Family responses to disclosure of self-as-lesbian.

Disclosure or nondisclosure of self-as-lesbian to family is a difficult task. Eleven lesbians aged 25-47 years old described their experiences of disclosure or nondisclosure to family. The primary source of data collection was focus groups. Family disclosure was preceded by recognition of self-as-lesbian. Five story patterns of lesbians and their families related to disclosure or nondisclosure were derived from text analysis. The participants also described missing sociocultural landmarks and symbols for lesbian lives. Implications are included for lesbians who are contemplating disclosure and their health care providers.

Coping in young women: theoretical retroduction.

Although there is increasing interest in women's health, there remains little empirical evidence concerning concepts related to health and women's life trajectory. Our purpose in conducting this research was to examine women's developmental stressors and coping during young adulthood. Lazarus and Folkman's coping model provided sensitizing concepts for data generation in a retroductive research methodology. The sample included 26 women of diverse perspectives who participated in interviews and groups. Philosophical concerns of subjectivity, context and gender sensitivity were actualized in iterative stages of data collection, analysis and comparison to extant theory. Rapidly expanding multiple roles were identified as developmental stressors for young women. Decontextualized coping strategies are arranged on a behavioural continuum: avoidance, distraction, and confrontation. Contextualized descriptions of coping are presented in two representative accounts: Lauren and Mary Ellen. A philosophical stance, assumed at about the age of 30, provides a lens for assessing developmental stressors that influence the appraisal process. Rich descriptions of young women's coping and developmental influences move beyond abstract theory to a contextual understanding of young women's experiences.

Teaching caring within the context of health.

Changes in the delivery of healthcare have created an environment viewed as uncaring to both the patient and healthcare providers. Thus teaching concepts of health and caring becomes a priority for nurse educators. The authors discuss how caring can be taught in the context of health. Specifically, they describe a teaching method which was aimed at sensitizing students to Allen's model of health and Watson's carative factors.

Telecommunication interventions for caregivers of elders with dementia.

Caregiver Interventions via Telecommunications (CIT) is designed for family caregivers of elders with dementia. Building on Riegel's dialectical theory of human development, the authors argue that psychotherapeutic interventions, made highly accessible by telecommunication technology, assist caregivers to achieve positive developmental outcomes. Specific components of CIT are described, and an outline for a structured protocol is provided. Advantages, disadvantages, and future directions of telecommunications therapy are discussed.

Neuropsychological comparison of alcohol-exposed children with or without physical features of fetal alcohol syndrome.

Fetal alcohol syndrome (FAS) is associated with behavioral and cognitive deficits. However, the majority of children born to alcohol-abusing women do not meet the formal criteria for FAS and it is not known if the cognitive abilities of these children differ from those of children with FAS. Using a set of neuropsychological tests, 3 groups were compared: (a) children with FAS, (b) children without FAS who were born to alcohol-abusing women (the PEA group), and (c) normal controls. The results indicated that, relative to controls, both the FAS and the PEA groups were impaired on tests of language, verbal learning and memory, academic skills, fine-motor speed, and visual-motor integration. These data suggest that heavy prenatal alcohol exposure is related to a consistent pattern of neuropsychological deficits and the degree of these deficits may be independent of the presence of physical features associated with FAS.

Heavy prenatal alcohol exposure with or without physical features of fetal alcohol syndrome leads to IQ deficits.

OBJECTIVE: To assess general intellectual functioning in children with histories of heavy prenatal alcohol exposure, with or without the facial features and growth deficiencies characteristic of fetal alcohol syndrome (FAS). DESIGN: Forty-seven alcohol-exposed children were recruited on evaluation at a dysmorphology clinic and evaluated as part of a university research project using standard tests of IQ. Thirty-four of the alcohol-exposed patients met the traditional diagnostic criteria for FAS. The other 13 alcohol-exposed children lacked both the pattern of facial features and prenatal or postnatal growth deficiency characteristic of the diagnosis. RESULTS: Compared with normal control subjects matched for age, sex, and ethnicity, both groups of alcohol-exposed children displayed significant deficits in overall IQ measures and deficits on most of the subtest scores. Although those in the nondysmorphic group usually obtained marginally higher IQ scores than those in the FAS group, few significant differences were found between the two alcohol-exposed groups. CONCLUSIONS: These results indicate that high levels of prenatal alcohol exposure are related to an increased risk for deficits in intellectual functioning and that these can occur in children without all of the physical features required for a diagnosis of FAS. They also emphasize the need for conducting a thorough history of prenatal alcohol exposure in children with intellectual deficits.

Grey glasses: sadness in young women.

Sadness as a developmental phenomenon in young women was discovered in a study designed to identify developmental transitions and the relationship of these transitions to mental health. Sadness is conceptualized as a pervasive feeling of disillusionment and unhappiness that influences the meaning of life events and decision-making. Field research and interpretive analysis techniques were used to observe, describe and analyse the life experiences of 25 volunteer participants. For most women in the study, sadness was found to be time-limited and perhaps had beneficial effects. Some women, however, were unable to resolve sadness and became depressed. Sadness can be an antecedent to depression. Sadness that is recognized and validated may facilitate reshaping of a woman's expectations, a form of cognitive restructuring. The transitional nature of sadness has important implications for women's mental health.

Eskimo women and a menstrual cycle study: some ethnographic notes.

This article examines ethnographic data collected from indigenous Alaskan women who participated in a menstrual cycle study conducted by The Tremin Trust Research Program, initially known as the Menstruation and Reproductive History Program (MRH). In the 1960s, the MRH program was expanded to Alaska to study non-Caucasian women's menstrual cycles. In addition, an ethnographer collected data through participation observation from some 345 women who participated in the MRH study. These data were recorded in field notebooks during site visits to Alaskan villages. Major themes and contextual information were identified in the data that described the daily lives of the women and their experiences as research participants. Eskimo women described the cultural conflicts that arose during the conduct of the menstrual studies and problems encountered when the investigators failed to account for the traditional gender roles in Eskimo society. Cultural differences were apparent when the women described the culturally inappropriate health education provided by the research team. The goals of the menstrual cycle study emphasized research progress rather than the health needs of the research participants; this emphasis accentuated the severity of health problems and the lack of health services experienced by Eskimo women.

Living with dying: coping with HIV disease.

People diagnosed with HIV disease experience multiple and severe stressors; however, little is known about these stressors and coping among this population. This phenomenological study was undertaken to (1) gain an understanding of the informants' lived experiences of coping with HIV disease and (2) develop a disease-specific instrument to measure stress and coping. The study involved interviews with 36 people with HIV disease. The interviews were analyzed and synthesized to (1) derive the structure of the experience through phenomenological analysis and (2) identify stress and coping themes through content analysis. Only the findings from the phenomenological analysis are reported here. The structure of the lived experience of coping with HIV disease unfolds from the initial diagnosis of being HIV-seropositive through the diagnosis of AIDS to impending death. The processes involved in this structure were labeled Living with Dying, Fighting the Sickness, and Getting Worn Out.