Thesis (D. Min.)--Westminster Theological Seminary, 2006. / Vita. Includes bibliographical references (leaves 257-261).

Thesis (Ph. D.)--Texas State University-San Marcos, 2006. / Vita. Appendices: leaves 196-198. Includes bibliographical references (leaves 199-208).

Thesis (Ph. D.)--Texas State University-San Marcos, 2006. / Vita. Appendices: leaves 196-198. Includes bibliographical references (leaves 199-208).

The loss of muscle (mass, strength, and function) occurs in many individuals in their 40’s and begins to accelerate after 50 years of age resulting from multiple understood mechanisms. While many factors are thought to contribute to the changes that are observed in muscle with aging, one significant, yet modifiable factor is dietary protein intake. This study proposed to improve dietary protein intake in a group of middle-aged women living in South Florida over a 12-week period using individualized per-meal protein prescriptions (1.2 g protein/kg body weight evenly distributed for all three meals) provided by a Registered Dietitian, followed by weekly diet coaching from a Nurse Practitioner (coach). Aims included: (1) An examination of the effect of diet coaching on protein intake, nutrition knowledge, muscle mass, strength, and function and (2) An understanding of how diet coaching sessions help in the process of making dietary changes. A parallel mixed methods research design allowed for a synthesis of inferences from each aim resulting in a meta-inference highlighting interdisciplinary collaboration. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2020. / FAU Electronic Theses and Dissertations Collection

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Findings released from recent pivotal clinical trials on hormone therapy (HT) benefits and risks have stimulated a growing trend towards lower doses and earlier discontinuation of HT for menopausal women. Yet, there is little knowledge regarding women's personal experiences with the resultant earlier and possibly abrupt withdrawal of HT. The purpose of this study was to explore postmenopausal women's vasomotor symptom experiences after discontinuing HT. The data for this study was collected from menopausal women who discontinued HT. The study questionnaire was created through an extensive review of the literature as well as an expert panel review. The questionnaire was also piloted with a small group of women prior to its use in this study. Data analysis consisted of descriptive analysis with means and standard deviations and/or frequency distributions with percentages for demographic data, health behaviors, factors influencing HT decisions, use of CAM and perceived efficacy. Chi-square analysis, Spearman Rho correlation, and logistic regression analysis were conducted for contextual factors and vasomotor symptom experiences. A McNemar test was performed to assess within group differences for vasomotor symptoms experiences pre and post HT. Questionnaires were received from 563 menopausal women throughout the United States. This study revealed that 80% of participants experienced vasomotor symptoms after discontinuing HT. The most common predictors which accounted for only 13% of variance in the occurrence of vasomotor symptoms were younger age, type of menopause and the occurrence of vasomotor symptoms prior to initiation of HT. Of the 563 women participating in the study, less than half reported the use of CAM to treat reemerging vasomotor symptoms. For the most part, less than half of the women felt their treatment choices were helpful in relieving their reemerging vasomotor symptoms Because a woman's experience of menopause can be highly individualized, an adaptation of Bronfenbrenner's ecological theory was used guide this exploratory study. The study findings supported the usefulness of the adaptation of Bronfenbrenner's ecological theory as a model through which to view the vasomotor experiences of menopausal women who have discontinued HT. / text

Introduction: This multiphase qualitative study explored the understanding of middle-aged women’s sexuality and sexual difficulties and the way they address these difficulties. Nurses’ and midwives’ role in sexuality-related care was also explored. The need to address the subject was triggered by the multidimensional nature of female sexuality that could not be limited to one single definition; the medicalisation of female sexual problems that is based on the standards of sexual function and dysfunction; the scarcity of research that reflects on women’s subjective views on sexuality and sexual difficulties and the way they address these difficulties. This is particularly crucial at the middle-age where women undergo hormonal and psychosocial changes that may affect their sexual life. Methods: Interviews and focus group discussions were used to capture the narratives of 52 middle-aged women of 40-55 years in phases one and two of the study. They were chosen purposively by education and menopausal status from clinical and non-clinical settings regardless of their marital status and sexual orientation. Additionnally, a sample of 11 nurses and midwives working in the hospital and primary healthcare centres participated in two focus group discussions. Results: Women’s narratives led to a comprehensive understanding of sexuality and sexual problems and the implications for help-seeking. Findings showed how women’s interpretation of sexuality resonates within bio-psychosocial and cultural perspectives driven by double standards and inhibiting sexual socialisation. Women’s sexuality is ‘muted’, conflicting between frustrating experiences, personal expectations and the perception of sexual selves as affected by the middle-age and social myths. Yet, sexuality is central to women’s life where they tend to play a sacrificing role and gain agency. Their sexual difficulties are multifaceted mirroring their inhibitions, relational conflicts, husbands’ sexual problems and contextual burdens. Women would firstly rely on their husbands to discuss together their common sexual issues as nobody can understand their needs more than both of them. In parallel, the gynaecologist is reportedly the first one they consult as they are familiar with him/her. Yet, some do not know who else to turn to for help. Women highlighted many personal, relational and contextual barriers to help-seeking focusing on their husbands’ negative attitude. They also criticised the services offered and the lack of resources. Within this context and in focus group discussions, 11 nurses and midwives reflected on their attitude and behaviour towards sexuality-related care. They had opposing views concerning their involvment in the assessment of patients’ sexual health and identified many barriers to having an effective role in the field. Discussion and implications: This study has a unique contribution in voicing women’s views and concerns as sexuality is underreported and poorly researched in Lebanon. Women’s narratives shed light on many aspects of their sexuality, sexual difficulties and the facilitators and barriers to help-seeking focusing on the role of nurses and midwives in this field. This comprehensive perspective that is contextually based has implications on education, clinical practice and research. It is particularly important to provide middle-aged Lebanese women with a culturally sensitive professional assistance to satisfy their sexual life. In addition, the publication of two papers from the study enriches knowledge in the field. It is of note that in this study sexuality and sexual life are interchangeably used. Nevertheless, sexuality has a broader meaning and encompasses all the thoughts, fantasies, desires, beliefs, attitudes, values, behaviour, practices, roles and relationships (WHO, 2006), whereas sexual life is more related to sexual relationships and activities (Segen's Medical Dictionary, 2012).

This thesis examines the menopausal experiences of a non-clinical sample of lesbians living in Australia. Research on menopause to date has largely been conducted from a medicalised and heterosexual perspective: thus lesbians’ experiences remain unknown and invisible. Using a qualitative feminist multiple method research methodology combining content analysis and questionnaire/interview research, two hundred questionnaires were posted upon request to self-identified lesbians living in every Australian state and territory. Follow up in-depth interviews were conducted with twenty lesbians. Responses were grouped into four major themes: body image, sex and sexuality, hormone replacement therapy and health services and homophobia. The findings show that lesbians at menopause face some different and additional issues from those experienced by heterosexual midlife women. For many of the study participants, commonly discussed concerns at menopause such as weight gain and other physical signs of ageing, decreased fertility, lack of libido, sexual difficulties and hormone replacement therapy were of little relevance and importance. Lesbians in this study frequently raised other issues such as the universal assumption of heterosexuality and homophobia experienced when interacting with health professionals, which led to less than satisfactory health care and reinforced feelings of invisibility. In the Conclusion I argue that the study participants' views and experiences challenge negative, stereotypical views of both lesbians and menopause. The data thus add a new dimension to the presently narrow, heterosexist and medicalised view of women at midlife and contribute new knowledge to the body of literature on menopause. This thesis is a first important step in recording the experiences of lesbians regarding menopause in Australia. I include recommendations for further research in the area of lesbian health and improved practice, and discuss old and new obstacles lesbians face in a heteropatriarchal society in which lesbians continue to be invisible.

Given the high risk of relapse during the first year of exercise involvement, it is important to determine the processes of self-motivation which enable novice exercisers to become long-term maintainers. This study was designed to extend previous Stages of Change (Prochaska & DiClemente, 1983) research by comparing the Possible Selves (Markus & Nurius, 1986) of individuals at different points within the Maintenance stage of exercise. Participants consisted of female university employees, spouses, and dependents age 35-59 years who volunteered for the study. Participants completed the Stage of Exercise Scale (SOES; Cardinal, 1995) and a self-administered form of the Possible Selves Inventory (Cross & Markus, 1991) which was adapted to address the exercise domain. Women classified by the SOES as being in the Maintenance stage of exercise V=92) were assigned to one of three groups based on the duration of their exercise maintenance (6 months-5 years, 6-10 years, and 11-20 years). The three maintenance groups were compared with regard to the number and category of open-ended and exercise-related possible selves and the self-efficacy and outcome expectancy associated with three focused selves (most important, exercise-related, and exercise-specific). The results indicated that the three maintenance groups did not differ significantly in their possible selves. These findings provide support for the current conceptualization of the Stages of Change Model (Prochaska & Di Clemente, 1983) and suggest that differences between novice and expert maintainers may be behavioral, rather than cognitive, in nature. Several implications for intervention design and suggestions for future research are discussed. / Graduation date: 1998

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