Women & Health

Simoni, Jane M.; Huang, Bu; Goodry, Elissa J.; Montoya, Heidi D.

doi: 10.1300/J013v42n04_01pmid: 16782673

Women constitute an increasing proportion of individuals contracting HIV in the United States and, once diagnosed, are living longer lives since the advent of combination antiretroviral therapies. HIV-positive women, who are disproportionately ethnic minority, face unique challenges to their psychosocial adaptation. Findings from a survey of 373 mainly indigent African-American and Puerto Rican women living with HIV/AIDS in the New York City area indicated high levels of depressive symptomatology, which were inversely related to HIV-related social support from friends, relatives, partner, and groups/organizations. In line with the Cognitive Adaptation Model, structural equation modeling indicated that psychological resourcefulness (i.e., self-esteem and mastery) mediated the effects of social support on depressive symptomatology. Findings suggest the need to assess HIV-positive women for social isolation and depression and to provide them with interventions such as support groups that capitalize on their existing strengths, including their psychological resourcefulness.

Engelman, Kimberly K.; Cizik, Amy M.; Ellerbeck, Edward F.

doi: 10.1300/J013v42n04_02pmid: 16782674

Objective: Many steps in getting a mammogram may produce a less than satisfactory experience. Dissatisfaction with mammography could lead to lower routine mammography adherence. The purpose of this study was to use qualitative research methods to assess patient satisfaction with all stages of the mammography experience. Methods: Eleven focus groups were conducted with 103 women in rural (N=6) and urban (N=5) communities. Separate groups were held for African-American, non-Hispanic White, and Hispanic women. Participants spoke English, were 40 years of age or older, had a mammogram within the past three years, and had no history of cancer. Transcripts were analyzed for major themes related to mammography satisfaction. Results: Participants described 39 variables that affected their mammography satisfaction that may be categorized into seven primary themes: (1) appointment scheduling, (2) facility, (3) general exam, (4) embarrassment, (5) exam discomfort/pain, (6) treatment by the technologist, and (7) reporting results. The most common issues voiced were convenience and ease of scheduling appointments and follow-up tests, waiting room time and comfort, treatment by technologists, pain, and results reporting procedure and timing. Conclusions: Satisfaction was not limited to the mammography procedure itself, but encompassed the entire experience from appointment scheduling to receipt of results and arranging follow-up. These findings indicated a variety of areas that mammography facilities might address to enhance mammography satisfaction.

Gardner, Rebecca Ellis; Hausenblas, Heather A.

doi: 10.1300/J013v42n04_03pmid: 16782675

The purpose of this study was to examine prospectively the ability of direct and belief-based measures of the theory of planned behavior (TPB) constructs to predict exercise and diet intention and behavior of overweight women. Participants were 117 overweight, community-dwelling women and university students enrolled in a 4-week exercise and diet program. Participants completed baseline measures of demographic characteristics and the TPB constructs. Their exercise and diet adherence were also recorded. We found that: (1) the direct measure of perceived behavioral control (PBC) predicted exercise intention, (2) the direct measures of instrumental attitude, subjective norm, and PBC predicted diet intention, and (3) none of the direct or belief-based measures of the TPB constructs predicted 4-week exercise or diet behavior. Furthermore, several beliefs were associated with the direct measures of attitude, subjective norm, PBC, and intention. Implications of these results for designing exercise and diet interventions with overweight women are discussed.

Urizar, Guido G.; Hurtz, Shannon Q.; Albright, Cheryl L.; Ahn, David K.; Atienza, Audie A.; King, Abby C.

doi: 10.1300/J013v42n04_04pmid: 16782676

Few studies have examined the impact of motherhood on successful participation in physical activity (PA) interventions. The current study focused on mothers in the Increasing Motivation for Physical Activity or IMPACT study, which aimed to promote PA in sedentary, low-income, ethnically diverse women (74% Latina). The aim of this study was to determine whether certain maternal variables (e.g., number of children, number and intensity of maternal stressors) influenced successful participation in an 8-week, class-based, PA intervention. PA consisted of accumulating 30 minutes or more of moderate-intensity activities (e.g., walking) five or more days a week. Sixty-eight mothers (average age = 32 years) were assessed at baseline and 10 weeks. Paired comparison t-tests demonstrated a significant increase in PA-related energy expenditure from baseline to 10 weeks (p < 0.05). Furthermore, this increase in PA was significantly associated with a decrease in the number of maternal stressors reported over this time period (p < 0.01). Simultaneous regression analyses indicated that (1) having a higher number of maternal stressors at baseline was associated with lower class attendance (p ≤ 0.05) and (2) rating these maternal stressors (e.g., unable to control children's behavior) as being more stressful at baseline was associated with lower levels of PA at 10 weeks (p ≤ 0.01), independent of the number of children at home. These results suggest that the number and intensity of perceived maternal stressors may negatively impact attempts to become more physically active. Interventions should address such stressors.

Keogh, Louisey A.

doi: 10.1300/J013v42n04_05pmid: 16782677

The contradictions faced by women in the area of fertility management justify an in-depth qualitative study of contraceptive use. The experience of needing emergency contraception (EC) is an opportunity to study decision-making about fertility management. Thirty-two in-depth interviews were conducted with users of EC recruited in Melbourne, Australia. Women were juggling the needs of the sexual body and the fertile body. The sexual body was expected to be available in women's relationships, and the fertile body required protection from pregnancy in the present and preservation for the future. The needs of these two bodies were very often in conflict and women chose to resolve this conflict in subtly different ways; three strategies were identified. Some women chose to make sexual availability and security from pregnancy a priority; others felt forced to sacrifice sexual availability and security from pregnancy; and a final group chose to make the protection of the fertile body for the future a priority. This study provides a starting point for developing a context-based, woman-centered understanding of the experience of fertility management for women in developed countries.

MacInnes, J. D.

doi: 10.1300/J013v42n04_06pmid: 16782678

Coronary heart disease (CHD) has been socially constructed as a gender-specific disease, with women seen not to be at risk (Lockyer, 2002). This is despite CHD being the leading cause of mortality in both men and women in the Western world (DH, 2004). The aim of this research was to explore the illness perceptions of a sample of women following acute myocardial infarction (MI). Relationships between illness perceptions and adoption of health-promoting behaviours, and attendance at a programme of cardiac rehabilitation were explored. The influence of age was also considered. Leventhal and Nerenz' Self-Regulatory Model of Illness Behaviour (1985) was used as the theoretical framework. This model consists of three stages: interpretation of symptoms, coping and appraisal. A qualitative research design was used. A purposeful sample of 10 women was selected on the basis of age and decision to attend cardiac rehabilitation. Data were collected by semi-structured interview, 3 months following the acute infarct, and analysed thematically. Stress was considered to be the cause of the MI, and although lifestyle factors were recognized, their significance was uncertain; perhaps as a result, lifestyle changes were limited. Overall, women had a perceived lack of control over the illness. The decision to attend a cardiac rehabilitation programme was influenced by beliefs relating to the identification of a known cause and level of perceived control of the illness. A belief that the illness was inevitable seemed to be more prevalent in older aged women. These findings have implications for health service providers in that they suggest that illness perceptions need to be explored and addressed before the decision to attend a programme of cardiac rehabilitation is made and health-promoting behaviours adopted.

Muula, Adamson S.

doi: 10.1300/J013v42n04_07pmid: 16782679

Lindgren, Teri; Rankin, Sally; Rankin, William

doi: 10.1300/J013v42n04_08pmid: N/A

Brown, Tamara Mose; Bownds, Lynne

doi: 10.1300/J013v42n04_09pmid: N/A