Digital Commons Network^™

Telehealth Acceptance And Medical Mistrust Among The Elderly Of Rural Appalachia: A Correlational Study Using The Medical Mistrust Index And Technology Acceptance Model, Victoria Hood-Wells

Electronic Theses and Dissertations

Adults aged 65 years and above have grown substantially over with past decade. However, the chance of developing multiple comorbidities only increases with age. Because elderly residents of rural Appalachia often encounter barriers to healthcare, rural nurses, providers, and policy makers must overcome physical and structural barriers, but also gain a more in-depth understanding of the personal and cultural attitudes impacting the use of new and innovative forms of healthcare delivery. With a slow and variable uptake of telehealth adoption in rural Appalachia, and in the presence of well-documented medical mistrust, this study was designed to better understand the degree …

Exploring Sexual And Reproductive Health Care In Central Appalachia Through The Experiences Of Transgender And Gender Non-Binary People, Chase Harless

Electronic Theses and Dissertations

Background: Transgender or nonbinary (TNB) individuals in the United States experience higher rates of sexual and reproductive health disparities when compared to their cisgender counterparts, along with lower access to care. TNB people in the south experience higher rates of disparities. Societal, interpersonal, and individual barriers contribute to these disparities in the TNB population. However, there is a paucity of research examining the sexual and reproductive health experiences of TNB people living in Central Appalachia.

Methods: An interpretive phenomenological analysis (IPA) research design was used to collect and analyze semi-structured interviews with TNB individuals living in central Appalachia regarding their …

When The Costs Outweigh The Benefits: Examining Variations In Nulliparous, Term, Singleton, Vertex And Elective Cesarean Delivery Rates Across The United States, 2016-2020, Kathleen Tatro

Electronic Theses and Dissertations

The overutilization of cesarean deliveries is a major public health issue in the United States (U.S.). The rates of cesarean deliveries have increased substantially from the mid 1990s. Low-risk, defined as nulliparous, term, singleton, vertex (NTSV) pregnancies with no medical indication of need, and elective cesarean deliveries have been implicated as drivers of these increases. Elective cesarean deliveries are NTSV cesarean deliveries in which no trial of labor was attempted. There is a lack of clear rationale as to the noted increases in cesarean delivery rates as the evidence shows that these procedures provide no additional health benefits to mothers …

Job Embeddedess Of Nurses Working In South Central Appalachia’S North Carolina Counties, Susan L. Adams Mrs.

Electronic Theses and Dissertations

Nurses working in the North Carolina counties of South Central Appalachia (NC-SCA) are a unique subset of nursing professionals. A continued nursing shortage is projected in this area while staffing has improved in other areas of SCA. The purpose of this research was to ascertain the level of job embeddedness of nurses working in NC-SCA in order to offer guidance regarding retention of nurses working in this area. Actively working licensed practical nurses, registered nurses, and advanced practice nurses (nurse practitioners, certified nurse midwives, clinical nurse specialists, and certified registered nurse anesthetists) from 29 North Carolina counties included in South …

The Perceptions Of Success Of Latino Nursing School Graduates In The Appalachian Region Of The United States, Barbara M. Rauscher

Electronic Theses and Dissertations

This qualitative narrative descriptive study focused on nine successful Latino nursing school graduates. Five participants were interviewed twice and four participants were interviewed once for a total of fourteen interviews. Participants and their families immigrated from Brazil, Costa Rica, Cuba, and Mexico. Participants attended school in North Carolina, South Carolina, and Tennessee.

Interviews revealed themes of Familism, Empowerment, and Perseverance. Familism was an overriding theme throughout each of the interviews. Participants described family as being their greatest support. They discussed sacrifices made by their families which assisted them in being successful. In addition, they also shared their willingness to make …

Factors Influencing Healthy Eating And Physical Activity Behaviors Of Adolescents In Appalachia, Natalie Walker

Electronic Theses and Dissertations

This study examined the TPB constructs of attitude, perceived behavioral control, and subjective norms and their ability to predict healthy eating and physical activity behaviors among adolescents living in Southern Appalachia. The study also considered the relative utility of subjective norms and social support in predicting these behaviors. Data for this research were derived from a larger study, Team Up for Healthy Living, conducted September 2011 through November 2014 with high school students in the Appalachian region (Study ID: R01MD006200 from the National Institute on Minority Health and Health Disparities). Participants (n=963) completed a three-part paper survey collecting data about …

Women And Healthcare In Appalachia: Impeding Circumstance And The Role Of Technology, Ashley Cano

Electronic Theses and Dissertations

For decades, healthcare access and quality in central and southern Appalachia have trailed the rest of the country. Entrenched poverty and low educational attainment compound healthcare problems. This study examines the healthcare obstacles women encounter in southern and central Appalachia and analyzes how technology use, such as Internet searching and social media affect women’s healthcare decisions. Data were analyzed from four focus groups conducted with women from the region. Results indicate that seeing a physician or not did not influence women’s propensity to search the Internet for health-related information or to seek support through social media sites. Additionally, women reported …

Comeback Of Appalachian Female Stroke Survivors: The Interrelationships Of Cognition, Function, Self-Concept, Interpersonal, And Social Relationships., Patricia Mckenzie Vanhook

Electronic Theses and Dissertations

The purpose of this descriptive correlational study was to examine the comeback phase of the Trajectory of Chronic Illness Management for Appalachian women stroke survivors. This study predicted comeback as a relationship between physical healing, biographical reengagement, and psychological coming to terms that was mediated by rehabilitation.

The concepts were evaluated through investigation of function and cognitive abilities, self-assessment of recovery, health rating, ability to control life, relationship changes, physical and mental health, and limitations of activities due to poor physical or mental health. Data were collected using, the Stroke Impact Scale (3.0) (Duncan, Bode, Lia, & Perera, 2003), the …

Childhood Experiences Of Appalachian Women Who Have Experienced Intimate Partner Violence During Adulthood., Amy L. Reeves

Electronic Theses and Dissertations

Recent national surveys in the United States estimate one in five females will experience abuse by an intimate partner during her lifetime. Previous quantitative research linked childhood victimization to repeated victimization in adult relationships. This qualitative study explored the lived experiences of childhood in eight female victims of intimate partner violence who were born and reared in southern Appalachia. Interviews were analyzed using a descriptive-interpretative phenomenological method, as described by Van Manen. The three essential themes from childhood were identified as: living 'as if' an orphan; surviving in chaos; and, manifesting a devalued self. These themes were congruent with findings …