The impact of stress on the health of postpartum mothers is poorly understood. Although the postpartum period increases risk for stress related diseases such as depression and autoimmune disorders, little qualitative research has focused on women’s perceptions of postpartum stressors. A constant comparative content analysis using Atlas.Ti was done on data collected by Groer (NIH R01 NR05000“Influence of Lactation on Postpartum Stress & Immunity) from 2001 to 2005. Women (n=127) answered the prompt, “Think of any one incident, thought, or feeling that stands out as very stressful to you and describe in as much detail as you choose.” Researcher triangulation was provided by independent coding of data by two qualitative researchers. The women were predominantly white (91%), married (72%), and not yet working following the baby’s birth (70%). Only 28% had family incomes greater than $40,000 per year. Vaginal births were experienced by 66%, 83% without complications. Forty-seven percent were breastfeeding exclusively with 43% bottle feeding. Slightly less than half (48%) were first time mothers. Eighty-nine percent claimed no recent major life event, such as a death in the family. Twenty-seven postpartum stressors were identified that were grouped into five themes: 1) environmental stressors, 2) symptoms of depression, 3) infant health and safety issues, 4) maternal role strain, and 5) lack of support. Seventeen women identified fatigue or lack of sleep as stressful and each questioned her ability to parent a newborn. Though these women would seem low risk for stress (having had an uncomplicated birth, being married and not yet back at work postpartum), 27 different postpartum stressors were identified. Stressors such as lack of sleep may be known by maternal-child nurses, but women are unprepared for them. Interventions need to be designed to provide anticipatory guidance for new mothers regarding postpartum stressors. Tools should be developed for use by clinicians to assess maternal stress in the postpartum period. Prenatal preparation anticipating stressors and postpartum vigilance in assessing stressors could ease the transition into motherhood.

The purpose of this phenomenological study was to explore the lived experiences of Spanish-speaking men in the United States with limited English proficiency following their release from prison. The study specifically examined the experiences of these men in their efforts to access health care treatment, housing, education, and employment in Central Pennsylvania. An empirical, phenomenological research design was employed that used self-stigma, critical race, and self-determination theories for in-depth interviews with 8 men who spent 5 to 24 years in prison. A tiered coding method was used to generate 6 interconnected themes that tell the story of these men's lives: (1) a genuine desire to change (2) a lack of effective communication, (3) a sense of dependency on others, (4) a persistent lack of social support, (5) a perception of resentencing by society, and (6) a perception of entrapment with little possibility to get out. This study promotes positive social change by demonstrating a need for more effective transitional programs for this demographic and additional need for counselor training programs to actively recruit and train more Spanish-speaking counselors for work with this population. The results can be used by counselors and mental health providers to develop programs that would support families such as job training and second language instruction within correctional facilities. Implementing these recommendations is expected to reduce crime and facilitate the healthy integration of this population into the mainstream society post incarceration.

A qualitative, exploratory, descriptive and contextual study was conducted to explore and describe the experience and support received by newly-qualified four-year trained professional nurses while placed for remunerated community service in Gauteng province. Purposive sampling was used and five focus group interviews were conducted. Each focus group consisted of six to ten participants who had completed the four-year training programme and were qualified as nurses (general, psychiatric and community) and midwife placed for remunerated community service in Gauteng province (South African Nursing Council R425 of 22 February 1985). Data was analysed using Tesch’s method of data analysis. Two main themes emerged from the study and formed the basis of the discussion. The themes are “various experiences of the newly-qualified four-year trained professional nurses” and “support received by the newly-qualified four-year trained professional nurses”. Community service nurses reported mixed experiences such as feeling good and bad during community service placement. The majority of participants reported that remunerated community service placement is risky and it requires one to take chances. Furthermore, participants referred to remunerated community service placement as a scary venture at first but eventually they mastered practical activities. Support received by community service nurses varied from adequate, inadequate, incidental and lack of support. Community service nurses reported bad staff attitudes, severe staff shortage and that they were subjected to adverse events and low salaries. Recommendations to enhance community service placement were outlined for the following stakeholders: South African Nursing Council, Department of Health, nursing colleges, universities and managers of the health facilities. Copyright / Dissertation (MCur)--University of Pretoria, 2013. / Nursing Science / unrestricted