Now showing 1 - 10 of 10
  • Publication
    The Role of CAM (Complementary and Alternative Medicine): The Different Perspectives of Patients, Oncology Professionals and CAM Practitioners
    The purpose of this chapter is to describe the different perspectives of women with breast cancer, oncology professionals and CAM practitioners regarding the role of CAM in the cancer setting. While all three stakeholder groups considered CAM as supportive, perspectives differed among oncology professionals and CAM practitioners regarding the manner in which this was so.
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  • Publication
    Women's accounts of heterosexual experiences in the context of menopause
    A number of biomedical models of female sexuality have emerged during the past few decades, and these have been challenged by feminist theorists who have tended to focus on the influence of contextual issues that mediate women's sexual experiences. In this article, a qualitative analysis of accounts relating to heterosexual experiences obtained from 25 menopausal women in Ireland through in-depth interviews is presented and considered in light of existing theoretical perspectives on sexuality. The average age of women in the sample was 54.2 years, and a diverse range of socioeconomic backgrounds was represented. We found that in describing their contemporary sexual experiences, contextual issues were brought heavily to bear as participants drew on discourses of personal history and biography, including previous relationships, to explain their current sexual experiences. However, a few women foregrounded physiological and biological reasons associated with hormonal changes to explain alterations in their sexual relationship, although overall, these were featured to a far lesser extent compared with their prominent position in biomedical menopause literature. A dominant feature of data was the influence of the discourse of the male sex drive, and many women explained their lesser interest in sexual activity compared with that of their partner in terms of men's nature. The findings suggested that for participants, anxiety around sexuality was socially produced either through the expectation to satisfy a partner, or by dominant discourses that defined sexual engagement as “healthy” and sexual apathy as “unhealthy.”
      316Scopus© Citations 3
  • Publication
    Social regulation, medicalisation and the nurse's role: insights from an analysis of nursing documentation
    Background: Medicine is recognised as a dominant source of governmentality and social regulation, and although nursing has been implicated in the same process, analytical work in this area has been sparse. Objectives: The article aims to present an analysis of nursing records in order to understand the structural and social processes that mediate the texts. Methods: 45 sets of nursing records drawn from four clinical sites in Ireland were subjected to a discourse analysis. Results: This article focuses on two main themes that were derived from data: (i) the manner in which nurses controlled, regulated and invigilated patients' activities of daily living and (ii) the way in which activities of daily living were mediated by a biomedical worldview in the clinical settings. Through the organising framework of Activities of Daily Living (ADLs), normative social practices relating to hygiene, eating and drinking, sleeping and so forth were surveyed and monitored within clinical settings. We construct qualitative categories around a range of ways that nurses assessed and judged patients' capacities at ADLs. Furthermore, it is argued that the framework of ADLs epitomises the medicalisation of normative social practices, whereupon the most mundane of normal functions become redefined as an actual or potential clinical pathology, legitimating nursing interventions. According to the nursing documentation, biochemical interventions in the form of various medications were the most dominant means through which nurses attempted to restore or improve the functional capacity of an ADL. Conclusion: We conclude by proposing that nurses' invigilation of patients' ADLs is not necessarily a repressive feature of nursing practice, but rather has the potential to be used to advocate on patients' behalf in certain circumstances.
      2243Scopus© Citations 27
  • Publication
    Menopause narratives: the interplay of women's embodied experiences with biomedical discourses
    Conventional approaches to menopause tend to contrast the biomedical position on menopause with women’s actual experiences of it. Rather than focusing primarily on the tensions between these perspectives (biomedical vs. lay), our emphasis here is on the impact of biomedicine in shaping participants’ perceptions of their status as menopausal. Based on interview data gathered from 39 women in Ireland, we argue that the cultural authority of biomedicine shaped participants’ experiences of the body and how they constituted their health identity. We assert that, ironically, this was particularly the case among those who most strongly contested biomedical definitions of their situation. In addition, biomedical practitioners’ definitions had a strong normalizing power in how the body was experienced. We conclude by noting that our analysis problematizes the notion of privileging “women’s experiences” as advocated by some feminist perspectives. The heavy influence of biomedical discourses in shaping participants’ embodied experiences demonstrates the pervasive impact of prevailing discourses on women’s experiences.
      859Scopus© Citations 19
  • Publication
    Parents' constructions of communication with their children about safer sex
    Aims and objectives: To analyse how a sample of parents reportedly communicated with their adolescent and preadolescent children about safer sex (contraceptive and condom use). Background: Among the plethora of existing research available on parent–child communication about sexuality (more broadly), very few studies detail the substance and tenor of what parents actually convey specifically about safer sex.Design: The study adopted a qualitative methodology and involved interviewing 43 parents (32 mothers and 11 fathers). Data were analysed using modified analytical induction. Results: Findings indicated that although the majority of parents professed to being open about sexuality with their children, only a minority reportedly conveyed direct messages about contraception and condom use. Moreover, these direct messages appeared to be imparted at a superficial level. Parents were more likely to communicate such messages in a tacit manner through innuendo and intimation. The complacency that parents displayed about the need to undertake safer sex education with their adolescents arose from an understanding that this was covered adequately at school and the belief that their teenager was not in a romantic relationship. In addition, some parents expressed concern that discussing safer sex with teenagers might actually encourage sexual activity. Conclusion: We conclude that some parents may consider themselves to have engaged in sexuality education around safer sex when it appears to be predominantly surface-level education; that what constitutes ‘doing’ sexuality education is far from clear-cut may cast some light on why there is little consistency in the literature on the impact of parental communication on sexual health outcomes for young people. Relevance to clinical practice: For nurses engaged in sexuality health promotion with parents, we caution about presenting unequivocal messages to parents about the impact of parental communication about sexuality on adolescent sexual behaviour without due acknowledgement of the grey areas indicated in the literature.
      678Scopus© Citations 28
  • Publication
    Hormone therapy and the medical encounter:  a qualitative analysis of women's experiences
    Objective: The aim of this article was to explore women's experiences in biomedical consultations for menopause symptoms, with a particular focus on how hormone therapy (HT) featured during the encounter. Methods: Semistructured interviews were conducted with 39 women, and data were analyzed using a qualitative strategy referred to as Thematic Networks. Results: Several participants whose menopause started before the period of the HT "scares" described being "put on" HT as a matter of course, even when their symptoms were mild. By contrast, some of those presenting in the more recent time period with what they deemed to be severe symptoms were more likely to describe scenarios whereby they pressured their physicians for an HT prescription. Once on HT, participants were found to be far from passive recipients of a biomedical "treatment" but rather embarked on an active dialogue with themselves about how to manage the distressing aspects of menopause. Conclusions: Using HT did not tend to spell a transition to biomedical advocacy, despite its reported effectiveness in moderating bodily distresses. Rather, HT tended to retain a tentative status as a temporary relief and not a long-term panacea.
      225Scopus© Citations 8
  • Publication
    Modes of rationality in nursing documentation: biology, biography and the 'voice of nursing'
    This article is based on a discourse analysis of the complete nursing records of 45 patients, and concerns the modes of rationality that mediated text-based accounts relating to patient care that nurses recorded. The analysis draws on the work of the critical theorist, Jurgen Habermas, who conceptualised rationality in the context of modernity according to two types: purposive rationality based on an instrumental logic, and value rationality based on ethical considerations and moral reasoning. Our analysis revealed that purposive rationality dominated the content of nursing documentation, as evidenced by a particularly bio-centric and modernist construction of the workings of the body within the texts. There was little reference in the documentation to central themes of contemporary nursing discourses, such as notions of partnership, autonomy, and self-determination, which are associated with value rationality. Drawing on Habermas, we argue that this nursing documentation depicted the colonisation of the sociocultural lifeworld by the bio-technocratic system. Where nurses recorded disagreements that patients had with medical regimes, the central struggle inherent in the project of modernity became transparent--the tension between the rational and instrumental control of people through scientific regulation and the autonomy of the subject. The article concludes by problematising communicative action within the context of nursing practice
      825Scopus© Citations 37
  • Publication
    Parents' constructions of the sexual self-presentation and sexual conduct of adolescents: discourses of gendering and protecting
    In this paper, we explore the discourses on sexuality that a sample of parents drew upon when they talked about teenage sexual self-presentation and conduct. The sample consisted of 43 parents (32 mothers and 11 fathers) of young people aged 10–19 years. Data were gathered using in-depth interviews and were analysed using a strategy known as modified analytical induction. Findings indicated that while an acceptance the traditional heterosexual script permeated participants' accounts, and protective discourses in relation to young women were brought to bear, so, too, were protective discourses invoked in relation to young men. On the whole, young women tended to be cast as sexual subjects who chose to self-sexualise and this was sometimes seen by participants as a threat to young men. We argue that the discourses that parents connoted were multiple and sometimes contradictory, and our analysis problematises the notion that conventional discourses singularly cast women as objects of male sexuality. However, the overall picture indicated that in parents' narratives, young women tended to be more heavily regulated and either viewed as needing protection from male sexual advances or castigated for encouraging them.
      423Scopus© Citations 8
  • Publication
    The ending of menstruation: perspectives and experiences of lesbian and heterosexual women at menopause
    This article aims to theorize how a sample of menopausal women, lesbian and heterosexual, construct the ending of their periods, and what the experience means for them. Findings indicate that for most of the lesbian participants (who were in a sizeable minority), emotions of loss at the ending of periods were simultaneously expressed alongside positive feelings, and they engaged in greater introspection around the issue than did heterosexual women. However, lesbians did not all take up a singular subject position in relation to menstruation, indicating that there is fragmentation and plurality in how the body is experienced across a group.
      360Scopus© Citations 10
  • Publication
    The silent treatment: parents' narratives of sexuality education with young people
    This paper is based on research undertaken in Ireland that sought to understand how parents communicate with their children about sexuality. Forty-three parents were interviewed and data were analysed using analytical induction. Data indicated that while parents tended to pride themselves on the culture of openness to sexuality that prevailed in their home, they often described situations where very little dialogue on the subject actually transpired. However, unlike previous research on the topic that identified parent-related factors (such as ignorance or embarrassment) as the main impediments to parent-young person communication about sex, participants in our study identified the central obstacle to be a reticence on the part of the young person to engage in such dialogue. Participants described various blocking techniques apparently used by the young people, including claims to have full prior knowledge on the issue, physically absenting themselves from the situation, becoming irritated or annoyed, or ridiculing parents' educational efforts. In our analysis, we consider our findings in light of the shifting power of children historically and the new cultural aspiration of maintaining harmonious and democratic relations with one's offspring.
      613Scopus© Citations 22