RESUMEN
This analysis triangulates qualitative and quantitative data from interviews, Geriatric Depression Scale scores, and patient records to evaluate poststroke depression. Participants were veterans who were discharged home following a new stroke. Findings indicated underrecognition and treatment of depression. Narrative data uncovered a rich description of respondents' perceptions and emotional experiences during stroke recovery.
Asunto(s)
Depresión/epidemiología , Autoimagen , Accidente Cerebrovascular/psicología , Veteranos/psicología , Adulto , Negro o Afroamericano , Anciano , Anciano de 80 o más Años , Sesgo , Comparación Transcultural , Depresión/etnología , Depresión/etiología , Emociones , Hispánicos o Latinos , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Escalas de Valoración Psiquiátrica , Accidente Cerebrovascular/complicaciones , Encuestas y Cuestionarios , Estados Unidos/epidemiología , Población BlancaRESUMEN
In this article, the authors explore the narrative production of stroke from the perspectives of survivors, that is, the stroke itself, not its implications for the individual poststroke. In the vast amount of literature on both sudden onset and chronic illness, the narrative construction of the onset of the illness, for the most part, has been ignored by social scientists, most notably in qualitative research. This is certainly true of stroke. Drawing on existing literature in both chronic illness and the body, the authors extend this to explore the phenomenological construction of stroke onset. Using data gathered from in-depth interviews with 111 stroke survivors postdischarge, they suggest three narrative mechanisms are used in the construct of the sudden-onset event itself: the use of typifications to construct the body during stroke, stroke as an internal communicative act, and stroke as a physical sensation and the mechanisms used to minimize bodily concerns.
Asunto(s)
Narración , Accidente Cerebrovascular/psicología , Sobrevivientes/psicología , Enfermedad Aguda , Anciano , Imagen Corporal , Enfermedad Crónica , Humanos , Masculino , Persona de Mediana EdadRESUMEN
This paper reports findings related to the transition from hospital to home during the first month after discharge following acute stroke. Qualitative data were obtained from in-depth, semistructured interviews with 51 male stroke survivors and their caregivers. Data were analyzed with the N6 software application, designed to assist with qualitative data analysis. Stroke survivors described experiences related to changes in the temporal order of life, disruptions in sense of self, and strategies used to manage time. Findings indicate that changes in the temporal order of life are related to functional impairments and disruption in the taken-for-granted body. At 1 month post-discharge, survivors are struggling with establishing routines in their day and coping with an increased amount of idle time. In conclusion, strategies for managing increased idle time are "passing time," "waiting on time," and "killing time."
Asunto(s)
Adaptación Psicológica , Accidente Cerebrovascular/psicología , Administración del Tiempo , Anciano , Anciano de 80 o más Años , Actividades Humanas , Humanos , Estilo de Vida , Masculino , Persona de Mediana Edad , Alta del Paciente , Autoimagen , Ajuste SocialRESUMEN
The conceptual framework of biographical disruption has dominated studies into the everyday experience of chronic illness. Biographical disruption assumes that the illness presents the person with an intense crisis, regardless of other mitigating factors. However, our data suggests that the lives of people who have a particular illness that is notably marked by sudden onset are not inevitably disrupted. Extensive qualitative interviews were conducted with a sample of veteran non-Hispanic white, African-American, and Puerto Rican Hispanic stroke survivors, at one month, six months and twelve months after being discharged home from hospital. Narrative excerpts are presented to describe specific discursive resources these people use that offset the disrupting connotations of stroke. Our findings suggest a biographical flow more than a biographical disruption to specific chronic illnesses once certain social indicators such as age, other health concerns and previous knowledge of the illness experience, are taken into account. This difference in biographical construction of the lived self has been largely ignored in the literature. Treating all survivor experiences as universal glosses over some important aspects of the survival experience, resulting in poorly designed interventions, and in turn, low outcomes for particular people.
Asunto(s)
Acontecimientos que Cambian la Vida , Narración , Calidad de Vida/psicología , Rehabilitación de Accidente Cerebrovascular , Accidente Cerebrovascular/psicología , Sobrevivientes/psicología , Negro o Afroamericano/psicología , Anciano , Anciano de 80 o más Años , Biografías como Asunto , Femenino , Florida , Estudios de Seguimiento , Hispánicos o Latinos/psicología , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Puerto Rico/etnología , Accidente Cerebrovascular/etnología , Veteranos/psicología , Población Blanca/psicologíaRESUMEN
This article examines the work narratives of midwives practicing in the United States, specifically in the State of Florida. We focus analytic attention on how the discourse of medicine is used as a resource in constructing a sense of legitimation for midwifery. Data are drawn from in-depth interviews with 26 direct-entry, licensed midwives and certified nurse-midwives. Historically, social scientific literature on midwifery has placed a midwifery, or a holistic, model of childbirth in polar opposition to a technocratic or medical model. In practical work, however, midwives demonstrate knowledge of, and make use of, a discourse of medicine to serve their purpose-at-hand. In these 'narratives of legitimation', the medical model does not emerge as an entity definable as separate and necessarily at odds with the midwifery model. Rather, the medical model is a resource through which midwives work narratively to construct the validity of their profession. The midwives interviewed use the discourse of medicine in three specific ways. First, they draw upon it as a contrast device, setting themselves and their work apart from the medical establishment. Second, midwives use the medical model to communicate necessary daily aspects of their work. Finally, they construct a story of medical collaboration to equate their work with that of physicians.