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At least 19 recordsLinked to original sources

PubMed1991

The impact of rheumatoid arthritis on the household work performance of women.

We conducted a study to assess whether and to what degree household work disability exists in women with rheumatoid arthritis (RA) and to examine the role of health versus family and personal factors as predictors of household work disability. In addition, the participation of other family members and paid employees in household work was evaluated. One hundred forty-two women with RA and 58 female friends/neighbors completed questionnaires which assessed household work performance and health, family, and personal variables. Performance was measured in 4 ways: the current amount of time spent on household work, the proportion of the household work done, and the changes in time and proportion since just before the onset of RA. Functional status was measured via the Health Assessment Questionnaire. Pain, anxiety and depression, and general health perception were measured via the Arthritis Impact Measurement Scales. The results indicate that household work disability exists in women with RA, but is substantial only in women with moderate-to-severe disease. In families in which the wife/mother has moderate-to-severe RA, the other family members spend 7 hours more per week on household work than in control families, but there was no increase in the use of paid household employees. Health factors were the strongest predictors of household work disability, but family and personal factors also had significant effects. Household work disability in women with moderate or severe RA merits more attention because of the importance of household work to family functioning and the negative effects that changes in this area can produce.

Activities of Daily Living↗

PubMed2002

The influence of work, household structure, and social, personal and material resources on gender differences in health: an analysis of the 1994 Canadian National Population Health Survey.

Data from the 1994 Canadian National Population Health Survey (NPHS) do not confirm the widespread assumption that women experience considerably more ill health than men. The patterns vary by condition and age and at many ages, the health of women and men is more similar than is often assumed. However, we should not minimize the gender differences that do exist and in this paper we focus on three health problems which are more common among women: distress, migraine and arthritis/rheumatism. We consider to what extent work, household structure and social, personal and material resources explain these gender differences in health. Analysis of the distributions of paid work conditions, household circumstances and resources reveal mostly minor differences by gender and differences in exposure to these circumstances contribute little to understanding gender differences in health. There is also little evidence that greater vulnerability is a generalized health response of women to paid and household circumstances. We find limited evidence that social, personal and material resources are involved in pathways linking work and home circumstances to health in ways that differ between the sexes. In conclusion, we consider some reasons for the lack of support for our explanatory model: the measures available in the NPHS data set which contains little information on the household itself; the difficulty of separating 'gender' from the social and material conditions of men's and women's lives; and changes in women's and men's roles which may have led to a narrowing of differences in health.

Adolescent↗

PubMed2006

Orphan care in Botswana's working households: growing responsibilities in the absence of adequate support.

OBJECTIVES: Botswana has one of the world's highest HIV-prevalence rates and the world's highest percentages of orphaned children among its population. We assessed the ability of income-earning households in Botswana to adequately care for orphans. METHODS: We used data from the Botswana Family Health Needs Study (2002), a sample of 1033 working adults with caregiving responsibilities who used public services, to assess whether households with orphan-care responsibilities encountered financial and other difficulties. Thirty-seven percent of respondents provided orphan care, usually to extended family members. We applied logistic regression models to determine the factors associated with experiencing problems related to orphan caregiving. RESULTS: Nearly half of working households with orphan-care responsibilities reported experiencing financial and other difficulties because of orphan care. Issues of concern included caring for multiple orphans, caring for sick adults and orphans simultaneously, receiving no assistance, and low income. CONCLUSIONS: The orphan crisis is impoverishing even working households, where caregivers lack sufficient resources to provide basic needs. Neither the public sector nor communities provide adequate safety nets. International assistance is critical to build capacity within the social welfare infrastructure and to fund community-level activities that support households. Lessons from Botswana's orphan crisis can provide valuable insights to policymakers throughout sub-Saharan Africa.

Adolescent↗

PubMed2004

Appliances and their impact: the ownership of domestic technology and time spent on household work.

Ever since the appearance of Vanek's pioneering article in 1974, there has been a controversy about whether 'labour saving' domestic appliances actually save labour time. Vanek argued that time spent in housework had barely changed since 1926, despite the diffusion of practically every known domestic appliance over this period. Gershuny and Robinson challenge Vanek's 'constancy of housework' thesis, arguing that, between 1965 and 1985, domestic technology has significantly reduced the weekly hours of women's routine housework. Although there is much talking past each other, none of the protagonists in this dispute have any direct data about which households own or do not own domestic appliances. Instead, they all rely on the passage of the years as a proxy for ownership of domestic appliances, since a higher proportion of contemporary households now own domestic appliances. The Australian 1997 Time Use Survey (Australian Bureau of Statistics 1998b) is rare among official surveys, as it simultaneously provides detailed information on time spent in housework and an inventory of household appliances. The analysis of this data show that domestic technology rarely reduces women's unpaid working time and even, paradoxically, produces some increases in domestic labour. The domestic division of labour by gender remains remarkably resistant to technological innovation.

Australia↗

PubMed2006

The interference of paid work with household demands in different social policy contexts: perceived work-household conflict in Sweden, the UK, the Netherlands, Hungary, and the Czech Republic.

The article explores whether people experiences a lower level of work-household conflict in a context that is characterized by extensive family policies (Sweden and to some extent Hungary and Czech Republic) aimed at facilitating participation in the labour market. This is done by studying perceived work-household conflict among women and men living in Sweden, the UK, the Netherlands, Hungary, and the Czech Republic. The analyses are based on the answers to a questionnaire distributed to nearly 6,000 randomly selected individuals within the framework of the European Union financed 'Household, Work, and Flexibility' (HWF) study. The results show that women in Sweden experience conflicts between work and household demands to a higher degree than any other category in all five countries. The differences between Swedish women and women living in the Netherlands and the UK are explained by variables indicating qualifications and workload in the main job, but the lower degree of work-household conflict among Czech and Hungarian women is still significant when controlling for household composition and working conditions. Data indicate that a possible explanation for this can be found in the interplay between men's and women's attitudes toward gender roles and the actual situation in terms of division of labour.

Employment↗

PubMed2000

Menstrual cycle and headache in a population sample of migraineurs.

BACKGROUND: Migraine is three times more common in women than men. There is a clinical impression that migraines are more common and severe around the time of menses. OBJECTIVES: To determine 1) the distribution of headache attacks by day of the menstrual cycle in women with migraine, 2) if the excess occurrence varies by headache type, and 3) if headache features differ by time in the menstrual cycle. METHODS: In a population-based sample, 81 menstruating women with clinically diagnosed migraine were enrolled in a 98-day diary study and completed a total of 7219 diary days. The daily diary was used to record the occurrence of menses, headache days, and, on days with headache, associated headache features (i.e., symptoms, quality-of-pain, attack duration, pain intensity, and disability at work, household work, and nonwork activities). RESULTS: An excess risk of headache occurred perimenstrually and was highest on days 0 and 1 of the cycle (day 0 being the first day of menses). A significantly elevated risk of headache on days 0 and 1 was observed for migraine without aura (OR 2.04; 95% CI 1.49, 2.81) and for tension-type headache (OR 1.67; 95% CI 1.24, 2.25). Elevated risks were also observed in the 2 days before onset of menses for migraine without aura (OR 1.80; 95% CI 1.40, 2.30). A significantly lower risk was observed around the time of ovulation for all headaches (OR 0.44; 95% CI 0.27, 0.72). Few significant differences were observed in headache features (i.e., pain intensity, disability score, symptom score, headache duration) by day of the cycle overall or by headache type. Pain intensity was slightly greater for migraine headaches during the first 2 days of menses. CONCLUSIONS: Attacks of migraine without aura, but not migraine with aura, were more likely to occur 2 days before onset of menses and on the first 2 days of menses. This study does not support the clinical notion that headaches, regardless of type, are more severe during the perimenstrual period compared to other times in the cycle. Although migraine headaches are significantly more painful during the first 2 days of menses, differences are small.

Adolescent↗

PubMed1992

A woman's place: unpaid work in the home.

Household work has only recently become a valid topic of study. Feminist scholars were among the first social scientists to draw attention to women's unpaid work in the home. Although household work occupations are frequently used for assessment and treatment within practice, occupational therapy literature demonstrates a paucity in the area of these occupations. This review of the feminist literature summarizes theory and research that explore the historical, political, social, and personal meanings of household work. Feminist analysis of household work may sensitize occupational therapists to the complex interactions of these meanings and lead them to the realization that women's responsibility for unpaid work in the home may have repercussions in the daily lives of both women and men.

Attitude of Health Personnel↗

PubMed2004

The risk of acute myocardial infarction: interactions of types of physical activity.

BACKGROUND: Leisure time physical activity has previously been shown to be protective against cardiovascular disease. We estimated the influence of exercise, occupational physical activity, and household work with regard to risk of acute myocardial infarction (MI). Special interest was focused on potential interaction among these aspects of physical activity. METHOD: We analyzed data from a large population-based case-control study conducted in Stockholm, Sweden, 1992-1994. Cases comprised 1204 men and 550 women, age 45-70 years, who experienced their first MI during the study period. The controls, 1538 men and 777 women, were randomly selected from the study base, matched on sex, age, and hospital catchment area. The results were adjusted for several potential confounding factors. RESULTS: Exercise, walking or standing at work, and doing demanding household work were all associated with decreased risk of acute MI; the estimated relative risks (RRs) ranged from 0.31 to 0.90 when all cases (fatal and nonfatal) were considered. In contrast, lifting or carrying at work, and an occupational workload perceived to be strenuous, were related to an increased risk of MI (RRs ranging from 1.10-1.57). We observed a synergistic benefit from exercise and walking or standing at work, and from household work and walking or standing at work. CONCLUSION: Aerobic physical activities such as exercise or walking at work seemed to reduce the risk of MI, whereas anaerobic activities such as heavy lifting at work were related to increased risk of MI.

Aged↗

PubMed1998

Orchestration of work and play within families.

OBJECTIVES: Parental occupations within families include parents' participation in household work and in play with their children. This study explored the nature of parents' play with their preschool-aged children and how it was orchestrated within their daily occupations. METHOD: Participant observations and intensive interviews were conducted with 10 families with preschool-aged children. Data were analyzed with a grounded theory approach. RESULTS: Parents used two types of strategies to orchestrate work and play in their families: Strategies of segregation resulted in play interspersed with household work, and strategies of inclusion resulted in play embedded in household work. CONCLUSION: This study identified the process of occupational scaffolding through which parents foster their children's competence as adults; the need for deconstruction of the notion of work and play as separate experiences; and new ideas to guide occupational therapy practice with parents who are juggling paid work, household work, and time with their children.

Adult↗

PubMed1999

An international study to assess reliability of the Migraine Disability Assessment (MIDAS) score.

BACKGROUND: The Migraine Disability Assessment (MIDAS) instrument is a five-item questionnaire developed to measure headache-related disability and improve doctor-patient communication about the functional consequences of migraine. OBJECTIVES: To examine the test-retest reliability and internal consistency of the five items and of the overall MIDAS score in population-based samples of migraine sufferers in two countries and to compare consistency across countries. METHODS: Using a clinically validated telephone interview, population-based samples of migraine-headache sufferers were identified in the United States (Baltimore, MD) and the United Kingdom (Merton and Sutton, Surrey). Eligible individuals completed the MIDAS questionnaire on two occasions an average of 3 weeks apart. The MIDAS score is derived from five questions about missed time from work and household work (one question each about missed days and days with at least 50% reduced productivity) and missed days of nonwork activities. RESULTS: A total of 97 migraine-headache sufferers from the United States and 100 from the United Kingdom completed the MIDAS questionnaire twice. Mean and median item values and overall MIDAS scores were similar between the United States and the United Kingdom. Test-retest Spearman correlations of individual items ranged from 0.46 to 0.78. No significant differences in item-specific correlations were observed between the United States and United Kingdom. The test-retest Pearson correlation of the MIDAS score (i.e., sum of lost days and reduced-effectiveness days in each domain) was 0.80 in the United States and 0.83 in the United Kingdom. The Cronbach alpha, a measure of internal consistency, was 0.76 in the United States and 0.73 in the United Kingdom. CONCLUSIONS: This is the first international population-based study to assess the reliability of a disability-related illness severity score for migraine. The reliability and internal consistency of the Migraine Disability Assessment score are similar to that of a previous questionnaire (Headache Impact Questionnaire). However, the Migraine Disability Assessment score requires fewer questions, is easier to score, and provides intuitively meaningful information on lost days of activity in three domains.

Adolescent↗

PubMed2000

Validity of the Migraine Disability Assessment (MIDAS) score in comparison to a diary-based measure in a population sample of migraine sufferers.

The Migraine Disability Assessment (MIDAS) questionnaire is a brief, self-administered questionnaire designed to quantify headache-related disability over a 3 month period. The MIDAS score has been shown to have moderately high test-retest reliability in headache sufferers and is correlated with clinical judgment regarding the need for medical care. The aim of the study was to examine the validity of the MIDAS score, and the five items comprising the score, compared to data from a 90 day daily diary used, in part, to record acute disability from headache. In a population-based sample, 144 clinically diagnosed migraine headache sufferers were enrolled in a 90 day diary study and completed the MIDAS questionnaire at the end of the study. The daily diary was used to record detailed information on headache features as well as activity limitations in work, household chores, and non-work activities (social, family and leisure activities). The MIDAS score was the sum of missed work or school days, missed household chores days, missed non-work activity days, and days at work or school plus days of household chores where productivity was reduced by half or more in the last 3 months. Validity was assessed by comparing MIDAS items and the MIDAS score with equivalent measures derived from the diary. The MIDAS items for missed days of work or school (mean 0.96, median 0) and for missed days of household work (mean 3.64, median 2.0) were similar to the corresponding diary-based estimates of missed work or school (mean 1.23, median 0) and of missed household work (mean 3.93, median 2.01). Values for missed days of non-work activities (MIDAS mean 2.6 and median 1 versus diary mean 2.22 and median 0.95) were also similar. Responses to MIDAS questions about number of days where productivity was reduced by half or more in work (mean 3.77, median 2.00) and in household work (mean 3.92, median 2.00) significantly overestimated the corresponding diary-based measures for work (mean 2.94, median 1.06) and household work (mean 2.22, median 0.98). Nonetheless, the overall MIDAS score (mean 14.53, median 9.0) was not significantly different form the reference diary-based measure (mean 13.5, median 8.4). The correlation between the MIDAS summary score and an equivalent diary score was 0.63. The group estimate of the MIDAS score was found to be a valid estimate of a rigorous diary-based measure of disability. The mean and median values for the MIDAS score in a population-based sample of migraine cases were similar to equivalent diary measures. The correlation between the two measures was in the low moderate range, but expected given that two very different methods of data collection were compared.

Absenteeism↗

PubMed2000

Expectant parents' anticipated changes in workload after the birth of their first child.

OBJECTIVE: We hoped to evaluate gender differences in prenatal workload and anticipated prenatal to postpartum changes in workload for a group of expectant parents. METHODS: We included a total of 149 couples who were living together, expecting their first child, and enrolled in prenatal classes presented by 2 metropolitan hospitals. The couples completed a prenatal survey containing information about demographic characteristics and prenatal work responsibilities and a worksheet listing the number of hours per week that each partner planned to devote to various household, child care, and employment responsibilities at 6 months postpartum. RESULTS: Though both men and women anticipated large increases in workload from the prenatal to the postpartum period, women expected greater increases (85% vs 53%). As a result of their greater anticipated involvement in household work and child care, women planned to work 9 hours more per week than men after the arrival of the baby. These expectant parents tended to occupy somewhat traditional gender work roles, with women contributing more time to cooking, cleaning, laundry, and shopping, and men devoting more time to lawn care, snow removal, household repairs, and employment. Men appeared to be more satisfied than women with their partner's contribution to household work (mean=6.0 and 5.4; P=.000). Partners' perceptions of how they shared household work were congruent, with 90% of the couples' summed congruency scores in the range within 1 point of a perfect match. CONCLUSIONS: Expectant parents in this study anticipated large increases in workload after childbirth. The projected work increases were greater for women than for men. It is interesting to note that these gender differences are anticipated even when couples were given an opportunity to systematically plan their postpartum work distribution together.

Adult↗

PubMed2004

Social class and self-reported health status among men and women: what is the role of work organisation, household material standards and household labour?

Social class understood as social relations of ownership and control over productive assets taps into parts of the social variation in health that are not captured by conventional measures of social stratification. The objectives of this study are to analyse the association between self-reported health status and social class and to examine the role of work organisation, material standards and household labour as potential mediating factors in explaining this association. We used the Barcelona Health Interview Survey, a cross-sectional survey of 10,000 residents of the city's non-institutionalised population in 2000. This was a stratified sample, strata being the 10 districts of the city. The present study was conducted on the working population, aged 16-64 years (2345 men and 1874 women). Social class position was measured with Erik Olin Wright's indicators according to ownership and control over productive assets. The dependent variable was self-reported health status. The independent variables were social class, age, psychosocial and physical working conditions, job insecurity, type of labour contract, number of hours worked per week, possession of appliances at home, as well as household labour (number of hours per week, doing the housework alone and having children, elderly or disabled at home). Several hierarchical logistic regression models were performed by adding different blocks of independent variables. Among men the prevalence of poor reported health was higher among small employers and petit bourgeois, supervisors, semi-skilled (adjusted odds ratio-aOR: 4.92; 95% CI: 1.88-12.88) and unskilled workers (aOR: 7.69; 95%CI: 3.01-19.64). Work organisation and household material standards were associated with poor health status with the exception of number of hours worked per week. Work organisation variables were the main explanatory variables of social class inequalities in health, although material standards also contributed. Among women, only unskilled workers had poorer health status than the referent category of manager and skilled supervisors (aOR: 3.25; 95%CI: 1.37-7.74). All indicators of work organisation and household material standards reached statistical significance, excepting the number of hours worked per week. In contrast to men, among women the number of hours per week of household labour was associated with poor health status (aOR: 1.02; 95% CI: 1.01-1.03). Showing a different pattern from men in the full model, household material deprivation and hours of household labour per week were associated with poor health status among women. Our findings suggest that among men, part of the association between social class positions and poor health can be accounted for psychosocial and physical working conditions and job insecurity. Among women, the association between the worker (non-owner, non-managerial, and un-credentiated) class positions and health is substantially explained by working conditions, material well being at home and amount of household labour.

Adolescent↗

PubMed2005

Struggle as the context of household health work for Mexican American women.

A focused ethnographic study was conducted among 13 moderately to highly acculturated American mothers of Mexican ancestry to determine how they influence the health of their family members. Using the World Health Organization (WHO) definition of health (a state of physical, mental, and social well-being and not merely the absence of disease) as a guide for interview questions, we conducted 32 in-depth interviews with study participants. The thread of struggle ran through each woman's narrative. Women's process of struggle is presented as one way to conceptualize the gendered nature of household health work.

Acculturation↗

PubMed1994

Sex stratification and health lifestyle: consequences for men's and women's perceived health.

A representative national sample of 2,031 adults aged 18 to 90 was interviewed by telephone in 1990. Results showed that men report better health than women, but that the gap closes with age. We argue that a gender difference in labor and lifestyles explains sex differences in perceived health across the life course: gender inequality in paid and unpaid work and the subjective experience of inequality disadvantage women, whereas lifestyle disadvantages men. Women are less likely to be employed, and are more likely to work part-time, have lower incomes and more economic hardship, and to do more unpaid domestic labor than men, all of which except domestic labor are associated with poor health. Domestic labor improves health, up to doing 60 percent of the housework. Women also have more distress and fewer subjective work rewards, both of which are associated with poor health. If women had the same levels of paid work, household income, economic hardship, work rewards, and distress as men, their health would equal that of men's and surpass it by age 59. Although we expected to find an overwhelming male disadvantage in lifestyle, we did not. Men are more likely than women to walk and to exercise strenuously, both of which are associated with good health. If women's labor and leisure-time physical activity equalled men's, women over the age of 54 would experience better health than men. Men's lifestyle disadvantage comes from their greater tendency to smoke and to be overweight, both of which are associated with poor health.

Adolescent↗

PubMed2006

Work hours affect spouse's cortisol secretion--for better and for worse.

OBJECTIVE: In a sample of 52 German dual-earner couples with at least one child under age 5, we examined the bodily costs and benefits of the amount of time each spouse spent on productive activities. METHODS: Diary reports of time allocated to formal and informal work activities were analyzed according to the Actor-Partner Interdependence model. RESULTS: Hierarchical linear models showed that each hour an individual allocated to market, as well as household work, increased his or her total cortisol concentration (by 192 and 134 nmol/l, respectively). Unexpectedly, the time the spouse allocated to paid work also raised an individual's total cortisol concentration (by 64 nmol/l). In line with our expectations, there was a tendency for the time the spouse allocated to household work to decrease the individual's cortisol concentration (by 81 nmol/l). CONCLUSIONS: This study contributes to the body of evidence on the complex nature of social relationships and complements the literature on specific working conditions and couples' well-being.

Adult↗

PubMed2006

Age and temporal trends of total physical activity among Swedish women.

PURPOSE: Few epidemiological studies have been conducted among middle-aged women on long-term total and specific physical activity (PA) trends. We studied in a cross-sectional setting the relationship of self-reported total daily PA with age and calendar time. METHODS: In a population-based cohort of 38,988 women aged 49-83 yr in central Sweden, information was collected on physical activity, such as work or occupation, household work, walking or bicycling, exercise, watching TV or reading, and other lifestyle factors through a self-administered questionnaire. Total and specific daily PA levels at ages 15, 30, and 50 yr were recalled retrospectively and measured as metabolic equivalents (MET.h.d(-1)). RESULTS: Total PA level linearly decreased with calendar time in all three age groups (slope for 5-yr change in calendar time among those 15 yr of age = -0.82; 95% confidence interval (CI), -0.86 to -0.78; among those 30 yr of age=-0.42; 95% CI, -0.45 to -0.38; and among those 50 yr of age = -0.62; 95% CI, -0.66 to -0.58). High-intensity activities such as walking or bicycling decreased by 0.21 MET.h.d(-1) (95% CI, -0.22 to -0.20) every 5-calendar-year change among adolescents between the 1930s and 1960s. Total activity level decreased in all age groups by an average of approximately 3MET.h(-1).d(-1), corresponding to approximately 45 min of brisk walking. CONCLUSIONS: Our results suggest that intervention efforts aimed at engaging in healthful amounts of physical activity are needed throughout the life cycle.

Adult↗

PubMed2001

Clinical utility of an instrument assessing migraine disability: the Migraine Disability Assessment (MIDAS) questionnaire.

OBJECTIVE: We evaluated the agreement between Migraine Disability Assessment (MIDAS) scores and independent physician judgments about pain, disability, and treatment needs based on patient medical histories. BACKGROUND: The MIDAS questionnaire measures headache-related disability as lost time due to headache from paid work or school, household work, and nonwork activities. METHODS: Twelve histories from patients with migraine were presented to 49 primary and specialty care physicians unaware of the MIDAS scores. Physicians graded each patient for pain level (mild, moderate, or severe), level of disability (none, mild, moderate, or severe), and need for medical care (from 0 [lowest] to 100 [highest]). Physicians also identified MIDAS scores they associated with different degrees of disability and with the urgency to prescribe an effective treatment during the first consultation. RESULTS: The physicians' perceptions of the need for medical care based on medical histories correlated with the MIDAS score (r =.69). Estimates of pain and disability by physicians were directly correlated with increasing MIDAS scores. Using the physicians' clinical judgments, the overall MIDAS score was categorized into four grades of increasing severity. CONCLUSIONS: Scores on the MIDAS are highly correlated with physician judgments regarding patients' pain, disability, and need for medical care. These findings support the potential utility of the MIDAS questionnaire in clinical practice.

Disability Evaluation↗