Academic journal article Scholarly Inquiry for Nursing Practice

Alcoholism Recovery in Lesbian Women: A Theory in Development

Academic journal article Scholarly Inquiry for Nursing Practice

Alcoholism Recovery in Lesbian Women: A Theory in Development

Article excerpt

Utilizing the modified practice-theory strategy for theory building, a provisional theoretical model was developed to describe alcoholism recovery in lesbian women. Assumptions are acknowledged, key concepts are identified, and propositions are formulated for the purpose of generating nursing knowledge about a significant health problem in this aggregate of women. The theory's implications for nursing research, practice, and further theory development are discussed.

Alcoholism affects lesbians at three times the rate found in the general public (Lewis, Saghir, & Robins, 1982), presenting a significant health problem for this aggregate of women and a challenge for nursing practice. Research and theory about lesbian health and alcoholism recovery is rare in the nursing literature, offering little direction for nursing care of lesbian alcoholics. Theory development about the complex human phenomenon of alcoholism recovery in lesbian women is a promising step toward describing, explaining, predicting, and prescribing nursing care for lesbians. Lesbians are estimated to comprise 10% of the female population (Kite, 1976; Kinsey, Pomeroy, Martin, & Gebhard, 1953).

What is particularly lacking in the literature is an understanding of the long-term recovery process as it occurs in women, specifically lesbian women. Therefore, an attempt is made here to build a theoretical model expressing the salient issues for lesbians who are recovering from alcoholism within Alcoholics Anonymous (AA). Clinical insight for theory development is synthesized from the author's years of contact with the lesbian community and AA and a decade of nursing experience with addicted clients in mental health, substance abuse treatment, and community health. In addition, 10 interviews with recovering lesbian alcoholics in AA were completed over a year long period. Supported by a review of the literature, this clinical knowledge forms the basis from which assumptions, concepts, and propositions are formulated. A provisional theoretical model is constructed for the purpose of generating nursing knowledge about recovery from alcoholism in lesbian women.

ASSUMPTIONS

Theory development regarding the phenomenon of alcoholism recovery in lesbian women is based on several assumptions that require explicit description:

1. Lesbian women share a lesbian identity, which is an immutable quality that permeates the self and is pivotal to who the individual is. This essential identity is not limited to sexual activity, but encompasses a primary and oncological orientation toward women, a life-style that is women-centered, and a way of being that is women-relating (Ponse, 1978).

2. Lesbian women are widely diverse but constitute a subcultural group in that they share common identity, history, ethics, values, literature, music, and argot (Lockard, 1985; Ponse, 1978; Stevens & Hall, 1988).

3. Alcoholism is defined as intermittent or continual use of alcohol associated with physical or mental dependency or harm in the sphere of mental, physical, or social activity (Davies, 1976).

4. Abstinence is essential to full recovery from alcoholism (Brown, 1985; Clark, 1981; Vaillant, 1983), though recovery begins before drinking has stopped (Taylor, 1979), and abstinence may not be maintained perfectly in the initial phases.

5. Alcoholism is a serious problem among lesbians, affecting perhaps 30% of the lesbian population as compared to 10% of the general public (Fifleld & Latham, 1977; Lewis, Saghir, & Robins, 1982; Nardi, 1982).

6. Lesbian alcoholics, like most contemporary alcoholics, are often polydrug abusers (Celantano & McQueen, 1984; Morales & Graves, 1983). The use of the term alcoholism is meant to be inclusive of this dynamic.

7. Women in alcoholism recovery face different issues than men do (Beckman & Amaro, 1985).

8. Alcoholics Anonymous (AA) is a relatively effective mutual-help program for many alcoholic persons (Emrick, 1987; Zimberg, 1985). …

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