This thesis examines attitudes toward infertility in early modern England and colonial New England from c.1620 to 1720 through infertility’s representation in contemporary medical, religious, and literary sources. This study uses an expanded definition of infertility, namely a 'spectrum of infertility', to capture the tensions that arose during periods of infertility and experiences of reproductive failure such as miscarriages, stillbirths, monstrous births, and false conceptions. A spectrum, more than a modern definition, more accurately represents the range of bodily conditions experienced by early modern women and men that indicated reproductive disorder in the body; by extension, the language of infertility expressed fears about disorder in times of social, religious, and political crisis in early modern society. The two societies' relationship was often described through reproductive language and the language of infertility appears in both societies when order - within the body, within marriages, or within and between communities - was threatened. This thesis contributes to a growing body of scholarship on infertility in early modern society by analysing its presence in communications within and between early modern England and colonial New England. It argues that understanding the English origins of the colonists' attitudes toward infertility is fundamental both to understanding the close connection between the two societies and to providing context for the colonists' perceptions about their encounters with new lands, bodies, environments, and reasons for emigration. As a result, this thesis seeks to break new ground in providing an overview of social, medical, and cultural reactions in both England and New England, demonstrating that similar language and tropes were used in both regions to communicate concerns about infertility. Exploring the interplay between the many sources addressing this health issue more accurately represents the complexity of early modern attitudes toward infertility, and the intimacy of the relationship between the fledgling New England colonies and their metaphorical Mother England.

End-stage renal disease (ESRD) introduces physical, psychological, social, emotional and spiritual challenges into patients’ lives. Spirituality has been found to contribute to improved health outcomes, mainly in the areas of quality of life (QOL) and well-being. No studies exist to explore the influences of spirituality on the health outcomes and general well-being in patients with end-stage renal disease receiving haemodialysis (HD) treatment in Scotland. This study was therefore carried out to examine and explore spirituality in the day-to-day lives of patients with ESRD receiving HD treatment and how it may influence their health outcomes and, in particular, QOL and general well-being. The study described in this thesis employed a sequential mixed method approach over two stages: quantitative and qualitative. Following ethical approval, a cross-sectional survey was conducted with 72 patients from 11 dialysis units recruited from four Health Boards in Scotland. The participants in the study were regular patients attending the dialysis units three times per week. Data on patients’ quality of life, general well-being, and spirituality were collected using self-administered questionnaires including demographic information: the Short Form Medical Outcome Study Questionnaire (SF-36v2), the General Health Questionnaire, and the Spiritual Well-Being Questionnaire. The data were analysed using the Predictive Analytics Software for Windows. The findings highlighted that patients’ quality of life was markedly lower than the United Kingdom general population average norms of 50. Increasing age was associated with better mental health but worse physical health. The survey also found that there were no significant associations between spirituality and patients’ quality of life and general well-being. However, it was considered important to complement and enrich the survey findings by gaining a deeper understanding of the influences of spirituality on patients’ health outcomes and general well-being by carrying out the qualitative component of the study. Qualitative data were collected using semi-structured interviews with a subsample of 21 patients from those who participated in the survey. A thematic approach using Framework Analysis informed the qualitative data analysis. Four main themes emerged from the qualitative interviews: ‘Emotional and Psychological Turmoil’, ‘Life is Restricted’, ‘Spirituality’ and ‘Other Coping Strategies’. The findings from the interviews confirmed that patients’ quality of life might be affected because of the physical challenges such as unremitting fatigue, disease unpredictability, or being tied down to a dialysis machine, or the emotional and psychological challenges imposed by the disease into their lives such as wholesale changes, dialysis as a forced choice and having a sense of indebtedness. The findings also revealed that spirituality was an important coping strategy for the majority of participants who took part in the qualitative component (n=16). Different meanings of spirituality were identified including connection with God or Supernatural Being, connection with the self, others and nature/environment. Spirituality encouraged participants to accept their disease and offered them a sense of protection, instilled hope in them and helped them to maintain a positive attitude to carry on with their daily lives, which may have had a positive influence on their health outcomes and general well-being. The findings also revealed that humour was another coping strategy that helped to diffuse stress and anxiety for some participants and encouraged them to carry on with their lives. The findings from this study contribute knowledge to increase our understanding of the influence of spirituality on the health outcomes and general well-being of patients with end-stage renal disease currently receiving haemodialysis treatment. Based on the findings from this thesis, recommendations are made for clinical practice, patient and nurse education and for future research.