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Safa A, Adib-Hajbaghery M, Rezaei M. A model for older adults' coping with the death of their child: a grounded theory study. BMC Psychiatry 2024; 24:150. [PMID: 38383337 PMCID: PMC10882903 DOI: 10.1186/s12888-024-05597-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 02/07/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND Losing a child at an old age while also facing health problems and physical limitations can have significant negative impacts on parents' lives such as anxiety, depression, and impairment in social functions. The process of coping with the death of a child is particularly unknown among older adults. Therefore, this study aimed to explore how older adults cope with the death of their child. METHOD This qualitative study was conducted in 2020-2021, using Corbin and Strauss (2015) approach to the grounded theory method. The sampling began purposefully and continued theoretically until theoretical saturation was achieved. Semi-structured interviews were conducted to collect data from Iranian older adults who had experienced the death of their child. To ensure data trustworthiness, the Guba and Lincoln (1985) criteria were utilized. A qualitative data analysis software, MAXQDA2020, was used to manage the data. FINDINGS The results of this study were obtained from 27 participants. The main concern of older adults was the fear of their lives collapsing following the death of their child. Participants utilized three main strategies to address their concerns: attempting to rebuild themselves, connecting to a higher power, and searching for positivity amidst grief. The central category that emerged from the analysis was "improving physical, mental, and spiritual capacities," resulting in personal growth and improved social relationships. CONCLUSIONS Through the use of the three aforementioned strategies, older adults were able to overcome their primary concern of the fear of their lives collapsing following the death of their child. Further development of the theory is suggested in order to design a model that can facilitate older adults' coping with this difficult life event.
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Affiliation(s)
- Azade Safa
- Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | | | - Mahboubeh Rezaei
- Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Iran
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Norell Pejner M, Karlsson S. Restoring Balance-A Woman's Expressions of Lived Experience of Everyday Life During a Period of Aging: A Case Study. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2023; 60:469580231167133. [PMID: 37036069 PMCID: PMC10103273 DOI: 10.1177/00469580231167133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
Bereaved older people face stressors from the changes in roles associated with the death of a spouse. To illustrate the lived experience of everyday life during a period of aging after a woman's loss of her spouse. One woman born in 1918 was followed between 74 and 80 years of age after her husband died. Data consisted of daily diary. The text from the diaries were analyzed with a phenomenological hermeneutical approach. Everyday life after becoming a widow is characterized by balancing between personal resources to manage everyday life and vulnerability. In health and social care, it is important to identify experiences of vulnerability because these are associated with poor health.
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Affiliation(s)
| | - Staffan Karlsson
- Halmstad University, Halmstad, Sweden
- Kristianstad University, Kristianstad, Sweden
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Høy B, Hall EOC. "Take good care of yourself" An integrative review of older widows' self-care for health and well-being. J Women Aging 2020; 34:1-30. [PMID: 32339070 DOI: 10.1080/08952841.2020.1753484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Take good care of yourself is a regard often said to older bereaved women. However, what does it mean? Though self-care is a well-known phenomenon within health, it is not well understood in the context of late life spousal bereavement and widowhood. We undertook an integrative review to synthesize knowledge of older women's self-care challenges, resources and activities when bereaved and in a healthy transition to widowhood. Good care refers to health-promoting self-care and can be explained as the older widows' ability to access and mobilize resources and activities that are significant for a healthy transition to widowhood.
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Affiliation(s)
- Bente Høy
- Research Unit, Randers Regional Hospital, Randers, Denmark
| | - Elisabeth O C Hall
- Health, Aarhus University, Aarhus, Denmark.,Faculty of Natural and Health Sciences, University of Faroe Islands, Thorshavn, Faroe Islands
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Harder H, Starkings RM, Fallowfield LJ, Menon U, Jacobs IJ, Jenkins VA. Sexual functioning in 4,418 postmenopausal women participating in UKCTOCS: a qualitative free-text analysis. Menopause 2019; 26:1100-1109. [PMID: 31290761 PMCID: PMC6791508 DOI: 10.1097/gme.0000000000001377] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 03/26/2019] [Accepted: 03/26/2019] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Sexual well-being can contribute significantly to the overall quality of women's lives. This qualitative study aimed to examine sexual activity, functioning, and satisfaction in a large sample of postmenopausal women from the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) METHODS:: Thematic analysis was used to evaluate the free-text data of the Fallowfield Sexual Activity Questionnaire (FSAQ) completed by UKCTOCS participants at baseline before annual screening. RESULTS A total of 24,305 women completed the baseline FSAQ and 4,525 (19%) provided free-text data, with 4,418 comments eligible for analysis. Median age was 64 years; 65% had a partner and 22.5% were sexually active. Four interrelated themes were derived: partner availability, physical and sexual health, mental well-being, and interpersonal relationships. Primary reason for absence of sexual activity was lack of a partner, mainly due to widowhood (n = 1,000). Women discussed how partner's medical condition (27%) or sexual dysfunction (13.5%), their own physical health (18%) or menopause-related symptoms (12.5%), and prescribed medication (7%) affected sexual activity. Impact of low libido in self (16%) or partner (7%), relationship problems (10.5%) or logistics (6%), and perceptions of ageing (9%) were also mentioned. Few (3%) referred to positive sexual experiences or had sought medical help for sexual problems (6%). CONCLUSIONS This qualitative analysis explored postmenopausal women's perspective on their sexual functioning. Having an intimate partner and good physical health are key factors for continuation of sexual activity and satisfaction. Further sexual education for healthcare professionals is needed to raise awareness about sexuality and sexual difficulties in later life. : Video Summary: Supplemental Digital Content 1, http://links.lww.com/MENO/A426.
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Affiliation(s)
- Helena Harder
- Sussex Health Outcomes Research and Education in Cancer (SHORE-C), Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom
| | - Rachel M.L. Starkings
- Sussex Health Outcomes Research and Education in Cancer (SHORE-C), Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom
| | - Lesley J. Fallowfield
- Sussex Health Outcomes Research and Education in Cancer (SHORE-C), Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom
| | - Usha Menon
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials & Methodology, University College London, London, United Kingdom
| | - Ian J. Jacobs
- EGA Institute for Women's Health, University College London, London, United Kingdom
- University of New South Wales, Sydney, Australia
| | - Valerie A. Jenkins
- Sussex Health Outcomes Research and Education in Cancer (SHORE-C), Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom
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Holm AL, Berland AK, Severinsson E. Factors that influence the health of older widows and widowers-A systematic review of quantitative research. Nurs Open 2019; 6:591-611. [PMID: 30918710 PMCID: PMC6419130 DOI: 10.1002/nop2.243] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Revised: 11/22/2018] [Accepted: 01/07/2019] [Indexed: 11/16/2022] Open
Abstract
AIM To examine factors that influence the health of older widows and widowers. The review question was: What is the evidence of the relationship between widowhood and health in older adults? DESIGN Systematic review. DATA SOURCES Academic Search Elite, CINAHL, Medline (Ovid) and PubMed were searched for articles published between January 2013-December 2017. REVIEW METHODS A systematic review of quantitative research with a qualitative thematic analysis. RESULTS The selection process resulted in 12 studies. One of the themes that emerged was: emotional challenges related to experiences of bereavement, depression and anxiety, which was based on the sub-theme social support as the main strategy for coping with emotional pain and suffering. The second theme was: struggling with poor physical health. The findings indicate that healthcare professionals need knowledge and skills to deal with the health consequences of widowhood in old age. Building community teams can prevent emotional and physical health problems, as well as reduce mortality.
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Affiliation(s)
- Anne Lise Holm
- Faculty of Health and Social SciencesWestern Norway University of Applied SciencesHaugesundNorway
| | - Astrid Karin Berland
- Faculty of Health and Social SciencesWestern Norway University of Applied SciencesHaugesundNorway
| | - Elisabeth Severinsson
- Centre for Women’s, Family and Child Health, Faculty of Health and Social SciencesUniversity of South‐Eastern NorwayKongsbergNorway
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Hendrickson ZM, Kim J, Tol WA, Shrestha A, Kafle HM, Luitel NP, Thapa L, Surkan PJ. Resilience Among Nepali Widows After the Death of a Spouse: "That Was My Past and Now I Have to See My Present". QUALITATIVE HEALTH RESEARCH 2018; 28:466-478. [PMID: 29110564 DOI: 10.1177/1049732317739265] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Responses to the death of a spouse vary; although some are at increased risk of poorer physical and mental health outcomes, others have more resilient responses. In light of the limited scope of research on widows' experiences in Nepal, a setting where widows are often marginalized, we explore themes of resilience in Nepali widows' lives. Drawing from a larger qualitative study of grief and widowhood, a thematic narrative analysis was performed on narratives from four widows that reflected resilient outcomes. Individual assets and social resources contributed to these widows' resilient outcomes. Forgetting, acceptance, and moving forward were complemented by confidence and strength. Social support and social participation were key to widows' resilient outcomes. These four narratives reflect the sociocultural context that shape widows' resilient outcomes in Nepal. Future studies on the emergent themes from this exploratory study will help identify how best to encourage resilient outcomes among widows.
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Affiliation(s)
- Zoé M Hendrickson
- 1 Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jane Kim
- 1 Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Wietse A Tol
- 1 Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Abina Shrestha
- 2 Women for Human Rights, Single Women Group, Kathmandu, Nepal
| | - Hari Maya Kafle
- 2 Women for Human Rights, Single Women Group, Kathmandu, Nepal
| | | | - Lily Thapa
- 2 Women for Human Rights, Single Women Group, Kathmandu, Nepal
| | - Pamela J Surkan
- 1 Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Davies N, Crowe M, Whitehead L. Establishing routines to cope with the loneliness associated with widowhood: a narrative analysis. J Psychiatr Ment Health Nurs 2016; 23:532-539. [PMID: 27624679 DOI: 10.1111/jpm.12339] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/20/2016] [Indexed: 11/29/2022]
Abstract
UNLABELLED WHAT IS KNOWN ON THE SUBJECT?: Loneliness in older adults has been identified as an important public health issue in many countries. Widowhood is a time when many older people experience loneliness. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Little is known about strategies that are effective in mitigating experiences of loneliness and this paper explores this with older people who have been through the process. The narratives of the older people in this study described a trajectory in which loneliness was experienced as both a loss of spouse and a loss of routines that enabled them to maintain connections with others. This trajectory moved onto the establishment of new routines that enabled connections to be developed. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Loneliness is strongly associated with depression and anxiety in the elderly and mental health nurses should be encouraged to screen for loneliness when undertaking assessments. Interventions that facilitate the development of meaningful routines could be integrated into mental health nursing care of older people. ABSTRACT Background Loneliness in older people is a public health concern in many Western countries. While not necessarily a symptom of mental disorder, it is often associated with depression and anxiety. Widowhood is a transition period during which many older people experience acute loneliness but over time develops strategies to manage it. Little is known about effective strategies that older people have used to manage the experience. The strategies older people used to manage this was the focus of this paper. Aim The aim was to examine older widows' experiences of loneliness. Design The design of this study was a qualitative narrative analysis with thematic analysis and the participants were 40 older widow/widowers aged between 70 and 97 years. Findings The study found that the participants negotiated the experience of loneliness following widowhood from an acute phase of experiencing an absence and the associated loss of routine connection to the establishment of new routines that provided new connections and a new sense of identity as an individual rather than a couple. Conclusions It is important for mental health nurses to screen for loneliness and be able to facilitate interventions that may alleviate the experience of loneliness.
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Affiliation(s)
- N Davies
- Ara Institute of Canterbury and Adjunct Fellow, University of Canterbury, Christchurch, New Zealand
| | - M Crowe
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.
| | - L Whitehead
- School of Nursing and Midwifery, Edith Cowan University, Perth, WA, Australia
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Powers SM, Bisconti TL, Bergeman CS. Trajectories of social support and well-being across the first two years of widowhood. DEATH STUDIES 2014; 38:499-509. [PMID: 24845999 PMCID: PMC4160735 DOI: 10.1080/07481187.2013.846436] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The death of a spouse can be one of the most challenging events an older adult can face, yet many exhibit resilience. The present study examined the trajectories of structural and functional social support components, depression, and life satisfaction across the first two years of widowhood. The majority of structural and functional support trajectories exhibited stability across the first two years postloss. However, emotional support and support provided by family members did display a slight decline across time. Depression showed a linear pattern across time (e.g., decline in depressive symptomology) and life satisfaction demonstrated evidence of a one-year anniversary effect.
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Jenkins CL, Edmundson A, Averett P, Yoon I. Older lesbians and bereavement: experiencing the loss of a partner. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2014; 57:273-287. [PMID: 24798053 DOI: 10.1080/01634372.2013.850583] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Accepted: 09/27/2013] [Indexed: 06/03/2023]
Abstract
There is very little research focused on older bereaved lesbians. This study is a response to the lack of knowledge about the issues for older lesbians who lose a partner. We examined bereavement issues for 55 older lesbians. The study asked participants to describe their concerns and experiences after losing a partner. Qualitative analysis identified several themes that ran throughout, including disenfranchised grief, the loneliness of isolation, and the frustration of relentless battles. These findings indicate the need for social workers to educate themselves and others about the particular needs facing this vulnerable group of older women.
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Affiliation(s)
- Carol L Jenkins
- a School of Social Work , East Carolina University , Greenville , North Carolina , USA
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Holm AL, Severinsson E. Perceptions of the need for improvements in healthcare after implementation of the Chronic Care Model. Nurs Health Sci 2014; 16:442-8. [PMID: 24785824 DOI: 10.1111/nhs.12136] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Revised: 12/30/2013] [Accepted: 01/21/2014] [Indexed: 11/27/2022]
Abstract
Older people with depression constitute a vulnerable group, and evidence from different parts of the world has demonstrated the need for healthcare improvements at the community level. In this study, we described team members' perceptions of improvements in the care of older people with depression living in the community after the implementation of the Chronic Care Model, with a focus on delivery-system design, self-management support, and teamwork. This follow-up study was based on focus-group interviews with healthcare team members. The data were analyzed by qualitative content analysis. Four themes emerged: (i) ensuring a pathway to the top level of the organization; (ii) the need for leadership from senior managers; (iii) the need to formalize collaboration; and (iv) increasing self-management. Senior managers should cooperate with specialist care givers and administrators in the community. They must also redesign the delivery system to facilitate teamwork and the self-management ability of older people with depression.
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Affiliation(s)
- Anne Lise Holm
- The Centre for Women's, Family and Child's Health, Buskerud and Vestfold University College, Tønsberg, Norway
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A qualitative systematic review of older persons' perceptions of health, ill health, and their community health care needs. Nurs Res Pract 2013; 2013:672702. [PMID: 23738062 PMCID: PMC3664500 DOI: 10.1155/2013/672702] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Revised: 03/13/2013] [Accepted: 03/31/2013] [Indexed: 11/21/2022] Open
Abstract
The aim of this qualitative systematic review was to report a synthesis of older persons' perceptions of health, ill health, and their community health care needs. The review questions were what characterizes older persons' perceptions of health and ill health? and what are their community health care needs? Ten studies were identified in a systematic search for relevant qualitative papers published between January 2000 and January 2013 in the following electronic databases: PubMed, EBSCOhost/Academic Search Premier, and CINAHL. Publications were evaluated for quality, and a thematic analysis was performed. Two main themes were interpreted on a higher level: reconciliation with how life has become: and desire to regain their identity and sense of self-worth despite disability. Two themes emerged: creating meaning led to the experience of being valued in health care and society and a mental struggle to regain independence with the help of caregivers. Of special interest is the finding of perceptions related to the fear of becoming dependent on caregivers as well as the sorrow and pain caused by encountering caregivers who did not understand their desire to create meaning in their lives or their struggle for autonomy and independency.
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