Teenage mothers' narratives of self: an examination of risking the future.

The conventional wisdom that teenage mothering risks the future disregards the fact that the young mother's experience and understanding of her past as well as her anticipation of the future are intimately tied to the social world she inhabits. To recovery the contextual and temporal nature of teenage mothers' lives, this interpretive-phenomenological study explored young mothers' self-understandings of identity and the life course as participants and members of families and communities. Implications of interpretive findings for a narrative conception of identity and the life course are described and applied to community-based, community-focused primary health care.

The vulnerabilities of teenage mothers: challenging prevailing assumptions.

The belief that early childbearing leads to poverty permeates our collective understanding. However, recent findings reveal that for many teens, mothering makes sense of the limited life options that precede their pregnancies. The author challenges several assumptions about teenage mothers and offers an alternative to the modern view of the unencumbered self that drives current responses to teen childbearing. This alternative perspective entails a situated view of the self and a broader notion of parenting and citizenship that supports teen mothers and affirms our mutual interdependence.

Adolescent mothers four years later: narratives of the self and visions of the future.

This study examined patterns, variations, and existential turning points in young mothers' narratives of self and their visions of the future as part of a larger hermeneutic, longitudinal study. The study was philosophically based in the phenomenology of everyday practices as inherently meaningful, situated, and historically derived and drew on dialogical views of the self. The sample consisted of 13 (of the original 16) young mothers and family members who had been interviewed 4 years earlier. For the present study, data consisted of life history accounts of the intervening 4 years, stories of caregiving routines, and recent coping episodes of parenting elicited through in-depth interviews. Findings offer a situated understanding of young mothering and highlight meaningful distinctions in the ways young mothers experience the self and project themselves into the future. The discovery of patterns and variations in the young mother's sense of self and future have implications for guiding clinical practice and are preliminary to designing programs and interventions that are tailored to the practical understanding and situated possibilities of young mothers.

PIP: The prevailing view that an early pregnancy jeopardizes a young woman's emotional development disregards the social nature of the construction of self and others. Although parenting can be a stressful life experience, it also has the potential to create new ways of coping and to contribute to a revised understanding of the self. For many impoverished African-American teens, with few opportunities to establish an identity through education or a career, motherhood provides the route to adulthood. The present study investigated patterns in young mothers' narratives of self and their visions of the future. In-depth interviews were conducted with 13 US adolescent mothers 4 years after the birth of their first child at an average age of 15.6 years. In the majority of cases, mothering was described as a generally positive experience that engendered a sense of responsibility and supplied a social identity consistent with family and cultural meanings of becoming a woman. The mothers' efforts to become a responsible parent tended to transform their sense of identity and provide a sense of future possibility not previously available. Those who lived in conditions of extreme poverty and danger, without social support, were less able to turn motherhood into an opportunity for reconstruction of the self. Instead, mothering diminished the self and exacerbated feelings of powerlessness, frustration, and conflict. These findings suggest that motherhood is adversely affected by the conditions associated with poverty rather than maternal age per se. Needed, to improve the outcomes of adolescent pregnancy, are interventions that focus on ethical and political questions rather than technical issues.

The responsive use of self in community health nursing practice.

This interpretive study examined the expertise that is often unrecognized in the everyday practice of community health nurses. Twenty-five nurses participated in the study and were asked to describe meaningful clinical situations during group and individual interviews. Field notes of observations of clinical situations and transcribed interviews were analyzed as a text. A major finding of the study involved the nurse's responsive use of self. Responsiveness to the other enabled the nurse to gain a situated understanding of clients' lives and to cultivate clients' strengths and connections to a responsive community.

Developing a caregiving tradition in opposition to one's past: lessons from a longitudinal study of teenage mothers.

Although teenage mothering has been exhaustively studied, the cross-sectional designs and the deficit-finding focus of empirical-rational studies have exaggerated the negative consequences of an early pregnancy and have obscured how teenage mothering is often a rite of passage to adulthood, particularly in the absence of middle-class resources and aspirations. In examining the experiences of young mothers, an 8-year longitudinal study sought to understand how teenage mothers extend and develop family caregiving traditions. The original sample included 16 families and 39 subjects. Multiple individual and family interviews were conducted once the teen's first-born infant reached 8 to 10 months of age, and then 4 and 8 years later. Data from all three study periods were analyzed using the interpretive method. The following analysis provides an in-depth account of how young mothers with an oppressive past strive to become the parents they want to be. In addition, the teen mother's difficulties and struggles of creating a more positive maternal legacy and the role that positive and negative examples of parenting play in fostering or hindering the development of a new caregiving tradition are described. Study findings have implications for how clinical practice and social policy can better assist mothers to become the mothers they want to be.

Change and continuity in family caregiving practices with young mothers and their children.

PURPOSE: To examine how young mothers who gave birth during adolescence extended and developed caregiving practices within the context of family relationships, caregiving traditions, and life events. DESIGN: Longitudinal, interpretive-phenomenological. A community-based sample in 1993 consisted of 13 of the 16 young mothers and 11 of the 18 grandparents who had participated in a 1988 study. Three male partners of the young mothers also participated in this 1993 study. Families resided in a Western metropolitan area in the United States. METHODS: Life history accounts of the intervening years, stories of family routines, and recent coping episodes of parenting were elicited through in-depth interviews with the young mothers and their male partners; one interview was conducted with grandparents. Data were analyzed using the interpretive approach. FINDINGS: Adversarial caregiving practices develop or change in the context of transformed family relationships. CONCLUSIONS: Life-course and parenting experiences of young mothers are not private and located in the self, but are developed in interaction with others. Family-centered interventions are needed that support the efforts of young mothers and grandparents to become responsive caregivers.

Promoting clinical practice knowledge in an age of taxonomies and protocols.

The proliferation of classification schemes, practice guidelines, and critical pathways expresses our modern faith in theoretical reasoning and scientific evidence. This mode of knowing is almost universally championed for providing the evidence that will guide and advance nursing practice. The nature and complexity of clinical expertise, however, are misconstrued with the quest to standardize nursing practice. After distinguishing between theoretical and clinical reasoning, several narratives from two interpretive studies of public health nursing practice will illustrate how clinical practice resists theoretical understanding and must be more fully articulated if clinical and ethical reasoning is to be preserved and strengthened.

Sharpening the focus on populations: an intentional community health nursing approach. Part II.

An interpretive study conducted in a Midwestern metropolitan area was designed to examine expertise in everyday community health nursing (CHN) practice. Twenty-five nurses from three practice areas (traditional, nontraditional, and program development) participated in group and individual interviews and field observations, sharing stories of their practice. Transcribed interviews and field observation notes were analyzed as a text. One of the major findings of the study focused on experiences of the nurses as they developed the population aspects of their everyday practice. Part I describes the natural development of a population focus of CHN generalists whose care most often targeted individuals and families. The stories of how their practices evolved and were supported by their institutions provided insights into how nurses develop a broad population-focused practice perspective. Part II examines the practice of those CHN specialists who nurse their target populations from an intentional perspective. Their population-focused practice, in which they repeatedly displayed what the research team terms multilingual and multiperspectival skills, was solidly based in their prior individual and family-focused experience and expertise in program planning and evaluation.

Articulating the culture and tradition of community health nursing.

While community health nursing (CHN) leaders speculate about the future, nurses on the front lines care for vulnerable families and populations in the midst of diminishing resources, radical changes in health care delivery systems, and unwieldy bureaucracies. Narrative data from a recent interpretive study provided an unexpected opportunity to explore how CHN practice in diverse settings is evolving in response to such changes. Data consisted of interviews and observations of 25 nurses in their practice setting. Several clinical stories or exemplars are selected to highlight how the "culture" of agency settings shapes public health nursing (PHN) practice in ways that need to be recognized and strengthened or affirmed. Clinical storytelling can play a crucial role in preserving the PHN tradition and restoring and transforming local cultures when PHNs, administrators, educators, and researchers commit to PHN excellence.