Eun-Ok Im

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.

Theory and research.

This study evaluated the effectiveness of the Pyramid method, an educational method for 3to 6-year-olds. The Pyramid method seeks to improve young childrens chances for a successful primary school career, particularly among ethnic minorities (of Turkish, Moroccan, Cape Verdian, and Surinam origins) and Dutch children of poorly educated parents. The study compared, over a 3 year period, the performance of a group of children participating in the Pyramid method to that of children in a control group. Findings indicated that the Pyramid method accelerated the development of children, both ethnic and Dutch, compared to the control group, with the greatest success when children entered the program in preschool. (Contains 41 references, 5 figures, and 4 tables.) (EV) Reproductions supplied by EDRS are the best that can be made from the original document. Do not quote without permission I SubMitted for publication Pyramid, educational method for 3 to 6-year-old children Theory and research

Gender and ethnic differences in cancer pain experience: A multiethnic survey in the United States

Background: Inconsistent findings on ethnic differences in cancer pain experience suggest the need for further studies on this topic for adequate cancer pain management. Objectives: To determine ethnic differences in cancer pain experience of four ethnic groups in the United States. Methods: A feminist perspective was used as the theoretical basis. This was a survey of a multiethnic sample of 480 cancer patients asking questions on sociodemographic characteristics and health or illness status, 3 unidimensional cancer pain scales, 2 multidimensional cancer pain scales, the Memorial Symptom Assessment Scale, and the Functional Assessment of Cancer Therapy Scale. The data were analyzed using descriptive and inferential statistics including ANOVA and hierarchical multiple regression analyses. Results: The results indicated certain ethnic differences in types of pain and symptoms that patients experienced. Also, the results demonstrated significant ethnic differences in cancer pain and functional status. Discussion: The findings suggest further in-depth qualitative exploration on cultural values and beliefs related to cancer pain in each ethnic group and national studies with a larger number of ethnic minorities on this topic.

Situation-specific theories: philosophical roots, properties, and approach.

It is imperative to further develop theoretical bases in nursing, which incorporate diversities and complexities in nursing phenomena, and which consider sociopolitical, cultural, and historic contexts of nursing encounters. Situation-specific theories are proposed in this work as a future direction of such theoretical bases in nursing. Philosophical roots and properties of situation-specific theories are discussed, and an integrative approach to developing this type of theories is suggested. Situation-specific theories could be based on the assumptions of post-empiricism, critical social theory and feminism, and or hermeneutics. Six properties of situation-specific theories are presented: (1) low level of abstraction, (2) reflection of specific nursing phenomena, (3) context, (4) connection to research and/or practice, (5) incorporation of diversities, and (6) limits in generalization. The proposed integrative approach to developing situation-specific theories includes (1) a nursing perspective, (2) a linkage among theory, research, and practice, and (3) a conceptual scheme based on internal and external dialogues.

DEFINING AND REDEFINING WORK Implications for Women's Health

In this article the authors examine the ways in which the definition of work as paid employment has affected womens health research, the knowledge and understanding of the relationships between womens work and health, and health and social policies. The authors argue for research and public policy based on an expanded definition of womens work, a redefinition that goes beyond employment to reflect the multiple contexts and dimensions of womens work as well as the diversity and differences among women.

Recruitment of research participants through the Internet.

Despite an increasing amount of Internet research, issues in recruitment for studies in this environment rarely have been discussed. The purpose of this article is to provide some future directions for participant recruitment via the Internet, based on the experiences of recruiting participants for three Internet survey studies. The issues in the recruitment process include those related to low response rates, selected groups of participants, the importance of timing, and potential ethical issues. Based on the discussion of the issues, the following suggestions are proposed for future recruitment through the Internet: use of creative motivation strategies; sensitivity to the gender, ethnicity, and socioeconomic status of potential participants; consideration of the timing of data collection; and sensitivity to potential ethical issues.

Korean Women’s Breast Cancer Experience

The purpose of this study was to explore cultural meanings of breast cancer among Korean women in South Korea. A descriptive longitudinal study using methodological triangulation was conducted, and only qualitative findings are presented in this article. Ten Korean women who were newly diagnosed with a plan of surgery and subsequent chemotherapy, who did have severe fatigue at the time of recruitment, were recruited through Seoul National University Hospital. Data were collected using in-depth, 2-hour interviews and analyzed using thematic analysis. The themes emerged through the analysis process included: (a) “I did wrong,” (b) “I cannot ask male physicians,” (c) “I don’t want to show the operation site to my husband,” and (d) “I do household tasks by myself.” The overriding theme was marginalization of the women within the context of their patriarchal culture. The findings suggest that culture is an important context circumscribing women’s health/illness experience.

Meanings of Menopause to Korean Immigrant Women

The meanings of menopause among a vulnerable group of women—low-income Korean immigrant women—were explored using a cross-sectional descriptive research design focusing on how these meanings were constructed with their daily life experiences. Twenty-one peri- or post-menopausal women were recruited using convenience sampling methods; 2-hour in-depth interviews were conducted with audiotaping and field notes, and the data were analyzed using the-matic analysis, including line-by-line coding and categorization. Several themes related to the meanings of menopause emerged. The shock of menarche, various definitions of menopause, the negative view on middle age as falling down the hill, and other transitions the women were experiencing shaped the nature of their responses to menopause. The women were ambivalent about their menopausal transition, welcoming and fearing it. The authors propose that nurses initiate a dialogue about menopause with diverse populations to support the normalization of their menopausal transition and empower them to use culturally appropriate resources.

The Midlife Women's Symptom Index (MSI)

In this article, the Midlife Womens Symptom Index (MSI), a recently developed measurement scale for symptoms experienced during the menopausal transition, is presented with its psychometric properties. This was a cross-sectional study including (a) an expert review among 20 womens health experts and (b) a psychometric test among 77 middle-aged women. The instruments for the psychometric test were 19 questions on sociodemographic characteristics, the MSI, and the Menopausal Symptom Checklist (MSC). Data were analyzed using descriptive statistics, K-R 20, and item analysis. The reliability and validity of the MSI were supported among middle-aged women.

Menopausal symptoms among four major ethnic groups in the United States.

The purpose of the study was to explore ethnic differences in symptoms experienced during the menopausal transition among four major ethnic groups in the United States. This study was done via a cross-sectional Internet survey among 512 midlife women recruited using a convenience sampling. The instruments included questions on background characteristics, ethnicity-related factors, health, and menopausal status and the Midlife Women’s Symptom Index. The data were analyzed using descriptive and inferential statistics. Significant ethnic differences were found in the total number and severity of the symptoms. The most frequently reported symptoms and predictors of the total number and severity of the symptoms differed by ethnic identity. More in-depth cultural studies are needed to understand the reasons for the ethnic differences in menopausal symptom experience.