Diane C. Hatton

Children's accounts of attention-deficit/hyperactivity disorder

As a postmodern illness, attention-deficit/hyperactivity disorder (ADHD) is embedded in controversy, reflective of the cultural times in which we live. Within this debate, 2 perspectives, ADHD as myth and ADHD as behavioral disorder, are most frequently voiced. This article describes these 2 differing perspectives and reports qualitative data from 39 children and adolescents with a diagnosis of ADHD regarding their perceptions, meanings, and experiences of living with this disorder. None of the participants in this study denied that they had difficulties and many of the difficulties they described corresponded to DSM-IV-R criteria and the scientific literature. Given these discoveries, the continual debate about the authenticity of ADHD only further victimizes families who are in desperate need of services.

Racism as a source of health disparity in families with children with attention deficit hyperactivity disorder.

Although poverty and health are inextricably linked, one cannot assume that simple poverty and low socioeconomic status are the primary causes of health disparity among racial groups. Examining the roles of racism and discrimination in access to health care and in the health experiences of people of color is fundamental to the goal of eliminating health disparities by 2010. Data from ethnic minority groups on how race influences health and health care services are absent from much of the nursing research literature. This article explores racism as a source of health disparity and discusses methodological implications for research, using attention deficit hyperactivity disorder (ADHD) research as an example.

Homeless Women's Access to Health Services: A Study of Social Networks and Managed Care in the US

ABSTRACT Heterosexual transmission of HIV is growing at an increasing rate. One primary prevention strategy is to consistently use condoms. With the exception of female condoms, women do not “wear” condoms and therefore must negotiate condom use with their male partners. This present study examines the strategies women believe they would use in a safer sex negotiation with a male partner including (1) initiating negotiations, (2) resolving conflict, and (3) maintaining the intention to practice safer sex. The findings highlight the importance of understanding womens patterns of negotiation as well as their repertoire of negotiation skills prior to their exposure to behavioral interventions and prevention programs.

Modeling ADHD Child and Family Relationships

Little information is available on how to help families manage common negative sequelae of attention deficit/hyperactivity disorder (ADHD). This article is a report of the extent to which a theoretical formulation of child behavior, maternal distress, and family conflict was explained by data obtained from a community sample of families with children and adolescents with ADHD. Structural equation modeling was used to test the theoretical model. The primary variables of interest were (a) child behavior problems, (b) maternal distress, and (c) family conflict. The results suggest that maternal distress may mediate the relationship between child behavior problems and family conflict, indicating the critical importance of mothers in ADHD families and the need to provide them with additional support.

Latino parents' accounts of attention deficit hyperactivity disorder.

Although researchers have conducted a vast amount of research about attention deficit hyperactivity disorder (ADHD), few have addressed how Latino families experience ADHD. The purpose of this qualitative study was to explore how Latino parents managed their child’s ADHD within the sociocultural context of their everyday lives. This article presents a grounded theory of how Latino parents ( N = 24 families) managed their child’s ADHD. The following five themes emerged from the data analysis: (a) finding out about ADHD, (b) taking on a biomedical meaning, (c) living between two cultures, (d) caring for a child with ADHD, and (e) looking toward the future with ADHD. Although some of the circumstances encountered by Latino parents resemble those typically found in the literature about ADHD and families, their experience is rendered inordinately complex by multiple overlapping sociocultural, linguistic, and parental circumstances.

Homeless Women and Children's Access to Health Care: A Paradox

Homeless women and children who reside in shelters experience many health-related problems. The aim of the qualitative study¹ reported here was to (a) explore how shelter staffs manage health problems among their residents and assist them in accessing health services, and (b) identify clinical strategies for community health nurses working with this population. Findings demonstrate a paradox whereby homeless shelter staffs try to gain access to care for their residents through a system that is designed to keep them out. In addition, findings indicate a need for increased community health nursing services in homeless shelters. Strategies for resolving this paradox include providing assessment, policy development, and assurance of health care for homeless women and children.

Accessing vulnerable populations for research.

Nurses provide care daily to the most vulnerable of our society: the home less, the abused, the ill, the old, and the young. Each group includes persons of all racial, ethnic, and sexual orientation backgrounds. Nursing care depends on the nurse’s ability to meet the needs of these at-risk groups. Paramount to meeting these needs is an understanding of them from the perspective of the population served. This presents a significant challenge to nurse researchers because circumstances can make it difficult to recruit vulnerable individuals into a study, to ensure their informed consent, and to contend with the data obtained. The purpose of this article is to discuss methods of accessing vulnerable populations for research. More specifically, we consider (a) how to invite participants into a research project and respect their input, (b) how to care for oneself as a researcher, (c) how to reciprocate with staff and organizations where studies take place, and (d) how to obtain approval from an institu tional review board. The authors draw on their experiences as researchers and practitioners with homeless persons and with abused women (Anderson, 1996; Hatton, 1997).

Methodological and Ethical Issues Emerging from Pilot Testing an Intervention with Women in a Transitional Shelter

This article focuses on the methodological and ethical issues that emerged during the pilot test of a social support intervention with women who had experienced homelessness and were living in a transitional shelter. The overall goal of this project was to improve their health outcomes, more specifically their health maintenance behaviors and general health. This article briefly describes the nursing intervention to set the context for analyzing six methodological and ethical issues: (a) maintaining investigator relationships with shelter staff, (b) reducing bias, (c) dealing with sensitive issues, (d) adjusting the intervention to meet the women’s needs, (e) managing attrition, and (f) sustaining informed relationships with participants. Flaskerud and Winslow (1998) called for research designs with vulnerable populations that move beyond description and epidemiology, to intervention and outcomes. They also argued that it is critical for nurse scientists to explain the methodological challenges they encounter in research with vulnerable populations. This article offers such an explanation for future interventions with women who have histories of homelessness.

Using Participatory Methods to Examine Policy and Women Prisoners’ Health

This article describes how community-based participatory research (CBPR) led to the discovery of the unintended consequences of jail and prison copayment policy on women prisoners’ health. The article addresses (a) a working definition of participatory research; (b) the importance of research with women prisoners; (c) the origins and development of our work and its grounding in CBPR; (d) issues related to research with prisoners; and (e) recommendations for using participatory methods to bring women prisoners into the discourse about the practices and policies that impact their lives. These methods have the potential to minimize the invisibility of prisoners and their health disparities.