Thesis (Ph. D.)--Michigan State University, 2006. / Includes bibliographical references (leaves 134-142).

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The purpose of this study was to document, from a developmental perspective, midlife women's perceptions of their changing bodies within the larger cultural context, and to use ethnographic research as a tool for researching midlife women. The central question guiding the analysis of midlife women's lives was: What are midlife women's perceptions of their changing bodies? The self-reported experiences of 11 midlife women (ages 40–55) were obtained and the data analyzed using Spradley's (1979) Developmental Research Sequence Method. Data were collected by using individual and group interviews. During the individual interviews, three kinds of ethnographic questions (descriptive, structural, and contrast) were used to explore how each woman conceptualized her experiences. After the individual interviews were completed, three consecutive group interviews were conducted. The group interviews provided a context for determining the women's shared meaning of their changing bodies at this pivotal time of their development. To solidify the credibility of this qualitative study, the understandings derived from the study were subjected to member checking and the application of content analysis. Four general themes emerged from the analysis of the data. The first two themes—the media and medicine—involved aspects of the culture that most influenced the women's interpretations of their changing bodies and were, therefore, structural in nature. The second two themes—loss, and redefining of self (including the development of self-care)—involved the more personal aspects of the women's narratives such as reflected meanings and attitudes. Results of the study indicated that the midlife period in a woman's life encompasses a broad spectrum of experience, full of contradiction and change. Issues of loss, change in role functions, cultural influences that perpetuate ageism and sexism, ambivalence, strong emotional responses, lack of consistent information about menopause and sexuality, questioning, critical reflection, coping mechanisms, redefining self self-care—all played a central role in the women's lives during this important time of transition. Midlife events prompted the participants to question and challenge traditional cultural expectations about female roles and behavior; and in this way they reinterpreted their experiences and created new meaning from them. The women reformulated their self-definitions from that of caregiver to care receiver, from caring for others to caring more for oneself. This could be seen as a major developmental change in the women's lives, since through this process of facing the challenges of midlife, the women moved from self definitions that were based on negative cultural stereotypes to self definitions that were based on an affirmation of their ability to experience the events of their existence as autonomous individuals, less bound by stereotypes than they had been before. Health professionals can attempt to examine some of their own biases and assumptions about midlife women that could influence their treatment of, and attitudes towards, these women. Furthermore, health professionals are in the position to help their midlife clients question and become critically aware of the social, historical, and political context that defines women's midlife experience, so that midlife women need not take for granted the established interpretation of their physical changes. Suggestions for further research are included. / Graduate

Please read the abstract in the 00front part of this document / Thesis (DPhil (Social Work))--University of Pretoria, 2007. / Social Work and Criminology / unrestricted

This investigation, comprising two studies, examined the number of barriers to physical activity (Study 1) and barrier strength (Study 2) reported by middle-aged and older adults using a social ecological framework (McLeroy et al., 1988). Researchers were interested in assessing age group (45-54; 55-64; 65-74 yrs) by physical activity group (active, less active) effects for barrier responses using analyses of variance. In Study 1, 180 participants completed a physical activity level survey (Godin & Shephard, 1985) and answered open-ended questions about barriers. Results indicated that 45-54 yr-olds reported more barriers overall, and more intrapersonal barriers than older groups. Less active 45-54 yr-olds reported more organizational-interpersonal barriers than the other groups. Descriptive analyses of coded themes demonstrated that common intrapersonal barrier sub-themes cited by younger adults related to family commitments, while sub-themes reported by middle-aged and older adults related to having a health problem or an injury. In the organizational-interpersonal category, the most common barrier sub-theme related to the workplace. In Study 2, 116 participants completed a survey assessing weekly physical activity and barrier strength for items pertaining to ecological categories and barrier sub-factors. Results showed that less active adults reported each of intrapersonal, interpersonal, and physical environment barriers more strongly than active adults, irrespective of age; the intrapersonal category was relatively the most constraining for our participants. In terms of barrier sub-factors, results showed that significantly higher barrier strength scores are most often associated with physical activity level (i.e., less active), and only occasionally associated with age group. The overall investigation can provide valuable information for improving physical activity interventions for middle-aged and older adults.

Over 260,000 Americans are living with a traumatic spinal cord injury (SCI). Medical advances have increased the longevity of individuals living with SCI into middle age and beyond. The majority of these individuals are living with an incomplete SCI (NSCISC, 2012), and the proportion of incomplete injuries is rising (DeVivo, 2012). There is little research that specifically examines the changes in physical function experienced by individuals aging with a traumatic incomplete SCI. The purpose of this qualitative descriptive study was to describe the changes in physical function experienced by participants with a traumatic incomplete SCI aging through middle age. Data were collected through moderately structured individual interviews (N=17), in either a face-to-face (n=6) or an email (n=11) format. The seventeen participants ranged in age from 35 to 65 years, with a 16 to 36 year duration of injury. Participants described changes in various body systems and recalled the timing of those changes as they transitioned through their middle years. Qualitative content analysis revealed that participants described primarily gradual changes including decreased muscle strength, decreased endurance, weight gain, and wear and tear changes. When asked to identify sources of information about physical changes, participants predominantly emphasized their lack of knowledge about anticipated changes. Further content analysis revealed three themes related to this transition. Participants likened their experience to travelling through uncharted territory. They described strategies for living in uncharted territory that help them to prevent or manage changes in physical function, with sub-themes of being vigilant in their self-assessment and self-management practices, investing time in figuring out what changes they experienced and why those changes happened, and staying positive. They also described the importance of recognizing the impact of changes. These findings provide a foundation for understanding this age-related transition, and identify the need for further research to support effective self-management strategies and efficient mechanisms for disseminating this knowledge to people with SCI, their caregivers and families. In acute and chronic patient care settings, nurses are well-positioned to be a valuable support and information source for individuals living with an incomplete SCI.

The central thesis of this paper is that the social work profession needs to know much more about menopause and its concomitants in order to enhance diagnosis and treatment. Unfortunately, the woeful lack of research and consequent paucity of data on the subject require a heavy reliance upon intuitively plausible statements in support of larger propositions about many of the strategic relationships advanced in the course of the argument. When these propositions and statements are taken as a whole, the paper is also an outline of essential research topics.

京都大学 / 0048 / 新制・課程博士 / 博士(人間健康科学) / 甲第19643号 / 人健博第35号 / 新制||人健||3(附属図書館) / 32679 / 京都大学大学院医学研究科人間健康科学系専攻 / (主査)教授 坪山 直生, 教授 山田 重人, 教授 松田 秀一 / 学位規則第4条第1項該当 / Doctor of Human Health Sciences / Kyoto University / DFAM

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