Background: Advanced breast cancer (ABC) is affecting substantial number of Chinese women in Hong Kong. Understanding their unmet supportive care needs (SCNs) is important for health care system to precisely allocate resources to areas demanded for help the most and for patients to achieve better quality of life. Objectives: (1) To validate Chinese version of Supportive Care Needs Survey Questionnaire (SCNS-SF34), (2) to address the prevalence of unmet SCNs at baseline (newly diagnosis of ABC) and explore relevant factors associating with baseline unmet SCNs, (3) to identify the trajectories of unmet SCNs from baseline, 6-week, 12-week, 18-week to one-year post-diagnosis of ABC among Hong Kong Chinese women and identify the predictors related to individual resources. Methods: The study consisted of two phases. In Phase I, breast cancer (BC) patients were recruited from six public hospitals and the SCNS-SF34 (which covers five domains of needs) was administered concurrently with measures of psychological distress CHQ-12 (Chinese Health Questionnaire-12), HADS (Hospital Anxiety and Depression Scale), symptom distress (MSAS-SF), and patient satisfaction (ChPSQ-9) to explore factor structure by using Exploratory Factor Analysis (EFA) and to examine internal consistency, and convergent, divergent and discriminant validities of the identified factor structure. In phase II, women newly diagnosed with ABC were recruited and followed up to assess their unmet SCN trajectories one year after diagnosis. Prevalence of initial baseline SCNs and associated demographic, medical and psychological factors were identified. Linear Mixed Modeling (LMM) was performed to assess trajectories for each SCNs domain. Hypothesized variables reflecting personal and social resources (optimism, trait hope, social support, psychological distress and patient satisfaction) were examined for association with the changes of unmet SCNs after adjusting for demographic and medical characteristics. Results: Instead of five-factor structure identified in the original SCNS-SF34, a four-factor structure with 33 items was identified, comprising: 1) Health system, information and patient support needs (HSIPS), 2) Psychological needs (PSYC), 3) Physical and daily living needs (PDL) and 4) Sexuality needs (SEX). The SCNS-SF33-C demonstrated moderate-to-good internal consistency (Cronbach’s alphas=0.75-0.92) across all domains. Acceptable convergent and divergent validity were demonstrated. Discriminant validity was demonstrated in the SCNS-SF33-C’s ability to differentiate between clinically distinct patient groups (ABC vs. localized BC and active treatment vs. no active treatment). Of the top 15 unmet SCNs, all belonged to the HSIPS domain. There were significant linear declines in unmet HSIPS and PSYC needs over the year after diagnosis, but not in PDL and SEX. After adjusting for demographic and medical factors, LMM identified symptom distress, patient satisfaction and patient satisfaction x time are predictors of HSIP. Total symptom distress, optimism, anxiety and anxiety x time predicted PSYC. Total symptom distress was predictor of PDL. Anxiety was predictor of SEX. Conclusions: The SCNS-SF33-C has a suitable factor structure and psychometric properties for the use in assessing unmet psychosocial SCN among Chinese women with BC. Generally, unmet HSIP and PSYC tended to decline, while levels of unmet PDL and SEX tended to persist over time. Specific individual resources predicted the future change of unmet SCNs. / published_or_final_version / Community Medicine / Master / Master of Philosophy

This ex post facto correlational study seeks to identify if a relationship between blood glucose values and vasomotor instability intensity exists. The population consisted of a convenience sample of seven type 2 diabetic postmenopausal women experiencing vasomotor instability living in Southern Alberta. This study hypothesizes that a significant negative correlation would be identified between these two variables based on research done by Dormire and Reame (2003). The correlational results suggest that a small to moderate significant positive relationship exists between blood glucose and vasomotor instability: increased vasomotor instability was associated with increased blood glucose values. Overall, this study suggests a relationship exists between blood glucose and vasomotor instability but causality or direction of this relationship cannot be determined. Further research studies are recommended to clarify and validate this research. In particular, such a study should include type 1 diabetic postmenopausal women, a larger sample size, and sampling a wider geographical area. / ix, 109 leaves ; 29 cm.

Menstruation is all at once a cultural, social, historical, and biological process. Intertwined, these forces create menstrual experiences which are neither fixed nor universal, but rather adaptable and transformable not only between cultures, but from within cultures as well. How these factors interrelate, what menstrual discourse they create, and how that translates into women's everyday lives, becomes the focus of this research. Structured around the relationship between prescription and reality, this study examines the interplay of those who defined the menstrual discourse: doctors, mothers, and the sanitary napkin industry, and those who experienced it. / Listening to the lives of twenty-four women, born between 1910 and 1965, a complex and ambiguous tale of the menstrual experience emerges. Through their narratives, we learn the importance of early instruction by mothers; the emphasis placed on hygiene and concealment; the effect menstruation had on women's sexual, feminine, and (re)productive identity. Once women's voices are taken into consideration, it becomes clear that the dynamic between prescription deeming menstruation as unclean or deviant and women's reality is not straightforward. Women reacted to the menstrual discourse, at times they rejected it, other times adhered to it, but for the most part, simply transformed it to meet their daily needs.

No abstract available. / Thesis (LL.M.)-University of KwaZulu-Natal, Durban, 2012.

Studies have shown that pregnant women do understand and value information of their unborn child. However, those providing health promotion services often focus on medical procedures and health education messages, ignoring the cultural, socio-economic and psychological dimensions that impact on women's health. This research aimed to look at a specific component of health promotion, i.e. health promotion messages shared with pregnant women attending Stellenbosch and Klapmuts Community Health Centre Antenatal Health Promotion Programme and their perceptions of how they apply messages in their daily lives.

Thesis (MA)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Across the globe scientists are taking issue with pseudoscience, as well as the role of the media in promoting it. Articles based on pseudoscience, especially those relating to Complementary and Alternative Medicine (CAM) that fall outside the realms of orthodox medicine, are common in all forms of media, but especially in women’s health and lifestyle magazines. Scientists are quite vociferous in their condemnation of CAM for both ethical and safety reasons, since neither the therapies nor the remedies associated with CAM practices have been proven to be efficacious, or even safe. In fact, some of the therapies and advice offered by CAM practitioners are dangerous and, in some instances, may even be life threatening. Nevertheless, the media continue to promote CAM, and the public continues to support it – despite the warnings and denunciation by scientists. This is an exploratory study to determine the prevalence of pseudoscience, generally, in South African women’s health and lifestyle magazines, and to uncover the reasons the public supports it. The magazine Longevity is used as an example of this type of publication, and a content analysis is used to illustrate the prevalence of pseudoscience articles and adverts in South African media, while field research, in the form of personal interviews, attempts to determine the reasons people support CAM in spite of its denunciation, as well as the media’s role in fostering this support. Both mainstream science and pseudoscience are described, while a literature review reveals the scientific perspective of CAM, provides examples of the more popular forms of CAM and the dangers inherent in them, as well as the ways in which science and pseudoscience in general, are handled by the media. Using the hypodermic needle theory, plus the results of the content analysis and field research, this study shows that media promote pseudoscience because it pays; the public support CAM because they believe it works; and that that belief is primarily the result of public disillusionment with the practice of orthodox medicine, rather than the result of media’s promotion of CAM, as scientists contend. / AFRIKKANSE OPSOMMING: Wetenskaplikes van regoor die wêreld het ’n probleem met pseudowetenskap, sowel as die rol wat die media speel om dit bevorder. Artikels gebaseer op pseudowetenskap, veral dié met betrekking tot Aanvullende en Alternatiewe Medisyne (AAM), wat buite die grense van ortodokse medisyne val, is algemeen in alle vorme van media, maar veral in gesondheid-en lewenstyltydskrifte vir vroue. Wetenskaplikes is baie uitgesproke in hul veroordeling van AAM om beide etiese en veiligheidsredes, omdat nóg die terapie nóg die middels wat verband hou met AAM praktyke bewys is om doeltreffend, of selfs veilig te wees. Trouens, sommige van die terapieë en advies wat aangebied word deur AAM beoefenaars is gevaarlik, en in sommige gevalle selfs lewensgevaarlik. Tog hou die media aan om AAM te bevorder, en die publiek om dit te ondersteun – ten spyte van die waarskuwings en veroordeling deur wetenskaplikes. Hierdie narvorsing is ’n verkennende studie om die voorkoms van pseudowetenskap in Suid-Afrikaanse vroue se gesondheid- en lewenstyltydskrifte te bepaal, en die redes te ontbloot waarom die publiek dit ondersteun. Die tydskrif Longevity word gebruik as ’n voorbeeld van hierdie tipe publikasie, en ’n inhoudsanalise word gebruik om die voorkoms van pseudowetenskaplike artikels en advertensies in die Suid-Afrikaanse media te illustreer, terwyl navorsing in die veld, in die vorm van persoonlike onderhoude, poog om die redes te bepaal waarom mense AAM ondersteun, ten spyte van veroordeling, sowel as die rol wat die media speel in die bevordering van hierdie ondersteuning. Beide hoofstroom wetenskap en pseudowetenskap word beskryf, terwyl ’n literatuuroorsig die wetenskaplike perspektief van AAM ontbloot, voorbeelde van die meer populêre vorme van AAM word verskaf asook van die gevare daaraan verbonde, sowel as die maniere waarop wetenskap en pseudowetenskap in die algemeen, hanteer word deur die media. Met behulp van die spuitnaald teorie, plus die resultate van die inhoudsanalise en navorsing in die veld, bewys hierdie studie dat die media pseudowetenskap bevorder, want dit betaal; die publiek ondersteun AAM omdat hulle glo dit werk; en dat daardie geloof primêr die gevolg is van openbare ontnugtering met die beoefening van ortodokse medisyne, eerder as die gevolg van die media se bevordering van AAM, soos wetenskaplikes beweer.

African American breast cancer survivors (N=22) in this exploratory study had a mean of 15.55 years since diagnosis (SD=10.734, min-5 years, max= 47 years). The women reported good quality of life, good health, good health care, very good provider care, very good sensitivity by their provider for their being a cancer survivor, and very good sensitivity and competence by their provider for treating them as an African American breast cancer survivor. Both the quantitative and qualitative data reinforce each other, showing evidence of posttraumatic growth from breast cancer, including a significant increase from before breast cancer to after breast cancer in their spirituality. Perhaps, most importantly, this exploratory study with a small sample found suggestive positive correlations between two types of self-efficacy coping and quality of life: i.e., the higher the rating for quality of life, then the greater the use of problem focused coping (r=.798, p=.000), and greater the use of support from friends/family coping (r=.776, p=.000). Hence, coping emerges as vital with regard to achieving a higher quality of life. This is consistent with Gaston-Johansson et al. (2013), urging exposing women to a Comprehensive Coping Strategy Program (CCSP). As an implication of this study, such a focus on coping strategies is recommended for health educators in their work with breast cancer survivors, and also with the newly diagnosed. While women may emerge from a breast cancer diagnosis with greater spirituality and having discovered they are stronger than they think, there may be those women who are struggling. They have yet to achieve the key factors associated with a higher quality of life such as high self-efficacy to cope with stress. Thus, health educators are advised to ensure that African American breast cancer survivors and those newly diagnosed receive culturally tailored interventions designed to improve their self-efficacy to cope. Health educators may conduct support groups with survivors and newly diagnosed women, so as to ensure they have adequate social support—especially if spousal/partner support is not high. This may counter the tendency of some women to withdraw and isolate, as per the emergent theme: emotional numbing, withdrawing, and isolating.

Summaries in English and Sesotho / This qualitative, exploratory, descriptive study explored culturally sensitive health information about the use of herbal medicine by pregnant women in Lesotho, in order to provide culturally sensitive health advice to pregnant women. Pregnant women used herbal medicine and remedies during pregnancy resulted in still births and complications during labour. Data on the beliefs and practices of fifteen purposively and conveniently sampled pregnant women attending a rural antenatal clinic was collected through semistructured interviews and analysed using Colaizzi’s seven-step method. Ethical principles and strategies to ensure trustworthiness were applied. One central theme emerged: ‘Women believe that the use of herbal medicine and remedies is a traditional practice that pregnant women need to follow due to culture’. The cultural beliefs and practices of the women were deeply rooted in Basotho culture, which guided the use of herbal medicine. However, some considered herbal medicines to be harmful, as the dosage and content of these medicines vary. Nurses are therefore key to providing culturally sensitive health care advise on using herbal medicine during pregnancy. / Boithuto bona ba boleng bo botle, bo hlalosang le ho fumaneng tlhaiso-leseling e mabapi le bophelo bo botle mabapi le ts’ebeliso ea meriana ea litlama ke basali ba baimana Lesotho, ele ho fana ka likeletso tsa bophelo bo botle ba setso. Lintlha tse mabapi le litumelo le litloaelo tsa basali ba baimana ba leshome le metso e mehlano ka boomo le ka mokhoa o fumanehang li ile tsa bokelloa ka lipuisano tse hlophisitsoeng le ho hlahlojoa ho sebelisoa mekhoa e supileng ea Colaizzi. Melao-motheo ea boits’oaro le maano a ho netefatsa hore a ts’epahetse a sebelisitsoe. Ho ile hoa hlaha sehlooho se le seng se bohareng: ‘Basali ba lumela hore ts’ebeliso ea litlama ke tloaelo eo basali ba baimana ba lokelang ho e latela ka lebaka la moetlo’. Litumelo le litloaelo tsa basali li ne li metse ka metso moetlong oa Basotho, o neng o tataisa ts’ebeliso ea meriana ea litlama. Leha ho le joalo, ba bang ba ne ba nka meriana ea litlama e le kotsi, hobane litekanyetso le litlhare tsa meriana ena li ea fapana. Ka hona baoki ke senotlolo sa ho fana ka thuto ea bophelo bo botle ba setso mabapi le ho sebelisa litlama nakong ea boimana. Mehopolo ea bohlokoa Meriana ea litlama, litumelo le litloaelo tsa moetlo, basali ba baimana, thuto ea bophelo bo botle / Health Studies / M.A. (Public Health)

Although there has been a great deal of research in the areas of social networks, social support and well-being over the past two decades, little of that research has been cross-cultural, and virtually none has been carried out in countries outside the West. The present study attempted to describe the structure and functioning of the social networks of a group of relatively modern urban Moroccan women, and the associations among their social networks, social support, physical health and psychological well-being. Extensive interviews were conducted with 108 married or previously-married women who were living in a middle-class neighborhood in Rabat, Morocco. Subjects were asked to identify social network members, defined as friends, family or others who provided various types of support in typically encountered life situations, or with whom the subject had negative interactions. Standardized self-report instruments were used to assess physical and psychological well-being, and to assess the occurrence of stressful life events. Additional observational data were collected on respondents' neighborhoods and immediate physical surroundings. A model describing the interactions between well-being, network structure and network function was tested using factor-analytic and set-regression techniques. Stressful life events predicted reduced physical well-being. Enhanced psychological functioning was predicted by reciprocity in relationships, marital satisfaction, and to a lesser degree, practical and emotional support. Contrary to predictions, patronage support was associated with both enhanced physical and psychological well-being. Results were generally consistent with Conservation of Resources (COR) theory, which predicts that the uniformly large and well-functioning networks found in this study would produce effect sizes that were small, but consistent with Western research findings.

Uganda has experienced substantive shifts in HIV prevention and treatment resulting in marked declines in HIV incidence and mortality rates across the country despite being among the top 5 highest new prevalence rates for HIV transmission and infection among women (Uganda Ministry of Health, 2019). Prior research has revealed that fear of stigma and discrimination, disclosure of HIV status, and quality of services are key factors in women’s healthcare decisions and care-seeking behaviors (Akatukwasa et al. 2021; Lancaster et al., 2016; Grossman & Stangl, 2013). Yet, there continue to be significant knowledge gaps regarding the mechanisms through which intersectional stigma exacerbates health outcomes for people living with HIV. This dissertation draws on baseline data, from the Kyaterekera project an efficacy trial testing the effects of a structural intervention on the HIV-health outcomes of women engaged in sex work within the Masaka region, Uganda. Using an explanatory sequential mixed method design, this study utilized Structural Equation Modeling (SEM) to test the direct and indirect effects of intersectional stigma on mental health, while also evaluating mechanisms (i.e., social support and quality of care) through which stigma impacts mental health, treatment adherence and subsequent viral load. There were no direct or indirect effects of intersectional stigma on mental health, but intersectional stigma was positively associated with social support. Additionally, depression and adherence were negatively associated with viral load. Next, in-depth interviews (n=52) explored personal and community-level factors that may influence women’s care-seeking attitudes and overall health decisions. The following themes were most salient for women: 1) disclosure risk, 2) Intersectional community stigma permeates marginalized women’s health decisions, 3) adaptive behaviors and coping strategies are essential to maximizing care experiences, and 4) the Care Seeking Cost-Benefit Tradeoff. Through an integrative framework, quantitative and qualitative findings were then juxtaposed through a joint display and found to be predominantly complementary (McCrudden, M. T., Marchand, G., & Schutz, P. A., 2021). Findings suggest that a positive association between intersectional stigma and social support may underscore the significant long-term effects of living with HIV. Moreso, holding other stigmatized social statuses. Moreso, this link between intersectional stigma and social support may be due to women anticipating the likelihood of experiencing community-level/interpersonal stigma with HIV disclosure and extensive contact with their social support network. Also, more contact with social networks, particularly those in which stigma norms and discriminatory attitudes are pervasive on the community/ interpersonal level (or perceived to be so) may account for the positive associations between HIV stigma and social support. Sex work had a higher degree of concealability than HIV. As such, sex work was disclosed less frequently than HIV to healthcare providers, family, and friends due to anticipatory community stigma. Despite the finding that the explanatory sequential design produced no direct or indirect effects of intersectional stigma on mental health or viral load via SEM, the exploratory analysis provides substantive insights into the negative impact of HIV-related intersectional stigma on women’s care-seeking experiences and broader health decisions. Women’s care-seeking attitudes and behaviors reveal the intrinsic adaptive skills, strength, and resilience they possess to address individual health needs despite known barriers to care. Overall, this study provides further support for holistic interventions that can enhance and build resilience and successful adaptive strategies to mitigate the effects of HIV-related intersectional stigma.