Menopause is a complex phenomenon which encompasses physiological, psychological, and social aspects of this midlife experience. The meaning of menopause or what it symbolizes to women in American society depends on multiple factors and differs among women. The assumption is that although menopause is a biological event, social meanings determine how a woman perceives and interprets the reality of that event. How this transition is experienced by women may depend on their cultural norms, social influences and personal knowledge about menopause. The purpose of this phenomenological study is to Understand the complexities of the human experience of menopause in American women from diverse ethnic and socioeconomic backgrounds. The research question is “What is the meaning of menopause as experienced by American women?” The specific aims of this phenomenological study were to (a) examine and interpret the reality of the menopausal transition as experienced by American women and (b) identify common elements and themes that occur as a result of the complexities of this experience. Data were gathered through semi-structured interviews with fifteen women who had experienced natural menopause. Three major themes were extracted during the data analysis: (a) expectations and realization, (b) sorting things out, and (c) a new life phase. Although some women expressed similar thoughts in particular categories, no two women had the same experience of menopause. The data from this study support the premise that the experience of menopause in American women is unique and individualized and that the meaning or perspective differs among women. The data revealed the complexities of this human experience by explicating personal meanings related to experiences, expectations, attitudes and beliefs about menopause.

The incidence and prevalence of intimate partner violence and abuse among Puerto Rican women has not been adequately studied in the island Commonwealth of Puerto Rico. The dearth of research and the lack of awareness about the problem by health care providers and within the lay community influence the health status of women resulting from violence and abuse in Puerto Rico. This research study used a descriptive-exploratory design to examine the health effects of intimate partner violence and abuse among 60 Puerto Rican women living in shelters located across the island. The purpose of the study was to examine the perceived health effects of intimate partner violence and abuse on the lives of these abused Puerto Rican women. Four instruments (ISA-Index of Spouse Abuse, DA-Danger Assessment, HARASS-Harassment tool, RAND-36 (SF-36 v2)-Health Status Inventory), and two semi-structured interviews were used to collect data. The interviews provided information on socio-cultural context and health care response experienced by the women. The objective was to gain understanding of the health effects and determine if there was any link between the abuse and health effects. Secondly, the researcher explored and described the violence and abuse among Puerto Rican women, and brought to the analysis a theoretical understanding of the women's experiences specifically, how this abuse influences their health. The results reflect the association between abusive and violent intimate relationships and poor health status and addressed recognition of the health effects of intimate partner violence. The findings revealed the need for planning, development and implementation of effective health care protocols, social advocacy and government policies to develop a surveillance system and educational programs that address this issue of intimate partner violence. Advancing scholarship in the area of intimate partner violence is needed to generate concrete strategies designed to heighten public and professional awareness and to provide nursing leadership and policy development in this critical area of women's health.

Nursing has been identified as one of the most sex-typed occupations in the United States. Moreover, nurses typically practice in settings where there is an unequal distribution of power. These conditions make their workplace a particularly ripe environment for sexual harassment, yet some research literature suggests that sexual innuendo and even some touching is "normal" for these workers, concluding that sexual harassment does not happen to nurses. However, much of sexual harassment is embedded in gestures that are grounded and constructed both socially and culturally, implying that definitions of harassment are dependent on the context in which the behaviors occur. In this qualitative study, the term--sexual harassment--was not used at the outset of the semi-structured interviews that were conducted with thirty-seven working female nurses. Instead, respondents were asked to describe their job-related sexual advances, after which they determined how and under what circumstances they would (or would not) affix the sexual harassment label. This design allowed for analysis of the interpretive grounds under which definitions of sexual harassment are made and is predicated on the notion that harassment is not merely a list of proscribed behaviors but a range of actions subject to interpretation and constrained by factors which may be internal to the job. The respondents furnished details on 129 unwanted or unpleasant sexual acts. Yet the majority of the group equivocated when applying the label to those actions they had directly experienced. Other findings revealed that they expected that they would be sexually mistreated by male doctors and patients because they were female nurses--the treatment accorded them was "part of the job," thus their experiences were rendered invisible. Those who accept the current social definition of sexual harassment might argue that the nurses' reactions failed to appropriately label these experiences. However, the nurses' own interpretations of their situations mean that these acts and the responses available to them are constructed in light of their particular occupational situation where gender and the job are fused.

This study examined moral reasoning used by nurses to resolve conflict and choice in the workplace. This study also focused on how nurses saw themselves as leaders and caregivers. Ten nurse leaders were purposively selected from a large urban acute care magnet hospital. In open-ended, semi-structured interviews, each participant discussed an actual workplace conflict that they experienced, the course of action taken, and evaluation. Nurse leaders also described themselves as leaders and as caregivers. Demographic data was gathered on age, sex, educational background and career positions. Two research questions were addressed in this study: How do nurse leaders respond to conflict and choice in the workplace? Does level of leadership influence response to conflict and choice? Interview data were analyzed using Carol Gilligan's protocol described in the Reading Guide (Brown et al. 1988). The results indicate that nurse leaders used justice and care voices to respond to conflict and choice in the workplace. Seven out of ten used both a justice and care voice. Three of the leaders responded with only one voice: two with only a care voice and one with only a justice voice. In this study, leadership level did not influence choice of moral voice in workplace conflict. Managers and executives both used justice and care in describing their dilemmas. Nurse leaders described three kinds of workplace conflict: organizational, interpersonal and intrapersonal. Four themes emerged as central to how nurse leaders view themselves: the importance of relationships in the leader role; power as a piece of the leader role; the leader as a team member; standards as guides to decision-making. Nurse leaders underscored the importance of the worksetting and its influence on nursing's ethic of care. Congruence of institutional philosophy, climate, and larger administrative presence with nursing's professional care values are the contextual influences cited by the nurse leaders.

The purpose of this study is to explore how auxiliary nurse-midwives (ANM) in government service in Nepal articulate the mediation of the multiple roles their lives encompass. ANMs are pivotal to the government's ability to increase access to health care for pregnant and parenting women and their children in the rural areas of Nepal. Nepal has one of the highest rates of maternal and infant morbidity and mortality in the region. ANMs in the rural health clinics not only provide direct care but also provide supervision and training to a variety of community based health workers who also serve women of child-bearing age. Most studies on women's health in Nepal focus on service delivery with few reports focusing on the experience of women health professionals. The ANM program was developed to achieve two goals: to increase access to health care for rural women and to increase the status of women by increasing access to professional training and a profession. Girls who reach the minimum educational requirements to enter ANM training are often young, unmarried, from urban centers, and protected by the family structure. By virtue of the position, they are put into roles that contradict societal and family norms. Retention and the provision of quality services by ANMs have been raised as major concerns by the government. The main method of research was the use of open-ended and guided interviews with auxiliary nurse-midwives. Document review and meetings with health development workers in Nepal was also carried out. Four themes were focused on to help guide the research: the profession, the role of education, family and other supports, and being a woman. The cornerstone of the study is the women's narratives. The narratives demonstrate the uniqueness of each woman's experience, yet all speak to the dynamics of their own power, agency, resistance and resiliency. It is hoped that this document will add to the discourse on gender, education and health development. The study concluded with recommendations about the ANM program in Nepal and about the roles professionals and institutions play in international health development or social change.