Kaysi Eastlick Kushner

Interactive Use of Genograms and Ecomaps in Family Caregiving Research

This article argues for the concurrent and comparative use of genograms and ecomaps in family caregiving research. A genogram is a graphic portrayal of the composition and structure of ones family and an ecomap is a graphic portrayal of personal and family social relationships. Although development and utilization of genograms and ecomaps is rooted in clinical practice with families, as research tools they provide data that can enhance the researchers understanding of family member experiences. In qualitative research of the supportive and nonsupportive interactions experienced by male family caregivers, the interactive use of genograms and ecomaps (a) facilitated increased understanding of social networks as a context for caregiving, (b) promoted a relational process between researcher and participant, and (c) uncovered findings such as unrealized potential in the participants social network that may not be revealed with the use of the genogram or ecomap alone, or the noncomparative use of both.

Where There Is Smoke, There is Stress: Low-Income Women Identify Support Needs and Preferences for Smoking Reduction

Efforts to assist low-income women with tobacco reduction and cessation have typically not been informed by assessment of their needs and wishes. This multi-site qualitative study focused on assessing 64 low-income womens support needs and intervention preferences. These women were interested in smoking cessation, but identified many barriers and needed appropriate supports. However, available smoking cessation programs did not address underlying conditions, such as income instability and stress. The support recommended was psychosocial (e.g., buddy and group support), included self-care (e.g., nutrition, activity, and personal time), and reflected their social-economic circumstances (e.g., free cessation aids and child care).

Interpreter-facilitated cross-language interviews: a research note

This research note focuses on interpreter-facilitated cross-language qualitative interviews. Although researchers have written about strategies and procedures for working with interpreters, rarely have they offered adequate detail to determine the relative merits of various approaches, and little attention has been paid to the influence that interpreters have on the validity of qualitative data. We advance this body of literature by describing and critically examining the strategies and procedures we used to work with an interpreter to conduct qualitative interviews with Mandarin-speaking grandparents who participated in our study of intergenerational social support during the transition to parenthood. In addition, we examine the influence that our strategies and procedures had on the data generation process and on the validity of the data. Drawing on our experiences, we argue that with adequate preparation, validity checks, and the supplementary strategies that we describe in this article, an interpreter-facilitated interview approach to generating data in cross-language studies can be an effective alternative to more commonly used and more laborious and expensive translation practices.

Understanding the language, the culture, and the experience: Translation in cross-cultural research.

Achieving conceptual equivalence between two languages is a challenge in cross-cultural, cross-language research, as the research is conducted in a language that is not the researchers or research teams first language. Therefore, translation provides an additional challenge in cross-cultural research. The comprehension and interpretation of the meaning of data is central in cross-cultural qualitative analysis. The purpose of this article is to provide an overview of the translation process and explore some of the challenges, such as difficulties in finding a suitable translator, and the importance of communication between the researcher and the translator.

In-home nursing care for women with high-risk pregnancies: outcomes and cost ☆

Objective To evaluate a program that provides in-home care to women with pregnancies threatened by preterm delivery (including preterm labor, preterm premature rupture of membranes, and multiple gestation) and women with pregnancy-related hypertension. Methods Data from hospital discharge summaries were used to compare birth outcomes and cost of care for women in the in-home program and a cohort of women who received in-hospital antenatal care before the new program. Birth outcomes included data for mothers and infants. The sample included 437 women with threatened preterm delivery (n = 228 in-home, n = 209 in-hospital) and 308 with hypertension (n = 155 in-home, n = 153 in-hospital). The cost per woman included all costs of services for mothers and infants. Results Women at risk of preterm delivery who received in-home care were half as likely to have their infants in the neonatal intensive care unit more than 48 hours (odds ratio 0.53, 95% confidence interval 0.36, 0.78). On average, their infants weighed more (2732 ± 716 g versus 2330 ± 749 g, P < .001) and were 2 weeks older at birth (36.1 ± 3.1 weeks versus 34.0 ± 4.0 weeks, P < .001). There was a wide range in the total cost per woman and no significant difference between cohorts. For women with hypertension, there were no significant differences between in-home and in-hospital cohorts in birth outcomes or costs of care per woman. Conclusion The program with current admission criteria, staffing, and guidelines for antenatal hospital admission provides safe care to women at similar cost to that of hospitalization.

Impacts of a support intervention for low-income women who smoke

The objective of this pilot study was to implement and evaluate the impact of a support intervention tailored to the assessed support needs, resources and preferences of low-income women who smoke in three Canadian cities. The support intervention, informed by theoretical foundations, provided holistic one-to-one and group support over 14 weeks. The support intervention was facilitated by trained professional and peer facilitators. The impact was evaluated through analysis of qualitative and quantitative data collected at pre-, post-, and delayed post-test contacts. This analysis revealed that the intervention exerted positive impacts on smoking reduction/cessation, social networks, coping, and health behaviors. Participants reported satisfaction with the intervention.

Critical feminist narrative inquiry: advancing knowledge through double-hermeneutic narrative analysis.

Critical feminist narrative inquiry is informed by the theoretical triangulation of critical, feminist, and symbolic interactionist perspectives. We first locate this approach within narrative research and identify the epistemological underpinnings and assumptions supporting this innovative methodology. The analytic and interpretive objectives and processes involved to achieve a double-hermeneutic narrative analysis are detailed. We conclude by proposing that this novel approach is suitable to advance knowledge about the nature and context of individual experiences, to expose circumstances leading to social injustice and health inequities, and ultimately to contribute to improved health outcomes for traditionally silenced, marginalized, or vulnerable populations.

Social inclusion/exclusion as matters of social (in)justice: a call for nursing action

Social inclusion/exclusion involves just/unjust social relations and social structures enabling or constraining opportunities for participation and health. In this paper, social inclusion/exclusion is explored as a dialectic. Three discourses--discourses on recognition, capabilities, and equality and citizenship--are identified within Canadian literature. Each discourse highlights a different view of the injustices leading to social exclusion and the conditions supporting inclusion and social justice. An Integrated Framework for Social Justice that incorporates the three discourses is developed and used to critique the dominant focus on distributive justice within foundational Canadian nursing documents. We propose a broader conceptualization of social (in)justice that includes both relational and structural dimensions. Opportunities for multilevel interventions to promote social justice are identified. This framework is congruent with nursings moral imperative to promote health equity and with the multiple roles played by nurses to promote social justice in everyday practice.

Anticipating Parenthood: Women's and Men's Meanings, Expectations, and Idea(l)s in Canada

The study purpose was to explicate meanings, expectations, and contexts of parenting as women and men prepared to become parents for the first time. We used a prospective, qualitative study design informed by symbolic interactionist and critical feminist perspectives. In-depth interviews were conducted during pregnancy with 21 expectant mothers and 18 expectant fathers, including 18 couples reflecting socioeconomic and cultural diversity in a western Canadian city. We identified a main theme of life-altering and all-consuming responsibility that conveyed participants’ meanings of being a parent and included subthemes: shared or individual responsibility, status change, partial knowing, and reorienting. Participants initiated the reproduction of gendered sociocultural ideals of parenthood before the birth of their infant. Dominant social discourses and ideals shaped their meanings and expectations, ultimately constraining the alternatives they envisioned for themselves as they prepared to become parents.

The Experience of Korean Immigrant Women Adjusting to Canadian Society

The acculturation process is an important factor in the experience of all immigrants. Although previous studies have indicated the challenges faced by Korean immigrants, little attention has been paid to Korean women’s immigration experiences. A focused ethnography was used to examine midlife and older Korean immigrant women’s experiences following their immigration to Canada. Fifteen women were interviewed in a city in Western Canada. The findings showed that in coming to Canada, women focused on caring for their children and often sacrificed their personal dreams. They had to be employed to support their families, and received support from family and government. Women participated regularly in a Korean Church and drew on their Christian faith to ease their adjustment. They retained hopes for the future including good health and a better life for their children. Most women indicated that it was difficult to integrate into Canadian society but they never gave up on their adjustment to a new culture. In this manuscript, the adjustment experience of the immigrant women is discussed in the context of an acculturation framework. The findings will enhance health professionals’ awareness of adjustment patterns and associated challenges to Korean immigrant women’s quality of life.