Chronic obstructive pulmonary disease as disability: dilemma stories.

The purpose of this work was to develop an understanding of the meaning of disability for individuals living with chronic obstructive pulmonary disease (COPD) in a Canadian midwestern community from an emic perspective. A focused ethnographic design was used. Fifteen individuals participated in interviews. Narrative analysis was used to examine the interview data. Data analysis revealed 65 dilemma stories consisting of two structural components: the impairment, and the justification/explanation of the impairment. Participants' impairment might or might not have been known to others. In both situations, individuals were faced with choices of whether to explain/justify or attempt to conceal the impairment. Participants told these dilemma stories to convey the meaning of COPD as a disability invisible to others, and at times, to themselves. The information gained from this research will serve as an essential complement to the existing knowledge about this important yet often invisible chronic illness.

Locating Carper's aesthetic pattern of knowing within contemporary nursing evidence, praxis and theory.

Carper's (1978) seminal work has been used in nursing education for many years as a method for introducing students to the multitude of ways of knowing that support nursing practice. This manuscript focuses on the aesthetic pattern of knowing and the ongoing debate in nursing literature surrounding aesthetics, evidence and nursing practice. Writers will describe and critique a strategy used to introduce first year undergraduate nursing students to this pattern of knowing. The implications of the critique of the project and the ongoing debate in relation to Carper's (1978) work, evidenced based practice and nursing praxis are discussed.