Sandra K. Plach

Self-Care of Women Growing Older With HIV and/or AIDS

The purpose of this report is to describe the ways older women living with HIV perceive of and practice self-care. Data are taken from a culturally diverse subsample of 9 women age 50 years or older who participated in a larger longitudinal qualitative study of women who were HIV infected. During a period of 2 years, 10 semistructured narrative interviews were conducted with each of the 9 participants to gain an in-depth understanding of their experiences with symptom management, adherence to medical regimens, reduction of HIV risk, access to health care and social services, and personal efforts to maintain their health. Transcribed data were managed using Nvivo software and analyzed using multistaged narrative analysis. Findings suggest that mature women living with HIV integrate actions to maintain bodily comfort and improve physical well-being with actions that champion and conserve the existential self. Excerpts from their interviews illustrate this dialectical understanding of self-care.

Social Role Experiences of Women Living with Rheumatoid Arthritis

This study was designed as the qualitative arm of a larger quantitative study (N= 156) of the relationships among social role quality, physical health, and psychological well-being of women living with rheumatoid arthritis (RA). A subset of 20 midlife and late-life women from this larger sample participated in semistructured interviews with the specific aims of investigating how fulfilling they found social roles to be, including their spouse, mother, worker, and homemaker roles, while contending with RA, and what circumstances made social role experiences more positive. The results of the current followup qualitative study illustrate how difficult it can be to fulfill social roles during exacerbations of the illness in their formative adult years. The circumstance that best facilitated their positive experience in social roles was the unburdening of social role obligations as they grew older. Implications for nursing practice are discussed.

Effect of a postdischarge education class on coronary artery disease knowledge and self-reported health-promoting behaviors

OBJECTIVE To determine the effect of a single 2-hour postdischarge education class on knowledge and health-promoting behaviors of patients undergoing cardiac catheterization. DESIGN Descriptive, two-group, posttest survey. SETTING Midwestern community hospital. SUBJECTS One hundred fourteen patients who had experienced a cardiac catheterization, 53 patients who had attended a postdischarge coronary artery disease education class, and 61 patients who had not attended the class. OUTCOME MEASURES Knowledge of coronary artery disease and coronary artery disease risk factor, and health-promoting behaviors. RESULTS Those who attended the postdischarge class scored significantly higher on both knowledge and health-promoting behaviors. CONCLUSION Patients who attended a single 2-hour postdischarge education class had significantly higher knowledge of coronary artery disease and coronary artery disease risk factors. Knowledge may better prepare people to increase health-promoting behaviors.

Psychological Well-Being in Women with Heart Failure: Can Social Roles Make a Difference?

I performed this study to examine whether the quality of womens social roles influences the impact of heart failure (HF) on their psychological well-being. Survey questionnaires measuring social role quality, physical health, and psychological well-being were completed by 169 midlife, older, and late-life women. Hierarchical multiple regression indicated that, after controlling for age, income, and physical health, social role quality accounted for a significant proportion of variance in multiple well-being outcomes. The quality of womens social roles may be an important consideration in the development of interventions to help women with HF live satisfying and productive lives.

DEPRESSION DURING EARLY RECOVERY FROM HEART SURGERY AMONG EARLY MIDDLE-AGE, MIDLIFE, AND ELDERLY WOMEN

Theories and studies about the psychological processes of midlife propose a transition that may result in a more integrated personality structure throughout the second half of life. This more integrated structure includes concepts such as generativity, self-assertion, and independence. However, this structure, especially in early middle-age, can be affected by a life-threatening health disruption such as heart disease. One hundred and fifty-five women participated in a cross-sectional survey designed to investigate depression in early middle age, midlife, and elderly women who had undergone heart surgery. Women aged 40–55 years composed the early middle-age group, women aged 56–65 years composed the midlife age group, and women aged 66+ years were identified as the elderly age group. Affective components of depression were measured by asking participants to respond to three items regarding frequency of sadness, depression, and “the blues.” Affective depression scores were summed and a mean score derived. Mean scores significantly differed by age group (F [2, 152] = 3.05, p =. 05). Older women in the study fared better than their younger counterparts in terms of depression scores after a major cardiac health disruption. Post hoc comparisons indicated that mean scores for the early middle-age participants were significantly higher than for the midlife and older participants. Depression in the context of a cardiac health disruption appears to be linked to the developmental stage of a woman’s life trajectory on which it is superimposed.

Social, health, and age differences associated with depressive disorders in women with rheumatoid arthritis.

Depression in women with rheumatoid arthritis (RA) may be related to social role experiences, physical health, and age. The purpose of this study was to examine the social and health factors contributing to depression in two age groups of women with RA. One-hundred and thirty-eight midlife and late-life women with a diagnosis of RA participated in this cross sectional survey study. Multiple regression analysis indicated that social role balance, functional status, number of co-existing health problems, and age were significant predictors of depression in midlife and late-life women with RA. Role balance was the strongest factor contributing to a womans depression score. Compared to midlife women, late-life women reported significantly higher role balance and lower depression scores, despite poorer functional status and more concomitant health problems.