Journal of Family Nursing

An individual autonomy framework, rather than a family framework, has prevailed in the national debate about physician-assisted suicide for the terminally ill. However, the separation of individual andfamily is artificial in the context of life-threatening illness. This article describesfamily issues when terminally ill patients consider physician-assisted suicide. Issues includefamily roles, motives, disagreements, and grief; the problems of misuse of a lethal prescriptive; and failed suicide attempts. For multiple reasons described, thefamilyperspectiveis needed in debates about physician-assisted suicide.

Perinatal death is a profound and common experience, and one that is often underestimated in terms of itsfrequency and its impact. As primary caregivers of parents suffering perinatal loss, nursing and medical staffhave tremendous power to shape parental experiences. In this qualitative, exploratory study, unstructured interviews were conducted with 26 individuals (21 women and 5 men) who had experienced perinatal loss. Subjects' experiences ranged from parents whose perinatal losses had occurred during the 1st trimester, to one man who had lost two children in late pregnancy and a third child to sudden infant death syndrome shortly after birth. Using grounded theoryfor the analysis, this study identifies a number of areas parents cited as problematic during interactions with medical and nursing personnel and also reports gestures and interventions that parentsfound extremely helpful and supportive. Recommendationsfor ways caregivers couldfacilitate parental grief proactively and with insight are offered.

The purpose of this article is to explore social support and life satisfaction of the Wisconsin Hmong women in the postpartum period. A convenience sample of 52 childbearing Hmong women from northcentral and north-eastern Wisconsin were interviewed using a semistructured interview. Data were analyzed using the sensitization method. The women in this study received supportfrom relatives, many of whom lived in the home with them. Thefathers were the primary source of support, helping with infant care and assisting with child care tasks. A great deal of support in child care was also receivedfrom their mothers, mothers-in-law, and other relatives. Life satisfaction depended on the length of stay in the United States and was generally related to education, employment, independence in self-care, a desirefor a smallerfamily, and the ability to access existing resources for child care.

This article is an exploratory descriptive investigation of the meanings given by pregnant African American adolescents to the experience of being pregnant. Twenty-one participants between the ages of 13 and 19 were recruited from two community clinics and two private physicians'offices in California. Data were collected through in-depth interviews that elicited information regarding the experience of pregnancy, changes experienced during pregnancy, and strategies used to manage these changes. The interviews were tape-recorded, transcribed, and analyzed using the grounded theory technique of constant comparative analysis. The two major themes that emerged from the data regarding the pregnancy experience were pregnancy disclosing and role transforming. These themes were related to the extent of difficulty experienced during pregnancy. Coping strategies aimed at ameliorating stress during pregnancy included conceptualizing support as need fulfillment. Identified needs were met by the adolescents' boyfriends and mothers.

This study used the Wicksfamily health model to test relationships among family health and time since diagnosis, perception of symptom severity, caregiver stress, and family stressors in 140families coping with chronic obstructive pulmonary disease. Hypotheses were tested using Pearson's correlation coefficients and hierarchical multiple regression analysis. Family health was influenced by time since diagnosis, patient perceptions of symptom severity, caregiver stress, and family stressors as predicted. Cognitive impairment (patient-reported poor memory) was the only symptom significantly influencing family health. Even when physicalfrailty is the hallmark of a disease, it may be the cognitive aspects of the disease that strain family relationships.