Women's journey of recovery from sexual assault trauma: a grounded theory--part 1.

Thousands of women and children experience sexual assault trauma annually in South Africa. The challenge posed by recovery from sexual assault trauma is a reality that confronts the survivors of sexual assault, their families and the larger community of service providers. Yet, little research has been conducted on recovery from sexual assault as a phenomenon. The purpose of the study was to explore and analyse the journey of recovery which is undertaken by women who have been sexually assaulted, with the aim of discovering and developing the grounded theory of recovery from sexual assault trauma within the first six months following the event of rape. The main research question was: What constitutes the journey of recovery undertaken by women within the first six months following sexual assault? A longitudinal qualitative study was conducted using the principles of grounded theory methodology as proposed by Strauss and Corbin (1990, 1998). A series of in-depth one-to-one interviews were conducted with a sample of ten women. The participants were selected through open, purposive and theoretical sampling procedures. The study was conducted over a period of six months following the event of sexual assault. The substantive theory was discovered and constructed through the inductive and deductive analysis of data, grounded on the ten women's descriptions of their journey of recovery from sexual assault. The theory of women's journey of recovery that was discovered and developed consisted of eight theoretical concepts or categories. These included the following concepts: 1. Sexual assault trauma 2. Awakening 3. Pragmatic acceptance 4. Turning point 5. Reclaiming what was lost 6. Defining own landmarks of healing 7. Readiness for closure 8. Returning to self. The grounded theory of the journey of recovery from sexual assault is a contribution to the knowledge about women's journey of recovery from sexual assault. It provides a process and language for understanding women's experiences within the larger social context of recovery from assault. The findings suggested that women's journey of recovery from sexual assault trauma is an individual experience that is influenced by many and varied causal and intervening conditions. These included personal biographies, relationships, supportive and non-supportive environments at individual, family, community and societal levels. Recommendations for future research and clinical management of sexual assault are made based on the researcher's interpretation of the findings.

Women's journey of recovery from sexual assault trauma: a grounded theory--part 2.

The purpose of the study was to explore and analyse the journey of recovery which is undertaken by women who have been sexually assaulted, with the aim of discovering the grounded theory of recovery from sexual assault within the first six months following the event of rape. The main research question was: 'What is the journey of recovery that is undertaken by women within the first six months following sexual assault?' Another question that developed during data collection and data analysis was 'What is the meaning that women attach to recovery?' The findings are discussed under the eight concepts or categories and the context and the intervening conditions that influence the journey of recovery from sexual assault trauma. Refer to part 1 article. These are complemented with abstracts of data from the participants' voices and the related discussions. The developed theory highlights the process and the interconnectedness of the different stages of what the women experience in their journey of recovery from sexual assault trauma.

Changes in parents' mental distress after the violent death of an adolescent or young adult child: a longitudinal prospective analysis.

This study examined changes in bereaved parents' mental distress following the violent deaths of their 12- to 28-year-old children. A community-based sample of 171 bereaved mothers and 90 fathers was recruited by a review of medical examiner records. Data were collected 4, 12, and 24 months post-death. Repeated measures analysis of variance showed significant reductions in 8 of 10 measures of mental distress among mothers and 4 of 10 for fathers, with the most change for both genders occurring between 4 and 12 months post-death. During the 2nd year of bereavement, mothers' symptoms continued to decline, whereas fathers, who started out with less distress than mothers, reported slight increases in 5 of 10 symptom domains. Nonetheless, 2 years after the deaths, mothers' mental distress scores were up to 5 times higher than those of "typical" U.S. women and fathers' scores were up to 4 times higher than "typical" U.S. men. Of the 7 intervening variables examined, higher scores on self-esteem and self-efficacy predicted lower distress for both mothers and fathers 4, 12, and 24 months post-death. Repressive coping was predictive of distress among fathers. It was concluded that violent death bereavement has sustained, distressing consequences on parents of children who die as a result of accidents, homicides, and suicide.

Coaching persons with lung cancer to report sensory pain. Literature review and pilot study findings.

Because clinicians often do not recognize that patients have pain and patients do not spontaneously communicate their pain, clinicians may fail to prescribe or administer adequate pain medications. One method of improving clinicians' assessments of pain is to coach patients to communicate their pain in ways that clinicians recognize. The aims of our pilot study were to (a) examine the feasibility of implementing a randomized clinical trial of a COACHING protocol in 18 outpatients with lung cancer pain and (b) estimate the effects of COACHING on nurses' knowledge of patients' pain location, intensity, quality, and pattern. The expectation was that COACHING would show a trend toward reducing the discrepancy between patients self-report of sensory pain and sensory pain data known to nurse clinicians. Patients were randomly assigned to be COACHED or NOT-COACHED (usual care) and pretest-posttest measures with the McGill Pain Questionnaire (MPQ) and Visual Analogue Scale (VAS) were taken from nurses and patients. Patients- and nurse-completed MPQs and VASs were compared for agreement. Improvement in percent agreement occurred consistently more often (pretest to posttest) between patient self-report of sensory pain and nurses' pain assessments in the COACHED group than in the NOT-COACHED group. Pilot study findings demonstrated feasibility of implementing the COACHING protocol and suggest that COACHING may be effective in reducing discrepancies between patients' self-reports and nurses' assessments of sensory pain. Design modifications are recommended for implementation of future studies.

Commitment to patient care: an exploratory study among registered nurses in Bophutatswana.

In this second article on the commitment to patient care the methodology and results of the study are briefly described and discussed. The research method was a non-experimental qualitative survey, using several data-gathering methods such as semi-structured interviews with registered nurses and patients, the examination of nurses' and patients' records and non-participant observations. Although the responses of nurses and patients indicated that both groups considered commitment to be essential to patient care, the examination of patient records, nurses' evaluation reports and observations showed lack of commitment in practice. Various reasons for this are explored and recommendations made.

A concept analysis of nurses' commitment to patient care.

Commitment to the service of mankind has always been a key concept of professional nursing. However, very little effort seems to have been made to analyse the nature of commitment as a factor in nursing. This article explores the meaning of the concept 'commitment' as revealed by a review of the literature and the responses of a group of registered nurses in unstructured interviews. It goes on to analyse the concept by means of a number of techniques such as an analysis of critical attributes, the construction of model cases and related cases, the identification of antecedents and consequences and of empirical referents. The information gleaned was used to structure a study of the commitment to patient care of a group of professional nurses which will be published in a subsequent article.