Relationship between psychosocial factors and health behaviours for women experiencing menopause

This study investigated the psychosocial factors related to the health behaviours of women at menopause. These health behaviours included choice of intervention by women for menopause, particularly consultation of health professionals, use of hormone replacement therapy and preferred information sources. A postal questionnaire was distributed to a structured random population-based sample of 400 women in the 45-54 years age group living in south-east Queensland, Australia. Explanatory variables were: attitudes to menopause, social functioning, mental health, vitality, preventive health practices and lifestyle factors. This study found that information, preventive health practices, attitudes towards menopause, exercise, number of children living at home, years of formal education and working in paid employment, were related to the health behaviours of women at menopause. The study concludes that a number of related psychosocial factors not associated with hormonal changes may influence the health behaviours of menopausal women. It will be important for nurses, other health professionals and counsellors to decide how best to respond to these findings in consultation with the women affected by their decisions.     

已婚妇女生殖系统健康状况及相关知识知晓率、需求情况调查分析

目的了解已婚妇女生殖系统健康状况及她们对生殖系统健康知识的知晓情况、健康教育需求形式状况，以便提出相应的对策。方法对2005年1月～2006年12月在本院进行体检的24677名已婚妇女进行妇科体检，并随机抽取370名妇女进行问卷调查，内容包括对生殖系统健康相关知识的知晓情况及健康教育知识需求方式。结果已婚妇女生殖道疾病患病率为36．9％，患病率从高到低依次为宫颈疾病27．5％、阴道炎7，7％、附件炎1．0％、妇科肿瘤0．6％、子宫颈癌0．05％．宫颈疾病占所有妇科疾病首位；其中宫颈糜烂患病率为20．3％，占宫颈疾病的首位。对生殖系统健康教育知识平均知晓率为36、4％，需要多种形式的健康教育方式。结论已婚妇女妇科疾病患病率较高，特别是宫颈疾病患病率高；已婚妇女对生殖系统健康知识的知晓率低，自我保健意识和能力较弱，对健康服务需求非常迫切；因此，应对已婚妇女开展多元化健康教育。引导妇女转变观念，加强自我生殖系统保健意识，建立良好的健康行为，可减少妇科疾病的发病率。     

Health practices of adult Hispanic women

The purpose of this focused ethnography was to discover the patterns and variability of health practices used by Hispanic women aged 20-40 years. Seven adult Hispanic women from an urban New Mexico county were interviewed four to seven times each about their health practices. The women described their views of good health. They were aware of current health promotion practices such as good nutrition and exercise. They also practised safety measures for themselves and their families. These women did not report any information on specific cultural disease prevention behaviours and described few practices related to their Hispanic culture. A theme that also emerged from the data was an emphasis on the importance of spirituality and the integration of the spiritual dimension as important to healthy living. Implications for health care providers include knowing that urban adult Hispanic women are versed in contemporary health literature and take better care of their families than of themselves.     

The effects of marital dissolution and marital quality on health and health service use among women.

BACKGROUND: Little is known about the impact of marital dissolution and/or marital harmony on health service use. OBJECTIVES: To examine the ways in which marital dissolution and/or marital quality influence health and health service use. RESEARCH DESIGN: The Americans' Changing Lives (ACL) survey was designed to provide a longitudinal study of successful aging. The ACL contains a nationally representative sample of people over age 24, with an oversampling of individuals age 60 and above. SUBJECTS: Nine hundred and twenty seven female subjects who were married at baseline (1986); 101 (10.9%) of those were no longer married at follow up (1989). MEASURES: Health status and health service use at follow up. RESULTS: Marital dissolution, alone and together with marital quality, was associated with worsened mental and physical health and increased mental health service use. Marital harmony was associated with better sleep and fewer depressive symptoms and physician visits. Widowhood was associated with worsened health, but not with greater health service use. Separated women and women divorced from a discordant marriage were not more depressed but used more mental health services. Women separated from a marriage they had rated as harmonious increased their alcohol consumption. CONCLUSIONS: Marital dissolution increases the risk for mental and physical health problems, some of which emerge only among women who had harmonious marriages. Marital harmony appears protective against physician visits. Widows should be encouraged to seek help for their health difficulties. Separated women should be counseled that they are at heightened risk for increased alcohol consumption. Divorced and separated women appear to seek help for emotional problems, over and above depressive symptoms.     

Intimate partner abuse factors associated with women's health: a general population study

Title.  Intimate partner abuse factors associated with women's health: a general population study.
Aim.  This paper is a report of a study to investigate the correlates of physical and psychological health in a general population-based sample of Icelandic women who experienced abuse in close relationships.
Background.  Most studies examining the health concerns associated with intimate partner abuse have been based on clinical populations; however, their findings may not be representative of the general population of women experiencing intimate partner abuse.
Method.  A cross-sectional correlational study was conducted. The Women's Response to Battering Model was used to guide the choice of variables. Questionnaires were mailed to 7523 randomly-selected Icelandic women. Data collection started in December 2005 and ended a year later. A total of 1974 married and 772 cohabiting women answered the questionnaires ( n  = 2746). Independent t -tests and stepwise regression were used to analyse the data.
Findings.  Health risk behaviours (e.g. alcohol misuse, smoking), chronic health conditions/illnesses (e.g. sleep disturbance, depression, eating disorders) and currently being victim of intimate partner violence predicted the women's physical and psychological health.
Conclusion.  Interventions designed to decrease health risk behaviours, treat chronic health conditions/illnesses and offer best practice first response to women who are victims of intimate partner violence can be offered to reduce the short- and long-term effects of violence on their physical and psychological health. Public health policy needs to focus specifically on intimate partner violence against women and the role that public health nurses can have in early identification and offering appropriate interventions within primary healthcare settings.     

Functionalism and holism: community nurses' perceptions of health

This paper reports the results of a study that was designed to explore and examine the perceptions of two groups of newly qualified community nurses about the factors they considered to be embedded within the concepts of health, health-enhancing behaviours at individual, family and community levels and their 'innermost self'. The research was exploratory in nature, and included two sample groups: group 1 comprised 16 newly qualified health visitors; group 2 comprised 16 newly qualified community mental health nurses. Purposive sampling was used and data were collected using semi-structured interviews. The group of health visitors perceived health in terms of physical fitness and functional states. At a global level they perceived the need to provide education on health matters. They gave generously to 'charities' and perceived the 'inner self' as 'that part that matters'. The group of community mental health nurses perceived health in terms of holism and being states. Their concept of health was related to listening to each individual's perception of what is 'right' and 'health-enhancing' for them. At a global level they considered the protection of the ozone layer and the promotion of a just and equitable society which focused on the reduction of poverty, to be key health-enhancing activities. They perceived their 'innermost self' to be 'that part of me that makes life worth living', and the soul. The findings have implications for developing new and creative approaches for teaching the holistic concept of health and healing. Educational activities could be designed which strive to ensure that nurses themselves have safe and health embracing opportunities for exploring all the elements that are embedded within the topic of health. Their role in facilitating holistic health promoting activities for all clients also needs to be addressed.     

Assessing Intimate Partner Abuse: Associated Factors and Health Consequences among Jordanian Women

In this cross-sectional study, we assessed levels and types of psychological and physical intimate partner abuse (IPA), and the association of IPA with socio-demographic factors and health consequences. The Abusive Behavior Inventory was completed by 471 Jordanian women. IPA was higher among older women who were: of older age, of younger age at marriage, married to unemployed spouses, living in urban residence, and of lower educational level. IPA was associated with most of the health problems except dental injuries and burns. We recommend educational programs that raise women's awareness to their rights to education, free choices in marital age, and policies that mitigate IPA in Jordan and similar patriarchal societies.     

“We are always asked; ‘where are you from?’”: Chilean women’s reflections in midlife about their health and influence of migration to Sweden

Scand J Caring Sci; 2010; 24; 445–453
“We are always asked; ‘where are you from?’”: Chilean women’s reflections in midlife about their health and influence of migration to Sweden Aim: This study explored how Chilean immigrant women living in Sweden perceived and related their life situations and health status during midlife to their migration experiences. Method: Three focus group discussions (FGDs) were performed with 21 middle‐aged Chilean women (40–60 years) who had lived in Stockholm for at least 15–20 years. In‐depth interviews were held with three key informants. A combination of manifest and latent content analysis was performed to structure and categorize the tape‐recorded and transcribed data. Findings: Three main themes emerged from the data: (i) Chilean women’s reflections about migration and resettlement; (ii) Health during midlife; perceptions of Chilean women living in Sweden; and (iii) Strategies to manage their lives and to gain social acceptance and position. The Chilean women reflected about the discrimination they had met in the Swedish society and within the health care system along with health changes they had had during midlife. They connected some of their health related problems to their hardships of migration. They also expressed confusion about the health care they had received in Sweden including conflicting and mistrusting relationship with some health care providers. Important for their way of coping with their own health seemed to be a recognition of their own space, level of independence, self‐acceptance and awareness of power relationships. Conclusion: The results illuminate the importance of awareness of influence of gender and socio‐cultural aspects, power relationships and communication skills among health care providers on women’s health. Complementary interventions to the biomedical paradigm are needed and should be addressed in Swedish health staff educational programmes as well as in clinical training.     

Wealth Index association with gender issues and the reproductive health of Egyptian women

This study investigated the association of the Wealth Index of married women in Egypt with a number of gender and reproductive health issues found in the 2005 Egypt Demographic Health Survey. The data from a subsample of 5249 currently married women from a total of 19 474 was examined using logistic regression analysis. The women's lowest wealth quintile predicted the intention to continue female genital cutting for their daughters, exposure to physical and sexual marital violence, not being empowered in household decisions, having a higher number of children, having an unintended last child, mothers' maltreatment of their children, the perception of a lack of health‐care providers or drugs as an obstacle to receiving care, and not being covered by health insurance. The association of poverty with the aforementioned adverse health outcomes are discussed. Physicians should understand the effect of poverty on health and endeavour to influence policy‐makers to reduce the poverty burden on health.     

Associations between headache and stress, alcohol drinking, exercise, sleep, and comorbid health conditions in a Japanese population

We conducted a cross-sectional survey of 12,988 subjects aged 20–79 years (5,908 men and 7,090 women) receiving health checkups at a Tokyo clinic. They filled out a self-administered structured questionnaire, and 5.4% of the men and 15.4% of the women reported having headaches. Younger subjects were more prone to having headaches. The likelihood of having headaches increased with stress level and decreased ability to relieve stress in both genders. There was an inverse dose–response relationship between having headaches and alcohol consumption, and less walking/exercise and sleep problems increased the likelihood of headaches in both genders. Headache sufferers of both genders were more likely to report multiple additional poor health conditions. A multivariate stepwise logistic analysis showed that age, self-estimated degree of stress, reported number of additional poor health conditions, and less alcohol consumption were independently correlated with having headaches. In conclusion, although women were more susceptible to headache, Japanese men and women in Tokyo shared factors associated with headache, including age, stress, having other poor health conditions, alcohol consumption, sleep, and exercise.     

Exercise and older women's wellbeing

Older women are one of the most inactive groups in the population despite being at an age where they are at greater risk of health problems. Knowing what influences these women to exercise regularly may help the development of strategies to assist sedentary women in this age group to become active. This paper reports the findings of a study that explored why a group of older women attending a fitness centre participate in regular exercise activities. The study used a qualitative approach to data collection and analysis. Data were collected using in-depth interviews from ten women over 50 years of age who exercised on a regular basis. The findings revealed four themes relating to the maintenance of general wellbeing: exercise as a socially supportive activity, exercising to maintain wellbeing, exercising to maintain independence, and exercise as liberating. The implications of the findings for nursing education, clinical practice and research are discussed.     

Patients' and health care professionals' attitudes towards the PINK patient safety video

Rationale, aims and objectives Patients can play an important role in reducing health care harm. Finding strategies to encourage patients to take on an active role in issues related to the quality and safety of their care is therefore essential. The aim of this study was to examine patients' and health care professionals' attitudes towards a video aimed at promoting patient involvement in safety‐related behaviours. Method A within‐subjects design was used where participants were required to complete a questionnaire pre and post screening of a patient safety video. Participants are 201 patients aged 19–103 years (mean 52) and 95 health care professionals aged 23–48 years (mean 32). Main outcome measures include (i) patients' willingness to participate and perceived importance in participating in safety‐related behaviours; and (ii) health care professionals' willingness to support patient involvement. Results After watching the video patients elicited more positive attitudes towards asking doctors and nurses if they had washed their hands and notifying them about issues to do with personal hygiene. No significant effects were observed in relation to patients notifying staff if they have not received their medication or if they were in pain or feeling unwell. In relation to health care professionals, doctors and nurses were more willing to support patient involvement in asking about hand hygiene after they had watched the video. Conclusion Video may be effective at changing patients' and health care professionals' attitudes towards patient involvement in some, but not all safety‐related behaviours. Our findings suggest video may be most effective at encouraging involvement in behaviours patients are less inclined to participate in and health care professionals are less willing to support.     

Health beliefs and their influence on United Kingdom nurses' health-related behaviours

BACKGROUND: Because there is a demonstrated empirical link between nurses' personal health habits and their tendency to raise health issues with clients, researchers suggest that nurses can improve their health promotion role if they adopt health-related behaviours. Few researchers, however, have identified the factors that influence nurses' health-related behaviours. AIMS: To describe nurses' beliefs about the importance of health-related behaviours, and investigate the relationship between these beliefs and their health-related behaviours. DESIGN: A cross-sectional survey from which nested-case control comparisons were made. SAMPLE: One hundred and thirteen nurses attending tertiary level education courses in London and Essex. MEASURES: Health Behaviour Survey and a scale measuring nurses' beliefs about the importance of health-related behaviours. RESULTS: Nurses' health beliefs significantly influenced the practice of 14 health-related behaviours. CONCLUSIONS: The findings from this study support the view that nurses' practice of many behaviours linked to health and longevity are influenced significantly by their beliefs about the importance of these behaviours. Changing nurses' beliefs about the importance of health-related behaviours through specific health promotion sessions are meaningful as they may improve nurses' health promotion role.     

The role of stress in the relationships between gender and health‐promoting behaviours

Scand J Caring Sci; 2010; 24; 572–580
The role of stress in the relationships between gender and health‐promoting behaviours Studies have shown that in Western societies, women live longer than men. Among other factors, this has been attributed to health behaviours; men engage in health‐risking behaviours, while women perform health‐promoting behaviours. These tendencies were argued to align with cultural notions of masculinity and femininity. There may be some evidence, however, that men and women engage in different types of health‐promoting behaviours, and stress may play a role in these tendencies. This study attempts to examine the various types of health‐promoting behaviours women engage in and compare them to the tendencies of men. Secondly, it examines the mediating role of stress in the relationships between gender and health‐promoting behaviours. The sample was comprised of 402 young Israeli adults. Half were undergraduate university students majoring in social work. The remaining participants were sampled by ‘snowball sampling’. Participants completed a questionnaire containing 63 closed‐ended questions on various health issues. For the purpose of this study, gender, stress and health‐promoting behaviours measures were used. Data were collected over three academic years by the teacher responsible for the course and were received by the author at the end of the data collection phase. The study was approved by the institution’s internal review board. The results indicate that,‐while women engage in ‘type 2 behaviours’‐ refraining from smoking and drinking, eating breakfast regularly and sleeping 7–8 hours per night‐men engage in ‘type 1 behaviours’‐ physical exercise, refraining from snacking, and maintaining an appropriate body mass. We also found that, to some extent, women refrain from ‘type 1 behaviours’ because of their levels of general stress. Our study suggests that the social construction of masculinity and femininity which undermines individuals’ health needs to be challenged and addressed. In particular, the enduring role of stress in women’s health outcomes should be addressed.     

Effects of moderate and low intensity long-term exercise by older adults

The goal was to determine the existence of differential effects of long-term moderate- or low-intensity exercise on selected bio-behavioral variables in 72 community-dwelling persons over 60 years of age. After screening, subjects were randomly assigned to a moderate (n = 39, 60-70% heart rate reserve [HRR]) or low (n = 33, 30-40% HRR) intensity exercise protocol. Both groups exercised three times per week for 9 months and dependent measures were taken at baseline, 4.5 months and after 9 months. Repeated measures ANOVA with Tukey post hoc comparisons constituted the analysis approach. Moderate exercise showed no superiority over low-intensity exercise; both groups improved about equally. Variables that significantly improved included: self-reported sleep (sleep quantity and dream recall), mental status (attention/concentration, short-term memory and higher cognitive functioning), health perceptions (health outlook, health worry, rejection of the sick role), and cardiovascular fitness indicators (submaximum stress test heart rate, maximum oxygen consumption (VO2max), maximum work capacity and maximum exercise time). Similarity of outcomes in both groups may mean that the moderate exercise protocol was too conservative. Conversely, the findings may indicate that lower levels of exercise, which may be safer and more feasible over time, do improve fitness levels, prolong independent functioning, and promote positive perceptions of well-being in older adults.