In the past ten years there has been a tremendous growth in outpatient surgery. Technical advancements in surgery techniques and anesthesia delivery have made it possible for lengthy, complex surgical procedures to be done on an outpatient basis. While surgery is dramatically changing, the basic nursing needs of surgical patients remain constant. It is widely accepted that most patients face the same spiritual issues of coping, hope, inner-peace and a sense of emotional and physical well-being, which have long been associated with the surgical experience, yet the newer processes necessitate adaptation at an accelerated rate. The purpose of this phenomenological study was to describe the meanings of the lived spiritual experiences of patients transitioning through major outpatient surgery. The philosophical framework of this research was operationalized congruent with interpretive phenomenological methodology. The philosophic methodological approach of van Manen formed the foundation for this study while Munhall’s stepwise approach guided the methodology. Seven research participants who had just completed major outpatient surgery were recruited through a purposeful criterion based sample. The participant interviews resulted in rich descriptions of each individual experience framed within the context of the four existential life-worlds. After interviewing and readdressing the participant’s accounts, four distinct themes emerged. The identified themes were; a) a point in time, b) holy other, c) vulnerability in the operating theater and d) appraisals of uncertainty. Several suggestions for perioperative nursing practice were discussed as well as two general recommendations for future research.

Background Studies indicate that the vast majority of adult Americans do not regularly consume recommended daily servings of fruits and vegetables. One major issue with research in this area is how to measure fruit and vegetable intake, especially in ethnically diverse populations. Objectives The specific aims of the study were to a) compare the percentage of participants categorized as regularly consuming five or more („5 or more‟) daily servings of fruits and vegetables using two commonly used instruments, b) assess if percentages varied by race/ethnicity, and c) assess if the different instruments interacted with race/ethnicity. Methods The source for the current study was the Healthy Hawai„i Initiative (HHI) which collected baseline data from adult residents of Hawai„i in 2002. The data used in this study are baseline data from the HHI longitudinal study. „Five or more‟ was calculated using two instruments: a single question instrument and a multi-item food frequency questionnaire (FFQ) 19-item instrument. The latter allowed for variations in how „5 or more‟ was calculated (e.g. not including fried potatoes). Percentages were compared overall and by race/ethnicity. Results The percentage meeting „5 or more‟ criteria varied greatly depending on how „5 or more‟ was calculated ranging from 20.9% with the single question instrument to 60.8% when all items on the multi-item FFQ instrument were used. Caucasians were iii significantly more likely to consume „5 or more‟ than were Japanese and Filipinos. With the single question instrument the results for Filipinos were exceedingly low and inconsistent with results using the multi-item FFQ and with State of Hawai„i survey data for 2002. Female gender and older age were also associated with „5 or more‟ while education was not. No specific food items explained differences by race/ethnicity. Conclusions The percentage of participants meeting „5 or more‟ criteria varied significantly depending on how „5 or more‟ was calculated. Race/ethnicity was significantly associated with „5 or more‟. The single question method for determining „5 or more‟ categorization appeared to interact with race/ethnicity, greatly underestimating intake for some groups relative to Caucasians and therefore it should not be used in studies in Hawai„i.

Thesis (Ph. D.)--University of Hawaii at Manoa, 2003. / Includes bibliographical references (leaves 150-161).

Thesis (Ph. D.)--University of Hawaii at Manoa, 2003. / Includes bibliographical references (leaves 291-308).

Thesis (M.A.)--University of Hawaii at Manoa, 2003. / Includes bibliographical references (leaves 117-121).

Originally presented as the author's thesis, University of Hawaii. / Bibliography: 197-210.

Thesis (Ph. D.)--University of Wisconsin--Madison, 1964. / Typescript. Vita. Description based on print version record. Includes bibliographical references (leaves 388-413).

Thesis (Ph. D.)--University of Hawaii at Manoa, 2000. / Includes bibliographical references (leaves 580-605). Also available on microfiche.

Thesis (Ph. D.)--University of Hawaii, 2000. / eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Originally presented as the author's thesis, University of Hawaii. / Bibliography: 197-210.