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This article was downloaded by: [Linnaeus University] On: 10 October 2014, At: 03:24 Publisher: Routledge Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK Health Care for Women International Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/uhcw20 PROMOTING ATTENTIONAL HEALTH: IMPORTANCE TO WOMEN’S LIVES Mary Ann Stark a & Bernadine Cimprich b a Bronson School of Nursing, Western Michigan University, Kalamazoo, Michigan, USA b University of Michigan School of Nursing, Ann Arbor, Michigan, USA Published online: 21 Jun 2010. To cite this article: Mary Ann Stark & Bernadine Cimprich (2003) PROMOTING ATTENTIONAL HEALTH: IMPORTANCE TO WOMEN’S LIVES , Health Care for Women International, 24:2, 93-102, DOI: 10.1080/07399330390170079 To link to this article: http://dx.doi.org/10.1080/07399330390170079 PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http:// www.tandfonline.com/page/terms-and-conditions

PROMOTING ATTENTIONAL HEALTH: IMPORTANCE TO WOMEN’S LIVES

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This article was downloaded by: [Linnaeus University]On: 10 October 2014, At: 03:24Publisher: RoutledgeInforma Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House,37-41 Mortimer Street, London W1T 3JH, UK

Health Care for Women InternationalPublication details, including instructions for authors and subscription information:http://www.tandfonline.com/loi/uhcw20

PROMOTING ATTENTIONAL HEALTH: IMPORTANCE TOWOMEN’S LIVESMary Ann Stark a & Bernadine Cimprich ba Bronson School of Nursing, Western Michigan University, Kalamazoo, Michigan, USAb University of Michigan School of Nursing, Ann Arbor, Michigan, USAPublished online: 21 Jun 2010.

To cite this article: Mary Ann Stark & Bernadine Cimprich (2003) PROMOTING ATTENTIONAL HEALTH: IMPORTANCE TOWOMEN’S LIVES , Health Care for Women International, 24:2, 93-102, DOI: 10.1080/07399330390170079

To link to this article: http://dx.doi.org/10.1080/07399330390170079

PLEASE SCROLL DOWN FOR ARTICLE

Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) containedin the publications on our platform. However, Taylor & Francis, our agents, and our licensors make norepresentations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of theContent. Any opinions and views expressed in this publication are the opinions and views of the authors, andare not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon andshould be independently verified with primary sources of information. Taylor and Francis shall not be liable forany losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoeveror howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use ofthe Content.

This article may be used for research, teaching, and private study purposes. Any substantial or systematicreproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in anyform to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http://www.tandfonline.com/page/terms-and-conditions

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HCW 24(2) #6032

Health Care for Women International, 24:93–102, 2003Copyright © 2003 Taylor & Francis0739-9332/03 $12.00 + .00DOI: 10.1080/07399330390170079

PROMOTING ATTENTIONAL HEALTH:IMPORTANCE TO WOMEN’S LIVES

Mary Ann Stark, PhD, RNCBronson School of Nursing, Western Michigan University,

Kalamazoo, Michigan, USA

Bernadine Cimprich, PhD, RN, FAANUniversity of Michigan School of Nursing, Ann Arbor, Michigan, USA

Promoting attentional health is an important opportunity to support and empowerwomen to actively participate in their own health care and function effectively inmultiple roles. Attention, the ability to focus or concentrate, is a necessary cognitiveresource used throughout the life span in participating in self-health care. However,women can inadvertently overuse this essential capacity, especially when respondingto life’s multiple demands, resulting in mental or attentional fatigue. When womenexperience this mental fatigue, many daily activities, including self-health care, aremore difficult. An attentional perspective in women’s health allows approaches toimprove daily functioning and reduce the risk of attentional fatigue. In this article wepresent the conceptual dimensions of directed attention and its relevance to women’shealth; practice and research implications are identified.

Women have the opportunity to make significant contributions to their own health(Taylor, & Woods, 1996; Woods, 1995). A shift from viewing health from a medicalmodel to examining the fit between women and their environment has been advocatedfor women’s health. We use this perspective to consider the interplay of many factorsinfluencing women’s health (Writing Group of the 1996 AAN Expert Panel onWomen’s Health, 1997). One key factor often overlooked in women’s health is theimportance of effective cognitive functioning. A cognitive resource that is essentialin helping women to function effectively and participate in their own health careis attention, or the ability to focus and concentrate in purposeful activity. Althoughthis resource is often taken for granted, attention supports every aspect of self-careand functioning and is necessary for maintaining new health behaviors. However,women can inadvertently overuse this essential capacity, especially when respondingto life’s multiple demands, resulting in mental or attentional fatigue. Such fatigue can

Received 28 November 2000; accepted 15 April 2002.Address correspondence to Dr. Mary Ann Stark, Bronson School of Nursing, 1903 W.

Michigan Ave., Kalamazoo, MI 49008, USA. E-mail: [email protected]

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undermine all efforts at self-care, thereby affecting women’s health and functioning.Thus, better understanding of the essential role of attention for effective functioningis important for women’s health.

Our purpose in writing this article is to examine the concepts underlying atten-tional health and their importance to women’s health and self-care. First, we discussthe two kinds of selective attention, involuntary and directed attention, and theirimportance in daily functioning. We explain factors that increase the use of directedattention and place women at greater risk for attentional fatigue. Next, we proposesuggestions for promoting attentional health for women and health care providers.Last, we make recommendations for practice and research with the goal of empow-ering women to participate in their own self-health care.

Difficulty concentrating is a common experience for women, particularly whendealing with multiple life demands. Decreased ability to concentrate has been re-ported during pregnancy (Brindle, Brown, Brown, Griffith, & Turner, 1991; Buckwal-ter et al., 1999; Poser, Kassirer, & Peyser, 1986; Sharp, Brindle, Brown, & Turner,1993; Silber, Almkvist, Larsson, & Uvnas-Moberg, 1990; Stark, 2000), postpar-tum (Eidelman, Hoffman, & Kaitz, 1993; Fishbein & Burggraf, 1998), with high-risk pregnancies requiring bedrest (Maloni, 1998), following miscarriage (Swanson,1999), during menopause (Kendig & Sanford, 1998), after hysterectomy (Kuczyn-ski, 1982), and following diagnosis and during treatment of breast cancer (Cimprich,1992a; 1998; Cimprich & Ronis, 2001). Thus, at times when women are encouragedto participate in their own health care, they may find they have more difficulty con-centrating, attending to important information, making decisions, and carrying outself-care.

UNDERSTANDING ATTENTION

Attention is a complex cognitive process that operates to focus awareness onselected information from the environment while excluding irrelevant or distractinginformation (Cimprich, 1995; Kaplan & Kaplan, 1989; Posner, 1995). The successfuluse of attention allows for clarity of focus and effective mental activity. Two kindsof selective attention are important for effective functioning in daily life, namely,involuntary attention and voluntary or directed attention. Some stimuli in life haveintrinsic interest and easily capture attention; for example, a baby’s cry, a beautifulscene, laughter, and threats to health or survival. Involuntary attention is used in thesesituations. Because the stimuli that attract involuntary attention are so fascinating,other stimuli easily can go unnoticed. However, many activities of daily living areimportant but not necessarily interesting. To deal effectively with these activities, thesecond type of attention, voluntary or directed attention, is needed. Directed attentionis the ability to actively inhibit distractions or competing thoughts in order to pursuean intended activity. Directed attention requires mental effort and is experienced asconcentrating or paying attention. Because of the mental effort required in directedattention, it is a limited capacity and susceptible to fatigue, unlike involuntaryattention (Cimprich, 1995; Kaplan, 1995). An important relationship exists betweeninvoluntary attention and directed attention in daily functioning. When involuntaryattention is captured effortlessly, directed attention is rested. However, to engagedirected attention in the presence of fascinating stimuli requires considerable effortto block the compelling thought in order to focus on the task at hand.

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Functional Importance of Attention

Women rely on directed attention daily in order to function effectively in mul-tiple roles. In the multidimensional context in which many women function, thecapacity to direct attention is essential for effective cognitive, behavioral, and socialfunctioning. Directed attention supports cognitive function by blocking distractionsto permit clarity of thought and problem solving. Higher level cognitive activities,known as the executive functions, also require a strong capacity for attention. Suchhigher level cognitive activities include formulating goals, planning, carrying outtasks, and monitoring and adjusting behavior to meet desired goals (Lezak, 1982).Directed attention supports goal-directed behavior, as well as suppresses impulsiveactions and thoughts. Being patient or listening are important for effective socialinteractions and rely on the capacity to direct attention. Thus, directed attention is apivotal cognitive resource in helping women to manage multiple demands of dailyliving.

Attentional Fatigue and Its Consequences

One important and often unrecognized consequence of continual use of directedattention is the tendency to develop fatigue. Attentional fatigue is thought to occuras a result of overuse of the underlying brain mechanisms involved in inhibitionof distracting or competing stimuli (Kaplan, 1995; Kaplan & Kaplan, 1989). At themost basic level, attentional fatigue is manifested as a loss of the ability to focus andconcentrate and often is experienced as increased distractibility, affecting all aspectsof daily functioning (Cimprich, 1992a; 1993). Women who become attentionally fa-tigued may find the consequences to be profound and to affect cognitive, behavioral,and affective functioning (Kaplan, 1995). Maintaining a coherent train of thought isimpossible when distracting stimuli capture attention. Distractibility interferes withproblem solving by occupying attention, so one is not free to contemplate solutions(Cimprich, 1995; Kaplan, 1995). Directed attentional fatigue makes one feel lesscompetent in mental activities such as learning, planning, decision making, and goalsetting (Kaplan, 1995). Initiating or maintaining effortful activities becomes difficult,if not impossible. Even simple activities such as driving a car, grocery shopping,or balancing a checkbook may seem overwhelming. Momentary impulses, thoughts,and inclinations may be difficult to inhibit. As a result, impatience, irritability, de-creased tolerance for frustration, and a tendency to act with only short-term goals inmind become more likely. In addition, fatigued and irritable people are less likelyto seek or obtain the help of others at a time when help is most needed (Cimprich,1995; Kaplan, 1995).

Drain on Directed Attention: Attentional Demands

Understanding life situations that demand greater use of directed attention canhelp women and health care providers to more easily identify and predict factorsthat undermine attentional health and increase risk for attentional fatigue. As womenfunction in many roles and relationships, the ability to recognize these factors in theirunique context can allow women to care for themselves more effectively (Lauver,2000).

Attentional demands are factors that increase the mental effort needed in dailylife and can be categorized as informational, affective, behavioral, and environmental

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(Cimprich, 1992a; Jansen & Keller, 1998). Informational demands are factors thatinterfere with efforts to gather and interpret information. In exercising self-care andhealthy lifestyle choices, many women rely on the ability to gain new knowledge.If the information is unfamiliar, unclear, or difficult, greater mental effort is needed,increasing demands on directed attention. Affective demands can increase the workof directed attention when worries, concerns, and preoccupations serve as distractionsand must be inhibited in order to carry out purposeful tasks. Situations that requirebehaviors that are unfamiliar or difficult increase behavioral demands on attention.For example, driving a car requires many skills, and having young children or aninfant in the car may introduce other and sometimes competing demands on attention.Environmental demands include factors in the environment that require mental effortto manage, such as noise and crowded areas (Jansen & Keller, 1998).

Women in unfamiliar cultures and languages may experience informational, af-fective, behavioral, and environmental demands. Attaining necessary informationfor self-health care will be more difficult in a second or foreign language (Callister,2001). Relying on an unfamiliar health care system may prompt worries, concerns,and uncertainties, which function as affective demands. Integrating new self-healthskills with cultural tradition may be difficult, increasing behavioral demands. Nego-tiating unfamiliar environments requires effort, placing environmental demands onattention. The mental effort required by women living in unfamiliar cultures or beingconsumers of an unfamiliar health care system should be evaluated carefully. Theirpotential demands on directed attention may compromise their ability to focus onself-care.

PROMOTING ATTENTIONAL HEALTH

Because the ability to direct attention is so valuable for daily functioning andself-care, promoting attentional health and preventing directed attentional fatigueis a means for empowering women to effectively participate in their health care.When attentional demands exceed the capacity for directing attention, the situationmay seem overwhelming and unmanageable. To change or prevent this situation,demands can be reduced or resources increased. Theory and research suggest thattwo approaches to improving attentional health may be useful (Cimprich, 1993,1995; Kaplan, 1995). The first approach is to reduce attentional demands that lead toattentional fatigue. The second approach is to promote rest and recovery of directedattentional capacity.

Reducing Demands

Reducing attentional demands is an important means of conserving directedattention. Women have multiple demands as they work, care for their families,contribute to their communities, and nurture relationships. Managing such multipledemands or tasks requires a great deal of mental effort and can overuse attention.Women may conserve attention by incorporating attention-sparing strategies in theirdaily lives. Simple activities such as making lists of important tasks, breaking largetasks into smaller ones, and carrying out multiple tasks sequentially rather thanconcurrently reduce mental effort and conserve attention (see Table 1; Cimprich,1995). These strategies allow women to focus more easily by reducing distractions,thereby lessening mental effort. The overall effect is to decrease mental effort andprevent overuse of directed attention.

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Table 1. Strategies forconserving attention

Reduce or avoid time pressureFocus on prioritiesBreak large tasks into smaller goalsCreate structure by use of lists or schedulesPrevent distractions when carrying out a taskAvoid multiple concurrent tasksDesign and modify environments to support functioningMinimize noise and other distractionsDevelop supportive networks

Adapted from Cimprich (1995).

In encouraging women to be participants in their own health care, women’shealth care providers also can reduce attentional demands associated with self-care.Research has consistently reported that women want useful information throughouttheir lives (Beger & Cook, 1998; DiMatteo, Kahn, & Berry, 1993; Evans & Jeffrey,1995; Fleissig, 1993; Moran, Holt, & Martin, 1997; Swanson, 1999; Wade, Pletsch,Morgan, & Menting, 2000). However, health information is not always adequate oraccurate, and may be overwhelming (Cimprich, 1995; Drake, 1999; Stark, 2000).Several principles to reduce mental effort and support ease of learning have beenproposed (Cimprich, 1995). First, information can be presented so that main pointsare clear and unlikely to get lost in distracting details. Vivid, accurate informationthat can be understood easily is useful in reducing the mental effort and distressof a new situation (Johnson, 1972). Second, providers can help women to evaluatethe quality of available health information in printed or on-line sources. Third, theinformation can be presented so that it is imaged easily or visualized by usingpictures, examples, or diagrams. Fourth, each woman’s capacity to concentrateshould be considered, with opportunities for questions, clarification, and furtherinformation as needed. Last, health care providers can evaluate and modify thephysical health care environment to reduce unnecessary distractions and attentionaldemands.

Recent research has begun to focus on identifying attentional demands in dailylife. In a study that involved in-depth interviews with elderly community-dwellingpeople who were mostly women, Jansen and Keller (1998) identified informational,affective, behavioral, and physical environmental demands that increased mentaleffort. Having trouble finding interesting activities, distractions due to personalthoughts, and hearing and vision difficulties were factors that interfered with percep-tion or interpretation of information for this elderly sample. Thoughts and worriesabout health, finances, and safety, in addition to missing former work, activities,family, and friends were affective demands that served as distractions and increasedtheir mental effort. Feeling tired, being alone or isolated, and having financial restric-tions were factors that interfered or restricted valued activities, creating behavioraldemands. Factors in the physical environment that required mental effort for seniorsin this sample were noise, weather, lighting, and difficult designs of furniture andappliances.

In a study of women in the last trimester of pregnancy, Stark (2001a) found thatsome of the psychosocial tasks that prepare women for parenting required mental

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effort and were related to difficulty directing attention. Concerns about health andsafety for herself and her baby, conflict in her relationship with her mother, anddifficulty in accepting the pregnancy were found to place demands on attention inthis sample. While research has identified some demands on women’s attention,understanding the many demands of the multiple roles in which women functionshould be the focus of further research.

Restoring Attention

A second approach for counteracting attentional fatigue is to rest and restoredirected attention. Sleep is necessary but not sufficient to rest directed attentionwhen there are multiple demands. Engaging involuntary attention for brief periodscan rest directed attention because no inhibitory effort is needed when fascinationis captured. Certain activities have been found to have important attention-restoringproperties (Kaplan, 1995, 2001; Kaplan & Talbot, 1983). The components necessaryfor an experience to be restorative include (1) engaging fascination or effortlessattention, (2) having a sense of being away from usual thoughts and concerns,(3) providing extent or sufficient scope to allow exploration and to prevent boredom,and (4) creating compatibility between the activity and an individual’s inclinationand purposes (Kaplan, 1995). Nature and experiences in nature can offer theseproperties and a variety of options. People are drawn to the natural environmentand are captivated by the sights and sounds of nature. Spending time in the naturalenvironment provides opportunity for resting directed attention while involuntaryattention is effortlessly engaged.

Research has supported the effectiveness of spending time in the natural environ-ment to increase ability to direct attention. In a variety of samples, including col-lege students (Hartig, Mang, & Evans, 1991; Tennessen, & Cimprich, 1995), AIDScaregivers (Canin, 1991), women undergoing treatment for breast cancer (Cimprich,1993), hospitalized patients (Ulrich, 1984), inner-city urban public housing residents(Kuo & Sullivan, 2001), and women in the third trimester of pregnancy (Stark, 1999),researchers found that spending time in activities involving nature was beneficial fordaily attentional functioning.

There are many ways for women to spend time in attention-restoring activities(Frumkin, 2001). Outdoor activities may include walking; collecting leaves or rocks;listening to birds or wind; sitting by a lake, river, or pond; flying a kite; or eatingoutside. Sitting by a window, watching birds or animals, playing with a pet, orcaring for plants are indoor activities that involve nature. Women can select activitiesthat are interesting and enjoyable. These restorative activities have been shownto help women who are prone to attentional fatigue to restore their attentionalfunctioning (Cimprich, 1993; Stark, 1999, 2001b). Participating in activities in thenatural environment for 20 to 30 minutes three to four times a week has beenuseful in improving directed attentional functioning (Cimprich, 1993; Stark, 2001b).If women engage in these activities intermittently throughout the week, they willpromote attentional health and contribute an important component to self-care.

Health care providers can incorporate the natural environment into health caresettings to allow opportunity for restoration of directed attention (Frumkin, 2001;Ulrich, 1992). Waiting rooms, hospital rooms, classrooms, and treatment areas withthe best window view of gardens, trees, or other natural scenery should be designedand provide the context for care whenever possible. Rooms without windows or

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natural views could be decorated with plants, aquariums, or landscape art. Healthcare facilities can bring restorative experiences into their environments.

IMPLICATIONS FOR WOMEN’S HEALTH PRACTICEAND RESEARCH

As former biomedical models have been ineffective in addressing women’s healthissues, a new paradigm has emerged (Leuning, 1994). We propose that includingcare to enhance attentional health in this new paradigm would promote the goals ofwomen’s health while empowering women to participate in their own health care.

The context in which women live is multidimensional (Andrist, 1997; Raftos,Mannix, & Jackson, 1997; Walker, & Tinkle, 1996; Writing Group of the 1996AAN Expert Panel on Women’s Health, 1997). Since each woman is unique in herown context, the experience of a woman in her environment provides valuable infor-mation (Lauver, 2000). Applying an understanding of directed attention, attentionaldemands, and risk of attentional fatigue may be useful in women’s health by em-phasizing the context in which women function. Health care providers can workto improve the fit between a woman and her environment by assessing her atten-tional demands and functioning. Assessing for early signs of attentional fatigue andhow this affects daily life allows a woman the opportunity to share her experiences(see Table 2). Incorporating approaches to conserve and restore attention may helpprevent fatigue and aid accomplishment of self-care strategies.

Rather than focusing on organ systems, women’s health care should be holis-tic and woman centered (Andrist, 1997; Raftos et al., 1997; Walker, & Tinkle,1996; Woods, 1995; Writing Group of the 1996 AAN Expert Panel on Women’sHealth, 1997). Directed attention is a valuable resource that underlies women’s dailyfunctioning. If this resource is diminished, women may not have the mental effortnecessary to undertake self-care and lifestyle changes. By conserving and restoringdirected attention, women can learn more effectively, participate in decision-making,and pursue healthy behaviors. Rather than focusing on problems or diseases, prevent-ing attentional fatigue promotes a holistic approach to health and self-care. Healthyattentional functioning supports harmony of body, mind, and spirit.

Directed attention is important for effective functioning across the life span.Women who make efforts to prevent attentional fatigue throughout their lives maybe better able to participate in self-health care. Especially during times of transi-tion when there are more demands, such as pregnancy (Maloni, 1998; Stark, 2000),

Table 2. Assessing cognitive, behavioral, andaffective indicators of attentional fatigue

Difficulty concentratingIncreased distractibilityInability to maintain thoughts (forgetfulness)Difficulty with decision making, problem solvingTendency to overreactImpatience, frustration, impulsiveness (actions and comments)Irritability

Cimprich, 1995; Kaplan, 1995.

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postpartum (Eidelman et al., 1993; Fishbein, & Burggraf, 1998), miscarriage (Swan-son, 1999), menopause (Kendig & Sanford, 1998), hysterectomy (Kuczynski, 1982),and life-threatening illness (Cimprich, 1992a), women may overuse directed atten-tion and become fatigued without noticing. While studies are limited, researcherssuggest that women with greater capacity to direct attention may experience less cog-nitive and affective distress. In a study of 74 women with newly diagnosed breastcancer, greater ability to concentrate was associated with lower levels of distressfrom symptoms such as insomnia and tiredness (Cimprich, 1999). In a sample of57 gravidas, women who had more difficulty directing attention in the third trimesterreported that labor was more painful than women who had greater capacity to directattention (Stark, 1999). This may suggest that women best able to direct attentionmay have more cognitive resources for self-care in managing labor. The findings ofthese studies, suggesting that promoting attentional health and preventing attentionalfatigue may provide benefits across the life span, warrant further research.

Encouraging women to value themselves in order to care and self-nurture body,mind, and spirit is another important component of women’s health (Lauver, 2000).Restorative activities involving nature are opportunities for women to nurture them-selves, allowing time for stillness and reflection. As women escape to nature forbrief periods, they momentarily can tune out the noise of their many roles andresponsibilities while increasing cognitive ability.

An attentional perspective offers many benefits to women’s health. Yet far moreresearch is needed for understanding this important cognitive resource. While somestudies have identified times in women’s lives when they are especially suscepti-ble to fatigue (Cimprich, 1992b, 1998, 1999; Eidelman et al., 1993; Fishbein &Burggraf, 1998; Kendig & Sanford, 1998; Maloni, 1998; Poser et al., 1986; Silberet al., 1990; Stark, 2000; Swanson, 1999), more research is needed to understand thislived experience. In addition to qualitative research to understand this phenomenon,a simple assessment tool for detecting directed attentional fatigue in women acrossthe life span is needed also. While some attentional demands have been identifiedfor the elderly (Jansen & Keller, 1998) and women in the third trimester and earlypostpartum (Stark, 2000, 2001a), more research is necessary to identify other atten-tional demands, especially for diverse groups of women. Attention conserving andrestoring approaches are holistic, easily available, safe, and inexpensive, but addi-tional research is needed to evaluate the effectiveness of specific attention conservingstrategies. Also, the amount and type of restorative activities and their relationshipto self-care practices should be tested by further studies. This new area of researchoffers hope for improving women’s health care.

SUMMARY

Promoting attentional health is an opportunity for practitioners and researchersto support women as they “regain, maintain, and attain the fullest health possibleof bodies, minds, and spirits” (Lauver, 2000, p. 81). Women function in multipleroles and carry out many responsibilities daily. Their well-being is related to theirability to function in many dimensions (Lauver, 2000). One important resource uti-lized throughout the life span is attention. Incorporating an attentional perspectivein women’s health allows approaches for maximizing attentional functioning andreducing the risk of attentional fatigue. The benefit for women is integrated, harmo-nious functioning that supports and empowers them to be active participants in theirown health care.

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