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Biomedical subjects

D L Kahn

Publications and source records attributed to D L Kahn.

15 recordsLinked to original sources

Coming to terms with perceived danger. A researcher's narrative.

Little attention has been given to the topic of perceived or imagined dangers in fieldwork, even though such dangers may significantly affect both collection and interpretation of data in qualitative research. Furthermore, methodological arguments persist in regard to interpreting qualitative research that gives voice simultaneously to the research participant and the researcher. In this article reflexivity and narrative methods were used to examine the concept of perceived danger(s) in a field setting using naturalistic inquiry. First, reflexivity and narrative methods were used to retrospectively construct a personal narrative that describes the impact of the field experience on the researcher. Then, narrative analysis was used to interpret this personal narrative and to further examine why the researcher "perceived" certain dangers, and how she came to know that these risks and dangers were presumed but unwarranted. This narrative is an example of how qualitative researchers can give voice to their field experiences.

Anecdotes as Topic↗

Making the best of it: adapting to the ambivalence of a nursing home environment.

This article is based on a 9-month ethnographic study of a nursing home for older Jewish people. In this article, the process that 21 key informants went through in adapting to the dual nature of the nursing home as institution and as home is examined. A widely used phrase, "making the best of it," was used by informants and other residents of the nursing home to describe this process. Interpretive analysis of this emic phrase revealed four dimensions: (a) recognizing the ambivalence of their living environment and situation, (b) downplaying negative aspects of it, (c) having no other options, and (d) using their will to transcend and create a home.

Adaptation, Psychological↗

Beyond body image: the experience of breast cancer.

PURPOSE/OBJECTIVES: To describe the mental and emotional impact of treatment for breast cancer with a focus on the ways the body is experienced. DESIGN: Phenomenologic, descriptive, and interpretive. SETTING: An outpatient treatment area of a comprehensive cancer center in the southwestern United States. SAMPLE: 20 women, ages 20-68 (mean = 50 years), who had mastectomies (including both modified radical mastectomies and lumpectomies, with some having reconstruction) for breast cancer. METHODS: Content analysis of verbatim transcriptions of open-ended interviews using hermeneutic phenomenology and descriptive and interpretive presentation of a paradigm case. MAIN RESEARCH VARIABLES: Reaction to breast cancer and its treatment. FINDINGS: Informants' descriptions demonstrate that the body can be viewed as having three aspects: (a) the body as symbol or social expression (i.e., how bodies make a social statement and tell others who you are); (b) the body as a way of being in the world, including sensations and symptoms such as nausea, fatigue, and pain; and (c) the existential sense that one needs a body to be in the world (i.e., the body expresses existence), which led to more awareness of the possibility of death. CONCLUSIONS: Women treated for breast cancer view their bodies in ways that go beyond what is suggested by the literature on body image and breast cancer, encompassing a wide range of responses. IMPLICATIONS FOR NURSING PRACTICE: The contribution of this study is the documentation of the complexity of the meaning of "body" for women with breast cancer. Appropriate interventions differ for each aspect of the body: for the body as social symbol, programs such as Look Good ... Feel Better or image centers; for the body's sensations and symptoms, information about what to expect and about symptom prevention and management; for the existential body, active listening to fears and concerns and providing assistance as needed.

Adaptation, Psychological↗

The significance of suffering in cancer care.

Understanding suffering as a possible meaning of cancer for patients and families is a necessary part of cancer nursing care. This article presents a discussion of suffering as a possible meaning of cancer for patients and family members. Suffering is addressed in the context of its definition as an experience of the whole person. First, to illustrate suffering, a narrative of a young man treated for leukemia with bone marrow transplantation is presented. The narrative focuses on the man's suffering as he struggles to make meaning of what has happened to him, a struggle that ends with his death. The second part of the article presents eight aphorisms or succinct principles of suffering. Each aphorism is discussed with examples from the case narrative and related literature.

Adult↗

Nurses' views of the coping of patients.

The findings of a study that explored the beliefs, assumptions and ideas nurses have about the coping of patients are presented. Interactive interviews with 26 nurses were used to elicit explanations of the meaning of coping and stories from their practice that illustrated coping. Analysis of the interview transcripts revealed three themes in the form of idioms or particular and different ways of talking about coping. Each idiom represented a different perspective or view of coping. The first idiom represented a view of coping as a rational, cognitive problem-solving response to illness. The nurses attributed, and thus valued, this view to science. In the second idiom the nurses spoke of coping as permeated with values that contrasted with the prior view of coping as a rational process. In the final idiom the nurses spoke of coping as courage--they told stories of patients who had faced existential situations with strength and will. The focus of this idiom was on issues of spirituality, struggle, personal meaning and acceptance. After each idiom is delineated and illustrated by data, the discussion is concentrated on the orientational and ontological metaphors that underlie them. Interpretation of the origin and construction of these different ways of talking about coping, and their underlying metaphorical meanings, is made in the context of cultural and subcultural influences.

Adaptation, Psychological↗

The experience of suffering: conceptual clarification and theoretical definition.

This paper is concerned with the phenomenon of human suffering and is an attempt to justify and begin theoretical development of this phenomenon for nursing science. The paper is divided into three sections. The first section describes the interest of nursing science in the phenomenon and critically examines relevant literature in order to further conceptualize development and clarification. This section concludes with a theoretical definition of suffering derived from this critique. Suffering is defined as an individual's experience of threat to self and is a meaning given to events such as pain or loss. The second section elaborates on this definition and examines how it can inform theoretical discussion in two areas with import for nursing--the patient's experience of suffering and the nurse's experience of patient suffering. The final section briefly considers some implications for clinical research.

Culture↗

Tasks of bereavement for burn center staffs.

Considerable research and theoretic work is reviewed to identify the major tasks of the grieving process. These tasks are diffusing the emotional energy of loss, reknitting the social fabric, and forming a new relationship with the deceased. A narrative approach to understanding human experiences is outlined, and specific application is given to the grieving process. Through the use of a narrative report of the death of twins in a hospital burn unit, the tasks of grieving are applied to professionals who work with patients with burns. Finally, practical suggestions for help with the tasks of grieving in a burn center are offered.

Adaptation, Psychological↗