Formerly Homeless,Older Women's Experiences with Health,Housing, and Aging

The perspectives of formerly homeless, older women are absent in the academic literature on aging and homelessness. In this study, a group of formerly homeless women, aged 45 years and older were surveyed (N = 15) and interviewed (n = 11) about their experiences with health, housing, and aging. The qualitative themes to be explored include the women's perceptions of their current health, coping with low incomes, dealing with addictions to alcohol and drugs, and the importance of supportive housing and other community services. The female participants' views on adapting to home, planning for their elderly years, and views on growing older are also explored.     

When it hurts I think: Now the baby dies. Risk perceptions of physical activity during pregnancy

BackgroundA decrease in the level of physical activity from pre-pregnancy to pregnancy seems to be a general problem, despite the obvious health benefits of physical activity. Quantitative studies indicate that pregnant women's fears might explain why they reduce their level of physical activity, but still no qualitative research has investigated the experiences influencing these women.QuestionTo explore healthy women's perceptions of risk associated with physical activity during pregnancy.MethodAn interpretive narrative approach was used to gain insight into pregnant women's personal stories and lived experiences. Five Danish pregnant women aged 26–36 years participated in semi-structured, in-depth interviews between September and December 2010. The analysis method was based on two types of narrative inquiry: (1) a narrative analysis to cover the story, and (2) a paradigmatic analysis to cover the themes.FindingsMost of the pregnancy stories highlighted a specific experience, which made the women anxious. These experiences were: previous miscarriages, fertility treatment and shortened cervix. Also bodily challenges and pain scared the women, such as hypertonic pelvic muscles, Braxton Hicks contractions, abdominal pain, exhaustion, and shortness of breath. The stories also described the impacts of women's relatives and friends on their perceptions of risk.ConclusionSpecial consideration should be given to pregnant women who have had negative experiences in previous pregnancies and bodily challenges, which make them anxious and discourage them from being physically active. Healthcare professionals could also pay attention to the fact that women's relatives and friends play a major role in women's perceptions of risk.     

"I Do" or Don't:

Although the health and social benefits of physical activity have been well documented, a majority of females at every life stage are insufficiently active to acquire those benefits. Explanations for this lack of commitment to physical activity have not been found. Marriage, as a social role and life circumstance, has been neglected as a possible explanation for the inactive lie patterns of women. This paper highlights the available scientific evidence on the relationships of marital status and spousal influence with the leisure-time physical activity of women throughout the lifespan. Research showed that women's leisure-time physical activity decreased upon marriage. The major factor in the maintenance of healthy levels of exercise for married women at all ages appeared to be a physically active and supportive spouse.     

Experiencing menopause in the UK: The interrelated narratives of normality,distress, and transformation

ABSTRACT

We investigated the experience and perspectives of menopause among 48 UK mothers through qualitative in-depth interviews. Interviews were analyzed thematically then explored using social science theories. Three interdependent narratives emerged: menopause as a normal, biological process, distinct from self and social transitions; menopause as struggle, an “idiom of distress” expressing upset, identity loss, shame, and social upheaval; and menopause as transformative and liberating, arising from biopsychic and relational changes. Some women followed a predictable “rite of passage” trajectory with transformation emerging from distress, but not all: Menopause arises from a complex interplay of personal predicament, somatic change, and sociocultural context.     

Gender and geographic differences in Medicare service utilization during the last six months of life

ABSTRACT

End-of-life issues are important for senior women, particularly rural women, who are more likely than their urban counterparts to live alone. The role of residence as a factor for health-care utilization among Medicare beneficiaries during the last six months of life has yet to be investigated. The purpose of this study is to examine whether service utilization in the last six months of life differs across gender and rurality. The sample was restricted to fee-for-service Medicare beneficiaries who died between July 1, 2013, and December 31, 2013 (n = 39,508). The odds of rural beneficiaries using home health (aOR 0.87; 95% CI 0.81–0.93) and/or hospice (aOR 0.82; 95% CI 0.77–0.87) in the last six months of life were lower than urban beneficiaries. Female beneficiaries were more likely to use support services such as hospice (aOR 1.24; 95% CI 1.18–1.29) and/or home health services (aOR 1.07; 95% CI 1.02–1.13) than male beneficiaries. The odds of female beneficiaries using inpatient (aOR 1.14; 95% CI 1.08–1.20) and/or outpatient (aOR 1.06; 95% CI 1.01–1.12) were higher than male beneficiaries. This research is important as we examine the range of health services used during the last six months of life, by gender and rurality. Future research is needed to understand how access to health services, residential isolation, and age- and disease-related factors relate to women’s observed greater use of inpatient, outpatient, hospice, and home health services in the last six months of life.     

案例教学法在卫生事业管理学教学中的应用研究

为加强医学院校课堂教学质量,促进医学院校卫生事业管理学的教学改革和研究,我们基于层次分析法（AHP）的模糊数学,对皖南医学院卫生事业管理学实施案例教学法的整体教学效果进行综合评价研究,评价结果显示：案例教学法是医学院校课堂教学的一种有效方法,有利于改善教学效果和提高学生的综合素质.     

The health care system of the People's Republic of China: Between privatization and public health care

Chinese health care policy has undergone numerous reforms in recent years that have often led to new challenges, inciting the need for further reform. The most recent reforms attempt to find a middle path between public health care provision and commercial private insurance. In this way, China is following in the footsteps of countries that initially increased the role of privatization in the 1990s and at the beginning of the 21st century, but are now gearing towards public health care. However, this process of constant reform has led to a lack of transparency in the functioning of the health care system, provoking a loss in public trust. There remains an important degree of uncertainty about the future direction of developments in China. Nonetheless, a dual financing approach to health care using tax finance and social insurance might yet crystallize, offering a potential model to inform developments in other countries.     

Possibilities for Intervention in Domestic Violence: Frame Analysis of Health Care Professionals’ Attitudes

ABSTRACT. Violence is a serious problem, and social and health care providers are in a key position for implementing successful interventions. This qualitative study of 6 focus groups with professionals (n = 30) examines the health care professionals’ ways of framing a domestic violence intervention. Of special interest here is how professionals see their own roles in the process of recognizing and helping victims of domestic violence. By using Erving Goffman's frame analysis, this study identifies several frames that either: a) emphasize the obstacles to intervention and justify nonintervention, or on the contrary, b) question these obstacles and find justifications for intervention. The possibilities for intervention are further explored by analyzing the ways in which the dynamics between the different frames allow redefinition of domestic violence interventions. Despite the challenges involved in a domestic violence intervention, there seems to be potential for change in personal attitudes and reform of professional practices. The research findings underline the role of social and health care professionals as members of a larger chain of service providers working collaboratively against domestic violence. Implications for practice and directions in policy and future research are suggested.     

Measuring Family Caregiver Perceptions of Support in Caring for Children and Youth With Mental Health Concerns

ABSTRACT

This correlational study assessed how families of children with mental illness perceived the levels of support they received from informal and formal resource providers and the associations between perceived support and child outcomes. Adult caregivers (N = 904) of youth receiving public mental health care services were administered the Family Caregiver Perceptions of Support Scale developed by the authors to assess family caregiver perceptions of support prior to and at termination of services. Factor analysis identified three types of caregiver anticipated supports: informal support resources, support for treatment plan influence, and health care resources. The domains were significantly and positively associated with one another but did not uniformly correlate with youth mental health outcomes. The study provides preliminary evidence that treatment gains in youth mental health outcomes are observed when caregivers perceive support in treatment processes. Suggestions for future research are made, stressing the importance of caregivers and providers working together and describing needs related to future scale improvements.