Stories of illness: authorship in medicine.
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Anecdotes as Topic↗
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Doctors telling stories: the place of anecdote in GP registrar training.
Observational studies within a hospital setting confirm the widespread use of anecdotes in hospital-based medical education and hypothesize a number of reasons for this. Whilst anecdotes may be used effectively in teaching there can be dangers in their inappropriate use. There is no information on the level and nature of the use of anecdotes within medical education in the community. The authors undertook a questionnaire study that asked GP trainers about how they used anecdote in their GP registrar teaching. The results suggested that GP trainers use anecdotes frequently in their registrar teaching, recognize the use of anecdotes described in the literature and have little concern that anecdotes might mislead. The authors discuss how anecdotes may be used to help build registrars' illness scripts, and to develop ways of thinking and working congruent with the existing professional community.
Anecdotes as Topic↗
Traumatic brain injury: a view from the inside.
Information about the outcomes after traumatic brain injury comes from observational studies and, increasingly, subjective sources. Narrative analysis provides an avenue to explore life after the trauma, and a perspective that may illuminate critical aspects of the relationship between the health professional and health consumer. Language use by health professionals in their interactions with health consumers may profoundly bias expectations and outcomes. Terms such as 'recovery', for example, may be inappropriate, as severe traumatic brain injury may not be an injury that one is able to 'recover' from. If the brain is seen as the basis of the personality and is altered by the trauma, then, philosophically, it is difficult to argue that the person is the same as before. Concepts of rehabilitation after severe traumatic brain injury should, therefore, take into account the expectation of the health consumer in shaping the outcomes and the possibility that new and adaptive patterns of behaviour need to be developed rather than focusing on returning to the pre-injured person. This introduces the notion of rehabilitation as assisting the injured person to re-orientate or rebuild their life using a new set of 'maps' with which to navigate through life. The paradigm of 'new maps' is positive, challenging, and honest as far as expectations are concerned, and encompasses the idea of actively exploring new and unknown territory.
Adaptation, Psychological↗
Women living with ovarian cancer: dealing with an early death.
Our intent to explore the emotion of anger in women living with ovarian cancer revealed a basic social concern of "dealing with an early death." The findings of this grounded theory study also identified the core variable of "finding meaning in life" as assisting the nine women in dealing with an early death. The categories of hope and physical wellness influenced the women's search for meaning after a diagnosis of ovarian cancer. Several action and interactional coping strategies were identified as positive coping behaviors. The consequences of finding meaning in life was a perception of well-being defined by the women as satisfaction with their lives. Conversely, an inability to find meaning in life resulted in feelings of despair. The women's perceptions of well-being were not static and could fluctuate as they lived with ovarian cancer. Implications for further research and practice are discussed.
Adaptation, Psychological↗
Wellness and the "mind/spirit/body connection": a personal experience.
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Anecdotes as Topic↗
Western medicine and marketing: construction of an inadequate milk syndrome in lactating women.
I conducted a longitudinal phenomenological study in England to explore the perceptions of 10 lactating women related to the nature of their breast milk and their ability to exclusively breast-feed their babies. The women viewed breast-feeding as a mechanical manufacturing process, and they carefully monitored the output of breast milk. Health care professionals contributed to the women's perceptions and displayed mechanistic assumptions in relation to breastfeeding, reflecting their enculturation through the biomedical paradigm. I present personal accounts to highlight the influence of two dominant Western ideologies-biomedical science and capitalism-upon women's perceptions of their breast milk.
Adult↗
The meaning of health in mammography screening for African American women.
Inadequate use of mammography screening for early detection of breast cancer is an important factor associated with the disproportionate breast cancer death rates in African American women. To improve understanding of the mammography screening experience and health for African Americans, focus groups were held with 30 African American women. Seven categories emerged: (a) the mind, body, and spirit connection: (b) living your life; (c) looking good; (d) good health-bad health; (e) prevention-detection confusion; (f) being afraid of cancer; and (g) what gets in the way. Implications for developing tailored messages and for addressing system barriers are discussed.
Adult↗
Incompatible expectations: the dilemma of breastfeeding mothers.
The maternal process of managing established breastfeeding and, ultimately, weaning the child from the breast was explored using the grounded theory method. Data were analyzed from interview transcripts from mothers, field notes, postal questionnaires from fathers, and individual and discussion group interviews with child health nurses within a Western Australian context. A common social problem emerged for women in the management of their breastfeeding when personal expectations were found to oppose the expectations of others. Being confronted with these incompatible expectations resulted in confusion, self-doubt, and guilt for mothers. These findings are discussed to assist health professionals support breastfeeding mothers.
Adaptation, Psychological↗
Life as mothers in a new land: the experience of motherhood among Thai women in Australia.
In this article, we examine the accounts of 30 migrant Thai women in Australia who had become mothers. The women recognized that they had entered a new environment, which was different from their previous one. This had a marked impact on their lives as wives and mothers. Cultural differences play a major role in their coping with motherhood and the mothering role. We find that the women had several main concerns in their new land: social isolation, different childrearing and child disciplinary practices, and the desire to preserve Thai culture. Most women wish to have more children in their new land, but others are concerned about social and political environments in Australia. We also find that the social class of the women and the ethnic background of their spouses play an important role in their coping with motherhood and childrearing. We conclude that motherhood and mothering is a great challenge, which is made more complex when it is combined with migration. This is important if we are to understand motherhood from an ethnicity perspective. Only then may we see better health care for immigrant women who choose to become a mother in their new land.
Adult↗
Giving birth in the hospital: childbirth experiences of Thai women in northern Thailand.
In this article, I examine how Thai women perceive and experience childbirth in hospitals. The article is based on in-depth interviews with 30 women living in Chiang Mai, Thailand. The women's narratives reveal that childbirth was managed within the medical system. The women believed that safety was the primary reason for their choice of birth in the hospital. Women's embodied experiences with hospital birth reveal the "passivity" discourse; women accord total trust to their doctors and very rarely question the many routine procedures in hospitals. It seems that in northern Thai hospitals the involvement of women's partners or their significant others is kept to a minimum. Of interest among postpartum care provided in Thai hospitals in the north is the use of a spotlight to help heal the episiotomy wound. This is an adaptation of Thai traditional confinement practices in the era of modernity. The use of a spotlight in hospital not only provides the women with symbolic ritual but also is believed to assist them in the healing process. Women in general were satisfied with postpartum care received during their hospital stay, except for rooming-in practice. The data suggest some differences between rural poor and urban middle-class women in terms of hospitals of birth, the opportunity to have a family member at birth, and so on. It is clear that middle-class educated women are able to exercise their choices and control over their childbirth experiences much more than rural poor women. I argue that care provided to women during birth needs to take into account women's emotional and subjective experience so that sensitive birthing care can be achieved. This will only make childbirth of many women a more positive one.
Adult↗
Taking care of self: Health care decision making of American Indian women.
In this article, I report a component of a qualitative grounded theory study on health care decision making of American Indian women (AIW) residing in the Northeastern United States. Analysis was based upon data collected from 20 women who self-identified as American Indian. Taking care of self was a primary factor influencing health care decisions among this sample of AIW. As women moved between their Native, traditional health practices and conventional Western health practices, efforts toward taking care of self were especially salient. The properties of taking care of self include knowing family history; balancing mind, body, and spirit; understanding the body; and integrating natural practices. I also address some implications of the study findings for practitioners working with Native women.
Adult↗
The lived experience of genital warts: the Swedish example.
Our aim in this study was to analyze and describe young Swedish women's experiences of living with genital warts. Interviews with 10 young women, aged 16-21 years, were interpreted within a lifeworld hermeneutic tradition. The women experience themselves as victims of a disgusting disease. Furthermore, they appear to disregard the fact that their own lifestyles could be a risk factor for contracting venereal infections. On the other hand they get to know their bodies better after the gynecological examinations where the treatment begins. Their loss of innocence is considerable; thus it seems fair to compare this experience with earlier epochs' ideas about loss of virginity due to the first intercourse. Consequently the young women also start looking at themselves as adults, and they take responsibility for the consequences of their sexuality.
Adaptation, Psychological↗
Work life and psychological health: the experiences of Thai women in deprived communities.
I discuss women's work life and the psychological health of women in low-income communities in Northeast Thailand. Previous research has shown that low-income women are part of a disadvantaged group who struggle against several problems in their everyday life, and who work hard to survive. These women worked as either manual laborers in agriculture or factories or as self-employed vendors, and were busy Ha Yoo Ha Kin (working and earning a living). The women's way of life was complex and involved being responsible for their children, husband, extended family, work, and themselves. Understanding women's beliefs and practice relating to work life and health is essential in designing effective intervention programmes to promote the health and well-being of low-income women in Thailand.
Adaptation, Psychological↗
Strategies of social and sexual control of Malaysian women in psychiatric institutional care.
An ethnographic study of female psychiatric patients was undertaken in East Malaysia. Findings indicate that these service users were subject to a number of sexist and oppressive practices that militate against their freedom of movement on the wards as well as their social interaction in the wider context of the hospital. Stereotypic notions of female sexuality and morality act as forms of moral containment and are interpreted in the hospital context as requiring heavy custodial care by the hospital authorities.
Anecdotes as Topic↗
Seeking safe passage: Argentine women's perceptions of routine prenatal care.
When we were studying in Argentina, we became aware that many of the women did not participate in routine prenatal care. We completed descriptive qualitative interviews with 17 hospitalized women about their perceptions regarding prenatal care. Several themes arose related to the women's use of prenatal care: prenatal care utilization and outcomes, getting there, getting by, waiting, turning red, and knowing. Future research should concentrate on identifying components of prenatal care to build a best practice model of prenatal care that is culturally sensitive and personally relevant to provide safe passage for the women of Tucumán.
Adolescent↗
Psychological functioning in women with fibromyalgia: a grounded theory study.
The aim of this study was to elucidate psychological functioning and psychological processes in women with fibromyalgia. Twenty-one females with fibromyalgia (aged 26-72 years) were interviewed in-depth. The interviews were analysed in line with grounded theory. A core concept, "unprotected self," mirroring childhood conditions and adult psychological functioning, was identified. Intense activity or hypomanic helpfulness often was used as self-regulation in adult life. Later an increased exposure to mental load is accompanied by reduction of cognitive functioning and generalised pain. The phase of persistence of fibromyalgia is marked by reduction of cognitive functions, unprotected psychological functioning, and increased mental load as from crisis and somatic symptoms.
Activities of Daily Living↗
The encounters that rupture the myth: contradictions in midwives' descriptions and explanations of circumcised women immigrants' sexuality.
The purpose of the study was to analyze how Swedish midwives (n = 26) discuss sexuality in circumcised African women patients. In focus groups and interviews, discussions concentrated on care provided to circumcised women, training received for this care, and midwives' perceptions of female circumcision. An analytic expansion was performed for discussions pertaining to sexuality and gender roles. Results from the analysis show the following: (1) ethnocentric projections of sexuality; (2) a knowledge paradox regarding circumcision and sexuality; (3) the view of the powerless circumcised women; and (4) the fact that maternity wards function as meeting places between gender and culture where the encounters with men allow masculine hegemonic norms to be ruptured. We conclude that an increased understanding of cultural epistemology is needed to ensure quality care. The encounters that take place in obstetrical care situations can provide a space where gender and culture as prescribed norms can be questioned.
Adult↗
Restorative health: lessening the impact of previous abuse and violence in the lives of vulnerable girls.
"Restorative health" is the idea that those who have been denied access to the social determinants of health, particularly as young children, should have the right to restoration of healthy functioning. In interviewing a group of vulnerable young women, ranging in age from 15 to 22, we discovered how they experience the link between health and justice in their lives. Participants were living on the street, in extreme poverty, or both. Traumatic early childhood events continued to affect their ability to function healthy. We conclude and suggest that certain rights-based principles need to ground the development of interventions with this group.
Adolescent↗