Critical thinking in African American mothers who care for adult children with HIV: a cultural analysis.

This research study defines critical thinking in nursing and examines the thinking processes revealed by 15 African American mothers who are caregivers to adult children with HIV. The purpose of this cultural analysis was to compare the mothers' decision-making processes with their critical-thinking processes. Their culture, heritage, faith, and value of family influenced caregivers in this study. Their testimony revealed the patterns of creating a different path of care, weaving together resources, choosing among negative alternatives, and selecting stories to tell. Mothers' decisions were based on complex and holistic knowledge of their situations and culture and could be termed multilogical, a type of thinking considered necessary for managing complex situations. Health providers can benefit from an understanding of these decision-making processes.

Patterns of resistance: African American mothers and adult children with HIV illness.

Although the research on caregiving and caregivers has been extensive, there have been few studies on the cultural context and meaning of African American caregiving in relation to HIV illness. Many Black feminists have argued that African American women experience a world different from those who are not Black and that failure to take account of race, class, and gender is paramount in an attempt to authentically portray the lives of African American women. This study argues that rural African American culture and experiences of racism and discrimination in the rural South shaped the responses of mothers when their adult children developed HIV illness. The study employed the ethnographic techniques of participant observation and in-depth interviews with 14 rural, poor, African American mothers who cared for adult children with HIV illness. Analysis of the data identified patterns of resistance that mothers employed throughout the caregiving experience. Mothers resisted labels and other controlling images that they believed marginalized them and negated what was happening to their children. Mothers used culturally patterned behaviors to protect their families and resist the stigma of HIV/AIDS.

Advanced practice nursing certification: where do we go from here?

Certification requirements for advanced practice nurses (APNs) vary between APN specialties and the certification agencies. This variability perpetuates confusion for APNs, the health care system, and the public. Recommendations are made for the certification of APNs: (1) standardization of the certification process for APNs, (2) consistency in the requirement for graduate level education for all APNs, (3) regulation requiring certification for practice in all states, and (4) nurse practitioner (NP) program accreditation or preaccreditation for eligibility to take the certification examination. To support these recommendations, two questions are considered: Where are we now in certification? Where do we need to go?

Going home: African-American caregiving for adult children with human immunodeficiency virus disease.

The caregiving literature has focused on European-American caregivers who are providing care to spouses or parents with Alzheimer's disease. The article reports ethnographic research exploring aspects of caregiving by rural African-American mothers for adult children with human immunodeficiency virus (HIV) disease. Eight African-American mothers were interviewed to elicit cultural domains of caregiving. Two major domains were a personal relationship with God and God's will. Taken together, these domains framed the context in which African-American mothers understood HIV disease, provided care, and resolved the death of their adult child.

Nominations for excellence: collegial advocacy for nurse practitioners.

This study examined physician nomination data submitted for Syntex Nurse Practitioner of the Year Awards for 1988, 1989, and 1990. The physicians identified nurse practitioner contributions to patient care, community service/outreach, and education and research. A content analysis of the text data yielded themes within four major domains that described outstanding nurse practitioners in mutual practice relationships with physicians. The domains were clinical expertise, holistic caring, patient-centered activism, and leadership. The findings in this study indicated that physicians value the contributions of nurse practitioners that enhance the quality and scope of health care for patients within a mutual practice.

Homeless mothers' caring for children in a shelter.

Homeless mothers with children are a vulnerable population that faces problems from multiple sources. Little is known about their experiences, as current homeless studies report women's data as part of the aggregate findings with men. This study sought to identify the dimension of homeless mothers' family caring in a shelter. In-depth interviews were conducted with six homeless mothers who were participants in a larger study of homeless women. Constant comparative analysis of transcribed interviews led to the identification of homeless mothers' caring behaviors for their children. These behaviors were sacrificing for children, struggling with limitations, guarding from harm, and seeking answers. This taxonomy reflects the pain and hardship these homeless families experience while living a human disaster.

The Sea of Life: a metaphorical vehicle for theory explication.

Metaphorical expression is viewed as a fundamental way of symbolizing used to develop nursing theory. The Sea of Life poem depicts a metaphor for explicating a theoretical structure derived from principles of the human becoming theory: Transforming occurs in the revealing-concealing of valuing. The Sea of Life, an original poem, sets forth the idea that unique meanings are co-created through human-environment relationships. The concepts of valuing, revealing-concealing, and transforming are linked through the poem to lived experiences. The easily recognizable concrete lived experiences which flow from the poem are re-conceptualized to formulate research questions.

Women's perspectives on homelessness.

An increase in the number of individuals who are homeless since the 1980s has made homelessness a major social, economic, and political problem in the United States. The number of homeless in this country is estimated as high as 3 million, with women and children constituting the fastest growing subgroup of this population. A study of eight homeless women using a shelter in a southeastern city was conducted to explore the experience of homelessness from the women's perspectives. A modified ethnographic approach using a semistructured interview provided qualitative data. The constant comparative method of analysis identified themes of heightened awareness, guarding, identification of needs, and strategies for resolution. This study provides a new understanding of how some women experience homelessness, as well as the responses they take to solve this problem.

Homelessness: health-care implications.

The homeless population is changing in relation to age, race, income status, educational level, gender, and composition of families. Economic, social, and political factors are identified as increasing the risk of becoming homeless. The implications of homelessness on the health of an individual and strategies to improve the health status from multiple avenues is explored.

Glaucoma screening: an important role for NPs.

Glaucoma continues to be a major cause of blindness and visual impairment in the United States today. However, with early detection through screening followed by prompt treatment, sight can be spared. This article discusses the pathophysiology of both acute open-angle and acute and chronic angle-closure glaucoma and describes the high-risk population. The rationale behind obtaining an accurate intraocular pressure reading and converting the scale reading to mm Hg is explored. A step-by-step outline of the procedure for Schiotz tonometry is presented. Nurse practitioners who are functioning within primary care settings can provide valuable early detection screening to high-risk clients and make timely referrals for further evaluation.