Transnational perspectives on women's domestic work: experiences of Brazilian immigrants in the United States.

This article focuses on immigrant women's transnational experiences and perceptions of paid and unpaid domestic work. The dominance of work was an evident theme throughout the interviews with 26 Brazilian women who had been employed in domestic or food service work in the United States. Various intersections of gender, class, culture, and migration were evident in the women's changing definitions of work, measures of the quantity and quality of their paid and unpaid domestic work, and perceptions of their own fluid identities as Brazilian women, domestic workers, and immigrants. Through their daily lives and work experiences these immigrant women made concerted efforts to forge, maintain, or recreate contacts and connections with values and perspectives from both Brazilian and U.S. society. In the process they created dynamic transnational understandings and perspectives on women's domestic work.

Experiencing transitions: an emerging middle-range theory.

Changes in health and illness of individuals create a process of transition, and clients in transition tend to be more vulnerable to risks that may in turn affect their health. Uncovering these risks may be enhanced by understanding the transition process. As a central concept of nursing, transition has been analyzed, its components identified, and a framework to articulate and to reflect the relationship between these components has been defined. In this article, the previous conceptual analysis of transitions is extended and refined by drawing on the results of five different research studies that have examined transitions using an integrative approach to theory development. The emerging middle-range theory of transitions consists of types and patterns of transitions, properties of transition experiences, facilitating and inhibiting conditions, process indicators, outcome indicators, and nursing therapeutics. The diversity, complexity, and multiple dimensionality of transition experiences need to be further explored and incorporated in future research and nursing practice related to transitions.

Growing up with congenital heart disease: the dilemmas of adolescents and young adults [see comment].

Advances in diagnosis, medical management and surgical intervention have improved the longevity and quality of life for children with congenital heart disease. Despite this, research studies specifically examining the psychosocial concerns of adolescents and young adults with congenital heart disease are few. To explore the subjective experiences and dilemmas of this population during the transition from adolescence to young adulthood, we interviewed, using a semi-structured protocol, a convenience sample of nine adolescents and young adults. Using analytic procedures inherent in Grounded Theory methodology, seven themes were identified: the dilemma of normality; dilemmas in disclosure; dilemmas in strategies for management of illness; the challenge of social integration versus social isolation; the challenge of dependence versus independence; the challenge of uncertainty; and strategies for coping. An understanding of these experiences by health professionals can be beneficial in helping this clinical population as they grow up and face the challenges of an uncertain, yet promising, future.

The dilemmas of parents of adolescents and young adults with congenital heart disease.

OBJECTIVE: To provide a better understanding of parents' experiences as their children with congenital heart disease mature through adolescence and young adulthood. DESIGN: A qualitative pilot study. SETTING: The physician practices of the pediatric cardiology service of a large university medical center. SUBJECTS: Eight parents of adolescents and young adults with congenital heart disease. INTERVENTION: Each parent was separately interviewed with use of a semistructured interview guide. RESULTS: Our study has identified seven themes--the dilemmas of normality, disclosure dilemmas, the challenge of uncertainty, illness management dilemmas and strategies, social integration versus social isolation, the impact of illness on the family, and coping--with which parents have struggled through-out their adolescent's and young adult's life. It was not possible to determine whether the experiences described by these parents are unique. CONCLUSIONS: Parents experience distress, as outlined in the seven themes. They need assistance to determine what is "normal" for their child and how to monitor their child's health and safety. Further research is needed to develop specific interventions.

Patients' perspectives of fatigue while undergoing chemotherapy.

PURPOSE/OBJECTIVES: To explore the experience of fatigue from the perspective of patients undergoing chemotherapy. DESIGN: Qualitative research and secondary analysis of data from a larger study. SETTING: Participants were recruited from 18 sites, including large outpatient chemotherapy clinics and private medical oncologists' offices. SAMPLE: 127 adult patients who were beginning their first protocol of chemotherapy. METHODS: Data were collected through individual and open-ended interviews and a qualitative, thematic analysis of the participants' responses using grounded theory techniques. MAIN RESEARCH VARIABLE: The experience of fatigue as perceived by patients undergoing chemotherapy. FINDINGS: The analysis resulted in eight major thematic categories: (a) experiencing fatigue, (b) effects on well-being, (c) attribution of origin, (d) awareness and expectations, (e) emotional reactions, (f) activity, (g) the "biggest" concern, and (h) strategies and plans. CONCLUSIONS: This study demonstrates the variation, extent, duration, and temporality of fatigue among patients receiving chemotherapy and the dynamic, changing aspects of the experience. IMPLICATIONS FOR NURSING PRACTICE: Fatigue must be considered within the context of patients' daily lives and environments, disease processes, and treatment modalities. Nurses must listen carefully to patients' own descriptions of being tired. Further research examining patients' perspectives of and experiences related to fatigue is necessary to increase the theoretical understanding of fatigue and to improve therapeutic nursing interventions.

Women's work environment and health: clerical workers in Brazil.

Although women are participating more in the formal workforce, the majority are employed primarily in low-income and low-status occupations. While work roles may provide women with some rewards, employment may also create many stressful demands on their daily lives. As part of an international study, 60 female Brazilian clerical workers responded to a self-administered questionnaire describing what they liked, disliked, and found stressful about the structural, physical, and social aspects of their work environment. Participants also identified strategies they used to cope with stress in the work environment. Dimensions of healthy environments identified in the data included utility, challenge, participation, safety, pleasing workplace, valuation, clarity of roles, and empowerment. Unhealthy environments were characterized by hazards, bureaucracy, devaluation, and economic constraints. Participants described their concerns about the effect of the environment on their physical and mental health, but tended to adopt a passive, resigned coping style rather than a proactive approach to co-creating a healthier work environment. The results and their relationship to healthy work environments are discussed within the context of the larger sociopolitical environment of Brazil.

Voices of impoverished Brazilian women: health implications of roles and resources.

This qualitative study was based on individual interviews with 75 Brazilian women in an impoverished peri-urban squatter community (favela) in southeastern Brazil. The purposes of the study were to describe women's role involvement in domestic and employment contexts; identify stresses and satisfactions of maternal, spousal, and employment roles; and assess personal and environmental role constraints and resources from the perspective of women's health. The analytic approach to the interview data was qualitative content analysis, through which thematic categories of maternal, spousal, and employment role satisfactions and stresses were identified by the researchers. Women's unrelenting work in the face of harsh social and economic environments was a broad theme woven throughout the women's descriptions of their lives. The confluence of role constraints affecting the participants' lives included poverty, marginalization, abuse, and lack of support and recognition by partners and society. In order to overcome great adversity and meet heavy role demands, these women relied on self, faith in God, family, and health resources. Implications for women's health promotion are discussed.

PIP: This article describes a qualitative study of women's role in an impoverished peri-urban squatter community in Brazil. The convenience sample included 75 women, comprised of Roman Catholics (51%), Protestants (17%), Spiritists (17%), and unreligiously-affiliated (11%). 26 women were illiterate. 49 had some primary school education. 59% had income that was below the poverty line. 92% reported their income as inadequate. 17 households did not have piped water, and 5 households did not have electricity. None had telephones. Only 28 had refrigerators. Interviews were conducted at the local health post among a sample that was largely unexposed to the questionnaire survey process, which sometimes posed difficulties. Attempts were made to seek out divergent cases or experiences and alternative explanations. Findings indicate that all the women identified themselves as the member of the household responsible for domestic housekeeping, and all saw that role as their most time- and energy-consuming. Most had at least 1 child. 72% were married, and 16% lived with a male partner. 12% were single, widowed, or divorced. Most were dependent upon spouses for economic support. 29 women had some employment outside the home. Women reported the lack of child care as a major reason for not being employed. There were other barriers. The women valued their role as mothers, but work and worries were dominant themes. Women complained about their partner's alcohol and drug misuse, domestic violence, and a lack of appreciation or affection. Working women reported socioeconomic satisfaction and work overload. Women's living conditions were harsh. Women showed considerable inner strength and creativity in dealing with demands and stresses.

Employed Mexican women as mothers and partners: valued, empowered and overloaded.

This study was designed to explore the daily lived experiences of a group of employed, low-income Mexican women in their maternal and spousal roles. The participants were 41 auxiliary nurses recruited from two large urban hospitals in Mexico. Data were collected through the Women's Roles Interview Protocol (WRIP), which solicited the participants' perceptions of the satisfaction and stresses they experienced in their roles as mothers and spouses, and their descriptions of the coping strategies and the resources they used to deal with stressful life experiences related to these roles. Data analysis consisted of a qualitative thematic analysis of the narrative responses to open-ended questions in the WRIP. Satisfying aspects of the maternal and spousal roles, as identified by the participants, included giving to and receiving from their children and being valued and supported by their partners. Spousal approval of their work was also satisfying. These employed mothers, however, experienced many stressful aspects of functioning in multiple roles, including lack of resources, being absent from their children, self-doubt about their maternal role functioning, role overload and spousal absences. The women coped by juggling priorities and utilizing family resources. From the data analysis, the investigators developed a conceptual framework for understanding these women's experiences with parenting and marriage. The centrality of the family, a sense of value and empowerment as women in maternal and spousal roles, and the reality of role overload are discussed within the Mexican culture context of machismo, its female counterpart hembrismo, and family life. Implications for women's health are framed within a context of family and work.

Concept development: exploring undocumentedness.

Concept development involves multiple processes, one of which is concept exploration. The purpose of this paper is to present the process of concept exploration as exemplified in the case of undocumentedness. This particular exploration of undocumentedness was grounded in the discipline of nursing and approached from a feminist perspective. The exploratory process of the concept included personal reflexivity, the construction of definitions, examination of the historical, social, political, and legislative context of undocumented immigration in the United States, exploration of the meanings and implications of the concept, discussion of the relationship of undocumentedness to nursing and health, and identification of the needs for research to further develop the concept of undocumentedness for nursing.

[Women and health: their concerns]. / Mulher e saúde: suas preocupações.

This investigation is part of a transcultural research project on women and health, which has as its conceptual framework women's life experiences. This research is qualitative in nature, and the methodology utilized is a content analysis of the documented discourses of a group of lower class women in Ribeirão Preto (SP). The results demonstrate that for these women, health is much more than the absence of disease". Their health concerns are biological, interpersonal, social and economic in nature, and are based more upon their personal experiences and social perceptions than on the concept of health and disease. The importance of this research is its relevance for quality nursing care which takes into consideration the many aspects of being a woman.