Throughout West African societies, at times of social crises, postmenopausal women — the Mothers — make a ritual appeal to their innate moral authority. The seat of this power is the female ...genitalia. Wielding branches or pestles, they strip naked and slap their genitals and bare breasts to curse and expel the forces of evil. In An Intimate Rebuke Laura S. Grillo draws on fieldwork in Côte d’Ivoire that spans three decades to illustrate how these rituals of Female Genital Power (FGP) constitute religious and political responses to abuses of power. When deployed in secret FGP operates as spiritual warfare against witchcraft; in public it serves as a political activism. During Côte d’Ivoire’s civil wars FGP challenged the immoral forces of both rebels and the state. Grillo shows how the ritual potency of the Mothers’ nudity and the conjuration of their sex embodies a moral power that has been foundational to West African civilization.
Aim
To explore the barriers and facilitators to sexual discussions in primary care according to a sample of women aged 50 and older living with Type 2 diabetes.
Design
A qualitative, interpretative ...phenomenological analysis study.
Methods
Ten women aged 50–83 years living with Type 2 diabetes were interviewed between August 2016 ‐March 2017. Data were analysed using interpretative phenomenological analysis.
Results
The participants reported changes to their sexual health and well‐being, which they attributed to diabetes, menopause, ageing and changes in intimate relationships. Not all changes were considered problematic, but those that were, tended not to be discussed with healthcare professionals. The women assumed that the topic of sex was not broached by professionals due to embarrassment (both their own and that of the healthcare professional), ageism and social taboos around older women's sexual pleasure. The place that sexual health and well‐being held in the women's lives also influenced primary care discussions.
Conclusion
These findings demonstrate that social taboos around gender, ageing and sex influenced the barriers to sexual health and well‐being discussions in primary care. Facilitators to overcoming these barriers were professional–patient rapport, consulting with a female healthcare professional and instigation of the conversation by healthcare professionals.
Impact
Type 2 diabetes can have a negative impact on women's sexual health and well‐being. Prior to this study, little evidence existed of the barriers that older women with Type 2 diabetes faced with regard to sexual health care. This study shows that midlife‐older women with Type 2 diabetes can experience sexual health and well‐being problems which are neglected in primary care. It also shows that women want their healthcare professionals to explore these problems. Raising awareness and giving training for healthcare professionals may lead to better provision of sexual health support for midlife‐older women with Type 2 diabetes.
摘要
目的
以50岁及以上患有2型糖尿病的妇女为样本, 探讨初级保健中性讨论的障碍和促进因素。
设计
一项定性的、解释性的现象学分析研究。
方法
在2016年8月至2017年3月期间, 对10名年龄在50至83岁且患有2型糖尿病的女性进行了访谈。采用解释现象学分析对数据进行了分析。
结果
参与者报告了其性健康和幸福的变化, 将其归因于糖尿病、更年期、衰老和亲密关系的变化。并非所有的改变都认为是有问题的, 而实际上那些有问题的改变, 往往不会与医疗保健专业人员讨论。这些女性认为, 因为感到尴尬 (她们自己以及医疗保健专业人员都会感到尴尬) 、存在年龄歧视以及谈论老年女性性快感等社会禁忌, 专业人员不会提起性话题。性健康和幸福在女性生活中的地位也对初级保健的讨论造成了阻碍。
结论
这些调查结果表明, 性别、老龄化和性等社会禁忌对初级保健中性健康和幸福的讨论造成了障碍。要想克服这些障碍, 需要专业人员与患者建立融洽关系, 提供女性医疗保健专业人员以便患者咨询以及医疗保健专业人员不断进行沟通。
影响
2型糖尿病会对妇女的性健康和幸福产生负面影响。在进行本研究之前, 很少有证据表明患有2型糖尿病的中老年妇女在性保健方面面临障碍。本研究表明, 患有2型糖尿病的中老年妇女可能会遇到在初级保健中被忽视的性健康和幸福问题。此外,还表明妇女希望相关医疗保健专业人员能够对此类问题进行探讨。提高对保健专业人员的认识和培训, 可以更好地为患有2型糖尿病的中年老年妇女提供性健康支持。
Design
This study applied a cross‐sectional, descriptive correlational design.
Aims and objectives
The purpose of the study was to examine the relationship between cognitive function and ...self‐reported antihypertensive medication adherence in middle‐aged and older hypertensive women.
Background
Although medication adherence is an essential key for preventing complications from hypertension, poor medication adherence is common among middle‐aged and older hypertensive women. Taking medications involves a cognitive process. Little is known about the contribution of cognitive function to adherence to antihypertensive medication in middle‐aged and older women.
Methods
This study used a convenience sample of 137 women aged ≥50 years recruited from a medical centre in southern Taiwan. Participants completed a survey of demographic and clinical information and self‐reported medication adherence, and received cognitive function tests. Hierarchical regression analyses were used to evaluate the association between cognitive function and medication adherence. This study followed the STROBE guidelines.
Results
More than one‐fourth of the women (27%) reported poor adherence. Women with poor adherence appeared to have a significantly lower memory than women with good adherence. Memory was positively associated with antihypertensive medication adherence after controlling for age, blood pressure and duration of hypertension. Working memory, executive function and psychomotor speed were not significantly related to antihypertensive medication adherence.
Conclusions
Reduced memory function was associated with poorer antihypertensive medication adherence among middle‐aged and older women. Middle‐aged and older women with hypertension and poor memory performance are at risk of poor medication adherence. Future prospective studies examining the causal relationship between cognitive function and antihypertensive medication adherence are warranted.
Relevance to clinical practice
Nurses could evaluate the memory of middle‐aged and older hypertensive women when assessing antihypertensive medication adherence in clinical practice and provide relevant interventions.
Trotman and Brody, along with expert contributors, view older women through a feminist lens and examine social constructs concerning aspects of aging, caregiving, elders' relationships with family, ...health, body image, and sexuality concerns. The authors define issues that are important to older women and their emotional health and bring into sharp relief some of the painful issues professionals must confront in counseling older women.
In a period when care is being cast as an individual responsibility there is a need to invigorate analyses of caring capacity, of the factors and relations that make care possible. This paper ...develops caring‐with as an analytic to guide analyses of caring capacity. Caring‐with brings feminist care ethics together with assemblage thinking. It innovates from Tronto's identification of “caring with” as the fifth phase of care to figure care as a generative sociomaterial relation that is productive of and emergent through assemblages of actors who are not always supportive of care. Caring‐with advances three frames for conceptualising caring capacity. First, caring‐with situates care in a sociomaterial and performative frame. Second, it places care in a temporal frame, speaking to the historical and generative depth of relations that are the foundation and future of care. Third, it theorises the production and translation of care across space. These concepts are empirically examined through the caring experiences of single older women living in precarious housing in Sydney, Australia. Interviews with these women show how housing assemblages shape the emergent potential for care, co‐constituting the capacity for individuals to take part in caring practices (for self and others) and to achieve basic care needs (including needs for food, energy, and appropriate housing). Caring‐with provides a framework for conceptualising caring capacity in unequal worlds and illuminates the adaptive and creative agencies that generate and hold care together. It also points to new ways of conceptualising caring responsibility as a distributed achievement. Finally, caring‐with suggests an approach to conceptualising housing within care research.
At a time when care is being cast as an individual responsibility, this paper asks what makes care possible. It develops caring‐with as an analytic to guide analysis of caring capacity. Caring‐with brings feminist care ethics together with assemblage thinking to place care in a sociomaterial, temporal, and spatial frame. The paper theorises the production and translation of care across space and identifies the assemblages that enable future care. Empirically it asks how older women care in precarious housing.
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