Women's Adjustment Research Articles

Women’s emotional adjustment to IVF: a systematic review of 25 years of research

This review provides an overview of how women adjust emotionally to the various phases of IVF treatment in terms of anxiety, depression or general distress before, during and after different treatment cycles. A systematic scrutiny of the literature yielded 706 articles that paid attention to emotional aspects of IVF treatment of which 27 investigated the women's emotional adjustment with standardized measures in relation to norm or control groups. Most studies involved concurrent comparisons between women in different treatment phases and different types of control groups. The findings indicated that women starting IVF were only slightly different emotionally from the norm groups. Unsuccessful treatment raised the women's levels of negative emotions, which continued after consecutive unsuccessful cycles. In general, most women proved to adjust well to unsuccessful IVF, although a considerable group showed subclinical emotional problems. When IVF resulted in pregnancy, the negative emotions disappeared, indicating that treatment-induced stress is considerably related to threats of failure. The concurrent research reviewed, should now be underpinned by longitudinal studies to provide more information about women's long-term emotional adjustment to unsuccessful IVF and about indicators of risk factors for problematic emotional adjustment after unsuccessful treatment, to foster focused psychological support for women at risk.

Psychosocial Issues Confronting Young Women with Breast Cancer

The current paper reviews the literature regarding psychosocial issues confronting young women with breast cancer. The findings indicate that younger women with breast cancer experience a lower quality of life after cancer compared to older women. In part, this lower quality of life results from the effects of medical treatment. The effects of surgery and removal of the breast result in more negative feelings regarding body image, particularly for young women. With systemic treatment, many younger women experience the sudden onset of menopause, with the attendant symptoms of hot flashes, decreased sexual desire, and vaginal dryness. These physical effects along with a variety of relationship issues contribute to a high level of sexual concerns for young women. From a psychosocial perspective, breast cancer affects both females and their male partners. Both partners experience psychological distress including depression and anxiety. Within the relationship, emotional support from the partner is important in women's adjustment. In terms of psychosocial interventions for breast cancer, findings suggest that the most frequently employed interventions, which treat the woman without her partner, are not optimal. Initial findings provide encouraging evidence that couple-based psychosocial interventions for women and their partners might be of particular assistance to both partners.

Are women different from men in ways that matter? Maybe

In thi sissu eo fthe Journal ,Toumpouli san dcolleagues 1 repor tth eresult sof their study comparing 2598 men with 1162 women in terms of the demographic and perioperative factors that predict long-term (5-year) postoperative survival after coronary artery bypass grafting (CABG). The presentation of data is unusual in its emphasis on the number of independent predictors in one gender versus the other. Although there were more predictors in men, twice as many men as women were studied, making the statistical tests performed on the men’s data more powerful than those performed on the women’s data. Therefore, the reported gender differences in the absolute number of predictors may be merely a statistical artifact. Also, cause of death was not captured, so it is possible that many of the reported deaths were not related to cardiovascular disease. Whether female gender is a risk factor for short- or long-term mortality after cardia csurger yi sa subjec to fongoin gdebate .I na recen tstud yo f15,44 0patients, 2 female gender independently predicted higher in-hospital mortality even when all comorbidities were taken into account (eg, age, emergency or urgent status, associated valvular surgery, prior cardiac surgery, congestive heart failure, history of cerebrovascular accident, renal insufficiency). In contrast, another large study used propensity-modeling techniques to show that female gender was not associated with increase din-hospita lmortalit yi nwell-matche dpatients. 3 Studies of the influence of gender on long-term mortality after cardiac surgery have also yielded results that are subject to interpretation. In one such study, mortality was significantly higher in women than in men 15 years after CABG, but this sex difference was largely attributable to the women’s higher in-hospital mortality. 4 Anothe rstud ynote dtha tunadjuste dmortalit ywa ssignificantl yhighe rin women than in men at 30 days and at 2 years after CABG; however, once the investigators adjusted for baseline comorbid disease, there were no sex-related difference sa t2 years. 5 Furthermore ,i nsevera lrecen tstudies ,adjustmen tfor women’s greater number of baseline comorbidities yielded the surprising result that 5-yea rpost-CAB Gsurviva lwa sactuall ybette ri nwome ntha ni nmen. 6-8

Self-Forgiveness, Spirituality, and Psychological Adjustment in Women with Breast Cancer

We evaluated whether a self-forgiving attitude and spirituality were related to psychological adjustment among 81 women being treated for breast cancer at a medical oncology clinic in a county general hospital. Both a self-forgiving attitude and spirituality were unique predictors of less mood disturbance and better quality of life (p's < 0.001). These results are consistent with previous research that has demonstrated a positive relationship between spirituality and well-being. The findings also suggest that self-forgiveness should be explored experimentally to determine whether it can protect against the psychological effects of breast cancer-related stress. Interventions targeting these characteristics could improve the quality of life and alleviate stress, especially in women with breast cancer in public sector settings.

Health Goal Cognition and Adjustment in Women with Fibromyalgia

The purpose of this study was to identify individual differences in symptom-specific goal for persons diagnosed with fibromyalgia syndrome (FMS) and to determine whether those differences are related to adjustment outcomes. Women with FMS (N=71) rank ordered 12 FMS-specific goals and completed a packet of psychosocial outcome measures. Cluster analysis suggested that there were three relatively homogeneous subgroups defined. Cluster 1 ranked goals related to seeking professional care higher than all other groups. Cluster 2 ranked self-sufficiency goals higher than the other two groups. Cluster 3 ranked social-validation goals higher than the other two clusters. Multivariate analyses of variance (MANOVAs) and post-hoc tests showed that goal profiles covaried with differences in pain, negative affect, goal-specific social support, general social support, goal-related interference, and negative life events. Differences between groups are discussed in the context of proposed relations between goals and environmental support.

A Qualitative Investigation of the Cultural Adjustment Experiences of Asian International College Women.

This qualitative study explored the cultural adjustment experiences of 15 Asian Indian, Japanese, Korean, and Vietnamese international college women through semistructured interviews. By using consensual qualitative research methodology (C. E. Hill, B. J. Thompson, & E. N. Williams, 1997), 6 primary domains or themes related to these women's cultural adjustment experiences were identified via data analysis: their feelings and thoughts about living in the United States, perceived differences between their country of origin and the United States, their English language acquisition and use, their prejudicial or discriminatory experiences in the United States, their peer and family networks, and their strategies for coping with cultural adjustment problems. Implications of the findings for mental health practice are discussed.

Sexual Minority Women's Coping and Psychological Adjustment after a Diagnosis of Breast Cancer

To determine factors that influence sexual minority women's coping responses and adjustment to breast cancer. We conducted a cross-sectional study with 64 sexual minority women with breast cancer who were recruited through targeted community-based sampling. In this study, sexual minority women consisted of three sexual orientation groups: those who self-reported partnering with women and those with a lesbian or bisexual identity. We determined the number of years of sexual minority status and disclosure of sexual orientation and used standardized measures to assess these women's coping and adjustment to breast cancer. Data were analyzed using statistical methods as appropriate for the level of data. We determined that sexual minority factors, such as sexual orientation group, influenced coping and adjustment even after illness and social support factors were controlled. In multivariate analyses, women who identified as lesbians or bisexuals used less maladaptive coping compared with women who reported partnering with women. The association between reporting a lesbian identity and lower distress approached significance in multivariate regression equations. Of the sexual minority factors that were considered, sexual orientation group, number of years of sexual minority status, and disclosure of sexual minority status, only sexual orientation group was related to coping and lower distress. Contrary to expectations, disclosure of sexual orientation did not relate to coping and lower distress. The findings support the need for future studies to include different aspects of sexual minority status, in particular, clearly defined sexual orientation groups.

Baseline Anxiety Foretells Women's Adjustment to Cancer

Baseline Anxiety Foretells Women's Adjustment to Cancer

Predictors of Physical, Psychological and Social Adjustment in Women with Rheumatoid Arthritis

Abstract This study examined the extent to which illness perceptions, coping and disease indicators predict physical, social and psychological adjustment in patients with rheumatoid arthritis. Baseline data were collected on 75 women attending an out-patient clinic in the West of Ireland. Disease status was assessed by physician ratings of joint involvement, and laboratory indices of erythrocyte sedimentation rate and C-reactive protein. The Illness Perception Questionnaire, the COPE, the Coping Efficacy Scale and the Arthritis Impact Measurement Scale were administered during a semi-structured interview. In stepwise regression analyses (p < .01) illness perceptions accounted for 17% to 28% of the variance on measures of physical function, pain, depression and anxiety. All relationships were in the expected direction. Disease status explained variance on the illness-related aspects of physical function (21%) and coping predicted social activity (16%). Interventions based on understanding and modifying ill...

Psychological distress among healthy women with family histories of breast cancer: effects of recent life events

The experience of breast cancer in a close family member can be a major life stressor for many women as evidenced by various psychosocial and biological indicators. However, existing studies have found considerable variability in the levels of psychological distress among women with family histories of breast cancer (FHBC). Based on cognitive processing models, we examined moderating effects of recent life events on the impact of having a family member with breast cancer and psychological distress. Specifically, we hypothesized that negative recent life events would be associated with greater psychological distress and that positive recent life events would be associated with less psychological distress, and these patterns will be more prominent among women with FHBC than women without FHBC. Women with (FHBC+, N = 59) and women without (FHBC-, N = 94) FHBC completed measures of recent life events, cancer-specific distress (intrusion and avoidance) and general distress. Results indicated that among FHBC+ women, negative life events were associated with higher levels of breast cancer-specific intrusion and positive life events were associated with lower levels of breast cancer-specific avoidance. These results support the application of cognitive processing models for understanding variability in women's psychological adjustment to their FHBC. Psychological interventions designed to facilitate coping with negative life events and to increase the occurrence of positive events may be warranted.

Women's Adjustment to Widowhood: Does Social Support Matter?

ABSTRACT Widowhood is a stressful event for women, often coinciding with health, financial, and relationship losses. Researchers have considered many aspects of women's adjustment to widowhood, typically including social support in analyses. This study analyzed relationships between social support and adjustment from 19 previous widowhood studies. Contrary to intuition and most researchers' assumptions, the majority of relationships did not show that social support positively impacted adjustment. Analyses examined whether type of support or study methods affected the likelihood of finding a significant relationship between support and adjustment. Chi-square statistics indicated that neither of these factors influenced the effect of social support on women's adjustment to widowhood.

Economic stress and marital adjustment among couples: analyses at the dyadic level

AbstractThis survey study of 608 Finnish couples investigated the question of how economic stress is reflected in marital adjustment on the basis of the model presented by Conger and colleagues. We used the couple as a unit of analysis, performing a dyadic‐level analysis within the framework of LISREL models. The model showed that the path by which economic circumstances were linked to marital adjustment was as follows: poor economic circumstances were linked to economic strain, which was related to increased psychological distress, and psychological distress in turn was negatively reflected in marital adjustment. However, psychological distress only partially mediated the link between economic strain and marital adjustment: economic strain was also directly linked to decreased marital adjustment. In addition, there occurred crossover between partners' experiences. First, wives' psychological distress was negatively related to husbands' reports of marital adjustment and vice versa. Second, unemployment among men was directly linked to reports of marital adjustment among women: the longer the man's total spell of unemployment, the poorer the woman's marital adjustment. Copyright © 2004 John Wiley &amp; Sons, Ltd.

Breast Reconstruction and Psychosocial Adjustment: What Have We Learned and Where Do We Go from Here?

For women with breast cancer, there are many treatment options, with surgery often the primary treatment for early-stage disease. An increasing number of women are choosing to have reconstruction following their mastectomies. Both surgical and medical treatments for breast cancer are increasingly evaluated not only on the basis of their safety and medical outcomes but also their impact on women's psychosocial and quality of life (QOL). The objective of this article is to describe current knowledge regarding the psychosocial adjustment of women undergoing reconstruction, identify limitations in the existing literature, and offer suggestions for the direction of future work in this area. Though most studies have found comparable general QOL in women who have different surgical treatments for breast cancer, some research suggests that reconstruction may provide benefits in terms of body image and sexuality, especially compared with women who have mastectomies only. Most of the existing studies have failed to consider the potential importance of demographic- and treatment-related variables on women's psychosocial adjustment. As reconstruction procedures continue to be developed and refined, the impact of these procedures on women's short- and long-term psychosocial adjustment and QOL is needed.

Cognitive Adaptation and Women's Adjustment to Conjugal Bereavement

ABSTRACT Conjugal bereavement is experienced by the majority of older women in enduring relationships. Although most experience considerable distress in the immediate aftermath of this loss, the majority adjusts over the course of time. The current study of self-selected participants applies the theory of cognitive adaptation in an attempt to distinguish between women who have successfully adjusted to the death of their husbands versus those who exhibit prolonged distress. Results of this study suggest that positivity biases in personally relevant information processing (i.e., self-deception, marital aggrandizement, dispositional optimism) are significantly associated with life satisfaction and the absence of psychiatric distress. The contribution of cognitive adaptation is maintained over and above that provided by personality variables (i.e., neuroticism, extraversion, openness to experience). Intervention strategies to treat enduring distress among widowed women are considered on the basis of these findings.

Psychological and physical symptoms in the final phase of breast cancer

The purpose of this study was to identify factors that affect the adjustment of women and their husbands to recurrent breast cancer and to examine the mutual effect that partners have on one another. An exploratory study was designed to determine the relationship between four predictor variables (support, uncertainty, symptom distress, hopelessness) and women's and husbands' adjustments. The sample consisted of 155 subjects; 81 women, who had a first recurrence of breast cancer, and 74 husbands. Multiple standardized instruments with established reliability and validity were used to measure the study variables. The independent variables were measured with the Social Support Questionnaire, the Mishel Uncertainty in Illness Scale, McCorkle Symptom Distress Scale and the Beck Hopelessness Scale. The dependent variable, psychosocial adjustment, was measured with the Brief Symptom Inventory and the Psychosocial Adjustment to Illness Scale. The results indicated that the independent variables accounted for 43% of the variance in women's distress and 32% of the variance in husbands' distress; they also explained 66% of the variance in women's role adjustment problems and 57% of the variance in husbands' role problems. Symptom distress and hopelessness accounted for the most variance in women's and husbands' levels of adjustment. A significant and positive relationship was found between women's and husbands' adjustment scores, indicating that partners have a mutual influence on one another. The findings suggest that there are multiple factors that influence couples' adjustment to recurrent breast cancer, and that these factors need to be taken into consideration when planning care for women and their partners.

Renegotiating identity and relationships: men and women's adjustments to retirement

Retirement is frequently a period of change, when the roles and relationships associated with individuals' previous labour market positions are transformed. It is also a time when personal relationships, including the marital relationship and relationships with friends and family, come under increased scrutiny and may be realigned. Many studies of adjustment to retirement focus primarily on individual motivation; by contrast, this paper seeks to examine the structure of resources within which such decisions are framed. The paper examines the contribution that gender roles and identities make to the overall configuration of resources available to particular individuals. It draws upon qualitative research conducted with older people in four contrasting parts of the United Kingdom, and examines the combination of labour market and non-labour-market activities in which they are involved prior to state retirement age and as they withdraw from paid work. It explores how older people invoke various gendered identities to negotiate change and continuity during this time. The paper argues that gender roles and identities are central to this process and that the reflexive deployment of gender may rank alongside financial resources and social capital in its importance to the achievement of satisfying retirement transitions. Amongst those interviewed, traditional gendered roles predominated, and these sat less comfortably with retirement for men than for women.

Locating Breast Cancer in the Context of Women's Lives

Research has generally suggested that positive life circumstances may help alleviate the distress brought on by breast cancer. Little attention has been paid to the effects of negative life circumstances on women's adjustment to the disease. In this study, 110 women answered in writing an open-ended question about life circumstances (positive, negative, or both) that they perceived to have influenced their experience with breast cancer. Many women described both positive and negative circumstances, but negative circumstances were reported more commonly. The women described 28% of the negative circumstances as more salient or more distressing than breast cancer; these circumstances were coded as “negative distracting” circumstances. Exploratory regression analyses found that positive circumstances were associated with better adjustment and negative circumstances were associated with poorer adjustment. In addition, distracting circumstances were associated with better adjustment. Findings suggest that considering breast cancer in the context of women's lives is important.

Women Adjusting to Prison

Although studies over the years have measured the prison adjustment of male prison inmates by examining the frequency and severity of their disciplinary infractions, there is much less similar research on the adjustment of female inmates. While there is evidence that female inmates commit more, but less serious, infractions than do male inmates, it is not clear how these infractions affect the adjustment of women to prison. This article includes a study of the disciplinary behavior of a sample of 222 women released from a large maximum security prison. The sample is divided into different disciplinary groups based on the seriousness of behavior. Logistic regression analysis is utilized to assess the implications of disciplinary behavior. The study attempts to delineate the circumstances and conditions that provide the best opportunity for a woman's adjustment to prison. The findings indicate that the majority of women inmates do not commit infractions or engage in only minor infractions. However, there is a core group of chronic offenders who engage in violent infractions, and whose characteristics can be used to determine prison placement and programming for all inmates.

Tiredness and fatigue in the postnatal period.

This paper aims to analyse critically a selective review of the literature on tiredness and fatigue in health and illness. This analysis is then applied to the experience of the new mother in the postnatal period. Although the twin concepts of tiredness and fatigue are well known in both sickness and health, our understanding of them is less complete. This paradox of familiarity and lack of understanding applies particularly to the postnatal period. A literature search was undertaken using MEDLINE, CINAHL and Web of Science. The search terms 'tiredness', 'fatigue' and 'post natal' were used. This search of the literature produced a small number of articles. Few of these, however, addressed the problem of tiredness or fatigue in the postnatal period, suggesting that this problem needs more research attention. On the basis of this analysis, it is suggested that childbirth education could be extended to foster more realistic expectations and more effective coping skills to facilitate women's adjustment to motherhood. The possibility of midwives educating mothers about the need to access, recruit and delegate some household activities to willing helpers is addressed. We propose that midwives can help women to have more realistic expectations about life after the birth, by providing advice and legitimizing the need for support and the use of coping mechanisms to assist the transition to motherhood.

Women's adjustment to widowhood. Theory, research, and interventions.

1. People respond differently to loss and grieve in their own time. 2. Frequently, the hardest time for new widows is after the funeral. 3. Young widows often have no peer group and generally are less prepared emotionally and practically than older widows to cope with the loss. 4. Widowhood often causes financial stress because a major income source is lost with the death of a husband.