Thesis (Ph. D.)--University of Alabama at Birmingham, School of Education, 1998. / eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 103-109).

Thesis (M.N.)--Memorial University of Newfoundland, School of Nursing, 1996. / Typescript. Bibliography: leaves 115-123. Also available online.

This phenomenological study was designed to explore the privacy needs of gynecological patients, as perceived by the clients during hospitalization, for the purpose of adding to knowledge and understanding of patients' privacy. Data were collected through sixteen in-depth interviews with eight recently hospitalized patients. The interviews were tape-recorded and transcribed verbatim for each participant. Data were analyzed using Giorgi's (1975) procedure. Analysis of participants' accounts revealed that privacy was important to participants' maintenance of their self-identity. Characteristics of privacy that participants identified as helping to maintain their self-identity included providing time alone for contemplation and helping to control interactions with others. Participants reported that privacy was important for their comfort during situations involving nursing care, basic needs and social interactions with others. Participants suggested that even though they reduced their expectations of privacy during the hospital stay, their privacy needs in hospital were at times still not met. Factors within the hospital setting that contributed or detracted from participants' hospital privacy included behavior of the nurses, doctors, roommates and the physical environment of the hospital. Participants indicated that nurses were the main factor in meeting privacy needs especially while caring for participants and participants' roommates. The findings of this study indicated that participants were willing to trade some privacy for health care. However, participants still valued privacy and considered it important during their hospital stay. There is a lack of research on privacy and acute care hospitalization. Recommendations for further nursing research, nursing practice, nursing education and nursing administration, based on the findings of this study, are presented in the final chapter of the study. / Applied Science, Faculty of / Nursing, School of / Graduate

This dissertation describes the patient experience. In Chapter One, we review the currentstate of patient-centered care with a specific focus on women’s experiences in infertility treatments, highlighting the gaps in our understanding of their experiences. The four independent but complementary aims of the dissertation studies are then introduced, and we identify how they address current gaps to advance our understanding of women’s experiences using reproductive technology. In Chapter One, we also introduce an innovative service design tool, journey mapping, as well as the Burden of Treatment Framework which guided the dissertation. Chapter Two, An Integrative Review of Journey Mapping to Document the Patient Experience, presents an integrative review examining the use of journey mapping in health care services research. In the analysis of these twenty-two studies, we demonstrate how journey mapping has been adapted to describe the patient experience. While the qualitative rigor of the included studies is of good quality, the inconsistent application of design standards in the accompanying visualizations, when present, suggests that further work and guidance is needed in the adaptation of this service design tool for the health research field. In Chapter Three, Journey Mapping the Patient Experience of IVF: A Social Media Analysis, we used posts from the largest infertility subreddit and patient-facing online resources to describe and visually depict the patient experience of IVF in two journey maps representing the experiences of women in their first cycle of infertility treatment and women in repeat cycles. Findings highlighted problems and unmet needs in the infertility treatment experience, including information needs, communication needs, and support needs. Chapter Four, The Burden of Treatment in IVF: An Analysis of Social Media Using a Framework for Chronic Complex Conditions, used qualitative descriptive methodology to guide inductive and deductive content analysis of posts from the same infertility subreddit. Findings suggest that Eton’s framework is applicable to infertility, but can be expanded by the inclusion of three new constructs that we identified. Finally, Chapter Five synthesizes the key findings across these four aims, outlining their strengths and limitations, and discussing implications for future research, policy, and clinical practice.

This dissertation layers trauma studies theory with feminist theories of performance and autobiography to investigate how women's autobiographically based performances of illness experience disrupt and/or reinforce master discourses of medicine, identity, and knowledge. Feminist theories of performance and autobiography share with trauma studies the distrust of traditional frames and mechanisms of representation, and seek to discover new methods of interpreting experiences that lie "outside the realm" of normative discourse. These theories are further linked by their shared focus on agency and identity construction and an understanding of autobiography that emphasizes the limitations of language and memory which allows for aporia, contradiction, and dissonance, and the belief that testimony functions as a politicized performative of truth. Employing these theoretical perspectives, Carr investigates how these performances witness to radical reconfigurations of identity through the transference of trauma into conveyable life narrative -- even when those narratives falls outside the paradigm of traditional storytelling structures. Carr questions how the structures and content of these performances reveal what traumas are inflicted not only through illness, but also through treatment and care within the western medical model. Throughout the study Carr examines the moments when the cognitive structures of trauma are transmitted into performance through a variety of feminist and avant-garde performance techniques. Carr investigates the work of specific performers and contextualizes the performances within popular culture and medical discourse. Performances analyzed include; Robbie McCauley's Sugar, Susan Miller's My Left Breast, Brandyn Barbara Artis's Sister Girl, and Deb Margolin's bringing the fishermen home and Three Seconds in the Key. Carr questions how the formerly or currently ill female body performing in public disrupts notions of fixed and stable identity while examining the myriad identity constructions embedded within illness narrative. Rather than simplistic triumphant stories of individual cure and recovery, these complex expressions of traumatic experience reveal patterns of cultural oppression that keep the ill female body isolated and silenced. This study attempts to intervene in that silence by foregrounding these politicized performances.

Obstetric surgical repair is the common therapeutic intervention available to women with obstetrical fistula. While surgical repair can address the physical symptoms, it may not end the psychological challenges that women with fistula face. This longitudinal study investigated the effects of surgical obstetric fistula repairs on the severity of depression and anxiety associated with obstetric fistula among 219 women admitted at six fistula hospitals in Ethiopia. Data was collected through structured Likert-scale questionnaire both on admission (prior to surgical obstetric fistula repairs) and on discharge (post obstetric fistula repairs).. Statistical Package for Social Science plus Analysis of Moment Structures (SPSS-AMOS) version 20 was used for data analysis. Findings indicate that women with obstetric fistula have higher psychological distress such as depression (91%) and anxiety (78%) pre-surgical repair than post-surgical repair. These psychological distresses were exacerbated by poor social and psychological support of women with obstetric fistula by the family and health care professionals. The findings were used to develop integrated mental health treatment model for women with obstetric fistula in order to address psychological health needs of this population. / Health Studies / D. Litt. et Phil. (Health Studies)

This is an ethnographic study of discourses and experiences concerning sexual exchanges among kin “who are too closely related to marry each other” (OED), or what in lay language is called “incest”. I investigate the ways in which a certain kind of incest, that between older men and younger women, primarily from different generations, is experienced by women of predominantly rural origin, who have been hospitalized in the major public psychiatric hospital in Bolivia, in Sucre. In this sense, this research is as much a study of incest as it is of psychiatric institutionalization. These experiences will be considered in the context of a wider field of ethnic, class and gender discourses that are produced by medical staff, community organizations, as well as national judicial institutions. The category of 'incest' is problematized in terms of how kinship is constructed, not only as a series of dynamic discourses (as practices whose effect is the production of events) but also as mobile experiences, however socially regulated. With this in mind, I present an account of Andean concepts and treatment of incest, as well as of legal and medical categories. Specifically, I focus on the play between discourses in the context of the psychiatric hospital, the judicial court and the communities of selected inmates. I show how the inmates' experiences of intergenerational incest and sexual violence in general are related to the dominant ethnic, class and gender narratives produced by medical staff, community organizations, and judicial institutions.

A non-experimental quantitative, descriptive and contextual study which sought to examine the level of awareness about Diabetic Retinopathy (DR), and how aware female diabetic patients were about retinal screening as a preventative measure to eye complications and blindness was conducted. The objective of the study was to explore and describe the variables related to the awareness level of female diabetic patients about Diabetic Retinopathy and diabetic retinal screening. A convenient sample of 149 respondents was obtained. A questionnaire was used to collect data. Data was analysed using the Statistical Package for Social Sciences (SPSS), 13.0 computer software program. Results evidenced a good level of awareness about DR. Recommendations based on the findings were made for consideration in clinical practice, education and research. / Health Studies / M.P.H.