Psychosocial correlates of women's health in middle adulthood

Anger, stress and blood pressure in overweight children

Among adults, trait anger, patterns of anger expression, and stress have been associated with blood pressure (BP). Less apparent is the effect of these variables on BP in overweight and obese children. To characterize the relationships between these psychological variables and BP, the authors conducted a secondary analysis of data from 73 overweight and obese 9- to 11-year-old children. Findings indicate a positive correlation between trait anger and systolic BP (SBP). Regression results indicate that the overall model significantly predicted SBP by explaining 15.4% of the variance and that trait anger was a significant predictor of SBP.

The first anniversary: stress, well-being, and optimism in older widows

The first anniversary for older widows (n = 47) has been explored during Months 11, 12, and 13. Concurrent correlations show that optimism inversely correlates with psychological (intrusion and avoidance) stress as measured with the Impact of Event Scale (r = -.52 to -.66, p < .005) and positively correlates with well-being (physical: r = .36 to .46, p < .025; psychosocial: r = .58 to .72, p < .005; spiritual: r = .50 to .69, p < .005). Lagged correlation patterns suggest that higher levels of optimism at a given time are associated with higher life satisfaction and spiritual well-being at later times. Psychological stress is higher at Month 12 when compared to Month 13, t(43) = 2.54, p = .01, but not when compared to Month 11, t(43) = 1.49, p > .10. There are no significant differences in physiologic stress (salivary cortisol) or well-being during the first anniversary of spousal bereavement.

Retention in a computer-based outreach intervention for chronically ill rural women

The study's purpose was to examine retention factors in a computer intervention with 158 chronically ill rural women. After a 22-week intervention, 18.9% of the women had dropped out. A Cox regression survival analysis was performed to assess the effects of selected covariates on retention. Reasons for dropping out were tallied and categorized. Major reasons for dropping out were as follows: lack of time, decline in health status, and nonparticipation in study activities. Four covariates predicted survival time: level of computer skills, marital status, work outside the home, and impact of social events on participants' lives. Retention-enhancing strategies are suggested for implementation.

Social support networks and maternal mental health and well-being

The link between social networks and mental health has increasingly been recognized by public health as an important topic of interest. In this paper, we explore this association among a specific group: mothers. Specifically, we discuss how maternal mental health can be understood in the context of social networks, the influence of specific social relationships, and how the type and quality of support can mediate maternal mental health outcomes. We review interventions that foster social networks to address maternal mental health as well as other related health outcomes. Findings suggest that interventions that combine multiple treatment approaches may be more effective in addressing mental health. Also, traditional measures of social networks may not be appropriate for vulnerable populations, with qualitative, rather than quantitative, indicators of social networks being more predictive of maternal health and well-being. The implications of these findings and future research directions are discussed.

Influence of a Computer Intervention on the Psychological Status of Chronically Ill Rural Women

BACKGROUND

Adaptation to chronic illness is a lifelong process presenting numerous psychological challenges. It has been shown to be influenced by participating in support groups. Rural women with chronic illness face additional burdens as access to information, healthcare resources, and sources of support are often limited. Developing virtual support groups and testing the effects on psychosocial indicators associated with adaptation to chronic illness may help remove barriers to adaptation.

OBJECTIVE

To examine the effects of a computer-delivered intervention on measures of psychosocial health in chronically ill rural women including social support, self-esteem, empowerment, self-efficacy, depression, loneliness, and stress.

METHODS

An experimental design was used to test a computer-delivered intervention and examine differences in psychosocial health between women who participated in the intervention (n = 44) and women in a control group (n = 56).

RESULTS

Differences between women who participated in the intervention and controls were found for self-esteem, F(1,98) = 5.97, p =.016; social support, F(1,98) = 4.43, p =.038; and empowerment, F(1,98) = 6.06, p =.016. A comparison of means for depression, loneliness, self-efficacy, and stress suggests that differences for other psychosocial variables are possible.

DISCUSSION

The computer-based intervention tested appears to result in improved self-esteem, social support, and empowerment among rural women with chronic illness. Descriptive but nonsignificant differences were found for other psychosocial variables (depression, loneliness, self-efficacy, and stress); women who participated in the intervention appeared to improve more than women in the control group.

Types and sources of social support and maternal-student role stress in married associate degree nursing students

This paper presents findings from a secondary data analysis designed to determine, specifically, which types and sources of social support are associated with Maternal Student Role Stress for women in two age groups. Participants in the study were students in an Associate Degree nursing program who were married and had at least one child living at home. Data were collected at 11 community colleges in New York and New Jersey. For women aged 37 years and older, all types of support from their husbands and children were associated with less Maternal Student Role Stress. For women under 37 years of age, affirmation and aid from their husbands; aid from their children; and affect, affirmation, and aid from their mothers-in-law were associated with less Maternal Student Role Stress. Findings are interpreted in light of the groups' varied developmental stages, and recommendations for future research and practice are offered.

Coexistent concerns: assessing the social and health needs of dental clinic patients

University dental clinic professionals identified increasing numbers of patients with complex problems and generated 2 research questions: (1) Are there significant health and social concerns within the dental clinic population that indicate the need for high-risk screening and social work services?; and (2) How do age, gender, and income influence health and social concerns in this population? This exploratory descriptive cross-sectional study employed a brief self-report survey in a clinic waiting area. Logistic regression was used to understand the influence of age, gender and income on the existence of specific concerns. Results indicate that caregiving, finances and health are issues for 1/3 of the participants and that 44% endorsed 2 or more concerns. These findings were used to develop a routine high-risk screening tool for dental clinic patients and social work services within the clinic; they suggest that community clinics with dental services are an important place for identifying complex unmet needs.

Reflexão social, controle percebido e motivações à adoção: características psicossociais das mães adotivas

A literatura mostra que a adoção é associada no imaginário social ao altruísmo e ao hedonismo dos adotantes. O objetivo deste estudo foi investigar algumas características psicossociais de mães adotivas, como as motivações à adoção, o nível de julgamento moral, as crenças de locus de controle e a percepção de apoio social. A amostra foi composta por 20 mães adotivas e 20 mães biológicas. Os dados foram coletados utilizando um questionário com itens psicossociais, o Sociomoral Reflection Objective Measure e a Escala Multidimensional de Locus de Controle de Levenson. Os resultados revelaram que 60% das participantes relacionaram a adoção a problemas de fertilidade, mas as análises não indicaram diferenças significativas entre o tipo de maternidade e as variáveis investigadas, à exceção do apoio social percebido. Os resultados sugerem novas direções às pesquisas sobre os fatores moderadores da adaptação psicológica das famílias adotivas.

Relationships of alcohol use, stress, avoidance coping, and other factors with mental health in a highly educated workforce

PURPOSE

The relationships of drinking, stress, life satisfaction, coping style, and antidepressant use to mental health were examined in a highly educated workforce.

DESIGN

This study used a one-time mail-out, mail-back cross-sectional survey design to examine the relationships of mental health with three kinds of stress (life events, work stress, home stress); two kinds of life satisfaction (work and home); use of avoidance coping; and antidepressant use.

SETTING

This study was conducted at a large worksite in northern California in which the workforce was comprised of predominantly highly educated employees.

SUBJECTS

Questionnaires were mailed to a random sample of 10% of 8567 employees, and 504 were completed and returned by participants (59%). Complete data were provided by 460 participants (53%).

MEASURES

Respondents completed the Mental Health Index, the Alcohol Use Disorders Identification Test (AUDIT), and measures of coping style, work and home stress and satisfaction, stressful life events, and antidepressant use.

RESULTS

Mean Mental Health Index scores were at the 32nd percentile of the U.S. population-based norms, with low percentile values associated with worse mental health. Using multiple regression analysis, the factors examined in this study were significantly related to Mental Health Index scores as the dependent variable [F(16, 443) = 27.41, p < .001, adjusted overall R2 = .48]. Poor mental health scores were significantly related to the following: age (p < .05); screening positively for current harmful or hazardous drinking (p < .05); having high levels of stress at work (p < .05) or home (p < .01); experiencing dissatisfaction with work (p < .001) or home life (p = .01); engaging in avoidance coping (p < .001); and using antidepressants (p < .001). Employees currently using antidepressants had significantly more outpatient medical and mental health visits, indicating higher health costs. Furthermore, mental health status was also significantly related to the interactions between several pairs of these variables: education and gender, age and job stress, home satisfaction and work stress, home satisfaction and avoidance coping, and home satisfaction and use of antidepressants.

CONCLUSION

Mental health status was poorer on average in a highly educated workforce compared with general U.S. norms. Most of the factors that were found to be associated with poorer mental health were ones that are potentially modifiable, such as experiencing more stress and less satisfaction in work and home life and engaging in current hazardous or harmful drinking. The findings that mental health is worse among individual employees who exhibit combinations of these factors suggest that we need to better understand possible effects of these factors in the context of one another. As interpretation of these results may be limited by the single worksite that participated in this study, future research should re-examine these relationships in other worksites varying from this one in geography and demographic characteristics.

Ten rural women living with fibromyalgia tell it like it is

The purpose of this qualitative study was to gain an understanding of the personal experiences of 10 rural women dealing with fibromyalgia based on the theoretical frameworks of adaptation to chronic illness and social support. The data were gathered from a nursing intervention that provided computer-based peer support and encouragement. The women described themes of pain, fatigue, depression, and sleep disturbances; expressed views on the experience of rural isolation; and shared positive philosophies of dealing with this disease. With this understanding, professionals and significant others can compassionately respond to the needs of sufferers of fibromyalgia.

A theory-based clinical nurse specialist practice exemplar using Neuman's systems model and nursing's taxonomies

This article illustrates the process of theory-based advanced nursing practice by presenting an exemplar of clinical nurse specialist practice using Neuman's systems model and nursing's taxonomies. A brief explanation of Neuman's systems model is given, and the process of assessment, diagnosis, and planned outcomes/interventions is fully described. A clinical example illustrates the entire process.

Marriage and health: his and hers

This review focuses on the pathway leading from the marital relationship to physical health. Evidence from 64 articles published in the past decade, particularly marital interaction studies, suggests that marital functioning is consequential for health; negative dimensions of marital functioning have indirect influences on health outcomes through depression and health habits, and direct influences on cardiovascular, endocrine, immune, neurosensory, and other physiological mechanisms. Moreover, individual difference variables such as trait hostility augment the impact of marital processes on biological systems. Emerging themes in the past decade include the importance of differentiating positive and negative dimensions of marital functioning, the explanatory power of behavioral data, and gender differences in the pathways from the marital relationship to physiological functioning. Contemporary models of gender that emphasize self-processes, traits, and roles furnish alternative perspectives on the differential costs and benefits of marriage for men's and women's health.

Women's midlife confusion: "why am I feeling this way?"

Midlife is a multifaceted stage of woman's development, characterized by important transitions. In an ethnographic study of women's midlife experience of their changing bodies, 11 participants voiced their uncertainty and confusion around bodily changes, responses exacerbated by the lack of consistent health-related information in this area. This confusion emerged as one of the major thematic elements of the study. Midlife women's experience of confusion may reflect a much broader problem, the locus of which is not so much in the women themselves, but rather in negative societal attitudes about aging women. This article describes various aspects of confusion that emerged from the data, and offers implications of the research and recommendations for practitioners.

Interactive model of women's stressors, personality traits and health problems

Theories have linked various stressors with health problems, and some studies have identified personality traits that enhance health. However, few studies have examined the interaction among women's stressors, personality traits and their health. This retrospective study (1996-1997) analysed the effects of women's major stressors and personality traits on symptoms of health problems, and developed a model of women's health based on the interaction among these factors. A convenience sample of 300 women aged between 18 and 66 years completed a questionnaire that measured three types of stressors, eight personality traits and 40 symptoms of health problems. Principle components and factor analyses identified the best items to measure the stressors, traits and problems. New reduced data subsets were constructed for classification tree analyses to identify the effects of stressors and personality traits on women's health. Women with medium or high stressors and low assertiveness, low hardiness, or the inability to express their feelings, were more likely to report physical symptoms than women who were stronger in these personality traits. Also, women with medium or high stressors and low to medium trust or love relationships were very likely to report high emotional symptoms, as were women with high trust or love, who did not express their feelings. An interactive model of women's health was supported. The amount of women's stressors and their personality traits may increase or diminish their stress response and affect their health. Nurses can identify women with high stressors and unhealthy personality traits that increase their risk for stress-related illnesses, and assist these women to modify their stressors or personality traits to enhance their health.

Women's 'inner-balance': a comparison of stressors, personality traits and health problems by age groups

Women's 'inner-balance': a comparison of stressors, personality traits and health problems by age groups The purposes of this descriptive study were to identify differences in women's stressors, personality mediating traits and symptoms of health problems by age groups, and to guide revisions for development of a shorter, reliable questionnaire to measure women's health and risks for stress-related illnesses. A convenience sample of 299 women aged between 18 and 66 years who resided in the south-western United States and could read English completed a lengthy questionnaire. ANOVAs were used to compare women by three age groups. Young women (18-29 years) reported high stressors, less healthy personality traits, and significantly more physical and emotional symptoms of health problems than middle-age and older women. Middle-age women (30-45 years) had significantly more stressors than other women, but their healthy personality traits may have contributed to fewer health problems. Older women (46-66 years) had the fewest stressors, highest healthy personality traits, and fewest symptoms of problems compared to other age groups. In their roles and relationships as wives, mothers and employees, women experienced multiple stressors such as inadequate physical and emotional support from their spouse/partner, along with parenting and employee difficulties that contributed to their health problems. Young and middle-aged women were more stressed, juggling the multiple responsibilities and demands of their spouse, children, ageing parents, and their occupation, while trying to maintain their own 'inner balance'.

Distressing aspects of women's roles, vicarious stress, and health consequences

Individuals internalize the roles they play and the statuses they occupy in their social networks. It logically follows that the benefits and costs of women's role commitments may be critically important to their physical and mental health. This literature review focuses on distressing or negative aspects of enacting the specific primary roles of worker, wife, and mother. Vicarious stress and inadequate social support for women in these roles may contribute to immunosuppression and disease vulnerability. Some women may choose the sick role as a means of escape from taxing role responsibilities. Future directions for women's health research are suggested, along with adoption of an empowerment model of health.

Relationship of social roles and nutrition beliefs to fat avoidance practices: investigation of a US model among Danish women

OBJECTIVE

This study was designed to investigate the associations among women's social roles, their nutrition beliefs, and their dietary fat avoidance practices. Role theory and prior qualitative research among US women provided the theoretical framework.

DESIGN/SUBJECTS

A random-sample mail survey (76% response) was used to gather information on the usual pattern of dietary fat use, nutrition beliefs, and social positions of Danish women aged 30 to 60 years. A fat avoidance score was calculated for each respondent on the basis of 12 fat consumption practices. Sequential multiple linear regression was used to develop an explanatory model for fat avoidance using responses from 594 women.

RESULTS

Interactions between nutrition attitudes and beliefs and social roles suggested that the roles themselves did not influence fat avoidance practices, but the nutrition beliefs associated with particular roles did have an influence. Among employed women, fat avoidance was lower among those who perceived many barriers to healthful eating. Among women who were not employed, fat avoidance was lower among those who perceived little social support for healthful eating. The association of fat avoidance with caretaking responsibility varied by age group. Caretaking was positively associated with fat avoidance among women in their forties, but not in older or younger age groups.

CONCLUSIONS

Nutrition messages should be tailored to fit women's unique social roles and the beliefs associated with them. Nutrition professionals in Denmark and the United States can adapt these findings to their own cultural context.