Digital Commons Network^™

The Impact Of A Competitive Healthcare Environment On Cost And Quality, Maureen E. Buckley

Dissertations

A descriptive longitudinal (1988-1993) case study design, with the Resource Dependence Theory as the conceptual framework, was used to investigate the effect of a competitive health care market on the cost and quality of hospital care. The secluded geographic area in which the three study hospitals were located served to minimize the influence of additional competitors. The Resource Dependence theory emphasizes the adaptation of an organization to changes in the environment or competitive market.

Exploring How Philippine American Nonprofit Leaders Build Trust With Their Staff And Volunteers, Dominic Fernando Laureano

Dissertations

Purpose: Although a considerable amount of literature exists regarding leadership and trust, little research focuses on Philippine American nonprofit organizations and their leadership. The purpose of this phenomenological study was to explore how Philippine American nonprofit leaders build trust with staff and volunteers using the five domains of competency, consistency, concern, candor, and connection.

Methodology: This phenomenological qualitative study collected data via semi-structured interviews, participant observations, and review of artifacts. The study sample was comprised of 10 Philippine American nonprofit leaders from Southern California. Weisman’s Trust Model served at the theoretical framework of the study and guided data collection and …

Unveiling Identities: A Cultural Study Of The Portrayal Of Leading Women In Zhang Yimou Films, Patrick Mcguire

Dissertations

It is imperative to recognize the ongoing collaborations of filmmakers from different countries. Film director Zhang Yimou, cited in this work, has reached out beyond his Chinese borders in recruiting both cast and crew on many of his latest features. But the field of film studies appears to have limited their investigations of such cross-cultural analyses, in particular the subjective analysis of the female lead character in film. Subjective and culturally wired as such, researchers bring forth conscious observations from their socialized unconscious minds.

This textual analysis begins with a comparison of two Chinese films, particularly observing their similar female …

The Changing News Paradigm Of South Mississippi’S Sun Herald As Seen Through The Eyes Of Its Journalists: 1968-2018, Judy Day Isbell

Dissertations

From the earliest days of the American democracy, one of the key tenets of the new government was rule by an informed electorate. This notion of rule of the people, by the people, for the people was established in the first article of the United States Constitution when the houses of Congress were carefully designed, and the idea of a knowledgeable constituency was emphasized in the first amendment when among such basic freedoms as speech, religion and assembly was freedom of the press.

Newspapers in America have changed significantly since the writing of that constitution, but most particularly in the …

From Carver To Carter: The Political Economy Of Peanut Cultivation In The South, 1945-1976, Hayden Noel Mcdaniel

Dissertations

This dissertation focuses on the creation of a robust peanut industry in the South during the twentieth century, tracing its growth from a minor, local subsistence commodity to an agribusiness contributing to mass consumption. This study argues that local groups, constituents of peanut producing regions, and their representation in Congress worked together to establish a national peanut culture. Because peanuts’ rise in importance happened nearly simultaneously with the escalation of federal agricultural policies, studying peanuts rather than other traditional crops best demonstrates the interconnected relationship between federal policy and agricultural politics in the South.

History And Development Of British Secular Song For Solo Voice And Clarinet, Nancy Williams

Dissertations

Even though the use of the solo clarinet in British song made large advances in the twentieth century, many clarinetists are unaware of its repertory. A study of these songs will make it easier for performers to find these scores and will encourage them to program a greater variety of these songs, many of which are significantly underserved. Furthermore, a study of this repertory will lead to greater understanding of the importance of the repertoire and the role of the clarinet in it, resulting in informative and engaging performances. Both the investigation of the history of the clarinet's use in …

Negotiating American Racial Constructs: First- Generation African Caribbean Immigrants’ Experience With Race, Rommel Johnson

Dissertations

The purpose of this study is to describe and understand what race means to first-generation African Caribbean immigrants. Specifically, the study seeks to understand these immigrants’ experience of being Black in America. African Caribbean immigrants migrate to America with a concept of race that is very different from that of the United States. However, upon arriving in America, they encounter the American construct of race that not only diverges significantly from that with which they are familiar, but find that they are being racialized in the American sense. In professional counseling, we have yet to understand the way these immigrants …

Understanding Counselor Educators’ Experiences Of Professional Identity And Leadership In A Group Private Practice, Jessica L. Hopkins

Dissertations

Similar to other mental health professionals, Counselor Educators work in a variety academic, clinical and business settings. The Council for Accreditation of Counseling and Related Educational Programs (CACREP) (2016) describes CES doctoral programs as preparing “graduates to work as Counselor Educators, supervisors, researchers, and practitioners in academic and clinical settings” (p. 38). However, research has only minimally focused on Counselor Educators who work in private practice settings, especially group counseling practices. Swickert’s (1997) research on the professional identity of Counselor Educators in private practice settings signifies the most recent study of counselor education that references Counselor Educators’ professional identities and …

Vines In The Neotropics: Phylogenomics, Biogeography And Systematics In Passion Flowers (Passiflora Subgenus Decaloba Section Decaloba), Serena Acha

Dissertations

With 600 species, Passiflora is a large, morphologically complex and broadly distributed genus in Passifloraceae that represents a major challenge to scientists interested in understanding the evolutionary history of tropical vines. Passiflora has been divided into subgenera, super sections and sections. One of the most enigmatic and species-rich (~120 spp.) groups in Passiflora is section Decaloba, which occurs in the Neotropics and is particularly diverse in Andean montane forests. In this study, we used phylogenomic and population genomic approaches to investigate the evolutionary history, biologeography, species boundaries, and taxonomy of Passiflora section Decaloba. We sampled herbarium specimens, extracted …

What Does Time Management Mean To You? Exploring Measures Of Time Management And Group Differences., Allison Burrus

Dissertations

For centuries people have been trying to find ways to effectively manage their time. Meanwhile, research in this area has lagged and provided inconsistent results about the outcomes (i.e., well-being and job performance) of the use of time management behaviors. A potential reason for the inconsistent results is the lack of a universal conceptualization of time management making it difficult to compare results. Further, it may be that certain groups use and/or interpret time management behaviors in different ways. This study investigated three of the most popular measures of time management concurrently. First, the measures were examined for statistical artifacts, …

Improving Access To Mental Health Care With Nurse Practitioners, Jessica Whelan

Dissertations

Problem: Over 40% of those with mental illness are untreated since the supply of psychiatrists does not meet the demand. The psychiatric mental health nurse practitioner (PMHNP) may be an adjunct in providing those services. The purpose of this quality assurance study was to evaluate outcomes of care between a PMHNP and a psychiatrist (medical doctor [MD]).

Methods: An observational, descriptive design with a retrospective medical record review of adult patients over a six-month period in a suburban, Midwestern, privately owned psychiatric practice.

Results: A total of 787 individual patients encountered at least one visit (N=787) although 3,679 …

When The Injured Nurse Returns To Work: An Institutional Ethnography, Laurie Clune

Dissertations

Nursing is a high risk profession for injury. A Canadian survey reports many nurses are in poor physical and emotional health; they sustain more musculoskeletal and violence related injuries than other occupational groups. In Ontario, an injury management approach called Early Return to Work (RTW) requires injured workers, including nurses, to go back to work before full recovery. The Workplace Safety and Insurance Board cite this approach as beneficial to both the employer and employee. This study uses an institutional ethnographic approach to examine critically the RTW process from the standpoint of injured registered nurses. Through interviews and mapping activities …

Emerging Adults' Lived Experience Of Perinatally Acquired Human Immunodeficiency Virus, Angela Marie Wright

Dissertations

The purpose of this qualitative heuristic study was to explore the emerging adults' lived experience of PAHIV. The aim of this study was to determine if the emerging adults were meeting the benchmarks of their developmental stage as their unaffected peers and to elucidate their voices to understand their essence of the experience of PAHIV. This study answered the questions: What is the emerging adults' lived experience of perinatally acquired HIV (PAHIV)? What benchmarks of the developmental stage are the emerging adults with PAHIV meeting? Philosophical Underpinnings: This study utilized the qualitative research approach with interpretivism and constructivism as the …

Selected African American First-Time Teenage Mothers' Perceptions Of Nurse Caring Behaviors During The Postpartum Period, Danita R. Potter

Dissertations

Nurse caring behaviors are essential to improving health outcomes. However, there has been little research conducted that has investigated nurse caring behaviors during the postpartum period, particularly behaviors directed toward African American first-time teenage mothers. The purpose of this study was to explore and describe African American first-time teenage mothers' perceptions of nurse caring behaviors during the postpartum period. Watson's (1985) Theory of Human Caring was the conceptual basis of this study. Data were collected using the Caring Behaviors Assessment (CBA) instrument, a 63-item questionnaire that included two open-ended questions that were used to identify themes, and a 9-item demographic …

Development Of An Instrument To Measure Quality Of Nurses' Worklife, Beth A. Brooks

Dissertations

This study reports the development process and factor structure of a questionnaire to measure quality of nursing work life for registered nurses in hospital settings. Included is information on item generation, content validation, initial pilot testing, and results from the full study.

Adult Learning Principles Used With Nontraditional Students In Higher Education To Enhance Learner Satisfaction And Retention, Brenda M. Smith

Dissertations

As enrollment of adult learners increases in higher education, addressing their different needs and providing resources to aid their success and retention is important. The purpose of this study was to garner quantitative data regarding adult learning principles used in higher education with nontraditional students, as reported by faculty and students, and identify if any differences exist. The theoretical framework included adult learning theories of andragogy, self-directed learning, and transformative learning. Adult learning principles and learning strategies were explored utilizing the survey instrument, Principles of Adult Learning Scale, by Gary Conti (2004). Descriptive statistics and two sample independent t-tests were …

Students Of Black Or African American Ancestry In Grades 10th -12th Perceptions Of Their Schooling Experiences, Annette Renee Kennedy

Dissertations

California continues to tackle blatant racist acts within school systems across the state as recent headlines read, “Deeply offensive blackface video of California high school student sparks backlash” (Yancey-Bragg, Guynn, & Rhor, 2019, n.p.) and “Four teachers and their principal placed on leave after cheerfully posing for photo with noose” (Lunning, 2019, n.p.). Gaining a greater awareness of the non-headlining actions that take place on a day-to-day basis that have an equally powerful adverse effect on the school experiences of black learners was the focus of this study. Microaggressions are “subtle, stunning, often automatic, and non-verbal exchanges which are put …

Factors Influencing Hispanic Soldiers Seeking Treatment For Alcohol Abuse : Secondary Analysis Of The Army Study To Assess Risk And Resilience Of Servicemembers (Starrs), Karina L. Bocanegra

Dissertations

This study examined factors that influenced whether Hispanic soldiers will elect to seek treatment for alcohol abuse. The data for this study were collected using archival data from the Army Study to Assess Risk and Resilience in Servicemembers (STARRS) survey conducted between the years 2011 and 2013. The STARRS dataset consisted over 21,000 surveys but for this study the sample size was specific to Hispanic soldiers wi th alcohol abuse (n= 917). The impact of seven independent variables on the dependent variable of treatment seeking was examined in the final statistical model. The seven independent variables examined were pri mary …

Collaborative Practice By Nurse Practitioners And Physicians In Long-Term Care Homes: A Mixed Methods Study, Faith C. Donald

Dissertations

To understand how nurse practitioners (NPs) and physicians (MDs) collaborate with one another to provide resident care in Ontario long-term care homes (LTCHs).

Gaining A Voice: A Study Of The Breastfeeding Experiences Of A Select Group Of Educated, Low-Income, Minority Women Supported By Peer Counselors, Maryanne Phyllis Locklin

Dissertations

This grounded theory study describes the experiences of a small select group of educated, low-income, culturally diverse women who were supported by peer counselors/breastfeeding advocates in their communities as they attempted to breastfeed. The study explores their issues and concerns. In-depth interview data from seventeen women (ten African-American and seven Latina) were analyzed, using constant comparative analysis. Findings from the study indicated that the perception of successful breastfeeding can have an empowering effect on women when support for their endeavors are gender--and culturally--appropriate, The five themes that emerged as primary descriptors of the experience were Making the Discovering, Seeking a …

The Perspectives Of The Woman/Nurse/Executive Working In The Managed Care Environment Of Southern California, Cheryl L. Brandi

Dissertations

The purpose of this study was to explore the perspectives of the woman/nurse/executive working in the managed care environment of Southern California. This research was extremely timely because (a) Southern California leads the nation in managed care market penetration, (b) changes in health care financing have resulted in a prolific expansion of nurse executive responsibilities, and (c) nurse executive experiences regarding increased responsibilities have not been researched. Role expansion impacts both male and female nurse executives, but female nurse executives must confront the dilemma of functioning in administrative domains which have been largely dominated by men. Knowledge about their experiences …

Sex, Drugs, And Religion: A Multi-Ethnic Analysis Of Health Behaviors, Attitudes, And Perceptions Of Childbearing Women, Robin L. Page

Dissertations

Maternal health behaviors such as substance use and sexual promiscuity can put the health of mothers and their offspring at risk. Sociodemographic factors such as low socioeconomic status are also found to correlate with health risks for childbearing women. Hispanic women—especially those less-acculturated—often have sociodemographic risk factors present, but have paradoxically positive pregnancy outcomes. Healthy behaviors in addition to religiosity have been hypothesized to contribute to such positive outcomes. Past studies offer support for the positive influence of religion on healthy behaviors. The purpose of this study was to investigate the patterns and predictors of healthy behaviors and well-being of …

Collective Self-Esteem And Attitudes Toward Collaboration As Predictors To Collaborative Practice Behaviors Used By Registered Nurses And Physicians In Acute Care Hospitals, Karen D. Bankston

Dissertations

Beginning in 2000, the Institute of Medicine clearly established the importance of fostering interdisciplinary collaboration and teamwork with regard to improving patient care quality and safety in acute care hospitals. IOM documents also presented evidence of the positive impact that interdisciplinary collaboration and teamwork can have on other key dimensions of organizational performance. Interdisciplinary collaboration represents a significant issue confronting hospital and nursing executives, deans of colleges of nursing and medicine and practicing nurses and physicians. The aim of this study was to examine the extent to which collective self-esteem and attitudes toward collaboration were predictors to nurse-to-nurse, nurse-to-physician and …

Community Nursing Support For Schizophrenic Clients, Lora Humphrey-Beebe

Dissertations

Decreasing hospital stays necessitate various community supports for persons with schizophrenia. However, there is little research on the effectiveness of community-based nursing interventions for this population. A true experimental, post test only design was used to evaluate the effectiveness of a telephone nursing intervention in increasing community survival, and decreasing the number and length of stay of rehospitalizations for persons with schizophrenia.

Parenting A Lone Twin: When One Twin Dies, Kelly L. Grady

Dissertations

Parents who simultaneously grieve the loss of one twin and nurture the surviving twin experience a paradox of grief and joy. The acute grief of losing a twin coincides with a critical time in the development of the parental role and relationship with the surviving twin. Very few researchers have addressed the unique parenting situation in which one twin infant dies. The aim of this qualitative descriptive study was to describe the experience of parents who lose one twin in utero, at birth, or in the neonatal period. The study question was "What is the parenting experience of mothers and …

Influence Of The Economy On Teen And Adult Birth Patterns In Oklahoma 1980 Through 1995: A Time Series Analysis, Sandra Kay Cesario

Dissertations

Influence of the economy on birth patterns was examined separately for teen and adult women. Competing theories and conceptual frameworks currently exist to describe the cyclic patterns found in reproductive behavior and their relationships to economic condition. Pro-cyclic models suggest a lagged positive association between economic conditions and numbers of births whereas counter-cyclic models indicate that a negative or inverse relationship exists. Three distinct problems were addressed in this study. First, the competing economic models was addressed. Second, this study of daily and weekly births to allow greater sensitivity in testing the relationship of an economic variable number and timing …

Development Of The Woman Abuse Screening Tool, Wendy K. Taylor

Dissertations

Researchers reported that 25%-33% of female trauma victims had injuries caused by battering. More than one million women per year seek medical care for injuries caused by battering. Of those who seek medical care, only one in ten is officially identified as a battered woman. Women are routinely screened for a variety of problems, conditions, or medical disorders, but violence is not included. An important issue related to identifying battered women is the lack of an appropriate comprehensive screening tool. The purpose of this study was threefold: (a) determine whether using a comprehensive abuse screening tool results in an increased …

A Silent Epidemic With No Voice: Alzheimer's Education In An African American Midwest Community, Sandra D. Fields

Dissertations

Alzheimer’s disease is a growing crisis in this country, particularly in the African American community. Despite this awareness by the health care community and educational programs offered about the disease, a deficit in research assessing the impact of these programs exists. Consequently, the purpose of this study is to analyze the key criterion relative to the educational programs about Alzheimer’s offered by local organizations and the impact they have on a Midwest African American community.

According to research regarding Alzheimer’s disease, African Americans continue to go undiagnosed and untreated. The literature review in this study explores the synergy of three …

Minority Students In Stem Careers In The U.S. – The Role Of Ap Calculus, Kendall Coleman

Dissertations

“The number of native-born S&E [science and engineering] graduates entering the workforce is likely to decline unless the nation intervenes to improve success in educating S&E students from all demographic groups, especially those that have been underrepresented in S&E careers” (National Science Board [NSB], 2003, p. 13). More than a decade ago, the National Science Board (NSB) sounded an alarm regarding the projected decline in native-born science and engineering graduates with the aim of driving strategic fundamental changes. There is limited evidence that the NSB’s prognostication is actively being addressed. Approximately 81% percent of all full-time graduate students in U.S. …

Using The Revised Wilson And Cleary Model To Explore Factors Affecting Quality Of Life In Persons On Hemodialysis, Daria L. Kring

Dissertations

The purpose of this study was to describe the quality of life in persons with end stage renal disease and examine factors that may affect quality of life. A revised version of Wilson and Cleary's model for health-related quality of life was used to guide the study. Biological factors (serum albumin and serum hemoglobin), symptoms (dialysis symptoms, anxiety, depression, and fatigue), functional status, general health perception, characteristics of the individual (age, gender, race/ethnicity), and characteristics of the environment (time on dialysis, marital status, and socioeconomic status) were examined to determine their potential impact on overall quality of life. A cross-sectional, …