Margaret M. Quinlan

Parkinson patients as partners in care

Increasing physical activity, as part of an active lifestyle, is an important health goal for individuals with Parkinsons disease (PD). Exercise can positively impact health related quality of life. Given this, how can we promote physically active lifestyles among PD patients (most of whom are sedentary)? Here we suggest that health care professionals could significantly expand their impact by collaborating with PD patients and their spouses (or caregivers) as partners-in-care. We outline reasons why partners-in-care approaches are important in PD, including the need to increase social capital, which deals with issues of trust and the value of social networks in linking members of a community. We then present results of a qualitative study involving partners-in-care exercise beliefs among 19 PD patients and spouses, and conclude with our perspective on future benefits of this approach.

“The Keepers of Stories”: Personal Growth and Wisdom Among Oncology Nurses

This study examined whether oncology nurses experience personal growth and wisdom as a result of caring for patients. Using a grounded theory approach, 30 nurses were interviewed regarding their experiences caring for cancer patients. Every nurse in this sample cited at least one example of growth and wisdom. Subthemes of personal growth were largely consistent with the documented domains of posttraumatic growth and included appreciation of life, new perspective on life, relating to others, spiritual/religious growth, and personal strength. Subthemes of wisdom were more varied, reflecting the diversity of this construct in the context of nursing. Benevolence arose as a unifying theme between personal growth and wisdom, with subthemes centering on altruistic attitudes and behavior toward patients and the greater community. Findings suggest that nurses develop personal growth, wisdom, and benevolence as a result of the emotional connections formed with patients and the subsequent struggle to cope with their loss. This process accords well with findings in other populations experiencing trauma and adversity directly.

Technical Versus Public Spheres: A Feminist Analysis of Women’s Rhetoric in the Twilight Sleep Debates of 1914–1916

Twilight Sleep (TS) describes the delivery, via an injection, of an amnestic drug cocktail to a parturient woman throughout labor. In order to understand the development of modern-day rhetoric surrounding childbirth methods and procedures, this article explores the debate over TS between the public and technical sphere in New York City between 1914 and 1916 and examines the ways in which this debate altered obstetric health care for middle- and upper-class White women. The public response to this campaign posed a direct challenge to male obstetricians in New York City, many of whom were ill-equipped, both literally and figuratively, to use this procedure. Using a feminist rhetorical criticism, we examined the pro-TS rhetoric of women writers in New York City, the methods they borrowed from the women’s movement, and the ensuing dialogue between the public and technical spheres. For this study, we analyzed journal and newspaper articles, a pamphlet, a collection of pro-TS organizational documents, letters to the editor, and books published about TS and the history of birth. Lastly, we analyzed theoretical notions of childbirth in women’s health and communication studies. After examining the TS debate, we found that birth practices for middle- and upper-class women in New York City shifted and the obstetric community gained ascendancy over female midwifery. We also found that in certain instances, the rhetoric of pro-TS activists was more technically accurate than the rhetoric of some physicians. Hence the TS debate emerged from an argument over the right to use technical language in the technical and/or the public sphere. Conclusions and implications offered by this historical, feminist analysis question our current understanding of women’s health and birthing practices, doctor–patient communication, and patient empowerment and access to technical knowledge.

A Transpersonal Approach to Care A Qualitative Study of Performers’ Experiences With DooR to DooR, a Hospital-Based Arts Program

The arts have a history of relaxing and calming patients in the hospital setting, yet research is limited on how arts may aid in the healing process. DooR to DooR was established to bring comfort, respite, and healing to hospitalized patients, family members, and health care staff. DooR to DooR is located in the University of North Carolina Hospitals at Chapel Hill, North Carolina; professional performing artists visit there, spending 5 to 10 minutes with each patient, family member, and health care staff. The purpose of this qualitative study is to understand performers’ experiences and of how arts-based programs can facilitate improved patient outcomes in the hospitalized setting to help nurses better use the arts in their care of patients and families. Three overarching themes were identified: (a) the arts are therapeutic for all involved, (b) the arts transforms the hospital environment, and (c) nurses and the other medical staff play an important role. The significance of this study for nursing practice is that the arts are a plausible intervention for the hospital because they may help improve patient outcomes by reducing pain and depression and by relieving stress among staff and family members. More research is needed to determine the level of arts-as-an-intervention knowledge among nurses.

Commerce, Industry, and Security: Biomedicalization Theory and the Use of Metaphor to Describe Practitioner–Patient Communication Within Fertility, Inc.

ABSTRACTAn infertility diagnosis is distressing. Supportive communication between practitioners and patients before, during, and after treatment is key to mitigating this distress. In the present study, interview questions prompted 22 cis-women who underwent fertility treatment(s) to reflect on practitioner–patient communication during treatment, and their metaphor use was analyzed in light of biomedicalization theory. Participants used metaphors to describe their health care experiences within the infertility-industrial complex known as Fertility, Inc. Findings suggest that metaphor use allowed patients both to participate in and to critique Fertility, Inc.—specifically, their individual communicative experiences with medical practitioners. Recommendations for communication between practitioners and patients and suggestions for future research are discussed.

Insiders and Outsiders and Insider(s) Again in the (In)fertility World

At 28, while studying the history of women’s health in graduate school, I attended a panel examining the relationship between feminism and reproductive technology. When a panelist said, “We’ve been able to change so much for women, but we still can’t control the age of our eggs,” the entire room drew a sharp breath. After turning 30, my husband and I started trying to conceive and after 4 months I visited a reproductive endocrinology and infertility (REI) practice for testing, given my “advancing maternal age.”My partner and I received the common yet maddening diagnosis “infertile, unexplained,” and over the course of 4 years, we pursued corrective surgeries, fertilitymedicines, intravenous (IV) antibiotic courses, two intrauterine inseminations (IUI), and three in vitro fertilizations (IVF). To our deep disappointment, nothing resulted in pregnancy. At 34, my experiences as an infertile woman and Maggie’s experiences as a potentially infertile woman and fertile ally became the focus of a qualitative study. I believed that interviewing individuals undergoing familiar infertility treatments provided a therapeutic outlet; shortly after my third failed IVF I started conducting them (Birch & Miller, 2000; Drury, Francis, & Chapman, 2007). After each interview, I felt exhausted but energized, grateful to be a principal investigator (PI) in a study giving voice to the struggles of infertile women like myself. However, my body remained “leaky”—my weight fluctuated and my energy did not return after the last IVF. I feared years of treatments caused new medical problems and anxiously sought medical advice. This led to the discovery that I was pregnant with a “miracle baby” in the midst of research on infertility.

Informing or Exploiting? Public Reponses to Giuliana Rancic’s Health Narrative

ABSTRACT Popular entertainment journalist Giuliana Rancic has shared her struggles with pregnancy loss, infertility, and breast cancer in an array of public forums. In this study, we analyzed online comments responding to public discourses surrounding Rancic’s revelations, including her miscarriage and fertility treatments, her breast cancer diagnosis, and her decision to undergo a double mastectomy. Our goal was to explore how the public framed Rancic’s health challenges. Using a narrative lens, we argue that online comments reveal the tensions that celebrities like Rancic must manage as they contend with public scrutiny of their stories. Online commenters in this study framed Rancic’s narrative as a privileged vantage point in which she exploited her health struggles for personal and financial gain. Our analysis of these comments also demonstrates how Rancic’s narrative exists in concert with other discourses that challenge and disrupt her own account of events. The examination of these mediated discourses has implications for understanding the role of celebrity experiences in personal and public conversations about health.

High-Society Framing: The Brooklyn Eagle and the Popularity of Twilight Sleep in Brooklyn

ABSTRACT Twilight Sleep (TS) is an obstetric intervention during which a laboring woman enters a semiconscious state via injection. TS received enthusiastic support in Brooklyn, NY, in The Brooklyn Eagle (TBE) newspaper between 1914 and 1918. The purpose of this article is to analyze the framing of TS in TBE as the most popular obstetric intervention among wealthy, White socialites in Brooklyn during the period. The coverage in TBE prompted a nearly universally positive perception of TS among the newspaper’s wider readership. After extensive historiographical research and rhetorical analysis of newspaper coverage of TS in TBE, we discovered a form of framing we call “high-society framing,” rooted in both wealth and notoriety. We discuss four possible effects of high-society framing: The first is the ability of high-society framing to attract or repel the public regarding a health care issue, and the second is the impact of high-society framing on public perception of medical interventions, procedures, or pharmaceuticals. A third possible effect of high-society framing is that it can alter notions of necessity, and a fourth is that high-society framing can elicit a tacit acceptance of medical interventions, procedures, and pharmaceuticals, thus obfuscating risk. Finally, we argue that high-society framing has implications for the discussion of health care in present-day mediated discourses.

Constructing the dead: Retrospective sensemaking in eulogies

ABSTRACT Eulogies serve a sensemaking function of identity construction—both for the deceased and for the survivors. This work examines the communicative construction of identity in eulogies and shows how eulogia discourse affirms and reconstructs our relational identity through communication. The article extends scholarship on eulogies by using relational communication theories to investigate how eulogic discourse functions as identity construction, considering eulogies of ordinary people, and exploring the gendered nature of eulogies. We discuss how eulogies are specific ritualized forms of communication in which the bereaved focus on self-identity as they articulate their experience of grief.

A View From the Top: Crafting the Male "Domdentity" in Domestic Discipline Relationships

Domestic discipline (DD) is a relationship approach that advocates wifely submission and male dominance through the use of disciplinary tactics such as spanking. Because DD is seen as a deviant behavioral approach to relationships, men often turn to blogs to chronicle their experiences with DD. These blogs provide insight regarding their identity as a Dominant (Dom), or what they refer to as their “Domdentity.” The purpose of our study is to investigate how Doms socially construct and perform their Domdentity. The Domdentity is constructed through a dialectic of discipline and love in the DD relationship, continuously working to maintain the DD relationship, and actively participating, and questioning their roles, in the DD relationship.