Medicine and Health Sciences Commons^™

Teen Dating Violence: Co-Occurrence With Bullying Among African American Teens In South Florida, Rosemarie Hemmings

Walden Dissertations and Doctoral Studies

Teen dating violence and bullying are major public health concerns but are preventable. Both dating violence and bullying occur within similar social context and the prevalence of teen dating violence was highest for African American teens as reported on the 2011 Youth Risk Behavior Survey (YRBS). Social learning theory provides a foundation for understanding and changing behavior related to dating violence victimization and bully victimization. The research questions focused on relationships between bully and teen dating violence victimization when controlling for race/ethnicity, gender, substance abuse, age, and age of first sexual intercourse. Additionally, the potential mediating variable of spending time …

Hiv-Positive Status Disclosure Barriers In Stable Heterosexual Partners In Warri, Nigeria., Edith Nkechinyere Ogbozor

Walden Dissertations and Doctoral Studies

Nondisclosure of positive status drives the secondary transmission of human immunodeficiency virus (HIV) infection. This cross sectional quantitative survey study grounded by the consequence theory evaluates fear of stigma, lack of social support, and level of HIV-related knowledge as barriers to self-disclosure of HIV-positive status to stable heterosexual partners. A sample of 303 HIV-infected respondents (111 men and 192 women) accessing antiretroviral therapy at 4 designated centers in Warri, Nigeria, completed the self-administered questionnaires. Logistic regression analysis was used to assess the association between these factors and spousal HIV-positive status disclosure. Results demonstrated: (a) social support availability significantly predicted HIV …

Evidence-Based Alternative Therapy To Reduce Anxiety In Ambulatory Mental Health Patients, Renee Ann Denobrega

Walden Dissertations and Doctoral Studies

Evidence-Based Alternative Therapy to Reduce Anxiety in Ambulatory Mental Health Patients

by

Renee Denobrega

MS, Widener University, 2013

BS, Alvernia University, 2007

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

January 2016

The Relationship Between Physical Fitness And School Performance In Middle School Girls, Jamie Anne Donnelly

Walden Dissertations and Doctoral Studies

Past research has indicated a significant relationship between physical fitness and standardized test scores; however, the relationship between physical fitness and other aspects of school performance has yet to be empirically examined in a population specifically composed of middle school girls. This study examined several factors that contribute to school success, such as classroom behavior, attendance, and grades, in relation to physical fitness among a group of adolescent girls. It was specifically designed to examine the statistical relationship between physical fitness, as measured by the Fitnessgram, and quantitative data on school performance including grades, standardized test scores, school behavior, and …

Healthy Weight Maintenance: Narrative Analysis Of Weight Cycling In The Formerly Obese, Cheri Renee Lewis

Walden Dissertations and Doctoral Studies

Medical and economic costs for obesity are estimated at $147 billion per year, yet less than 1/3 of overweight individuals successfully maintain weight loss. The literature is replete with descriptions of the problem and research on treatments, yet demonstrations of effective loss and maintenance are lacking. Missing is an understanding of the experiences of individuals who successfully maintained healthy weight loss, which could provide insights regarding effective psycho-social interventions. The purpose of this qualitative narrative study was to explore key events and experiences in the lives of former weight cyclers. The primary phenomena of interest included weight cycling and sustained …

The Experience Of Being Unsheltered In Atlanta, Ikeranda Smith

Walden Dissertations and Doctoral Studies

In the United States, it is estimated that millions of adults are homeless. Some individuals choose not to use homeless shelters or are ineligible for their use. Researchers have indicated that many unsheltered homeless are men over the age of 45 years. The purpose of this phenomenological study was to examine the experiences with social services providers among unsheltered men. Understanding the social networks of unsheltered homeless and the use of spirituality or faith as a resource for coping was also examined, as a significant gap exists in the research on unsheltered homeless. Face-to-face, in-depth interviews were conducted with 8 …

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 …

The Role Of Illness Intrusiveness And Personal Control In Mediating The Relationship Between The Intravenous Immunoglobulin Treatment Experience And Quality Of Life In Neurological Autoimmune Patients, Pamela Jane Gennari

Walden Dissertations and Doctoral Studies

Intravenous immunoglobulin (IVIG) is a common treatment for the neurological autoimmune diseases multiple sclerosis, multifocal motor neuropathy, myasthenia gravis, and chronic inflammatory demyelinating polyneuropathy. However, there is scant literature regarding the psychological effects of this treatment on quality of life (QOL). Using illness intrusiveness theory and personal control theory, this correlational, cross-sectional study examined the relationship between the IVIG treatment experience and QOL in neurological autoimmune patients. Surveys were employed to collect data from 79 patients at a neurological infusion center in Phoenix, AZ. Quantitative analyses included correlation, multiple regression, and mediation analyses to determine whether (a) IVIG treatment experience …

High School Teachers' Perceptions Of Mental Health And Adolescent Depression, Christine Ann Breuer

Walden Dissertations and Doctoral Studies

Adolescents have a high rate of untreated mental health issues, specifically related to depression. Current literature does not indicate the impact of teachers' attitudes toward mental health on their decisions to refer students for services. This study provides understanding specifically, how teachers' beliefs about mental health, as well as their age, gender, ethnicity, years of education, and years of teaching, were analyzed to determine the impact each these characteristics had on the decision to refer a student for services. 92 high school teachers participated in this quantitative study by completing a survey measuring their attitudes of mental health, and then …

Diminishing Stigma Sentiments In Individuals With Depression: Sociopsychological Predictors Of Deflecting And Challenging Coping Orientations, Jennifer Marie Lee

Walden Dissertations and Doctoral Studies

Individuals who suffer from depression can be stigmatized by labeling and resort to negative stigma coping orientations such as secrecy and withdrawal, resulting in internalized self-stigma. Self-stigma can have negative effects such as low self-esteem, low self-efficacy, isolation, and feeling like a failure. Guided by modified labeling theory, the purpose of this study was to fill a gap in the literature on predictors of two orientations (challenging and deflecting) of positive stigma coping. Challenging stigma involves taking action, and deflecting is a cognitive strategy; both are used to positively cope with the stigma of mental illness. Predictors included symptom severity, …

Evaluating The Implications Of Parental Mental Illness For Children Using An Ecological Perspective, Jessica Elizabeth-Rose Carroll

Walden Dissertations and Doctoral Studies

Researchers have extensively studied the experiences and potential consequences of being a child whose parent has a mental illness (COPMI). However, there is no consensus on the best way to support these children, in general or in schools. The purpose of this quantitative study was to examine the effects of parental mental illness on children by using an ecological approach. Researchers have used ecological theory to illustrate the importance of internal characteristics, skills, and supports for children to enhance resiliency. This study looked at whether COPMI differed significantly from the children of parents of parents with no current or past …

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 …

Young Adults Adherence To Cancer Treatment As Compared To Older Adults, Laurie Ann Cox

Walden Dissertations and Doctoral Studies

As compared to pediatric and older adult cancer patients, young adults are the only oncology group that has not demonstrated an increase in survival rates. Low treatment adherence rates have been one explanation for this discrepancy, although this hypothesis has not been explored specifically. Guided by the biopsychosocial model of health and wellness, this study compared the treatment adherence rates of 46 young adult cancer patients (ages 18-39 years) to 46 older adult cancer patients (ages 40 years and older). Adherence was measured by a dichotomized variable, as yes/no, adhering to radiation treatment and follow-up appointments recommended by the physician, …

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 …

Public Health Leaders' Perceptions Of And Attitudes Concerning Eating Disorders, Karin L. Lightfoot

Walden Dissertations and Doctoral Studies

Eating disorders are associated with high mortality rates. Most eating disorder prevention research is conducted within the fields of psychology and psychiatry, not in public health. This gap in public health research can lead to insufficient attention to the root causes of eating disorders and minimal upstream prevention efforts. The purpose of this phenomenological study was to identify public health leaders' perceptions of and attitudes concerning eating disorders as a public health issue. Objectification theory was used to describe how societal expectations have created an environment in which people's self-worth is based on their outward physical appearance. Ecological theory was …

Outcomes Of Aggression Replacement Training For U.S. Adolescents In Residential Facilities, Coral Ann Ondrus

Walden Dissertations and Doctoral Studies

A National Survey indicated that 1.6 million adolescents in the U.S. were arrested in 2010 and 1.5 million in 2011 for erratic aggressive behaviors, thus showing a decline from the 2.18 million adolescent arrests in 2007. Residential facilities in the state of Pennsylvania offer a group intervention called Aggression Replacement Training (ART) to help adjudicated adolescents regain control of erratic behaviors. The purpose of this study was to examine the extent to which level of group participation in ART and certain demographic factors (age, gender, ethnicity, family socioeconomic status, parental involvement, and education) predict decreased aggression and increased anger control …

Utilization And Intensity Of Integrated Behavioral Health Services Within A Primary Care Setting, Joseph Aron Shafer

Walden Dissertations and Doctoral Studies

Integrated behavioral health care within primary care has become a popular style of health care delivery within the United States. However, individuals with a behavioral health concern face several barriers in using these services. The purpose of this quantitative study was to identify key factors accounting for individuals' utilization and intensity of behavioral health services. Andersen's behavioral model of health care use and the integrated theory of health behavior change served as the theoretical framework. It was hypothesized that gender, age, race, ethnicity, family size, payer type, poverty level, and certain preexisting medical conditions (obesity, diabetes, hypertension, and tobacco use) …

Veterans' Perceptions Of Military Stigma And The Shame Associated With Combat-Related Posttraumatic Stress, Alexander J. Buelna

Walden Dissertations and Doctoral Studies

Military stigma is a heavy burden of social stigma internalized by veterans who are diagnosed with posttraumatic stress disorder (PTSD) during post-deployment psychological screening. PTSD is classified as a mental disorder associated with widespread reluctance to seek medical assistance. Among military veterans who suffer from combat-related posttraumatic stress (PTS), military stigma is considered a widespread problem. The purpose of this phenomenological study was to explore veterans' perceptions of various aspects of military stigma, including post-deployment psychological screening, the diagnosis of PTSD, and factors associated with reluctance to seek medical assistance for PTS. In-depth interviews were conducted with a convenience sample …

Integrated And Reducing Re-Entry Into The Criminal Justice System, Scott Huntington

Walden Dissertations and Doctoral Studies

Numerous studies have focused on the effectiveness of integrated treatment services for people with cooccurring disorders (CODs) within the criminal justice system (CJS). However, there has been a paucity of research on the effectiveness of community-integrated treatment services with CODs and influences on decreasing their interaction within the CJS. This study quantitatively examined the possible relationships between integrated treatment services and CODs and their effect on decreasing interactions within the CJS. The sample (N = 320) consisted of people with CODs from a community-based facility. The statistical analysis was a 2-way (2 x 2) and 3-way (2 x 2 x …

Master's Students' Self-Assessment Of Competency In Grief Education And Training In Cacrep-Accredited Counseling Programs, Jane Earline Wood

Walden Dissertations and Doctoral Studies

Counseling can promote positive outcomes for grieving clients by addressing personal loss and helping the client process their grief. However, a lack of understanding on the part of counselors of how people grieve may result in negative client outcomes such as psychological stress, poor health, or an increased risk of depression. Education and training in grief counseling can improve counselors' problem recognition and skills in treatment planning. The purpose of this study was to examine whether Council for Accreditation of Counseling and Related Educational Programs (CACREP) master's degree counseling students view themselves as having been adequately trained in grief theories …

The Effect Of Media Literacy Training On The Self-Esteem And Body-Satisfaction Among Fifth Grade Girls, Holly Mathews

Walden Dissertations and Doctoral Studies

Repeated exposure to media images that portray women as sex objects can have negative long-term effects on self-esteem beginning in preadolescence. Negative effects include decreased feelings of competence, increased focus on appearance, increased body dissatisfaction, and limited achievement in domains not related to appearance. There is a gap in the literature examining if media literacy training can mitigate the negative effects of exposure to sexualized media content. Festinger's social comparison theory and Vygotsky's theory of cognitive development provided the framework for this study. A quasi-experimental pre-post-test design was used to examine the interaction of media literacy training and time of …

Referral And Treatment Settings For Pregnant Women, Linda D. O'Daniel

Walden Dissertations and Doctoral Studies

Drug and alcohol addiction in pregnant women is a significant public health issue. The purpose of this study was to assess drug and alcohol addiction in pregnant women and the setting in which they sought service or treatment to determine whether U.S. census regions and race data could predict the type of addiction service or treatment that pregnant addicts chose. The theories of self-efficacy, cognitive behavioral therapy, and rational emotive behavioral therapy were used as the theoretical framework for this study. The research questions were used to examine whether there was a relationship between the source of addiction treatment referral …

The Experience Of Survivorship: Quality Of Life For African American Breast Cancer Survivors, Angela L. Grimmett

Walden Dissertations and Doctoral Studies

African American breast cancer survivors are at a greater risk of experiencing disparities in mortality, treatment, and quality of life. The purpose of this phenomenological study was to explore the impact that breast cancer had on the quality of life of African American breast cancer survivors from a psychosocial, physical, spiritual, and economic perspective. Face-to-face, in-depth interviews were conducted with 9 volunteers who met the eligibility criteria of being breast cancer survivors of African American decent. The sample of survivors ranged in ages 45 to 80 and was between 6 to 30 years postdiagnosis. Giorgi's phenomenological method was used to …

Behavioral Health Medical Interpreters: Cluster Analysis Of Vicarious Traumatization And Posttraumatic Growth, Pauline N. Stahlbrodt

Walden Dissertations and Doctoral Studies

Medical interpreter services will be essential for developing and implementing culturally relevant interventions and treatment for limited English proficiency (LEP) populations. This study sought to identify the possible risks or protective factors that may be associated with vicarious traumatization (VT) or vicarious posttraumatic growth among medical interpreters in behavioral health settings. A 2-step cluster analysis was conducted yielding 2 distinct groupings of medical interpreters (Subtype 1, n = 73; Subtype 2, n = 101). The most important predictor determining the 2 subtypes was whether the participant had a personal history of trauma. In addition, there were significant differences between the …

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.

The Exposure Of Workplace Conflict On Residential Mental Health Clients, Shawna Deann Stoneking

Walden Dissertations and Doctoral Studies

Individuals who receive residential mental health services rely on caregivers for support, supervision, and a safe living environment. Residential clients exposed to workplace conflict among staff may feel insecure and mistrust their caregivers, which in turn could negatively impact quality of life and treatment outcomes. The theory of therapeutic alliance proposed by Zetzel, emphasizing the client's perception of the therapist as a nurturing beneveolent figure, was used as the conceptual framework for this phenomenological study. Semi-structured interviews were conducted with 6 adults, recruited with homogenious sampling, who had experienced conflict among staff members and who had been discharged from residential …

Airline Pilots In Recovery From Alcoholism: A Quantitative Study Of Cognitive Change, Heather Christina Hamilton

Walden Dissertations and Doctoral Studies

In order to perform their duties, airline pilots must have no clinical diagnosis of mental illness or any substance use disorder. However, provisions have been in place since the 1970s that provide for a return to work for airline pilots with alcohol problems. To date, over 5,000 airline pilots have undergone rehabilitation for Alcohol Use Disorder (AUD) and successfully returned to work. An important gap in the literature remains with regard to what extent improvements in cognitive performance may be experienced by airline pilots who complete treatment and to what extent age influences the amount of change. This study examined …

Attitudes Of Nigerian Mothers Toward Children With Autism Spectrum Disorder, Valentine Ntoo Chukwueloka

Walden Dissertations and Doctoral Studies

Autism spectrum disorder (ASD) is a form of developmental disability that affects many children in the U.S. and abroad. The Center for Disease Control (CDC) has indicated that 1 out of every 68 children is diagnosed with ASD in the United States. However, there was limited literature about the attitudinal dispositions of Nigerian mothers toward children with ASD and their lived experiences with a child with autism. The purpose of this qualitative study was to explore the attitudes of Nigerian mothers toward their children with autism. The theoretical foundation of this study was the variation of the social relational understanding …

Psychological Stress In Critical Care Nurses, Oladele Augustine Odunayo Akinwolere

Walden Dissertations and Doctoral Studies

Increased levels of stress in the workplace have led the American Psychological Association to predict a looming public health crisis. Critical care nurses (CCNs) are highly exposed to stressors in the workplace, more than other nurses. Tens of billion dollars were reported lost in productive work time yearly due to ill health from depression alone. An important gap remains in understanding the relationships of stressors with the amount of stress. Supported by the biopsychosocial stress theory, the purpose of this study was to determine the relationship between frequencies of perceived stressors (IVs) as a source of perceived levels of stress …

Perceptions Of Immunizations As Health Prevention Among Female Mexican Immigrants In Oklahoma, Jennifer Doyle

Walden Dissertations and Doctoral Studies

Research on health prevention behaviors of Mexican immigrant mothers regarding immunizations has been limited. As of 2014, Hispanics or Latinos comprised 9.6% of the population of the state of Oklahoma and were the largest minority group within Oklahoma. This minority population has continued to grow at a rapid rate in Oklahoma. The purpose of this study was to explore the perceptions of immunizations held by Mexican immigrants who are mothers residing in Oklahoma. The aim of this study was to identify their perceived risk of contracting a vaccine-preventable disease if not immunized and knowledge of immunizations as a health prevention …