Social determinants of impaired functioning among Nepali widows: A mixed methods study

摘要

Despite considerable stigmatisation of widows in Nepal, little is knownabout factors affecting their ability to function in society. Using mixedmethods, we studied psychosocial factors associated with impairedfunctioning among Nepali widows. For the qualitative analysis, weanalysed 3 focus groups, 25 in-depth interviews, and 12 key-informantinterviews. The quantitative analysis was based on data from 204widows. Odds ratios were calculated linking psychosocial exposures toimpaired functioning using adjusted logistic regression models. Lowsocial support (aOR = 2.35, 95% CI: 1.2, 4.6, generally; aOR = 3.3, 95% CI:1.7, 6.42, specifically from family members), experiences ofdiscrimination (aOR = 2.97, 95% CI: 1.43, 6.14), and low life control (aOR= 4.3, 95% CI: 1.86, 10.1) were risk factors for impaired functioning.Qualitative findings suggested how discrimination and lack of controlcontribute to impaired functioning. Support from the husband’s familyappeared to be more important to a widow’s functioning, compared tofrom her own parents. Knowledge about risk factors for impairedfunctioning can help inform interventions for Nepali widows.