Perspectives Of Older Women Research Articles

Perspectives of older women with coexisting urinary incontinence and high fall risk

Perspectives of older women with coexisting urinary incontinence and high fall risk

Perspectives of older women in the Netherlands: identifying motivators and barriers for healthy lifestyles and determinants of healthy aging

BackgroundWomen have a higher life expectancy than men but experience more years with physical disabilities in daily life at older ages, especially women with a migration background. This pinpoints older women as an important target group for strategies that stimulate healthy lifestyle, which benefits healthy aging. Our study investigates motivators and barriers for healthy lifestyles and perspectives on determinants of healthy aging of older women. This provides essential information for developing targeted strategies.MethodsData was collected by semi-structured digital interviews from February till June 2021. Women aged 55 years and older living in the Netherlands (n = 34) with a native Dutch (n = 24), Turkish (n = 6) or Moroccan (n = 4) migration background were included. Two main subjects were investigated: (1) motivators and barriers on their current lifestyles regarding smoking, alcohol consumption, physical activity, diet and sleep and (2) perspectives on determinants of healthy aging. Interviews were analyzed using Krueger’s framework.ResultsPersonal health was the most common motivator for a healthy lifestyle. In addition, peer pressure and being outdoors were specific motivators for physical activity. Bad weather conditions and personal dislike to be active were specific barriers. The social environment, personal preferences and personal belief to compensate with other healthy lifestyle behaviors were barriers for low alcohol consumption. Personal preferences (liking unhealthy food and not making time) were the main barriers for a healthy diet. Sleep was not perceived as a form of lifestyle behavior, but rather as a personal trait. Since there were no smokers, specific barriers were not mentioned. For Turkish-Dutch and Moroccan-Dutch women, additional barriers and motivators were culture and religion. These were strong motivators to abstain from alcohol consumption and smoking, but a barrier for a healthy diet. With regard to perspectives on determinants of healthy aging, positive views on aging and being physically active were perceived as most important. Women often wanted to increase their physical activity or healthy diet to stimulate healthy aging. Among Turkish-Dutch and Moroccan-Dutch women, healthy aging was also perceived as something in the hands of God.ConclusionsAlthough motivators and barriers for a healthy lifestyle and perspectives on healthy aging vary for distinct lifestyles, personal health is a common motivator across all lifestyles. Having a migration background added culture and religion as distinct barriers and motivations. Strategies to improve lifestyle among older women should therefore have a tailored, culture sensitive approach (if applicable) for distinct lifestyle factors.

Perspectives of older women with early breast cancer on telemedicine during post-primary treatment.

Telemedicine has the potential to lessen healthcare burden of older patients due to frequent appointments, physical disabilities, and reliance on caretakers. To benefit from telemedicine, patients must have the capacity and willingness to engage with technology. This study aimed to better understand the telemedicine experiences of older women with non-metastatic breast cancer regarding visit convenience, completeness, and interpersonal satisfaction. Semi-structured interviews were conducted in a convenience sample of women age 65+, post-primary treatment for stage I-III breast cancer, who had received in-person outpatient care at a cancer center in urban North Carolina before a telemedicine appointment occurring after March 2020. Patients were interviewed about their perceptions of telemedicine (telephone, video) as compared to in-person visits. Audio files of interviews were transcribed and analyzed for themes and subthemes established a priori in the interview protocol. Fifteen patients (telephone = 5, video = 10) were consented and interviewed July-October 2021, mean age 74. Thirteen participants reported they preferred a hybrid care model that included telemedicine care over in-person care alone. COVID-19, physical disability, and transportation burden were the most common factors for telemedicine preference. Comfort with familiar face-to-face interactions and having a physical exam were common factors for in-person appointment preference. In-person appointment was favored early in the post-primary treatment phase; telemedicine was more acceptable when relationships were well-established and patients were farther out from diagnosis. Patient-provider discussions about appointment modality should take into account newness of diagnosis, patient familiarity with the care team, travel burden, and necessity of physical exam.

Lived experience and perceived advantages of therapeutic De-escalation: A qualitative study of older patients with breast cancer

IntroductionOne option for therapeutic de-escalation in older women with early breast cancer (EBC) is partial breast irradiation (PBI) instead of whole-breast irradiation (WBI) when the latter has no clear advantages. We aimed to explore the decision-making processes and the lived experiences of WBI and PBI from the perspectives of older women with EBC. Materials and methodsThematic content analysis was performed on qualitative data collected using narrative interviews. ResultsTwenty-two women aged 65 and over participated (ten patients who underwent WBI and twelve who underwent PBI). We identified three themes from their narratives: 1) Acceptance of a paternalistic relationship with physicians, 2) Strong need for an informed choice, and 3) PBI can help people conceal cancer-related physical marks. Narratives underlined participants' preferences for each of the two treatments and their perceptions about therapeutic de-escalation. Misconceptions about therapeutic de-escalation were observed. DiscussionWhen providing information about EBC treatment options, patients' perceived burden of side effects should be considered. Moreover, eliciting the value older patients place on available breast cancer treatments, as well as their related goals and preferences, could foster their participation in the therapeutic de-escalation decision-making process.

"The Internal Police Officer Has Not Retired but Has Slowed Down": Israeli Women Reframe Their Aging Experiences in the Second Half of Life.

Compared with gains, losses have received a substantial amount of research and public attention. The present study aims to shed light on the positive gains associated with older age from the perspective of older women. Five focus groups with 19 Israeli women over the age of 54 were conducted. Trailers of three different films were used to stimulate discussion about old age and aging and allow for reflections on societal norms in light of personal experiences. Focus group interviews were analyzed thematically. Respondents identified four contexts, characterized by reframing their experiences against societal norms. These included gender stereotypes, physical appearance, interpersonal relations, and employment. This study represents an opening to a different discourse around old age, which is characterized by gains and possibilities brought about by changes in reframing one’s experiences, while distancing oneself and exerting free will vis à vis social norms.

Cultural Care of Pregnancy and Home Birth: An Application of the Sunrise Model.

The role of older women close to the pregnant woman may be relevant when conveying information. The use of theories/models can guide the development of nursing practice. To explore beliefs and practices related to pregnancy and childbirth from the perspective of older women who gave birth at home, applying Leininger's Sunrise Model. Qualitative approach, using semi-structured interviews with 24 older women who gave birth at home (rural area, Spain). Manual content analysis of the data was used, and Sunrise Model guided to explore the role of culture and the factors affecting maternity care. Two main categories emerged: beliefs/practices related to physiological aspects (subcategories: minimal intervention, hygiene, pain control, rest, feeding) and to psychosocial aspects (subcategories: spiritual well-being, company). The experiences of older women who gave birth at home helped us to understand some beliefs that survive in some pregnant women, similar in different cultures, and divided into physiological and psychosocial aspects. Older women have a relevant role as transmitters of information, and can provide some keys to plan health interventions, as companions or counselors. Applying the Sunrise Model, we verified the weight that culture has in maternal health care, and the multiple factors that interfere with the way of caring. The application of models helps us to improve nursing practice: not only should we focus on knowing the physical aspects, but also the social and cultural circumstances surrounding the pregnant woman.

Managing menopausal vasomotor symptoms in older women

This review considers the persistent vasomotor symptoms (VMS) of menopause—hot flashes—from the perspective of older women. Although these symptoms are most prevalent in younger women during the menopause transition and recent postmenopausal years, emerging data, corroborated by clinical experience, support the observation that for some women, VMS can remain bothersome into advanced age. Most clinical guidance focuses on treating VMS in younger women because of the concerns of increasing cardiovascular disease (CVD) risks and possibly dementia when menopausal hormone therapies (MHT) are initiated at more advanced ages. Furthermore, recent studies into the physiology of VMS suggest a potential link with endothelial dysfunction and evidence of increased subclinical CVD and CVD events. Clinical trials have reported that older women with VMS have markedly increased CVD risk in response to oral MHT initiation compared with asymptomatic women. Nonhormonal treatment options are available for those who elect not to use, or are advised not to use, menopausal hormone therapies. As the global population ages, more research is needed to clarify the physiology of VMS in older women, suggest optimal approaches to enhance awareness of potential health risks of VMS, and recommend strategic management of VMS in older women, with the goal of promoting health and maintaining quality of life.

The effects of ageing on female genital and sexual health.

This article will explore the impact of ageing on sexual function in older women and will reflect on the social influences on women's sexual ageing, identify the effects of ageing on sexual activity, particularly on genital skin, and consider the concerns from the perspective of older women. The article will then focus on vulval skin conditions and the functional aspects of living with these conditions. Finally, the article provides a starting point for nurses to consider their own knowledge, skills and attitudes through a series of reflective questions and recommendations for those working with older women to aid the identification of issues relating to older women's sexual health and vulval skin conditions, leading to further discussions to promote genital health.

Adjusting to the transition into assisted living: Opportunities for nurse practitioners.

Transition from an independent living residence to assisted living (AL) is challenging. The study purpose was to understand such a transition from the perspective of older women. A hermeneutic phenomenological approach was used to explore how 17 older women living in a Continuing Care Retirement Community, many of whom were recently widowed, experienced this transition. Three major themes emerged from the interviews: preplanning, executing, and adjusting to the transition. Even with facility, family and staff assistance, the transition was challenging, and adjustment was affected when participants had physical or sensory impairments. Older adult women transitioning to AL settings should be assessed for adjustment to the new setting. Those with sensory, cognitive, emotional, or physical problems will need additional supportive strategies to help with adjustment. With a rapidly expanding population, AL settings offer new opportunities for nurse practitioners to promote the health and well-being of older adults.

Les classifications du vieillissement

L’objectif de cet article vise à confronter les classifications savantes relatives à la vieillesse aux représentations sociales du vieillissement de femmes âgées de 65 ans et plus. En utilisant la théorie des classifications interactives de Hacking (2006), nous chercherons à cerner de quelle manière les classifications de l’âge, de l’activité et de la fragilité résonne dans les représentations du vieillissement de femmes aînées, interrogées dans le cadre d’une récente recherche qualitative. Les interactions entre ces deux dimensions catégorielles s’expriment en termes de résistance face à la catégorie « femmes aînées/âgées ». La notion de l’activité est utilisée tant pour réfuter la vieillesse que pour assurer cette « continuité de soi » et son engagement dans la vie malgré le processus de fragilisation vécu.

Unlocking stories: Older women's experiences of intimate partner violence told through creative expression.

Intimate partner violence (IPV) impacts significantly on the lives and health of those who experience abuse The impact of IPV exerts a detrimental impact on mental health as well as physical health, but this is often not recognized by professionals WHAT THE STUDY ADDS TO EXISTING KNOWLEDGE: This study highlights the impact of IPV on the lives and health of older women from the perspective of older women themselves The approach taken to the study illuminates the ways in which older women describe their experiences within the broader narratives of their experiences This study has explored the particular situation for older women as told through creative expression and their own stories of survivorship. Nurses and other healthcare professionals need to be aware of the enduring impact of IPV for older women, particularly within the context of mental health Those working with older women also need to be alert to the potential barriers to disclosure and disjuncture between professional dialogue and personal narrative ABSTRACT: Introduction Intimate partner violence (IPV) exerts a detrimental impact on the lives and health of all who experience abuse. This includes both physical and mental health and well-being. The experiences of older women however may be different, and these differences may not be recognized or accounted for within existing care provision. Aim To explore the impact of IPV on the lives and health of older women told from the particular perspective of older women themselves as these accounts are largely absence from existing IPV discourse. Method An arts-based research approach with five older women survivors of IPV through the codevelopment and organization of an arts-based workshop. The workshop essentially encompassed four main arts strands and included the creation of clay models and poetry. Findings The findings of the study highlight the significant impact of IPV on the lives, mental health and well-being of older women. This included feelings of social isolation, inability to trust others and a loss of self-identity. Discussion Intimate partner violence is a global issue and as such of relevance for those working in healthcare contexts beyond the UK. While there is a growing body of evidence surrounding IPV and older women, this has largely been presented through researcher-led accounts and as such the narratives of women themselves may not have been adequately acknowledged. Unlike much of the existing evidence, this study has explored the particular situation for older women as told through creative expression and their own stories of survivorship. In this study, the fluidity of the potential materials available in the workshops meant that both the representations through which the women spoke and the primacy of their voices, over those of more traditional researcher accounts, were in evidence throughout. Implications for Practice Mental health nurses and practitioners are often on the front line for care and support for older client populations. IPV across the life span is a global issue for healthcare practitioners. It is anticipated that the findings of this study will provide the mechanism through which mental health nurses and other practitioners may reflect on older women's accounts of IPV as told by older women in this study in their own words. Reframing from dominant professional discourse to personal narrative is central to person-centred approaches and is central to contemporary practice. Ultimately, this has the potential to improve the effectiveness of care provision and support. Relevance to Mental Health Nursing The findings presented in this study have the potential to provide a powerful tool for those working within mental health contexts and healthcare professionals working with older populations more generally to consider both the hidden nature of IPV and the ways in which IPV can significantly impact on mental health and well-being in later life.

Perspectives of Older Women on Toileting

Abstract Date Presented 4/16/2015 Deficits in self-care have been linked to older adults’ ability to remain at home; little research has focused on toileting. In this qualitative study, we used interviews to explore attitudes, experiences, practices, and preferences associated with toileting by older women. Results will inform the development of client-centered interventions to maximize performance and to support aging in place.

The perspectives of older women with chronic neck pain on perceived effects of qigong and exercise therapy on aging: a qualitative interview study

Chronic pain is prevalent in elderly populations. The goals of this study were 1) to understand the results of a randomized clinical trial – Qigong and Exercise Therapy for Elderly Patients with Chronic Neck Pain (QIBANE) – that showed no difference between qigong, exercise therapy, and no-treatment on quality of life, and 2) to understand how elderly individuals with chronic pain experience interventions of qigong and exercise therapy. A qualitative interview study was conducted with 20 QIBANE participants. Interviews asked about motivation for and expectations of trial participation, experiences with the exercise classes (qigong or exercise therapy), and changes in pain experience. Interviews were transcribed, entered into the software program ATLAS.ti, and coded thematically by two coders. Content analysis was performed. All interviewees reflected positively on their QIBANE experience and described their participation in QIBANE as helpful. However, what was discussed in both groups when they talked about “positive experiences” in the study differed between the two groups. For example, themes that emerged in the exercise-therapy group related to difficulties associated with aging and staying physically active. In the interviews with qigong group members, emergent themes related to qigong as a method that improved bodily experiences and influenced daily activities. The effects that exercise therapy and qigong have on an elderly population cannot be captured by health-related quality-of-life measurements, such as the Short Form (36) Health Survey. Broader concepts of quality of life that include the concepts of self-efficacy and positive affect may be more appropriate. The results presented in this study suggest that for this population group, the approach of patient-centered outcomes is especially pertinent in order to design meaningful intervention studies in the elderly. This means that research questions, interventions, and outcome measurements need to take into account the special situation of elderly people.

Telling our stories: writing for publication to enhance reflective and contextualised family and community practice.

Health care provision is an area in which constant innovation and improvement is needed, with nurses and others involved in service planning and delivery being called upon to do more with less, and to meet the needs of individuals and communities facing ever more complex health challenges and disease processes (Jackson & Saltman, 2011). In addition, health care is delivered within a culture of increasing performativity, accountability and demand for evidence (Jackson, 2009; Taylor, Lyon, & Harris, 2005). These two factors create a need for innovation in service design and delivery as well as for focused and considered dissemination of such innovations and how they are applied, through stories of practice - reflective and contextualised accounts of what has worked well, what has not worked so well, where improvements have been made and where further improvements are necessary.Necessity is the mother of invention, and right from Nightingale's time (Stanley, 2007), nurses have shown themselves to be inventive and able to adapt to various settings and situations in order to provide the best possible care in all manner of circumstances (Biedermann, Usher, Williams, & Hayes, 2001; Hegney, McCarthy, Rogers-Clark, & Gorman, 2002; O'Brien & Jackson, 2007; Rewi, 2007). But, when working with families and communities there are various persuasive cultural and social imperatives that will exert a strong, even decisive influence on openness and adherence to education, intervention and treatment (Mohan, Wilkes, & Jackson, 2006; Ogunsiji, Wilkes, & Jackson, 2007; Wade, Jackson, & Daly, 2003). The strength of these factors may be such that they cannot be ignored and quite possibly accounts, at least in part, for the poorer health status of some minority community groups.In establishing trusting and respectful relationships with patients, clients and families, there is much that can be learned. In this issue we are pleased to present a range of papers that portray perspectives from consumers, and cover diverse issues such as the meaning of childbirth for African women in Canada (Etowa, 2012), experiential accounts of Muslim people with diabetes, and how they manage this in the context of Ramadan (Peterson, Nayda, & Hill, 2012), the meaning of smoking from the perspective of older women (Treloar & Gunn, 2012), and older New Zealand women's perspectives of factors that impact on their quality of life while living with chronic illness (Lowe & McBride-Henry, 2012). These papers all contribute insights that can inform practice and services so as to make them more appropriate and sensitive to a wider range of health consumers.However, there are many innovative approaches to practice and service delivery that are potentially very useful to others, but that are never adequately disseminated (Cleary, Walter, & Luscombe, 2007). This means that other nurses, patients, clients and communities may not ever benefit from the knowledge that has been generated. There is a disconnect between doing and writing and it may be that we are more comfortable with talking than writing, as some information about innovations in practice development and novel approaches to care can only be found in the form of conference abstracts, which, while of some use, tend to lack the contextual and other detail necessary to make full and informed decisions about their efficacy, benefits and potential for further development or application.It is known that there are all sorts of reasons why writing is an activity that can cause avoidance and procrastination in many people (Jackson, 2009). Even where there is a high level of commitment and desire to write, in today's highly pressured organisational environments, it can still be very difficult to find the time to write. So how can we approach writing to facilitate targeted and focused, rather than informal and unplanned, dissemination?Given that there are a limited number of hours in a day, and ever-increasing demand, simple and realistic goal setting is essential. …

Resistance and Reconstruction: Older Women Talk about Childhood Sexual Abuse

Research which explores the experiences of women, who have experienced childhood sexual abuse is, in the main, focused on young and middle aged women. The perspectives of older women is often absent or hidden in the literature. This study explores the experiences of 16 Australian women aged 57 years and older who have experienced childhood sexual abuse. It aims to privilege their views and highlight their particular contexts in order to redress professional assumptions regarding the notions of recovery. Additionally, in discussing their experiences, the women contribute to insights regarding the patterns of inequality which are produced as a result of dominant discourses that promote ageist and sexist prescriptions in the construction of the self. These insights demonstrate how the women have resisted a range of oppressive patterns in their everyday lives. The study follows a feminist research framework and aims to contribute to the fields of social work practice and critical feminist gerontology.

Older women's experiences of depression: a hermeneutic phenomenological study

This hermeneutic phenomenological study, informed by Max van Manen and Martin Heidegger, describes what it is like for four older women to live with depression. Each participant was interviewed up to three times. Interviews were semi-structured, audiotaped and transcribed verbatim. Data were analysed using van Manen's methodological themes and Heidegger's philosophical concepts of Being-in-the-world and Being-with-others. The themes that emerged were: self-loathing; being overwhelmed by the feelings; hiding from the world; the struggle of everyday life; Being-alone; misinterpreting self and other people; the stigma of mental illness - society and self; and seeking understanding from other people. The findings revealed that depression had a major effect on the women's beliefs about themselves, resulting in a self-loathing and a feeling of failure. The participants described how their self-loathing caused them to believe that other people thought badly of them, which led to their withdrawal. Their inability to connect contributed to them feeling alone and isolated. These women were more able to talk to other people when they were met with understanding. This has implications for the therapeutic nurse-patient relationship, which is fundamental to mental health nursing, because the relationship should be based upon an understanding of the patient's world.

The Rhythm of Health in Older Women With Chronic Illness

Trends in population growth indicate that nurses increasingly will be caring for older adults, especially older women, who are at risk for less than optimal health due to chronic illnesses. The purpose of this qualitative study was to obtain a better understanding of the meaning of health from the perspective of older women. Focus group interviews with 51 women, aged 55 to 93, were held. Data were analyzed using directed qualitative content analysis. A Rogerian perspective of human health provided the broad conceptual lens for the study. Three themes explicating the meanings of health emerged from the data: realizing the potential for purpose, listening to energy flow, and purposefully participating in health-related changes. The three themes represented ways in which the women dealt with the paradoxes posed by their chronic illness. Findings captured the hopeful, although sometimes conflicting, meanings of health among the women as brought forth by experiences with chronic illness and the challenges of aging.

Cancer Care From the Perspectives of Older Women

To understand how older age affects cancer care, from the perspectives of older women. Qualitative, participatory. Urban southern region of Ontario, Canada. Purposive sample (age groups and income) of 15 women diagnosed with cancer at age 70 or older; 10 women were diagnosed with breast cancer, 5 with gynecologic cancer. Two face-to-face interviews, with data analysis in collaboration with the project team based on constructivist grounded theory, including negative case analysis. Age, experience of cancer care. Age-related life and health circumstances intersect with professional practice and wider social contexts and are implicated in treatment decision making, including decisions against treatment, as well as in the day-to-day "getting around" that cancer care requires. The nursing history should be holistic in scope, attending to the supportive care domains to elicit older women's physical, social, practical, informational, psychological, and spiritual needs after a diagnosis of cancer. History taking should draw forward older women's life contexts and examine these contexts in relation to cancer care, including treatment decision making. Individual-level care and systems advocacy are required to ensure that older women's worries about sustaining independence, including worries generated by inadequacies in home-based care, do not act as determinants of treatment choices.

Gender Differences in Life Expectancy Free of Impairment at Older Ages

SUMMARY This article uses data from the United Kingdom Medical Research Council Cognitive Function and Ageing study (MRC CFAS) to analyze morbidity associated with three areas of impairment. We use cognitive status, functional status, and physical illness to examine differences in the proportion of time that older women and men will spend with co-morbidity. We also analyze differences among various impairments, and investigate the relationship between missing data and sex. Women have a larger burden of impairment than men, and, by including cognitive impairment together with functional impairment, a very large impairment burden is highlighted at all ages. Policy implications of the findings from the perspective of older women in the United Kingdom are discussed.

“And there's Always this Great Hole Inside that Hurts”: An Empirical Study of Bereavement in Later Life

Stage theoretical approaches to bereavement have long been used in both academic and clinical work. Their impact has been so great that they have permeated lay understanding of bereavement, to become, as Tony Walter puts it, the “clinical lore” of bereavement. This paper examines this clinical lore from the perspective of older women's narratives of widowhood. We suggest that, though these widows experience the sorts of emotions stage theories predict, there is little evidence to support the notion of steady progression from one stage to another. Nor is there evidence to support the idea that widows “recover” from their loss in the sense of surrendering their attachment to the dead, nor that “renewal” equates with a fully restored sense of wellbeing. The widows themselves argue cogently that the idea of “recovery” is an inappropriate (and indeed insensitive) aim for them to strive for. They feel uncomfortable with the pathologizing of lasting grief; they also express strong views about those who try to “help” them. It concludes that, though stage theories are useful in identifying some of the physical effects and emotions associated with bereavement, they do not adequately reflect the experiences of women widowed in later life.