Learning Objective #1: Discuss the refinement and testing of the middle-range theory of inner strength in women

Learning Objective #2: Discuss nursing implications of this gender-sensitive theory in women's health

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The purpose of this presentation is to describe the generation and testing of inner strength in women as a middle-range theory. Over the last 12 years, the theory has been refined and researched as a gender-sensitive theory. Im and Meleis (2001) proposed gender-based studies as the direction for theoretical development in women's health to empower women to manage their health. Theory generation was based on results of qualitative studies and the psychometric testing of a theoretically-based instrument. The theory has been tested with populations of women with chronic health conditions such as breast cancer, heart disease, multiple sclerosis, and transplantation. Based on these studies, inner strength is defined as having capacity to build self through a developmental process that positively moves the individual through challenging events. While inner strength exists prior to event, it is the experience of a life-changing event that initiates a tapping into the capacity of inner strength. The concepts of the theory of inner strength and definitions are: 1) Anguish & Searching describes the fear, vulnerability, and searching for meaning experienced to process the challenging life event. 2) Connectedness describes the nurturing of supportive relationships with self, family, friends, and a spiritual power. 3) Engagement describes the self-determinism, reframing, and engaging in possibilities. 4) Movement describes the dimension of movement, rest, activity, honest self-appraisal, and balance. The current theory challenges the generally received view of women as being weak or fragile. Understanding the possibility that nurses can assist these women to foster strengths confronts the stereotypical paradigm and challenges the way nurses interact with clients. The theory highlights interventions that can be assessed and quantified with the theoretically-based instrument for improvement in care and quality of life. Development of inner strength in women requires societal and nursing commitment to women's access to quality, gender-sensitive healthcare.