Social and Behavioral Sciences Commons^™

This Is Herpes: A Qualitative Investigation Of The Disclosure Patterns Of Hsv2 Individuals, Katrina Miles

Masters Theses, 2010-2019

It is estimated that by 2025, 49% of the female population and 39% of the male population, aged 15-39, will have contracted herpes simplex virus 2, or as it is more commonly known, genital herpes (Fisman, Lipsitch, Hook & Goldie, 2002). However, little is understood about the ways that those with genital herpes communicate their condition with potential partners, friends, or family members. Using in-depth qualitative interviews this research focuses on understanding the unique patterns that individuals with genital herpes engage to disclose their status to significant others. Utilizing the theories of Communication Privacy Management and the Disclosure Decision-Making Model …

Promoting Trustworthiness And Discoverability In An S-Town Of Osn Documents, Laurie J. Bonnici

Proceedings from the Document Academy

The realm of online social networks (OSN) has evolved rapidly over the last decade. While literature has primarily focused on Twitter, Facebook presents a unique forum for seeking secondhand knowledge on highly specialized topics including life-threatening medical conditions. Cognitive authority expressed through accounts of personal experiences augments authoritative resources that often are inaccessible or non-existent. OSN posts in Facebook groups appear as a plethora of documents thrown upon the virtual floor, disorganized and unsearchable. This paper offers ideas of what could be possible when interaction design (Ixd) is applied to Facebook groups to promote trustworthiness and discoverability for the information …

Patients With Dementia Are Easy Victims To Predators, Ronald C. Hamdy, J. V. Lewis, Rebecca Copeland, Audrey Depelteau, Amber E. Kinser, T. Kendall-Wilson, Kathleen Whalen

Amber E. Kinser

Patients with dementia, especially Alzheimer’s disease and particularly those in early stages, are susceptible to become victims of predators: Their agnosia (see Case 1) prevents them from detecting and accurately interpreting subtle signals that otherwise would have alerted them that they are about to fall for a scam. Furthermore, their judgment is impaired very early in the disease process, often before other symptoms manifest themselves and usually before a diagnosis is made. Patients with early stages of dementia are therefore prime targets for unscrupulous predators, and it behooves caregivers and health care professionals to ensure the integrity of these patients. …

Personal Identity Changes Of Female Cancer Survivors In Southern Appalachia, Kathryn L. Duvall, Kelly A. Dorgan, Sadie P. Hutson

Kelly A. Dorgan

Navigating personal identity changes through the cancer journey can be challenging, especially for women in a culture that places emphasis on traditional gender roles and values close-knit families. Drawing on a story circule approach, this study examined the intersecting identities of female cancer survivors in southern Appalachia. Stories of 29 female Appalachian cancer survivors from Northeast Tennessee and Southwest Virginia were collected via a mixed methods approach in either a day-long story circule (N-26) or an in-depth interview (N=3). Transcripts from both phases were audio-recorded and transcribed verbatim; NVivo 8.0 facilitated qualitative content analysis of the data. Inductive analysis revealed …

Omnibus Survivorship Narratives: Multiple Morbidities Among Female Cancer Survivors In South Central Appalachia, Kelly A. Dorgan, Kathryn L. Duvall, Sadie P. Hutson

Kelly A. Dorgan

This study examines the illness narratives of female cancer survivors living in Southern Central Appalachia. Stories of 29 female Appalachian cancer survivors from northeastern Tennessee and southwcstmn Virginia were collected via a mixed methods approach in either a day-long story circle (n=26) or an in-depth interview (n=3), Qualitative content analysis was used to guide an inductive analysis of the tTanscript<;, What emerged was that as participants survived cancer, they also survived other health conditions, their intorsccting stories yielding an omnibus survivorship narrative.

Navigating Family Cancer Communication: Communication Strategies Of Female Cancer Survivors In Central Appalachia, Kathryn L. Duvall, Kelly A. Dorgan, Sadie P. Hutson

Kelly A. Dorgan

In a multiphasic study, the stories of 29 female Appalachian cancer survivors were collected through either a day-long modified story circle event (n=26) or an in-depth interview (n=3). Qualitative content analysis was used to identify emergent themes in the data. The analysis revealed 5 types of family cancer communication including both pre-diagnosis and postdiagnosis cancer communication strategies

Too Many Choices Confuse Patients With Dementia, R. C. Hamdy, J. V. Lewis, Amber Kinser, A. Depelteau, Rebecca Copeland, T. Kendall-Wilson, K. Whalen

Amber E. Kinser

Choices are often difficult to make by patients with Alzheimer Dementia. They often become acutely confused when faced with too many options because they are not able to retain in their working memory enough information about the various individual choices available. In this case study, we describe how an essentially simple benign task (choosing a dress to wear) can rapidly escalate and result in a catastrophic outcome. We examine what went wrong in the patient/caregiver interaction and how that potentially catastrophic situation could have been avoided or defused.

Hallucinations Are Real To Patients With Dementia, R. C. Hamdy, Amber E. Kinser, J. V. Lewis, Rebecca Copeland

Amber E. Kinser

In this case study, we present a patient with preexistent posttraumatic stress disorder and psychosis who has been recently diagnosed with Dementia with Lewy Bodies. He is experiencing vivid hallucinations. What went wrong between him and his wife as a result of these hallucinations is presented. Alternative actions that could have been used are suggested.

Changes In The Utilization Of Osteoporosis Drugs After The 2010 Fda Bisphosphonate Drug Safety Communication, Bander Balkhi, Enrique Seoane-Vazquez, Rosa Rodriguez-Monguio

Pharmacy Faculty Articles and Research

Introduction

In October 2010, the US Food and Drug Administration (FDA) issued a safety communication regarding the risks of atypical fractures of the femur, with bisphosphonates drugs. This study evaluated the impact of the bisphosphonates FDA safety communication on the utilization of osteoporosis medications in Medicaid programs.

Methods

Osteoporosis drugs utilization data from the July 2006 to June 2014 were extracted from the national Summary Files from the Medicaid State Drug Utilization Data maintained by the Centers for Medicare & Medicaid Services (CMS). We performed an interrupted time series analyses to evaluate trends in utilization of osteoporosis drugs before and …

A Mixed-Methods Study: An Examination Of The Relationship Between Private Social Media Participation And Accountability, Adherence, And Social Connectedness In, Diana A. Cabori

Dissertations

Purpose: The purpose of this mixed-methods sequential explanatory study was to examine the influence of private social media usage on accountability, adherence, and social connectedness in weight loss and fitness program participants.

Methodology: This study utilized a mixed-methods sequential explanatory research design comprised of a multi-state quantitative survey of weight loss and fitness participants and subsequent qualitative interviews to elucidate the influence of private social media on weight loss and fitness program participants regarding program accountability and adherence, and social connectedness to others. The population included 3,000 participants of The Camp Transformation Center and 1,000 participants of Warrior Fitness and …

Hallucinations Are Real To Patients With Dementia, R. C. Hamdy, Amber E. Kinser, J. V. Lewis, Rebecca Copeland

ETSU Faculty Works

In this case study, we present a patient with preexistent posttraumatic stress disorder and psychosis who has been recently diagnosed with Dementia with Lewy Bodies. He is experiencing vivid hallucinations. What went wrong between him and his wife as a result of these hallucinations is presented. Alternative actions that could have been used are suggested.

Too Many Choices Confuse Patients With Dementia, R. C. Hamdy, J. V. Lewis, Amber Kinser, A. Depelteau, Rebecca Copeland, T. Kendall-Wilson, K. Whalen

ETSU Faculty Works

Choices are often difficult to make by patients with Alzheimer Dementia. They often become acutely confused when faced with too many options because they are not able to retain in their working memory enough information about the various individual choices available. In this case study, we describe how an essentially simple benign task (choosing a dress to wear) can rapidly escalate and result in a catastrophic outcome. We examine what went wrong in the patient/caregiver interaction and how that potentially catastrophic situation could have been avoided or defused.

The Relationship Between Nonverbal Communication And Patient Willingness To Comply In Framed, Low-Risk Medical Settings, Rachael A. Katz

Communication Studies

This study discusses framing and communication tactics in the medical field. It specifically aims to understand whether expertise and empathetic nonverbal communication impacts patient willingness to comply with physician directives in gain- and loss-framed medical settings. Framing has been studied in many settings, including medical situations, and has been found to impact decision-making. This experiment utilizes college-aged individuals to examine Meningitis, a disease where the most at-risk group is college aged young adults. Participants were exposed to one of six conditions to examine whether perceived expertise/empathy in their scenario impacted willingness to comply with the doctor directives. Although no mediation …

Patients With Dementia Are Easy Victims To Predators, Ronald C. Hamdy, J. V. Lewis, Rebecca Copeland, Audrey Depelteau, Amber E. Kinser, T. Kendall-Wilson, Kathleen Whalen

ETSU Faculty Works

Patients with dementia, especially Alzheimer’s disease and particularly those in early stages, are susceptible to become victims of predators: Their agnosia (see Case 1) prevents them from detecting and accurately interpreting subtle signals that otherwise would have alerted them that they are about to fall for a scam. Furthermore, their judgment is impaired very early in the disease process, often before other symptoms manifest themselves and usually before a diagnosis is made. Patients with early stages of dementia are therefore prime targets for unscrupulous predators, and it behooves caregivers and health care professionals to ensure the integrity of these patients. …

Interns Matter: Maximizing Integration Of Interns Into Community Agencies, Valerie Garcia

Capstone Projects and Master's Theses

Hope Services is a non-profit agency serving individuals with developmental disabilities in six counties. Over the years, there have been many agencies that have formed connections with Hope Services. One of these collaborative partnerships has been with CSU Monterey Bay’s (CSUMB) integration of interns through their field placement program. However, recently former Hope Services South District Manager, Greg Dinsmore, witnessed a lack of utilization and integration of interns across all Hope Services agencies. Through firsthand experience as a mentor, he witnessed the benefits of utilizing interns and saw the need for further advocacy and support for the integration of interns …

Reducing Symptom Distress In Patients With Advanced Cancer Using An E-Alert System For Caregivers: Pooled Analysis Of Two Randomized Clinical Trials, David H. Gustafson, Lori L. Dubenske, Amy K. Atwood, Ming-Yuan Chih, Roberta A. Johnson, Fiona Mctavish, Andrew Quanbeck, Roger L. Brown, James F. Cleary, Dhavan Shah

Health and Clinical Sciences Faculty Publications

Background: Symptom distress in patients toward the end of life can change rapidly. Family caregivers have the potential to help patients manage those symptoms, as well as their own stress, if they are equipped with the proper resources. Electronic health (eHealth) systems may be able to provide those resources. Very sick patients may not be able to use such systems themselves to report their symptoms but family caregivers could.

Objective: The aim of this paper was to assess the effects on cancer patient symptom distress of an eHealth system that alerts clinicians to significant changes in the patient’s symptoms, as …

Patient Experience Of Taking Adjuvant Endocrine Therapy For Breast Cancer: A Tough Pill To Swallow, Kuang-Yi Wen, Rita Smith, Aruna Padmanabhan, Lori Goldstein

Patient Experience Journal

Adjuvant endocrine therapy (AET) has substantially improved the mortality rate among breast cancer survivors. Despite the proven efficacy, the non-adherence rate to therapy is still high. This study is aimed to examine women’s challenges related to AET adherence and management. Semi-structured interviews were conducted with six Caucasian and six African American breast cancer survivors who were prescribed for AET. The transcripts of audio-taped interviews were qualitatively analyzed. Key themes were: 1) positive beliefs in AET, 2) uncertainty about long-term adherence, 3) experiences with side effects, 4) forgetting and remembering, 5) other concerns and information needs, 6) potential intervention format, and …

Effects Of A Hospital-Wide Physician Communication Skills Training Workshop On Self-Efficacy, Attitudes And Behavior, Minna Saslaw, Dana R. Sirota, Deborah P. Jones, Marcy Rosenbaum, Steven Kaplan

Patient Experience Journal

Hospital systems interested in improving patient experience and physician engagement may look to physician communication skills training (CST) as a means of improving both. This study examines a 7.5-hour, multi-specialty, hospital-wide physician CST workshop in a large academic hospital system and its effects on participants’ self-efficacy, attitudes, and behaviors related to communicating with patients. Data was gathered from October 2014 through June 2016 through a web-based questionnaire sent to participants 6-weeks post-workshop which focused on skills taught in the course, attitudes toward communication training, and provider behaviors when communicating with patients. Along with demographic questions, a ten question retrospective pre-post …

Listening To Unheard Voices: Nurses’ Communication Experiences With The Nrs Pain Scale, Matthew H. Barton, Kevin Stein

Discourse: The Journal of the SCASD

This study examines nurses’ experiences with the Numeric Rating Scale (NRS). These responses characterize the communication trials that nurses face with pain diagnosis, pain management, and overall patient care. Interviews with 20 nurses reveal three themes: subject dissatisfaction, feeling limited, and subjective satisfaction. An analysis of these themes reveals the need for renewed discussion about the way pain is communicated and the challenging expectations nurses must regularly confront. Implications for listening to important, but often quiet, even silent, voices in pain management and clinical practice are discussed.

Improving Interviewing And Conversational Skills Using "Speed Interviewing", Colleen Arendt

Discourse: The Journal of the SCASD

A great deal of research focuses on the importance of effective interviewing skills across professions and interpersonal settings. This activity, based on “speed dating,” is designed to improve students’ interviewing skills. Specifically, the activity develops listening and probing skills by having students conduct mini interviews without preparation. The lack of preparation forces students to rely only on their listening and probing skills instead of an interview protocol. To increase difficulty, the questions can be tailored to employment or internship interviews to help the interviewees prepare while their partners practice listening and asking probing questions. This activity can also be modified …

Gender Differences In Virologic Response After Antiretroviral Therapy In Treatment-Naïve Hiv-Infected Individuals: Results From The 550 Clinic Hiv Cohort Study., Andrea Reyes-Vega, Alejandra Loban, Kavitha Srinivasan, Stephen P. Furmanek, Conner English, Mary Bishop, Cathy Spencer, Daniel Truelove, Julio A. Ramirez, Anupama Raghuram, Paula Peyrani

Faculty Scholarship

Background

Controversy still exists regarding gender differences in virologic response between treatment-na•ve HIV-infected individuals. The objective of this study was to evaluate gender difference in virologic and immunologic response to antiretroviral therapy in treatment-na•ve HIV-infected individuals. Methods

This was a retrospective, observational study of treatment-na•ve HIV-infected individuals managed at the 550 clinic who started antiretroviral therapy (ART) between January 1st, 2010 and December 31, 2015. Patients with available viral load and CD4 counts before and one year after initiating ART were included in this study. Virologic suppression was defined as < 48 HIV-1 RNA copies/mL, and mmunologic recovery was defined as a CD4 count increase of at least 150 cells/mm3. Dichotomous variables were reported in number and percentages and analyzed using Chi-squared tests and Fisher’s exact (whichever was appropriate). Continuous variables were reported as median and interquartile range (IQR) and analyzed using Wilcox rank-sum tests. Multivariate analyses performed were logistic regressions with adjustment for other covariates. P value <0.05 was considered statistically significant. R version 3.3.2 was used for the statistical analysis. Results

A total of 70 women and 90 men were included …

Design And Validation Of Patient-Centered Communication Tools (Pact) To Measure Students' Communication Skills, Gloria R. Grice, Nicole M. Gattas, Theresa Prosser, Mychal Voorhees, Clark D. Kebodeaux, Amy Tiemeier, Tricia M. Berry, Alexandria Garavaglia Wilson, Janelle Mann, Paul Juang

Pharmacy Practice and Science Faculty Publications

Objective. To develop a comprehensive instrument specific to student pharmacist-patient communication skills, and to determine face, content, construct, concurrent, and predictive validity and reliability of the instrument.

Methods. A multi-step approach was used to create and validate an instrument, including the use of external experts for face and content validity, students for construct validity, comparisons to other rubrics for concurrent validity, comparisons to other coursework for predictive validity, and extensive reliability and inter-rater reliability testing with trained faculty assessors.

Results. Patient-centered Communication Tools (PaCT) achieved face and content validity and performed well with multiple correlation tests with significant findings for …

Community Perception Of The Hiv Vaccine In Western Kenya: Acceptability, Potential Behavior Changes, And Views On Compulsory Vaccination, Deborah Keen

Independent Study Project (ISP) Collection

Human Immunodeficiency Virus (HIV) suppresses the immune system by attacking T cells, leading to the development of acquired immunodeficiency syndrome (AIDS). HIV affects over 30 million people around the world and 1.6 million people in Kenya. On August 18, 1987, the FDA sanctioned the first human testing of a candidate vaccine for HIV. Currently, multiple HIV vaccines—projected to be on the market in five to ten years—are being tested for efficacy and safety. The goal of this study was to explore opinions related to the HIV vaccine so that there is a guide for future policy development in Western Kenya. …

Deaf 101: How To Navigate Clinical Interactions With Deaf Sign Language Users, Melissa L. Anderson, Timothy Riker

Melissa L. Anderson

This webinar provides some basic guidelines for interacting with culturally Deaf clients, including how to work with American Sign Language interpreters and Certified Deaf interpreters, how to respect Deaf culture and Deaf social norms, and how to adapt common treatment approaches to be more Deaf-friendly.

Readability Of Colorectal Cancer Online Information: A Brief Report, Corey Basch, Danna Ethan, Sarah A. Maclean, Philip Garcia, Charles E. Basch

Publications and Research

Purpose: Colorectal cancer (CRC) is the third leading cause of cancer-related death in the United States. A decline in deaths caused by CRC has been largely attributable to screening and prompt treatment. Motivation, shown to influence cancer-related screening and treatment decisions, can be shaped by information from the Internet. The extent to which this information is easily readable on cancer-related websites is not known. The purpose of this study was to assess the readability levels of CRC information on 100 websites.

Methods: Using methods from a prior study, the keyword, “colorectal cancer,” was searched on a cleared Internet browser. Scores …

Interdepartmental Rounding, Peggy Anderson, Carrie Strick, R3 Med-Surg Unit, Haley Pelletier, Suneela Nayak, Stephen Tyzik, Ruth Hanselman, Maine Medical Center Operational Excellence

Maine Medical Center

STRATEGIES FOR IMPROVING COMMUNICATION BETWEEN DOCTORS AND NURSES IN AN ACUTE CARE HOSPITAL

Effective interdisciplinary communication is imperative for safe patient care in an acute care hospital environment.

A surgical unit used their HCAHPs scores to assess how often patients perceived there was good communication between different doctors and nurses during their hospital stays. The data demonstrated that this occurred 22% less often than the national average.

As a result of a root cause analysis, a number of countermeasures were initiated with the goal of achieving scores greater than the national average. Post KPI inception in the second quarter of …

Exploring Workplace Connections Of Employees With Multiple Role Expectations: Accommodating Communication Behaviors Of Hospital Chaplains, Stephen Spates

Doctoral Dissertations

The purpose of this study was to explore the communication behaviors of hospital chaplains in an effort to understand their workplace role. In the literature, most chaplain recognition related to spiritual interactions and improved health outcomes for patients, which left much information about their workplace lives unknown. This study used interviews with hospital chaplains to explore their communication behaviors. Using communication allowed chaplains to manage roles and uncertainty, build relationships, and handle the paradoxical interactions they encounter at work. The findings revealed that hospital chaplains, who operate as liaisons in their organizations, practiced convergence to accommodate others. They also managed …

The Influence Of Parental Communication About Sexual Health On Quality Of Emerging Adult Romantic Relationships, Jaclyn Denise Powers

Master's Theses

The research on relationships between parent-child communication about sexuality and sexual communication between adult partners is currently lacking. The current study aims to examine the influence of parent-child sexual communication on adult sexual communication when those children reach adulthood and engage in romantic relationships. Parent-child sexual communication, attachment styles, sexual attitudes, and partner sexual communication were examined for influence on the physical and emotional relationship satisfaction of emerging adults. Study 1 included a quantitative analysis with 553 emerging adults participating in an online survey, and study 2 incorporated a qualitative analysis with an additional 7 emerging adults participating in online …

Activity Spotlight: Zika Prevention, Breakthrough Research

Poverty, Gender, and Youth

In collaboration with Breakthrough ACTION, an affiliated project led by the Johns Hopkins University Center for Communication Programs, Breakthrough RESEARCH is supporting and strengthening USAID’s Zika response efforts to optimize social and behavior change programming to minimize negative pregnancy outcomes in USAID’s priority countries in Latin America and the Caribbean. Breakthrough RESEARCH is leading an evidence review of commonly promoted Zika preventive behaviors and with Breakthrough ACTION will develop a process for prioritizing these behaviors using criteria considering efficacy, feasibility, and potential impact. A key outcome of this process will be an evidence-based list of priority prevention behaviors shared via …

Incorporating Lesbian, Gay, Bisexual, And Transgender (Lgbt) Health Concepts Into Nursing Curricula: What Nursing Faculty Should Know, Paul Smith, Julie Fitzwater

Faculty Presentations

The objective of this presentation is to help faculty learn how to effectively teach students about lesbian, gay, bisexual, and transgender (LGBT) health, health promotion, and health care disparities. Learning outcomes for this session include how to utilize specific tools, strategies, and resources for incorporating essential LGBT content into undergraduate and graduate nursing programs.

• LEARNING OUTCOME 1: Describe ways to incorporate LGBT content into nursing curricula and discuss the importance of this inclusion;
• LEARNING OUTCOME 2: Identify resources appropriate for nursing students that may be integrated into nursing curricula;
• LEARNING OUTCOME 3: Identify specific health disparities that are applicable to …