Search Results (22)

This study explores the effects of husbands’ post-infidelity behaviors on wives’ forgiveness from a gender perspective. The study employs a longitudinal research design and hermeneutic phenomenology to investigate the wives’ forgiveness potential paths/experiences after their husband’s infidelity. It involves 15 years of in-depth interviews with five wives who had encountered their husbands’ infidelity, with three to six interviews per participant. The findings reveal that husbands’ post-infidelity behaviors are associated with power dynamics in the marriage. At the same time, pressures from culture, gender roles, and social expectations lead wives to adopt “pseudo-forgiveness.” The study proposes two pathways to “genuine forgiveness” for wives. The path includes phases of “Her Rethinking,” leading to the “Balance Marital Relationship and Non-Self-Sacrifice stage.” For low-power-in-relationship wives, the path comprises stages such as “Her Awakening,” “Challenge Women’s Roles in Social Expectations,” and “Take Actions to Enhance Her Power/Ability,” ending in “Balance Marital Roles and Self-Realization.” Both pathways emphasize that forgiveness is a personal decision-making process and that empowerment and enhanced wives’ ability are essential for achieving “genuine forgiveness.” These findings can contribute to marriage and family work and welfare services, helping wives and professionals understand the types and processes of forgiveness and better navigate complex challenges related to marital infidelity. Full article

Parental concerns about the education of children usually reflect deep-seated anxieties. This study identifies the most influential factors shaping these global concerns based on World Values Survey (WVS) data spanning several decades. Using advanced techniques, including feature selection (Adaptive and Gradient Boosting, Pairwise Correlations, LASSO, Bayesian Model Averaging), mixed-effects modeling, cross-validation procedures, different regressions and overfitting, collinearity, and reverse causality checks together with two-way graphical representations, this study identified three enduring predictors: fear of job loss, fear of war, and respondent age. These findings mainly underline the role of socio-economic and geopolitical stability and security and, in addition, that of generational perspectives in shaping global parental priorities. All three predictors were consistent across seven dataset versions, various subsets considering random (ten-folds) or non-random criteria (different values for socio-demographic variables in mixed-effects models), and distinct feature selection approaches. Secondary influences, including opinions regarding the priority of work in life, other fears, and socio-demographic variables (e.g., gender, number of children, marital and professional status, income, education level, community size, etc.) provided more nuances to this study and additional explanatory power. The findings have implications for designing socio-economically sensitive educational policies that address parental priorities and anxieties in diverse global contexts. Full article

Background: With the increase in the elderly population, institution-based care has become another option for elderly people. In Changhua, Taiwan, the number of long-term institutions has doubled in the past decade, and more families are choosing to send their elders to institutions for care. However, there is stress induced by having to care for these elders when they come back to their family members when hospitalized. Therefore, this study aimed to understand the stress and coping behaviors of family members in regard to hospitalized long-term care facility residents and identify relevant factors that affect and predict the stress and coping behaviors exhibited by these family members. Method: In this study, a quantitative and cross-sectional survey was conducted using the convenience-sampling method; family members of long-term care facility residents hospitalized in a regional hospital in central Taiwan were selected as the research participants and a total of 162 family members were admitted. The data were collected in the form of questionnaires including basic information and data on the stress and coping behaviors of the family members. The data were collected and coded by using SPSS 22.0 to perform descriptive and inferential statistical analysis. Results: The standard average score of total stress for family members was 57.03 points, which corresponds to a moderate level. The four perceptions of stress by family members were, in order, physiological, life, psychological, and economic. Furthermore, family income, work status, and the relationship between residents of the family members and physiological, psychological, and economic factors had predictive power for their problem-oriented coping behaviors, with an explanatory power of 59.6%. Life aspects, gender, marital status, and the number of hospitalizations in half a year had significant predictive power for the family members’ emotion-oriented coping behaviors, with an explanatory power of 19.0%. Conclusions: The family members had high levels of stress, especially physical stress, and the total scores of stress perception were higher for those who were younger than 39 years old and had no rotating family members. Additionally, the coping behavior of the main caregiver was mainly problem-oriented. The results of this study may serve as a reference that can help nursing staff in clinical or long-term care facilities to provide or develop effective and individualized services for family members of facility residents. Full article

PURPOSE: Disparities in the screening, treatment, and survival of African American (AA) patients with breast cancer extend to adverse events experienced with systemic therapy. However, data are limited and difficult to obtain. We addressed this challenge by applying temporal association rule (TAR) mining using the SEER–Medicare dataset for differences in the association of specific adverse events (AEs) and treatments (TRs) for breast cancer between AA and White women. We considered two categories of cancer care providers and settings: practitioners providing care in the outpatient units of hospitals and institutions and private practitioners providing care in their offices. PATIENTS AN METHODS: We considered women enrolled in the Medicare fee-for-service option at age 65 who qualified by age and not disability, who were diagnosed with breast cancer with attributed patient factors of age and race, marital status, comorbidities, prior malignancies, prior therapy, disease factors of stage, grade, and ER/PR and Her2 status and laterality. We included 141 HCPCS drug J codes for chemotherapy, biotherapy, and hormone therapy drugs, which we consolidated into 46 mechanistic categories and generated AE data. We consolidated AEs from ICD9 codes into 18 categories associated with breast cancer therapy. We applied TAR mining to determine associations between the 46 TR and 18 AE categories in the context of the patient categories outlined. We applied the spark.mllib implementation of the FPGrowth algorithm, a parallel version called PFP. We considered differences of at least one unit of lift as significant between groups. The model’s results demonstrated a high overlap between the model’s identified TR-AEs associated set and the actual set. RESULTS: Our results demonstrate that specific TR/AE associations are highly dependent on race, stage, and venue of care administration. CONCLUSIONS: Our data demonstrate the usefulness of this approach in identifying differences in the associations between TRs and AEs in different populations and serve as a reference for predicting the likelihood of AEs in different patient populations treated for breast cancer. Our novel approach using unsupervised learning enables the discovery of association rules while paying special attention to temporal information, resulting in greater predictive and descriptive power as a patient’s health and life status change over time. Full article

Background: Major stressful life events have been shown to be associated with an increased risk of lung cancer, breast cancer and the development of various chronic illnesses. The stress response generated by our body results in a variety of physiological and metabolic changes which can affect the immune system and have been shown to be associated with tumor progression. In this study, we aim to determine if major stressful life events are associated with the incidence of head and neck or pancreatic cancer (HNPC). Methods: This is a matched case–control study. Cases (CAs) were HNPC patients diagnosed within the previous 12 months. Controls (COs) were patients without a prior history of malignancy. Basic demographic data information on major stressful life events was collected using the modified Holmes–Rahe stress scale. A total sample of 280 was needed (79 cases, 201 controls) to achieve at least 80% power to detect odds ratios (ORs) of 2.00 or higher at the 5% level of significance. Results: From 1 January 2018 to 31 August 2021, 280 patients were enrolled (CA = 79, CO = 201) in this study. In a multivariable logistic regression analysis after controlling for potential confounding variables (including sex, age, race, education, marital status, smoking history), there was no difference between the lifetime prevalence of major stressful event in cases and controls. However, patients with HNPC were significantly more likely to report a major stressful life event within the preceding 5 years when compared to COs (p = 0.01, OR = 2.32, 95% CI, 1.18–4.54). Conclusions: Patients with head, neck and pancreatic cancers are significantly associated with having a major stressful life event within 5 years of their diagnosis. This study highlights the potential need to recognize stressful life events as risk factors for developing malignancies. Full article

Background: The purpose of this study was to analyze the effects of general characteristics, fatigue, depression, self-efficacy, job stress and interpersonal relationships on the quality of life (QoL) of caregivers in nursing hospitals and use them as basic data for intervention programs to improve the quality of life of caregivers. Methods: The participants in the study were 137 caregivers, aged 52–76, who were actively working in nursing hospitals. Data were collected from caregivers by visiting 9 hospitals in 6 cities, with a questionnaire of fatigue, depression, self-efficacy, job stress, interpersonal relationship, quality of life. Results: Age, marriage, marital satisfaction, education, education experience of QoL, monthly income, perceived economic status, hobby or leisure activity, and number of disease showed differences in the degree of QoL at a statistically significant level. In stage 1, economic status (β = −0.18, p = 0.033) and hobby or leisure activity (β = 0.19, p = 0.025) were influencing factors (F = 4.58, p < 0.001). In stage 2, monthly income (β = −0.19, p = 0.034) and perceived economic status (β = −0.18, p = 0.035) were influencing factors. In stage 3, age (β = −2.80, p = 0.006), perceived economic status (β = −2.41, p = 0.017), self-efficacy (β = 3.19, p = 0.002) and interpersonal relationship (β = 7.12, p < 0.001) were influencing factors which showed 61.5% explanatory power (F = 12.88, p < 0.001). Since the subject’s fatigue, depression, and stress did not affect the quality of life, further research is needed. Conclusions: In order to improve the quality of life of caregivers, it would be necessary to develop interventions for raising their self-efficacy and interpersonal relationship by considering their degree of economic status, hobby or leisure activity, monthly income, and age. Full article

Background The lifespan of patients diagnosed with de novo metastatic breast cancer (dnMBC) has been prolonged. Nonetheless, there remains substantial debate regarding immediate breast reconstruction (IBR) for this particular subgroup of patients. The aim of this study was to construct a nomogram predicting the breast cancer-specific survival (BCSS) of dnMBC patients who underwent IBR. Methods A total of 682 patients initially diagnosed with metastatic breast cancer (MBC) between 2010 and 2018 in the Surveillance, Epidemiology, and End Results (SEER) database were included in this study. All patients were randomly allocated into training and validation groups at a ratio of 7:3. Univariate Cox hazard regression, least absolute shrinkage and selection operator (LASSO), and best subset regression (BSR) were used for initial variable selection, followed by a backward stepwise multivariate Cox regression to identify prognostic factors and construct a nomogram. Following the validation of the nomogram with concordance indexes (C-index), receiver operating characteristic (ROC) curves, calibration curves, and decision curve analyses (DCAs), risk stratifications were established. Results Age, marital status, T stage, N stage, breast subtype, bone metastasis, brain metastasis, liver metastasis, lung metastasis, radiotherapy, and chemotherapy were independent prognostic factors for BCSS. The C-indexes were 0.707 [95% confidence interval (CI), 0.666–0.748] in the training group and 0.702 (95% CI, 0.639–0.765) in the validation group. In the training group, the AUCs for BCSS were 0.857 (95% CI, 0.770–0.943), 0.747 (95% CI, 0.689–0.804), and 0.700 (95% CI, 0.643–0.757) at 1 year, 3 years, and 5 years, respectively, while in the validation group, the AUCs were 0.840 (95% CI, 0.733–0.947), 0.763 (95% CI, 0.677–0.849), and 0.709 (95% CI, 0.623–0.795) for the same time points. The calibration curves for BCSS probability prediction demonstrated excellent consistency. The DCA curves exhibited strong discrimination power and yielded substantial net benefits. Conclusions The nomogram, constructed based on prognostic risk factors, has the ability to provide personalized predictions for BCSS in dnMBC patients undergoing IBR and serve as a valuable reference for clinical decision making. Full article

Background: The aim of the study was to present the process of cultural adaptation to Polish conditions and the validation of a scale assessing the quality of life of Polish women during the menopause and to identify the factors determining this quality of life. Methods: The research tools were the menopause-specific quality of life (MENQOL) questionnaire and a standardized interview questionnaire comprising questions on the participants’ characteristics. The study involved 516 women using health care services who had symptoms caused by the menopause. Results: The value of the Cronbach’s alpha coefficient was 0.923. The discriminative power coefficients of all the questionnaire items were higher than 0.3. The study confirmed the validity and internal consistency of the Polish version of the MENQOL questionnaire for measuring the quality of life of postmenopausal women, suggesting that the tool can be used for screening menopausal symptoms in women. There was a relationship between general quality of life and age (p = 0.002), marital status (p < 0.001), education (p = 0.021), the impact of professional work (p < 0.001), the impact of physical activity (p < 0.001) and the impact of social life (p < 0.001). Conclusion: In the group of women who took part in the study, the authors observed a lower quality of life during menopause reported by older women who were married/in a stable relationship, with no formal education (no formal education) and who, according to their subjective assessment, negatively evaluated the impact of the accompanying menopause-related symptoms on their work, physical activity and social life. Full article

In this article, a case study is utilized to determine how personal relations and individual life events were used as tools in religious politics in the sixteenth century. The correspondence of sixteenth-century reformer Martin Luther is examined between 1528–1530 regarding Wolf and Katharina Hornung’s marriage and the role of Luther’s opponent, Joachim I Nestor, Elector of Brandenburg (1484–1535), in their case. By investigating Luther’s representation of this marital strife, the relationship between personal and political is examined to determine if and how he used the case as means of religious–political influencing. The main method used is careful close reading. At the explicit level, Luther’s aim in the case was to restore the Hornung marriage by bringing Wolf and Katharina back together. His letters suggest there was competition for Katharina between Wolf and Joachim, which actually, in his rhetoric, turned out to be a competition of two men representing different religious views: an evangelical one and a Catholic one. I will argue that in Luther’s efforts to maintain the marriage and the prevailing gender system, the underlying goal was to gain power over an opposing religious–political figure and to prove one’s own supremacy. Full article

The division of labor within married couples in ministerial professions is a special case of gender-specific division of labor. Since their relationship is marital and professional at the same time, the divisions of professional and familiar tasks are interconnected. Previous research demonstrates that, in such cases, gender roles may override professional status, which implies that clergywomen may easily fall into the traditional role of the pastor’s wife. Through semi-structured in-depth interviews with female members of ministerial couples in Hungary, we explore the professional and family roles, divisions of labor, and power relations that characterize relationships where both spouses are clergy. Based on these interviews, we identify three different career strategies which clergywomen use to cope with the tension between their emancipatory role as clergywomen and the traditional expectations of a clergyman’s wife: (1) the Conformist Strategy, (2) the Conformist with a Second Career Strategy, and (3) the Co-equals Strategy. Our results also demonstrate that unequal relations in professional and family tasks are reinforced by traditional gender roles typical for Hungary in general and for Hungarian clergy in particular. Full article

In the 1580s and 1590s, the English state required that all subjects of the crown attend the Protestant state church. Those who refused (called recusants) faced imprisonment as part of the government’s attempt to bring them into religious conformity. Those imprisonments forced involuntary marital separation onto Catholic couples, the result of which was to disrupt traditional gender roles within Catholic households. Separated wives increasingly fulfilled the work their husbands performed in addition to their own responsibilities as the matriarch of a landed estate. Gentlewomen were practiced at estate business since they worked in partnership with their husbands, but a spouse’s imprisonment often meant that wives wrote more petitions and settled more legal and financial matters than they did when their husbands were at liberty. The state also imprisoned Catholic wives who undermined the religious conformity of their families and communities. Spousal imprisonment deprived couples of conjugal rights and spousal support and emphasized the state’s power to interfere in marital relationships in early modern England. Full article

This article seeks to recover the financial rights of separated women living in the Muslim communities of Russia’s Volga-Ural region in the eighteenth and early nineteenth centuries. It argues that by the 1780s–1820s, separated Muslim women were guaranteed certain rights and powers over their marital finances and personal property. These rights emerged out of a complex plural legal landscape created by the Volga-Ural region’s complicated religious and political history in the late medieval and early modern periods. By the end of the eighteenth century, separated Muslim women could claim certain financial rights under both Islamic law and Russian civil law, but had to pursue different kinds of claims through different legal systems. The legal landscape and practices that evolved in relation to separated women’s rights during the early modern period became formalized and institutionalized in the nineteenth century and persisted until the collapse of the Russian empire. Full article

An increasing number of subjects are affected by health problems related to the advanced involutional processes. It is extremely important to identify the determinants of the rate of occurrence of physiological, psychological, and social manifestations of aging. The aim was to determine how factors such as lifestyle, level of education, or severity of stressful life events indicate the appearance of aging symptoms in adult men. The material consisted of data of ethnically homogeneous group of 355 men (32–87 years), invited to the study as a part of the Wroclaw Male Study research project. The analyzed features included (1) socioeconomic status: age, educational level, marital status, and having children; (2) elements of lifestyle: alcohol drinking, cigarette smoking, and physical activity; (3) major and most important stressful life events—the Social Readjustment Rating Scale; (4) symptoms related to male aging—the Aging Males’ Symptoms. The backward stepwise regression models, the Kruskal–Wallis test, and multiple comparisons of mean ranks were used. Noncentrality parameter δ (delta), two-tailed critical values of the test, and test power with α = 0.05 were calculated. Among the analyzed variables, age was most strongly associated with the intensity of almost all groups of andropausal symptoms in men (p = 0.0001), followed by the level of education (p = 0.0001) and the intensity of stressful life events (p = 0.0108). Selected lifestyle elements turned out to be much less important (p > 0.01). Preventive actions aimed at slowing down the intensification of involutional processes, including teaching strategies for coping with stressful life events, should be implemented in groups of men with specific risk factors from an early age. Full article

Women in Bangladesh are generally perceived as caregivers, often confined within the households to perform various activities, whereas men are perceived as the providers. These complex gendered roles intersect with multiple factors such as household structure, marital status, religion, cultural beliefs, economic shocks, and livelihood opportunities. This study used the feminist political ecology framework to contextualize and analyze time allocated toward unpaid works, culturally accepted as female/gendered activities, and the nuanced power dynamics between men and women within the rural households of Bangladesh. We used the household survey data collected from the Bangladesh Integrated Household Survey of 2015 to create a multiple linear regression model that helps understand the impacts of economic, cultural, and environmental shocks on the total time allocated toward unpaid activities by women within the household. Results suggest women who experienced climate-change shocks such as crop losses due to disasters and non-climatic shocks such as dowry tend to allocate more time toward unpaid tasks. In contrast, women who own their businesses tend to give less time toward unpaid tasks. This study provides guidelines for necessary gender-sensitive national policies to address the United Nation’s goal of gender equity and sustainable development. Full article

Background: A growing body of scientific literature indicates that risk factors for COVID-19 contribute to a high level of psychological distress. However, there is no consensus on which factors contribute more to predicting psychological health. Objectives: The present study quantifies the importance of related risk factors on the level of psychological distress and further explores the threshold effect of each rick factor on the level of psychological distress. Both subjective and objective measures of risk factors are considered in the model. Methods: We sampled 937 individual items of data obtained from an online questionnaire between 20 January and 13 February 2020 in China. Objective risk factors were measured in terms of direct distance from respondents’ housing to the nearest COVID-19 hospital, direct distance from respondents’ housing to the nearest park, and the air quality index (AQI). Perceived risk factors were measured in regard to perceived distance to the nearest COVID-19 hospital, perceived air quality, and perceived environmental quality. Psychological distress was measured with the Kessler psychological distress scale K6 score. The following health risk factors and sociodemographic factors were considered: self-rated health level, physical health status, physical activity, current smoker or drinker, age, gender, marital status, educational attainment level, residence location, and household income level. A gradient boosting decision tree (GBDT) was used to analyse the data. Results: Health risk factors were the greatest contributors to predicting the level of psychological distress, with a relative importance of 42.32% among all influential factors. Objective risk factors had a stronger predictive power than perceived risk factors (23.49% vs. 16.26%). Furthermore, it was found that there was a dramatic rise in the moderate level of psychological distress regarding the threshold of AQI between 40 and 50, and 110 and 130, respectively. Gender-sensitive analysis revealed that women and men responded differently to psychological distress based on different risk factors. Conclusion: We found evidence that perceived indoor air quality played a more important role in predicting psychological distress compared to ambient air pollution during the COVID-19 pandemic. Full article