Medicine and Health Sciences Commons^™

A Phenomenological Exploration Of Children's Experiences During The Therapeutic Process, Katherine Destefano

Walden Dissertations and Doctoral Studies

Billions of mental health care dollars for millions of children and adolescents in need has garnered significant attention within the behavioral health industry to reduce costs while improving treatment efficacy through the identification and implementation of evidence based practices with youth populations requiring therapeutic services. This hermeneutic phenomenological qualitative research approach in the field of psychology is a consumer driven one in the world of business. Line by line context and discourse analyses, which included both a prior and inductive coding, of the verbiage and phraseology of 10 boys and 10 girls, aged 8-12, actively engaged in outpatient psychotherapy, formed …

16pf® Traits As Predictors Of Emergency Medical Service Worker Tenure, Beverly J. Paschal

Walden Dissertations and Doctoral Studies

The United States is experiencing a severe shortage of Emergency Medical Service (EMS) paramedics. The job outlook for paramedics (EMT-P) for the years 2012-2022 is predicted to increase by 23%-33%, which is much faster than the 4% average increase of other first-response professions. The average tenure of paramedics is less than 4 years. There is a significant gap in the literature concerning paramedic personality traits and tenure. The primary objective of the current study is to provide empirical data on the personality traits possessed by long-term paramedics (5+ years), and compare them to those with shorter tenure (< 5 years). Using Allport's Trait Theory, I predicted that personality would affect paramedic longevity. The 6 personality traits tested were warmth, reasoning, emotional stability, liveliness, social boldness and openness to change. A socio-demographic questionnaire, determined the length of their EMS career, while the 16PF® Assessment, tested their personality traits. Using t tests, Mann-Whitney U tests, and a set of regression analyses, data were examined to determine if length of career and personality traits predicted paramedic tenure. The research sample consisted of long term paramedics and former paramedics. The results showed that of the 6 personality traits, only warmth was a significant predictor of paramedic tenure. A logistic regression showed for every additional point in warmth, the odds of leaving EMS prior to 5 years increased by a factor of 2.77. This study provides support for positive social change by helping EMS to learn how to increase recruitment and tenure. It also helps by advising EMS agencies to attend to the mental and emotional health of their paramedics by being aware of the level of their warmth personality trait.

Perceptions And Attitudes Of A Sample Of Primary Care Patients Receiving Psychological Care From Their Pcp, Nadine Henzes Gowarty

PCOM Psychology Dissertations

With millions of Americans suffering from a mental health disorder and slightly more than half receiving treatment, the demand for psychological services far outweighs the number of practitioners available to provide direct care. Therefore, the majority of all primary-care visits are based on psychosocial factors; one third of a PCP’s caseloads consist of patients with mental-health problems. Given the fact that PCPs provide comprehensive psychosocial care, it is important to determine the beliefs and perceptions of their patients. Results from this study identified numerous factors that influence the relationship between patients receiving mental health care from their PCP. Specifically, if …

Determinants Of An Individual's Suicide Intention In South Korea, Nam Keun Choi

MPA/MPP/MPFM Capstone Projects

This study has examined a variety of variables that influence an individual’ s suicide intention, and analyzed the impact of these variables. The data are from the 2014 wave of the Korea Welfare Panel Survey (KoWePS). I analyze data on 13,687 out of 17,134 survey participants.

The dependent variable of my study is suicide intention such as suicidal thoughts and behaviors. The independent variables are classified into three categories: socio-demographic, psychological and mental health. Socio-demographic variables are gender, age, education, marital status, and income. Psychological variables are self-esteem, satisfaction with life, and religion. Mental health variables are depression, alcohol use, …

Reducing Depression Among Older Adults: Informal Helping Versus Volunteering, Salih Salihoglu

MPA/MPP/MPFM Capstone Projects

Volunteerism is an unpaid productive activity that is exercised within a formal organization to benefit others that are not part of family or friends (Musick & Wilson, 2008). Alternatively, individuals could engage in informal helping which would be an activity undertaken outside a formal, structured organization. This paper addresses whether informal helping is also effective in reducing depression for older adults alongside volunteering. I hypothesize that informal helping is effective in reducing depression only when exercised for short durations. On the other hand, I hypothesize that volunteerism is only effective when exercised for long periods of time. I try to …

The Impact Of African-Centered Psychotherapy On Depressive Symptoms And Africentric Worldview In African Americans, Larae Tillis

Walden Dissertations and Doctoral Studies

Depression is a prominent issue in the African American community. However, there are significant gaps in the literature on the delivery and outcomes of culturally relevant mental health psychotherapy to African Americans. Cultural variables, such as worldview, have been noted to impact an individual's overall psychosocial functioning and have significant implications for mental health service delivery. The purpose of this study was to use archival data to analyze the impact of African-centered therapeutic services on depressive symptoms and on Africentric worldview among African Americans. Archival data on 38 African American adults, recorded from 2012-2015, were obtained from a community mental …

The Relationship Between Emotion Regulation, Social Support, And Alcohol-Related Problems Among Racially Diverse Adolescents., Briana A. Woods-Jaeger, Richard H. Nobles, Linnea Warren, Mary E. Larimer

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Relationship Among Motivation, Emotion Regulation, And Psychological Well-Being Of Sophomore And Senior Level Baccalaureate Nursing Students, Aryene C. Delgado, Douglas Garner, Nicole Langhals

Williams Honors College, Honors Research Projects

Nursing education and professional work involve stressful circumstances that may indirectly lead to attrition, which can further contribute to the projected nursing shortage. This study examines the relationships between motivation, emotional regulation, psychological well-being and academic performance in baccalaureate sophomore and senior level nursing students at a Midwest urban university in the United States. The non-experimental, correlational study is guided by the self-determination theory (Deci & Ryan, 2000) and uses online survey data collection and convenience sampling. Motivation, emotional regulation, psychological well-being (burnout; inauthenticity), and academic performance (GPA) are measured respectively with Deci and Ryan’s scale, the Emotion Regulation Questionnaire, …

A Systematic Review: Effects Of Psychosocial Interventions On Outcomes In Refugee Adolescents Resettled In The Us, Canada, And The Uk, Lauren Herr, Halle Kurtz

Williams Honors College, Honors Research Projects

Abstract

Problem: The number of refugee and displaced people in the United States (US) increases annually. Because of trauma in countries of origin, they may have mental health problems and disrupted adjustments during resettlement, resulting in problems with refugee adolescents and their quality of life, self-esteem, self-efficacy, and overall well-being.

Purpose: To describe and appraise evidence about the effects of psychosocial interventions in refugee adolescents resettled in the US.

Methods: Studies from US, Canada, and the United Kingdom (UK) were identified in four databases. Inclusion criteria included: primary studies, children and/or adolescents, psychosocial health interventions, and refugees.

Review of …

Hot And Cold Executive Functions In Pure Opioid Users Undergoing Methadone Maintenance Treatment: Effects Of Methadone Dose, Treatment Duration, And Time Between Last Methadone Administration And Testing, Usha Barahmand, E. Tavakolian, A. Khazaee, K. Mohammadi

Publications and Research

Context: Methadone maintenance is a standard treatment for opiate‑dependent individuals. However, deficits in cognitive functioning have been associated with this treatment.

Aim: This study aimed to determine the dose and treatment duration‑related effects of methadone on executive functions.

Setting and Design: Pure male opioid users with no considerable history of other drug abuse, undergoing methadone maintenance treatment (MMT) were recruited from a major government‑run de‑addiction center.

Methods: Hot executive functions including decision‑making and emotion recognition were assessed using the Iowa gambling task and Ekman faces test, whereas cold executive functions including working memory (WM), cognitive flexibility, and response inhibition were …

Heath And The Homeless Population Of Missoula: “Housing First” As A Solution, Marissa S. Ginnett

Undergraduate Theses, Professional Papers, and Capstone Artifacts

Missoula, Montana has an extremely high rate of homelessness at .75% of the population (compared to other large cities, Seattle, Washington at .23% and Los Angeles, California at .32%). This is due to there not being much done to help chronically inebriated homeless individuals. All are turned away from Missoula's overnight shelters if they are not sober. For an inebriated homeless person, the jail and the hospital are the only two places where they can stay the night. Through comparison to other cities, such as Seattle, Washington, I have identified that Missoula needs a wet housing program. Wet housing provides …

Missoula’S Homeless Children: Effects Of Homelessness On Mental, Emotional And Social Health, Sarah L. Shapiro

Undergraduate Theses, Professional Papers, and Capstone Artifacts

Missoula’s Homeless Children: Effects of Homelessness on Mental, Emotional and Social Health

The mental, emotional, and social health of children are greatly affected by being homeless. Being homeless as a child could effect a person’s coping skills and lead to mental health issues that increase the likelihood of substance abuse , suicide attempts, or adult homelessness. The purpose of this research project is to explore the negative effects of homelessness on Missoula children, and to identify services that could be useful in combating those effects. Methods for this project, included two data collection strategies. First, a literature review was completed …

Brief Gatekeeper Training For Suicide Prevention In An Ethnic Minority Population: A Controlled Intervention, Alan R. Teo, Sarah B. Andrea, Rae Sakakibara, Satoko Motohara, Monica M. Matthieu, Michael D. Fetters

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Suicide is a critical public health problem around the globe. Asian populations are characterized by elevated suicide rates and a tendency to seek social support from family and friends over mental health professionals. Gatekeeper training programs have been developed to train frontline individuals in behaviors that assist at-risk individuals in obtaining mental health treatment. The purpose of this study is to assess the efficacy of a brief, multi-component gatekeeper intervention in promoting suicide prevention in a high-risk Asian community in the United States.

Methods: We adapted an evidence-based gatekeeper training into a two-hour, multi-modal and interactive event for Japanese-Americans …

Pain And Psychiatric Comorbidities Among Two Groups Of Iraq- And Afghanistan-Era Veterans, Kristin M. Phillips, Michael E. Clark, Ronald J. Gironda, Suzanne Mcgarity, Ronald W. Kerns, Christine A. Elnitsky, Elena M. Andresen, Rose C. Collins

OHSU-PSU School of Public Health Faculty Publications and Presentations

This study aimed to (1) identify the prevalence and severity of pain and psychiatric comorbidities among personnel who had been deployed during Operation Iraqi Freedom (OIF), Operation Enduring Freedom (OEF), and Operation New Dawn (OND) and (2) assess whether the Department of Veterans Affairs (VA) Polytrauma System of Care and an OIF/OEF/OND registry reflect real differences among patients. Participants (N = 359) were recruited from two VA hospitals. They completed a clinical interview, structured diagnostic interview, and self-report measures. Results indicated pain was the most common complaint, with 87% experiencing pain during the prior week and 56% reporting moderate or …

Short Message Service (Sms) Reminders And Real-Time Adherence Monitoring Improve Antiretroviral Therapy Adherence In Rural Uganda, Jessica E. Haberer, Angella Musimenta, Esther Atukunda, Nicholas Musinguzi, Monique A. Wyatt, Norma C. Ware, David Bangsberg

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objective: To explore the effects of four types of short message service (SMS) plus realtime adherence monitoring on antiretroviral therapy (ART) adherence: daily reminders, weekly reminders, reminders triggered after a late or missed dose (delivered to patients), and notifications triggered by sustained adherence lapses (delivered to patient-nominated social supporters).

Design: Pilot randomized controlled trial.

Methods: Sixty-three individuals initiating ART received a real-time adherence monitor and were randomized (1 : 1 : 1): (1) Scheduled SMS reminders (daily for 1 month, weekly for 2 months), then SMS reminders triggered by a late or missed dose (no monitoring signal within 2 h …

The Aftermath Of Violence: The Lived Experience Phenomena Of Assault In Nursing, Kathleen Clark

Walden Dissertations and Doctoral Studies

Despite the high incidence of violence directed at registered nurses while on duty, there is limited qualitative data that explores the lived experience of returning to the workplace after an assaultive incident. This phenomenological study sought to explore and analyze the phenomena of registered nurses who are employed in high-risk settings. The research questions considered the detailed descriptions of the experiences of nurses returning to the workplace. The conceptual framework was resiliency, as these participants continued to survive and thrive after the adverse assaultive events. Data were collected using in-depth interviews from purposeful sampling. Registered nurses working in the high …

African American Clergy's Attitude Toward Professional Mental Health Services, Ebony Gaffney

Walden Dissertations and Doctoral Studies

Evaluating the attitude of African American clergy toward parishioners seeking professional mental health services for mental illness has important treatment implications. Religion and spirituality are equally important determinants of mental health and can affect African American clergy's attitudes toward professional care for mental illness. Utilizing the health belief model (HBM), this quantitative study examined the role of theological beliefs, education, and personal experience with mental illness as they correlated with clergy's attitudes toward seeking professional mental illness services. Approximately 98 African American Protestant Clergy in the states of Georgia and South Carolina participated in this study. Data were collected using …

Impact Of Distance, Diagnosis, And Demographics On Attendance For Rural Outpatient Treatment, Trey Howard Jensen

Walden Dissertations and Doctoral Studies

Missed psychotherapy appointments inhibit mental health treatment, limit the availability of treatment to those waiting for care, and reduce clinician revenue. Previous research has revealed that the factors that predict missed appointments vary depending on the geographic location in which that research is conducted. There is not a complete understanding of the characteristics of people who miss appointments in a rural context. This study used information from 281 client records to examine the predictive relationships among missed appointments and the distance traveled to the clinic, mental health diagnosis, age, and gender at a rural outpatient mental health clinic. The purpose …

Clergy Characteristics As Predictors Of Mental Health Literacy, Jodi Vermaas Vermaas

Walden Dissertations and Doctoral Studies

The mental health literacy (MHL) rates of Christian clergy in the United States remains underinvestigated in the current literature. This gap of knowledge is problematic for the large numbers of individuals with mental illness who seek assistance from clergy and may receive inadequate care for their concerns. As theoretically designated by the behavioral models of health care and MHL research, denomination-type, educational variables, and demographic characteristics were investigated as potential predictors of MHL. A sample of 238 Christian clergy from throughout the United States completed the web-based Mental Health Literacy Scale and demographic questionnaire. Results of analysis of variance (ANOVA) …

Chronic Pain Causal Attributions In An Interdisciplinary Primary Care Clinic: Patient-Provider And Provider-Provider Discrepancies, Bryan Jensen

Theses and Dissertations

The purpose of the present study was to investigate the influence of pain causal attributions on patient pain-related functioning, treatment engagement, and clinical outcomes. Additionally, the impact of discordant pain causal attributions between patients and their providers as well as between interdisciplinary providers was examined. Patients rated their pain functioning and causal pain attributions during a regular clinic visit. Following the patient’s visit both the behavioral medicine provider and internal medicine resident provided ratings of similar pain-related functioning domains and causal attributions. Follow-up data were collected from the electronic medical record three months following that clinic visit. Overall, results revealed …

Development And Evaluation Of A Peer-To-Peer Intervention To Increase Self-Management Among Adult In-Center Hemodialysis Patients, Jennifer J. St Clair Russell

Theses and Dissertations

Background: Peer-to-peer (P2P) support programs have the potential to assist ESRD patients in managing their disease and improve outcomes. Yet, there is little research examining P2P programs’ impact on psychosocial outcomes and disease management behaviors.

Methods: A 4-month P2P mentoring intervention was designed and piloted in a facility serving 249 in-center hemodialysis patients in Lynchburg, Virginia. Preceded by a social marketing effort, which included a program naming contest and participant recruitment, the intervention included: (1) mentor training, (2) pairing of mentees and mentors, (3) kick-off social mixers, (4) ongoing meetings between mentees and mentors, (5) mentor training booster, and (6) …

Distributed Cognition In Cancer Treatment Decision Making: An Application Of The Decide Decision-Making Styles Typology, Janice L. Krieger, Jessica L. Krok-Schoen, Phokeng M. Dailey, Angela L. Palmer-Wackerly, Nancy Schoenberg, Electra D. Paskett, Mark Dignan

Department of Communication Studies: Faculty Publications

Distributed cognition occurs when cognitive and affective schemas are shared between two or more people during interpersonal discussion. Although extant research focuses on distributed cognition in decision making between health care providers and patients, studies show that caregivers are also highly influential in the treatment decisions of patients. However, there are little empirical data describing how and when families exert influence. The current article addresses this gap by examining decisional support in the context of cancer randomized clinical trial (RCT) decision making. Data are drawn from in-depth interviews with rural, Appalachian cancer patients (N = 46). Analysis of transcript …

Test–Retest, Retest, And Retest: Growth Curve Models Of Repeat Testing With Immediate Post-Concussion Assessment And Cognitive Testing (Impact), Arthur C. Maerlender, Caitlin J. Masterson, Tiffany D. James, Jonathan Beckwith, Per Gunner Brolinson, Joe Crisco, Stefan Duma, Laura A. Flashman, Rick Greenwald, Steven Rowson, Beth Wilcox, Tom W. Mcallister

Department of Psychology: Faculty Publications

Computerized neuropsychological testing has become an important tool in the identification and management of sports-related concussions; however, the psychometric effect of repeat testing has not been studied extensively beyond test–retest statistics. The current study analyzed data from Division I collegiate athletes who completed Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) baseline assessments at four sequential time points that varied over the course of their athletic careers. Administrations were part of a larger National Institutes of Health (NIH) study. Growth curve modeling showed that the two memory composite scores increased significantly with successive administrations: Change in Verbal Memory was best represented …

Creating A Community Of Practice To Prevent Suicide Through Multiple Channels: Describing The Theoretical Foundations And Structured Learning Of Pc Cares, Lisa Wexler, Diane Mceachern, Gloria Difulvio, Cristine Smith, Louis F. Graham, Kirk Dombrowski

Department of Sociology: Faculty Publications

It is critical to develop practical, effective, ecological, and decolonizing approaches to indigenous suicide prevention and health promotion for the North American communities. The youth suicide rates in predominantly indigenous small, rural, and remote Northern communities are unacceptably high. This health disparity, however, is fairly recent, occurring over the last 50 to 100 years as communities experienced forced social, economic, and political change and intergenerational trauma. These conditions increase suicide risk and can reduce people’s access to shared protective factors and processes. In this context, it is imperative that suicide prevention includes—at its heart— decolonization, while also utilizing the “best …

Reasons For Tubal Sterilisation, Regret And Depressive Symptoms, Karina M. Shreffler, Arthur L. Greil, Julia Mcquillan, Kami L. Gallus

Department of Sociology: Faculty Publications

Objective—To examine the associations between sterilisation reasons, regret, and depressive symptoms.

Study Design—Black, Hispanic, and non-Hispanic White US women ages 25–45 who participated in the National Survey of Fertility Barriers (NSFB) and reported a tubal sterilisation surgery were included in the sample for this study (n=837). Logistic regression was used to examine how characteristics of the sterilisation surgery (reasons for sterilisation, time since sterilisation, and new relationship since sterilisation) are associated with the odds of sterilisation regret, and linear regression was used to examine associations between sterilisation regret, sociodemographic factors, and depressive symptoms.

Results—Findings revealed that 28 …

Supervisory Working Alliance And Job Satisfaction In Community Mental Health Settings, Jennifer Weigelt

Walden Dissertations and Doctoral Studies

Researchers have written extensively on many facets of supervision in the counseling profession, including the supervisee benefits associated with a strong supervisory working alliance. While the majority of studies have focused on the working alliance in academic settings with student trainees, there has been a lack of research exploring the role of the supervisory working alliance in workplace settings, where supervision can be different from supervision offered in a university clinic or counseling center. Employee job dissatisfaction has been a problem identified within the mental health workforce. Researchers have identified effective supervision as a mediating factor. The purpose of this …

Equine Facilitated Psychotherapy For Veteran Survivors With Full Or Partial Ptsd, Mark Aaron Mayfield

Walden Dissertations and Doctoral Studies

Symptom severity among veteran survivors with partial or full posttraumatic stress disorder (PTSD) continues to increase, with approximately 40% of U.S. veterans reporting significant symptomology 10 years after initial onset of the condition. Veteran survivors often struggle to find therapeutic interventions that meet their specific needs and have a difficult time maintaining a therapy that is both equitable and evidenced based. Grounded in the Rogerian, client-centered theory, the purpose of this qualitative collective exploratory case study was to explore the effects of equine-facilitated psychotherapy with 3 veteran survivors with partial or full PTSD. A 4-stage process was used to collect …

Barriers To Colorectal Cancer Screening In People Obtaining Care From Community Mental Health Agencies, Kelly L. Gardiner

Walden Dissertations and Doctoral Studies

Barriers to Colorectal Cancer Screening in People Obtaining Care

From Community Mental Health Agencies

by

Kelly Gardiner

MSN, Wayne State University, 1997

BSN, Wayne State University, 1988

Dissertation Submitted in Fulfillment

of the Requirements for the Degree of

Doctor of Philosophy

Public Health

Walden University

August 2016

Despite being highly treatable with early intervention and preventative screenings, the overall mortality rate of colorectal cancer is substantially higher in participants with a preexisting mental disorder. Variables affecting the likelihood of completing screening for those with mental illnesses were unknown in people who obtain services from a Community Mental Health agency. Using …

A Curriculum On Culturally Competent Practices To Prevent Retraumatization In Diverse Survivors, Luana Rodriguez

Walden Dissertations and Doctoral Studies

This DNP project addresses the healthcare issue of intimate partner, domestic, and sexual violence (IPDSV), its impact on survivors, and reducing the potential for retraumatization by those who care for them in the clinical, behavioral, and social settings. Trauma-informed care interventions are designed to address the sequelae of trauma, promote recovery, and support resilience. Since IPDSV is a global health issue, supporting cultural needs of all clients is an essential aspect of trauma-informed care. This project was guided by a central research question that examined if trauma-informed, culturally competent curriculum be viewed by community stakeholders as an appropriate intervention for …

Measuring Self-Reported Exercise, Motivation To Exercise, And Sexism In Women, Sydney C. Jensen

All Master's Theses

The harmfulness and pervasiveness of benevolent sexism is not a well disseminated issue, despite the belief that women are treated with equality in today’s society. The current study was designed to investigate whether exercise type and motivation to exercise would predict participants’ self-reported benevolent and hostile sexism, particularly in light of gender-related stereotypes about physical activity. A sample of 79 females completed an online survey that included questions about demographic characteristics, primary exercise type (i.e., cardiovascular exercise, weight-lifting, or hobbies), average number hours spent engaging in their primary exercise weekly, exercise motivations, and finally the Ambivalent Sexism Inventory which served …