Submitted in accordance with the requirements for the degree of Masters of Arts in the subject of Clinical Psychology in the Department of Psychology (Faculty of Arts) at the University of Zululand, South Africa, 2011. / Spousal abuse is a public health concern and is common in all races and ethnicities. It may take on various forms such as; physical beating, verbal/ emotional/ psychological abuse, sexual abuse, or financial abuse. Women often remain in abusive relationships for financial security, fear of further harm, and because of socials stigmatization. This study focuses on the psychological empowerment of female victims of spousal abuse through philophonetics. Philophonetics-counselling is a therapeutic intervention which appreciates the complexities of the human form. It is an approach that offers the possibilities of healing and experiencing the fullness of what life could be. Seven female victims of spousal abuse participated in the study and these participants reside in the Rustenburg area. A qualitative approach was utilized, with data being analysed applying hermeneutics. The results indicated the success and effectiveness of the philophonetics modality. Each participant disclosed and described significant shifts in their production of the imprints (IT) of abuse. Self help tools were given so as to ensure that participants could prevent further IT’s from entering their body, and thereby heal themselves. Findings in the current study show that the utilization of such a modality is effective in empowering the target population. It is therefore recommended that the process of empowerment through philophonetics be continuous.

When a family member is incarcerated, the task of emotionally and financially supporting the remaining family members and the incarcerated loved one often falls upon women, who are likely to be under-resourced and overwhelmed. Women whose husbands are incarcerated in India are likely to possess multiple marginalized identities, increasing their vulnerability to intersecting forms of oppression. Empirical research is lacking on wives of incarcerated men in India, contributing to their invisibility in policy-making and programmatic interventions. Guided by intersectional feminism and symbolic interactionism, the purpose of this study was to document the stories of women who had experienced spousal incarceration in the Indian context. In-depth, semi-structured interviews were conducted with 14 wives of prison inmates who resided in or around the National Capital Territory of Delhi, all of whom either held a lower caste identity or a Muslim religious identity. Transcribed interviews were analyzed following the steps of narrative analysis. Results illustrate the diversity of storied experiences of wives of incarcerated husbands in India. First, by grouping narratives that conveyed the same overall storyline into the same cluster, I identified three story clusters: Ambivalent but Hanging On, Unconditionally Devoted, and Independent and Disillusioned. Second, by attending to how women's day-to-day lives are shaped by intersecting systems of privilege and oppression, particularly those tied to gender and class, I identified three overarching themes that spanned women's narratives: (a) a complicated relationship with patriarchy, (b) the weight of socioeconomic disenfranchisement, and (c) when resilience is not a choice. The results of this study emphasize the need to distinguish between feminist agency and welfare agency, to recognize women's experiences of ambiguous loss and disenfranchised grief, and to critique the systemic injustices that forced women to be resilient. Documenting their stories is instrumental in bringing attention to the needs, challenges, and triumphs of this underserved and overlooked population. / Doctor of Philosophy / When a family member is incarcerated, the task of emotionally and financially supporting the remaining family members and the incarcerated loved one often falls upon women, who are likely to be under-resourced and overwhelmed. Women whose husbands are incarcerated in India are likely to possess multiple marginalized identities, increasing their vulnerability to intersecting forms of oppression. Empirical research is lacking on wives of incarcerated men in India, contributing to their invisibility in policy-making and programmatic interventions. The purpose of this study was to document the stories of women who had experienced spousal incarceration in the Indian context. Interviews were conducted with 14 wives of prison inmates who resided in or around the National Capital Territory of Delhi, all of whom either held a lower caste identity or a Muslim religious identity. Results illustrate the diversity of women's stories and experiences with spousal incarceration. First, by grouping narratives that conveyed the same overall storyline into the same cluster, I identified three story clusters: Ambivalent but Hanging On, Unconditionally Devoted, and Independent and Disillusioned. Second, by attending to how women's day-to-day lives are shaped by intersecting systems of privilege and oppression, particularly those tied to gender and class, I identified three overarching themes that characterized women's narratives: (a) a complicated relationship with patriarchy, (b) the weight of socioeconomic disenfranchisement, and (c) when resilience is not a choice. The results of this study emphasize the need to distinguish between feminist agency and welfare agency, to recognize women's experiences of ambiguous loss and disenfranchised grief, and to critique the systemic injustices that forced women to be resilient. Documenting their stories is instrumental in bringing attention to the needs, challenges, and triumphs of this underserved and overlooked population.

No description available.

While studies have indicated the onset of fertility transition in Nigeria as in most Sub- Saharan countries, no systematic attempt has been made to identify the factors responsible for this trend. Existing explanation tends to draw from the demographic transition theory without exploring the value of other key variables. One of these variables is the degree of preference implementation. This study explores the role of fertility preference implementation on the onset of fertility transition in Nigeria. The study estimated the extent to which couples have been able to implement their fertility preferences with a view to better understand the factors that are responsible for the fertility changes in the country. This study was based on the socio-economic and microeconomic frameworks of fertility namely: the Bongaarts et al (1984) version and its Stover’s reformulation (1998) of the proximate determinants of fertility and the Bongaarts (1993) supply-demand framework for the analysis of the determinants of fertility, respectively. The proximate determinant of fertility frameworks holds that all demographic, socioeconomic, cultural, institutional, psychological, health and environmental factors (background variables) operate through the proximate or intermediate variables to affect fertility. The Bongaarts (1993) supply-demand framework posits that fertility (F) as measured by total fertility rate is an outcome of the interaction of supply of births (natural fertility), demand for births (wanted fertility) and degree of fertility preference implementation (an index, which measures the extent to which people have been able to implement their fertility preferences). The degree of preference implementation is in turn dependent on cost of fertility regulation and that of unwanted childbearing. The husbands’ family planning attitude and desired number of children were incorporated into the latter framework to recognize and bring out the crucial roles of the males in eventual fertility outcomes. The 1990, 1999 and 2003 Nigeria Demographic and Health Survey (NDHS) data sets for men, women and couples were used. The methodology of the three NDHS is not too different from each other. They are nationally representative cross-sectional survey of women between the ages of 15 and 49 in 1990, 1999 and 2003 and men between 15 and 64 in 1999 and 15-59 in the 2003 survey. Twenty-four focus group discussions were also conducted among the sexes across the country to gain better insight and understanding into the issues examined. Focus group research is based on facilitating an organized discussion with a group of individuals selected because they were believed to be representative of some class. The discussion is used to bring out insights and understandings in ways, which cannot be captured by questionnaire. The focus group discussions (FGD) are also national in scope. Participants were drawn from the Northern, South Eastern and South Western regions of the country. The study population consisted of 8,781; 8,199 and 7,620 women aged 15-49 interviewed during the 1990, 1999 and 2003 NDHS, respectively. In addition, 2,584 men aged 15-64 and 2,346 men aged 15-59 interviewed during the 1999 and 2003 NDHS, respectively were used. One thousand, one hundred and sixty-eight (1,168) couples’ records derived from the 2003 NDHS and 1,280 (constructed) couples’ records for 1999 were also used. A total of eighty-nine (89) men and eighty-five (85) women participated in the twenty-four (24) focus group discussion sessions. To achieve the research objectives, a wide range of analysis was carried out in the study. In the estimation of all means and medians, the Kaplan Meier survival analysis is used. Some other estimations were done using specific formulations developed for the purpose. Thirty-six binary logistic regression models were also fitted to bring out spousal influences on each other’s attitude to family planning and desired number of children. Lastly, the focus group discussion sessions were analysed by themes to give better understanding into the issues examined. Five hypotheses were tested in the study. There was a general decline in the age specific fertility rates (ASFR) between 1990 and 2003 in all the age groups. This is reflected in the total fertility rate (TFR) for the country as a whole, which declined from 6.32 in 1990 to 5.82 in 2003. The national average masks large variations in the fertility levels between subgroups in the country. The women in the North generally have higher number of children than their Southern counterparts. This is particularly marked in the early childbearing years. Fertility levels are also higher among rural residents compared to those in the urban area. Substantial differences equally exist in the fertility levels of women by their level of education with fertility being negatively associated with level of education. A comparison of the past and current fertility also confirms that fertility has been on the decline in the country. Age at first and last births have been declining and the differentials between the two show that the number of years spent in childbearing is decreasing. Non-marital birth was also found to be increasing over time but at a level below six percent and with no identifiable educational or regional pattern. Teenage motherhood is equally declining both nationally and regionally and is relatively high among teenagers from the rural area and those with less than secondary level of education. The proportion of women that progress from one parity to another decreases as parity increases and no socially imposed optimum number of children is observed (although there is a political four-child policy in existence) among the Nigerian women. Apart from age of mother at the birth of child, which has a positive association with median length of birth interval and the surviving status of preceding child (which is understandably shorter if the preceding child is dead), length of birth interval by other characteristics shows no significant variation across sub groups. Age at first marriage remained between 16 and 17 over the years. This is lower for respondents from the rural, the North and for those with less than secondary level of education. For age at first sexual intercourse, it increased over time in the age groups. Respondents from the North and rural area however initiated sexual intercourse earlier and age at first sexual intercourse increases with level of education. Among the proximate determinant indices, the index of postpartum insusceptibility has the greatest inhibiting effect, followed by that of marriage/sexually active, contraception and then sterility. In the Bongaarts model, the indices reduced total fecundity by 12.46 births in the total sample of married women in 1990; 8.90 births in 1999 and 9.45 births in 2003 while the indices jointly reduced potential fertility by 17.69 births in the total sample of sexually active women in 1990; 16.06 births in 1999 and 16.50 births in 2003 in the Stover’s reformulation. The number of children desired marginally increased over time. This could have been affected by the high proportion of non-response especially in the 1990 survey. The desired number of children is positively related to age and number of surviving children while it is negatively related to education. Number of children desired is found to be lower among urban residents and respondents from the Southern part of the country and highest among currently married women. The focus group discussion sessions also show that people have been revising the number of children they are having downward due to ‘supposed’ economic hardship in the country and the need to give quality education, training and care to the children. However, their desire remain high. The extent, to which fertility preference is achieved, is generally high and increasing over the years in the total sample of married women with some variations in the sub groups. It is higher in the urban compared to the rural; increases with level of education, lowest in the North East and highest in the South West. Surprisingly, the extent to which concordant couples achieve their fertility preferences was lower than that of discordant couples. The fitted logistic models showed no evidence of the husbands having an upper hand in the number of children desired by the wives or on their attitude to family planning and vice versa. While the husbands play greater role in fertility decision-making in households, who has the upper hand between the husbands and the wives in actual fertility outcome was not conclusive in this study. Knowledge about family planning methods and their availability is high. The costs of fertility regulation in terms of its social, economic and in particular health components as well as obstacles to the use of fertility regulation methods were highlighted. The psychological, health, social and more frequently the economic costs of unwanted childbearing were also brought out. The responses to questions on pregnancy wantedness was also validated in this study as people generally acknowledged the circumstance of the birth of additional child(ren) as accidental. Two of the five hypotheses proposed were confirmed. One, the hypothesis that ‘the degree of fertility preference implementation is higher in the south than in the North, higher among urban residents compared to the rural residents and increases as the level of education increases’ is supported by the results of the study. Two, that ‘the degree of fertility preference implementation is increasing and playing an increasing (a more positive) role in fertility changes in Nigeria’ is also supported. The study could not confirm that ‘the indices of marriage/sexual activity, postpartum insusceptibility and contraception (in that order) have the most inhibiting effect on fertility in Nigeria.’ The other two hypotheses could not be proven conclusively either. These were that ‘degree of fertility preference implementation is higher among couples with similar desired number of children than among discordant couples’ and ‘the Husbands have more influence on their wives’ family planning attitude and desired number of children than the wives have over their husbands’. These findings have programme and policy implications. For instance, although the reduction in the number of years spent in child bearing is welcome as a result of decline in the number of older women in active childbearing, the increasing entrance of women under the age of eighteen years is worrisome. This could impact negatively on school enrolment and retention as well as on the health of the women since it is recognised that women under the age of eighteen years is one of the four groups of women with higher risk of morbidity and mortality during pregnancy and childbirth. Despite the pertinent findings of this study, a number of study limitations can be identified. This include not identifying people who have achieved their desired fertility and those who have not and conducting in-depth interview with them to gain greater insight into their fertility decision-making, desire and behaviour. This aspect requires further detailed investigation. A number of programme, policy and research recommendations are made based on the findings of this study.

Thesis advisor: Dorothy A. Jones / The purpose of this qualitative research study was to answer the following questions: What is the life pattern manifested by individuals caring for spouses who have had coronary artery bypass surgery? What are the thematic expressions of life patterns among individuals caring for spouses who have had coronary artery bypass surgery? The theoretical framework guiding this study was Margaret Newman’s Health as Expanding Consciousness. The research method created by Newman facilitated the understanding of the individual participant’s experience, pattern identification, similarities in pattern across participants and the potential for expansion of consciousness. The study sample included ten women and two men whose spouses were recovering at home following cardiac surgery. These twelve spousal caregivers shared their life stories and their spousal caregiving experience in the first two weeks at home following their spouses discharge from the hospital. There were various levels of potential for expansion of consciousness for these spousal caregivers. Looking across participants six themes emerged from the data. First, disruption in the spousal caregivers’ roles and responsibilities impacts the relationship between the spousal caregivers and their spouses and shifts life patterns. Second, spousal caregivers face coping challenges with changes in lifestyle and response to illness. Third, Spousal caregivers experience vigilance in an effort to ease the uncertainty of the recovery process. Fourth, knowledge helps spousal caregivers gain a sense control in the face of uncertainty. Fifth, mutuality within the partnership of nurse and the spousal caregiver relationship impacts the potential for transformation. Sixth, Spousal caregivers’ awareness of their life pattern gives meaning and offers the caregivers a new perception on life they have left to live. Findings from this study have important implications for nursing theory, practice, research, education and health care policy. The study adds empirical support to Newman’s Theory of Health as Expanding Consciousness and provides a new way to examine spousal caregiving and the nurse-client relationship. / Thesis (PhD) — Boston College, 2008. / Submitted to: Boston College. Connell School of Nursing. / Discipline: Nursing.

The overall aim of this thesis is to gain a better understanding how people with dementia and their spouses experience dementia over time, especially the impact it has on their inter-personal relationships and patterns of everyday life. Data were collected using separate semi-structured interviews with 20 persons with dementia and their spouses of 6 monthly intervals over an 18-months period (132 interviews in total), and analysed using constructivist grounded theory. Analysis suggested that whilst spouses are aware of and acknowledge the diagnosis of dementia, they do not routinely talk about it but rather the focus of their combined efforts is on making life as meaningful as possible. To do this couples, rather than individuals, actively ‘work together’ to create a ‘nurturative relational context’ in order to sustain the quality of their relationship, and maintain the self-image and sense of agency of the person with dementia. In order to create a ‘nurturative relational context’ couples continued to ‘do things together’ for as long as possible by understanding complementary roles underpinned by a mutual appreciation of each others contribution in a way that builds upon the remaining strengths of the person with dementia. Their focus is therefore on ‘couplehood’ as much as ‘personhood’. An analysis of the complete data set identified three temporally sequenced but overlapping phases of the experience of couplehood termed ‘sustaining couplehood’, ‘maintaining involvement’, and ‘becoming alone’. ‘Sustaining couplehood’ had the primary goal of ensuring that the spuses’ ‘work’. This involved four interrelated sets of activities: talking things through, in order to ensure good communication and acknowledge and value differences; being affectionate and appreciative by demonstrating continued attractiveness to their spouse; making the most of things by enjoying everyday pleasures, looking for positive interpretations of events and focussing on the present (living for today); and finally, keeping the peace by being aware of potential points of friction and not responding to difficult behaviour. Both the person with dementia and the non-affected spouse were active strategies in the above process. In addition both spouses worked to ‘maintain the involvement’ of the person with dementia by ensuring that they had an active role to play. However, despite their efforts, eventually the non-affected spouse took on an increasing role and this occurred in a number of ways, either by the person with dementia consciously ‘handing over’ responsibility or more passively ‘letting go’, or by the non-affected spouse ‘taking over’. ‘Sustaining couplehood’ and ‘maintaining involvement’ often occurred simultaneously but the relative emphasis changed over time as ‘sustaining couplehood’ became more difficult and increasing effort was expended in ‘maintaining involvement’. As this occurred the data suggested that the non-affected spouse became increasingly ‘alone’ as the dementia progressed. This process has yet to be fully explored, however, it is clear that for spouses a complete understanding of the dementia experience is not possible without consideration of ‘couplehood’.

Death is a universal event that all living things experience. Older adults, in particular, are more mindful of death than younger generations because of their proximity and increased exposure to it. In addition, thoughts of one’s own death often increase with the death of a spouse. Previous research has explored the role of social support in death acceptance and the effect of previous marital satisfaction on a widow’s well-being. However, there is a lack of research regarding the experience of a widow’s personal death acceptance relative to spousal death acceptance and marital satisfaction. This phenomenological study aims to better understand the personal death acceptance of eight older widows (age 65+) through their experiences with marital satisfaction and spousal death acceptance. Seven women and one man participated in two rounds of semi-structured telephone interviews and completed supplemental surveys regarding their marriage and death attitudes. Findings indicate that essential dimensions of recalled high marital satisfaction and spousal death acceptance relates to experiences of positive personal death acceptance.

Thesis (M.S.) in Education--University of Maine, 2007. / Includes vita. Includes bibliographical references (leaves 45-48).

No description available.

abstract: Spousal bereavement is one of the most stressful life events, resulting in increased morbidities and mortality risk. Negative health outcomes include depressive episodes, anxiety, sleep disruption, and overall poorer physical health. The older adult population is rapidly increasing and over 30% of the US population 65 years and older are widowed. Current studies regarding older adults and spousal bereavement treatment have been limited to psychological and educational interventions. Meditative movement practices (e.g. Tai Chi) have shown benefits such as mood elevation, anxiety reduction, and other physical function improvements. A feasibility study applying an 8-week Tai Chi Easy intervention was examined to address the sequelae of spousal bereavement among adults 65 and older. Grounded in geriatric nursing as a discipline that addresses the unique needs of older adults' psychological and physiological health needs and related theoretical constructs, this project also draws from exercise science, mental health, and social psychology. Theoretical premises include Orem's Self Care Deficit Theory (nursing), Stroebe and Schut's Dual Process Model (thanatology), and Peter Salmon's Unifying Theory (exercise). Aims of the study examined feasibility as well as pre-post-intervention changes in grief, and the degree of loss orientation relative to restoration orientation (Inventory of Daily Widowed Life). A trend in the direction of improvement was found in measured subscales, as well as a statistically significant change within the loss orientation subscale. Based upon these encouraging findings, effect sizes may be used to power a future larger study of similar nature. / Dissertation/Thesis / Ph.D. Nursing and Healthcare Innovation 2012