Dyadic association between mindfulness, family avoidance of communication about cancer and fear of cancer recurrence among breast cancer couples: A cross-sectional study.

PURPOSE: The research focused on examining the dyadic relationship between mindfulness, fear of cancer recurrence (FCR), and family avoidance of communication about cancer (FACC) within breast cancer couples. METHODS: This study utilized a cross-sectional approach to gather data from 249 breast cancer couples. Participants completed self-report measures assessing mindfulness, FCR, and FACC. The Actor-Partner Interdependence Mediation Model was applied to analyze how each individual's and their partner's mindfulness affected their own and their partner's FCR, as well as the mediating role of FACC in this relationship. RESULTS: The study found that the average FCR score for breast cancer patients was (32.59 ± 10.05), while their spouses had a score of (34.39 ± 8.60). The bootstrap method showed that self-FACC as a mediator between mindfulness in breast cancer couples and their own FCR (patient: ß = -0.044, P = 0.019; spouse: ß = -0.046, P = 0.007). Patients' FACC influenced the connection between their mindfulness and spouses' FCR (ß = -0.031, P = 0.030). CONCLUSIONS: The findings highlight the potential for interventions that focus on mindfulness and communication enhancement to alleviate FCR and improve the overall well-being of breast cancer couples.

Home-based music therapy for persons with dementia and their spouses as primary caregivers.

Music therapy has been found to be an effective intervention for persons with dementia (PWD) and their primary caregivers (PC), yet the implementation of musical strategies to improve daily care in the home environment requires further exploration. This study developed and examined a home-based music therapy (HBMT) work model that offers weekly joint music therapy sessions, and additional bi-weekly phone-counseling sessions with the PC. This was followed by an additional 12-week support period that included 3 therapy sessions and 3 phone counseling sessions once every other fortnight, so that the same type of session occurred at a frequency of once a month. Participants were five couples (PWD + spouse as PC) who live in their home. Findings based on the qualitative multiple case study research method showed the importance of the music therapist's (MT) continuous support. The MT's presence made it possible to address the needs of both spouses, separately and together, while maintaining the required balance. Moreover, the MT's presence enabled better implementation of the musical strategies independently and this was maintained during the intervention and the support period.

Role playing and interdependence among husbands of Iranian women after a mastectomy.

BACKGROUND: Breast cancer is the most prevalent cancer among women. AIM: To investigate the impact of breast cancer on the husbands of Iranian women. METHODS: A content analysis based on a Callista-Roy adaptation model was conducted on 23 patients with breast cancer and their husbands and therapists. After asking questions about coping with cancer through telephone interviews, the following subcategories were obtained: role play and interdependence. Data analysis was completed via the Elo and Kyngas approach. RESULTS: Data analysis led to the production of 51 initial codes from participants' experiences. The category role-playing included three further sub-categories: primary role, secondary role and tertiary role. Independence/dependence problems included seven sub-categories: personal beliefs, love and heartfelt attachment, organised support, non-organised support, support failure, economic problems and dependence problems/independence. CONCLUSIONS: Husbands of women who have had a mastectomy have to take on new roles in their life in order to care for their wife. Also, despite the financial, spiritual, psychological, and medical support that they receive, husbands still felt that the support was insufficient.

Maternal and newborn healthcare utilization in Kampala urban slums: perspectives of women, their spouses, and healthcare providers.

BACKGROUND: It is assumed that the health conditions of urban women are superior to their rural counterparts. However, evidence from Asia and Africa, show that poor urban women and their families have worse access to antenatal care and facility childbirth compared to the rural women. The maternal, newborn, and child mortality rates as high as or higher than those in rural areas. In Uganda, maternal and newborn health data reflect similar trend. The aim of the study was to understand factors that influence use of maternal and newborn healthcare in two urban slums of Kampala, Uganda. METHODS: A qualitative study was conducted in urban slums of Kampala, Uganda and conducted 60 in-depth interviews with women who had given birth in the 12 months prior to data collection and traditional birth attendants, 23 key informant interviews with healthcare providers, coordinator of emergency ambulances/emergency medical technicians and the Kampala Capital City Authority health team, and 15 focus group discussions with partners of women who gave birth 12 months prior to data collection and community leaders. Data were thematically coded and analyzed using NVivo version 10 software. RESULTS: The main determinants that influenced access to and use of maternal and newborn health care in the slum communities included knowledge about when to seek care, decision-making power, financial ability, prior experience with the healthcare system, and the quality of care provided. Private facilities were perceived to be of higher quality, however women primarily sought care at public health facilities due to financial constraints. Reports of disrespectful treatment, neglect, and financial bribes by providers were common and linked to negative childbirth experiences. The lack of adequate infrastructure and basic medical equipment and medicine impacted patient experiences and provider ability to deliver quality care. CONCLUSIONS: Despite availability of healthcare, urban women and their families are burdened by the financial costs of health care. Disrespectful and abusive treatment at hands of healthcare providers is common translating to negative healthcare experiences for women. There is a need to invest in quality of care through financial assistance programs, infrastructure improvements, and higher standards of provider accountability are needed.

Point of care obstetric ultrasound knowledge retention among mid-wives following a training program: a prospective cohort pilot study.

BACKGROUND: Obstetric ultrasound has become a routine part of antenatal care in many parts of the world including low income settings. However, there is a shortage of radiologists and sonographers to perform routine obstetric scans in many areas especially in the rural settings of low income countries, despite having equipment available to do this. As a result, Point of care ultrasound (POCUS) has been suggested to bridge this gap by training other health workers such as midwives to perform basic obstetric ultrasound as part of their clinical care. METHODS: It was a prospective cohort pilot study in which trained midwives in point of care obstetric ultrasound were followed up at 6 months post training to assess their knowledge retention. Eleven trained midwives were purposively selected and followed up for knowledge retention. These were trained for 6 weeks and were given a knowledge assessment immediately after training, then given an assessment at 6 months following training. Data was analyzed using SPSS. Wilcoxon signed rank test was used to compare assessments and perceived knowledge as well as Spearman correlation to test the relationship between the number of scans performed and exam assessments, knowledge and exam assessments, and number of scans and knowledge. RESULTS: There were eleven midwives, all female with an average age of 42.3 years. The mean exam score (out of 50) was 44.2 at the end of the training and 42.9 at 6-months follow up. The midwives demonstrated higher perceived knowledge at the end of the training when compared to the 6-months follow up. However, this perceived higher knowledge was not statistically significant when correlated with the exam scores either at the end of the training or at the follow up of 6 months. CONCLUSION: This pilot study has demonstrated that training midwives in point of care obstetric ultrasound can result into acceptable levels of knowledge retention that assist the midwives to apply this knowledge when making routine clinical decisions in relation to pregnant women.

Experiences of carers of youth, adult children and spouses with ME/CFS.

OBJECTIVES: The debilitating nature of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) means that family members often take on a caring role. This study compared the experiences of people caring for three groups: youth, young adults, spouses. METHODS: An opportunistic sample of 36 carers completed an online survey of open-ended questions asking about their experiences. Thematic analysis was used to consider the three sets of responses separately and Thematic Comparison was used to identify points of connection and disconnection across the sets. RESULTS: The themes identified were very similar to those identified in past studies. Two super-ordinate themes were identified: "Lack of knowledge and understanding" and "Holistic Impact". Though most sub-ordinate themes were evident across all three groups, important differences were found. The sub-ordinate themes "Caring Blindly", "Emotional and physical health cost", and "Impact on the whole family" were more evident amongst carers of youth while the theme "Worry for the future" was more evident from carers of young adults and spouses. DISCUSSION: Differences seemed to be related to both the time since diagnosis and the life stage. A longitudinal study would help to understand how carer experiences change over the life course of caring for someone with ME/CFS.

Mindfulness-based stress reduction for men on active surveillance for prostate cancer and their spouses: Design and methodology of a randomized controlled trial.

BACKGROUND: Although active surveillance (AS) is an increasingly adopted treatment paradigm for management of very low risk prostate cancer, many men and their partners face a variety of AS-related psychosocial stressors. Stressors may include anxiety and fear of progression, which may negatively affect short- and long-term psychosocial adjustment and influence early withdrawal from AS in order to seek definitive therapies such as surgery or radiation. Here we describe the protocol for an NCI-funded trial, which seeks to examine the efficacy of mindfulness training compared with a time/attention-matched health promotion control condition in a geographically generalizable sample of men on AS and their spouses. METHODS: Using a randomized, controlled, partially double-blinded study design, this study involves the delivery of 8 weeks of standardized mindfulness training (MBSR; mindfulness-based stress reduction) and patient reported outcomes over a 12-month period (proposed enrollment of 80 men on AS and spouses), compared with a health promotion control (proposed enrollment of 80 men on AS and spouses) that has been matched for time and attention. Baseline (T1) measures (e.g., anxiety, fear of progression, quality of life) are administered just prior to randomization to the two study arms, followed by repeated assessments at 2 months (T2), 6 months (T3) and 12 months (T4). CONCLUSION: This study has the potential to offer men and their partners on AS with important educational and self-regulatory skills to better cope and adjust with known stressors related to being placed on this protocol.

[Husbands' involvement in antenatal-related care in the Bosomtwe District of Ghana: inquiry into the facilitators and barriers]. / Implication des maris dans les soins anténatals: enquête sur les facilitateurs et les barrières: Cas des habitants de Bosomtwe au Ghana.

BACKGROUND: This paper explored the facilitators and barriers to husbands' involvement in antenatal-related care in the Bosomtwe District of Ghana from the perspectives of husbands, pregnant women with and without delivery experience, nursing mothers, midwives and traditional birth attendants. METHODS: The study relied on the qualitative research design to collect and analyse data on the facilitators and barriers to husbands' involvement in antenatal-related care. The unit of analysis was made up of 36 participants-husbands (14), pregnant women with delivery experience and, nursing mothers (8), pregnant women without delivery experience (6), male and female midwives (6) and traditional birth attendants (2) who were purposively selected. The study's data was gathered using in-depth interviews and analysed through the content approach. RESULTS: Various economic [work and time constraint], cultural [the association of childbearing and its allied duties to women] and health-system factors [lack of antenatal services targeted at husbands and health professionals' attitude] hinder husbands' active participation in antenatal care. Despite these, some husbands participated in antenatal care owing to the importance they accord to the health and safety of their wives and the foetus; changing gender roles and preferential treatments received by their wives at antenatal clinics [as a result of the involvement of their husbands in prenatal care]. CONCLUSION: The implementation of alternative strategies, like, couple counselling, prolonging operating times of health centres to accommodate working men are recommended to provide a more accommodative and attractive avenue for husbands to support their wives during pregnancy. These efforts must be reinforced by the entire society through modifying the "ill-held view" that pregnancy and childcare is the sole duty of a woman.

The involvement of males [husbands] in antenatal-related care is noted to have significant impacts on the wellbeing of pregnant women and lessen burden of pregnancy, delivery and childcare. In this study, we examined the opinions of some stakeholders in the space of pregnancy and childcare [husbands, pregnant women with delivery experience, nursing mothers, midwives and traditional birth attendants], regarding the involvement of husbands in antenatal-related care. The study was conducted in the Bosomtwe District of Ghana, West Africa.The participants were asked to narrate experiences of husbands' involvement in pregnancy-related care, in addition to the barriers and facilitators of such engagement processes. A total of 36 participants were involved in the study. The narrative approach was used to report the findings.It was found that male's involvement in antenatal-related care is minimal in the study area. Factors such as limited time due to economic activities and the responsibility of providing financial resources for the wellbeing of the family and cultural factors in the form of childbearing being a responsibility of women deterred husbands from antenatal-related care. Again, absence of services that target males also served as a barrier. That notwithstanding, the importance attached by husbands to the health and safety of their wives and the foetus, the changing gender roles and preferential treatments given to pregnant women who are accompanied by their husbands facilitated males involvement.In conclusion, the study has implications for male-friendly antenatal care services development and continuous effort to undo the "cultural-ills" of male's involvement in pregnancy care in Ghana.

Challenges and coping mechanisms among women living with unrepaired obstetric fistula in Ethiopia: A phenomenological study.

INTRODUCTION: Obstetric fistula remains a debilitating complication of childbirth and maternal morbidity in developing countries. Few studies document the challenges and coping mechanisms among women living with obstetric fistula in Ethiopia. Therefore, this study aimed to explore the challenges and coping mechanisms among women with obstetric fistula in Ethiopia. METHODS: A phenomenological study was employed among purposively selected eleven women with obstetric fistula and three key informants at five fistula treatment centers in Ethiopia. An in-depth interview was conducted, audio-recorded, and transcribed into a Microsoft Word document. The transcripts were imported into Atlas. ti version 8.4 for thematic analyses. RESULTS: Painful social life, consequences of fistula, and coping mechanisms with fistula problems were the main themes in this study. Difficult social life, stigma, discrimination, impaired marital status; psychological, physical, sexual, and reproductive health problems were the major challenges for women with obstetric fistulas. Women with fistulas used coping mechanisms such as-going to spiritual sites and drinking alcohol to cope with their fistula disease; separating themselves from community participation and living alone in the forest to cope with a painful social life; restricting the amount of drinking water and wearing many clothes at a time to cope with wetness and odors, and allowing their husband to marry a new wife to cope with the impaired marital responsibilities. CONCLUSION: Women with obstetric fistulas encountered challenges such as a painful social life, impaired marital status, psychological, physical, sexual, and reproductive health problems; and used coping mechanisms with their fistula condition, difficult social life, and impaired marital responsibility that may have an added negative effect on their overall health. Therefore, policymakers need to prioritize the availability and early utilization of obstetric fistula surgery in all settings for all women living with obstetric fistulas to restore their holistic health.

Transitions and challenges for people with Parkinson's and their family members: A qualitative study.

OBJECTIVE: To explore the experiences and challenges of people with Parkinson's and their family members living in the community through the lens of their transitions to better understand the phases and changes in their lives. DESIGN: Qualitative study using semi-structured interviews and analysed using codebook thematic analysis. SETTING/PARTICIPANTS: Purposive sampling was used in primary and secondary healthcare services across Southern England in 2019 to recruit 21 people with Parkinson's (aged between 45-89 years) and 17 family members (13 spouses and 4 adult children, aged between 26-79 years). RESULTS: Participants' descriptions were classified in three main phases of transition from a place of health towards greater dependency on others: 1) 'Being told you are a person with Parkinson's' (early), 2) 'Living with Parkinson's' (mid), and 3) 'Increasing dependency' (decline). Seven sub-themes were identified to describe the transitions within these three phases: phase 1: receiving and accepting a diagnosis; navigating reactions; phase 2: changing social interactions and maintaining sense of self; information: wanting to know but not wanting to know; finding a place within the healthcare system; and 3: changes in roles and relationships; and increasingly dependent. CONCLUSION: This study has identified points of change and means of supporting key transitions such as diagnosis, changes in social connections, and increased use of secondary healthcare services so that comprehensive, holistic, individualised and well-timed support can be put in place to maintain well-being.

My Wife Has Breast Cancer: The Lived Experience of Arab Men.

OBJECTIVES: Breast cancer is a leading cause of mortality and morbidity among women in Middle Eastern countries. In Bahrain, breast cancer is the second-leading cause of death and first among women. Prior research has shown that Middle Eastern women will often delay seeking treatment for breast cancer and subsequently hide the diagnosis from friends and family. As a result, women rely heavily on their spouses for support and care. There is limited research on spouses' experience of breast cancer, especially in the Middle East. This study explored the lived experience of Arab men following their wives' diagnosis and treatment for breast cancer in Bahrain. DATA SOURCES: Data from semi-structured interviews with Arab men (n = 6) were analyzed using the interpretative phenomenological approach (IPA). Participants' wives had completed their treatment 3 to 6 months prior to the interviews. CONCLUSION: Three main themes emerged: Perceptions of breast cancer diagnosis and treatment, coping strategies, and impact on quality of life. Findings revealed that Arab men in Bahrain relied on family and friends for support and drew on religious beliefs to give them hope so they could better support their wives. Findings also highlighted the unique culturally related coping strategies used by Arab men. This study highlights the specific needs of Arab men following their wives' diagnosis and treatment for breast cancer. Faith and beliefs were overwhelmingly a foundation for coping and support. Therefore, this must be considered within the health care service to improve support strategies for Arab patients and their spouses in treatment and care plans encompassing a holistic interprofessional, multidisciplinary, and communicative approaches including the need for culturally sensitive care pathways that are cognizant of the care needs through help-seeking and information-sharing throughout the illness. Nurses should provide the education and encourage open communication among the couple and their family. IMPLICATIONS FOR NURSING PRACTICE: Findings can be used by nurses and other health care professionals to provide better support and holistic care to Arab women with breast cancer and their spouses.

Same-sex competition and sexual conflict expressed through witchcraft accusations.

There is significant cross-cultural variation in the sex of individuals most likely to be accused of practising witchcraft. Allegations of witchcraft might be a mechanism for nullifying competitors so resources they would have used become available to others. In this case, who is targeted may result from patterns of competition and conflict (same-sex or male-female) within specific relationships, which are determined by broader socio-ecological factors. Here we examine patterns of sex-specific accusations in historic cases from sub-Saharan Africa (N = 423 accusations). Male 'witches' formed the greater part of our sample, and were mostly accused by male blood-relatives and nonrelatives, often in connection to disputes over wealth and status. Accusations of women were mainly from kin by marriage, and particularly from husbands and co-wives. The most common outcomes were that the accused was forced to move, or suffered reputational damage. Our results suggest that competition underlies accusations and relationship patterns may determine who is liable to be accused.

Quantifying the emotional experiences of partners of veterans with PTSD service dogs using ecological momentary assessment.

The objective of this study was to investigate the day-to-day experiences of positive and negative emotions among partners of veterans assigned service dogs for posttraumatic stress disorder (PTSD). As part of a larger clinical trial, a total of N = 87 partners of post-9/11 veterans with PTSD were recruited from a nonprofit service dog provider and participated in an ecological momentary assessment (EMA) protocol. The sample included partners of veterans who received a PTSD service dog after baseline (n = 48, treatment group) and partners of veterans on the waitlist for a service dog (n = 39, control group). Data were collected twice daily for two weeks at baseline and again at follow-up three months later, for approximately 56 assessments per participant (28 at baseline, 28 at follow up). Participants completed an average of 84% of questionnaires at baseline (n = 23.6) and 86% (n = 24.1) at follow-up. A total of 3780 EMA questionnaires were collected among partners for this analysis. Data were analyzed using a generalized linear mixed model. Three months following baseline, partners of veterans with service dogs reported statistically significant higher levels of positive emotions than the control partners (p = .01, d = 0.39) with small-to-medium effect sizes for each individual positive emotion. No statistically significant differences were reported for negative emotions (p = .77, d = 0.21). This study quantitatively identifies higher levels of positive emotion in partners who are cohabitating with a PTSD service dog compared to those partners who remained on the waitlist. Given the influence that positive emotions have on well-being and coping, findings suggest that the influence of service dogs may go beyond veterans to influence their cohabitating partners.

Concerns about transmission, changed services and place of birth in the early COVID-19 pandemic: a national survey among Danish pregnant women. The COVIDPregDK study.

BACKGROUND: The outbreak of the COVID-19 pandemic caused great uncertainty about causes, treatment and mortality of the new virus. Constant updates of recommendations and restrictions from national authorities may have caused great concern for pregnant women. Reports suggested an increased number of pregnant women choosing to give birth at home, some even unassisted ('freebirth') due to concerns of transmission in hospital or reduction in birthplace options. During April and May 2020, we aimed to investigate i) the level of concern about coronavirus transmission in Danish pregnant women, ii) the level of concern related to changes in maternity services due to the pandemic, and iii) implications for choice of place of birth. METHODS: We conducted a nationwide cross-sectional online survey study, inviting all registered pregnant women in Denmark (n = 30,009) in April and May 2020. RESULTS: The response rate was 60% (n = 17,995). Concerns of transmission during pregnancy and birth were considerable; 63% worried about getting severely ill whilst pregnant, and 55% worried that virus would be transmitted to their child. Thirtyeight percent worried about contracting the virus at the hospital. The most predominant concern related to changes in maternity services during the pandemic was restrictions on partners' attendance at birth (81%). Especially nulliparous women were concerned about whether cancelled antenatal classes or fewer physical midwifery consultations would affect their ability to give birth or care for their child postpartum.. The proportion of women who considered a home birth was equivalent to pre-pandemic home birth rates in Denmark (3%). During the temporary discontinue of public home birth services, 18% of this group considered a home birth assisted by a private midwife (n = 125), and 6% considered a home birth with no midwifery assistance at all (n = 41). CONCLUSION: Danish pregnant womens' concerns about virus transmission to the unborn child and worries about contracting the virus during hospital appointments were considerable during the early pandemic. Home birth rates may not be affected by the pandemic, but restrictions in home birth services may impose decisions to freebirth for a small proportion of the population.

Rationale and Methods for a Randomized Controlled Trial of a Dyadic, Web-Based, Weight Loss Intervention among Cancer Survivors and Partners: The DUET Study.

Scalable, effective interventions are needed to address poor diet, insufficient physical activity, and obesity amongst rising numbers of cancer survivors. Interventions targeting survivors and their friends and family may promote both tertiary and primary prevention. The design, rationale, and enrollment of an ongoing randomized controlled trial (RCT) (NCT04132219) to test a web-based lifestyle intervention for cancer survivors and their supportive partners are described, along with the characteristics of the sample recruited. This two-arm, single-blinded RCT randomly assigns 56 dyads (cancer survivor and partner, both with obesity, poor diets, and physical inactivity) to the six-month DUET intervention vs. wait-list control. Intervention delivery and assessment are remotely performed with 0-6 month, between-arm tests comparing body weight status (primary outcome), and secondary outcomes (waist circumference, health indices, and biomarkers of glucose homeostasis, lipid regulation and inflammation). Despite COVID-19, targeted accrual was achieved within 9 months. Not having Internet access was a rare exclusion (<2%). Inability to identify a support partner precluded enrollment of 42% of interested/eligible survivors. The enrolled sample is diverse: ages 23-81 and 38% racial/ethnic minorities. Results support the accessibility and appeal of web-based lifestyle interventions for cancer survivors, though some cancer survivors struggled to enlist support partners and may require alternative strategies.

Linking Sexual Mindfulness to Mixed-Sex Couples' Relational Flourishing, Sexual Harmony, and Orgasm.

Marriage is an important adult relationship, and recent research indicates that sexual mindfulness, awareness and non-judgment, may be an important tool in helping maintain relational and sexual well-being. Using a nationally representative U.S. sample of newly married, mixed-sex couples (women's age M = 29.70 years; men's age M = 31.76 years; N = 1473 couples), we evaluated whether the two factors of sexual mindfulness, awareness and non-judgment, were linked with relational flourishing, sexual harmony, and orgasm consistency. We utilized an actor-partner interdependence model within a structural equation modeling framework to evaluate how husbands' and wives' awareness and non-judgment were associated with relational flourishing, sexual harmony, and orgasm consistency. Results indicated that both wives' and husbands' awareness was positively associated with relational flourishing, sexual harmony, and orgasm consistency. Partner effects were found for all outcomes. However, no partner effects were found between non-judgment and orgasm consistency. Therapists, educators, and couples may consider the use of sexual mindfulness skills when addressing marriage and sexual relationships.

Complicated grief, unusual perceptual experiences, and hope in widowhood / Luto complicado, experiências perceptivas incomuns e esperança na viuvez / Duelo complicado, experiencias perceptuales inusuales y esperanza en la viudez

The overall objective of this study is to assess grief in religious widows and hope, and the frequency of unusual perceptual experiences after the death of the spouse. It is hypothesized that (H1) religious widows will experience a less complicated grief, (H2) a greater hope, and (H3) a higher frequency of unusual perceptual experiences than non-religious widows. Three instruments, the Complicated Grief Inventory, the Hope Scale, and the Hallucinations Questionnaire were administered to a sample consisting of religious widows and a control group (non-religious widows). The results showed that religious widows experienced less complicated grief than non-religious widows, and fewer feelings of pessimism about the death of the loved one. Religious widows who showed higher feelings of hope, compared to non-religious ones, tended to have fewer indicators of complicated grief. Furthermore, those religious widows who displayed feelings associated with remembering the deceased tended, for example, to hear voices and smell perfumes. It is possible that these occurrences may even be functional and adaptive in order to cope with the negative feelings of grief and loss, rather than resulting in a resource deficit mechanism for dealing with pain and hopelessness.

O objetivo geral deste estudo é avaliar o luto e a esperança em viúvas religiosas, e a frequência de experiências perceptivas incomuns após a morte do cônjuge. A hipótese é que (H1) viúvas religiosas experimentarão um luto menos complicado, (H2) mais esperança e (H3) maior frequência de experiências perceptivas incomuns do que viúvas não religiosas. Três instrumentos, o Inventário do Luto Complicado, a Escala de Esperança e o Questionário de Alucinações, foram administrados a uma amostra composta por viúvas religiosas e um grupo de controle (viúvas não religiosas). Os resultados mostraram que as viúvas religiosas experimentaram um luto menos complicado do que as viúvas não religiosas e menos sentimentos de pessimismo em relação à morte de um ente querido. As viúvas religiosas que mostraram maior senso de esperança, em comparação com as viúvas não religiosas, tendem a ter menos indicadores de luto complicado. Além disso, aquelas viúvas religiosas que demonstravam sentimentos associados à memória do falecido tendiam, por exemplo, a ouvir vozes e cheirar perfumes. É possível que essas ocorrências possam até ser funcionais e adaptativas para lidar com os sentimentos negativos de luto e perda, em vez de ser um mecanismo de déficit de recursos para lidar com a dor e a desesperança.

El objetivo general de este estudio es evaluar el duelo en viudas religiosas y la esperanza, y la frecuencia de experiencias perceptuales inusuales después de la muerte del cónyuge. Se hipotetiza que (H1) las viudas religiosas experimentarán menor grado de duelo complicado, (H2) mayor esperanza y (H3) mayor frecuencia de experiencias perceptuales inusuales que las viudas no religiosas. Se administraron tres instrumentos, el Inventario de Duelo Complicado, la Escala de Esperanza, y el Cuestionario de Alucinaciones a una muestra integrada por viudas religiosas y un grupo control (viudas no religiosas). Los resultados mostraron que las viudas religiosas experimentaban menos duelo complicado que las viudas no religiosas, y menos sentimientos de pesimismo en torno a la muerte del ser querido. Las viudas religiosas que mostraron mayor sentimiento de esperanza, en comparación con las no religiosas, tendieron a menos indicadores de duelo complicado. Además, aquellas viudas religiosas que mostraban sentimientos asociados al recuerdo del difunto tendían, por ejemplo, a oír voces y oler perfumes. Es posible que estas ocurrencias puedan incluso ser funcionales y adaptativas para afrontar los sentimientos negativos del duelo y la pérdida, en lugar de resultar un mecanismo de déficit de recursos para lidiar contra el dolor y la desesperanza.

Relationship between mindfulness and general health among couples in Mainland China: A crossover perspective.

RATIONALE: Previous research has indicated that mindfulness can be beneficial both intrapersonally and interpersonally. Although mindfulness has been shown to improve an individual's health, much less is known about whether these health benefits extend to the individual's spouse. OBJECTIVE: The present study aims to establish a crossover model to expound ''how'' and ''why'' mindfulness might be associated with both the individual's and the spouse's general health. METHODS: In total, 319 married couples in Mainland China participated in a two-wave survey study with a 3-month interval. The hypotheses were tested by Structural Equation Modeling. RESULTS: As expected, mindfulness was positively correlated with personal general health through decreases in perceived social undermining. However, mindfulness had an asymmetrical crossover effect on spouses' general health. Whereas wives' mindfulness had significant benefits for husbands' general health, husbands' mindfulness was not a significant protective factor of wives' general health. The benefits of wives' mindfulness on husbands' general health were mediated by the direct crossover of lower perceived social undermining from wives to husbands. CONCLUSIONS: This study is the first to investigate the relationship between mindfulness and general health at the couple level. Our findings help clarify the benefits of mindfulness on couples' health management from a systemic perspective and provide further support for the crossover theory.

Factors related to the use of religious coping by informal caregivers: an integrative review.

OBJECTIVES: to identify the factors related to the use of religious coping in informal caregivers. METHODS: integrative literature review carried out through a search in the databases LILACS, PubMed, Scopus, Web of Science, and CINAHL, in addition to the Virtual Health Library and SciELO. The study selected primary articles in English, Portuguese, and Spanish, using the descriptors Coping Behavior, Caregivers, Spirituality, and Religion, which were combined with each other and with synonyms. There was no time limit for the publications. RESULTS: nine articles were selected. Factors related to the use of religious coping in informal caregivers included: having an advanced age, experiencing traumatic situations, being under overload, being a spouse or mother, caring for hospitalized individuals, or for those with chronic diseases and high degrees of dependence. CONCLUSIONS: the factors related to the use of religious coping are multifaceted and involve physical, psychological, psychosocial, and situational aspects.

Perceptions of women, their husbands and healthcare providers about anemia in rural Pakistan: Findings from a qualitative exploratory study.

BACKGROUND: In Pakistan, there is a dearth of literature on the perceptions of anemia among women of reproductive age (WRA). This study was undertaken to explore the perceptions of women, their husbands, and healthcare providers about anemia, its possible causes, and how anemia impacts maternal and child health in Thatta, Pakistan. METHODS: A qualitative study was conducted in Thatta, Pakistan from September to December 2018. Using a pre-tested semi-structured interview (SSI), we collected data to understand their definitions of anemia through ten focus group discussions (FGDs) with women and their partners and ten primary informant interviews (KIIs) with healthcare providers. We identified six major themes: (I) Knowledge and awareness of anemia, (II) Causes and consequences of Anemia, (III) Dietary practices, (IV) Knowledge and practices regarding the use of iron-folic acid supplements, (V) Factors influencing prevention and control of anemia and (VI) Women's health behavior. We analyzed the data through thematic analysis using NVivo 10 software. RESULTS: Most community members were not aware of the term anemia but described anemia as a condition characterized by 'blood deficiency' in the body. All study participants perceived anemia as an important health problem tending to cause adverse outcomes among WRA and their children. Study participants perceived gutka (chewable tobacco) consumption as an important cause of anemia. Healthcare providers identified short inter-pregnancy intervals, lack of family planning, poor health-seeking behavior, and consumption of unhealthy food as causes of anemia in the district. Consumption of unhealthy food might not be related to related to a poorer knowledge of iron-deficient foods, but economic constraints. This was further endorsed by the healthcare providers who mentioned that most women were too poor to afford iron-rich foods. All men and women were generally well versed with the sources of good nutrition to be consumed by WRA to prevent anemia. CONCLUSION: The findings suggest that the government should plan to develop strategies for poverty-stricken and vulnerable rural women and plan health awareness programs to improve dietary practices, compliance with supplements, and health-seeking behavior among women of reproductive age. There is a need to develop effective counseling strategies and context-specific health education sessions to improve the health-seeking behavior of women and men in the Thatta district of Pakistan. Besides, there is need to address social determinants of health such as poverty that pushes women of poorer socioeconomic strata to eat less nutritious foods and have more anaemia. Therefore, a comprehensive and robust strategic plan need to be adopted by government that focuses not only on the awareness programs, but also aim to reduce inequities that lead to pregnant women eat iron-poor foods, which, in turn, forces them to become anemic.