Sandra P. Thomas

A Phenomenologic Study of Chronic Pain

Researchers have seldom invited patients with chronic pain to describe their lived experiences. This phenomenologic study involved in-depth interviews with nine women and four men with nonmalignant chronic pain. The essence of participants’ experiences was unremitting torment by a force or monster that cannot be tamed. The body was altered and recalcitrant, the life world was shrunken, and the pain set up a barrier that separated them from other people. Time seemed to stop; the future was unfathomable. Findings of this study contribute to the phenomenological literature that explores the human body and its symbolic meanings and call into question the idealized positive depiction of chronic illness that is prominent in contemporary literature.

Life Trajectories of Female Child Abuse Survivors Thriving in Adulthood

A narrative study of thriving adult female survivors of childhood maltreatment was undertaken to discover how they had achieved success. Life trajectory patterns, turning points, and setbacks were identified. Data consisted of 81 interview transcripts derived from a series of three interviews, spaced over 6 to 12 months, with 27 survivors. The childhood abuse was intrafamilial, beginning as early as infancy and continuing, in most cases, until participants left home. The onset and pace of the healing trajectory were quite variable, including a roller-coaster pattern as well as patterns of slow, steady progress and continued struggle. Four types of redemption narratives were delineated. Survivors had not been spared depression but had made achievements in work and education and displayed remarkable generativity, parenting their own children well, and mentoring other young girls, especially victims of abuse.

Problematic interviewee behaviors in qualitative research.

The interview is a staple of many qualitative approaches. Although textbooks offer extensive guidance to researchers about conducting interviews, less guidance is available about problematic interviewee behaviors, such as flattery or statements indicative of social desirability response bias. In this study, a secondary analysis of 22 phenomenological interview transcripts, we sought to examine problematic interviewee behaviors. More than 300 pages of typed text were subjected to line-by-line scrutiny, yielding only six potential instances of the phenomenon. Each could be interpreted several ways. What appeared to be flattery could also be perceived as simple gratitude or appreciation. We concluded that problematic behavior was rare in this data set.

Women's Anger, Aggression, and Violence

Themes of powerlessness, power, and paradox predominate in this reflection on more than 15 years of research on womens anger. Studies conducted in the United States, France, and Turkey are highlighted. These studies have negated several myths while illuminating the general rationality of womens anger: It is squarely grounded in interpersonal interactions in which people deny women power or resources, treat them unjustly, or behave irresponsibly toward them. The offenders are not strangers; rather they are their closest intimates. But few women learned healthy anger expression while growing up. Anger is a confusing and distressing emotion for women, intermingled with hurt and pain. Its complexity requires greater attention by researchers, with regard to health-promoting interventions and to cultural differences, because anger in non-Western cultures has seldom been explored.

Perceived stress, trait anger, modes of anger expression, and health status of college men and women.

Relationships among perceived stress, trait anger (general propensity to become angry), modes of anger expression, and health status were examined in a sample of 720 college students. Although stress was significantly correlated with trait anger and all four modes of anger expression, most correlations were of low magnitude. College men and women did not differ in trait anger, anger-in, or anger-out. Significant gender differences were found in only two modes of anger expression—discussing anger and expressing it somatically (women scoring higher on both). The contribution of anger variables to the variance in health status was negligible.

Distressing Aspects of Women's Roles, Vicarious Stress, and Health Consequences

Individuals internalize the roles they play and the statuses they occupy in their social networks. It logically follows that the benefits and costs of womens role commitments may be critically important to their physical and mental health. This literature review focuses on distressing or negative aspects of enacting the specific primary roles of worker, wife, and mother. Vicarious stress and inadequate social support for women in these roles may contribute to immunosuppression and disease vulnerability. Some women may choose the sick role as a means of escape from taxing role responsibilities. Future directions for womens health research are suggested, along with adoption of an empowerment model of health.

Trait anger, anger expression, stress, and health status of American and Turkish midlife women

In a cross-cultural study, we investigated the relationships of trait anger, anger expression modes, and stress to physical and mental health in Turkish and American midlife women. Zero-order correlations and multiple regression analyses indicated that regardless of cultural origin, stress was a strong predictor of health status. Stress was negatively related to physical health and positively related to depression. Trait anger, the angry temperament dimension of trait anger, and anger-out were positively related to depression in both American and Turkish women. The negative relationship between somatic mode of anger expression and health was also consistent for both groups. However, anger-in was positively correlated with depression only in American women; suppression of anger was unrelated to health status in Turkish women. Cross-cultural comparisons indicated that Turkish midlife women were higher in trait anger, somatic anger symptoms, perceived stress, and depression than American women. American women, on the other hand, had higher scores on physical health status. These findings are discussed with regard to theory, previous research, and sociocultural context.

Women's anger: Relationship of suppression to blood pressure

The relationship of anger suppression to blood pressure was examined in a university sample of 210 female staff, faculty, and students 18 to 71 years of age. Most were White and in good or excellent health. The study replicated that of Goldstein et al. (1988) using their method of assessing anger frequency, intensity, and expression at work (or school) and home. With age, body mass index, family history of hypertension, and exercise controlled, higher systolic blood pressure and diastolic blood pressure were evident when women suppressed anger at home. Women who had grown up in families that readily showed anger were more likely to do so as adults.

I felt violated: Women's experience of childbirth-associated anger

Purpose To investigate the lived experience of childbirth-associated anger. Design Descriptive phenomenology. Methods Open-ended interviews were conducted with 10 women who had experienced the phenomenon of interest and volunteered to participate. All of the women had experienced vaginal delivery of term or near-term infants without anomalies or birth sequelae of note. Interviews were recorded on audio tape, transcribed verbatim, and analyzed for themes by an interdisciplinary group of researchers. Results Women’s narratives described violation of the implicit relational contract with their healthcare providers. Themes focused on the anger experienced when their expectations about trust, power, control, and being kept informed were not met. Clinical Implications Nursing implications include the need to educate women prenatally about the process of labor and delivery, establish relationships that convey care and concern, keep women informed about events and progress, and treat women as full participants in the decision-making process.

Anger and cancer: an analysis of the linkages.

The purposes of this article are to review literature on anger’s link to cancer, to analyze the state of the science in this area, and to propose some directions for future research. Extremely low anger scores have been noted in numerous studies of patients with cancer. Such low scores suggest suppression, repression, or restraint of anger. There is evidence to show that suppressed anger can be a precursor to the development of cancer, and also a factor in its progression after diagnosis. Some studies indicate that it may be beneficial for patients to mobilize anger to battle their cancer. However, there is a paucity of research on the outcomes of various anger interventions. Longitudinal studies that repeatedly measure anger and other moods over the disease trajectory are needed.