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    Health anxiety among older people : a study of health anxiety and safety behaviours in a cohort of older adults : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University
    (Massey University, 2008) Boston, Ann Frances
    There is a pervasive stereotype that characterises older people as excessively anxious about their health; however, there is little research into this phenomenon. The present study examined three aspects of the subject. Firstly, the study considered whether a cohort of older adults was unduly health anxious. Secondly, determined which demographic and health factors contributed to health anxiety. Lastly, the study examined the relationship between health anxiety and safety behaviours and medical utilisation to determine whether this aspect of the cognitive behavioural model of health anxiety was applicable to older adults. Participants were a convenience sample of individuals over 65 and living independently in the greater Auckland area. Participants completed an anonymous self report questionnaire measuring demographic factors, physical health and disability, health anxiety, safety behaviours and medical utilisation. 104 women and 4l men completed the survey. Although a majority of participants reported some physical illness and limitations on physical activity this cohort of adults over 65 was not unduly health anxious. Only increased physical disability and lower education were significant contributors to scores on the health anxiety measure. Consistent with the cognitive behavioural model of health anxiety; health anxiety was a significant predictor of safety behaviours. Demographic and health factors did not make a significant contribution to this relationship. Health anxiety also predicted medical utilisation, although increased disability was a better predictor. In spite of stereotypes to the contrary, this cohort of over 65's was not excessively health anxious. Factors that contributed to scores on the health anxiety measure were similar to those found in other studies. The proposition that the cognitive behavioural model of health anxiety may be applicable to older people was supported. The implications of the findings and directions for future research were discussed.
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    Health anxiety and older adults : a cross sectional study comparing predictors of health anxiety between an older and younger cohort : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Clinical Psychology at Massey University, Albany, New Zealand
    (Massey University, 2012) Boston, Ann Frances
    Health anxiety is a universal experience ranging from adaptive concerns about physical health to debilitating worry that may merit clinical diagnosis. Little is known about health anxiety in older adults and the overall objective of this study was to contribute to the nascent literature in this subject. The present study was conducted within a cognitive framework that emphasises the perception of bodily sensations in the origin and maintenance of health anxiety. The research comprised three interrelated studies. The principal investigation examined body perception (anxiety sensitivity, body vigilance and somatosensory amplification) variables as predictors of health anxiety across two cohorts. These findings were supported by assessment of the factor structure of measures of health anxiety and body perception in the older cohort. Finally, a measure of attention to bodily sensations in health anxiety (BVS-H) was trialled. The study was a self-report survey measuring demographic, physical health, current distress, body perception and health anxiety variables, which was administered to 221 adults over 65 and a comparison group of 177 adults aged 18 – 30. Regression analyses showed that consistent with the cognitive model, body perception predicted health anxiety. Body vigilance predicted health anxiety in both groups. The amplification of bodily sensations was a more important predictor of health anxiety for older adults. Inter-relationships between anxiety sensitivity, body vigilance and health anxiety in the older cohort, differed from expectations and warrant further study. The effects of control variables varied between groups with worry emerging as a predictor only for the older cohort. Physical health predicted health anxiety, but contributing variables differed between cohorts. Pain was a predictor for both groups, but physical illness was a predictor only for the younger cohort. Consistent with prior studies, older adults reported lower levels of health anxiety than the younger cohort. Factor analyses supported the structure of health anxiety, body vigilance and somatosensory amplification measures. Factor analysis of the anxiety sensitivity measure was inconclusive. BVS-H measure gave satisfactory results. These findings support the cognitive theory of health anxiety as an explanatory model of health anxiety in older adults and highlight cohort differences in variables contributing to health anxiety.
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    From men to the media and back again : an analysis of mediated help-seeking : a thesis submitted in partial fulfilment of the requirements for the degree of Master of Science in Psychology (with endorsement in health psychology) at Massey University, New Zealand, 2011
    (Massey University, 2011) Anstiss, David; Anstiss, David
    Life-expectancy and mortality statistics position the health of western men as in crisis. Not only has popular media facilitated this notion of crisis, the media has played an active role in creating the views that this crisis is ‘fact,’ that men are unwilling to accept responsibility for their own health, and that change is inconceivable. However, although many men have indeed been found to be reluctant to seek help from these services despite wanting to, instances of seeking help do exist and even occur against a social backdrop that seems to actively deter it. In response, this thesis sought and examined a sample of help-seeking texts, written by men, with the aim of uncovering discourses that might be empowering to men in regards to their health and healthy lifestyles. Two discourses emerged that reflect predominant enactments of western versions of masculinities, particularly hegemonic masculinity. Firstly, the biomedical discourse allows men to position themselves, relative to experts, in a way that appears to elicit health information and control consultation directions. Secondly, the (re)establishing masculinity discourse allows men to position themselves as masculine where their masculinity might be threatened. Implications of these discourses are discussed.
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    The mindful self : sense of self and health-promoting lifestyle behaviours among Thai college women : a thesis presented in fulfillment of the requirements for the degree of Doctor of Philosophy in Nursing at Massey University, New Zealand
    (Massey University, 2007) Mongkhonsiri, Pitsini
    Wellness educators have faced a great challenge to develop strategies to move people toward the adoption of positive lifestyle behaviours. This research explores concepts of self and the impact of Thai culture on the motivation of young college women to engage in health-promoting lifestyle behaviours (HPLBs) in the context of northeastern Thailand. A sequential mixed methods design enables an exploration of the relationships among sense of coherence, identity status, and HPLBs in the first phase, and an inductive analysis of the impact of Thai cultural context in the second phase. In study A, three instruments: the Health-Promoting Lifestyle Behaviors Profile II (HPLP II), the Extended Version of the Objective Measure of Ego Identity Status (EOM-EIS), and the Orientation to Life Questionnaire (SOC-29), were used with 350 senior college women. Sense of Coherence was significantly correlated with achieving a sense of identity, lessening diffusion identity and engaging in health-promoting behaviours. Although a considerable proportion of the variance (26.7 %) for engaging in HPLBs was accounted for by SOC, identity achievement, and identity moratorium, the magnitude of the unexplained variance was considerable. This led to inductive exploration of other variables influencing HPLBs in Study B. By data-driven thematic analysis, the Model of the Mindful Self emerged from in-depth interviews with 25 college women. The model describes three main themes: (a) the cultural background and the surrounding ongoing influences which impact on the development of Thai women's sense of self and their health-related behaviours, (b) the sense of self and identity formation in the Thai context, and (c) the health-related behaviours that stem from the sense of self. Sense of self and its behaviours are socially constructed within the specific culture in which individuals are embedded. The social phenomena and research outcomes are interpreted under the lens of social constructionism. The knowledge generated by this study provides guidance for teaching about health promotion in Thai undergraduate nursing programmes and also provides a basis for initiating health-promoting programmes based on the individual's sense of self for female adolescents in Thailand.
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    Transformation and time-out: The role of alcohol in identity construction among Scottish women in early midlife
    (Elsevier, 2015) Emslie C; Hunt K; Lyons AC
    Despite the increase in drinking by women in early midlife, little alcohol research has focused on this group. We explore how alcohol is associated with the construction of gender identities among women aged 30-50 years in the west of Scotland, United Kingdom. We draw on qualitative data from 11 focus groups (five all-female, six mixed-sex) with pre-existing groups of friends and work colleagues in which women and men discuss their drinking behaviours. Analysis demonstrated how alcohol represented a time and space away from paid and unpaid work for women in a range of domestic circumstances, allowing them to relax and unwind. While women used alcohol to construct a range of identities, traditional notions of femininity remained salient (e.g. attention to appearance, drinking 'girly' drinks). Drinking enabled women to assert their identity beyond the roles and responsibilities often associated with being a woman in early midlife. For example, some respondents with young children described the transformative effects of excessive drinking which allowed them to return temporarily to a younger, carefree version of themselves. Thus, our data suggest that women's drinking in early midlife revolves around notions of 'idealised' femininity but simultaneously represents a way of achieving 'time out' from traditional female responsibilities such as caring for others. We consider these findings within a broader social and cultural context including alcohol marketing, domestic roles and motherhood and their implications for health promotion.