“Continuing the Connection” or “Carrying On”? A Qualitative Evidence Synthesis of How Widows Explain the Physical Health Outcomes After Spousal Loss

2020 ◽  
pp. 106648072097341
Author(s):  
Umair Majid ◽  
Jeffrey Ennis
Keyword(s):  
Health Outcomes ◽  
Physical Health ◽  
Meaning Making ◽  
Evidence Synthesis ◽  
Well Being ◽  
Qualitative Evidence Synthesis ◽  
Spousal Loss ◽  
Physical Health Outcomes ◽  
Qualitative Evidence ◽  
Increased Risk

The experience of losing a loved one can have profound effects on physical and psychological well-being, and previous research has reported an increased risk of mortality after spousal loss. This qualitative evidence synthesis reviewed 16 studies on the perspectives of widows who experienced adverse physical health outcomes after spousal loss. This review examines how widows described or explained the physical health outcomes after losing their spouse. We found that widows implicitly associated the physical health outcomes they experienced with losing their spouse. They described that losing their spouse exacerbated preexisting illness and led to new disease conditions such as heart failure, rheumatoid arthritis, infections, acute urinary retention, shingles, and impaired mobility. While these physical health outcomes limited widows’ ability to come to terms with their loss, widows in multiple studies prioritized the emotional and mental consequences associated with grief over any physical health outcomes they experienced. Furthermore, since the deceased spouse performed caregiving responsibilities, the surviving spouse experienced a shift from caregiving to self-management of their preexisting medical condition. In situations where widows were unable to meet their own health needs, they experienced an intensification of their own illness. Given these findings, we consider the relationship between widows’ meaning-making and physical and clinical outcomes. We discuss how meaning-making can contribute to severe emotional, mental, and physical health outcomes after a traumatic event such as spousal loss.

scholarly journals Long-Term Physical Health Outcomes of Resettled Refugee Populations in the United States: A Scoping Review

2021 ◽  
Author(s):  
Gayathri S. Kumar ◽  
Jenna A. Beeler ◽  
Emma E. Seagle ◽  
Emily S. Jentes
Keyword(s):  
Health Outcomes ◽  
Physical Health ◽  
Public Health Practice ◽  
The United States ◽  
Inclusion Criteria ◽  
Physical Health Outcomes ◽  
Increased Risk ◽  
The Us ◽  
Bhutanese Refugee

AbstractSeveral studies describe the health of recently resettled refugee populations in the US beyond the first 8 months after arrival. This review summarizes the results of these studies. Scientific articles from five databases published from January 2008 to March 2019 were reviewed. Articles were included if study subjects included any of the top five US resettlement populations during 2008–2018 and if data described long-term physical health outcomes beyond the first 8 months after arrival in the US. Thirty-three studies met the inclusion criteria (1.5%). Refugee adults had higher odds of having a chronic disease compared with non-refugee immigrant adults, and an increased risk for diabetes compared with US-born controls. The most commonly reported chronic diseases among Iraqi, Somali, and Bhutanese refugee adults included diabetes and hypertension. Clinicians should consider screening and evaluating for chronic conditions in the early resettlement period. Further evaluations can build a more comprehensive, long-term health profile of resettled refugees to inform public health practice.

scholarly journals Hispanic/Latino Ethnic Identity and Diabetes: An Examination of Underlying Acculturation Processes and the Hispanic/Latino Health Advantage

2021 ◽  
Vol 48 (3) ◽  
pp. 285-294
Author(s):  
Jeannie B. Concha ◽  
Kristen Kelly ◽  
Briana Mezuk
Keyword(s):  
Ethnic Identity ◽  
Confidence Interval ◽  
Health Outcomes ◽  
Physical Health ◽  
Odds Ratio ◽  
Well Being ◽  
The United States ◽  
Diabetes Prevalence ◽  
Physical Health Outcomes ◽  
The Relationship

Background. Hispanics/Latinos in the United States experience both a health advantage and disadvantage in developing diabetes. Ethnic identity, a predictor of psychological well-being, has not been widely applied to physical health outcomes. The objective of this study is to apply what is known regarding ethnic identity and psychological health to physical health outcomes (diabetes) and to explore the moderating effect of education as a possible underlying mechanism of the Hispanic Health Advantage/Disadvantage. Specifically, this study examines (a) the association between ethnic identity and diabetes prevalence among adult Hispanics/Latinos and (b) determines whether education modifies this relationship. Method. Data come from the nationally representative adult U.S. household study, National Latino and Asian American Study (NLAAS), collected in 2001 to 2003 ( N = 1,746). Multiple logistic regression was conducted to examine the relationship between ethnic identity, education, and their interaction with likelihood of diabetes. Results. Hispanics/Latinos with high ethnic identity have a higher odds of reporting diabetes among those with 13 to 15 years of education (odds ratio: 1.84; 95% confidence interval: 1.16–2.92) and a lower odds among those with 16+ years of education (odds ratio: 0.53; 95% confidence interval: 0.34–0.84). Ethnic identity is associated with diabetes prevalence and the relationship is moderated by educational attainment. Conclusion. Given the growth, diversity, and diabetes disparities among Hispanics/Latinos, our buffering and exacerbating findings exemplify the complexity and fluidity of theory in understanding psychological/behavioral processes. The findings highlight the importance of designing targeted health interventions that take into account the diverse psychosocial and educational experiences of Hispanics/Latinos.

The Widowhood Effect: Explaining the Adverse Outcomes After Spousal Loss Using Physiological Stress Theories, Marital Quality, and Attachment

2020 ◽  
Vol 28 (3) ◽  
pp. 241-246 ◽  
Author(s):  
Jeffrey Ennis ◽  
Umair Majid
Keyword(s):  
Health Outcomes ◽  
Marital Quality ◽  
Physiological Stress ◽  
Adverse Outcomes ◽  
Loved One ◽  
Spousal Loss ◽  
Adverse Health Outcomes ◽  
Physical Health Outcomes ◽  
Risk Of Mortality ◽  
Increased Risk

The loss of a loved one is one of the most ubiquitous life experiences. There have been multiple reviews that have found adverse health outcomes for individuals experiencing spousal loss, particularly the widowhood effect that characterizes an increased risk of mortality after loss. However, there is a lack of clarity on the relationship between physiological stress and the widowhood effect. This commentary uses the literature on stress, marital quality, and attachment to explain the widowhood effect and other adverse physical health outcomes. We discuss three points: (1) the chronic nature of stress may be the source of adverse outcomes, (2) the quality and quantity of available resources may moderate the effects of stress, and (3) the level and style of attachment may explain why these outcomes may persist many years after spousal loss.

scholarly journals Women’s perceptions and experiences of reproductive coercion and abuse: a qualitative evidence synthesis

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261551
Author(s):  
Jessica E. Moulton ◽  
Martha Isela Vazquez Corona ◽  
Cathy Vaughan ◽  
Meghan A. Bohren
Keyword(s):  
Social Inequalities ◽  
Evidence Synthesis ◽  
Well Being ◽  
Asia Pacific ◽  
Public Health Issue ◽  
Qualitative Evidence Synthesis ◽  
Women’S Experiences ◽  
Reproductive Coercion ◽  
Women's Experiences ◽  
Qualitative Evidence

Background Reproductive coercion and abuse is a major public health issue, with significant effects on the health and well-being of women. Reproductive coercion and abuse includes any form of behaviour that intentionally controls another person’s reproductive choices. The aim of this qualitative evidence synthesis is to explore women’s experiences of reproductive coercion and abuse globally, to broaden understanding of the different ways reproductive coercion and abuse is perpetrated, perceived and experienced across settings and socio-cultural contexts. Method We searched Medline, CINAHL and Embase for eligible studies from inception to 25th February 2021. Primary studies with a qualitative study design that focused on the experiences and perceptions of women who have encountered reproductive coercion and abuse were eligible for inclusion. Titles and abstracts, and full texts were screened by independent reviewers. We extracted data from included studies using a form designed for this synthesis and assessed methodological limitations using CASP. We used Thomas and Harden’s thematic analysis approach to analyse and synthesise the evidence, and the GRADE-CERQual approach to assess confidence in review findings. Results We included 33 studies from twelve countries in South Asia, the Asia Pacific, North America, South America, Africa and Europe. Most studies used in-depth interviews and focus group discussions to discuss women’s experiences of reproductive coercion and abuse. Reproductive coercion and abuse manifested in a range of behaviours including control of pregnancy outcome, pregnancy pressure or contraceptive sabotage. There were a range of reasons cited for reproductive coercion and abuse, including control of women, rigid gender roles, social inequalities and family pressure. Women’s different responses to reproductive coercion and abuse included using covert contraception and feelings of distress, anger and trauma. Across contexts, perpetration and experiences of reproductive coercion and abuse were influenced by different factors including son preferences and social exclusion. Conclusions We reflect on the importance of socio-cultural factors in understanding the phenomenon of reproductive coercion and abuse and how it affects women, as well as how the mechanisms of power and control at both individual and societal levels work to perpetuate the incidence of reproductive coercion and abuse against women.

scholarly journals Exploring the facilitators, barriers, and strategies for self-management in adults living with severe mental illness, with and without long-term conditions: A qualitative evidence synthesis

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0258937
Author(s):  
Abisola Balogun-Katung ◽  
Claire Carswell ◽  
Jennifer V. E. Brown ◽  
Peter Coventry ◽  
Ramzi Ajjan ◽  
...  
Keyword(s):  
Mental Illness ◽  
Physical Health ◽  
Severe Mental Illness ◽  
Evidence Synthesis ◽  
Barriers And Facilitators ◽  
Self Management ◽  
Qualitative Evidence Synthesis ◽  
Long Term Conditions ◽  
Qualitative Evidence

Background People living with severe mental illness (SMI) have a reduced life expectancy by around 15–20 years, in part due to higher rates of long-term conditions (LTCs) such as diabetes and heart disease. Evidence suggests that people with SMI experience difficulties managing their physical health. Little is known, however, about the barriers, facilitators and strategies for self-management of LTCs for people with SMI. Aim To systematically review and synthesise the qualitative evidence exploring facilitators, barriers and strategies for self-management of physical health in adults with SMI, both with and without long-term conditions. Methods CINAHL, Conference Proceedings Citation Index- Science, HMIC, Medline, NICE Evidence and PsycInfo were searched to identify qualitative studies that explored barriers, facilitators and strategies for self-management in adults with SMI (with or without co-morbid LTCs). Articles were screened independently by two independent reviewers. Eligible studies were purposively sampled for synthesis according to the richness and relevance of data, and thematically synthesised. Results Seventy-four articles met the inclusion criteria for the review; 25 articles, reporting findings from 21 studies, were included in the synthesis. Seven studies focused on co-morbid LTC self-management for people with SMI, with the remaining articles exploring self-management in general. Six analytic themes and 28 sub-themes were identified from the synthesis. The themes included: the burden of SMI; living with co-morbidities; beliefs and attitudes about self-management; support from others for self-management; social and environmental factors; and routine, structure and planning. Conclusions The synthesis identified a range of barriers and facilitators to self-management, including the burden of living with SMI, social support, attitudes towards self-management and access to resources. To adequately support people with SMI with co-morbid LTCs, healthcare professionals need to account for how barriers and facilitators to self-management are influenced by SMI, and meet the unique needs of this population.

scholarly journals Forgiveness of others and subsequent health and well-being in mid-life: a longitudinal study on female nurses

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Katelyn N. G. Long ◽  
Everett L. Worthington ◽  
Tyler J. VanderWeele ◽  
Ying Chen
Keyword(s):  
Mental Health ◽  
Psychological Distress ◽  
Health Behaviors ◽  
Health Outcomes ◽  
Physical Health ◽  
Well Being ◽  
The United States ◽  
Physical Health Outcomes ◽  
Female Nurses ◽  
Forgiveness Of Others

Abstract Background Forgiveness is a concept of growing interest within psychology and of potential relevance to public health. While there has been increasing evidence suggesting positive associations between forgiveness of others and a range of psychosocial well-being and mental health outcomes, its associations with health behaviors and physical health are less clear. Methods This study used longitudinal data from the Nurses’ Health Study II (2008 Trauma Exposure and Post-traumatic Stress Supplementary Survey to 2015 questionnaire wave, N = 54,703), to conduct an outcome-wide analysis among a cohort of female nurses in the United States (age range: 43–64 years). The study prospectively examines the association between spiritually motivated forgiveness of others and a number of of subsequent psychosocial well-being, mental health, health behavior, and physical health outcomes in midlife. A set of linear, logistic, and Poisson regression models were used to regress each outcome on forgiveness in separate models. Sociodemographic factors, prior religious service attendance, and prior values of all outcome variables were controlled for wherever data were available. To account for multiple testing, we performed Bonferroni correction. Results Forgiveness was associated with subsequent improved psychosocial well-being and reduced psychological distress outcomes in a monotonic pattern. For instance, the top versus bottom level of forgiveness was associated with substantially higher levels of subsequent positive affect (β = 0.18, 95% CI: 0.15, 0.21) and social integration (β = 0.15, 95% CI: 0.13, 0.17), and was inversely associated with several indicators of subsequent psychological distress such as depressive symptoms (β = − 0.16, 95% CI: − 0.19, − 0.14). However, in this sample, there was little evidence that forgiveness was associated with health behaviors or physical health outcomes. Discussion This study suggests that forgiveness may be a health asset for promoting population mental health and psychosocial well-being, and moreover may also be understood as a good in itself. Further investigation on the dynamics between forgiveness and physical health is warranted to explore the discrepancy between the results here and some past research.

scholarly journals Effects of non-pharmacological and non-surgical interventions on health outcomes in systemic sclerosis: protocol for a living systematic review

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e047428
Author(s):  
Marie-Nicole Discepola ◽  
Andrea Carboni-Jiménez ◽  
Linda Kwakkenbos ◽  
Richard S Henry ◽  
Jill Boruff ◽  
...  
Keyword(s):  
Systematic Review ◽  
Systemic Sclerosis ◽  
Health Outcomes ◽  
Physical Health ◽  
Well Being ◽  
Cochrane Library ◽  
Pharmacological Interventions ◽  
Surgical Interventions ◽  
Physical Health Outcomes ◽  
Mental And Physical Health

IntroductionSystemic sclerosis (SSc; scleroderma) is a rare, chronic, autoimmune disease with a high level of burden, a significant impact on the ability to carry out daily activities, and a considerable negative impact on health-related quality of life. Non-pharmacological interventions could be provided to potentially improve mental and physical health outcomes. However, the effectiveness of non-pharmacological interventions on health and well-being among individuals with SSc has not been well established. The proposed living systematic review aims to identify and evaluate randomised controlled trial (RCT) evidence on the effectiveness of non-pharmacological and non-surgical interventions on mental and physical health outcomes and on the delivery of such services in SSc.Methods and analysisEligible studies will be RCTs that examine non-pharmacological and non-surgical interventions aimed at improving health outcomes among individuals with SSc or the delivery of services intended to improve healthcare or support of people with SSc (eg, support groups). All RCTs included in a previous systematic review that sought studies published between 1990 and March 2014 will be evaluated for inclusion. Additional trials will be sought from January 2014 onwards using a similar, augmented search strategy developed by a health sciences librarian. We will search the MEDLINE, Embase, CINAHL, PsycINFO, Cochrane Library and Web of Science databases and will not restrict by language. Two independent reviewers will determine the eligibility of identified RCTs and will extract data using a prespecified standardised form in DistillerSR. Meta-analyses will be considered if ≥2 eligible RCTs report similar non-pharmacological interventions and comparable health outcomes. We will conduct a qualitative synthesis for interventions that cannot be synthesised via meta-analysis.Ethics and disseminationWe will post initial and ongoing results via a website, publish results periodically via peer-reviewed journal publication, and present results at patient-oriented events.PROSPERO registration numberCRD42020219914.

The Impact of Caring for Grandchildren on Grandparents’ Physical Health Outcomes: The Role of Intergenerational Support

2016 ◽  
Vol 39 (5) ◽  
pp. 612-634 ◽  
Author(s):  
Jing Zhou ◽  
Weiyu Mao ◽  
Yura Lee ◽  
Iris Chi
Keyword(s):  
Longitudinal Data ◽  
Health Outcomes ◽  
Physical Health ◽  
Rural China ◽  
Well Being ◽  
Intergenerational Support ◽  
Grandparent Caregivers ◽  
Physical Health Outcomes ◽  
The Impact

Little longitudinal data exist on grandparent caregivers and few studies have examined their physical health outcomes. This study examined the effect of caring for grandchildren on grandparents’ physical health and the role of intergenerational support from adult children. Longitudinal data derived from a survey on the well-being of older adults in China were used to conduct path analysis of previous grandparent caregivers (vs. noncaregivers) and repeated grandparent caregivers (vs. noncaregivers). The final sample was 799 grandparents aged 60 or older living in rural China. Three aspects of intergenerational support were measured: financial, emotional, and instrumental support. Repeated grandparent caregivers had better self-rated health (SRH) and fewer limitations than noncaregivers. Previous grandparent caregivers had better SRH compared to noncaregivers. Emotional support mediated the relationship between caregiving and SRH among repeated caregivers. Findings suggest that any caregiving experience (previous or repeated) provides health benefits to grandparents.

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