Inner strength among HIV-infected women: nurses can make a difference

The purpose of this qualitative study was twofold. First, the authors examined the phenomenon of inner strength as a resource that women infected with HIV use to cope with and manage their difficult lives. Second, the authors sought the women's views on the potential impact health care workers, specifically nurses, can have on the activation of inner strength. This study was phenomenologically informed and qualitatively structured. The goal was to construct an analytical understanding of inner strength as it is perceived, defined, experienced, and activated by women infected with HIV. Data were collected by means of 19 conversational, biographical interviews. These interviews were conducted with a stratified (by ethnicity and social class) sample of women infected with HIV. The data were elicited in terms of respondents' stories of living with HIV. The women listed a number of definitions for inner strength such as "the ability to fight" and "the motivation to go on and do better." The women recommended that nurses working with them be sensitive to the following patient concerns: validation, reality, sensitivity, and autonomy. The concept of inner strength can be of great scholarly and clinical value if it is defined as follows: Inner strength refers to the different ways women with serious illnesses experience and talk about the deepest, existential resources available to and used by them to manage severe risks to self-integrity. The recommendations, although somewhat critical of nurses, are plausible because they incorporate nurses' traditional approaches to caring for patients.