Dissertations / Theses on the topic 'Older women Care Australia'
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1
Kingsley, Elizabeth J. S. "Articulating and ameliorating elder abuse in Australia." Thesis, Curtin University, 2002. http://hdl.handle.net/20.500.11937/1753.
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The abuse of older people is a largely unrecognised and under acknowledged social problem in Australia. My major objective in undertaking the work, which is represented by the original published articles that comprise the thesis, was to make a scholarly and practical contribution toward the minimisation of 'elder abuse. This objective was achieved with the development and implementation of a series of studies that articulated and ameliorated elder abuse in Australia.The thesis provides an erudite synthesis of these studies, which fall into four themes that illustrate the nature and scope of my theoretical and professional work in elder abuse. Much of the work was guided by a conceptual framework of ways of knowing in nursing, and was underpinned by the principles and practice of community development and participatory community-based action processes.The outcomes of these studies include work with three stakeholder groups: professionals who deal with elder abuse, older people who are victims or potential victims of abuse, and those who perpetrate abuse on an older person. The work, illustrated in the four themes, includesthe articulation of elder abuse issues with West Australian aged care workersthe development of elder abuse protocols, policy guidelines and ethical principles, to guide professional practice in abuse prevention and interventionthe design and implementation of participative community programs to empower older people, and their carers, to resist being abused or abusing and to assist perpetrators stop their abusethe amelioration of abuse of nursing home residents by staff.The thesis situates my conceptual and clinical effort within the wider corpus of Australian knowledge and practice on elder abuse and contributes to addressing the social problem of elder abuse within the context of Australian aged care.
2
Harley, Emma Elizabeth Harlin. "Social support in later life : cross-sectional and longitudinal analyses of inter-relationships between psychosocial variables in the Women's Health Australia Study /." [St. Lucia, Qld.], 2004. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe18295.pdf.
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3
Chalmers, Jane. "The oral health of older adults with dementia." Title page, contents and abstract only, 2001. http://web4.library.adelaide.edu.au/theses/09PH/09phc438.pdf.
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Bibliography: leaves 347-361. Presents results of 2 longitudinal studies investigating the oral health of older adults with dementia, using questionnaires and clinical inspections at baseline and one year. Groups studied were nursing home residents and those living in the community, with moderate to severe dementia or no dementia diagnosis. Caries experience was related to dementias severity and not to specific dementia diagnoses. Coronal and root caries experience was higher in dementia participants with moderate-severe dementia, the socio-economically disadvantaged, more functionally dependent, taking neuroleptic medications with high anticholinergic adverse effects, with eating and swallowing problems, were not attending the dentist, who needed assistance and were behaviourally difficult during oral hygiene care and whose carers were burdened.
4
Kingsley, Elizabeth J. S. "Articulating and ameliorating elder abuse in Australia." Curtin University of Technology, School of Nursing, 2002. http://espace.library.curtin.edu.au:80/R/?func=dbin-jump-full&object_id=13966.
Full textAbstract:
The abuse of older people is a largely unrecognised and under acknowledged social problem in Australia. My major objective in undertaking the work, which is represented by the original published articles that comprise the thesis, was to make a scholarly and practical contribution toward the minimisation of 'elder abuse. This objective was achieved with the development and implementation of a series of studies that articulated and ameliorated elder abuse in Australia.The thesis provides an erudite synthesis of these studies, which fall into four themes that illustrate the nature and scope of my theoretical and professional work in elder abuse. Much of the work was guided by a conceptual framework of ways of knowing in nursing, and was underpinned by the principles and practice of community development and participatory community-based action processes.The outcomes of these studies include work with three stakeholder groups: professionals who deal with elder abuse, older people who are victims or potential victims of abuse, and those who perpetrate abuse on an older person. The work, illustrated in the four themes, includesthe articulation of elder abuse issues with West Australian aged care workersthe development of elder abuse protocols, policy guidelines and ethical principles, to guide professional practice in abuse prevention and interventionthe design and implementation of participative community programs to empower older people, and their carers, to resist being abused or abusing and to assist perpetrators stop their abusethe amelioration of abuse of nursing home residents by staff.The thesis situates my conceptual and clinical effort within the wider corpus of Australian knowledge and practice on elder abuse and contributes to addressing the social problem of elder abuse within the context of Australian aged care.
5
Grochowski, Julie. "Predictors of Independent Living Outcomes Among Older Women Receiving Informal Care." FIU Digital Commons, 2014. http://digitalcommons.fiu.edu/etd/1685.
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This study examined the predictors of independent living outcomes among community–living older women who received informal care. The central hypothesis was that older women’s level of functioning is influenced by their relationship with their informal caregiver. The study attempted to understand the independence of older women through the perspective of both informal caregivers and the older women themselves. The following eight variables were measured: 1) the older women’s independence (dependent variable); 2) the relationship between older women and their informal caregivers (independent variable); 3) roles of both the informal caregiver and older women (independent variable); 4) the older women’s attitudes toward aging (independent variable); 5) the older women’s age identity (independent variable); 6) the older women’s health (control variable); 7) the older women’s level of social support (control variable); and 8) the older women’s level of depression (control variable). The variables were measured from the perspective of the older woman herself and her informal caregiver. This study used an ecological and developmental framework along with role theory to understand the interaction among the aforementioned variables through a cross-sectional design. The recruited older women participants of this study were receiving ongoing care and personal assistance from two large home care agencies located in Miami, FL. An analysis was conducted through a mixed-methods incorporated into the study design. The present study aimed to contribute to the understanding of how the relationship between older women and their informal caregivers influences older women’s ability to maintain independent outcomes. The primary finding of this study was that there were both positive and negative experiences within the relationship dynamic of older women and their informal caregivers and that this relationship was either unidirectional or bi-directional.
6
Loh, Poh Kooi. "Innovations in health for older people in Western Australia." University of Western Australia. School of Medicine and Pharmacology, 2009. http://theses.library.uwa.edu.au/adt-WU2010.0051.
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Australia and many other developed communities are ageing rapidly, placing a strain on the delivery of health services. This thesis examines the use of innovative health services management coupled with information and communication technology (ICT) to more efficiently deliver services to disabled older people in the hospital, community and residential care. The hypothesis explored is that ICT can provide clinical services to older people in poorly serviced communities and groups, thus extending the influence and capabilities of specialist health care professionals. The relevance of these studies is predominantly for those people who live outside the metropolitan regions, particularly in remote and rural communities, and also for those frail older people, who because of disability, are unable to travel to specialist health services. There are a series of studies presented in this thesis which have all been published. They have demonstrated that in a community and rural setting, ICT use in the assessment and management of geriatric syndromes such as dementia is valid and practical. This included the validation of commonly used assessment tools via Telehealth. A Telehealth protocol for assessment of Alzheimer's Dementia (AD) was developed and published. The use of ICT to link health services clinical and administrative data for determining stroke outcomes and disability has been evaluated and a resource utilization prediction model developed. Finally, in residential care a survey and a qualitative study of poor uptake of ICT services in hostels and nursing homes revealed insights into ICT perception by the older people in care facilities and their professional staff. The implications and future development of these studies have been discussed, especially barriers to increased uptake of ICT, cost comparisons and the potential of future technologies such as video conferencing mobile phones.
7
Fleming, Brian James. "The social gradient in health : trends in C20th ideas, Australian Health Policy 1970-1998, and a health equity policy evaluation of Australian aged care planning /." Title page, abstract and table of contents only, 2003. http://web4.library.adelaide.edu.au/theses/09PH/09phf5971.pdf.
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Beaumont, Nerida. "The relative importance of barriers to cervical cancer screening in older women : A review of 140 women and their pap smear providers." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 1999. https://ro.ecu.edu.au/theses/1218.
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Cervical cancer remains a significant cause of death in women. There is a notable age related decrease in levels of screening and women aged over 50 years with later, more invasive disease. One hundred and forty women aged between 50 and 69 years (M "'58.21 years) and 23 Pap smear providers completed a Cervical Cancer Screening Questionnaire designed to identify the relative importance of barriers to attendance for cervical screening, as well as providers own barriers and issues. Responsibility for health, familiarity with, and ratings of the usefulness of Pap smears were the major dimensions along which regular and non-regular attenders differed supporting the hypothesis. Additionally, women who had regular Pap smears were younger, with higher levels of confidence in their provider, in the ability of the test to detect cervical cancer and in their overall value for the usefulness of the test. The application of the findings of the present study may improve the currently inconsistent promotion of cervical screening to older women. The use of a theoretical framework informed by the Theory of Reasoned Action and Multi-Attribute Utility Theory showed promising results in incorporating the diverse factors involved in participating. in preventative health screening. Recommendations are made on the necessity of both targeted and general intervention strategies to increase the uptake of preventative screening by at-risk groups.
9
Girdham, Marie Shirley. "At the receiving end of male care : experiences of older disabled women." Thesis, University of Hull, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.440659.
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10
Correll, Patricia Kay. "Completion of Preventive Health Care Actions by Older Women with HIV/AIDS." ScholarWorks, 2015. http://scholarworks.waldenu.edu/dissertations/1494.
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The widespread use of highly active antiretroviral therapy (HAART) has resulted in longer lifespans for HIV seropositive women in the United States, during which preventive health care is recommended. Failing to complete recommended cancer screening tests can result in cancer being diagnosed at a later stage with a poorer prognosis. The purpose of the study, based on the ecosocial theory, was to describe the sociodemographic and clinical variables of HIV seropositive women who failed to complete recommended screening tests for breast, cervical, and colorectal cancers, and determine if the presence of hypertension, obesity, diabetes, depression, or tobacco use impacted the completion of these screening tests. The electronic medical records of 142 HIV seropositive women were reviewed. Univariate analysis, bivariate analysis, and logistic regression were conducted to create a model associated with the completion of preventive health care screening tests. For breast cancer, cervical cancer, and colorectal cancer, 69%, 71.8%, and 69.7% failed to complete screening, respectively. Number of years living with HIV infection and HIV stage were associated with breast cancer screening; distance between residence and health care facility, and HIV stage were associated with cervical cancer screening; and age and marital status were associated with colorectal cancer screening. Addressing issues related to the completion of cancer screening tests over the lifespans of HIV seropositive women can result in positive social change by preventing disease and disability, which can negatively impact these women, their families, and their communities.
11
Sanders, Fiona Ellen Sara. "The association between perceived social relationships, depression and early parental care in the later lives of women." Thesis, Bangor University, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.251169.
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12
Brown, Debora. "Depressed men angry women: Non-stereotypical gender responses to anti-smoking messages in older smokers." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2001. https://ro.ecu.edu.au/theses/1034.
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This qualitative study into the effective use of fear arousal in social marketing advertising, focused on exploring gender differences in smokers' attitudes towards threats in anti-smoking messages in the 40 to 50 year old age group. This age group of smokers has received relatively little attention in the fear arousal literature to date, presumably because their 'hard core' attitudes are perceived as difficult to change by social marketing and medical practitioners. The key purpose of this study was to explore the attitudinal responses of male and female smokers in the 40 to 50 year old age group to anti-smoking messages and in particular to those using death and non-death threats. Unexpected findings from a previous study (Henley 1997) were the first to indicate that significant gender differences occurred in this age group to anti-smoking messages. Henley's (1997) study focused on death versus non-death threats in social marketing messages in two age groups of smokers: 16 to 25 and 40 to 50 year aids. Response to the death threat, 'Quit smoking or you'll die of emphysema' was compared to the response of the non-death threat, 'Quit smoking or you'll be disabled by emphysema', in producing change in attitude, motivation and intention to adopt the recommended behaviour. The appropriateness of these threat messages was considered in relation to male and female smokers in two age groups, 16-25 years and 40-50 years. Henley (1997) found that significant differences occurred between older male and female smokers' responses to death and non-death threats in social marketing messages, and that in general, 40-50 year old males responded more to death threats and 40-50 year old females responded more to non-death threats, with the exception of death threats and loved ones. Focus groups were the qualitative method used for data collection in this study. Data was collected from four focus groups (2 male and 2 female), that consisted of 40 to 50 year old regular smokers. Group interviews were conducted as free flowing discussions interspersed with questions pertaining to the major objectives of the study. Projective questioning techniques were used to draw out participants' deeply held beliefs rather than their more easily accessible altitudes. As such, they were not asked direct questions pertaining to attitudes or specifically prompted for response to death and non-death threats. The men and women in this study fitted the characteristics of 'hard core', precontemplative smokers due to their long term smoking behaviour and low-involvement with anti-smoking information. Data were analysed manually according to themes in relation to the major objectives with special consideration given to gender differences that emerged. Attitudes were examined according to emotional, cognitive and behavioural responses. Gender differences are discussed in relation to how responses were articulated. Significant gender differences occurred in attitudinal response to threat in antismoking messages. In particular, gender differences occurred in relation to perceived self-efficacy, and strategies employed to cope with cognitive dissonance and negative emotions that emerged from exposure to anti-smoking messages. Men in this study revealed low levels of perceived self-efficacy, self-esteem and a sense of helplessness and powerlessness over their smoking behaviour. Discussions revealed the men had adopted maladaptive coping responses such as avoidance behaviour and denial in relation to anti-smoking messages. Women in this study revealed higher levels of self-efficacy and derived more benefits from smoking than men. However, their responses indicated anger towards patriarchal and authoritarian anti-smoking messages. Data also revealed that women had adopted maladaptive coping responses such as defiance, reactance and avoidance behaviour in relation to anti-smoking messages. An unexpected finding in this study was that both genders were clearly more accepting of positively framed anti-smoking messages that engendered self-esteem and higher efficacy. The implications for practitioners and researchers are that market segmentation is advisable for older smokers. 'Hard core' smokers may be a difficult group to reach via negatively framed anti-smoking messages and it is possible that positively framed messages may offer a solution. Further quantitative research is indicated into the relative effectiveness of positively framed messages and 'hard core' smokers.
13
McNamara, Laurence James. "Just health care for aged Australians : a Roman Catholic perspective /." Title page, contents and abstract only, 1997. http://web4.library.adelaide.edu.au/theses/09PH/09phm1682.pdf.
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Irwin, Pamela Margaret. "The development of resilience in two cohorts of older, single women, living on their own, in a small rural town in Australia." Thesis, University of Oxford, 2015. https://ora.ox.ac.uk/objects/uuid:e6820ead-3b23-4b87-8f68-ef4404a8c40c.
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Australian rural women are stereotypically perceived as stoic, self-reliant, and used to handling adversity. Since this iconic portrayal of resilience is traditionally (and contemporaneously) located in the harsh countryside, it is surprising that there are few articles examining this environment, person, and resilience nexus. This thesis addresses this omission by exploring the development of resilience in two cohorts of single, older women, living on their own in rural Australia. Accordingly, an ethnographic study was conducted in a small Australian town in 2012. Documentary evidence, participant observation, and interviews captured the separate and intersecting environment and person related contributors to resilience, mediated and moderated through situational relations over time. The results revealed the persistence and reinforcement of rural historical cultural stereotypes about older women, and the systematic exclusion of younger women retirees who chose to move to the town but did not fit these embedded cultural norms. When confronted with a societal attitude that socially constrains their social identity and role, and boxes them in, the older old women pragmatically accepted their situation, and successfully adapted to their new circumstances. For them, resilience is a reactive response to regain and maintain equilibrium in their lives. Conversely, the late middle-aged retirees were boxed out from actively participating and contributing to the community; for these women, resilience is equated to resignation and endurance. And as there is a symbiotic relationship between a town and its residents, this community represents a constraining force, both in terms of its stalled response to sociodemographic and structural change, and its passive indifference to the older women as exemplars of resilience. In effect, the community exerts an oppressive, dampening effect on the women's agentic resiliency; thus contradicting the prevailing literature where resilience is widely portrayed as a positive and active agentic concept.
15
Ruler, Amanda Jane. "Culture of nursing homes : an ethnomethodological study /." Title page, contents and abstract only, 2000. http://web4.library.adelaide.edu.au/theses/09PH/09phr935.pdf.
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16
Schalkwyk, Mathilde Geertruide. "The experience of caregiving : a qualitative study of older women whose husband have Parkinson's disease." Thesis, University of British Columbia, 1988. http://hdl.handle.net/2429/27733.
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This phenomenological study was designed to explore and describe the experience of older women who are caring for husbands with Parkinson's disease.
The study was conducted with a sample of seven caregivers ranging in age from 50 -74 years who had lived with husbands with Parkinson's disease for 9-38 years. Data were collected by intensive interviewing usually at the home of the caregiver. The data were analyzed for common themes.
The findings revealed that each wife experienced three phases during the course of caregiving. The three phases were: coping with illness, taking over, and separating life paths. These phases occurred in relation to the changes due to the illness, that each wife perceived in her husband, her marriage and herself. Each phase developed as the disease progressed and was meaningful to each wife because of her personal perceptions.
Understanding the nature of caregiving in this way may help health care workers to provide more appropriate support for caregivers. Implications for practice are discussed.Applied Science, Faculty of
Nursing, School of
Graduate
17
Pun, Wai-yi Helena, and 潘偉儀. "A study of caregiving in aging mother-adult daughter relationships." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1992. http://hub.hku.hk/bib/B44569658.
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18
Campbell, Kathleen J. "People over 85 years say I'd rather go under a train than go into a nursing home." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2008. https://ro.ecu.edu.au/theses/202.
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This study uses a qualitative in-depth research design to explore the attitudes that community living people over 85 years of age (n=lO) hold towards relocating to an aged care facility. Aged care facilities are supported accommodation options for the elderly that were previously known as nursing homes or hostels (Commonwealth Department of Health and Family Services, 1997). This type of accommodation currently houses 31 % of the total population of people over 85 years of age (Australian Bureau of Statistics, 2004-2005). Attitudes towards new environments are associated with relocation adjustment, and a review of the literature reveals negative perceptions by younger elderly people towards aged care facilities. Demographic trends indicate a rapid increase in the number of very-old people who are in the high-risk group for admission to aged care facilities; however there is a paucity of research regarding their attitudes towards such relocation. There are many implications for aged care service providers as a result of these demographic trends, but particularly in relation to accommodation options for the elderly. This research examines the attitudes that the very-old hold about going into residential care. It also explores the emotions underpinning that attitude. The main areas that emerged included concerns over media representation, perceived lack of control and fear of a loss of independence. There were very negative attitudes toward the loss of the home itself followed by concerns over loss of personal possessions. The very-old have such rich histories embedded in their home and possessions that these things become a part of their identity and culture (Moore, 2000) rather that a separate entity, and therefore the loss of these possessions could ultimately lead to the loss of self. The results have proven to be generally negative toward relocation to an aged care facility and combined with an assumption by the participants that there is no opportunity for future planning once in care, some expressed they would choose death rather than relocation. The implications of allowing these negative attitudes to continue without interventions based on further research and community consultation, will only add to the relocation stress syndrome already being experienced by many of very senior members of society (Capezuti, Boltz, & Renz, 2004).
19
O'Sullivan, Therese Anne. "The relationship between glycemic intake and insulin resistance in older women." Thesis, Queensland University of Technology, 2008. https://eprints.qut.edu.au/17814/1/Therese_Anne_O%27Sullivan_Thesis.pdf.
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Glycemic intake influences the rise in blood glucose concentration following consumption of a carbohydrate containing meal, known as the postprandial glycemic response. The glycemic response is a result of both the type and amount of carbohydrate foods consumed and is commonly measured as the glycemic index (GI) or glycemic load (GL), where the GI is a ranking in comparison to glucose and the GL is an absolute value encompassing both the GI and amount of carbohydrate consumed. Evidence from controlled trials in rat models suggests that glycemic intake has a role in development of insulin resistance, however trials and observational studies of humans have produced conflicting results. As insulin resistance is a precursor to type 2 diabetes mellitus, lifestyle factors that could prevent development of this condition have important public health implications. Previous observational studies have used food frequency questionnaires to assess usual diet, which could have resulted in a lack of precision in assessment of individual serve sizes, and have been limited to daily measures of glycemic intake. Daily measures do not take fluctuations in glycemic intake on a per meal basis into account, which may be a more relevant measure for investigation in relation to disease outcomes. This PhD research was conducted in a group of Brisbane women aged 42 to 81 years participating in the multidisciplinary Brisbane Longitudinal Assessment of Ageing in Women (LAW study). Older women may be at particular risk of insulin resistance due to age, hormonal changes, and increases in abdominal obesity associated with menopause, and the LAW study provided an ideal opportunity to study the relationship between diet and insulin resistance. Using the diet history tool, we aimed to assess the glycemic intake of the population and hypothesised that daily GI and daily GL would be significantly positively associated with increased odds of insulin resistant status. We also hypothesised that a new glycemic measure representing peaks in GL at different meals would be a stronger predictor of insulin resistant status than daily measures, and that a specially designed questionnaire would be an accurate and repeatable dietary tool for assessment of glycemic intake. To address these hypotheses, we conducted a series of studies. To assess glycemic intake, information on usual diet was obtained by detailed diet history interview and analysed using Foodworks and the Australian Food and Nutrient (AUSNUT) database, combined with a customised GI database. Mean ± SD intakes were 55.6 ± 4.4% for daily GI and 115 ± 25 for daily GL (n=470), with intake higher amoung younger participants. Bread was the largest contributor to intakes of daily GI and GL (17.1% and 20.8%, respectively), followed by fruit (15.5% and 14.2%, respectively). To determine whether daily GI and GL were significantly associated with insulin resistance, the homeostasis model assessment of insulin resistance (HOMA) was used to assess insulin resistant status. Daily GL was significantly higher in subjects who were insulin resistant compared to those who were not (134 ± 33 versus 114 ± 24 respectively, P<0.001) (n=329); the odds of subjects in the highest tertile of GL intake being insulin resistant were 12.7 times higher when compared with the lowest tertile of GL (95% CI 1.6-100.1, P=0.02). Daily GI was not significantly different in subjects who were insulin resistant compared to those who were not (56.0 ± 3.3% versus 55.7 ± 4.5%, P=0.69). To evaluate whether a new glycemic measure representing fluctuations in daily glycemic intake would be a stronger predictor of insulin resistant status than other glycemic intake measures, the GL peak score was developed to express in a single value the magnitude of GL peaks during an average day. Although a significant relationship was seen between insulin resistant status and GL peak score (Nagelkerke’s R2=0.568, P=0.039), other glycemic intake measures of daily GL (R2=0.671, P<0.001) and daily GL per megajoule (R2=0.674, P<0.001) were stronger predictors of insulin resistant status. To develop an accurate and repeatable self-administered tool for assessment of glycemic intake, two sub-samples of women (n=44 for the validation study and n=52 for the reproducibility study) completed a semi-quantitative questionnaire that contained 23 food groupings selected to include the top 100 carbohydrate foods consumed by the study population. While there were significant correlations between the glycemic intake questionnaire and the diet history for GL (r=0.54, P<0.01), carbohydrate (r=0.57, P<0.01) and GI (r=0.40, P<0.01), Bland-Altman plots showed an unacceptable difference between individual intakes in 34% of subjects for daily GL and carbohydrate, and 41% for daily GI. Reproducibility results showed significant correlations for daily GL (r=0.73, P<0.001), carbohydrate (r=0.76, P<0.001) and daily GI (r=0.64, P<0.001), but an unacceptable difference between individual intakes in 25% of subjects for daily GL and carbohydrate, and 27% for daily GI. In summary, our findings show that a significant association was observed between daily glycemic load and insulin resistant status in a group of older women, using a diet history interview to obtain precise estimation of individual carbohydrate intake. Both the type and quantity of carbohydrate are important to consider when investigating relationships between diet and insulin resistance, although our results suggest the association is more closely related to overall daily glycemic intake than individual meal intake variations. A dietary tool that permits precise estimation of carbohydrate intake is essential when evaluating possible associations between glycemic intake and individual risk of chronic diseases such as insulin resistance. Our results also suggest that studies using questionnaires to estimate glycemic intake should state degree of agreement as well as correlation coefficients when evaluating validity, as imprecise estimates of carbohydrate at an individual level may have contributed to the conflicting findings reported in previous studies.
20
O'Sullivan, Therese Anne. "The relationship between glycemic intake and insulin resistance in older women." Queensland University of Technology, 2008. http://eprints.qut.edu.au/17814/.
Full textAbstract:
Glycemic intake influences the rise in blood glucose concentration following consumption of a carbohydrate containing meal, known as the postprandial glycemic response. The glycemic response is a result of both the type and amount of carbohydrate foods consumed and is commonly measured as the glycemic index (GI) or glycemic load (GL), where the GI is a ranking in comparison to glucose and the GL is an absolute value encompassing both the GI and amount of carbohydrate consumed. Evidence from controlled trials in rat models suggests that glycemic intake has a role in development of insulin resistance, however trials and observational studies of humans have produced conflicting results. As insulin resistance is a precursor to type 2 diabetes mellitus, lifestyle factors that could prevent development of this condition have important public health implications. Previous observational studies have used food frequency questionnaires to assess usual diet, which could have resulted in a lack of precision in assessment of individual serve sizes, and have been limited to daily measures of glycemic intake. Daily measures do not take fluctuations in glycemic intake on a per meal basis into account, which may be a more relevant measure for investigation in relation to disease outcomes. This PhD research was conducted in a group of Brisbane women aged 42 to 81 years participating in the multidisciplinary Brisbane Longitudinal Assessment of Ageing in Women (LAW study). Older women may be at particular risk of insulin resistance due to age, hormonal changes, and increases in abdominal obesity associated with menopause, and the LAW study provided an ideal opportunity to study the relationship between diet and insulin resistance. Using the diet history tool, we aimed to assess the glycemic intake of the population and hypothesised that daily GI and daily GL would be significantly positively associated with increased odds of insulin resistant status. We also hypothesised that a new glycemic measure representing peaks in GL at different meals would be a stronger predictor of insulin resistant status than daily measures, and that a specially designed questionnaire would be an accurate and repeatable dietary tool for assessment of glycemic intake. To address these hypotheses, we conducted a series of studies. To assess glycemic intake, information on usual diet was obtained by detailed diet history interview and analysed using Foodworks and the Australian Food and Nutrient (AUSNUT) database, combined with a customised GI database. Mean ± SD intakes were 55.6 ± 4.4% for daily GI and 115 ± 25 for daily GL (n=470), with intake higher amoung younger participants. Bread was the largest contributor to intakes of daily GI and GL (17.1% and 20.8%, respectively), followed by fruit (15.5% and 14.2%, respectively). To determine whether daily GI and GL were significantly associated with insulin resistance, the homeostasis model assessment of insulin resistance (HOMA) was used to assess insulin resistant status. Daily GL was significantly higher in subjects who were insulin resistant compared to those who were not (134 ± 33 versus 114 ± 24 respectively, P<0.001) (n=329); the odds of subjects in the highest tertile of GL intake being insulin resistant were 12.7 times higher when compared with the lowest tertile of GL (95% CI 1.6-100.1, P=0.02). Daily GI was not significantly different in subjects who were insulin resistant compared to those who were not (56.0 ± 3.3% versus 55.7 ± 4.5%, P=0.69). To evaluate whether a new glycemic measure representing fluctuations in daily glycemic intake would be a stronger predictor of insulin resistant status than other glycemic intake measures, the GL peak score was developed to express in a single value the magnitude of GL peaks during an average day. Although a significant relationship was seen between insulin resistant status and GL peak score (Nagelkerke’s R2=0.568, P=0.039), other glycemic intake measures of daily GL (R2=0.671, P<0.001) and daily GL per megajoule (R2=0.674, P<0.001) were stronger predictors of insulin resistant status. To develop an accurate and repeatable self-administered tool for assessment of glycemic intake, two sub-samples of women (n=44 for the validation study and n=52 for the reproducibility study) completed a semi-quantitative questionnaire that contained 23 food groupings selected to include the top 100 carbohydrate foods consumed by the study population. While there were significant correlations between the glycemic intake questionnaire and the diet history for GL (r=0.54, P<0.01), carbohydrate (r=0.57, P<0.01) and GI (r=0.40, P<0.01), Bland-Altman plots showed an unacceptable difference between individual intakes in 34% of subjects for daily GL and carbohydrate, and 41% for daily GI. Reproducibility results showed significant correlations for daily GL (r=0.73, P<0.001), carbohydrate (r=0.76, P<0.001) and daily GI (r=0.64, P<0.001), but an unacceptable difference between individual intakes in 25% of subjects for daily GL and carbohydrate, and 27% for daily GI. In summary, our findings show that a significant association was observed between daily glycemic load and insulin resistant status in a group of older women, using a diet history interview to obtain precise estimation of individual carbohydrate intake. Both the type and quantity of carbohydrate are important to consider when investigating relationships between diet and insulin resistance, although our results suggest the association is more closely related to overall daily glycemic intake than individual meal intake variations. A dietary tool that permits precise estimation of carbohydrate intake is essential when evaluating possible associations between glycemic intake and individual risk of chronic diseases such as insulin resistance. Our results also suggest that studies using questionnaires to estimate glycemic intake should state degree of agreement as well as correlation coefficients when evaluating validity, as imprecise estimates of carbohydrate at an individual level may have contributed to the conflicting findings reported in previous studies.
21
Harding, Sandra B. "Planning for social equality in the urban environment : a case study of planning for elderly women in Brisbane." Thesis, Queensland University of Technology, 1992.
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22
Stehlik, Daniela Anna. "Making the invisible visable : an analysis of the Home and Community Care Program : a socialist-feminist perspective." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 1991. https://ro.ecu.edu.au/theses/1118.
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As the population of Australia ages, social policy and human service practice in the field of aged care is increasingly important and relevant. The Home and community Care (H.A.C.C.) Program was established in 1985 by the Labor Government as a response to a demand for more community services for the frail aged and was designed to reduce the incidence of institutionalisation by increasing home care services. In this way the Home and Community Care Program is seen as linchpin in the Federal Government's initiative to create an efficient and cost-effective aged care policy to contend with the future growth of Australia's ageing population. This thesis argues that there are several assumptions intrinsic to the H.AC.C. Program that are potentially jeopardising and undermining its usefulness. These assumptions are based on familial ideology and nostalgic conceptualizations of 'the community’ and 'the family'. In addition, these assumptions also involve stereotypic attitudes to women as primary carers and nurturers that ignore, to a great degree, the needs of women themselves. These assumptions, combined with an increasingly neo-conservative view about a reduction in the role of the State and a corresponding increase in family responsibility in welfare, have major implications for Australian women. This socialist-feminist analysis argues that women who are providing care for aged spouses or relatives are doing essential, hard and stressful work, work which is unpaid and often unacknowledged, and that the Australian welfare system is now structured around the invisible labour of such women. Consequentially, the assumption that a social policy program such as H.A.C.C. makes, that is, that there will always be women who care, requires further analysis. This research has revealed that such assumptions have implications for the future development of social policy for the aged in Australia and on the future roles of women in this country. Particular questions which this thesis addresses include, firstly, who actually provides care? Empirical research indicates that the majority of care is provided by one individual, usually the spouse, daughter or daughter-in law. Secondly, what are the assumptions underlying the development and implementation of Home and Community Care social policy in relation to the social construction of caring? Such assumptions are found to include, that the H.A.C.C. Program is premised upon an erroneous concept of the 'community' and consequentially 'community care' and that traditional 'family' and familial values are a precondition to H.A.C.C. service delivery. A socialist-feminist critique offers a deeper analysis of such assumptions by disclosing that the Home and Community Care policies assume that service delivery can be best undertaken by extending the traditional domestic role of women, thus utilising them as an unpaid, or poorly paid, labour force. This analysis also discloses the explicit rejection of the informal service system as having any real economic significance but rather being viewed as ‘complementary’ to the formal service system. Finally, there are future implications of such assumptions for women as primary carers, services users or paid staff within the H.A.C.C. Program which require urgent cognisance in order to develop a future aged care policy in Australia that avoids exploitation of women.
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Howrie, Paul. "How general practitioners and aged care workers perceive incidences of elder abuse." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2000. https://ro.ecu.edu.au/theses/1351.
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As the Australian population is expanding and ageing, there is an associated need for a focus to be placed on the Individual rights of elderly people, and for the general populus to be made more aware of areas related to our older generation. Elder abuse, as an area of concern, developed as an offshoot of investigations into child abuse and general domestic violence, and initially surfaced in the 1970s and 80s. Some sections of the medical profession were made specifically aware of the problem initially in 1975, through a letter that was sent to the British Medical Journal. However, throughout some of the literature, GPs have been criticised about their level of awareness of the issue of elder abuse, and for their lack of involvement in this area. The purpose of this study was to explore how General Practitioners and Aged Care workers perceive incidences of elder abuse. Due to the limited amount of research which has been undertaken on elder abuse within Australia, the study looked at exploring the issue rather than trying to measure its cause, or trying to identify the extent of the problem. The study investigated the perceptions of general practitioners (GPs) toward the area of elder abuse, and looked further to explore how general practitioners were perceived by aged care workers. The approach used for data collection consisted of circulating 100 mailed out questionnaires to general practitioners within metropolitan Perth, and follow up face-to-face interviews with some of the respondents to this questionnaire. Additionally, face-to-face interviews were also held with key informants who worked in the aged care industry, to ascertain their perceptions of elder abuse. The mailed questionnaires were analysed by adding the frequencies of responses given to each question. The data from the face-to-face doctor interviews and the key informant interviews were transcribed verbatim from the tape recordings and then assessed by looking for consistent regularities from each response made, therefore using a cross-case analysis. From this analysis, patterns emerged in the data, from which themes were developed. The recommendations from the data suggest that a clear and concise definition of elder abuse needs to be developed, to assist in clearly Identifying the prevalence of the problem. The data further recommended the need for an awareness campaign on the area of elder abuse to be undertaken. This should focus on raising the awareness of the possible characteristics of individuals who are vulnerable to being abused, as well as the characteristics of likely perpetrators of abuse. This study also recommended that a coordinated approach to dealing with the area of elder abuse should be developed, which should include the development of specific roles that should be undertaken by professional and non-professionals. Training of people across the Human Services field in the area of elder abuse, and in particular, GPs, social workers and paraprofessionals who work with elderly people, was identified as a recommendation of the study. Areas of training should include: awareness of the problem's existence; providing people with the required skills to detect cases of abuse; providing insight to referral agencies who may be able to assist; having a clear and exhaustive list of interventions to use to assist with addressing the problem; and having knowledge of the characteristics that abused individuals, and perpetrators are likely to have. This study also Identified that more research is required to ascertain if the amount of time which GPs spend with elderly people, is sufficient for them to identify cases of elder abuse, and if the allocated time from Medicare is adequate for GPs to Identify elder abuse.
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Marquis, Ruth. "The meaning of quality in living service environments: An analysis of the experiences of people with disabilities, elderly people and service workers." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 1998. https://ro.ecu.edu.au/theses/976.
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The purpose of the study was to examine the experiences of both people with disabilities and elderly people and to identify their perceptions of quality as it relates to living in a service or being supported by a service to live in the community. The study was naturalistic in design and used a phenomenological approach and inductive analysis. It involved immersion in living services for a two year period, in-depth interviews with people living and working in services and participant observation. Fifty service users between the ages of twenty-one and ninety-six, and twenty-six service workers between the ages of twenty-six and fifty-four were informants in the study. The study comprised of three phases, the first phase involved repeated in-depth interviews with service users in two disability and two aged care living services to examine the experiences of people living in services and their perceptions of quality. As a result of the consistency with which relationships with key staff members emerged in the context of quality experiences, selected service workers who were named by service users were also interviewed. The findings in this phase indicated that relationships experienced by service users in their encounters with service workers were more significant in service users' evaluation of quality than tangible acts of physical and environmental care. Relational experiences of people living in services were variable. Some informants experienced consistent validation and socio-emotional support, whilst others experienced role distancing and negative communication experiences. Service workers who were interviewed as a result of being identified by service users in the context of quality, attached importance to the relational domain in the acts and behaviours of providing a service. They also attached personal meaning to their roles as service workers and shared the view that their role as service worker was underpinned by an ethos of communality. The second phase of the study involved accessing another five disability and five aged care services to collect further data to support or refute the findings from phase one. As a result a large data bank was established to confirm the consistency with which relational experiences in living services were linked to perceptions of quality by both service users and service providers. Acts and behaviours which were consistently present in the context of quality were also identified and the need for emotional support in the living context was further confirmed. The third phase of the study involved an in-depth analysis and identification of commonly experienced categories of relationships between service users and workers. Relationships were categorised into ethical and technical living service experiences and exemplars used to illustrate findings. Data analysis indicated that service experiences lie on a continuum, with mutually supportive relationships between service users and workers at one end, and physical and psychological abuse at the other. Experiences were variable in singular service contexts. This highlighted the individual nature of service relationships between service users and workers and the need to articulate human service as relationship. It also highlighted the inadequacies of using standard measures to evaluate quality in living services.
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Trigg, Lisa. "Improving the quality of residential care for older people : a study of government approaches in England and Australia." Thesis, London School of Economics and Political Science (University of London), 2018. http://etheses.lse.ac.uk/3772/.
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Improving the quality of residential care for older people is a priority for many governments, but the relationship between government actions and high-quality provision is unclear. This qualitative research study uses the cases of England and Australia to examine and compare regulatory regimes for raising provider quality. It examines how understandings of quality in each country are linked to differences in the respective regulatory regimes; how and why these regimes have developed; how information on quality is used by each government to influence quality improvement; and how regulatory regimes influence providers to deliver quality. The study develops a new typology of three provider quality orientations (organisation-focused, consumer-directed, relationship-centred) to examine differences between the two regulatory regimes. The research draws on interviews conducted between January 2015 and April 2017 with 79 individuals from different stakeholder groups in England and Australia, and interviews with 24 individuals from five provider organisations in each country. These interviews highlighted greater differences between the two regimes than previous research suggests. For example, while each system includes a government role for inspecting or reviewing provider quality, there are differences around how quality is formally defined, the role and transparency of quality information, and how some provider quality behaviour is influenced by different policy interventions. Two important findings emerge from the study for policymakers and researchers. First, the importance of considering the broader historical and institutional context of the care sector overall, not simply the regulatory environment, as shown by the more welfare-oriented approach in England when compared to Australia’s highly consumerist approach. Second, the importance of considering the overall ‘regulatory space’ when designing policy interventions for quality. Policymakers should consider the effects and interaction of multiple policy interventions, the impact of funding mechanisms and the activity of multiple stakeholders, and not restrict attention to those policy interventions explicitly developed for quality improvement goals.
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McEwen, Marylyn. "Family adaptability, family cohesion, spirituality and caregiver strain in women as caregivers of elder kin." Thesis, The University of Arizona, 1987. http://hdl.handle.net/10150/558069.
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Motenko, Aluma K. "The gratifications, frustrations, and well-being of older women caring at home for husbands with Alzheimer's disease or a related disorder." Thesis, Boston University, 1988. https://hdl.handle.net/2144/38083.
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Thesis (Ph.D.)--Boston UniversityPLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you.
There is growing evidence of the burden of family care giving, particularly among spouses. but little attention has been paid to the gratifications experienced. A cross-sectional, non-probability, interview study conducted in Massachusetts of 50 wives ages 58 and older supports the hypothesis that caregivers who are more gratified have greater well-being and those who experience greater frustration are more distressed. The caregivers were gratified by having their husbands at home; by believing that caregiving involved reciprocity and nurturing; enjoying moments of warmth. comfort, and pleasure: having gratification from their emotional support systems; and experiencing no change in marital closeness since the illness. Caregivers at risk of mental health problems are those who are highly frustrated and not gratified by the care giving experience. The general frustrations of feeling overwhelmed, resentful, fearful and not resigned were associated with low well-being. Frustration of wives with husbands' ADL ability, with inadequate time for themselves. with constraints of caregiving, with household chore responsibility. and with changes in their emotional support systems also contributed to low well-being. Comparison of the sample with national studies all utilizing the Dupuy WellBeing Scale, shows that the majority of caregivers are in no more distress than the general adult population. Thirty-two percent, however, are in severe distress. Caregiver distress is associated primarily with anxiety, not with depression as widely believed. Distress is not associated with caregiver age or health or with patient illness characteristics, factors that should no longer be used in clinical circles to assess the status of caregivers. Maintaining continuity in preferences and patterns is important to the well-being of caregivers. The study findings can guide the mental health treatment of caregivers particularly as the data lends support to the theory that disruption in the lives of caregivers is a stressor.
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Merkes, Monika, and monika@melbpc org au. "A longer working life for Australian women of the baby boom generation? � Women�s voices and the social policy implications of an ageing female workforce." La Trobe University. School of Public Health, 2003. http://www.lib.latrobe.edu.au./thesis/public/adt-LTU20051103.104704.
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With an increasing proportion of older people in the Australian population and increasing health and longevity, paid work after the age of 65 years may become an option or a necessity in the future. The focus of this research is on Australian women of the baby boom generation, their working futures, and the work-retirement decision. This is explored both from the viewpoint of women and from a social policy perspective. The research draws on Considine�s model of public policy, futures studies, and Beck�s concept of risk society. The research comprises three studies. Using focus group research, Study 1 explored the views of Australian women of the baby boom generation on work after the age of 65 years. Study 2 aimed to explore current thinking on the research topic in Australia and overseas. Computer-mediated communication involving an Internet website and four scenarios for the year 2020 were used for this study. Study 3 consists of the analysis of quantitative data from the Healthy Retirement Project, focusing on attitudes towards retirement, retirement plans, and the preferred and expected age of retirement. The importance of choice and a work � life balance emerged throughout the research. Women in high-status occupations were found to be more likely to be open to the option of continuing paid work beyond age 65 than women in low-status jobs. However, the women were equally likely to embrace future volunteering. The research findings suggest that policies for an ageing female workforce should be based on the values of inclusiveness, fairness, self-determination, and social justice, and address issues of workplace flexibility, equality in the workplace, recognition for unpaid community and caring work, opportunities for life-long learning, complexity and inequities of the superannuation system, and planning for retirement. Further, providing a guaranteed minimum income for all Australians should be explored as a viable alternative to the current social security system.
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Bonar, Rita Aguzzi. "Intra-ethnic differences of the perceptions of aged Italian women in receiving care." Thesis, McGill University, 1993. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=41096.
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This thesis is qualitative study of the perceptions of aged Italian women in receiving care. It examines intra-ethnic group differences between Italian-Immigrant and Italian-Canadian women, and their definition of the experience of receiving care. Also, it addresses gender, class, and ethnicity issues which have implications for social work practice, policy, and research.Sixty-one interviews were conducted with thirty participants, over the age of sixty-five. Participants were interviewed in their treatment environments with follow-up interviews in their home settings. Semi-structured in-depth interviews documenting these women's life histories, as well as participant observation, were the qualitative methods used to collect data. Interview transcripts and field notes were analyzed qualitatively to identify similarities and differences in participants' perceptions as care-receivers. A feminist theoretical perspective was applied to the discussion of the data.
The study suggests that differences exist between aged Italian-Immigrant and Italian-Canadian women care-receivers. These differences are directly related to specific personal and social factors which nurture and oppress them. Aged Italian-Canadian women were found to have more resources, greater independence with their supportive alliances, and higher levels of self-esteem and life satisfaction than aged Italian-Immigrant women. The findings provide insight into resources these women developed to deal with the constraints imposed on them by their gender, class, and ethnicity.
The study suggests an integrated-interactive approach of practice, policy, and research to implement changes so as to meet the needs of these individuals. The study recommends that a feminist social work approach be adopted in the educational curriculum for the training of social work professionals.
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Sims, Colette Marie. "Recipes Run in Our Families Not Illnesses: Older Black Women on Race, Health Disparities and the Health Care System." Diss., The University of Arizona, 2006. http://hdl.handle.net/10150/194759.
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Reducing racial and ethnic disparities in healthcare are ongoing concerns. A paucity of data on healthcare seeking behavior among older Black women has hampered efforts to make culturally responsive healthcare services available to this population. Little is known about how older Black women's expectations and perceptions of care affect their patterns of health behavior.This study explored sociocultural contexts of health behavior with fifty Black women, aged 40 and older, in Tucson, Arizona by examining what prompts these women to seek services, identifying key factors affecting their access to and utilization of healthcare, documenting their experiences in healthcare settings and how these interactions influence their healthcare-seeking behavior. If effective healthcare service access and utilization are to be encouraged among older Black women, an informed understanding of the role cultural difference plays is essential.This research has three purposes: to provide a forum for discussion of culturally relevant strategies and models for prevention of disease and promotion of wellness in Black communities; to provide perspectives on older Black women's health issues for policymakers and administrators in public health sciences; and to gain insight and document reasons for selected health behaviors among this population. Research funding from the NIH/ NIA has helped to establish this small multi-disciplinary data set on a specific race, gender and age sub-population group for future research and development of community resource partnerships; including public health education and effective healthcare service delivery with intervention / promotion efforts targeting older Black women.Findings: Older Black women's poorer health status reflects the cumulative effects of inadequate health care due to various discriminatory experiences and their mistrust of the health care system. Mistrust, expectations of racial bias, perceived cultural insensitivity, and lack of effective communication within healthcare settings were found to be barriers to their healthcare-seeking behavior. Neither healthcare providers nor older Black women can address these issues alone. Working towards more trusting relationships within healthcare settings is critical in beginning to address avoidable inequities in health status experienced by older Black women.This research is applicable to such disciplines as Sociocultural/Medical Anthropology, Health Education, Public Health, and Africana/Ethnic Studies.
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Larson, Karen Louise. "The impact of caregiving." Thesis, University of British Columbia, 1985. http://hdl.handle.net/2429/24418.
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The increased incidence of chronic illness among the elderly makes long-term care a health concern as the population ages. Little is known about the impact of chronic confusion on the family. This study used a qualitative approach to look at the impact on the caregiving wife of caring for a chronically confused, elderly husband. Six wives whose elderly husbands experienced chronic confusion and who lived alone with their husband were interviewed using the phenomenological method described by Giorgi (1975). The findings indicated that there is a substantial impact when the husband depends on his caregiving wife to remain in the home, especially when the wife is older and experiences chronic illness herself. Overall, these negative effects were congruent with those reported by other researchers, suggesting that the general impact of long-term care is burden.
The themes in the caregivers' accounts revolved around three main concerns: the management of the husband's dependency, the maintenance of the family as a unit, and the acceptance of the caregiving situation. Chronic confusion occurred with other chronic illnesses and compounded the husbands' impairments. Interpersonal relations were also adversely affected, and the wives had to learn to take control of the family amidst physical strain and social isolation. The caregiver found that her life came to revolve around the needs of her husband; she derived meaning from fulfilling her perceived duty as a wife. The presence of chronic illness and aging intensified her experience of burden. Despite the costs to her well-being, the wife was devoted to maintaining her husband at home.
The caregiving wife needs support to deal with the husband's care and its negative consequences, but her desire to remain as independent as possible appears to conflict with her utilization of outside support. Nursing intervention should be directed toward assisting the caregiver to cope with the husband's care and with its negative effects on her. Nursing education should prepare the practitioner with a broad background in community health nursing, gerontology, and geriatrics to enable her to provide nursing care to these kinds of families. Future nursing research should focus on furthering the understanding of the impact of caregiving as a basis for planning the most helpful interventions to support the caregiver.Applied Science, Faculty of
Nursing, School of
Graduate
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Mji, Gubela. "Exploring the health knowledge carried by older Xhosa women in their home situation, with special focus on indigenous knowledge." Thesis, Stellenbosch : Stellenbosch University, 2013. http://hdl.handle.net/10019.1/79978.
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Thesis (PhD)--Stellenbosch University, 2013.ENGLISH ABSTRACT: Rationale: Critical questions have been raised about the overcrowding of primary care services, such as community health centres (CHCs) and clinics in predominantly Xhosa-occupied areas in the Western and Eastern Cape, with clients who present with minor health ailments. Suggestions have been made about the integration and the use of the indigenous health knowledge (IHK) carried by older Xhosa women in the services as a strategy for managing minor health ailments, and as a way of encouraging appropriate health-seeking behaviour. Preliminary studies have reinforced the need for the revival of the IHK that currently is lying dormant within communities. The studies affirm that such knowledge could be an asset if integrated into, and valued by, the Western biomedical model, and could play a major role in contributing towards alleviating the problem of overcrowding in primary care (PC) services. Aim: This study primarily explored and described the IHK carried by older Xhosa women and used in the management of health problems in their home situation. Secondary recommendations were made to key stakeholders regarding the use, retainment and integration of the IHK into PC services. Method: This ethnographic, feminist and emancipatory study used qualitative methods of data collection. Thirty-six (36) older Xhosa women were purposefully selected to participate in four FGDs, to explore the IHK that they used for managing health problems in their home situation. Sixteen (16) in-depth interviews were conducted with the elite older Xhosa women and their family members to validate the findings from the four FGDs. The process of analysis and interpretation was informed by an inductive process of a combination of narrative analysis and the analysis of narratives strategies. Findings: The findings showed that the older Xhosa women possess IHK regarding the management of minor health problems within the home situation. Assessment, treatment strategies and medications were identified. Functionality and observation are mainly used to diagnose and manage illness. This approach also includes monitoring the progress, severity and recovery from illness in the patient. The findings further demonstrated that older Xhosa women were also managing illnesses that could be classified as major. They could clearly distinguish between what was health and what was illness in their village. Distance from health care services had an impact on the health-seeking behaviour of the older Xhosa women, with those closer to health care services wanting all illnesses, even those that could be classified as minor health ailments, to be managed by the health service, and those who were farther away from the hospital appearing to manage complex illnesses, and only referring clients with those illnesses to external health care services quite late. The findings further showed communication and attitudinal problems that existed between the clients and health care providers. Conclusion: Many studies have already challenged the manner in which PHC was implemented in developing countries, as it appeared to focus on the curative approach to disease and left out disease prevention and health promotion. It is within this area that the older Xhosa women appear to express the greatest concern for the health of their homes and villages. The older Xhosa women in the Eastern Cape appear to be struggling with problems of broken family units, and are left behind to struggle to keep the home together, as they lack the necessary resources to do the hard work involved with producing food and building the home and village. In the light of the promise of National Health Insurance and the revitalisation of PHC, the study proposes that the two major national health policies should take cognisance of the IHK utilised by the older Xhosa women, and that there should be a clear plan as to how the knowledge can be supported within a health care systems approach. A rural health model is proposed by the study to do this.
AFRIKAANSE OPSOMMING: Rasionaal: Daar word kritiese vrae gestel oor die toeloop van mense met geringe ongesteldhede by primêre-sorg(PS)-dienste, soos gemeenskapgesondheidsentrums (GGS) en klinieke, hoofsaaklik in Xhosa-woongebiede in die Wes- en Oos-Kaap. Voorstelle is geopper dat ouer Xhosa-vroue se inheemse gesondheidskennis (IGK) by die dienste geïntegreer en benut moet word as ’n strategie om minder ernstige gesondheidsprobleme te bestuur en om mense aan te moedig om toepaslike keuses oor gesondheidshulp te maak. Voorlopige navorsing het die nodigheid bevestig dat die kundigheid wat tans onbenut in gemeenskappe lê, herontgin behoort te word. Die navorsing bevestig dat sulke kennis ’n bate kan wees indien dit as ’n gewaardeerde element by die Westerse biomediese model ingeskakel word en dat dit ’n groot rol kan speel om die druk op PS-sentrums te verlig. Doelstelling:Hierdie navorsing ondersoek en beskryf hoofsaaklik die IGK waaroor ouer Xhosa-vroue beskik en wat in die hantering van gesondheidsprobleme in hul tuisomgewing aangewend word. Aanvullende aanbevelings rakende die gebruik, behoud en integrasie van IGK by PS-dienste is aan bepalende belanghebbers voorgelê. Metode: Kwalitatiewe data-insamelingsmetodes is in hierdie etnografiese, feministiese en bevrydingsgerigte navorsing gebruik. Ses-en-dertig ouer Xhosa-vroue is spesifiek uitgesoek vir deelname aan vier fokusgroepbesprekings (FGB’s) om hul hantering van gesondheidsprobleme in hul tuisomgewing aan die hand van hul IGK te ondersoek. Sestien indringende onderhoude is met die elite- ouer Xhosa-vroue en hul gesinslede gevoer om die bevindings van die vier besprekings te bevestig. Die proses van ontleding en vertolking is gerig deur ’n induktiewe proses wat ’n kombinasie van narratiewe ontleding en die ontleding van narratiewe strategieë behels het. Bevindings: Die bevindings wys dat ouer Xhosa-vroue IGK het rakende die hantering van minder ernstige gesondheidsprobleme in die tuisomgewing. Evalueringsmetodes, behandelingstrategieë en medikasie is uitgewys. Kwale word hoofsaaklik volgens funksionaliteit en waarneming gediagnoseer en hanteer. Die werkwyse sluit in dat pasiënte se vordering, die erns van hul siekte en hul herstel gemoniteer word. Die bevindings wys verder dat ouer Xhosa-vroue ook siektetoestande hanteer wat as ernstig geklassifiseer kan word. Hulle kan duidelik tussen gesondheid en siekte in hul gemeenskap onderskei. Die afstand vanaf gesondheidsorgdienste speel ’n rol in die gedrag van ouer Xhosa-vroue wat keuses oor gesondheidshulp betref; diegene wat na aan ʼn gesondheidsorgsentrum woon, verkies dat die gesondheidsdienste alle siektes - selfs dié wat as minder ernstige gesondheidskwale geklassifiseer kan word - moet hanteer, terwyl diegene wat verder van ’n hospitaal woon, klaarblyklik self komplekse siektetoestande behandel en eers op ’n gevorderde stadium sulke kliënte na eksterne gesondheidsorgdienste verwys. Die bevindings het ook probleme rakende kommunikasie en houdingsingesteldheid tussen kliënte en gesondheidsdiensverskaffers uitgewys. Gevolgtrekking: Verskeie ondersoeke het al die manier waarop PG-sorg in ontwikkelende lande toegepas word, bevraagteken, aangesien die benadering oënskynlik op genesing fokus terwyl dit siektevoorkoming en gesondheidsvoorligting verontagsaam. Dis oor hierdie aspek dat die ouer Xhosa-vroue skynbaar die grootste kommer oor die welstand van hul huishoudings en gemeenskappe het. Die ouer Xhosa-vroue in die Oos-Kaap het klaarblyklik met dieselfde probleme van gebroke gesinne as dié in die Wes-Kaap te kampe, en word dikwels alleen agtergelaat om die huishouding te laat oorleef. Hulle kry swaar om sonder die nodige hulpbronne die harde werk te doen om voedsel te produseer en om huishoudings en die gemeenskap op te bou. In die lig van die vooruitsigte wat nasionale gesondheidsversekering en vernuwing van die PGS inhou, stel hierdie navorsingsprojek voor dat bogenoemde twee hoofelemente van die nasionale gesondheidsorgbeleid aandag skenk aan die IGK wat ouer Xhosa-vroue toepas, asook dat ’n duidelike plan uitgewerk word oor hoe hierdie kennis binne die benadering tot gesondheidsorg ondersteun kan word. Die navorsings stel ’n model vir plattelandse gesondheidsorg voor om dié doelstellings te verwesenlik.
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Salamah, Seham. "The quality of life, social care and family relationships of older unmarried Saudi women living in Jeddah : a qualitative study." Thesis, University of Surrey, 2018. http://epubs.surrey.ac.uk/845801/.
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Changes in the Saudi family structure are having profound effects on the current cohort of older Saudi women. This is reflected in living arrangements whereby family patterns have been transformed from extended to nuclear ones. Previous social research has not examined the current situation of older Saudi women, with little known about their Quality of Life (QoL). This study explores the QoL of older unmarried Saudi women by analysing their family relationships, social lives and daily activities. It examines how family relationships, social integration, health and financial aspects are influenced by social policies and gender-related issues. The study is based on in-depth interviews with a purposive sample of 50 widowed, divorced and never-married women aged 60-75 in Jeddah, Saudi Arabia from a range of socio-economic classes; 25 lived alone and 25 lived in inter-generational households. Gender segregation was a decisive factor that adversely affected the QoL of interviewees. They were dependent on their family or maids socially, instrumentally, and some financially on the ‘Goodwill’ of their children or relatives. Older divorced women were particularly likely to experience financial and social problems. Lower class and many middle class older women who lived alone were dissatisfied and suffered from depression, isolation and loneliness, whereas higher class women living alone demonstrated greater autonomy, independence and life satisfaction. Most interviewees had poor health and multiple chronic diseases, such as diabetes and high blood pressure, which are linked to their socially and geographically restricted lives. Also, urbanization and associated cultural changes have adversely affected their QoL. Gender segregation driven by ultra-conservative patriarchy has resulted in the economic and social dependency and restricted lives of older unmarried Saudi women. State intervention is needed to improve the general situation of older women, such as establishing care homes, increasing social insurance income and providing medical insurance.
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Hicks, Nytasia M. ""It's a care free way of life": A qualitative descriptive study on living-apart-together relationships among older black women." Miami University / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=miami1595603122018959.
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Pangerl, Sabine. "The adherence to group b streptococcus screening guidelines amongst pregnant women in Western Australia – A quantitative descriptive analysis." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2021. https://ro.ecu.edu.au/theses/2448.
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Colonisation with Group B Streptococci (GBS) is a major risk factor for neonatal infection acquired via vertical transmission during pregnancy, labour, or birth, potentially resulting in significant morbidity and mortality. Universal screening at 35 – 37 weeks gestation for maternal GBS colonisation and the use of intrapartum antibiotic prophylaxis has resulted in substantial reductions in the burden of neonatal Early-Onset GBS Disease (EOGBSD). Women in Western Australia (WA) are offered GBS screening in pregnancy and intrapartum antibiotic prophylaxis. Anecdotal evidence suggests variations in viewpoints and thus low adherence to relevant clinical guidelines amongst midwives and pregnant women in the midwifery led model of care. To date, no research has been undertaken to provide empirical evidence for these anecdotal reports, suggesting the need for research.
This study has aimed to investigate the adherence to recommended GBS screening guidelines across five maternity hospitals in metropolitan and regional WA. Three objectives guided this research conducted within two different cohorts (midwifery and non-midwifery led) plus subgroups including Midwifery Group Practice (MGP), Community Midwifery Program (CMP) and Private Midwives (PM): 1) determination of GBS colonisation rates; 2) the examination of adherence to antenatal GBS screening; and 3) examination of adherence to the intrapartum antibiotic prophylaxis protocol.
This retrospective WA study has employed a quantitative research design using administrative health data that included 22,417 pregnant women who gave birth between 2015 – 2019. Descriptive statistics were applied using secondary data analysis to describe the characteristics and patterns of GBS screening guideline adherence. The results were compared between all involved study cohorts.
The study revealed similar GBS colonisation rates amongst pregnant women in all included study groups. A lower adherence to the GBS screening guidelines was found in the midwifery led model of care when compared to the non-midwifery led model of care. Over the five-year period, screening rates trended down in the midwifery led population whilst the numbers remained stable in the non-midwifery led cohort. When the MGP groups were compared across the five hospitals, vast variations were discovered. Further, when rates of adherence were investigated in relation to intrapartum antibiotic prophylaxis, discrepant findings emerged between the study groups.
This study not only fills an important gap in the existing literature, it also seeks to assist guidance and improvement of clinical protocols in relation to GBS screening to reduce the risk of neonatal infection. Recommendations include educational interventions and the need for further research.
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Hill, Heather, and heatherhill@hotkey net au. "TALKING THE TALK BUT NOT WALKING THE WALK: BARRIERS TO PERSON CENTRED CARE IN DEMENTIA." La Trobe University. School of Public Health, 2004. http://www.lib.latrobe.edu.au./thesis/public/adt-LTU20041215.100826.
Full textAbstract:
While the concept of person-centred care in dementia has been around for 15 years or more and has attracted much interest and enthusiasm, aged care facilities continue to have difficulty in actually implementing and maintaining person-centred practices. In this study I explore the experience of one aged care facility in order to identify the barriers to changing care practice. The research took place in an ethno-specific (Jewish) aged care facility, Star of David, which was in the process of setting up a program for its residents with dementia based on person-centred principles. The methodology used in the research study was ethnographic, involving participant observation and interview, with a particular focus on a limited number of participants: four residents and their families, four senior staff, four personal care attendants and the executive director. Interviews were also conducted with staff members from three other aged care facilities. The findings showed that Star of David was unable to bring about substantial change in its care practices, while the external interviews and the literature suggest that other facilities have similar difficulties. I identify three major types of barrier: procedural barriers within the institution itself; (government) policy; and barriers relating to hegemonic values and beliefs which underpin established health care practice. These three types of barrier interact with and reinforce one another. I conclude that if we are to change care practice in institutions, we must address all of these barriers at the same time. Finally, I suggest that person-centred care itself, which continues to place emphasis on professional service provision, may only be the beginning of necessary change. In order to be truly person-centred, we need to move towards a more community based or public health approach which recognizes the need of all persons to be treated both as significant individuals and accepted as part of a community.
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Polimeni, Anne-Maree, and Anne-Maree Polimeni@dhs vic gov au. "Narrative of women's hospital experiences the impact of powerlessness on personal identity." Swinburne University of Technology, 2004. http://adt.lib.swin.edu.au./public/adt-VSWT20050309.143640.
Full textAbstract:
Since women dominate the health care system as consumers, it is important to understand how women want to be treated by medical staff, and the factors that contribute to satisfactory hospital experiences. The present research comprised two separate but integrated studies exploring these issues. The first study adopted an
atheoretical approach. Qualitative and quantitative methods were used to examine the
importance of hospital experiences in the lives of women, and the role of power within those experiences. Closed answer items about hospital experiences were completed by 124 women who had had a hospital stay of at least one night. In addition, ten of the women provided open-ended oral and written comments about their hospital
experiences, which were used as the basis of the qualitative data. The majority of the women were satisfied with their hospital stay, but a small group recalled experiences of powerlessness associated with the non-medical aspects of their treatment, such as behaviours on the part of health professionals that influenced participants� sense of control as hospital inpatients. The qualitative data reflected similar issues to the quantitative data and provided �process� information by demonstrating how health professionals� behaviour could contribute to patients� feelings of powerlessness. The results suggested that hospital experiences were a salient part of these women�s lives. The richness of the qualitative data suggested that qualitative methodology would be a productive way to further study this area.
The second study was an extension of the first via in-depth interviews with 19 women who perceived their hospital experiences as life-altering. The interview content and the analysis were based on a narrative approach that used the theoretical framework of McAdams� (1993) Life Story Model of Identity. Using McAdams� methodology enabled the researcher to evaluate how women constructed meaning from their hospital
experiences, and the main issues they faced. The life story interview also proved a useful way to explore issues of loss and self-growth in the face of traumatic hospital experiences. Transcripts of descriptions of positive and negative experiences were analysed according to McAdams� themes of agency (sense of power and control) and communion (relationships with others), and sequences of redemption and
contamination. Redemption sequences involve the storyline moving from a bad, affectively negative life scene, to a good, affectively positive life scene. In a contamination sequence, the narrator describes a change from a good, affectively
positive life scene, to a subsequently bad, affectively negative life scene (McAdams & Bowman, 2001). Participants also rated their experiences according to Hermans� (Hermans & Oles, 1999) list of affects. There was strong agreement between McAdams� coding of agency and
communion and Hermans� agentic and communal indices: the women�s hospital stories strongly emphasised the negative or opposite of McAdams� agentic theme �Self Mastery through Control�, which indicated powerlessness, and Hermans� affects, which involved low self-enhancement. It may be useful for future studies to conceptualise
McAdams� themes as bipolar by incorporating currently coded themes and their reverse; in particular, by expanding ideas of agency to incorporate powerlessness, as this theme was pervasive in women�s hospital experiences. The rating of affects added to the findings as this showed a latent dimension of communion manifested as isolation. The common agency and communion themes were apparent in the two distinct but related aspects of hospitalisation that affect patients� sense of control: the medical condition and the manner in which patients are treated by medical staff. The findings of the main study built on the pilot study by showing how ideas of control and powerlessness can inform better practice. For example, respectful, dignified and fair treatment by health professionals played a part in determining redemption sequences; women also indicated this was how they wanted to be treated. Due to the vulnerability of the �sick role�, disrespectful or offhand treatment by health professionals had particularly distressing effects evident in contamination sequences, such as negative changes to sense of self and attitudes toward the health care system. In some cases, such treatment led to participants� avoiding subsequent interactions with doctors and to sustained feelings of helplessness. The present thesis demonstrates that doctors, nurses
and other health professionals need to allow time to attend to the affective as well as the medical aspects of the encounter. Health professionals need a good bedside manner, compassion, and communication skills, as these characteristics play a part in maintaining female patients� sense of self and their faith in and satisfaction with the health care system.
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Straka, Silvia M. "How social workers in community health care understand and respond to concerns of intimate partner abuse in the lives of older women." Thesis, McGill University, 2009. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=111904.
Full textAbstract:
Guided by a feminist intersectionality framework and conducted within an action research paradigm, this dissertation reports on how social workers in community health care respond to concerns of intimate partner abuse in the lives of older women. The study was undertaken in 18 publicly-funded community health and social services agencies (CLSCs) in Quebec, Canada. Interviews were carried out with 30 social workers and three focus groups were held with some of the same social workers.In this dissertation, I argue that social workers in community health care might benefit from using certain theoretical frameworks, as they tend to see older women as a homogeneous group, view older women's agency as problematic, and lack a cohesive understanding of the problem of intimate partner abuse -- all of which leaves them less than optimally equipped for intervention. Furthermore, certain features of intimate partner abuse at the intersection of gender, age, and disability can make intervention very complex. As a result, social workers tend to view intimate partner abuse in the lives of older women as an intractable problem, rife with double-binds, contradictions, and tensions, which can leave them feeling powerless.
In the first three chapters of this dissertation I present the study's theoretical framework, its location within the empirical scholarship on intimate partner abuse, and the methods used. I also provide background information on the Quebec context of practice. Chapters 4 and 5 are empirical chapters reporting the findings as they relate to social workers' understandings and their responses. Chapter 6 is the concluding chapter and discusses the three principal findings. The first key finding was that the practice setting shapes social workers' understandings of and responses to the problem. The second key finding was that social workers could benefit from certain theoretical frameworks that would greatly enhance their practice. The third finding is that social workers view intimate partner abuse as both enduring and changing in form, frequency, and intensity over time. The implications for theory, practice, and research are offered for each key finding.
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Hatton, Jacinta. "Fear of falling and its relationship to depression and anxiety in older adults living in the community and in extended care facilities in Australia." Thesis, Hatton, Jacinta (2016) Fear of falling and its relationship to depression and anxiety in older adults living in the community and in extended care facilities in Australia. Professional Doctorate thesis, Murdoch University, 2016. https://researchrepository.murdoch.edu.au/id/eprint/35039/.
Full textAbstract:
One of the most common psychological costs of falls in older adults is the development of a fear of falling, which can then result in an increased risk of future falls. The purpose of this research was to examine the relationships between fear of falling and two of the most common psychological disorders in later life; depression and anxiety. To extend on previous research, study one aimed to investigate the relationships between fear of falling, depression and anxiety in an Australian community-dwelling population using quantitative analysis. Due to the limited number of studies examining fear of falling in the extended care population, study two was an exploratory investigation of the above relationships in this population using both quantitative and qualitative analysis. A total of 80 community-dwelling older adults and 47 extended care older adults completed the questionnaires. A further 12 older adults participated in the interviews. The findings, overall, extended on previous research, where anxiety was consistently associated with fear of falling constructs in both the community and extended care populations. In contrast, associations between fear or falling and depression were variable within and across studies, depending on the fear of falling measurement that was used. In addition, an important finding from the qualitative analysis revealed that older adults may view their feelings as a “concern” rather than a “fear”, supporting recent suggestions to revise how fear of falling is described. The clinical implications were discussed in terms of the importance for clinicians who work with older adults with mood disorders to screen for fear of falling and address this in clinical interventions. Furthermore, results suggest that assessment should include both an interview and questionnaires in order to capture all fall-related psychological concerns.
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Rhodes, Patricia Joan. "Older indigent women’s economic crimes: Subsuming feminism in favour of a human rights explanation." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2017. https://ro.ecu.edu.au/theses/2024.
Full textAbstract:
Many people today believe the concept of gender inequality is outmoded, irrelevant and unnecessary in Western societies that are deemed egalitarian. As a consequence, feminism as a movement with gender equality at its core has often been proclaimed ‘dead’,a relic of the past. Feminist perspectives, nevertheless, have produced differing points of view about the sources of gender inequality affecting crime rates and criminal behaviour.
For the last 50 years or so, women and girls have been the subject of criminological research that has largely evolved from sociological perspectives and specifically from feminism. Although gender intersects with other social realities and disadvantages, it is a crucial factor in relation to offending behaviour. A substantial body of feminist literature confirmed that marginality and poverty are factors leading to female criminality.
Using a sequential explanatory mixed methods design, this research explores the consequences of gender inequalities affecting older indigent Australian women convicted of acquisitive crimes. This thesis argues that the term ‘feminism’, and feminist discourse and communications, ought to be abandoned in favour of advancing the human rights framework in the 21st century. Stigma associated with the feminist label has been detrimental. The most significant finding in this research is that financial need rather than greed was a precursor to older women’s involvement in acquisitive crimes. Having primary custody of children after divorce and relying on welfare support were factors contributing to their impoverished status. The feminisation of poverty, the segregation of women into low-paid feminine occupations and an accumulation of disadvantages over the life course often contribute to women’s impoverishment in their later years. Potentially, law-abiding older women are put at risk of transgressing the law for the first time later in their lives to alleviate their poverty.
From a human rights perspective, violations of the women’s rights were factors contributing to their offending behaviour. Gender inequality, a condition that disadvantages women, however, is alive and well in Australia as confirmed here and is an unrelenting feature of many male-dominated social structures throughout the world today. Since a great deal of negativity surrounds the feminist label, it would be more pragmatic to abandon the feminist label and adopt a human rights approach.
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Dao, Tran Tiet Hanh. "Stressful life events, modifiable lifestyle factors, depressive symptoms, health-related quality of life, and chronic disease among older women in Vietnam and Australia : a cross-cultural comparison." Thesis, Queensland University of Technology, 2017. https://eprints.qut.edu.au/105851/6/Tiet%20Hanh%20Dao%20Tran%20Thesis.pdf.
Full textAbstract:
This research validated measures to assess stress, social support, sleep disturbance, depressive symptoms, and health-related quality of life and compared stress, lifestyle, and health of older women in Vietnam and Australia. The research revealed a number of differences in stressful life event exposure among women in these nations. Also, Vietnamese women were more likely to report higher levels of daily physical activity, no exercise; and having sleep problems, depression, and low physical health. High BMIs, smoking and alcohol consumption were more common among Australian women. Stress and lifestyle impacted health for Vietnamese and Australian women in different patterns.
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Chu, Eva Pui Yi. "Women in the middle : economic restrictions and informal care : an exploratory study on the economic disadvantages of female informal carers of the Chinese old people in Hong Kong." HKBU Institutional Repository, 1995. http://repository.hkbu.edu.hk/etd_ra/45.
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Thomson, Lisa, and FRANCISandLISA@bigpond com. "Clerical Workers, Enterprise Bargaining and Preference Theory: Choice & Constraint." La Trobe University. School of Social Sciences, 2004. http://www.lib.latrobe.edu.au./thesis/public/adt-LTU20050801.172053.
Full textAbstract:
This thesis is a case study about the choices and constraints faced by women clerical workers in a labour market where they have very little autonomy in negotiating their pay and conditions of employment. On the one hand, clerical work has developed as a feminised occupation with a history of being low in status and low paid. On the other hand, it is an ideal occupation for women wanting to combine work and family across their life cycle. How these two phenomena impact upon women clerical workers ability to negotiate enterprise agreements is the subject of this thesis.
From a theoretical perspective this thesis builds upon Catherine Hakim�s preference theory which explores the choices women clerical workers� make in relation to their work and family lives. Where Hakim�s preference theory focuses on the way in which women use their agency to determine their work and life style choices, this thesis gives equal weighting to the impact of agency and the constraints imposed by external structures such as the availability of part-time work and childcare, as well as the impact of organisational culture.
The research data presented was based on face-to-face interviews with forty female clerical workers. The clerical workers ranged in age from 21 to 59 years of age. The respondents were made up of single or partnered women without family responsibilities, women juggling work and family, and women who no longer had dependent children and were approaching retirement. This thesis contends that these clerical workers are ill placed to optimise their conditions of employment under the new industrial regime of enterprise bargaining and individual contracts. Very few of the women were union members and generally they were uninformed about their rights and entitlements.
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Austin, Nicole. "Vitamin D, neuromuscular control and falling episodes in Australian postmenopausal women." University of Western Australia. School of Medicine and Pharmacology, 2009. http://theses.library.uwa.edu.au/adt-WU2010.0009.
Full textAbstract:
Falls in the older population have devastating consequences on the psychological and physiological health of the individual. Due to the complexity of interacting factors associated with ageing, pathology and falling episodes, determination of a primary cause or set of causes has been difficult to establish. Deficits in components of neuromuscular control have been widely studied with the coordinated interaction of sensory and motor system components being presented as a fundamental factor in the reduction of falling episodes. A causal relationship between deficits in vitamin D status and falling episodes has also been suggested. Furthermore, a relationship between poor vitamin D status, falling episodes and poor neuromuscular performance has been reported. The aims of the current study were designed to advance understanding in three aspects of the problem of falls prevention. Firstly an examination of the reliability of testing procedures commonly used in assessment of falls risk was undertaken. The Physiological Profile Assessment (PPA) testing procedure was selected as a commonly used tool and the reliability of its various components (sensory, motor and balance) was undertaken as an independent assessment of this approach to assessing falls propensity. Secondly, a case control study of fallers and non fallers was undertaken in which the neuromuscular tests evaluated in the reliability study were used to assess differences in neuromuscular control. The influence of vitamin D status on these measures was also considered. Thirdly, a 12-month randomised controlled trial of vitamin D/calcium supplementation or placebo/calcium was undertaken to identify the effect on falls outcome and individual measures of neuromuscular control.
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Parfitt, Mary. "Perceptions of becoming a nursing home resident : a qualitative study of the impact on identity and self-esteem." Thesis, McGill University, 1995. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=22709.
Full textAbstract:
This thesis presents a study about the experience of becoming a nursing home resident as it affects the identity and self-esteem of very old persons.In a qualitative study with six female residents of an English-speaking Centre d'Acceuil in Montreal, themes are explored in the light of theory about the effects of institutionalization. Consideration is given to the dynamics of relationships with family, friends, peers and staff. Loss of autonomy is singled out as the factor having the most impact on the individuals in the study.
As life draws to a close, each of the women interviewed struggles in her own way with conflict between the value of self-determination and the value of acceptance of dependence on others. The author suggests that the attempt to reconcile these two values may be a "life-task" for very old institutionalized persons. Questions are raised at the level of planning for institutional policy and a direction is indicated for the education of social workers planning to work with an elderly clientele.
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Buckley, Patricia Louise, and pbuckley@swin edu au. "'A sense of place' : the role of the building in the organisation culture of nursing homes." Swinburne University of Technology, 2000. http://adt.lib.swin.edu.au./public/adt-VSWT20060317.114711.
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This study attempted to identifj and explore the role the building plays in the
organisation culture of nursing homes. To do this a research plan was formulated in
which the central plank was a case-study of a seventy-five bed high care nursing home.
As part of the case-study, interviews were conducted at the nursing home with ten
members of staff, two residents and a daughter of a resident. The study was also
informed by interviews with two architects, who specialise in the design of nursing
homes and aged care facilities. A theoretical model entitled the 'Conceptual
Framework' was developed prior to the case-study. It was tested by applying it to
findings related to the physical context and the organisation culture of the case-study
venue. The hypothesis that the building does influence the culture of the nursing home
environment was explored by studying the manner in which the building influenced the
lives of those who work in the nursing home and those who live there. This challenge
was met with the use of theoretical contributions from organisation theory and psychodynamics,
which together provided a vehicle for analysis of the culture and the
building's role in it.
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Summers, Michael. "Great expectations : a policy case study of four case management programs in one organisation /." Connect to thesis, 2007. http://repository.unimelb.edu.au/10187/2182.
Full textAbstract:
Four different case management programs delivered by UnitingCare Community Options (UCCO) in the eastern suburbs of Melbourne were examined against the expectations of case management as a policy solution to a range of perceived policy problems at the micro-, meso- and macro-levels. The micro-level expectations were related to client and family experiences of the service system and outcomes. At the meso-level expectations were focused on perceived service delivery problems such as poor matching of services to the needs of ‘complex’ clients including a lack of integration, flexibility and responsiveness to clients’ needs and preferences. Perceived macro-level policy problems were concerned with a variety of issues including increasing rates of institutionalisation, increasing costs to governments, lack of economic efficiency and the desire to create market or quasi-market conditions in the community care service delivery sector. (For complete abstract open document)
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Rouamba, George. "« Yaab-rãmba » : une anthropologie du care des personnes vieillissantes à Ouagadougou (Burkina Faso)." Thesis, Bordeaux, 2015. http://www.theses.fr/2015BORD0397/document.
Full textAbstract:
Les transformations politiques, familiales, religieuses, économiques et spatiales amènent à rompre avec les évidences entretenues sur les sociétés africaines comme celles de care au profit des personnes âgées au nom du respect social des âges. Ce travail déconstruit les représentations sociales de la vieillesse en montrant d’une part que les catégories de la vieillesse sont les produits des politiques publiques et d’autre part que les vieillesses sont hétérogènes, contextuelles et dynamiques. A partir d’études de cas élargis, cette thèse explore les expériences du vieillir à partir des formes de prise en charge des personnes vieillissantes dans la capitale Ouagadougou (Burkina Faso).Une ethnographie au sein des familles, dans une unité de soins spécialisé dans un centre hospitalier universitaire et dans un centre d’accueil de femmes accusées de sorcellerie permet de décrypter les relations complexes de prise en charge entre le niveau micro et macro sociale. Cette thèse est une contribution à une anthropologie du care de la vieillesseThe political, family, religious, economic and spatial lead to break with evidence maintained on African societies like those in care for the elderly in the name of social respect of ages. This work deconstructs social representations of old age by showing both on the on hand, that the categories of old age are the product of public policies and on the other the old ages are heterogeneous, dynamic and contextual. From a broader the case studies, this thesis explores the experiences from old forms of care for elderly in the capital, Ouagadougou (Burkina Faso). An ethnography within families, in a special care unit in a university hospital and a reception center for women accused of witchcraft allows to decrypt the complex relationships of care between the micro and macro social level. This thesis is a contribution to the anthropology of care in old age
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Chen, Yong. "Comparative Effectiveness of Alendronate and Risedronate on the Risk of Non-Vertebral Fractures in Older Women: An Instrumental Variables Approach: A Dissertation." eScholarship@UMMS, 2011. https://escholarship.umassmed.edu/gsbs_diss/582.
Full textAbstract:
Osteoporosis is a significant public health problem in the U.S. It not only affects the physical well-being of the older women but also creates a substantial financial burden for the health care system. The mainstay of osteoporosis medications is bisphosphonate treatment of which alendronate and risedronate are the most commonly prescribed in clinical practice. However, there have been no head-to-head randomized controlled trials (RCTs) evaluating the effects of these two bisphosphonates on fracture outcomes.
In the absence of RCTs, observational studies are necessary to provide alternative evidence on the comparative effectiveness between alendronate and risedronate on fracture outcomes. However, existing observational studies have provided inconclusive results partially due to residual confounding from unobserved variables such as patients’ health status or behavior. IV analysis may be one method to address unmeasured confounding bias in observational studies. While it has not been applied in bisphosphonate research, it has been used in research on a variety of other prescription medications.
In this dissertation, we applied the IV approach with an IV, date of generic alendronate availability, to evaluate the comparative effectiveness between alendronate and risedronate using observational data. This dissertation improved current research in several ways. First, we extended the IV approach to research on bisphosphonates. Second, compared with the current observational studies on bisphosphonates, this dissertation may more accurately estimate the relative effects between alendronate and risedronate because IV analysis is not subject to unmeasured confounding bias. Third, the study results extended the current evidence of the comparative effectiveness between the two most commonly prescribed bisphosphonates. Finally, we proposed and provided empirical evidence of a new IV that might be used for future prescription drug research.
The finding of this dissertation can be summarized from three aspects. First, we found that the evidence supported the validity of the date of generic availability as an IV in the study of bisphosphonates. Second, applying IV approach to study the comparative effectiveness of alendronate and risedronate, we found that alendronate and risedronate were comparable to reduce the risk of 12-month non-vertebral fractures in older women. Since generic alendronate is availability on the market while generic risedronate is not, promoting the use of alendronate may help reduce the healthcare cost and not sacrifice the clinical effectiveness. Finally, by comparing the proposed IV with a popular IV-physician preference, we found that both the calendar time IV based on the date of generic availability and the physician preference appeared to be valid. It might be practically easier to use the calendar time IV than the physician preference IV.
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Barrett, Thomas. "Elder Abuse : Agencies' Experiences and Seniors' Relationships." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 1998. https://ro.ecu.edu.au/theses/234.
Full textAbstract:
This study examines elder abuse in an Australian context and comprises two parts: agencies' experiences with elder abuse; and seniors and their relationships. The first part sought baseline data on elder abuse as recorded by a range of agencies in New South Wales (NSW) and Western Australia (WA). A mailed questionnaire was sent to a random sample of 400 agencies per State, seeking information for the 1994 calendar year regarding abused elders 65 years of age or older, and resulted in an overall return rate of 57.62%. Data was analysed using SPSS for Windows.
The second part of the study was qualitative, exploratory and phenomenological in nature. The objectives were: to increase the knowledge and understanding of elder abuse within an Australian context by examining the experiences and feelings of care givers and care recipients in the transition from independence to dependence for one partner; to identify factors contributing to the abuse of elderly persons in private accommodation; to determine the relevance of a disability-related dependency to the likely occurrence of elder abuse; and to explore the applicability of a range of theories, in particular social exchange theory and the situational model, to caring situations.
A purposive, nonrandom sample of nine cases was drawn totalling 12 persons who were interviewed using a semi-structured questionnaire. Four general research questions examined the characteristics of the participants prior to the onset of caring; explored the impact of the change from the pre-caring stage to the caring stage on the respondents; assessed caring demands on the care giver; and sought to determine the impact of continuous care provision on the care giver/care recipient relationship. Seven ancillary research questions addressed more specific aspects of the care giver/care recipient relationship. Qualitative data analysis utilised NUD.IST.
The major findings from part 1 of the study revealed 92 (44%) agencies in NSW and 66 (26.2%) in WA had seen cases of elder abuse in 1994. In both States, female elder abuse victims as care recipients, were represented three times more often over a greater range of victims per agency than male counterparts. Psychological, physical, material/financial and sexual forms of abuse, plus neglect, were represented in both States' findings. Psychological abuse was most frequent in NSW, and in WA, neglect. Sexual abuse was reported with least frequency in both States. In each State, victims were represented in a ratio of approximately 1:6 (care giver to care recipients). For care givers, the most common forms of abuse received were physical, psychological and material/financial.
No reliable Australian data exists on the incidence and prevalence of elder abuse. These research findings indicated its presence and found similarities with findings in the USA, Canada and the UK for perpetrators and abuse types. Perpetrators of elder abuse included: spouses; sons; sons-in-law; de facto partners; daughters; and daughters-in-law. Spouses were cited most often as perpetrators in both States followed by sons and daughters in NSW and daughters-in-law and sons in WA.
Direct agency services for victims were found wanting. Where available, they provided information; counselling; mediation; and referral.
Mandatory reporting of elder abuse was supported in both NSW ( 4 7 .1 % ) and WA (44.8%). One-third of the agencies in both States were undecided on the issue and the remainder were opposed. However, many agencies ignored the question, leaving the results inconclusive.
The major findings from part 2 of the study revealed eight of nine care givers interviewed to have been in long-term marriages and of having satisfying relationships prior to the onset of the partner's disability. Trauma, loss and grief experiences prior to their partner's disability, for some, exacerbated the demands of caring in later years.
The onset of the disability-related dependency whether sudden, or gradual, determined how the care giver coped initially. Regardless of the type of disability, common feelings expressed by care givers included: social isolation; change or loss in communication; a sense of coping alone; lack of external supports; feeling trapped; a loss of intimacy with the partner; stress, both structural and situational; having health problems related to carer stress; physical and mental exhaustion; anger; disappointment; frustration; general loss and grief; resentment; sadness; anxiety; and the monotony of the caring role. Environmental factors were rarely mentioned as being stressful. There appeared to be a connection between care giver stress and elder abuse in eight of the nine cases studied, notably psychological abuse. Physical abuse was indirect, and only one possible instance of neglect was noted. Sexual and material/financial abuse were not represented in the sample of case studies.
Theories associated with elder abuse explored in the study included: stress theory; crisis theory; learned violence; issues of dependency; mental impairment; loss and grief; societal ageism and sexism. The findings lend only partial support to the situational model as a possible explanation for elder abuse. This study identified as situational factors: physical dependency; poor health; impaired mental status; difficult personalities in the care recipients; and corresponding care giver health problems. Only one structural factor was identified, namely social isolation. The concepts associated with social exchange theory - including power advantage/disadvantage, positive sentiments, rewards and punishments, instrumental services and personal resources - were evident across the nine cases. However, without the application of additional variables, it could not be concluded that social exchange theory, on its own, adequately explained elder abuse. No one theory emerged as offering a satisfactory explanation for the causes of elder abuse, suggesting that its complex and diverse nature defies a single causal theory.