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PubMed2006

Protocol for stage 1 of the GaP study (Genetic testing acceptability for Paget's disease of bone): an interview study about genetic testing and preventive treatment: would relatives of people with Paget's disease want testing and treatment if they were available?

BACKGROUND: Paget's disease of bone (PDB) is characterised by focal increases in bone turnover, affecting one or more bones throughout the skeleton. This disrupts normal bone architecture and causes pain, deformity, deafness, osteoarthritis, and fractures. Genetic factors are recognised to play a role in PDB and it is now possible to carry out genetic tests for research. In view of this, it is timely to investigate the clinical potential for a programme of genetic testing and preventative treatment for people who have a family history of PDB, to prevent or delay the development of PDB. Evidence from non-genetic conditions, that have effective treatments, demonstrates that patients' beliefs may affect the acceptability and uptake of treatment. Two groups of beliefs (illness and treatment representations) are likely to be influential. Illness representations describe how people see their illness, as outlined in Leventhal's Self-Regulation Model. Treatment representations describe how people perceive potential treatment for their disease. People offered a programme of genetic testing and treatment will develop their own treatment representations based on what is offered, but the beliefs rather than the objective programme of treatment are likely to determine their willingness to participate. The Theory of Planned Behaviour is a theoretical model that predicts behaviours from people's beliefs about the consequences, social pressures and perceived control over the behaviour, including uptake of treatment. METHODS/DESIGN: This study aims to examine the acceptability of genetic testing, followed by preventative treatment, to relatives of people with PDB. We aim to interview people with Paget's disease, and their families, from the UK. Our research questions are:1. What do individuals with Paget's disease think would influence the involvement of their relatives in a programme of genetic testing and preventative treatment? What do relatives of Paget's disease sufferers think would influence them in accepting an offer of a programme of genetic testing and preventative treatment? DISCUSSION: Our research will be informed by relevant psychological theory: primarily the Self-Regulation Model and the Theory of Planned Behaviour. The results of these interviews will inform the development of a separate questionnaire-based study to explore these research questions in greater detail.

Adult↗

PubMed2003

"Retirement lost"-the new role of the elderly as caretakers for orphans in Western Kenya.

A study on the new role of the elderly as caretakers of orphans was conducted in a rural part of Kenya applying a combination of qualitative and quantitative methods. One out of three children had lost at least one biological parent and one of nine had lost both. These figures are increasing exponentially. Most orphans were cared for by relatives, and about one out of five caretakers was 55 years of age or above. These elderly caretakers faced major difficulties in caring for the orphans in terms of schooling, food and medical care. There is a major difference between the present hardships of these caretakers and the traditional position of the elderly in the past. This dramatic deterioration in the situation of the elderly should be seen in the context of the rampant HIV/AIDS epidemic, population growth, changing socio-cultural values, and unfavourable macroeconomic trends.

Adolescent↗

PubMed2003

Institutionalization in Taiwan. The role of caregiver gender.

The role of caregiver gender in the likelihood of institutionalization of Taiwanese older adults was explored in this study. A sample of 78 male and 69 female primary caregivers of elderly patients who had experienced a stroke at least 6 months prior to the study were interviewed. Logistic regression analyses were applied to examine direct and interaction effects of the elderly adult's functioning the caregiver's available resources, the degree of caregiver burden, perceived public opinion toward institutionalization, and precipitating events on the likelihood of institutionalization among Taiwanese male and female caregivers. Women were more likely to institutionalize the older adult for whom they cared. The proposed model correctly predicted the likelihood of institutionalization of an elderly adult based on male versus female caregivers at the 92% level. Perceived public opinion toward institutionalization was the most significant predictor of institutionalization for both genders. Perceived public opinion toward institutionalization has a strong influence on whether or not caregivers institutionalize an elderly relative. This is consistent with Chinese culture in which public opinion has a much stronger effect on individual behavior than in the United States. American concepts of "minding one's own business" do not exist in Taiwan. It is logical that the older adults' level of functioning would predict the likelihood of institutionalization regardless of caregiver gender. In terms of caregiver characteristics, working hours in male caregivers is more predictive, and the quality of the relationship with the older adult was more predictive of institutionalization for female caregivers.

Adult↗

PubMed1997

Coping strategies of people living in multigenerational households: effects on well-being.

Analyses examined whether information about the coping strategies used by family members adds to an understanding about the psychological well-being of individuals. Data from 140 women and their husbands and children who were living in multigenerational households that included a disabled older relative indicated that for the women and children, the best predictors of depression, positive affect, and mastery were their own coping strategies; the coping strategies used by other family members did not add significantly to the predictive equation. For husbands, however, depression was predicted by both their own coping strategies and the coping strategies of their wives. Husbands' positive affect was predicted only by the coping strategies of their wives and children, and their mastery was predicted by their own coping strategies and those of their wives and children.

Adaptation, Psychological↗

PubMed2006

The mother-daughter relationship: what is its potential as a locus for health promotion?

In this article we examine the potential influence of adolescent girls on mothers' health-related knowledge and behaviors. Surveys were conducted with 131 mothers and 145 daughters to explore the extent of shared social activities between mothers and their adolescent daughters in a low-income South African community, and the degree to which mothers are receptive to advice from daughters. Eighty-six percent of daughters reported that their mothers had asked them for advice, and 93% of mothers indicated that they would listen to health advice from their daughters. This analysis suggests that the mother-daughter relationship may be a potential asset for culturally viable, community-based health promotion.

Adolescent↗

PubMedDate not supplied

Meaning of family reunification as interpreted by young Chinese immigrants.

This paper is a narrative analysis of young Chinese immigrants' subjective interpretation of their family reunification in Hong Kong. The major objectives of the study were to understand what family reunification actually meant to them and how it affected their subsequent adjustment. It also tried to examine the similarities and differences in the experience and interpretation of family reunification among young immigrants who had different levels of adjustment. Participants in this study included 45 immigrants, aged between 12 and 17. Research findings show that family reunification was their long-cherished wish and the main reason for their migration. It was not only their primary concern before coming to Hong Kong but also the stance from which separation with close relatives in their native place and the subsequent hardships as a new comer in the competitive host society were justified. Reunification of the family and harmonious and caring relationship among family members had been the source of comfort and support for those who had successful adjustment. However, for those who did not experience warmth and concern from family members, the disillusionment with a happy family reunification and the experience of distant or even conflictive family relationship had not only created in them a sense of alienation but also resulted in poor adjustment in the new environment.

Adolescent↗

PubMed1991

Generational equity and public health policy: a critique of "age/race war" thinking.

A potent new tool in the politics of fiscal retrenchment lies in the creation of a framework for policy analysis which implicitly or explicitly "blames" the old for poverty and economic hardships in the young. This paper examines the recent efforts to promulgate this generational equity or "age/race wars" perspective and demonstrates that opinion poll data fail to support the rhetoric of growing age/race group antagonisms over entitlement programs for the old. The assumptions underlying the generational equity framework are critiqued, and the race and ethnic issues embedded within this framework are examined. In particular, we explore spurious assumptions concerning the relative financial wellbeing of the elderly, escalating Social Security and Medicare costs as a primary cause of poverty in the young, and growing resentment of programs for the old among minorities and youth. Attempts to deligitimate the claims of the elderly through the advancement of the ideology of age/race wars are seen to have significant implications for public health policy, with the country's recent experience with the Medicare Catastrophic Coverage Act serving as an important case in point. The need for an alternative policy framework stressing the interdependence of generations is suggested, and some guiding principles put forward toward the development of such an alternative framework.

Age Factors↗

PubMedDate not supplied

The influence of ethnicity and generational status on parent and family relations among Chinese and Filipino adolescents.

OBJECTIVE: The purpose of this study was to explore the influence of ethnic and generational differences on perceptions about parent and family relationships in a nationally representative sample of Chinese and Filipino adolescents living in the United States. DESIGN: This was a cross-sectional descriptive study, utilizing data from the National Longitudinal Study on Adolescent Health. SAMPLE: The sample was weighted to produce a nationally representative sample, based on 216 self-identified Chinese and 387 self-identified Filipino adolescents. RESULTS: Results indicated that generational status plays a role in predicting how adolescents perceive the parent-adolescent relationship. CONCLUSIONS: Findings provide a basis by which community health nurses can begin to understand the uniqueness of Asian subgroups, as well as generations of immigrant youth.

Adolescent↗

PubMed2003

Transforming vulnerability.

Asian American immigrant women engaged in filial caregiving are at special risk for health problems due to complex contextual factors related to immigration, cultural traditions, and role transition. This study examines the experience of two groups of immigrant Asian American women who are caring for older parents. A total of 41 women (22 Chinese American and 19 Filipino American) were interviewed in a study based on Strauss and Corbin's grounded theory methodology. The women were determined to be loyal to their traditional culture, which included strong filial values, while adapting to a new culture. Through the struggle of meeting role expectations and coping with paradox, the women mobilized personal and family resources to transform vulnerability into strength and well-being.

Adaptation, Psychological↗

PubMed2003

Social interaction distance and stratification.

There have been calls from several sources recently for a renewal of class analysis that would encompass social and cultural, as well as economic elements. This paper explores a tradition in stratification that is founded on this idea: relational or social distance approaches to mapping hierarchy and inequality which theorize stratification as a social space. The idea of 'social space' is not treated as a metaphor of hierarchy nor is the nature of the structure determined a priori. Rather, the space is identified by mapping social interactions. Exploring the nature of social space involves mapping the network of social interaction--patterns of friendship, partnership and cultural similarity--which gives rise to relations of social closeness and distance. Differential association has long been seen as the basis of hierarchy, but the usual approach is first to define a structure composed of a set of groups and then to investigate social interaction between them. Social distance approaches reverse this, using patterns of interaction to determine the nature of the structure. Differential association can be seen as a way of defining proximity within a social space, from the distances between social groups, or between social groups and social objects (such as lifestyle items). The paper demonstrates how the very different starting point of social distance approaches also leads to strikingly different theoretical conclusions about the nature of stratification and inequality.

Hierarchy, Social↗

PubMedDate not supplied

A follow-up case study on teenage pregnancy: "havin' a baby isn't a nightmare, but it's really hard".

Two adolescent mothers who participated in a previously published study on teenage pregnancy agreed to participate in follow-up interviews in their homes about 1 1/2 years after giving birth. A naturalistic, qualitative case study approach was used to examine the participants' views and perceptions related to adolescent pregnancy and childbearing. Both mothers reported general satisfaction with their lives as young mothers, but indicated that their attitudes about early maternity changed once they experienced the day-to-day realities of motherhood. Overall, the participants adequately managed single motherhood with support from family. Regrets and hopes for a better future, mended and broken relationships, and thinking about and avoiding or engaging in fighting behavior were themes that emerged from the data. In addition, some of the findings of this case study were compared and contrasted with the initial study (Spear, 2001), and implications for practice and research are discussed.

Adaptation, Psychological↗

PubMedDate not supplied

Older widows' intention to keep the generations separate.

As the population ages, increasing numbers of older persons face decisions related to their living arrangements. In predictive studies of coresidence of older parents and their adult children, scholars have not studied older persons' preferred living arrangements. To consider the intentions of 16 older widows with regard to their future situations, a descriptive phenomenological investigation was conducted. The phenomenon "keeping the generations separate" is presented with its two components: continuing to live alone at home and avoiding being a burden to the children. Considered in the contexts of their experience of living alone at home and the life-world, "keeping the generations separate" is a source of insight about influences on older widows' preferences for future living arrangements.

Activities of Daily Living↗

PubMed2005

Strengthening American Indian nurse scientist training through tradition: partnering with elders.

American Indian elders have long been the grandparents to not only their own relatives but also other 'grandchildren' in their tribes, clans and extended families. This worldview demands an elder-youth connection and has been integral to the success of the "American Indian MS to PhD Nursing Science Bridge" at the University of Minnesota, School of Nursing. Elders support the program mission to increase the number (from 12) of doctorally prepared Native nurses. They have been participants in formal and informal programming, special advising, and presence from reservations and in urban Minneapolis. Program feedback reveals cultural value in the elders' presence.

Adult↗

PubMed1999

Family experiences related to the decision to institutionalize an elderly member in Taiwan: an exploratory study.

Industrialization and urbanization have changed the structure of Taiwanese families. Placing elder family members with impairments in nursing homes has become a new caregiving alternative. However, Taiwanese commonly consider this placement to be a violation of traditional filial obligation. Therefore, institutionalization is a highly sensitive cultural issue. Data were gathered through semi-structured interviews with nine family members, revealing three major processes in the decision of institutionalization -- breaking harmony, rebuilding harmony and evolution, as well as four important factors that influence the decision -- the quality of the relationship between the elder and his/her family, characteristics of the elder, financial condition of the family and perceived public opinion toward institutionalization. The findings suggest that the decision process in institutionalization is a gradual, fluid, cyclical movement without definite steps.

Adult↗

PubMed2004

Generations Exercising Together to Improve Fitness (GET FIT): a pilot study designed to increase physical activity and improve health-related fitness in three generations of women.

A 6-month home-based (HB) physical activity program was compared to a control (CTL) condition in terms of effect on physical activity and health-related fitness in three generations of women (daughter/ mother/maternal grandmother). Volunteers were randomly assigned to a HB or CTL condition. HB participants (n = 28) were asked to participate in lifestyle, aerobic, muscular strength, and flexibility activities at least 3 times per week and they completed 73% of the recommended PA bouts. CTL condition participants (n = 9) were asked to continue their usual pattern of physical activity. Changes in physical activity were measured pre-and post-intervention using the Physical Best questionnaire and pedometer step counts (3-day average). Changes in health-related fitness were assessed using Fitnessgram tests. Group x Time interactions were significant for changes in participation in flexibility activity (d/wk) and steps/day, indicating that the HB group experienced significant positive changes in the expected direction (+305% and +37%, respectively), while the CTL group regressed (-15% and -13%, respectively). The G x T interaction for mile time was significant, although not in the expected direction (CTL group < by 14% and HB group < by 5%). Findings should be interpreted with caution due to several limitations of the study, but several suggestions are made for more effectively studying this topic in the future.

Adolescent↗

PubMed2006

Sex, gender role orientation, gender role attitudes and suicidal thoughts in three generations. A general population study.

BACKGROUND: Suicide and other suicidal behaviours are markedly (though differently) patterned by gender. The increase in young male suicide rates in many countries has heightened interest in whether suicidal behaviours and ideation (thoughts) are related to masculinity. Relatively little research has explored the relationship between gender role attitudes and orientation and suicidal behaviours and ideation. Most research in this area has been conducted with young people. OBJECTIVE: We investigated whether gender role orientation (masculinity and femininity scores) and gender role attitudes were related to the reporting of serious suicidal thoughts in three generations (early adulthood, and early and late middle age) in a community sample. METHODS: Subjects (653 men and women aged around 23 years, 754 aged around 43 years, 722 aged around 63 years) completed home interviews with nurses as part of an ongoing longitudinal community-based study of social factors and health. These included measures of suicidal ideation (thoughts), attitudes to traditional gender roles, and a validated measure of gender role orientation (masculinity and femininity scores). RESULTS: The prevalence of serious suicidal thoughts was higher in early adulthood (10% men, 15% women) than in early (4% men, 8% women) and late (6% men, 5% women) middle age. In early adulthood only sex was significantly related to suicidal thoughts, with women at higher risk (adjusted OR 1.74, 95% CI 1.01-3.00). In early middle age masculinity scores were negatively related to suicidal thoughts (adjusted OR for each unit increase in score 0.65: 95% CI 0.46-0.93), and more traditional views on gender roles were positively associated with suicidal thoughts (adjusted OR 1.48: 95% CI 1.07-2.04). In late middle age trends were in the same direction as in early middle age, but were not statistically significant. Femininity scores were unrelated to serious suicidal thoughts at any age. CONCLUSION: The high rates of suicidal thoughts amongst men and women in early adulthood point to the importance of understanding mental health problems at this age. The results raise a number of questions and suggest that suicide researchers should pay more attention to gender roles and attitudes in older adults.

Adult↗

PubMed2006

Peer and family influences on adolescent anger expression and the acceptance of cross-gender aggression.

Past research has examined the relative impact of family and peers on adolescent behavior, but very little research has examined it in relation to youth dating violence. Eight hundred and sixty-five adolescents, primarily urban Latino youth, completed self-administered surveys at school. Multivariate analyses indicated that exposure to prior family violence was not significantly associated with adolescents' aggressive expression of anger or their acceptance of cross-gender aggression. However, current conflict--either family or peer--was associated with adolescent behavior and attitudes, with the exception that current peer conflict was not significantly associated with adolescents' acceptance of male on female aggression. Parental monitoring and attachment were not found to be moderators of these relationships. Implications for dating violence interventions and future directions for research are explored.

Adolescent↗

PubMed1992

Long-term care personnel assess their attitudes and knowledge of the older adult.

The purpose of this study was to compare long-term care employees' attitude and knowledge about myths of ageing and normal age changes, before and after exposure to formal educational sessions. The researchers investigated if there was a difference in knowledge level and change in attitudes of long-term care employees after educational sessions. The subjects for this study were defined as persons who had any contact with the residents at St Charles Care Center. The final data set used in the analysis contained 84 observations. Each participant attended three 1-hour classes which consisted of simulation of handicaps, normal age-related changes, and myths and realities of ageing. Overall, there was a significant increase in knowledge from the pre-test to the post-test. The study also tested for a negative (anti-aged) bias attitude and a positive (falsely pro-aged) bias attitude among the individuals. At the end of the study there was still a slight negative biased attitude towards ageing. The data suggest that continuing education is an effective means of influencing the knowledge and attitudes of personnel in long-term care facilities. Recommendation for future research should be that this study be replicated in another long-term care facility with the addition of a job satisfaction tool.

Aged↗