The business of death: A qualitative study of financial concerns of widowed older women

© DiGiacomo et al.; licensee BioMed Central. Background: The feminisation of ageing and increasing number of widowed women in contemporary society has significant implications. Older women are at risk of poor health, social, and economic outcomes upon widowhood. The aim of the study was to describe women's experiences in the period soon after their husbands' death, including their financial issues and concerns, and the ways in which these experiences impacted on the transition to widowhood late in life. Methods: This was a longitudinal study using serial in-depth semi-structured interviews with 21 community-dwelling women over the age of 65 in Australia. Verbatim transcripts underwent Interpretive Phenomenological Analysis. Results: Thematic analysis revealed: 1) administrative burden increases vulnerability; 2) gender roles impact on transitions; and 3) financial adjustments render housing insecurity and health risk. High administrative burden within the context of significant grief and mourning was a defining feature of the early bereavement period. Complicated protracted administrative processes, insensitive interactions, and reminders of loss contributed to distress, anxiety and feelings of demoralisation. Several women identified assumption of household financial management as the most difficult aspect of coping with their husband's death. Conclusions: Older women may have unmet needs for assistance with administrative, financial, and legal issues immediately following spousal death and potentially for years afterward. Lack of familiarity and absence of instrumental support with financial and legal issues signal the need for policy reform, resources to improve financial literacy in women throughout the life course, increased advocacy, and consideration of different support and service models

Nurse educators in Australia: High job satisfaction despite role ambiguity

Purpose: The purpose of this study was to describe the nurse educator role in Australian hospitals, including their practice and performance standards. Methods: A cross-sectional, online survey of nurse educators employed in acute care hospitals in Australia was administered over a three-month period. The survey comprised established and researcher-developed scales, and a single open-ended question. Quantitative data was analysed using descriptive statistics. Qualitative data was analysed using a general inductive approach. Results: Nurse educators who were more likely to fulfill nurse educator competency practice domains had master’s degrees in education, defined professional development needs, and met regularly with their managers. These educators also had higher levels of job satisfaction. Participants identified that role ambiguity and role confusion adversely impacted nurse educator role expectations, responsibilities, and job satisfaction. Despite this, the majority of educators intended to stay in their role for the foreseeable future. Conclusions: Role ambiguity influenced professional identity and job satisfaction, highlighting the need for clarification of nurse educator roles. These findings suggest the need for review of the nurse educator role and incorporation of professional and educational requirements and practice competencies. Ongoing role monitoring is recommended to identify the effects of role change

Health transitions in recently widowed older women: a mixed methods study

Older recently widowed women are faced with increased health risks and chronic conditions associated not only with bereavement, but also, older age. Loss and grief, adjusting to living alone, decreased income, and managing multiple chronic conditions can impact on older women?s ability to transition following recent spousal bereavement. Providing appropriate, timely, and effective services to foster this life transition is of critical importance, yet few services directed towards these women exist in Australia, and there is little data describing the experiences of women and their support needs at this time. We conducted a longitudinal mixed method study using in-depth semi-structured interviews and questionnaires that were administered three times over a twelve month period to understand the experiences and needs of older women in the period following their husbands? deaths

An Integrative and Socio-Cultural Perspective of Health, Wealth, and Adjustment in Widowhood

Women comprise a larger proportion of the ageing population than men, often outlive their spouses, and face a variety of challenges upon widowhood. Discrete aspects of the health impact of widowhood have been described in the literature; however, the expanse of sociocontextual issues that impact on older women's adjustment is less prominent. We undertook a literature review to synthesize recent research and interventions and identify current trends and gaps in knowledge and services. Although many health, social, cultural, and economic factors impact on recently widowed older women throughout the world, we found that few interventions targeting this population incorporate these factors. © 2013 Copyright Taylor and Francis Group, LLC

Acknowleding attributes that enable the career academic nurse to thrive in the tertiary education sector: A qualitative systematic review

© 2016 Objective To optimise the career development in early career academic nurses by providing an overview of the attributes necessary for success. Background Evidence of early prospective career planning is necessary to optimise success in the tertiary sector. This is particularly important for nurse academics given the profession's later entry into academia, the ageing nursing workforce and the continuing global shortage of nurses. Design A qualitative systematic review. Methods Academic Search Complete, CINAHL, Medline, ERIC, Professional Development Collection and Google Scholar databases were searched; resulting in the inclusion of nine qualitative nurse-only focussed studies published between 2004 and 2014. The studies were critically appraised and the data thematically analysed. Results Three abilities were identified as important to the early career academic nurse: a willingness to adapt to change, an intention to pursue support and embodying resilience. These abilities give rise to attributes that are recommended as key to successful academic career development for those employed on a continuing academic basis. Conclusions The capacity to rely on one's own capabilities is becoming seen as increasingly important. It is proposed that recognition of these attributes, their skilful application and monitoring outlined in the review are recommended for a successful career in academia

Meditation and secondary prevention of depression and anxiety in heart disease: A systematic review

Heart disease is the leading cause of global mortality, accounting for 13.7 million deaths annually. Optimising depression and anxiety symptoms in adults with heart disease is an international priority. Heart disease secondary prevention is best achieved through implementation of sustainable pharmacological and non-pharmacological interventions, including meditation. Meditation is a means of generating self-awareness and has implications for enhanced self-management of depression and anxiety symptoms. This review aims to identify high-level quantitative evidence for meditation interventions designed to improve depression and/or anxiety symptoms among adults with heart disease and ascertain the most important elements of meditation interventions that facilitate positive depression and/or anxiety outcomes. This systematic review and narrative synthesis was completed in accordance with the PRISMA Statement and has adhered to the Cochrane Risk of Bias guideline. Six databases were searched between 1975 and 2017. Statistically significant outcomes were demonstrated in over half (5/9) of phase II meditation studies for depression and/or anxiety and involved 477 participants. Meditation interventions that generated positive outcomes for depression and/or anxiety included elements such as focused attention to body parts (or body scan) (3/4 studies) and/or group meetings (4/5 studies). Meditation is a means of reframing heart disease outpatient services towards an integrated model of care. Future adequately powered phase III studies are needed to confirm which meditation elements are associated with reductions in depression and anxiety; and the differential effects between concentrative and mindfulness-based meditation types among adults with heart disease

Facilitators and Barriers to Health-Seeking Behaviours among Filipino Migrants: Inductive Analysis to Inform Health Promotion

Understanding factors that influence health-seeking behaviour of migrants is necessary to intervene for behaviour change. This paper explores Filipino migrants’ perceptions of facilitators and barriers to maintaining health in Australia. Open-ended survey item responses reflecting factors that assisted and hindered health following migration to Australia were inductively analysed. Three hundred and thirty-seven of the 552 survey respondents (61%) provided open-ended responses. Responses were grouped into two major categories: individual factors, including personal resources and cultural influences, and environmental factors encompassing both the physical conditions in the host country and health service access. Awareness of practices that enhance health was a major personal facilitator of health-seeking behaviour; however, competing priorities of daily living were perceived as barriers. Cultural beliefs and practices influenced health-seeking behaviour. Despite high self-rated English language skills in this population, new migrants and the elderly cited communication difficulties as barriers to accessing health services. Insight into facilitators and barriers to health-seeking behaviour in this less researched migrant population revealed tools for enhancing engagement in health promotion programs addressing healthy lifestyle

Caregiver characteristics and bereavement needs: Findings from a population study

© 2016, © The Author(s) 2016. Background: Globally, most care for people with life-limiting illnesses is provided by informal caregivers. Identifying characteristics of caregivers that may have unmet needs and negative outcomes can help provide better support to facilitate adjustment. Aim: We compared characteristics, expressed unmet needs and outcomes for spousal caregivers, with other caregivers at the end of life, by gender and age. Design: The South Australian Health Omnibus is an annual, random, face-to-face, cross-sectional survey wherein respondents are asked about end-of-life care. Setting/participants: Participants were aged over 15 years, resided in households in South Australia and had someone close to them die from a terminal illness in the last 5 years. Results: Of the 1540 respondents who provided hands-on care for someone close at the end of life, 155 were widows/widowers. Bereaved spousal caregivers were more likely to be older, female, better educated, have lower incomes, less full-time work, English as second language, sought help with grief and provided more day-to-day care for longer periods. Spousal caregivers were less likely to be willing to take on caregiving again, less able to ‘move on’ with life and needed greater emotional support and information about illness and services. The only difference between widows and widowers was older age of spouse in women. Younger spousal caregivers perceived greater unmet emotional needs and were significantly less likely to be able to ‘move on’. Conclusion: Spousal caregivers are different from other caregivers, with more intense needs that are not fully met. These have implications for bereavement, health and social services

Facilitating uptake of Aboriginal Adult Health Checks through community engagement and health promotion

Background: Adult Health Checks (AHCs) for Aboriginal and Torres Strait Islander people (MBS Item 710) promote comprehensive physical and psychosocial health assessments. Despite the poor uptake of health assessments in Aboriginal and Torres Strait Islander people, a small number of successful implementation initiatives have been reported. In order to ensure uptake of these screening initiatives, there remains a need to demonstrate the feasibility of models of implementing AHCs. Aims: The aim of this paper is to address the process issues and overarching outcomes of a two-day targeted screening and assessment programme to increase the uptake of AHCs at an Aboriginal Community Controlled Medical Service. Method: Clients of an urban Aboriginal Medical Service (AMS) were invited to undertake an AHC during a two-day screening initiative. On-site general practitioners (GPs), nurses, and Aboriginal Health Workers (AHWs) worked within a team to facilitate screenings at an AMS. Barriers and facilitators to the initiative and strategies for quality improvement were discussed by the team. A review of medical notes was undertaken six months following the screening days to document uptake of recommendations.Results: Forty clients undertook AHCs as part of the initiative. In total, 113 diagnostic tests, interventions, specialist referrals and medication initiatives had been enacted within the following six months as a result of screening day visits. Benefits to individual clients, the community, the AMS and staff were identified. Conclusions: The screening day demonstrated feasibility and acceptability of this approach and provides support for its implementation in other health facilities. Importantly, this service was provided in a culturally sensitive framework and within an interdisciplinary teamwork model. This targeted approach increased uptake of assessment items and provided opportunities for health advice and risk factor modification