Graduation Date

Spring 5-7-2016

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Programs

Nursing

First Advisor

Diane Brage Hudson

Abstract

The purpose of this study was to construct the explanatory models of postpartum depressive symptomatology (PPDS) from the perspective of rural Nebraska women and to compare these models with the medical model of PPDS. A sample of 20 rural Nebraska women were interviewed in a one-on-one qualitative descriptive telephone interview using questions based on Kleinman’s (1980) explanatory model of illness. This study used feminist pragmatism as a guiding philosophical paradigm. Qualitative data were analyzed using content analysis, and results were compared and contrasted with the medical model of PPDS, which included the onset, symptoms, and duration listed in the DSM-5 for major depressive disorder with a peripartum onset specifier; a primarily physiological etiology; and pharmacological antidepressants as the treatment of choice. Rural women were more likely to attribute their PPDS to nonphysiological causes than physiological causes. Rural women reported the onset, duration, and symptomatology of PPDS were similar to what is outlined in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Women considered the effects of PPDS on their lives far-reaching and serious. Rural women in this study preferred nonpharmacological treatment options and care from informal networks to that available from health care providers. Although the rural women in this study did not believe PPDS could be prevented, they believed women could better prepare themselves for PPDS by having a support system in place and by planning for practical life concerns. Health care providers and researchers should consider rural women's explanatory models of PPDS when considering interventions and program development for women in rural communities.

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