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Biomedical subjects

P N Stern

Publications and source records attributed to P N Stern.

At least 19 recordsLinked to original sources
PubMed2000

Being strong: how black West-Indian Canadian women manage depression and its stigma.

PURPOSE: To discover how women from a nondominant cultural background (West Indian) experience and manage depression. DESIGN: Explanatory using grounded theory. METHODS: Semistructured interviews were conducted with 12 Black West-Indian Canadian women who experienced depression. Between 1994 and 1996, the first author engaged in participant observation. FINDINGS: The women used the basic social process they called "being strong" to manage or ameliorate depression. Being strong included "dwelling on it," "diverting myself," and "regaining my composure." For most of the women, the range of available life choices was limited to the three processes; however, a few engaged in "trying new approaches." These women were less limited in their range of cultural and behavioral boundaries than were the others, and began tentatively to explore other options for themselves. CONCLUSIONS: Black West-Indian Canadian women in this study managed their depression in culturally defined ways by being strong and not showing vulnerability. Because being strong was also evident in a previous study of dominant-culture women as a prelude to depression, the process may be widespread in women prone to depression. The findings provide helpful information for intervening in an unfamiliar culture.

Black or African American↗
PubMed2000

Women's responses to sexual violence by male intimates.

The purpose of this grounded theory study was to devise a theoretical framework that describes the problem of sexual violence by male intimates from the point of view of 23 women who have experienced such violence at some time in their adult lives. The core variable, forging ahead in a dangerous world, reflects the women's descriptions of life after violence as a struggle to get on with their lives in a social world they know through first-hand experience to be unsafe. The theoretical framework includes three variations of forging ahead (getting back on track, starting over again, and surviving the long, hard road) described by three subgroups of women who experienced different types of sexual violence. The framework also outlines three common processes used to forge ahead: telling others, making sense of the violence, and creating a safer life. The nature and meaning of these processes differ according to group.

Adaptation, Psychological↗
PubMed2000

Awakening as a change process among women at risk for HIV who engage in survival sex.

Women who exchange sex for survival requirements risk exposure to the human immunodeficiency virus (HIV). This grounded theory study was conducted to better understand these women's concerns, attitudes, and behaviors related to HIV, with the goal of informing prevention research. Interviews with 11 women engaged in survival sex were analyzed. Women described sliding into survival sex as a result of economic crises. Survival sex exposed women to violence, drug use, sexually transmitted infections, and HIV. Mitigating these risks is a process of awakening in which women reconstruct risk and survival and make changes in their behavior. These findings highlight the complexity of the problem of survival sex and suggest interventions to help women protect themselves against HIV.

Adult↗
PubMed1998

The contexts for managing depression and its stigma among black West Indian Canadian women.

There is a paucity of literature available to assist nurses and other care providers in knowing how to meet the needs of depressed women from non-dominant cultural backgrounds. To begin to address this need, we conducted a grounded theory study on black West Indian Canadian Women's strategies for managing depression. We discovered a basic social process, Being Strong, that the women used to manage or ameliorate depression. Being strong occurs within the overlapping areas of three social contexts: the cultural stigma of depression, male-female roles and relationships, and belief in Christian doctrine. These contexts are located against a backdrop of visible minority status within a eurocentric society. This socio-cultural contextual material provides the setting within which black West Indian Canadian women live and make decisions. In this article, we present findings related to the social and cultural aspects of the women's situation.

Adaptation, Psychological↗
PubMed1996

Grounded theory as feminist research methodology.

Feminist research is evolving, and with it new methods of doing science. In this feminist post-positivist era, grounded theory, while less inclusive and descriptive than ethnography, allows for complex analysis of complex questions. While Glaser & Strauss (the originators of this methodology) have written about grounded theory in an esoteric way, others have written extensively about this method in a much clearer and less rigid fashion. In this paper we discuss how grounded theory could be used in a creative and constantly evolving manner for feminist research.

Female↗
PubMed1996

Reflective action--strategies for solving client-nurse partnerships in primary care.

In this grounded theory study, which addressed the research question. 'What strategies do nurses use to form client-nurse partnerships,' a variety of data sources were used. The first data set consisted of participant observation, and reports of focus groups formed as part of the 'First International Conference on Nursing Theory and Primary Health Care' at Massey University, New Zealand which was attended by an international group of 80 nurses in 1990. As an adjunct to the formal presentations, members of the focus groups addressed four questions: a) Is a nurse-client partnership viable in primary care? b) What do you plan to do to promote this partnership? c) What do you think others should do? and d) What is the next step? Reports from these focus groups, pooled with questionnaires (n = 17) and informal interviews completed this data set. The central process that described participants' perceptions of the viability of nurse-client partnerships was named reflective action. Ethical questions arose and were placed along a continuum of viability. A second data set consisted of interviews with, and selected literature by, Canadian nurses on partnerships in primary care. The perceptions of this international study group are seen as adding to our knowledge of barriers to nurse-client partnerships in primary care, and strategies for transcending these barriers.

Focus Groups↗
PubMed1996

Restructuring life after home loss by fire.

When fire destroys a home, victims endure the disorientation, feelings of helplessness, sadness, and depletion that are engendered by privation and the problem of restructuring their lives. The research questions in this grounded theory study were: How do victims process losing their homes to fires? and How does social ritual connect with their needs? With a sample of 113 people from eight countries we found that, despite the seriousness of the problems victims face, social ritual guides support. In many instances, this ritual dictates support that is short-term and only loosely related to the actual needs of victims. In other words, the support that victims receive is determined by social ritual rather than need. We have named this, "Ritual-Support Connection," the dimensions of which are (a) connected support, (b) unconnected support, and (c) disconnected support. In a noncomforting social framework, victims must integrate the salient life event of home loss by fire, through a process we have named "restructuring life." Two dimensions of restructuring are limiting grief displays and developing new rituals. New rituals include benchmarking, taking precautions, and becoming expert.

Adaptation, Psychological↗
PubMed1994

Falling apart: a process integral to the remodeling of male incest offenders.

This article describes the falling apart component of a theoretical framework for incest offenders, the remodeling process. Methodology included 20 audiotaped interviews, 65 direct observations during group therapy, and record analysis of a theoretical sampling of adult male incest offenders currently in, graduates of, and dropouts from a community sexual abuse treatment program. Constant comparative analysis was used to collect and analyze data concurrently. Falling apart, a dynamic multifaceted process, occurs first when offenders are discovered, can be life-threatening, and few resources are presently available. Dimensions, properties, strategies, and contexts are discussed.

Adaptation, Psychological↗
PubMed1994

Becoming strangers: the changing family caregiving relationship in Alzheimer's disease.

Alzheimer-type dementia (AD) is an insidious pervasive debilitating disorder that destroys the affected person's capacity for self-care. In this grounded theory study, we explored the reciprocal process of becoming strangers in which eastern Canadian family caregivers and care recipients with AD interact on a continuum from intimacy to alienation through dimensions of dawning, holding on and letting go. The findings illuminate the experiences of family members who struggle on a daily basis with their commitment to the person they knew and their increasing detachment from the stranger that person has become. With the increasing emphasis on home care, these findings offer insights for individual care and health policy development.

Aged↗
PubMed1993

Finding meaning in chronic illness as the key to self-care.

Self-care is an important element in the successful management of a long-term illness. However, people with chronic illnesses are often reluctant to adopt self-care behaviors. The purpose of this grounded theory study was to investigate the evolution of a readiness to self-manage a nonfatal chronic illness. A purposive sample of twelve individuals with a nonfatal illness whose course can be controlled by treatment were interviewed. In addition, the primary nurse caring for each informant at home was also interviewed. The findings indicate that the key process in self-care readiness was finding meaning in chronic illness. This process involved assenting to the illness and reframing its implications positively. It allowed informants to make sense of self-care teaching and to perceive themselves as self-care agents having some control over their illness course.

Adaptation, Psychological↗
PubMed1992

Method slurring: the grounded theory/phenomenology example.

Increasingly, qualitative research methods are being embraced by nurse researchers because these approaches allow exploration of human experience. Failure to explicate qualitative methodologies is resulting in a body of nursing research that is either mislabelled or is classified broadly as qualitative and subject to charges that qualitative research lacks rigour. In this paper, the authors discuss the importance of specificity in methodology and distinguish between phenomenology and grounded theory, two frequently misused terms in the description of qualitative methodology.

Data Collection↗
PubMed1990

The impact of fluctuating relationships with the Canadian health care system on family management of otitis media with effusion.

The analysis of data from a grounded theory study of family interaction when a child has otitis media with effusion (OME) shows that these families are engaged in the process of learning to manage. Their relationship with the health care system, coupled with the effects of the disease on the child and the family lifestyle, has a powerful influence on how this process proceeds. In this paper, the authors discuss the impact of the family's relationship with the Canadian health care system on the development of management skills. Relationships with the health care system fluctuate forward and backward through entrusting, becoming disillusioned, learning the rules and negotiating, as families learn to manage the effects of the disease process on the child and the family. The family perspective of the quality and availability of health care at a time when health care systems throughout the world are under close scrutiny, adds to our understanding of consumer expectations. Some recommendations for improving current relationships between families and the health care system are made.

Adult↗
PubMed1990

Childhood otitis media: the family's endless quest for relief.

Otitis media with effusion (OME) is a common disease of childhood that has a profound influence on family life. The findings of a grounded theory study that explored family interaction when a child has OME are contained in this article. Three variables were found to influence the position of the family on a continuum of learning to manage: effects of the disease on the child, disruption to family life, and relationship with the health care system. In this discussion the authors focus on the effects on the child and family life. Comparisons are made with the effects of chronic illness on a family. The documentation of the effects of OME on family life is significant to assist health care professionals in appreciating the gravity of this often trivialized illness. Some strategies are suggested for positive health promotion in these families.

Adaptation, Psychological↗
PubMed1990

Women of Denmark.

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Cultural Characteristics↗
PubMed1990

Horror story.

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Carcinoma in Situ↗