Purpose: We investigated how mothers employed in support staff positions make personal and family health decisions. Design: We used a critical feminist grounded theory design. Methods: Twenty women employed at a large Canadian institution participated over two years in repeat interactive interviews. Findings: “Finding a balance” was the emergent core process of health decision making in response to the basic social problem of multiple demands and uncoordinated, sometimes conflicting ideologies. Women emphasized recursive movement within a continuous process of four action phases: cueing in, figuring out, generating solutions, and assessing results. Two distinct views of finding a balance were revealed: weighing competing interests or harmonizing multiple interests. These distinctive views contributed to variation in women’s approaches to decision making and to their personal and family health experiences. Conclusions: Women’s experiences suggest a capacity for reflective practice in health decision making that provides an excellent basis for holistic, emancipatory nursing practice.
DeMarco, R., Ford-Gilboe, M., Friedemann, M., McCubbin, H.I., & McCubbin, M.A. (2000). Stress, coping, and family health. In V. H. Rice (Ed.), Handbook of stress, coping, and health: Implications for nursing research, theory, and practice (pp. 295-332). Thousand Oaks, CA: Sage.
2.
Garey, A. ( 1999). Weaving work and motherhood. Philadelphia , PA: Temple University Press.
3.
Glaser, B. ( 1978). Theoretical sensitivity: Advances in the methodology of grounded theory. Mill Valley, CA: Sociology Press.
4.
Granzow, K. ( 2008). The imperative to choose: A qualitative study of women’s decision-making and use of the birth control pill. Social Theory & Health, 6, 1-17.
5.
Griffin, J.M., Fuhrer, R., Stansfeld, S., & Marmot, M. ( 2002). The importance of low control at work and home on depression and anxiety: Do these effects vary by gender and social class? Social Science & Medicine, 54, 783-798.
6.
Gross, J., & Howard, M. ( 2001). Mothers’ decision-making processes regarding health care for their children. Public Health Nursing, 18, 157-168.
7.
Hall, J., & Stevens, P. ( 1991). Rigor in feminist research. Advances in Nursing Science, 13(3), 16-29.
8.
Harding, S. ( 1987). Introduction. Is there a feminist method? In S. Harding (Ed.), Feminism and methodology (pp. 1-14). Bloomington: Indiana University Press.
9.
Harrison, M.J., Neufeld, A., & Kushner, K. ( 1995). Women in transition: Access and barriers to social support . Journal of Advanced Nursing, 21, 858-864.
10.
Hattery, A. ( 2001). Women, work, and family: Balancing and weaving. Thousand Oaks, CA: Sage.
11.
Janis, I.L., & Mann, L. ( 1977). Decision making: A psychological analysis of conflict, choice, and commitment. New York, NY: Free Press.
12.
Korner, H. ( 2007). Negotiating cultures: Disclosure of HIV-Positive status among people from minority ethnic communities in Sydney. Culture, Health & Sexuality, 9, 137-152.
13.
Kouvonen, A., Kivimaki, M., Baananen, A., Heponiemi, T., Elovainio, M., Ala-Mursula, L., . . . Vahtera, J. (2007). Job strain and adverse health behaviors: The Finnish Public Sector Study. Journal of Occupational and Environmental Medicine, 49(1), 68-74.
14.
Kushner, K.E. ( 2007). Meaning and action in employed mothers’ health work. Journal of Family Nursing, 13, 33-55.
15.
Kushner, K.E. ( 2005). Embodied context: Employed mothers’ personal and family health decision making. Health Care for Women International , 26(1), 69-86.
16.
Kushner, K.E., & Harrison, M.J. (2002). Employed mothers: Stress and balance-focused coping. Canadian Journal of Nursing Research , 34, 47-65.
Lowe, G.S. ( 2000). The quality of work: A people-centred agenda. Don Mills, Ontario, Canada: Oxford University Press .
19.
Marshall, B.L. ( 1994). Engendering modernity: Feminism, social theory and social change. Boston, MA: Northeastern University Press.
20.
Matarese, C. ( 2005). Navigating the journey to menses cessation: A study of change in an emancipatory context. Journal of Holistic Nursing , 23, 34-50.
21.
O’Connor, A., Tugwell, P., Wells, G.A., Elmslie, T., Jolly, E., Hollingworth, G., . . . Drake, E. ( 1998). A decision aid for women considering hormone therapy after menopause: Decision support framework and evaluation. Patient Education and Counseling, 33, 267-279.
22.
Rettig, K.D. ( 1993). Problem-solving and decision-making as central processes of family life: An ecological framework for family relations and family resource management. In B. H. Settles, R. S. Hanks, & M. B. Sussman (Eds.), American families and the future: Analyses of possible destinies (pp. 187-222). New York, NY: Haworth Press.
23.
Roxburgh, S. ( 1996). Gender differences in work and well-being: Effects of exposure and vulnerability. Journal of Health and Social Behavior , 37, 265-277.
24.
Seibold, C., Richards, L., & Simon, D. ( 1994). Feminist method and qualitative research about midlife . Journal of Advanced Nursing, 21, 394-402.
25.
Sherwin, S. ( 1998). A relational approach to autonomy in health care. In S. Sherwin (Coordinator), The politics of women’s health: Exploring agency and autonomy (pp. 19-47). Philadelphia : Temple University Press.
26.
Statistics Canada. (2001). Low income cutoffs from 1990 to 1999 and low income measure from 1989 to 1998 . Ottawa, Ontario, Canada: Author .
27.
Taylor, B. ( 2004). Technical, practical, and emancipatory reflection for practicing holistically. Journal of Holistic Nursing, 22, 73-84.
28.
Vahabi, M., & Gastaldo, D. ( 2003). Rational choice(s)? Rethinking decision-making on breast cancer risk and screening mammography. Nursing Inquiry, 10, 245-256.
29.
Waters, M. ( 1994). Modern sociological theory. Thousand Oaks, CA: Sage.
30.
Wittmann-Price, R.A. ( 2004). Emancipation in decision-making in women’s health care. Journal of Advanced Nursing, 47, 437-445.
31.
Woods, N.F., Lentz, M., & Mitchell, E.S. (1993). The new woman: Health-promoting and health-damaging behaviors. Health Care for Women International , 14, 389-405.
32.
Wordsmyth. (2008). Home page. Retrieved from http://www.wordsmyth.net
33.
Wuest, J. ( 2001). Precarious ordering: Toward a formal theory of women’s caring. Health Care for Women International, 22, 167-193.
34.
Wuest, J. ( 2007). Grounded theory: The method. In P. Munhall (Ed.), Nursing research: A qualitative perspective (4th ed., pp. 239-271). Toronto, Ontario , Canada: Jones & Bartlett.
