PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Women's Status--changes”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 37 records · Page 2Linked to original sources
PubMed1997

Measuring quality of life in women with osteoporosis. Osteoporosis Quality of Life Study Group.

The objective of the study was to test an instrument for measuring health-related quality of life (HRQL) for women with osteoporosis and back pain caused by vertebral fractures related to osteoporosis. A longitudinal cohort study design was used in which women were seen at baseline, after 2 weeks, and after 6 months. The setting was a secondary care rheumatology practice in Canada and four separate secondary care metabolic bone disease practices in the United States. The patients were 226 women suffering from osteoporosis and back pain with a mean bone mineral density of 0.84 +/- 0.14 g/cm2 and a mean of 2.78 (median 2, range 1-11) vertebral fractures. We administered the Osteoporosis Quality of Life Questionnaire (OQLQ) with 30 items distributed across five domains: Symptoms, Physical Function, Activities of Daily Living, Emotional Function, and Leisure. In addition, we administered the Sickness Impact Profile (SIP), the 36-item short form of the Medical Outcomes Survey instrument (MOS SF-36), and the Brief Pain Inventory (BPI). On the basis of what women told us about the areas of their lives adversely affected by their osteoporosis, we constructed the OQLQ. Reliability coefficients between baseline and 2-week follow-up varied from 0.80 to 0.89 for the five domains. Cross-sectional correlations between OQLQ domains and other measures were consistently higher than predicted (0.51-0.81). The OQLQ proved to be as powerful or more powerful than alternative instruments for detecting improvement or deterioration in patients whose status changed. Sample sizes of less than 150 per group should be required to detect minimally important differences in parallel-group clinical trials. Longitudinal correlations between OQLQ and other measures were generally lower than predicted. This may be due to limitations in either the OQLQ or the other instruments. It is concluded that the OQLQ may prove to be a useful instrument for discriminating between women with different levels of impaired HRQL, and for evaluating change in women undergoing treatment for back pain related to osteoporosis.

Activities of Daily Living↗
PubMed1993

Studying the treatment contract in intensive psychotherapy with borderline patients.

A pilot study on the process of psychodynamic psychotherapy of borderline personality disorder at the Cornell University Medical College is designed to investigate the teaching and application of a specific model of treatment for borderline patients (Clarkin et al. 1992; Kernberg and Clarkin 1992). The project has involved teaching a group of self-selected trainees and faculty the manualized therapy (Kernberg et al. 1989); taping each of the twice-weekly therapy sessions over a period of 2 years; and rating (1) each therapist's adherence to the manual (Koenigsberg et al. 1985), (2) each therapist's skill, and (3) patient change. The patients are women with borderline personality disorder, between 20 and 40 years of age, diagnosed by DSM-III-R criteria (American Psychiatric Association 1987), SCID-II (Spitzer et al. 1987), and a self-report questionnaire for level of personality organization. At regular intervals, the patients are evaluated for symptom status, change in BPD criteria, and functioning. The therapists are evaluated for adherence to the manual and level of therapeutic skill. In teaching and carrying out the manualized therapy, it became clear that a critical moment in the treatment was the setting up of the treatment contract. A study was organized to look systematically at the adherence of the therapists to the model of treatment with regard to this initial phase of the therapy.

Adult↗
PubMed1998

The association between chronic illness and functional change among participants in a comprehensive geriatric assessment program.

OBJECTIVE: To examine the association between chronic illness and functional status change during a 3-year period in older people enrolled in an in-home comprehensive geriatric assessment (CGA) and preventive care program. DESIGN: Secondary analysis of data from a longitudinal cohort study. SETTING: Santa Monica, California. PARTICIPANTS: Two hundred two community-dwelling older persons (mean age at baseline was 81 years, 70% were women, and 72% reported good health) randomized to the intervention group in a trial of in-home comprehensive geriatric assessment and preventive care. MEASUREMENTS: We studied 13 common chronic illnesses/conditions determined clinically from an annual comprehensive evaluation by gerontologic nurse practitioners (GNPs) in consultation with study geriatricians. These target conditions included hypertension, osteoarthritis, coronary artery disease, obesity, undernutrition, urinary incontinence, sleep disorders, falls, gait/balance disorders, hearing and vision deficits, depression, and unsafe home environment. The dependent variable was functional change as measured by instrumental activities of daily living (IADL) and basic activities of daily living (BADL) assessed at baseline and annually for 3 years by independent research personnel. Potential confounding variables, including comorbid conditions and other subject characteristics, were controlled for in the analyses. RESULTS: Although functional status was similar at baseline, the presence of certain target conditions in this sample was associated significantly with functional decline in IADL and BADL during the 3-year period. Four conditions (gait/balance disorders, depression, unsafe home environment, and coronary artery disease) were associated with significant declines in IADL, and four conditions (gait/balance disorders, depression, hypertension, and urinary incontinence) were associated with significant declines in BADL. Conversely, subjects with obesity had no significant change in IADL or BADL throughout the study period and had less decline in IADL compared with nonobese subjects. CONCLUSIONS: Certain chronic conditions, particularly gait/balance disorders and depression, are associated with significant decline in functional status in older persons who receive CGA. These findings may help identify older persons at risk for greatest functional decline despite participation in CGA and may also suggest the need for more effective intervention strategies in these individuals.

Activities of Daily Living↗
PubMed1998

Changes in functional health status during normal pregnancy.

BACKGROUND: Pregnancy is a period of physical and emotional stress that can have a significant impact on the well-being of an expectant mother. To explore the extent to which normal pregnancy affects the life of a mother, we sought to assess changes in a standard quality-of-life measure throughout normal pregnancy. METHODS: We performed serial assessments of health-related functional status in a cohort of 125 healthy women who obtained care from a residency-training clinic during pregnancy. Before each antenatal visit, women completed the Medical Outcomes Study Short-Form 36 (SF-36) along with a questionnaire to assess any complications with their pregnancy. Scores for each of the SF-36 subscales were calculated and examined to determine the influence of gestational age and socioeconomic factors on quality of life during pregnancy. RESULTS: Of the eight subscales of the SF-36, three of the four associated with physical health status changed significantly with gestational age. Physical functioning (P < .001), role limitation due to physical problems (P < .001), and pain scales (P < .001) all decreased as pregnancy progressed. These scales showed linear decreases during the first two trimesters, with relative flattening in the third trimester. Sociodemographic factors such as employment, level of income, and presence of a spouse or support partner had only a small influence on functional status in pregnancy. CONCLUSIONS: Health-related functional status during pregnancy changes only for physical measures of health. Sociodemographic factors appear to have only limited influence on health-related functional status during pregnancy.

Adult↗
PubMedDate not supplied

The effect of marital dissolution on contraceptive protection.

An analysis of data from the 1973 and 1976 National Surveys of Family Growth indicates that although marital disruption affects contraceptive practice, the patterns of contraceptive behavior among separated women who remain sexually active are very similar to those of women who remain married. Women about to separate rely less on barrier methods than do continuously married women, and this pattern persists after separation. It is likely that coitus-related methods are less frequently used because they require cooperation between the spouses. In addition, coitus-related methods are probably used less after separation because these methods are less effective, and unintended pregnancies are less desirable in the intermarital or postseparation period. As might be expected, both before and after separation, women who experience marital dissolution are less likely than the continuously married to be sexually active. The difference is greater after separation, but the major finding is the similarity of separated and continuously married women with respect to both coitus and contraceptive protection.

Contraception↗
PubMed1998

Impact of risk-adjusting cesarean delivery rates when reporting hospital performance.

CONTEXT: Hospitals and health plans are often ranked on rates of cesarean delivery, under the assumption that lower rates reflect more appropriate, more efficient care. However, most rankings do not account for patient factors that affect the likelihood of cesarean delivery. OBJECTIVE: To compare hospital cesarean delivery rates before and after adjusting for clinical risk factors that increase the likelihood of cesarean delivery. DESIGN: Retrospective cohort study. SETTING: Twenty-one hospitals in northeast Ohio. PATIENTS: A total of 26127 women without prior cesarean deliveries admitted for labor and delivery from January 1993 through June 1995. MAIN OUTCOME MEASURES: Hospital rankings based on observed and risk-adjusted cesarean delivery rates. RESULTS: The overall cesarean delivery rate was 15.9% and varied (P<.001) from 6.3% to 26.5% in individual hospitals. Adjusted rates varied from 8.4% to 22.0%. The correlation between unadjusted and adjusted hospital rankings (ie, 1-21) was only modest (R=0.35, P=.12). Whereas 7 hospitals were classified as outliers (ie, had rates higher or lower [P<.05] than overall rate) on the basis of both unadjusted and adjusted rates, outlier status changed for 5 hospitals (24%), including 2 that changed from outliers to nonoutliers, 2 that changed from nonoutliers to outliers, and 1 that changed from a high outlier to a low outlier. CONCLUSIONS: Cesarean delivery rates varied across hospitals in a single metropolitan region. However, rankings that fail to account for clinical factors that increase the risk of cesarean delivery may be methodologically biased and misleading to the public.

Adolescent↗
PubMed1993

Outcome of a multimodal treatment including intensive physical training of patients with chronic low back pain.

A comprehensive 4-week inpatient treatment including intensive physical training was evaluated in 194 chronic low back pain patients of whom 101 were working and 79 were on sick leave. Physical performance was assessed by measurements of spinal mobility, isometric trunk flexion and extension strength, and isokinetic lifting strength. Outcome was evaluated by a functional capacity index and work status changes reported at a 12-month follow-up. There was a 30-50% average increase in physical performance during treatment. At the 12-month follow-up the functional capacity index showed an average increase from 35.4 to 39.3 points (score range 24-48). At follow-up 28% of the sicklisted patients had returned to work and of those employed before treatment 14% were on sick leave. Associations between outcome and the improvement in physical measurements and their level at discharge were determined by stepwise multiple and logistic regression analyses. Among the physical measurements only increase in spinal mobility was associated with functional capacity index in women and return to work in both men and women at the 12-month follow-up. The overall results showed that intensive physical training and improved physical performance did not play crucial roles in the rehabilitation of chronic low back pain patients, at least when return to work was used as the outcome criterion.

Adult↗
PubMed1996

Mood improvement in elderly women after in-hospital physical rehabilitation.

OBJECTIVE: To evaluate the relationship between change in depressive symptoms and in-hospital physical rehabilitation in elderly women. DESIGN: Longitudinal study. SETTING: Hospital facility (geriatric evaluation and rehabilitation unit). PATIENTS: One hundred twenty-three elderly inpatient women (mean age: 78.4+/-6.9 years, range 60 to 93) with good cognitive status (Mini Mental State Examination: 23.1+/-5.1) consecutively admitted over a 7-month period. INTERVENTION: Physical therapy tailored to individual needs (five sessions a week of 30 to 45 minutes each). MAIN OUTCOMES MEASURES: On admission: cognition (MMSE), depressive symptoms (Geriatric Depression Scale [GDS]), functional status (basic and instrumental activities of daily living [BADL, IADL], Tinetti scale), and somatic health. On discharge: depressive symptoms and gait and balance performances (Tinetti scale). RESULTS: Seventy-five patients (61%) did not show changes on Tinetti scale over the hospitalization period and 48(39%) had a change of 3 or more points. Nonresponders had no change of GDS over the hospitalization period for all levels of physical disability on admission, whereas responders had relevant improvement of depressive symptoms when markedly disabled on admission, and progressively smaller improvements of depressive symptoms with increasing function on admission. CONCLUSIONS: The study provides evidence that mood status changes synchronically with disability.

Activities of Daily Living↗
PubMedDate not supplied

Education and timing of parenthood among Canadian women: a cohort analysis.

This research examines factors associated with the timing of first birth in Canada, focusing primarily on the role of women's educational attainment. Proportional hazards modelling techniques are applied to data from the 1984 Canadian Fertility Survey (CFS) in order to determine how educational attainment, estimated as close as possible to the date of first birth, influences the timing of first birth and whether the importance of this variable varies according to age cohorts. The results suggest that among a number of variables useful for distinguishing different levels of risk, educational attainment proves to be the most important predictor in the model. Education exerts a substantial positive influence on birth timing for women of all age groups. As expected, moreover, significant cohort differences are also evident, with the greatest to the smallest impact on the risk from the youngest to the oldest cohorts. These clear-cut cohort differences indicate a fundamental change in the effects of education over time, a trend most likely resulting from substantial changes in both the content and social significance of formal schooling during the past few decades.

Adolescent↗
PubMed1992

Future caregivers: projected family structures of older persons.

Elderly persons depend upon spouses and children for emotional, physical, and financial support. In particular, the use of institutional long-term care has been shown to vary by family status. Changes in past and future levels of mortality, fertility, marriage, and divorce will influence the probability that elderly persons of the future have surviving spouses and children. This research uses multiple decrement life tables and component projection methods to project the future family status of elderly persons until the year 2020. The high level of fertility among women during the 1950s will result in greater proportions of future elderly persons having surviving children. Declines in mortality, coupled with increases in rates of marriage, increase the probability that both men and women will have spouses surviving in their old age.

Black or African American↗
PubMedDate not supplied

Grief and depression after miscarriage: their separation, antecedents, and course.

Bereavement is a major risk factor for physical illness, grief, depression, and anxiety. In contrast to recent tendencies in the psychiatric literature to equate grief and depression, we propose that a careful discrimination between the two must be made for diagnostic, therapeutic, and investigative purposes. We report the results of a longitudinal study of a frequent but neglected event, miscarriage early in pregnancy, to make this point. Clinical criteria for differentiating grief and depressive reactions were developed based on phenomenological criteria and theoretical considerations. We hypothesized that the detrimental psychological and physical consequences occur only when the miscarriage was not mourned and resulted in a depressive reaction, but not in a grief reaction. In a controlled, representative study, 125 consecutive women were assessed shortly after their miscarriage (before the 20th week of gestation) and 6 months (N = 94) and 12 months (N = 90) later. Assessments included standardized questionnaires for life events, depression, physical complaints, anxiety, and a specific, multidimensional grief scale (Munich Grief Scale) that we had developed previously. Immediately after the miscarriage, the average anxiety and depression scores were elevated when compared with 80 pregnant and 125 age-matched community controls. Twenty percent of the patients who had miscarried showed a grief reaction, 12% showed a depressive reaction, and 20% responded with a combined depressive and grief reaction. The remaining women (48%) reported no changes in their emotional reactions. As predicted, longer-lasting psychological, social, and health status changes followed the initial depressive, but not the grief reactions. Depressive reactions were predicted by a history of previous depression, a lack of social resources, and an ambivalent attitude to the lost fetus. The grief measures were reliable and made it possible to discriminate between grief and depression.

Abortion, Spontaneous↗
PubMed1991

Exogenous human growth hormone reduces body fat in obese women.

The effects of biosynthetic methionyl human growth hormone (met-hGH) on body composition and endogenous secretion of insulin-like growth factor I (IGF-I) were studied in obese women ranging between 138 and 226% of ideal body weight. Following double-blind procedures, 12 subjects were assigned at random to either treatment with met-hGH (n = 6, 0.08 mg/kg desirable body weight) or placebo (n = 6, bacteriostatic water diluent). Treatments were delivered intramuscularly three times per week for a period of 27-28 days. Subjects were instructed to follow a weight-maintaining diet and their pre- and posttreatment kilocaloric intake was monitored for verification. The baseline peak serum GH response to L-dopa/arginine stimulation for the study population as a whole, was in the hyposecretory range (9.6 +/- 1.9 ng/ml), accompanied by a low level of circulating IGF-I (0.56 +/- 0.09 U/ml). Hydrodensitometry revealed that the met-hGH-treated subjects had a significant reduction in body fat, while an observed mean increase in fat-free mass (FFM) approached significance. The percent change in body fat was unrelated to pretreatment levels of body fat, total body weight, or initial endogenous GH status. Changes in circulating IGF-I were similar to those for FFM, with increases approaching significance. There were no significant changes in body composition or IGF-I in the placebo-treated subjects. No significant differences were observed in the self-reported dietary intake of kilocalories during the experimental period between the two groups. We conclude that exogenous GH reduces body fat in obese women in the apparent absence of significant kilocaloric restriction. The effect appears to be unrelated to endogenous GH secretion or body composition.

Adipose Tissue↗
PubMed1988

Race and sex differences in the correlates of blood pressure change.

Potential predictors of systolic and diastolic blood pressure change between 1960 and 1967 in the biracial population of Evans County, Georgia, were investigated. An all possible regressions multiple linear regression analysis was used. For systolic blood pressure change, the level of systolic blood pressure, age, and change in Quetelet index were significant (p less than 0.05) correlates in white men. The level of systolic blood pressure, the level and change of socioeconomic status, change in Quetelet index, and change in cholesterol were significant correlates for white women. The level of Quetelet index was of borderline significance (p less than 0.055) when the other significant variables were included in the model for white women. The change in Quetelet index was the only significant correlate of systolic blood pressure change in blacks. For diastolic blood pressure change, age, change in hematocrit, and change in Quetelet index were significant correlates for white men. Age, level and change of socioeconomic status, level and change of Quetelet index, and change in hematocrit were the significant correlates in white women. In black men, change in Quetelet index and age were significant. In black women, only age was a significant correlate of diastolic blood pressure change. These results indicate that there may be important differences in these correlates between race-sex groups and thus in the mechanism of blood pressure change for different race-sex groups. groups.

Adult↗
PubMed1987

Profile of Danish women undergoing reversal of sterilization, 1978-1983.

To help identify those women who might regret undergoing sterilization, the Danish women refertilized from 1978 to 1983 were contacted by mailed questionnaire. Eighty-three percent (120/144) responded. These women were younger at the time of sterilization than Danish women sterilized in the same period (mean age 29 years versus 34 years). Furthermore, they had more children at the time of sterilization and had their first and last child at a younger age than Danish women generally, in the same age group. Their social and educational status was lower than the background population and fewer were in gainful employment. At sterilization, most of the women were in an emotionally stressful situation (e.g., marital disharmony (78% of the married women), single parenthood (28%), unwanted pregnancy (27%], or had chronic health problems in the family. Alternative contraceptive methods had not been fully explored. Thirty-eight percent complained of late secondary effects attributable to the sterilization, but the main reason for wanting reversal of sterilization was a new partner (75%). The study suggests that the psycho-social situation and contraceptive alternatives should be carefully evaluated in women requesting sterilization, especially in those below the age of 30.

Adult↗
PubMed1989

[Follow-up studies of gerontopsychiatric long-term patients following a change in residential status].

Changes in living conditions of the elderly are considered as critical life events. The degree of stress produced by such critical life events is seen largely dependent on controllability and predictability of the situation. Our study focuses on changes in behavior and well-being at four times during ten weeks while 34 long-term gerontopsychiatric patients moved into reconstructed wards, which were mainly improved under ecological aspects. Investigations were performed with the "Beobachtungsskala für alternde Patienten (BAP)" and by free observation. In summary, the results show reduced well-being and behavioral problems at all four times of measurement for female patients compared to the male group. In contrary, for male patients there is a significant reduction in need of help, physical disability, aggression and depression one week after the move. But these improvements are not stable. Partly, they are followed by decreases even beyond the baseline six weeks after the move. Therefore, unlike the male patients it seems that the older and more impaired women in our sample can not at all profit from the positive changes in the new living conditions on the ward at any time during our study. Their well-being remains obviously unsatisfactory and becomes even worse and threatening for single cases after the move. Results are discussed with respect to psychiatric impairments like dementia, paranoia, with regard to stress and coping as well as with respect to some contradictory findings in this field of research.

Activities of Daily Living↗
PubMedDate not supplied

American household structure in transition.

The number of U.S. households rose by 58 percent between 1960 and 1983, with nontraditional household types accounting for most of the increase. Whereas the number of households containing married couples with children younger than 18 rose by only four percent over the period, one-parent households increased by 175 percent; one-person households, by 173 percent; and households composed of unmarried couples, by 331 percent. In 1983, households maintained by married couples constituted six in 10 U.S. households; the second most common household type--adults living alone--accounted for about one-quarter of all households. Lone parents living with their children represent nearly one in 10 households. Almost all of these parents are women--of whom two-thirds are separated or divorced, one-quarter have never been married, and fewer than one in 10 are widows. Among adults living alone, women aged 45 and older predominate; but the rate at which the practice has been adopted since 1960 has been greatest among those under age 45. Most of the growth in the number of one-person households occurred during the 1970s. The increase in cohabitation--most of it also in the 1970s--has similarly been concentrated in the younger age-groups. The living arrangements of children younger than 18 have changed accordingly over the two decades. Since 1960, the number of children living with two parents has declined by nearly one-fifth, and the number living with one parent--generally the mother--has more than doubled.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗