Parent-Child Grief Interactions: A Qualitative Analysis and Conceptual Framework of the Lived Experiences of Young Widowed Parents.

A young parent's death is an unexpected event that incurs family stress and grief for the surviving parent and young children. However, few studies have examined widowed parents' grief experiences and parent-child interactions following a co-parent's death. Guided by phenomenology, this qualitative study examined the lived experiences of (N = 12) surviving parents grieving the loss of their co-parent. Data were collected using semi-structured interviews and analyzed using an inductive analytic procedure. Findings included themes of (1) not showing grief with child; (2) talking through grief/emotions with child; (3) maintaining connection between deceased parent and child; (4) timing of sharing things with children; and (5) utilizing bereavement and group support. These findings suggest that support services for surviving parents include providing information to them about the timing of when to share mementos with children and psychoeducation on emotion sharing and masking as part of the grief process with young children.

Stress, anxiety, and health-related quality of life in BRCA1/2-positive women with and without cancer: A comparison of four US female samples.

Introduction: Women with BRCA1/2 mutations have a 11-72% increased risk of breast/ovarian cancers throughout their lifetime. The current study examines psychosocial differences between the current sample of BRCA1/2-positive women with and without cancer histories and three comparable United States (US) female samples without BRCA1/2 mutations. Methods: Sixty BRCA1/2-positive women (with and without cancer histories) were recruited through multiple private online support groups in the US. Participants completed an online survey outlining sociodemographic and genetic counseling information, and anxiety, stress, and health-related quality of life (HRQoL) outcomes. Outcomes were compared to three similar US female normative samples via independent samples t-test analyses. Results: State and trait anxiety (p = 0.00) and stress (p = 0.001) were significantly worse in the current sample of BRCA1/2-positive women compared comparable US female samples. All HRQoL domains were significantly better in the current sample except energy/vitality, which was significantly lower (p = 0.02) in the current sample. Results were stratified by cancer and recurrence status. Conclusions: This study provides insight into how a sample of BRCA1/2-positive women both with and without cancer fare post-genetic counseling as compared to three normative female populations. Results infer the need for additional education, patient-provider training, and mental health referrals to support this population in order to circumvent unintended consequences and to improve psychosocial health in those being tested for, and those who test positive for, BRCA1/2 genetic mutations.

Perceptions and care Recommendations from Previvors: Qualitative analysis of female BRCA1/2 mutation Carriers' experience with genetic testing and counseling.

Introduction: It is estimated that 12.5% of women will be diagnosed with breast cancer and 1.10% with ovarian cancer during their lifetime. Although less common, women with these mutations have a 11-72% increased risk of breast/ovarian cancers and are hereditary. Genetic testing/counseling presents the opportunity to identify carriers of BRCA1/2 genetic mutations before a cancer diagnosis. Methods: Thirty-four BRCA1/2-positive women (with and without histories of breast/ovarian cancers) were recruited through online national support groups to gain a better understanding of their genetic testing/counseling perceptions and experiences. After confirming eligibility, they were invited to participate in either a telephone or webcam interview. Interview transcripts were analyzed using qualitative thematic text analysis and descriptive coding techniques. Results: Six major themes emerged, capturing the perceptions and experiences of genetic testing/counseling for these women: 1) Emotional Reactions to Results and Genetic Counseling, 2) Future Recommendations, 3) Family Solidarity and Support, 4) Experiences with the Healthcare System, 5) Preventive Concerns and Decisions, and 6) Sources Affecting Perceived Risk. Two subthemes also emerged within the first theme, which are termed "Pre-vivor," and "Testing Intuition." Conclusions: Participants indicated that genetic testing/counseling improvements would be helpful for women in this population surrounding quality care, including sensitivity training for healthcare professionals involved in testing/counseling, additional educational resources, and increased emotional and financial support. Although these recommendations may be beneficial, more widespread research with greater generalizability to disparate groups may be necessary prior to implementation.

Effects of three caregiver interventions: support, educational literature, and creative movement.

The primary focus of this study is to compare the effectiveness of three distinct intervention techniques in relieving some of the stress experienced by midlife daughters' caregiving for their frail mothers. The three techniques are: (a) a home-based literature "tip of the week" group, (b) a caregiver's support group, and (c) a creative-movement group. Based on a review of caregiving literature, no other studies have utilized a home-based literature intervention or a creative-movement intervention with midlife daughters providing informal care to frail mothers. As part of the weekly assessment evaluation, participants were asked to rate how helpful the previous week's session was with respect to five mental health variables: irritability, depression, anxiety, stress, and concentration. Overall, the support-based group had higher average scores for each of the five mental health variables and the highest overall mental health score. Future research and promising applications of future intervention programs are discussed.

To drive or not to drive, that isn't the question-the meaning of self-regulation among older drivers.

PROBLEM: This research examines older drivers and how they rationalize and cope with their own changing psychological and physical functioning vis-à-vis self-regulation and driving. METHOD: A national survey was mailed to a sample of drivers over the age of 50. An overall response rate of 53.11% was achieved, with 3,824 valid responses returned. This paper discusses the qualitative findings of the open-ended questions in this survey. RESULTS: A rich, multidimensional description of self-regulation emerged from the data. Driving self-regulation was not simply a checklist of behaviors performed but a combination of attitudes and behaviors, including important social and psychological processes and automobile attributes. Household composition played an important role in determining what one's options were for getting around and how serious they were in enforcing self-regulation behaviors. DISCUSSION & SUMMARY: As a society, we must realize the importance of driving in maintaining independence, feelings of self-worth, and being connected to life and society. This research presents the qualitative findings of a nationwide survey of drivers over the age of 50. The results revealed that older drivers define self-regulation as much more than the changes in behaviors due to declining health and ability. The older adults in our research strongly emphasized the psychological processes surrounding independence, self-worth, remaining connected to life and society, and what role the automobile plays. Household composition impacted decisions related to self-regulation. For instance, those from a two-person household were more willing to let their partner drive or share in the driving, while those who lived alone were less likely to self-regulate their driving. IMPACT ON INDUSTRY: Education programs targeting older adults need to be expanded to include not only the behavioral components of self-regulation, but also the psychological factors that play an equally meaningful role. Legislators devising policy programs need to reconsider what are viable transportation options for the older adult.

Health, safety, self-regulation and the older driver: it's not just a matter of age.

PROBLEM: The purpose of this research was to examine the impact of age and health on patterns of driving and self-regulation among older adults who still drive. METHOD: This analysis presents the results of a nationwide survey of drivers who are 50+(N=3,824, 53.11% response rate), focusing on questions about the impact of their self-reported health on attitudes toward and self-regulation of driving. RESULTS: The data indicate that as age increases, so too does reported self-regulation of driving, increasing sharply among those ages 70 and older. The data also indicate that respondent's reported confidence in driving and their enjoyment of driving decline as they age. Health status bears a significant relationship with all three of these variables, positively related to confidence in driving skills and to enjoyment in driving, but negatively related to self-regulation reports. As self-reported health declines, respondent's report engages in greater voluntary restrictions of their driving. DISCUSSION: All too often, the driving decision is linked primarily to chronological age. Analysis done here indicates that age alone is not the best indicator of self-regulation and how older adults change their driving behaviors. SUMMARY: This research presents the results of a nationwide survey of 50+ drivers and their self-reported driving, self-regulation behaviors, and health status. Strong support was found for the argument that chronological age is not an adequate measure of self-regulating behaviors and driver safety among those 50+. In particular, it was found that a person's health status and the interaction between age and health are essential considerations in the decisions around self-regulation and driving. People tend to self-regulate more with age, but the effect becomes much more pronounced as health status declines. IMPACT ON INDUSTRY: In the coming years, if older adults can't get to where they want to go and continue to be viable consumers in our national fabric, all industries will eventually suffer. Transportation is a key component to the nation's social contract with older individuals and their families.

A qualitative exploration of self-regulation behaviors among older drivers.

While much of the research on aging and driving has focused on sensory and motor changes, little is known about older drivers and the actual self-regulation adjustments they employ to continue driving safely. This research looks at how older drivers have made changes to driving patterns and behaviors that have allowed them to continue to drive without compromising their perceived safety, independence, and quality of life. Nine focus groups were held with older men and women aged 58 to 89 years. Some of the major themes that emerged were the following: older adults are very aware of age-related changes to driving; they perceive that self-regulation behaviors change with age; and they view transportation alternatives as limited or nonexistent. Policy implications include developing functional transit programs for older adults and car manufacturer training workshops to educate older adults on the safety features of newly purchased automobiles.

Gender differences in self-regulation patterns and attitudes toward driving among older adults.

The automobile is essential for many older adults to fulfill their daily needs, especially since many live where they lack access to public transit or other acceptable modes of transportation. Increased self-regulation is one way older drivers continue to drive safely and maintain mobility. This research considers whether self-regulation attitudes and patterns differ by gender. Results indicate that women and men report distinct patterns of self-regulation behaviors. Age, health status, and household status also interact with gender, influencing the extent of self-regulation. The results also show that women report lower levels of confidence in their driving skills than men, although the difference varies based on whether or not a woman lives alone. Implications of these results are considered for an aging population--particularly women--that over the coming decades will be more reliant on the automobile for transportation than ever before.