Erica V. Bennett

'You learn to live with all the things that are wrong with you': gender and the experience of multiple chronic conditions in later life

ABSTRACT This article examines how older adults experience the physical and social realities of having multiple chronic conditions in later life. Drawing on data from in-depth interviews with 16 men and 19 women aged 73+ who had between three and 14 chronic conditions, we address the following research questions: (a) What is it like to have multiple chronic conditions in later life? (b) How do older men and women ‘learn to live’ with the physical and social realities of multiple morbidities? (c) How are older adults’ experiences of illness influenced by age and gender norms? Our participants experienced their physical symptoms and the concomitant limitations to their activities to be a source of personal disruption. However, they normalised their illnesses and made social comparisons in order to achieve a sense of biographical flow in distinctly gendered ways. Forthright in their frustration over their loss of autonomy and physicality but resigned and stoic, the mens stories reflected masculine norms of control, invulnerability, physical prowess, self-reliance and toughness. The women were dismayed by their bodies’ altered appearances and concerned about how their illnesses might affect their significant others, thereby responding to feminine norms of selflessness, sensitivity to others and nurturance. We discuss the findings in relation to the competing concepts of biographical disruption and biographical flow, as well as successful ageing discourses.

Constructing the moral body: Self-care among older adults with multiple chronic conditions

Older adults are increasingly living with and managing multiple chronic conditions. The self-management of illness occurs in a social and political context in which the responsibility for health has shifted from the State to the individual, who is expected to be an active consumer of health care. Although there has been extensive investigation of the management of single chronic conditions, the realities of living with multiple morbidities have largely been ignored, particularly among older adults. Addressing this gap, our study entailed in-depth interviews with 35 older Canadian adults, aged 73 to 91, who had between three and 14 chronic conditions. Self-care emerged as a primary means by which our participants managed their illnesses. Specifically, all of our participants were engaged in some form of self-care in order to cope with often debilitating physical symptoms and functional losses. They also utilized self-care because they had reached the limits of available medical treatment options. Finally, our participants argued that self-care was a moral responsibility that was underscored by gendered motivations. Whereas the men tended to emphasize the importance of self-care for the achievement of masculine ideals of control and invulnerability, the women suggested that self-care allowed them to maintain feminine norms of selflessness and sensitivity to the needs of others. In this way, self-care enabled the men and women to reframe their aging, chronically ill bodies as moral, socially valued bodies. We discuss our findings in relation to the extant research and theorizing pertaining to self-care, gender, and healthism.

Negotiating Vulnerabilities: How Older Adults with Multiple Chronic Conditions Interact with Physicians

La littérature concernant les interactions entre les patients et les médecins a largement ignoré les points de vue des personnes âgées souffrant de comorbidités multiples. Cette étude, avec des données recueillies à partir d’entretiens approfondis avec 16 hommes et 19 femmes qui ont eu une moyenne de six affections chroniques, a porté sur la façon dont les participants ont perçus et vécus les soins fournis par leurs médecins de soins primaires. Les participants ont suggéré que les médecins qui soignent les patients atteints de maladies chroniques multiples devraient être minutieux, prête à “gate-keeping,” fiables et ouvert à différents styles de prise de décision. Cependant, nombreux participants à l’étude ont perçu qu’ils recevaient des soins inadéquats en raison de faiblesses personnelles de leurs médecins, les contraintes de consultations médicales, et l’âgisme sociétal. Par conséquent, beaucoup de participants, surtout les femmes, ont utilisé des diverses stratégies pour maximiser les soins reçus et pour gérer les impressions des médecins à leur egard comme dignes patients. Nos résultats suggèrent que les patients âgés atteints de morbidités multiples perçoivent que leur besoins de santé ne sont pas suffisamment satisfaits. The literature on patient-physician interactions has largely ignored the perspectives of older adults with multiple morbidities. Featuring in-depth interview data from 16 men and 19 women with an average of six chronic conditions, this study focused on how participants perceived and experienced the care provided by their primary care physicians. Participants suggested that physicians caring for patients with multiple chronic conditions should be thorough, amenable to gate keeping, trustworthy, and open to different decision-making styles. However, many study participants perceived that they received inadequate care due to the personal failings of their physicians, constraints of medical consultations, and societal ageism. Consequently, many of the participants, especially the women, employed various strategies to maximize the care they received and manage their physicians’ impressions of them as worthy patients. Our findings suggest that elderly patients with multiple morbidities perceive that their health needs are not being adequately met.

Aging and masculinity: Portrayals in men's magazines

Textual and visual representations of age are instructive as they suggest ideals towards which individuals should strive and influence how we perceive age. The purpose of our study was to investigate textual and visual representations of later life in the advertisements and interest stories of six widely read North American male-oriented magazines (namely, Esquire, GQ, Maxim, Mens Health, Mens Journal, and Zoomer). Through a content analysis and a visual textual analysis, we examined how older men were depicted in the magazine images and accompanying texts. Our findings revealed that older men were largely absent, and when portrayed, were positively depicted as experienced and powerful celebrities or as healthy and happy unknown individuals. The magazine advertisements and interest stories collectively required individuals to engage in consumer culture in order to achieve age and masculinity ideals and stave off the transition from the Third Age to the Fourth Age. We consider our findings in relation to theorizing about ageism, age relations, the Third and Fourth Ages, and idealized aging masculinity.

No emotion is an island: an overview of theoretical perspectives and narrative research on emotions in sport and physical activity

Abstract Within sport and physical activity settings emotions have typically been conceived and explored from an individualistic or intrapersonal perspective, although researchers are increasingly turning their attention to the interpersonal aspects of emotions and emotion regulation. In this paper, we provide a theoretical overview of the social or interpersonal aspects of emotions from a psychological perspective, and we also consider theoretical perspectives of emotion as intersubjective, social, performative and embodied. We then provide a review of narrative research on emotion in sport and physical activity contexts and provide suggestions for future research in this area. We suggest that narrative approaches can advance research on emotions in sport and physical activity by exploring how emotions arise within the context of social relationships; by exploring how emotional stories or narratives function and are used by athletes, coaches, and others within sport and physical activity contexts; by examining how emotions are created, recreated, and sustained through the stories people tell; by examining how collective and group-based emotions are intertwined with one’s identity and identity development; and by highlighting the ways in which social and cultural narratives within sport shape athletes’ emotional experiences. We conclude by describing some challenges we have faced in conducting qualitative research from a narrative lens, and we describe how we have navigated these issues as a way of offering some ‘lessons learned’ from our own research.

Negotiating (athletic) femininity: the body and identity in elite female basketball players

Abstract The purpose of this study was to examine the role of body perceptions in elite women basketball players’ negotiation of their athletic and feminine identities in and outside of sport. Semi-structured interviews were conducted with six elite female basketball players and data were analysed using interpretative phenomenological analysis. Findings revealed that some participants perceived their athletic and feminine selves to be separate entities. Their athletic identities came to the forefront in athletic contexts through displays of strength and assertiveness, and their feminine identities were emphasised in social contexts through appearance and dress. Other participants perceived their athletic and feminine identities to be compatible and at the forefront in both athletic and social contexts. Despite their perceptions of the (in)congruence of their athletic and feminine identities, all participants expressed some satisfaction with the instrumental capabilities of their bodies, but desired aesthetic body changes that would increase their compliance with a lean and toned female body ideal. The women also engaged in appearance management through the use of clothing, makeup, and dieting to emphasise their femininity. Media images of women’s bodies and coach feedback influenced these body-related perceptions and experiences. Findings contribute to existing research exploring female athlete identity and body image.

“I’ll do anything to maintain my health”: How women aged 65–94 perceive, experience, and cope with their aging bodies

We explored how physically active women perceived, experienced, and coped with their aging bodies, and examined their perceptions of the utility of self-compassion to manage aging body-related changes. Findings from a thematic analysis of interviews with 21 women aged 65-94 revealed that they were appreciative of how their bodies worked and accepting of their physical limitations, yet concurrently critical of their bodys functionality and appearance. Participants engaged in physical activity and healthy eating to maintain their health and body functionality, yet also used diet, hair styling, anti-aging creams, makeup, physical activity, and clothing to manage their appearances. To assess their bodies (in)adequacies, they engaged in upward or downward social comparisons with others their age. Participants perceived self-compassion for the aging body to be idealistic and contextual. Findings highlight the importance of health and body functionality in influencing the cognitive, emotional, and behavioral management of the aging body.

‘It’s all about modifying your expectations’: women’s experiences with physical activity during pregnancy

The purpose of this study was to qualitatively examine women’s experiences with physical activity throughout the course of pregnancy. Nine pregnant women participated in two semi-structured interviews (total of 18 interviews) – between one and five months apart. The data were analysed using interpretative phenomenological analysis. Results revealed that participants felt the need to ‘slow down’ from their previous physical activity levels due to physical changes brought on by pregnancy such as fatigue, nausea and/or vomiting and injury potential. The women negotiated underlying tensions associated with the experience of being physically active while pregnant by changing their activities and also by changing their activity-related attitudes as pregnancy progressed. Despite these changes, activity remained important for the women as they persisted with physical activity throughout the course of pregnancy to maintain physical fitness, their health and the health of the baby, to socialise and to relieve stress. These behaviours were partially supported by the participants’ partners, family and friends; however, the women did not perceive this partial support to be constraining and sought out prenatal exercise classes to create a social network with other expecting mothers. Findings highlight the importance of considering women’s experiences when devising health-promotion interventions focused on increasing and improving women’s physical activity behaviours during pregnancy. Participants were heterosexual, highly educated, predominantly white and English speaking; thus, future studies should examine the experience of physical activity during pregnancy in more diverse populations.

“The zipper effect”: Exploring the interrelationship of mental toughness and self-compassion among Canadian elite women athletes

Objectives: The purpose of this study was to explore how elite women athletes perceived and experienced mental toughness and self‐compassion and their compatibility in the pursuit of athletic success and stress management. Method: Adopting an interpretivist constructionist approach, we conducted two semi‐structured interviews with seven participants (14 interviews), aged 22 to 34. Through a thematic analysis, we identified and analyzed patterns within the data related to how the athletes experienced and perceived self‐compassion and mental toughness. Results: Three overarching themes were identified, including the role of mental toughness as critical for coping with sport‐related adversity, the role of self‐compassion as critical for coping with sport‐related adversity, and self‐compassion and mental toughness as compatible. Participants experienced mental toughness as a coping resource, which included perseverance through adversity, remaining present, maintaining perspective, and adequate competition preparation. They perceived that common humanity, mindfulness, and self‐kindness were also key to coping with sport‐related adversity. Finally, the women identified self‐compassion and mental toughness as compatible and contextual processes. Self‐compassion was critical to the development of mental toughness, and mindfulness was key to developing and maintaining both self‐compassion and mental toughness. Conclusions: The findings revealed that self‐compassion and mindfulness are worthy of investigation in elite women athletes, particularly with regards to their utility in coping with sport‐related adversity and in achieving a mentally tough mindset. Self‐compassion and mental toughness are compatible processes that may both require mindfulness, and if used in an effective and complementary balance could create optimal mindsets for the pursuit of athletic success.