<p> The purpose of this study was to describe the lived experience of nurses who care for hospitalized women outside of an addiction treatment setting who have a problem with drugs and / or alcohol. The relational experiences of ten registered nurses who had cared for women with drug and alcohol problems were elicited. Heideggerian hermeneutic phenomenology was the method used to interpret the nurse participants&rsquo; meaning of their experience. The theoretical framework that was used to explore the nurses&rsquo; experience of caring for women who abuse or are dependent on alcohol was Boykin and Schoenhofer&rsquo;s <i> Nursing as Caring</i> (1993). The relational themes that emerged were: Caring in the dark; Intentionally knowing the woman with AOD as a unique person; and Experiencing sisterhood.</p>

<p> Postpartum depression (PPD) is linked to diminished maternal, pediatric, and family health outcomes and is designated as the most common childbirth complication. PPD is an international public health concern and found in most populations. Studies suggest that American Indian/Alaska Native (AI/AN) women suffer higher PPD prevalence (14% to 29%) than other United States' women, revealing a racial/ethnic disparity. Health disparities research is a national public health priority and substantiates the need to explore PPD in AI/AN women. Clinicians define PPD as an episode of major depressive disorder with a "peripartum onset" specifier that occurs within the first year after delivery. </p><p> This dissertation work explored and synthesized PPD research about AI/AN women, where there remains considerable mystery surrounding the causes and consequences of PPD. Even with federal regulations in place requiring the inclusion of minorities and women and other underrepresented groups in research, AI/AN women have been mostly excluded, as evidenced by few studies and small sample compositions that include AI/AN women in PPD research. </p><p> Using a comparative analysis approach, validation studies of the EPDS and the PHQ-9 were examined. While possessing excellent concurrent validity, the low predictive accuracy of both tools in non-Western samples suggests cultural bias. No PPD screening instrument has been validated in samples of AI/AN women. Cross-cultural adaptation advances the science of comparative effectiveness research, and is therefore a logical next step. Using a phenomenological methodology with a community-based participatory approach, AI/AN women's "lived" PPD experiences were described. AI/AN women who experienced PPD now or in the past were interviewed using a semi-structured interview guide. De-identified demographic data were collected. Thematic analysis guided by Moustakas' (1994) procedure followed and seven major themes emerged. </p><p> This dissertation has advanced nursing science by providing an understanding of PPD in AI/AN women. Future research for AI/AN women with PPD should focus on: 1) their access to and use of PPD services; 2) the cross-cultural adaptation for PPD screening; 3) the possible relationship between PPD and intimate partner violence; 4) their preferences for PPD treatment; and 5) the possible relationship between PPD and acculturation.</p><p>