Browsing by Author "McCaffrey, Graham"
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- ItemOpen AccessA hermeneutic reappraisal of nurse patient relationships on acute mental health units, using Buddhist perspectives(2012) McCaffrey, Graham; Raffin Bouchal, ShelleyThis dissertation is a hermeneutic study of the nurse-patient relationship on acute care, inpatient mental health units, using Buddhist perspectives. At its centre is a research study in the form of interpretive analysis of interview data from nurses with experience of working in acute mental health settings. The work in its entirety functions as a triangulation between the topic of nurse-patient relationship, Buddhist thought, and philosophical hermeneutics as an approach to research. Each of the three elements serves to illumine something about the others in a series of reciprocal discussions. There is necessarily a linear structure to the dissertation, so that one of the three elements is highlighted in a given chapter, but with reference to the other two. The arc of the work thus proceeds through the background to the topic and a discursive literature review; philosophical hermeneutics; Buddhist thought; hermeneutics in a research context; interpretive chapters based on interview data; and implications for practice. This is an intercultural study, in which different traditions of thought and practice are exposed to each other without any intention of subordinating one to another, but of allowing for a shifting of perspective and creation of new understanding. Among the three elements, however, the target is of course nursing practice and the extension of the theoretical, philosophical, and practical vocabularies, which are available to the nursing profession to articulate and develop its therapeutic practice with nurse-patient relationship.
- ItemOpen AccessEmerging Adult Women with Chronic Pain: A Narrative Inquiry(2022-03) Finlay, Jenise; dela Cruz, Añiela; Estefan, Andrew; McCaffrey, GrahamWomen are disproportionately affected by chronic pain, yet women’s pain is frequently discounted or underestimated by medical professionals. Emerging adult women are at higher risk for insufficient pain management and face unique challenges navigating chronic illness, dating, body image, college, careers, establishing independence from family, and bearing children at an age where youth is equated to being healthy. An increasing prevalence in chronic pain has been observed across all age groups in Canada, most notably among those aged 20 to 29 with no other health conditions, yet few qualitative studies examine chronic pain exclusively in women under 30. The purpose of this narrative inquiry was to understand how the experience of living with chronic pain affects the identity of emerging adult women aged 18 to 29. Clandinin and Connelly’s (2000) form of narrative inquiry was used to explore the lived and told stories of two emerging adult women living with chronic pain, gaining a deeper understanding of how their experiences shape, and are shaped by, social, cultural, familial, and institutional narratives. Data were generated through composition of field texts that included in-depth conversational interviews and field journal writing. Participant artwork, poetry, and writing were also used for data generation and data analysis. Transitioning from field texts to research texts, narrative accounts were then co-composed with research participants. Narrative threads that resonated across narrative accounts include: silenced, invisible, and locating self with pain; pain experiences storied through relationships; and resisting the singular stories of people living with chronic pain. Personal, practical, and social significance of this work are discussed with implications for nursing practice, health education, research, and policy before concluding with final reflections.
- ItemOpen AccessEvaluating the Impact of Mindfulness Meditation on Family Medicine Residents' Well-being(2016) Horton, Joan; Kassam, Aliya; Donnon, Tyrone L.; Palacios Mackay, Maria; Myhre, Douglas; McCaffrey, GrahamProfessional competence in medicine requires a commitment to physician health and well-being, for sustainable practice and optimal patient care. Yet few doctors are taught wellness-enhancing techniques during their training. Mindfulness-based stress reduction has been extensively studied and can be beneficial in reducing stress and burnout while enhancing empathy in medical personnel. This study evaluated the impact of an adapted 8-week program of mindfulness meditation on the well-being of a convenience sample of family medicine residents. Significant improvements were seen in the active group in measurements of personal burnout (d = 1.02, p < 0.05) and mindfulness (d = 1.04, p < 0.05) at 8 weeks, with significant improvement in perceived stress (d = 1.002, p < 0.05) and mindfulness (d = 1.48, p < 0.01) persisting at 16 weeks. Post-mindfulness training evaluations rated the initial group training, meditation recordings and feasibility positively but identified fatigue, conflicting schedules and lack of group time as barriers to the practice of mindfulness-based stress reduction. Protected program time for stress management training may benefit residents' development of Professional competence and patient care outcomes.
- ItemOpen AccessExploring How Alberta Health Services Nurses are Making Sense of Their Role in Relation to the Recent Changes to the Mental Health Act of Alberta(2024-04-30) Mustapha, Wafa; Smith, Jacqueline; Estefan, Andrew; Dimitropoulos, Gina; McCaffrey, GrahamThe purpose of this qualitative study is to explore how Alberta Health Services nurses are making sense of their role in relation to the recent changes to the Mental Health Act of Alberta. The Mental Health Act (MHA) of Alberta was enacted to protect and ensure the rights of people suffering from mental disorders. The most recent MHA amendment, which was enacted in September 2020, includes expanded duties required of the hospital and health care providers. Social Constructivism, Carper’s Ways of Knowing theory, and Uncertainty theory will provide the theoretical framework for this study. A Thematic Analysis method was utilized to elicit responses using a semi-structured interview tool. Data analysis will be conducted using the six-step thematic analysis as introduced by Braun and Clarke (2006). The way nurses make sense of their role contributes to the composition of ethically informed, safe, and effective care within the scope of professional practice and current legislation. This study helps address this gap in the context of mental health nursing practice in Alberta.
- ItemOpen AccessExploring protective factors for pregnancy-related anxiety in Tanzanian women(2017) Wall, Vanessa; Premji, Shahirose; Letourneau, Nicole; McCaffrey, Graham; Dimitropoulos, GinaPregnancy-related anxiety is highly correlated with pre-term birth which can be fatal in low-and-middle-income countries. Modifiable protective factors for pregnancy-related anxiety need to be identified to prevent this condition. This study aimed to identify factors associated with low or no pregnancy-related anxiety among women attending two antenatal clinics in districts of Mwanza, Tanzania. A cross-sectional secondary data analysis was completed using data from a longitudinal study that examined biomarkers of stress, anxiety, depression, and birth outcomes. Data were analyzed using bivariate analysis and multiple linear regression. Findings did not reveal any modifiable protective factors. Perceived stress, active depression, and number of people living in the home were the only statistically significant predictors of pregnancy-related anxiety in our sample. Findings indicated that pregnancy-related anxiety may be associated with cultural factors such as family dynamics, and stigmatization of fear or anxiety. Before protective factors can be identified, more qualitative research may be needed in these countries to better understand the cultural nuances of pregnancy-related anxiety in low-and-middle income countries.
- ItemOpen AccessExploring the intersection of hermeneutics and implementation: a scoping review(2023-03-02) MacLeod, Martha L. P.; McCaffrey, Graham; Wilson, Erin; Zimmer, Lela V.; Snadden, David; Zimmer, Peter; Jónatansdóttir, Steinunn; Fyfe, Trina M.; Koopmans, Erica; Ulrich, Cathy; Graham, Ian D.Abstract Background An enduring challenge remains about how to effectively implement programs, services, or practices. Too often, implementation does not achieve its intended effectiveness, fidelity, and sustainability, even when frameworks or theories determine implementation strategies and actions. A different approach is needed. This scoping review joined two markedly different bodies of literature: implementation and hermeneutics. Implementation is usually depicted as focused, direct, and somewhat linear, while hermeneutics attends to the messiness of everyday experience and human interaction. Both, however, are concerned with practical solutions to real-life problems. The purpose of the scoping review was to summarize existing knowledge on how a hermeneutic approach has informed the process of implementing health programs, services, or practices. Methods We completed a scoping review by taking a Gadamerian hermeneutic approach to the JBI scoping review method. Following a pilot search, we searched eight health-related electronic databases using broadly stated terms such as implementation and hermeneutics. A diverse research team that included a patient and healthcare leader, working in pairs, independently screened titles/abstracts and full-text articles. Through the use of inclusion criteria and full-team dialogue, we selected the final articles and identified their characteristics, hermeneutic features, and implementation components. Results Electronic searches resulted in 2871 unique studies. After full-text screening, we retained six articles that addressed both hermeneutics and implementing a program, service, or practice. The studies varied widely in location, topic, implementation strategies, and hermeneutic approach. All addressed assumptions underpinning implementation, the human dimensions of implementing, power differentials, and knowledge creation during implementation. All studies addressed issues foundational to implementing such as cross-cultural communication and surfacing and addressing tensions during processes of change. The studies showed how creating conceptual knowledge was a precursor to concrete, instrumental knowledge for action and behavioral change. Finally, each study demonstrated how the hermeneutic process of the fusion of horizons created new understandings needed for implementation. Conclusions Hermeneutics and implementation have rarely been combined. The studies reveal important features that can contribute to implementation success. Implementers and implementation research may benefit from understanding, articulating, and communicating hermeneutic approaches that foster the relational and contextual foundations necessary for successful implementation. Trial registration The protocol was registered at the Centre for Open Science on September 10, 2019. MacLeod M, Snadden D, McCaffrey G, Zimmer L, Wilson E, Graham I, et al. A hermeneutic approach to advancing implementation science: a scoping review protocol 2019. Accessed at osf.io/eac37.
- ItemEmbargoFalling Straight Down(2019-09-17) Grove, Jane Chamberlin; Van Herk, Aritha; McCallum, Pamela; Vandervlist, Harry; Ohlin, Alix; McCaffrey, GrahamFalling Straight Down is a novel that examines the power imbalances inherent in comprehending the affective states of the cultural other. Set in Calgary, Canada, this work of fiction centers on a character named Thea Lavallee, an advertising creative who is adept at wielding empathy. As she spearheads a charitable campaign filled with non-Western refugees, she struggles to justify marketing materials that sell trauma in order to solve it. Written from Thea’s point of view, the novel employs narrative devices such as interior monologue, dramatic irony and analepsis to explore tensions between neoliberal expectations of multicultural subjectivity, and face-to-face encounters with the cultural other. Set in the recent past, the narrative contextualizes this exploration alongside sociocultural, economic and political issues such as identity politics, climate change, global economic instability and its links to consumerism, the global refugee crisis, and Calgary’s own oil-patch recession. More specifically, Falling Straight Down examines the ethics of representation in the humanitarian aid industry, juxtaposing the vulnerable subject’s desire for agency and dignity with their need for security and tolerance. It also interrogates the relationship between empathy and death, by examining the role of affect and altruism in palliative medicine. Through imperfect intersubjective relationships, the text explores the conflicting impulses to share and recoil from the emotional experiences of others, particularly those who are culturally diverse. Arising from this narrative context is the novel’s key assertion: In a world where definitions of cultural and economic stability are constantly shifting, and where technology makes stories of distant suffering highly accessible, empathy—in all its imperfections—has the potential to nurture cross-cultural understanding and prosocial behavior. The accompanying exegesis analyzes theories that inform the narrative, and explores intersections between empathy and mortality through the lens of narrative medicine. By delving into the role of empathy in border-crossing relationships, the essay makes connections between theories of affect, narrative medicine, photographic representation, and humanitarianism.
- ItemOpen AccessHe Seemed Like Such a Nice Guy: Young Adults' Understandings of Intimate Partner Violence(2016) Corcoran, Lynn Ann; Kawalilak, Colleen; Bohac-Clarke, Veronika; Moules, Nancy; McCaffrey, Graham; Charles, GrantIntimate partner violence is a serious concern with consequences related to physical, social, and emotional health of individuals, families, and society. Despite extensive research and targeted strategies to address this problem, incidents of intimate partner violence occur while local, provincial, and national agencies track this violence over time. Emerging adults are in a life stage where they are forming beliefs about intimate partner relationships. They are engaged in adult learning that occurs incidentally as they navigate experiences in life, work, and love. As such, they are in a position to contribute to an understanding of the range of intimate partner relationships (healthy, unhealthy, and violent) with the possibility of informing strategies aimed at preventing this violence. In light of the magnitude of the concern of intimate partner violence, I conducted a study using hermeneutics as a philosophy and method to explore how emerging adults understand violence in relationships. Data sources included unstructured interviews with 12 individuals aged 18 to 29 years and media reports of a critical incident of intimate partner violence wherein four young people were shot by an ex-boyfriend of one of the young adults before he shot himself. Findings included: the importance of being connected to friends and not isolating oneself; the existence of sexual pressure and issues of ambiguity regarding consent to sexual activity; the challenge of recognizing violence in relationships and the stigma that goes with labelling it as such; the influence of media reports of intimate partner violence, in particular the use of the rhetoric of he seemed like such a nice guy; the powerful impact that texting has in communication between emerging adults in intimate partner relationships and its connection to stalking and jealousy; and the protective effect of loving family and friends on young people as they navigate intimate partner relationships. Implications of this study include the possibility of multiple strategies for prevention of intimate partner violence situated in adult learning. These strategies include utilizing the voices of emerging adults to reflect the challenge of recognizing and naming violence in relationships to make a powerful impact on cognitive and emotional levels.
- ItemOpen AccessHealth Promotion Through Physical Activity in the Classroom: Exploring Teachers' Perceptions(2015-12-22) Foran, Christine; Rutherford, Gayle; Mannion, Cynthia; McCaffrey, GrahamChildren are becoming increasingly sedentary, contributing to increased childhood obesity and negative health outcomes. Schools are ideal environments to target increasing physical activity (PA), because it is important for students’ developing brains and improving their learning. Some teachers routinely incorporate PA into their classrooms, despite challenges meeting curriculum requirements. Using constructivist grounded theory methodology, I interviewed seven teachers to understand their perceptions of the factors and processes instigating and sustaining their use of classroom PA. Teachers used PA because their students demonstrated enhanced focus in classroom activities following PA. Four factors influenced teachers to prioritize PA: 1) culture of movement, 2) comfort with activity, 3) personal responsibility for student learning, and 4) teaching philosophy. These teachers approached PA as an integral and positive influence on their students’ learning. School nurses can facilitate the knowledge translation of peer experiences, empowering other teachers to adopt similar strategies.
- ItemOpen AccessHow Might We Understand Mothers’ Experiences of the VID-KIDS Intervention? More than Meets the Eye(2021-02-09) Bon Bernard, Jennifer; Letourneau, Nicole Lyn; Tough, Suzanne C.; Moules, Nancy Jean; Tryphonopoulos, Panagiota; McCaffrey, GrahamPostpartum depression (PPD) is a complex public health concern that can disrupt the healthy interaction between a mother and her infant. An impairment in this foundational relationship is perceived by infants to be a toxic stressor, and as a result negative long-term outcomes on growth and development can ensue. Parenting interventions in the early years of an infant’s life that aim to modify this significant stressor are a type of support that can alleviate potential concerns associated with the experience of PPD. Video-Feedback Interaction Guidance for Improving Interactions Between Depressed Mothers and their Infants (VID-KIDS) is an example of a parenting intervention that has been evaluated to improve the quality of mother-infant interactions when mothers are experiencing PPD, improve maternal depression and decrease infants stress levels. To ensure successful uptake of VID-KIDS in public health care settings, it is essential that maternal perspectives are heard and applied accordingly. The goal of this research project was to understand the perspectives of mothers who participated in the VID-KIDS intervention, as this was a gap that required further exploration. Four mothers were interviewed, following the tenets of hermeneutics, to understand the meaning that they attached to this experience. The findings of this study provided encouragement that VID-KIDS makes a positive difference in the lives of mothers and their infants when experiencing PPD.
- ItemOpen AccessHow Undergraduate Nursing Students Cope with Stress during the COVID-19 Pandemic: An Interpretive Description(2021-11) Park, Glennis Laurel; McCaffrey, Graham; Raffin Bouchal, Shelley; Smith, JacquelineStress is a critical issue globally in undergraduate nursing education with studies showing stress among undergraduate nursing students as a decades-old concern. The COVID-19 pandemic is a new stressor which has created changes and disruptions in undergraduate nursing educational programs. The purpose of this qualitative, Interpretive Description research study was to gain an understanding of the lived experiences of undergraduate nursing students during the exceptional context of the COVID-19 including their perceptions of stress and their identified coping strategies to manage stress amid their nursing program. Lazarus and Folkman’s (1984) Transactional Model of Stress and Coping was used as the theoretical foundation to guide this study. The setting for this study was the Faculty of Nursing at the University of Calgary, in Calgary, Alberta, Canada. Convenience and purposive sampling were used with voluntary participation from the undergraduate nursing students. Semi-structured, individual interviews were conducted to gather participant data. All data was transcribed verbatim, analyzed for themes, and reported in aggregate form. The perception of a stressor is unique to each individual, however, broad categories of stressors were found to be common amongst nursing students, along with new stressors associated with the COVID-19 pandemic. The findings indicated that the participants exhibited a common characteristic of strong personal motivation with a focused desire to succeed in the nursing program.
- ItemOpen AccessNurses' Experience of the Clinical Opioid Withdrawal Scale(2020-04-23) Jow, Carlina; Smith, Jacqueline M.; Estefan, Andrew; McCaffrey, GrahamOpioid withdrawal is a complex medical process that can adversely affect physical and mental health, employment and finances, often resulting in strained and lost relationships. Nurses are central figures in acute and ongoing care of people who use opioids. Within inpatient contexts, nurses are responsible for the observation and assessment of patients who are experiencing opioid withdrawal. The Clinical Opioid Withdrawal Scale (COWS) is a tool that was designed to assess and document the common signs and symptoms related to the physical and psychological withdrawal from opioids. Although COWS has been validated for use in both inpatient and outpatient settings, its use by nurses is inconsistent. Using a descriptive phenomenological method, this study will investigate the nurses’ experience with the COWS while caring for opioid withdrawal patients. Insights gained from this study can inform possibilities for changes in practice and policy that enhance the treatment of opioid withdrawal patients on inpatient addictions and mental health units within Alberta Health Services.
- ItemOpen AccessStudent Nurses’ Perception of Preceptors’ Authentic Leadership Effect on Self-Efficacy(2019-08-19) Bryan, Venise D.; Mendaglio, Sal; Cummings, Greta G.; Kowch, Eugene G.; Vitello-Cicciu, Joan M.; McCaffrey, GrahamThe study examined the relationship between final year nursing students’ perceptions of preceptor authentic leadership and self-efficacy. Nursing students are required to engage in a preceptorship experience at the end of their nursing education for socialisation into the profession and learning consolidation to facilitate optimum transition from student to nurse. Unfortunately, preceptorship has been identified as the most stressful experience that nursing students engage in and poor relations with clinical staff and low competence beliefs to nurse have led to attrition after graduation. To date, a limited number of studies have examined preceptors’ leadership style, particularly authentic leadership and student nurses’ self-efficacy. Authentic leadership has been identified in the nursing literature as a root element for creating healthy work environments to enhance nurturing leader-follower relationships. Hence, this study addresses: a) the relationship between perceived preceptor authentic leadership and nursing students’ self-efficacy, job satisfaction, and job performance; b) the influence of the final clinical practicum on nursing students’ self-efficacy to nurse; and c) the mediating effect of self-efficacy on perceived preceptor authentic leadership, job satisfaction and job performance. A multi-phase mixed methods approach of an explanatory sequential design was used. Data were collected from 94 randomly selected final year nursing students using four standardized instruments: authentic leadership questionnaire, adapted self-efficacy scale, global job satisfaction survey, and general performance scale. A semi-structured interview was also done. Data were analysed using descriptive and inferential statistics as well as thematic analysis. The results showed that students perceived preceptors’ authentic leadership, and the final clinical practicum experience positively influenced their self-efficacy. Authentic leadership had a direct association with self-efficacy and job satisfaction, and an indirect relationship with job performance as mediated through self-efficacy. The thematic analysis identified five key themes which included the two overarching themes of preceptor attributes and preceptor effects. The study’s findings show that authentic leadership has implications for nursing practice, leadership, and education as the study provides support for the effectiveness of the theory in the preceptorship experience of the final year nursing student population in enhancing their self-efficacy, job satisfaction, and job performance.
- ItemOpen AccessSuffragettes for Caesareans: "Every woman should have a choice"(2016) Imanoff, Julia; Mannion, Cynthia; McCaffrey, Graham; White, Deborah; McNeil, DeborahPatient choice for caesarean delivery (CD) is complex. This choice poses a challenge to maternity Health Care Providers (HCPs) in terms of resource allocation, economics, and surgical risks. Yet, women’s understanding of choice is poorly understood. This study answers the question: how HCPs might understand women’s choice for CD? Four primiparous women who chose a CD were recruited. Semi-structured interviews were used to generate data. The interpretation followed a hermeneutic approach. The interpretations emphasized the complexities of choice, HCPs’ role in birth experiences, and how the woman in this study understood vaginal deliveries as risky and unpredictable and caesarean deliveries as safe and controlled. These findings question how HCP’s understandings of choice can shape patient care. HCPs have the opportunity to recognize the meaning of the choice for each woman and how it is situated in a broader historical context, and how they can promote positive birth experiences in their practice.
- ItemOpen AccessTeachers' Experiences of the Fort McMurray Wildfire: A Story of Surviving the Beast(2018-07-12) Turcato, Whitney Cameron; McCaffrey, Graham; Moules, Nancy J.; Estefan, Andrew; Kawalilak, ColleenThere are groups of professionals who experience emergency evacuations differently from others due to their public service roles. These groups of professionals (teachers, nurses, social workers, physicians, healthcare aides and more) are responsible for the safety and wellbeing of others during an emergency evacuation. Due to an increased amount of responsibility and lack of control over when and with whom they evacuate, emergency evacuations affect these public service communities differently than others in the larger community. In this philosophical hermeneutic inquiry, four high school teachers were interviewed following the 2016 Fort McMurray wildfire evacuation in order to expand our understanding of the experience of these professionals during times of crisis. Findings exposed the duality of roles that these communities are faced with in times of crisis as well as the importance of story and story telling in the recovery of individual and community. This research offers new insights into the effects of disasters and emergency evacuations on these public service communities and allows mental health nurses and emergency management professionals to improve their understanding of appropriate interventions following disasters.
- ItemOpen AccessUnderstanding Role Transitions: Bedside to Boardroom(2019-09-10) Gauthier, Whitney; Venturato, Lorraine; McCaffrey, Graham; Laing, Catherine M.The nurse manager (NM) role is an increasingly complex and vital role, providing a link between patients, staff, and the larger health system. Experienced nurses who demonstrate clinical expertise are often promoted to the NM role without prior leadership experience or training. As such, the transition from frontline nursing into this role can present significant challenges, leading to decreased job satisfaction, attrition, and poor staff and patient outcomes. Five new NMs were interviewed to gain an understanding of their experience with role transition. Based upon these conversations, this study found that moving from a frontline nursing role to that of an NM presented unique challenges in terms of negotiating a new professional identity, shifting personal and professional relationships, and setting reasonable expectations and boundaries within a new and unfamiliar context. Keywords: nurse manager, leadership, role, transition, professional identity
- ItemOpen AccessUnderstanding the Experiences of Nurses Managing Querulous Complainants: What Does Health Care Know?(2020-04-13) Liddle, Amie Cameal; Moules, Nancy J.; Venturato, Lorraine; McCaffrey, Graham; Moules, Nancy J.; McCaffrey, Graham; Venturato, Lorraine; King-Shire, Kathryn M.; George, Theodore D.Society demands and rightfully deserves excellence in health care but unfortunately, this expectation is not always met. Having worked in the Department of Patient Relations for 13 years, I am privileged to have conversed with thousands of patients and families to resolve concerns related to unsatisfactory health care experiences. Unfortunately, I have also engaged with countless patients and families who remained unsatisfied with their care and are thus labeled difficult or querulous. I became increasingly perplexed by the presentation of such complainants and recognized that there was more to be understood about the experience of attempting to reach resolution. For this research study, I have utilized a qualitative design of hermeneutic inquiry as guided by the philosophical hermeneutics of Hans-Georg Gadamer (1900-2002) to address my research question: How might we understand experiences of nurses managing querulous complainants? I recruited five Registered Nurses (RN) employed by Alberta Health Services (AHS) as Patient Concerns Consultants (PCC). The data for my research were generated through planned, skilfully conducted, semi-structured interviews with participants. This approach allowed me to listen and be open to the participants’ understandings of their experience with querulous complainants. My research relied on the concepts of the hermeneutic circle and fusion of horizons in order to understand the experiences and bring forth interpretations. Through the research process, new and altered understandings emerged through the interpretations of Apology, War, Monsters, Soldiers, Robots, Gods, and the Black Hole. The research suggests that there is an absence of relationship between querulous complainants and PCCs. Querulous complainants cause distress, suffering, and require a unique concerns management process. The ways in which politics and Groupthink in health care play an integral part in querulous complaint management is also tendered. This study is the first known qualitative research inquiry intended to explore querulous complainants which creates a platform for new research related to managing health care complaints.
- ItemEmbargoWomen's Experiences of Prenatal Ultrasound in the Context of Atypical Findings(2019-11-04) Powell, Christopher David; Moules, Nancy J.; McCaffrey, Graham; Estefan, Andrew; Kawalilak, ColleenPrenatal ultrasound (U/S) can play a vital role in supporting reproductive choice. As a diagnostic modality, U/S provides clinical data that inform approaches to managing complicated pregnancy. The capability of U/S to detect fetal anomalies intensifies the hunt for clinically suspicious features and consequently advances the frontier of prenatal intervention. These features of U/S create tension between ideologies about how pregnancy should be experienced and set conditions that complicate physician-patient relationships. In light of ethical concerns about the dialogue in which atypical U/S images are presented to patients and what these images mean to them, I interviewed six participants to further understand women's experiences of prenatal U/S, in the context of atypical findings. I used tenets of philosophical hermeneutics to guide my analysis of the text of our conversations, which revealed how language surrounding atypical U/S is laden with prejudice against women's decisions to maintain atypical pregnancies. Participants assumed that U/S is routine, with little to no awareness that it is a procedure they can decline. There was a prevailing belief that U/S sessions would be positive experiences that carry no risk. However, autonomy and personal values are threatened in the setting of clinically remarkable U/S images. The concept of risk is problematic to physician-patient dialogue about potentially difficult decisions in the wake of discovering fetal anomalies. The current language of risk fails to bridge the abstract ideas of numeracy with real-world practice. Risks arise when physicians' biases overshadow a patient's preference to decline diagnostic testing altogether, or to decline abortion when anomalies are detected. Participants who gave birth to babies with Down syndrome shared grave concerns about U/S's potential role in systematically eradicating trisomy-21. Their experiences give reason to seriously consider the history of eugenics in the context of prenatal screening, and how the current application of U/S threatens human diversity. Physicians must acknowledge how language reinforces power dynamics that transform clinical encounters into experiences of acute and lasting injury to their patients. A hermeneutic approach to practice can enhance communication about the challenges ensuing from atypical U/S and restore ethical integrity to physician-patient dialogue.