Social role quality, physical health, and psychological well-being in women after heart surgery

Predictors of uncertainty among postdischarge coronary artery bypass graft patients in Jordan

Uncertainty impacts negatively on adaptation and disease outcomes. During recovery, coronary artery bypass graft (CABG) patients experience uncertainty, symptom distress, and learning needs. This study aimed to examine predictors associated with uncertainty among CABG patients. This cross-sectional correlational study recruited CABG patients conveniently from out-patient clinics 1 month after discharge. Participants completed a self-administered questionnaire which included: demographic questionnaire, Mishel's Uncertainty of Illness Scale, Cardiac Symptoms Survey, and Cardiac Patients Learning Needs. A total of 161 participants completed the study questionnaires. Participants showed a moderate level of uncertainty, less cardiac symptom distress, and high learning needs. Uncertainty was significantly correlated with learning needs while less correlated with symptom distress. Hierarchal multiple regression revealed that gender, employment status, education level, and learning needs are factors associated with uncertainty among CABG patients. It was concluded that symptom distress does not necessarily induce uncertainty. Intensive care professionals should undertake individual's characteristics to anticipate uncertainty.

Social, Health, and Age Differences Associated with Depressive Disorders in Women with Rheumatoid Arthritis

Depression in women with rheumatoid arthritis (RA) may be related to social role experiences, physical health, and age. The purpose of this study was to examine the social and health factors contributing to depression in two age groups of women with RA. One-hundred and thirty-eight midlife and late-life women with a diagnosis of RA participated in this cross sectional survey study. Multiple regression analysis indicated that social role balance, functional status, number of co-existing health problems, and age were significant predictors of depression in midlife and late-life women with RA. Role balance was the strongest factor contributing to a woman's depression score. Compared to midlife women, late-life women reported significantly higher role balance and lower depression scores, despite poorer functional status and more concomitant health problems.

The validation of a new measure quantifying the social quality of life of ethnically diverse older women: two cross-sectional studies

BACKGROUND

To our knowledge, the available psychometric literature does not include an instrument for the quantification of social quality of life among older women from diverse ethnic backgrounds. To address the need for a tool of this kind, we conducted two studies to assess the initial reliability and validity of a new instrument. The latter was created specifically to quantify the contribution of a) social networks and resources (e.g., family, friends, and community) as well as b) one's perceived power and respect within family and community to subjective well-being in non-clinical, ethnically diverse populations of older women.

METHODS

In Study 1, we recruited a cross-sectional sample of primarily non-European-American older women (N = 220) at a variety of community locations. Participants were administered the following: a short screener for dementia; a demographic list; an initial pool of 50 items from which the final items of the new Older Women's Social Quality of Life Inventory (OWSQLI) were to be chosen (based on a statistical criterion to apply to the factor analysis findings); the Single Item Measure of Social Support (SIMSS); and the Medical Outcome Study 36-item Short-Form Health Survey (MOS SF-36). Study 2 was conducted on a second independent sample of ethnically diverse older women. The same recruitment strategies, procedures, and instruments as those of Study 1 were utilized in Study 2, whose sample was comprised of 241 older women with mostly non-European-American ethnic status.

RESULTS

In Study 1, exploratory factor analysis of the OWSQLI obtained robust findings: the total variance explained by one single factor with the final selection of 22 items was over 44%. The OWSQLI demonstrated strong internal consistency (α = .92, p < .001), adequate criterion validity with the SIMSS (r = .33; p < .01), and (as expected) moderate concurrent validity with the MOS SF-36 for both physical (r = .21; p < .01) and mental (r = .26; p < .01) quality of life. In order to confirm the validity of the 22-item OWSQLI scale that emerged from Study 1 analyses, we replicated those analyses in Study 2, although using confirmatory factor analysis. The total variance accounted for by one factor was about 42%, again quite high and indicative of a strong single-factor solution. Study 2 data analyses yielded the same strong reliability findings (i.e., α = .92, p < .001). The 22-item OWSQLI was correlated with the SIMSS (r = .27, p < .001) in the expected direction. Finally, correlations with the MOS SF- 36 demonstrated moderate concurrent validity for physical (r = .14; p < .01) and mental (r = .18; p < .01) quality of life, as expected.

CONCLUSIONS

The findings of these two studies highlight the potential for our new tool to provide a valid measure of older women's social quality of life, yet they require duplication in longitudinal research. Interested clinicians should consider using the OWSQLI in their assessment battery to identify older women's areas of lower versus higher social quality of life, and should establish the maximization of patients' social quality of life as an important therapeutic goal, as this variable is significantly related to both physical and mental health.

Gender differences in coping and anxiety in patients after coronary artery bypass graft surgery in Taiwan

BACKGROUND

Greater use of coping strategies and lower anxiety levels may be related to positive outcomes after coronary artery bypass graft surgery; however, the relationship between them, including by gender, has not been examined in Taiwan.

METHODS

Cross-sectional survey research design and purposive sampling were used in this study, for which 50 men and 50 women were recruited from a medical center in northern Taiwan.

RESULTS

After coronary artery bypass graft surgery, both male and female patients used more problem-focused coping strategies than emotion-focused coping strategies. In comparison with men, women tended to use more blaming of self and had slightly higher scores on both state and trait anxiety.

CONCLUSION

Clinicians need to be aware that the use of appropriate coping strategies can reduce patient anxiety, a finding that needs to be considered when designing effective interventions for these patients.

Sleep Satisfaction of Older Adults Living in the Community: Identifying Associated Behavioral and Health Factors

The purpose of this study was to explore sleep satisfaction and its related factors among 130 older adults living in the community. Descriptive analyses indicated a small proportion of participants (n = 20, 15.4%) were not satisfied with sleep. Best descriptors of sleep satisfaction were the total amount of sleep, number of awakenings, depth of sleep, and overall quality of sleep. Regression analysis showed depression was negatively related to sleep satisfaction after controlling for age and number of illnesses (p < .05). Findings indicate the need for nurses to assess for factors such as depressive symptoms and anxiety associated with sleep satisfaction.

Social roles and health in women living with HIV/AIDS: A pilot study

The purpose of this report is to share results from a pilot study about the social role experiences and health of women living with HIV/AIDS. This pilot was designed as part of a larger study undertaken to ensure cultural competence of measures and methods proposed for testing a model of role quality and health in culturally diverse low-income women. Thirteen women participated in the study (69% African American; 77% less than dollar 10,000 annual income; range of years since HIV diagnosis, 3-21). Measures of physical health, role quality, and psychological well-being previously used to test relationships among the variables in women with chronic illness were administered using a face-to-face interview format. Results indicated that the women experienced a number of HIV symptoms and coexisting health problems, moderate physical limitations, positive perceptions of their roles, moderate levels of well-being, and high depression scores. The pilot study represents the first step in the development of a theory-based approach to understanding linkages among health and role quality in women with HIV.

Gender differences in recovery after coronary artery bypass graft surgery

This study examined the effect of gender on symptom evaluation, symptom response, and physical functioning following coronary artery bypass graft surgery. Symptom evaluation and symptom response were measured at baseline and 2, 4, and 6 weeks and 3 months following surgery, and physical functioning was measured at baseline, 6 weeks, and 3 months. The sample included 46 men and 19 women randomly assigned to the routine care group of a larger study examining symptom management intervention influence on recovery outcomes in elderly coronary artery bypass graft patients. No significant differences were found in symptom evaluation, symptom response, or physical functioning by gender over time. Women reported consistently higher symptom evaluation scores for shortness of breath, fatigue, depression, sleep disturbance, swelling, and anxiety and lower mean physical and vitality subscale scores than men at every time point. Gender-specific symptom management strategies should be developed and tested to address the differences in the reporting of symptoms by men and women.

Relationship of social role quality to psychological well-being in women with rheumatoid arthritis

The purpose of this study was to examine the mediating and moderating effects of women's social role quality on the psychological well-being of women with rheumatoid arthritis (RA). One hundred and fifty-six women with a diagnosis of RA (M age = 59, SD = 11) completed self-report measures of arthritis history, physical health, psychological well-being, and role quality. Hierarchical multiple regression analyses indicated that role quality mediated the effects of physical health on depression and purpose in life, moderated the effects of health on depression, and moderated the effects of pain on purpose in life. Women in poor health with high role quality were significantly less depressed than women in poor health with poor role quality. Women with high levels of pain and high role quality had more purpose in life than women with high levels of pain and low role quality. Despite difficulties with their physical health, women who had high role quality had higher levels of psychological well-being. Findings from this study may aid in the development of meaningful interventions to help women with RA manage their daily lives to optimize well-being.

Women and cardiac rehabilitation after heart surgery: patterns of referral and adherence

This cross-sectional, descriptive study examined patterns of referral of women to cardiac rehabilitation programs after heart surgery, their adherence to those programs, and whether their participation differed according to their age ranges. A Cardiac Rehabilitation Participation questionnaire was mailed to 157 women who were selected from the records of 4 hospitals and 7 physician groups. Of the 157 women, 122 had been referred to a cardiac rehabilitation program. Ten (8.3%) of 122 did not attend the program at all, and 25 (29%) did not attend as often as had been recommended. Women who had bypass surgery were more likely to have been referred than were those who had valvular surgery. Patterns of referral and adherence were similar in older women (66 years or older) to the patterns for women in midlife (32 to 65 years). Study participants indicated that health, convenience, work or time constraints, or personal preferences were factors that most interfered with their attending the programs. Age was not a factor.