Investigating the Effects of Cognitive Apprenticeship-Based Instructional Coaching on Science Teaching Efficacy Beliefs

The overall purpose of this collected papers dissertation was to examine the utility of a cognitive apprenticeship-based instructional coaching (CAIC) model for improving the science teaching efficacy beliefs (STEB) of preservice and inservice elementary teachers. Many of these teachers perceive science as a difficult subject and feel inadequately prepared to teach it. However, teacher efficacy beliefs have been noted as the strongest indicator of teacher quality, the variable most highly correlated with student achievement outcomes. The literature is scarce on strong, evidence-based theoretical models for improving STEB. This dissertation is comprised of two studies. STUDY #1 was a sequential explanatory mixed-methods study investigating the impact of a reformed CAIC elementary science methods course on the STEB of 26 preservice teachers. Data were collected using the Science Teaching Efficacy Belief Instrument (STEBI-B) and from six post-course interviews. A statistically significant increase in STEB was observed in the quantitative strand. The qualitative data suggested that the preservice teachers perceived all of the CAIC methods as influential, but the significance of each method depended on their unique needs and abilities. STUDY #2 was a participatory action research case study exploring the utility of a CAIC professional development program for improving the STEB of five Bahamian inservice teachers and their competency in implementing an inquiry-based curriculum. Data were collected from pre- and post-interviews and two focus group interviews. Overall, the inservice teachers perceived the intervention as highly effective. The scaffolding and coaching were the CAIC methods portrayed as most influential in developing their STEB, highlighting the importance of interpersonal relationship aspects in successful instructional coaching programs. The teachers also described the CAIC approach as integral in supporting their learning to implement the new inquiry-based curriculum. The overall findings hold important implications for science education reform, including its potential to influence how preservice teacher training and inservice teacher professional development in science are perceived and implemented. Additionally, given the noteworthy results obtained over the relatively short durations, CAIC interventions may also provide an effective means of achieving improvements in preservice and inservice teachers’ STEB more expeditiously than traditional approaches.

Teachers' knowledge, awareness, and pedagogy of global education in secondary schools

Professor Mohammed K. Farouk, Major Professor In 1979, the Florida State Board of Education approved the teaching of global education in the state of Florida. The purpose of this study was to examine the factors that contributed to teachers' global knowledge, global mindedness, and pedagogy in global education. The Hanvey model of teaching from a global perspective was the theoretical framework for the study. A total of 90 secondary teachers from Miami-Dade County Public Schools were randomly selected and placed in three groups: Globally Oriented Social Studies Program (GOSSE), Non-Globally Oriented Social Studies Program (non-GOSSE), and Teachers Who Teach Other Subjects (TWTOS). Seven teachers, two of whom team-taught a class, were selected for classroom observations and interviews. A mixed methods design that combined quantitative and qualitative data was used. ANOVA and Chi square techniques were used to determine whether the factors that contributed to teachers' global knowledge and global mindedness differ among groups. Classroom observations and interviews were conducted to determine whether the instructional strategies differ among the seven selected teachers. The findings of the study show that teachers who were trained in teaching from a global perspective differed in their global knowledge and used more appropriate instructional strategies than teachers who were not trained in teaching global perspectives. There was no significant difference in the combined global knowledge of the non-GOSSE and TWTOS groups when compared with the GOSSE group. There was no significant difference in the combined global knowledge of the GOSSE and non- GOSSE groups when compared with the TWTOS group. There was no significant difference among the teachers in their global mindedness. Observation and interview data indicate that current events, role-playing, simulations, open-ended discussion, debates, and projects were the predominant instructional strategies used by globally trained teachers. Cable networks, Internet, magazines, and newspapers were found to be the dominant tools for teaching global education. This study concluded that teachers who were trained in globally oriented programs had more global knowledge than teachers who were not. It is recommended that teacher education programs should incorporate a global perspective in the preparation of social studies teachers, with particular attention to developing their global attitudes.

School desegregation in Broward County, Florida 1970-1998 : a historical study of power

This is a historical case study on school desegregation and power in Broward County, Florida from 1970 to 1998. The purpose of this study is to describe, explain and analyze types of power used by the School Board of Broward County, Florida and community activists, in their efforts to influence desegregation decisions from 1970 to 1998. In addition, this study explains who benefited and who won from the School Board's desegregation decisions and who governed those decisions? A historical case study approach was used as the method for conducting this study. Data sources included 11 interviews of individuals who were involved in school desegregation issues as either School Board officials or community activists and 10 archival data sources. The theoretical models of Russell, Galbraith, Wartenberg and Domhoff were used to determine the different types of power techniques used by School Board officials and community activists and to answer the questions: who benefited and who won from the School Board's desegregation decisions and who governed those policies and practices? The primary beneficiaries of school desegregation policies and practices in Broward County were: white, affluent communities and the builders, developers, realtors and other businesses in the western suburban communities. All of the data sources indicated that the black community did not benefit from the School Board's desegregation policies. The primary power techniques used by School Board officials to influence desegregation policies and practices was "power over opinions" and compensation. These power techniques were manifested by the School Board publicly disputing the allegations raised by community activists and by compensating those who supported and promoted the School Board's desegregation policies and practices. The power techniques primarily used by community activists were coercive force and "power over opinions." They effectively used these power techniques to change the School Board's policies and practices they felt were detrimental to black children and the black community. Based on the analysis of the qualitative data, it can be concluded that black children did not benefit from school desegregation in Broward County, Florida and the community continues to suffer residual effects from past desegregation policies and practices.

Perceptions of collaboration between emergency nurses and paramedics

Collaboration between emergency room (ER) nurses and paramedics is vital due to the increasing number of critically ill patients entering the hospital via the "911" system. This descriptive study examined the perception of the collaborative relationship using the Revised Pehl Collaboration Scale (RPCS) and by qualitative data from four free response questions. The results of this study indicated that the overall relationship between the ER nurses and paramedics was friendly but not fully trusting. The content analysis of the free response questions identified that the "report" of patient information was the origin the most conflict. The nurses felt that paramedic patient assessment, patient priorities, and by-pass protocol were problems. Whereas, the paramedics identified the nurses condescending manner and mistrust, not being "listened" to, and overcrowded emergency rooms as the source of conflict. Data was not statistically significant with regards to personal attributes or social demographics from the RPCS.

Usuários de crack, instituições e modos de subjetivação: estudo das práticas e da eficácia terapêutica em uma comunidade terapêutica religiosa (RN)

This anthropological research has as main goal to grasp the meanings and perceptions - mode of subjectivity - of crack users in relation to the proposals of Therapeutic Communities (TC) of religious character. The work emphasizes the analysis of Therapeutic Communities of Rio Grande do Norte state, studying a particular organization, called Anzóis da Dor. I intend to analyze qualitative data, focusing on an analysis of the discursive content of speeches and the observation of social interaction, which results in an ethnographic text characterized by a dense description. In relation to the dissertation’s specific goals, we seek to present a general overview of the emergence and development of Therapeutic Communities – encompassing general and local considerations - and pointing out to the dynamics of religious healing systems of these institutions, besides the principles that guide them. In methodological terms, I conducted the partial mapping of therapeutic communities located in Rio Grande do Norte state; interviews with Therapeutic Communities coordinators, visits, participant observation in one of these institutions as well as some interviews with crack users and people close to these social agents in relation to the Therapeutic Communities and the treatment offered by them

A simulação realística como estratégica de ensino-aprendizagem em enfermagem

The study aims to examine the methodology of realistic simulation as facilitator of the teaching-learning process in nursing, and is justified by the possibility to propose conditions that envisage improvements in the training process with a view to assess the impacts attributed to new teaching strategies and learning in the formative areas of health and nursing. Descriptive study with quantitative and qualitative approach, as action research, and focus on teaching from the realistic simulation of Nursing in Primary Care in an institution of public higher education. . The research was developed in the Comprehensive Care Health discipline II, this is offered in the third year of the course in order to prepare the nursing student to the stage of Primary Health Care The study population comprised 40 subjects: 37 students and 3 teachers of that discipline. Data collection was held from February to May 2014 and was performed by using questionnaires and semi structured interviews. To do so, we followed the following sequence: identification of the use of simulation in the discipline target of intervention; consultation with professors about the possibility of implementing the survey; investigation of the syllabus of discipline, objectives, skills and abilities; preparing the plan for the execution of the intervention; preparing the checklist for skills training; construction and execution of simulation scenarios and evaluation of scenarios. Quantitative data were analyzed using simple descriptive statistics, percentage, and qualitative data through collective subject discourse. A high fidelity simulation was inserted in the curriculum of the course of the research object, based on the use of standard patient. Three cases were created and executed. In the students’ view, the simulation contributed to the synthesis of the contents worked at Integral Health Care II discipline (100%), scoring between 8 and 10 (100%) to executed scenarios. In addition, the simulation has generated a considerable percentage of high expectations for the activities of the discipline (70.27%) and is also shown as a strategy for generating student satisfaction (97.30%). Of the 97.30% that claimed to be quite satisfied with the activities proposed by the academic discipline of Integral Health Care II, 94.59% of the sample indicated the simulation as a determinant factor for the allocation of such gratification. Regarding the students' perception about the strategy of simulation, the most prominent category was the possibility of prior experience of practice (23.91%). The nervousness was one of the most cited negative aspects from the experience in simulated scenarios (50.0%). The most representative positive point (63.89%) pervades the idea of approximation with the reality of Primary Care. In addition, professors of the discipline, totaling 3, were trained in the methodology of the simulation. The study highlighted the contribution of realistic simulation in the context of teaching and learning in nursing and highlighted this strategy while mechanism to generate expectation and satisfaction among undergraduate nursing students

Possibilidades de enfoque CTS para o ensino superior de química: proposta de uma abordagem para ácidos e bases

Scientific education has been passing by redefinitions, contestations and new contributions from the research on science teaching. One contribution is the idea of science and technology literacy, allowing the citizens not only knowing science but also understand aspects on the construction and motivation of scientific and technological research. In accordance with this idea, there is the Science-Technology-Society (STS) studies which, since the 1970s, has been contributing for science teaching and learning according to the comprehension of the relationships with society in the Western countries of the North. In Brazil, this approach began to gain projection from the 1990s when the first essays on the theme were published. Currently, there is a clear influence of this approach on the national curriculum guidelines, especially for the area of Natural Sciences, and also on the textbooks chosen by the High School National Program (Programa Nacional do Ensino Médio). However, there seems to be a gap in relation to the discussion on the specific curricular component seen in college on this approach. Thus, this study aims at adopting the approach STS, face to the preparation of complimentary educational material on acid and bases concepts studied in the course of General Chemistry of the Natural Sciences graduation program. To this end, it was performed a bibliographical research aiming at making the state-of-the-art in in these concepts in specific literature to science teaching. It is divided in two stages: systematic study (with sixteen journals chosen according to Qualis-Capes and an unsystematic study with direct search in databases and references in the papers of the systematic study. The studies had their content analyzed and the categories chosen a priori were the level of education, the acid-base theory adopted, and the strategy/theoretical frame of reference adopted. A second stage aimed at identifying attitudes and beliefs on STS (Science-Technology-Society) and CSE (Chemistry-Society-Environment) of students in the teacher and technologist training course in three diferent institutions: UTFPR, UFRN and IFRN. In this study, it was used two questionnaires, composed of a Likert scale, semantic differential scale and open questions. The quantitative data reliability was estimated through Cronbach’s alpha method, and tha data were treated according to classic statistics, using the mean as the centrality measures, and the mean deviation as dispersion. The qualitative data were treated according to the content analysis with categories taken from the reading of answers. In the third stage, it was analyzed the presence of STS and CSE content in chapters on acid and bases concepts of nine General Chemistry textbooks, frequently used in graduation programs in public institutions of the state of Rio Grande do Norte. The results showed that there are few proposals of acid and bases teaching, and they are generally aimed at High School or at instrumentation for teaching courses, and no course for General Chemistry. The student’s attitudes and beliefs show the presence of a positivist point of view based on the concept of Science and Technology neutrality and the salvation of its mediation. The books analysis showed just a few content on STS and CSE are found in the studied chapters, and they are generally presented disjointedly in relation to the rest of the main text. In the end, as suggestion to solve the absence of proposals STS in General Chemistry books, as well as the student’s positivist attitudes, it was developed some educational material to be used in the course of General Chemistry at College. The material is structured to introduce a historical view of the concepts preparation, present the use of materials, the industrial and technological processes, and social and environmental consequences of this activities

Adiamento da aposentadoria e o significado do trabalho para servidores de uma universidade federal

This study investigated the intention of the older workers to continue working after state pension age/time. On this way, it explores the relation between this intention and factors related with the meanings of the work and retirement. Specifically, it was examined that factors related to work and non-work are predictors of the intention to continue working, and it was explored if meanings of retirement are linked to this decision. It is a crosssectional mixed methods study, using a survey conducted with 283 federal civil servants of a federal Northeastern University which were near retirement. It envolved an on-line questionnaire, with open-ended questions and the likert-type scale "Older Worker's Intention to Continue Working" (OWICW) of Shacklock and Brunneto (2011), which was validated to the Brazilian version. The quantitative data were analyzed using descriptive and multivariate statistics, specifically procedures for comparing means and coefficients of multiple logistic regression. The qualitative data were analyzed using the lexicographical technique Descending Hierarchical Classification. The findings indicate that most participants want to continue in paid work, and that perception of personal autonomy at work, interpersonal relationships at work, interests outside of work, and flexible working arrangements are significant predictors of intention to continue working. Furthermore, the perception of personal autonomy at work, flexible working arrangements, and the financial incentives are predictors of decision to postpone retirement and remain in the organization. The analysis revealed five patterns of meanings of retirement: "worker's right", "resting", "idle time at home", "new stage in the life course", and "enjoy the use of time”. The decision to postpone retirement is linked to idleness and lack of substitutionary activities work, and the decision to stop working linked to retirement as a life with more quality. The study provides information that can contribute with management policies before the process of retirement decision.

Química em cena: uma proposta para formação inicial de professores de química

In educational observed difficulty in train teachers to meet the medium and higher education needs, and one reason for this is the different experiences in the training of educators in relation to those found in the classroom. So often arise criticisms related to relevance and efficiency of degree courses, as regards the performance of its natural mission, which weakens the teacher training. Thus, improving the quality of education is very dependent on the initiatives of teachers, creating teaching alternatives to strengthen their performance in school. From this reflection, it is concluded that teacher training needs new educational proposals that qualify, and so can promote the formation of his students more adequately. Among the educational proposals as alternatives to initial teacher training may use the scientific theater (TC). Considering this possibility, this work has been proposed as investigate and discuss the influence of TC combined with experimentation in the initial training of future teachers in Chemistry who participate in the Groups Fanatics chemistry Theatre (UERN) and Chemistry on Stage (UFRN). Therefore, there was, in a first stage, theatrical essays based on the theater of the oppressed, and written dramaturgical scripts, a collaborative proposal. To incorporate experimentation in chemistry to theater rehearsals, there was a systematic literature search and after content analysis, were selected categories, materials and reagents easily accessible, easy procedures and implementation with low risk of accidents and easy care chemical waste. In the second part we identified: a) the beliefs of student teachers in the use of TC ally trial for initial training of chemistry teachers; b) the influence of TC ally to trial on learning of chemical concepts of high school students who attended the shows; c) the reasons for using or not TC ally to trial by chemistry teachers who participated in the TC group and currently work in the classroom. In this study, questionnaires and interviews were used, compounds, respectively, by a Likert scale and open questions. Quantitative data were analyzed by classical statistics the media, using as centrality measures the average, the concordance argument and the average deviation. Qualitative data were discussed according to content analysis, with categories that emerged from reading the answers. These analyzes concluded that the licensees have a positive view on the use of scientific theater for disclosure of the chemical for use in the learning of chemical concepts, pedagogical and disciplinary knowledge, and to form promotion strategy for research and extension at the University. They credit improvements in their initial training on the use of scientific theater combined with experimentation. The TC provides motivation for the construction of conceptual thinking in an informal way of chemical communication, allowing the student to expand their knowledge, not only favoring the phenomenological approach, but also the construction of chemical knowledge and the internalization of scientific concepts.

Minicontos: uma prática de letramento emergente na escola

Like numerous other mini ficçion genres, the Flash fiction is configured as a concise and brief genre, but it can still preserve some elements of the traditional tale, such as: narrator, space-temporal unit, characters and plot. For some authors, the emergence of this genre is strictly connected to the speed and diversity of forms of communication in the current social context, that require the reader other skills in addition to reading and writing. Considering the importance of these skills in a literate society and recognizing this genre as potentially effective tool for the development of literacy, this research has as objective to describe the development and implications of didactic sequence directed the literacy practices with the Flash fiction genre. Thus, the research becomes effective in an elementary school vespertine class in 9th grade from Escola Estadual Dr. José Gonçalves de Medeiros, located in the city of Acari-RN. As theoretical assumptions, it will be used fundamentals from Literacy Studies as social practice, especially that ones discussed by the writings Kleiman (1995), Hamilton (2000), Soares (2012), Mortatti (2004) and Rojo (2012). To subsidize the literary literacy, it will be used the theoretical contibutions of Borges (2000), Candido (2004), Pinheiro (2001) and Silva e Silveira (2013). In what relates to the study about the storytellers, it was taken by support the postulates of Gotlib (2006), Bosi (1997), Cortázar (1999), Talbot (2002), Poe (s/d), Luzia de Maria (2004), as well as studies by researchers and writers as Spalding (2007; 2008; 2011), George (2007), Freire (2004) and Trevisan (1994), among others who are dedicated to study Flash fiction. In the methodological field, the proposed perspective anchors itself in an action-researching guidelines (MOREIRA; CALEFFE, 2006) and in the approach of a qualitative data (BOGDAN; BIKLEN, 1994), since it talks to interpretation of diagnosed situation, implementation of intervention actions organized in didactic sequence (SCHNEUWLY; DOLZ, 2004; BARROS; RIVERS-registry, 2014), including description and evaluation of results achieved from the implementation of such actions. The discussions generated indicate that the work with Flash ficition, developed by means of didactic sequences, contributes to the reflection on teaching strategies of Portuguese, used to prepare the students to meet the demands of reading and writing of contemporary society.

Operações linguístico-discursivas em relatos retextualizados por alunos do ensino fundamental

The following paper attempted to investigate and discuss the possible improvements in the writing of students from the public network in the 6th grade of elementary school. This research was run in the professional master degree In Portuguese Language. Also based upon Genetic Criticism, this study attempting to analyze in which way and in which proportions the alterations done in the texts reveal and perspective capacity in the students as they replace, broad, remove or just move terms in their assignments. We tried to develop our analysis in the pragmatic perspective in which Textual Linguistic is included, investigating the texts and appreciating them as a construction process of meaning. Our theoretical discussion will be based on and socio-interactional conception of language (MARCUSCHI, 2008), as well as in the postulates of Analyze of Discursion (ADAM, 2010, 2008). It has also been used the theoretical assumptions taken from Genetic Criticism which regard the relation between text and genesis, due to the fact that it considers the text and a the result of a construction of progressive elaboration and the writing as an activity of constant movement (DE BIASI, [2000] 2010; GRÉSILLON, 1989; [1990] 2008; [1992] 2002; SALLES, 2008a). To assemble the data in this research we took into consideration the social variables related to the students and the sociocultural context. Nonetheless, this investigation point towards a real classroom situation where we tried to analyze the language functioning in application conditions, thus, giving us authority to describe more precisely the reality we lived in, which provided us with a more attentive look to the observed particularities. This description of the reality appreciated built a path that point to a research of qualitative data approach to which meanings deriving from interpretation were attributed. To conduct this research we resourced to the Action-Research process. The data are comprised of ten personal reports that were created from rewriting assignments, which constitutes a range of twenty texts assessed starting from the linguistic operations acknowledged by Generative Grammar and continued by Lebrave and Grésillon (2009). As result of this analysis, we identified the operation of adding more often than the other ones. The replacement and removal operations display a very close offspring. Nevertheless, the moving operation was scarcely used. These results, besides demonstrating linguistic creativity of the students, revealed that for a text to be seen as “concluded”, the writing student articulates new elaborations through these linguistic operators and that these movements of coming and going, of erasures and amendments contribute significantly for the teacher to approach the relationship the student keeps with his textual and discursive expression, and then, with that, to hold information that eventually provides individual and collective directions in school productions.

The first time delivery of the first link learning series using Skype and YouTube

Introduction: This case study documented the experiences of informal and service providers who participated in the first time delivery of the First Link Learning Series from May–August 2013 in Newfoundland and Labrador. The aim of this study was to understand how informal caregivers of people with dementia experience this Internet mediated health resource, and how Skype and YouTube can be used as tools for the Alzheimer Society of Newfoundland and Labrador to effectively deliver the First Link Learning Series. Methods: Sources of data included key informant interviews (n=3), pre- study and post-study interviews with informal dementia caregivers (n=2), institutional documentation, field notes, and YouTube analytics. Framework Analysis was used to make meaning of the qualitative data, and descriptive statistics were used to report on quantitative outcomes. Findings: Between 3% and 17% of registered First Link clients attended the learning series sessions, however only two caregivers participated using Skype or YouTube. Framework Analysis revealed three shared themes: access, connection and privacy. Discussion: The themes helped to begin building theory about barriers and facilitators to Internet mediated health resources for informal dementia caregivers. Experiences of service providers using the Internet to support clients served to begin building a case for the appropriateness of these media. A modified version of Dansky et al.’s (2006) theoretical framework for evaluating E-Health research that situates the person/user in the model, helped guide discussion and propose future directions for the study of Internet based health resources for informal dementia caregivers.

Caminhos da professoralidade no Curso de Dança da UFU: impasses e desafios na construção da identidade profissional

Teacher identity is a subject of study and discussion in the academic world whichhas become an object of attention of researchaddressing teaching and teacher formation. Life history, initial and continuing formation, the meaning of teaching to the teacher, and also pedagogical practice are all contributing factors to teachers’ professional identity. The present study is a proposal developed in the research field of Educational Knowledge and Practice, and its main focus lies in university teaching. Higher education teaching in the context of a dance course, and the issues and challenges of constructing teachers’ professional identity are presented. Thus, my main questions were: what is the teaching path followed by newly hired dance teachers in the Federal University of Uberlândia? How is teaching identity developed in these new teachers’ professional socialization process? What kind of educational knowledge is (re)produced and mobilized by teachers when they join university teaching? In order to answer these questions, my objectives are: to analyze the teaching path of the newly hired dance teachers of the Federal University of Uberlândia; to investigate how their teaching identity is built within their professional socialization process; and identify the kinds of educational knowledge they (re)produce and mobilize as soon as they become university teachers. The present research comprises a qualitative data analysis from previous studies on the subject, having as starting point relevant bibliographic research, followed by an identification questionnaire and an interview conducted with the newly hired dance teachers. The construction of teaching identity is related to objective and subjective conditions involving a teaching job and how the teacher perceives this identity as constantly evolving. Hence I understand the importance of personal and institutional incentives to prepare studies which raise or problematize issues specific to this area, contributing to extend the debate over higher education professionals’ formation, in particular that of dance course teachers on national scope.

The Timing of Motherhood While Earning a PhD in Engineering

In spite of tremendous efforts, women are still under-represented in the field of science. Post-graduate education and early tenure track employment are part of the academic career establish-ment in research and development during periods that usually overlap with family formation. Though women tend to leave science mainly after obtaining their PhD, and the timing of mother-hood plays a vital role in a successful research career, qualitative data on this life period are scarce. Our paper focuses on how the normative and institutional contexts shape female PhD engineering students’ family plans. The research was based on intersections of life course and risk and uncertainty theories. Using qualitative interviews we explored how contradicting social norms of childbearing cause tensions in postgraduate students’ lives, and how the different uncer-tainties and risks permeate young researchers’ decisions on early life events. We concluded that, despite the general pattern of delaying motherhood among higher educated women, these students struggle against this postponement, and they hardly have any good options to avoid risk stem-ming from uncertainties and from some characteris-tics of studying and working in engineering. Find-ings of this research may call the attention of stake-holders to possible intervention points.

Experiences of Internalized and Enacted Stigma among Women with Obstetric Fistula in Tanzania

Background: Obstetric fistula is the development of a necrosis between the bladder and the vagina and/or the bladder and the rectum as a result of prolonged obstructed labor, resulting in urinary or fecal incontinence. In Tanzania surgical repair for obstetric fistula is provided freely by the government but it is estimated that there are over 25,000 women living with an untreated fistula. These women experience high degrees of psycho-social stresses exacerbated by the stigma surrounding their condition. There is a dire need to explore stigma within this population in order to better understand its impact, as stigma affects both treatment seeking behavior as well as long term recovery of those who access surgical repair.

Study Aims: This study aims to understand the experiences of stigma among women with obstetric fistulas by examining both internalized and enacted stigma, and by identifying pertinent correlates of internalized stigma.

Methods: This mixed-methods study utilized both quantitative and qualitative data collected in two related studies at a single hospital in Moshi, Tanzania. All study participants were women receiving surgical repair for an obstetric fistula. In the quantitative portion, cross-sectional survey data were collected from 52 patients. The primary outcome was fistula-related stigma, measured using an adaptation of the HASI-P stigma scale, which included constructs of both internalized and enacted stigma. In the qualitative portion, 45 patients participated in a semi-structured in-depth interview, which explored topics such as stressors caused by the fistula, coping mechanisms, and available support. The transcripts were analyzed using analytic memos and an iterative process of thematic coding using the framework of content analysis.

Results: Expressions of internalized stigma were common in the sample, with a median score of 2.1 on a scale of 0 – 3. Internalized was significantly correlated with negative religious coping, social participation, impact of incontinence and enacted stigma. Qualitative analysis was consistent and demonstrated widespread themes of shame and embarrassment. Experiences of enacted stigma were not as common (median score of 0), although some items, like those pertaining to mockery and blame, were endorsed by up to 25% of the study sample. Themes of anticipated stigma (isolation and non-disclosure due to the possibility of stigmatization) were also evident in the qualitative sample and may explain the low enacted stigma scores observed.

Conclusion: In this sample of women receiving surgical repair for an obstetric fistula, stigma was evident, with internalized stigma resulting in psychological impacts for patients. Experiences of both anticipated and enacted stigma were also observed. There is a need to explore interventions that would decrease stigma while also increasing support for these women, as stigma may be a barrier towards accessing surgical repair and reintegration following surgery.

Keywords: Tanzania, obstetric fistula, stigma, maternal health