Joanne M. Hall

Rigor in feminist research.

Verifying the scientific adequacy of feminist studies is necessary to assure that research processes and outcomes are well grounded, cogent, justifiable, and relevant. The authors analyze what scientific adequacy means in feminist inquiry and propose standards of rigor by which nurse investigators can plan and evaluate their studies. In the process, conventional empiricist criteria of reliability and validity are critiqued, and more appropriate concepts representing dimensions of adequacy in feminist research are presented.

Marginalization: a guiding concept for valuing diversity in nursing knowledge development.

This article explicates marginalization as a guiding concept for the development of nursing knowledge that values diversity. The seven key properties of marginalization as it applies to the domain of nursing are (1) intermediacy, (2) differentiation, (3) power, (4) secrecy, (5) reflectiveness, (6) voice, and (7) liminality. Through examination of each of these properties, the relationship between marginalization and vulnerability is clarified, and by this means the relevance of marginalization for health is established. The implications for shaping future nursing research, theory, and practice related to the health of diverse populations are discussed.

Marginalization Revisited: Critical, Postmodern, and Liberation Perspectives

Marginalization was advocated by Hall, Stevens, and Meleis in 1994 as a guiding concept for valuing diversity in knowledge development. Properties, risks, and resilience associated with the concept were detailed. This conceptualization of marginalization is reexamined here for its sociopolitical usefulness to nursing, from (1) critical theory, (2) postmodern, and (3) liberation philosophy perspectives. Additional properties are proposed to update the original conceptualization. These include: exteriority, Eurocentrism, constraint, economics, seduction, testimony, and hope. Effects of Eurocentric capitalism on all marginalized people are explored. Nursing implications include the need for interdisciplinary dialogue about the ethics of promoting and exporting Eurocentrism in nursing education and practice, and the need for integrated economic analyses of all aspects of life and health.

A Critical Historical Analysis of the Medical Construction of Lesbianism

Lesbians are frequently treated with insensitivity, antagonism, and discrimination in health care encounters. The authors argue that contemporary health care experiences of lesbian clients cannot be understood apart from a critical examination of the historical construction of medical ideologies that pathologized lesbianism. An excavation of historical data about medical conceptualizations of lesbian women is undertaken to demonstrate how cultural and medical ideologies throughout the century have reinforced each other to shape lesbians health care experiences and influence public policies. By illuminating both the prejudicial content of medical theories as well as the emancipatory actions of lesbian and gay communities to change stigmatizing diagnostic and treatment situations, the authors attempt to demystify ideologies about lesbians that motivate clinicians, administrators, educators, researchers, and theorists in the delivery of health services.

Geography of Childhood Sexual Abuse: Women's Narratives of Their Childhood Environments

This article explores the geography of childhood sexual abuse by describing characteristics of the home, school, and community environments in which abused girls grew up. Results of this focused life story research involving 20 women survivors who narrated their childhood experiences suggest a topography of 20 distinct characteristics integral to the milieux of these abusive childhood homes. Dynamics of the home environment were reinforced in school and community environments. Implications for prevention and early, environmentally based interventions for girls at risk of abuse and retraumatization are discussed.

Pervasive Effects of Childhood Sexual Abuse in Lesbians' Recovery from Alcohol Problems

In narratives of 35 lesbians in alcohol recovery, 46% unexpectedly disclosed having survived childhood sexual abuse (CSA), linking it with addiction and recovery experiences. This subgroup described unbounded difficulties that pervaded their lives well into recovery. They reported multiple addictions, self-harm, isolation, sexual problems, depression, self-loathing, physical illness, and inability to work more often than did other participants. Those not reporting CSA were more socially and occupationally stable, self-satisfied, and physically well in recovery; their alcohol problems seemed circumscribed and responsive to conventional intervention. Conclusions indicate that CSA history may foster health risks that complicate alcohol recovery, necessitating more comprehensive clinical attention.

The Experiences of Lesbians in Alcoholics Anonymous

A feminist ethnographic study of lesbians experiences in recovery from alcohol problems was done to understand from their perspectives how they identified alcohol use as problematic, sought help, experienced health care interactions and participation in Alcoholics Anonymous (AA), and maintained recovery. Through community-based purposive sampling in San Francisco, 35 lesbians recoveringfrom alcoholproblems participated in semistructured ethnographic interviews of 2 hours duration, which were subsequently interpreted using ethnographic coding, narrative analysis, and matrix analysis. A majorfinding was thatparticipation in AA wasfraught with tension in three areas. Each tension was defined by two poles of experience that appear to be in conflict. They were assimilation versus differentiation, authority versus autonomy, and false consciousness versus politicization. These tensions are elaborated and supported by examplesfrom the women s interviews. Nursing implications regarding the role of AA in recovery for marginalized women are discussed.

Beyond "true" and "false" Memories: Remembering and Recovery in the Survival of Childhood Sexual Abuse

As survivors of childhood sexual abuse (CSA) struggle to grasp and reclaim their selves, their stories, and their futures from the grip of aftereffects of trauma, the processes of recovery and rehabilitation are interwoven with remembering. Questions about womens delayed memories of CSA have stirred a controversy that places clients credibility at stake. Nurses need to understand the historical and political roots of this controversy and to be familiar with the empirical knowledgebase that exists about traumatic memory. This article is a critical feminist analysis of the topic. Its purposes are to provide a historical context for the current debate about true and false CSA memories; to discuss selected literature about conventional understandings of memory and their relevance to this debate; to present an integrative, phenomenological approach to memory in the recovery and rehabilitation of women CSA survivors; and to use the insights gained to draw conclusions from a nursing perspective about the authenticity of delayed CSA memories. Phenomenological concepts of reminding, reminiscing, recognition, body memory, place memory, and commemoration are discussed as they illuminate the complexity of traumatic memories and the recovery and rehabilitation needs of survivors of childhood sexual abuse.

How lesbians recognize and respond to alcohol problems: a theoretical model of problematization.

To determine how one specific at-risk population problematizes alcohol use and responds to alcohol-related difficulties, findings from an ethnographic interview study of lesbians recovering from alcohol problems were used to develop a theoretical model of problematization. Problematization consists of two phases: recognition and response. Recognition involves problem indicators varying by type (cumulative vs immediate) and source (personal vs environmental). Movement from recognition to response is hindered by perceptual and enviromental constraints. Response consists of interrelated processes of construction, interaction, action, and validation. On the basis of validation, problems are reconstructed and new problems are recognized as the cycle continues.

Race and microaggression in nursing knowledge development.

Race is a social environmental element in many nursing knowledge contexts. We explore how race and racism have been conceptualized in nursing research and theory, situating these issues in the debate between Critical Race Theory and postracialism. Contemporarily, racism is more subtle than overt. Subtle racism takes the form of microaggressions in everyday discourse and practices by whites toward African Americans. This occurs with little to no awareness on the part of whites. Using this concept, practice and education are explored. We hold that microaggressions contribute to stress for the target person, which may partly account for racial health disparities.