Health Services Research Commons^™

Comparative Analysis Of Acceptance And Commitment Therapy’S Effectiveness In An Intensive Outpatient Program Setting, Efrain Frank Ellin Iii

Electronic Theses and Dissertations

This thesis presents a comparative analysis of acceptance and commitment therapy (ACT) and treatment as usual (TAU) within an intensive outpatient program setting, evaluating their effectiveness in enhancing various dimensions of psychological well-being. Guided by two main research questions, the study investigates whether ACT demonstrates greater or equal effectiveness compared to TAU and if it provides more immediate effects on psychological well-being within three weeks. Utilizing a quasi-experimental design, the research incorporates a comprehensive array of measurement tools to assess outcomes related to anxiety, depression, stress, psychological flexibility, cognitive flexibility, emotion regulation, mindfulness self-efficacy, and life satisfaction among participants. The …

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 …

The Relationship Between Parental Trauma History And Perceptions Regarding Their Child’S Healthcare And Utilization Of Healthcare Services, Krishna Patel

Theses and Dissertations

Abstract

TITLE: The Relationship Between Parental Trauma History and Perceptions Regarding Their Child’s Healthcare and Utilization of Healthcare Services

Adverse child events (ACEs) have been associated with a number of physical and mental health problems and have also been linked to increased health care utilization. While parents who have an ACE history may tend to seek healthcare services for themselves, limited studies have examined the impact of their trauma history on seeking healthcare services for their child. Healthcare utilization may also depend on the parents’ level of health anxiety, as well as their anxiety about their child’s health status. This …

Evidence-Based Practices And Self-Efficacy: A Quantitative Study Of Mental Health Counselors Treating Clients With Substance Use Disorder, Carl Bastien

Dissertations

Substance use disorder affects a substantial number of individuals in the United States. The specific problem of this research is that it was not known to what extent their use of evidence-based practices is driven by their sense of self-efficacy. The purpose of this quantitative correlational research was to examine to what extent the use of evidence-based practices covary with a sense of self-efficacy for mental health counselors treating individuals diagnosed with a substance use disorder. The study population was 121 mental health counselors who specialized in substance use disorder treatment who completed a digital survey. The study findings did …

Still, We Thrive: Understanding How Gay, Bisexual, Transgender, And Other Men Who Have Sex With Men (Gbtmsm) Experience Structural Barriers & Facilitators To Wellness, Lucas Gergyek

Theses and Dissertations (Comprehensive)

Historically and concurrently, structural violence has been a significant force influencing the sexual health and broader health of gay, bisexual, transgender and other men who have sex with men (GBTMSM). Yet to date, the majority of projects exploring the health inequities facing GBTMSM have focused on intrapsychic and behavioural factors as most related to poor health outcomes. As well, these studies are sometimes deficits focused, and fail to evaluate how GBTMSM continue to thrive, and maintain positive health. As a result, the ways in which systems and policies underlie and perpetuate health inequities facing GBTMSM have been somewhat obscured. Connectedly, …

An Updated Look At Mental Health Services In American Public And Private Prisons, Lieren E. Tyira

Student Theses

People residing in American prisons have the legal right to mental health care while incarcerated (Justia, 2021). This is important, as the prevalence of mental disorders is high in this population (Prins, 2014), and incarceration is a psychologically damaging experience, which hinders a person’s success at rehabilitation. Numerous of issues related to the mental health services (MHSs) in both public and private prison facilities have been reported in recent years, which warrants systematic exploration. The little existing research comparing the presence of MHSs in these facilities has produced mixed results, it uses out-of-date datasets, and none has explored MHSs in …

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 …

The Coping Strategies Of Older Adults With Age Related Vision Loss (Arvl) – A Narrative Account, Zakara J. Stampp

Electronic Thesis and Dissertation Repository

The goal of this study was to share the stories of older adults with age-related vision loss (ARVL) and how they have coped to maintain meaningful occupational engagement. Grounded in a constructivist paradigm, data collection and analysis were guided by the narrative inquiry methodology. The participants consisted of six older adults aged 60 or older, diagnosed with one of the following ARVL conditions: macular degeneration, diabetic retinopathy, and/or glaucoma. Participants were recruited from vision loss non-profit organizations such as the Canadian National Institute for the Blind (CNIB) and the Alliance for Equity of Blind Canadians (AEBC). One older adult was …

Testing Barriers To Non-Suicidal Self-Injury With College Students: Narcissistic Traits As Moderators, Philip Stoner

Dissertations

Research on non-suicidal self-injury (NSSI) has produced mixed findings, resulting in a lack of clarity regarding these behaviors (Klonsky & Meuhlenkamp, 2007). To address this, Hooley and Franklin (2018) developed the Benefits and Barriers Model (BBM) to provide a comprehensive understanding of NSSI, in which they identified the barriers that commonly prevent people from engaging in these behaviors (e.g., self-esteem, shame, and peer-bonding motivations/social norms). They also identified adverse childhood experiences (ACEs) as a distal predictor of NSSI, which aids people in overcoming the barriers to engaging in these behaviors. Recent NSSI literature has shown that college women in the …

Implementing Trauma-Informed Care Through A Multi-Agency Learning Collaborative: A Theory-Driven Analysis Of Outcomes And Sustainability, Mira D H Snider M.S.

Graduate Theses, Dissertations, and Problem Reports

Learning collaboratives (LCs) are often used in large-scale implementation initiatives to promote evidence-based practice across provider networks. Although the outcomes and stakeholder perspectives of many LCs have been documented, support for the effectiveness of LCs is equivocal, and the means by which LCs achieve long-term improvements in clinical care are not understood. The current study investigated outcomes and sustainability of a multi-agency LC for implementing trauma-informed care in 23 rural Pennsylvania counties. Changes in outcomes (i.e., trauma symptom screening, trauma-informed care training attendance, clinician confidence with using trauma informed-care, utilization of trauma-related diagnostic codes, retention in service, service unit density) …

Patient Reported Outcomes In Sickle Cell Disease Examined Within A Conceptual Model, Swapandeep Mushiana, Marsha Treadwell Phd, Sherif M. Badawy Md, Ms, Liliana Preiss Phd, Allison King Md Mph Phd, Barbara Kroner Phd, Yumie Chen Bs, Jeffrey Glassberg, Victor Gordeuk Md, Nirmish Shah Md, Angie Snyder Phd Mph, Theodore Wun Md

Doctoral Dissertations

Objective: To examine the relations between patient reported outcomes (PROs) within a conceptual model for adults with sickle cell disease (SCD) ages 18 – 45 years enrolled in the Sickle Cell Disease Implementation Consortium (SCDIC) registry. We hypothesized that patient and SCD related factors and barriers to care would independently contribute to functioning as measured using the PRO domains. Additionally, pain and other SCD related complications are expected to impact the relation between the variables. Methods: Participants completed a 48-item survey that included socio-demographics and PRO measures, such as social functioning, pain impact emotional distress, and cognitive functioning. …

Vulnerability To And Protection Against Covid-19 Fear, Threat, And Worry, Marsha Kim Huh

Graduate Theses and Dissertations

Drawing from a sample of 10,368 adults living in the U.S., the current study examines the role of social and psychological resources in lowering COVID-related fear, threat, and worry, controlling for a number of social vulnerabilities (e.g. gender, race/ethnicity, and presence of children). The impact of social location, particularly in regards to race, and how one accesses and/or utilizes social and psychological resources is also examined through disaggregated regression models. Results demonstrate that some social and psychological resources impact COVID-specific distress (fear/threat/worry), but depending on the resource, relationships vary in direction and significance. The strength of social ties and mastery …

A Descriptive Case Study Of The Challenges Of Drug And Alcohol Counselors, Ruben Herron

Graduate Theses and Dissertations

Substance abuse is the number one public health problem in Oklahoma and nationally. Annual related expenses of substance abuse in Oklahoma are nearly $2 billion. This qualitative descriptive case study asks the question what are the challenges of substance-abuse counseling? The researcher will be describing in detail the history of drug and alcohol treatment and counseling in America. Using interviews, observations and document collection which will allow the interviews voices to be heard.

Medical Knowledge As A Recalcitrant Epistemological System: An Application Of Standpoint Epistemology In The Analysis Of Marginalization Within U.S Healthcare, Abby Deshazo

CMC Senior Theses

Research on healthcare disparities outside the field of epistemology tend to miss the true origins of oppressions imposed on marginalized individuals by the U.S healthcare system. This happens because of the false belief that these oppressions are reducible to social or political oppressions. By employing the perspective of a standpoint epistemologist, we can better identify the origins of these oppressions and subsequently consider more appropriate solutions. The standpoint epistemologist’s perspective (1) provides an intuitive case for the role individuals’ schemas play in the evaluation of what healthcare professionals know; (2) situates medical knowledge within epistemology, leading us to …

Perceptions Of Integrated Mental And Behavioral Health In Pediatric Specialty Care Settings: A Mixed-Methods Study, Desireé Nicole Williford

Graduate Theses, Dissertations, and Problem Reports

Pediatric patients are at an increased risk of experiencing mental and behavioral health concerns, which have direct associations with HRQOL, physiological health, and likelihood that youth will engage in health promoting behavior. Researchers and practitioners have increased their awareness of these concerns and identified strategies for improving the mental and behavioral health of these youth, specifically via implementing organizational efforts (i.e., task forces) and guidelines around integrating psychosocial screening and other services into routine practice. Despite this, there are several identified barriers to families receiving mental/behavioral health care in these settings. These barriers exist at all levels, including at the …

Nursing Students’ Knowledge And Attitudes About Pain Management And Opioids, Hedieh Hatami Sirjani

Health Services Research Dissertations

Statement of the problem: healthcare professionals’ knowledge of using opioids for pain management safely is critical in preventing opioid abuse and overdose. Undergraduate curricula of health professional schools, including undergraduate nursing programs, need to improve and adopt a comprehensive education regarding this issue.

Method: the first project was a systematic analysis of the literature regarding the educational interventions’ impact on healthcare professional knowledge and practice behavior regarding prescription opioids. The second project was a qualitative study of nursing students to explore their experience, self-efficacy, and knowledge of prescription opioid use for pain management and whether they feel the need for …

Empowering Nurses Of Minority In The Face Of Incivility And Bullying: Through The Lens Of Phenomenology, Corrine Floyd

Dissertations

Abstract

Up to 85% of nurses have reported exposure to incivility in the workplace (Hunt & Marini, 2012). The often-subtle nature of incivility toward nurses in a minority population may partially explain why it remains a problem. Healthcare organizations realize the need for civility to counter the high turnover rate, staff shortages, and low job satisfaction reported by nurses, but lack understanding of how nurses of a minority population perceive incivility and bullying. This study aimed to answer the research question how do nurses with minority representation experience incivility and bullying versus empowerment in the workplace? A descriptive phenomenological design …

Managing Stress In A Constantly-Changing Workforce, Lorri Burch-Hubbard

Electronic Theses and Dissertations

When staffing reductions occur in the workplace, staff left behind may face increased stress, may not be given the support they need to manage the feelings caused by the reduction. This study was conducted to evaluate the impact of stress caused by staffing reductions has on medical technologists (MT), medical technicians (MLT) and respiratory therapists (RT), and to identify any common methods of stress management used by those staff who remain in the organization.

Literature research showed the negative impact stress can have on individuals when it is not addressed, such as decreased work performance, health issues, and even the …

An Interdisciplinary Study To Understand Treatment Seeking Behavior Among Female Survivors Of Anorexia Nervosa, Meaghan Victoria Tipton

Graduate Theses and Dissertations

This study was done to examine what psychosocial factors influence treatment seeking behavior among female survivors of eating disorders. This study uses a mixed methods survey consisting of open-ended item questions regarding treatment experience and social environment, and close-ended items to measure constructs from the Health Belief Model. Fourteen participants were recruited for this study to retrospectively detail their experiences of treatment during their eating disorder. All fourteen participants identified as Caucasian, thirteen identified as female, one identified with other gender, each with a history of medically diagnosed anorexia nervosa. The mean of age of current participants was 29.46, and …

“Is Therapy For Me?” Perceptions Of Therapy Inclusivity And Willingness To Seek Help Among Black Emerging Adults, Randl B. Dent

Theses and Dissertations

Mental health issues are prevalent among Black emerging adults; however, they tend to underutilize mental healthcare services. The goals of the current study were to examine whether: (1) perceived therapy inclusivity would predict willingness to utilize mental healthcare services and (2) the relationship between perceived therapy inclusivity and willingness would be moderated by two indices of racial identity (i.e., centrality and private regard). Results provide evidence that greater perceptions of therapy inclusivity are associated with greater willingness to seek mental health services even after controlling for factors, such as gender, self-stigma, and previous mental healthcare utilization. Additionally, there was no …

Adverse Childhood Experiences, Homeless Chronicity, And Age At Onset Of Homelessness, Joseph T. Tucciarone Jr.

Electronic Theses and Dissertations

Childhood adversity is associated with numerous negative outcomes across multiple domains, including mental and physical health, interrelationships, and social functioning. Notably, research suggests that childhood adversity has a dose-response relationship with these outcomes; that is, greater numbers of adverse experiences in childhood are associated with worse outcomes. These outcomes overlap with many risk factors of homelessness. This study sought to address two questions: 1) Does a dose-response relationship exist between childhood adversity and chronic homelessness? 2) Does childhood adversity negatively predict the age at which homelessness first occurs? Adults experiencing homeless who are accessing homeless services in the Tri-Cities area …

Are Chronic Inflammatory Diseases Associated With Trauma Exposure And Gender? An Empirical Analysis Of Self-Reported Trauma And Health Histories Of Men And Women, Meghan Lacienski

Electronic Theses and Dissertations

A growing body of research indicates an association between trauma, inflammation, and chronic inflammatory disease; however, the mechanisms of this relationship are not fully understood, and the salience of potential risk factors, such as cumulative effects of trauma, trauma type, and gender, remain unclear. Trauma is associated with poor mental and physical health, such as PTSD, depression, and chronic inflammatory conditions, and this association may be stronger when certain risk factors are considered (Brody, Pratt, & Hughes, 2018; Groer, Kane, Williams, & Duffy, 2014; Husky, Mazure, & Kovess-Masfety, 2018; Kilpatrick et al., 2013). For example, sexual trauma and multiple traumatic …

Sexual Violence Victimization, Mental Health, And University-Based Health Service Use Among College Females, Julie E. Stoner

Health Services Research Dissertations

Females between the ages of 18 and 24 consistently experience higher rates of sexual violence compared to females in any other age group (Sinozich & Langton, 2014). Approximately one in five college women experience sexual violence victimization (SVV; Krebs, Lindquist, Berzofsky, Shook-Sa & Peterson, 2016) during the academic year. Among undergraduate female students, 23.1% are victims of sexual violence due to physical force, violence or incapacitation (Cantor et al., 2015). Sexual victimization has been associated with several short- and long-term psychological health consequences, accounting for enhanced symptoms of depression, anxiety, PTSD, and suicide risk (Basile, Smith, Breiding, Black & Mahendra, …

Queer Health Equity And Cervical Cancer: Identifying Social Determinants Of Papanicolaou Test Uptake In A Sample Of Sexual Minority Women And Gender Nonbinary Individuals, Ariella R. Tabaac

Theses and Dissertations

Sexual minority women (SMW) demonstrate lower rates of cervical cancer screening than heterosexual women. This is concerning as lesbian and bisexual women tend to engage in higher rates of substance-related cancer risk behaviors, unprotected sex, and tend to have higher body mass indices, all of which are risk factors for cancer development. Another major risk factor, screening avoidance, places SMW at increased risk for the development of high grade cervical lesions in the absence of early detection practices, which is likely to impact overall cervical cancer morbidity in this population. The aim of the present study was to utilize the …

Understanding Behavioral Health And Treatment Engagement With Former Users Of Prenatal Substances: A Strengths-Focused Mixed Methods Inquiry, Jennifer G. Benson, Peggy Maclean, Andrew Hsi, Sarah J. Erickson

Psychology ETDs

Accessible services for users of prenatal substances are lacking, and treatment engagement is poor with services that are available. Furthermore, legal consequences are often punitive, which ultimately damages the well-being of mother and child. Milagro and FOCUS are two New Mexico programs that provide comprehensive, coordinated care, including medication-assisted treatment, to former users of prenatal substances during pregnancy (in the Milagro Program) and for three years post-birth (in the FOCUS Program). This mixed methods study explored the lived experiences of women from this complex, high-risk population, using a high-engagement sample of women who utilized services at both Milagro and FOCUS. …

During The Wait: A Phenomenological Study On Denied Social Security Dissability Applicants Awaiting Appeal, Stefanie A. Ford

Graduate Theses and Dissertations

The purpose of the present study is to investigate the essence of the experience of individuals who were denied Social Security Disability benefits and who sought the appeals process. In the first round, five semi-structured face-to-face interviews allow the participants to share their thoughts, feelings, and actions taken and, if any, what life changes occurred during the appeals process. Data analysis using phenomenological methods create textural-structural descriptions from which, in a second interview, applicants choose to confirm, edit, or add to their analyzed interviews. The findings present as seven major themes that describes the phenomenon. They are: (a) procedural unfairness …

Cancer Center Regional Benchmarks For Psychosocial Care, Desiree R. Azizoddin

Loma Linda University Electronic Theses, Dissertations & Projects

The American College of Surgeons (ACoS) Commissions on Cancer (CoC) formulated and implemented standard 3.2 for Psychosocial Distress Screening. This standard requires that all accredited cancer centers evaluate psychosocial distress and provide appropriate triage and intervention for all cancer patients. Over the past decade, Loma Linda University Medical Oncology Center (LLUMOC) administration, physicians, nurses, psychosocial care staff, and chaplaincy collaborated to implement a psychosocial screening and referral program throughout cancer patient services. This current research includes qualitative analysis assessing strengths and barriers of the psychosocial program at LLUMOC from the perspective of LLUMOC providers and two directors of Supportive Care …

A Descriptive Study Of The Elderly In California Substance Abuse Treatment Programs, David Berenschot

Electronic Theses, Projects, and Dissertations

As gerontologists may know, there are a great deal of studies and a variety of academic literature on the misuse of alcohol and prescription medication amongst the elderly population. While there is a plethora of information on alcohol and prescription misuse, there is little reported data about the prevalence of other substance misuse experienced by this population. This study aims to help to fill that gap in the data by using quantitative methods to describe the scope of substance abuse of individuals 55-years or older. This study utilizes data from the Treatment Data Set Admission (TEDS-A). The TEDS-A is a …

Communicative Behaviors Elicited By Leisure Activities In Memory Care Units, Tarynn Clune

Honors Projects

A wide variety of leisure activities used in reminiscence care have been studied for their merits in terms of preventing cognitive decline, and increasing quality of life; however, little is known about what different types have to offer in terms of communicative opportunities. Communication with peers is imperative for quality of life, and is crucial for maintenance of relationships between the person with dementia (PWD) and their loved ones. As a result of this importance, an exploration of communication elicited by different activities facilitated in a unit was conducted. The communication explored in this study was solely vocal, and included …

Urine Cotinine In Children And Parental Behavior Modification: A Pilot Study, Teresa Lachance

Muskie School Capstones and Dissertations

“Urine Cotinine in Children and Parental Behavior Modification” was designed by Dr. Deirdre Burns, a pediatrician at the Barbara Bush Children’s Hospital (BBCH). It was implemented as a pilot study to determine whether urine cotinine testing in children who are admitted to the hospital for respiratory illness and tracking parental smoking behaviors over time was feasible. Parents were given a brief survey to assess their current smoking behaviors and to understand their readiness to quit smoking. They received smoking cessation materials provided by the Breathe Easy Coalition of Maine. These materials outline information about second-hand and third-hand smoke, and encourage …