Western Journal of Nursing Research

Studies of self-care behaviors in the management of type 2 diabetes of ten focus on patient knowledge and montivation, without considering the role of practitioner orientations. Using an exploratory descriptive design, we conducted open-ended interviews with 51 type 2 diabetes patients and 35 practitionersfrom clinics in San Antonio and Laredo, Texas. We found critical differences between patient andpractitioner goals, evaluations, and strategies in diabetes management, especially regarding such key concepts as "control" and "taking care of self:" Practitioners' perspectives are rooted in a clinical context, emphasizing technical considerations, whereas patients'perspectives exist within a life-world context andforeground practical and experiential considerations. These result in very different approaches to treatment. Practitioners, presuming failed treatment indicates uncooperativeness, try to inform and motivate patients. The patients we interviewed, however, understood and were committed to type 2 diabetes selfcare, but lackedfull access to behavioral options due to theirpoverty and limited social power.

This qualitative study was designed to describe women's experiences with changes in sexual function related to physical comfort, sexual satisfaction, and fielings of intimacy post-treatment for gynecological cancer. The 17 women who participated in this study described sexuality as a much broader construct. Contrary to existing literature, sexual functioning was found to be one aspect that contributed to the view of the self as a sexual being, but the women's perceptions were not limited to this single dimension. The identification of multidimensional components to be considered in developing a conceptual model to describe sexual health are presented. This study indicates that sexuality should be viewed as a health issue that has an impact on quality of life.

Demographic trends indicate a growth in the older adult population, and in turn, are affecting the availability and use of health services. Although placement of an older adult charge into nursing home care is often described as a logical progression through the continuum of available services, informal caregivers often view placement as a last resort or as an indication of failure. This qualitative study used grounded theory methods to explore the experiences of caregivers actively involved in the process ofplacing an older adult in a long-term carefacility upon discharge from acute care. Four themes (uncertainty, surrendering to the system, urgency, and validating) were interwoven throughout caregivers'perspectives of the conflictive decision to use nursing home care after hospitalization.

Clinicians express concern that because percutaneous transluminal coronary angioplasty (PTCA) is minimally invasive and yields rapid symptom relief, patients with successful PTCA may be too optimistic about theirfuture health status, may no longer perceive heart disease as a threat to health, and thus, may view cardiac risk-reduction behaviors as unnecessary. This study examined the relationship between patients'cognitive appraisal of PTCA (treatment appraisal and heart disease threat) and subsequent participation in cardiac risk-reduction behavior 2 weeksfollowing hospital discharge. The sample included S8subjects with successful PTCA. The majority were older, married, Caucasian men who reported participation in cardiac riskreduction behavior (not smoking, exercising regularly, andfollowing a lowfat/low sodium diet) following PTCA. Although heart disease threat was a significant negative predictor of psychological well-being, itdid notpredict self-reportedparticipation in cardiac risk-reduction behavior

The purposes of this study were to describe and compare, specifically, African American family members of critically ill adults'perceptions of the professional support they would like (ideal) to receive with the professional support they received (actual)from critical care nurses. The Professional Support Questionnairefor Critical Care Nurses Working With Family Members (PSQ) was administered by mail or telephone to 36 African American family members. The PSQ consists of three domains of support-information, comfort, and assurance. Paired t-test analyses indicated there were differences between the descriptions of professional nursing support expected (ideal) byfamily members and the professional support provided (actual) bycriticalcare nurses. Although there was not an absence of professional nursing support, the degree andfrequency to which African American family members wanted nurses to support them were not comparable to the support that nurses provided them.

In this study, I describe the cardiovascular-related diet and exercise experiences of 24 married immigrant Mexican women (21 to 40 years-old) who have children. I used semistructured taped interviews in Spanish to elicit qualitative data concerning the diet and exercise experiences of this sample. The data were analyzed in Spanish using grounded theory procedures. A majorfinding in this study is a core process of realizing a covert overweight image. Women described an ongoing process of coming to terms with diet and exercise decisions in a sociocultural disempowering environment that limited their options to promote their health. Despite these limitations, some of the women assessed and formulated options that developed into transcending strategies for engaging in diet and exercise behaviors. Such sociocultural factors as women's roles and theirsocial support structures were found to be critical in describing those behaviors.