What is the Relationship between Widowhood What is the Relationship between Widowhood and Occupational Restructuring Amongst Older and Occupational Restructuring Amongst Older
Adult Women?Adult Women?
Group OneGroup OneNadia Abdel-Hafez, Vivien Chan, Paul Furtado, Melissa Lamasan,Nadia Abdel-Hafez, Vivien Chan, Paul Furtado, Melissa Lamasan,
Heather Moyse, Katherine Reece, Tatum WilsonHeather Moyse, Katherine Reece, Tatum Wilson
Seminar Presentation November 22nd, 2004
Presentation OutlinePresentation Outline
Working DefinitionsWorking Definitions Thought Evolution & Thought Evolution &
Research ProcessResearch Process Initial ModelInitial Model Critical AppraisalCritical Appraisal Additional FindingsAdditional Findings Final ModelFinal Model Gaps & Constructive Gaps & Constructive
Research ApproachesResearch Approaches ConclusionConclusion Facilitated DiscussionFacilitated Discussion
Working DefinitionsWorking Definitions
WidowhoodWidowhood “…“…bereavement followed by adjustment to a bereavement followed by adjustment to a
new role…” (Treas & Bengtson, 1987)new role…” (Treas & Bengtson, 1987) State, condition of having lost one’s spouse to State, condition of having lost one’s spouse to
death (webster-dictionary.org, 2004)death (webster-dictionary.org, 2004)
Occupational RestructuringOccupational Restructuring Change in occupational engagement and/or Change in occupational engagement and/or
meaning as a result of life events meaning as a result of life events
Process of Finding our Question
1. Brainstorming Ideas1. Brainstorming Ideas Discussion of different topicsDiscussion of different topics Empty nest syndrome and its impact on Empty nest syndrome and its impact on
occupation vs. widowhood and its impact on occupation vs. widowhood and its impact on occupationoccupation
Consensus: WidowhoodConsensus: Widowhood Widowhood involves a more traumatic experienceWidowhood involves a more traumatic experience
Thought Process Cont’d
2. Preliminary Questions2. Preliminary Questions
Discussion of focus: adults, gender, generation Discussion of focus: adults, gender, generation
11stst question: question:““What are the effects of widowhood on female What are the effects of widowhood on female occupation – A generational comparison”occupation – A generational comparison”
Problem:Problem:
- This question limited the study to - This question limited the study to only only quantitative research quantitative research
Thought Process cont’d
22ndnd Question: Question: ““How does widowhood amongst older adults lead to How does widowhood amongst older adults lead to
occupational restructuring?”occupational restructuring?” Problem:Problem:
- We realized it is difficult to - We realized it is difficult to answeranswer
3. Final Question:“What is the relationship between widowhood and occupational
restructuring amongst older women?”
Research Process
Databases usedDatabases used:: Medline, Eric, Psychinfo, Ageline, EmbaseMedline, Eric, Psychinfo, Ageline, Embase
Interfaces usedInterfaces used:: Ovid, Pubmed, Webspir, J-stor, Proquest, Cambridge Ovid, Pubmed, Webspir, J-stor, Proquest, Cambridge
scientificscientific Key wordsKey words::
Widow, widowhood, elderly, women, occupation, Widow, widowhood, elderly, women, occupation, activity, consequences, participation, bereavement, activity, consequences, participation, bereavement, coping, adaptationcoping, adaptation
Subject AreasSubject Areas:: Nursing, Gerontology, Sociology, Psychology, Death Nursing, Gerontology, Sociology, Psychology, Death
StudiesStudies
Initial Model: How Does Widowhood Amongst Older Adult Women Affect Occupational Restructuring?
Widowhood
External FactorsCulture/religionSocial economic statusPhysical environmentTimeSocial supportEssential activities previously performed by spouse (now unfulfilled)
Internal FactorsSpiritualityMental status
oCognitive, EmotionalIdentity
oMorals, Values
Occupational Restructuring
OccupationalPerformance
(increase, decrease)
Yield Occupation
Development of New Occupation
No Change in Occupation
Adapting to Widowhood through Meaningful Occupations: A Case Study
McIntyre & Howie
Method:
Purpose:
Participant:
Results:
Qualitative, case study
To explore one older woman’s adaptation to widowhood through meaningful occupations
One woman over 65 years old Widowed twice
Three major themes emerged from the data Doing, Social relationships, Occupational
adaptation
Critical Analysis in Relation to our Topic McIntyre & Howie
Strengths: Link between internal and external factors affecting the person (eg. Social support and mental health)
Occupational restructuring in return affects the persons mental health
Occupational restructuring can take place by way of partaking in new occupations as well as maintaining pre-widowhood occupations
Critical Analysis in Relation to our Topic McIntyre & Howie
Weaknesses: Case study of only one woman’s experience, therefore hard to relate the results to our model
The researches chose a participant that had already adapted well to widowhood and did not have any negative side effects to explore
Woman had been widowed twice therefore may have a different view on widowhood than a first-time widow
Critical Appraisal of Research Critical Appraisal of Research MethodologyMethodology
Adapting To Widowhood Through Adapting To Widowhood Through Meaningful Occupations: A Case StudyMeaningful Occupations: A Case Study
McIntrye & HowieMcIntrye & Howie
Paradigm: The qualitative approachParadigm: The qualitative approach
Criteria for Judging Trustworthiness in Criteria for Judging Trustworthiness in Qualitative ResearchQualitative Research
Lincoln and Guba, 1985Lincoln and Guba, 1985
CredibilityCredibility
Numerous Quotes embedded to support themes Numerous Quotes embedded to support themes generated.generated.
Member-checking suggested.Member-checking suggested. The length of engagement is unknown. The length of engagement is unknown. Triangulation attempted: literature used to confirm Triangulation attempted: literature used to confirm
themes. themes. Peer debriefing not indicatedPeer debriefing not indicated..
Criteria for Judging Trustworthiness in Criteria for Judging Trustworthiness in Qualitative ResearchQualitative Research
TransferabilityTransferability
Purposeful sampling.Purposeful sampling. Describing in detail the context. Describing in detail the context. Rich, thick description for themes Rich, thick description for themes
emerged.emerged.
Criteria for Judging Trustworthiness in Criteria for Judging Trustworthiness in Qualitative ResearchQualitative Research
Dependability Dependability
A Pilot interview was conductedA Pilot interview was conducted A detailed list of interview questions provided.A detailed list of interview questions provided. 3 interviews3 interviews Interviews tape recorded and transcribed.Interviews tape recorded and transcribed. Coding scheme described in detail.Coding scheme described in detail.
..
Criteria for Judging Trustworthiness in Criteria for Judging Trustworthiness in Qualitative ResearchQualitative Research
Confirmability Confirmability
TriangulationTriangulation Audit trail suggested. Audit trail suggested. Independent raters not Independent raters not
identifiedidentified..
Criteria for Judging Trustworthiness in Criteria for Judging Trustworthiness in Qualitative ResearchQualitative Research
Despite noted limitations, the study by McIntyre and Despite noted limitations, the study by McIntyre and Howie did demonstrate adequate trustworthiness in Howie did demonstrate adequate trustworthiness in the research methodology.the research methodology.
Therefore, results can transferable to our final model. Therefore, results can transferable to our final model.
Additional FindingsAdditional Findings
Majority of research quantitative in natureMajority of research quantitative in nature
Level 2, Depoy & GitlinLevel 2, Depoy & Gitlin
Most research from a psychology, sociology, Most research from a psychology, sociology, nursing and gerontology backgroundnursing and gerontology background
Numerous studies focused on religion and Numerous studies focused on religion and spiritualityspirituality
Most researchers eluded to engagement in Most researchers eluded to engagement in occupation as a means of adapting to widowhoodoccupation as a means of adapting to widowhood
Additional FindingsAdditional Findings
Limitations
Lack of research & limited researchers in the field
Prospective design and/or comparison groups only in 1/3 of quantitative studies
Not viewed from an Occupational therapy or Occupational science lens
Occupational Restructuring
OccupationalPerformance
New Meaning For Occupation
Yield Occupation
Take Over Occupationsof Deceased Spouse
Change in Meaning of Occupation
Development of New Occupations
OccupationalParticipation
The Final Model
Widowhood
Internal External
• Spirituality
• Mental Status
• Identity
• Culture/Religion
• Social Economic Status
• Physical Environment
• Time
• Social Support
• Essential activities of spouse unfulfilled
• Grieving
• Health Status
• Previous Exposure to Widowhood
• Gender Roles
The Final Model
Gaps in Research and Constructive Gaps in Research and Constructive ApproachesApproaches
GapGap: Relevant research focusing on period of : Relevant research focusing on period of preparation for spouse’s deathpreparation for spouse’s death
e.g., long-term/sudden deathe.g., long-term/sudden death
Occupational Science ApproachOccupational Science ApproachExamine the differences between widows who Examine the differences between widows who
had time to prepare for the death of their had time to prepare for the death of their spouse versus widows who lost their spouse spouse versus widows who lost their spouse suddenly on occupational restructuring suddenly on occupational restructuring
Gaps in Research and Constructive Gaps in Research and Constructive ApproachesApproaches
Gap:Gap: Lacking literature examining gender Lacking literature examining gender roles and the experience of widowhoodroles and the experience of widowhood
Occupational Science Approach:Occupational Science Approach:
Examine gender roles and their effects on Examine gender roles and their effects on specific occupations following spousal lossspecific occupations following spousal loss
- Quantitative Approach (e.g., comparing genders)- Quantitative Approach (e.g., comparing genders)
Gaps in Research and Constructive Gaps in Research and Constructive ApproachesApproaches
Gap:Gap: Limited research on changes in role or Limited research on changes in role or circumstances and their impact on occupational circumstances and their impact on occupational restructuring in widowsrestructuring in widows
Occupational Science Approach:Occupational Science Approach:
Examine changes in daily roles and circumstances Examine changes in daily roles and circumstances and how this affects occupational restructuringand how this affects occupational restructuring
- Quantitative Approach (e.g., comparing pre/post)- Quantitative Approach (e.g., comparing pre/post)
Gaps in Research and Constructive Gaps in Research and Constructive ApproachesApproaches
Gap:Gap: Insufficient literature regarding the Insufficient literature regarding the meaning of occupations after the loss of a meaning of occupations after the loss of a spousespouse
Occupational Science Approach: Qualitative
Exploring the meaning of occupations
in widowhood
Constructive Approaches to OT & OS Constructive Approaches to OT & OS ResearchResearch
Areas for Future Research:Areas for Future Research:
Facilitating positive aging throughout widowhoodFacilitating positive aging throughout widowhood Does engaging in occupation in widowhood increase health and Does engaging in occupation in widowhood increase health and
well-being?well-being? What occupations facilitate positive aging?What occupations facilitate positive aging?
Cultural considerationsCultural considerations How does the mourning period as influenced by culture affect How does the mourning period as influenced by culture affect
occupations?occupations? What effect does moving in with children have on occupational What effect does moving in with children have on occupational
restructuring?restructuring?
Constructive Approaches to OT & Constructive Approaches to OT & OS Research Cont’dOS Research Cont’d
Areas for Future Research:Areas for Future Research:
Disability throughout widowhoodDisability throughout widowhood What is the relationship between disability and What is the relationship between disability and
occupational restructuring in widowhood? occupational restructuring in widowhood?
IdentityIdentity What is the relationship between widowhood and What is the relationship between widowhood and
occupational identity?occupational identity?
ConclusionConclusion
It is essential for further research to focus on It is essential for further research to focus on widowhood using an occupational lenswidowhood using an occupational lens Increasing geriatric population, particularly Increasing geriatric population, particularly
womenwomen Understanding of dynamic relationship between Understanding of dynamic relationship between
widowhood and other aspects of daily life is widowhood and other aspects of daily life is neededneeded
Facilitated DiscussionFacilitated Discussion
Our original question wasOur original question was: : “How does “How does widowhood amongst older female adults lead widowhood amongst older female adults lead to occupational restructuring?”to occupational restructuring?” Why is the question “how” problematic in this Why is the question “how” problematic in this
context of ‘widowhood’?context of ‘widowhood’?
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