Medicine and Health Sciences Commons^™

Senior Mental Health Clinicians’ Understanding Of Their Self-Efficacy While Providing Services At Community-Based Agencies, Rukiya Symister

Walden Dissertations and Doctoral Studies

Many mental health clinicians strive to provide their clients with rehabilitative and psychotherapy services resulting in a client gaining stable income and housing. However, the role of a senior mental health clinician (SMHC) is not without its challenges of trying to balance their well-being while dealing with increased coworker turnover, demanding caseloads, and limited access to community resources to provide clients with getting their lives back on track, thereby impacting clinicians’ understanding of their self-efficacy. Much of the research on self-efficacy has focused on mental health clients, mental health graduate students, and mental health trainees, often leaving out the lived …

The Impact Of Human Attachment To A Pet Bird On Psychological Well-Being, Kathryn Marie Trautann

Walden Dissertations and Doctoral Studies

Few studies have addressed human attachment to a pet bird and psychological well-being, and the research that has been conducted is largely anecdotal and anthropomorphic perspectives on human relationships with birds. In this quantitative study, the relationships between humans and their birds were explored using Bowlby's attachment theory and Fredrickson and Losada's broaden and build theory. The study consisted of a randomized experiment, in which individuals were randomly assigned to either an attachment (n = 81) or detachment (n = 88) group. The security priming manipulation was used to prime the groups. The attachment group was asked to list things …

The Effects Of Secondary Traumatic Stress And Resilience On The Indicators Of Compassion Fatigue Among Occupational Therapists, Gayla Ann Aguilar

Walden Dissertations and Doctoral Studies

AbstractCompassion fatigue (CF) has been described as the “cost of caring” for traumatized individuals, which may lead to missed workdays, diminished work satisfaction, increased turnover, and decreased client care. CF has long been studied in other caring professionals, but occupational therapy practitioners (OTPs) have been largely overlooked. The purpose of this quantitative correlation study was to determine the relationship between secondary traumatic stress (STS) and resilience (RES) on burnout (BO) and compassion satisfaction (CS; i.e., indicators of CF) in OTPs. In this study, the moderation effect that RES has on STS and BO as related to CF in 68 completed …

Challenges In Discharge Planning For Adults Transitioning From An Inpatient Psychiatric Level Of Care Experiencing Homelessness, Deanna` R. Mccaskill

Walden Dissertations and Doctoral Studies

Mental illness and the homeless population are a growing concern in the United States. Homeless individuals utilize emergency rooms and acute inpatient stays more than those with housing. Social workers play a vital role in discharge planning, starting on the first day of admission. This action research study explored the challenges of social workers developing discharge plans for adults transitioning from an inpatient psychiatric level of care experiencing homeless. The theoretical framework implemented in this study was systems theory. Data were collected from 12 purposively selected master’s level social workers in the format of individual and focus group interviews. Eight …

Impact Of Resilience On Quality Of Life In Spinal Cord Injured Clients, Crystal D. Glover

Walden Dissertations and Doctoral Studies

Abstract Impact of Resilience on Quality of Life in Spinal Cord Injured Clients by Crystal D. Glover

MSM, Troy University, 2006BSN, University of North Carolina at Greensboro, 1995

Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health

Walden University August 2023

Experience Of Established Mental Health Counselors Working With Adults Who Have Intellectual Disabilities, Margarete Denk

Walden Dissertations and Doctoral Studies

Individuals with disabilities make up the largest minority population in the United States. Individuals with intellectual and developmental disabilities (I/DD) make up a significant portion of this population, yet there are limited studies addressing counseling with the I/DD population. The Council for Accreditation of Counseling and Related Educational Programs has addressed the need for disability competence in their upcoming 2024 standards. The purpose of the phenomenological study was to describe lived experiences of established counselors working with adult clients diagnosed with an I/DD. A descriptive phenomenological approach was used along with the social model of disability. The study involved six …

Promotion To Fire Officer: Ems Is An Essential Component Of Promotional Testing, Brenda Kay Farlow

Walden Dissertations and Doctoral Studies

AbstractFor the past 25 years, the number of fire department responses to structure fires nationally has gone down. Structure fires now reflect less than ten percent of the responses of the fire service. In the same period, emergency medical services (EMS) have become the overwhelming activity of most fire departments. The problem is the promotional process focuses on firefighting knowledge and skills while ignoring the absolute need for EMS competencies, in some capacity, for a supervisory position. The lack of change in the promotional process is related to the organizational culture of the individual fire departments and the collective difficulty …

Examining The Relationship Of Social Inclusion On Job Satisfaction And Turnover Intentions Of Us Post-9/11 Veterans, Sheree' L. Peters

Walden Dissertations and Doctoral Studies

Many American veterans return to the civilian workforce and report having problems reintegrating into society, as well as finding their role in the new corporate social realms. Over 80% leave their civilian jobs within the first two years of employment, and over 70% report experiencing feelings of loneliness. Recently, the World Health Organization reported that the lack of perceived social inclusion also has a significant economic impact on both individuals and societies. A quantitative, nonexperimental methodology was used to examine the moderating relationship of social inclusion on the relationship between job employee turnover intentions of post-9/11 enlisted veterans. This study …

Moral Injury Themes Involving Criminal Recklessness Among Adults With Alcohol Use Disorder, Sandra Starch

Walden Dissertations and Doctoral Studies

Moral injury (MI) can emerge following transgressive acts against one’s deeply held moral beliefs. Its symptomology involves individual psychological, spiritual, behavioral, and social spheres. It has primarily been studied within the military and in a few select civilian populations. This descriptive phenomenological study involved exploring MI themes among adults with alcohol use disorder (AUD) who had engaged in criminally reckless acts. Data collected from semi-structured interviews with eight participants were coded and analyzed, leading to six major themes revealing the symptomology of MI. Responses from study participants supported Festinger’s theory of cognitive dissonance via their descriptions of alcohol abuse cycles …

Structural Empowerment Of Nurse Leaders In New York State During The Covid-19 Pandemic, Tracey Braithwaite

Walden Dissertations and Doctoral Studies

The current phenomenological study explored the lived experience of Acting Chief Nursing Officers, Chief Nursing Officers, Chief Nursing Executives (henceforth CNOs) at hospitals in New York State who were charged with responding to executive orders while maintaining quality of patient care despite staffing constraints, inadequate supplies, or lack of additional support for the duties associated with their role. Their experience of structural empowerment in relation to the COVID-19 pandemic was also studied. The theoretical framework was Kanter’s theory of structural empowerment that addressed organizational behavior in the context of employee empowerment. The research question addressed how the CNOs perceived their …

Organizational Strategies And Best Practices For Telehealth Delivery During Covid-19, Maria D. Mejia

Walden Dissertations and Doctoral Studies

Organizational Strategies and Best Practices for Telehealth Delivery during COVID-19

Strategies To Reduce Turnover Among Black Home Healthcare Aides, Diane Allen Tate

Walden Dissertations and Doctoral Studies

AbstractMany individuals prefer to remain in their homes as they age instead of entering a long-term care facility. As the proportion of older Americans rapidly grows, the demand for delivery of nonmedical services by home healthcare aides (HHAs) is expected to increase. However, the national and local supply of HHAs is insufficient and must be rectified to meet a projected increase of older Americans by 2050. This research study involved exploring this problem for one small home healthcare organization in the Maryland suburbs outside of Washington, DC with an HHA workforce that was comprised predominantly of Black/African American and African …

Exploring The Benefits Of A Collaboration Between Behavioral Health Coaches And Clinicians, Devan White

Walden Dissertations and Doctoral Studies

This case study addressed how to best use health coaches in the field of behavioral health to improve the accessibility and outreach of a new program launched by the target organization that emphasizes coaching as an intervention for improving well-being and mental fitness. The purpose of this qualitative case study was to investigate the potential influence of coaching within the behavioral health field and explore how health coaches could partner with clinicians or behavioral health leaders to allow for more collaboration and accessibility to services. The RQs centered on how health coaches might support the treatment of those who have …

Retention Of Foster Parents For At-Risk Youth In Tennessee, Marvin Amos

Walden Dissertations and Doctoral Studies

Federal legislation with the Family First Prevention Service Act (FFPSA) of 2017 required Tennessee to increase foster parent retention strategies. Tennessee does not have enough available foster homes for adolescents. The purpose of this generic qualitative study was to explore foster parent retention in Tennessee and to inform policymakers on how to adapt policy to increase the retention. The theoretical foundation for this study was based on the policy feedback theory, to identify the policy scope in Tennessee, and the two-factor theory, to guide the data analysis in the context of employee satisfaction and retention measures. Purposive sampling techniques were …

Trauma-Informed Behavioral Health Leadership And Employee Engagement At A Child Advocacy Center, Andrew Krantz

Walden Dissertations and Doctoral Studies

Employee engagement is essential for an organization to meet its mission and vision. When employees are not engaged, there are higher levels of turnover, secondary traumatic stress, and burnout. Furthermore, when employees are not engaged, there is a decrease in the quality of patient care. Behavioral health leaders can positively impact employee engagement by engaging in trauma-informed behavioral health leadership. This qualitative case study reviews the impact of trauma-informed behavioral health leadership on employee engagement at a large Child Advocacy Center in the northeastern United States who was struggling with low levels of employee engagement and high levels of turnover …

Ambiguous Loss Feelings Amongst Caregivers Of Operation Enduring Freedom Veterans, Stephanie T. Spann

Walden Dissertations and Doctoral Studies

This quantitative study compares the possible relationship between ambiguous loss and the stress level of caregivers of Operation Enduring Freedom (OEF) veterans who served in combat. Injured servicemembers need caregivers to assist them in caring for their physical and mental health needs. This study examined whether there is a relationship between the perceived ambiguous loss among caregivers of OEF injured veterans and the stress level experienced by caregivers. The theoretical framework for this study is the ambiguous loss theory. The methodology used to test the hypothesis is a quantitative correlational design to compare ambiguous loss variables amongst caregivers of injured …

Examining The U.S. Disaster Management Program: A Case Study Of The U.S. Virgin Islands Hurricanes Irma And Maria Evacuation, Victoria F. Vachon

Walden Dissertations and Doctoral Studies

AbstractWhether from natural or human causes, every global community is at risk for overwhelming, destabilizing incidents. Hurricanes Irma and Maria devastated the U.S. Virgin Islands in late August and early September 2017, necessitating the urgent evacuation of hemodialysis patients over 1000 miles to the U.S. mainland. Because the damage and response to the U.S. territory were unprecedented, the public health implications of the government’s strategies on the evacuated population subset were unexplored. However, available information suggested that some evacuees sustained avoidable harm while in the protracted care and custody of the government. This qualitative case study, conceptually framed by Bronfenbrenner’s …

Overcoming Barriers To Private-Public Partnerships, Lavina Valentine

Walden Dissertations and Doctoral Studies

SA is an organization that promotes science, technology, engineering, and math (STEM) education. As a small organization, it continues to look for partnerships that allow the expansion and development of this educational coursework. The organization faces barriers to receiving private and public partnerships. In this professional administrative study, barriers were identified and addressed. Opportunities to improve the availability of collaborations and effective partnerships for this organization were also addressed, expressing the significant benefit that the community receives. The evidence drawn from scholarly resources, quantitative research, and articles highlighted the importance of STEM subjects, and their role in their community. The …

Experiences Of Older Adults With Hiv/Aids Enrolled In Case Management Programs In Northwest Indiana, Antoinette Cardenas

Walden Dissertations and Doctoral Studies

AbstractIn 2016, more than half of those infected with HIV/AIDS were age 50 years or older. Since the introduction of antiretroviral therapy, the survival rate of HIV patients has been on the rise with a predicted increase by 2030, but this has also contributed to early onset of comorbidities such as cardiovascular disease, osteoporosis, and kidney failure. The purpose of this generic qualitative study, driven by ecological systems theory, was to explore the experiences of older adults (age 50 and older) with HIV/AIDS who were enrolled in case management programs in Northwest Indiana. Data were collected from semi structured interviews …

Admission Timing, Age, Sex, Pain, And Disability As Outcome Predictors Of Short-Term Pain Programs, Nanesha Courtney

Walden Dissertations and Doctoral Studies

Researchers have found that age, sex, education level, and pretreatment pain levels may be significant predictors of patient outcomes; however, it remained unknown whether the timing of treatment predicts pain and disability after a multidisciplinary short-term intensive pain treatment program. The purpose of this quantitative nonexperimental study was to use archival data to examine whether the timing of entry into a multidisciplinary short-term intensive pain treatment program predicted pain and functioning levels at posttreatment. Glasser’s choice theory was used to examine whether the combined effect of pretreatment pain, occupational disability level, age, sex, education level, and time of entrance predicted …

Effect Of Family Engagement On The Behavioral Health Of Mentally Ill Offenders, Jessica Rae Horn

Walden Dissertations and Doctoral Studies

In the United States, 40% of incarcerated individuals have been diagnosed with a mental health disorder, but they often lack the support system needed to navigate their incarceration. This study addressed ways to understand how family engagement opportunities can improve the behavioral health of mentally ill offenders. Specifically, five research questions were used to explore the degree to which the practice of family engagement was understood as a method for providing support to mentally ill incarcerated individuals. The study followed the Baldrige Framework of Excellence to identify current organizational leadership and management issues that can help reach its goals, improve …

Relationship Between Childhood Trauma, ,Adverse Childhood Experiences, And Self-Management Of Type 1 And Type 2 Diabetes, Deserie J. Otoole

Walden Dissertations and Doctoral Studies

AbstractPoorly controlled diabetes is the result of lack of self-care, which contributes to complications, ill quality in life, the rise in health care costs, and early death. The purpose of this quantitative, nonexperimental study was to examine the extent to which diabetes type (Type 1 and Type 2), childhood trauma, and adverse childhood experiences predict diabetes self-management (glucose management, dietary control, physical activity, health care use, total self-management). Contemporary trauma theory suggests that early childhood trauma results in negative health-related consequences in adulthood. Standard multiple regression analyses showed that (a) higher levels of physical neglect and emotional abuse predicted poorer …

Behavioral Health Leadership Strategies To Increase Telehealth Engagement, Ramona Singletary-Robertson

Walden Dissertations and Doctoral Studies

One of the challenges brought on by the recent COVID-19 pandemic has been the promotion and use of telehealth services. While recent data from Medicare has depicted an increase in this new service delivery modality (over 4,000%), there has been a stark disparity in the use of telehealth services in lower socioeconomic demographics, such as rural and underrepresented communities, and among Medicare recipients. Equitable, consistent, and optimal service expansion of the telehealth modality requires therapists and leaders of behavioral health organizations to develop and deploy creative tactics to remedy this disparity. In this case study, leaders of Miss Emma's Behavioral …

Parents’ Perceptions Of The Traits, Characteristics, And Circumstances Of Modern-Day Mass Shooters, Matt Talbot

Walden Dissertations and Doctoral Studies

There is little research on parents’ perceptions about the traits, characteristics, and circumstances ascribed to mass shooters and the sources of information shaping these perceptions. Understanding parents’ beliefs about mass shooters and mass shootings can serve to inform approaches to training and education and recommendations for media reporting on such events. Evidence-based knowledge helps parents become more equipped to serve as early interventionists for those who may be moving along a pathway of violence. Application of Gerbner’s cultivation theory frames the process by which media sources shape perceptions. In this phenomenological qualitative study, semi structured interviews were conducted with 19 …

Experience Of Established Mental Health Counselors Working With Adults Who Have Intellectual Disabilities, Margarete Denk

Walden Dissertations and Doctoral Studies

Individuals with disabilities make up the largest minority population in the United States. Individuals with intellectual and developmental disabilities (I/DD) make up a significant portion of this population, yet there are limited studies addressing counseling with the I/DD population. The Council for Accreditation of Counseling and Related Educational Programs has addressed the need for disability competence in their upcoming 2024 standards. The purpose of the phenomenological study was to describe lived experiences of established counselors working with adult clients diagnosed with an I/DD. A descriptive phenomenological approach was used along with the social model of disability. The study involved six …

First Responder And Veteran Yoga For Posttraumatic Stress, Coping, And Anxiety, Nicole M. Mckenna

Walden Dissertations and Doctoral Studies

Constant exposures to trauma and violence often impact the wellbeing of veterans and first responders. Related heavy tolls have created an urgent need for wellness programs and coping strategies. This study utilized organismic valuing process theory as a lens to explore two research questions with a purpose to describe participants’ lived experiences and related perceptions of effectiveness. Specifically, the research was an exploration of (a) how first responders and veterans using yoga for posttraumatic stress, anxiety, and coping described their lived experiences with the intervention and (b) how first responders and veterans perceived the effectiveness of yoga for symptom improvement, …

Generalized Anxiety Disorder Symptoms Stratified By Age In Primary Care, Robin E. Mccoy

Walden Dissertations and Doctoral Studies

Little is known as to the age-related presentation of somatic complaints of those diagnosed with generalized anxiety disorder in primary care settings. A retrospective medical records review sought to identify the affective symptoms of generalized anxiety disorder (GAD) by age as recorded by primary care providers and to test the association of these symptoms by age. Guided by Engle’s (1977) biopsychosocial (BPS) model, a large administrative claim database system was used to derive a sample of 1,336, including 500 patients diagnosed with generalized anxiety disorder between 2018 to 2021. Binary logistics regression, one-way ANOVA, chi-square, correlation, and logistical regression with …

Moral Injury Themes Involving Criminal Recklessness Among Adults With Alcohol Use Disorder, Sandra Starch

Walden Dissertations and Doctoral Studies

Moral injury (MI) can emerge following transgressive acts against one’s deeply held moral beliefs. Its symptomology involves individual psychological, spiritual, behavioral, and social spheres. It has primarily been studied within the military and in a few select civilian populations. This descriptive phenomenological study involved exploring MI themes among adults with alcohol use disorder (AUD) who had engaged in criminally reckless acts. Data collected from semi-structured interviews with eight participants were coded and analyzed, leading to six major themes revealing the symptomology of MI. Responses from study participants supported Festinger’s theory of cognitive dissonance via their descriptions of alcohol abuse cycles …

The Effects Of Secondary Traumatic Stress And Resilience On The Indicators Of Compassion Fatigue Among Occupational Therapists, Gayla Ann Aguilar

Walden Dissertations and Doctoral Studies

AbstractCompassion fatigue (CF) has been described as the “cost of caring” for traumatized individuals, which may lead to missed workdays, diminished work satisfaction, increased turnover, and decreased client care. CF has long been studied in other caring professionals, but occupational therapy practitioners (OTPs) have been largely overlooked. The purpose of this quantitative correlation study was to determine the relationship between secondary traumatic stress (STS) and resilience (RES) on burnout (BO) and compassion satisfaction (CS; i.e., indicators of CF) in OTPs. In this study, the moderation effect that RES has on STS and BO as related to CF in 68 completed …

The Essence Of Therapeutic Relationships In Equine-Assisted Psychotherapy, Joy Clark Akin

Walden Dissertations and Doctoral Studies

AbstractTraditional psychotherapeutic approaches are not always effective in alleviating psychological symptoms and improving functioning in young adults. Equine-assisted psychotherapy (EAP) has been shown as a beneficial alternative therapeutic method developed for clients not helped by traditional methods. However, the essence of the therapeutic relationship that develops between the client, horse, therapist, and equine specialist has not been explored. The purpose of this phenomenological study was to explore the lived experience of the therapeutic relationship in young adults who participated in EAP. The frameworks of person-centered theory and self psychology guided the development of interview questions, data analysis, and interpretation. Four …