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Gunn AJ, Hardesty M, Overstreet N, Wallace S. "Every time I tell my story I learn something new": Voice and inclusion in research with Black women with histories of substance use and incarceration. CRIMINOLOGY & CRIMINAL JUSTICE : THE INTERNATIONAL JOURNAL OF POLICY AND PRACTICE 2022; 22:505-524. [PMID: 38362478 PMCID: PMC10868846 DOI: 10.1177/17488958211005820] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
While current ethical procedures aim to minimize risks to imprisoned individuals, there is heightened awareness of the need to protect those who participate in research post-incarceration while under community-based supervision. Formerly incarcerated women, in particular, face myriad challenges to community reintegration which also make them vulnerable participants in research. As such, this study explores how 28 formerly incarcerated Black women experience the qualitative research process. Findings revealed that women engaged in research because these contexts were viewed as therapeutic spaces for raising awareness that can help others. Moreover, the interview process allowed women to share their pasts in ways that promote their recovery from addiction. Participants also reported risks of emotional distress and fears regarding researcher stigma. The implications for trauma-informed interviewing practices underscore the need for greater considerations of the role of the researcher, research environment, and how they contribute to one's personal recovery.
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Jemal A, Gunn A, Inyang C. Transforming responses: Exploring the treatment of substance-using African American women. J Ethn Subst Abuse 2020; 19:659-687. [PMID: 30940008 PMCID: PMC6776726 DOI: 10.1080/15332640.2019.1579141] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
This article explores how intrapersonal and structural oppression may impact treatment and the recovery process of 23 self-identified African American women with histories of incarceration and substance use. Using a critical consciousness (CC) framework and content-based thematic analysis, researchers systematically coded and extracted themes and patterns from focus group data to evaluate how marginalizing processes-such as race-based discrimination-impact treatment, the therapeutic relationship, and service provision. Results indicate that participants' health and treatment were negatively impacted by oppressive factors, specifically the oppressive process of silencing. The authors discuss research and practice implications.
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Affiliation(s)
- Alexis Jemal
- Silberman School of Social Work at Hunter College, 2180 3 Ave, New York, NY 10035
| | - Alana Gunn
- Department of Criminology, Law, and Justice, University of Illinois at Chicago, 1007 W. Harrison ST, Chicago, IL 60607
| | - Christina Inyang
- Clarity Treatment Center, LLC, 262 State St., Perth Amboy, NJ 08861
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Schmanski A, Roberts E, Coors M, Wicks SJ, Arbet J, Weber R, Crooks K, Barnes KC, Taylor MRG. Research participant understanding and engagement in an institutional, self-consent biobank model. J Genet Couns 2020; 30:257-267. [PMID: 32951257 DOI: 10.1002/jgc4.1316] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 06/25/2020] [Accepted: 07/04/2020] [Indexed: 11/09/2022]
Abstract
The number of institutional and governmental biobanks and the target enrollment sizes of modern biobanks are increasing, affording more opportunities for the public to participate in biobanking efforts. In parallel with these expansions are pressures to increase the efficiency of obtaining informed consent using shorter consent forms that cover a broader scope of research and increasingly include provisions for return of research or clinical genetic test results to participants. Given these changes, how well these participants understand genetics, their level of understanding of what they are consenting to, and their wishes to engage longitudinally and receive biobank results are not well understood. We surveyed participants in a large, medical system-based biobank who had enrolled through a two-page, self-consent process about their baseline knowledge of genetics, understanding and recall of the consent process, wishes for future contact and engagement, and level of interest in receiving clinical genetic testing results. A total of 856 consented persons participated in the survey (67% women; 67% white). Participants' general reported genetics knowledge was relatively high (mean 11.60 of 15 questions answered correctly) as was recall of key elements from the two-page consent form. Overall participant enthusiasm for future contact by the biobank and for receiving clinical genetic testing results was high. The use of a two-page, self-consent process in a large, institutional biobank resulted in high levels of consent recall and enthusiasm for future ongoing engagement and receipt of genetic testing results by participants.
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Affiliation(s)
- Andrew Schmanski
- Department of Genetic Medicine, Munroe-Meyer Institute for Genetics and Rehabilitation, University of Nebraska Medical Center, Omaha, NE, USA
| | - Emily Roberts
- Department of Medicine, Colorado Center for Personalized Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Marilyn Coors
- Department of Medicine, Colorado Center for Personalized Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Stephen J Wicks
- Department of Medicine, Colorado Center for Personalized Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Jaron Arbet
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Rachel Weber
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Kristy Crooks
- Department of Medicine, Colorado Center for Personalized Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Kathleen C Barnes
- Department of Medicine, Colorado Center for Personalized Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Matthew R G Taylor
- Department of Medicine, Colorado Center for Personalized Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,Adult Medical Genetics Program, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Noge S, Botma Y, Steinberg H. Social norms as possible causes of stillbirths. Midwifery 2020; 90:102823. [PMID: 32862100 DOI: 10.1016/j.midw.2020.102823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 07/17/2020] [Accepted: 08/17/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE High stillborn rates are a concern in developing countries. Hence, this article aims to describe the sociocultural norms contributing to the high number of stillbirths as perceived by mothers, significant others, midwives and records of the Pregnancy Problem Identification Programme (PPIP). DESIGN & SETTING A multimethod qualitative descriptive study was conducted in a district in the Free State, South Africa. Each of the five sub-districts has a district hospital where most pregnant women give birth. Eighty per cent of the community is black of which about a quarter live in poor conditions below the poverty line. PARTICIPANTS The first author conducted unstructured in-depth interviews with 36 mothers and their significant other who gave birth to a stillborn. She also extracted relevant data from the PPIP record of each mother. A skilled moderator conducted three focus group interviews with a convenience sample of midwives. The data were inductively analysed to identify subthemes under the central theme of social norms. KEY CONCLUSIONS The authors concluded that traditional practices, traditional role players (traditional healer, mother-in-law, partner), abuse, and prescriptive social norms might contribute to stillbirths. Pregnant women are oppressed as they adhere to traditional social norms and are unable to make independent, informed healthcare decisions. The midwives, who are mostly female, may find it difficult to empower pregnant women because they are under the same social oppression as their clients. IMPLICATIONS FOR PRACTICE It is imperative that healthcare providers consider social determinants of health, including social norms, when providing healthcare, especially to pregnant women as some social practices may have detrimental outcomes for the mother and/or baby.
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Affiliation(s)
- Sesi Noge
- School of Nursing, Faculty of Health Sciences, University of the Free State, Bloemfontein, RSA
| | - Yvonne Botma
- School of Nursing, Faculty of Health Sciences, University of the Free State, Bloemfontein, RSA.
| | - Hannes Steinberg
- Family Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein, RSA.
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Yous ML, Strachan PH, Ploeg J. Is feyerabendian philosophy relevant for scientific knowledge development in nursing? Nurs Philos 2020; 21:e12309. [PMID: 32537914 DOI: 10.1111/nup.12309] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 03/20/2020] [Accepted: 05/27/2020] [Indexed: 11/28/2022]
Abstract
To revitalize nursing science, there is a need for a new approach to guide nurse scientists in addressing complex problems in health care. By applying theoretical concepts from a revolutionary philosopher of science, Paul K. Feyerabend, new nursing knowledge can be produced using creativity and pluralistic approaches. Feyerabend proposed that methods within and outside of science can produce knowledge. Despite the recognition of Feyerabendian philosophy within science, there is currently a lack of literature regarding the relevance of Feyerabendian philosophy for nursing science. We aim to (a) describe and critique Feyerabendian concepts, (b) discuss the potential application of Feyerabendian philosophy for knowledge production within gerontological nursing and (c) describe theoretical possibilities for nurse scientists in using Feyerabendian philosophy to guide nursing knowledge development. We begin by introducing Feyerabend's life and his inspirations for his theoretical concepts, epistemological anarchism, theoretical pluralism and humanitarianism, and conclude by offering suggestions of how to apply Feyerabendian philosophy in nursing research.
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Affiliation(s)
- Marie-Lee Yous
- School of Nursing, McMaster University, Hamilton, ON, Canada
| | | | - Jenny Ploeg
- School of Nursing, McMaster University, Hamilton, ON, Canada.,Aging, Community and Health Research Unit, Department of Health, Aging and Society, Faculty of Health Sciences and Associate Member, School of Nursing, McMaster University, Hamilton, ON, Canada
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Lambert C, Jomeen J, McSherry W. Women’s Decision-Making About Birthplace Choices: Booking for Birth Center, Hospital, or Home Birth in the North of England. INTERNATIONAL JOURNAL OF CHILDBIRTH 2018. [DOI: 10.1891/2156-5287.8.2.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Aim:This article presents findings from an interpretive phenomenological study that illuminates unique characteristics of the different social representations of antenatal primigravida and multigravida women who book to birth their babies in a birth center, hospital, or at home.Methods:Semi-structured interviews were conducted with 19 women and analyzed by interpretive phenomenological analysis.Findings:Analysis revealed different social representations independent of each other that illustrate how these social groups, determined by women’s collective voices, are uniquely characterized by group views, beliefs, misinterpretations, and preconceptions that establish what influences women in decision-making about choice of birthplace.Conclusion:Women make decisions about what they want for themselves in this birthing experience. These decisions are made long before this impending experience. Recognizing the different social representations of women in pregnancy reveals deeper insight into the complexities of women’s decision-making about birth choices and highlights why some women might opt for certain choices. Knowing that some women may make decisions based on little or misrepresented information confirms midwives are best placed in their interactions with women to provide positive influences, empowering them to make decisions based upon what they want for themselves. This affirms the woman and her midwife should remain partners in the decision-making process.
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Nhamo-Murire M, Macleod CI. Lesbian, gay, and bisexual (LGB) people's experiences of nursing health care: An emancipatory nursing practice integrative review. Int J Nurs Pract 2017; 24. [PMID: 29064143 DOI: 10.1111/ijn.12606] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 08/10/2017] [Accepted: 09/17/2017] [Indexed: 11/28/2022]
Abstract
AIM To review current research on lesbian, gay, and bisexual (LGB) individuals' experience of nursing services from an emancipatory nursing practice framework. BACKGROUND As LGB issues are marginalized in health care, it is important to understand LGB individuals' experiences of nursing. DESIGN An integrative literature review using critical analysis based on an emancipatory nursing practice framework was conducted. DATA SOURCES A search of all English nursing journals in the World of Science database was conducted. REVIEW METHODS Established methods were used to search, identify, and appraise articles meeting the criteria of examining LGB individuals' experiences of nursing services, published in the years 2009 to 2015. Sixteen articles that met the inclusion criteria were identified independently by the two authors. Data were analysed using descriptive and critical phases of enquiry. RESULTS Results show a nexus of experiences of exclusion and oppressive social norms. Our analytical framework highlighted absences in nursing practice. No research indicates that LGB people experience nurses as advocates or participatory health care processes. CONCLUSION Standards, training, and systems need to be devised that ensure inclusionary nursing practices, that encourage nurses to act as advocates for LGB health care justice, and that allow LGB individual to participate in the development of health care policies and procedures.
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Affiliation(s)
- Mercy Nhamo-Murire
- Critical Studies in Sexualities and Reproduction (CSSR), Psychology Department, Rhodes University, Grahamstown, South Africa
| | - Catriona Ida Macleod
- Critical Studies in Sexualities and Reproduction (CSSR), Psychology Department, Rhodes University, Grahamstown, South Africa
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Nyoni CN, Botma Y. Aligning summative clinical examination with competence-based curriculum: Midwifery educators experiences in Lesotho. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2017. [DOI: 10.1016/j.ijans.2017.05.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Macleod C, Nhamo-Murire M. The emancipatory potential of nursing practice in relation to sexuality: a systematic literature review of nursing research 2009-2014. Nurs Inq 2016; 23:253-66. [PMID: 27147132 DOI: 10.1111/nin.12131] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2015] [Indexed: 11/28/2022]
Abstract
Nurses play a key role in the provision of services in relation to sexuality in both primary and sexual and reproductive health-care. Given the intersection of sexualities with a range of social injustices, this study reviews research on nursing practice concerning sexuality from an emancipatory/social justice perspective. A systematic review of English articles published in nursing journals appearing on the Web of Science database from 2009 to 2014 was conducted. Thirty-eight articles met the inclusion criteria. Analysis consisted of a descriptive phase (types and location of studies, aspects of sexualities focused on, target health users and aspects of nursing practice focused on) and a critical/emancipatory phase. In terms of practice, our analysis revealed that: barriers exist to the integration of issues relating to sexuality in nursing practice; the social location of nurses and their personal feelings regarding sexuality influence their practice; content that addresses gendered norms and media that assist in communication underpin some emancipatory practices. Few studies locate analyses of nursing practice within gendered, cultural and social norms; consider advocacy as part of the practice of nurses; or analyse the promotion of health user participation in health services and structures. The implications for emancipatory practice are drawn out.
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Affiliation(s)
- Catriona Macleod
- Psychology Department, Critical Studies of Sexualities and Reproduction (CSSR), Rhodes University, Grahamstown, South Africa
| | - Mercy Nhamo-Murire
- Psychology Department, Critical Studies of Sexualities and Reproduction (CSSR), Rhodes University, Grahamstown, South Africa
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The social space of empowerment within epilepsy services: The map is not the terrain. Epilepsy Behav 2016; 56:139-48. [PMID: 26874865 DOI: 10.1016/j.yebeh.2015.12.045] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2015] [Revised: 12/04/2015] [Accepted: 12/30/2015] [Indexed: 11/20/2022]
Abstract
Empowerment is now seen as an integral component of holistic practice and service design in healthcare, particularly as it relates to the improvement of quality of life for people with epilepsy. However, the literature suggests that empowerment is a neglected and poorly understood concept by service users and providers alike within epilepsy services. Conceptual ambiguity is a further impediment to its understanding and implementation. Bearing this in mind, a clear definition of empowerment is needed in order to realistically recognize, encourage, and prioritize empowerment as a service design philosophy. Therefore, this paper undertakes a concept analysis of empowerment with reference to epilepsy services. Results indicate that empowerment demands a transformation of consciousness and a readiness to act on this transformation in order to allow people to gain personal power and autonomy over their own life, including the self-management of their condition. With this in mind, a critical reflection on the 'micro' and 'macro' levels of power that exist within epilepsy services is warranted with reference to theoretical principles. In this context although the map is not the terrain, we argue that an educational intervention guided by critical social theory principles has the potential to encourage an understanding of empowerment and 'holds the key' to future advances for its implementation within epilepsy services.
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Boz İ, Teskereci G, Akman G. How did you choose a mode of birth? Experiences of nulliparous women from Turkey. Women Birth 2016; 29:359-67. [PMID: 26846560 DOI: 10.1016/j.wombi.2016.01.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 01/15/2016] [Accepted: 01/15/2016] [Indexed: 11/18/2022]
Abstract
BACKGROUND One of the most important decisions that women have to make after becoming pregnant concerns their mode of birth, and these decisions are influenced by complex physiological, psychological and socio-cultural factors. AIM To obtain in-depth descriptions of nulliparous women's experiences during the decision-making process for their mode of birth and to reveal their beliefs, attitudes and values. METHODS This is a qualitative, phenomenological study that included 29 nulliparous women. Data were collected using semi-structured, face-to-face interviews and analysed using the constant comparison method and guidelines developed by Collaizi. FINDINGS The women's experiences during their decision-making process for their mode of birth were placed into one of four categories, "getting confused", "no matter what happens", "others influencing women's decisions" and "make a decision one way or the other". Vaginal births were considered under the theme "natural but hard way" and caesarean sections under the theme "easy choice". The women indicated that they wanted to have vaginal births, but that they were not offered knowledge and support about modes of birth from health care professionals and, as a result, they asked their relatives for support. CONCLUSION It is important to obtain pregnant women's preferences for modes of birth so that knowledge, support and care can be provided and so that they can be involved in the decision-making process. Therefore, health care professionals should understand pregnant women's experiences during the decision-making process for their mode of birth.
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Affiliation(s)
- İlkay Boz
- Akdeniz University, Nursing Faculty, Antalya, Turkey.
| | | | - Gülay Akman
- Samsun School of Health, Ondokuz Mayıs University, Samsun 55100, Turkey.
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Obeidat RF. Promoting emancipated decision-making for surgical treatment of early stage breast cancer among Jordanian women. Asia Pac J Oncol Nurs 2015; 2:257-263. [PMID: 27981122 PMCID: PMC5123509 DOI: 10.4103/2347-5625.159351] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Accepted: 03/29/2015] [Indexed: 11/28/2022] Open
Abstract
To use the critical social theory as a framework to analyze the oppression of Jordanian women with early stage breast cancer in the decision-making process for surgical treatment and suggest strategies to emancipate these women to make free choices. This is a discussion paper utilizing the critical social theory as a framework for analysis. The sexist and paternalistic ideology that characterizes Jordanian society in general and the medical establishment in particular as well as the biomedical ideology are some of the responsible ideologies for the fact that many Jordanian women with early stage breast cancer are denied the right to choose a surgical treatment according to their own preferences and values. The financial and political power of Jordanian medical organizations (e.g., Jordan Medical Council), the weakness of nursing administration in the healthcare system, and the hierarchical organization of Jordanian society, where men are first and women are second, support these oppressing ideologies. Knowledge is a strong tool of power. Jordanian nurses could empower women with early stage breast cancer by enhancing their knowledge regarding their health and the options available for surgical treatment. To successfully emancipate patients, education alone may not be enough; there is also a need for health care providers' support and unconditional acceptance of choice. To achieve the aim of emancipating women with breast cancer from the oppression inherent in the persistence of mastectomy, Jordanian nurses need to recognize that they should first gain greater power and authority in the healthcare system.
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Wittmann-Price RA, Price SW. Development and revision of the Wittmann-Price Emancipated Decision-Making Scale. J Nurs Meas 2015; 22:361-7. [PMID: 25608425 DOI: 10.1891/1061-3749.22.3.361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE The original Emancipated Decision-Making (EDM) scale was revised to test 3 subconcepts (flexible environment, personal knowledge, and awareness of social norms) of an emancipated decision-making process. METHODS The original EDM scale was significantly related to the Satisfaction with Decision (SWD) scale in two separate studies (r = 0.79, r = 0.59). Two of the original 5 subconcepts showed a lack of contribution. The third study (N = 50) had good total scale reliability (r = 0.89). RESULTS The revised EDM (EDM-r) scale was then leveled to the SWD scores and quantified into 2 categories and the subscales for the 3 subconcepts were reanalyzed for reliability and scale-if-item contribution. CONCLUSION The final EDM-r is a generically worded, 20-item, 3-subscale instrument with good total and individual subscale reliability.
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Abstract
Women's choice and control impact birthing experiences. This study used a qualitative, descriptive approach to explore how women develop their initial birth plan and how changes made to the plan affect overall birth experiences. Narrative, semistructured interviews were conducted with 15 women who had given birth in Waterloo Region, Ontario, Canada, and data were analyzed using a phenomenological approach. Findings showed that women relied on many resources when planning a birth and that changes made to a woman's initial birth plan affected her recollection of the birth experience. Conclusions are that women's positive and negative recollections of their birth experiences are related more to feelings and exertion of choice and control than to specific details of the birth experience.
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Stepanuk KM, Fisher KM, Wittmann-Price R, Posmontier B, Bhattacharya A. Women's decision-making regarding medication use in pregnancy for anxiety and/or depression. J Adv Nurs 2013; 69:2470-80. [PMID: 23488910 DOI: 10.1111/jan.12122] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2013] [Indexed: 11/30/2022]
Abstract
AIM To increase understanding of women's decision-making process concerning the medication use for anxiety and/or depression while pregnant. BACKGROUND Anxiety and depression affects many pregnant women, yet the decision to take psychotropic medication is complex and possibly subject to social oppression. DESIGN Cross-sectional descriptive survey design. METHODS A web-based survey was used to collect data from a convenience sample of 143 pregnant women over 3 months beginning in early 2011. An independent t-test was conducted to determine differences in satisfaction between women with high and low levels of emancipated decision-making (EDM). A multiple regression analysis was conducted to determine which subscales of the emancipation scale best predict level of satisfaction with the decision. FINDINGS The majority of respondents were White, between 25-34 years of age. The group with lower levels of emancipation reported lower mean satisfaction scores compared with those with higher levels of emancipation. Regression analysis showed that the three subscale emancipation model was a statistically significant predictor of satisfaction with the decision and accounted for 54% of the variance in satisfaction. The subconcept of personal knowledge was most predictive of satisfaction with decision. CONCLUSIONS Women may be able to overcome oppressive forces by using an EDM process. EDM allows them to make a decision that feels right for them and to feel satisfied with the decision.
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Affiliation(s)
- Kathleen M Stepanuk
- College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA
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Busanello J, Lunardi Filho WD, Kerber NPDC, Lunardi VL, dos Santos SS. [Woman's participation in the decision process of the pregnancy and puerperal cycle: nursing care integrative review]. ACTA ACUST UNITED AC 2012; 32:807-14. [PMID: 22299285 DOI: 10.1590/s1983-14472011000400023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
This is an integrative review that aims to identify the contribution of nursing care for woman's participation in the decision process of the pregnancy and puerperal cycle, as described in Brazilian scientific publications. The scientific productions were retrieved in May, 2010, from the Virtual Library of Health (Biblioteca Virtual em Saúde) database. From the eight articles reviewed, two themes stood out: Contributions of nursing care to the woman's participation in the decision process of the pregnancy and puerperal cycle; and Limitations of nursing care to the woman's participation in the decision process of the pregnancy and puerperal cycle. The following review supports the production of knowledge in nursing, by identifying a gap in what nurses know and do about this issue, as shown by the lack of nursing researches that concern, specifically, the participation of the woman in the decision process during the pregnancy and puerperal cycle and the possible contributions of nursing care to ensure women of this right.
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Affiliation(s)
- Josefine Busanello
- Programa de Pós-Graduação em Enfermagem da Escola de Enfermagem da Universidade Federal do Rio Grande (FURG), Rio Grande do Sul, Brasil.
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Abstract
Purpose: We investigated how mothers employed in support staff positions make personal and family health decisions. Design: We used a critical feminist grounded theory design. Methods: Twenty women employed at a large Canadian institution participated over two years in repeat interactive interviews. Findings: “Finding a balance” was the emergent core process of health decision making in response to the basic social problem of multiple demands and uncoordinated, sometimes conflicting ideologies. Women emphasized recursive movement within a continuous process of four action phases: cueing in, figuring out, generating solutions, and assessing results. Two distinct views of finding a balance were revealed: weighing competing interests or harmonizing multiple interests. These distinctive views contributed to variation in women’s approaches to decision making and to their personal and family health experiences. Conclusions: Women’s experiences suggest a capacity for reflective practice in health decision making that provides an excellent basis for holistic, emancipatory nursing practice.
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Affiliation(s)
- Kaysi Eastlick Kushner
- Centre for Health Promotion Studies, School of Public Health at the University of Alberta, Faculty of Nursing atUniversity of
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Abstract
PURPOSE The purpose of this ethnographic study was to describe the perceptions of Ecuadorian childbearing women BACKGROUND No studies published in English could be found documenting the perspectives of Ecuadorian childbearing women about their birth experiences. METHOD Thirty-two women who had recently given birth in Guayaquil, Ecuador participated in audiotaped interviews, which were analyzed as appropriate for ethnographic inquiry. RESULTS "Enduring birth to obtain the gift" was the overarching theme. Supporting themes included caring for self and accessing prenatal care to have a healthy newborn; relying on God to ensure positive maternal/newborn outcomes; submission of self to healthcare providers because of fear, pain, and lack of education; and valuing motherhood. The focus was on the well-being of the child rather than the quality of the birth experience. IMPLICATIONS FOR CLINICAL PRACTICE With a growing population of women of childbearing age immigrating into the United States from Central and South America, the need for culturally competent care is increasing. Sensitivity to the cultural beliefs and practices of Hispanic and other culturally diverse childbearing women is critical. Women's reliance on God to ensure positive outcomes should be respected. The provision of education and supportive care will help ensure positive outcomes in culturally diverse women.
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Häggström E, Bruhn S. Caregivers' attitudes to education and supervision in work with the older people in a nursing home. NURSE EDUCATION TODAY 2009; 29:850-854. [PMID: 19500887 DOI: 10.1016/j.nedt.2009.05.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2008] [Revised: 04/15/2009] [Accepted: 05/11/2009] [Indexed: 05/27/2023]
Abstract
Community-based care in Sweden has problems recruiting and keeping staff with formal competence and education. Both the caregiver's well-being and the receiver's care improve when the personnel receive support in the form of continuing supervision and education. Yet the caregivers in this study did not participate in a training and supervision programme during working hours. The aim of this study was to describe the attitudes towards education, support and supervision in the care of older people in municipal care in Sweden. The study used a qualitative approach with a descriptive design. Twelve caregivers, nine enrolled nurses and three nurses' aides from four wards in a nursing home were interviewed. The interviews were analysed with qualitative content analysis. The main findings showed that all of the caregivers were positive towards the idea of participating in training and asked for education and supervision but felt that the management did not create conditions that made it possible to participate during working hours. According to the findings there is a need for developing new forms and methods for learning that can be integrated into working life.
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Wittmann-Price RA, Fliszar R, Bhattacharya A. Elective Cesarean births: are women making emancipated decisions? Appl Nurs Res 2009; 24:147-52. [PMID: 21777789 DOI: 10.1016/j.apnr.2009.08.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2009] [Revised: 08/12/2009] [Accepted: 08/16/2009] [Indexed: 11/29/2022]
Abstract
This mixed method study investigated the extent to which women used emancipated decision making when selecting a birth method, whether they perceived they had a choice, and if they were satisfied with their decision. Findings suggest that vaginal birth is still the preferred method of delivery for these study participants.
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Affiliation(s)
- Ruth A Wittmann-Price
- Drexel University College of Nursing and Health Professions, Philadelphia, PA 19102, USA.
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22
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Wadensten B, Engström M, Häggström E. Public nursing home staff's experience of participating in an intervention aimed at enhancing their self-esteem. J Nurs Manag 2009; 17:833-42. [PMID: 19793240 DOI: 10.1111/j.1365-2834.2009.00968.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM The aim of the present study was to gain an understanding of how nursing staff experienced participating in a training programme aimed at strengthening their self-esteem and empowering them, to determine whether participation benefited them in any way, and to describe their opinions about possible benefits or disadvantages. BACKGROUND Staff working in institutions such as nursing homes have a low status in society. A training programme was introduced to staff in a public nursing home. It focused on helping them understand factors in the work situation that influence them and on empowering them. METHOD The study was explorative and qualitative in design. FINDINGS The participants in the programme were generally satisfied with it. Their opinions about the benefits they received from the programme can be described using three themes: 'improved communication skills', 'enhanced self-esteem' and 'sees work in a different light'. CONCLUSIONS The most important finding of the present study is that it was possible to strengthen and empower staff. Staff members were generally pleased and satisfied with the content/organization of the training programme. They felt the programme had been of value to them by improving their communication skills and increasing their self-esteem. IMPLICATIONS FOR NURSING MANAGEMENT The present result could be of value to managers and educators working in the area of nursing home care when planning education and development activities for staff. Learning to communicate better and understand the social structure at the workplace could improve staff members' self-esteem, thereby enhancing the work situation and atmosphere as well as empowering the individuals.
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Affiliation(s)
- Barbro Wadensten
- Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University, SE-752 37 Uppsala, Sweden.
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Van Den Tillaart S, Kurtz D, Cash P. Powerlessness, marginalized identity, and silencing of health concerns: voiced realities of women living with a mental health diagnosis. Int J Ment Health Nurs 2009; 18:153-63. [PMID: 19490225 DOI: 10.1111/j.1447-0349.2009.00599.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Using a feminist qualitative approach, this study substantiated many earlier research findings that document how women with a mental health diagnosis experience unequal access to comprehensive health care compared to the general population. Accounts of this disparity are documented in the literature, yet the literature has failed to record or attend to the voices of those living with mental health challenges. In this paper, women living with a mental health diagnosis describe their experiences as they interface with the health-care system. The participating women's stories clearly relate the organizational and interpersonal challenges commonly faced when they seek health-care services. The stories include experiences of marginalized identity, powerlessness, and silencing of voiced health concerns. The women tell of encountered gaps in access to health care and incomplete health assessment, screening, and treatment. It becomes clear that personal and societal stigmatization related to the mental health diagnosis plays a significant role in these isolating and unsatisfactory experiences. Lastly, the women offer beginning ideas for change by suggesting starting points to eliminate the institutional and interpersonal obstacles or barriers to their wellness. The concerns raised demand attention, reconsideration, and change by those in the health-care system responsible for policy and practice.
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24
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Häggström E, Engström M, Barbro BW. A nine-month intervention programme focusing on empowerment; caregivers’ descriptions of changed behaviour and increased room for acting. J Clin Nurs 2009; 18:866-73. [DOI: 10.1111/j.1365-2702.2008.02595.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
In the United States, federal acts and regulations, as well as professional guidelines, clearly dictate that every pregnant woman has the right to base her maternity care decisions on accurate, up-to-date, comprehensible information. Despite these efforts, evidence suggests that informed consent within current health-care practice is restricted and inconsistently implemented. Patient access to evidence-based research is imperative under the scope of informed consent and is particularly important during a time when perinatal mortality and morbidity rates, interventions, and disparities are on the rise in the United States. This article describes the Coalition for Improving Maternity Services' investigation of the breakdown of informed consent in maternity care.
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Affiliation(s)
- Holly Goldberg
- HOLLY GOLDBERG is a doctoral candidate in prenatal and perinatal psychology at Santa Barbara Graduate Institute in Santa Barbara, California. For more than 14 years, she has worked in the birthing field as a researcher, advocate, childbirth educator, prenatal yoga and t'ai chi instructor, and birth attendant
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Reexploring the subconcepts of the Wittmann-Price Theory Of Emancipated Decision Making in women's healthcare. ANS Adv Nurs Sci 2008; 31:225-36. [PMID: 18724112 DOI: 10.1097/01.ans.0000334286.81354.16] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study explored the 5 subconcepts (empowerment, flexible environment, personal knowledge, reflection, and social norms) of the Wittmann-Price Theory of Emancipated Decision Making (EDM) in women's healthcare, a theoretical model. Pain management for labor was the clinical exemplar. The correlation of EDM and satisfaction with the decision (SWD) was measured, and flexible environment was the subscale with the highest mean score. There was a significant relationship between EDM and SWD (r = 0.70, P < .001). Personal knowledge and flexible environment were the best predictors of satisfaction. This study advances the theory of EDM for the nursing care of women.
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Blix-Lindström S, Johansson E, Christensson K. Midwives’ navigation and perceived power during decision-making related to augmentation of labour. Midwifery 2008; 24:190-8. [PMID: 17320254 DOI: 10.1016/j.midw.2006.12.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2006] [Revised: 10/27/2006] [Accepted: 12/03/2006] [Indexed: 10/23/2022]
Abstract
OBJECTIVE to explore and understand how midwives perceive and experience decision-making about augmentation of labour. DESIGN focus-group discussions. SETTING Stockholm, Sweden. PARTICIPANTS 20 midwives experienced in working in labour wards. FINDINGS five categories were identified that illustrate the factors considered by the midwives to influence decision-making during augmentation of labour: 'regulations and guidelines'; 'shortage of delivery rooms'; 'influence of obstetricians'; 'women in labour'; and 'midwives' professional selves'. The theme identified was how midwives managed to 'navigate' these factors, which provided midwives with a decisive influence during the decision-making process. KEY CONCLUSIONS AND IMPLICATIONS midwife job satisfaction can result from a sense of professional power over the possibility of navigating factors that influence decision-making during augmentation of labour. This sense of power can subsequently influence co-operation with both obstetricians and women during labour.
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Affiliation(s)
- Sabine Blix-Lindström
- Department of Woman and Child Health, Karolinska Institutet, Stockholm, SE-171 77, Sweden.
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28
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Abstract
This study examines the informed consent process from the perspective of intensive care patients. Using the largest single-method database of patient-derived information in the United States, we systematically outlined and tested several key factors that influence patient evaluations of the intensive care unit (ICU) informed consent process. Measures of information, understanding, and decision-making involvement were found to predict overall patient satisfaction and patient loyalty intentions. Specific actions supportive of ICU informed consent, such as giving patients information on advance directives, patient's rights, and organ donation, resulted in significantly higher patient evaluation scores with large effect sizes. This research suggests that the effectiveness of the informed consent process in the ICU from the patient's perspective can be measured and evaluated and that ICU patients place a high value on the elements of the informed consent process.
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Wittmann-Price RA. Exploring the Subconcepts of the Wittmann-Price Theory of Emancipated Decision-Making in Women's Health Care. J Nurs Scholarsh 2006; 38:377-82. [PMID: 17181087 DOI: 10.1111/j.1547-5069.2006.00130.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE To explore the subconcepts of the Wittmann-Price Theory of Emancipated Decision-Making (EDM); which is proposed as a new theoretical model for the nursing care of women to increase women's satisfaction with decision-making about healthcare issues. Infant feeding method was used as the clinical exemplar. DESIGN AND METHOD A descriptive correlational design was used to test the five identified subconcepts of EDM (empowerment, flexible environment, personal knowledge, reflection, and social norms) in women's healthcare. The relationship of emancipated decision-making and satisfaction were explored with the Subject Demographic Questionnaire (SDQ), the Wittmann-Price Theory of Emancipated Decision-making Scale (EDMS), and the Satisfaction with Decision (SWD) scale. The research design was retrospective, without random sampling of subjects. Four research questions were posed for this investigation. Women who had uncomplicated deliveries and met the selected criteria were enrolled (N=97). FINDINGS All five subconcepts of EDM were scored on subscales on the EDMS; flexible environment and personal knowledge had the highest mean scores. Pearson correlations showed that all five subscales were significantly related to each other except reflection with personal knowledge and reflection with social norms. A significant relationship was found between the EDM and satisfaction with the decision. Personal knowledge and flexible environment were the best predictors of satisfaction with the decision. CONCLUSIONS The Wittmann-Price Theory of EDM is a theoretical model with implications for nursing care of women who are involved in a healthcare decision, such as choice of infant feeding. Further studies are needed to determine the importance of each of the subconcepts in relation to emancipated decision-making.
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Abstract
The decision-making process in childbearing women regarding birth preferences raises ethical dilemmas related to caring for women during labor and birth. Giving birth is a powerful, life-changing event that leaves a lasting impact on the childbearing woman. The birth experience may be perceived positively or negatively or with feelings of ambivalence. This descriptive qualitative study asked what factors influence a woman's change in her stated birth preference from an unmedicated birth to a medicated birth. A purposive convenience sample of 33 primiparous and multiparous childbearing women who had changed their stated birth preference for pain management during labor participated in interviews conducted within a month of giving birth. Themes included wanting an unmedicated birth; changing to a medicated birth; feeling disappointed, ambivalent, or satisfied; and reflecting on the change. Changing birth preferences is a result of many complex factors, including the influence of professional support by nurses. Ethical principles such as autonomy, veracity, beneficence, informed consent, standard of best interest, and obligations should be applied when caring for laboring women, framed by the ethics of caring.
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Affiliation(s)
- Troy Carlton
- University of Colorado School of Nursing, Denver, USA.
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