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PubMed2004

The inspiration of hope in bereavement counseling.

While most healthcare workers would agree that hope is necessary for healthy living, the current understanding of hope and hoping is incomplete. This article reports on a study that attempted to answer the question: Do bereavement counselors inspire hope in their clients, and if so, how? The study used a modified grounded theory method and collected data, by means of interviews, from a total sample of 12 participants, comprising bereavement counselors and ex-clients who had received bereavement counseling. The data were coded and analysed using the constant comparative method, which produced an emerging, integrated, substantive grounded theory of hope inspiration for this client group. This theory includes a core variable: the implicit projection of hope and hopefulness; and three subcore variables: forging the connection and the relationship; facilitating a cathartic release; and experiencing a good (healthy) ending. The theory indicates that this hope inspiration appears to be a subtle, unobtrusive process that was bound up with the necessary and sufficient human qualities in the counselor and the projection of these into the environment (and client).

Bereavement↗
PubMed2004

Grief in the shadows: exploring loss and bereavement in people with developmental disabilities.

A greater understanding of how developmentally disabled people cope with loss and bereavement is needed to improve assessment and intervention for these individuals. Misconceptions exist about how effectively developmentally disabled persons can articulate their perceptions and feelings about traumatic experiences, death, and the subsequent impact of the events that follow. The lived experience and expression of grief may differ for the developmentally disabled population. As a result, their reactions may not be adequately recognized, interpreted, or managed therapeutically, compounding their distress. Three case reports of developmentally disabled individuals who experienced a loss are presented, along with helpful guidelines regarding assessment and intervention.

Adaptation, Psychological↗
PubMed2005

The language of cutting: initial reflections on a study of the experiences of self-injury in a group of women and nurses.

Non-suicidal self-injury is a distressing act, which can arouse dissent and negative comment in service users and providers. The purpose of the study was to describe how women who self-injure and nurses assign meaning to shared discourses about self-injury. The wider study is framed in a grounded theory methodology. Fourteen qualified nurses and 11 women who have self-injured were interviewed using unstructured and initially open-ended interviews, lasting 45-90 minutes. Initially a thematic analysis was used to code data. In this report, three of the early themes are reported with some comparative interpretations. Nurses lack understanding of the meanings of cutting behaviour. A common language is needed if nurses are to be effective in helping women who have self-injured to express distress in less damaging ways.

Attitude of Health Personnel↗
PubMed2006

Drug users' participation in addiction care: different groups do different things.

This study allocated 201 (nearly) daily users of heroin and/or crack into four groups, depending on their addiction care participation. Earlier studies have compared treatment groups and nontreatment groups. In this study the treatment group is divided into three categories: (1) drug users in contact with only treatment agencies--i.e., methadone maintenance, clinical and ambulant drug treatment; (2) drugs users in contact with only care agencies--i.e., day and night shelters and drug consumption rooms, which have no explicit aims to change patterns of drug use; and (3) drug users in contact with both treatment and care agencies. This allocation intro three different groups fits the notion of harm reduction, one of the policy aims in The Netherlands. The fourth group consists of drug users in contact with neither treatment nor care agencies. The results show that it is useful to distinguish these four categories, instead of two. The four groups are different from each other with respect to some of their characteristics (e.g. debt situation, prostitution, homelessness) and their drug use (e.g. drug use in public, use of crack, and use of other drugs). A much clearer distinction can be made between the "care" group and the "treatment and care" group. Treatment and care agencies can thus better match their services to their clients or patients.

Adult↗
PubMedDate not supplied

Responding to the cues of suffering.

Enduring and suffering are fundamental and normal responses to catastrophic loss, yet strangely these two basic states have not been extensively explored using qualitative methods. Both states occur commonly as a human response to illness, injury, and bereavement, and it is the role of professional caregivers to respond to people who are in distress. In this article, I distinguish between states of enduring and suffering, discuss the distinctly different and appropriate comforting strategies to be used with each, and conclude by presenting questions for future research.

Adaptation, Psychological↗
PubMed2003

Promoting attentional health: importance to women's lives.

Promoting attentional health is an important opportunity to support and empower women to actively participate in their own health care and function effectively in multiple roles. Attention, the ability to focus or concentrate, is a necessary cognitive resource used throughout the life span in participating in self-health care. However, women can inadvertently overuse this essential capacity, especially when responding to life's multiple demands, resulting in mental or attentional fatigue. When women experience this mental fatigue, many daily activities, including self-health care, are more difficult. An attentional perspective in women's health allows approaches to improve daily functioning and reduce the risk of attentional fatigue. In this article we present the conceptual dimensions of directed attention and its relevance to women's health; practice and research implications are identified.

Attention↗
PubMedDate not supplied

Health-related concerns and experiences of employed perimenopausal women in Alexandria, Egypt.

Our purpose in conducting this descriptive study was to assess the health-related concerns and experiences of a sample of employed perimenopausal women in Alexandria, Egypt. In addition, we explored their help-seeking behavior and their perception of symptoms. We interviewed two hundred working women ages 40-60 years, 42% of whom were nurses, using a semistructured interview form as well as Koos's list of symptoms. The commonly mentioned concerns, in order of frequency, were chronic headaches, chronic fatigue, transportation and phone communication problems, financial problems, job dissatisfaction, backaches, hypertension, kidney disease and gall bladder disease, gastritis/indigestion, menstrual disturbances, arthritis, AIDS, and hepatitis B. With respect to the problems experienced by the women in the past 6 months, there was a high self-reported prevalence of headaches, fatigue, transportation and communication problems, backaches, job dissatisfaction, dissatisfaction with health insurance, financial problems, menstrual disturbances, gastritis/indigestion, gall bladder disease, anxiety, disturbed sleep, and hypertension. Women attempted to manage their problems mainly by taking over-the-counter drugs and self-prescribing (75.5%), doing nothing or using traditional remedies (56.5%), and going to a doctor or health insurance office (40%). Symptoms perceived by the majority of the women as not needing medical attention included loss of appetite, persistent backache, bleeding gums, chronic fatigue, persistent headaches, and loss of weight. The influence of education and occupation on women's perceptions and practices is discussed.

Adult↗
PubMed1990

The work of patients and spouses in managing advanced cancer at home.

The purpose of this paper is to report the findings of a descriptive study which identified the resources used by patients with advanced cancer and their spouses to manage at home. Data were collected through semi-structured interviews with a sample of seven couples identified through two ambulatory clinics at a regional cancer institute. Participants were patients with advanced cancer, between the ages of 45 and 66, and their spouses. Interviews, conducted with each individual and with each couple, were audiotaped, transcribed, and subjected to qualitative analysis. Content analysis showed that patients and spouses utilized internal and external resources, and that external resources were either physical or interpersonal in nature. Conceptual analysis indicated that both patients and spouses dealt with facing either inevitable or uncertain death by engaging in various types of "work." Understanding the dimensions of such work has implications for health care professionals caring for patients and families in palliative care.

Activities of Daily Living↗
PubMed1992

College health services should promote good Samaritan rules as part of university alcohol policies.

When a student or organization assists an intoxicated individual in procuring Safety and Security, local or state police, and/or professional medical assistance, neither the intoxicated individual, if a Dartmouth student, nor the individual or group who assists will be subject to formal College disciplinary action for (1) being intoxicated, or (2) having provided that person alcohol. This refers to isolated incidents only and does not excuse or protect those who flagrantly or repeatedly violate the College Alcohol Policy.

Alcohol Drinking↗
PubMedDate not supplied

Use of alternative therapy among pediatric oncology patients in Taiwan.

Both alternative medicine and western medicine have been commonly used to treat pediatric cancer patients in Taiwan. Each has its own intrinsic strengths and weaknesses and they can be complementary. Little is known about medical help-seeking behaviors of parents of pediatric cancer patients, especially those related to alternative therapies. This study investigated the extent and parental expectations on use of alternative therapies. All primary caregivers of 63 eligible patients were interviewed. Use of alternative therapies, regardless of education level or social status of their families, is prevalent (n = 46, 73%) in Taiwan. Commonly used alternative therapies included, in order of popularity, formulated functional food (n = 22, 48%), temple worship/shamanism (n = 19, 40%), traditional Chinese medicine (n = 9, 20%), secret recipes/herbs (n = 13, 28%), and diet supplements (n = 9, 19%). Such practices generally occur without medical guidance from oncologists, largely because of poor interactions between parents and oncologists. Future efforts should be made to encourage both parents and oncologists to discuss this issue. Nurses may serve as mediators by developing mutual trust and a sharing relationship between these groups.

Adolescent↗
PubMed2002

Incidence of chaotic eating behaviors in binge-eating disorder: contributing factors.

Because dieting is not as common in patients with binge-eating disorder (BED) as among patients with bulimia or anorexia nervosa, the authors assessed the incidence, frequency, and contributing factors of semistarvation-like eating patterns in BED patients in this study, the first to explore such behaviors in a clinical population. They administered the Semistarvation-Associated Behaviors Scale (SSABS) to 54 women seeking BED treatment and to 29 controls. The aberrant eating behaviors among BED clients were associated with current dieting and certain BED criteria, (p < .05). The strongest contributor to chaotic eating patterns was negative affect preceding BED (r = .45, p < .001). This finding highlights the behavioral psychopathology of BED and strengthens the role of negative affect in precipitating binge episodes associated with the disorder. These behaviors may help maintain BED by creating a binge-negative affect cycle. The SSABS is a tool that may help break this cycle.

Adolescent↗
PubMed1995

Intimacy and sexual risk behaviour in serodiscordant male couples.

Several studies have demonstrated individual-level determinants of HIV sexual risk behaviour. Very little research has been conducted to identify couple-level factors associated with unsafe sexual behaviour. As part of a three-year study of more than 100 serodiscordant male couples, we conducted an in-depth qualitative study of 15 Latino and non-Latino male couples via focus groups and a follow-up telephone survey. We identified the sexual risk behaviour that occurs in these male couples, their perceptions of susceptibility for HIV transmission, and numerous couple-level and intrapsychic factors associated with their risk behaviour. We also describe the challenges confronted by these couples and barriers to emotional intimacy and couple satisfaction. Finally, we provide suggestions for ways of intervening to facilitate improved couple functioning, pleasure, satisfaction, and communication, and ways of reducing sexual risk behaviour without loss of emotional intimacy.

Adaptation, Psychological↗
PubMed2006

Informal in-hospital care in a rehabilitation setting in Greece: an estimation of the nursing staff required for substituting this care.

PURPOSE: To explore: (a) the type and frequency of care-giving activities provided by family members in the Rehabilitation Setting (RS), (b) opportunities for family members to receive training in care-giving activities, (c) to what extent caregivers feel free to ask the nursing staff for help and (d) to estimate the number of nursing staff required to substitute this care and thus to estimate the money saved by the RS due to the in-hospital informal care. METHOD: A convenience sample of 80 family members was selected. A questionnaire was developed to investigate several aspects of informal in-hospital care. Data was analysed using SPSS for Windows (Release 10.1). RESULTS: Cultural reasons and nursing staff shortage led 78.8% (n = 63) of the sample to provide informal in-hospital care. Oral and facial care (67.5%), help with getting dressed (62.5%), help with feeding (61.25%, n = 49), making patients' beds (57.5%, n = 46) and assistance with transferring patients from one hospital department to another (56.25%, n = 45) was provided on a daily basis by the subjects. 48.75%, (n = 39) changed sheets 1 - 2 times per week, while assistance with transfers from bed to wheel-chair and vice-versa (43.75%, n = 35) was provided 3 - 4 times per week. The estimated total time spent per week by the subjects on care-giving activities was 34,034 minutes that corresponds to a total of 75.6 working days or 15.12 working weeks. In order to substitute this care, the RS would need to hire 17 more assistant nurses, entailing a cost of from Euro 14,450 to Euro 20,060 per month. CONCLUSIONS: Informal in-hospital care is provided by Greek families in the RS. Nursing care staff shortage combined with cultural factors are the main reasons for this phenomenon. However, it saves the RS and the Greek State money and policy makers should be looking for ways to overcome the nursing shortage.

Adult↗
PubMed2005

The impact of a self-help pamphlet on reducing risk drinking among 30- to 49-year-old men in Helsinki, Finland.

This study evaluates the impact of a self-help pamphlet designed to support self-control of drinking. It was conducted in Helsinki, Finland, in 2001 and 2002 and focused on men between 30 and 49 years of age. The respondents were randomly selected in an intervention and a control area and compared with each other before and after the intervention using independent samples (N = 4418) The results support previous findings showing that interventions like this serve as a supplement to other prevention and early treatment measures. Although the results were encouraging, there is a need for more in-depth studies in the field.

Adult↗
PubMed2006

"I intend to donate but ...": non-donors' views of blood donation in the UK.

Although only 6% of the eligible United Kingdom population regularly donate blood, reasons for low donation rates remain poorly understood. In a grounded theory investigation, blood donors (n = 23) and non-donors (n = 27) completed a questionnaire that included 15 open-ended items. Semi-structured interviews were conducted with sub-samples of donors (n = 5) and non-donors (n = 7). Analysis of open-ended responses and interview transcripts identified five themes. Three themes, namely pro-social views, helping behaviour and awareness had similar relevance for donors and non-donors. Two themes, anxiety and practical difficulties, were used by non-donors to account for non-donation despite intentions to donate. Although non-donors' anxieties may be difficult to overcome, perceived practical difficulties provide scope for intervention. The removal of perceived barriers to donation offers one way of increasing donation rates.

Adolescent↗
PubMed2006

Mid-age health in women from the Indian subcontinent (MAHWIS): general health and the experience of menopause in women.

OBJECTIVES: First, to examine the experience of menopause and quality of life in a migrated Asian population from the Indian subcontinent living in Birmingham, UK, and, second, to compare their experience with a matched sample of Caucasian women living in the same geographical area and also with a sample of Asian women with similar socioeconomic background living in Delhi, India. METHODS: In this cross-sectional study of 153 peri- and postmenopausal women aged 45-55 years, 52 Asian women originating from the Indian subcontinent living in Birmingham (UKA, mean age 51.4 years), 51 Caucasian women (UKC, mean age 52.3 years) and 50 Asian women living in Delhi, India (DEL, mean age 49.72 years) were interviewed to collect information about their lifestyle, general health, menopause experience and help-seeking behavior. The Women's Health Questionnaire and the Menopause Representation Questionnaire (both translated and linguistically validated in Hindi) were used to examine the prevalence of physical and emotional symptoms and the extent to which these were attributed to the menopause. RESULTS: The two Asian groups (UKA, DEL) reported poorer health and generally more physical and emotional symptoms than the UKC group. However, for menopausal symptoms (hot flushes and night sweats) there was a different pattern; the DEL group reported significantly fewer symptoms compared to the UKA and UKC groups (hot flushes: UKC 60.8%, UKA 75%, DEL 32% (p < 0.001); night sweats: UKC 50%, UKA 56.9%, DEL 24% (p = 0.002)). The prevalence of vaginal dryness was highest in the UKA group and lowest in the DEL group (UKC 21.6%, UKA 38.2%, DEL 7.3% (p = 0.005)). The number of symptoms attributed to menopause was significantly lower in the DEL group (9.3 +/- 7.8) compared to the two UK groups (UKC 18.9 +/- 7.4, UKA 19.8 +/- 10.7), but the UKA women tended to attribute some physical symptoms to the menopause such as breathlessness, weight gain and stiff joints that might have other causes. CONCLUSIONS: The UK Asian women's experience of the menopause is more similar to the Caucasian women in the UK than that of the women in Delhi. However, Asian women living in the UK and the Indian subcontinent shared the experience of poor health and reports of more physical and emotional symptoms in general. The possible reasons for these differences are discussed.

Asian People↗