Understanding Women's Recovery from Illness and Trauma

Books

Margaret H. Kearney

  • Citations
  • Add to My List
  • Text Size

  • Chapters
  • Front Matter
  • Back Matter
  • Subject Index
  • Women's Mental Health & Development

    Series Editor: Barbara F. Okun, Northeastern University

    Women's Mental Health and Development covers therapeutic issues of current relevance to women. This book series offers up-to-date, practical, culture-sensitive, professional resources for counselors, social workers, psychologists, nurse practitioners, family therapists, and others in the helping professions. Volumes in this series are also of significant value to scholars in gender studies and women's studies.

    This series is designed to deal particularly with those issues and populations underrepresented in the current professional literature. Particular attention is paid to the socio-cultural contexts of these issues and populations. While some of the volumes of this series cover topics pertinent to all women, others focus on topics applicable to specific groups. The series integrates material from established models, emerging theoretical constructs, and solid empirical findings in a format designed to be applicable for clinical practice. Professionals and trainees in a variety of mental health fields will find these readable, user-friendly volumes immediately useful.

    Authors of volumes in this series are selected on the basis of their scholarship and clinical expertise. The editorial board is composed of leading clinicians and scholars from psychology, counseling, and social work.

    Editorial Board

    Paula Allen-Meares, University of Michigan

    Laura S. Brown, Private Practice, Seattle, Washington

    Christine Courtois, Psychiatric Institute of Washington, DC

    Ingrid Grieger, Iona College

    Allen Ivey, University of Massachusetts

    Aurora Jackson, Columbia University

    Helene Jackson, Columbia University

    Mark Kiselica, Trenton State College

    Mary Sue Richardson, New York University

    Derald Wing Sue, California School of Professional Psychology, Alameda, and California State University at Hayward

    Copyright

    View Copyright Page

    Series Editor's Introduction

    One of the outcomes of the women's movement is the increasing attention to women's experiences of and responses to health issues across the life span. Just as women's development differs from that of men, the types of illnesses, treatments, and the overall impact on women's sense of self, relationships, family, and work also differ. Although research in the areas of women's health is burgeoning, there are still many health care providers who are not attuned to gender differences in the nature and types of illness experiences. Clinicians can learn about how women restructure their identity, relationships, and life patterns in response to health-related events from a comprehensive overview of the research to-date and from women's personal stories.

    In Volume 4 of the Sage Women's Mental Health and Development series, Margaret H. Kearney synthesizes existing theories about women's experiences of health crises, recovery, and growth from different disciplines with personal stories of women into a cohesive phase model that allows us to provide meaningful support, understanding, and care for women undergoing health transformations. Working with Dr. Kearney on this volume has positively affected my clinical work: Teaching her transformation model to clients and their families has provided a guiding framework for understanding the difficult and challenging process of transformation. This process involves letting go of pre-illness or trauma assumptions about who we are, what we can do, and how things are “supposed” to be so that we can develop a more flexible self paradigm that allows us to shift roles, responsibilities, and identities. Husbands, friends, parents, and children face the same challenges to their views of “the way things are supposed to be.”

    Dr. Kearney presents her material in a way that allows us to view differences in the perspectives of the meaning of health, illness, and treatment through the lenses of culture, ethnicity, socioeconomic class, and spirituality, as well as consideration of the impact of one's unique personal history and environmental stressors. This aspect of women's development is critical to our understanding and treatment of women in all stages of life, given the reported prevalence of depression, eating disorders, cancer, heart disease, chronic illness, and strokes. The author brings her 25 years of women's health nurse practitioner experience in urban, rural, poor, and wealthy areas of the United States to this commendable task. Researchers, clinicians of all disciplines, and academicians interested in women's issues can all benefit from this thoughtful, clarifying volume.

    The Editorial Board and I believe this book is an invaluable companion to the other volumes in the series. Forthcoming volumes will deal with women and cancer and women's psychopharmacology.

    Barbara F.Okun, Ph.D., Northeastern University

    Dedication

    For Emily and Paul

    Preface

    Through struggle and surrender, ill people paradoxically grow more resolute in self as they adapt to impairment… They believe in their inner strength as their bodies crumble. They transcend their bodies as they surrender control… With this stance comes a sense of resolution and an awareness of timing. They know when to struggle and when to flow into surrender. They grow impervious to social meanings, including being devalued. They can face the unknown without fear while remaining themselves. At this point, chronically ill people may find themselves in the ironic position of giving solace and comfort to the healthy.

    Charmaz, 1995, p. 675
    Listening to Women about Illness

    Women in pain, whether physical, emotional, or spiritual, make up much of the clientele in counseling caseloads. Counselors spend many hours eliciting and listening to women's stories of how their lives and views of themselves have changed as they have suffered losses, setbacks, and surprises along life's path. Some life transitions or untoward events–such as divorce, bereavement, infertility, or parenting difficulties–are common enough that counselors have plentiful literature to draw from in helping these women and are able to recognize common responses and stages of recovery and healing.

    The goal of this book is to provide similar support for counseling of women suffering illness or recovering from trauma. It offers real-life experiential information from women themselves. I also theorize about common threads of experience of women who have moved through these difficulties and reached a point of resolution. The theory presented in Chapter 2, which is rooted not in hypothetical “armchair” speculation but in a careful analysis of over 100 studies of many hundreds of women, is reiterated in the subsequent chapters focusing on particular situations of illness and trauma. Counselors may find this model useful for their work with women in health-related transitions. The women quoted in the book provide insights into how they found strength and resilience in integrating great loss and devastation into their lives.

    This book is written by a nurse and draws predominantly from nursing research literature. It explores and synthesizes theoretical viewpoints on health arising from nurses' interest in patients' experiences and their research methods drawn from anthropology and medical sociology. It may be useful to researchers who are interested in a collection of small studies of health experiences.

    Yet the main purpose here is to offer insights for clinicians. I bring to this project many years of experience as a women's health nurse practitioner; my clinical work has served as a testing ground for the ideas in this book. Nurse researchers have made important contributions to understanding the experiences of health and illness, which should be disseminated beyond our profession. Although nurses focus on prevention and treatment of physical and mental illness, like counselors, our broad focus is on supporting individuals toward their optimal level of wellness and growth within their unique life contexts. Therefore, the goal of this book is to offer a synthesis of ideas from nurses' and others' observations of women's illness experiences that will be useful to counselors and others working directly with women undergoing health changes.

    Although nurse researchers and other scientists are conscientiously seeking to remedy this deficit, women marginalized by poverty, language and cultural difference, and illness itself have been inadequately studied and heard in past years and as a result are less visible in this book than I would like. Context is indeed critical to every woman's view of herself and her possibilities. What illness means, what recovery consists of, what a woman with a disability should be doing within a culture or society, how much a woman should attend to her own rather than her family's needs, the role of the environment and the spiritual world in disease all are defined differently within diverse age groups, families, social worlds, and cultural traditions. In my nursing practice with women of all income ranges and educational levels and in my nursing research with women who are substance users and survivors of domestic violence, I have gained sensitivity to the importance of ethnic, cultural, and socioeconomic differences in women's understandings of their lives and relationships.

    Unfortunately, due to lack of available research, this book will not answer all the important questions about how diversity affects illness experience. Any effort like this one to generalize about experience must smooth over the bumps and irregularities of unique life stories and pass over the minute differences in personal histories and conditions of women's lives. One can only tell a few parts of a story at a time, which flattens out a three-dimensional life into a line or diagram. Although this book brings together many studies of many kinds of illness and trauma experiences, we can only speculate about other unstudied situations. Many questions will remain.

    One question this book will not answer is whether women's illness experience resembles men's experience. Certainly, women's roles and relationships and how women are socialized from infancy to understand themselves and their place in the world create different experiences of illness and loss, but the focus here is on women's stories in themselves rather than on contrasts or comparisons. Another unanswered question is how women in the United States and Canada resemble women from other regions. With a very few exceptions, this book is based on studies of North American English-speaking women.

    The Power of Stories Told Together

    As will become obvious in the next chapter, there is a surprising dearth of large-scale research on women's health problems. With the exception of health problems affecting reproduction, neither the physical manifestations and consequences nor the psychological impact of women's illness has been studied in depth until very recently. The studies that exist are often limited to women of racial and ethnic majority status. Major new initiatives also are limited to a focus on menopause and related health problems. Therefore, we are unable to make broad-based statements about “what happens to women with multiple sclerosis” or “the psychological effects of arthritis for women.”

    Nor would this meet the needs of counselors who see individual women, one at a time, and seek to understand their unique experiences. We respond to women as they seek to put illness into context and readjust their lives and goals around their changing health. This book aims to give therapists and other professionals a head start–an opportunity to hear from many women who have told their stories to researchers, who in turn have organized the stories into a cohesive set of findings.

    This book is a synthesis of qualitative research: systematic study of human experience using text, visual observation, the spoken word, and other “live” sources as data, rather than converting personal experiences into numbers and using statistical analysis to come to conclusions. Qualitative researchers study “lived reality,” the subjective experience of being in a particular situation at a particular time (Munhall, 1995). This approach recognizes that the values and beliefs of both researcher and researched will affect the goals and outcomes of study and that the findings of such research are cocreated by scientist and participant. The product of a qualitative research study is a description of an experience, in theoretical terms or in the form of narrative or themes.

    The epistemological tenet here is that personal stories have truth value that is different than that of large-sample survey research with high statistical power. I make no claim of generalizability of the experiences portrayed here, nor do the small studies from which these. women's voices are drawn rely on random sampling or large numbers. The rigor of this text-based (as opposed to numbers-based) science is found not in random sampling or statistical compensation for chance findings but in the researcher's adherence to a specific interpretive approach, a meticulous faithfulness to the participants' perspective during a systematic analysis of meanings. The value of small-scale, in-depth research is not in its applicability to large groups but in the relevance of the experiences portrayed herein to the reader's own professional needs. A woman's statement or a theoretical conclusion drawn from many statements is meaningful and valid if it has what Glaser and Strauss (1967) called “fit” with the reader's experience and “grab” in its recognizability, logical coherence, and believability.

    Qualitative research can attempt to answer the “why” and “how” questions of human responses to illness. Listening to 6 women can yield more about their lived experience of suffering and processes of self-transformation than can reading an excellent statistical report on the effectiveness of a medical treatment or the frequency of depression or anxiety. Readers rather than computerized analyses judge the significance of this type of research, which is designed to gather vivid and meaningful examples of human experience on a particular topic.

    What is Grounded-Theory Research?

    This book is built on studies that employed grounded theory, a form of qualitative research aimed at discovering theory about human perceptions and actions (Glaser & Strauss, 1967). The goal is not to simply describe the essence of an experience for a group of people but to make theoretical conclusions about how people respond to this situation and how the experience changes over time. This makes it well-suited to the process of illness and recovery. Theory discovered in this way is systematically developed from experiential information using a technique of constant comparison, drawing theoretical ideas from the original data and expanding and modifying these ideas by constant comparison of all data sources to each other.

    Grounded theorists develop samples for research not by restricting themselves to a homogeneous group but by seeking to maximize the variation within a sample. Theoretical sampling involves seeking out new situations to observe and new participants to speak with who can help clarify the areas of the emerging theory that are still unclear. The researcher continues to collect data until no new information is being discovered. The usual result is a theoretical model of a social-psychological process shared by a variety of participants in a particular life situation and the conditions and contingencies that affect individuals' progress through the phases of the process (Strauss & Corbin, 1990). Using a theory of recovery from a particular illness or loss, clinicians can begin to predict the phases of recovery and the potential obstacles or resources, and help clients move toward positive outcomes.

    Here, we will take the act of bringing together women's stories one step further by providing an overarching theoretical framework that can be used to place women's statements along a continuum of change. For this book, a higher-level grounded theory known as grounded formal theory (Strauss, 1987) was developed. It is presented in Chapter 2. This is the result of analysis of the many single grounded-theory studies presented in the later chapters to find a process that all the groups studied have in common. It was developed using the same steps of constant comparison and theoretical sampling that the original studies used, but the “participants” were not individual women but the hundred-plus individual articles, books, or dissertations. The resulting theory is of necessity very general, but its basic concepts are important to any woman struggling to come to terms with illness or trauma. With this simple model in mind, counselors can be alert to important issues and support women as they work through their unique and particular losses.

    In bookstores and magazines can be found many stories of women's personal journeys through illness or misfortune. These books are mainly by or about women who were writers or public figures before they became ill. They have value in their own right, but they are not drawn on here because they are not produced by systematic research on ordinary people. Nonetheless, these single-person accounts echo all the components of the processes described here and can serve as in-depth examples. Among professional publications, there are also other book-length collections of studies of women's illness experiences (e.g., Munhall, 1994, 1995; Young-Mason, 1997).

    This book does not aim to teach counselors new techniques or even new ways of applying old skills. Rather, it is designed to provide windows into aspects of women's experience that counselors may not encounter on a regular basis. Whenever feasible, direct quotations from women as cited by grounded theory researchers are used to demonstrate important components of illness experience. The result is a story that makes sense and that can be used to understand and support women who are living through it. This is a tale of reckoning with hard truths over time and finding ways to reconcile these losses with the ongoing priorities of women's lives. Reckoning and reconciling form a framework of illness recovery that produces not only accommodation to the daily demands of poor health but growth toward a new idea of self-actualization.

    Acknowledgments

    This book was made possible by more than 100 qualitative researchers in nursing, counseling, and the health sciences. Their publications and dissertations are the platform on which this work is built, and any misinterpretations are mine alone. Thanks also to Boston College for a Faculty Research Expense Grant that funded a summer of library work, and to my editors, Barbara Okun and Jim Nageotte, without whose support and excellent judgment this book would not be what it is. I am continually grateful to the women and men who told their stories of illness, pain, and healing to the researchers cited in this book, and to all those who continue patiently to instruct their health care providers about the experience of illness.

  • References

    Allen, J., & Blumenthal, R. (1998). Risk factors in the offspring of women with premature coronary heart disease. American Heart Journal, 135, 428–434. http://dx.doi.org/10.1016/S0002-8703%2898%2970318-7
    Anderson, C. (1993). Women's stories on growing up with a father who abused alcohol: Adding new distinctions. Unpublished masters thesis, University of Guelph, Guelph, Ontario, Canada.
    Anderson, D., Ellenberg, G., Leventhal, C., Reingold, S., Rodriguez, M., & Silverberg, H. (1992). Revised estimate of the prevalence of multiple sclerosis in the United States. Annals of Neurology, 31, 333–336. http://dx.doi.org/10.1002/ana.410310317
    Angell, M. (1993). Caring for women's health: What is the problem? (Editorial). The New England Journal of Medicine, 329, 271–272. http://dx.doi.org/10.1056/NEJM199307223290409
    Annas, G. (1994). Women, health care, and the law: Birth, death, and in between. In E.Friedman (Ed.), An unfinished revolution: Women and health care in America, pp. 29–45. New York: United Hospital Fund of New York.
    Armstrong, N. (1987). Coping with diabetes mellitus: A full-time job. Nursing Clinics of North America, 22, 559–568.
    Armstrong, N. (1990). Perceptions of adults with insulin-requiring diabetes of factors influencing their self-management. Unpublished dissertation, University of Georgia, Athens, Georgia.
    Asch, A., & Fine, M. (1988). Introduction: Beyond pedestals. In M.Fine and A.Asch (Eds.), Women with disabilities: Essays in psychology, culture, and politics, pp. 1–37. Philadelphia: Temple University.
    Barrett-Connor, E., & Wingard, D. (1984). Sex differences in diabetes mellitus. In E.Gold (Ed.), The changing risk of disease in women, pp. 257–286. Lexington, MA: Heath.
    Bayne-Smith, M. (Ed.). (1996). Race, gender, and health. Thousand Oaks, CA: Sage.
    Belenky, M. (1997). Women's ways of knowing: The development of self, voice, and mind. New York: BasicBooks.
    Berman, A. (1993). Sailing a course through chemotherapy: The experience of women with breast cancer. Unpublished dissertation, University of California at San Francisco.
    Boston Women's Health Book Collective. (1985). The new our bodies, ourselves (
    2nd ed.
    , rev.). New York: Simon & Schuster.
    Callaghan, D., & Williams, A. (1994). Living with diabetes: Issues for nursing practice. Journal of Advanced Nursing, 20, 132–139. http://dx.doi.org/10.1046/j.1365-2648.1994.20010132.x
    Carlton, S. (1992). Women's experience of childhood sexual abuse and subsequent development of bulimia nervosa: A grounded theory exploration. Unpublished dissertation, University of Calgary, Alberta, Canada.
    Centers for Disease Control and Prevention. (1994). Recent trends in reported US AIDS cases. Atlanta, GA: Author.
    Centers for Disease Control and Prevention. (1995). Facts about women and HIV/AIDS. Atlanta, GA: Author.
    Charmaz, K. (1980). The social construction of self-pity in the chronically ill. Studies in Symbolic Interaction, 3, 123–145.
    Charmaz, K. (1983). Loss of self: A fundamental form of suffering in the chronically ill. Sociology of Health and Illness, 5, 168–195. http://dx.doi.org/10.1111/1467-9566.ep10491512
    Charmaz, K. (1991). Good days, bad days: The self in chronic illness and time. New Brunswick, NJ: Rutgers University Press.
    Charmaz, K. (1995). The body, identity, and self: Adapting to impairment. Sociological Quarterly, 36, 657–680. http://dx.doi.org/10.1111/j.1533-8525.1995.tb00459.x
    Cochrane, B. (1992). Women's integration of the myocardial infarction experience: Reclaiming independence after a heart attack. Unpublished dissertation, University of Washington, Seattle.
    Constable, D. (1994). The process of recovery for adult survivors of childhood sexual abuse: A grounded theory study. Unpublished dissertation, University of Alberta, Edmonton, Alberta, Canada.
    Corbin, J., & Strauss, A. (1988). Unending work and care: Managing chronic illness at home. San Francisco: Jossey-Bass.
    Davis, T., & Jensen, L. (1988). Identifying depression in medical patients. Image: Journal of Nursing Scholarship, 20, 191–195. http://dx.doi.org/10.1111/j.1547-5069.1988.tb00074.x
    Dempsey, S., Dracup, K., & Moser, D. (1995). Women's decision to seek care for the symptoms of acute myocardial infarction. Heart & Lung, 24, 444–456. http://dx.doi.org/10.1016/S0147-9563%2895%2980022-0
    DeVault, M. (1990). Talking and listening from women's standpoint: Feminist strategies for interviewing and analysis. Social Problems, 37, 96–116. http://dx.doi.org/10.1525/sp.1990.37.1.03a00070
    Dildy, S. (1992). A naturalistic study of the nature, meaning and impact of suffering in people with rheumatoid arthritis. Unpublished dissertation, University of Texas at Austin.
    Dildy, S. (1996). Suffering in people with rheumatoid arthritis. Applied Nursing Research, 9, 177–183. http://dx.doi.org/10.1016/S0897-1897%2896%2980043-7
    Dolhanty, J. (1990). The urge to overeat: A qualitative analysis of personal accounts. Unpublished masters thesis, York University Graduate Programme in Psychology, North York, Ontario, Canada.
    Dow, K. H. (1994). Having children after breast cancer. Cancer Practice, 2, 407–413.
    Draucker, C. (1991). The healing process of female adult incest survivors: Constructing a personal residence. Image: Journal of Nursing Scholarship, 24, 4–8. http://dx.doi.org/10.1111/j.1547-5069.1992.tb00691.x
    Draucker, C. (1997). Early family life and victimization in the lives of women. Research in Nursing & Health, 20, 399–412. http://dx.doi.org/10.1002/%28SICI%291098-240X%28199710%2920:5%3C399::AID-NUR4%3E3.0.CO;2-J
    Eagan, A. (1994). The women's health movement and its lasting impact. In E.Friedman (Ed.), An unfinished revolution: Women and health care in America, pp. 15–27. New York: United Hospital Fund of New York.
    Edelstein, L. (1994). Maternal bereavement: Coping with the unexpected death of a child. New York: Praeger.
    Ehrenreich, B., & English, D. (1977). Complaints and disorders: The sexual politics of sickness. In C.Dreifus (Ed.), Seizing our bodies: The politics of women's health, pp. 43–56. New York: Vintage Books.
    Fitzgerald, M., & Paterson, K. (1995). The hidden disability dilemma for the preservation of self. Journal of Occupational Science, Australia, 2, 13–21. http://dx.doi.org/10.1080/14427591.1995.9686392
    Fleury, J., Kimbrell, C., & Kruszewski, M. (1995). Life after a cardiac event: Women's experience in healing. Heart & Lung, 24, 474–482. http://dx.doi.org/10.1016/S0147-9563%2895%2980025-5
    Folden, S. (1994). Managing the effects of a stroke: The first months. Rehabilitation Nursing Research, 3, 79–85.
    Friedman, E. (1994). Women and health care: The bramble and the rose. In E.Friedman (Ed.), An unfinished revolution: Women and health care in America, pp. 1–12. New York: United Hospital Fund of New York.
    Fuchs, C. (1999). Dietary fiber and the risk of colorectal cancer and adenoma in women. The New England Journal of Medicine, 340, 169–176. http://dx.doi.org/10.1056/NEJM199901213400301
    Gamble, V., & Blustein, B. (1994). Racial differentials in medical care: Implications for research on women. In A.Mastroianni, R.Faden, & D.Federman (Eds.), Women and health research: Vol. 2. Workshop and commissioned papers. Washington, DC: National Academy Press, Institute of Medicine.
    Germain, C. (1994). See my abuse: The shelter transition of battered women. In P.Munhall (Ed.), In women's experience (Vol. 1), pp. 201–231. New York: National League for Nursing Press.
    Gilligan, C. (1993). In a different voice: Psychological theory and women's development. Cambridge, MA: Harvard University Press.
    Glaser, B., & Strauss, A. (1967). The discovery of grounded theory: Strategies for qualitative research. New York: Aldine de Gruyter.
    Gloerson, B., Kendall, J., Gray, P., McConnell, S., Turner, J., & Lewkowicz, J. (1993). The phenomena of doing well in people with AIDS. Western Journal of Nursing Research, 15, 44–58. http://dx.doi.org/10.1177/019394599301500104
    Goffman, E. (1993). Stigma. Englewood Cliffs, NJ: Prentice Hall.
    Gregg, C., Robertus, J., & Stone, J. (1989). The psychological aspects of chronic illness. Springfield, IL: Thomas.
    Gulley, L. (1991). The etiology of anorexia: The client's viewpoint. Unpublished dissertation, Vanderbilt University, Nashville, TN.
    Haberman, B. (1996). Day-to-day demands of Parkinson's disease. Western Journal of Nursing Research, 18, 397–413. http://dx.doi.org/10.1177/019394599601800403
    Hainsworth, M. (1986). An ethnographic study of women with multiple sclerosis using a symbolic interactionist approach. Unpublished dissertation, University of Connecticut, Storrs, CT.
    Hainsworth, M. (1994). Living with multiple sclerosis: The experience of chronic sorrow. Journal of Neuroscience Nursing, 26, 237–240. http://dx.doi.org/10.1097/01376517-199408000-00008
    Hall, J. (1994). How lesbians recognize and respond to alcohol problems: A theoretical model of problematization. Advances in Nursing Science, 16, (3), 46–63.
    Hall, J., Roter, D., & Katz, N. (1988). Meta-analysis of correlates of provider behavior in medical encounters. Medical Care, 26, 657–675. http://dx.doi.org/10.1097/00005650-198807000-00002
    Hamilton, D. (1988). Continual monitoring: A theoretical model of the weight loss maintenance process. Unpublished dissertation, University of California at Berkeley.
    Hawthorne, M. (1993). Women recovering from coronary artery bypass surgery. Scholarly Inquiry for Nursing Practice, 7, 223–248.
    Henderson, D., Boyd, C., & Mieczkowski, T. (1994). Gender, relationships, and crack cocaine: A content analysis. Research in Nursing & Health, 17, 265–272. http://dx.doi.org/10.1002/nur.4770170405
    Herman, J. (1992). Trauma and recovery. New York: BasicBooks.
    Hesse-Biber, S. (1996). Am I thin enough yet? The cult of thinness and the commercialization of identity. New York: Oxford University Press.
    Hinds, P., & Martin, J. (1988). Hopefulness and the self-sustaining process in adolescents with cancer. Nursing Research, 37, 336–340. http://dx.doi.org/10.1097/00006199-198811000-00005
    Howell, S. (1994). Natural/alternative health care practices used by women with chronic pain: Findings from a grounded theory research study. Nurse Practitioner Forum, 5, 98–105.
    Hulbert, J. (1985). Women addicted to alcohol and drugs: The recovery process. Unpublished dissertation, University of Toronto, Toronto, Ontario, Canada.
    Hutchinson, S. (1986). Chemically dependent nurses: The trajectory toward self-annihilation. Nursing Research, 35, 196–201. http://dx.doi.org/10.1097/00006199-198607000-00002
    Hutchinson, S. (1987). Toward self-integration: The recovery process of chemically dependent nurses. Nursing Research, 36, 339–343. http://dx.doi.org/10.1097/00006199-198711000-00004
    Jayne, R. (1993). Self-regulation: Negotiating treatment regimens in insulin-dependent diabetes. Unpublished dissertation, University of California at San Francisco.
    Johnson, J., & Morse, J. (1990). Regaining control: The process of adjustment after myocardial infarction. Heart & Lung, 19, 126–135.
    Johnson, R. (1990). Restructuring: An emerging theory on the process of losing weight. Journal of Advanced Nursing, 15, 1289–1296. http://dx.doi.org/10.1111/j.1365-2648.1990.tb01744.x
    Johnston, K. (1996, August). Physician gender and physician-patient relationships: A critical review of the literature (Paper presented to American Sociological Association). San Francisco: University of California Department of Social and Behavioral Sciences.
    Kagan, S. (1994). Integrating cancer into a life mostly lived. Unpublished dissertation, University of California at San Francisco.
    Kasperkowski, U. (1991). The body speaks: Seeking voice in a culture that silences. Unpublished dissertation, University of Toronto, Toronto, Ontario, Canada.
    Kearney, M. (1996). Reclaiming normal life: Mothers' stages of recovery from drug use. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 25, 761–768. http://dx.doi.org/10.1111/j.1552-6909.1996.tb01492.x
    Kearney, M., Murphy, S., & Rosenbaum, M. (1994). Mothering on crack cocaine: A grounded theory analysis. Social Science and Medicine, 38, 351–361. http://dx.doi.org/10.1016/0277-9536%2894%2990405-7
    Kelly-Powell, M. (1994). Personalizing choices: The experiences of adults with potentially life-threatening conditions in their decision-making regarding treatment options. Unpublished dissertation, University of Wisconsin, Milwaukee.
    Kesselring, A. (1990). The experienced body, when taken-for-grantedness falters: A phenomenological study of living with cancer. Unpublished dissertation, University of California at San Francisco.
    King, K., & Jensen, L. (1994). Preserving the self: Women having cardiac surgery. Heart & Lung, 23, 99–105.
    Kleinman, A. (1988). The illness narratives: Suffering, healing, and the human condition. New York: Basic Books.
    Klonoff, E., & Landrine, H. (1997). Preventing misdiagnosis of women: A guide to physical disorders that have psychiatric symptoms. Thousand Oaks, CA: Sage.
    LaFramboise, B. (1993). Finding voice: The psychosocial process of healing wounded women religious. Unpublished dissertation, University of Alberta, Edmonton, Alberta, Canada.
    Landenburger, K. (1989). A process of entrapment in and recovery from an abusive relationship. Issues in Mental Health Nursing, 10, 209–227. http://dx.doi.org/10.3109/01612848909140846
    Langner, S. (1995). The experience of being a woman with HIV/AIDS. In P.Munhall (Ed.), In women's experience (vol. 2), pp. 141–184. New York: National League for Nursing Press.
    LaRosa, J., & Pinn, V. (1993). Gender bias in biomedical research. Journal of the American Medical Women's Association, 48, 145–151.
    Lasker, R. (1997). Medicine and public health: The power of collaboration. New York: New York Academy of Medicine.
    Lavizzo-Mourey, R., & Grisso, J. (1994). Health, health care, and women of color. In E.Friedman (Ed.), An unfinished revolution: Women and health care in America, pp. 47–63. New York: United Hospital Fund of New York.
    Lee, T. (1991). The Human Genome Project: Cracking the genetic code of life. New York: Plenum.
    Lemke, D., Pattison, J., Marshall, L., & Cowley, D. (1995). Primary care of women. Norwalk, CT: Appleton-Lange.
    LeMone, P. (1993). Human sexuality in adults with insulin-dependent diabetes. Image: Journal of Nursing Scholarship, 25, 101–105. http://dx.doi.org/10.1111/j.1547-5069.1993.tb00764.x
    Lempert, L. (1994). A narrative analysis of abuse. Journal of Contemporary Ethnography, 22, 411–441. http://dx.doi.org/10.1177/089124194022004001
    Leonard, K. (1990). Women's experience of surviving invasive cervical cancer: Maintaining the self. Unpublished dissertation, University of Alberta, Edmonton, Alberta, Canada.
    Lewis, F., & Deal, L. (1995). Balancing our lives: A study of the married couple's experience with breast cancer recurrence. Oncology Nursing Forum, 22, 943–953.
    Limandri, B. (1989). Disclosure of stigmatizing conditions: The discloser's perspective. Archives of Psychiatric Nursing, 3, 69–78.
    Lombardi, J. (1982). Growing up with violence: An analysis of retrospective accounts of female offspring. Unpublished dissertation, University of Maryland, College Park, MD.
    Lowery, C. (1994). Life histories: Addiction and recovery of six Native American women. Unpublished dissertation, University of Washington, Seattle.
    Lubkin, I. (1995). Chronic illness: Impact and intervention (
    3rd ed.
    ). Boston: Jones & Bartlett.
    Maroni, J. (1986). Alcoholic women: A study of their recovery process. Unpublished dissertation, Catholic University of America, Washington, DC.
    Marshak, L., & Seligman, M. (1993). Counseling persons with physical disabilities: Theoretical and clinical perspectives. Austin, TX: Pro-Ed.
    Mastroianni, A., Faden, R., & Federman, D. (Eds.). (1994). Women and health research: Vol. 1. Ethical and legal issues of including women in health studies. Washington, DC: National Academy Press, Institute of Medicine.
    Mathews, H., Lannin, D., & Mitchell, J. (1994). Coming to terms with advanced breast cancer: Black women's narratives from eastern North Carolina. Social Science and Medicine, 38, 789–800. http://dx.doi.org/10.1016/0277-9536%2894%2990151-1
    Mays, M., & Croake, J. (1997). Treatment of depression in managed care. New York: Brunner/Mazel.
    McBarnette, L. (1996). African-American women. In M.Bayne-Smith (Ed.), Race, gender, and health, pp. 43–67. Thousand Oaks, CA: Sage.
    Merritt-Gray, M., & Wuest, J. (1995). Counteracting abuse and breaking free: The process of leaving revealed through women's voices. Health Care for Women International, 16, 399–412. http://dx.doi.org/10.1080/07399339509516194
    Meyerowitz, B., & Hart, S. (1995). Women and cancer: Have assumptions about women limited our research agenda? In A.Stanton & S.Gallant (Eds.), The psychology of women's health, pp. 51–84. Washington, DC: American Psychological Association.
    Montgomery, C. (1994). Swimming upstream: The strengths of women who survive homelessness. Advances in Nursing Science, 16, (3), 34–45.
    Morrow, S. (1992). Voices: Constructions of survival and coping by women survivors of child sexual abuse. Unpublished dissertation, Arizona State University at Tempe.
    Morrow, S., & Smith, M. (1995). Constructions of survival and coping by women who have survived childhood sexual abuse. Journal of Counseling Psychology, 42, 24–33. http://dx.doi.org/10.1037/0022-0167.42.1.24
    Morse, J., & Carter, B. (1995). Strategies of enduring and the suffering of loss: Modes of comfort used by a resilient survivor. Holistic Nursing Practice, 9, (3), 38–52.
    Morse, J., & Carter, B. (1996). The essence of enduring and expressions of suffering: The reformulation of self. Scholarly Inquiry for Nursing Practice, 10, 43–60.
    Munhall, P. (1994). In women's experience (Vol. 1). New York: National League for Nursing Press.
    Munhall, P. (1995). In women's experience (Vol. 2). New York: National League for Nursing Press.
    Munhall, P., & Boyd, C. (1993). Nursing research: A qualitative perspective (
    2nd ed.
    ). New York: National League for Nursing Press.
    Nelson, A. (1990). Patients' perceptions of a spinal cord injury unit. SCI Nursing, 7, 44–63.
    Newman, K. (1993). Giving up: Shelter experiences of battered women. Public Health Nursing, 10, 108–113. http://dx.doi.org/10.1111/j.1525-1446.1993.tb00033.x
    Parratt, J. (1994). The experience of childbirth for survivors of incest. Midwifery, 10, 26–39. http://dx.doi.org/10.1016/0266-6138%2894%2990006-X
    Payne, S. (1990). Coping with palliative chemotherapy. Journal of Advanced Nursing, 15, 652–658. http://dx.doi.org/10.1111/j.1365-2648.1990.tb01887.x
    Persic, A. (1993). An exploration of bulimia and coping. Unpublished masters thesis, University of Calgary, Calgary, Alberta, Canada.
    Pilowsky, J. (1993). The price of a wife is thirteen cents: An exploration of abused Spanish-speaking women. Unpublished dissertation, University of Toronto, Toronto, Ontario, Canada.
    Price, M. (1993). An experiential model of learning diabetes self-management. Qualitative Health Research, 3, 29–54. http://dx.doi.org/10.1177/104973239300300103
    Quinn, A., Barton, J., & Magilvy, J. (1995). Weathering the storm: Metaphors and stories of living with multiple sclerosis. Rehabilitation Nursing Research, 4, 19–27.
    Rankin, S. (1992). Psychosocial adjustments of coronary artery disease patients and their spouses: Nursing implications. Nursing Clinics of North America, 27, 271–284.
    Reast, R. (1993). Experiences of women who have had myocardial infarction treated with angioplasty. Unpublished masters thesis, Texas Tech, Health Sciences Center, Lubbock, TX.
    Register, C. (1987). Living with chronic illness: Days of patience and passion. New York: Free Press.
    Rosser, S. (1994). Women's health: Missing from U.S. medicine. Bloomington: Indiana University Press.
    Schaefer, K. (1995). Struggling to maintain balance: A study of women living with fibromyalgia. Journal of Advanced Nursing, 21, 95–102. http://dx.doi.org/10.1046/j.1365-2648.1995.21010095.x
    Seals, B., Sowell, R., Demi, A., Moneyham, L., Cohen, L., & Guillory, J. (1995). Falling through the cracks: Social service concerns of women infected with HIV. Qualitative Health Research, 5, 496–515. http://dx.doi.org/10.1177/104973239500500410
    Soderberg, S., Lundman, B., & Norberg, A. (1997). Living with fibromyalgia: Sense of coherence, perception of well-being, and stress in daily life. Research in Nursing & Health, 20, 495–503. http://dx.doi.org/10.1002/%28SICI%291098-240X%28199712%2920:6%3C495::AID-NUR4%3E3.0.CO;2-H
    Stanton, A. (1995). Psychology of women's health: Barriers and pathways to knowledge. In A.Stanton & S.Gallant (Eds.), The psychology of women's health, pp. 3–21. Washington, DC: American Psychological Association.
    Stevens, P. (1996). Struggles with symptoms: Women's narratives of managing HIV illness. Journal of Holistic Nursing, 14, 142–161. http://dx.doi.org/10.1177/089801019601400206
    Strauss, A. (1975). Chronic illness and the quality of life. St. Louis, MO: C.V. Mosby.
    Strauss, A. (1987). Qualitative analysis for social scientists. Cambridge, UK: Cambridge University Press. http://dx.doi.org/10.1017/CBO9780511557842
    Strauss, A., & Corbin, J. (1988). Shaping a new health care system: The explosion of chronic illness as a catalyst for change. San Francisco: Jossey-Bass.
    Strauss, A., & Corbin, J. (1990). Basics of qualitative research: Grounded theory procedures and techniques. Newbury Park, CA: Sage.
    Stuart, E., & Campbell, J. (1989). Assessment of patterns of dangerousness with battered women. Issues in Mental Health Nursing, 10, 245–260. http://dx.doi.org/10.3109/01612848909140848
    Stuifbergen, A., & Rogers, S. (1997). The experience of fatigue and strategies of self-care among persons with multiple sclerosis. Applied Nursing Research, 10, 2–10. http://dx.doi.org/10.1016/S0897-1897%2897%2980023-7
    Swanson, J., & Chenitz, C. (1993). Regaining a valued self: The process of adaptation to living with genital herpes. Qualitative Health Research, 3, 270–297. http://dx.doi.org/10.1177/104973239300300302
    Taggart, L., McCammon, S., Allred, L., Horner, R., & May, H. (1993). Effect of patient and physician gender on prescriptions for psychotropic drugs. Journal of Women's Health, 2, 353–357. http://dx.doi.org/10.1089/jwh.1993.2.353
    Taylor, S., & Aspinwall, L. (1990). Psychological aspects of chronic illness. In P.Costa & G.VandenBos (Eds.), Psychological aspects of serious illness: Chronic conditions, fatal diseases, and clinical care, pp. 7–60. Washington, DC: American Psychological Association.
    Telch, C., & Telch, M. (1986). Group coping skills interaction and supportive group therapy for cancer patients: A comparison of strategies. Journal of Consulting and Clinical Psychology, 54, 802–808. http://dx.doi.org/10.1037/0022-006X.54.6.802
    Ternulf Nyhlin, K. (1991). The fine balancing act of managing diabetes. Scandinavian Journal of Caring Sciences, 5, 187–194.
    Thorne, S. (1990). Constructive noncompliance in chronic illness. Holistic Nursing Practice, 5, 62–69.
    Thorne, S. (1993). Negotiating health care: The social context of chronic illness. Newbury Park, CA: Sage.
    Ulrich, Y. (1993). What helped most in leaving spouse abuse: Implications for interventions. AWHONN's Clinical Issues, 4, 385–390.
    Vourakis, C. (1989). The process of recovery for women in Alcoholics Anonymous: Seeking groups “like me.” Unpublished dissertation, University of California at San Francisco.
    Weisman, C., & Cassard, S. (1994). Health consequences of exclusion or underrepresentation of women in clinical studies (I). In A.Mastroianni, R.Faden, & D.Federman (Eds.), Women and health research: Vol. 2. Workshop and commissioned papers, pp. 35–40. Washington, DC: National Academy Press, Institute of Medicine.
    Welch, H. (1996). Nurse midwives as primary care providers for women. Clinical Nurse Specialist, 10, 121–124, 143. http://dx.doi.org/10.1097/00002800-199605000-00004
    West, C. (1984). Routine complications: Troubles with talk between doctors and patients. Bloomington: Indiana University Press.
    Westra, B. (1991). Getting back to living life: Older adults' experience at home after hospitalization. Unpublished dissertation, University of Wisconsin at Milwaukee.
    Westra, B. (1993, January). Elders' experiences at home after hospital discharge. Minnesota Nurses' Association Accent, 1, 9.
    Wiener, C., & Dodd, M. (1993). Coping amid uncertainty: An illness trajectory perspective. Scholarly Inquiry for Nursing Practice, 7, 17–31.
    Wilson, H., Hutchinson, S., & Holzemer, W. (1997). Salvaging quality of life in ethnically diverse patients with advanced HIV/AIDS. Qualitative Health Research, 7, 75–97. http://dx.doi.org/10.1177/104973239700700105
    Woodhouse, L. (1992). Women with jagged edges: Voices from a culture of substance abuse. Qualitative Health Research, 2, 262–281. http://dx.doi.org/10.1177/104973239200200302
    Young-Mason, J. (1997). The patient's voice: Experiences of illness. Philadelphia: F. A. Davis.

    About the Author

    Margaret H. Kearney, RN (Ph.D., University of California at San Francisco), is a certified women's health nurse practitioner and an associate professor of nursing at Boston College, in Chestnut Hill, MA. She is interested in the self-care experiences of pregnant and parenting women and has conducted a number of qualitative studies with addicted and recovering women using the grounded theory approach. Her current research focuses on the impact of violence during pregnancy, on nursing support of socially high-risk pregnant women and mothers, and on qualitative approaches to meta-analysis.


    • Loading...
Back to Top

Copy and paste the following HTML into your website