Commonalities in women's spirituality and women's health.

Both women's spirituality and women's health movements have grown dramatically in recent years. If clinicians understood in greater depth the commonalities between these two perspectives, then they would be better positioned to foster the health of women more fully. In this article, concepts of feminism, religion, spirituality, and women's health are described briefly. After identifying some assumptions, themes, and characteristics of both women's spirituality and women's health, the commonalities between these two perspectives are delineated. Next, processes critical to women's spirituality and women's health are proposed. Finally, implications for clinical practice are offered.

Understanding lesbians' mammography utilization.

Lesbians face unique barriers to health care, and may be at higher risk for breast cancer than are other women. Yet, no research on lesbians and mammography utilization exists. We conducted telephone interviews of 107 lesbians aged 51-80, of whom 68 had had mammograms in the last year and 39 had not. Responses to open-ended questions identified the barriers lesbians face in obtaining mammography, lesbians, reasons for obtaining mammograms, and factors that would help lesbians obtain mammograms. Some issues identified were particular to lesbians; many issues were common to those identified by general samples of women (which include lesbians).

Women's uncertainties, coping, and moods regarding abnormal papanicolaou results.

The overall purpose of this study was to understand the process of coping with the news of abnormal cervical cancer screening results. The specific aims were (1) to compare women's uncertainty about the implications of abnormal Papanicolaou (Pap) tests and women's psychological distress over time and (2) to describe relationships among uncertainty, perceived coping ability, coping strategies that were used and helpful, and psychological distress. Seventy-five women were interviewed using standardized measures after hearing the news of their abnormal Paps tests; 40 completed similar questionnaires before follow-up colposcopy, and 35 of these also completed questionnaires after colposcopy. Women's uncertainty about abnormal Pap test results decreased over time. Negative mood scores, reflecting psychological distress, did not change over time. Uncertainty about Pap tests, ambiguity about cancer, and perceived inability to deal with Pap test results were related positively. Uncertainty was related positively to the coping strategy of catharsis as well as to negative mood scores both after receiving the news and precolposcopy. Catharsis was associated with higher negative mood scores, but acceptance was associated with lower negative mood scores. The helpfulness of relaxation and diversion was associated with lower negative mood scores. Clinical interventions can address women's uncertainty and promote coping strategies to reduce psychological distress among women with abnormal cervical cancer screening results.

Explaining women's intentions and use of hormones with menopause.

The purposes of this theoretically-based study were (a) to examine the contributions of psychosocial variables (i.e., affect, beliefs, and norms), habit, and facilitating conditions to explaining women's intentions and use of hormones with menopause and (b) to assess whether clinical or demographic factors explained intentions and use, when controlling for psychosocial, habit, and facilitating conditions variables. In a cross-sectional design, 184 pre-, peri-, and postmenopausal women completed questionnaire measures. To explain intentions, data from 124 participants who were not using hormones were analyzed. To explain use, data from 125 peri- and postmenopausal participants were analyzed. In multivariate analyses, anxiety was associated inversely with use; norms were associated positively with intentions and use. Age was associated inversely with intentions; hot flashes were associated inversely with use. Future researchers can examine the combined influences of affect, beliefs, and norms on decisions about hormones. Clinicians can address anxieties and assess social influences about hormone use, as well as offer ways to deal with hot flashes.

Women's experiences in coping with abnormal Papanicolaou results and follow-up colposcopy.

OBJECTIVES: To delineate the primary concerns women associate with abnormal Papanicolaou (Pap) results and colposcopy and to identify women's strategies for coping with these potential stressors. DESIGN: A longitudinal, descriptive study involving telephone interviews after participants received abnormal Pap results and mailed questionnaires before and after colposcopy. SETTING: Private and public women's health clinics in the midwestern United States. PARTICIPANTS: Seventy-five women who had abnormal Pap results and needed initial colposcopy completed telephone interviews; 40 completed a precolposcopy questionnaire and 35 completed a postcolposcopy questionnaire. MAIN OUTCOME MEASURES: Clients' concerns and coping strategies were assessed after they learned their Pap results were abnormal, the day before colposcopy, and the day after the procedure. RESULTS: Women's primary concerns involved not understanding the Pap results, cancer, or infertility. Coping strategies used most, and rated as helpful throughout the experience, were seeking social support and distraction. CONCLUSIONS: Nursing interventions can be designed to improve women's understanding of the meaning of abnormal Pap results, address concerns about abnormal Pap results, and encourage women to use social support and distraction while awaiting colposcopy.

A motivational message, external barriers, and mammography utilization.

Based on a theory of behavior, the interaction of a motivational message and external barriers on mammography utilization was tested. Participants (N = 101) had not had mammograms annually, and were identified from an urban clinic serving a disproportionally high percentage of indigent clients. Fifty-five percent were Caucasian; 45% were African-American. In an experimental design, half of the sample received a telephone discussion about rationale, feelings, and beliefs regarding mammograms, and half did not receive this contact. Four months later, nurses assessed women's recent mammography utilization and external barriers (e.g., affordability and accessibility). A logistic regression revealed an interaction between the intervention and barriers on postintervention mammography utilization (odds ratio: 2.12; p < 0.05). As proposed, the intervention was associated with a 64% rate of mammography utilization among women without barriers, but only a 26% rate among women with barriers. Not only should clinicians offer motivational messages about mammography, but also administrators should address external barriers to maximize mammography among socioeconomically disadvantaged groups.

Engagement in breast cancer screening behaviors.

PURPOSE/OBJECTIVES: To distinguish women who engaged in recommended breast cancer screening from those who did not. DESIGN: Descriptive design, with quantitative measures. SETTING: Urban, county hospital serving many low-income clients. SAMPLE: 119 women, age 51 to 80, who had not had mammograms in the last 13 months. METHOD: Nurse-conducted telephone interviews that incorporated a modified Profile of Mood States, Attitudes Towards Mammography Scale, Barriers Scale, and reports of engagement in mammography and clinical breast exam (CBE) in the last 13 months and breast self-exam (BSE) practice in the last 3 months. MAIN RESEARCH VARIABLES: Affect, beliefs, facilitators, and knowledge regarding screening; engagement in mammography, CBE, and BSE. FINDINGS: In discriminant analyses of engagement in mammography and CBE, affect, barriers, prior history of breast problems, and race were significant variables. In discriminant analysis of BSE, history of breast biopsy, family history of breast cancer, beliefs about screening and cancer, prior instruction in BSE, and being single were significant variables. CONCLUSIONS: Variables that discriminated between use and non-use of professional screening were different from those that discriminated between use and non-use of BSE. IMPLICATIONS FOR NURSING PRACTICE: Nurses can promote professional breast screening by addressing women's negative affect, prior breast concerns, and barriers, especially among Caucasians. Nurses can promote monthly BSE by supporting realistic beliefs about screening and cancer as well as by demonstrating BSE, especially among married women.

Process of coping with radiation therapy.

Evaluated the ability of self-regulation and emotional-drive theories to explain effects of an informational intervention entailing descriptions of the experience in concrete objective terms on outcomes of coping with radiation therapy (RT) in men (N = 84) with prostate cancer. The experimental group had significantly less disruption in function during and for 3 months following RT than the comparison group. The intervention had no significant effect on negative mood. Consistent with self-regulation theory, similarity between expectations and experience and degree of understanding of the experience mediated the effect of the intervention on function. Emotional-drive theory was not supported. These results are consistent with prior research with surgical patients and support the relevance of the information-processing explanations of self-regulation theory to coping with stressful experiences associated with physical illness.

Alternative explanations of coping with stressful experiences associated with physical illness.

This article contains a review of the components of four theories (emotional-drive, self-regulation, cognitive appraisal, and self-efficacy) relevant to explanations of the relationship between informational interventions and coping with stressful experiences associated with physical illness. Data from recent clinical studies are used to illustrate the process of evaluating alternative hypotheses about mediating processes from each of the theories. Hypotheses from emotional-drive theory are not supported. Hypotheses from self-regulation theory are supported when the outcome measure is returned to usual activities. Additional analyses reveal the limitations of cognitive appraisal and self-efficacy theories.