acase@tulane.edu

acase@tulane.edu

This study examined the geographic variation of infant mortality using zip codes as the unit of analysis in order to facilitate site location and site specific health services for community health centers and/or mobile health units. The relationship between infant mortality and the place of residence by zip code was analyzed using factors related to residential deprivation and selected maternal-infant factors. The design of this study was non-experimental retrospective correlational using a mix of ecological and individual variables. The sample chosen included all births and associated infant deaths from 1988 through 1992 in 22 of the 64 parishes in Louisiana. The 22 sample parishes contained 192 zip codes. Variable data was extracted from linked birth and death files and 1990 Census tapes. Chi-square was used to test variation of infant mortality among and within parishes by zip codes. Correlation and multivariate regression analysis were used to examine the association of six maternal/infant factors and five residential deprivation factors, separately and then combined, with infant mortality. A geographic information system was also used to formulate thematic maps for presentation of data. Results indicated that the mother's marital status was the most significant predictor of infant mortality; being married was associated with decreased infant mortality. Identification of significant predictors varied on an individual basis. The results also indicate that infant mortality does vary significantly within each parish. Overall use of this model in order to locate healthcare services or in predicting infant mortality by zip code is questionable, but may be useful in those parishes that have large populations and exhibit greater internal variability and segregation in general / acase@tulane.edu

acase@tulane.edu

This research explored relationships between levels of job burnout, intrinsic spirituality and social support in women who are perinatal social workers, defined as those who were currently employed or had been employed in perinatal settings. The study population consisted of membership and active mailing list of the National Association of Perinatal Social Workers (NAPSW). Research packets mailed to this group included a cover letter, demographic survey, and three instruments including the Maslach Burnout Inventory Human Services Survey, the Intrinsic Spirituality Scale and an amended form of the Shortened Social Support Scale, amended to include support provided inside and outside the workplace. Measures were taken to insure that participation was completely voluntary and could be anonymous if desired. Demographic surveys and test instruments were statistically examined for correlations. Participants were also asked to provide comments on study topics, which were examined for key words and themes and quotations illustrative of those themes. Themes found included spirituality and social support as preventive of job burnout and stress, stresses and benefits unique to perinatal social work, identification with the specialty as social support, NAPSW as social support, stresses and benefits of working with families experiencing death and loss, other factors in stress and burnout prevention, and other sources of stress. Quantitative research yielded correlations among depersonalization (DP), emotional exhaustion (EE) and personal accomplishment (PA) subscales of the burnout instrument, and the following significant correlations: DP was negatively correlated with PA, social support, years in practice and in perinatal social work, and PA was positively correlated with social support, age, years in practice and in perinatal social work. Social support was positively correlated with marital status, as was having an organized social work department with having a supervisor who is a social worker. After recognition of personal accomplishment as a possible confounding variable, the following pairs of variables were significantly correlated: Years in perinatal social work was negatively correlated with intrinsic spirituality and positively correlated with age and years in social work. Years in social work was positively correlated with age / acase@tulane.edu

acase@tulane.edu

acase@tulane.edu

acase@tulane.edu

acase@tulane.edu

acase@tulane.edu