Biomedical subjects

D Kralik

Publications and source records attributed to D Kralik.

9 recordsLinked to original sources

PubMed2001

Women's experiences of 'being diagnosed' with a long-term illness.

AIMS: In this paper we share women's storied accounts of 'being diagnosed' with a long-term illness. The purpose of the paper is to raise awareness of health professionals that receiving a medical diagnosis is a potentially calamitous event, challenging self-identity. BACKGROUND: The three authors were involved in three separate inquiries which explored women's experiences of living with illness. The authors realized that 'being diagnosed' was a common memorable event for the women across the inquiries. The literature around receiving a diagnosis was scarce. DESIGN: This paper is the result of secondary analysis of data from three different projects where we researched women living with long-term illness. In this paper, we focus on the experience of 'being diagnosed' as we share and show women's perceptions of receiving a medical diagnosis. FINDINGS: Receiving a medical diagnosis of a long-term illness was a memorable event in the women's lives. Many women felt alone with their illness, often without adequate information to find meaning in the relationship between their familiar self and their new identity as a woman living with illness. They felt vulnerable and lost as they tried to understand the meanings and consequences that the diagnosis held for their present and their future. Informational needs may be specific and individual. For many, receipt of a diagnostic label was momentous and should not be underestimated, despite the initial feeling of chaos, many women felt validated. CONCLUSION: Receiving a medical diagnosis is one event where health care professionals could be on standby. It is important to take the woman's articulation of the event seriously. Open, genuine communication, with willingness on behalf of the health professional to listen would be affirming for women who are coming to terms with the diagnosis of a chronic illness.

Adaptation, Psychological↗

PubMed2001

Constructions of sexuality for midlife women living with chronic illness.

AIM: In this paper, we reveal constructions of sexuality that were articulated by women who participated in an inquiry which aimed to understand the experiences of midlife women who live with chronic illness. The aim of this paper is to illuminate sexuality as an important health issue for women living with chronic illness and to offer ways that nurses may acknowledge and facilitate sexuality issues for women. BACKGROUND: The first author, as part of her doctoral study, corresponded with 81 women living with chronic illness. The participatory inquiry was framed by feminist principles and enabled women to anonymously share their experiences and collaborate in the direction of the research. During the analysis phase of the research, it became evident that illness had altered the way in which women conceptualized sexuality. DESIGN: The three authors performed secondary analysis of the original data set in order to re-examine the impact that chronic illness had on the sexuality of midlife women who live with chronic illness. Whilst we acknowledge that sexuality has multiple meanings, in this paper we describe the way in which women themselves have constructed and articulated their sexuality. FINDINGS: We found that sexuality incorporated women's desires, appearance, sexual feelings and expression and imposed on aspects of their lives that they had not needed to acknowledge before illness intruded. Three concerns are discussed; the changing body, meeting the needs of others and communicating sexuality. CONCLUSIONS: This paper reveals that issues of sexuality are an important health concern for women who live with long-term illness and should be acknowledged in sensitive and responsive health practices. The paper concludes that it is important for nurses to provide women opportunity for open and genuine communications about sexuality. In this way, a foundation of acceptance for the whole person is established which provides women permission to ask questions and seek assistance with sexuality issues.

Adult↗

PubMed2001

Chronic illness: reflections on a community-based action research programme.

AIM: The purpose of this paper is to describe the birth of a research culture in a community nursing service, and the development and implementation of an action research programme that focuses on understanding the experiences of living with chronic illness. BACKGROUND: Approximately 70% of the clients of our community nursing practice in South Australia live with chronic illness. Our research interest has focused on how community nurses can assist people living with chronic conditions to live 'well'. In this paper we describe the way in which we have applied the principles of participatory action research (PAR) when working with women who live with multiple sclerosis (MS) and urinary incontinence. We then draw on elements of PAR research with men who live with MS and men and women who live with type 2 diabetes. In total, we have convened eight PAR groups researching with people who live in the community with chronic illness and this work constitutes our chronic illness research programme. DESIGN: The PAR philosophy is based on the principles of democratic, equitable, liberating and life enhancing relations within a research process, and is operationalized in cycles of: look, think and act. In these collaborative inquiries the researchers have facilitated participants to reflect on how illness affects their lives, to tell their own story, make connections, plan action and help them negotiate the rites of passage. We select two areas for discussion: methodological issues in the application of PAR principles and our tentative findings from the chronic illness research programme. FINDINGS: We assert that the facilitator's skill in managing group dynamics is crucial to the life and outcome of the project. Change can occur as a result of action at an individual level, with improved self-management of chronic illness, or at a collective level where the PAR group instigates larger reform strategies. In terms of tentative findings, men and women living with a chronic illness appear to be involved in an ongoing process of transition toward incorporating the illness into their lives. Although we have not yet identified specific events, we have noted that there are critical turning points in the illness transition experience. Participants feel validated in telling their story of living with a chronic illness. Story telling may be the turning point that enhances the lives of all those who participate. CONCLUSION: If health care professionals can understand the process that facilitates people to move toward incorporating chronic illness into their lives, we can make a substantial contribution to enhance their chronic disease self care management.

Chronic Disease↗

PubMed2001

Breaking the silence: women living with multiple sclerosis and urinary incontinence.

This study examined women's understandings of living with multiple sclerosis (MS) and urinary incontinence and the challenges they have encountered in their day-to-day lives. As health-care professionals, we aimed to understand how people living with MS manage urinary incontinence. This paper reports the findings from a Participatory Action Research (PAR) group with four women, the researcher and two Continence Nurse Advisors (CNAs). The group met on five occasions between March and June 1999. The women's stories held personal and gendered meanings about living with MS and urinary incontinence. Four themes were derived from the transcripts: maintaining control; seeking understanding; avoiding shame; and good and bad days. The women and the CNAs benefited from an exchange of knowledge about living with MS and incontinence. The CNAs became sensitive to the women's experience and have been able to incorporate these understandings into their practice. By sharing our research we hope the findings may be more widely incorporated into sensitive health practice.

Adaptation, Psychological↗

PubMed2001

The domination of chronic illness research by biomedical interests.

The interest of biomedicine is the physical body viewed in isolation from the contextual understandings which shape the chronic illness experience. This neglect of the illness experience was evident in an inquiry conducted by the first author with 81 women who live with chronic illness. Herein we discuss a secondary analysis of the correspondence data in which we found many common elements across different medical diagnoses.

Chronic Disease↗

PubMed2000

Pen pals: correspondence as a method for data generation in qualitative research.

The study aimed to understand the impact of chronic illness on the lives of midlife women and explore and share the ways in which women adapt to and/or tolerate chronic illness in their lives. In 1998, 80 women participated in a study in which data were generated by corresponding with the researcher. Guided by feminist principles of collaboration, reciprocity and disclosure, we created rich stories about what it is like to live with a chronic illness. In this paper we will discuss the first phase of this inquiry which utilized correspondence between the researcher and the women. The issues posed by the use of correspondence as an innovative data generation process will be analysed. Correspondence, at first glance, may appear to be a rather impersonal communication medium. However, we are committed to this method of data generation and believe we have unlocked the doors to a viable qualitative research process. The literature to guide this process is scarce so we are keen to share work in progress. We will describe the preparation phase in setting up the study; discuss some practical issues, share some of the researcher's experiences in generating narratives from dialogues and hear from the women themselves what they consider to be significant about this research process.

Adaptation, Psychological↗

PubMed2000

Men living with diabetes: minimizing the intrusiveness of the disease.

In this paper we present the findings from the second of four Participatory Action Research (PAR) groups with men and women who have been diagnosed with type two diabetes. The findings of the men's group are reported here. People who have received a diagnosis of diabetes must immediately absorb a great deal of information about how to control their diabetes, care for themselves and make lifestyle changes. In this study, we have asked men about this transition and about what it is like to live with diabetes. We aimed to understand how people with type two diabetes incorporate chronic illness into their lives. Utilizing the processes of PAR, we created a conducive environment for the voices of people with diabetes to be clearly heard in relation to their health. Men who live with type two diabetes met with a researcher and two Clinical Nurse Consultants, for two hours, once a week, for four weeks, during November 1998. The men expressed that diabetes had made a positive impact on their lifestyle; they viewed diabetes as part of life and not as an illness. Men chose foods with confidence; their concern about potential complications meant they chose to take better care of themselves. They were confident in their knowledge of diabetes, and while they took responsibility for themselves, being supported by their partner was helpful in managing their diabetes. They managed their life with diabetes by minimizing the intrusiveness of the disease.

Adaptation, Psychological↗

PubMed1999

Women living with type II diabetes: the intrusion of illness.

This study is part of a larger research project which aimed to create an understanding of how people with type II diabetes incorporated chronic illness into their lives. We aimed to find wellness in the context of a chronic illness. The participatory action-orientated research (PAR) approach is consumer based and managed, and six women with diabetes and the research team met for eight two-hour sessions in August and September 1998. The objectives were to contribute to understanding of the health of adults who live with chronic illness by providing greater insight and understanding into the worlds of people who live with a chronic illness and allowing the voices of people with diabetes to be clearly heard in relation to their health. There was a wellness theme around taking time out, but considering the other dominant negative experiences, this study can only be considered as an attempt to find wellness in the context of chronic illness. The PAR process, built upon sharing, listening and reconstructing stories, worked toward the women being heard and having a voice for the first time. Listening and acting upon the voices of the women has implications for the practice of health care professionals.

Activities of Daily Living↗

PubMed1997

Engagement and detachment: understanding patients' experiences with nursing.

This study aimed to understand what post-operative patients perceived was important about the nursing care they had experienced. The participants were nine women recovering from total hip replacement surgery which had been performed in a large public, acute care hospital in south Australia. Participants volunteered to be involved in the study and were interviewed pre- and post-operatively and interviews continued in their home environment following discharge. The study took place during 1995 within a 10-month time frame. Methodological guidance was sought from the phenomenology literature, with the ideas from Husserl and Heideggar providing shape for the interpretive framework. The analysis of data utilized Colaizzi's (1978) seven procedural steps. For the purposes of this paper the authors have selected to focus only on the findings of this study. Two major themes emerged from the conversations with women. Patients described nurses as being engaged or detached with their nursing care. These themes will be explicated in this paper. In the light of these dominant themes the nursing literature around engagement and detachment are examined. The implications for nursing practice are discussed.

Attitude to Health↗