• Managing Change: The Process of Caregiving for Informal Caregivers of Head and Neck Cancer Patients

      Edmonds, Maura Fulham; McGuire, Deborah B. (2013)
      Purpose: The goal of this study was to gain a better understanding of the process undertaken by the informal caregivers of head and neck cancer (HNC), with an eye toward theory development. Although the development of a theory was beyond the scope of this project, it was meant to be a first step toward understanding the important categories and concepts that are part of this process. Methods: This study used grounded theory methods and was conducted at a large urban National Cancer Institute (NCI)-designated cancer center in the Mid-Atlantic region of the US. Constant comparative analysis and theoretical sampling were used to gather and analyze data from six caregivers of HNC patients. Audio-recorded and transcribed, de-identified raw data were analyzed using Atlas ti Software<sup>TM</sup>. Results: The caregiving process was described in terms that yielded a core category and two other categories. Subcategories were identified as well as dimensions of some of the subcategories. The core category was entitled Managing Change and the two other categories were entitled Types of Change and Strategies for Managing Change. Types of Change encompassed the subcategories of Changes in Life Patterns, Witnessing Physical Changes, Relationship Changes, and Increased Uncertainty. Strategies for Managing Change included the subcategories of Controlling Life Pattern Changes, Utilizing the Quality of the Relationship, and Managing Stress. Key findings included the identification of many different types of change, variation in types and amounts of change over time, utilization of quality of the relationship between patient and caregiver as an important strategy for caregivers, and caregivers' use of a variety of strategies to manage change. Conclusions: This study has attempted to broaden the understanding of the role of a caregiver of a patient with HNC using grounded theory methods. This work is the first step in developing a theory of caregiving related to this population which may also be applied to a broader population of caregivers.
    • Sexual risk behavior among African American college women: Understanding socio-cultural factors in the context of HIV/AIDS

      Gibbons, Maya; Belcher, John R. (2010)
      African American women are at the center of the discussion on health disparities, specifically disparities regarding HIV/AIDS and Sexually Transmitted Infections (STIs). Though there has been substantial research examining sexual risk behavior among low-income African American women, little has been done to understand sexual behavior decision-making among African American women who are not disadvantaged. The purpose of this qualitative study was to explore social and cultural influences on the sexual attitudes and behaviors of African American college women. Ten African American undergraduate college women, between the ages of 20 - 24 years, were individually interviewed for this study. Grounded theory methodology was used to elicit themes, ultimately leading to the working hypotheses, which helped to describe the factors influencing safe and risky sexual behavior in this sample. The first working hypothesis indicated that there are specific individual, social, and cultural factors that influence both risky and safe sexual behavior among the African American college women in the study. The individual factors include self-esteem, perceived power in a relationship, substance use, and perceived risk of contracting HIV/STIs. The social factors were peer norms, media/education exposure, and past sexual experiences. The cultural factors consisted of religion and spirituality as well as parental messages regarding sex, intimacy, and relationships. The second working hypothesis suggested that trust in a romantic partner tends to override protective factors and lead to risky sexual behavior. The findings from this study indicate that African American women in college are at risk for contracting HIV/AIDS and STIs, though there are protective influences that can minimize their risk. This research highlights that prevention programs aimed at eradicating HIV/AIDS and STI disparities for African American women should include the sub-group specific realities such as those found in this study. Implications for social work education and practice center on elevating the understanding of behaviors and attitudes that can put people at risk for HIV/STIs and infusing information about socio-cultural influences on sexual risk behavior in work with young adults. Future research suggestions include further exploring trust and intimacy as a salient influence on the sexual behavior decisions of African American college women.