Growing up with Chuck and Dick and Viktor Hamburger.
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Anecdotes as Topic↗
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Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
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Hope I die before I get old.
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Anecdotes as Topic↗
Decision-making in the diagnosis and treatment of leukemia.
OBJECTIVES: To review the precepts of decision-making for people diagnosed with leukemia. DATA SOURCES: Professional journals, research studies, review articles, and personal experience. CONCLUSION: Decision-making is one of the most complex and demanding tasks faced by people diagnosed with leukemia. There are multiple dimensions of decision-making, including access to information, psychosocial support, spiritual support, education options for treatment and participation in clinical trials. IMPLICATIONS FOR NURSING PRACTICE: Health care professionals are integral to the decision-making process for people diagnosed with leukemia and are involved in most situations where decisions must be made relative to treatment, research, and symptom management.
Anecdotes as Topic↗
The story behind the story: the use of storytelling in spiritual caregiving.
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.
Adaptation, Psychological↗
A double concern: grandmothers' experiences when a small grandchild is critically ill.
Grandmothers play an active part in family health and illness, but so far they are peripheral in both nursing and nursing research. This article addresses grandmothers' lived experiences when a small grandchild is critically ill. A convenience sample of 7 grandmothers was interviewed once. With the use of the methodology of Van Manen, (1990), the essence of the phenomenon was found to be a "double concern," a worry and loving care that encompassed both parents and grandchildren. Although the findings have limitations, they constitute a systematic and thematic description of Danish grandmothers' experiences and therefore add to a family-oriented body of knowledge in pediatric nursing.
Anecdotes as Topic↗
Adolescents' perspectives of chronic illness: "it's hard".
An exploratory, qualitative study with tenets from grounded theory was used to elicit detailed descriptions of adolescents' chronic illness experiences. The philosophy of symbolic interactionism guided this study. Understanding the adolescents' experiences included exploring adolescents' perspectives of the following: (1) what it is like to have a chronic illness, and (2) how they deal with having a chronic illness. A sample of 23 adolescents, 13 to 16 years of age, and diagnosed with either diabetes, asthma, arthritis, Crohn's disease, or ulcerative colitis participated. Data collection involved the adolescents participating in open-ended interviews. The constant comparative method was used to analyze all data from the interviews. The findings revealed that having a chronic illness made life more difficult for the adolescents. Adolescents experience extra effort, restriction, pain, and additional worries because of having a chronic illness. However, adolescents also clearly had ways to help them deal with their illness. These strategies and recommendations for practice and future research are discussed.
Adaptation, Psychological↗
Mothers' experiences caring for children with disabilities who require a gastrostomy tube.
In this qualitative study, mothers' experiences of feeding children with severe disabilities by a gastrostomy tube are described. Twelve mothers each participated in one, open-ended, home interview. Mothers gave detailed accounts of their activities and the tremendous stress involved in feeding the children. They described spending enormous time and energy seeking confirmation of the feeding problem and devising extraordinary practices to ensure the child's survival before "giving in" to the gastrostomy tube. Following gastrostomy tube insertion, they initially felt relief and disappointment, before customizing feeding and moving on. Mothers' suggestions for improving professional services are discussed along with implication for practice and research.
Adult↗
Fat fetishism, dietary dread, and the freedom factor: an autobiographical memorandum.
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Aged↗
Instructions for editors: a "revenge fantasy".
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Anecdotes as Topic↗
Trial and error in my quest to be a partner in my health care: a patient's story.
A fearful stranger to the healthcare sector when she became a frequent user 2 years ago, Goeltz clearly is now a sophisticated and creative partner. She is fully engaged in decision-making and holds the decisions made as her own. Physicians often worry that their patients don't fully consent to the treatment given them because they don't fully understand the risks. This is often a factor in malpractice litigation. Goeltz's healers don't have that worry. When it comes to the complicated process of treatment, Goeltz doesn't take for granted that the system will operate optimally and holds herself accountable for doing what she can to deliver good outcomes for herself and her loved ones. She knows her active participation keeps the system safer. She challenges those she meets who want to discount her role and refuses to be treated by those who can't meet and adapt to those challenges. She has a lot to teach us all. The circumstances of my brother's death are what taught me the crucial importance of active participation in my own health care. The best tribute I can pay to him is to continue trying to show consumers and those in health care how they can partner with each other to truly improve safety. To those health care workers who are willing to work with me and put up with my challenging them from time to time, please accept my deepest gratitude. I would not be as healthy as I am today without you, and maybe I wouldn't even be alive. I know your jobs aren't easy, and you have earned my greatest respect.
Anecdotes as Topic↗
Socio-cultural aspects of menstruation in an urban slum in Delhi, India.
This paper attempts to understand the experience of menstruation in the socio-cultural context of an urban Indian slum. Observations were gathered as part of a larger study of reproductive tract infections in women in Delhi, using both qualitative and quantitative methods. The qualitative phase consisted of 52 in-depth interviews, three focus groups discussions and five key informant interviews. In the quantitative phase inferences were drawn from 380 respondents. Mean age at menarche was 13.5. Onset of menarche is associated with physical maturity and the ability to marry and reproduce. However, a culture of silence surrounds menarche, an event which took the women interviewed almost by surprise. Most were previously unaware that it would happen and the information they were given was sparse. Menstruation is associated with taboos and restrictions on work, sex, food and bathing, but the taboos observed by most of the women were avoidance of sex and not participating in religious practices; the taboo on not going into the kitchen, which had been observed in rural joint households, was not being observed after migration from rural areas due to lack of social support mechanisms. There is a clear need to provide information to young women on these subjects in ways that are acceptable to their parents, schools and the larger community, and that allow them to raise their own concerns. Education on these subjects should be envisaged as a long-term, continuous process, beginning well before menarche and continuing long after it.
Adolescent↗
Adolescent parenthood: a costly mistake or a search for love?
Family life is changing worldwide and an increasing number of women are choosing single parenthood. Adolescents who become pregnant and early childbearers do not always become pregnant unintentionally; some actively plan pregnancy while others are ambivalent mainly about the timing. This paper reports on a study using an ethnographic approach that explored the mothering experiences of five sole-supporting Australian teenage mothers who had a child over six months of age. It focuses on the story of one of them, a young woman who gave birth at 16 and set up home for herself and her son. Early childbearing is often a response to adverse social conditions such as poverty or homelessness and is not uncommonly chosen by teenage girls from socially deprived backgrounds. Educational and employment opportunities may be limited, whilst motherhood may provide a purpose in life when few other options are possible. Young women who make this choice need comprehensive services to support them in the parenting role, including appropriate health care, welfare and housing benefits, and support in dealing with parenting, a role which they may greatly desire but are not automatically well prepared for.
Adolescent↗
Perceptions of sexual coercion: learning from young people in Ibadan, Nigeria.
This study explored the problem of sexual coercion from the perspectives of 77 young people aged 14-21 in Ibadan, Nigeria, the behaviours they perceive to be sexually coercive and the contexts in which these occur through four narrative workshops. Participants were drawn from two secondary schools and 15 apprentice workshops. All four groups identified similar coercive behaviours and developed narratives of the events that typically lead up to them. Behaviours included rape, unwanted touching, incest, assault, verbal abuse, threats, unwanted kissing; forced exposure to pornographic films, use of drugs for sedation and traditional charms for seduction, and insistence on abortion if unwanted pregnancy occurs. Men were typically the perpetrators and young women the victims. Perpetrators included acquaintances, boyfriends, neighbours, parents and relatives. All the narratives revealed the inability of young people to communicate effectively with each other and resolve differences. The results suggest the need for life-skills training that facilitates communication, seeks to redress gender power imbalances, teaches alternatives to coercion as a means of resolving conflict over sexual relations and respect for sexual and reproductive rights, and provides victims with information on appropriate services, support and referral.
Adolescent↗
Challenges and dilemmas in counselling young women on pregnancy options.
This paper is about counselling young women up to 21 years of age who have an unintended pregnancy and need to decide whether to continue the pregnancy, have an abortion or give the baby up for adoption. What is important for a counsellor is to be able to respond appropriately to the issues they raise and support them to make a decision that they feel is right for them. Some young women know what they want to do and only need information to help them put this into effect. Others lean strongly towards one option or the other because it is what others want them to do, or is the opposite of what others want. Still other young women are unable to verbalise their feelings or opinions; they can be easily influenced by others and feel great indecision. During a counselling session, parents sometimes try to influence their daughter to make one decision or another. Some parents feel left out when their daughter will not discuss the pregnancy with them, and some bring up unrelated family problems. Counsellors need to acknowledge their own biases in working with young women, respond in ways that fit a young woman's level of development and acknowledge the difficulties parents sometimes have in coping with and responding to their daughter's situation.
Adolescent↗
Psychosexual development among HIV-positive adolescents in Abidjan, Côte d'Ivoire.
Some 84,000 children with HIV/AIDS live in Côte d'Ivoire, where very little therapeutic or psychological help is available to them. The Yopougon Child Programme of the "Agence Nationale de Recherche sur le Sida" was launched in Abidjan in October 2000. It provides services for HIV-infected children and psychological consultations for children and their parents. This paper is about the psychosexual development of the HIV-positive adolescents in the Programme, 11 girls and 8 boys aged 13-17, their problems with HIV-related physiological and psychosexual changes, and relationships with their parents. The information was gathered in individual therapy sessions, group discussions and family support sessions. Bodily development was of major importance to these adolescents, particularly among those who had not yet developed secondary sexual characteristics and were shorter and weighed less than their peers. Those who had not achieved puberty were unable to participate in traditional rituals and worried whether they could ever marry or have children. In most cases, adolescents with HIV have been infected by a sexually transmitted virus without having had sexual relations themselves. They need support dealing with their sexual development and sexual feelings, along with medical care, in a context in which HIV infection is a secret, impossible to talk about with their peers.
Adolescent↗
Listening to "felt needs": investigating genital prolapse in western Nepal.
The global prevalence of genital prolapse is estimated to be 2-20% in women under age 45. In Nepal, genital prolapse appears to be widespread, but little published evidence exists to buttress this claim. This paper presents findings of two studies, one ethnographic and one clinic-based, in western Nepal. The ethnographic study involved 16 focus group discussions with 120 community members and key informants, and covered community perceptions and women's experience of prolapse and its perceived causes and consequences. The clinic-based study was conducted among 2,072 women who presented with gynaecological complaints and received a diagnosis. One in four of them had genital prolapse, of whom 95% had self-reported the prolapse. The most commonly perceived causes of prolapse were lifting heavy loads, including in the post-partum period. The adverse effects reported included difficulty urinating, abdominal pain, backache, painful intercourse, burning upon urination, white watery discharge, foul-smelling discharge, itching, and difficulty lifting, sitting, walking and standing. The results confirm prolapse as a significant public health problem in western Nepal. We strongly recommend developing systematic, rotational gynaecological clinics in rural districts, the use of a screening checklist and counselling for prevention and early management of genital prolapse by district health workers for family planning and antenatal patients.
Adult↗
Late motherhood: the experience of parturition for first time mothers aged over 35 years.
Australia, like other developed nations, is exhibiting a trend towards later childbearing. At present, the birth rate of women aged 35 years and older is growing faster than for any other age group. Approximately 35% of mothers aged >35 years are first-time mothers, and it is commonly held that these women have particular issues of adjustment to motherhood. This longitudinal qualitative study entitled 'Transition to motherhood for first-time mothers aged 35 years and above' explores their experiences. In-depth interviews were conducted with 20 primiparae aged >35, over three junctures: 35-38 weeks gestation; 7-10 days postpartum; and 6-8 months postpartum. Preliminary findings from interviews conducted immediately postpartum are presented in this paper. Participants identified adjustment to motherhood as a particularly challenging event.
Adaptation, Psychological↗
The delivery of medical abortion services: the views of experienced providers.
This study examined beliefs about the delivery of medical abortion services and current roles of 76 providers of methotrexate-induced abortion. The sample included physicians, midlevel professionals, administrators, and counselors/other medical staff. Over 75% of participants believed that, given proper training and emergency backup, physicians and midlevel clinicians alike could provide medical abortions. Over 85% agreed that methotrexate-induced abortions could be provided in any physician's office or medical facility. There were no differences in perceptions by participant group. Involvement of midlevel providers in provision of medical abortion could potentially increase access and options for women seeking to terminate an early pregnancy.
Abortifacient Agents, Nonsteroidal↗