Differentiation of women with three perimenstrual symptom patterns

The purpose of this study was to differentiate women with three perimenstrual symptom severity patterns: premenstrual syndrome (PMS), premenstrual magnification (PMM), and low symptom (LS). Factors entered into the discriminant functions included social demands, personal resources, socialization, parity, age, personal health practices, and psychological distress. A community-based sample of 142 women taking no oral contraceptives was classified into one of the three symptom severity patterns. Three two-way discriminant analyses were performed. Women with PMS had more psychological distress, more education, and a mother with more premenstrual symptoms than those with an LS pattern. Women with PMM had more psychological distress and a mother with more premenstrual symptoms, but they also had more stress and were younger than those with an LS pattern. Finally, the women with PMS, when compared to the PMM subgroup, were older, had more education, engaged in more positive health practices, and had more nontraditional attitudes toward women. In addition, the women with PMM had more stress in their lives than women with PMS.

The new woman: health-promoting and health-damaging behaviors

Compared with their mothers, contemporary women are better educated, live alone more of their adult lives, and participate in the labor force more consistently throughout their lives. Most studies of the New Woman have focused on the effects of the configuration of her roles on her health and health-related behavior. Few have considered both the influence of women's roles and the broader context of their lives on their health. Moreover, investigators have devoted little attention to the health behavior patterns of the New Woman, despite the demonstrable impact of health-related behaviors on mortality and morbidity. The present study was designed to test models relating women's roles, gender role norms, social demands and resources, and health-promoting and -damaging behaviors. Women who resided in middle-income and racially mixed neighborhoods (N = 659) were interviewed in their homes. The women were a mean age of 32.7 years and had an educational level of 14.2 years. Approximately 57% were married or partnered, and 76% reported some level of employment outside the home. Women who had fewer life stressors and were better educated performed more health-promoting behaviors. Women who experienced more stressors, were less well educated, had more contemporary attitudes toward women, were not partnered, or experienced depressed mood engaged in more health-damaging behaviors. These results underscore the importance of considering women's social context in health promotion efforts and as a deterrent to health-damaging behaviors.

The family's functioning with newly diagnosed breast cancer in the mother: the development of an explanatory model

Despite the high rates of breast cancer in the child-rearing mother, there is extremely limited research on the effects of the illness on the children, marriage, and parent-child relationship. The current study tested an explanatory model of family functioning with breast cancer based on data obtained from standardized questionnaires from 80 diagnosed mothers and partners with young school-age children. Path analysis results for data obtained from both the mothers and the partners revealed a similar pattern. More frequently experienced illness demands were associated with higher levels of parental depressed mood which negatively affected the marriage. When the marriage was less well adjusted, it negatively affected the family's coping behavior. Household functioning was positively affected by heightened coping activity and by higher levels of marital adjustment. Children functioned better when the non-ill parent more frequently interacted with them and their families coped more frequently with their problems.

Design and measurement challenges in family research

Closing the chasm between family theory, nursing practice, and family research requires design and methods that foster the study of families as dynamic, holistic entities. This article has outlined several strategies for capturing morphostasis and morphogenesis and for studying the family as a unit of analysis.

Infertility: women's experiences

Recent scientific nursing literature and clinical practice yield important information regarding women's varied responses to the diagnosis and treatment of infertility, as well as the multiple pathways women take through the infertility experience. In this article, we examine infertility through women's eyes, explore the influence of the social context on women's infertility experiences, and present ideas for clinical approaches to working with infertile women. Three approaches for nursing practice are suggested: (a) preserving self-esteem, (b) promoting access to social resources, and (c) facilitating use of coping methods to reduce distress.

Sleep patterns related to menstrual cycle phase and premenstrual affective symptoms

An ovulatory menstrual cycle is characterized by fluctuating levels of progesterone. Progesterone, a gonadal hormone known for its soporific and thermogenic effects, is present in negligible levels prior to ovulation and in high levels after ovulation. To describe and compare sleep patterns in relation to ovulatory cycles and premenstrual mood state, sleep was monitored in healthy women at two phases of the menstrual cycle. Results indicated that rapid-eye-movement (REM) latency was significantly shorter during the postovulatory (luteal) phase compared to the preovulatory (follicular) phase, but there was no significant difference in latency to sleep onset or the percentage of REM sleep. While there were no menstrual cycle phase differences in the percentages of various sleep stages, the women with negative affect symptoms during the premenstruum demonstrated significantly less delta sleep during both menstrual cycle phases in comparison with the asymptomatic subjects.

Social support for women during chronic illness: the relationship among sources and types to adjustment

The purpose of this study was to explore who in the network provided what type of support in relation to psychosocial adjustment for women experiencing chronic illness. The Norbeck Social Support Questionnaire was administered to 125 chronically ill women, along with measures of depression (CES-D), family illness demands (Demands of Illness Inventory), marital quality (Spanier Dyadic Adjustment Scale), and family functioning (FACES-II). Repeated-measures ANOVA was used to examine the average amount of support from four main sources: partner, family, friends, and others. Women perceived more support from the partner than from any other source. Family members provided more affective support than friends or others. Friends provided more affirmation than family or others. After the partner, women reported confiding about their illness more to health care providers, counselors, or religious personnel than family or friends. Pearson correlation coefficients were computed for the amount of support from each source and the measures of individual, dyadic, or family adjustment. In general, affect, affirmation, and reciprocity from both the partner and family were associated with less depression, higher marital quality, and better family functioning.

Living with cancer. Family experiences

The focus of this paper is to describe what it is like to live with cancer from the perspective of families. Recent studies indicate that family members' concerns vary with their roles as family members and patient/nonpatient status. Moreover, concerns vary with stage of illness and time since diagnosis. Not all concerns are shared among all family members. Families influence the adjustment of the person with cancer. Family members cope in different ways, and coping patterns vary with status of the disease and the person's role in the family. Nevertheless, families coping in different ways can achieve similar outcomes.

The family's functioning with chronic illness in the mother: the spouse's perspective

While previous research has studied the impact of chronic illness on the patient or spouse, the impact on the marriage, the child, the parent-child relationship, and the family's functioning have been relatively ignored. To date ther is no known study of the impact of a mother's chronic illness on the family. The purpose of the current exploratory study was to test a set of interrelated hypotheses about family functioning with the mother's chronic illness from the spouse's perspective based on a family systems perspective. Data were obtained from standardized questionnaires from 48 fathers with young school-age children whose wife had either breast cancer, diabetes, or fibrocystic breast disease. Results of a path analysis revealed that the number of illness demands the father experienced was a significant predictor of his level of depression. More demands resulted in higher depression scores. Marital adjustment was significantly affected by both the father's level of depression as well as by his wife's type of disease. Spouses of women with breast cancer had significantly higher levels of marital adjustment than did partners of the other women. More depressed spouses had lower levels of marital adjustment. Both illness demands and level of marital adjustment significantly predicted the type of coping behavior the family used. More frequent illness demands and higher levels of marital adjustment were associated with familial introspection, that is, coping behavior characterized by frequent feedback, reflection, and discussion in the family. The quality of the father-child relationship was significantly affected by this type of coping behavior. Families characterized as introspective had fathers who reported more frequent interchange with their children.(ABSTRACT TRUNCATED AT 250 WORDS)

Being healthy: women's images

Although the concept of health is central to nursing practice and science, measurement of the concept has lagged far behind theory development. The study presented extends Laffrey's earlier work by describing the meaning of health for a population of women representing multiple ethnic groups residing in the Pacific Northwest. A sample of 528 women from a cross-section of a community who had participated in a study of women's health was asked to respond to the question, "What does being healthy mean to you?" In addition to evidence of the clinical, role performance, and adaptive models of health, the women's responses yielded nine dimensions consistent with the eudaemonistic model. Each dimension included multiple descriptors identified through content analysis of the women's verbatim responses. The women's images of health were consistent with Smith's and Laffrey's four conceptions, but the eudaemonistic category included multiple dimensions. The women reported images of health consistent with contemporary nursing theorists' views. Moreover, their emphasis on eudaemonistic images crossed all categories of age, education, income, ethnicity, and employment status.

Premenstrual symptoms: another look

A collection of over 200 symptoms has been labeled premenstrual syndrome. Common belief is that most women experience a marked increase in symptoms premenses. Cyclic variations in the prevalence of commonly cited perimenstrual symptoms were estimated from daily symptom recording. A community-based, multiethnic sample of 345 women recorded symptom severity from "not present" to "extreme" for 90 days. Maximum total reported symptom score occurred during menses, not during premenses. When individual symptoms are considered, the prevalence of those rated as moderate to extreme during menses is less than 15 percent. A method for identifying symptom severity patterns throughout the menstrual cycle is described. Six symptom severity patterns were identified. Only 13 percent of the women exhibited a pattern of increased symptom severity in the premenses. Another 13 percent had a pattern of decreased symptom severity in the premenses.