Medicine and Health Sciences Commons^™

Exploring The Lived Experience Of Self-Care In Young Adults With Type 2 Diabetes, Holly Berry-Price

Electronic Theses and Dissertations

Introduction

The prevalence of prediabetes in adults aged 18 or older was as high as 38% between 2017-2020. Youth-onset T2DM is a more aggressive phenotype than T2DM that occurs later in life. Young adults with T2DM have poorer health outcomes, lose an average of 15 years of life, all resulting in significant economic burden impacting the person. Current self-management interventions do not improve health outcomes in young adults with T2DM.

Purpose

The purpose of this research was to explore the self-care experiences of young adults living with T2DM.

Methods

Existential hermeneutic phenomenology informed the research. Inclusion criteria as follows: adults …

Balancing Wellness And Leadership: Exploring Black Women Administrators’ Subjective Well-Being, Resilience, And Radical Self-Care In Higher Education, Lashae Grottis

Electronic Theses and Dissertations

Leaders in higher education experience high and unrealistic demands for their skills, time, and energy, causing stress, competing priorities, burnout, compromised health, and attrition. However, unlike other racial and gender groups, Black women higher education administrators experienced these challenges more intensely. As a result of chronic stress associated with being undervalued and overworked, discriminatory and unwelcoming workplaces, and intersectional biases, Black women leaders are leaving higher education workplaces. Despite the link between gendered racism and unwellness, little is known about the problem from a positive leadership perspective. This study addressed the lack of knowledge of the wellness strategies Black women …

Older Women’S Stories Of Covid-19 Loss: Communicated Narrative Sense-Making Through Photography, Anne Walker

Electronic Theses and Dissertations

The diverse array of challenges associated with the COVID-19 pandemic make it difficult to assess the full impact of this global health crisis. More than 300,000 older Americans died, leaving a nation of grieving survivors in their absence. This profound loss of life will undoubtedly inform the field’s understanding of grief and grieving for many years to come. Pre-pandemic, older women in the United States understood grief to be part of their life stage; COVID-19 amplified the grief experience through both cumulative losses and the isolation particular to the novel coronavirus response. However, few qualitative studies explore older women’s grief, …

On-Campus Mental Health Service Use Among College Students With Autism: A Case Study Applying The Andersen Behavioral Model Of Health Services Use, Estella C. Lilyquist

Electronic Theses and Dissertations

The unique set of impairments and limitations presented by students with autism spectrum disorder (ASD) make the accessing of campus-based nonacademic resources more difficult and complicated than their typically developed peers. Each year, the rate of students entering college with disabilities continues to grow, but their mental well-being is relatively poor. The purpose of this qualitative case study was to apply the conceptual framework of the Andersen behavioral model of health services use (ABMHSU) to the experiences of college students with ASD to understand and predict their utilization of campus-provided mental health resources. The participants were seven college students with …

The Effects Of Peers For Young Adults On Anxiety And Quality Of Life For Young Adults With Autism Spectrum Disorder, Alysha Cecile Dagg

Electronic Theses and Dissertations

Social skills deficits as well as comorbid anxiety are two characteristics commonly experienced by people with Autism Spectrum Disorder - Level 1 (ASD-1; American Psychiatric Association, 2013). These characteristics are also both contributors to a lower quality of life for young adults (Smith et al., 2019). The current study aimed to identify how the quality of life and anxiety are affected by social skills intervention, specifically the PEERS® for Young Adults program (Laugeson, 2017). PEERS® for Young Adults is an evidence-based social skills intervention intended to support individuals with ASD-1 (Laugeson, 2017). Prior research has demonstrated its success in both …

Postpartum Depression In Jamaica: Exploring The Lived Experiences., Shakeyrah Elmore

Electronic Theses and Dissertations

The purpose of this study was to explore the lived experiences of Jamaican women with postpartum depression (PPD). It is estimated globally, postpartum depression impacts 10-20% of women. In Jamaica, rates exceed global averages, with 26-60% of women experiencing PPD. Untreated maternal depression poses a significant physical, social, and economic threat to Jamaican women, children, and society as a whole. This study affirms that maternal mental health and postpartum depression are global public health concerns. There are limited studies that have examined PPD in Jamaican women, especially qualitatively. This research study utilized a qualitative descriptive approach to examine PPD experiences …

Reducing Readmission Rates Among Patients Who Have A Dual Diagnosis Of Both Mental And Physical Illnesses, Hannah M. Shahan

Electronic Theses and Dissertations

Readmission rates are a primary indicator used by acute care hospitals to determine the effectiveness of healthcare treatments and interventions. High readmission rates indicate the existence of a gap in the continuum of care. Acute care hospitals focus on the treatment of the immediately urgent physical health condition. Once the immediate presenting illness is treated or stabilized, the patient is discharged. This focus largely leaves mental illness undiagnosed and untreated. However, chronic, untreated mental illnesses are often comorbid with physical illnesses. In studies comparing patients with comorbid physical and mental illness to patients with only a physical illness, comorbidity was …

Mental Confidence In Alzheimer's Disease, Harrison Adams

Electronic Theses and Dissertations

A simple symptom like forgetfulness can lead to a gradual, subtle decline in the individual’s sense of identity. In dementia, self-efficacy is the foundation that allow individual to prolong their capacity of independence and identity. Alzheimer’s disease (AD) is the most prominent form of dementia with tens of millions in the world currently living with Alzheimer’s disease. AD is most often associated with impaired memory, confusion, language impairment, and unpredictable, agitated, aggressive, and paranoid behavior. While there are many studies examining the quality of life in individuals with AD, there are fewer investigating the psychological effects of AD on the …

Burnout In Medical Assistants In Primary Care: Can Mindfulness Be A Solution?, Natalee D. Calais

Electronic Theses and Dissertations

Burnout is described as feelings associated with emotional exhaustion, depersonalization of patients, and a loss of sense of personal accomplishment and it is unique to healthcare workers. Current research highlights this condition among physicians, nurses, and mid-level providers; however, insufficient research exists regarding the effects of burnout on medical assistants. Research led to mindfulness as a possible solution defined as an intentional regulation of attention and awareness of the present moment. This project sought to see if mindfulness practices could be utilized to mitigate the effects of burnout in medical assistants. It was hypothesized that mindfulness could be a solution. …

The Relationship Between Age, Sport, And Years Coaching On Knowledge, Confidence, Preparedness, And Intention To Intervene With Youth Athletes Experiencing Mental Health Challenges, Allyson P. Looby

Electronic Theses and Dissertations

Introduction: Mental disorders can affect all ages and populations, but there is an increasingly high prevalence in the pediatric population. It is estimated that 1 in 5 youth between the ages of 9-17 experiences some degree of impairment from a diagnosable mental health disorder (Merikangas et al., 2010). Youth are often not equipped to seek professional support; making parents, teachers, and coaches key to detection and referral to professional help (Ng et al., 2021). The environment youth sports creates gives coaches the opportunity to have a greater impact on youth mental health (Das et al., 2016). Purpose: Determine if age, …

Mental Health Help-Seeking Behaviors Of First-Year University Students, Kylie A. Roberts

Electronic Theses and Dissertations

The early college years represent a specific period in a student’s life that is crucial for their development. Approximately one in three college students meet the criteria for a mental health problem (Eisenberg et al., 2013). Universities have unique opportunities for identifying risk and delivering prevention or intervention strategies to students in need. The purpose of this study was to investigate factors associated with First-Year University students’ help-seeking behaviors for university-based mental health services. H₁: There will be group differences between gender and race/ethnicity on help-seeking behaviors, knowledge barriers of services or providers and perceived stigma. H_{2 …}

Racial Differences In Depression Indicators Before And After 2008 Financial Crisis In A Sample Of Older Adults, Angelina E. Jackson

Electronic Theses and Dissertations

The present study was designed to examine patterns of mental health outcomes in older Black and White adults after the national 2008 financial crisis. The data was acquired from the University of Michigan Health and Retirement Study, a publicly available dataset. This longitudinal study has obtained data from a representative sample of approximately 20,000 older adults in America, aged 55 and older. The hypotheses were (1) rates of mental health indicators related to symptoms of depression will increase after the 2008 financial crisis and (2) that increase will be significantly higher in Black respondents compared to White respondents. The analysis …

The Art Of Surviving: Alchemy Of Healing Trauma In Relation To Identity: A Self Study., Rebecca Morgan

Electronic Theses and Dissertations

The following thesis explores trauma’s physical and psychological aspects concerning identity as an artistic practice. Through exploring materials, subject matter, and media, my approach to trauma is based on personal and socially engaged experiences and my attempt to re-conceptualize that experience through the language of contemporary art. Extensively this work is governed by childhood memories and the critical aspect of being raised as a female in a patriarchal society. Being raised female comes with a certain number of expectations and requirements. This work creates a physical and spiritual connection between trauma and the identity of what is female. Discussing these …

The Correlation Between Transformational Leadership And Mental Health Clinician Burnout, Rebekah E. Shutter

Electronic Theses and Dissertations

Mental health clinicians working in a hospital setting are at a high risk of experiencing burnout due to the stressful demands of their caseloads, compassion fatigue, limited resources, and unsupportive leadership. While there is ample research regarding the cause and effect of burnout on clinicians there is a gap in the literature when it comes to the impact leadership has on mental heath clinician burnout. The purpose of this quantitative, correlational study is to determine if and to what extent there is a correlation between Transformational Leadership and mental health clinician burnout. Participants for this study consisted of 200 mental …

Emergency Care For Youth Who Experience Suicidality And Identify As Lesbian Gay Bisexual Transgender Queer/Questioning (Lgbtq+): An Interpretive Phenomenology, Theresa Schultz

Electronic Theses and Dissertations

Purpose: Suicide is a leading cause of death in children; youth who identify as LGBTQ+ are at an exponentially higher risk of suicide. The purpose of this study was to explore the lived experiences of young adults who identify as LGBTQ+ and sought emergency care for suicidality when they were adolescents.

Methods: Heideggerian hermeneutics phenomenology is the research method used in this study. Youth, ages 18-25 years, who identify as LGBTQ+ and sought emergency treatment for suicidality when they were adolescents (13-17 years) were recruited to participate;fifteen youth enrolled. Individuals ranged in age from 20 to 25 years. Participants described …

Meeting The Mental Health Needs Of College-Aged Young Adults: Evaluating The Value And Impact Of Digital Mental Health Interventions., Sara Atherton Choate

Electronic Theses and Dissertations

BACKGROUND: The growing prevalence of common mental health problems poses a serious hindrance to young adults, and the majority of those in need of mental health support do not seek professional psychological services. Digital mental health interventions (DMHIs) that allow for self-management of mental health symptoms could provide a useful adjunctiveto traditional one-on-one counseling or therapy and offer a useful prevention tool for students at risk for experiencing mental health crises. This dissertation explored the efficacy of self-guided DMHIs targeting college students, the factors associated with help-seeking in young adults, and the impact of implementing an evidence-based DMHI at a …

Narrative Authority: A Narrative-Based Multicultural Ethics To Overcome Western Biases In The Current Models Of Care, Fahmida Hossain

Electronic Theses and Dissertations

Technological advances and globalization are transforming healthcare dramatically. But unfortunately, current medical practices remain blind to their multicultural patients’ varied worldviews and norms, especially in the West. As a result, patients often find themselves isolated, anxious, and resentful.

All the humanistic models in the current literature view the individual as a unique and autonomous being and, in turn, provide practices to access and recognize the patient’s personhood. These models—Narrative Medicine, Narrative Ethics, and Ethics of Care—attempt to catch sight of the individual, the person’s situation, and some semblance of the person’s story before diagnosing or offering prescriptions. However, all these …

Early Detection Of Atypical Motor And Neurobehavior Of Infants At Risk Secondary To Opioid Exposure: A Prospective Study, Kara Boynewicz

Electronic Theses and Dissertations

Prenatal opioid exposure has been studied in relation to infants' medical outcomes. However, large gaps exist in the literature supporting early identification of atypical neurobehavior and motor development of infants with prenatal opioid exposure. The purpose of the study was to investigate whether prenatal opioid exposure has a negative influence on a newborn infant’s neurobehavior and motor development to aid in the early identification of potential delays. Using a prospective quasi experimental design, infants motor development using the Test of Infant Motor Performance (TIMP) and neurobehavior using the NICU Neonatal Network Scale (NNNS) was assessed on 58 infants in a …

Caregiver-Child Conversations About Sex In African American Women, Hannah King

Electronic Theses and Dissertations

Using grounded theory methods, this study examines the experience of African American women during their caregiver-child conversations about sex and the impacts of the conversations on their sexual attitudes. The process of these conversations begins with an unplanned topic and progresses further to identify six essential themes of these conversations: gender differences, race and religion, protective/emphasis on protection, lack of knowledge, withholding knowledge, and sex negativity/shame. African American women’s description of the process included feelings of shame and negativity towards their sexuality. Caregivers promoted positive messages about sex by having open conversations that advocated for equality between the genders, empower …

Exploring The Potential For Therapeutic Art-Making In School Psychology Practice: A Single Case Study Of A Training Experience, Alexandra G. Manion

Electronic Theses and Dissertations

The purpose of this study was to investigate the impact of a training experience on the use of therapeutic art-making for school psychologists, with a focus on how to incorporate these concepts into their school-based mental health practice. Therapeutic artmaking includes the use of visual art activities (drawing, painting, clay, and collage) with specific therapeutic intent. Although there are examples of art therapists providing inschool therapeutic art-making services to support the mental health needs of students, there is far less information regarding the use of therapeutic art-making by school-based mental health providers, including school psychologists. This single case study explored …

Understanding And Supporting Asian American Youth’S Mental Health Within Cultural And Family Contexts, In Young Park

Electronic Theses and Dissertations

Mental health problems are a major health issue among East Asian American (EAA) youth. Although previous research has explored the risk and protective factors associated with mental health problems of EAA youth, many studies have employed Eurocentric perspectives, thereby excluding their unique cultural backgrounds, beliefs, and values. To better understand mental health needs and support these youth, further research that identifies different factors associated with mental health problems in their cultural context and assesses evidence-supported and culturally responsive interventions is needed.

This three-manuscript dissertation is presented in three papers. The first manuscript presents an integrative conceptual framework that uses two …

Well-Being Development: Parents’ Perceptions Of Gifted Adolescents, Barbara Moncure Washington

Electronic Theses and Dissertations

The purpose of this study was to examine parents’ perceptions of well-being development in their gifted adolescents. This was a qualitative study that used Narrative Inquiry as a research approach. Cloninger’s (1993) Psychobiological Model of Temperament and Character the (TCI) and Clandinin and Connelley’s (2000) Three-Dimensional Narrative Inquiry Space were utilized to address the research questions: What are parents’ perceptions of temperament in their gifted adolescent? What are parents’ perceptions of character in their gifted adolescent? What are the parents’ perceptions of well-being development? Dabrowski’s Theory of Positive Disintegration (TPD) provided an analysis lens for the study.

The framework for …

Stress, Stress Appraisal And Coping In Athletic Trainers During The Covid-19 Pandemic, Lawson Holton

Electronic Theses and Dissertations

Introduction: There have been many studies conducted on the stress and mental health of frontline healthcare workers (HCWs) over the past months since the COVID-19 pandemic began. Very limited literature has examined the effect of the pandemic on athletic trainers (ATs). Objective: The aim of this investigation was to examine the stress, stress appraisal, and coping measures of ATs during the COVID-19 pandemic. Methods: Participants were recruited members from the National Athletic Trainers’ Association (NATA). The Perceived Stress Scale-10 was used to measure stress, the Stress Appraisal Measure was used to measure stress appraisal, and the Brief COPE was used …

The Tragedy Of Caspian: C. S. Lewis And His Trauma, Chandler Hanton

Electronic Theses and Dissertations

This thesis reconsiders C.S.Lewis’ The Chronicles of Narnia as a type of scriptotherapy that enabled Lewis to process and come to terms with a life full of serious and significant traumatic events. Trauma theory offers a vehicle for us to consider the alignments and connections between Lewis himself and his fictional creation, Caspian. In the specifics of both characterization and incident, Lewis mirrors the events and relationships that instilled and healed the trauma in his own life. In situating Caspian as his alter-ego, Lewis allowed his writing to function as a gender-specific therapeutic process for addressing the effects of his …

Sexual Minority Stress And Mental Health: An Investigation Of Rural-Urban Differences In Social Support, Justin T. Miller

Electronic Theses and Dissertations

As mental health disparities and discrimination facing the LGB (sexual minority) community continues to come into public focus, researchers and clinicians are moving toward identifying LGB-specific mental health interventions to support well-being efforts within this population. Furthermore, much of the current literature on sexual minority mental health is focused on predominantly urban samples failing to consider the sociocultural impacts of living in low resourced and geographically isolated regions of the United States (US). To this end, social support is a promising prevention factor, but few studies to date examine its influence on different minority stress models. As such, the current …

A Public Health Ethics Approach To Substance Use Disorder, Adele Flaherty

Electronic Theses and Dissertations

The goal of the dissertation is to undertake an analysis of substance use disorders that focuses on a public health ethics perspective. The ethical argument focuses upon justifying the use of harm reduction and is primarily concerned with the current opioid crisis. While substance abuse/misuse over the course of history has been identified as a public health concern, this dissertation presents substance use disorders over the course of the lifespan, examining various contexts in which it can affect daily living and health outcomes. It achieves this by analyzing substance use disorders through the lens of the socioecological model of public …

Exploring The Contextual Factors And Decision-Making Process Of Risky Sexual Behavior Among Homeless Adults In Louisville, Kentucky., Sarah C. Van Heiden

Electronic Theses and Dissertations

Homelessness is a complex public health issue; individuals who experience homelessness are said to engage in risky sexual behaviors at an increased rate and experience a higher prevalence of sexually transmitted infection (STI). While the sexual behaviors of homeless adolescents are commonly studied, little is known about the sexual behaviors of the growing population of older adults, or how they make decisions to engage in sex. Three aims guided this research: 1) to describe the sexual behaviors and sexual decision-making process of homeless older adults, 2) to examine how homeless older adults evaluate the outcomes associated with engaging in risky …

Opioid Use Disorder: A Crisis Of Concern, Evangella Harville

Electronic Theses and Dissertations

According to a statement from the U.S. Centers for Disease Control and Prevention, between 2000 and 2017, approximately 700,000 people died from drug overdoses in the United States. Approximately 128 persons lose their life each day from an opioid overdose. The data for this study were collected by the vice president of operations at the study site from a preexisting database for 2019 and 2020. The participants were inpatient patients, 18 and older, both male and female, and were from all ethnicities. The study facility was located in Western New York and offered a 30-bed inpatient treatment center with 24-hour …

Decreasing Unintentional Pregnancies For Tennesseans, Paula M. Todd

Electronic Theses and Dissertations

In 2018, 49% of all pregnancies in the United States were unintended, with women with a lower- income status being five times more likely to experience an unplanned pregnancy. Tennessee has a high rate of unintended pregnancies, particularly among the uninsured, low-income, and rural teen populations; some 22% of these unintended pregnancies end in abortion. Oral or transdermal contraceptives that are affordable and accessible for women of childbearing age can reduce unintentional pregnancies. The addressed gap in clinical practice was that contraceptives are not currently available over the counter in Tennessee pharmacies without a prescription, which necessitates a costly medical …

The Effect Of Postpartum Depression Screening Education For Postpartum Nurses, Shecarra S. Cook

Electronic Theses and Dissertations

Depression affects about 13% of pregnant women and about 10% of women after childbirth. Some cases are so severe, the mother may even commit suicide. If left untreated, postpartum depression (PPD) affects both the mother’s and the infant’s health as well as their quality of life. The gap in clinical practice is that currently, patients only complete a postpartum depression screening tool during their 6-week follow-up appointment with their OB/GYN, leaving a gap in PPD detection and care during the immediate postpartum period. Postpartum nurses are not usually given specialized training in postpartum depression. The purpose of this study was …