This is an exploratory study of depression in pregnant women incarcerated in a state prison in California. It was hypothesized that the inmates would experience higher levels of postpartum depression than would nonincarcerated women who have recently given birth. Participants were 120 inmates who recently gave birth while incarcerated. They were interviewed and given the Beck Depression Inventory. It was found that none of the participants were clinically depressed. Descriptive statistics are presented in detail. A qualitative component of the study explored the life experiences of pregnancy by participants. Future research will empirically address the lack of depression or negative reaction to incarcerated pregnancy.

In conclusion, careful evaluation of symptom experiences can ensure appropriate treatment. Patients with advanced cancer may not report pain even though pain medications often improve their other symptoms and well-being. Patients valued selection of medication that allowed them to remain alert and functional. The meaning of symptoms clearly altered patients' reports and limited treatments they found acceptable. Understanding these meanings is important to ensure that patients are treated in the most appropriate ways possible.

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The rating tool demonstrated a high interrater reliability (97.57 percent), indicating its accuracy for systematically rating the specific intervention behaviors. Subsequently, the rating tool was used to determine interuser and test-retest performances of the PIOMI and resulted in high reliabilities (97.59 percent and 97.58 percent, respectively). This demonstrates that the intervention can be reliably delivered as prescribed, supporting intervention fidelity.

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