Foreign Swamis at Home in India: Transmigration to the Birthplace of Spirituality

Women and men use local experience and experiences gained elsewhere when they embark on migratory projects to reconfigure social space and practices back home. To explore this claim, the authors argue that we must analyze the relationship between mobility and authority, especially how experiences of mobility bestow authority on the moving subjects. This argument is illustrated by an examination of three differently situated narratives from which two interrelated fields of analysis emerge. One field is related to how authority is perceived in relation to control. The other field is related to the kinds of experience that are produced through acts and narrations of movement and how these experiences become articulated to provide authority to individuals. The authors conclude that movement may subvert and / or reproduce authority, just as authority may be both a source and an effect of movement.     

Does Nursing Home Ownership Change Affect Family Ratings on Experience with Care?

Person-centeredness may suffer in nursing homes (NHs) with recent ownership changes. This study identifies associations between ownership change and reported care experiences, important measures of person-centered care for long-term residents in Maryland NHs. Care experience measures and ownership change data were collected from Maryland Health Care Commission reports, which reported data on 220 Maryland NHs from 2011 and 2012. Facility and market covariates were obtained from 2011 NH Compare and Area Health Resource Files. Linear regression was used to examine whether ownership change in 2011 was associated with lower care experience ratings reported during April to June 2012. Dependent variables were overall care rating (scale 1–10), percentage of respondents answering that they would recommend the NH, and assessments of five care and resident life domains (scale 1–4). Care experiences reported in 2012 were high; however, after controlling for covariates, ownership change was associated with significant decreases in 6 out of 7 measures, including a 0.39-point decrease in overall care rating (p = .001). NH managers and policy makers should consider strategies to improve patient-centeredness after ownership change.     

Everyday territories: homelessness,outreach work and city space

This article develops a situational approach to understanding urban public life and, in particular, the production of urban territories. Our aim is to examine the ways in which city space might be understood as comprising multiple, shifting, mobile and rhythmed territories. We argue that such territories are best understood through attending to their everyday production and negotiation, rather than handling territory as an a priori construct. We develop this argument from the particular case of the street‐level politics of homelessness and street care. The experience of street homelessness and the provision of care in the public spaces of the city is characterised by precarious territorial claims made and lost. We describe some of the ways in which care work with rough sleepers is itself precarious; ‘homeless’, in lacking a distinct setting in which it might get done. Indeed, outreach work takes place within and affirms homeless territories. The affirmation of territory is shown to be central to the relationship developed between the workers and their rough sleeping clients. We also show, however, the ways in which outreach workers operate on territory not their own, twice over. Outreach work is precarious in that it is practised within, and can run counter to, other territorial productions in which the experience of urban need and the work and politics of care are entangled. In sum, this article aims to move beyond static and binary understandings by developing a mobile and situational approach to city space which recognises the intensive yet overlooked work of territorial production.     

Administrators and Quality of Care in Long-Term Care Facilities

This exploratory study investigated administrator and facility-related predictors of quality of care in long-term care facilities. Quality was measured using several unmet standards of care identified in the last inspection report of the Ontario Ministry of Health and Long-Term Care (2007). Supplemental data were gathered from surveys mailed to all 602 long-term care administrators in Ontario, Canada, 302 of whom completed the questionnaire. Multiple regression analyses were conducted to test sets of hypotheses linking characteristics of administrators and those of the long-term care facility to quality of care. Education and experience as an administrator in a participant's current position had a moderate positive influence on quality of care; however, negative associations were found between administrator salary and effort devoted to resident care problems and quality of care. In addition, smaller facilities, being located in less populated communities, and administrators with a nursing background significantly affected quality of care in a positive manner.     

Confounding issues related to determining sample size in qualitative research

The debate on determining sample size in qualitative research is confounded by four fundamental methodological issues: the exclusive focus on theme analysis; the diverse and imprecise use of ‘qualitative’; a reliance on only two logics of inquiry, induction and deduction, and the occasional confusion of abduction with induction; and a general lack of recognition of the importance of differences in ontological assumptions. Embedded in these issues is an unwarranted acceptance of limited associations between certain assumptions, logics, forms of data, and methods of data collection/generation and analysis. What is required is a reformulation of the problem and its discussion with reference to ontological assumptions and logics of inquiry.     

Family members’ experiences and management of resident-to-resident abuse in long-term residential care

ABSTRACT

Objectives: Resident-to-resident (RRA) abuse is increasingly recognized as a significant problem in long-term residential care.Families have a constant presence in this setting, yet their inclusion in research about RRA is minimal. The purpose of this study was to examine family members’ experiences and management of RRA. Methods: The methodology was critical ethnography.Twelve family members participated in in-depth interviews and 56 hours of participant observation were conducted. Data were analyzed thematically. Results: The main themes illuminate families’ experiences of RRA in a context that largely normalizes it.In the absence of formal supports, families developed a range of management strategies, ranging from passive to active intervention.Organizational factors, such as staffing levels and mix, and the physical environment also contributed to RRA. Discussion: Families are actively managing RRA in long-term residential care. Policies and programs, including educational supports, should be developed to validate and support families.     

Making the Case for Interpretative Phenomenological Analysis with LGBTGEQ+ Persons and Communities

ABSTRACT

The emergence of interpretative phenomenological analysis (IPA) in qualitative scholarship offers a means to derive in-depth meaning attending to the complexities of lived experience. IPA extends qualitative inquiry through a double hermeneutic whereby the researcher is making sense of the experiences of participants who are making sense of a phenomenon. In this article, the authors present seminal empirical studies using IPA with lesbian, gay, bisexual, transgender, gender expansive, queer communities, argue a rationale for its usefulness, discuss methodological insights and strategies, and offer potential future directions.     

Exploring the Experiences of Lesbian,Gay, Bisexual,and Questioning Adolescents in Foster Care

This article is based on the findings from a subset of gender identity and sexual orientation questions from The Casey Field Office Mental Health Study (CFOMH). It aims to contribute the experiences of youth in the care of Casey Family Programs to the increasing body of research on lesbian, gay, bisexual, transgender, or questioning (LGBTQ) youth in foster care, as well as inform future studies in this area. The CFOMH study interviewed 188 adolescents ages 14 to 17 who were receiving foster care services from Casey Family Programs in 2006. The experiences in care of youth who identified as LGBQ (n = 10) are presented in narrative form, along with data from all youth in care (N = 188) regarding their perceptions of the foster care environment for LGBTQ youth. These findings are intended to underscore the need to conduct a larger, more in-depth study of the experiences of LGBTQ youth in foster care and the environment that foster care provides for them.     

‘He is Quirky; He is the World's Greatest Psychologist’: On the Community of Those Who Have Nothing in Common

In this article, we challenge the concept of the therapeutic relationship as an operationalisable entity. In contrast to this idea, we introduce Alphonso Lingis’ concept of community, and his distinction between the rational community and the community of those who have nothing in common. This is done through speculative analysis of a transcribed sequence from a research interview with a boy who speaks about his experiences of receiving mental health care. This boy and his family were helped through a network‐oriented, dialogical approach. In the sequence highlighted here, the boy speaks of the significance of a particular mental health practitioner. The boy expresses appreciation for the help he has received, yet it is difficult to translate the boy's utterances into meaningful professional jargon. Although the paper makes use of an actual sequence from a research interview, the argument is not empirical in nature. The purpose of the paper is to elaborate on theory, and to examine some possible consequences for future practice.     

The Role of the American Nurses' Association in Maintaining Professional Accountability

Abstract

A professional association has been defined as a group of practitioners who organize to perform functions they cannot perform as separate individuals and to judge one another as professionally competent. History reveals that when a profession becomes clearly defined, the responsible practitioners form an association in order to establish standards of practice and enforce rules of conduct.

As the professional association for nurses, the American Nurses' Association is inextricably involved in the development of mechanisms that guarantee professional accountability. A standing priority of the association is to improve the quality of care provided to the public by such means as 1) setting a timetable for establishing qualifications for entry into nursing practice; 2) evolving a coherent credentialing system; 3) establishing systems to assure the profession's accountability for practice and for the delivery of services; and 4) providing for expansion, accessibility, and improvements in continuing education in nursing.

If nurses are to assume greater responsibility, the profession must be in a position to assure the public of quality nursing care. Since the public holds the profession (as a whole) accountable for the competence of its practitioners, the professional association has a responsibility to establish mechanisms by which to judge the competence of its practitioners and to evaluate the quality of care.     

Making Sense of After‐School Care Dilemmas in Mothers' Stories of After‐School Care in Finland and Sweden

The study focuses on dilemmas in storied experiences of everyday after‐school care arrangements among Swedish and Finnish mothers. Finland and Sweden, which share a history of strong labour market attachment among women, arrange institutional after‐school care in similar ways. The data consist of interviews with three Swedish and six Finnish mothers. A positioning analysis of four stories shows how decisions related to children's after‐school hours were allocated among different actors. Two reoccurring dilemmas, Competent‐dependent child stories and Unburdened‐deficient mother stories, emerged from the data analysis as related to prevailing moral discourses on childhood and motherhood.     

A proposal for change to achieve competence in long-term psychosocial nursing care

Psychiatric nursing in a large institutional setting presents challenges to the nursing staff, who must remain competent in the specialized areas of psychiatric and medical nursing. Chronically mentally ill individuals present complex and continuing nursing care needs that must be addressed using a holistic approach to nursing assessment and care. The complex needs of nursing staff and patients in an institutional setting have been described. Methods of assisting the nurse to achieve competence using education and experience have been implemented and described with the goal of improving holistic nursing care to chronically institutionalized individuals.     

Breadwinning as care? The meaning of paid work in mothers’ and fathers’ constructions of parenting

As some scholars have argued for a distinct conceptualisation of breadwinning and for understanding breadwinning as a form of care, this study addresses parents’ constructions of breadwinning and its connections to care. It is based on an in-depth interpretive analysis of multiple-perspective, qualitative longitudinal interviews with 22 Austrian mothers and fathers from three points in time during their transition to parenthood. The analysis revealed four different types of breadwinning concepts by considering the jointly constructed meaning of mothers’ and fathers’ paid work within a parental couple and further relied on Tronto’s [(1993). Moral boundaries. A political argument for an ethic of care. New York, NY: Routledge] conceptualisation of care as a four-step process. The results indicate that respondents construct a clear difference between earning money and breadwinning. Additionally, a difference is made between breadwinning and taking care of the family’s subsistence, predominantly so for mothers. In conclusion, breadwinning can definitely be considered a form of care and thus a form of involvement in parenting, but it cannot be regarded a form of involvement in caregiving. The holistic picture of parents’ joint constructions enabled us to contribute to the existing conceptualisations of breadwinning and of parental involvement, thus providing a novel perspective on matters of gender equality.     

Healing from Childhood Sexual Abuse: A Meta-Synthesis of Qualitative Studies

ABSTRACT

Although the global prevalence of childhood sexual abuse (CSA) is very high, the experience of healing after such abuse has not been well documented. The goal of this study was to characterize the healing experience among CSA survivors presented in the literature. Metaethnography was used to synthesize an integrative literature review. The CINAHL, PubMed, PsycINFO, and Web of Science databases were used as data sources. Eight articles that explored healing experiences from CSA, published between 2007 and 2017, were included in the analysis. After performing a quality assessment, line-of-argument synthesis was used to construct the integrating scheme of healing experiences from CSA. CSA healing experiences included dissociating oneself from the memories of CSA, finding peace by creating a comfort zone, disclosure as the start of healing, attempting to establish identity through ongoing self-reflective activities, feeling comfort by sharing experiences and connecting with CSA survivors, and accepting CSA as part of the life history and stepping forward. Healing experiences from CSA synthesized from the analysis focused on personal growth, supporting previous theory on CSA health in the broader literature. A tailored care plan could be developed for CSA survivors who are at varying stages of healing.     

Health and Well-Being for Late Middle-Aged and Old Lesbians in a Rural Area

Abstract

Previous research on lesbian health care has drawn primarily from samples of young lesbians living in metropolitan areas. Through face-to-face interviews with twenty-one lesbians aged 54 or older and living in rural communities, this exploratory, naturalistic inquiry begins to fill a gap in the literature by examining the health care experiences of older, rural lesbians. Five themes emerged from the narrative data: issues of access; good health/good care; open to her own diversity; family and community; and visions-ideals and fears. We present these themes through informant quotes and discuss implications for policy and practice.     

Representations of homelessness,home environments,and authority in the context of runaway behaviors reported by foster care youth residing in an emergency shelter

Between 31 and 46% of youth with histories of foster care placement were homeless at least once. Studies of the incidence of runaway behavior have identified a host of risk factors associated with running away from foster care placement, but less is known about the internalized processes of these individuals at risk for running away or the contextual experience surrounding it. This study is designed to investigate the representations made by individuals who have engaged in running away to uncover and explore thematic patterns. Accordingly, a secondary analysis was performed on data from four group interviews (n?=?15) collected from youth under the care of one child protective services (CPS) agency-operated emergency shelter setting, using thematic content analysis by two independent reviewers. Codes were networked and themes that emerged were discussed through a framework of power dynamics. Themes around the participants’ perceptions of homelessness, lack of control, and their resistance to authority were all identified as contributory to the theme of running away. The act of running away is, therefore, framed as a threshold event representing a multifaceted phenomenon combining perceptions of self-identity, conflict, and power in the home.     

Somatic Complaint and Social Suffering Among Survivors of the Cambodian Killing Fields

Summary

Illness narratives from two Cambodian Killing Fields survivors are used to explore conflicts between professional and lay perspectives on somatic complaints. Professionals see somatic complaints as psychopathology, while Cambodian survivors see it as authentic embodied pain. Survivor perspectives implicate professionals and care systems as causes of suffering. More inquiry is needed to understand survivor perspectives and the role of care systems in exacerbating/alleviating survivor suffering.     

Social Monitoring as Social Control: The Case of Drug Testing in a Medical Workplace

While workplace drug testing has received considerable public and scholarly attention, little of this discussion has focused on the social context within which testing is likely to occur. This paper conceptualizes drug testing as social monitoring and examines testing within a framework suggested by Donald Black's theory of social control. The central idea is that the formality of social monitoring within a group is a function of its members' social status and the social distance among them. The paper evaluates this argument in one empirical setting. Analysis of data from U.S. departments of anesthesiology indicates that drug testing, an example of formal monitoring, most often emerges in a context marked by low normative respectability and a lack of intimate relationships. The paper concludes by suggesting how variations in monitoring procedures like drug testing may affect ensuing processes of social control.     

The body as existential midpoint—the aging and dying body of nursing home residents

The human body has been the object of extensive attention in the social sciences, recently receiving increasing interest from social gerontology as well. However, the issue of old bodies and particularly the body in the fourth age of life remains relatively under-researched. The need to give emphasis to the subjective experiences of the oldest old during their final phase of life has been pointed out. This article is based on data obtained from ethnographic fieldwork carried out on a nursing home ward, and explores and analyses how the residents talk about and regard their own aging and dying bodies. The focus is on the link between the disintegrating body, aging and death in an institution-based care context. It was found that the body is the central entity through which the residents experience daily life, through pain, through the caring process, through diminished physical and cognitive functions, and as such constitutes the existential nucleus of their being. The article includes a discussion on how these experiences also elucidate the way in which the body is a mediator for issues seldom acknowledged such as existential needs.