"If looks would kill then I would be dead": intimate partner abuse and breast cancer in older women

The objective of this study was to describe the experiences of older women diagnosed with breast cancer while experiencing intimate partner abuse (IPA), determined by scores on the Women's Experience With Battering (WEB) Scale. Semi-structured qualitative interviews were conducted with a convenience sample of 11 women ages 51 to 84 (mean age = 64.8). Data were analyzed using hermeneutic phenomenological analysis. Themes that emerged were Cancer and Control, Negative Relationship Changes, Changes in Intimacy, and Moving On. Older women simultaneously experiencing IPA and breast cancer have unique needs due to the complex interplay among three factors: age, IPA, and breast cancer. Gerontological nurses should be aware of issues surrounding older women with breast cancer and older women experiencing IPA. Assessment of older breast cancer patients should take into consideration patients' social support network and quality of intimate partner support.     

浙江省舟山市40 819名孕妇妊娠期血压变化趋势及影响因素研究

目的 描述浙江省舟山市40 819名孕妇妊娠期血压的变化趋势,并分析其影响因素。 方法 采用回顾性分析,对2001年1月至2016年12月期间在浙江省舟山市妇幼保健院进行围产保健并住院分娩的40 819名孕妇的血压变化趋势进行描述,并采用多因素广义估计方程分析其影响因素。 结果 随着孕周增加,孕妇的平均收缩压（SBP）和平均舒张压（DBP）均呈上升趋势;孕妇的年龄越大,孕前体质量指数（BMI）越大,孕期血压水平越高。 此外,孕妇文化程度越高,孕期DBP也会越高,但对SBP的影响不显著。孕妇分娩史和胎儿性别对血压无显著性影响。 多因素广义估计方程分析结果显示,孕前BMI、孕妇年龄、孕龄、文化程度与孕期SBP、DBP有关,而孕妇产次、胎儿性别等与孕期SBP、DBP关系不明显。 结论 孕妇年龄、孕前BMI、孕龄、文化程度是影响孕期血压升高的主要因素。 孕期血压的监测管理应贯穿整个孕期,在体重管理过程中应特别关注孕前超重或肥胖以及高龄孕妇的血压管理工作。      

Health‐promoting lifestyle behaviours in pregnant women in Turkey

This study aims to describe the health‐promoting lifestyle behaviours of pregnant women. The study was carried out with pregnant women who applied to the polyclinics in different maternity and children hospitals located in Adana, Turkey, between 1 March and 30 May 2009. The data collection tools used in the study were (i) a questionnaire that was used to collect sociodemographic data from the participants and (ii) the Health Promoting Lifestyle Profile II (HPLP II). The results obtained from the study showed that total HPLP II scores were moderate; the highest scores were obtained on the spiritual growth dimension and the lowest scores on the physical activity dimension. Pregnant women with older age, those with a higher educational level, those with a better socioeconomic status and those living in a nuclear family were found to be more likely to have health‐promoting lifestyles. Health promotion and healthy lifestyle need to be an integral part of health services provided for pregnant women. Midwives and nurses have prominent roles in encouraging pregnant women to engage in health‐promoting behaviours.     

Population-based osteoporosis education for older women

With an increased focus on wellness and health promotion, there is a need for community-based strategies to complement traditional strategies aimed at improving individual and aggregate health. An educational program on the prevention, diagnosis, and treatment of osteoporosis was provided for 188 women age 60 and older in three different community settings: churches, retirement homes, and senior citizen centers. The major purposes of the study were to determine whether a community-based program might (a) contribute to older women's knowledge about osteoporosis and (b) promote their intent to use this knowledge. Each participant completed a demographic profile, the Osteoporosis Risk Checklist, and the Osteoporosis Knowledge Questionnaire (OKQ), with the OKQ serving as a pre- and post-test. Before post-testing, a 30-min educational program was provided. Differences among the three groups were risk factors, prior knowledge about osteoporosis, and knowledge at the completion of the program. A majority of the clients indicated an intent to increase calcium in their diet, discuss osteoporosis with their health care provider, check their home environment for safety/falls, and discuss what they had learned with others. Nurses need to plan educational programs in all settings to teach older clients about the risk factors, prevention, diagnosis, and treatment of osteoporosis.     

The impact of health education on health status: an experimental program for elderly women in the community

Until recently, little research has been conducted on the effect of health education and promotion programs on older adults. As the number of older adults increase and costs for health care skyrocket, educational efforts aimed at delaying the negative effects of chronic illness will become increasingly important. In this study, a pretest-posttest design was used with a 3-month follow-up assessment to determine whether participation in a teacher-directed or learner-paced health education program was related to changes in health-risk status, cholesterol levels, blood pressure readings, or life satisfaction. The program, sponsored by a community health department, enrolled 78 women with a mean age of 71 living in the suburban areas of a large metropolitan county. Women who were randomly assigned to one of the intervention groups were more likely to reduce their stress levels, decrease salt consumption, and decrease their systolic blood pressure.     

城市育龄期女性对定期妇科检查的认知调查

目的 调查育龄期女性对定期妇科检查的认知水平,为制定教育干预措施提供依据。 方法 采用自行设计的问卷对社区150例育龄期女性定期妇科检查的认知情况进行调查。 结果 96%的成年育龄期女性曾患有不同程度的妇科疾病,而只有10.7%的人每半年进行1次体检;38.7%的女性身体不适出现症状才会去医院看病,而54.7%的女性是忍受疾病、不处理而导致疾病越来越严重;28.0%的女性认为根本没有必要体检;年龄越大,妇科体检的间隔时间越长,体检频率越低。 结论 城市育龄期女性对妇科检查的认知水平较低,需要通过教育策略提高育龄期女性的防病知识,从而增进健康水平和生活质量。     

Relationships of older women: exploring the implications for health professionals

Five older women were interviewed about their relationships, particularly those with health professionals. The taped interviews were analyzed according to Colaizzi's method and four themes emerged. They were: older women do not matter any more; older women have no legitimate complaints; professionals who care about their work, care about me; and older women are worthy of being treated with honesty and respect. Findings indicated that there may be more negative stereotyping of older women by health professionals than by members of the public. Implications of this study include the need to: promote the concept of health co-existing with illness in health education; recognize the connection between personal feelings and professional responses to older women; and devise strategies to enhance positive attitudes and respect for all people, regardless of age.     

Community blood donors' knowledge of anemia and design of a literacy-appropriate educational intervention

BACKGROUND: The purpose of this project is to improve the health of blood donors by educating and motivating them to seek medical attention for anemia. The National Anemia Action Council, BloodCenter of Wisconsin, and the Medical College of Wisconsin formed a partnership to engage volunteer blood donors and develop an educational intervention to motivate donors with anemia to seek appropriate medical care.
STUDY DESIGN AND METHODS: Partners developed an educational pamphlet and conducted two focus groups with volunteer blood donors for feedback. Participants were recruited from volunteer donors at BloodCenter of Wisconsin found to have anemia (men age, 18 years and older with a hematocrit [Hct] level of <38%; women age 50 years and older with a Hct level of <36%) at blood screening before donation.
RESULTS: Participants (n = 25) addressed their understanding of anemia, information they received after being deferred, their reactions about the deferral, and comments on the educational material. The educational pamphlet was revised based on focus group comments.
CONCLUSION: Volunteer donors are extremely dedicated and interested in increasing their understanding of anemia and the ability to continue donation. Community members' feedback on educational material is a valuable resource to improve the literacy level of information.     

Determinants of preventive services utilization in rural older women

Research describing preventive services utilization and determinants of preventive services utilization for rural older women is scant. The purpose of this study was to: (a) describe the prevalence of preventive services utilization in compliance with the U.S. Preventive Services Task Force (USPSTF) recommendations for screening, counseling, and immunizations among rural older women in four Nebraska counties and (b) determine the extent to which personal influences (e.g., demographics, definition of health, perceived health status) and contextual influences (e.g., access to care, sources of health information, provider recommendations) explain preventive services utilization among those women. A sample of 102 community-dwelling rural women age 65 and older participated in the study. The prevalence of receipt of USPSTF-recommended preventive services utilization among these rural women was alarmingly low. Multiple regression analyses revealed that provider recommendations, access to care, sources of health information, and perceived health status were significantly associated with preventive services utilization. These findings provide information that is relevant in designing interventions to increase preventive services utilization among rural older women.     

Promoting breast health: older women's perceptions of an innovative intervention to enhance screening

Aims and objectives. This study is a continuation of prior funded research in which we tested the use of age and ethnically sensitive video breast health kits to increase knowledge about breast cancer and enhance the screening practices of breast self‐examination and mammography among older Caucasian and African‐American women. Background. Breast cancer is the most frequent cancer in women worldwide and accounts for 23% of all cancers. Mammography is currently the best procedure available for mass screening of breast cancer. However, underutilization of mammography is a problem among older women in the United States. Elders are at the greatest risk for developing and dying from breast cancer but they are the least likely group to be screened routinely with mammograms or to practice breast self‐examination, particularly if they are African‐American. Design. Participatory qualitative evaluation focus groups were used to assess the overall impact of the video kit intervention programme and to elucidate the quantitative findings of the original study. Methods. Four focus groups were conducted in two diverse settings with a purposive sample of 23 participants (N = 23). The overall sample was predominantly African‐American (87%) with mean age of 71 ± 7.9 years and mean education completed of 12 ± 3.4 years. Results. Five major themes emerged from group discussions: usability and appeal of the intervention, fear and empowerment, personal relevance and intergenerational sharing, impact on screening behaviours, and story telling. Conclusions. Analyses suggest that customized media materials constructed especially for older African‐American women empowered participants in this sample to action regarding their own breast health. Relevance to clinical practice. These findings may translate to global populations where risk is increasing but screening programmes are not widely available. Given that older women are historically difficult to access and impact, further design and evaluation of innovative and sensitive educational programmes such as the one described here are recommended.     

浙江省舟山群岛地区妊娠期糖尿病流行情况及影响因素研究

目的描述浙江省舟山地区孕妇妊娠期糖尿病（GDM）的流行情况并分析其影响因素。方法采用回顾性调查研究,对2014年1月至2018年6月舟山市妇幼保健院GDM筛查情况进行分析,并采用logistic回归模型分析GDM及其亚型的影响因素。结果采用口服葡萄糖耐量试验（OGTT）筛查的10 802名孕妇中,GDM患病率为13.78%;其中,亚型A（单纯空腹型）占21.49%,亚型B（单纯餐后型）占66.15%,亚型C（空腹与餐后型）占12.36%。 多因素logistic回归分析显示,年龄较大、孕早期体质指数（BMI）高、孕早期血糖高、孕早期心率快、孕早期白蛋白高、OGTT筛查时间为冬春季和初产妇等因素增加GDM的发生风险,而文化程度与GDM无关。 不同亚型GDM多分类logistic回归分析显示,孕早期BMI高、孕早期血糖高、OGTT筛查时间为冬春季等因素增加GDM亚型A发生的风险;年龄较大、孕早期血糖高、孕早期心率快、孕早期白蛋白高、OGTT筛查时间为冬春季和高文化程度等因素增加GDM亚型B的发生风险,而经产妇则降低GDM亚型B的发生风险。 年龄较大、孕早期BMI高、孕早期血糖高、孕早期心率快、OGTT筛查时间为冬春季等因素增加GDM亚型C的发生风险,而文化程度高和经产妇则降低GDM亚型C的发生风险。结论舟山地区GDM的发病率较高,年龄较大、孕早期BMI高、孕早期血糖高、孕早期心率快、孕早期白蛋白高、OGTT筛查时间为冬春季等因素与GDM的发病有关。 因此,应加强健康宣教,避免高龄妊娠。 同时,重视围产期保健和GDM筛查,控制孕前BMI,促进母婴健康。     

Determinants of health-promoting behavior among women ages 65 and above living in the community

This study utilized Pender's Health Promotion Model to investigate through canonical correlation analysis the role that select cognitive-perceptual factors (health self-determinism, learned helplessness, self-esteem, and perceived health) and modifying factors (age, race, marital status, education, and income) play in understanding participation of community-living older adult women (age > or = 65) in the health-promoting behaviors of health responsibility, physical activity, nutrition, spiritual growth, interpersonal relations, and stress management. These were measured by the Health-Promoting Lifestyle Profile II in a convenience sample of 107 community-living older adult women (mean age 76.7 years). Gender-specific benefits and barriers to participating in health-promoting behaviors were also explored using open-ended questions. Two significant canonical variates were demonstrated. These indicated that age, marital status, race, education, and self-esteem and the two health-related factors of perceived health and health self-determinism made statistically significant contributions to the health-promoting behaviors of physical activity, nutrition, spiritual growth, and interpersonal relations. Benefits identified included better psychological well-being, coping with the general issues of aging, social interaction, improved function, and management of existing health problems. Internal barriers focused on perceived physical difficulties with all types of health-promoting behaviors; external barriers included aspects of the activity itself, lack of support from others and structural barriers. Study results suggest that older adult women (age > or = 65) participate in health-promoting behaviors for both health enhancement and health management reasons and that barriers may be a more important determinant of older women's health-promoting lifestyle behaviors than previously described in the model.     

Older women and the meaning of health

Health promotion has become an essential component of comprehensive health care, especially considering the growing female population. Older women, in particular, have demonstrated an increasing need for preventive services or health care maintenance and promotion. These needs consist of services provided by health care professionals that can help women meet their own self-care demands. However, before the health care needs of women can be met, they first must be identified. Using Orem's Self-Care Theory, a three-part qualitative phenomenological study was conducted in an attempt to understand what health actually means to older women and what types of health behaviors they feel are important to maintain or promote health. Three different groups of women age 55 and older with a variety of education, socioeconomic, and racial backgrounds were interviewed. Their responses were analyzed carefully, and each participant was interviewed a second time to validate recurrent themes regarding their statements about health. Results of the interviews with the three different groups of women were surprisingly similar. Although each participant had a unique application of their definition of health, there were five recurrent themes identified by 75% to 80% of the women. The themes were interactions with a being greater than themselves, acceptance of self, humor, flexibility, and being other-centered. Numerous examples supported the five themes. In addition, several "healthy behaviors" also were identified. Based on the findings of this 3-year study, older women seem to have their own perspectives on what health actually means and how they can best monitor or maintain their health. While the list is slightly different than the traditional one prescribed by health care professionals, perhaps it is time to encourage older adults to become more of a partner in their care. These healthy behaviors could be incorporated easily into the treatment and management plans and thereby reflect both parties' definitions of what it means to be healthy. Health care professionals must continue to ask older adults about their view of health and encourage their partnership in health-related issues. All individuals, no matter what age, are being encouraged to assume more responsibility for their own personal health, and by including older adults in the decision-making process, this partnership can be strengthened.     

Healthy aging for older women

Healthy aging is a multifaceted phenomenon, incorporating biological and psychosocial developmental factors. The population of older women is diverse in health, function, social context, and age. Health promotion strategies, therefore, should be customized accordingly to optimize the health of the varied subgroups of older women, according to their health trajectory and personal preferences. Research and evaluation of approaches to promote health among these subgroups is an important next step in understanding and influencing the health of older women.     

Gender,exercise, and health: A life‐course cross‐sectional study

The purpose of this study is to explore relationships between the practice of exercise, gender, and health, from adolescence to old age, testing the magnitude of gender differences throughout the life cycle in the practice of exercise of Spanish people. A cross‐sectional study with 4,575 women and 4,334 men, aged 13–85 years, was conducted. The participants were assessed on the weekly hours they dedicated to the practice of exercise, masculine/instrumental and feminine/expressive traits, mental health symptomatology, and self‐rated health). Univariate and multivariate analyses were performed in the age groups of adolescence, late adolescence, young adulthood, middle adulthood, and older age. Results showed that men dedicated significantly more hours to the practice of exercise than women within all age groups, except in older age (men´s average = 4.07; women´s average = 2.55). The masculine/instrumental trait played a mediating role between gender and practice of exercise hours. Furthermore, a decline in the amount of time dedicated to exercise from adolescence to older age was found, with higher drops in men. Finally, the practice of exercise was associated with better self‐rated health and less mental symptoms. These results underline the important role that gender and masculine‐instrumental trait play on the practice of exercise .     

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

Women's social role quality may be an important factor in their adaptation after heart surgery. Relationships among different dimensions of role quality, physical health, and psychological well-being were examined in 157 midlife and older women who had undergone heart surgery. Overall, older women (n = 89) were similar to younger women (n=68) in physical recovery from heart surgery. Poorer health outcomes were associated with number of health problems, not age. Women with more health problems and lower subjective health perceptions had lower role quality. Multiple regression analyses indicated that, in general, role quality mediated the effects of physical health on psychological well-being. Regardless of the extent of physical health problems, women with higher role quality had higher levels of psychological well-being.     

Functional Health Status of Older Women

By the year 2000 in the United States, there will be 32 million adults age 65 or over, representing 12% of the population, with the majority being women. Older women are experiencing greater longevity but worse overall health than men. The assessment of functional health status in older women is often neglected yet is the major contributor to independent living. Functional health status includes the dimensions of physical health, independent health, and psychosocial health. Studies of two different groups of non-institutionalized older women who reside in the same Southwestern state are discussed in relation to national study samples and implications for nurse practitioners.     

Prevalence of urinary incontinence in older Korean women

Worldwide prevalence of any type urinary incontinence (UI) in women 20 years and over is estimated to be over 275 million in 2013 and the 4th International Consultation on Incontinence expects it to increase to over 300 million in 2018. While UI in women is considered to be an aging and public health issue with global implications, most research cited in the UI literature comes from English language sources. The absence of information from many Asian and other countries may be due to reliance on scientific reports written in English by editorial policies, authors of systematic literature reviews and other researchers. Moreover, the financial costs and time constraints associated with translation and dissemination of findings into English language journals could act as dissemination barriers. Therefore, the purpose of this study was to describe the current state of knowledge about prevalence and correlates of UI in Korean older women from non‐English language sources. Twelve research articles, two research monographs and one master's thesis, and data on UI abstracted from South Korea's 2008 National Health Insurance Cooperation Reports were reviewed in full. The prevalence of UI in women 60 years and older ranged from 11·2% to 76·3%. Personal, physical and psychological factors were found to be associated with UI including age, income and educational level, presence of comorbidities, body mass index, depression, anxiety and cognitive impairment. There was little difference between rural and urban dwelling older women in help‐seeking behavior: 93.8% rural and 90.5% urban dwelling older women sought no help for their incontinence. Inclusion of reports from non‐English sources is considered as an important contribution to better understanding of the worldwide epidemiology of UI in older women.     

Personal characteristics that influence exercise behavior of older adults

Long-term exercise participation among older adults will result in healthier lifestyles and reduced need for health care. A better understanding, therefore, of what influences older individuals to start and maintain exercise plans would be beneficial. The twofold purpose of this study was (1) to create a knowledge base of determinants that influence exercise behavior in older adults and (2) to have health professionals prioritize determinants that affect exercise initiation and adherence in older adults. The expert panel examined nine determinants within the category of personal characteristics: age, gender, ethnicity, occupation, educational level, socioeconomic status, biomedical status, smoking status, and past exercise participation. The experts rated the determinants on importance for influencing exercise behavior of older adults. This expert panel concluded that older adults who are in good health and have a history of exercise activity might be more likely to participate in long-term exercise programs.     

Hyperthyroidism in elderly women. Registered and detected by screening in a primary health care district

A laboratory screening for thyroid disease was performed among women older than 60 years in a primary health care district in a goiter region. The screening was combined with a questionnaire regarding previously treated thyroid disorder. A total of 1442 women i.e., 97.3% of the population studied were investigated. Through the laboratory screening we found 28 women (1.9%) with hyperthyroidism and they were successfully treated. Through the questionnaire 50 women (3.4%) were identified with previously treated hyperthyroidism--of these 42 were diagnosed after the age of 60. We suggest that physicians should maintain increased awareness to order thyroid laboratory tests (e.g. free T4 index, free T3 index) in women older than 60 years of age because atypical symptoms and signs are often difficult to separate from the age process per se.