Medicine and Health Sciences Commons^™

Immersion Research Education: Students As Catalysts For International Collaboration Research, Kathryn H. Anderson, Marie-Luise Friedemann, Andreas Buescher, Julita Sansoni, Donna R. Hodnicki

Kathryn H. Anderson

Background:  This paper describes an international nursing and health research immersion program. Minority students from the USA work with an international faculty mentor in teams conducting collaborative research. The Minority Health International Research Training (MHIRT) program students become catalysts in the conduct of cross-cultural research. Aim:  To narrow the healthcare gap for disadvantaged families in the USA and partner countries. Methods:  Faculty from the USA, Germany, Italy, Colombia, England, Austria and Thailand formed an international research and education team to explore and compare family health issues, disparities in chronic illness care, social inequities and healthcare solutions. USA students in the …

Transition Of Premature Infants From Hospital To Home Life, Greta L. Lopez, Kathryn H. Anderson, Johanna Feutchinger

Kathryn H. Anderson

Purpose: To conduct an integrative literature review to studies that focus on the transition of premature infants from neonatal intensive care unit (NICU) to home. Method: A literature search was performed in Cumulative Index to Nursing and Allied Health Literature (CIN AHL), PubMed, and MEDLINE to identify studies consisting on the transition of premature infants from hospital to home life. Results: The search yielded seven articles that emphasized the need for home visits, child and family assessment methods, methods of keeping contact with health care providers, educational and support groups, and described the nurse's role in the transition program. The …

Alzheimer’S Care At Home: A Focus On Caregivers’ Strain, G. Valera, L. M. Varona, Kathryn H. Anderson, J Sansoni

Kathryn H. Anderson

The aging population is increasing worldwide. According to Italian authors, Italy is one of the leading and increasing aging populations in the world. Placing more numbers on the elderly increases the number of people who will live with dementia in the future and in our case of study, in an increase of people with Alzheimer's disease. Researchers have demonstrated that Alzheimer's disease comes with aging and it eventually affects the person's cognitive, emotional, and physical well being. Those who become diagnosed with Alzheimer's will eventually need assistance in their daily living, especially when it begins to progress to a higher …

Lived Experience Of Diabetes Among Older, Rural People, S.R. George, Sandra Thomas

Sandra Thomas

This paper is a report of a study conducted to elucidate experiences and perceptions of self-management of diabetes as narrated by older people diagnosed with insulin-dependent diabetes living in a rural area.

Authors' And Editors' Perspectives On Peer Review Quality In Three Scholarly Nursing Journals, M.M. Shattell, P. Chinn, Sandra Thomas, W.R. Cowling

Sandra Thomas

This study examined the quality of peer review in three scholarly nursing journals from the perspectives of authors and editors. Specifically, the study examined the extent to which manuscript reviews provided constructive guidance for authors to further develop their work for publication, and for editors to make informed and sound decisions on the disposition of manuscripts.

Junior Nursing Students' Experiences Of Vertical Violence During Clinical Rotations, Sandra Thomas, R. Burk

Sandra Thomas

Horizontal violence is a form of workplace violence, a phenomenon that is prevalent in the nursing profession. Research has revealed a variety of negative peer-to-peer behaviors that lower morale and lead to turnover. However, little research has been conducted on “eating our young” (violence occurring between individuals with unequal power, such as staff nurse and student). We propose “vertical violence” as the appropriate term when abusive registered nurse (RN) behavior is directed towards students. We report a content analysis of stories written by junior nursing students about incidents of injustice perpetrated by staff RNs during their clinical experiences. Four levels …

Mental Health Patients' Experiences Of Being Misunderstood, L.M. Gaillard, M.M. Shattell, Sandra Thomas

Sandra Thomas

Mental health patients describe “being understood” as an experience that evokes feelings of importance, worthiness, and empowerment. However, the experience of “being misunderstood” is more prevalent in patients’ relationships with health care providers. Negative consequences such as vulnerability, dehumanization, and frustration reveal that being misunderstood has the potential to damage or destroy therapeutic relationships.

Life Trajectories Of Female Child Abuse Survivors Thriving In Adulthood, Sandra Thomas, J.M. Hall

Sandra Thomas

A narrative study of thriving adult female survivors of childhood maltreatment was undertaken to discover how they had achieved success. Life trajectory patterns, turning points, and setbacks were identified. Data consisted of 81 interview transcripts derived from a series of three interviews, spaced over 6 to 12 months, with 27 survivors. The childhood abuse was intrafamilial, beginning as early as infancy and continuing, in most cases, until participants left home. The onset and pace of the healing trajectory were quite variable, including a roller-coaster pattern as well as patterns of slow, steady progress and continued struggle. Four types of redemption …

How Patients And Nurses Experience The Acute Care Psychiatric Environment, M.M. Shattell, M. Andes, Sandra Thomas

Sandra Thomas

The concept of the therapeutic milieu was developed when patients’ hospitalizations were long, medications were few, and oneto- one nurse–patient interactions were the norm. However, it is not clear how the notion of ‘therapeutic milieu’ is experienced in American acute psychiatric environments today. This phenomenological study explored the experience of patients and nurses in an acute care psychiatric unit in the USA, by asking them, ‘What stands out to you about this psychiatric hospital environment?’ Three figural themes emerged, contextualized by time, which was a source of stress to both groups: for patients there was boredom, and for nurses, pressure …

"Take My Hand, Help Me Out:" Mental Health Recipients' Experience Of The Therapeutic Relationship, M.M. Shattell, S.S. Starr, Sandra Thomas

Sandra Thomas

The purpose of this study was to describe mental health service recipients' experience of the therapeutic relationship. The research question was ‘what is therapeutic about the therapeutic relationship?’ This study was a secondary analysis of qualitative interviews conducted with persons with mental illness as part of a study of the experience of being understood. This secondary analysis used data from 20 interviews with community-dwelling adults with mental illness, who were asked to talk about the experience of being understood by a health-care provider. Data were analysed using an existential phenomenological approach. Individuals experienced therapeutic relationships against a backdrop of challenges, …

Understanding The Meaning Of Urban Spaces And Places To Women: Impact On Health And Well-Being, Sandra Thomas

Sandra Thomas

No abstract provided.

Violence On Campus: Practical Recommendations For Legal Educators, H. Smith, Sandra Thomas, C.M. Parker

Sandra Thomas

Recent rampage killings compel greater attention to anger and violence on the college campus. In each of these tragic mass murders, vengeful individuals sought to address perceived grievances against faculty and/or other employees of the university. In each of these situations, numerous clues of impending violence were evident. Sadly, however, in each of these cases the schools failed to take preventive actions. While prediction of violent behavior will never be an exact science, universities must begin to enact violence prevention strategies. Maintaining an attitude that 'this couldn't happen here' hampers the necessary education of faculty, staff, and security personnel.

Our …

Inflammatory And Immune System Correlates Of Rape, M.W. Groer, Sandra Thomas, G.W. Evans, S. Helton

Sandra Thomas

The purpose of this study was to evaluate the feasibility of measuring stress hormones and immunity following rape. The long-term goal is to evaluate the predictive value of stress-immune-inflammatory responses to later health outcomes. Fifteen women reporting rape were compared with 16 control participants. Serum stress hormones, proinflammatory cytokines, acute phase proteins, functional assays, and lymphocyte subsets were measured in blood samples. Women reporting rape had higher cytotoxic cells, lower B lymphocyte counts, higher proinflammatory biomarkers, and decreased lymphocyte proliferation compared to the control group. This finding suggests that rape produces activation of the innate immunity and suppression of some …

Talking It Over With The Gals: An Analysis Of Editorials By Phyllis Stern, Sandra Thomas

Sandra Thomas

Editorials written by a journal editor proved a glimpse of that individual's philosophy and opinions about topical events. The purpose of the present project was to analyze the editorials of Phyllis Noerager Stern during the years that she served as editor-in-chief of Health Care for Women International (1983-2001). Using ethnographic content analysis, 65 editorials were examined to ascertain: (1) what event triggered the editorial; (2) what aim or objective could be identified; and (3) what rhetorical devices the editor employed. Personal narratives and editorials about the abuse/exploitation of women made up the largest categories. Stern's grounded theory orientation, fascination with …

Nurses' Narratives Of Unforgettable Patient Care Events, M.E. Gunther, Sandra Thomas

Sandra Thomas

Purpose: To explore the experience of registered nurses (RNs) caring for patients in contemporary hospitals.

Design: The descriptive phenomenological study was based in the philosophical perspectives of Husserl and Merleau-Ponty.

Methods: A purposive sample of 46 RNs employed in acute care hospitals in the southeastern United States (US) were recruited by network sampling. Data from unstructured interviews were analyzed in an interpretive group and themes were identified.

Findings: Four themes were identified: (a) extraordinary caregiving events, (b) incomprehensibility, (c) questioning whether anything else could have been done, and (d) “alone or together,” indicating the isolation nurses often experience while giving …

Through The Lens Of Merleau-Ponty:Advancing The Phenomenological Approach To Nursing Research, Sandra Thomas

Sandra Thomas

No abstract provided.

Women's Anger, Agression, And Violence, Sandra Thomas

Sandra Thomas

Themes of powerlessness, power, and paradox predominate in this reflection on more than 15 years of research on women's anger. Studies conducted in the United States, France, and Turkey are highlighted. These studies have negated several myths while illuminating the general rationality of women's anger: It is squarely grounded in interpersonal interactions in which people deny women power or resources, treat them unjustly, or behave irresponsibly toward them. The offenders are not strangers; rather they are their closest intimates. But few women learned healthy anger expression while growing up. Anger is a confusing and distressing emotion for women, intermingled with …

An Exploration Of Problematic Interviewee Behaviors In Qualitative Research, M. Collins, M. Shattell, Sandra Thomas

Sandra Thomas

The interview is a staple of many qualitative approaches. Although textbooks offer extensive guidance to researchers about conducting interviews, less guidance is available about problematic interviewee behaviors, such as flattery or statements indicative of social desirability response bias. In this study, a secondary analysis of 22 phenomenological interview transcripts, we sought to examine problematic interviewee behaviors. More than 300 pages of typed text were subjected to line-by-line scrutiny, yielding only six potential instances of the phenomenon. Each could be interpreted several ways. What appeared to be flattery could also be perceived as simple gratitude or appreciation. We concluded that problematic …

The Interaction Model Of Client Health Behavior As A Conceptual Guide In The Explanation Of Children's Health Behaviors, C.H. Robinson, Sandra Thomas

Sandra Thomas

This study used the Interaction Model of Client Health Behavior (IMCHB) as a conceptual guide to explain the correlates of children's diet and physical activity and explore the relationships of sex with their diet and physical activity of the school-aged child. A descriptive correlational study was conducted on 371 fifth-grade students and their parents. Information on the family's demographics, health experience, social influence, and environmental resources was collected, as well as data on the children's intrinsic motivation, cognitive appraisal, and affective response to food/physical activity. Children's self-reports on diet and physical activity were collected, as were parents' self-reports on health …

Men's Health And Psychosocial Issues Affecting Men, Sandra Thomas

Sandra Thomas

Contemporary scholars are calling on men to rethink "the male deal." As Samuels describes it, "In the male deal, the little boy, at around the age of 3 or 4. strikes a bargain with the social world in which he lives. If he will turn away from soft things, feminine things, maternal things...then the world will reward his gender certainty by giving him all the goodies in its possession." But the "deal" can have damaging effects, as shown in the studies reviewed in this article. Clinicians can help men to rethink the restrictions of the "male deal" so that they …

School Connectedness, Anger Behaviors, And Relationships Of Violent And Nonviolent Youth, Sandra Thomas, H. Smith

Sandra Thomas

PROBLEM: Youth violence research often focuses on risk factors arising from early familial interactions rather than school-related factors. METHODS: Via an Internet questionnaire, 282 girls and boys (ages 7-19, mean 15.3) from 47 states and Washington, DC, reported on school connectedness, interpersonal relationships, and anger behaviors. FINDINGS: Substantial percentages of violent youth did not perceive themselves to be liked by classmates and reported loneliness. If not liked by classmates, 80% hated school. Likers and haters of school differed on seven variables (all p < or = .01). CONCLUSIONS: Insufficient attention is paid to the alienation experienced by disliked and lonely students. Mental health nurses could play a pivotal role in fostering change in the social climate of schools and helping youth to achieve better anger management and social skills.

"A Fly In The Buttermilk:" Descriptions Of University Life By Successful Black Undergraduate Students At A Predominately White Southeastern University, M. Davis, Y. Dias-Bowie, K. Greenberg, G. Klukken, H.R. Pollio, Sandra Thomas, C.L. Thompson

Sandra Thomas

Although many predominantly white universities exert great effort to recruit minority students, statistics regarding retention and graduation for these students are disturbing. Previous research indicates that academic concerns are not paramount in the attrition of minority students, suggesting that greater attention must be given educational experiences of black students over and above academic matters. Using in-depth phenomenological interviewing, 11 graduating seniors from diverse majors were asked to describe salient incidents of their university experience. These interviews were transcribed verbatim and subjected to hermeneutic interpretation by an interdisciplinary research group. Dominant in student descriptions of their experiences were five themes: (1) …

"None Of Us Will Ever Be The Same Again:" Reactions Of American Midlife Women To 9/11, Sandra Thomas

Sandra Thomas

According to terror management theory (TMT), an event that heightens awareness of death produces the need to defend against existential anxiety. The horrifying events of September 11, 2001 (9/11), created an unparalleled opportunity to apply TMT beyond the laboratory. This study examined post-9/11 stress (via perceived stress scale [PSS] scores) and interview responses of a diverse community sample of American midlife women (ages 35-60). Previous studies showed that many women have high stress during midlife, suggesting that 9/11 could have a unique impact on this segment of the U.S. population. Education of the sample ranged from 12 to 23 years. …

Men's Anger: A Phenomenological Exploration Of Its Meaning In A Middle Class Sample Of American Men, Sandra Thomas

Sandra Thomas

This study explored the meaning of men's anger, using the methodology of eidetic (descriptive) phenomenology. A community sample of 19 middle-class American men, ranging in age from 20 to 50 years, participated in audiotaped interviews. Two prominent themes, right versus wrong and being controlled versus having control, were contextualized by the world in which masculinity has been socially constructed and emotion is regulated accordingly. Interwoven throughout anger narratives were descriptors of the intense physical arousal felt within the body. Time was an important contextual ground for men's anger experience, with sharp contrasts drawn between anger then and now. Findings suggest …

Age Differences In Anger Frequency, Intensity, And Expression, Sandra Thomas

Sandra Thomas

BACKGROUND: Although research consistently indicates harmful effects of mismanaged anger, little attention has been given to age differences in the experience and expression of this emotion. It is plausible that, with age and experience, people have less intense anger or learn to manage it more constructively.

OBJECTIVE: The purpose of this project was to examine age differences in anger frequency, intensity, and expression in a nonclinical sample of students, faculty, and staff who participated in a health fair at a large southeastern university.

STUDY DESIGN: This descriptive study involved a predominantly white sample, ranging in age from 18 to 76 …

What's Therapeutic About The Therapeutic Milieu?, Sandra Thomas, M. Shattell, T. Martin

Sandra Thomas

While the milieu of an inpatient facility is considered a treatment modality, extant literature focuses on the staff's role in creating the milieu rather than the patient's perception of it. Not since Goffman's Asylums (1961) has there been an in-depth examination of the phenomenal world of the hospitalized psychiatric patient. In this study, eight inpatients (ages 23 to 58) on the acute psychiatric unit of a metropolitan general hospital participated in phenomenological interviews about their experience of the environment. The essential meaning of the hospital was refuge from self-destructiveness. Prominent aspects of patients' experience within the place of refuge were …

A Phenomenological Study Of The Experience Of The Spouse Of A Heart Transplant Recipient, A.H. Mccurry, Sandra Thomas

Sandra Thomas

In this phenomenological study, in-depth interviews were used to obtain a description of spouses’ experiences in heart transplantation. Thematic analysis of the transcripts revealed four major, interrelated themes: death-life, vigilance, change, and gift. The experience was contextualized by the existential grounds of time and other people. Findings suggested that the changes inherent in the transplant experience have not been fully described in previous studies. The theme of death-life was dominant and pervasive in all interviews. As the threat of their husbands’ deaths became less prominent, wives reported difficulty letting go of their vigilance. Although the most outstanding gift was that …

Testing A Theory Of Decision Making Derived From King's Systems Framework In Women Eligible For A Cancer Clinical Trial, H.E. Ehrenberger, M.R. Alligood, Sandra Thomas, D.C. Wallace, C.M. Licavoli

Sandra Thomas

The purpose of this study was to test an explanatory theory of decision-making in women eligible for a cancer clinical trial. The theory derived from King’s framework proposed that the concepts of uncertainty, role functioning, and social support relate to emotional health (hope and mood state), which in turn relates to the treatment decision. A correlational study design was used to test the theory in a sample of 40 women. Findings provided empirical evidence of the adequacy of King’s framework and supported, in part, theorized relationships among the critical factors. However, these factors did not illuminate the treatment decision.

The View From The Edge Of The Cauldron, Sandra Thomas

Sandra Thomas

No abstract provided.

The "Good-Enough Dissertation:" A Modest Proposal, Sandra Thomas

Sandra Thomas

This article addresses the paralysis of perfectionism, a factor in the failure of a doctoral candidate to complete the dissertation. A remedy is proposed.