Tracie Harrison

Marriage, impairment, and acceptance in persons with multiple sclerosis.

The purpose of this study was to investigate the relationship between marital status, marital concern, perceived impairment, health-promoting behaviors, and acceptance of disability using cross-sectional and longitudinal data from a sample of persons with multiple sclerosis (MS). We hypothesized that the quality and stability of the marital relationship would influence people’s ability to accept their disability and protect from accumulation of impairment over time. Furthermore, men and women would receive dissimilar benefits from marriage. These hypotheses were considered with repeated measures analysis, Pearson correlations, and independent sample t tests of data obtained from a longitudinal study of persons with MS. The findings indicate that acceptance of disability and perceived impairment increase significantly over time for men and women. For men, being married was associated with a greater acceptance of disability and less perceived impairment. Men were more concerned than the women about how MS affected their sexual relationships.

Health promotion for persons with disabilities: what does the literature reveal?

A search of MEDLINE and CINAHL databases for research on disability and health promotion was done. Twenty-three articles were categorized into 1 of 3 areas: the meaning of health and health promotion, factors that contribute to health and health promotion, and health promotion interventions. Overall, health and health promotion were inductively defined concepts that emphasized function, relationships, and a positive mental attitude. Barriers to health promotion were frequently reported, fatigue being most common. Moreover, better health outcomes were reported when people with disabilities engaged in health-promoting behaviors. There were few interventions found, with only 1 being a randomized clinical trial.

A Hermeneutic Phenomenological Analysis of Aging with a Childhood Onset Disability

In this qualitative study, we combined multiple interviews, field notes, life history review charts, and demographic questions to explore the life course experiences of 25 women, ages 55 to 65 years, who developed impairments due to paralytic polio during childhood. Based on a hermeneutic phenomenological methodology using thematic analysis, multiple themes emerged that traced their lives from childhood to later adulthood. The women described how they pushed their bodies and dismissed their physical decline as long as possible. The womens early experiences combined with the culturally defined role expectations for women to influence their perceptions of how to react to changing physical abilities with age.

Barriers that further disablement: a study of survivors of polio.

&NA; This exploratory study of polio survivors was undertaken to clarify current level of function, comorbidity, and secondary conditions and to discover the relationships between perceived barriers to health, functional limitation, comorbidity, secondary conditions, and disability in a small convenience sample. Given the underrepresentation of research in the literature explaining the health status, perceived function, and barriers to health in this disabled population, a descriptive study with correlation was conducted. Thirty‐one individuals living with the effects of polio were surveyed. Disability was correlated with perceived barriers to health but not with functional limitations, comorbidity, or secondary conditions. Secondary conditions were correlated with the number of years living with the illness. The findings support a model of disablement and allostatic load. Further research is needed to test these models and to provide direction for nurses caring for those aging with the effects of polio.

Disability rites: the cultural shift following impairment.

Persons with disabilities experience barriers to health within a culture. The local culture assigns meanings to those with impairments and their activities. In order to understand the experience of disability as influenced by culture, anthropological models of rites of passage and liminality have been used, but these can be extended further. The authors posit that local cultures should be the context for studying disability, and thus extend on previous work by Murphy 1 on the rites of passage for persons with disabilities. This article will: (1) review how disability has been culturally created and defined, (2) provide additional evidence for the argument regarding the existence of disability culture, and (3) extend the work on rites of passage for persons with disabilities. A brief discussion of how this expanded model might guide the understanding of disability and the understanding of barriers to health follows.

Disability, social support, and concern for children: depression in mothers with multiple sclerosis.

OBJECTIVE To investigate the relationship between disability, concern for children, social support, and depressive symptoms in a group of mothers with multiple sclerosis (MS). DESIGN An exploratory secondary analysis using correlation and multiple regression techniques. SETTING AND PARTICIPANTS Two hundred one women with MS responded to a survey as part of a cohort participating in a longitudinal study of health promotion and quality of life. OUTCOME MEASURES Depressive symptoms were measured using the CESD-10. RESULTS The results indicate that disability and concern for children are independent predictors of depressive symptoms, and social support can partially mediate the effect of concern for children on depressive symptoms. CONCLUSION Appropriate support should be identified and provided by nurses caring for mothers with disabilities such as MS to decrease the depressive symptoms related to the concern they have for their children.

Timing of Impairment and Health-Promoting Lifestyles in Women With Disabilities

The purpose of this study was to develop a substantive theory to explain how the timing of impairment in women’s lives influenced health-promoting lifestyles among 45 women age 43 to 79 years with impairments of varying onset across the life course. From this grounded theory exploration, we suggest that women created health-related lifestyles that were comprised of changing abilities, roles, and rituals in support of perceived self. The ultimate goal of a healthy lifestyle was healthy aging, which was self-determination in the support of positive relationships. Environment and resources had direct influence on the perceived self. Our proposed substantive theory provides an understanding of how women develop a healthy lifestyle after the onset of permanent sensory or physical impairment. It also takes steps toward an understanding of how timing of impairment influences the perceptions women have of themselves and their health behaviors.

Women Aging with Childhood Onset Disability A Holistic Approach Using the Life Course Paradigm

Women with childhood onset disabilities (CODs) are living longer and it is time for holistic nurses to focus on understanding such women from a life course perspective. As women with CODs live into later adulthood, nurses must be prepared to anticipate and assist as needed. Without studies designed to understand the life course of these women, nursing can neither gain a clear understanding of the problems they face with aging nor help prevent the high number of social inequities, secondary conditions, and comorbidities experienced. To begin nursings exploration of the problems faced by women with CODs, the relevant historical changes and literature associated with aging with a COD are reviewed. Next, the life course paradigm is critically analyzed in relation to the lives of these women. In conclusion, it is posited that the life course paradigm provides the most useful guide for a holistic understanding of women with CODs.

Longitudinal predictors of attitudes toward aging among women with multiple sclerosis.

The purpose of the study was to explore the impact of change in functional limitation (FL), controlling for social support (SS), on attitudes toward aging using longitudinal survey data collected over a 7-year period. The 503 women with multiple sclerosis (MS; age, M=57 years, SD=10.25) were mostly Anglo (93%) and married (69%). First, the authors identified a quadratic growth model as the best for describing change in FL. Next, they considered SS as a time-varying covariate of FL to assess both within- and between-individual effects of SS on FL over time. Within individuals, higher FL levels were associated with lower SS levels. Between individuals, level of but not change in FL was associated with average SS level. Finally, average SS and response level and change in FL were studied as predictors of attitudes toward aging, accounting for 38% of the variance. Women with higher FL and lower SS scores had more negative views of aging. Negative views of aging among women with MS may have long-term consequences for their health outcomes as well as for the quality of their later years.

A qualitative analysis of the meaning of aging for women with disabilities with policy implications.

This is a report of a hermeneutic phenomenological study of the meaning of aging for women with childhood-onset disabilities due to the effects of paralytic polio. Twenty-five women aged 55–65 years were interviewed 2 to 4 times regarding their life course experiences and the meaning they assigned to aging. Field notes, audiotaped interviews, life course charts, and demographics were used in thethematic analysis that produced 5 themes: Bodies Change, Disrupted Meaning, The Unpredictibility of Aging, Slowing Down, and Changing Perspective. Overall, the findings indicate that the experiences of disability due to the result of paralytic polio could not be separated from the experiences of aging, which ultimately led the author to question policies that distribute and fund benefits based on age and disability status without an understanding of the varied experiences of women with disabilities.