Alcohol (ethanol) use is a global, health-related problem that spans a continuum ranging from low-risk, at-risk, and problem drinking to alcohol dependence and chronic abuse. Clinicians and researchers alike have the need to quantify drinking patterns to determine the risk for adverse, health-related events such as injury, liver damage, and cancer Biochemical measures of ethanol consumption are affected by temporal patterns of drinking as well as individual characteristics such as gender and age. The choice of a laboratory analysis to determine ethanol consumption is complex; no single laboratory test will predict drinking accurately across all drinking patterns, across the life span, and across gender. In conjunction with interviews and physical assessment, however, biochemical laboratory tests are sensitive tools used to measure both recent and long-term patterns of alcohol consumption.
Alcohol is a known teratogenic substance that operates under a dose-response mechanism. Before we conducted a larger study that examines the use of alcohol both before pregnancy and during pregnancy, it was important to pilot our method for measuring a pregnant mother's alcohol use that would allow us to capture the number of drinks consumed per day while addressing recall bias. The purpose of this study was 1) to pilot the Time Line Followback (TLFB) method developed by Sobell and Sobell (1992, Measuring Alcohol Use. Totowa, NJ: Humana Press) as a method for examining alcohol use during pregnancy and 2) to determine if the use of a study protocol that included biological markers of alcohol use would affect our ability to recruit subjects. Using a descriptive design, we tested our protocol for collecting alcohol use data with 10 mothers receiving prenatal care. We measured alcohol use using the TLFB method (Sobell and Sobell, 1992, Measuring Alcohol Use. Totowa, NJ: Humana Press, 1996). We also collected collected biological blood markers for heavy alcohol use. Of the 10 maternal subjects we recruited, 5 mothers (50%) reported alcohol use during pregnancy. We successfully recruited 10 out of 11 mothers approached and had a 100% retention rate for the second interview. The TLFB method is viable for measuring fetal alcohol exposure over the pregnancy, and the collection of blood samples did not impact our ability to recruit or retain mothers.
The phenomenological study described in this paper examines the lived experience of adult children of dysfunctional families. Self-identified adult children ( N = 10) participated in nonstructured, audiotaped interviews with the researcher. Subsequent transcripts were analyzed using Heideggerian hermeneutic phenomenology to identify common meanings and themes in the texts. The major findings of the study included three constitutive patterns of lived experience shared by adult children: "remembering breakdown," "comporting toward breakdown," and "living in thrownness." As a result of the emergence of these patterns, "adult rememberers of family breakdown" replaced "adult children of dysfunctional families" as the named used to identify these persons. Recommendations for nursing include a renewed awareness and valuation of remembering and the therapeutic use of storytelling in multiple practice settings.
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