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Bypassing the middleman: A grounded theory of women's self -care for vaginal symptoms

Rosemary Theroux, University of Massachusetts Amherst


This research generated theory related to women's self-treatment of vaginal symptoms utilizing the grounded theory method. Data collection guided by theoretical sampling consisted of interviews with women and pharmacists, consumer literature related to vaginal conditions, and advertisements for non-prescription vaginal antifungal products. Data analysis identified that the basic problem experienced by the women was relief of symptoms. Because of many competing demands on their personal time, the women needed to resolve their problem in a way that was uncomplicated and involved minimal use of time and resources. In order to accomplish this, women used the process of Bypassing the Middleman. The use of this process enabled women to resolve the problem in a convenient and timely manner, and provided the least disruption to their current lifestyles and beliefs. Bypassing the middleman consisted of four stages: Noticing Vaginal Symptoms, Making Sense of Symptoms, Choosing a Treatment Path, and Bypassing the Middleman. The pace and progression through the stages is influenced by each women's unique attributes and circumstances. Several conditions that facilitated this process were low degree of uncertainty about cause of symptoms and low need to know specific cause, judgment that the symptoms were low-risk and minor, feeling capable of solving the problem, perception that the time and effort to access the middleman (health care provider) were beyond her resources, a high priority for convenience, the belief that self-treatment (non-drug) was safer than medical treatment, and low congruence of beliefs between woman and health care provider. Analysis of advertisements and consumer literature provided the context for understanding environmental influences on women's knowledge and decision-making about self-treatment. Four principal factors emerged as the primary reasons for variance in participants' behavior during bypassing the middleman: symptom characteristics, available resources, knowledge and experience, and beliefs about symptom management. This theory contributes to nursing knowledge about women's self-care because it is grounded in data, and provides nurses with the ability to explain and predict which women will choose to use this process. In addition, this theory identifies controllable conditions for designing nursing interventions to enhance women's self-care skills.

Subject Area


Recommended Citation

Theroux, Rosemary, "Bypassing the middleman: A grounded theory of women's self -care for vaginal symptoms" (2000). Doctoral Dissertations Available from Proquest. AAI9978564.