[Anthropological research method. Facing life transitions in an alien culture: the case of American women giving birth in Japan].
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Biomedical subjects
Publications and source records attributed to N S Engel.
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Birth practices in modern Japan differ markedly from those currently observed in the United States and the outcomes are among the best in the world. A fundamental question is whether such practices could be exported apart from the underlying system of cultural values. While autonomy is cherished in America, birth practices in Japan directly and indirectly reflect the values of order and harmony in social groups. Strict adherence to traditional gender roles is seen as promoting the social order. I used a participant-observer approach to study this phenomenon, teaching on a maternity nursing faculty in Japan for two years, providing childbirth counseling in the foreign community, touring various birth facilities, interviewing health professionals and Ministry of Health officials, and bearing my first child in that country.
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Little consensus exists for a definition of health. Economic and other forces are pushing health professionals to develop not only a definition of health consistent with the prevalent construct, holism, but also a means of quantifying health. One approach, which was used as part of a study to explore perceived health status among middle-aged women, was to select measures of specific dimensions of health and to sum scores on each. Factor analysis revealed validity to this approach when Perceived Health Status was operationally defined as the sum of scores on the Health Perceptions Questionnaire, the Affect Balance Scale, and the Life Satisfaction Index.
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The impact of menopausal stage, current life change, and attitude toward traditional women's role on perceived health status was studied in 249 women 40 to 55 years of age. Instruments included the Life Experiences Survey (LES), Index of Sex Role Orientation (ISRO), and the Perceived Health Status (PHS). The relationship between menopausal stage and PHS was inverse and significant, though small. That between the LES score and PHS was inverse and significant. No direct, significant relationship between the ISRO score and PHS was observed. Multiple regression analysis accounted for 15% of variance in PHS.