Yvonne M. Sterling

Characteristics of African American women caregivers of children with asthma.

Purpose To describe the attributes and characteristics of African American women who were the primary caregivers of children with asthma. Methods Descriptive qualitative ethnography. Data collection consisted of formal interviews, participant observation, and fieldnotes. Each study participant was formally and informally interviewed (audiotaped) during a 1-year period. The researchers also observed and participated in family activities in various naturalistic settings. Results Six themes emerged that depict the characteristics of these women: (1) Knowledge about the child’s asthma; (2) Gatekeepers to the child’s care; (3) Being religious; (4) Support; (5) Roles as teacher, counselor, and advisor to the child; and (6) Self-sufficiency and industriousness. Clinical Implications Nurses should use the information in this study to examine the ways in which they interact with caregivers of asthmatic children. The caregivers personal beliefs, need for information, and previous experiences with asthma and family illness should be assessed. These mothers and grandmothers should be respected as the gatekeeper to the family’s healthcare. Nurses should be nonjudgmental and supportive of caregivers when they express their religious beliefs and practices. Nurses who understand how mothers cope can reinforce these coping skills and provide better nursing care.

Explanatory models of asthma from African-American caregivers of children with asthma

Explanatory models (EMs) were collected from 20 African-American adult primary caregivers, in Seattle and New Orleans, who have children with asthma, to understand asthma from their perspective. Family EMs of asthma shed light on the meaning family members give to the illness, and how they make internally logical decisions related to their healthcare behavior. Study findings show that families have their own EMs of asthma. Families draw on their cultural context to understand asthma. They compare their lived experience with healthcare-provider explanations of asthma. Specifically, the African-American families in this study drew much of their information about asthma from other family members and from personal experience. Collecting EMs of asthma may help healthcare providers know the meaning of asthma as understood by specific families and may reduce unscheduled use of health services. Further research should include encounters which increase the healthcare providers context for understanding patient and family EMs.

Children's Perceptions of Asthma: African American Children Use Metaphors to Make Sense of Asthma

INTRODUCTION Childrens views of their illness often are absent in decisions that affect their lives. This research, which is a component of a larger study, reports how African American children described their asthma. METHOD The studys design was descriptive and longitudinal, using an ethnographic approach. A subsample of 10 children diagnosed with asthma who resided in one of two study sites spontaneously described their asthma. The study was conducted in various settings where the researchers observed/participated in selected activities. Participants were interviewed several times, and field notes were recorded. RESULTS The qualitative findings are from participant observation and interviews of 10 children ages 9 to 12 years. Four of the most developed metaphors are reported here. Out of their experiences, children created their own metaphors for asthma that are concrete, familiar, and multi-vocal, allowing for embellishment. DISCUSSION Not all children use metaphors to explain or describe their asthma. Children who explain asthma in their own terms will feel valued and invested in their own health care as they find that their voices make a difference in decisions about their care.

Access to Health Care: Perspectives of African American Families with Chronically III Children

&NA; This article describes a vulnerable group, African American families with children who have a chronic illness (asthma). Primary caretakers explain how they view asthma and the strategies they developed for caring for their child. The article focuses on ethnographic data from seven families and their experiences of access to health care. These experiences fall into four categories: getting health care that is wanted, getting health care that is unwanted, not getting health care that is wanted, and not getting health care that is unwanted. Each category represents different implications for advocating for health care for this vulnerable population.

Case management roles of clinicians: a research case study.

THE PURPOSE OF this research multiple case study was to determine case management roles as demonstrated by four clinicians employed at a university medical center. Multiple sources of evidence were used to collect data, including interviews, nonparticipant observations, and chart audits. Case management was defined by the clinicians as a process for delivery of health care at the institution studied. Despite a lack of a uniform framework for case management practice, the clinicians used similar case management components. Chart audits demonstrated deficits and inconsistency in documentation that were supported by interview and observations. It was recommended that exposure to formal case management models and theory could strengthen clinical practice in this area. Additionally, investigation of factors that facilitate and/or impede consistent documentation of interventions and patient outcomes, particularly by CNSs is recommended.