Coping Behaviors of African Americans With Inflammatory Bowel Disease: A Focused Ethnography.

INTRODUCTION: Increased numbers of African Americans (AAs) are being diagnosed with inflammatory bowel disease (IBD), little is known about the influence of culture on their coping. PURPOSE: To explore the beliefs and experiences of AAs with IBD and coping in the context of their culture. METHOD: Twelve AA adults with IBD were interviewed and observed using focused ethnography. RESULTS: Data analysis revealed four themes: (1) spending time living in the bathroom, (2) time and food restricted eating practices and cultural food avoidance, (3) dealing with chronic stress and perceived racial injustice, and (4) the practice of seclusion to manage bathroom urgency and emotions of fear, anxiety, and embarrassment. DISCUSSION: Participants described coping and culture with experiences similar to other IBD populations, except in the area of perceived racial injustice. Opportunities for nurses to assist with stressors related to bathroom access, cultural eating practices, and participating in activities outside their homes.

Coping in African Americans With Inflammatory Bowel Disease: An Integrative Review of the Literature.

Given the chronic nature of inflammatory bowel disease, understanding the coping behaviors of individuals affected with the disease is important to influence health outcomes. Although minorities comprise a significant portion of individuals with the disease, little is known about the potential influence of one's culture, specifically among African Americans, on coping with inflammatory bowel disease. This integrative literature review examined the past decade of research related to the coping behaviors of African Americans living with inflammatory bowel disease to identify opportunities for further research. Five studies were identified via database searches of PubMed, PsychInfo, CINAHL, and the Cochrane Library and limited to studies published in English, full-text, peer-reviewed, and adult samples that included African Americans. Findings lacked information specific to coping in African Americans. Results were categorized by coping and disease activity, acquisition of knowledge, and personal coping. An association between poor coping behaviors and active disease was reported. The disease frequently hindered academic pursuits of college students, with increased knowledge about the disease associated with the use of better coping strategies. Personal coping behaviors were reported in stressful social situations, food choices, and religion. Results emphasized the need for future research to explore the influence of culture on the coping behaviors of African Americans with inflammatory bowel disease.

Men with implantable cardioverter defibrillators: A qualitative study of gender and age.

OBJECTIVE: The purpose of this study was to examine men's adjustment to living with an implantable cardioverter defibrillator (ICD) as influenced by gender and age. BACKGROUND: Living with an ICD requires psychological and social adjustments throughout the lifespan. Approximately 60-70% of the ICD population are men, yet little is known about men's gender-specific issues related to living with ICDs. METHOD: Ethnographic methods were used with 12 men, 26-85 years of age. Data were analyzed using constructs of gender, chronic illness, and Life Course theory. RESULTS: Themes were identified: Maintaining a masculine image, Sudden cardiac death and social implications through time, and Self-image influenced by chronic illness. DISCUSSION: Gender and location in the life-course may influence adjustment to living with an ICD. Understanding where an individual is within place and time, as well as where they are at the present may account for many aspects of their acceptance, adjustment, and recovery.

Cultural Beliefs, Perceptions, and Practices of Young Adult Offspring of African Immigrants Regarding Healthy Eating and Activity.

INTRODUCTION: African immigrants and their offspring are increasing in the United States. Yet little is known about the beliefs, perceptions, and practices of second-generation African immigrants regarding healthy eating and physical activities within the context of culture and environment. METHOD: Five small group interviews using a focused ethnography qualitative method were conducted with 20 college-age students who were offspring of African immigrants. Data were analyzed using Leininger's four phases of analysis. RESULTS: Four themes emerged: (1) family, community, and religious ties to traditional African foods; (2) traditional African cuisine as healthy and american foods as nonhealthy; (3) eating patterns vary according to availability and resources; and (4) exercise patterns have familial, peer-driven, and generational influences. DISCUSSION: African food was a connection to family and the African community. Food choices and activities were strongly influenced by accessibility, social structures, and the environment. Dietary and activity-based interventions should include both American and African influences.

Reimplantation surgery in patients with implantable cardioverter defibrillators: A qualitative study.

OBJECTIVE: The purpose of this study was to examine the experience of recurrent surgery for patients with implantable cardioverter defibrillators (ICD). BACKGROUND: Device replacement is typically required every 4-7 years due to battery depletion. Furthermore, recurrent surgery may be related to lead malfunction or pocket infection. METHODS: Ethnographic methods were used for data collection with 23 ICD reimplanted recipients, 12 men and 11 women, 26-85 years of age. Data were analyzed using a with-in case and cross-case method. RESULTS: Three major themes were identified: Anticipation regarding implantation with three sub-themes of logistics and social considerations, decisions regarding replacement, and financial considerations. Relinquishing control and somatic changes frame perceptions related to the operative and postoperative periods. CONCLUSIONS: The frequency of ICD reimplantation differentiates it from other surgical interventions. Perceptions varied according to past experiences and present day social, financial, and somatic differences. Recipients are resolved to life-long surgery aided by their trust in health care professionals.

Severe Symptomatic Aortic Stenosis in Older Adults: Pathophysiology, Clinical Manifestations, Treatment Guidelines, and Transcatheter Aortic Valve Replacement (TAVR).

The only effective treatment for symptomatic aortic stenosis in the older adult population is surgical aortic valve replacement. However, more than 30% of candidates are denied surgery due to advanced age and multiple comorbidities. Without surgical intervention, death from symptomatic aortic stenosis approximates 2% per month, with mortality rates of approximately 50% within 2 years of symptom onset. There is no effective medical treatment for severe symptomatic aortic stenosis; care has been limited to palliative remedies and end-of-life decisions. Nascent advances in miniaturization and catheter technologies provide a new and less invasive approach: transcatheter aortic valve replacement (TAVR). The current article summarizes treatment guidelines; pathophysiology; clinical manifestations, progression, and classification of severe symptomatic aortic stenosis; and introduces TAVR and discusses randomized controlled trials involving three patient populations from the United States, with relevant nursing implications.