1
|
Alnamnakani A. A narrative case study of an older disabled Muslim woman during the COVID-19 pandemic in the UK. FRONTIERS IN SOCIOLOGY 2024; 9:1369188. [PMID: 38694185 PMCID: PMC11061519 DOI: 10.3389/fsoc.2024.1369188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 04/05/2024] [Indexed: 05/04/2024]
Abstract
This paper explores the experiences and perceptions of Zora, an older Muslim woman living with a disability in the UK. Older disabled Muslim women in the UK often face multiple discriminations based on disability, age, gender, religious, and racial grounds and this has arguably been intensified by the COVID-19 pandemic. Drawing on multiple narrative interviews with Zora, this paper focuses on the intersections of disability, ageing, gender, race and religion within a particular social context during the COVID-19 pandemic in the UK. The paper describes the complex ways in which Zora experienced various modes of everyday disablism which were not related to the COVID-19 virus itself, rather the consequences of the movement restrictions associated with it. Much of the oppression and barriers she described were socially determined, both through direct discrimination, stares and prejudicial attitudes, and indirectly through stigmatization and an embodied fear of the reaction of others in public spaces. Nevertheless, Zora did not present herself as a victim. Instead she portrayed herself in affirmative terms, as a 'brave' woman who resisted and overcame daily social challenges and movement restrictions as part of working toward creating a more accessible, inclusive and age-friendly society. One that is inhabitable for herself and other older disabled women facing an uncertain future.
Collapse
Affiliation(s)
- Amani Alnamnakani
- School of Healthcare Sciences, Cardiff University, Cardiff, United Kingdom
| |
Collapse
|
2
|
Krabbe SH, Bjorbaekmo WS, Mengshoel AM, Sveen U, Groven KS. A suffering body, hidden away from others: The experience of being long-term bedridden with severe myalgic encephalomyelitis/chronic fatigue syndrome in childhood and adolescence. Nurs Inq 2024:e12625. [PMID: 38280185 DOI: 10.1111/nin.12625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 01/13/2024] [Accepted: 01/16/2024] [Indexed: 01/29/2024]
Abstract
In this article, we present findings from a qualitative study examining how young women experience being long-term bedridden with myalgic encephalomyelitis (ME), also known as chronic fatigue syndrome (CFS), during childhood and adolescence. The aim is to explore how young women who fell ill with ME/CFS during childhood and adolescence look back on their lived experience of being long-term bedridden from the vantage point of being fully or partially recovered. Informed by a phenomenological theoretical perspective, the researchers applied a narrative methodological approach involving the analysis of interviews with 13 women, aged 16-29 years at the time of the interview. Attention was particularly paid to how participants structured their narratives and to the events (telling moments) they identified as important. Four major storylines were developed: Ambivalent responses to the presence of others; A body on the edge of life; An eternity in the dark; and Recasting painful memories of being bedridden and alone. Based on our findings, we argue that the experience of being long-term bedridden with ME/CFS during childhood and adolescence can be understood and communicated as a plot in which individuals find themselves pushed to the extreme limit of suffering and loneliness.
Collapse
Affiliation(s)
- Silje Helen Krabbe
- Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Children's Surgical Department, Division of Head, Neck and Reconstructive Surgery, Oslo University Hospital, Oslo, Norway
| | | | - Anne Marit Mengshoel
- Department for Interdisciplinary Health Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Unni Sveen
- Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Department of Physical Medicine & Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Karen Synne Groven
- Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Faculty of Health Studies, VID Specialized University, Sandes, Norway
| |
Collapse
|
3
|
Marinus MA, Cense M. A Life Course Perspective on the Sexual Development of Young Intersex People. Healthcare (Basel) 2024; 12:239. [PMID: 38255126 PMCID: PMC10815015 DOI: 10.3390/healthcare12020239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/15/2024] [Accepted: 01/16/2024] [Indexed: 01/24/2024] Open
Abstract
Previous research has indicated that intersex people face specific challenges in their sexual development, including uncertainties or confusion about their gender, a negative genital self-image, and hesitance to engage in romantic and sexual relationships. However, in-depth knowledge regarding a central period in this development, adolescence, is missing. In our qualitative study, we explore which factors influence the relational and sexual development of intersex youth and what elements contribute to positive development. We interviewed eighteen intersex persons aged 18-38. We identified three main themes: (1) intersex experiences, (2) the described sexual and relational life course, and (3) factors influencing a positive development. Our findings show that intersex youth face many obstacles in their relational and sexual development, many of which are related to healthcare. However, their life stories also illuminate how healthcare professionals, as well as parents, friends, partners, teachers, and others, can make a substantial difference in intersex lives by breaking normative, binary thinking on sex and gender.
Collapse
Affiliation(s)
- Mir Abe Marinus
- NNID Netherlands Organisation for Sex Diversity, Staddijk 91, 6537 TW Nijmegen, The Netherlands
| | - Marianne Cense
- Rutgers Sexual and Reproductive Health and Rights, Arthur van Schendelstraat 696, 3511 MJ Utrecht, The Netherlands
| |
Collapse
|
4
|
Krabbe SH, Mengshoel AM, Schrøder Bjorbækmo W, Sveen U, Groven KS. Bodies in lockdown: Young women's narratives of falling severely ill with ME/CFS during childhood and adolescence. Health Care Women Int 2023; 44:1155-1177. [PMID: 35404768 DOI: 10.1080/07399332.2022.2043862] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 02/10/2022] [Accepted: 02/15/2022] [Indexed: 10/18/2022]
Abstract
Thirteen women (16-30 years) storied their experiences about the process of falling severely ill with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome during childhood and adolescence. We performed a narrative analysis informed by phenomenology which yielded three central themes: The active and meaningful life I used to live; gradually developing unhomeliness and feeling pushed toward the edge; and left abandoned on the sidelines. Out of the incomprehensible and unpredictable emerges an understanding of the scale of their ordeal, along with advice that may have made it worse. This portrays a gradual developing uncertain, unhomely life situation with no outlooks for future recovery.
Collapse
Affiliation(s)
- Silje Helen Krabbe
- Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Children's Surgical Department, Division of Head, Neck and Reconstructive Surgery, Oslo University Hospital, Oslo, Norway
| | - Anne Marit Mengshoel
- Department for Interdisciplinary Health Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | | | - Unni Sveen
- Faculty of Health Sciences, Department of Occupational Therapy, Prosthetics and Orthotics, Oslo Metropolitan University, Oslo, Norway
- Department of Physical Medicine & Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Karen Synne Groven
- Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Faculty of Health Studies, VID Specialized University, Sandes, Norway
| |
Collapse
|
5
|
Franzosa E, Kim P, Reckrey JM, Zhang M, Xu E, Aldridge MD, Federman AD, Ornstein KA. Care Disruptions and End-Of-Life Care Experiences Among Home-Based Primary Care Patients During the COVID-19 Pandemic in New York City: A Retrospective Chart Review. Am J Hosp Palliat Care 2023; 40:225-234. [PMID: 35775300 PMCID: PMC9253522 DOI: 10.1177/10499091221104732] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Background: Research on deaths during COVID-19 has largely focused on hospitals and nursing homes. Less is known about medically complex patients receiving care in the community. We examined care disruptions and end-of-life experiences of homebound patients receiving home-based primary care (HBPC) in New York City during the initial 2020 COVID-19 surge. Methods: We conducted a retrospective chart review of patients enrolled in Mount Sinai Visiting Doctors who died between March 1-June 30, 2020. We collected patient sociodemographic and clinical data and analyzed care disruptions and end-of-life experiences using clinical notes, informed by thematic and narrative analysis. Results: Among 1300 homebound patients, 112 (9%) died during the study period. Patients who died were more likely to be older, non-Hispanic white, and have dementia than those who survived. Thirty percent of decedents had confirmed or probable COVID-19. Fifty-eight (52%) were referred to hospice and 50 enrolled. Seventy-three percent died at home. We identified multiple intersecting disruptions in family caregiving, paid caregiving, medical supplies and services, and hospice care, as well as hospital avoidance, complicating EOL experiences. The HBPC team responded by providing clinical, logistical and emotional support to patients and families. Conclusion: Despite substantial care disruptions, the majority of patients in our study died at home with support from their HBPC team as the practice worked to manage care disruptions. Our findings suggest HBPC's multi-disciplinary, team-based model may be uniquely suited to meet the needs of the most medically and socially vulnerable older adults at end of life during public health emergencies.
Collapse
Affiliation(s)
- Emily Franzosa
- Brookdale Department of Geriatrics
and Palliative Medicine, Icahn School of Medicine at Mount
Sinai, New York, NY, USA
- Geriatric Research, Education, and
Clinical Center (GRECC), James J. Peters
VA Medical Center, Bronx, NY, USA
| | - Patricia Kim
- Brookdale Department of Geriatrics
and Palliative Medicine, Icahn School of Medicine at Mount
Sinai, New York, NY, USA
| | - Jennifer M. Reckrey
- Brookdale Department of Geriatrics
and Palliative Medicine, Icahn School of Medicine at Mount
Sinai, New York, NY, USA
| | - Meng Zhang
- Department of Medicine, Icahn School of Medicine at Mount
Sinai, New York, NY, USA
| | - Emily Xu
- Department of Medical Education,
Icahn School of Medicine at Mount
Sinai, New York, NY, USA
| | - Melissa D. Aldridge
- Brookdale Department of Geriatrics
and Palliative Medicine, Icahn School of Medicine at Mount
Sinai, New York, NY, USA
| | - Alex D. Federman
- Brookdale Department of Geriatrics
and Palliative Medicine, Icahn School of Medicine at Mount
Sinai, New York, NY, USA
- Department of Medicine, Icahn School of Medicine at Mount
Sinai, New York, NY, USA
| | - Katherine A. Ornstein
- Brookdale Department of Geriatrics
and Palliative Medicine, Icahn School of Medicine at Mount
Sinai, New York, NY, USA
| |
Collapse
|
6
|
Spencer NE, Taubenberger SP, Roberto R, Krishnamurti LS, Chang JC, Hacker K. "Stories of starting": Understanding the complex contexts of opioid misuse initiation. Subst Abus 2021; 42:865-872. [PMID: 33617751 PMCID: PMC10947450 DOI: 10.1080/08897077.2021.1878084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Background: The impacts of opioid use disorder and opioid-involved overdose are known, but less is known about the contexts in which people first misuse opioids, and the motivations for continued misuse. Methods: In-depth interviews with 26 individuals in Allegheny County, Pennsylvania with current or past histories of opioid misuse were conducted. Narratives were analyzed to understand the circumstances and influences contributing to initial and continued misuse of opioids. Results: Participants described social and familial contexts that normalized or accepted opioid misuse-this often included their own use of other illicit substances prior to initiating opioids. Participants also described initial use of opioids as related to efforts to cope with physical pain. They also described recognizing and then seeking psychological/emotional benefits from opioids. All three of these themes often overlapped and intersected in these stories of starting opioid misuse. Conclusions: Opioid misuse stemmed from complex interacting influences involving coping with physical and psychological pain, perception that opioids are needed to feel "normal", and acceptance or normalization of opioid use. This suggests a multi-pronged approach to both prevention and treatment are needed.
Collapse
Affiliation(s)
- Noelle E. Spencer
- Magee-Womens Research Institute, Pittsburgh, Pennsylvania, USA
- University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA
| | | | - Raisa Roberto
- Magee-Womens Research Institute, Pittsburgh, Pennsylvania, USA
| | | | - Judy C. Chang
- Magee-Womens Research Institute, Pittsburgh, Pennsylvania, USA
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Karen Hacker
- Allegheny County (Pennsylvania) Health Department, Allegheny County, Pennsylvania, USA
- Centers for Disease Control, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, Georgia
| |
Collapse
|
7
|
The temporal nature of social context: Insights from the daily lives of patients with HIV. PLoS One 2021; 16:e0246534. [PMID: 33571283 PMCID: PMC7877603 DOI: 10.1371/journal.pone.0246534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 01/20/2021] [Indexed: 11/28/2022] Open
Abstract
Background Patients’ life contexts are increasingly recognized as important, as evidenced by growing attention to the Social Determinants of Health (SDoH). This attention may be particularly valuable for patients with complex needs, like those with HIV, who are more likely to experience age-related comorbidities, mental health or substance use issues. Understanding patient perceptions of their life context can advance SDoH approaches. Objectives We sought to understand how aging patients with HIV think about their life context and explored if and how their reported context was documented in their electronic medical records (EMRs). Design We combined life story interviews and EMR data to understand the health-related daily life experiences of patients with HIV. Patients over 50 were recruited from two US Department of Veterans Affairs HIV clinics. Narrative analysis was used to organize data by life events and health-related metrics. Key results EMRs of 15 participants documented an average of 19 diagnoses and 10 medications but generally failed to include social contexts salient to patients. In interviews, HIV was discussed primarily in response to direct interviewer questions. Instead, participants raised past trauma, current social engagement, and concern about future health with varying salience. This led us to organize the narratives temporally according to past-, present-, or future-orientation. “Past-focused” narratives dwelled on unresolved experiences with social institutions like the school system, military or marriage. “Present-focused” narratives emphasized daily life challenges, like social isolation. “Future-focused” narratives were dominated by concerns that aging would limit activities. Conclusions A temporally informed understanding of patients’ life circumstances that are the foundation of their individualized SDoH could better focus care plans by addressing contextual concerns salient to patients. Trust-building may be a critical first step in caring for past-focused patients. Present-focused patients may benefit from support groups. Future-focused patients may desire discussing long term care options.
Collapse
|
8
|
Mengshoel AM, Bjorbækmo WS, Sallinen M, Wahl AK. 'It takes time, but recovering makes it worthwhile'- A qualitative study of long-term users' experiences of physiotherapy in primary health care. Physiother Theory Pract 2019; 37:6-16. [PMID: 31081435 DOI: 10.1080/09593985.2019.1616343] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
In several European countries, patients with chronic pain conditions are high consumers of physicians' and physiotherapists' health services in primary health care. This study aimed to explore how patients in a Norwegian context make sense of their long-term use of physiotherapy. Narrative interviews were conducted with six long-term users. The data material was subjected to a narrative analysis with a focus on the stories' content and how health professionals and informants were inscribed in the stories. The stories provide rich and varied information about the informants' experiences with prior and present health services inscribed in their experiences of illness and recovery. The narrative's introduction portrays a shared illness narrative, centered around negative experiences as illustrated by the theme 'A long time searching for explanations and solutions to recover'. The narrative's plot describes a gradually ascending story of recovery where abilities overshadowed disabilities, as the informants are 'Learning their own meaningful ways to proceed'. The narrative has no definite ending, but instead depicts an 'Uncertainty about future and own ability to reverse relapse'. The shared narrative's storyline is that 'It takes time, but recovering makes it worthwhile'.
Collapse
Affiliation(s)
- Anne Marit Mengshoel
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, Medical Faculty, University of Oslo , Oslo, Norway
| | - Wenche Schrøder Bjorbækmo
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, Medical Faculty, University of Oslo , Oslo, Norway.,Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University , Oslo, Norway
| | - Merja Sallinen
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, Medical Faculty, University of Oslo , Oslo, Norway.,Faculty of Health and Wellbeing, Satakunta University of Applied Sciences , Pori, Finland
| | - Astrid Klopstad Wahl
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, Medical Faculty, University of Oslo , Oslo, Norway
| |
Collapse
|
9
|
Crawford H, Wilkinson H. The Novel Use of Life Grids in a Phenomenological Study of Family Carers of People With Profound Intellectual and Multiple Disabilities and Dysphagia. QUALITATIVE HEALTH RESEARCH 2019; 29:589-596. [PMID: 29553299 DOI: 10.1177/1049732318761028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Life grids have been used in qualitative studies for the last two decades. They provide an activity which researcher and participant can focus their attention on, help build rapport, and reduce the control the researcher may hold within a session. Here we describe the novel use of life grids at the end of a data collection phase. Used in this previously unreported way, life grids assisted the closure of the data collection phase by summarizing the data collection and marking departure from the field. Creation of a life grid produced a tangible outcome, evidencing the work undertaken within the data collection period. They served as a powerful member checking tool, allowing participants to make additions and corrections to the data. In this article, the use of life grids in this novel way is described and recommended by the authors.
Collapse
Affiliation(s)
- Hannah Crawford
- Tees, Esk and Wear Valleys NHS Foundation Trust, Middlesbrough, United Kingdom
| | | |
Collapse
|
10
|
Samuels A. Embodied narratives of disaster: the expression of bodily experience in Aceh, Indonesia. JOURNAL OF THE ROYAL ANTHROPOLOGICAL INSTITUTE 2016. [DOI: 10.1111/1467-9655.12493] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Annemarie Samuels
- Institute of Cultural Anthropology and Development Sociology; Leiden University; P.O. Box 9555 2300 RA Leiden The Netherlands
| |
Collapse
|
11
|
Abstract
Sociological approaches to understanding narratives of illness usually begin with oral or textual discourse. This article extends the study of illness narratives beyond oral and textual accounts to photographs. It takes the position that attempts to distinguish clearly images and words, or verbal and visual narratives, are utopian projects. It examines three photographs taken by British feminist Jo Spence (1934–92) to document her experiences of breast cancer from the time of her diagnosis in 1982 until the time of her death in 1992. After defining ‘narrative’ and ‘photography’ and explaining how some photographs are narratives, the article considers how Spence’s photographs are narratives of living with cancer that incorporate visual and textual elements. It concludes by suggesting how and why extending the study of illness narratives beyond oral and textual accounts can enlarge and enrich social science understandings of people’s experiences of illness.
Collapse
|
12
|
Haxaire C, Tromeur C, Couturaud F, Leroyer C. A Qualitative Study to Appraise Patients and Family Members Perceptions, Knowledge, and Attitudes towards Venous Thromboembolism Risk. PLoS One 2015; 10:e0142070. [PMID: 26536460 PMCID: PMC4633063 DOI: 10.1371/journal.pone.0142070] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 10/16/2015] [Indexed: 11/18/2022] Open
Abstract
Objective This study aimed to examine perception, knowledge and concerns developed by patients and their family as regards venous thromboembolism (VTE) risk. Methods We conducted a qualitative study. Participants were: (1) patients with unprovoked VTE with either factor V Leiden mutation or G20210A prothrombin gene mutation or not; and (2) their first-degree relatives. Interviews took place mostly at Brest University Hospital. Participants produced narratives of the patient’s illness, stressing their perception of the disorder, its mechanisms, etiology, circumstances and risk factors. Interviews were audiotaped and transcribed verbatim. On an ongoing basis, central themes were identified and data from narratives were categorized by these themes. Results A total of ten patients and 25 first-degree relatives were interviewed. Analyses of patient’s narratives suggested 4 main themes: (1) concerns about initial symptoms and suspicion of VTE. The longer the duration of the initial phase, the more likely anxiety took place and persisted after diagnosis; (2) underestimation of potential life-threatening episode once being managed in emergency; (3) possible biographical disruption with inability to cope with the event; and (4) secondary prevention attitudes motivated by remains of the episode and favoring general prevention attitudes. Analyses of the first-degree relatives narratives suggested 3 main themes: (1) common interpretation of the VTE episode shared within the family; (2) diverse and sometimes confusing interpretation of the genetic status; and, (3) interpretation of clinical signs linked to VTE transmission within the family. Conclusions Construction of the risk of VTE is based on patient’s initial experience and shared within the family. Collection of narratives illustrates the gap between these perceptions and current medical knowledge. These results support the need to collect the perceptions of the VTE episode and its consequences, as a prerequisite to any health education process.
Collapse
Affiliation(s)
- Claudie Haxaire
- LABERS, EA 3149, Université Européenne de Bretagne, Université de Brest, Brest. France
- CERMES3,Université Paris Descartes, EHESS, CNRS UMR 8211, INSERM U988, Paris, France
| | - Cécile Tromeur
- Université Européenne de Bretagne, Université de Brest, EA3878, IFR148, Hôpital La Cavale Blanche, Département de Médecine Interne et Pneumologie. Brest, France
| | - Francis Couturaud
- Université Européenne de Bretagne, Université de Brest, EA3878, IFR148, Hôpital La Cavale Blanche, Département de Médecine Interne et Pneumologie. Brest, France
| | - Christophe Leroyer
- Université Européenne de Bretagne, Université de Brest, EA3878, IFR148, Hôpital La Cavale Blanche, Département de Médecine Interne et Pneumologie. Brest, France
- * E-mail:
| |
Collapse
|
13
|
Jarvie R, Letherby G, Stenhouse E. “Renewed” “Older” Motherhood/Mothering: A Qualitative Exploration. J Women Aging 2015; 27:103-22. [DOI: 10.1080/08952841.2014.927728] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
14
|
Pilon R, Bailey PH, Montgomery P, Bakker D. The future is the present: diabetes complication stories. ACTA ACUST UNITED AC 2011. [DOI: 10.1111/j.1752-9824.2011.01095.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
|
15
|
Salim NR, Gualda DMR. Sexuality in the puerperium: the experience of a group of women. Rev Esc Enferm USP 2011; 44:888-95. [PMID: 21329111 DOI: 10.1590/s0080-62342010000400005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Puerperium is a period of great changes in women's lives, in physiological, psychological and socio-cultural terms. Female sexuality is a broad topic that should be explored vis-à-vis the singularity of woman's experiences which themselves vary at different moments in time. This article is part of the project: Sexuality in the Puerperium, the objective of which was to understand what women's experience of their sexuality is in the postpartum period. Observation and semi-structured interview were used. The research approach was qualitative and narrative was used as the conceptual and methodological method. Six primiparas who gave birth in a public hospital in São Paulo took part in the study. Observation took place in the in-patients unit in the immediate post-partum period. The interviews were conducted in the women's homes. The results of the study have enabled an understanding to be formed of the meanings and changes in sexuality during the postpartum period as well as of the experiences every woman faces in her new roles, relationships and difficulties.
Collapse
Affiliation(s)
- Natália Rejane Salim
- School of Arts, Sciences and Humanities at the University of São Paulo, São Paulo, SP, Brazil.
| | | |
Collapse
|
16
|
McMillan Boyles C, Hill Bailey P, Mossey S. Chronic obstructive pulmonary disease as disability: dilemma stories. QUALITATIVE HEALTH RESEARCH 2011; 21:187-198. [PMID: 20855908 DOI: 10.1177/1049732310383865] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The purpose of this work was to develop an understanding of the meaning of disability for individuals living with chronic obstructive pulmonary disease (COPD) in a Canadian midwestern community from an emic perspective. A focused ethnographic design was used. Fifteen individuals participated in interviews. Narrative analysis was used to examine the interview data. Data analysis revealed 65 dilemma stories consisting of two structural components: the impairment, and the justification/explanation of the impairment. Participants' impairment might or might not have been known to others. In both situations, individuals were faced with choices of whether to explain/justify or attempt to conceal the impairment. Participants told these dilemma stories to convey the meaning of COPD as a disability invisible to others, and at times, to themselves. The information gained from this research will serve as an essential complement to the existing knowledge about this important yet often invisible chronic illness.
Collapse
|
17
|
Blum LS, Pelto GH, Pelto PJ. Coping with a Nutrient Deficiency: Cultural Models of Vitamin A Deficiency in Northern Niger. Med Anthropol 2010; 23:195-227. [PMID: 15370198 DOI: 10.1080/01459740490487080] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Cultural explanations and management strategies for specific signs and symptoms of vitamin A deficiency are explored in a Hausa-speaking community in northern Niger. Their interpretations of the etiology of nightblindness in young children and pregnant women focus on food-related causes, in which "lack of good food" is central. In parallel with the significance of food in the etiology of nightblindness, the recommended treatments are home food remedies, primarily involving liver, meat, or green leaves. The locally attributed etiology for the more severe manifestation of vitamin A deficiency, xerophthalmia, stands in sharp contrast to this. People believe the primary cause is "heat" produced by acute infectious disease (particularly measles). A trip to the medical dispensary or a reliance upon home remedies are the preferred treatment options for this condition. We explore the striking correspondence between local interpretations of nightblindness and contemporary medical knowledge and treatment in relation to the very different explanations and curative measures offered for more serious manifestations of vitamin A deficiency.
Collapse
Affiliation(s)
- Lauren S Blum
- ICDDR, B: Centre for Health and Population Research, Dhaka, Bangladesh
| | | | | |
Collapse
|
18
|
Kierans CM, Maynooth NUI. Sensory and narrative identity: The narration of illness process among chronic renal sufferers in Ireland. Anthropol Med 2010. [DOI: 10.1080/13648470120101381] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
19
|
Gualda DMR, Praça NDS, Merighi MAB, Hoga LAK, Bergamasco RB, Salim NR, Orlandi FDS, Caldeira S. O corpo e a saúde da mulher. Rev Esc Enferm USP 2009. [DOI: 10.1590/s0080-62342009000600030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
O artigo teve como objetivo realizar uma reflexão teórica sobre corpo durante eventos no curso da vida da mulher na perspectiva teórica fenomenológica e os métodos de pesquisa usados na sua abordagem, conduzidas por docentes da área da Saúde da Mulher da Escola de Enfermagem da Universidade de São Paulo. Esta temática foi escolhida em decorrência da centralidade adquirida pelo corpo na sociedade atual e a relevância do tema. Neste texto mostramos sua aplicabilidade na área da Saúde da Mulher, os resultados de algumas pesquisas com diferentes métodos, tendo como foco o corpo em eventos do curso da vida da mulher.
Collapse
|
20
|
Montgomery P, Bailey P, Purdon SJ, Snelling SJ, Kauppi C. Women with postpartum depression: "my husband" stories. BMC Nurs 2009; 8:8. [PMID: 19732461 PMCID: PMC2760554 DOI: 10.1186/1472-6955-8-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2009] [Accepted: 09/05/2009] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The research on Postpartum Depression (PPD) to date suggests that there is a knowledge gap regarding women's perception of their partners' role as carer and care activities they perform. Therefore, the purpose of this study was to describe women's understanding of their partners' or husbands' involvement in the midst of PPD. METHODS This study used interview data from a larger study of northern and rural Ontario women's stories of help-seeking for PPD. The interpretive description approach was used to illustrate the complexity of women's spousal connections in PPD. Data from a purposive community sample of 27 women who self-identified as having been diagnosed with PPD was used. From the verbatim transcribed interviews a number of data excerpts were identified and labeled as "my husband" stories. Narrative analysis was employed to examine these stories. RESULTS During this time of vulnerability, the husbands' physical, emotional and cognitive availability positively contributed to the women's functioning and self-appraisals as wife and mother. Their representations of their husbands' 'doing for' and/or 'being with' promoted their well-being and ultimately protected the family. CONCLUSION Given that husbands are perceived to be central in mitigating women's suffering with PPD, the consistent implementation of a triad orientation, that includes woman, child and partner rather than a more traditional and convenient dyadic orientation, is warranted in comprehensive postpartum care. Finally, this study contributes a theoretical understanding of responsive as well as reactive connections between women and family members during the postpartum period.
Collapse
Affiliation(s)
- Phyllis Montgomery
- School of Nursing, Laurentian University, Ramsey Lake Road, Sudbury, Ontario, Canada
| | - Pat Bailey
- School of Nursing, Laurentian University, Ramsey Lake Road, Sudbury, Ontario, Canada
| | - Sheri Johnson Purdon
- Canadian Mental Health Association, Sudbury Branch, 111 Elm Street, Sudbury, Ontario, Canada
| | - Susan J Snelling
- Sudbury & District Health Unit, 1300 Paris Street, Sudbury Ontario, Canada
| | - Carol Kauppi
- School of Social Work, Laurentian University, Ramsey Lake Road, Sudbury, Ontario, Canada
| |
Collapse
|
21
|
Lovell AM. "The City Is My Mother": Narratives of Schizophrenia and Homelessness. AMERICAN ANTHROPOLOGIST 2008. [DOI: 10.1525/aa.1997.99.2.355] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
22
|
Alves PC. [Phenomenology and systemic approaches in socio-anthropological studies of illness: a brief critical review]. CAD SAUDE PUBLICA 2006; 22:1547-54. [PMID: 16832526 DOI: 10.1590/s0102-311x2006000800003] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This paper aims to identify the ways by which the principal frames of reference in the social sciences explain the structure of social actors' knowledge, practices, values, and behaviors regarding health care. The article begins by examining some of the assumptions underlying studies produced within what are called systemic theories. It then proceeds to discuss phenomenological approaches to the health and illness experience. The goal is to clarify how these approaches focus on experience and depart from prevailing systemic models.
Collapse
Affiliation(s)
- Paulo César Alves
- Faculdade de Filosofia e Ciências Humanas, Universidade Federal da Bahia, Salvador, Brasil.
| |
Collapse
|
23
|
Pownall E. Using a patient narrative to influence orthopaedic nursing care in fractured hips. ACTA ACUST UNITED AC 2004. [DOI: 10.1016/j.joon.2004.06.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
24
|
Lewis SD, Johnson VR, Farris RP, Will JC. Using Success Stories to Share Knowledge and Lessons Learned in Health Promotion. J Womens Health (Larchmt) 2004; 13:616-24. [PMID: 15257853 DOI: 10.1089/1540999041280954] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Compelling success stories, rich with details about real-life events and people, are a tool that health agencies can use to convey how their health promotion programs work, why they are successful, what lessons they have learned, and how others can launch similar programs. Success stories describe project accomplishments that are not easily captured by quantitative evaluation methods, such as surveys. METHODS Although success stories have not been widely used in public health, the North Carolina Department of Health and Human Services developed a series of stories, the Community Change Chronicles, to highlight environmental and policy changes that promote cardiovascular health. In 2003, the Well-Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN) program used the Community Change Chronicles as a model to develop success stories about WISEWOMAN projects. RESULTS WISEWOMAN Works: A Collection of Success Stories from Program Inception Through 2002 includes 12 stories and offers advice on how to create and use success stories in public health. This paper reviews the rationale for developing the stories, presents one success story as an example, and describes the process used to gather information, write the stories, and produce a resource for others interested in developing success stories. We also discuss how the WISEWOMAN success stories are being used to promote women's health and cardiovascular health. CONCLUSIONS As the WISEWOMAN experience suggests, healthcare providers and organizations can use success stories to gain support for successful activities, inform the public about program benefits, complement other quantitative and qualitative evaluation methods, and publicly acknowledge the contributions of staff and organizational partners.
Collapse
Affiliation(s)
- Sonya D Lewis
- Centers for Disease Control and Prevention, Division of Nutrition and Physical Activity, Office of the Director, Atlanta, Georgia 30333, USA.
| | | | | | | |
Collapse
|
25
|
Abstract
BACKGROUND This methodology utilizes narrative analysis and the elicitation of life stories as understood through dimensions of interaction, continuity, and situation. It is congruent with Aboriginal epistemology formulated by oral narratives through representation, connection, storytelling and art. Needed for culturally competent scholarship is an experience of research whereby inquiry into epiphanies, ritual, routines, metaphors and everyday experience creates a process of reflexive thinking for multiple ways of knowing. Based on the sharing of perspectives, narrative inquiry allows for experimentation into creating new forms of knowledge by contextualizing diabetes from the experience of a researcher overlapped with experiences of participants--a reflective practice in itself. AIM The aim of this paper is to present narrative inquiry as a relational methodology and to analyse critically its appropriateness as an innovative research approach for exploring Aboriginal people's experience living with diabetes. NURSING APPLICATION Narrative inquiry represents an alternative culture of research for nursing science to generate understanding and explanation of Aboriginal people's 'diabetic self' stories, and to coax open a window for co-constructing a narrative about diabetes as a chronic illness. The ability to adapt a methodology for use in a cultural context, preserve the perspectives of Aboriginal peoples, maintain the holistic nature of social problems, and value co-participation in respectful ways are strengths of an inquiry partial to a responsive and embodied scholarship.
Collapse
Affiliation(s)
- Sylvia S Barton
- Nursing Program, University of Northern British Columbia, British Columbia, Canada.
| |
Collapse
|
26
|
Karasz A, Dyche L, Selwyn P. Physicians' experiences of caring for late-stage HIV patients in the post-HAART era: challenges and adaptations. Soc Sci Med 2003; 57:1609-20. [PMID: 12948570 DOI: 10.1016/s0277-9536(03)00013-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
As medical treatment for AIDS has become more complex, the need for good palliative and end-of-life care has also increased for patients with advanced disease. Such care is often inadequate, especially among low-income, ethnic minority patients. The current study investigated physicians' experiences with caring for dying HIV patients in an underserved, inner city community in the Bronx, NY. The goals of the study included: (1) to investigate the barriers to effective end-of-life care for HIV patients; and (2) to examine physicians' experiences of role hindrance and frustration in caring for dying patients in the era of HAART. Qualitative, open-ended interviews were conducted with 16 physicians. Physicians identified two core, prescriptive myths shaping their care for patients with HIV. The 'Good Doctor Myth' equates good medical care with the delivery of efficacious biomedical care. The role of the physician is defined as technical curer, while the patient's role is limited to consultation and compliance. The 'Good Death Myth' envisions an ideal death which is acknowledged, organized, and pain free: the role of the physician is defined as that of comforter and supporter in the dying process. Role expectations associated with these myths were often disappointed. First, late-stage patients refused to adhere to treatment and were thus dying "unnecessarily." Second, patients often refused to acknowledge, accept, or plan for the end of life and as a result died painful, chaotic deaths. These realities presented intense psychological and practical challenges for providers. Adaptive coping included both behavioral and cognitive strategies. Successful adaptation resulted in "positive engagement," experienced by participants as a continuing sense of fascination, gratification, and joy. Less successful adaptation could result in detachment or anger. Participants believed that engagement had a powerful impact on patient care. Working with dying HIV patients in the post-HAART era of efficacious treatment challenges physician's cherished roles and values. Physicians adapt to the challenge through a variety of cognitive and behavioral strategies. The failure to adapt successfully has psychological consequences for providers that may impact patient care.
Collapse
Affiliation(s)
- Alison Karasz
- Albert Einstein College of Medicine and Montefiore Hospital, 3544 Jerome Avenue, Bronx, NY 10467, USA.
| | | | | |
Collapse
|
27
|
Gray ML, Fossey EM. Illness experience and occupations of people with chronic fatigue syndrome. Aust Occup Ther J 2003. [DOI: 10.1046/j.1440-1630.2003.00336.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
28
|
Browner CH, Preloran HM, Casado MC, Bass HN, Walker AP. Genetic counseling gone awry: miscommunication between prenatal genetic service providers and Mexican-origin clients. Soc Sci Med 2003; 56:1933-46. [PMID: 12650730 DOI: 10.1016/s0277-9536(02)00214-9] [Citation(s) in RCA: 106] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Amniocentesis, and other prenatal genetic tests, have become a well-established feature of modern prenatal care. But these tests place a considerable decision-making burden on the expectant mothers to whom they are offered: the genetic issues involved are complex and the appropriate course of action sometimes ambiguous. Genetic counseling aims to help pregnant clients make an informed decision about prenatal genetic tests. But the clientele of prenatal genetic counseling has changed significantly in the years since the practice was established. Clients were once a self-selected group of women well-informed about the genetic services being offered. In contrast, clients now include an increasing number of women, particularly ethnic minority women, who had no prior knowledge of genetic testing, but were found to be at risk of birth defects after routine screening. Little is known about how well genetic counseling serves the needs of this new clientele. This paper investigates the possibility that miscommunication between genetic counselors and their Mexican-origin clients contributed to the higher rates of amniocentesis refusal. We interviewed 156 pregnant Mexican-origin women who screened positive on a blood test routinely offered in California to detect birth defects. We also observed the genetics consultations of a sub-sample of the women. We identified five common sources of miscommunication: (1) Medical jargon; (2) The non-directive nature of counseling; (3) The inhibitions of counselors stemming from misplaced cultural sensitivity; (4) Problems of translation; (5) Problems of trust. We found that many Mexican-origin women are skeptical of genetic testing and do not easily surrender their own lay theories about the causes of their condition. In order to dislodge the misunderstandings of their clients, counselors must give clients the opportunity to air their own views, however contrary to those of genetics professionals these may be.
Collapse
Affiliation(s)
- C H Browner
- Center for Culture and Health, Department of Psychiatry and Biobehavioral Sciences, University of California--Los Angeles, CA, USA.
| | | | | | | | | |
Collapse
|
29
|
Abstract
This article presents a process-oriented perspective that relates to the broad question of how self-related experience comes to be endowed with meaning. The approach highlights the implications of 'living by' particular culturally based understandings in specific contexts and centers on how jointly cultural, social, and cognitive processes offer potentialities for orienting the experiential self without determining self-related experiences. This process-oriented perspective revolves around the interplay between the range of historically contingent cultural resources available for endowing experience with meaning and the socially and structurally grounded processes through which individuals learn about, orient towards and traffic in interpretive plausibilities--a socially situated experientially based process. This perspective is informed by, and provides an entree for exploring, variability within a cultural setting. The narrative accounts examined are from individuals who grew up speaking either Ojibwa or Cree (both Algonkian languages) in First Nations communities in Manitoba, Canada.
Collapse
Affiliation(s)
- Linda C Garro
- Department of Anthropology, University of California at Los Angeles, 90095-1553, USA.
| |
Collapse
|
30
|
Pierret J. The illness experience: state of knowledge and perspectives for research. SOCIOLOGY OF HEALTH & ILLNESS 2003; 25:4-22. [PMID: 14498927 DOI: 10.1111/1467-9566.t01-1-00337] [Citation(s) in RCA: 97] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Over the last quarter of a century, research on the illness experience has thrived. Publications on this subject are reviewed in relation to three themes: subjectivity; coping actions and strategies for managing everyday life; and the social structure. Sociology of Health and Illness has contributed significantly to this field. In conclusion, research perspectives are suggested for tackling the problems in passing from a micro to a macro level of analysis.
Collapse
Affiliation(s)
- Janine Pierret
- Centre de Recherche Médecine, Sciences, Santé, Société CNRS/INSERM/EHESS, Paris.
| |
Collapse
|
31
|
Coles RL. Elderly narrative reflections on the contradictions in Turkish village family life after migration of adult children. J Aging Stud 2001. [DOI: 10.1016/s0890-4065(01)00030-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
32
|
Gwilliam B, Bailey C. The nature of terminal malignant bowel obstruction and its impact on patients with advanced cancer. Int J Palliat Nurs 2001; 7:474-81. [PMID: 11923747 DOI: 10.12968/ijpn.2001.7.10.9904] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Patients with bowel obstruction due to advanced cancer often have a poor prognosis and suffer distressing symptoms that can be difficult to manage. Research to date has focused on medical interventions and the measurement and control of symptoms. Little attention has been given to patients' perceptions of their quality of life or the impact of their illness. This study aimed to explore patients' lived experience of bowel obstruction. Semi-structured interviews were conducted with ten patients with bowel obstruction due to gynaecological or gastric cancer. Data analysis was based on an adaptation of Giorgi (1975) and Parse et al's (1985a,b) phenomenological method. Findings suggest that the 'meaning' of being unable to eat is more significant for patients than the nutritional or biological loss of food. For some patients, bowel obstruction marks a process of transition from life to death which is characterized by a sense of social disengagement and disrupted identity. Interviews highlighted aspects of the nurse-patient relationship that were therapeutic in their own right.
Collapse
Affiliation(s)
- B Gwilliam
- Department of Palliative Medicine, The Royal Marsden Hospital NHS Trust, London, UK
| | | |
Collapse
|
33
|
Hunt LM, Arar NH. An analytical framework for contrasting patient and provider views of the process of chronic disease management. Med Anthropol Q 2001; 15:347-67. [PMID: 11693036 DOI: 10.1525/maq.2001.15.3.347] [Citation(s) in RCA: 84] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Medical anthropologists involved in clinical research are often asked to help explain patients' "noncompliance" with treatment recommendations. The clinical literature on "noncompliance" tends to problematize only the patient's perspective, treating the provider's perspective as an uncontroversial point of departure. Explicating the articulation between provider and patient assumptions, expectations, and perceptions in managing chronic illness is an area well suited to the unique perspective of medical anthropologists. In this article we present an analytical framework for contrasting patient and provider goals, strategies, and evaluation criteria in chronic illness management, using examples from research on type 2 diabetes care in South Texas. This approach goes beyond contrasting patient and provider concepts and explanations of the illness itself and examines their contrasting views within the dynamic process of long-term care. This approach may prove especially useful for research aimed at a clinical audience, since it maintains a clinically relevant focus while giving serious consideration to the patient's perspective.
Collapse
Affiliation(s)
- L M Hunt
- Department of Anthropology, Julian Samora Research Institute Michigan State University, USA
| | | |
Collapse
|
34
|
Lima AF, Gualda DM. [Oral history of life: in search of the meaning of hemodialysis in chronic renal patients]. Rev Esc Enferm USP 2001; 35:235-41. [PMID: 12432603 DOI: 10.1590/s0080-62342001000300006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This article has the objective to show the use of life oral history as methodological framework for qualitative data collection and analysis, aimed to understand the meaning of hemodialysis and the impact of this therapeutic modality of treatment in the patient's life in the Hemodialysis Unity at the University Hospital at the University of São Paulo.
Collapse
Affiliation(s)
- A F Lima
- Serviço de Hemodiálise, Hospital Universitário da Universidade de São Paulo
| | | |
Collapse
|
35
|
Bailey PH. Death stories: acute exacerbations of chronic obstructive pulmonary disease. QUALITATIVE HEALTH RESEARCH 2001; 11:322-338. [PMID: 11339077 DOI: 10.1177/104973201129119136] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The underlying premise of narrative research within social science literature is the belief that individuals most effectively make sense of their world by (re)constructing stories. Chronic Obstructive Pulmonary Disease (COPD) is a progressive degenerative respiratory disorder that affects approximately 15% of Canadians annually. Prior to the study discussed in this article, no research had been done to understand the frightening event of an acute exacerbation episode of COPD from the perspective of patients and their family caregivers. Hence, 10 family-nurse units were interviewed during an acute exacerbation event. The participants told a number of near-death and shadow-of-death stories that describe these episodes as life changing and illustrate the centrality of these events in the participants' understanding of their chronic illness.
Collapse
Affiliation(s)
- P H Bailey
- Laurentian University School of Nursing, Sudbury, Ontario, Canada
| |
Collapse
|
36
|
Steeves R, Kahn D, Ropka ME, Wise C. Ethical considerations in research with bereaved families. FAMILY & COMMUNITY HEALTH 2001; 23:75-83. [PMID: 11401625 DOI: 10.1097/00003727-200101000-00009] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
This article describes a research project aimed at delivering an intervention to bereaved family members living in the community. The issues covered are access to subjects, recruitment and retention of subjects, and random assignment to control and experimental groups.
Collapse
Affiliation(s)
- R Steeves
- University of Virginia, School of Nursing, Charlottesville, Virginia, USA
| | | | | | | |
Collapse
|
37
|
Woodgate R. Part I: an introduction to conducting qualitative research in children with cancer. J Pediatr Oncol Nurs 2000; 17:192-206. [PMID: 11063514 DOI: 10.1177/104345420001700402] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Over the past decade, pediatric nurse researchers have acknowledged the need to study children's cancer illness experiences within the qualitative research framework. Support for more qualitative research is based on the belief that it will afford researchers the opportunity to get closer to understanding children's perspectives of their cancer experience. A priori theories or generalizations by the researcher are not imposed; therefore, information emerging from the research is believed to be more a reflection of the perspectives of child participants and not adult researchers. Although pediatric oncology nurses may be interested in using more qualitative methods in their research, deciding on the appropriate qualitative research design may not always be so evident, considering that the adoption of qualitative inquiry in the study of childhood cancer is in its infancy. Accordingly, the purpose of this article is to increase the reader's understanding of the use of the qualitative research paradigm in the study of children's experiences with cancer. An overview of four qualitative research designs that pediatric oncology nurse researchers may adopt is presented. Specifically, the qualitative designs of grounded theory, ethnography, phenomenology, and biography or illness narratives are examined. To facilitate discussion, each of the four designs are applied to the study of symptom experiences in children with cancer.
Collapse
Affiliation(s)
- R Woodgate
- Faculty of Nursing, University of Manitoba, Winnipeg, Manitoba, Canada.
| |
Collapse
|
38
|
Johnson N, Cook D, Giacomini M, Willms D. Towards a "good" death: end-of-life narratives constructed in an intensive care unit. Cult Med Psychiatry 2000; 24:275-95. [PMID: 11012101 DOI: 10.1023/a:1005690501494] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
End-of-life decisions regarding the withdrawal and withholding of life supporting technology have become commonplace within intensive care units (ICUs). In this paper, we examine the dialogue between ICU team members and families regarding limitation of treatment as a therapeutic narrative--that is, as a story which frames therapeutic events as well as the critically ill patient's experience in a meaningful and psychologically comforting way for families and health care providers alike. The key themes of these end-of-life narratives are discussed, as well as the qualities that the stories share with other narratives of the same genre.
Collapse
Affiliation(s)
- N Johnson
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
| | | | | | | |
Collapse
|
39
|
Abstract
Massive disruptions to a way of life, such as those brought on by widespread violence, terror, and genocide, disorder the body as well as the social order. When they flee their homelands, refugees bring their experiences of violence and terror with them. Drawing on an ethnographic study of 40 Cambodian refugees between the ages of 50 and 79 who suffered from one or more chronic illnesses, we explore how refugees who live with chronic illnesses and are dependent on government support were affected by the threat of welfare reform. When welfare reform threatened to cut Cambodian refugees' income, it posed a new crisis for those who were chronically in limbo and placed further constraints on their lives. Through their narratives, Cambodian refugees enacted their bodily distress and resisted the threat of welfare reform. The story of threatened welfare reform in the U.S. and its possible consequences for refugees is a story of quixotic U.S. politics, policies and antidotes for refugeeism gone awry.
Collapse
Affiliation(s)
- G Becker
- Medical Anthropology Program, University of California, San Francisco 94143-0646, USA.
| | | | | |
Collapse
|
40
|
Abstract
Cultural criticism is used to describe the political role of autobiographical illness narratives or pathographies. In expressing the subjective experience of illness, authors of pathographies illuminate ideological differences between patient and health care cultures, reveal the dominance of health care ideologies, and explicate patients' moral and political claims. The contributions of these literary works to nursing practice provide direction for relational restructuring. Gadow's concept of the relational narrative is proposed as a way to restore patient subjectivity and agency and establish the dialogue necessary for cultural pluralism in nursing and health care.
Collapse
Affiliation(s)
- J A Sakalys
- Professor, School of Nursing, University of Colorado Health Sciences Center, 4200 East 9th Avenue, Box C288, Denver, Colorado 80262, USA
| |
Collapse
|
41
|
Miller T. Losing the plot: narrative construction and longitudinal childbirth research. QUALITATIVE HEALTH RESEARCH 2000; 10:309-323. [PMID: 10947478 DOI: 10.1177/104973200129118462] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
This article seeks to explore the ways in which theories of narrative might be significant in the study of childbearing. The event of childbirth and the process of women becoming mothers have major significance for individual biographies and are publicly defined. The medicalization of childbearing and the placing of a natural event into a pathological illness model has repercussions for the ways in which women experience and make sense of the event. The complex interweaving of public and lay narratives that surround this period of transition can lead to bafflement and the eventual construction of personal counternarratives. The context in which narratives are managed is explored.
Collapse
Affiliation(s)
- T Miller
- Center for Family and Household Research, Oxford Brookes University
| |
Collapse
|
42
|
|
43
|
Mattingly C, Lawlor M. Learning from Stories: Narrative Interviewing in Cross-cultural Research. Scand J Occup Ther 2000; 7:4-14. [PMID: 21399739 PMCID: PMC3051197 DOI: 10.1080/110381200443571] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
This paper argues for the importance of eliciting stories when trying to understand the point of view and personal experience of one's informants. It also outlines one approach to eliciting and analyzing narrative data as part of a complex and multi-faceted ethnographic study. The paper draws upon ethnographic research among African-American families who have children with serious illnesses or disabilities. However, it is not a report of research findings per se. Rather, it is primarily a conceptual paper that addresses narrative as a research method. Features that distinguish a story from other sorts of discourse are sketched and current discussions in the occupational therapy and social science literature concerning the importance of narrative are examined. The heart of the paper focuses on a single narrative interview and examines what we learn about the client and family caregiver perspective through stories.
Collapse
Affiliation(s)
- Cheryl Mattingly
- Department of Occupational Science & Occupational Therapy, Department of Anthropology, University of Southern California, Los Angeles, CA, USA
| | | |
Collapse
|
44
|
Hinton WL, Levkoff S. Constructing Alzheimer's: narratives of lost identities, confusion and loneliness in old age. Cult Med Psychiatry 1999; 23:453-75. [PMID: 10647944 DOI: 10.1023/a:1005516002792] [Citation(s) in RCA: 93] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
This paper is a qualitative study based on retrospective, unstructured, qualitative interviews with Mrs. Jones and other African-American, Chinese-American, Irish-American and Latino family caregivers in the Boston area. A narrative approach is used to show how family caregivers draw on their cultural and personal resources to create stories about the nature and meaning of illness and to ask how ethnic identity may influence the kinds of stories family caregivers tell. Three different story types are identified and described, each with a distinctive configuration of illness meanings and overarching theme, or storyline: a subset of African-American, Irish-American, and Chinese-American caregivers told us stories about Alzheimer's as a disease that erodes the core identity of a loved one and deteriorates their minds; a subset of Chinese caregivers narrated stories that emphasized how families managed confusion and disabilities, changes ultimately construed as an expected part of growing old; a subset of Puerto Rican and Dominican families, while using the biomedical label of Alzheimer's disease or dementia, placed the elder's illness in stories about tragic losses, loneliness, and family responsibility. To construct their stories, caregivers drew upon both biomedical explanations and other cultural meanings of behavioral and cognitive changes in old age. Their stories challenge us to move beyond the sharp contrast between ethnic minority and non-ethnic minority views of dementia-related changes, to local clinics and hospitals as sites where biomedical knowledge is interpreted, communicated, discussed, and adapted to the perspectives and lived realities of families.
Collapse
Affiliation(s)
- W L Hinton
- Department of Psychiatry, UC Davis Medical Center, Sacramento, CA, USA
| | | |
Collapse
|
45
|
|
46
|
Martin CM, Banwell CL, Broom DH, Nisa M. Consultation length and chronic illness care in general practice: a qualitative study. Med J Aust 1999; 171:77-81. [PMID: 10474581 DOI: 10.5694/j.1326-5377.1999.tb123525.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To study the relationship between duration and content of general practice consultations for patients with chronic conditions. DESIGN A qualitative analysis of transcripts of consultations. The major themes and concepts of psychosocial support were identified and coded using the Ethnograph computer package. SETTING A mix of rural and urban general practices in two States of Australia in 1993-1994. PARTICIPANTS 14 selected general practitioners and 50 of their patients with complex chronic conditions. RESULTS Transcriptions of 106 consultations were analysed. General practitioners (GPs) led most consultation dialogue and emphasised disease management. The major themes were provision of information by the GP, review of treatment by the GP, review of illness by the GP, and description and explanations of their illness by patients (patient narrative). The first three themes predominated in consultations of all lengths. Longer consultations (20 minutes and over) contained more dialogue initiated by patients and more patient narrative about living with their illness. CONCLUSIONS Patients with complex chronic conditions may require longer consultations to allow adequate time for review of their illness and treatment as well as an opportunity to raise issues and concerns about their illness, its impact on their lives and their personal management strategies. Longer consultations may thus provide the mechanism for what has been described as patient "enablement".
Collapse
Affiliation(s)
- C M Martin
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT.
| | | | | | | |
Collapse
|
47
|
Lockhart C. Biomedicine on the spatial periphery: the (re)production of a metaphorical landscape by rural health care practitioners in northern California. Med Anthropol Q 1999; 13:163-85. [PMID: 10440028 DOI: 10.1525/maq.1999.13.2.163] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
I examine the use of spatial concepts by rural health care practitioners in Northern California and suggest that rural and urban spatial metaphors are important means of expressing and (re)producing problems associated with their search for legitimacy and moral authority within a field of relations defined by biomedicine. I present three broad ways in which spatial metaphors are used by rural health care practitioners to continuously enact a "metaphorical landscape." I situate this landscape in the context of a hierarchical field of relations within biomedicine, which is itself underpinned by a distinct urban bias and the uneven distribution of material and technological resources. I suggest that this landscape is partly the result of the rural health care practitioners' position within this field of relations and partly the result of implicit and historically situated frameworks of spatial meanings derived from capitalism.
Collapse
Affiliation(s)
- C Lockhart
- Medical Anthropology Program, University of California at San Francisco, USA
| |
Collapse
|
48
|
Abstract
The experiences of dementia sufferers have rarely been examined in sociological literature. This article seeks to describe the experiences of one Alzheimer's Disease patient at the point of institutionalization in order to address a series of questions. Can Alzheimer's Disease patients be thought of as experiencing subjects? Is experience tied to modes of expression? An answer to this set of questions is sought by problematizing the concept of 'voice,' freeing it from a restricted location in natural language to embed it in other forms of embodiment.
Collapse
Affiliation(s)
- R Chatterji
- Department of Sociology, Delhi School of Economics, Delhi University, India
| |
Collapse
|
49
|
Hunt LM, Valenzuela MA, Pugh JA. Porque me tocó a mi? Mexican American diabetes patients' causal stories and their relationship to treatment behaviors. Soc Sci Med 1998; 46:959-69. [PMID: 9579748 DOI: 10.1016/s0277-9536(97)10014-4] [Citation(s) in RCA: 90] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This paper reports findings from an ethnographic study of self-care behaviors and illness concepts among Mexican-American non-insulin dependent diabetes mellitus (NIDDM) patients. Open-ended interviews were conducted with 49 NIDDM patients from two public hospital outpatient clinics in South Texas. They are self-identified Mexican-Americans who have had NIDDM for at least 1 yr, and have no major impairment due to NIDDM. Interviews focused on their concepts and experiences in managing their illness and their self-care behaviors. Clinical assessment of their glucose control was also extracted from their medical records. The texts of patient interviews were content analyzed through building and refining thematic matrixes focusing on their causal explanations and treatment behaviors. We found patients' causal explanations of their illness often are driven by an effort to connect the illness in a direct and specific way to their personal history and their past experience with treatments. While most cite biomedically accepted causes such as heredity and diet, they elaborate these concepts into personally relevant constructs by citing Provoking Factors, such as behaviors or events. Their causal models are thus both specific to their personal history and consistent with their experiences with treatment success or failure. Based on these findings, we raise a critique of the Locus of Control Model of treatment behavior prevalent in the diabetes education literature. Our analysis suggests that a sense that one's own behavior is important to the disease onset may reflect patients' evaluation of their experience with treatment outcomes, rather than determining their level of activity in treatment.
Collapse
Affiliation(s)
- L M Hunt
- School of Nursing, University of Texas Health Science Center, San Antonio 78284-7947, USA
| | | | | |
Collapse
|
50
|
Abstract
OBJECTIVES To briefly discuss the nature and function of stories that patients tell, and offer practical tips on how to listen and make sense of these stories. DATA SOURCES Books and articles from disciplines in the humanities and health care professions. CONCLUSION Stories are a medium for assessment and intervention in areas that essentially reflect an individual's spirituality. IMPLICATIONS FOR NURSING PRACTICE Encouraging storytelling is an intervention nurses can use to promote spiritual health. Suggestions for eliciting and analyzing stories are offered.
Collapse
Affiliation(s)
- E J Taylor
- University of Southern California, Department of Nursing, Los Angeles 90033, USA
| |
Collapse
|