Help-seeking by older wife caregivers of demented husbands: a grounded theory approach

The purpose of this study was to gain an understanding of patterns of help seeking by older wife caregivers of demented husbands. Essential to an understanding of service utilization is an understanding of the more basic process of help-seeking.Research to date has largely concentrated on help-seeking as a variable, rather than as an independent entity.Grounded theory methodology with a nursing perspective of health as expanding consciousness, was used to explore interactions, thoughts and feelings associated with patterns of help-seeking by eleven older wife caregivers and allowed for a more holistic view of the process of help-seeking by these older women. This methodology led to discovery of a new substantive theory entitled Help-seeking choices: Taking one day at a time which was grounded in reality as experienced by the participants and illuminates help-seeking for this group of caregivers. The core category of reaching out/reaching within described the main phenomena of wives reaching out to involve both informal and formal sources and reaching within themselves to manage care and seek help on a day-to-day basis. Wives made choices to employ strategies of avoiding,shouldering and facing to accomplish continuing to provide care at home for the husbands. These choices were influenced by a myriad of facilitating and hindering intervening conditions.Understanding obtained from the study indicates that earlier screening and intervention are essential to assisting with identification of dementia and to help caregivers realize that a problem exists. Further suggestion is for more comprehensive case management across health care settings for this group, and a recognition of the impact of previous experiences on future health choices by these caregivers. The Importance of pattern recognition which enables caregivers to view, seek, and manage their husbands\u27 health care in creative ways is also indicated. Understanding gained may lead ultimately to the development of interventions which can increase the effectiveness of help-seeking patterns, result in more appropriate utilization of formal and informal resources, reduce burden and stress associated with the caregiving role, and assist women to sustain the caregiving role

DISASTER RISK IN THE LAKE NYOS AREA, CAMEROON: EFFECTS OF THE GAS HAZARD AND SOCIALLY PRODUCED VULNERABILITY

Effective disaster risk reduction (DRR) efforts depend on comprehensive risk assessments that consider potential hazard events and social vulnerability. The Lake Nyos Disaster (LND) caused the deaths of about 1,700 people, forced another 4,000 people from their homes, and left survivors more vulnerable to future hazards. There is considerable research on the gas hazard and some work on local vulnerability; however studies rarely consider both aspects of disaster risk (DR). This study addresses both the hazard and vulnerability and uses several qualitative and quantitative methods which have never been applied to LND survivor vulnerability or gas hazard. Interviews, participant observation, the Pressure and Release (PAR) and Access models are used to analyze vulnerability. A modified LAHARZ model and GIS mapping are used to categorize the gas hazard. By modeling various gas release scenarios and determining the main factors affecting vulnerability, DR for survivors in the Nyos area is calculated

A Controlled Comparison of Aerobic Exercise and Behavioral Treatment for Recurrent Tension Headache

Tension headache is a widespread problem, with an estimated lifetime prevalence rate of 69% for males and 88% for females. Empirical evidence supports the clinical observation that daily stress is a powerful precipitant of tension headaches. Research also supports the contention that tension headache sufferers tend to appraise and cope with daily stressors in ways which exacerbate or prolong this stress. Because aerobic exercise (EX) has been implicated as a useful stress relieving agent, this study examined the use of aerobic exercise as a treatment for tension headache. A comparison treatment consisting of progressive relaxation, stress management, and biofeedback (PR), was used because of its effectiveness in treating tension headache. A total of eighteen subjects were randomly assigned to either treatment and participated in an eight week treatment. Four weeks prior to treatment, subjects monitored headache activity, and completed three questionnaires (State-Trait Personality Inventory-Trait scale, Orientation to Life Questionnaire, and Headache Locus of Control- Revised scale). Subjects monitored headache activity throughout treatment and four weeks posttreatment. The questionnaires were also completed by subjects immediately after completing treatment. Subjects in the EX treatment group also completed these questionnaires midway through treatment to determine the effectiveness of treatment at that point. ANOVAs were used to compare the dependent measures between and within groups. Although trends toward improvements in average headache intensity and peak headache intensity emerged for both groups, they were not significant. It was also found that neither group showed significant improvements on dimensions measured by the questionnaires, with the exception of the curiosity dimension on the Trait State Personality Inventory-Trait scale and the health professionals externality dimension of the Headache Locus of Control-Revised scale. On these dimensions, those in the EX treatment group scored significantly lower than those in the PR treatment group across pre and posttreatment. When treatment groups were combined, peak headache intensity scores were significantly lower at posttreatment than at pretreatment. The lack of significant findings for both groups were likely due to small sample size; therefore, it is difficult to conclude whether or not aerobic exercise is an effective treatment for tension headache