DOCSLIB.ORG

A Narrative Review

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
A Narrative Review This work is protected by copyright and other intellectual property rights and duplication or sale of all or part is not permitted, except that material may be duplicated by you for research, private study, criticism/review or educational purposes. Electronic or print copies are for your own personal, non- commercial use and shall not be passed to any other individual. No quotation may be published without proper acknowledgement. For any other use, or to quote extensively from the work, permission must be obtained from the copyright holder/s. Psychological needs and support following stoma surgery: exploring the perspectives of young adults and healthcare professionals Kay Polidano A thesis submitted for the degree of Doctor of Philosophy March 2020 Keele University Abstract Stoma surgery is commonly described as a life-changing procedure, due to the radical bodily changes and related psychosocial challenges it brings about; especially so for individuals with Inflammatory Bowel Disease (IBD) who may undergo this surgery at a relatively young age. Although the psychological impact of stoma formation is emphasised in the literature, how stoma-related psychological needs are addressed remains unexplored. This study explores the perspectives of young adults with a stoma and healthcare professionals about access to psychological support within and beyond the healthcare system. In-depth interviews were conducted with 13 young adults with a stoma (aged 18-29 years) and 15 healthcare professionals (including colorectal surgeons, gastroenterologists, specialist nurses in IBD and stoma care, and general practitioners). Data collection and analysis were informed by constructivist grounded theory and narrative inquiry. Most young adults reported a positive transformation following stoma surgery, explicated through the concept of ‘biographical renewal’, which is characterised by physical relief from IBD symptoms and a reconfiguration of self and biography. Psychological distress, however, was sometimes found to co-exist alongside these transformations. Several barriers to the identification and management of psychological problems were identified on patient, professional, and systemic levels. Whilst peer support was recognised as a valuable support avenue, preference was expressed for these psychological needs to be met by healthcare services. Findings indicate the need for clinicians to encourage disclosure of psychological concerns following stoma surgery. The development of more effective care pathways, which include psychological services, as well as more age-appropriate peer support, are recommended to enhance access to psychological support for young adults with a stoma. i ii Table of Contents Abstract .................................................................................................................................. i List of abbreviations ........................................................................................................ viii Acknowledgments ............................................................................................................... ix Chapter 1. Introduction ................................................................................................... 1 1.1 A clinical overview .................................................................................................... 2 1.1.1 Inflammatory bowel disease ........................................................................... 2 1.1.2 Stoma surgery ................................................................................................. 4 1.2 Stoma care in the National Health Service in England .............................................. 7 1.3 Rationale for the study ............................................................................................. 11 1.3.1 The psychological impact of stoma surgery ................................................. 12 1.3.2 Access to psychological care and support .................................................... 17 1.4 The approach to the thesis ....................................................................................... 20 1.5 Thesis structure ........................................................................................................ 21 Chapter 2. Experiences of living with chronic illness: a narrative review ................ 23 2.1 A sociological perspective on chronic illness .......................................................... 24 2.2 The impact of chronic illness: Body, self and biography ........................................ 26 2.2.1 Health-related stigma .................................................................................... 26 2.2.2 The self in chronic illness ............................................................................. 30 2.2.3 Biographical impact of illness ...................................................................... 33 2.3 Chronic illness in young adulthood ......................................................................... 36 2.4 Illness narratives ...................................................................................................... 39 2.5 Conclusion ............................................................................................................... 43 Chapter 3. Experiences of living with a stoma: A review of psychological impact and support needs ...................................................................................................................... 44 3.1 Approach to the literature review ............................................................................ 44 3.2 Understanding the impact of IBD ............................................................................ 46 iii 3.3 Decision-Making: To have or not to have surgery? ................................................. 50 3.4 Understanding the impact of stoma surgery ............................................................ 52 3.4.1 Stoma-related Quality of Life ....................................................................... 53 3.4.2 Lived Experiences: benefits and challenges? ................................................ 55 3.5 Psychological effects of stoma surgery .................................................................... 64 3.5.1 Stoma care self-efficacy ................................................................................ 66 3.5.2 Acceptance of the stoma ............................................................................... 67 3.5.3 Illness perceptions and coping ...................................................................... 68 3.6 Access to care, support, and services ....................................................................... 69 3.6.1 Perceptions of stoma-related care ................................................................. 69 3.6.2 Role of informal support ............................................................................... 73 3.6.3 Online resources and support ........................................................................ 75 3.7 Research aim and objectives .................................................................................... 79 Chapter 4. Methodology and Methods .......................................................................... 82 4.1 Philosophical Underpinnings ................................................................................... 82 4.2 Methodological framework ...................................................................................... 85 4.2.1 Constructivist grounded theory ..................................................................... 86 4.2.2 Narrative inquiry ........................................................................................... 88 4.2.3 Combined methodological approaches ......................................................... 91 4.3 Study design and methods........................................................................................ 95 4.3.1 Sampling strategy .......................................................................................... 95 4.3.2 Recruitment process ...................................................................................... 99 4.3.3 Data generation ........................................................................................... 104 4.3.4 Ethical issues in interviewing ..................................................................... 110 4.3.5 Data analysis ............................................................................................... 112 4.4 Reflexivity .............................................................................................................. 119 4.5 Summary ................................................................................................................ 121 iv Chapter 5. The biographical impact of stoma formation in young adulthood ........ 122 5.1 Profiles of young adult participants ....................................................................... 123 5.2 The lead-up to stoma surgery ................................................................................. 125 5.2.1 Stoma as an ‘anticipated biographical disruption’ ...................................... 126 5.2.2 From resistance to acceptance .................................................................... 128 5.3 Post-surgery experiences ....................................................................................... 129 5.4 Biographical impact of stoma surgery ..................................................................
Load more

Recommended publications
  • Rediscovering the Rhetoric of Women's Intellectual
    ―THE ALPHABET OF SENSE‖: REDISCOVERING THE RHETORIC OF WOMEN‘S INTELLECTUAL LIBERTY by BRANDY SCHILLACE Submitted in partial fulfillment of the requirements For the degree of Doctor of Philosophy Dissertation Adviser: Dr. Christopher Flint Department of English CASE WESTERN RESERVE UNIVERSITY May 2010 CASE WESTERN RESERVE UNIVERSITY SCHOOL OF GRADUATE STUDIES We hereby approve the thesis/dissertation of ________Brandy Lain Schillace___________________________ candidate for the __English PhD_______________degree *. (signed)_____Christopher Flint_______________________ (chair of the committee) ___________Athena Vrettos_________________________ ___________William R. Siebenschuh__________________ ___________Atwood D. Gaines_______________________ ________________________________________________ ________________________________________________ (date) ___November 12, 2009________________ *We also certify that written approval has been obtained for any proprietary material contained therein. ii Table of Contents Preface ―The Alphabet of Sense‖……………………………………...1 Chapter One Writers and ―Rhetors‖: Female Educationalists in Context…..8 Chapter Two Mechanical Habits and Female Machines: Arguing for the Autonomous Female Self…………………………………….42 Chapter Three ―Reducing the Sexes to a Level‖: Revolutionary Rhetorical Strategies and Proto-Feminist Innovations…………………..71 Chapter Four Intellectual Freedom and the Practice of Restraint: Didactic Fiction versus the Conduct Book ……………………………….…..101 Chapter Five The Inadvertent Scholar: Eliza Haywood‘s Revision
    [Show full text]
  • The University of Sheffield Object
    The University of Sheffield Object Relations Middle Group and Attachment Theory: Gender Development, Spousal Abuse, and Qualitative Research On Youth Crime s. S. Wier PhD Object Relations Middle Group and Attachment Theory: Gender Development, Spousal Abuse, and Qualitative Research on Youth Crime Stewart Scott Wier PhD Centre for Psychotherapeutic Studies January 2003 Acknowledgments There are a number of people to whom I wish to express my sincere thanks and appreciation for their role in facilitating this achievement. Dr. Don Carveth first introduced me to the subject of psychoanalytic thought. He encouraged me to develop the potential he saw as an undergraduate student, and has continued to do so over the years, the most recent being through his endorsement of this particular dream. Dr. Gottfried Paasche is responsible for acquainting me with the process of qualitative methods of research, around which much of this paper is based, as well as for sponsoring my application to pursue this endeavor. The initial efforts for this project began over a decade ago at the University of Exeter under the direction of Dr. Paul Kline. He provided outstanding support and optimism surrounding these labours, in addition to showing compassion about my eventual decision to suspend them. Several years later, and following the retirement of Dr. Kline, Dr. Robert Young ofthe University of Sheffield, willingly assumed the responsibility ofacting as my subsequent supervisor despite the enormous demands on his time. The chair of the department for Psychotherapeutic Studies, Geraldine Shipton, displayed integrity, moral commitment, and consistency throughout the entire process. Dr. Christopher Cordess and Dr. Corinne Squire provided informed and respectful critical comments through a very cordial session which served to make a potentially distressing experience exceedingly pleasant, and brought considerable improvement to the first effort.
    [Show full text]
  • Conceptual Blending, Metaphors, and the Construction Of
    Conceptual Blending, Metaphors, and the Construction of Meaning in Ice Age Europe: An Inquiry Into the Viability of Applying Theories of Cognitive Science to Human History in Deep Time By Timothy Michael Gill A dissertation submitted in partial satisfaction of the requirements for the degree of Doctor of Philosophy in Anthropology in the Graduate Division of the University of California, Berkeley Committee in Charge: Professor Margaret Conkey, Chair Professor Rosemary Joyce Professor Kent Lightfoot Professor Eve Sweetser Fall 2010 Copyright Timothy Michael Gill, 2010 All rights reserved Abstract Conceptual Blending, Metaphors, and the Construction of Meaning in Ice Age Europe: An Inquiry Into the Viability of Applying Theories of Cognitive Science to Human History in Deep Time by Timothy Michael Gill Doctor of Philosophy in Anthropology University of California, Berkeley Professor Margaret Conkey, Chair Although the peoples of Ice Age Europe undoubtedly considered the drawings, engravings and other imagery created during that long period of prehistory to be deeply meaningful, it is difficult for people today to discern with any degree of accuracy or reliability what those meanings may have been. Grand theories of meaning have been proposed, criticized, and in some cases rejected. The development over the last few decades of modern cognitive science presents us with another angle of approach to this difficult problem. In this dissertation I review two related cognitive science theories, Conceptual Metaphor Theory and Conceptual Integration
    [Show full text]
  • A Decision Rule for Diagnostic Testing in Obstructive Sleep Apnea
    A Decision Rule for Diagnostic Testing in Obstructive Sleep Apnea Willis H. Tsai, John E. Remmers, Rollin Brant, W. Ward Flemons, Jan Davies, and Colin Macarthur Department of Medicine, Division of Respiratory Medicine; Department of Community Health Sciences; and Department of Anesthesia, University of Calgary, Calgary, AB, Canada Obstructive sleep apnea (OSA) is traditionally diagnosed using over- hourϪ1 or more) of 5.17% and 81%, respectively. In contrast, night polysomnography. Decision rules may provide an alternative patients with the lowest clinical score had a likelihood ratio to polysomnography. A consecutive series of patients referred to of 0.25 and a post-test probability of OSA of 17%. a tertiary sleep center underwent prospective evaluation with the A morphometric model developed by Kushida and col- upper airway physical examination protocol, followed by determi- leagues had an OSA diagnostic sensitivity and specificity of nation of the respiratory disturbance index using a portable moni- 98% and 100%, respectively; however, selection bias was a tor. Seventy-five patients were evaluated with the upper airway physical examination protocol. Historic predictors included age, potential concern (3). Nevertheless, the model illustrated the snoring, witnessed apneas, and hypertension. Physical examination– potential value of physical examination–based decision rules based predictors included body mass index, neck circumference, in clinical decision-making. mandibular protrusion, thyro–rami distance, sterno–mental distance, Current decision rules have only intermediate diagnostic sterno–mental displacement, thyro–mental displacement, cricomen- characteristics and are frequently too cumbersome, either tal space, pharyngeal grade, Sampsoon-Young classification, and over- arithmetically or logistically, for bedside implementation (2, bite. A decision rule was developed using three predictors: a crico- 4–10).
    [Show full text]
  • Complex Odontogenic Infections
    Complex Odontogenic Infections Larry ). Peterson CHAPTEROUTLINE FASCIAL SPACE INFECTIONS Maxillary Spaces MANDIBULAR SPACES Secondary Fascial Spaces Cervical Fascial Spaces Management of Fascial Space Infections dontogenic infections are usually mild and easily and causes infection in the adjacent tissue. Whether or treated by antibiotic administration and local sur- not this becomes a vestibular or fascial space abscess is 0 gical treatment. Abscess formation in the bucco- determined primarily by the relationship of the muscle lingual vestibule is managed by simple intraoral incision attachment to the point at which the infection perfo- and drainage (I&D) procedures, occasionally including rates. Most odontogenic infections penetrate the bone dental extraction. (The principles of management of rou- in such a way that they become vestibular abscesses. tine odontogenic infections are discussed in Chapter 15.) On occasion they erode into fascial spaces directly, Some odontogenic infections are very serious and require which causes a fascial space infection (Fig. 16-1). Fascial management by clinicians who have extensive training spaces are fascia-lined areas that can be eroded or dis- and experience. Even after the advent of antibiotics and tended by purulent exudate. These areas are potential improved dental health, serious odontogenic infections spaces that do not exist in healthy people but become still sometimes result in death. These deaths occur when filled during infections. Some contain named neurovas- the infection reaches areas distant from the alveolar cular structures and are known as coinpnrtments; others, process. The purpose of this chapter is to present which are filled with loose areolar connective tissue, are overviews of fascial space infections of the head and neck known as clefts.
    [Show full text]
  • Fascial Infections Derived from Maxillary Odontogenic Origins the Spread Pattern of Maxillary Infection Differed from That of Mandibular Infection
    Odontogenic infections arising in the mandible first spread upward, into the masseter and/or medial pterygoid muscles in the masticator space, and downward, into the sublingual and/or submandibular spaces, and then spread into the spaces or muscles adjacent to one or more of these locations. Infections from the masseter muscle spread into the parotid space to involve the temporalis and lateral pterygoid muscles. Infections from the medial pterygoid muscle spread into the parapharyngeal space to involve the lateral pterygoid muscle. Infections in the maxilla did not spread downward; instead, they tended to spread upward and superficially into the temporal and/or masseter spaces and deeply involve the lateral and/or medial pterygoid muscles in the medial masticator space. CONCLUSION: CT may be useful to depict the extent of infection and to plan treatment of Odontogenic infections rarely extend beyond the jaw bone barriers into the deep spaces of the face and neck (1). But once they occur, they are often difficult to assess accurately by clinical and conventional radiologic techniques, and the outcome may be serious and potentially life threatening (2). Because of its ability to locate diseases in clinically inaccessible portions of the body, computed tomography (CT) has been used to evaluate deep facial and neck infections (2– 4). However, CT studies in large populations of patients with widespread deep infections of the neck originating from odontogenic infections have been scarce, and pathways through which the inflammatory processes extend have not been studied intensively. We assessed profiles of involvement of the deep facial and upper neck spaces by infections of odontogenic origin.
    [Show full text]
  • เรื่อง Management of Odontogenic Infection
    เอกสารประกอบการสอน กระบวนวิชา DOS 408482 เรื่อง Management of odontogenic infection วัตถุประสงค : เพื่อใหนักศกษาสามารถึ 1. เพื่อใหนักศึกษามีความรู ความเขาใจในการร ักษาการติดเชื้อสาเหตุจากฟน 2. เพื่อใหนักศึกษาสามารถประยุกตความรูดังกลาวมาใชในทางคล ินิกได จัดทําโดย... อาจารย วุฒินันท จตพศุ ภาควิชาศัลยศาสตรชองปาก คณะทันตแพทยศาสตร มหาวิทยาลยเชั ียงใหม -1- Management of Odontogenic Infection การแพรกระจายของการติดเชื้อจากชองปาก 1. ทางเนื้อเยื่อเกยวพี่ ัน (connective tissue) or direct spread 2. ทางระบบไหลเวียนนาเหล้ํ ือง (lymphatic drainage) 3. ทางระบบไหลเวียนโลหิต (hematogenic spread) ลักษณะของการติดเชื้อสาเหตุจากชองปากและฟน 1. Dentoalveolar infection เชน gum boil จากโรคปริทันต 2. Maxillary sinusitis (ติดเชื้อใน maxillary sinus) 3. Fascial space infection 4. Osteomyelitis of jaw bone 5. Septicemia (systemic infection) 6. Other organs infections Fascial space infection แบงตามลักษณะกายวิภาค ดังน ี้ 1. Lower vestibular infection (vestibule of mandible) เปนการติดเชื้อทําใหเก ิดการบวมบริเวณ vestibule เปนโพรงหนองที่มี buccinator muscle เปน ขอบเขตดานลางและดานบน เปน oral mucosa อาการและอาการแสดง(sings and symptoms) : บวมบริเวณ vestibule ทาง buccal หรือ labial ตรงตําแหนงฟ นท ี่เปนสาเหต ุ กดนิ่ม หรือแข็ง มีอาการเจ็บ สาเหต ุ : Apical infection, periodontal abscess การแพรกระจาย : อาจลกลามผุ าน buccinator muscle เขาสู buccal space การผาระบายหนอง : ลง incision ตามแนวขนานกับสันเหงือก บริเวณ vestibule ที่บวม 2. Mental space infection เปนชองวางระหวางกล ามเน ื้อ mentalis และ depressor labii inferioris กับกระดูก mandible บริเวณดานหนา (symphysis) โดยอยูใตกลามเนื้อ
    [Show full text]
  • The Case of Gastrointestinal Endoscopy Cognitive Load
    Invitation A ACRITICAL CRITICAL LENS LENS to attend the public defense of my thesis COGNITIVECOGNITIVE FORFOR EXAMINING EXAMINING LOADLOAD PROCEDURALPROCEDURAL SKILLS SKILLS TRAININGTRAINING IN IN THE THE COGNITIVE THEORY:THEORY: HEALTHHEALTH PROFESSIONS PROFESSIONS LOAD THEORY: A CRITICAL LENS FOR EXAMINING PROCEDURAL SKILLS TRAINING IN THE HEALTH PROFESSIONS THE CASE OF GASTROINTESTINAL ENDOSCOPY 230 mm (final size) 240 mm (final size) 30 August 2019 | 2:30 PM Senate Hall, Academy Building THETHE CASE CASE OF OF Domplein 29, Utrecht Utrecht University Reception in the Academy Building immediately following the defense 236 mm (with bleed 3 mm) 246 mm (with bleed 3 mm) GASTROINTESTINALGASTROINTESTINAL JustinJustin LouisLouis Justin Louis Sewell ENDOSCOPYENDOSCOPY SewellSewell [email protected] 170 mm (final size) 170 mm (final size) 65 mm 173 mm (with bleed 3 mm) 173 mm (with bleed 3 mm) 71 mm 15 mm Cognitive Load Theory: A Critical Lens for Examining Procedural Skills Training in the Health Professions The Case of Gastrointestinal Endoscopy Justin Louis Sewell ISBN: 978-94-6375-352-4 Copyright © 2019 by Justin Louis Sewell, San Francisco, CA, USA All rights reserved. No part of this thesis may be reproduced, stored in retrieval systems, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise without prior permission of the author. All previously published papers were reproduced with permission from the publisher. Cover art courtesy of Mark van Wijk. Cover: Ridderprint BV, the Netherlands
    [Show full text]
  • Space Infections
    Dr. Mohit Bindal Senior Lecturer Department Of OMFS DR.MOHIT BINDAL, Subharti Dental College, SVSU CONTENTS INTRODUCTION HOST DEFENSE AND INFECTION MICROBIOLOGY AND ANTIBIOTIC THERAPY FASCIAE OF HEAD AND NECK CLASSIFICATION OF SPACES MAXILLARY SPACES MANDIBULAR SPACES SECONDARY SPACES COMPLICATIONS OVERALL MANAGEMENT STAGES OF INFECTION CONCLUSION INTRODUCTION Fascial spaces are potential spaces between the layers of fascia- Shapiro Represent major pathways for spread of infections When infections spread deeply into soft tissue- involvement following path of least resistance INFECTIONS AND HOST DEFENSE In establishing presence of an infection, interaction occurs among three factors: 1. Host 2. Environment 3. Microorganism Infection occurs when either host is immunocompromised or when pathogenecity and number of microbes invading host is more SPREAD OF OROFACIAL INFECTION FACTORS INFLUENCING SPREAD GENERAL FACTORS: Host resistance Virulence of microorganism Medically compromised LOCAL FACTORS: - Intact anatomical barriers Alveolar bone Periosteum Adjacent muscles and fascia. ANATOMICAL CONSIDERATIONS MUSCLE ATTACHMENTS- Posteriors- Buccinator- midroot level Anteriors –Intrinsic lip muscles & risorius- at apex In maxilla- infection above attachment of muscle enters extra oral space In mandible- infection below attachment of muscle enters extra oral space PREDISPOSING FACTORS 1. Dental caries or periodontal infections 2. Lowered body resistance 3. Trauma Primary signs & symptoms of these infections: - Redness - Raised temperature
    [Show full text]
  • Shifting Materialities in Early American Natural History
    STRANGE AND UNSTABLE BODIES: SHIFTING MATERIALITIES IN EARLY AMERICAN NATURAL HISTORY CORRESPONDENCE NETWORKS by JULIE MARIE MCCOWN DISSERTATION Submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at The University of Texas at Arlington May, 2016 Arlington, Texas Supervising Committee: Stacy Alaimo, Supervising Professor Neill Matheson Desiree Henderson Cedrick May ABSTRACT STRANGE AND UNSTABLE BODIES: SHIFTING MATERIALITIES IN EARLY AMERICAN NATURAL HISTORY CORRESPONDENCE NETWORKS Julie Marie McCown, PhD The University of Texas at Arlington, 2016 Supervising Professor: Stacy Alaimo This dissertation fills a gap in the study of early American natural history literature by investigating the representation of animal bodies within early American natural history writing and attending to the role animal bodies play in shaping natural history knowledge and how natural history in turn shapes animal bodies. It also examines the effect the shifting materiality of animal bodies has on constructions of race and ethnicity in early America, as well as the ways non-white, non-male, and non-human persons exercise agency via natural history correspondence networks. Employing animal studies, posthumanism, and new materialism, I contend that, within natural history’s correspondence networks, there occurs a constant circulation of ideas and information, as well as materials and bodies. Providing a crucial link between real animals and representations of them, specimens offer convincing, tangible proof of the natural world, allowing a more effective vicarious experience of American animals than just words or images. They enrich and enliven verbal and visual descriptions of them, but at the same time serve as reminders of how incomplete and partial a grasp natural history has over animals.
    [Show full text]
  • The Symbiosis of Creativity and Wellness: a Personal Journey
    E.H. Butler Library at Buffalo State College Digital Commons at Buffalo State Creative Studies Graduate Student Master's Projects International Center for Studies in Creativity 5-2015 The yS mbiosis of Creativity and Wellness: A Personal Journey Jennifer A. Quarrie International Center for Studies in Creativity, Buffalo State College, [email protected] Advisor Dr. Cynthia Burnett To learn more about the International Center for Studies in Creativity and its educational programs, research, and resources, go to http://creativity.buffalostate.edu. Recommended Citation Quarrie, Jennifer A., "The yS mbiosis of Creativity and Wellness: A Personal Journey" (2015). Creative Studies Graduate Student Master's Projects. Paper 238. Follow this and additional works at: http://digitalcommons.buffalostate.edu/creativeprojects Part of the Social and Behavioral Sciences Commons The Symbiosis of Creativity and Wellness: A Personal Journey by Jennifer A. Quarrie An Abstract of a Project in Creative Studies Submitted in Partial Fulfillment of the Requirements for the Degree of Master of Science April 2015 ii ABSTRACT OF PROJECT The Symbiosis of Creativity and Wellness: A Personal Journey The Symbiosis of Creativity and Wellness project explored how holistic personal wellness practices nurture creativity, and conversely, how creativity fosters personal wellness. The project specifically explored wellness from the standpoint of sleep and circadian rhythms, somaticism and movement, nutrition and hydration, meditation and mindfulness, as well as connection and support. By immersing in research-based wellness practices and building a customized approach to personal wellness, this project not only facilitated measurable personal wellness improvements over the six-week period, but also highlighted more profound insights within the relationship between creativity and wellness.
    [Show full text]
  • Experiencing Invisible Chronic Illnesses at Work and in the Clinic: “It’S Almost Like People Have to Physically See It.”
    Experiencing Invisible Chronic Illnesses at Work and in the Clinic: “It’s almost like people have to physically see it.” A dissertation submitted To Kent State University in partial fulfillment of the requirements for the Degree of Doctor of Philosophy By Ginny L. Natale August 2019 © Copyright All rights reserved Except for previously published materials Dissertation written by Ginny L. Natale B.A., Mount Vernon Nazarene University, 2012 B.S., Mount Vernon Nazarene University, 2012 M.A. Kent State University, 2014 Ph.D., Kent State University, 2019 Approved by Dr. Clare L. Stacey , ,Co-Chair, Doctoral Dissertation Committee Dr. Manacy Pai , Dr. Richard Adams ,Members, Doctoral Dissertation Committee Dr. Juan Xi , Dr. Kelly Cichy , Accepted by Dr. Richard Serpe ,Chair, Department of Sociology Dr. James L. Blank , Dean, College of Arts and Sciences TABLE OF CONTENTS……………………………………………………..………………….iii ACKNOWLEDGEMENTS……………………………..……………………………..………….v I. INTRODUCTION…..…………………………………….……………………………1 II.. LITERATURE REVIEW………………………………………………………...…..13 III. METHODOLOGY…………………………………………………………………..26 IV. “IT KIND OF STOPS ME IN MY TRACKS SOMETIMES.”: BIOGRAPHICAL DISRUPTIONS AND PSYCHOLOGICAL DISTRESS………………………………..43 INTRODUCTION……………………………………………….………………43 REVIEW OF RELATED LITERATURE…………………………..…………...44 METHODOLOGY…………………………………...……..........……………...51 RESULTS……………………………………………………..…………………52 DISCUSSION………………..……………………………………………….….75 REFERENCES………………..…………………………………………………86 V. “MY BODY IS NOT LYING TO ME”: GAINING LEGITIMACY IN PATIENT- PROVIDER INTERACTIONS………………………………………………………….92
    [Show full text]