Medicine and Health Sciences Commons^™

Clinician Perspectives On Fistula Mental Health, Victoria K. Leonard

Doctoral Dissertations

Background – Obstetric fistula is a childbirth injury caused by prolonged labor that leads to stillbirth and incontinence, spurring social exclusion and isolation. These layers of trauma put women with fistula at great risk for psychological suffering, which has profound negative socioeconomic impacts on them, their families, and communities. This study captured treatment as usual at Comprehensive Community Based Rehabilitation in Tanzania (CCBRT), the country’s largest provider of fistula care.

Method – Improving holistic fistula treatment requires engaging the clinicians who care for women with fistula. This study aimed to investigate the training, beliefs, and treatment approaches of nurses and …

Faith Influences On Health Of Rural Appalachian Older Adults In East Tennessee: An Ethnonursing Study, Karina Elizabeth Strange

Doctoral Dissertations

As the U.S. older adult population increases and diversifies, healthcare providers need innovative, cost-effective, and culturally congruent approaches to gerontological nursing care. Decades of multidisciplinary evidence demonstrate that spirituality enhances older adult holistic health. However, although research about spirituality and nursing has become more culturally diverse, little is known about spirituality-health linkages of rural Appalachian older adults (RAOAs). This knowledge gap is significant because Appalachia leads the country in mortality related to chronic comorbidities such as heart disease, cancer, and depression. Given age, poverty, limited transportation, and health provider shortage areas, RAOAs experience severe health disparities. Moreover, spirituality is an …

Efficacy Of Integrated Mental Health Care With Dual Diagnosis Patients And Their Utilization Of Psychiatric Emergency Services, Denton Scott

Doctoral Dissertations

Historically, patients with dual diagnosis have been subjected to ineffective treatment and negative attitudes from healthcare providers. Further, these patients are plagued with myriad afflictions that exist beyond substance abuse and mental illness. The treatments and collateral damage associated with the diagnosis impose excessive healthcare costs and can be of significant detriment to society. Largely, patients suffering from dual diagnosis do not receive adequate treatment. As such, psychiatric emergency services are frequently utilized as an alternate treatment, wherein the main focus of care is on the substance abuse alone. This study argues that solely treating the substance abuse is not …

Evaluating The Effectiveness Of Peer Engagement And Knowledge (Peak): A Community-Based Group Intervention For Youth In Hawai‘I, Jennifer T. T. Ho

Doctoral Dissertations

This study is a program evaluation with a mixed methods design that evaluated the effectiveness of Peer Engagement and Knowledge (PEAK), a six-week community-based group intervention that incorporates mindfulness-based interventions (MBIs) to address multiple health behaviors for multiracial youth in Hilo, Hawai‘i. A total of 51 youth, ages 12-23 years old, participated in this study which included pre-/posttest analyses of health risk factors such as substance use and depression and health promoting factors such as resilience, self-esteem, and mindfulness. Responses from two subsets of participants, who engaged in a focus group (n = 11) and composed gratitude letters ( …

The Impact Of Perceived And Observed Food Environments On Fruit And Vegetable Consumption And Obesity: A Theory-Based Study Among U.S. Older Adults, Qianzhi Jiang

Doctoral Dissertations

The overall diet quality of U.S. older adults is less than optimal, featured by inadequate fruits and vegetables (FV), whole grains and dairy, and excessive sodium and fat. The current food environment can be challenging for older adults to improve their FV consumption. Both perceived and observed food environments are linked to FV consumption and health outcomes such as Body Mass Index (BMI) with mixed results. My research was guided by a social-ecological framework and the theory of planned behavior (TPB) to identify environmental supports for FV consumption in older adults. Adults aged 60 and older in Massachusetts, Iowa, and …

A Program Evaluation Of A Drug And Alcohol Family Treatment Program, Katrina Ramirez

Doctoral Dissertations

The current study is a program evaluation at John Muir Behavioral Health, Center for Recovery. The research determined the effectiveness of the program at Center for Recovery that is offered to patients that struggle with substance use disorder and their families. The purpose of this study is to assess patients’ behavioral, cognitive and social/environmental factors as it relates to their commitment to sobriety and examine how the involvement of family members influences the patient’s recovery process. I utilized a mixed methodology of quantitative and qualitative interviews of patients and family members. The findings suggest depressive symptoms were negatively correlated with …

Communication, Control, And Time: The Lived Experience Of Uncertainty In Adolescent Pregnancy, Elizabeth Dortch Dalton

Doctoral Dissertations

This study qualitatively examined the lived experience of uncertainty among pregnant adolescents. Utilizing a phenomenological approach, long interviews were conducted with 10 pregnant adolescent women between the ages of 15-18 years. Interviews were transcribed and analyzed using the process of phenomenological explication. Data, emergent themes, memos, and a detailed audit trail were maintained using the qualitative data analysis package Nvivo 10 for Mac (beta version). Findings can be summarized with eight themes that underlie the essence of uncertainty in adolescent pregnancy: suspicion and denial, disclosure and reactions, controlling the flow of information, relational renegotiation, the emerging reality of pregnancy, information …

Evidence Based Practice Implementation: Perceptions And Expectations Of Master Of Social Work Students, Mholi Kent Vimba

Doctoral Dissertations

Abstract

Efforts to develop sustainable Evidence-Based Practice (EBP) implementation strategies in work settings have been generally unsuccessful. Scholars have focused on perceptions of workers already in work settings to identify implementation barriers and facilitators. None have focused on perceptions of social workers in training. This nationwide non-probability correlational study assessed Master of Social Work (MSW) students’ perceptions of EBP using a self-administered online survey. A total of 212 (57%) completed this survey with 164 (43%) timed out.

Perceptions were assessed using three sets of questions corresponding to the independent variables: EBP knowledge, attitude toward EBP and EBP self-efficacy. A …