Promoting Optimal Native Outcomes (PONO) by Understanding Women’s Stress Experiences

Abstract

A growing body of evidence links stress with mental illness and chronic disease. Existing scales of women's stress fail to capture the daily stressors of low-income, rural women. We explored the psychosocial stressors of local women residing in a rural Hawaii community with a large Native Hawaiian and Other Pacific Islander population. We recruited women, aged 18–35 years, at a community health center. We convened four focus groups to elicit information about women's stress. We identified key themes from the focus group data to generate questions that target concerns raised by participants. These were corroborated by additional focus groups. Thirty-six women participated in the study. Seven stressor themes emerged: intimate relationships—limited partner assistance, gender stereotype; family and home life—feeling like an outsider, lack of respect; childrearing—quality and affordable childcare, conflicting discipline styles; time for self—never-ending duties, being too tired to relax; neighborhood environment—safety concerns, not feeling part of the community; workplace—workload and transportation obstacles; and finances—making ends meet and arguments about money. Women in this study articulated a broad range of daily stressors. Sociocultural factors leading to feeling like an outsider within their own family, intercultural marriage conflicts, and perceptions of community discrimination are not included in other published scales. Our focus group investigations thus provided critical knowledge for developing a community-relevant scale. This is a prerequisite for developing and testing innovative intervention strategies designed to reduce stress in this population. We believe that reducing stress is necessary to mitigate the negative effects of stressors on physical and mental health among women in this rural community.

Perceived stress and sickness absence: a prospective study of 17,795 employees in Denmark

“…The term ‘stress’ has been used to describe working conditions (Jarvelin-Pasanen et al 2018), the body’s reaction to stressors (Yang et al 2015), or feelings of distress (Vitaliano et al 1984). Okihiro et al suggested to divide stress into three sub-categories: (a) stressors—negative events and conditions; (b) perceived stress—the subjective experience; and (c) stress symptoms—physiological and mental reactions (Okihiro et al 2017). This article focuses on ‘perceived stress’, i.e., an individual’s own perception of his or her stress-level.…”

Associations of regional-level perceived stress and depression with health-related quality of life in Korean adults: a multilevel analysis of 2017 Korea Community Health Survey data

“…Among the three subcategories of stress [18], we selected perceived stress as the concept of The KCHS assessed perceived stress using the question, "How much stress do you feel in your daily life?" The response options were "Very much," "A lot," "A little bit," and "Hardly any."…”

“…Psychological factors such as perceived stress and depression are also important health determinants at both population and individual levels [12][13][14][15][16]. The concept of stress has a long history and various dimensions in the health literature [17,18]. Okihiro et al [18] suggested three subcategories of stress: (a) stressors (negative events and conditions such as divorce or job loss); (b) perceived stress (the subjective experience associated with stressors, reflecting the ability to cope); and (c) stress symptoms (physiological and mental reactions) [18,19].…”

Psychometric testing of the Brief Coping Orientation to Problems Experienced Inventory among diverse women from a rural community in Hawai‘i.

“…Identifying positive and effective coping strategies and ways to enhance resilience are essential to overall well-being. In response to community needs, Project Promoting Optimal Native Outcomes aimed to better understand maternal stress and coping strategies among women from a rurally based community in Hawai‘i using community-based participatory research approaches (Okihiro et al, 2017). The Brief COPE Inventory was used as a standardized measure to assess for coping among women who participated in this study.…”