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Rural Hospital Closures And Perceived Access To Care: A Qualitative Descriptive Study In An Appalachian County Of Tennessee, Amanda M. Letheren

Doctoral Dissertations

Background: Tennessee has suffered more hospital closures per capita than anywhere else in the nation. The impact of hospital closures on access to care in rural and economically distressed Appalachian counties of Tennessee is of particular concern because these communities experience great health disparities. Hospital closures may exacerbate these disparities and create additional barriers when accessing care.

Objectives: The aim of this study was to describe community residents’ perceptions of health and access to care following a hospital closure in a rural and economically distressed Appalachian county of Tennessee.

Methods: This study used a qualitative descriptive approach to present community …

The Effects Of Motivational Interviewing On Heart Failure Self-Care During Transitional Care In An Appalachian Population, Jennifer Lynn Mabry

Doctoral Dissertations

Research has shown that patients who are successfully engaged in self-care for a chronic illness have a higher quality of life and reduced hospitalizations than those who are not. According to the National Center for Health Statistics, transitional care in the home setting has seen a 51% increase in mortality over the last 15 years (Reeder et al., 2015). This finding contrasts with the reported decline in hospital readmissions for chronic illnesses. With the lack of agreement on best practices for patient discharge education, transitional care has proven to be a weakness in chronic illness care that requires further research. …

Prenatal Care Choices In Appalachia: A Qualitative, Critical Realist Description & Content Analysis, Julia Cain Phillippi

Doctoral Dissertations

Introduction: Appalachian women have high rates of preterm birth and low birth weight infants. A new format of group prenatal care, known as CenteringPregnancy, decreases the rate of preterm birth and low birth weight when compared with individual care. However, clinics in Appalachia often struggle to recruit women into group care. Theory & Methods: Using critical realism and the middle-range theory of motivation-ease as frameworks, this qualitative study had two research questions: ‘What influences Appalachian women’s choice of traditional prenatal care instead of CenteringPregnancy care?’ and ‘What are Appalachian women’s perceptions of prenatal care and their access to prenatal care?’. …