Medicine and Health Sciences Commons^™

Assessing Social Determinants Of Health In Primary Care, Vicki Carpenter

Doctoral Projects

The social determinants of health encompass the various circumstances and environments in which individuals reside, develop, labor, and experience aging (Social Determinants of Health, 2022). These variables significantly contribute to the existence of health inequities and disparities within populations. In order to effectively mitigate health disparities, it is imperative to consider the various determinants that influence health outcomes, as this consideration is crucial for advancing the goal of achieving health equity. This public health concern encompasses multiple sectors within our society, necessitating the collaboration of various organizations and communities to effectively address and mitigate its impact.

The fundamental …

Self-Care, Resilience, Self-Compassion, And Burnout In Doctoral Nursing Students: An Exploratory Needs Assessment, Logan Justice

Dissertations

Abstract

Problem: In the United States, one in three nurses experience symptoms of burnout, and doctoral nursing students are additionally challenged to juggle multiple school, work, and life demands (Reith, 2018; Woo et al., 2020). The purpose of this project was to explore the current self-care practices of doctoral nursing students to understand how self-care relates to resilience and burnout.

Methods: This exploratory needs assessment utilized a convenience sample of Doctor of Nursing practice (DNP) and Doctor of Philosophy (PhD) nursing students at a medium sized midwestern university. An electronic data collection survey was constructed to assess student self-care practices, …

The Motherhood Crusade: Rural Low-Income Mothers, Support, And Empowerment, Christina Castellano

Dissertations

Previous research has shown that postpartum women with untreated mental health conditions are more likely to fail to manage their own health, have inadequate nutrition, abuse substances, experience abuse, be less responsive to their baby’s needs, have fewer positive interactions with their baby, experience difficulties breastfeeding, and question their abilities as a mother. Rural culture plays a complex role in the transition to motherhood, influencing whether mothers seek out and use resources. While more is known about location and access issues, less is known about how rural culture and, more specifically, how empowerment and social support impact postpartum experience. The …

My Baby, My Move+: Feasibility Of A Community Prenatal Wellbeing Intervention, Jenn A. Leiferman, Rachael Lacy, Jessica Walls, Charlotte V. Farewell, Mary K. Dinger, Danielle Symons Downs, Sarah S. Farrabi, Jennifer L. Huberty, James F. Paulson

Psychology Faculty Publications

Background

Excessive gestational weight gain (EGWG), insufficient prenatal physical activity and sleep, and poor psychological wellbeing independently increase risks for adverse maternal and infant outcomes. A novel approach to mitigate these risks is utilizing peer support in a community-based prenatal intervention. This study assessed the feasibility (acceptability, demand, implementation, and practicality) of a remotely delivered prenatal physical activity intervention called My Baby, My Move + (MBMM +) that aims to increase prenatal physical activity, enhance mood and sleep hygiene, and reduce EGWG.

Methods

Participants were recruited through community organizations, local clinics, and social media platforms in the Fall of 2020 …

Enabling Social Care Services For Older Adults During Periods Of Long-Term Social Isolation: Service Provider Perspectives, Amy Budrikis, Cate Parry, Claire Adams, Eyal Gringart, Moira Sim, Daniel Mcaullay, Natalie Strobel

Research outputs 2022 to 2026

Objective: To investigate how small, local organisations were impacted by and responded to COVID-19 in their delivery of social care services to older adults (70 years and older). Lessons learnt and future implications are discussed. Methods: Six representatives from four social care services (five females and one male) participated in individual semistructured interviews. Responses were analysed thematically. Results: The key themes identified were service providers' experience, perceived needs of older adults and adapting services. Service providers positioned themselves as front-line essential workers for their older adult clients, resulting in some emotional toll and distress for the service providers. They provided …

Experiences Of Critical Care Nurse Managers In Addressing Nurses' Work-Related Stress, Mariana Tsucuneli

Walden Dissertations and Doctoral Studies

AbstractNurses who work in the critical care unit are more likely to experience work-related stress, fatigue, understaffing, undesirable performance outcomes, and compromised workplace safety than general care nurses. Nurse managers in these units possess insights into nurses' stress-inducing challenges, in addition to managerial and administrative perspectives. Yet there is a lack of available knowledge about the experiences of critical care nurse managers in addressing nurses' work-related stress. The purpose of this study was to explore critical care nurse managers’ experiences of potential strategies to effectively address work-related stress among nurses. The job-demand resource model was the theoretical framework for the …

Experiences Of Critical Care Nurse Managers In Addressing Nurses' Work-Related Stress, Mariana Tsucuneli

Walden Dissertations and Doctoral Studies

AbstractNurses who work in the critical care unit are more likely to experience work-related stress, fatigue, understaffing, undesirable performance outcomes, and compromised workplace safety than general care nurses. Nurse managers in these units possess insights into nurses' stress-inducing challenges, in addition to managerial and administrative perspectives. Yet there is a lack of available knowledge about the experiences of critical care nurse managers in addressing nurses' work-related stress. The purpose of this study was to explore critical care nurse managers’ experiences of potential strategies to effectively address work-related stress among nurses. The job-demand resource model was the theoretical framework for the …

Perceived Social Support, Family Relationships, And Health-Related Quality Of Life Among Women With Breast Cancer In Jordan., Hedaya Rateb Hina

Electronic Theses and Dissertations

Introduction: Breast cancer is the most common cancer among Jordanian women. Perceived social support (PSS) and family relationships are strongly associated with positive psychosocial outcomes and health-related quality of life (HRQoL). This area was widely explored in Western countries, but little attention was devoted to investigate this area in Middle East region. Purpose: to investigate the interrelationships among PSS, family relationships, and HRQoL of women with breast cancer in Jordan using an exploratory cross-sectional design. Method: The contextual model of HRQoL designed by Ashing-Giwa (2005) provided the foundation for this study. A total of 140 women were …

Social Support Of Mexican Immigrant Women With Gestational Diabetes Mellitus: A Constructivist Grounded Theory Study, Angela Sojobi

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to explore the perception of social support among Mexican immigrant women with gestational diabetes mellitus (GDM) within the context of their culture and discern the process through which social support can influence their adherence to the GDM management protocols. The incidence of GDM is highest in low-income, ethnic minority communities such as the Mexican immigrant community. Adhering to the GDM management protocols may prove challenging for some women, especially if social support is lacking. If uncontrolled, GDM can result in adverse maternal-fetal outcomes. Among Mexican immigrant women, the incidence of poor glycemic control and …

The Mediating/Moderating Role Of Cultural Context Factors On Self-Care Practices Among Those Living With Diabetes In Rural Appalachia, Brittany L. Smalls, Adebola Adegboyega, Ellen Combs, Matthew Rutledge, Philip M. Westgate, Md. Tofial Azam, Felipe De La Barra, Lovoria B. Williams, Nancy E. Schoenberg

Family and Community Medicine Faculty Publications

Background

The aim of this study was to examine whether cultural factors, such as religiosity and social support, mediate/moderate the relationship between personal/psychosocial factors and T2DM self-care in a rural Appalachian community.

Methods

Regression models were utilized to assess for mediation and moderation. Multilevel linear mixed effects models and GEE-type logistic regression models were fit for continuous (social support, self-care) and binary (religiosity) outcomes, respectively.

Results

The results indicated that cultural context factors (religiosity and social support) can mediate/moderate the relationship between psychosocial factors and T2DM self-care. Specifically, after adjusting for demographic variables, the findings suggested that social support may …

Leadership Strategies To Support Resilience, Katee Paine

Nursing Masters Papers

Healthcare institutions have garnered national attention due to high levels of healthcare worker burnout, stress, and turnover rates. As the largest population of healthcare workers, nurses are often confronted with stressors that can lead to burnout in their practice and work environment. The global COVID-19 pandemic has highlighted and magnified these stressors over the past year, such as emotional strain of caring for dying patients, long shifts, rotating schedules, increased workload demands, and high-stress work environments. Resilience, characterized by an ability to bounce back from adverse situations, has been found to play an important role in navigating and adapting to …

Postpartum Support: Application Of A Local Peer Support, Community Care Model, Stephanie E. Ward

Theses and Graduate Projects

The postpartum period is one of the most influential developmental stages of a women’s life and represents a time of heightened risk for mental health decline. Perinatal mood and anxiety disorders have been implicated as a key influence of negative parenting experiences, poor newborn psychological outcomes, delayed newborn development, and inadequately adaptive family development behaviors. Integrating established resiliency components against mental illness, such as social support, into a postpartum care model can benefit postpartum women and secondarily positively impact the aforementioned outcomes. A community care model highlighting social support for postpartum mothers was integrated into a rural Minnesota region and …

Maternal Social Support, Depression And Emotional Availability In Early Mother-Infant Interaction: Findings From A Pregnancy Cohort, Kelli K. Macmillan, Andrew J. Lewis, Stuart J. Watson, Declan Bourke, Megan Galbally

Nursing Papers and Journal Articles

Background: Social support theory suggests that parental social support may influence the nature of early parenting behaviours and specifically the mother-infant relationship. This study examines whether support from a partner, friends or family is associated with differences in quality of mother-infant interactions in the context of maternal depression.

Methods: 210 women were followed from early pregnancy to six months postpartum within Australian pregnancy cohort, the Mercy Pregnancy and Emotional Wellbeing Study (MPEWS). Mother-infant interactions within a standardised observation at six months postpartum were measured by the Emotional Availability (EA) Scales using total scores of the parental scales. In early and …

The Impact Of A Digital Intervention On Perceived Stress, Resiliency, Social Support, And Intention To Leave Among Newly Licensed Nurses: A Randomized Controlled Trial, Lisa Concilio

Electronic Theses and Dissertations

The nursing shortage has been deemed a public health crisis with the turnover rate of newly licensed nurses (NLNs) growing (Robert Wood Johnson Foundation, 2014). One out of five NLNs are leaving the profession due to work dissatisfaction and feelings of inadequacy (National Academy of Medicine, 2017). NLN attrition during the first year of hire has been associated with feelings of overwhelming stress and decreased sense of support which negatively impact patient safety (Spence Laschinger et al., 2016). As seasoned nurses are attempting to retire amidst a nursing shortage (American Association of Colleges of Nursing, 2018), NLNs require more support …

The Effect Of Hope On The Relationship Between Personal And Disease Characteristics And Anxiety And Depression In Adolescents And Young Adults With Cancer, Sharon B. Mcneil

USF Tampa Graduate Theses and Dissertations

Adolescents and young adults (AYAs) with cancer face physical, psychosocial, emotional, and developmental challenges that are unique to their age group. In facing the crisis of a cancer diagnosis, both social support and hope have been shown to be tools utilized by some AYAs. However, AYAs have higher rates of anxiety and depression than in older adults which may have an effect on their levels of hope.

This cross-sectional study examined the mechanistic effects of hope on the relationship between personal characteristics of age, gender, and social support, the disease characteristics of type of cancer and length of time since …

Exploring The Efficacy Of A Perinatal Mental Health Community Based Organization’S Social Media Engagement, Johanna Bermudez Vera, Semira Semino-Asaro

Doctor of Nursing Practice Final Manuscripts

Abstract

Purpose: The purpose of this project is to explore the utilization of social media outlets (Facebook and Instagram) affiliated with a local community-based perinatal mental health organization in order to inform current and future outreach and health messaging efforts by that organization. Exploring the level of engagement and associated demographics of social media users will assist the organization regarding possible expansion of their social media presence.

Background: Worldwide, 10-13% of women experience a mental health disorder such depression and/or anxiety during the postpartum period. Perinatal mood and anxiety disorders (PMADs) are associated with increased risks of maternal and infant …

Social Support As A Risk Factor Of Postpartum Depression Among Women Of Various Ethnicity, Jingle Xu

MSN Capstone Projects

Postpartum depression is considered the most important mental disorder after delivery because of the high prevalence and the serious negative mother-baby outcomes. Education and support of mothers for postpartum depression are deeply held values of nursing care during pregnancy and the postpartum period (Ladewig, London & Davidson, 2014). Risk factors are the common target of these interventions, among which social support is one of the most popular factors in research currently. Social support is composed of instrumental, informational, and emotional support given by a social network to maintain an individual’s mental health status when they are faced with significant or …

Association Between Mental Health Problems, Substance Use, And Social Support In Youth, Venida Gray

Walden Dissertations and Doctoral Studies

Mental health problems are a major public health concern and may be associated with substance use among youth. Youth who receive inadequate social support are at risk of experiencing mental health problems and engaging in substance use. The purpose of this study, guided by the relational regulation theory of social support and the self-medication theory, was to determine whether there was an association between mental health problems, social support, and substance abuse among middle school (MS) and high school (HS) students and whether this association varies with age, using secondary data from the Maine Integrated Youth Health Survey This study …

Educational Interventions For Women And Their Support Persons On Breastfeeding Outcomes, Alexandra Cordell

Electronic Theses and Dissertations

n the United States breastfeeding duration and exclusivity rates are not at ideal levels, therefore there is a need to examine existing interventions. The purpose of this systematic review was to examine the effects of education and support interventions during the third trimester, immediate postpartum, and the first six months of life on breastfeeding duration and exclusivity from six weeks to six months. Inclusion criteria were (a) randomized controlled trials or controlled clinical trials, (b) pregnant and/or postpartum women, (c) lactation education and support interventions, (d) measurement of breastfeeding outcomes from six weeks to six months, and (e) published between …

Perinatal Mood And Anxiety Disorders, Stigma, And Social Support Among Postpartum Women, Ellen K. Fleischman

Dissertations

Purpose/Aims: The purpose of this descriptive, correlational, cross-sectional study was to examine the relationships among perinatal mood and anxiety disorder (PMAD) symptomatology, select demographics, stigma of mental illness, and social support, among inpatient postpartum women. Rationale: PMADs affect as many as 21% of childbearing women, yet these disorders are identified and treated less than half the time. There is a gap in the literature regarding the relationships among stigma, social support, and PMADs in postpartum women.

Conceptual Basis/Background: Despite recommendations from professional organizations, screening for PMADs is not consistently completed using a valid, reliable instrument. Stigma contributes to the low …

Exploring Help-Seeking Intentions Of Homeless Veterans Attending A Stand Down Event, Tara Vaughn

Nursing Theses and Dissertations

Lack of help-seeking behavior among homeless veterans results in higher burden of disease and lower quality of life. No studies have been conducted involving help- seeking intentions of homeless veterans within the veteran stand down population. Pender’s Revised Health Promotion Model was used to guide this descriptive correlational study with the aim of exploring the extent selected personal characteristics and experiences and behavior-specific factors affect help-seeking intentions among homeless veterans attending a stand down event.

A convenience sample of 86 homeless veterans (mean age 56) was recruited from a 3-day veteran stand down event in Northern California. Each participant was …

Perceived Family Support And Antiretroviral Adherence In Hiv-Positive Individuals: Results From A Community-Based Positive Living With Hiv Study, Krishna Poudel, David Buchanan, Rachel Amiya, Kalpana Poudel-Tandukar

Krishna C. Poudel

The purpose of this study was to examine the association between perceived family support, either positive or negative, and adherence to antiretroviral medication regimens among HIV-positive individuals in the Kathmandu Valley, Nepal. We measured past 3-month antiretroviral adherence among 233 HIV-positive individuals, in relation to perceived family support, both positive (in terms of emotional and instrumental support) and negative (in the form of negative interactions), using the 10-item Nepali Family Support and Difficulty Scale. Medium and high levels of perceived emotional support from family were associated with reduced risk of antiretroviral nonadherence, compared with low levels of perceived emotional support …

Predicting Decision-Making In Relation To Health-Risk Behavior In College Freshmen, Anne Bijumon Luckose

Dissertations

Method/Measurements: A cross-sectional correlational design explored the relationships between decision-making, health-risk behaviors and social support systems in college freshmen. The aims of the study were: 1) to explore the relationship between decision-making and health-risk behaviors among college freshmen; 2) to determine whether or not family support and social support jointly predict decision-making among college freshmen; and 3) to ascertain whether or not the effect of family support on decision-making is different for male and female college freshmen. Measurement was collected at one time-point and participants in this study completed on-line questionnaires through a web-based online survey software application with measures …

A Systematic Review Of The Relationships Among Psychosocial Factors And Coping In Adults With Type 2 Diabetes Mellitus, Melissa A. Mccoy, Laurie A. Theeke

Faculty & Staff Scholarship

Type 2 diabetes mellitus contributes to poor health outcomes including mortality, yet there is a gap in the literature when seeking to understand the influence of psychosocial factors on coping in this population. The paper presents a systematic review of quantitative studies that examined relationships among psychosocial determinants and coping in adults with type 2 diabetes. This review is the second layer of knowledge discovery for the concept, “Taking on a life-altering change is a rhythmical journey of experiencing ups and downs on the way to acceptance.” The life-altering change was determined to be a diagnosis of type 2 diabetes, …

Health Outcomes Of Adolescents And Young Adults After Traumatic Injury: The Role Of Stress Resilience And Social Support, Belanie Peavy

Dissertations & Theses (Open Access)

Background: Traumatic injury is a major health problem and has been linked to mental and physical disability following injury. Although it is the leading cause of disability in the United States (US) for adolescents and young adults, there is a paucity of evidence in the literature regarding association(s) of perceived stress on the outcomes of anxiety and depressive symptoms and the moderating role of resilience and social support in which to develop prevention and treatment interventions for this patient population.

Purpose: The purpose of this study was to examine the effect of perceived stress on anxiety and depressive symptoms …

Women's Quality Of Life After Leaving An Abusive Relationship: The Effects Of Past And Ongoing Intimate Partner Violence, Mastery And Social Support, Diana Jaradat

Electronic Thesis and Dissertation Repository

Intimate Partner Violence (IPV) is considered a major stressor that threatens the lives of women globally. Although qualitative research suggests that IPV has substantial negative effects on women’s quality of life, few quantitative studies have examined the quality of life of women who have experienced IPV due, in part, to the lack of an appropriate, brief measure of QOL. Consequently, little is known about the contextual process by which IPV experiences affect women’s quality of life (QOL) after leaving an abusive relationship. Mastery and social support are two important resources that women may use to deal with IPV but whether …

Mediating Effects Of Positive Thinking And Social Support On Suicide Resilience, Denise M. Matel-Anderson, Abir K. Bekhet, Mauricio Garnier-Villarreal

College of Nursing Faculty Research and Publications

Suicide has been the second leading cause of death for 18- to 24-year-olds in the United States since 2011. The stress experienced by undergraduate college students has the potential to increase one’s risk for suicide. Resilience theory was used as a theoretical framework to examine the interplay between risk and protective factors. A cross-sectional and correlational design was used to assess the mediating effects of positive thinking and/or social support on suicide resilience in 131 college students 18 to 24 years old who completed an online survey. The study found an indirect effect of self-esteem on suicide resilience through positive …

A Mixed Methods Study Of Symptom Perception In Patients With Chronic Heart Failure, Elliane Irani

Faculty Scholarship

Background: Early heart failure (HF) symptoms are frequently unrecognized for reasons that are unclear. We explored symptom perception in patients with chronic HF. Methods: We enrolled 36 HF out-patients into a longitudinal sequential explanatory mixed methods study. We used objectively measured thoracic fluid accumulation and daily reports of signs and symptoms to evaluate accuracy of detected changes in fluid retention. Patterns of symptom interpretation and response were explored in telephone interviews conducted every 2 weeks for 3-months. Results: In this sample, 44% had a mismatch between objective and subjective fluid retention; younger persons were more likely to have mismatch. In …

Maternal Life Course Adversity: The Intersection Of Psychosocial And Biobehavioral Adaptive Response In Pregnancy, Crystal Modde Epstein

Theses & Dissertations

The link between life course adversity and adverse health outcomes is well established, particularly early life adversity (ELA). There is also evidence that the physiologic adaptations associated with stress, depression and ELA can be transmitted intergenerationally via long-term set-point changes within the maternal hypothalamic-pituitary-adrenal axis (HPA). It is unknown how the type and timing of maternal stress and adversity influences HPA regulation during pregnancy and whether maternal coping attenuates this relationship. Manuscript 1 was an integrative review of studies examining the association between maternal ELA and HPA regulation during pregnancy. In manuscripts 2 and 3 the findings of the dissertation …

Predictors Of Cognitive Function Among Cognitively Impaired Older African Americans Living In Congregate Residential Settings, Zyra Daffodil Apugan

Dissertations

The purpose of this secondary data analysis was to identify potential psychosocial predictors of cognition, including social support, depression, and functional activity, among older African Americans, ≥ 65 years, with a diagnosis of Alzheimer’s disease and living in congregate residential settings. Guided by the main effect model of social support, this study used existing data from the National Alzheimer’s Coordinating Center Uniform Data Set, an NIH-funded multicenter study. Results showed that on average, the participants (n=56) were 81.7 years of age with 13.8 years of education. All, but six, were married. Bivariate Pearson correlations indicate a moderately strong negative relationship …