Narrative Analysis of Urban-Dwelling Pregnant Puerto Rican Women: Fuerza y Tenacidad.

Among Latina subgroups residing in the mainland United States, Puerto Rican women have the highest infant mortality rates when compared to all Latinas. Despite this, little is known about their daily lives in urban settings. This narrative analysis describes the stories regarding the life course of 21 pregnant Puerto Rican women living in an urban area in the mainland United States to identify plot types and underlying dimensions of their social ecology. Holistic form analysis was used to identify the structure of the narratives with graphical representations of the three identified types of plots (series of events that make up a story). Holistic content analysis was used to describe the major components of the narratives. Three primary plot types emerged from the narratives: Progressive, Neutral, and Circular. The women exhibited strength and tenacity to survive within a challenging urban setting often complicated by social pressures of their culture. The findings show the diversity of their lives and their social contexts even though from the viewpoint of being pregnant, Puerto Rican women who lived in a single neighborhood they may seem remarkably similar to an outsider.

Social Determinants of Health in the Lives of Urban-Dwelling, Pregnant Puerto Rican Women and Families: Nursing Implications From a Secondary Narrative Analysis.

Urban-dwelling childbearing Puerto Rican women and families on the U.S. mainland face a myriad of social determinants that affect pregnancy and overall health outcomes. Historically, Puerto Ricans have poorest pregnancy outcomes of all Hispanic women. Acknowledgment of the cyclic, structural barriers faced by this patient population is essential to providing wholistic care. Here, we discuss family nursing implications derived from narrative analysis of a parent study that investigated ecological systems affecting 21 pregnant Puerto Rican women residing in an impoverished and crime-ridden neighborhood in Philadelphia. Content analysis of interviews revealed interwoven social determinants of health embedded in participant narratives. Furthermore, we present case vignettes based on integration of participant interviews that encapsulate the everyday experiences of these women and their families and provide clinicians with guidance and strategies for interacting with and advocating for this population.

CE: Early Intervention in Patients with Poststroke Depression.

: Nearly one-third of stroke survivors experience depression. Poststroke depression is associated with longer hospital stays, poor physical and cognitive recovery, poor quality of life, high caregiver distress, increased risk of recurrent stroke, and higher rates of morbidity and mortality. Poststroke depression, however, often goes unrecognized and untreated because the physical and cognitive repercussions of stroke make it difficult to identify. Nurses are well positioned to recognize poststroke depression, educate patient caregivers, and aid patients who have poststroke depression in their efforts to achieve physical, cognitive, and emotional recovery. This article explains how poststroke depression often manifests, describes associated risk factors, and discusses the screening tools and therapeutic interventions nurses can use to identify and help manage depression in patients following stroke.