ORCID Profile
0000-0003-2065-8662
Current Organisation
Western Sydney University
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In Research Link Australia (RLA), "Research Topics" refer to ANZSRC FOR and SEO codes. These topics are either sourced from ANZSRC FOR and SEO codes listed in researchers' related grants or generated by a large language model (LLM) based on their publications.
Public Health and Health Services | Health, Clinical And Counselling Psychology | Gender Psychology | Health Promotion | Health Counselling | Psychology | Health, Clinical and Counselling Psychology | Culture, Gender, Sexuality | Mental Health | Gender Specific Studies | Gender Specific Studies | Health Counselling | Health And Community Services | Public Health and Health Services not elsewhere classified |
Women’s health | Health Education and Promotion | Women's Health | Health Inequalities | Reproductive System and Disorders | Specific Population Health (excl. Indigenous Health) not elsewhere classified | Substance Abuse | Cancer and related disorders | Behaviour and Health | Gender and Sexualities | Health and support services not elsewhere classified | Cancer and Related Disorders | Health Related to Specific Ethnic Groups | Behaviour and health
Publisher: Springer Science and Business Media LLC
Date: 04-04-2017
Publisher: Informa UK Limited
Date: 02-04-2020
Publisher: Hindawi Limited
Date: 10-07-2016
DOI: 10.1111/ECC.12216
Abstract: Changes to sexuality can be one of the most difficult aspects of life following cancer. This study examines the experience of discussing sexuality post cancer with health care professionals (HCPs), from the perspective of women and men with cancer (PWC), and their partners (PPWC), across a range of cancer types. A total of 657 PWC (535 women, 122 men) and 148 PPWC (87 women, 61 men) completed a survey containing closed and open-ended items, analysed by analysis of variance and thematic analysis. Discussions about sexuality with a HCP were more likely to be reported by men (68%) compared to women PWC (43%), and by women (47%) compared to men PPWC (28%), as well as by those with a sexual or reproductive cancer. Men PWC and women PPWC were most likely to want to discuss sexuality with a HCP, with men PWC and PPWC reporting highest levels of satisfaction with such discussions. Open-ended responses revealed dissatisfaction with the unwillingness of HCPs to discuss sexuality, unhappiness with the nature of such discussion, and positive accounts of discussions about sexuality with HCPs. These findings lend support to the notion that people with cancer and their partners may have unmet sexual information and support needs.
Publisher: SAGE Publications
Date: 02-2008
Abstract: Research on differences between heterosexual and lesbian relationships has reported that lesbian relationships are more satisfying, more egalitarian, more empathic, and facilitate more effective conflict resolution. These differences are of key relevance in terms of the construction and experience of PMS (Premenstrual Syndrome), as is illustrated through interviews with 15 lesbian women who experience PMS and 10 of their partners. While experiences of premenstrual distress were similar to those previously reported by heterosexual women, the lesbian relationship context and positioning of PMS were markedly different. In contrast to the lack of understanding or support, rejection, and pathologization commonly found in heterosexual women's accounts, lesbian interviewees reported awareness and recognition of premenstrual change, responsiveness to needs, open communication, and responsibility sharing. This had significant consequences for the construction and experience of premenstrual change, facilitating open expression of needs, self-care, and avoidance of guilt and self-blame, reinforcing the view that PMS needs to be understood within a framework of inter-subjectivity.
Publisher: Wiley
Date: 24-08-2017
DOI: 10.1002/PON.4518
Abstract: The emerging discipline of oncofertility advocates for the timely provision of fertility information and referral for fertility preservation to all cancer patients of reproductive age (<45 years). A systematic review was undertaken on the clinician provision of oncofertility support to determine whether cancer patients are having their support needs adequately met by staff. An initial search conducted in May 2016 identified 351 potentially relevant studies. The papers were ided into 2 categories: Papers on the clinician provision of oncofertility support were reviewed for this study, and papers on patient oncofertility support needs were reviewed for a separate systematic review. A total of 23 studies were included within the final review of this manuscript. Although many clinicians are broadly informed about the risk to their patients' fertility brought about by cancer treatment, there are many factors which hinder the appropriate discussion, referral, or service utilisation needed to provide adequate oncofertility support to patients of reproductive age. Oncofertility support is often not delivered to the standard of current guidelines, with many clinicians not providing the recommended care to all eligible patients, and as such many patients may lack the oncofertility support that they require. The implementation of a clear procedural process would assist clinicians in the provision of oncofertility support for cancer patients of reproductive age.
Publisher: Informa UK Limited
Date: 08-05-2013
DOI: 10.1080/13691058.2013.789129
Abstract: Men can experience significant changes to their sexuality following the onset of cancer. However, research on men's sexuality post-cancer has focused almost exclusively on those with prostate and testicular cancer, despite evidence that the diagnosis and treatment for most cancers can impact on men's sexuality. This Australian qualitative study explores the experiences of changes to sexuality for 21 men across a range of cancer types and stages, sexual orientations and relationship contexts. Semi-structured interviews were analysed with theoretical thematic analysis guided by a material discursive intra-psychic approach, recognising the materiality of sexual changes, men's intrapsychic experience of such changes within a relational context and the influence of the discursive construction of masculine sexuality. Material changes included erectile difficulty, decreased desire, and difficulty with orgasm. The use of medical aids to minimise the impact of erectile difficulties was shaped by discursive constructions of 'normal' masculine sexuality. The majority of men reported accepting the changes to their sexuality post-cancer and normalised them as part of the natural ageing process. Men's relationship status and context played a key role managing the changes to their sexuality. We conclude by discussing the implications for clinical practice.
Publisher: Springer Science and Business Media LLC
Date: 15-06-2017
DOI: 10.1007/S12529-017-9662-3
Abstract: Migrant and refugee women are at risk of negative sexual and reproductive health (SRH) outcomes due to low utilisation of SRH services. SRH is shaped by socio-cultural factors which can act as barriers to knowledge and influence access to healthcare. Research is needed to examine constructions and experiences of SRH in non-English-speaking migrant and refugee women, across a range of cultural groups. This qualitative study examined the constructions and experiences of SRH among recent migrant and refugee women living in Sydney, Australia, and Vancouver, Canada. A total of 169 women from Afghanistan, Iraq, Somalia, South Sudan, Sudan, India, Sri Lanka and South America participated in the study, through 84 in idual interviews, and 16 focus groups comprised of 85 participants. Thematic analysis was used to analyse the data. Three themes were identified: "women's assessments of inadequate knowledge of sexual and reproductive health and preventative screening practices", "barriers to sexual and reproductive health" and "negative sexual and reproductive health outcomes". Across all cultural groups, many women had inadequate knowledge of SRH, due to taboos associated with constructions and experiences of menstruation and sexuality. This has implications for migrant and refugee women's ability to access SRH education and information, including contraception, and sexual health screening, making them vulnerable to SRH difficulties, such as sexually transmissible infections and unplanned pregnancies. It is essential for researchers and health service providers to understand socio-cultural constraints which may impede SRH knowledge and behaviour of recent migrant and refugee women, in order to provide culturally safe SRH education and services that are accessible to all women at resettlement irrespective of ethnicity or migration category.
Publisher: SAGE Publications
Date: 14-10-2016
Abstract: Experiences and constructions of menarche and menstruation are shaped by the sociocultural environment in which women are embedded. We explored experiences and constructions of menarche and menstruation among migrant and refugee women resettled in Sydney, Australia, and Vancouver, Canada. Seventy-eight semistructured in idual interviews and 15 focus groups comprised of 82 participants were undertaken with women from Afghanistan, Iraq, Somalia, South Sudan, Sudan, Sri Lanka, and varying South American countries. We analyzed the data using thematic decomposition, identifying the overall theme "cycles of shame" and two core themes. In "becoming a woman," participants constructed menarche as a marker of womanhood, closely linked to marriage and childbearing. In "the unspeakable," women conveyed negative constructions of menstruation, positioning it as shameful, something to be concealed, and polluting. Identifying migrant and refugee women's experiences and constructions of menarche and menstruation is essential for culturally safe medical practice, health promotion, and health education.
Publisher: Informa UK Limited
Date: 26-01-2019
DOI: 10.1080/08870446.2018.1543764
Abstract: Infertility is a significant concern for people with cancer and fertility preservation is often recommended. However, uptake of preservation interventions remains low. In this study, we examined how people with cancer construct their subjectivity - their sense of self - in relation to decision making and processes of fertility preservation. Six-hundred and ninety-three women and 185 men completed a self-report survey 61 women and 17 men participated in semi-structured interviews. Subject positions adopted in relation to constructions of fertility preservation in transcripts and open-ended survey responses were examined using thematic decomposition. Three main discursive themes were identified: 'Limited agency and choice, or resisting risk: not taking part in fertility preservation', 'Fertility preservation as a means to retain hope and control', and 'Fertility preservation as uncertain and distressing'. It is important for health professionals to provide accurate information, acknowledge the complexity of fertility preservation and implications for 'liminal' survivorship where exclusion, uncertainty or unsuccessful interventions have occurred.
Publisher: Hindawi Limited
Date: 21-03-2023
DOI: 10.1155/2023/9836967
Abstract: People experiencing homelessness can often have small and fragmented social networks, due to the loss and absence of critical connections, leaving them particularly susceptible to loneliness. During the course of homelessness, some people experience a changing profile of networks, transitioning away from family and some friends and forming new/substitute networks, such as service providers or pets. The resulting loneliness can have profound impacts on this group, threatening their physical and mental health and their ability to exit homelessness successfully. This study aimed to understand the social network characteristics and support associated with loneliness. MOS Social Support and social network questionnaire data from 124 participants (either currently or formerly homeless) were used in three hierarchical regression models to predict romantic, social, and family loneliness (SELSA-S), respectively. Findings suggested the more supportive, important, and (often) more satisfying that participants deemed current relationships to be, the lonelier they tended to feel. This occurred even if they were no longer homeless. These findings suggest that loneliness can operate differently in the context of poverty and homelessness. Whilst experiencing homelessness, people may prioritise relationships that provide resources and safety over those that assuage loneliness. Service providers can support people exiting homelessness to (re)connect with important and valued networks to reduce loneliness.
Publisher: Wiley
Date: 02-2019
DOI: 10.1002/PON.4990
Abstract: Infertility-related distress is recognised to be a long-term effect of cancer. There have been attempts to examine predictors of such distress, but there is inconsistency in the findings. This study examined the psychological impact of infertility-related distress in women and men cancer survivors, across age group, parity, cancer type, time since diagnosis, and relationship context and the association of distress with acceptance of illness and relationship satisfaction. 693 women and 185 men completed a self-report survey examining infertility-related distress (fertility problem inventory [FPI], acceptance of cancer (acceptance of illness scale [AIS]), psychological distress (Kessler psychological distress scale [K10]), quality of life (QoL) (ladder of life), and relationship satisfaction relationship assessment scale [RAS]) 61 women and 17 men took part in one-to-one interviews to examine subjective experiences of infertility distress. Infertility distress was positively correlated with psychological distress and negatively correlated with QoL, relationship satisfaction, and acceptance of cancer across gender, cancer type and stage, relationship status, and age. Women reported significantly higher infertility distress than men. In multiple regression analysis, unique statistical predictors of infertility distress for women were childlessness, cancer acceptance, and QoL. Childlessness and relationship satisfaction were unique predictors for men. Thematic analysis of interviews identified loss and grief, identity threat, relationship concerns or support, and acceptance of cancer and infertility as key themes. Concern about cancer-related infertility is associated with decrements in psychological well-being and QoL, particularly for those without children. Psychological support to address cancer-related infertility distress should acknowledge the different meanings of infertility across gender, and the impact of acceptance of cancer and relationship satisfaction.
Publisher: SAGE Publications
Date: 06-2010
DOI: 10.1111/J.1471-6402.2010.01564.X
Abstract: This study examined gender differences in self-silencing, the relationship between self-silencing and psychological distress, and reasons for self-silencing in informal cancer carers (329 women, 155 men), using a mixed-method design. Men reported greater self-silencing than women on the Silencing the Self Scale however, women reported higher depression and anxiety, even though depression and anxiety were significantly correlated with self-silencing. These gender differences in patterns of self-silencing were explored in follow-up interviews with 34 women and 19 men carers, selected to represent a cross-section of cancer type and stage and analyzed using thematic decomposition and positioning theory. Both men and women reported self-silencing because of their desire to prioritize patient needs or to avoid conflict. However, women positioned self-silencing as a requisite for coping and demonstrated awareness of external judgement, reflecting self-policing linked to constructions of idealized femininity, in particular the positioning of women as natural carers. In contrast, men positioned self-silencing as a normal aspect of masculinity, regarding expressions of needs or feelings as signs of weakness and maintaining a positive front as a means of coping. These findings confirm that men and women self-silence for different reasons and with differential consequences for mental health. The significant association of self-silencing with depression and anxiety suggests that it is not an adaptive behavior for caregivers, supporting previous reports that avoidance of emotional discussion in couples living with cancer is detrimental to coping and to mental health.
Publisher: Springer Science and Business Media LLC
Date: 23-01-2023
DOI: 10.1007/S10508-023-02530-9
Abstract: There is a pressing need for greater understanding and focus on cancer survivorship and informal cancer caring of trans people (binary and non-binary), across tumor types, to inform culturally safe trans inclusive cancer information and care. This qualitative study, part of the mixed methods Out with Cancer project, examined experiences of trans embodiment and identity after cancer diagnosis and treatment. We drew on open-ended survey responses from 63 trans cancer survivors and 23 trans cancer carers, as well as interviews and a photo-elicitation activity with a subset of 22 participants (15 cancer survivors, 7 cancer carers). Reflexive thematic analysis identified three themes: Cancer enhances trans embodiment, through experiences of gender euphoria following cancer treatment, and acceleration of decisions about gender affirmation cancer erases or inhibits gender affirmation trans embodiment is invisible or pathologized in cancer care. These findings demonstrate that trans embodiment and identity, as well as the process of gender affirmation, may be disrupted by cancer or informal cancer caring. Conversely, cancer and cancer treatment can positively impact the embodied identity and lives of trans people, despite the anxiety and strain of negotiating medical procedures. However, if healthcare professionals operate within a cis-heteronormative framework and do not understand the meaning of embodied change following cancer treatment for trans in iduals, these positive benefits may not be realized.
Publisher: SAGE Publications
Date: 12-08-2020
Abstract: Transgender (trans) women are at higher risk of sexual violence than cisgender women, with trans women of color reported to be at highest risk. This study examined subjective experiences of sexual violence for 31 trans women of color living in Australia, average age 29 (range 18–54), through in-depth interviews. An additional photovoice activity and follow-up interviews were completed by 19 women. Data were analyzed through thematic analysis and feminist intersectionality theory, identifying the following themes. The first theme, “‘A sexually tinged violation of boundaries’: Defining sexual violence,” examined women’s definition of sexual violence, including staring and verbal abuse, nonconsensual touching and sexual assault, in both public and private contexts. The second theme, “‘Crossing people’s boundaries’: Sexual harassment in the public domain,” examined the frequent sexual harassment women experienced in their daily lives. This included the subtheme, “A hostile gaze: Public staring and ‘weird looks’” and “Mockery and transphobic abuse: Verbal abuse is sexual violence.” The third theme, “‘Crossing bodily boundaries’: Experiences of sexual assault,” included the subthemes “‘Unwanted sexual touch’: Groping and forced sex by strangers,” “Danger in relationships: Sexual assault and manipulation,” “Sexual violence in the context of sex work,” and “‘We’re turned into something we’re not’: Fetishization and the sexual other.” The poor health outcomes experienced by many trans women are closely associated with their exposure to sexual violence and the social inequities and transphobia to which they are subjected. Trans women of color may experience additional prejudice and discrimination due to the intersection of gender, sexuality, race, and social class. Our research suggests that understanding these intersectionalities is integral in understanding the sexual violence experiences of trans women of color.
Publisher: Common Ground Research Networks
Date: 2010
Publisher: MDPI AG
Date: 22-01-2018
Publisher: Informa UK Limited
Date: 18-08-2017
Publisher: Springer Science and Business Media LLC
Date: 16-10-2018
Publisher: Springer Singapore
Date: 2019
Publisher: Springer Singapore
Date: 2019
Publisher: Bowling Green State University Libraries
Date: 11-2009
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2012
Publisher: Springer Science and Business Media LLC
Date: 11-04-2015
Publisher: Informa UK Limited
Date: 03-02-2022
DOI: 10.1080/00918369.2021.2020542
Abstract: This study investigated how transgender parents negotiate "coming out" and pursuit of gender affirmation (GA) with their children and co-parents. Sixty-six open-ended survey responses and 38 one-on-one interviews conducted with Australian trans parents, aged 24-67 years, were analyzed using thematic analysis. The main themes were: (i) Anticipating their Response: "Coming Out" to co-parents and children (ii) "Having that talk"-Negotiating disclosure of trans identity with co-parents and children and (iii) Negotiating Gender Affirmation alongside Parenting. "Coming out" was experienced as both vital and a point of vulnerability, with GA necessitating communication and negotiation alongside parenting. Many participants reported significant anxiety before "coming out" to co-parents and children. Children's age was an influential factor in reaction to changes in parental gender identity, with younger and adult children reportedly being the most receptive. Results are discussed in terms of the reported benefits of pursuing GA for trans parents.
Publisher: Informa UK Limited
Date: 03-2009
Publisher: Frontiers Media SA
Date: 24-06-2022
Abstract: Lesbian, gay, bisexual, transgender, queer and/or intersex (LGBTQI) people with cancer and their carers report poorer psychological outcomes than the general non-LGBTQI cancer population. There is growing acknowledgement that these health inequities can be explained by minority stress, which can be buffered by social support. To examine subjective experiences of minority stress and social support for LGBTQI people with cancer and their carers, drawing on qualitative findings from the Out with Cancer study. An online survey including open ended items was completed by 430 LGBTQI cancer patients and 132 partners and other carers, representing a range of tumor types, sexual and gender identities, age and intersex status. A sub-s le of 104 patients and 31 carers completed an interview, with a follow-up photovoice activity and second interview completed by 45 patients and 10 carers. Data was thematically analysed using an intersectional theoretical framework. Historical and present-day experiences of discrimination, violence, family rejection and exclusion created a legacy of distress and fear. This impacted on trust of healthcare professionals and contributed to distress and unmet needs in cancer survivorship and care. Social support, often provided by partners and other chosen family, including intimate partners and other LGBTQI people, buffered the negative impacts of minority stress, helping LGBTQI patients deal with cancer. However, some participants lacked support due to not having a partner, rejection from family of origin and lack of support within LGBTQI communities, increasing vulnerability to poor psychological wellbeing. Despite the chronic, cumulative impacts of minority stress, LGBTQI patients and carers were not passive recipients of discriminatory and exclusion in cancer care, demonstrating agency and resistance through collective action and advocacy. LGBTQI people have unique socio-political histories and present-day psycho-social experiences that contribute to distress during cancer. Social support serves to buffer and ameliorate this distress. There is a need for cancer healthcare professionals and support services to be aware of and responsive to these potential vulnerabilities, including the intersectional differences in experiences of minority stress and social support. There is also a need for recognition and facilitation of social support among LGBTQI people with cancer and their carers.
Publisher: Public Library of Science (PLoS)
Date: 18-04-2017
Publisher: Hindawi Limited
Date: 27-12-2014
DOI: 10.1111/ECC.12165
Abstract: This qualitative study examines the subjective experience of infertility in a large s le of Australian women with breast cancer. Participants were 1830 women, average age 54, who responded to an email invitation to complete an online survey on sexual well-being and fertility concerns after breast cancer. 24.6% (n = 452) reported that cancer had affected their fertility 21.3% (n = 391) did not know their fertility status. In thematic analysis of open-ended responses provided by 381 women about changes to fertility status, reactions to infertility, and experiences of information and interventions to assist fertility, five themes were identified: 'Negative responses to infertility and early menopause' 'Sexual changes associated with menopause and infertility' 'Uncertainty and anxiety about fertility status' 'Information and fertility preservation' 'Acceptance of the end of fertility'. These findings confirm previous reports that infertility and premature menopause are a significant cause of anxiety for many women with breast cancer. However, some women closer to natural menopause, or who had completed their families, reported acceptance of changed fertility status. Accounts of deficits in information provision and fertility counselling suggest an urgent need for accessible and comprehensive information about fertility and cancer to be developed and evaluated, as well as education and training of health professionals in addressing fertility concerns following cancer.
Publisher: Cambridge University Press
Date: 20-12-2018
Publisher: Wiley
Date: 13-09-2017
DOI: 10.1002/PON.4502
Abstract: Decline in fertility potential brought about by a cancer diagnosis or cancer treatment is one of the biggest impacts to cancer patients' long-term quality of life. As such, the current manuscript aimed to systematically review the literature on oncofertility support needs for cancer patients of a reproductive age (14-45 years of age). A systematic review of the literature was conducted in May 2016 through the searching of electronic databases Medline, EMBASE, PSYCH Info, Web of Science and SCOPUS, alongside the screening of relevant reference lists. An initial search identified 351 potentially relevant studies. The papers were ided into 2 categories papers on patient oncofertility support needs were reviewed for this systematic review, and papers on clinician provision of oncofertility support were reviewed for a separate systematic review. A total of 30 studies were included within the final review. Support needs were categorised as information, service, clinician-patient interactions, psychological, and family. A number of studies indicated that cancer patients place great important on their oncofertility care and have unmet support needs. Patients were satisfied and felt supported when additional care was taken to ensure fertility information and service needs were met. Patients desire for clinicians to support their concerns through the provision of adequate information, access to oncofertility services, taking time to discuss oncofertility treatment and concerns, specialised psychological support, and responsiveness to in idual needs.
Publisher: Oxford University Press (OUP)
Date: 08-05-2012
Abstract: The very long-term unemployed (i.e. those unemployed for more than 2 years) face serious mental health problems and social difficulties in regaining employment. To assess the effectiveness of a pilot vocationally oriented cognitive behaviour therapy (CBT) programme on mental health and vocational outcomes among a group of very long-term unemployed. A pre-test-post-test design with follow-up assessment at 12 weeks was used to assess the effects of CBT group training on mental health, self-esteem, optimism and attitudes to work. Participants were recruited through employment agencies in Sydney, Australia. Twelve weeks following CBT training, the 21 participants reported increased optimism and attitudes to work, and more than half of them had participated in some kind of paid employment. While this study is small and non-generalizable, the findings suggest the value of vocationally oriented CBT approaches in assisting the very long-term unemployed to get back into the workforce.
Publisher: Informa UK Limited
Date: 03-04-2018
Publisher: Oxford University Press (OUP)
Date: 03-2016
DOI: 10.1016/J.JSXM.2015.12.026
Abstract: Decrements in health-related quality of life (HRQOL) and sexual difficulties are a recognized consequence of prostate cancer (PCa) treatment. However little is known about the experience of gay and bisexual (GB) men. HRQOL and psychosexual predictors of HRQOL were examined in GB and heterosexual men with PCa to inform targeted health information and support. One hundred twenty-four GB and 225 heterosexual men with PCa completed a range of validated psychosexual instruments. Functional Assessment of Cancer Therapy – Prostate (FACT-P) was used to measure HRQOL, with validated psychosexual measures, and demographic and treatment variables used as predictors. GB men were significantly younger (64.25 years) than heterosexual men (71.54 years), less likely to be in an ongoing relationship, and more likely to have casual sexual partners. Compared with age-matched population norms, participants in both groups reported significantly lower sexual functioning and HRQOL, increased psychological distress, disruptions to dyadic sexual communication, and lower masculine self-esteem, sexual confidence, and sexual intimacy. In comparison with heterosexual men, GB men reported significantly lower HRQOL (P = .046), masculine self-esteem (P & .001), and satisfaction with treatment (P = .013) higher psychological distress (P = .005), cancer related distress (P & .001) and ejaculatory concern (P & .001) and higher sexual functioning (P & .001) and sexual confidence (P = .001). In regression analysis, psychological distress, cancer-related distress, masculine self-esteem, and satisfaction with treatment were predictors of HRQOL for GB men (R2Adj = .804) psychological distress and sexual confidence were predictors for heterosexual men (R2Adj = .690). These findings confirm differences between GB and heterosexual men in the impact of PCa on HRQOL across a range of domains, suggesting there is a need for GB targeted PCa information and support, to address the concerns of this “hidden population” in PCa care.
Publisher: Frontiers Media SA
Date: 20-09-2022
Abstract: There is growing acknowledgement of the psycho-social vulnerability of lesbian, gay, bisexual, transgender, queer and/or intersex (LGBTQI) people with cancer. The majority of research to date has focused on cisgender adults with breast or prostate cancer. This study examined psycho-social factors associated with distress and quality of life for LGBTQI cancer patients and survivors, across a range of sexualities and gender identities, intersex status, tumor types, ages and urban/rural/remote location using an intersectional theoretical framework. 430 LGBTQI people with cancer completed an online survey, measuring distress, quality of life (QOL), and a range of psycho-social variables. Participants included 216 (50.2%) cisgender women, 145 (33.7%) cisgender men, and 63 (14.7%) transgender and gender erse (TGD) people. Thirty-one (7.2%) participants reported intersex variation and 90 (20%) were adolescents or young adults (AYA), aged 15-39. The majority lived in urban areas (54.4%) and identified as lesbian, gay or bisexual (73.7%), with 10.9% identifying as bisexual, and 10.5% as queer, including reproductive (32.4%) and non-reproductive (67.6%) cancers. Forty-one percent of participants reported high or very high distress levels, 3-6 times higher than previous non-LGBTQI cancer studies. Higher rates of distress and lower QOL were identified in TGD compared to cisgender people, AYAs compared to older people, those who identify as bisexual or queer, compared to those who identify as lesbian, gay or homosexual, and those who live in rural or regional areas, compared to urban areas. Elevated distress and lower QOL was associated with greater minority stress (discrimination in life and in cancer care, discomfort being LGBTQI, lower outness) and lower social support, in these subgroups. There were no differences between reproductive and non-reproductive cancers. For the whole s le, distress and poor QOL were associated with physical and sexual concerns, the impact of cancer on gender and LGBTQI identities, minority stress, and lack of social support. LGBTQI people with cancer are at high risk of distress and impaired QOL. Research and oncology healthcare practice needs to recognize the ersity of LGBTQI communities, and the ways in which minority stress and lack of social support may affect wellbeing.
Publisher: Springer Science and Business Media LLC
Date: 09-09-2015
Publisher: Frontiers Media SA
Date: 10-05-2022
Abstract: Awareness of the specific needs of LGBTQI cancer patients has led to calls for inclusivity, cultural competence, cultural safety and cultural humility in cancer care. Examination of oncology healthcare professionals’ (HCP) perspectives is central to identifying barriers and facilitators to inclusive LGBTQI cancer care. This study examined oncology HCPs perspectives in relation to LGBTQI cancer care, and the implications of HCP perspectives and practices for LGBTQI patients and their caregivers. 357 oncology HCPs in nursing (40%), medical (24%), allied health (19%) and leadership (11%) positions took part in a survey 48 HCPs completed an interview. 430 LGBTQI patients, representing a range of tumor types, sexual and gender identities, age and intersex status, and 132 carers completed a survey, and 104 LGBTQI patients and 31 carers undertook an interview. Data were analysed using thematic discourse analysis. Three HCP subject positions – ways of thinking and behaving in relation to the self and LGBTQI patients – were identified:’Inclusive and reflective’ practitioners characterized LGBTQI patients as potentially vulnerable and offered inclusive care, drawing on an affirmative construction of LGBTQI health. This resulted in LGBTQI patients and their carers feeling safe and respected, willing to disclose sexual orientation and gender identity (SOGI) status, and satisfied with cancer care. ‘Egalitarian practitioners’ drew on discourses of ethical responsibility, positioning themselves as treating all patients the same, not seeing the relevance of SOGI information. This was associated with absence of LGBTQI-specific information, patient and carer anxiety about disclosure of SOGI, feelings of invisibility, and dissatisfaction with healthcare. ‘Anti-inclusive’ practitioners’ expressed open hostility and prejudice towards LGBTQI patients, reflecting a cultural discourse of homophobia and transphobia. This was associated with patient and carer distress, feelings of negative judgement, and exclusion of same-gender partners. Derogatory views and descriptions of LGBTQI patients, and cis-normative practices need to be challenged, to ensure that HCPs offer inclusive and affirmative care. Building HCP’s communicative competence to work with LGBTQI patients needs to become an essential part of basic training and ongoing professional development. Visible indicators of LGBTQI inclusivity are essential, alongside targeted resources and information for LGBTQI people.
Publisher: Springer Science and Business Media LLC
Date: 19-05-2022
DOI: 10.1186/S12905-022-01767-1
Abstract: Rheumatoid arthritis (RA) can result in difficulties for mothers when undertaking daily care activities and increased psychological distress. However, few studies have examined how women with RA subjectively experience coping and wellbeing as part of their motherhood. Twenty mothers with a diagnosis of RA and a dependent child (18 years or younger) who were living in Australia took part in a semi-structured interview between June and November 2017. Purposive s ling was undertaken to include participants across degree of current RA severity, number and age of children, and having received a diagnosis before or after a first child to take account of variability across these experiences. A qualitative thematic analysis was conducted on the interview transcripts. The following themes were identified: ‘Burden and complexity in the mothering role’, ‘Losing control: Women’s experiences of distress’, and ‘Adjusting and letting go: Women’s experiences of wellbeing’. Experiences of distress, including feelings of failure, were associated with accounts of a loss of control over mothering practices among women, regardless of child age. In contrast, accounts of adjusting mothering practices and relinquishing control were associated with reports of enhanced wellbeing. In addition, some mothers reported greater ease due to increased independence of older children. The absence of social support exacerbated burden and distress in the women’s accounts, while the availability of support alleviated burden and was associated with reports of wellbeing. Health professionals and services can provide support to mothers with RA by addressing feelings of failure, acknowledging strategies of adjustment and letting go, and encouraging access to social support.
Publisher: Informa UK Limited
Date: 07-2014
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2010
Publisher: Elsevier BV
Date: 06-2021
Publisher: SAGE Publications
Date: 21-10-2018
Abstract: Personalized music playlists are increasingly being utilized in aged care settings. This study aims to investigate how musical features influence the affective response to music of people with probable dementia. A factorial experiment (2 × 2 × 3) was conducted to investigate the influence of tempo (fast, slow), mode (major, minor), and lyrics (none, negative, positive). Ninety-nine people with probable dementia were randomly assigned to 3 conditions, listening to 3 personalized playlists. Galvanic skin response and activation of facial action units were measured. Music with fast tempos increased arousal and reduced enjoyment. Music in minor keys increased activation of the depressor anguli oris, suggesting increased sadness. Lyrics had no significant effect on response. The findings demonstrate that both tempo and mode influenced the response of the listener. As well as accounting for personal preferences, music for people with dementia should be carefully targeted toward the affective outcome desired.
Publisher: CSIRO Publishing
Date: 2016
DOI: 10.1071/SH15235
Abstract: The proportion of women from culturally and linguistically erse backgrounds is growing in Australia. Synthesising existing evidence concerning the views and experiences of these women in accessing sexual and reproductive health care is crucial to future policy and service development. A systematic review of scientific articles and grey literature published in English between 1990 and 2015 was conducted to identify the barriers and facilitators in accessing sexual and reproductive health care in Australia experienced by culturally and linguistically erse women. The search strategy covered seven electronic databases (ProQuest, PubMed, EMBASE/Elsevier, SCOPUS, PsycINFO, CINAHL and Infomit) and websites. Thematic analysis methodology was used to analyse and interpret the data extracted from in idual studies. From the 1401 potentially relevant articles identified, 22 articles that represent the views and experiences of 1943 culturally and linguistically erse women in accessing sexual and reproductive health care in Australia were reviewed. The main barriers and facilitators identified were grouped into three major themes. These include personal level experiences of accessing health care, women’s interaction with the healthcare system and women’s experience with healthcare providers. Implications for clinical practice and future research are discussed based on the findings of the review.
Publisher: Informa UK Limited
Date: 19-08-2014
DOI: 10.1080/08870446.2014.948876
Abstract: Providing care to a partner with cancer can have a significant impact on a carer's well-being and experience of subjectivity. However, there is little research examining how men experience the role of cancer carer, and in particular, how they negotiate constructions of gender in this role. This paper draws on a single case study of a heterosexual man caring for his partner, and conducts a narrative analysis of the construction and performance of masculine subjectivity. It was found that rather than inhabiting a stable masculinity, this carer engaged in a complex negotiation of masculinities, enacting a caring role associated with victimisation, rejection, distress and powerlessness, as well as strength and heroic resilience. We highlight the importance of the relationship context to the experience of caring, and suggest that research into the gendered experience of cancer care needs to acknowledge the active negotiation of masculinities and caring. We also discuss the utility of case study research in analyses of masculinity and cancer care, and in health psychology more broadly.
Publisher: Informa UK Limited
Date: 30-08-2008
DOI: 10.1080/03630240802134134
Abstract: Recent research has demonstrated the importance of family relationships in women's experience of premenstrual changes, their construction of these changes as "PMS." However, the discursive process by which women take up the subject position of "PMS" sufferer through the explicit naming of "PMS" to an intimate partner has received little research attention. Drawing on 60 in idual interviews with Australian women, conducted between 2004 and 2006, we examined accounts of naming "PMS" in intimate relationships, women's explanations for naming or not naming, their experiences of their partner naming them as premenstrual. The analysis process identified an overarching theme of naming "PMS," which was made up of three themes: naming to explain "PMS" becoming the only explanation for distress "PMS" as not a legitimate explanation for distress. The findings suggest that clinicians need to be aware of women's complex, often ambivalent, experiences of naming "PMS" within their relationships, when working with women, couples, seeking treatment or support for premenstrual distress.
Publisher: SAGE Publications
Date: 03-2020
Abstract: The body is central to women’s construction of premenstrual change as premenstrual syndrome (PMS), and to experiences of premenstrual distress. Embodied change, such as bloating or breast tenderness, can act as a marker of PMS. Within biomedical models, PMS is located within the body. Women’s dissatisfaction with their bodies is also reported to be higher in the premenstrual phase of the cycle. What is absent from this analysis is the meaning and experience of embodied change, in the context of broader constructions of femininity and embodiment. In this paper, we adopt a feminist material-discursive theoretical framework to examine the role of premenstrual embodiment in women’s premenstrual distress, drawing on open-ended survey responses and interviews with 83 women who self-diagnose as “PMS sufferers”. We theorize premenstrual body hatred as subjectification, wherein women take up cultural discourse associated with idealized femininity and the stigmatization of the fat body, resulting in self-objectification, distress and dehumanization. However, women can resist negative cultural constructions of premenstrual embodiment. We describe the impact of psychological therapy which increases awareness of emotional and embodied change, resulting in greater acceptance of the premenstrual body and self-care, serving to reduce premenstrual distress and self-objectification.
Publisher: Elsevier BV
Date: 07-2008
Publisher: Informa UK Limited
Date: 08-2013
DOI: 10.1080/08870446.2013.765004
Abstract: The absence of reports of premenstrual syndrome (PMS) in contexts such as China, Hong Kong, and India has led to the conclusion that PMS is a culture-bound syndrome. This qualitative study examines whether is it possible for women in a Western cultural context to negotiate negative premenstrual change in order to effectively avoid or reduce premenstrual distress. Sixty women who self-defined as a 'PMS sufferer' took part in one-to-one interviews, which were analysed using theoretical thematic analysis from a material-discursive-intrapsychic (MDI) perspective. Three major themes were consistently identified across relationship type and context, reflecting women's strategies of premenstrual self-regulation and coping: 'Self-monitoring and awareness: recognition and acceptance of premenstrual change' 'Coping through self-regulation of premenstrual distress', including: 'avoidance of stress and conflict', 'escaping relational demands and responsibilities', and 'care of the self' and 'Coping as an inter-subjective experience'. These findings challenge the view of PMS as a fixed unitary syndrome, suggesting that premenstrual change is an ongoing process of negotiation, in which women are agentic subjects, not passive 'PMS sufferers'. This has implications for therapists working with women reporting moderate-severe PMS, suggesting that the reframing of 'symptoms' as normal change, behavioural coping strategies, and self-monitoring, can effectively reduce premenstrual distress.
Publisher: Elsevier BV
Date: 09-2023
Publisher: Springer Science and Business Media LLC
Date: 10-2021
Publisher: Wiley
Date: 15-04-2013
DOI: 10.1111/J.1365-2648.2012.06010.X
Abstract: This article is the report of a study of sexual information needs, experiences of obtaining such information, and patient communication about sexuality with health professionals, after breast cancer. Changes to sexuality after breast cancer can significantly affect quality of life. However, information needs associated with such changes are little understood, resulting in the absence of a knowledge base to guide information provision aimed at preventing or ameliorating distress. This study employs a mixed method analysis, integrating qualitative and quantitative responses to an online survey. Participants were 1965 in iduals with breast cancer (98·8% female) drawn from the membership of a national Australian breast cancer organization. The data were collected over 2 weeks in December 2010. Eighty-five per cent of participants reported changes to sexual well-being after breast cancer, with 68% wanting information on such changes, primarily in a written form. Information on physical changes, sexual response, relationship issues, psychological consequences, and body image or identity, were rated as very important by a substantial proportion of participants. Only 41% had obtained such information however, 65% had spoken about sexual changes, to partner (76%), G.P. (49%), friend/relative (47%), oncologist (39%), or breast-care nurse (21%). Ratings of satisfaction with the discussion were highest for breast-care nurses (60%) and lowest for oncologists (34%). These findings provide clinicians and cancer organizations with specific suggestions about sexual information needs after breast cancer and the modalities which are preferred, to prevent and ameliorate distress.
Publisher: Elsevier BV
Date: 06-2018
DOI: 10.1016/J.SRHC.2018.03.007
Abstract: This study aimed to explore the health care professional (HCP) experiences of working with interpreters when consulting refugee and migrant women who are not proficient in English around sexual and reproductive health (SRH) issues, in order to identify service and policy implications. Semi-structured interviews were conducted with 21 HCPs, including: nurses (8), general practitioners (GP) (5), health promotion officers (5), sexual therapists (2) and one midwife. Interviews were audio-recorded, professionally transcribed and thematically analysed using socio-ecological theory. Overall HCPs stated that language and cultural discordance were barriers to SRH communication with refugee and migrant women. The lack of women interpreters and concerns with the interpreters such as lack of health/SRH knowledge were the main considerations HCPs reported related to working with interpreters when consulting refugee and migrant women. Communication barriers in the provision of SRH services to refugee and migrant women may not be avoided despite the use of interpreters. Great attention needs to be paid to the availability of women interpreters and training of interpreters to work in SRH.
Publisher: Springer Science and Business Media LLC
Date: 09-12-2010
DOI: 10.1007/S10508-008-9416-Z
Abstract: There is a growing body of evidence to show that cancer can result in dramatic changes in sexuality, sexual functioning, and intimate couple relationships, with significant implications for both quality of life and psychological well-being. However, the experiences of intimate partners are often neglected in research on sexuality and intimacy in the context of cancer. This study used a material-discursive framework and a qualitative methodology to investigate the ways in which intimacy and sexuality are renegotiated in the context of cancer, and what factors are associated with successful or unsuccessful renegotiation, from the perspective of partners caring for a person with cancer. Twenty participants were interviewed, across a range of cancer types, stages, and age groups. Eleven participants reported that they were unable to negotiate other ways of being sexually intimate when penetrative sexual intercourse was no longer physiologically possible or desirable. Nine were able to renegotiate sexual intimacy in the context of cancer to include practices previously positioned as secondary to "real sex," such as mutual masturbation, self masturbation, manual stimulation, oral sex, massage, the use of vibrators, kissing, and hugging. Grounded theory analysis identified two themes associated with renegotiation: "Alternative" sexual practices-redefining sexual intimacy, and couple communication and relationship context. Difficulties in renegotiation were associated with adherence to the coital imperative, sexual relationship or communication problems which existed prior to cancer, and the positioning of the person with cancer as a child or an asexual sick patient rather than a sexual partner. The implications for health professional intervention to ameliorate changes to sexuality in the context of cancer are discussed.
Publisher: Hindawi Limited
Date: 20-10-2021
DOI: 10.1111/ECC.13348
Publisher: Springer Science and Business Media LLC
Date: 10-10-2019
DOI: 10.1007/S11013-019-09654-5
Abstract: Bulimia is an eating disorder characterised primarily by binging and 'inappropriate' compensatory behaviours, such as purging or excessive exercise. Many in iduals with bulimia experience chronic disordered eating, dissatisfaction with treatment, and difficulty establishing a 'new life'. Recovery-oriented practice, which focuses holistically on the person and their own aspirations for treatment, has recently been advocated in the treatment of eating disorders in Australia and other countries. However, questions have been raised about how this practice might be integrated into existing treatment approaches. Taking a social constructionist approach and using a case study of one woman's account, together with literature on patients' treatment experiences, we examined recovery from bulimia. Three themes were identified: bulimia was constructed as 'consuming one's life', an experience protracted through treatment ('treatment and becoming the eating disorder'), which makes life 'beyond treatment and attempting to live without bulimia' challenging. Based on this analysis, we argue that recovery-oriented practice, while seemingly commensurate with patients' needs, may be challenged by long-standing meanings of mental illness and experience of bulimia specifically.
Publisher: Informa UK Limited
Date: 06-2013
DOI: 10.1080/08870446.2012.737466
Abstract: Research has increasingly recognised the profound impact that cancer can have upon embodied subjectivity. However, there has been little acknowledgement of the centrality of sexuality to subjectivity, and marginalisation of the experiences of intimate partners of people with cancer. This Australian qualitative study explores the post-cancer experiences of embodied sexual subjectivity for 44 people with cancer (23 women and 21 men) and 35 partners of people with cancer (18 women and 17 men) across a range of cancer types and stages. Semi-structured interviews were analysed with theoretical thematic analysis, guided by a post-structuralist approach to sexual subjectivity as a dynamic process of becoming that can change over time, and by Williams' [(1996). The vicissitudes of embodiment across the chronic illness trajectory. Body and Society, 2, 23-47] framework on post-illness embodiment. Participants took up the following post-cancer subject positions: 'dys-embodied sexual subjectivity' - characterised by bodily betrayal, sexual loss, lack of acceptance, depression, and anxiety 're-embodied sexual subjectivity'--characterised by greater sexual confidence, acceptance, the exploration of non-coital sexual practices and increased relational closeness and 'oscillating sexual subjectivity'--involving a shift between states of sexual dys-embodiment and sexual re-embodiment. The findings point to the importance of focusing on the sexual health of people with cancer and partners across the cancer trajectory.
Publisher: Elsevier BV
Date: 06-2021
Publisher: Wiley
Date: 20-11-2019
DOI: 10.1002/PON.4927
Abstract: Cancer patients experience reproductive concerns from diagnosis through to survivorship. However, research has yet to investigate the degree of fertility-related psychological distress at different treatment time points: diagnosis, treatment, and survivorship. Currently, cancer patients are offered fertility counselling at the time of diagnosis, to assist fertility preservation decision making. A systematic review of the short-term and long-term psychological impact of infertility in cancer patients would inform on an improved, longitudinal model of psychological care. A systematic review of the literature was conducted in January 2018 utilising electronic databases Medline, EMBASE, PSYCH Info, Web of Science, and SCOPUS. An initial search identified 708 potentially relevant studies. Literature was assessed that reported on fertility-related psychological distress experienced by male and female cancer patients of reproductive age (<45 years) across oncology treatment time points. A total of 47 papers were included within the final review. Fertility-related psychological distress persists from diagnosis through to survivorship, with cancer patients reporting a range of negative emotional experiences brought about by threatened infertility. In survivorship, reproductive concerns, unfulfilled desire for a child, nulliparous status, and early menopause were linked to higher rates of mental health disorders and psychological distress. Fertility-related psychological distress is prevalent and persistent in cancer patients and survivors. As such, patients and survivors would greatly benefit from fertility-related psychological support implemented into standard practice from diagnosis through to survivorship. A revised model of care is proposed.
Publisher: Informa UK Limited
Date: 18-06-2018
Publisher: Springer Science and Business Media LLC
Date: 10-05-2018
Publisher: Springer Science and Business Media LLC
Date: 12-04-2013
Publisher: Elsevier BV
Date: 08-2010
DOI: 10.1016/J.MATURITAS.2010.03.027
Abstract: It is widely recognised that women's sexuality can be particularly complex after breast cancer, with sexual changes often becoming the most problematic aspect of a woman's life. The impact of such changes can last for many years after successful treatment, and can be associated with serious physical and emotional side-effects. The objective of this paper is to review research on breast cancer and sexuality from the years 1998 to 2010. Research has documented a range of physical changes to a woman's sexuality following breast cancer, including disturbances to sexual functioning, as well as disruptions to sexual arousal, lubrication, orgasm, sexual desire, and sexual pleasure, resulting from chemotherapy, chemically induced menopause, tamoxifen, and breast cancer surgery. Women's intrapsychic experience of changes to sexuality includes a fear of loss of fertility, negative body image, feelings of sexual unattractiveness, loss of femininity, depression and anxiety, as well as alterations to a sense of sexual self. The discursive construction of femininity and sexuality shapes the way women construct and experience their illness and their body - leading many women to try to appear 'normal' to others post-breast surgery. Finally, the quality of a woman's partnered relationship consistently predicts sexual health post-breast cancer - reinforcing the importance of recognising the intersubjective nature of issues surrounding breast cancer and sexuality. It is concluded that analyses of sexuality in the context of breast cancer cannot conceptualise the physical body separately from women's intrapsychic negotiation, her social and relational context, and the discursive constructions of sexuality and femininity: a material-discursive-intrapsychic interaction.
Publisher: Informa UK Limited
Date: 15-04-2019
DOI: 10.1080/07399332.2019.1566334
Abstract: In this study, adult migrant and refugee women's negotiation of sexual agency in the context of marriage is explored. In Sydney, Australia and Vancouver, Canada, 78 semistructured in idual interviews, and 15 focus groups, comprised of 82 participants, were conducted with women who had recently migrated from Afghanistan, Iraq, Somalia, South Sudan, Sudan, Sri Lanka, and South America. Women's negotiation of sexual agency was evident with respect to husband choice, disclosure of sexual desire, pleasure, pain, and sexual consent. While some participants took up subjugated sexual subject positions reflecting dominant cultural or religious discourses, many women also resisted these discourses to enact sexual agency.
Publisher: Springer International Publishing
Date: 2019
Publisher: American Medical Association (AMA)
Date: 12-11-2021
Publisher: Springer Science and Business Media LLC
Date: 29-07-2014
Publisher: Informa UK Limited
Date: 09-07-2019
DOI: 10.1080/13691058.2019.1627420
Abstract: An online forum analysis was conducted to explore experiences of sexual violence and safety among transwomen, with a particular focus on transwomen of colour. Four online forums were chosen for the analysis. Three key themes were identified: dating and violence in intimate relationships fear of violence and safety strategies and coping after sexual assault. Forum posters faced heightened gender policing and scrutiny, due to not conforming to normative ideals of femininity. Femininity was also predicated on white, middle-class status, and associated with domesticity and romance. As a result, expressions of femininity from non-white backgrounds could be read as deviant or excessive. The intersection of deviation from gender norms and femininity based on whiteness meant that transwomen of colour faced disproportionate levels of violence, both in public and private spaces. Transwomen of colour also faced disadvantage due to participation in higher-risk forms of sex work, low socioeconomic status and employment, and institutional discrimination. Coping mechanisms to deal with cumulative disadvantage included seeking support from health professionals and transgender community networks. However, it also included more harmful forms of self-medicating such as heavy alcohol and drug use, self-harm and suicide attempts.
Publisher: Informa UK Limited
Date: 02-01-2017
Publisher: Springer Science and Business Media LLC
Date: 05-01-2018
Publisher: Informa UK Limited
Date: 02-01-2018
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 25-03-2020
Publisher: Springer Science and Business Media LLC
Date: 19-01-2021
DOI: 10.1186/S12889-021-10188-Y
Abstract: Cancer related infertility can have an impact on couple relationships, with evidence that couple communication facilitates coping. However, little is known about the ways in which couples communicate about cancer-related fertility concerns. The aim of this article is to examine couple communication about fertility concerns in the context of cancer, and the perceived quality of such communication from the perspective of cancer survivors and their partners. Eight-hundred and seventy-eight cancer survivors (693 women, 185 men) and 144 partners (82 women, 62 men), across a range of tumour types and age groups, completed a survey which examined cancer related fertility concerns. Seventy-eight survivors (61 women and 17 men), and 26 partners (13 women and 13 men), participated in semi-structured interviews, in order to examine the subjective experience of fertility concerns in-depth. Thematic analysis was used to analyse the interviews and open ended survey questions. Valid percentages for single items from the relationships subscale of the Fertility Preservation Inventory (FPI) related to qualitative themes, identified frequency of responses. The major theme was ‘talking but not always understanding”. 89.6% of cancer survivors and partners (95.1%) reported working well together handling fertility questions (FPI), but agreed that communication could be improved (65.9% survivors 65% partners). Open and honest couple communication was associated with feelings of support, understanding and relationship growth, including perception of partner comfort (79.2% survivors, 81.6% partners). However, 32% survivors and 31.1% partners concealed fertility concerns to avoid upsetting their partner, or reported that their partner doesn’t understand their fertility concerns (survivors 25.5%, partners 14.6%), with 14.1% of cancer survivors and 19.4% partners reporting fear of relationship breakdown because of fertility issues. Fear of rejection when forming new relationships, and concerns about how to talk to future partners, was reported by non-partnered in iduals. Health-care professionals should include partners of cancer survivors in fertility discussions. Couple interventions developed in general psycho-oncology should be extended to the domain of fertility, in order to facilitate effective couple communication. Communication in future relationships needs to be addressed for single people and adolescents and young adults (AYAs) who have fertility concerns.
Publisher: Hindawi Limited
Date: 30-09-2022
DOI: 10.1111/HSC.13593
Abstract: Loneliness research has tended to focus on mainstream and older populations despite evidence that non-mainstream groups, like those experiencing homelessness, may experience loneliness differently. Limited existing research indicates that (a) people who have been homeless experience loneliness as multidimensional (as a pluralistic, non-unidimensional emotion, experienced specific to lacked relationships) and (b) mainstream loneliness scales may be inappropriate for this group. The current study piloted and appraised the feasibility the short version of the Social and Emotional Loneliness Scale for Adults (SELSA-S) among 129 Australian adults with a lived experience of homelessness. Exploratory Factor Analysis and an observational questionnaire appraisal were used to assess factorial and content validity and showed the measure did not fit this s le as well as in mainstream s les. Removal of items that participants found difficult to comprehend/answer improved the factorial fit of the scale. In conclusion, the SELSA-S may be inappropriate for measuring loneliness among people who have experienced homelessness. Further research needs to explore the potentially different structure of loneliness among marginalised groups so that a better understanding of loneliness can be reached.
Publisher: SAGE Publications
Date: 03-2013
DOI: 10.1136/ACUPMED-2012-010228
Abstract: To determine the feasibility and acceptability of acupuncture in managing fatigue and well-being in breast cancer survivors. A randomised controlled trial compared acupuncture was with sham acupuncture and wait list controls was performed in Sydney, Australia. A total of 30 women with fatigue following breast cancer treatment participated in the trial. Women received six sessions of acupuncture over 8 weeks. Outcomes related to an assessment of interest to participate in the trial and identification of appropriate recruitment strategies, appropriateness of eligibility criteria and compliance with treatment attendance. Clinical outcomes assessed fatigue and well-being. In-depth interviews were undertaken with seven women, who described their experience of acupuncture. Our study demonstrated feasibility with appropriate trial entry criteria, good acceptability and treatment compliance with the study interventions, and with the completion of outcome forms. There was a significant reduction in fatigue for women receiving acupuncture compared with control after 2 weeks mean difference (MD) 5.3, 95% CI 4.5 to 6.2, p=0.05, and a significant improvement in well-being at 6 weeks for acupuncture compared with the sham and wait list control, MD 2.7, 95% CI 2.1 to 3.2, p=0.006. Women described their experience of acupuncture positively, and interview data may also offer explanations for the improved outcomes of well-being, with women reporting an improvement in sleep, mood and relaxation. Fatigue is a common symptom experienced by people recovering from treatment, and an appropriately powered trial to evaluate the effect of acupuncture is needed. Australian New Zealand Clinical Trials Registry, www.anzctr.org.au ACTRN12610000720011.
Publisher: MDPI AG
Date: 16-07-2019
DOI: 10.3390/NU11071611
Abstract: There are limited epidemiological data on exclusive breastfeeding (EBF) among culturally and linguistically erse (CALD) Australian mothers to advocate for targeted and/or culturally-appropriate interventions. This study investigated the determinants of EBF cessation in the early postnatal period among CALD Australian mothers in Sydney, Australia. The study used linked maternal and child health data from two local health districts in Australia (N = 25,407). Prevalence of maternal breastfeeding intention, skin-to-skin contact, EBF at birth, discharge, and the early postnatal period (1–4 weeks postnatal), were estimated. Multivariate logistic regression models were used to investigate determinants of EBF cessation in the early postnatal period. Most CALD Australian mothers had the intention to breastfeed (94.7%). Skin-to-skin contact (81.0%), EBF at delivery (91.0%), and at discharge (93.0%) were high. EBF remained high in the early postnatal period (91.4%). A lack of prenatal breastfeeding intention was the strongest determinant of EBF cessation (adjusted odds ratio [aOR] = 23.76, 95% CI: 18.63–30.30, for mothers with no prenatal breastfeeding intention and aOR = 6.15, 95% CI: 4.74–7.98, for those undecided). Other significant determinants of EBF cessation included a lack of partner support, antenatal and postnatal depression, intimate partner violence, low socioeconomic status, caesarean birth, and young maternal age ( years). Efforts to improve breastfeeding among women of CALD backgrounds in Australia should focus on women with vulnerabilities to maximise the benefits of EBF.
Publisher: Informa UK Limited
Date: 12-2013
DOI: 10.1080/08870446.2013.811242
Abstract: There is consistent evidence that health care professionals (hcps) are not addressing the sexual information and support needs of people with cancer. Thirty-eight Australian hcps across a range of professions working in cancer care were interviewed, to examine constructions of sexuality post-cancer, the subject positions adopted in relation to sexual communication, and the ways in which discourses and subject positions shape information provision and communication about sexuality. Participants constructed sexual changes post-cancer in physical, psychological and relational terms, and positioned such changes as having the potential to significantly impact on patient and partner well-being. This was associated with widespread adoption of a discourse of psychosocial support, which legitimated discussion of sexual changes within a clinical consultation, to alleviate distress, dispel myths and facilitate renegotiation of sexual practices. However, this did not necessarily translate into patient-centred practice outcomes, with the majority of participants positioning personal, patient-centred and situational factors as barriers to the discussion of sex within many clinical consultations. This included: absence of knowledge, confidence and comfort positioning sex as irrelevant or inappropriate for some people and limitations of the clinical context. In contrast, those who did routinely discuss sexuality adopted a subject position of agency, responsibility and confidence.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2013
Publisher: Informa UK Limited
Date: 11-2006
Publisher: Informa UK Limited
Date: 12-08-2016
DOI: 10.1080/00224499.2016.1211600
Abstract: Age is the predominant risk factor for developing prostate cancer, leading to its description as an "older man's disease." Changed sexual embodiment is a concern for men who develop prostate cancer, often compounding experiences of age-related sexual decline. Although research has examined heterosexual men's experiences of aging in the context of sexual embodiment after prostate cancer, gay and bisexual men have received little attention. This qualitative study used a material-discursive analysis, drawing on positioning theory and intersectionality, to explore constructions of aging following prostate cancer in 46 gay or bisexual men. Thematic decomposition of one-to-one interviews identified three subject positions: "mastering youth," involving maintaining an active sex life through biomedical interventions, accessing commercial sex venues, or having sex with younger men "the lonely old recluse," involving self-positioning as prematurely aged and withdrawal from a gay sexual scene and "accepting embodied aging," involving the incorporation of changed sexual function into intimate relationships and finding pleasure through nonsexual activities. These subject positions are conceptualized as the product of intersecting masculine and gay identities, interpreted in relation to broader cultural discourses of "new aging" and "sexual health," in which sexual activity is conceptualized as a lifelong goal.
Publisher: CSIRO Publishing
Date: 20-10-2022
DOI: 10.1071/SH22073
Abstract: Australia’s National Men’s Health Strategy 2020–2030 identifies refugee and migrant men from culturally and lingustically erse backgrounds as priority groups for sexual and reproductive health (SRH) interventions. The paucity of SRH research focusing on refugee and migrant men is a significant gap to advance men’s health and policy. Hence, this review aimed to synthesise the available evidence on refugee and migrant men’s SRH needs, understandings and experiences of accessing services after resettlement in Australia. A systematic search of peer reviewed literature in PubMed, Scopus, and PsyInfo was made. A World Health Organization framework for operationalising sexual health and its relationship with reproductive health was used to map the identified studies. The socio-ecological framework was applied to thematically synthesise data extracted from in idual studies and identify factors that influence the SRH of refugee and migrant men. We included 38 papers in the review. The majority of sexual health studies (16) were about sexually transmitted infections (STIs), mainly HIV (12), followed by sexual health education and information (5) and sexual functioning (3). Reproductive health studies focused on contraceptive counselling and provision (3), antenatal, intrapartum and postnatal care (1) and safe abortion care (1). Several factors influenced refugee and migrant men’s SRH, including a lack of access to SRH information, language barriers and stigma. We found that SRH literature on refugee and migrant men focuses on STIs, meaning other areas of SRH are poorly understood. We identified key gaps in research on experiences of, and access to, comprehensive SRH care.
Publisher: Public Library of Science (PLoS)
Date: 20-07-2017
Publisher: Mary Ann Liebert Inc
Date: 02-2023
Publisher: Springer Science and Business Media LLC
Date: 20-08-2022
DOI: 10.1186/S12905-022-01936-2
Abstract: Participation of culturally and linguistically erse (CALD) women from migrant and refugee backgrounds in cervical screening is crucial to eliminate cervical cancer as a public health problem within the next 20 years. However, CALD women report low participation in cervical screening. Barriers to participation can be addressed with culturally tailored, community-based programs. There is a need for research to explore the process, feasibility, acceptability and barriers to cultural tailoring in the delivery and evaluation of cervical screening health education. CALD community health workers took part in a 2 day training program then co-designed, culturally tailored and co-facilitated cervical screening health promotion forums within their communities. Forums were delivered to a total of seven groups, involving 12 sessions and 71 CALD women. The forums were evaluated for feasibility, acceptability, implementation and effectiveness using a survey, interviews and observations. Data were collected from CALD women, facilitators and researchers. The co-design and co-delivery of cervical screening health promotion forums was time and resource intensive however allowed for deeper cultural tailoring resulting in engagement with ‘hard to reach’ CALD women, improved health literacy and intention to screen. Flexibility in the intervention implementation was crucial to ensure forums were responsive to community interests and needs. Online delivery of the forums in response to the COVID-19 pandemic was acceptable to most groups. Co-designed, culturally tailored cervical screening health promotion forums are feasible and acceptable to CALD women, in both face-to-face and online formats. Adjustments to the intervention protocol were recommended to improve future implementation.
Publisher: Frontiers Media SA
Date: 11-07-2023
Publisher: Informa UK Limited
Date: 02-10-2014
DOI: 10.1080/13691058.2013.833651
Abstract: Minority ethnic immigrant women are frequently vulnerable to poor sexual health outcomes, due to poor use of sexual health services, lack of knowledge and social stigma associated with the discussion of sexuality. This paper explores the sexual health accounts provided by a group of young, unmarried heterosexual Muslim women immigrants residing and studying in Sydney, an under-researched group in the Australian context. Ten semi-structured interviews were conducted, focusing on sex before marriage, spouse selection and contraceptive use. Feminist discourse analysis identified 'purity versus corruption' as the primary construction of women's sexuality, where women positioned their sexual behaviour as that of purity and uninvolvement or corruption through unwedded participation. The subthemes 'maintaining ignorance and naivety', 'remaining virginal', 'sex segregation' and 'the fallen woman' capture women's personal sexuality-related experiences and values within the context of their religious and cultural communities. Additional research with this community is needed to examine the effects of negative social constructions of sex on young sexually active Muslim women, as well as further research on young women's sexual health within immigrant communities.
Publisher: Hindawi Limited
Date: 04-05-2011
DOI: 10.1111/J.1365-2354.2011.01257.X
Abstract: Women cancer carers report higher rates of distress than men however, there is little understanding of the mechanisms underlying these gender differences. The aim of this study was to examine the potential mediating roles of burden of care, unmet needs, self-silencing, self-efficacy and optimism, and the potential moderating influence of social support, cancer stage, patient gender, time spent caring and other responsibilities, on gender differences in carer distress. Of 329 informal cancer carers (245 women, 119 men), women reported significantly more anxiety, burden of care and unmet needs than men. In the mediation analysis, gender differences in anxiety were fully explained by both the independent contribution and combination of: Disrupted Schedule, Health Problems and Emotional and Spiritual Unmet Needs. Women cared for both men and women patients, across a broad range of relationships, whereas men predominantly cared for their female partner. There was no gender difference in number of hours spent caring or in companionship, amount of support received, and additional responsibilities for children, housework or studies, and none of these factors acted as moderators of gender differences in anxiety. It is concluded that women's gendered role is associated with unmet needs and burden of care, resulting in greater anxiety.
Publisher: Wiley
Date: 09-2021
DOI: 10.1002/CASP.2485
Publisher: Springer Science and Business Media LLC
Date: 14-02-2012
Publisher: Springer Science and Business Media LLC
Date: 03-01-2014
Abstract: Negative premenstrual change can result in distress for a significant proportion of women. Previous research has suggested that women employ a range of coping strategies and behaviours in order to manage and reduce premenstrual distress. However, as yet there has been no specific scale available to measure premenstrual coping. This research aimed to develop and validate a measure of premenstrual coping which can be used in future investigations of negative premenstrual experience. A s le of 250 women living in Australia, reporting mild to severe premenstrual distress, completed an online survey containing 64 items related to premenstrual coping. The items were generated by reviewing past literature related to premenstrual experience, in particular recent qualitative research on premenstrual coping. A principal components factor analysis with varimax rotation was conducted to determine item clusters that would form a measure. Reliability and validity were tested using calculations of Cronbach alphas, correlational analysis with psychological coping scales and a content analysis of participant reports of coping strategies. The factor analysis, which involved two principal component analyses, resulted in five factors containing 32 premenstrual coping behaviours. Interpretation of the factor solution drew on empirical and theoretical accounts of premenstrual coping and the emergent factors were labelled Avoiding Harm, Awareness and Acceptance of Premenstrual Change, Adjusting Energy, Self-Care, and Communicating. These factors form the subscales of the Premenstrual Coping Measure (PMCM). The subscales demonstrated acceptable to very good reliability and tests of construct, concurrent and content validity were supportive of sound validity. The PMCM provides a valid and reliable scale for quantifying ways of coping specific to negative premenstrual change. Conceptual similarity was found between some coping behaviours and behaviours positioned as symptoms of premenstrual change. Explanations for this overlap may be found in cultural discourses associated with idealised femininity and PMS (premenstrual syndrome). Further psychometric investigation of the PMCM will enhance knowledge of the role of coping with negative premenstrual experience.
Publisher: SAGE Publications
Date: 07-04-2015
Abstract: Medical discourse has positioned the menopausal transition as a time of sexual atrophy and loss of femininity, with hormonal replacement as the solution. In contrast, feminist critics have argued that women’s experience of sexual embodiment during menopause is culturally and relationally mediated, tied to discursive constructions of aging and sexuality, which are negotiated by women. The aim of this article is to present a critical examination of women’s experiences of sexuality during and after the menopausal transition, drawing on previous research in this field, as well as qualitative research we have conducted with women at midlife, and women who have experienced premature menopause as a consequence of cancer treatment. We aim to challenge myths and misconceptions about the inevitability of sexual decline at menopause, as well as normalise the embodied changes that some women experience – whether menopause is premature, or occurs at midlife. We argue that sexual difficulties or disinterest reported by women during and after menopause are more strongly associated with psycho-social factors than hormonal status, in particular psychological well-being, relationship context and a woman’s negotiation of cultural constructions of sex, aging and femininity. However, sexuality can continue to be a positive experience for women throughout adult life and into old age, with many menopausal women reporting increased sexual desire and response. This undermines the biomedical construction of menopause as a time of inevitable sexual atrophy and decay.
Publisher: Springer Science and Business Media LLC
Date: 05-01-2018
Publisher: Springer Science and Business Media LLC
Date: 21-10-2019
DOI: 10.1186/S12884-019-2501-6
Abstract: Sub-Saharan Africa has the highest rate of adolescent pregnancy in the world. While pregnancy during adolescence poses higher risks for the mother and the baby, the utilisation of maternity care to mitigate the effects is low. This review aimed to synthesise evidence on adolescent mothers’ utilisation of maternity care in Sub-Saharan Africa and identify the key determinant factors that influence adolescent mothers’ engagement with maternity care. A systematic review of scholarly literature involving seven databases: ProQuest, PubMed, EMBASE/Elsevier, SCOPUS, PsycINFO, CINAHL and Infomit was conducted. Studies published in English between 1990 and 2017 that examined Sub-Saharan adolescent mothers’ experiences of utilising biomedical maternity care during pregnancy, delivery and the post-partum period were included. From 296 relevant articles 27 were identified that represent the experience of adolescent mothers’ maternal health service utilisation in Sub-Saharan Africa. The review indicates that maternal health service utilisation in the majority of Sub-Saharan African countries is still low. There is also a wide discrepancy in the use of maternity care services by adolescent mothers across countries in Sub-Saharan Africa. The review reveals that a significant number of adolescents in Sub-Saharan Africa do not access and use maternity services during pregnancy. Several factors from in idual to systemic levels contributed to low access and utilisation. This implies that interventions targeting the women, their partners, healthcare professionals, communities and the organisations (local to national) are necessary to improve adolescent mother’s engagement with maternity care in Sub-Saharan Africa.
Publisher: SAGE Publications
Date: 04-04-2013
Abstract: Women cancer carers have consistently been found to report higher levels of distress than men carers. However, there is little understanding of the mechanisms underlying these gender differences in distress, and a neglect of rewarding aspects of care. We conducted in-depth semistructured interviews with 53 informal cancer carers, 34 women and 19 men, to examine difficult and rewarding aspects of cancer care. Thematic analysis was used to analyze the transcripts. Women were more likely to report negative changes in the relationship with the person with cancer neglect of self, social isolation, and physical health consequences anxiety personal strength and growth and to position caring as a privilege. Men were more likely to report increased relational closeness with the person with cancer, and the burden of additional responsibilities within the home as a difficult aspect of caring. We interpret these findings in relation to a social constructionist analysis of gender roles.
Publisher: Springer Science and Business Media LLC
Date: 12-01-2017
Publisher: Springer Science and Business Media LLC
Date: 15-06-2017
DOI: 10.1007/S10903-017-0611-7
Abstract: This Q methodological study was conducted to examine the perspectives of health professionals in providing sexual and reproductive health (SRH) care to refugee and migrant women. Forty-seven health professionals rank-ordered 42 statements and commented on their rankings in subsequent open-ended questions. A bi-person factor analysis was performed and factors were extracted according to the centroid method with a varimax rotation. Seven factors each with a distinct and meaningful viewpoint were identified. These factors are: "Communication difficulties-hurdles to counselling", "Lack of access to culturally appropriate care", "Navigating SRH care", "Cultural constraints on effective communication", "Effects of the lack of cultural competency", "Impacts of low income and language barrier" and "SRH services are accessible, but not culturally relevant". A more culturally adaptive healthcare model that considers refugee and migrant women's linguistic, cultural and socio-economic backgrounds and engages health professionals on an ongoing process of building cultural competency is central to improve SRH access to these women.
Publisher: Mary Ann Liebert Inc
Date: 10-2011
Abstract: The study objectives were to examine the effectiveness of acupuncture for reducing infertility-related stress. The study design was a randomized controlled trial of acupuncture compared with a wait-list control. The study was conducted at The University of Western Sydney. Thirty-two (32) women aged 20-45 years, with a diagnosis of infertility, or a history of unsuccessfully trying to conceive for 12 months or more, were the subjects of the study. Women received six sessions of acupuncture over 8 weeks. The primary outcomes were infertility self-efficacy, anxiety, and infertility-related stress. The women's experience of infertility and acupuncture is also reported. At the end of the 8-week intervention, women in the acupuncture group reported significant changes on two domains on the Fertility Problem Inventory with less social concern (mean difference [MD] -3.75, 95% confidence interval [CI] -7.58 to 0.84, p=0.05), and less relationship concern (MD -3.66, 95% CI -6.80 to -0.052, p=0.02). There were also trends toward a reduction of infertility stress on other domains, and a trend toward improved self-efficacy (MD 11.9, 95% CI -2.20 to 26.0, p=0.09) and less anxiety (MD -2.54, 95% CI -5.95 to 0.86, p=0.08) in the acupuncture group compared with the wait-list control. Women described the experience and impact of acupuncture as positive relating to a sense of relaxation and time out, the engagement with the practitioner, and an intervention that had very few negative side-effects. Changes were also perceived after treatment with women describing a physical and psychologic sense of relaxation and calmness, and a changed perspective in relation to coping. Acupuncture may be a useful intervention to assist with the reduction of infertility-related stress. Further research is justified.
Publisher: British Medical Journal Publishing Group
Date: 03-2021
Publisher: Springer Science and Business Media LLC
Date: 31-05-2013
Publisher: SAGE Publications
Date: 16-11-2017
Abstract: Multiple sclerosis can impact affected women’s experiences of motherhood through physical and cognitive impairment. This study examined how women construct and experience motherhood while living with multiple sclerosis. Twenty mothers diagnosed with multiple sclerosis took part in semi-structured interviews. Transcripts were analysed using theoretical thematic analysis, drawing on feminist poststructuralist theory to organise and interpret themes. Two main themes were identified: “Performing motherhood in the context of MS” and “Bringing up a ‘good’ child”. “Performing motherhood in the context of MS” comprises the subthemes, “The self-sacrificing mother: Negating women’s needs”, “The unreliable mother: Adjusting day-to-day mothering practices”, and “Resisting discourses of idealised motherhood”. “Bringing up a ‘good’ child”, comprises the subthemes, “The damaging mother: Fear of harming the child” and “The good mother: Caring and building resilience in the child”. Women positioned themselves as failing to be good mothers, because of limitations to their mothering, and fear of damaging children. Focusing on building children’s emotional resilience functioned to restore constructions of “good” mothering. Acknowledging how Western cultural ideals influence women’s experience of mothering when living with chronic illness is important. Health professionals can provide support by addressing women’s feelings of failure as mothers and supporting communication with children.
Publisher: MDPI AG
Date: 09-09-2020
Abstract: This paper discusses the way that trans women embody their transgender identity, focusing on identity questioning, gender dysphoria, clinical gatekeeping and medicalized narratives. Situated within the hermeneutics methodological approach, we adopted the unobtrusive research as our research method, where data was derived from online forums where trans women posted content about their perspectives and experiences of gender and gender transitioning. Thematic analysis method was used for data analysis. Our findings suggest that gender identity is embodied and socially negotiated. Many trans women were initially ambivalent about their transgender identity and some continued to question their desired identity throughout adulthood. When presenting to healthcare professionals many trans women reported being expected to adopt a ‘wrong body’ narrative in order to gain access to treatment and surgery for gender transitioning and affirmation. In doing so, trans women interact with significant others and health care providers, and face many challenges. These challenges must be understood so that trans women can perform self-determination practices as a way to achieve gender autonomy.
Publisher: Springer Science and Business Media LLC
Date: 22-07-2016
Publisher: Springer Science and Business Media LLC
Date: 05-03-2018
Publisher: Elsevier BV
Date: 2021
Publisher: SAGE Publications
Date: 04-02-2016
Abstract: Cancer and cancer treatments can cause significant changes to women’s sexual well-being. We explored how women construct a sense of their bodies and sexual “selves” in the context of cancer. Sixteen women, across a range of ages (20–71 years), cancer types, and cancer stages, took part in in-depth semistructured interviews. We conducted a thematic discourse analysis, drawing on feminist poststructuralist theory, identifying “the abject body” as a dominant theme. Participants constructed abject bodies as being “beyond abnormality,” “outside idealized discourses of embodied femininity,” and “out of control.” The women’s accounts varied in management and resistance of the abject body discourse, through bodily practices of concealment, resisting discourses of feminine beauty, and repositioning the body as a site of personal transformation. The corporeality of the cancerous body can be seen to disrupt hegemonic discourses of femininity and sexuality, with implications for how women practice and make meaning of embodied sexual subjectivity.
Publisher: Informa UK Limited
Date: 26-04-2017
DOI: 10.1080/08870446.2017.1320799
Abstract: Many women experience premature menopause following cancer treatment, accompanied by psychological distress, and poor health-related quality of life. In this qualitative study, we examined how women construct their gendered subjectivities - their sense of self as a woman - in the context of premature menopause after cancer. We analysed data from open-ended survey items and semi-structured interviews with women who had experienced cancer. Six hundred and ninety-five women completed the online survey and 61 took part in a semi-structured interview. A thematic decomposition was conducted to identify the subject positions associated with menopause taken up by the women. Three overall themes were identified: 'The Incomplete Woman,' 'The Abject, Asexual Woman' and 'Out of Time and Social Isolation.' Menopause was predominantly constructed as a negative experience, similar to older post-menopausal women and dissimilar to peers, contributing to experiences of social isolation. Menopause also signified the presence of a medically diagnosed cancer condition, and uncertainty around cancer prognosis. It is important for cancer support group leaders and other service providers to be sensitive to women's negotiation of menopause following cancer, in the context of broader cultural constructions, in order to provide appropriate information and support.
Publisher: Elsevier BV
Date: 09-2011
DOI: 10.1016/J.MATURITAS.2011.06.013
Abstract: Research in the area of gynaecological cancer has increasingly examined changes to women's sexuality, with the impact of treatment on sexual wellbeing considered particularly important. The objective of this paper is to review research on gynaecological cancer and sexuality from the years 1990 to 2011. Research has documented a range of post-treatment anatomical and physical changes to women's sexual wellbeing, including changes to sexual desire, pleasure, orgasm, vaginal lubrication, genital sensitivity, arousal, and frequency of sex. Women's intrapsychic experiences of changes to sexuality include anxiety, depression, distress, and negative perceptions of sexual identity and body image. Socially constructed discourses surrounding gender and sexuality also shape women's experiences of their sexual wellbeing post-gynaecological cancer and treatment, with many women feeling a loss of womanhood and femininity with the removal of, or changes to, their reproductive organs. Finally, women's relationship context, pattern of couple communication, and partner support are associated with women's ability to cope with changes to sexuality post-gynaecological cancer. Given that sexuality is an important part of quality of life, it is important that health professionals actively communicate information to women and their partner about the effects of treatment on sexual wellbeing, in order to legitimate and normalise sexuality in this context. It is concluded that research in the area of gynaecological cancer and sexuality needs to acknowledge not only the physical/anatomical/material effects of cancer treatments, but also women's intrapsychic experiences of changes to sexuality, her relationship context, and the role of gendered discourses in shaping women's experiences of sexuality post-gynaecological cancer and treatment.
Publisher: SAGE Publications
Date: 18-12-2017
Abstract: The significant impact of cancer on women’s sexual well-being has been acknowledged increasingly within research. However, the role of cultural discourse in shaping women’s construction and embodied experience of sexuality has received less attention. In this study, we examined heterosexual women’s constructions of sexual embodiment in the context of cancer. Sixteen women across a range of ages (20–71 years), cancer types and stages took part in in-depth semi-structured interviews. A thematic decomposition analysis was conducted on the interview transcripts, drawing on feminist poststructuralist theory. A main theme was identified in which the women took up subject positions of “Embodying sexuality” and “Embodying the absence of sexuality”. Accounts of “Embodying sexuality” included “Experiencing bodily ease during sex” and “Managing a dysfunctional body during sex”. The women’s positioning of “Embodying the absence of sexuality” included “Asexuality and the absence of desire” and “Unsuccessful attempts to renegotiate sex”. Women’s intrapsychic negotiation of sexual and gendered discourse, the materiality of embodied change and relationship context influenced their constructions of sexual subjectivity. These findings indicate a need for researchers and clinicians to acknowledge cultural discourses of sex and gender that shape the possibilities and constraints for women’s sexual well-being after cancer.
Publisher: SAGE Publications
Date: 19-06-2014
Abstract: This research examines the construction and experience of premenstrual syndrome (PMS) in the context of intimate couple relationships, through examination of two contrasting cases analysed using thematic decomposition of narrative interviews. Judith and her male partner pathologised premenstrual change, constructing the premenstrual self as out of control, and the epitome of the ‘monstrous feminine’. Judith reported feeling over-burdened and uncontrollably angry premenstrually, associated with relationship issues and absence of partner recognition or support. In contrast, Sophia normalised premenstrual change, challenging the association between PMS and the construction of woman as deviant or dysfunctional. Sophia reported heightened energy and creativity premenstrually, and engaged in self-care supported by her woman partner. These cases demonstrate that premenstrual distress is an intersubjective experience, with constructions and material practices within relationships providing the context for premenstrual women being positioned as pathological and needing to be contained, or conversely, as sensitive and needing support.
Publisher: Hindawi Limited
Date: 04-10-2018
DOI: 10.1111/HSC.12505
Abstract: Both loneliness and a lack of social integration are associated with serious physical and psychological health issues. One population highly susceptible to social isolation and loneliness are in iduals who are homeless, who also experience high rates of mental disorder and relationship breakdown. Despite this, little research has explored how social networks, isolation and loneliness are experienced for those with a history of homelessness. In-depth, semi-structured interviews were used to get a nuanced understanding of how social networks and isolation are experienced and understood by in iduals experiencing homelessness. Sixteen participants who were either homeless (n = 11) or previously homeless (n = 5) in Sydney, Australia, completed one-off interviews that were audio-recorded and transcribed. Data were analysed using thematic analysis. Participants constructed their social networks as being both constrained and enabled by marginalisation. They experienced rejection from the non-homeless: the loss of critical network members, including rejection from family and a lack of companionship, and low quality and precarious relationships within the homeless community. These accounts were best conceptualised through loneliness theory. Participant's accounts signal that the homeless will likely continue feeling isolated if mainstream attitudes towards homelessness remain stigmatising and discriminatory.
Publisher: Informa UK Limited
Date: 11-02-2021
Publisher: MDPI AG
Date: 03-2019
Abstract: : Antenatal care (ANC) services are an essential intervention for improving maternal and child health worldwide. In Ethiopia, however, ANC service use has been suboptimal, and examining the trends and factors associated with ANC service use is needed to inform targeted maternal health care interventions. This study aimed to investigate the trends and determinants of ANC service utilisation in Ethiopia for the period ranging from 2000 to 2016. This study draws on the Ethiopia Demographic and Health Survey data for the years 2000 (n = 7928), 2005 (n = 7276), 2011 (n = 7881) and 2016 (n = 7558) to estimate the trends in ANC service utilisation. Multivariate logistic regression models with adjustment for clustering and s ling weights were used to investigate the association between the study factors and ANC service utilisation. Over the sixteen-year period, the proportion of Ethiopian women who received the recommended four or more ANC visits increased from 10.0% (95% confidence interval (95% CI: 8.7–12.5%) in 2000 to 32.0% (95% CI: 29.4–34.3%) in 2016. Similarly, the proportion of women who received one to three ANC visits increased from 27.0% (95% CI: 23.6–30.7%) in 2000 to 62.0% in 2016 (95% CI: 60.4–67.3%). Multivariate analyses showed that higher maternal and paternal education, higher household wealth status, urban residency and previous use of a contraceptive were associated with ANC service use (1–3 and 4+ ANC visits). The study suggests that while Ethiopian pregnant women’s engagement with ANC services improved during the millennium development goal era (2000–2015), recommended ANC use remains suboptimal. Improving the utilisation of ANC services among pregnant women is essential in Ethiopia, and efforts should focus on vulnerable women.
Publisher: Wiley
Date: 21-04-2021
DOI: 10.1002/PON.5703
Abstract: This study evaluated the acceptability and impact of a written oncofertility educational resource (ER), as a self‐help intervention (SH), and as an adjunct to a one‐hour health‐care professional discussion (HP). Within a randomized control trial (RCT), 194 adults with cancer (175 womens 19 mens) were allocated to the SH or HP intervention. 127 completed 6‐weeks post‐intervention measures, a retention rate of 65.85%. Across interventions, the ER was rated as highly acceptable and useful, in terms of ease of understanding, and information. Heath literacy significantly increased post‐intervention, including functional literacy, communicative literacy, and critical health literacy. There were no significant changes in ratings of fertility distress or general distress pre‐post intervention. Quality of life was significantly reduced post intervention. Those in the HP condition reported higher quality of life and greater likelihood of communication with others about fertility, most notably with intimate partners, post‐intervention. Qualitative identification of increased knowledge, confidence with communication and normalization of fertility concerns, reflects increased health literacy, and provides explanation for significant reductions in feeling nervous and fearful about fertility treatments post‐intervention. Our findings confirm the importance of information provision about the impact of cancer on fertility. Written ERs are a useful adjunct to a patient‐clinician discussion, increasing health literacy, which facilitates knowledge, self‐efficacy and management of fertility concerns and changes.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2009
Publisher: SAGE Publications
Date: 13-10-2016
Abstract: In this article, we explore how young women encounter and counter discourses of smoking-related stigma. Twenty-seven young Australian women, smokers and ex-smokers, took part in interviews. A sub-s le of 18 participants took photographs to document their smoking experience, and took part in a second interview. Data were analyzed through Foucauldian discourse analysis. Four discourses were identified: "smoking as stigmatized," "the smoking double standard," "smoking as lower class," and "smokers as bad mothers." The women negotiated stigma in a variety of ways, shifting between agreeing, disagreeing, challenging, and displacing stigma onto "other" smokers. These experiences and negotiations of smoking-related stigma were shaped by intersecting identities, including gender, cultural background, social class, and mothering, which at times, compounded levels of stigmatization. It is concluded that tobacco control measures should consider the negative implications of smoking-related stigma, and the potential for women to experience compounding levels of stigma.
Publisher: SAGE Publications
Date: 13-10-2016
Abstract: Bulimia, an eating disorder that affects more women than men, involves binging and compensatory behaviors. Given the importance of food in experiences of these behaviors, in this article, we examine constructions of food in accounts of bulimic behavior: how these constructions relate to cultural discourses, and their implications for subjectivity. Fifteen women who engaged in bulimic behaviors were interviewed. Through a thematic decomposition of their accounts, we identified six discursive constructions of food: "good/healthy" or "bad/unhealthy," "contaminating body and soul," "collapsed into fat," "pleasurable reward," "comfort," and "fuel for the body." Many constructions were consolidated through participants' embodied experiences, but made available through discourses in public health, biomedicine, and femininity, and had implications for subjectivity in terms of morality, spirituality, and self-worth. Thus, despite women deploying these constructions to make sense of their bulimic behaviors, they are culturally normative this point has implications for therapeutic and preventive strategies for bulimia.
Publisher: Informa UK Limited
Date: 26-09-2022
DOI: 10.1080/13557858.2021.1980772
Abstract: Migrant and refugee women experience inequities in sexual and reproductive health (SRH) care, reflected in the low uptake of SRH services. It is essential for healthcare providers and educators to be aware of women's preferences for SRH information and service delivery, to provide culturally responsive care. Identifying migrant and refugee women's preferences for SRH information and service delivery is the objective of this study. This study investigated this issue, in communities of migrant and refugee women living in Australia and Canada. Eighty-four in idual interviews and 16 focus groups comprising 85 participants were conducted (total Thematic analyses identified that migrant and refugee women are enthusiastic to learn about SRH across the lifespan, using a variety of modalities including group education delivered by community leaders online and written material and information provided by general practitioners. Participants emphasised the need for empathetic SRH care, which encompassed longer times for consultations, being seen as experts of their own bodies, privacy and healthcare provided by women practitioners. Greater engagement with migrant and refugee men was positioned as an additional solution to addressing SRH concerns of women. Insights from this study can help facilitate the co-design and evaluation of acceptable and sustainable programs to address inequities in SRH experienced by migrant and refugee women.
Publisher: SAGE Publications
Date: 22-12-2011
Abstract: It is widely accepted that cancer is an intersubjective experience that impacts upon the psychological well-being of people with cancer and informal carers, as well as on couple relationships. This qualitative study examined the nature and consequences of cancer on the relationship between informal carers and the person with cancer, from the perspective of Australian cancer carers. Sixty-two carers (42 women and 20 men), across a range of cancer types, stages and relationship dyads took part in semi-structured interviews. Participants reported that cancer had precipitated a change in roles and in the dynamics of the relationship, including having to take on quasi-medical tasks and decisions, neglecting self and other relationships, changes to the emotions or personality of the person with cancer, changed patterns of communication, and changes to sexuality and intimacy. The impact of the changed relationship included sadness, anger and frustration, as well as feelings of love and being closer together, resulting in relationship enhancement. Women were more likely to report changes in the person with cancer and to mourn the previous relationship, while more men reported relationship enhancement.
Publisher: Springer Science and Business Media LLC
Date: 28-03-2014
Publisher: Informa UK Limited
Date: 06-07-2017
DOI: 10.1080/00224499.2017.1336745
Abstract: Constructions of normative sexuality shape the sexual scripts that women are permitted to adopt and the manner in which such sexuality can be expressed. We explored experiences and constructions of premarital sexuality among migrant and refugee women recently resettled in Sydney, Australia, and Vancouver, Canada. A total of 78 semistructured in idual interviews and 15 focus groups composed of 82 participants were undertaken with women who had migrated from Afghanistan, Iraq, Somalia, South Sudan, Sudan, Sri Lanka, and South America. We analyzed the data using thematic decomposition. Across all cultural groups, women's premarital sexuality was regulated through cultural and religious discourse and material practice. Such regulation occurred across three main facets of women's lives, shaping the themes presented in this article: (1) regulating premarital sex-the virginity imperative (2) regulation of relationships with men and (3) regulation of the sexual body. These themes capture women's reproduction of dominant discourses of premarital sexuality, as well as women's resistance and negotiation of such discourses, both prior to and following migration. Identifying migrant and refugee women's experiences and constructions of premarital sexuality is essential for culturally safe sexual health practice, health promotion, and health education.
Publisher: American Psychological Association (APA)
Date: 2005
Abstract: People with a psychiatric disability can experience difficulty in gaining and maintaining employment. Some of these difficulties are related to problems in managing employment-related stress. The aim of this study was to pilot a vocationally-oriented cognitive behavioral therapy (CBT) training program for people receiving public mental health services in Australia. Thirteen participants completed the program and reported significant improvements in general mental health, optimism and attitudes to work following training. The utility of CBT approaches to vocational rehabilitation for people with a psychiatric disability requires rigorous testing. It is likely that this approach may best be used in conjunction with other programs such as supported employment.
Publisher: Informa UK Limited
Date: 03-10-2019
DOI: 10.1080/13691058.2018.1514069
Abstract: There has been a call for research on migrant and refugee women's negotiation of erse discourses and cultural constraints associated with sexual embodiment, including menopause, in order to facilitate sexual and reproductive health and understand gendered subjectivity. This study examined the construction and experience of menopause among migrant and refugee women who had settled in Australia or Canada in the last 10 years. Eighty-four in idual interviews and 16 focus groups comprising 85 participants were conducted (total n = 169), with women aged 18 years and over from Afghanistan, India (Punjab), Iraq, Somalia, South Sudan, Sri-Lanka (Tamil), Sudan and various South American (Latina) backgrounds. Thematic decomposition identified three discursive themes: Menopause as the Age of Despair a Discourse of Silence and Secrecy and Menopause as a Life Stage - or when Life Starts. Negative constructions of menopause, associated with silence and secrecy, were evident across different cultural groups, with implications for women's positioning and experience of menopausal change and embodiment. However, resistance to negative discourse was also evident. This was primarily associated with having received menopause education and more open communication about menopausal change, suggesting that education and health information can facilitate affirming aspects of menopause.
Publisher: Hindawi Limited
Date: 26-02-2016
DOI: 10.1111/ECC.12469
Abstract: Although sexual changes after prostate cancer (PCa) have specific meanings and consequences for gay and bisexual (GB) men, little is known about how GB men navigate sexual well-being support. We surveyed 124 GB men with PCa and 21 male partners, and interviewed a sub-s le of 46 GB men and 7 male partners, to examine GB men's experiences of sexual communication with healthcare professionals (HCPs) since the onset of PCa. GB men perceived a number of deficits in HCPs communication: medical support dominated sexual and psychological support heterosexuality of GB patients was often assumed sexual orientation disclosure was problematic and GB men perceived rejection or lack of interest and knowledge from a majority of HCPs with regard to gay sexuality and the impact of PCa on GB men. Facilitators of communication were acknowledgement of sexual orientation and exploration of the impact of PCa on GB men. In order to target improved support for GB men with PCa, it is concluded that HCPs need to address issues of hetero-centricism within PCa care by improving facilitation of sexual orientation disclosure, recognising that GB men with PCa might have specific sexual and relational needs, and increasing knowledge and comfort discussing gay sexuality and gay sexual practices.
Publisher: Cambridge University Press (CUP)
Date: 06-2009
DOI: 10.1017/S1478951509000248
Abstract: Many studies have identified negative and distressing consequences experienced by informal cancer carers, but less attention has been given to positive and beneficial aspects of caring. This qualitative study examined the positive aspects of caring as subjectively constructed by bereaved informal cancer carers, a group of in iduals who are in a position to make sense of their caring experiences as a coherent whole. Twenty-three bereaved informal cancer carers were interviewed, and their accounts were analyzed using a thematic analytical approach from a phenomenological perspective. The participants were able to identify positive and beneficial aspects of caring. These included the discovery of personal strength, through adversity, acceptance, and necessity the deepening of their relationship with the person for whom they cared and personal growth through altered relationships with others and altered perspectives on living. Many participants gave accounts of focusing on these positive benefits when they reflected on their caring experiences. We concluded that benefit finding in the face of adverse events serves an important function in allowing in iduals to incorporate difficult experiences into their worldview in a meaningful way, thus maintaining positive beliefs about the world. This has implications for the development of interventions for informal cancer carers and for those who are bereaved following caring.
Publisher: SAGE Publications
Date: 03-2017
Abstract: Previous research has found that young women’s smoking relates to their performance of feminine gender identities. Using an intersectional approach, we explore in this study how young women’s smoking is implicated in the doing and undoing of femininities, as well as other intersecting identities. Discourse analysis was used to examine interviews and a photography activity conducted with young women, both current and ex-smokers. This analysis revealed four culturally dominant repertoires: “cigarettes and smoking styles as gendered”, “smoking as controlling weight”, “smoking as a sexual tool”, and “smoking as compromising appearance”. Young women’s experiences and negotiations of discourse surrounding smoking and femininity were shaped by intersecting social class and sexual identities. These findings can be used to inform the development of smoking cessation interventions which recognise the ersity in how young women perform femininity.
Publisher: Informa UK Limited
Date: 11-2006
Publisher: MDPI AG
Date: 29-12-2020
Abstract: Background: Most maternal deaths in the world occur during the postpartum period, especially within the first two days following delivery. This makes postnatal care (PNC) critical to improving the chances of maternal and child survival. Over the past 20 years, the proportion of women receiving antenatal care (ANC) in Ethiopia has increased while the proportion of those receiving PNC has remained low. This study aimed to understand the trends, determinants and urban–rural variations of PNC service utilisation. Methods: This study draws on the Ethiopian Demographic and Health Survey (EDHS) data for the years 2000 (n = 4552), 2005 (n = 4467), 2011 (n = 4445) and 2016 (n = 4275) to estimate the trends and determinants of PNC service utilisation. Multivariate logistic regression models with adjustment for clustering and s ling weights were used to investigate the association between the independent factors, the study factors and PNC service utilisation. Results: Over the twenty-year period of the EDHS, the proportion of Ethiopian women who received PNC services increased from 5.6% (95% CI: 4.6–6.9%) in 2000 to 18.5% (95% CI: 16.4–20.7%) in 2016. Similarly, women who received PNC services in urban areas increased from 15.2% (95% CI: 23.6–30.7%) in 2000 to 47% (95% CI: 60.4–67.3%) in 2016. Women who were in the wealthy quintile, had ANC visits, delivered in a health facility, and delivered by caesarean section were most likely to have PNC. The present study also showed that whilst birth spacing was a significant factor among urban women, wealth index, ANC visits, and perception of health facility distance were significant factors among rural women. Conclusions: The study suggests low levels of utilisation of PNC among Ethiopian women from rural districts. Geographically targeted interventions with a focus on low-socioeconomic rural women, and those with no previous contacts with the health system during pregnancy, are needed to improve PNC in Ethiopia.
Start Date: 10-2011
End Date: 12-2016
Amount: $489,824.00
Funder: Australian Research Council
View Funded ActivityStart Date: 06-2013
End Date: 03-2017
Amount: $171,663.00
Funder: Australian Research Council
View Funded ActivityStart Date: 2009
End Date: 03-2014
Amount: $420,000.00
Funder: Australian Research Council
View Funded ActivityStart Date: 06-2005
End Date: 01-2010
Amount: $238,000.00
Funder: Australian Research Council
View Funded ActivityStart Date: 05-2014
End Date: 05-2017
Amount: $271,144.00
Funder: Australian Research Council
View Funded ActivityStart Date: 01-2019
End Date: 10-2022
Amount: $369,960.00
Funder: Australian Research Council
View Funded ActivityStart Date: 08-2008
End Date: 12-2012
Amount: $405,308.00
Funder: Australian Research Council
View Funded Activity