Showing papers in "Health Care for Women International in 2002"

Social Factors That Make South African Women Vulnerable to HIV Infection

Abstract: The degree to which women are able to control various aspects of their sexual lives is clearly a critical question for health promotion and the prevention of AIDS. It is evident that social factors such as the high rate of rape, the unfavourable economic position of women, and the inability to insist on condom usage make South African women unable to negotiate the timing of sex and the conditions under which it occurs. They are thus rendered powerless to protect themselves against HIV infection. Prevention campaigns often do not take into account the reality of the daily lives of South African women and the difficulties they face gaining control over their own sexual lives. The rampant spread of this disease can only be stemmed if the subordinate position of women is acknowledged and addressed.

Effects of shiftwork on sleep and menstrual function in nurses

Abstract: Evidence suggests that shiftwork is associated with menstrual irregularities, reproductive disturbances, risk of adverse pregnancy outcome, and sleep disturbances in women, yet little has been done to evaluate the effects of shiftwork on menstrual function and fertility. The purpose of this study was to evaluate menstrual function, fertility, and pregnancy outcome in nurses working shiftwork, and to examine the relationship of sleep to menstrual function. Sixty-eight nurses < 40 years old completed a survey evaluating sleep, menstrual function, and pregnancy outcome. Fifty-three percent of the women noted menstrual changes when working shiftwork. Women noting menstrual changes reported more physiological symptoms (p < 0.003), slept approximately one hour less when working nights, and reported lengthened time to fall asleep (p < 0.01) when working nights. Findings suggest that sleep disturbances may lead to menstrual irregularities, and changes in menstrual function may be a marker of shiftwork intolerance.

Cervical cancer screening among South Asian women in Canada: the role of education and acculturation.

Abstract: Cervical cancer screening by Papanicolaou (Pap) smear lowers the incidence and provides early detection of cervical cancer and is a preventative health care measure that should be available on a regular basis to all women at risk. As the population of ethnic women increases, it is important to assess whether these women are aware of and are utilizing this health service. A self-administered questionnaire was completed by 124 South Asian women, aged 18 to 60 years. Sixty-two South Asian students were selected from a university setting and 62 Tamil women were selected from a community center for South Asian women. This study examined the knowledge and use of Pap smears in South Asian women in Canada, and whether their level of acculturation or formal education influenced whether they know about and receive Pap smears. Low level of knowledge about the Pap test and a low prevalence of Pap testing behaviour was significantly correlated (p < 0.001) with a low level of formal education, education taking place outside of Canada, and a low index of acculturation. South Asian students were significantly more acculturated than Tamil women (p < 0.001). In conclusion, there was a low level of knowledge and prevalence of cervical cancer screening among South Asian women. This study highlights the need for educational interventions in Canada directed to ethnic women especially from South Asia.

Factors that support women's successful transition to the community following jail/prison.

Abstract: The purpose of this study was to describe factors that support women's successful transition to the community following incarceration. The design is qualitative, utilizing open-ended data generating interview questions of women who participate in Welcome Home Ministries (WHM), a new community faith-based program for women released from jail/prison. A multitude of factors are necessary to support women's successful transition to the community following incarceration. Although no questions were asked about religion or spirituality, the rank-ordered dominant factors were a spiritual belief and practice and freedom from addiction. The role of support groups and their "sisters" in WHM, the nurse-chaplain's jail visit and support, and the role of supportive friends (not former drug using friends) were additional key factors. The study findings may be used to support the design of new interventions based upon women's needs and capacities to empower them to create their own and their children's healthy future.

Stroll your way to well-being: a survey of the perceived benefits, barriers, community support, and stigma associated with pram walking groups designed for new mothers, Sydney, Australia.

Abstract: In our survey of 500 mothers with children 0-5 years involving telephone interviews (n = 450) and focus groups (n = 50), we showed that 87% of mothers telephone surveyed used a pram for incidental activities, whilst 47% used the pram specifically for exercise Factors preventing mothers exercising more included poor weather, lack of time, and poor quality paths Ninety-two percent of mothers believed that pram walking would increase mental well-being, and 87% felt that it would help to reduce postnatal depression (PND) However, feedback from focus groups expressed less confidence in the program's ability to potentially benefit mothers with PND Programs will have to be marketed carefully to avoid the stigma associated with PND and successfully target mothers at risk

Illuminating social determinants of women's health using grounded theory.

Abstract: Emphasis in health policy has shifted from curative intervention to prevention and health promotion through personal responsibility for lifestyle choices and, most recently, to the social determination of health. These shifts draw attention to and legitimize women's health research that moves beyond biomedical, epidemiological, and subjective knowledge to question previously unquestioned societal norms and structures that influence women's health. The challenge is to avoid relying solely on population-based studies that support relationships between social determinants and indicators of women's health and to find ways to illuminate the processes by which social determinants interact with the health of specific groups of women. Without such research, our knowledge of how social factors that underpin women's health interact will be faceless and will not address the interplay of health and social policy within women's lives. One research method that may be useful for exploring the interplay between such poli...

Adherence to cultural practices following childbirth in migrant chinese women and relation to postpartum mood

Abstract: Chinese women (N = 102) who had migrated to Sydney, Australia, were interviewed about traditional cultural practices they had followed in the first six weeks of the postpartum period. The majority (90.2%) of these women had adhered to some form of practice, with the most frequent being eating warm ('yang') food (78%), following confinement for one month (55%), and using warm water for washing themselves (19%). Of note was that 18% of these women felt ambivalent about following such practices, with the impression being that the adoption of such practices was more a result of family or in-law expectations than the wishes of the woman. Of the 9.8% who did not follow any form of traditional Chinese postpartum practice, only half felt ambivalent or negative about not doing so. There was no relationship between the women's mood at six weeks postpartum and how she felt about following or not following such practices. The adherence to traditional cultural practices was not related to length of time in Australia, nor to whether the woman was residing with her parents or in-laws. There was some indication that more educated women were less likely to follow cultural practices following the birth.

Causal analysis of exercise and calcium intake behaviors for osteoporosis prevention among young women in Thailand

Abstract: The goal of health education is to provide information to affect attitudes, beliefs, and intentions for behavior change. However, little is known about the effects of changes in knowledge on behaviors for osteoporosis prevention. Our objective is to develop and test theoretical models of the effects of knowledge, attitude, and self-efficacy on exercise and calcium intake among young women before and after an intervention program. First, we hypothesized that knowledge would positively predict attitude, self-efficacy, calcium intake, and exercise. Second, attitude would positively predict self-efficacy, calcium intake, and exercise. Third, self-efficacy would positively predict calcium intake and exercise. Fourth, attitude and self-efficacy would mediate the effect of knowledge on calcium intake and exercise. At the beginning and end of the study, participants in the control group and intervention group completed the osteoporosis knowledge test, the osteoporosis health belief scale, the osteoporosis self-ef...

Physical activity: perspectives of Mexican American and Anglo American midlife women

Abstract: Despite the well-known health benefits of physical activity (PA), most midlife and older adults lead sedentary lifestyles Anglo American women and Mexican Americans of both genders are two of the least physically active groups We conducted three focus groups to identify attitudes and beliefs about PA among Mexican American and Anglo American midlife women Our long-term goal was to identify culture-specific interventions that promote long-term PA continuation Significant differences were found between the two groups While Anglo American women valued individual outcomes, and spoke of personal factors promoting or preventing exercise, Mexican American women viewed PA as prescriptive, important for restoring health, and cited family responsibilities and family attitudes as factors that promoted or prevented them from exercising We found that in order for PA interventions to be successful in each group, they must be tailored to the values of each cultural group

Relationship of body size, body image, and self-esteem in African American, European American, and Mexican American middle-class women.

Abstract: In this study we examined the influence of ethnicity on weight, body image, and self-esteem among adult women while controlling for socioeconomic status (SES). Fifty women of African American (AA), European American (EA), and Mexican American (MA) descent completed interviews and questionnaires related to body size and self-esteem, and were measured for weight and height. AA women were significantly heavier than EA women, but MA women did not differ materially from either grouping. Regardless of ethnic descent, all reported congruence between real and ideal body size. In addition no differences were found in self-esteem. This new comparative study calls into question variations previously attributed to race or ethnicity. It also provides a view of middle-class women missing from recent research. Based on the outcomes of our research, we suggest that socioeconomic differences could be more important than ethnic background. Health educators and providers may find these data helpful when designing prevention and intervention strategies for middle-class women regardless of their ethnic origin.

Cultural and gender issues related to HIV / AIDS prevention in rural Swaziland: a focus group analysis.

Abstract: HIV/AIDS is a serious public health problem in Swaziland, a small land-locked Southern African country. The epidemic affects all subpopulations, but women are increasingly at risk for contracting the disease. Focus groups were conducted in a rural area to obtain qualitative information on the rural dimensions of HIV/AIDS, vulnerability to HIV/AIDS, and sociocultural factors influencing the spread of AIDS. Five themes were identified from analyses of the focus groups that are relevant in developing an AIDS prevention program for this population in Swaziland. Implications for future research and health care practice focus on gender-sensitive cultural research (e.g., women and men's roles and responsibilities in rural Swaziland society) and how social, economic, and cultural factors impact the spread of AIDS. Recommendations include reorienting and allocating resources for health, education, and social services to address the relative neglect of rural areas and strengthening policies and programs to achieve ...

The conceptual structure of hwa-byung in middle-aged korean women

Abstract: The term hwa-byung (HB) as a culture-bound syndrome of Koreans has been used to refer to certain types of symptom complexes. However, there is an ambiguity in relation to what sorts of experiences and personal attributes can be identified for describing HB. Our study was designed to reexamine the conceptual structure of HB through a qualitative analysis of interview data with six middle-aged women experiencing HB. The emerging common themes of HB were identified in three dimensions: (a) those related to personal attributes or life situations such as quick-temperedness, strong commitment to traditional values, a hard or unhappy life , and conflicted marital relationship ; (b) those related to experiential accounts such as deep sorrow (hahn in Korean), a feeling of victimization, anger , and enduring ; and (c) HB symptoms. "Enduring" as one of the core concepts of HB viewed as the only way of life for these women needs further examination.

Women living with ovarian cancer: dealing with an early death.

Abstract: Our intent to explore the emotion of anger in women living with ovarian cancer revealed a basic social concern of "dealing with an early death." The findings of this grounded theory study also identified the core variable of "finding meaning in life" as assisting the nine women in dealing with an early death. The categories of hope and physical wellness influenced the women's search for meaning after a diagnosis of ovarian cancer. Several action and interactional coping strategies were identified as positive coping behaviors. The consequences of finding meaning in life was a perception of well-being defined by the women as satisfaction with their lives. Conversely, an inability to find meaning in life resulted in feelings of despair. The women's perceptions of well-being were not static and could fluctuate as they lived with ovarian cancer. Implications for further research and practice are discussed.

Western medicine and marketing: construction of an inadequate milk syndrome in lactating women.

Abstract: I conducted a longitudinal phenomenological study in England to explore the perceptions of 10 lactating women related to the nature of their breast milk and their ability to exclusively breast-feed their babies. The women viewed breast-feeding as a mechanical manufacturing process, and they carefully monitored the output of breast milk. Health care professionals contributed to the women's perceptions and displayed mechanistic assumptions in relation to breastfeeding, reflecting their enculturation through the biomedical paradigm. I present personal accounts to highlight the influence of two dominant Western ideologies-biomedical science and capitalism-upon women's perceptions of their breast milk.

Midlife development and menopause in African American and Caucasian women.

Abstract: Little is known about factors that enhance midlife women's well-being and even less about whether these factors differ for African Americans and Caucasians. We conducted focus groups with 30 women, grouped by ethnicity and menopausal status. Women identified midlife as a time of opportunity for self-development. Pre/perimenopausal women expressed more fears about severe emotional changes than did their postmenopausal counterparts. These fears were in sharp contrast to the women's descriptions of enhanced self-esteem. Caucasian women were primarily concerned about menopause as a harbinger of physical aging and the ensuing disadvantage of divergence from society's ideal of a youthful appearance, while African American women viewed menopause as a normal, even welcome, part of life. A language of emancipation and awareness of gender bias were prominent in the women's stories regardless of menopausal status or race. Further study should assess the role that feminist insights may play in the well-being of midlife women.

Physical activity in young african american women

Abstract: African American women are reported to be less physically active than other population groups. This study examined personal behavioral and psychosocial and environmental factors associated with physical activity in African American women living at or below poverty. Most participants engaged in some moderate physical activity through housework and child care; 71% engaged in activity such as walking from one to seven times per week; but only 5% were vigorously active. Seventy-seven percent were active in the past, but 80% dropped out within 6 months, citing "lack of time and feeling bad" as the main reasons. Exercise self-efficacy was positively correlated with beliefs about physical and social outcomes of activity, with more active than inactive women believing that physical activity had more physical health outcomes. One-third of the women reported that family or friends disapproved of their spending time being physically active, and 45% had never been encouraged to be active by a health professional. However, health professionals' influence was positively correlated with weight reduction but not physical activity participation.

The Ohio Midlife Women's Study.

Abstract: The Ohio Midlife Women's Study was longitudinal with measurements occurring at three, 9-month intervals. Our purpose in doing this research was to examine predictors, moderators, and outcome variables associated with the transition to midlife in Caucasian and African American women. Predictor variables included loss and gain of resources. Moderators included menopause symptoms, menopausal status, attitude toward menopause, coping, and demographic characteristics. Outcome variables included anxiety, depression, and health promoting activities. To obtain the proposed final sample of 160 midlife women, an initial sample of 103 African American and 105 Caucasian "healthy" women were recruited in the community. Consistent predictors of anxiety were loss of resources, coping effectiveness, and education. Consistent predictors of depression were loss of resources and education. Health promoting activities were consistently predicted by attitude toward menopause and coping effectiveness. Stress is a better predic...

Factors that promote and prevent preparation for future care needs: perceptions of older Canadian, German, and US. women.

Abstract: The risk of needing help with household tasks or of requiring care in old age increases. Using semi-structured, qualitative interviews, beliefs about the usefulness versus uselessness of planning ahead for future care needs (FCN) were investigated in 23 East German, 10 U.S., and 10 Canadian elderly-community dwelling women (> or= 65 years). Primary reasons in favor of planning for FCN were: gaining a feeling of security regarding the future, avoiding being a burden to potential helpers, and coping with one's present health conditions. Factors that prevent planning for FCN were: the difficulty foreseeing FCN, the lack of resources to plan, and low levels of perceived vulnerability. The women dealt with the contradictions between these factors that promote and prevent preparation by making general plans which could be adapted in the case of needing help by developing alternative plans or by avoidance of thinking about possible future health crises.

Application of feminist theory in nursing research: the case of women and cardiovascular disease.

Abstract: Researchers have provided evidence that women recover from and live with heart disease in very distinct ways from men. The challenge for researchers has been to discuss women in a manner that allows their differences to emerge but does not depict them as inferior to men. Our goal is to review current cardiovascular research on women from a feminist theoretical perspective. We believe that a feminist perspective in cardiovascular research will advance the knowledge and recognition of women's health. We examined nine qualitative research articles in depth and applied a model of feminist research critique to them (Bunting, 1997). Historical androcentric notions in women's health and cardiovascular research are discussed. Also included are recommendations for future research to influence social change in women's cardiac health.

Childbirth care-seeking behavior in Chiapas.

Abstract: This study was designed to better understand how women in a developing region choose between the multiple options available to them for birthing. We conducted focused, open-ended ethnographic interviews with 38 non-indigenous, economically marginal women in Chiapas, Mexico. We found that although medical services for birthing were readily available to them, these women most often chose traditional birth attendants (TBAs) for assistance with their births. They expressed a clear preference for TBAs in the case of a normal birth, but viewed medical services as useful for diagnosing and managing problem deliveries and for tubal ligations. They favored TBAs because they valued being able to choose birthing locations and birthing positions and to have relatives present during the birth, all features they must give up for medically attended births in this region.

Health care services for lesbian and bisexual women: some Canadian data.

Abstract: Specific health needs and health services for lesbian and bisexual women are relatively invisible in existing research, with little Canadian data on these topics. To redress such gaps, data were selectively analyzed from a larger study with 98 lesbian/bisexual women living in a Maritime Province in Canada. As part of a semistructured interview, women were asked to indicate whether a particular health care service was important to them. General physical examination, Pap smear, breast examination, and holistic medicine were the four services chosen with the highest frequency. HIV/AIDS information/screening and safer sex information were judged important by over half of the participants. When asked to rank their top three services, however, participants chose the physical examination, holistic medicine, and psychological counseling. Our results are discussed in terms of barriers to basic health care, accessibility of services, and the importance of accurate information about AIDS and safer sex.

Grounded theory and gender relevance.

Abstract: (2002). GROUNDED THEORY AND GENDER RELEVANCE. Health Care for Women International: Vol. 23, No. 8, pp. 786-793.

As normal a life as possible: mothers and their daughters with congenital heart disease

Abstract: In this study, I used a qualitative descriptive methodology to examine the effect of chronic illness on the mother-daughter relationship. Many studies have examined the effects of the child's illness on the mother-child relationship when the child is very young, but few have looked at the ongoing problems that chronic illness may cause. Eleven mothers and 11 daughters were interviewed. Normalizing in the face of chronic illness was the overriding theme of the study. Two subthemes related to normalizing arose from the data. "It's no big deal" was found to best describe how most mothers and their daughters with heart disease viewed their lives and relationships. One other subtheme, "Sometimes it's a very big deal," was described by those mothers and daughters who could not, due to ongoing health problems, normalize their lives. Relationships with family as well as age, severity of illness, and developmental stage, were seen as mediators of normalizing in the lives of the participants.

Exploring health promoting lifestyle behaviors of Japanese college women: perceptions, practices, and issues.

Abstract: The purpose of this study was to explore health promoting lifestyle behaviors (HPLBs) of college women in Japan. In addition, perceived health status and concerns were evaluated. The methods used were both qualitative and quantitative. The qualitative data from focus groups with 38 Japanese college women were used to develop a questionnaire. Subsequently, 546 randomly selected college women responded to the mailed survey (response rate 54%). Forty percent of the college women respondents perceived themselves as "rather unhealthy" or "unhealthy." The investigator conclude that (1) perceived HPLBs, health status, and health concerns were mutually associated, thus, to increase perceived health status and/or decrease perceived health concerns, promoting healthy lifestyle behaviors must be considered; (2) the number of perceived motives or cues and the number of perceived health concerns of importance to college women must be considered to promote healthy lifestyle behaviors.

"They don't trust us; we're just kids:" views about community from predominantly female inner city youth.

Abstract: The cornerstones of health promotion are the concepts of empowerment and community participation. There has been little research, however, on how these concepts are actualized within a youth population and even less from a gender perspective. Girls are socialized to be more compliant and cooperative; thus they feel less assertive to express themselves. The benefits of community participation, such as the development of personal identity and increased self-determination, may therefore be more important for girls' development. In this qualitative study I explored youth's perceptions about community, their ability to be heard, and their power to effect community change. Responses to focus groups and an on-line sentence completion exercise by 23 well-functioning, predominantly female (83%) youth, at an inner-city school in Canada, revealed that youth perceived that they were not heard and felt disempowered in the larger community. Three subthemes explain these threats to empowerment: "grown-ups run everything...

Examining the standardized application of rape kits: an exploratory study of post-sexual assault professional practices

Abstract: In this exploratory study we examine the practices surrounding with respect to standardization the administration and processing of the Sexual Assault Evidence Kit (SAEK). Despite the presumed scientific objectivity of this protocol, our survey of sexual assault nurses, physicians, police, and forensic scientists found that discretionary practices pervaded the evidentiary process. We argue that there must be greater awareness of the shaping of medicolegal evidence. Given the diverse characteristics of sexual assaults and of the health care needs of sexually assaulted women, we also suggest that it may be unreasonable to apply a single standard model of a rape kit.

Concepts of health: women's struggle for wholeness in the midst of poverty.

Abstract: This article describes the findings of a modest qualitative study that deals with the concept of health and involves the women-centered interviewing of six women who live in poverty. The themes uncovered in this study identify the struggle for wholeness in the midst of poverty. The findings validate many of the nursing theorists' definitions of health as wholeness, and challenge care providers to bring an appreciation of this view to their understanding of women's health.

Information women receive about heart attacks and how it affects their knowledge, beliefs, and intentions to act in a cardiac emergency.

Abstract: In this study we investigate (a) what information women receive on acute myocardial infarction (AMI) from different information sources, (b) how women evaluate this information, and (c) how information acquisition is related to women's knowledge of AMI, personal risk perceptions, and behavioral intentions regarding a cardiac emergency. A random sample of 844 women 50 years and over were telephoned in the state of Washington. Repeated measures regression analyses showed that women receive most of their information on AMI from the mass media, even though they evaluated the media as less believable, less useful, less clear, and making less of an impression than information received from health care providers. Logistic regression analyses showed that the total number of information sources from which heart attack information was received in the past year was positively related to knowledge of AMI symptoms, beliefs about AMI, and personal risk perceptions. The results are discussed in terms of their pragmatic ...

The quality of life of families of female-headed households in Botswana: a secondary analysis of case studies.

Abstract: Previous studies note a positive relationship between female-headed households (FHHs) and poverty in urban and rural areas of Botswana. To explore this further, data were collected from 7 FHHs through participant observation and open-ended interviews. A secondary analysis of data described the quality of life (QOL) of members of the households according to one's ability to meet basic human needs (food, water, shelter, safety, and health). FHHs ranged in age from 40-91 years, with family size ranging from 1-11 members. Monthly income for 6 of the 7 families was 30 dollars (U.S.) per month or less. Physical living environments were overcrowded, with poorly maintained latrines and unsafe refuse disposal. Family illnesses included hypertension, cataracts, mental illness, knee pain, ringworm, leg sores, and tonsillitis. Health risk behaviours included unprotected sex, alcohol abuse, and breastfeeding among potentially HIV positive mothers. Although Botswana claims rapidly rising levels of national income after independence, the QOL of FHHs remains poor. We suggest that, to alleviate poverty, governments in developing African countries should explore strategies that effectively target families headed by women.

Adolescent behavior and sexually transmitted diseases: the dilemma of human papillomavirus.

Abstract: Adolescence is a period of physical, cognitive, psychosocial, and moral development that often results in risk-taking behavior. As a consequence, adolescents are at high risk for sexually transmitted disease (STD). Two of the most common STDs in the United States, chlamydia and human papillomavirus (HPV), affect millions of adolescent women. HPV, contrasted with chlamydia, poses a unique challenge to health care providers. In addition to causing genital warts, HPV has been shown to be the causative agent in the development of cervical cancer. Interventions that are effective in decreasing the transmission of chlamydia, such as increasing condom use, are less effective in prevention of HPV. Efforts to increase adolescent awareness of HPV, to increase age of first coitus, and to decrease numbers of sexual partners are more effective for HPV prevention. Early screening for HPV, smoking cessation, and health promotion may be effective in decreasing the incidence of cervical cancer in young women. Nurse practitioners and other primary health care providers need a more holistic approach to the prevention of HPV in adolescent women.