DeMarco R F, Miller K H, Patsdaughter C A, Chisholm M, Grindel C G
Northeastern University, College of Nursing, Boston, MA 02115, USA.
Health Care Women Int. 1998 Nov-Dec;19(6):539-52. doi: 10.1080/073993398246106.
Feminist literature has demonstrated that women often maintain behaviors that support silencing of their voices. The critical issue is whether the silencing experience is (a) a destructive process of burying feelings and needs, (b) a protective strategy to preserve personal and professional relationships which they value, (c) a coping mechanism to divorce themselves from an androcentric/ethnocentric health care culture, or all of these. The transition from silence to action may be a process of reacting to a threat to self (i.e., HIV/AIDS diagnosis) where gender normative behaviors become irrelevant and self-advocacy becomes paramount for survival. Alternatively, the transition may be a conscious process of gaining insight into past behaviors that have been learned and culturally supported and making purposeful changes. Data for this study were extracted for secondary analysis from data from a larger study on experiences and needs of persons living with HIV/AIDS. Data were obtained from transcripts from three focus groups (N = 14 women) and six individual interviews. Women ranged in age from 21 to 55; 9 were European American, 7 were African American, and 4 were Latina American. Data were content analyzed and organized using four categories proposed by Jack (1991): (a) externalized self-perception, (b) care as self-sacrifice, (c) silencing the self, and (d) the divided self. Data supported that women with HIV/AIDS reported all four categories of silencing behaviors, particularly early in the HIV trajectory. For some women, an HIV/AIDS diagnosis ignited them to speak for themselves and to shape their own lives based on feelings and needs. For others, peer or professional support or both was the catalyst for the transition from silence to action. Findings suggest interventions that would assist women in judging themselves by internal versus external standards, putting their own needs before the perceived needs of others, expressing themselves toward action rather than avoidance, and feeling comfortable expressing anger.
女权主义文学表明，女性常常保持一些行为，这些行为支持她们压制自己的声音。关键问题在于，这种沉默的经历是（a）一个埋葬情感和需求的破坏性过程，（b）一种维护她们所珍视的个人和职业关系的保护策略，（c）一种使自己与以男性为中心/以种族为中心的医疗文化脱离的应对机制，还是所有这些。从沉默到行动的转变可能是一个对自我威胁（即艾滋病毒/艾滋病诊断）做出反应的过程，在这种情况下，性别规范行为变得无关紧要，自我倡导成为生存的首要任务。或者，这种转变可能是一个有意识的过程，即深入了解过去习得并得到文化支持的行为，并做出有目的的改变。本研究的数据是从一项关于艾滋病毒/艾滋病感染者经历和需求的更大规模研究的数据中提取出来进行二次分析的。数据来自三个焦点小组（N = 14名女性）的记录和六次个人访谈。女性年龄在21岁至55岁之间；9名是欧美裔，7名是非洲裔，4名是拉丁裔。数据采用杰克（1991年）提出的四个类别进行内容分析和整理：（a）外化的自我认知，（b）作为自我牺牲的关爱，（c）自我沉默，（d）分裂的自我。数据表明，感染艾滋病毒/艾滋病的女性报告了所有四类沉默行为，尤其是在感染艾滋病毒的早期阶段。对一些女性来说，艾滋病毒/艾滋病诊断促使她们为自己发声，并根据情感和需求塑造自己的生活。对另一些女性来说，同伴或专业支持或两者兼而有之是从沉默到行动转变的催化剂。研究结果表明，干预措施可以帮助女性以内部标准而非外部标准来评判自己，将自己的需求置于他人的感知需求之前，朝着行动而非回避的方向表达自己，并能自在地表达愤怒。
