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Biomedical subjects

Cynthia Peden-McAlpine

Publications and source records attributed to Cynthia Peden-McAlpine.

10 recordsLinked to original sources
PubMed2007

A qualitative study of the experiences of Taiwanese women having their first baby after the age of 35 years.

OBJECTIVE: to explore the experiences of Taiwanese women who become pregnant for the first time after the age of 35 years. DESIGN, SETTING AND PARTICIPANTS: a phenomenological method was used to collect data by interviews. This study was undertaken in a 1600-bed university hospital in southern Taiwan, with a purposive sampling of 10 first-time pregnant women aged 35-44 years. The interviews were tape-recorded and transcribed to develop data categories. FINDINGS: participants amply demonstrated that the core experience was 'jubilant apprehension' (Yu-Shee-Zhun-Ben in Mandarin). Five subcategories were expressed among pregnant women over 35 years of age. These were 'surprise and worry about childbirth outcomes;' 'embarrassment about being outside the societal age norm for pregnancy;' 'ambivalence about impending lifestyle changes;' 'loneliness and lack of support;' and 'concern about the safety of pregnancy and childbirth'. CONCLUSION AND IMPLICATIONS FOR PRACTICE: although pregnancy was a pleasant surprise for these women, they were concerned that their childbearing was beyond the social expectation for their age. We highlight new aspects of midwifery professionalism that should address the childbearing experience of women over 35 years of age, and provide a basis for care of this group.

Adaptation, Psychological↗
PubMed2006

Family decision-making for nursing home residents with dementia: rural-urban differences.

CONTEXT: Research has demonstrated substantial differences between end-of-life care in rural and urban settings. As the end of life approaches, rural elders are less likely to be hospitalized, to be placed in an intensive care unit, or to have a feeding tube, compared to their urban counterparts. These differences cannot be fully explained by rural-urban differences in access to medical services. PURPOSE: To describe and understand rural-urban differences in attitudes toward death and in end-of-life decision making. METHODS: Eight focus groups were convened in rural and urban Minnesota nursing homes. The 38 focus group participants were family members of nursing home residents with severe cognitive impairment. FINDINGS: Most rural focus group participants voiced unqualified acceptance of death and placed few conditions on death, beyond their hope that it would be quick and peaceful. Urban respondents presented a wider range of attitudes toward death, from unambiguous acceptance of immediate death to evident discomfort with welcoming death under any circumstances. These rural-urban differences had practical implications. Rural respondents were much less likely to endorse interventions that would impede death, compared to their urban counterparts. CONCLUSIONS: Rural respondents tended to express confidence in natural forces; death was seen as neutral or beneficent. Resistance to the approach of death was more characteristic of urban respondents, some of whom insisted upon aggressive medical care in advanced dementia.

Aged↗
PubMed2005

Evaluation of a reflective practice intervention to enhance family care.

AIM: This paper discusses the design, evaluation and outcomes of a reflective practice intervention (RPI) that taught paediatric critical care nurses how to incorporate a family intervention into their practice. BACKGROUND: The literature on reflective practice contains numerous descriptions of reflective practice and various frameworks on how to engage in reflective practice. Additionally, there has been wide debate about the benefits of and problems with the use of reflective practice. However, few empirical studies have been done to evaluate its effectiveness in changing nursing practice. METHOD: Van Manen's phenomenological research approach was adapted for use in this study. This approach was consistent with the experiential nature of reflective practice. Interviews were conducted with eight staff nurse participants after the RPI to determine changes in family practice. Analysis of the interview text produced three essential themes. FINDINGS: Three interrelated themes describe change in the nurses' experiences as a result of participating in the RPI: (1) acknowledging and re-framing preconceived ideas about families, (2) recognizing the meaning of family stress and (3) beginning to incorporate the family into nursing care. CONCLUSIONS: The RPI stimulated double loop learning that changed paediatric critical care nurses' attitudes about family, enhanced their communication and ability to build trusting relationships with families and brought about a new appreciation of the uniqueness of family stress. There was a new integration of family care into the nurses' practice as a result of the intervention.

Adult↗
PubMed2005

Phenomenological research among Canadian and United States indigenous populations: oral tradition and quintessence of time.

Researchers conducting phenomenological studies among indigenous peoples in the United States and Canada have identified a seamless link between phenomenology and indigenous oral tradition. Phenomenology is compatible with indigenous peoples, because it is synchronous with holistic indigenous cultural lifeway and values. Phenomenology, as a research method, assists indigenous people in reproducing, through narrative communication, features of the past, present, and future. In the narrative process, this method elicits significant implicit meaning of indigenous culture and assists with recording the essence of experiences and events of indigenous societies. A product of the telling of narrative stories is the capacity to reflect on change that will enhance health in a holistic and culturally acceptable manner.

Anthropology, Cultural↗
PubMed2004

The experience of using a combination of complementary therapies: a journey of balance through self-healing.

Literature on complementary or alternative therapies from the perspective of personal experience is limited, and to date, there are no published studies using a qualitative approach to study the contextual effects of combined complementary therapies. Evaluating the use of combinations of complementary therapies from the perspective of those who experience them is important in understanding their beneficial and synergistic effects. This article is a report of the findings of a hermeneutic phenomenological study on the lived experience of 8 guests participating in a structured naturopathic program that used combinations of complementary/alternative therapies to promote healing in illness.

Adult↗
PubMed2003

Experiencing health in the context of rheumatoid arthritis.

The purpose of this study was to explicate the health experience of persons with rheumatoid arthritis who manifest a strong sense of well-being. Five women and three men participated in unstructured interviews in order to answer the research question, What are the subplots that emerge in the descriptions of health given by persons with rheumatoid arthritis? A hermeneutic method was used to analyze the transcripts. Three subplots emerged: (a) The evolving--not knowing and then knowing something, but never really knowing, (b) the reframing, and (c) the relational fugue. The findings, including creation of healing spaces and an evolving relationship with assistive devices, provide evidence of turning points in the health process and are suggestive of a strong sense of well-being as a manifestation of a reorganized pattern.

Adult↗
PubMed2002

Clinical innovation for promoting family care in paediatric intensive care: demonstration, role modelling and reflective practice.

AIM: To explore family caregiving problems in paediatric crisis care and methods that could be applied to move the abstraction of family care to development of specific family interventions. BACKGROUND AND RATIONAL: Family centred care has been accepted as the ideal philosophy for holistic health care of children, but methods for its implementation are not well established. In paediatric health crises, family care requires special sensitivity to family needs and a type of complex nursing care for which many practitioners are not sufficiently prepared. Developing family sensitive models of intervention and finding a strategy for transfer of this knowledge to clinical practice is an important challenge facing family nursing today. Social learning theory provides a rich background to explore these issues. CONCLUSIONS: Specific techniques of role modelling and reflective practice are suggested as effective approaches to teach family sensitive care in clinical settings where families are part of the care environment.

Clinical Competence↗
PubMedDate not supplied

Early recognition of client status changes: the importance of time.

Early recognition of client status changes prevents or minimizes complications and reduces client morbidity, yet little is known about this phenomenon in nursing. Using a qualitative interpretive approach, this study investigated how expert critical care nurses are able to recognize and intervene in the early stages of client problems. The findings revealed a temporal unity in critical care nurses' thinking that informs their early recognition experiences.

Adult↗
PubMedDate not supplied

Diet strategies used by women to manage fecal incontinence.

Fecal incontinence occurs in community-living women who are elderly, as well as younger women, particularly after vaginal childbirth. Little is known about how women manage fecal incontinence in their everyday lives. Ten women who had fecal incontinence for at least 1 year participated in an audio-taped interview in a phenomenological study. Diet modification was identified as a key strategy for managing fecal incontinence. Various food types were avoided, restricted, or used as remedies. The meanings that the women applied to the diet strategies for managing fecal incontinence had 4 themes: restricting diet and eating patterns, eating and dealing with the consequences, treating fecal incontinence with foods and fluids, and lacking therapeutic guidance regarding diet modifications for fecal incontinence. The results of this study suggest that the continence nurse specialist recognize the important role and meaning of diet as a self-care strategy for women with fecal incontinence and address diet in their assessment and management recommendations.

Activities of Daily Living↗