Longo, Joy

Exclusive breastfeeding for at least 6 months provides numerous infant and maternal benefits. Yet mothers with risk factors, such as lower education, lower socioeconomic status, younger maternal age, planned cesarean birth, and anxiety and depression, are more likely to stop breastfeeding in the early postpartum period. Few studies have focused on perinatal depression as a risk factor for breastfeeding cessation. To tailor effective interventions, nurses must first understand the lived experience of breastfeeding for mothers at risk for perinatal depression.
A descriptive phenomenological study was conducted to elucidate the experience of breastfeeding for mothers with perinatal depression. The study was grounded in Swanson’s middle-range theory of caring. After university Institutional Review Board approval, a purposive sample of 10 women was recruited from various organizations. Participants completed a demographic questionnaire and the Edinburgh Postnatal Depression Scale, and semistructured, audiorecorded face-to-face or telephonic interviews were conducted. The researcher transcribed the data which was transformed into constituents of the mothers’ lived experience by utilizing Giorgi’s descriptive phenomenological method.
Five constituents emerged: choosing selflessness, harboring inadequacy, deliberate persevering, discerning meaning, and cherishing intimacy. The constituents embodied the essence of the mothers’ thoughts and feelings connected to breastfeeding. By daily choosing selflessness, mothers consciously decided to breastfeed despite physical or psychological struggles. They often were harboring inadequacy due to ongoing struggles which led to incessant thoughts of maternal incompetence. Yet they successfully breastfed for at least 2 weeks after birth by deliberate persevering. Through breastfeeding, they were discerning meaning to realize their value as mothers. Finally, they reveled in purposeful moments of togetherness with their babies through cherishing intimacy.
The study findings inform recommendations for nursing education, practice, research, and policy. Nursing education must include basic breastfeeding and perinatal mental health knowledge in prelicensure curricula and up-to-date lactation management techniques and perinatal mental health awareness training in continuing education. Practicing maternal-child nurses must provide education and support to mothers about advantages and difficulties of breastfeeding throughout the perinatal period. Future research includes determination of support needs for women with perinatal depression with subsequent development and evaluation of therapeutic actions to promote breastfeeding success.

It is estimated that there will be a 20% shortage of full time equivalent registered
nurses (RN) by 2015. Retention of nurses is a priority in health care, so a better
understanding of factors that contribute to job satisfaction and intent to leave is needed.
One possible factor is the quality of the interpersonal relationships that occur among
managers, peers, and nurses. A negative quality would be acts of hostility or horizontal
violence, which is nurse-to-nurse aggression. This is theorized to be a result of oppressed
group behavior. These behaviors may influence job satisfaction and the intent to stay on
the job and in the profession.
The overall purpose of the study was to explore relationships between horizontal
violence, oppressed group behavior, job satisfaction and intent to leave a position or
nursing in the next 12 months. This pilot study examined factors that influence registered nurses ' job satisfaction
and intent to leave a position or nursing. Convenience sampling was used to obtain the
sample of registered nurses from a BSN completion program and a Novice Nurse
Initiative Program (n=99). Written stories of conflict between nurses were obtained and
analyzed with linguistic analysis and word count (LIWC) software and various
standardized instruments were used including the Nurses Workplace Behavior Scale
(NWBS), the Organizational Climate for Caring Scale (OCCS), the Peer Group Caring
Interaction Scale (PGCIS), The McCloskey/Mueller Satisfaction Scale (MMSS) and two
visual analogue scales (VAS).
Significant relationships were found between job satisfaction and intent to stay in
a position and nursing (p<.01), oppressed group behavior and intent to stay in nursing
(p<.01), oppressed group behavior and job satisfaction (p<.01). Manager and peer caring
behaviors were related to intent to stay in a position and nursing (p<.01). Using stepwise
multiple regression, both manager and peer caring behaviors were found to influence the
relationship between job satisfaction and intent to stay in a position or nursing.
The findings of this study suggest that the quality of interpersonal relationships
between managers, peers and nurses can influence job satisfaction and intent to stay in a
position or nursing.