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Biomedical subjects

R H Steeves

Publications and source records attributed to R H Steeves.

17 recordsLinked to original sources
PubMed1998

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↗
PubMed1996

Coping patterns among bone marrow transplant patients: a hermeneutical inquiry.

Bone marrow transplantation (BMT) has recently become the treatment of choice for a number of malignancies. This procedure is highly technical, involving the use of radiation and chemotherapy to destroy the patient's diseased bone marrow and with it functions of the entire immune system. It is a process with toxic effects that are experienced by all patients to varying degrees. A great deal of research related to the physiological aspects of this procedure has already been done, but considerably fewer studies have examined the psychosocial aspects of the BMT procedure from the patient's perspective. Knowledge about how BMT patients understand this process and cope with its effects is important information for nurses taking care of these patients. The purpose of the study was to describe in depth the patterns of meaning employed by patients in the hospital as they coped with the experience of their BMT. Eleven patients were interviewed from one to four times a week throughout their hospitalization. Hermeneutic analysis was used to identify five major themes: physiological functioning, alertness, attitude, social relationships, and spirituality. Implications from the findings for nursing practice are discussed.

Adaptation, Psychological↗
PubMed1995

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↗
PubMed1994

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↗
PubMed1994

Surgeons', nurses' and bereaved families' attitudes toward dying in the burn centre.

Because death of a patient is one of the most emotionally disruptive events in the health professionals' life as well as the bereaved, it was hypothesized that surgeons' and nurses' attitudes in the burn centre would interfere with their emotional support of the bereaved family. Consequently, we performed a psychometric assessment of the surgeons', nurses' and bereaved families' attitudes about death and dying in the burn centre. A psychometric instrument was developed and validated that assessed 13 surgical directors' of burn centres, 13 burn nurses' and nine bereaved family members' attitudes on death and dying in the burn centre. In the case of the bereaved family member, this instrument was complemented by interviews to ensure that the respondents understood each question. All surgeons and nurses were experienced health professionals working for an average of 12 +/- 8 years and 3 +/- 1 years respectively. The majority of burn surgeons (six) and the burn nurses (seven) found it to be emotionally difficult to support emotionally the bereaved family after the death of the patient. Over half the burn surgeons (seven) and nurses (seven) felt that the process of dealing with the bereaved family was different from that experienced in other hospital settings. The surgeons attributed this difference to the long duration of the patients' illnesses, while the nurses felt that it was due to the traumatic and painful qualities of burn injury. These emotional difficulties experienced by the staff in dealing with the dying patients were associated with a relatively low frequency of contact with the bereaved families after the patients' death.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Patients who have undergone bone marrow transplantation: their quest for meaning.

This study investigates the processes of "meaning-making" and life interpretation as experienced by a group of patients who underwent bone marrow transplantation. Six adult male patients were followed until the 100th day after their transplantation or until their deaths. A hermeneutic study of their experiences revealed that they manipulated the meanings of their lives and sought meaning in their lives in two different ways: (1) they renegotiated their social position in a new situation, and (2) they tried to reach an understanding of their experiences as a whole.

Adaptation, Psychological↗
PubMed1986

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↗
PubMedDate not supplied

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↗