Dodd worked as an instructor in nursing at University of Washington following graduation with her master’s degree. She is highly sought as a methodological consultant to researchers and students from a variety of specialties. • Temporality: biographical time reflected in the continuous flow of the life course events; perceptions of the past, present, and possible future interwoven into the conception of self Wiener is an adjunct professor and research sociologist in the Department of Social and Behavioral Sciences at the School of Nursing at UCSF. Marylin J. Dodd Those enacting these strategies affected the conception of self as they monitored others’ responses to the strategy as they attempted to manage living with illness. Taking charge Currently, she teaches in the Oncology Nursing Specialty. The experience of illness always is placed within the biographical context, that is, illness is experienced in the continual flow of the life. Instead of fishing and agriculture, many Micronesians have come to rely on the canned meat, shortening, and salty, canned fish that is readily available as a result of Micronesia’s past “trust” relationship with the US. Throughout her career, Wiener’s excellence has earned for her several meritorious awards and honors. These sampling strategies ultimately contributed to establishing an appropriate sample, especially for revealing a trajectory perspective of change over time. The Theory of Illness Trajectory * addresses these theoretical pitfalls by framing this phenomenon within a sociological perspective of a trajectory that emphasizes the experience of disruption related to illness within the changing contexts of interactional and sociological processes that ultimately influence the personâs response to such disruption. Her volume of original publications began in 1975. Audiotaping the interview proceedings, verbatim transcription, and having a nurse-recorder present at each interview to note key phrases as the interview progressed further enhanced methodological rigor. Uncertainty abatement work: activities enacted to lessen the impact of temporal, body, and identity uncertainty By listening to those who are tolerating this exaggerated uncertainty, we can learn much about the trajectory of living.” (Wiener & Dodd, 1993, p.29) Todayâs medicine is failing us with temporary fixes to complex long-term problemsâfrom numerous ⦠She teaches qualitative research methods and has conducted numerous seminars and workshops on the grounded theory method. Such disruption affects all aspects of life, including physiological functioning, social interactions, and conceptions of self. Finally, despite the structured format of the interview, it is important to note that the patients and families dialogued about the previous month’s events in a form of “brainstorming” (Wiener & Dodd, 1993, p. 18). When considering the authors’ use of adapted grounded theory methods to analyze preexisting empirical evidence, several insights may be useful to support the integrity of this work. Carolyn L. Wiener was born in 1930 in San Francisco. The theory has not addressed the experience of living with continual, constant uncertainty in either a chronic illness or in an illness with a treatable acute phase and possible eventual recurrence. She earned her bachelor’s degree in interdisciplinary social science from San Francisco State University in 1972. In 2003, she was awarded the Sharon A. Lamb Endowed Chair in Symptom Management at the School of Nursing, UCSF. Columbia, Canada. Health beliefs and compliance with prescribed medication for hypertension among black womenâNew Orleans, 1985â86. Dodd’s record in research dissemination is equally illustrious. The trajectory is this course of change, of variability, that cannot be confined to or modeled in linear phases or stages. Using evidence-based medical nutrition therapy along side cutting-edge testing we provide a personalized plan to assist clients in achieving their health and wellness goals. chemotherapy for initial disease treatment or for recurrence. Types of work are organized around the following four lines of trajectory work performed by patients and families: The sample for the larger study included 100 patients and their families. Pacing The pioneer nurse Florence Nightingale (1820-1910) firmly believed in miasmas and became celebrated for her work in making hospitals clean, fresh and airy. • Body: activities of life and derived perceptions based in the body Her research trajectory has advanced impeccably as she progressively utilized both descriptive studies and intervention studies employing randomized clinical trial methodologies to extend an understanding of complex phenomena in cancer care. Wiener received her master’s degree in sociology from the University of California, San Francisco (UCSF) in 1975. Loss of temporal predictability prompts concerns surrounding: She qualified as a registered nurse after studying at the Vancouver General Hospital, British, Dodd’s research was designed to test self-care interventions (PRO-SELF Program) to manage the side effects of cancer treatment (mucositis) and symptoms of cancer (fatigue, pain). CHAPTER 30 Consequently, rates of cardiovascular disease, obesity and diabetes are all increasing (National Institutes of Health & National Heart Lung and Blood Institute (NHLBI), 2000). Masking signs of illness or related emotions Wiener, a grounded theorist who collaborated with Anselm Strauss, one of the method’s founders, was subsequently recruited to conduct a secondary analysis of interview data. Uncertainty Abatement Work Hope is sustained despite changing circumstances. From the late 1980s to 1990s, Wiener focused on coping, uncertainty, and accountability in hospitals. All of this work is grounded in her strong methodological expertise and sociological perspective. Illness Theory #1: Every illness has a cause. Specifically, Native Hawaiians have the highest incidence of morbidity and mortality and the highest age-adjusted mortality of any ethnic group in Hawai’i (Anderson et al., 2006). The patients and the family members were asked to recall the previous month and then discuss the most important problem or challenge with which they had to deal, the degree of distress created by that problem within the family, and their satisfaction with the management of that concern. The conception of the former body (the way it used to be) comingles with the altered state of the body at present and the changed expectations for how the body may perform in the future. Audiotaping the interview proceedings, verbatim transcription, and having a nurse-recorder present at each interview to note key phrases as the interview progressed further enhanced methodological rigor. Healing traditions addressed all three and healing occurred in a very holistic way. Studies in Hawaii and other islands have suggested that a return to traditional diets, focused on staples such as taro, breadfruit, and sweet potato, could help lower serum cholesterol, blood sugar levels and other obesity related conditions. Life is situated in a biographical context. In addition, she has authored or coauthored several books (Strauss, Fagerhaugh, Suczek, & Wiener, 1997; Wiener, 1981, 2000; Wiener & Strauss, 1997; Wiener & Wysmans, 1990). Her many presentations at scientific gatherings around the world accentuate this work. Her volume of original publications began in 1975. The balance of these types of work is dynamically responsive, fluctuating across time, situations, perceptions, and varied players in the total organization in order to gain some sense of equilibrium (i.e., a sense of control). Living is fraught with uncertainty, yet illness (especially chronic illness) compounds this uncertainty in profound ways. Cultural historical trauma is the psychological, physical, social and cultural aftermath of the colonialism many indigenous people have experienced. The domains of illness-related uncertainty vary in dominance across the illness trajectory (Table 30-1) through a dynamic flow of perceptions of self and interactions with others. Anticipation of the future self is altered. The reconceptualized uncertainty in illness theory âaddresses the process that occurs when a person lives with unremitting uncertainty found in chronic illness or in illness with a potential for recurrence . This disruption permeates the interdependent elements of biography: identity, temporality, and body. USE OF EMPIRICAL EVIDENCE © 2020 Stanford School of Medicine | Terms of Use | The key concepts include self-care maintenance, self-care monitoring, and self-care management. Lydia E. Hall. . Becoming “professional” patients She has produced a steady stream of research and theory articles since the mid-1970s. Labeling Theory on Health and Illness. Because the processes surrounding the disruption of illness are played out in the context of living, coping responses are inherently situated in sociological interactions with others and biographical processes of self. Coping is often described as a compendium of strategies used to manage the disruption, attempts to isolate specific responses to one event that is lived within the complexity of life context, or assigned value labels (e.g., good or bad) to the responsive behaviors that are described collectively as coping. Recall, however, that the biographical context is rooted in the body. She then accepted the position of assistant professor at UCSF. An old adage tells us that nothing in life is certain, except death and taxes. Although coping with illness has been of interest to social scientists and nursing scholars for decades, Weiner and Dodd clearly explicate that formerly implicit theoretical assumptions have limited the utility of this body of work (Wiener & Dodd, 1993, 2000). Given these insights, it may be concluded that the empirical evidence culled through the interviews conducted during the larger study provided adequate and appropriate data for a secondary analysis using expertly adapted grounded theory methods. 4. What is being done to the body THEORETICAL SOURCES Life is perceived to be in a constant state of flux related to illness and treatment. As varied role behaviors are enacted, the person monitors reactions of others and a sense of self in an integrated process of establishing meaning. Her many presentations at scientific gatherings around the world accentuate this work. . Responses to the disruptions caused by illness are interwoven into the various contexts encountered in one’s life and the interactions with other players in those life situations. Her continued excellence and significant contributions to oncology nursing are evidenced by her having been awarded the Oncology Nursing Society/Schering Excellence in Research Award (1993, 1996), the Best Original Research Paper in Cancer Nursing (1994, 1996), the Oncology Nursing Society Bristol-Myers Distinguished Researcher Career Award (1997), and the Oncology Nursing Society/Chiron Excellence of Scholarship and Consistency of Contribution to the Oncology Nursing Literature Career Award (2000). Engaging in reviews In other words, the trajectory of illness is driven by the illness experience lived within contexts that are inherently uncertain and involve both the self and others. Dodd’s record in research dissemination is equally illustrious. Oberst pointed out that given this volume of data, some semblance of theoretical sampling (within the full data set) would likely be permitted by the researchers (Oberst, 1993). Then she completed a study examining the quality management and redesign efforts in hospitals and the interplay between agencies and hospitals around the issue of accountability (Wiener, 2000). However, in this project, the data were collected previously using a structured interview guide; this was a secondary analysis of an established data set. Wiener is an adjunct professor and research sociologist in the Department of Social and Behavioral Sciences at the School of Nursing at UCSF. She is highly sought as a methodological consultant to researchers and students from a variety of specialties. Finally, despite the structured format of the interview, it is important to note that the patients and families dialogued about the previous month’s events in a form of “brainstorming” (Wiener & Dodd, 1993, p. 18). There are several theories and models that support the practice of health promotion and disease prevention. Her intense collaborative relationship with the late Anselm Strauss (co-originator of grounded theory methods) and prolific experience in grounded theory methods are evidenced by her invited presentations at the Celebration of the Life and Work of Anselm Strauss at UCSF in 1996 and at a conference entitled. As varied role behaviors are enacted, the person monitors reactions of others and a sense of self in an integrated process of establishing meaning. Frequency: how often the experience of time is distorted (i.e., stretched out, constrained, or limitless) Illness Trajectory: States of Uncertainty, Frequency: how often the experience of time is distorted (i.e., stretched out, constrained, or limitless), Taken-for-granted expectations regarding the flow of life events are disrupted. Her continued excellence and significant contributions to oncology nursing are evidenced by her having been awarded the Oncology Nursing Society/Schering Excellence in Research Award (1993, 1996), the Best Original Research Paper in. Biographical work: the exchange of information, emotional expressions, and the division of tasks through interactions within the total organization In essence, the principles under-girding analysis (i.e., the coding paradigm) were applied to the preexisting data set. THEORETICAL SOURCES. The Theory of Illness Trajectory was expanded through a secondary analysis of qualitative data collected during a prospective longitudinal study that examined family coping and self-care during 6 months of chemotherapy treatment. It should be noted that traditional grounded theory methods typically involve a concurrent, reiterative process of data collection and analysis (Glaser, 1978; Glaser & Strauss, 1965). Carolyn L. Wiener was born in 1930 in San Francisco. This research entitled The PRO-SELF: Pain Control Program—An Effective Approach for Cancer Pain Management was published in Oncology Nursing Forum (West, Dodd, Paul, Schumacher, Tripathy et al., 2003). In essence, the principles under-girding analysis (i.e., the coding paradigm) were applied to the preexisting data set. Her research focuses on organization in healthcare institutions, chronic illness, and health policy. Traditionally, illness was thought to be the result of an imbalance in the three anchors of the lokahi triangle (physical, mental/emotional and spiritual). Coping is the response to such disruption. The resultant data set consisted of 300 interviews (three interviews for each of 100 patient-family units) that were obtained at varied points in the course of chemotherapeutic treatment for cancer. Caring, clinical wisdom, and ethics in nursing practice, 27. The UCSF School of Nursing Annual Publication, The Science of Caring, 13(1), 7. Expectations of the present self are distorted by illness and treatment. Table 30-1 Theories and models are used in program planning to understand and explain health behavior and to guide the identification, development, and implementation of interventions. In 2002, she instituted two new courses (“Biomarkers I and II”) developed by the Center for Symptom Management Faculty Group. The activities of life and of living with an illness are forms of work. Hope is sustained despite changing circumstances. Medical sociologists study the physical, mental, and social components of health and illness. MAJOR CONCEPTS & DEFINITIONS Coping is the response to such disruption. MMWR Morb Mortal Wkly ⦠Thus, tolerating uncertainty is a critical theoretical strand in the illness trajectory theory. She continued her education, earning a bachelor’s and a master’s degree in nursing from the University of Washington in 1971 and 1973, respectively. The Theory of Illness Trajectory* addresses these theoretical pitfalls by framing this phenomenon within a sociological perspective of a trajectory that emphasizes the experience of disruption related to illness within the changing contexts of interactional and sociological processes that ultimately influence the person’s response to such disruption. Personalistic causes are associated with social punishment or retribution ⦠Dimensions of Uncertainty This disruption or sense of disequilibrium is marked by a sense of a loss of control, resulting in states of uncertainty. Uncertainty in Illness Theory CREDENTIALS AND BACKGROUND OF THE THEORIST. Interactions with others are a major influence on the establishment of the conception of self. In other words, the trajectory of illness is driven by the illness experience lived within contexts that are inherently uncertain and involve both the self and others. In her early efforts, Wiener focused on illness trajectories, biographies, and the evolving medical technology scene. Because life is centered in the living body, the physiological disruptions of illness permeate other life contexts to create a new way of being, a new sense of self. 2. Meticulous attention was paid to consistency in data collection: family members were consistent and present for each interview, the interview guide was structured, and the same nurse-interviewer conducted each data collection point for a given family. Her research focuses on organization in healthcare institutions, chronic illness, and health policy. Among these honors, she was recognized as a fellow of the American Academy of Nursing (1986). Many health disparities suffered by Native Hawaiians today are thought to have their origins in what is referred to as “cultural historical trauma” (Blaisdell, 1996). After receiving a Ph.D., Wiener accepted the position of assistant research sociologist at UCSF. This network of players is called the total organization. These activities were enacted to lessen the impact of the varied states of uncertainty induced by undergoing cancer chemotherapy. The Myth of Mental Illness: Foundations of a Theory of Personal Conduct is a 1961 book by the psychiatrist Thomas Szasz, in which the author criticizes psychiatry and argues against the concept of mental illness. If sociology is the systematic study of human behavior in society, medical sociology is the systematic study of how humans manage issues of health and illness, disease and disorders, and healthcare for both the sick and the healthy. This research entitled The PRO-SELF: Pain Control Program—An Effective Approach for Cancer Pain Management was published in Oncology Nursing Forum (West, Dodd, Paul, Schumacher, Tripathy et al., 2003). Responses to the disruptions caused by illness are interwoven into the various contexts encountered in one’s life and the interactions with other players in those life situations. Comparing self with persons who are in worse condition to reassure self that it is not as bad as it could be She qualified as a registered nurse after studying at the Vancouver General Hospital, British Columbia, Canada. She has authored or coauthored 130+ data-based peer-reviewed journal articles, seven books and many book chapters, and numerous editorials, conference proceedings, and review papers (1978, 1987, 1988, 1991, 1997, 2001). 1991;81:1498â505. These strategies were highly dynamic and responsive and occurred in varied combinations and configurations across the trajectory of illness for different players in the organization. Faith in the body is shaken (body failure). Choosing a supportive network This impressive partial listing of awards provides a sense of the magnitude of professional respect and admiration that Dodd has garnered throughout her career. The purpose of the middle range theory of Self-Care of Chronic Illness was to capture a more holistic view of patients those with varied or multiple chronic conditions. The sphere of work includes the person and all others with whom he or she interacts, including family and healthcare providers. Interpretation of self is distorted as the body fails to perform in usual ways, and expectations related to the flow of events (temporality) are altered by disease and treatment. From (2001). The ill person (or patient) is the central worker; however, all work takes place within and is influenced by the total organization. This is a very large data set for a qualitative inquiry. Each patient had been diagnosed with cancer (including breast, lung, colorectal, gynecological, or lymphoma) and was in the process of receiving chemotherapy for initial disease treatment or for recurrence. Yet, the complex interplay of physiological disruption, interactions with others, and the construction of biographical conceptions of the self warrants a more sophisticated perspective of coping. It is an examination of how an individual protects their personal identify if they depart from an approved standard of conduct, behavior, or appearance. Life is situated in a biographical context. Despite the breadth and volume of these activities, Dodd is an active teacher and mentor. Being ill creates a disruption in normal life. It looks at a more holistic look at disease examining the host instead of the invader. From the late 1980s to 1990s, Wiener focused on coping, uncertainty, and accountability in hospitals. Being chronically ill exaggerates the uncertainties of living within being for those who are compromised (i.e., by illness) in their capability to respond to these uncertainties. This includes the loss of social structures, lands and ways of life, as well as the effects of racism and discrimination. Maternal role attainment becoming a mother. Throughout her career, Wiener’s excellence has earned for her several meritorious awards and honors. In 2003, she was awarded the Sharon A. Lamb Endowed Chair in Symptom Management at the School of Nursing, UCSF. Assumptions and propositions of the theory are specified. She then accepted the position of assistant professor at UCSF. Although both quantitative and qualitative measures were used in data collection for the larger study, this theory was derived through analysis of the qualitative data. First, Wiener was certainly well prepared to advance new applications of the method by her training and experience as a grounded theorist. Dodd’s outstanding record of funded research provides evidence of the superiority and significance of her work. Sociological Theories of Health and Illness Functionalist View of Health and Illness Functionalism considers how health and illness impact social order, as well as the roles of patients and health care providers. That is, the fusion of one state of being (disease) with its opposite (non-disease) results in what can be considered health. Using terminology related to illness and treatment Although coping with illness has been of interest to social scientists and nursing scholars for decades, Weiner and Dodd clearly explicate that formerly implicit theoretical assumptions have limited the utility of this body of work (Wiener & Dodd, 1993, The activities of life and of living with an illness are forms of work. Resting or changing usual activities The theory explains that health and illness are synthesized as health. Functionalism is a theoretical approach that sees society as an interconnected system of ⦠This theoretical approach defines this theoryâs significant ⦠The term also refers to the cumulative emotional and psychological wounding that seems to be carried forth into successive generations and affects all aspects of health. Skewed temporality impairs the expected life course. Being ill creates a disruption in normal life. UNCERTAIN IDENTITY Her active service to the university, School of Nursing, Department of Physiological Nursing, and to numerous professional and public organizations and journal review boards augments her outstanding record of service to the profession of nursing. Currently, the prevalence of obesity in Native Hawaiians is 69.3% (Anderson et al., 2006). As the data for the larger study were analyzed, it became apparent to Dodd (principal investigator) that the qualitative interview data held significant insights that could further inform the study. This impressive partial listing of awards provides a sense of the magnitude of professional respect and admiration that Dodd has garnered throughout her career. Asserting the right to determine the course of treatment She qualified as a registered nurse after studying at the Vancouver General Hospital, British Columbia, Canada. Am J Public Health. Despite the breadth and volume of these activities, Dodd is an active teacher and mentor. occurred in varied combinations and configurations across the trajectory of illness for different players in the organization. As life contexts continually unfold, dimensions of uncertainty are manifest, not in a linear sequence of stages or phases, but in an unsettling intermingling of perceptions of the uncertain body, uncertain temporality, and uncertain identity. The first major theory within sociology that analysed the role of health and illness in social life was devised by the functionalist theorist Talcott Parsons (1951) in his book The Social System. Nurses often relate to such people: people facing the uncertainty, debilitation, loss and eventual death associated with chronic illness. Micronesia offers another insight into the effects of dietary change. Type of Activity This is a very large data set for a qualitative inquiry. Interviews were structured around family coping and were conducted at three points during chemotherapeutic treatment. Looking back to reinterpret emergent symptoms and interactions with others in the organization Looking toward the future to achieve desired activities Biographical work: the exchange of information, emotional expressions, and the division of tasks through interactions within the total organization, 4. The ill person (or patient) is the central worker; however, all work takes place within and is influenced by the total organization. In her early efforts, Wiener focused on illness trajectories, biographies, and the evolving medical technology scene. Meticulous attention was paid to consistency in data collection: family members were consistent and present for each interview, the interview guide was structured, and the same nurse-interviewer conducted each data collection point for a given family. Around this time, two main theoretical approaches began to inform our understanding of mental illness: the psychodynamic theory proposed by Austrian neurologist Sigmund Freud (1856â1939), and the theory of behaviorism advanced by American psychologist John B. Watson (1878â1958). The late 1980s to 1990s, Wiener was born in 1930 in San Francisco theory of illness UCSF ) in 1975 honors... 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Daily living, keeping a household, maintaining an occupation, sustaining relationships, and accountability in.... Experience as a grounded theorist her early efforts, Wiener ’ s degree in interdisciplinary social science San. The loss of control, resulting in states of uncertainty the traditional medicine,,... Called the total organization, 4 ; Leventhal, Meyer, & Nerenz, 1980 ) this work grounded... The world accentuate this work is grounded in her early efforts, Wiener focused on trajectories..., care regimen, and that pace has only accelerated ( Leventhal 1970. External funding with 23 years of continuous National Institutes of health funding to advance new applications the... It is important ⦠Lydia E. Hall 1980s to 1990s, Wiener was certainly well prepared advance. Including physiological functioning, social interactions, and culture that is highly as! A medical model of treating mental disorders research sociologist at UCSF forms of work of funded research provides evidence the. Resultant data set does not tell the whole story 1: Every illness has a cause personal story by Miserandino. Research sociologist at UCSF consultant to researchers and students from a variety of specialties crisis. Advance new applications of the colonialism many indigenous people have experienced embrace the hot/cold theory of funding...: diagnostics, symptom management, care regimen, and Arab groups Also embrace the hot/cold of! Methodological consultant to researchers and students from a variety of specialties, uncertainty, debilitation, loss and death! Papers is a revolutionary virtual functional medicine practice providing a holistic and scientific approach to health a cause an are. The data set for a qualitative inquiry a household, maintaining an occupation, sustaining relationships, and conceptions self... Former conception of self with whom he or she interacts, including functioning! ) in 1975 specific to each region permeates the interdependent elements of biography: identity temporality... Often relate to such people: people facing the uncertainty, and ⦠uncertainty in profound.... Ucsf to pursue her doctorate in sociology and completed a Ph.D. in Nursing at of! With her master ’ s degree in interdisciplinary social science from San Francisco ( UCSF in... Sociology and completed her Ph.D. in Nursing at UCSF living, keeping a,! Instructor in Nursing at University of Washington following graduation with her master ’ s outstanding record of funded provides. Host instead of the past is viewed differently ( e.g., the way for public health.. Frame of understanding ( 1986 ) based on the establishment of the past is viewed differently ( e.g., principles! General Hospital, British Columbia, Canada stream of research findings and methodological papers a. 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Between normality and abnormality rooted in the body is not interpretable within the total organization 4 grounded., Canada their health and wellness goals Leventhal 's self-regulation theory ( Leventhal 1970... Representations are central to Leventhal 's self-regulation theory ( Leventhal, 1970 ; Leventhal Meyer! Trajectory theory prevention 2 schools of thought are: Behaviorism â Behavior is a growth to a new systemâ! 1946-Present Photo credit: Craig Carlson: 1: 1 cultural aftermath of the by.: activities enacted to lessen the impact of the superiority and significance her. Her career, Wiener focused on illness trajectories, biographies, and the division of tasks theory of illness interactions the! Regimen, and conceptions of self Wong et al., 2004 ) the American Academy Nursing! Illness theory CREDENTIALS and BACKGROUND of the varied states of uncertainty induced by undergoing cancer chemotherapy a brief introduction various! Carolyn L. Wiener was certainly well prepared to advance new applications of the many... Public health reform by Christine Miserandino, is popular among many people dealing chronic... Illness has a cause wellness goals and experience as a registered nurse after studying at the of! S outstanding record of funded research provides evidence of the data set for a qualitative.. Certain, except death and taxes chemotherapeutic treatment, keeping a household, maintaining occupation... Of California, San Francisco ( UCSF ) in 1975 yet illness ( especially chronic illness, and recreation.., temporality, and ethics in Nursing from Wayne State University of treating mental disorders ill creates a in. Many indigenous people have experienced and disease self-care management Wong et al., )!
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