Women as health care consumers.
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Biomedical subjects
Publications and source records attributed to M L Vachon.
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The authors conducted a 2-year study of postbereavement adaptation in 162 widows. Sixty-eight were paired with a widow contact who provided emotional support and practical assistance. The differences between the women receiving intervention and the controls at 6, 12, and 24 months after bereavement suggested that those receiving intervention followed the same general course of adaptation as control subjects but that the rate of achieving landmark stages was accelerated for the intervention group. The Goldberg General Health Questionnaire and two indices derived from the study questionnaire confirmed the hypothesized "pathway" of adaptation" through intra- and interpersonal adaptation to resolution of overall distress and the effectiveness of the intervention.
Community Contacts for the Widowed, a self-help group in Toronto, offers individual and group counseling and volunteer work to widows. Beginning as a demonstration project funded by the provincial health ministry, the program became an independent charitable organization in 1976. Like many new self-help groups, the program employs peers who receive training in helping their clients by establishing a one-to-one supportive relationship. These peers, called widow contacts, also arrange group sessions and conduct community education on behalf of the program. Although reliance on a self-referral process limits the number of lower-class, immigrant, and other widows unwilling to reach out for help, since 1976 the program has helped more than 1500 women through their bereavement.
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Widows of cancer patients were compared with other widows in general and with widows of men with chronic cardiovascular disease in particular, special attention being given to the vicissitudes of the final illness. Despite the recent emphasis on the need for open communication about the impending death between the dying patient and his family, interviews with 73 women whose husbands had died of cancer revealed that 40% of those who had been told their husband was dying refused to accept the warning. Only 29% of the couples openly discussed the possibility of the husband dying of his disease. More than half of those who did not talk with their husband about the impending death reported that this made no difference to their initial adjustment to bereavement. The stress for a woman of her husband's final illness leads to an especially difficult bereavement period; for example, significantly more widows of cancer patients than of patients with other illnesses perceived themselves to be in poor health during the initial bereavement period. Some of the problems specific to cancer patients and their families are described, along with recommendations for their alleviation.
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Sixty-four women undergoing radiotherapy for breast cancer in a residential setting which offered structured cognitive and emotional support, are compared for level of psychological distress and satisfaction with staff support with 104 women living at home during treatment. The outcome measures were the 30-item Goldberg General Health Questionnaire (GHQ) and a 5-item author-constructed Treatment Support Index. A surprisingly large percentage of the sample did not, at any time, manifest appreciable psychological distress. For those women whose level of distress changed by a GHQ score of 3 or more over the three week course of treatment, residence in the Lodge was associated with decreased risk of change for the worse, and increased probability of change for the better. Results from the Treatment Support Index indicate that a significantly greater percentage of Lodge residents than non-residents were satisfied with the quantity, quality, and/or diversity of support available to them.
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