Young women with congenital heart disease (CHD) now survive to confront issues of sexuality, contraception, and pregnancy. Researchers have examined reproductive abilities and infant outcomes in these women, but have not addressed quality-of-life issues. Grounded-theory techniques were used to interview 13 women about the experience of growing up with CHD. The core variable identified was "growing up heartsick." This variable included manifestations of growing up with heart disease, such as feeling different from others, parental overprotectiveness, and fears of death. Two other related variables were also found: "growing up female" and "living against the body." "Growing up female" was characterized by concerns about fertility, contraception, and pregnancy in relation to CHD. Many of the participants were uninformed about their heart disease and reproductive matters. "Living against the body" was expressed in the women's feelings about their body size and their surgical scars. There were overlapping aspects of the categories; for example, manifestations of "growing up heartsick" appeared in each of the other categories.
The purpose of this article is to describe how our college of nursing began to integrate patient safety instruction into simulation experiences for undergraduate nursing students. A system for evaluating and grading students was developed. Data on student safety behaviors were collected before and after implementation of instruction designed to improve adherence to hand washing and patient identification procedures. In the first semester in which data were collected, students did not demonstrate satisfactory performance of either hand hygiene or patient identification 61% of the time. After instruction, students still did not perform these procedures consistently 38% of the time. Lessons learned and future plans for addressing these problems with basic patient safety behaviors are discussed.
In this study, I used a qualitative descriptive methodology to examine the effect of chronic illness on the mother-daughter relationship. Many studies have examined the effects of the child's illness on the mother-child relationship when the child is very young, but few have looked at the ongoing problems that chronic illness may cause. Eleven mothers and 11 daughters were interviewed. Normalizing in the face of chronic illness was the overriding theme of the study. Two subthemes related to normalizing arose from the data. "It's no big deal" was found to best describe how most mothers and their daughters with heart disease viewed their lives and relationships. One other subtheme, "Sometimes it's a very big deal," was described by those mothers and daughters who could not, due to ongoing health problems, normalize their lives. Relationships with family as well as age, severity of illness, and developmental stage, were seen as mediators of normalizing in the lives of the participants.
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