Melissa A. Talamantes

Prevalence and 3-Year Incidence of Abuse Among Postmenopausal Women

OBJECTIVES We examined prevalence, 3-year incidence, and predictors of physical and verbal abuse among postmenopausal women. METHODS We used a cohort of 91,749 women aged 50 to 79 years from the Womens Health Initiative. Outcomes included self-reported physical abuse and verbal abuse. RESULTS At baseline, 11.1% reported abuse sometime during the prior year, with 2.1% reporting physical abuse only, 89.1% reporting verbal abuse only, and 8.8% reporting both physical and verbal abuse. Baseline prevalence was associated with service occupations, having lower incomes, and living alone. At 3-year follow-up, 5.0% of women reported new abuse, with 2.8% reporting physical abuse only, 92.6% reporting verbal abuse only, and 4.7% reporting both physical and verbal abuse. CONCLUSIONS Postmenopausal women are exposed to abuse at similar rates to younger women; this abuse poses a serious threat to their health.

Becoming Better Health Care Providers: Outcomes of a Primary Care Service-Learning Project in Medical School

SUMMARY Medical educators have begun to embrace service-learning as a method for teaching medical students to be more socially responsible, patient-oriented practitioners. However, research documenting the learning outcomes of service-learning in medical education is limited. In this paper, written documents generated through evaluation of a mandatory, structured community service-learning experience were analyzed qualitatively to discover the diverse learning outcomes among 24 students who participated in the experience. Preliminary findings indicate that students developed skills and attitudes directly related to competencies of concern in most U.S. medical programs. These preliminary findings may help other programs articulate learning outcomes for their service-learning programs. Further, these preliminary findings may stimulate more systematic research (qualitative and quantitative) in this area.

Safely examining complex dynamics of intimate partner violence.

The overall goal of this study is to use complexity science to gain a deeper understanding of the nonlinear day-to-day dynamics of intimate partner violence, with implications for clinical interventions. This report describes research methods for gathering information about partner violence in real time and assesses recruitment and retention, adherence to study protocol, data validity, and participant safety. Research assistants enrolled 200 women in moderately violent intimate relationships and asked them to report about their relationships every day for 12 weeks. Daily, participants telephoned an Interactive Voice Response (IVR) system and responded to 34 survey questions. They also completed baseline and end-of-study surveys and maintained telephone contact with the study team weekly. Forty-two participants completed qualitative end-of-study interviews to describe their relationships and the impact of the study on their lives. Of 200 enrollees, 145 women provided enough data for nonlinear analyses, averaging 63.5 daily reports of 84 possible. Participants submitted 9,201 daily reports, documenting partners verbal or physical aggression on 39.4% of days, and their own aggression on 23.1%. Two women were withdrawn from the study for safety reasons; the remainder reported that study participation posed no additional threat. Eighty women sought assistance from community resources. Violence severity did not appear to change over the 12 weeks. The research team successfully and safely recruited and retained 145 women who provided valuable data for a study of complex dynamics of intimate partner violence.

Abuse and neglect in older men

Abstract Elder abuse and mistreatment is a growing national concern. While victims and perpetrators are both men and women, much of the focus has been on women. Reports of the gender distribution of elder mistreatment conflict with some studies citing a greater prevalence in males and others showing a female predominance. The article summarizes the research on elder mistreatment, emphasizing the gender distribution. Older men are more likely to be victims of neglect, particularly abandonment. We use case vignettes to illustrate these major research findings. We also present data from a series of focus group interviews that included older men. The comments of the men about elder mistreatment were analyzed and are presented in this article. Through these findings we show that more research is needed to understand the similarities and differences between male and female victims of elder abuse and mistreatment.

Physician-assisted suicide attitudes of older Mexican-American and non-Hispanic white adults: does ethnicity make a difference?

Little is known about attitudes toward physician‐assisted suicide (PAS) in various ethnic groups. This study compares attitudes held by older Mexican Americans and non‐Hispanic whites and examines subject characteristics that may influence their responses. A convenience sample of 100 older Mexican Americans and 108 non‐Hispanic whites (n=208) aged 60 to 89 were recruited from four primary care community‐based practice sites in San Antonio, Texas. Interview items measured attitudes toward PAS, cognitive status, functional status, and religiosity.

Reaching the heart of the caregiver

Abstract Rapidly increasing numbers of Spanish-speaking Hispanic elders portend similar increases in dementing disorders among this group; this, in turn, points to increasing numbers and challenges among the family caregivers (Janevic & Connell, 2001; U.S. Department of Commerce, 1996). Successful programs have been developed to equip non-Hispanic family members to effectively assume the caregiving role. This article reports on preliminary efforts to transform one such psychoeducation program into the “Cuidando con Respeto” program, a culturally appropriate, Spanish language program for Hispanic family caregivers. Principles of development, results from the prototype program, and future evaluation developments are presented.

Research or intervention or both? Women's changes after participation in a longitudinal study about intimate partner violence

Introduction: The tensions between risk and benefit in research are particularly evident in studies about intimate partner violence. Recalling and relating traumatic experiences may deepen posttraumatic stress or relieve the burden of terrible events long borne in secret. In this article, we examine the effects of study participation in a longitudinal investigation of intimate partner violence using both qualitative and quantitative data. Method: Researchers enrolled 200 women in moderately violent intimate relationships and asked them to report about their relationships every day for 12 weeks. Daily, participants telephoned an automated survey and responded to 34 survey questions. They also completed baseline and end-of-study surveys and maintained telephone contact with 1 researcher weekly. Forty-2 participants completed qualitative end-of-study interviews to describe their relationships and their experiences in the study. Results: Over 12 weeks, participants showed improvements in coping strategies, hope, and mental health, and increased readiness to leave their partners. In qualitative interviews, women reported gaining insight, feeling better emotionally, making behavioral changes, finding comfort in daily surveys, learning resources for help, and taking action to improve their lives. Fourteen percent left their partners by end-of-study; 35% sought counseling. Discussion: The study’s daily survey invited the participant to become more reflective about her relationship, which changed how she saw herself and her situation. The study methods also included weekly conversations with a compassionate researcher, allowing women to tell their stories. These 2 strategies may be incorporated into brief interventions for intimate partner violence in primary care settings.