Medicine and Health Sciences Commons^™

The Applicability Of The Decisional Conflict Scale In Nursing Home Placement Decision Among Chinese Family Caregivers: A Mixed Methods Approach, Yu-Ping Chang, Loralee Sessanna, Joanne Kraenzle Schneider

Asian/Pacific Island Nursing Journal

This study aimed to 1) examine relationships between uncertainty, perceived information, personal values, social support, and filial obligation among Chinese family caregivers faced with nursing home placement of an older adult family member with dementia; and 2) describe the applicability of the Decisional Conflict Scale in nursing home placement decision making among Chinese family caregivers through the integration of quantitative and qualitative data.

We used a mixed-methods approach. Quantitative data analysis consisted of descriptive and correlational statistics. We utilized a thematic analysis for the qualitative data. Data transformation and data comparison techniques were used to combine qualitative and quantitative data. …

Physical Exercise During Pregnancy And Its Related Factors: An Observational Study In Japan, Megumi Haruna, Masayo Matsuzaki, Mie Shiraishi, Seonae Yeo

Asian/Pacific Island Nursing Journal

This study aimed to investigate the exercise habits of pregnant women in the third trimester (N = 303). We assessed participation in physical activities, including exercise or sports, using the Japanese version of the Pregnancy Physical Activity Questionnaire. A total of 183 (60.4%) pregnant Japanese women participated in some form of exercise and 87 (28.7%) exercised for 2 hours or more, per week, in the third trimester. Multiple logistic regression analyses indicated that women who set themselves a gestational weight gain target (adjusted odds ratio [AOR] = 8.10, 95% CI [2.82, 23.4], p< .001), were more likely to participate in exercise or sports. In contrast, multiparous women (AOR = 0.44, 95% CI [0.26, 0.72], p = .001), and those whose …

Lived Experience In Patients With Recurrent Glioblastoma In Japan: A Narrative Study, Ai Chikada, Asako Takekuma Katsumata, Mariko Asase, Sayaka Takenouchi, Yoshiki Arakawa, Kazuko Nin

Asian/Pacific Island Nursing Journal

Glioblastoma (GBM) is well known to have one of the poorest prognoses among all cancers. Patients with GBM in progression-free survival (PFS) may be relatively stable and can often maintain their quality of life. Thus, PFS is a desirable goal. In Japan, the median PFS is 11 months. It is difficult to grasp a patient's thoughts and hopes when, after PFS, they are readmitted due to recurrence or acute deterioration. Therefore, this study aimed to describe the lived experience of illness in patients with recurrent GBM, focusing on PFS. We enrolled five patients into the study; however, only four patients …

“These Classes Have Been My Happy Place”: Feasibility Study Of A Self-Care Program In Native Hawaiian Custodial Grandparents, Loriena Yancura, Heather Greenwood-Junkermeier, Christine A. Fruhauf

Asian/Pacific Island Nursing Journal

Native Hawaiian custodial grandparents have a distinctive set of strengths and challenges that may lead them to benefit from a structured self-care program. The purpose of this paper is to describe a feasibility study with nine Native Hawaiian custodial grandparents who participated in a 6-week self-care intervention. Based on open-ended questions during the post-questionnaire and at the 6-month follow-up focus group, grandparent participants noted that their grandchildren needed education and clothing. Most grandparents did not endorse statements that their grandchildren had any mental or physical health conditions. Grandparents reflected that the intervention provided them with skills to help cope with …

Vietnamese American Women’S Beliefs And Perceptions On Cervical Cancer, Cervical Cancer Screening, And Cancer Prevention Vaccines: A Community-Based Participatory Study, Connie Kim Yen Nguyen-Truong, Kim Quy Vo Nguyen, Thai Hien Nguyen, Tuong Vy Le, Anthony My Truong, Keara Rodela, Rachael Allan

Asian/Pacific Island Nursing Journal

Cervical cancer remains commonly diagnosed in Vietnamese American women. Despite efforts to increase cervical cancer screening among Vietnamese American women, participation rates are persistently lower than the national goal. The objective of this study is to explore beliefs of Vietnamese American women about cervical cancer, cervical cancer screening, and cancer prevention vaccines. A qualitative descriptive investigation captured group perceptions about meaning and beliefs of cervical cancer, screening, and cancer prevention vaccines, and participants’ stories using a community-based participatory research approach.

Forty Vietnamese American women were recruited from the Portland, Oregon metropolitan area into four focus groups. Using a process of …

Korean Sibling Caregivers Of Individuals Diagnosed With Schizophrenia, Mijung Park, Kwang-Ja Lee

Asian/Pacific Island Nursing Journal

Siblings of individuals diagnosed with schizophrenia are an important source of family caregiving. Unfortunately, limited information is available about sibling caregivers because existing studies have focused on other family relationships such as parents, spouses, and children. To fill the knowledge gap, the purpose of this study is to describe Korean sibling caregivers’ experience with individuals diagnosed with schizophrenia.

Guided by Colaizzi’s descriptive phenomenological methodology, we conducted in-depth, semi-structured, face-to-face interviews with eight individuals who have a sibling (1) diagnosed with schizophrenia and (2) hospitalized in an inpatient psychiatric unit. We discerned six key themes: sorrow, burnout, shame, different perspectives in …

Exercise, Learning And Emotional Health: Interdisciplinary Approaches To Translational Action, Tessa L. Koschel

UNLV Theses, Dissertations, Professional Papers, and Capstones

Exercise positively effects physical, psychological and neurological wellbeing. Though the population at large is becoming increasingly aware of the multi-faceted benefits of exercise, the majority of people fail to meet daily exercise recommendations. Largely, demands of everyday life such as work, school and family take priority over fitness. The issue therefore becomes a matter of time. In a world of media multi-tasking and immediate gratification, the challenge to health professionals becomes incorporation and manipulation of these consistencies to improve exercise uptake and adherence. Focus must shift from the idea of making additional time for exercise, to adding exercise to time …

Sex Worker And Proud: A Phenomenological Study Of Consensual Sex Workers' Lives, Michael Gerald Curtis Jr.

UNLV Theses, Dissertations, Professional Papers, and Capstones

Ten consensual sex workers who were currently working in Nevada were qualitatively interviewed in an effort to explore their perceptions of the adult industry. Interviews specifically focused on their experience disclosing their profession to others and the potential effects that it has on their personal relationships, and access to effective treatment. The Moustakas method of phenomenological inquiry was used to analyze data from ten participants who self-identified as direct sex workers. Seven essential themes emerged from this analysis: (1) the adult industry provides professional and personal agency, (2) the industry is often transient, (3) disclosure is an impactful and ongoing …

The Role Of Pre-Existing Type 2 Diabetes Mellitus In Colorectal Cancer Stage And Survival In Elderly Americans: A Seer-Medicare Population-Based Study 2002-~2011, Sanae El Ibrahimi

UNLV Theses, Dissertations, Professional Papers, and Capstones

Diabetes is a common comorbid condition among colorectal cancer (CRC) patients, yet its effects in CRC outcomes, particularly stage at diagnosis, risk of death and variations by diabetes severity (complications vs no complications) and Hispanic ethnicity have not been adequately studied. The purpose of this study was to investigate the association between pre-existing T2DM and advanced stage at diagnosis in elderly patients with CRC; to examine whether diabetes is an independent predictor of poor survival from all-cause and CRC-specific mortality; to assess whether variations exist by diabetes severity and to analyze the outcomes for the Hispanic group.

The Surveillance Epidemiology …

Parents' Perceptions Of Smartphone Use And Parenting Practices, David Jackson Johnson

UNLV Theses, Dissertations, Professional Papers, and Capstones

The present study is a qualitative examination aiming to gain insight into parents’ perceptions of their smartphone use and the effects it may be having on their children as well as parenting practices. Participants (N=12) were smartphone using parents that consisted mostly of young college-educated females. Thematic analysis of individual interviews resulted in five primary themes: (1) Disengagement, (2) Concern for Future, (3) Change in Social Norms, (4) Boundaries, and (5) Cognitive Dissonance. These findings indicate significant effects parental smartphone use is having in the lives of study participants. These thematic findings call for additional research examining the impact parental …

Latino Lgbq Young Adults' Coming-Out Experiences, Monica Munoz

UNLV Theses, Dissertations, Professional Papers, and Capstones

There is limited research on Latino LGBQ individuals and their coming-out experiences. To understand the coming out process of Latino LGBQ individuals, interviews were conducted with 10 Latino LGBQ young adults between the ages of 18 and 30 years old. Using Moustakas (1994) phenomenological approach, six themes derived from the study: (a) The disclosure process impacts family closeness and distance, (b) Latino LGBQ individuals’ family members enter a state of disbelief about their sexual orientation, (c) control of disclosure influences Latino LGBQ young adults’ perception of their coming-out experience, (d) the experience of coming-out for Latino LGBQ individuals is influenced …

Acculturation And Causes Of Death Among Filipinos In The Us: Focus On Cancer, Abegail Terso Reyes

UNLV Theses, Dissertations, Professional Papers, and Capstones

Filipinos in the US are 3.4 million, yet the main causes of death among this primarily immigrant population have not been well characterized nor compared with the mortality experience of their counterparts in the Philippines. Age-adjusted mortality rates were computed for the main causes of death for three populations: Filipinos living in the Philippines (FPHs), Filipinos living in California (FCAs), and non-Hispanic whites in California (WCAs). Regression-derived mortality rate ratios stratified by sex were used to compare the populations, using WCA as the referent population. Included causes of death were ischemic heart disease, stroke, cancer and chronic lower respiratory disease, …

Attitudes, Attachment Styles, And Gender: Implications On Perceptions Of Infidelity, Christian M. Stewart

UNLV Theses, Dissertations, Professional Papers, and Capstones

Understanding the impact infidelity has on individuals, couples, families, and societies has increasingly become a topic of interest over the last few decades. In recent years, scholars have sought to increase understanding of infidelity through investigating the relationship between infidelity and attachment theory. This research study examines the impact attitudes about infidelity, attachment styles, and gender have on the way in which individuals perceive infidelity. Data was gathered from 310 participants recruited from the University of Nevada, Las Vegas and social media. Participants were 18 years of age and older and were, at the time of the study, either in …

Dietary Intake And Energy Expenditure Of Pararescuemen During Routine Training, Andrea Woita

UNLV Theses, Dissertations, Professional Papers, and Capstones

Pararescuemen are one group of Air Force Special Operations Forces (SOF) who engage in vigorous physical training to achieve mission readiness. This type of training requires high energy expenditures and matching dietary intake to support basic physiological needs and to meet performance demands. However, few studies have investigated the energy expenditure and dietary intake of SOF and none have specifically examined these behaviors in Pararescuemen. The goal of this investigation was to determine the energy expenditure and dietary intake of Pararescuemen during routine training - a period when these operators receive supervision and guidance for performance improvements, recovery, and career …

The Impact Of Economic Recession On The Health Of Adult Nevadans, Ariana Goertz

UNLV Theses, Dissertations, Professional Papers, and Capstones

Recessions are generally considered to cause negative consequences, but recent studies have provided evidence that some health outcomes improve as the economy deteriorates. The relationship between economic downfalls and health is not straightforward; it is important to look at how health has been impacted in one of the areas hit hardest by the recession. Las Vegas, Nevada was previously considered recession-proof, seemingly unaffected by previous economic downturns exhibited by the rest of the country. However, during the Great Recession of 2007-2009, Las Vegas led the country in highest rates of unemployment and foreclosures. This was quite a collapse for a …

Client’S Perception Of Therapist’S Way-Of-Being, Derek Holyoak

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this research is to investigate how clients’ perception of their therapist’s way of being impacts client engagement during the therapeutic process. By utilizing a common factors perspective, which emphasizes the importance of a strong therapeutic alliance between clients and therapists, the researcher aims to provide empirical evidence supporting the Therapeutic Pyramid Meta-Model. The Meta-Model, which was created by Fife and colleagues (2014), lays the foundation of effective psychotherapy as a therapist’s way-of-being. The meta-model is concurrent with the common factors literature which accounts for almost 30 percent of therapeutic change to therapist-relationship factors. A phenomenological framework, in …

The Relationship Of Religion, Religiosity, And Parental Communication In The Sexual Behaviors Of Filipinos Aged 18-25 Years In The United States And The Philippines, Ivy C. Tuason, Racidon Bernarte, Fanglong Dong

Asian/Pacific Island Nursing Journal

This cross-sectional survey research aims to explore and compare the relationship of religion, religiosity, and parental communication to the sexual behaviors of Filipinos aged 18-25 years in the United States and the Philippines. The Duke University Religion Index and Parent-Teen Sexual Risk Communication Scale-III was used to measure religiosity and parental communication. There were 130 participants living in the United States and 247 living in the Philippines included in this study. Among respondents from the Philippines, low levels of parental communication were associated with an increased report for the lack of condom use during the last intercourse. Catholics had a …

Hospice Utilization Of Medicare Beneficiaries In Hawai‘I Compared To Other States, Deborah Taira, Merle Kataoka-Yahiro, Angela Sy

Asian/Pacific Island Nursing Journal

The objective is to examine hospice utilization among Medicare beneficiaries in Hawai‘i compared to other states. Data were from the 2014 Medicare Hospice Utilization and Payment Public Use File, which included information on 4,025 hospice providers, more than 1.3 million hospice beneficiaries, and over $15 billion in Medicare payments. Multivariable linear regression models were estimated to compare hospice utilization in Hawai‘i to that of other states. Control variables included age, gender, and type of Medicare coverage. Medicare beneficiaries using hospice in Hawai‘i differed significantly from beneficiaries in other states in several ways. Hawai‘i beneficiaries were more likely to be Asian …

Mālama Nā Makua I Nā Keiki Me Ka Hānō: Native Hawaiian Parents Caring For Their Children With Asthma, May K. Kealoha, Merle Kataoka-Yahiro

Asian/Pacific Island Nursing Journal

Native Hawaiian children have the highest prevalence rate of asthma among all ethnicities in the State of Hawai‘i. Literature is limited regarding native Hawaiian parents’ perception and experience caring for their children with asthma. The purpose of this study is to explore contemporary native Hawaiian parents’ perspective and experience of caring for their children with asthma in the context of uncertainty. We applied a descriptive qualitative approach by means of directed content analysis using focus groups. Directed content analysis applied Mishel’s Uncertainty in Illness Theory to guide data collection, organization, and analysis. We found that parents’ personal stories about their …

The Importance Of Clinicians And Community Members Receiving Timely And Accurate Information About Waterborne Hazards, Steven S. Coughlin Phd, Osman Yousufzai

School of Medicine Faculty Publications

It is important for clinicians and community members to receive up-to-date information about the microbiological and elemental composition of local water supplies. Clinicians play an important role in helping their patients to interpret water quality data and understand the potential impact of water quality on their health. Expanding the medical school curriculum to include environmental health, public health, and health disparities—including disparities related to environmental quality and waterborne hazards—is key to clinicians’ fulfilling this role.

Insights Into How Hias Are Characterized In The Press: Findings From A Media Analysis Of Widely Circulated United States Newspapers, Max Gakh, Courtney Coughenour, Jennifer Pharr, Aaliyah Goodie, Samantha To

Public Health Faculty Publications

Background: Health impact assessments (HIAs) are burgeoning tools in the policy arena, where media plays an important role by focusing attention on issues, informing the public, and influencing positions. Examining how media portrays HIAs is critical to understanding HIAs in the policy context. Methods: This study considered how widely circulated, U.S. newspapers represent HIAs. After searching newspaper databases, we used a qualitative document analysis method consisting of open and axial coding to examine specific phrases of HIA depictions. Results: In coding over 1,000 unique phrases from the 62 documents generated in our search, we found an uptick in HIA-related publications …

Evaluating The Term ‘Disorders Of Sex Development’: A Multidisciplinary Debate, Natalie Delimata Phd, Margaret Simmonds Phd, Michelle O'Brien Msc, Georgiann Davis Phd, Richard Auchus Md, Phd, Karen Lin-Su Md

Sociology Faculty Research

In 2014, almost 10 years after the 2005 International Consensus Conference on Intersex in Chicago,1 one of the conference co-organisers, under the auspices of a number of international paediatric endocrinology societies, launched the Global DSD Update to assess progress. A consortium of fourteen work groups conducted online/email discussions to explore each of the fourteen key topics, one of which was use of the controversial medical umbrella term ‘Disorders of Sex Development (DSD)’. The initial key question for Work Group 1 (referred to hereafter as WG1) was to reconsider the nomenclature. Nineteen individuals from a variety of professional backgrounds, including medical …

A Roundtable On Cross-Sector Collaboration And Resource Alignment For Health Equity: Meeting Summary, Onyemaechi Nweke

Journal of Health Disparities Research and Practice

Cross-sector collaboration is a highly recommended strategy to eliminate health inequities nationally and globally. In the federal sector, it is evolving into an important approach for solving complex social problems, as evidenced by its steady proliferation the past few decades. Despite the increased adoption of cross-sector collaboration, it is still not a default strategy or preeminent option for managing complex social problems. In September 2015, the Federal Interagency Health Equity Team (FIHET) hosted a Roundtable event to discuss opportunities and strategies to foster widespread adoption of cross-sector collaboration and resource alignment. The Roundtable featured several expert panelists and participants from …

An Assessment Of Funding And Other Capacity Needs For Health Equity Programming Within State-Level Chronic Disease Programs, Tiffany Pertillar, Ann Pobutsky, Phd, Gail Brandt, Edd, Mph, Marisa New, Otr, Mph, Jamielou Delavan, Ba, Robyn Taylor, Mba, Amishi Shah, Mpa, Ma, Folasaya Adunola, Dds, Mph, Onyemaechi Nweke

Journal of Health Disparities Research and Practice

Background: Chronic diseases are an important contributor to morbidity and mortality among racial/ethnic minority, low-income, and other under-resourced populations. Given that state health departments (and their chronic disease programs) play a significant role in providing population and preventive health services, their capacity to promote health equity is an important consideration in national efforts to address chronic diseases. The purpose of this study was to examine capacity needs of state chronic disease programs with respect to promoting health equity.

Methods: In 2015, the National Association of Chronic Disease Directors (NACDD) conducted a survey of its members that work within a …

Achieving Health Equity For Indian Country, Jamie Ishcomer

Journal of Health Disparities Research and Practice

The essence of health equity is giving resources where they are needed most. American Indians and Alaska Natives (AI/AN) continue to have the worst health outcomes, live in some of the most desperate of conditions, and lack access to even basic amenities that many other Americans could not survive without. Although Tribes have been plagued with social, economic and political injustice for centuries, there is an opportunity to put a stop to the systematic oppression and build up the first peoples of this country. A partnership between the National Indian Health Board (NIHB) and the National Partnership for Action to …

Rhode Island’S Health Equity Zones: Addressing Local Problems With Local Solutions, Nicole Alexander-Scott, Md, Mph, Ana P. Novais, Ma, Carol Hall-Walker, Mpa, Angela B. Ankoma, Mph, Msw, John P. Fulton, Phd

Journal of Health Disparities Research and Practice

The Rhode Island Department of Health (RIDOH) describes the strategies and infrastructure it has developed to fund its placed-based initiatives to address the social determinants of health to eliminate health disparities. Using a data driven and community-led approach, RIDOH funded 10 local collaboratives, each with its own, geographically-defined “Health Equity Zone,” or “HEZ,” and, to support the collaboratives, created a new “Health Equity Institute,” a “HEZ Team” of 9 seasoned project managers, and direct lines of communications between these assets and the Office of the Director of Health.

Mapping The Alignment Of Programmatic Mission, Functions And Outcomes With The Attainment Of Health Equity: An Overview Of The Approach And Initial Outcomes Through The Lens Of The Usda’S Cyfar Scp Program, Onyemaechi Nweke, Kara Ryan, Mpp, Bonita Williams, Phd

Journal of Health Disparities Research and Practice

Eliminating health disparities is a priority across national agenda and initiatives such as the National Partnership for Action to End Health Disparities (NPA), the National Prevention Strategy, and Healthy People 2020. To advance this priority under the NPA, the Federal Interagency Health Equity Team (FIHET), which is an NPA federal cross-sector and collaborative platform, initiated a voluntary pilot “health equity mapping” exercise in 2014. This exercise served as a strategy to clarify the strategic alignment between participant federal partner program missions, goals, and activities, and the goal to end health disparities and promote health equity. The mapping process included an …

Implementation Of The National Partnership For Action To End Health Disparities: A Three-Year Retrospective, Oscar Espinosa, Brandon Coffee-Borden, Mpp Coffee-Borden, Mpp, Alexis Bakos, Phd, Mph, Rn, D. Bakos, Phd, Mph, Rn, Onyemaechi Nweke

Journal of Health Disparities Research and Practice

In April 2011, the U.S. Department of Health and Human Services’ (HHS) Office of Minority Health (OMH) launched the National Partnership for Action to End Health Disparities (NPA) to increase the effectiveness of efforts to eliminate health disparities by coordinating partners, leaders, and stakeholders committed to action. At its core, the NPA is an experiment in collaboration that relies heavily on those on the front line who are actively engaged in minority health work at multiple levels. It gives them the responsibility of identifying and helping to define core actions, new approaches, and new partnerships that ultimately will help to …

The Guide To Community Preventive Services Review Of Interventions To Promote Health Equity In The United States, Robert Hahn, Jonathan E. Fielding, M.D., M.P.H., M.A., M.B.A, Robert L. Johnson, M.D., Carles Muntaner, M.D., Ph.D., M.H.S., Benedict I. Truman, M.D., M.P.H., Tracy Orleans

Journal of Health Disparities Research and Practice

The optimal approach to eliminating health inequities is through evidence-based interventions. In 2009, the non-federal Community Preventive Services Task Force launched a series of systematic reviews of interventions to promote health equity. Topics to be considered include education, employment, housing, and transportation. Thus far, reviews have focused on educational interventions: center-based early childhood education, full-day kindergarten programs, out-of-school time academic programs, high school completion programs, and school-based health centers. These reviews demonstrate the benefits of diverse educational interventions in advancing health equity. Here, we summarize the strategy of Community Guide health equity reviews, first findings and challenges.

Improving Access And Utilization Of Data To Support Research And Programs Intended To Eliminate Disparities And Promote Health Equity, Rosaly Correa-De-Araujo

Journal of Health Disparities Research and Practice

Numerous Federal initiatives are addressing health and health care disparities. The ultimate goal is to achieve “a nation free of disparities in health and health care.” Social determinants of health remain mostly responsible for health/health care disparities among population groups within and between countries. In the United States, there is little evidence that disparities associated with such determinants are decreasing, with only 10% of those associated with race/ethnicity and income having demonstrated improvement in recent years. A variety of data sources are available from the Federal and private sectors to support research on disparities, but no single national survey seems …