Mothers with Mental Illness: Public Health Nurses' Perspectives Patricia Bourrier University of Manitoba a Thesis Submitted T
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Mothers with Mental Illness: Public Health Nurses’ Perspectives Patricia Bourrier University of Manitoba A Thesis submitted to the Faculty of Graduate Studies of The University of Manitoba In Partial Fulfillment of the Requirements for the Degree of MASTER OF NURSING Faculty of Nursing University of Manitoba Winnipeg, Manitoba February 3rd, 2011 Copyright © 2011 by Patricia Bourrier PHN PERSPECTIVES 2 PHN PERSPECTIVES 3 Table of Contents Page Acknowledgements ..............................................................................................................8 Abstract… ............................................................................................................................9 Chapter One: Introduction .............................................................................................10 Purpose of the Study ..........................................................................................................15 Healthy Child Development ..............................................................................................15 Conceptual Framework ......................................................................................................16 Research Questions ............................................................................................................17 Significance of the Study ...................................................................................................18 Chapter Two: Literature Review ...................................................................................19 Biology and Genetics .........................................................................................................19 Creating Supportive Environments ....................................................................................21 • Stigma of Mental Illness ........................................................................................21 • Attitudes of Health Care Professionals ..................................................................24 • Experience of Mothering with a Mental Illness .....................................................28 Develop Personal Skills .....................................................................................................30 Healthy Child Development ..............................................................................................32 • Impact of Custody Loss .........................................................................................35 • Perinatal Mental Illness .........................................................................................37 • Parenting Programs ................................................................................................38 Nurses’ Role in Caring for Mothers and Families .............................................................41 • Home Visiting ........................................................................................................43 PHN PERSPECTIVES 4 Reorient Health Services....................................................................................................43 • Interprofessional Focus ..........................................................................................44 Social Support Network .....................................................................................................47 Education ...........................................................................................................................48 Summary ............................................................................................................................49 Chapter Three: Methodology .........................................................................................51 Aims ...................................................................................................................................51 Research Design .................................................................................................................51 Interpretive Paradigm .........................................................................................................52 Participants .........................................................................................................................53 Inclusion Criteria ...............................................................................................................53 Population Health Profiles .................................................................................................54 Sampling Strategies ...........................................................................................................55 Data Collection ..................................................................................................................56 Procedure ..........................................................................................................................59 Interview Guide .................................................................................................................59 Role of the Moderator ........................................................................................................61 Focus Group Structure and Time Frame ............................................................................63 Ethical Considerations .......................................................................................................64 Data Analysis ....................................................................................................................65 Demonstration of Trustworthiness .....................................................................................67 Summary ............................................................................................................................68 PHN PERSPECTIVES 5 Chapter Four: Results .....................................................................................................69 Introduction ........................................................................................................................69 Description of the Sample ..................................................................................................69 “Helping Moms Succeed” .................................................................................................71 The Role of the Public Health Nurse .................................................................................72 • “Dealing with where they’re at”.............................................................................76 • “You can only do so much” ...................................................................................80 • “I kept wanting more” ............................................................................................85 Challenges and Barriers .....................................................................................................93 • “Treasure hunting” .................................................................................................93 • “You can only do so much” .................................................................................101 • “I kept wanting more” ..........................................................................................104 The Needs of Mothers with Mental Illness ...................................................................... 110 • “Treasure hunting” ............................................................................................... 110 • “Dealing with where they’re at” .......................................................................... 113 • “You can only do so much” ................................................................................. 115 Chapter Five: Discussion ............................................................................................... 117 Application of the Conceptual Framework ...................................................................... 117 • Who? ................................................................................................................... 117 • How? .................................................................................................................... 118 - Creating supportive environments ........................................................... 118 - Developing personal skills ....................................................................... 119 - Reorient health services ...........................................................................119 PHN PERSPECTIVES 6 • On What? ................................................................................................................... 119 • Social support networks ................................................................................. 120 • Health services ............................................................................................... 120 • Healthy child development ............................................................................. 120 • Personal health practices and coping skills .................................................... 121 Helping Moms Succeed ......................................................................................................... 122 Implications for PHN Practice and Recommendations ......................................................... 124 • Role of the Public Health Nurse ..................................................................... 124 • The Needs of Mothers with