidence on the practice remains inconclusive. Future research exploring social ecological interventions to assist pregnant women achieve optimal gestational weight gains are suggested to expand the evidence base.     

The experiences of pregnant women during the COVID-19 pandemic in Turkey: A qualitative study

BackgroundDue to spread and impact of COVID-19 in the world and Turkey lead to fear, stress and anxiety in individuals. This trend is increasing more especially in pregnant women at risk as they are concerned about the safety of themselves and the fetus.AimIn our study, concerns, problems and attitudes of pregnant women related to diseases in the pandemic process will be determined by detailed discussions based on their individual experience, and by increasing the awareness of midwives and nurses about what pregnant women experience in this process.MethodsContent analysis is used as qualitative study pattern. Due to the social isolation rules during the coronavirus pandemic, interviews with pregnant women were planned to be held via mobile phone. The study was completed with 15 pregnant women.ResultsAs a result of the content analysis of the interviews, 3 main themes and 11 sub-themes were identified. The identified themes were as following: (1) not understanding the seriousness and fear of the unknown, (2) coronavirus pandemic and disruption of the routine prenatal care (3) disrupted routines and social lives. Each theme was necessarily discussed separately.ConclusionThe results of the study show that coronavirus pandemic has a significant potential for creating anxiety, adversity and fear, which has a negative emotional effect on pregnant people. It will be useful to provide awareness for midwives and nurses not only about the physical health of pregnant women, but also their mental health, and to cooperate with mental health experts if necessary.     

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.     

Older Women's Body Image and Embodied Experience: An Exploration

ABSTRACT

This paper presents and analyzes findings from unstructured interviews with women aged 61 to 92 regarding their perceptions and feelings about their aging bodies. The data are discussed in light of the existing literature on women's body image which has largely ignored the experiences of women in later life and which has tended to focus on adolescent and middle-aged women. Given the fact that beauty is equated with youthfulness and thinness in our society, older women face unique challenges as they strive to construct and maintain positive evaluations of self. The women in the study exhibit the internalization of ageist beauty norms even as they assert that health is more important to them than physical attractiveness and comment on the ‘naturalness’ of the aging process.     

Co-designing preconception and pregnancy care for healthy maternal lifestyles and obesity prevention

ProblemA recognised gap exists between current and recommended practices in the provision of lifestyle advice and weight management support for women across preconception and pregnancy care.BackgroundPreconception and pregnancy are critical stages for promoting healthy maternal lifestyles and obesity prevention. Co-design is a novel approach with the potential to strengthen existing models of care to facilitate the implementation of clinical practice guidelines promoting preconception and pregnancy health, especially in relation to preconception weight management and preventing excessive gestational weight gain.Aim and methodsThe aims of this discussion paper are to (i) define co-design in the context of preconception and pregnancy care, (ii) outline key considerations when planning co-design initiatives and (iii) describe co-design opportunities in preconception and pregnancy care for promoting women’s health and obesity prevention.DiscussionWhile several definitions of co-design exist, one critical element is the meaningful involvement of all key stakeholders. In this discussion, we specifically identified the involvement of women and expanding the role of practice nurses in primary care may assist to overcome barriers to the provision of healthy lifestyle advice and support for women during preconception. Co-designing pregnancy care will involve input from women, nurses, midwives, obstetricians, allied health and administration and management staff. Additional attention is required to co-design care for women considered most at-risk.ConclusionThere is potential to enhance current provision of preconception and pregnancy care using co-design. Nursing and midwifery professions are active across both preconception and pregnancy and therefore, they have an important role to play.     

Placenta praevia,placental abruption and amphetamine use in pregnancy: A case study

Pregnant women who misuse alcohol or substances often develop obstetric conditions that further complicate their pregnancy. This case study reflects on the maternity care provided for a woman who continued to use amphetamines during her pregnancy; and who was diagnosed with placenta praevia and subsequently suffered a placental abruption. Alcohol and substance misuse in pregnancy is currently escalating, increasing the risk in maternal and neonatal morbidity and mortality. Midwives must be confident in the advice and care they provide in order to reduce the risks caused by substance misuse, and be able to support this with evidence-based care.PurposeThe purpose of this case study is to discuss the obstetric condition involved with placenta praevia with the occurrence of a placental abruption in a woman who uses amphetamines during pregnancy; and the midwifery and obstetric care involved.Interest/relevance/congruencyIt will highlight the importance of evidence-based care in high risk obstetrics.Content(1) Case summary; (2) discussion; (3) risk factors; screening, diagnosis and management; foetal and neonatal monitoring; postnatal management, and trauma informed care.ConclusionIt was shown with planning, understanding, communication, and vigilance, the care of an amphetamine using pregnant woman with a diagnosis of placenta praevia and abruption can be successfully accomplished. The management of the woman discussed in this case study was within the recommendations currently available in the literature.     

Resistance and acceptance: Ambivalent attitudes toward the aging body and antiaging practices among older Korean migrants living in New Zealand

ABSTRACT

Using intersectionality as a conceptual framework, this study investigated how older Korean women living in New Zealand perceived their aging bodies, antiaging practices and/or products, and how they used such products. Thematic analysis identified three themes: tension between acceptance of the aging body as an inevitable process and transformation of the aging body into a healthy body, juggling between abstinence and use of antiaging products and practices, and redefining natural aging. The findings challenge binary interpretations between “acceptance” of and “resistance” to the experiences of the aging process and the use of antiaging practices.