Helene Berman

Intrusion: The Central Problem for Family Health Promotion among Children and Single Mothers after Leaving an Abusive Partner

Like other single-parent families, those consisting of mothers and their children who leave abusive partners/fathers are broadly viewed as deficient, high-risk structures in which children are susceptible to multiple problems. The mechanisms of strength and vulnerability in these families are poorly understood, and, consequently, their health promotion processes remain virtually unexplored. In a feminist grounded theory study of health promotion processes of single-parent families after leaving abusive partners/fathers, the authors discovered intrusion to be the basic social problem as families strive to promote health in the aftermath of abuse. The authors discuss the complex nature of intrusion, demonstrating how health is socially determined, and the challenges of health promotion in terms of the issues and dilemmas faced by study families and consider implications for health promotion knowledge and practice.

Stories and numbers: coexistence without compromise.

Research methods are not paradigm specific but should be selected on the basis of whether they fit with the purposes of an investigation. In the postpositivist, interpretive, and critical paradigms, both qualitative and quantitative data or a combination of these may be used without violating paradigm assumptions. Attention to the four basic issues of quality of the data, investigator bias, quality of the research process, and usefulness of the finding is necessary to produce valid research. Although researchers in each paradigm deal with these differently, combining strategies across paradigms may enhance the scientific value of a study and result in new methodologies to address the health needs of all people.

Sexuality and the adolescent with a physical disability: understandings and misunderstandings.

The purpose of this descriptive study was to examine the areas of sexual knowledge, sexual behavior, and beliefs about sexuality among adolescents with congenital physical disabilities. The sample consisted of 15 males and 14 females, ranging in age from 12 to 22 years. The Sexual Knowledge Interview Schedule (SKIS) was administered to all participants during face-to-face interviews. In addition, the participants were asked questions regarding their ability to engage in intimate relationships and their future childbearing potential. Overall, the findings suggested that these adolescents are uninformed or misinformed about general sexual knowledge, have many misconceptions about sexuality and their disability, and depend on health care professionals and parents for sex education. Implications of this research are discussed.

ILLUMINATING SOCIAL DETERMINANTS OF WOMEN'S HEALTH USING GROUNDED THEORY

Emphasis in health policy has shifted from curative intervention to prevention and health promotion through personal responsibility for lifestyle choices and, most recently, to the social determination of health. These shifts draw attention to and legitimize womens health research that moves beyond biomedical, epidemiological, and subjective knowledge to question previously unquestioned societal norms and structures that influence womens health. The challenge is to avoid relying solely on population-based studies that support relationships between social determinants and indicators of womens health and to find ways to illuminate the processes by which social determinants interact with the health of specific groups of women. Without such research, our knowledge of how social factors that underpin womens health interact will be faceless and will not address the interplay of health and social policy within womens lives. One research method that may be useful for exploring the interplay between such policies and womens health is grounded theory. Grounded theory is a widely used approach in womens health research. The goal of grounded theory is the discovery of dominant social and structural processes that account for most of the variation in behavior in a particular situation. Despite the usefulness of this method for capturing the interaction between social conditions and womens health experiences, many grounded theory researchers restrict themselves to womens subjective experiences as a source of data for theory development. Consequently, the resultant theorys capacity to illuminate the effects of the social determinants of health is limited. The purpose of this article is to discuss how the grounded theory method can be used in a participatory way to theoretically sample structural conditions at many levels. Using examples from completed and ongoing womens health research where data have and have not been collected primarily from women themselves, we outline the benefits and process for using grounded theory to influence health and public policy in womens health.

Dating violence and the health of young women: a feminist narrative study.

Dating violence is a significant public health problem in the lives of young women. Their age, in conjunction with perceived pressures to engage in intimate relationships, makes these women particularly vulnerable to dating violence. The pressures to be in relationships can be intense and therefore may add to young womens willingness to overlook, forgive, or excuse the violence that is occurring. The authors’ purposes in this feminist study were to examine the experience of dating violence from young womens perspectives; investigate how contextual factors shape their experiences; examine how health is shaped by these experiences; and explore ways that dating violence is perpetuated and normalized in young womens lives. Findings revealed that family environment and gender are critical in shaping young womens experiences. The participants described a range of physical and emotional health problems and perceived few sources of support. Their efforts to obtain support were often met with skeptical and dismissive attitudes on the part of health care providers and other trusted adults. Recommendations for health care practice, education, and research are presented.

Combining Stories and Numbers: A Methodologic Approach for a Critical Nursing Science

The critical paradigm is increasingly being recognized as an appropriate perspective for the development of nursing knowledge. While different research approaches including feminist, neo-Marxist, and participatory research have been described, all share the goals of empowerment, emancipation, and change. As a relatively new world-view for nursing, the concept of a critical nursing science faces much the same resistance as the interpretive paradigm did a decade ago. This article reviews the aims and assumptions of the critical paradigm; discusses the merits of combining stories and numbers for the agenda of change; and, using examples from our research, describes three strategies for combining stories and numbers in the critical paradigm.

Homelessness and Health in Adolescents

Despite an abundance of resources, many of the worlds wealthiest nations have a large homeless population. People at all stages of development are affected by this problem, but adolescents who are homeless face a unique set of challenges. In this critical narrative study the authors examined the experiences of homeless adolescents with particular attention to the role of gender and public policy, health experiences and perceptions, and barriers to health care services. Six girls and 7 boys participated in semistructured dialogic interviews. Their stories revealed that living without a home had a substantial impact on their health and wellness. The findings from this study support the need for health care professionals to work in collaboration with homeless youth so that more effective care that is sensitive to their unique health needs can be provided.

Getting Critical With Children Empowering Approaches With a Disempowered Group

The study of children and childhood has historically been accorded a marginal place in the health, human, and social sciences. In part, this is due to prevailing Western ideology that constructs children as passive, presocial, innocent, and vulnerable. The dominant discourse is further characterized by the treatment of children as a homogeneous group, devoid of race, class, or gender. While many investigators have described strategies for the conduct of research that is situated in the interpretive paradigm, there has been no comparable articulation of ideas regarding the conduct of critically grounded research when our participants are children. The purpose of this article is to put forth a historical and contextual analysis of childhood, including a discussion of evolving perspectives about childhood. The manner by which changing social, political, and environmental landscapes have contributed to the marginalization and disenfranchisement of children is examined. Finally, strategies for conducting nursing research that is grounded in the critical paradigmatic perspective, with the simultaneous aims of action, change, and empowerment, are proposed.

“Violence Is an International Language”: Tamil Women's Perceptions of Intimate Partner Violence

Research on intimate partner violence (IPV) across populations is challenging because of the multiplicity of definitions and lack of clarity about the behaviors that constitute IPV. The purpose of this study was to examine the ways in which Sri Lankan Tamil women in Toronto understand, define, and experience IPV. Focus group interviews were conducted with women representing different ages and stages of life. Findings suggest that definitions of IPV were not culturally specific. Rather, the Tamil women defined IPV broadly and recognized different forms of coercive control. However, psychologically abusive behaviors were identified that held particular meanings for this community.

Perceptions of Factors Contributing to Intimate Partner Violence Among Sri Lankan Tamil Immigrant Women in Canada

In this article we explore Sri Lankan Tamil immigrant womens views on factors contributing to intimate partner violence (IPV). We conducted eight focus groups with young, midlife, and senior women and women who experienced IPV. Three main themes emerged: postmigration sources of stress and conflict, patriarchal social norms that dictated gendered behavior, and individual male attributes and behaviors. Study participants recognized gender inequality and financial dependence as contributing factors and the role of women in promoting marital harmony. Findings suggest that pre- and postmigration factors need to be considered in the prevention of IPV in newcomer communities.