Push and pull: Exposure of young Taiwanese women to sexually explicit materials.

This study was designed to understand young Taiwanese women's perception of sexually explicit materials (SEMs). Researchers conducted six focus group discussions with 38 young women between the ages of 18 and 22 in Taiwan in 2009-2010 and used content analysis to analyze the data based on the push-pull theory. The results showed that the exposure of young women to SEMs was a sexual exploration process from no sexual activity to future sexual activity. This process was affected by the interactions of three powers: push power, pull power, and personal factors. The push power included factors, such as parents and social values, which failed to satisfy their sexual curiosity and provide them with autonomy. The pull power included SEMs and peer influence, which increased sexual arousal stimuli and curiosity to try sexual activity. The most important personal factors were young women's growth, including sexual curiosity, cognition of SEMs, and gender equity in freedom to make sexual decisions. Understanding this push-pull process regarding SEM can help health-care providers with their own discourses in addressing sex and influence young women's participation in desired, protected, and enjoyable sex when sufficiently ready.

Thoughts and behaviors of women with symptoms of acute coronary syndrome.

OBJECTIVE: Women delay seeking care for symptoms of acute coronary syndrome (ACS) because of atypical symptoms, perceptions of invulnerability, or keeping symptoms to themselves. The purpose of this study was to explore how women recognized and interpreted their symptoms and subsequently decided whether to seek treatment within the context of their lives. METHOD: Grounded theory was used to provide the methodological basis for data generation and analysis. Data were collected using in-depth interviews with 9 women with ACS. RESULTS: All participants went through a basic social process of searching for the meaning of their symptoms which informed their decisions about seeking care. Stages in the process included noticing symptoms, forming a symptom pattern, using a frame of reference, finding relief, and assigning causality. The evolving MI group (n = 5) experienced uncertainty about bodily cues, continued life as usual, until others moved them toward care. The immediately recognizable MI group (n = 4) labeled their condition quickly, yet delayed, as they prepared themselves and others for their departure. CONCLUSIONS: All women delayed, regardless of their ability to correctly label their symptoms. Education aimed at symptom recognition/interpretation addresses only part of the problem. Women should also be educated about the potential danger of overestimating the time they have to seek medical attention.

The contralateral prophylactic mastectomy decision-making process.

Women facing an early-stage breast cancer diagnosis may elect to have a contralateral prophylactic mastectomy (CPM) to reduce the risk of developing a contralateral breast cancer. In the United States, CPM rates for all surgically treated women with stages I through III unilateral breast cancer increased dramatically from 1998 to 2003. In 1991, the National Institutes of Health Consensus Panel concluded that breast-conserving surgery is an appropriate and preferred treatment for the majority of women with stage I and II breast cancer because it provides survival rates equivalent to those of total mastectomy while preserving the breast. Owing to the near equivalence of the 2 surgical treatment options in terms of survival benefit and recurrence risk, surgical treatment for early-stage breast cancer qualifies as a "preference-sensitive decision" for which no one treatment is best (S. T. ; ). We performed a literature review to identify studies that examined CPM decision making in women facing an early-stage breast cancer diagnosis with the aim of determining the most influential factors affecting her surgical choice. Study outcome measures were largely based on demographic information retrospectively extracted from large databases representing trends rather than revealing influences reflecting preference-sensitive decision making. While we may know demographically, which women choose CPM, we do not know why. To better understand this increasing trend, which greatly impacts patient counseling, prospective research is needed using decision quality methods developed to illuminate factors influencing a woman's decision.

Cultural beliefs and attitudes toward health and health care among Asian-born women in the United States.

OBJECTIVE: To describe Asian-born women's cultural beliefs and attitudes towards health, illness, and health care practices. DATA SOURCES: Online databases PubMed and CINAHL. STUDY SELECTION: Twenty-four studies published between January 2000 and May 2009 were retrieved based on the inclusion criteria. DATA EXTRACTION: Data on publication year, authors, study sample, sample size (only Asian women in the United States were included), design, and related key findings were extracted. DATA SYNTHESES: Data were organized under three categories: Asian cultural beliefs about health and illness, health promotion and illness prevention, and health care practices. Common beliefs across groups and unique beliefs within specific Asian ethnic groups were synthesized. The results indicated that different Asian ethnic groups share some health beliefs, but each group also has unique health beliefs. Existing literature on cultural health beliefs of Asian-born women is limited. CONCLUSION: Health care providers can use the findings of this review to improve health care utilization among Asian-born women.

Barriers and facilitators for breastfeeding among working women in the United States.

OBJECTIVE: To review the literature and describe the barriers and facilitators to the continuation of breastfeeding for at least 6 months by working women in the United States. DATA SOURCES: A search of PubMed, CINAHL, Sociological Abstracts, ISI, PsychInfo, and ProQuest. STUDY SELECTION: Twenty studies based on the inclusion criteria and published between January 1, 1995, and January 2006. DATA EXTRACTION: An ecologic framework, which includes the individual (microsystem), social support and relationships (mesosystem), and the workplace environment (exosystem). DATA SYNTHESIS: When working mothers possess certain personal characteristics and develop a strategic plan, breastfeeding is promoted. When social support is available and when support groups are utilized, lactation is also facilitated. Part-time work, lack of long mother-infant separations, supportive work environments and facilities, and child care options facilitate breastfeeding. CONCLUSIONS: Health care providers can use the findings of this review to promote breastfeeding among working women by using tactics geared toward the mother, her social network, and the entire community.

Manifestations of enduring during interviews with sexual assault victims.

The retelling of a sexual assault, whether during sexual assault care or law enforcement interviews, or in the process of seeking social support, is an emotionally stressful event, yet there is little research describing the psychological experiences of retelling. In a study of barriers to sexual assault care, 43 survivors recounted 76 assault events during individual interviews. Although assaults occurred from 1 to 15 years prior to the interview, participants demonstrated emotional upset. Using the praxis theory of suffering as a scaffold, the author describes manifestations of enduring and emotional suffering. The separation of enduring from emotional suffering indicates potential usefulness of the praxis theory of suffering in the provision of post-sexual assault care.

Preventing violence in an academic setting: one school of nursing's approach.

Workplace violence occurs in many different contexts, including academic settings. However, the types of violence that make headlines are less common than the everyday behaviors that, left unchecked, may lead to extreme situations. This article describes how a school of nursing developed a program of workplace violence prevention, intervention, and response. Descriptions of the program, definitions, and workplace violence resources are included.

Agenda dissonance: immigrant Hispanic women's and providers' assumptions and expectations for menopause healthcare.

This focus group study examined immigrant Hispanic women's and providers' assumptions about and expectations of healthcare encounters in the context of menopause. Four groups of immigrant women from Central America and one group of healthcare providers were interviewed in Spanish and English, respectively. The women wanted provider-initiated, individualized anticipatory guidance about menopause, acknowledgement of their symptoms, and mainstream medical treatment for disruptive symptoms. Providers believed that menopause was an unimportant health issue for immigrant women and was overshadowed by concerns about high-risk medical problems, such as diabetes, heart disease and HIV prevention. The women expected a healthcare encounter to be patient centered, social, and complete in itself. Providers expected an encounter to be businesslike and one part of multiple visit care. Language and lack of time were barriers cited by all. Dissonance between patient-provider assumptions and expectations around issues of healthcare leads to missed opportunities for care.