Gestational diabetes (i.e. diabetes diagnosed during pregnancy) has important implications for maternal and foetal well-being. This paper presents an ethnographic study of gestational diabetes, an unexpected, potentially life-threatening illness diagnosed during the second half of pregnancy. While previous research has conceptualised gestational diabetes as producing few consequences since it commonly disappears after delivery, this study explores the meaning women attach to the disorder. It found that gestational diabetes had a profound effect on the respondents, resulting in fear, depression and anxiety. The respondents' imagery of diabetes as a debilitating disease concomitant with blindness, amputations, and prematxire death generated increased anxiety throughout pregnancy and six-weeks postpartimi. The personal disruption in complying with the diabetic regimen as well as health care provider transactions exaggerated the unique stress of a 'normal' pregnancy. We suggest that a strictly medical view of gestational diabetes minimises its broader psychosocial significance and recommend efTective provider-patient interactions with 'high-risk' pregnant women.
Hurricane Katrina has drawn increased interest in coping strategies, spirituality, and mental health among low-income Blacks. Given the paucity of information available regarding the role of spirituality in surviving Hurricane Katrina, this qualitative study explores active coping strategies of older Blacks. Older respondents who were evacuated to a Texas retirement apartment complex participated in a series of three in-depth interviews (starting approximately three weeks after their arrival in the host state and continuing weekly). Without exception, the findings indicate that this population coped with Katrina and its aftermath through reliance on a Higher Power. The relationship to a Higher Power did not necessarily translate into church membership. The conclusions of the respondents' spiritual coping mechanisms revealed the following themes: 1) regular communication with a supernatural power; 2) miracles of faith through this source of guidance and protection; 3) daily reading of the Bible and various spiritual and devotional materials; and 4) helping others as a consequence of faith and devotion to a supreme being. This study indicates that spirituality promotes emotional resilience in the aftermath of traumatic events such as Hurricane Katrina. These findings also point to the need for researchers to reconsider expressions of spirituality based solely on church membership/attendance and prayer, and to consider redefining spiritual coping as a form of cultural capital.
The oncology nurse's role in breast cancer management is enhanced by knowledge of the patient's perceptions of risks. This case study elucidates the process by which perceived risks of breast cancer are embedded in sequences of biographic experiences including childhood sexual abuse, childhood injuries, and an abusive marriage. The case study shows that risk perceptions and subsequent delayed breast cancer detection is related to (a) a belief that breast cancer results from "bad luck, or fate"; (b) lack of cancer-related symptoms; (c) belief that a higher power determines ill health; (d) reluctance to turn to others for help while in an abusive marriage; (e) family history of cancer invulnerability since generations of family members died of diabetes, heart disease, and pregnancy-related illnesses; and (f) fear of gynecologic exams resulting from childhood sexual abuse. Furthermore, nonapplicability of traditional breast cancer risk factors such as heredity, age older than 30 years at first full-term pregnancy, early menarche, and late menopause prohibit an accurate assessment of self-risk. This case study suggests that breast cancer risk perception often differs from that of biomedical factors, and that an understanding of risk judgments is essential for appropriate therapeutic responses.
Test-retest reliability and internal consistency of the Terry, a cartoon-based child mental health screener developed for African-American children, were measured in 36 boys (age 5 1/2 to 13) in a test-retest design. Reliability of the diagnosis (0.70 < or = k < or = 0.75) was good for ADHD, ODD, CD, and OAD, and excellent for MDD and SAD. Because of low base-rate, no kappa value was calculated for SPh. Both test-retest agreement, and reliability of the symptom scale (0.75 < or = ICC < or = 0.80) were very good for all 7 diagnoses. Internal consistency according to symptom scale (0.78 < or = Cronbach alpha < or = 0.90), was moderate for OAD, good for SPh, MDD, SAD, CD, and ODD, and excellent for ADHD. The Terry is a culturally-sensitive questionnaire with good reliability.
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