Needs,barriers and facilitators experienced by spouses of people with aphasia

Purpose.?Little is known about how spouses cope with their needs as a result of their partner's aphasia. This study described spouses' needs and identified the barriers and facilitators to satisfying them.

Methods.?Four associations of people with aphasia were approached. Eleven spouses were interviewed in small groups. They described the results of their inquiries and efforts to satisfy their needs because their partner had aphasia (mean time since onset 6 years 8 months) as a result of stroke or surgery. Discussions were transcribed and coded. Excerpts were grouped into categories.

Results.?Spouses mainly needed support and respite, and perceived their partner to need help for communication and well-being. Personal factors like the availability of close others to provide help were facilitating. However, participants encountered barriers, mainly organisational, i.e. the help needed did not exist. Some needs persisted over time.

Conclusions.?Results confirm the long-term needs of spouses in adjusting to the aphasia of their partner, as well as the limited services available to them. Many of the needs reflected spouses' concerns about their partner, while others were a consequence of their caregiving role as well as the unavailability of support. Spouses of people with aphasia should have access to support during and after rehabilitation.     

Aquatic exercise in older Korean women with arthritis: identifying barriers to and facilitators of long-term adherence

The purpose of this study was to identify factors influencing long-term adherence to aquatic exercise in older women with arthritis. Participants (n = 72) completed an educational program on aquatic exercise and underwent follow up for 6 months. At follow-up, women who continued aquatic exercise (adherence group, n = 25) had significantly higher scores than women in the nonadherence group (n = 47) in exercise self-efficacy (p < 0.0001) and group cohesion based on social aspects (p = 0.009). Both groups reported experiencing similar barriers to exercise (rho = 0.78). The findings provide insights for the development of strategies to promote long-term adherence to this type of aquatic exercise. Specifically, the findings encourage the fostering of exercise self-efficacy and social group cohesion during participation in educational programs to increase long-term exercise adherence.     

Development of a breast self-examination program for the Internet: health information for Korean women

Internet-based health information will enable us to interact with many people despite distance and time constraints. Informational media by computer is expected to become an important factor that affects health behavior. This study was done to develop an accessible multimedia program about breast self-examination on the Internet. This study was designed by using the two steps of need assessment and program development. For the need assessment step, a survey was carried out. The sample consisted of the 82 women of Yonsei University selected by convenient random sampling. At the program development step, screen design took into account perspectives of computer engineering. A storyboard for every screen was made via screen design and then ported to computer using the Netscape Navigator program. A breast self-examination program was developed using Netscape 4.0 on the Windows 98 platform. The multimedia program, including text, graphics, animation, and sound, was constructed with HTML language using Memo Sheet in Netscape Navigator. The contents of health information posted on the Internet included general information about breast cancer, the importance of breast self-examination, self-risk appraisal of breast cancer, the diverse methods about breast self-examination, the monthly check list graph, and social network for consultation. It is possible to interact with clients through the Question and Answer function on screen. This Internet-based health information program provides enough information, which can be accessed using search systems on the Internet.     

Acculturation and breast self-examination among immigrant Latina women in the USA

This article is an extension of previous work, which identified acculturation as an important variable in predicting breast self-examination (BSE) in this sample of women. Here, acculturation is further examined as an intervening factor in predicting BSE. This paper presents the association between level of acculturation to mainstream culture in the USA and the practice of BSE among a population of low-income immigrant Mexican and Puerto Rican women (n = 111) in an urban area of the Midwest in the USA. The majority of women (84.7%) scored a low level of acculturation and 85% did not practice correct BSE. The crude odds ratio indicated that Latina women having a high level of acculturation (15.3%) were twice as likely to practice correct BSE than women with low acculturation. We would suggest that a clearer understanding of the variables that define the performance of BSE will assist in enabling nurses globally to incorporate assessments in their practice that will lead to more successful interventions.     

Predictors of breast self-examination practice among elderly women

The purpose of the study presented in this article was to examine predictors of breast self-examination (BSE) practice among elderly female subjects in selected senior citizen centers. The health belief model served as the theoretical framework for the research study. Both the frequency of BSE performance and the technique subjects used to examine their breasts were measured by a questionnaire. Subjects who perceived few barriers to BSE had higher BSE technique scores. The findings also indicated that receiving instruction through a class on BSE was related to improved BSE technique. Perceived susceptibility to breast cancer and perceived benefits of BSE were not found to be significantly predictive of BSE practice.     

孕妇及其配偶压力的相关性分析

目的:描述孕妇及其配偶的压力水平,并分析两者的相关性。方法:对167对孕妇及其配偶采用妊娠压力量表分别进行调查。结果:孕妇及其配偶的压力均为中度,配偶的压力高于孕妇;孕妇及其配偶的压力呈正相关。结论:护理的服务对象不应局限于孕妇,还应包括其配偶,应以家庭为单位对孕妇进行护理,这样不仅能降低孕妇和配偶的压力,提高其心身健康水平,更能通过其相互影响,达到互相促进的目的,从而促使孕妇和配偶各自完成自己的职责,顺利地度过角色转变期,在妊娠和分娩的应激下保持心身健康。     

Factors related to practice of breast self-examination in rural women

The purpose of this study was to examine variables related to breast self-examination (BSE) in rural women. The sample of convenience consisted of 347 women who were members of selected county-extension homemaker clubs. Champion's Health Belief Model Scale was used to measure susceptibility, seriousness, benefits, barriers, health motivation, sociodemographics, and knowledge variables and frequency of BSE. Multiple regression analysis indicated that the Health Belief Model concepts accounted for 26% of the variance in BSE practice. Women who perceived more benefits of BSE in reducing the severity of breast cancer were more likely to report more frequent BSE. Women who perceived fewer barriers to performing BSE and those who scored high on health motivation were also more likely to report performing monthly BSE. Pearson product-moment correlation indicated a significant positive relationship between the variables of BSE knowledge and BSE practice (r = 0.1216; p = 0.023). The lambda statistics showed weak or no association between the demographic variables of age, race, marital status, religion, education, personal experience with breast disease, and friend's experience with breast disease and BSE practice. These findings suggest that perhaps educational programs emphasizing benefits of BSE may be implemented for women represented in this sample in an attempt to increase the number of women practicing BSE. Assessment of women's perceptions of potential barriers would allow nurses to plan appropriate strategies that could reduce the barriers. Finally, assessment of women's general health practices may identify women motivated toward good health. These women may be likely to complete monthly BSE if encouraged to do so.     

Context of barriers to Pap testing in Korean women

Because efforts to increase the Papanicolaou (Pap) test rate have not been effective in Korea, there is an urgent need to identify the underlying context of the barriers to Pap testing. Twenty-three women aged 27-37 years were organized into four focus groups for a qualitative analysis of their attitudes and feelings about the Pap test. Five contextual themes of barriers were identified under the categories of "misconceptions attributable to women's experiences of Pap testing" and "issues related to the health care system." Educational and clinical implications in regard to women, health care professionals, and the health service environment were discussed to increase the Pap test rate.     

Knowledge,facilitators and barriers to the practice of person-centred care in aged care workers: a qualitative study

The current study describes aged care workers' interpretation of the concept of person-centred care; and identifies the barriers that exist to impede its practice, and the facilitators that encourage person-centred care practice. Data were collected from interviews with aged care workers from two residential aged care facilities providing both high and low care for residents with and without physical and psychological issues based in Australia. Data were analysed to identify and explore categories of meaning for barriers and facilitators. Analysis is grounded in Brooker's VIPS framework for person-centred dementia care which is utilised as a comparative tool for analysing participants' understanding of person-centred care. Findings revealed that aged care workers have a reasonable but incomplete understanding of person-centred care. Insufficient time and residents' dementia behaviours acted as barriers to care workers' provision of person-centred care. Teamwork was found to facilitate person-centred care by increasing instrumental and relationship resources     

Nursing scholarship in Japan: Development, facilitators, and barriers

This qualitative study sought a contemporary view of the development, facilitators of, and barriers to nursing scholarship in Japan from the perspectives of the scholars. In-depth interviews were conducted with 13 scholars across Japan, which were digitally recorded, and the data were subjected to content analysis. Five themes emerged: a spirit of collectivism; a lack of nursing control; a lack of English ability; a high workload; and collaboration. The participants considered that culturally based consensus and communication behaviors, as well as the control and dominance by the medical profession, were hampering nursing scholarship. Furthermore, Japanese nurses were not in control of the profession in a period of unprecedented growth in university nursing education and a growing nursing shortage. A lack of English-speaking and English-writing abilities hindered collaboration with scholars internationally and the writing of international publications. Most of the participants felt unable to compare the extent and nature of Japanese scholarship with that of their Asian neighbors. The Japanese scholars need to grasp opportunities to learn English, collaborate with other nurses nationally and internationally, learn assertion and political skills to give them the confidence to take control of nursing education, and be more involved in research collaboration and international publications.     

Unmet needs in information flow between breast cancer patients,their spouses,and physicians

This study focused on the needs and sources of disease information of breast cancer patients and their spouses during early disease in two settings: at the department of oncology (AD) and on a rehabilitation course (RC). The aim was to characterize those patients and spouses who are not content with average information. Eighty percent of AD and 31% of RC patients were content with the available information (p<0.001) and 75% of AD spouses and 43% of RC spouses reported similarly (p=0.008). Higher education, younger age, and shorter time (<1 year) since diagnosis indicated a greater need for information among patients, whereas among spouses, only education level was associated with it. More information was needed on prognosis, cancer as a disease, its influence on daily life, and treatment effects. In both groups, the same proportion of patients reported to have felt involved in decision making sufficiently (60%), inadequately (27%), and 19% versus 16% did not want to be actively participating in decision making. The patients were mostly satisfied with participation in decision making, but they expressed unsatisfactory needs on information during early years of breast cancer. Similarly, their spouses were not content with available information.     

Attitudinal variables related to intention, frequency and proficiency of breast self-examination in women 35 and over

A correlational study was conducted to identify attitudinal variables specified by the Health Belief Model that were related to intent, frequency, and proficiency of breast self-examination. The probability sample consisted of 380 women age 35 and over who were contacted via random digit dialing. Data were collected during in-home interviews. Results supported the combined ability of susceptibility, seriousness, barriers, health motivation, and control to predict intent to practice breast self-examination (R = .61, p. less than or equal to .001). In addition, frequency and total proficiency for breast self-examination were predicted by health motivations, susceptibility, and barriers using discriminant analysis. Results lend support to use of the Health Belief Model variables in predicting women's intention and actual behavior of breast self-examination.     

Korean nurses’ perceived facilitators and barriers in provision of end‐of‐life care

This study examined nurses’ perceived facilitators and barriers to end‐of‐life (EOL) care in clinical settings. The study participants were 383 Korean nurses working at tertiary hospitals. The nurses had an average of 7.6 years of clinical experience. The three highest‐scoring facilitating items were ‘family member acceptance of patient death’, ‘having time to prepare the family for the patient's expected death’ and ‘having the physician meet with the family after the patient's death to offer support and validate the given care’. The top two perceived barriers were ‘families not accepting what the physician is telling them about the patient's prognosis’ and ‘dealing with angry family members’. Nurses who had received EOL care education showed a higher score in perception of facilitators than nurses who did not receive that education. EOL care for patients and their families is a challenge; thus, continuing education should be provided to improve nursing practice.