Valerie Swigart

The contextual nature of decision making near the end of life: hospice patients' perspectives.

Mr. C. was diagnosed with lung cancer seven months ago. The cancer then spread to his brain. He was fully aware that the physicians were treating his symptoms, not the disease; however, discussions regarding the goals of treatment did not occur. He continued the treatment regimen of chemotherapy and radiation therapy. While at home one evening, he fell and fractured his femur. His mobility and independence were at once greatly compromised. While recovering in the hospital, he made the decision to opt out of curative treatment. He stated, “I want to go home, play with my cat, smoke cigarettes, and be with my friends when they can visit.” What are the processes by which adults with life-threatening conditions make decisions about their care? What is the context of these decisions? The purpose of this study was to describe the process of decision making for adults with a terminal illness.

Think globally, act locally: understanding sexual harassment from a cross‐cultural perspective

Medical Education 2011: 45: 603–612

An Ethnographic–Feminist Study of Jordanian Women's Experiences of Domestic Violence and Process of Resolution

We interviewed 12 Jordanian women who had experienced domestic violence (DV) and were receiving assistance at the Jordanian Womens Union (JWU). Our aim was to explore the history and factors supporting attainment of freedom from DV. Narratives revealed themes of DV toward girls; forced marriage; physical, psychological, or sexual abuse before and during marriage; and escalation and enduring DV. Escaping from DV required family and JWU support. In the context of a strongly patriarchal, religious society, we observed a process of resolution by shifting cultural values and themes of empowerment, with an undercurrent of suffering blamed on inequalities in the legal process.

The association between bathing and weaning trial duration

OBJECTIVE To describe patterns of bath care for patients who are weaning from prolonged mechanical ventilation (PMV) and to explore the association between bathing and weaning trial duration. METHODS Descriptive correlational study. Clinical records from 439 weaning trial days for 30 patients who required PMV were abstracted for bathing occurrences during weaning trials, within 1 hour before a trial, and nocturnally. RESULTS Most baths occurred during weaning trials (30.8%) or at night (35.3%), and less frequently (16%) within 1 hour before a trial. No significant effects were found on trial duration for nocturnal bathing or bathing within 1 hour before a trial. By using random coefficient modeling, weaning duration was shown to be longer when bathing occurred during a weaning trial (P < .05), even when controlling for age, severity of illness, and days on bedrest. CONCLUSION Bathing occurred during approximately one third of PMV weaning trials. Baths during PMV weaning trials were associated with longer weaning trial duration.