Marital concerns of long-term hospitalised patients with diagnosed schizophrenia: A descriptive phenomenological study

Marital concerns can trigger emotional stress, especially among long-term hospitalised individuals diagnosed with schizophrenia, significantly affecting their treatment and recovery. Unfortunately, rehabilitation programs tend to overlook the marital needs of individuals with diagnosed schizophrenia. This research aimed to investigate the content related to marital concerns of Chinese individuals diagnosed with schizophrenia who were undergoing extended hospitalisation. Fifteen participants diagnosed with schizophrenia were recruited through purposive sampling for face-to-face semi-structured interviews. The gathered data were analysed using Colaizzi's method, revealing three themes: (1) manifestations of marriage-related concerns, (2) effects of marriage on disease progression, and (3) the need for support from family and the hospital. This study offers new insights into marital concerns among long-term schizophrenia inpatients and underscores the significance of screening and intervention for such concerns. Healthcare professionals and family members should extend support to patients to foster confidence within their marital relationships.

The life experiences of women with interstitial cystitis/bladder pain syndrome: A qualitative phenomenological study

AIM

To explore the life experiences of women with interstitial cystitis.

DESIGN

A qualitative phenomenological study.

METHODS

Fifteen women with interstitial cystitis were recruited from a regional hospital in Taiwan using purposive sampling. Data were collected via one-on-one semistructured interviews and analysed using the Colaizzi's method. Rigorous testing was conducted to identify the themes and subthemes.

RESULTS

Four major themes were identified: torment, restriction, acceptance and empowerment. These themes reflect the life experiences of women with interstitial cystitis. They endured unrelenting physical and psychological distress and loneliness, experienced obstacles and limitations in daily living because of their symptoms, accepted reality and considered their symptoms as a part of everyday life and developed coping skills for the disease.

CONCLUSION

Medical care, psychological support and emotional venting are crucial for women with interstitial cystitis. Despite living a life full of frustrations and suffering caused by the unpredictable and unrelenting nature of interstitial cystitis, through external support and intrinsic positive cognitive reconstruction, women with interstitial cystitis gradually accepted that they were ill. They adapted to their situation, developed a suitable lifestyle and pace and ultimately achieved stable coexistence with the disease.

IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE

Although women with interstitial cystitis are affected by an incurable disease, through adequate assistance and reconstruction of perception, they can develop coping skills and stably coexist with their disease. There is a delicate dynamic balance between their lives and disease.

IMPACT

This study may help clinicians to understand patients' life experiences and provide suitable care. This may improve the quality of care provided to women with interstitial cystitis and help them adapt to their disease, thereby improving their life satisfaction.

REPORTING METHOD

This study was reported according to the COREQ checklist.

PATIENT OR PUBLIC CONTRIBUTION

Women with interstitial cystitis contributed to the study data.

Family caregivers' lived experience of caring for hospitalised patients with cancer during the COVID-19 lockdown: A descriptive phenomenological study

AIMS

This study aimed to capture and explore family caregivers' lived experience of caring for hospitalised patients with cancer during the lockdown.

BACKGROUND

The unprecedented lockdown episodes due to COVID-19 have brought significant changes in the hospital visiting policies and caregiving practices. As part of the precautionary measures for hospital visits, the bedside companion was restricted to one caregiver for patients with cancer in Shanghai hospitals.

DESIGN

This study adopted a descriptive phenomenological approach.

METHODS

Data were collected among 20 family caregivers recruited from the Oncology department of a tertiary hospital in Shanghai in May 2022, using purposive sampling method and followed by unstructured, open-ended interviews. Colaizzi's seven-step data analysis method was used to analyse the data to reveal the emergent themes and subthemes of the phenomenon.

RESULTS

Four themes were generated on family caregivers' lived experience of caring for hospitalised patients with cancer during the lockdown, including (1) Feeling scared for the patient; (2) Living a life feeling trapped under COVID-19 surveillance; (3) Feeling neglected and unseen; (4) Growing resilience and appreciation.

CONCLUSIONS

The lockdown exacerbated the burden of family caregivers when they cared for the hospitalised patients with cancer during the lockdown period. However, positive reframing of the lived experience facilitated their coping with the challenging situation.

RELEVANCE TO CLINICAL PRACTICE

Findings from this study highlighted the potential proactive roles the healthcare providers could play in improving family caregivers' health and supporting them during and beyond the COVID-19 pandemic.

REPORTING METHOD

The study adhered to relevant EQUATOR guidelines; the study was reported according to the COREQ checklist.

PATIENT OR PUBLIC CONTRIBUTION

Family caregivers of patients with cancer were involved in data collection and member-checking of the transcripts and interpretations of their experiences.

Utilisation of HIV services by female sex workers in Zimbabwe during the COVID-19 pandemic: a descriptive phenomenological study

This study focuses on female sex workers as a key population group that suffers a degree of vulnerability according to the World Health Organisation (WHO). Key populations refer to people at heightened risk of contracting the human immunodeficiency virus (HIV) due to specific behaviours and social and legal environments which increase their vulnerability to the virus. Key populations are disproportionately affected by HIV, yet they have less access to HIV services compared to the general population. The coronavirus (COVID-19) lockdown and its restrictive measures have further widened the inequalities and gaps in accessing HIV services for this group. A descriptive phenomenological study was undertaken to explore female sex workers' experiences of utilisation of HIV services during COVID-19. The study setting was the Bulawayo Metropolitan Province, Zimbabwe. Data were collected through in-depth individual interviews with 10 female sex workers. Purposive sampling coupled with snowballing was utilised for recruiting participants. Data were analysed guided by the seven-step Colaizzi technique. Rigour was ensured through adhering to Lincoln and Guba's trustworthiness criteria. The study found that the COVID-19 pandemic adversely affected the livelihoods of sex workers and their utilisation of HIV services. There was limited access to HIV services due to an initial lack of travel authorisation letters and financial challenges experienced by study participants. In addition, the quality of care in health care facilities was further compromised by poor screening processes and reduced provider-client interactions. Maintaining access to HIV services for female sex workers during pandemics is critical for the country to attain HIV epidemic control.

How do you expect us to survive? Lamentation of female sex workers in Zimbabwe during COVID-19 lockdown

The restrictive measures taken to curb and mitigate the spread of the corona virus (COVID-19) had negative implications on the vulnerable populations. Of the latter, the most severely affected were sex workers, whose work venues and customers were locked down. This descriptive phenomenological study explored effects of COVID-19 on female sex workers in Bulawayo, Zimbabwe. Snowballing sampling was used to recruit participants. Data were collected through in-depth face-to-face individual interviews with ten female sex workers. The sample size was determined by data saturation. Colaizzi's seven-step content analysis approach was followed to guide data analysis. Rigour was ensured by adhering to Guba and Lincoln's trustworthiness criteria. The study found that the measures impacted negatively on sex workers' income, making it difficult for them to get money for food and rentals. In response, some sex workers adopted innovative entrepreneurship. Others engaged in risky sexual behaviours, further aggravating their situation emotionally and psychologically. It is recommended that the government and policy makers provide psychosocial and economic support to protect the rights of female sex workers in order to maintain the gains made in HIV response.

Condom use education, promotion and reasons for condom use: Perspectives of healthcare providers and young adults in Vhembe district, Limpopo province

BACKGROUND

Condom use is a critical component of a comprehensive and sustainable approach to the prevention of unintended pregnancies and sexually transmitted infections (STIs) (including HIV). Despite government making condoms freely available in the healthcare facilities in Vhembe district, there are reports of an increase in teenage pregnancies and STIs, including HIV, amongst young adults. The aim of the study was to gain an in-depth understanding of condom use promotion and reasons of condom use amongst young adults in Vhembe district, in Limpopo province.

METHODS

A descriptive phenomenological design was used to explore the reasons for promoting condom use amongst young adults themselves and from the perspectives of healthcare providers who are critical role players in condom education and provision. Purposive sampling was used to sample young adults and healthcare providers at three of Vhembe district's primary healthcare facilities. Individual semi-structured interviews were conducted, after which thematic data analysis was used to develop themes and subthemes.

RESULTS

Two superordinate themes emerged from data analysis, namely approaches to promote condom use and reasons for condom use. Two themes emerged in respect of approaches for promotion of condom use: information sharing in the form of education, the distribution of informative material, and the adoption of a multi-sectoral approach. Self-protection emerged as a reason for condom use, to prevent disease, pregnancy and 'u wela', and was indicative of not trusting a sexual partner.

CONCLUSION

To effectively promote condom use, a multidisciplinary team approach involving nurses, lay counsellors and peer educators need to be strengthened at local primary health facilities in order to facilitate the distribution of condoms and educate young adults on consistent condom use.

Here and now: Lived experiences of professional nurses practising caring presence in a rural public hospital in the North West Province, South Africa

BACKGROUND

Practising caring presence is recognised as an important nursing intervention indispensable to high-quality, patient-centred care. An awareness of the real world of professional nurses (PNs) practising caring presence will assist in expanding and supporting the existing literature on the same. A clear and rich description of what the concept of caring presence entails within the unique South African nursing context may guide nurses in the art of this nursing skill, enhance their professionalism and facilitate the formulation of recommendations on how to encourage nurses to implement the practice of caring presence within nursing.

AIM

This study explored and described the lived experiences of PNs practising caring presence in a rural public hospital.

SETTING

The study setting was a 120-bed, level-two district hospital in the North West Province of South Africa.

METHODS

A descriptive phenomenological method, specifically Husserl's approach, informed this study. Semi-structured interviews were conducted with a purposive sample of 10 PNs. Data were coded and analysed using Colaizzi's seven-step method.

RESULTS

Five themes emerged from the data analysis: professional caring presence, ethical caring presence, personal caring presence, healing caring presence and what caring presence is not.

CONCLUSION

Professional nurses experience practising caring presence as professionally and personally fulfilling, as an expression of their passion for the profession, as a way of portraying ethical care, as a willingness to be personally present and as a healing experience that involves commitment and taking care of patients holistically. Unprofessional, unethical behaviour and depersonalisation of patients were indicated as uncaring behaviour.

The Self-Management Experiences of Adolescents with Type 1 Diabetes: A Descriptive Phenomenology Study

Many adolescents with type 1 diabetes experience challenges in achieving good glycemic control and have insufficient understanding in executing interventions for glycemic control. This study aimed to understand self-management experiences of adolescents with type 1 diabetes in Taiwan. In this descriptive phenomenological study, we conducted in-depth interviews with 18 adolescents with type 1 diabetes from the pediatric outpatient clinic of a medical center. Data were analyzed using the Colaizzi's method. Four themes were identified: (1) misconception regarding self-management of blood glucose; (2) conflict between depending on and breaking away from parental assistance for glycemic control; (3) encounter with disruptions in glycemic control regimen due to the presence of schedule changes; and (4) lack of motivation to achieve good glycemic control. The findings indicated that the misconceptions of adolescents with type 1 diabetes about managing glycemic levels resulted from an insufficient understanding of self-management of diabetes. In Taiwan, the heavy emphasis of academic achievement and changes of schedules during breaks tended to disrupt the regimen for glycemic control. Healthcare professionals are encouraged to provide individualized education focusing on the adolescents' misconceptions regarding self-management of diabetes.

South African professional Super Rugby players' lived experiences of career-related traumatic injuries: A descriptive phenomenological analysis

Background

Historically, non-career-ending traumatic rugby injury (TRI) has been viewed from a predominantly biological perspective. However, dimensional perspectives, such as the biopsychosocial model, have highlighted the need to incorporate psychosocial understandings of TRI into treatment plans.

Aim

To describe the lived experiences of a cohort of traumatically injured South African Super Rugby players in order to add to the body of literature on the subject of TRI experience.

Methods

The employment of a qualitative, descriptive phenomenological method was used to achieve the research outcome.

Discussion

Common descriptive themes indicated that TRI seems to exist within three stages: the initial, emotional and subsequent reactions to the traumatic injury. Sub-themes described within each stage included attempts at remaining positive and appraising the severity of the injury during onset, fear responses and concomitant feelings of loss related to foregone career opportunities during the emotional reactions stage, the employment of coping mechanisms, and relying on specific support structures during subsequent reactions. Two novel experiences revealed within this study and not reported in the international literature included the injured players' reliance on compartmentalisation and positive religious belief structures as coping strategies. All themes were reduced to descriptive phenomenological essences that describe a lifeworld or biopsychosocial experience of TRI.

Conclusion

Themes drawn from this study can be applied in the future design and implementation of expanded studies and psychological interventions aimed at assisting traumatically injured rugby players during their recovery process. The identified themes affirm aspects from the international literature while highlighting some uniquely South African outcomes.

Lived Experiences of Iranian Cancer Patients After Survival: A Phenomenological Research

Background:

There are significant issues in the treatment of cancer patients. Despite these issues, there is still room to explore unique lived experiences after survival.

Aim:

This study aimed to explore the experiences of cancer survivors after chemotherapy.

Method:

A descriptive phenomenological study was conducted in Zabol, Iran. A purposeful sample of 15 cancer survivors was selected to gather data using semistructured interviews. Colaizzi’s method was used for data analysis.

Results:

Four themes were extracted from the interviews. These were altered body image, mood swings, uncertain and dark future, and choosing a solitary lifestyle.

Conclusion:

Cancer patients experience various physical, psychological, and social changes including stress, anger, nervousness, despair, worthlessness, depression, social isolation, and even the wish to die after chemotherapy.

International medical electives in selected African countries: a phenomenological study on host experience

OBJECTIVES

To explore the host experience on international medical electives at a selection of hospitals in low- and middle-income countries in Africa. Outcomes of the study may inform and improve the preparation of global health curriculum, pre-elective training and debriefing for international medical electives.

METHODS

A descriptive phenomenological study was undertaken, involving semi-structured interviews with ten elective hosts at seven study sites in three African countries. Purposive convenience sampling augmented by snowballing was utilised to recruit study participants. The data were thematically analysed and interpreted with reflexivity to generate an accurate aggregate of the experience of participants in hosting international medical electives.

RESULTS

Six main themes emerged from the thematic analysis of interview data:  international medical student contribution to host hospitals, host professional and personal fulfiment, barriers to student learning experience, international medical student preparedness, hope for reciprocity and barriers to cultural immersion and patient care.

CONCLUSIONS

Study participants described the experience of hosting international medical elective students as overwhelmingly positive. However, they highlighted issues such as barriers to students' learning experience and the lack of reciprocity between host and sending institutions as areas which could be addressed to optimize the experience for both hosts and international medical students. An understanding of the host experience provides stakeholders with a clearer idea of what is important in preparation, organisation and evaluation of the elective experience. This study provides the impetus for further research to examine the effectiveness of introducing appropriate pre-departure training and post-elective debriefing to students embarking on international medical electives.

A phenomenological understanding of residents' emotional distress of living in an environmental justice community

Deteriorative environmental conditions in environmental justice (EJ) communities not only post direct health risks such as chronic illnesses, but also cause emotional distress such as anxiety, fear, and anger among residents, which may further exacerbate health risks. This study applies a descriptive phenomenological method to explore and describe the emotional experience of residents living in Ironbound, a known EJ community located in Newark, New Jersey. Twenty-three residents participated in the study. Four essential themes regarding the residents’ emotional experiences were elicited from 43 interviews: (1) being worried about the harmful effects of the surrounding pollution; (2) being distressed by the known historical pollution sources; (3) being frustrated by the unheard voices and/or lack of responses; and (4) being angered by the ongoing pollution sources. Participants not only expressed their emotions of worry, distress, frustration, and anger in detail but also described reasons or situations that provoked such negative emotions. Such detailed depictions provide insights into potential meaningful strategies to improve residents’ psychological wellbeing by alleviating negative emotions and meaningfully engaging residents in developing, implementing, and enforcing environmental laws, regulations, and policies to achieve EJ goals.

Mothers' Decisions to Disclose or Conceal Their Child's Mental Health Disorder

Parents of children with mental health disorders are often faced with the dilemma of disclosing or concealing their child's disorder. These decisions have important implications for both child and parent. Our aim is to describe mothers' experiences with the disclosure dilemma; specifically, we describe what is disclosed (or concealed), how, and why, as well as the consequences of these decisions. Data from interviews with 11 mothers of children (aged 5-13 years) with mental health disorders, and a participatory action research group (four mothers) were thematically analyzed. Mothers selectively disclosed (and concealed) to protect and advocate for their child. Their decisions were often influenced by, or were a reactance to, others' opinions, with mothers not only avoiding, but also defending against stigma, and exercising their right to privacy. Despite anticipating negative feedback, mothers more often experienced empathy and support following disclosure. Recommendations are made for developing mothers' confidence in disclosing.

Lived experiences of Iranian parents of beta-thalassemia children

INTRODUCTION

Thalassemia is a chronic blood disease, which imposes adverse effects on patients and their families. Parents of such patients, given that they had the thalassemia trait, hold themselves responsible for their children's disease in addition to other difficulties, bear the burden of guilt and hopelessness and worry about the health and future of their children. This study aimed to explore the lived experiences of parents of children with thalassemia.

METHODS

The present research was conducted using a descriptive phenomenological approach. A purposive sampling was carried out until data saturation. Participants included 15 parents of children with thalassemia who were referred to the Thalassemia Center of Zabol to perform therapeutic procedures for their child in 2016.

RESULTS

Extracted interviews were analyzed employing Colaizzi's method, and four main themes were obtained, including "Gray marriage consanguinity", "Burdened with increased number of thalassemia children", "Socio-familial worries" and "Inexpressible wishes for having an ideal society".

CONCLUSION

The results revealed that parents of children with thalassemia experience a wide range of problems in different aspects, such as physical, emotional, mental, social, economic and familial dimensions. Their experiences are valuable and can help in achieving a better understanding of their problems, which in turn can enable the members of the treatment team to play a more active role and the society to have a better understanding of this disease.

A Qualitative Inquiry of the Lived Experiences of Music Therapists Who Have Survived Cancer Who Are Working with Medical and Hospice Patients

Cancer is a debilitating illness that affects more than one in every three Americans at sometime in their life time regardless of their social, cultural, ethnic, religious, or economic status. A few studies in the psychotherapy literature have investigated the impact of cancer on the personal and professional lives of psychotherapists. However, such investigations are yet unknown in medical or music therapy literature. In this descriptive phenomenological study, the researcher interviewed five American music therapists who have survived cancer and also work with patients in medical hospitals or hospice settings. The purpose of this study was to fully describe their lived experience of surviving cancer and examine how the cancer experience affected their clinical work thereafter. The data was analyzed using an open coding method from grounded theory which identified four major themes: (a) personal significance; (b) relational significance; (c) musical significance and (d) professional significance. The descriptions provided by these participants of their cancer experience as patients, survivors, and cancer surviving therapists, have revealed various psychosocial and physical issues encountered, and numerous coping methods they employed, and poignantly explained how their clinical approach evolved and expanded due to the personal experience of cancer. Specific issues in relation to countertransference, self-disclosure, and ways of developing empathic approaches without having such personal experience were discussed in addition to suggestions for future research.

Growing older in the context of needing geriatric assessment: a qualitative study

AIM

The number of older adults will increase worldwide in the next 30 years, with many expected to develop chronic diseases and consequently require additional medical assessments and adequate care. The aim of this study was to describe how a group of older adults who need geriatric assessment experience growing older.

METHODOLOGY

A qualitative study was performed. The empirical data consisted of qualitative in-depth interviews with eight older persons referred to geriatric assessment (median age 76, range 65-86). The interviews were analysed based on Giorgi's descriptive phenomenological methodology.

RESULTS

The results led to an overall essence and five themes. The five themes were identified: (i) considerations to avoid weakness, (ii) compensation for the inability to perform certain activities, (iii) aides - a symbol of freedom or limitation, (iv) lifestyle considered being particularly significant and (v) considerations about the end of life as a component of growing older. The essence was defined as: illness essential for the experience of growing older and pointed to the experience of growing older that highlighted that experiencing illnesses and limitations served as reminders of their advancing age.

CONCLUSION

Growing older while in need of comprehensive geriatric assessment led to participants feeling they were no longer able to do the same things, they used to do. Consequently, compensation became an essential part of adaption to the altered situation. Aides that helped to overcome limitations in every daily life had the status of either creating freedom or being limiting in things they wished to do. Considerations about lifestyle were focused on housing and change of dwelling. This also led to thoughts about the future and end of life. Additional research regarding accommodations in older age is warranted to offer the best solutions for older people.

Differentiating between descriptive and interpretive phenomenological research approaches

AIM

To provide insight into how descriptive and interpretive phenomenological research approaches can guide nurse researchers during the generation and application of knowledge.

BACKGROUND

Phenomenology is a discipline that investigates people's experiences to reveal what lies 'hidden' in them. It has become a major philosophy and research method in the humanities, human sciences and arts. Phenomenology has transitioned from descriptive phenomenology, which emphasises the 'pure' description of people's experiences, to the 'interpretation' of such experiences, as in hermeneutic phenomenology. However, nurse researchers are still challenged by the epistemological and methodological tenets of these two methods.

DATA SOURCES

The data came from relevant online databases and research books.

REVIEW METHODS

A review of selected peer-reviewed research and discussion papers published between January 1990 and December 2013 was conducted using CINAHL, Science Direct, PubMed and Google Scholar databases. In addition, selected textbooks that addressed phenomenology as a philosophy and as a research methodology were used.

DISCUSSION

Evidence from the literature indicates that most studies following the 'descriptive approach' to research are used to illuminate poorly understood aspects of experiences. In contrast, the 'interpretive/hermeneutic approach' is used to examine contextual features of an experience in relation to other influences such as culture, gender, employment or wellbeing of people or groups experiencing the phenomenon. This allows investigators to arrive at a deeper understanding of the experience, so that caregivers can derive requisite knowledge needed to address such clients' needs.

CONCLUSION

Novice nurse researchers should endeavour to understand phenomenology both as a philosophy and research method. This is vitally important because in-depth understanding of phenomenology ensures that the most appropriate method is chosen to implement a study and to generate knowledge for nursing practice.

IMPLICATIONS FOR RESEARCH/PRACTICE

This paper adds to the current debate on why it is important for nurse researchers to clearly understand phenomenology as a philosophy and research method before embarking on a study. The paper guides novice researchers on key methodological decisions they need to make when using descriptive or interpretive phenomenological research approaches.

Living with hepatitis C: a phenomenological study

AIMS AND OBJECTIVES

To explore the experience of adults living with hepatitis C over time.

BACKGROUND

Hepatitis C virus is a growing problem affecting thousands of people worldwide. The majority of individuals infected develop chronic liver disease, but treatment is not always successful, leaving many to live with the virus indefinitely. Experiences of living with hepatitis C are poorly understood yet essential to meet the needs of an increasing number of affected people.

DESIGN

A qualitative study using a descriptive phenomenological methodology.

METHODS

Unstructured interviews were conducted with 23 hepatitis C-positive individuals in the East of England; participants were interviewed twice within a year.

RESULTS

Data analysis revealed six themes of the experience of living with hepatitis C: hepatitis C and self; hepatitis C, self and others; self and handling hepatitis C; self and handling hepatitis C treatment issues; living with the consequences of hepatitis C; self, hepatitis C and thoughts of the future.

CONCLUSIONS

Diagnosis of hepatitis C can disrupt people's sense of identity and trigger a life transition. A complex range of factors create uncertainty for people living with hepatitis C. Many struggle to make a healthy transition to life with the condition, instead living in a state of sustained uncertainty.

RELEVANCE TO CLINICAL PRACTICE

Nurses working within a chronic care framework of ongoing advice and support can improve experiences for those living with hepatitis C. Practice aimed at reducing both the disruptive effect of the diagnosis and the uncertainties it creates can help facilitate a transition to life with the disease.

Experiences of preconception, pregnancy, and new motherhood for lesbian nonbiological mothers

OBJECTIVE

To describe the experiences of preconception, pregnancy, and new motherhood from the perspective of lesbian nonbiological mothers.

DESIGN

Descriptive phenomenology.

SETTING

A private room at the study site and participants' homes.

PARTICIPANTS

Twenty-four self-identified lesbian nonbiological mothers in a committed relationship and whose partner gave birth within the past 2 years participated. All of the participants were from urban or suburban areas in the Pacific Northwest.

METHODS

Women participated in semistructured in person interviews that were audio recorded and transcribed verbatim for analysis. Coliazzi's method guided the process.

RESULTS

An overarching theme of "feeling different" permeated the experiences of preconception, pregnancy, and new motherhood for the participants. The women's narratives revealed seven themes that illustrated their experiences: (a) Launching pregnancy: A roller coaster ride; (b) Having legal and biological concerns: Biology prevails; (c) There is a little person in there: Dealing with pregnancy issues; (d) Losing relationships over pregnancy: The elephant in the room; (e) Feeling incomplete as a mother; (f) Carving a unique role: There are very few of us out there; and (g) Sadness and regret: Nonbiological mothers get the postpartum blues, too.

CONCLUSIONS

The experience of preconception, pregnancy, and new motherhood for nonbiological lesbian mothers is complicated by the lack of biological and legal substantiation to the infant, few role models, and limited social support. Nurses and health care providers cognizant of these issues can play an important role in facilitating a positive transition to motherhood for this population.

A case study of a mother's intertwining experiences with incest and postpartum depression

The association between childhood sexual abuse (CSA) and major depression disorder (MDD) gives reason to suspect that many mothers with postpartum depression (PPD) have a history of CSA. However, few studies have investigated how CSA and PPD are related. In this case study we explore how the experience of incest intertwines with the experience of postpartum depression. We focus on participant subject “Nina,” who has experienced both. We interviewed her three times and we analysed the interviews with Giorgi's phenomenological descriptive method to arrive at a contextualised meaning structure. Nina's intruding fantasies of men who abuse her children merge with her recollections of her own incest experiences. She may succeed in forcing these fantasies out of her consciousness, but they still alter her perceptions, thoughts, and emotions. She feels overwhelmed and succumbs to sadness, while she also is drawn towards information about CSA, which in turn feeds her fantasies. The psychodynamic concepts of repetition compulsion, transference, and projection may provide some explanation of Nina's actions, thoughts, and emotions through her past experiences. With our phenomenological stance, we aim to acknowledge Nina's descriptions of her everyday life here and now. With reference to Husserl, Heidegger, Merleau-Ponty, and Minkowski, we show that Nina's past is not a dated memory; rather it determines the structure of her consciousness that constitutes her past as her true present and future. Incest dominates Nina's world, and her possibilities for action are restricted by this perceived world. Any suspension of action implies anguish, and she resolves this by incest-structured action that in turn feeds and colours her expectations. Thus anxiety and depression are intertwined in the structure of this experience.