Medicine and Health Sciences Commons^™

Patients And Nurses And Doctors Oh My!: Nurse Retention From A Multi-Foci Aggression Perspective, Kevin Oliver Novak

Dissertations and Theses

Attrition is a serious issue in the nursing industry. One factor influencing rates of attrition in nursing is aggression victimization at work (Estryn-Behar et al., 2010). However, there is little research in the aggression literature that examines how aggression from different sources affects attrition (both job and career turnover) differently. This study attempts to better understand the linkages between aggression victimization and nursing attrition; specifically how aggression from different sources (i.e. patients/patients’ families, coworkers, and licensed independent practitioners) differentially affects retention factors (i.e. job satisfaction, turnover intentions, and career commitment). This study also attempts to understand the role that prosocial …

Socioeconomic Determinants Of Health Disparities By Race And Ethnicity: The Mediating Role Of Social, Psychological And Behavioral Factors, Amanuel Zimam Melekin

Dissertations and Theses

Socioeconomic status (SES) is inversely related to health status. Disparities in health status among races and ethnic groups are partly attributable to differences in SES, but the indirect pathways by which SES may influence health status are not widely studied.

Using the Health and Retirement Study (HRS) data, this dissertation examined the pathways by which SES, via social, psychological, and behavioral factors predicted physical impairment and overnight hospitalization, and asked whether these indirect relationships differed by race/ethnicity. The HRS is a nationally representative multistage area probability sample administered biennially to respondents over the age of 51 and their spouses. Data …

Rural Interprofessional Health Care Education: A Study Of Student Perspectives, Curt Carlton Stilp

Dissertations and Theses

As the cost for health care delivery increases, so does the demand for access to care. However, individuals in a rural community often do not have access to the care they need. Shortages of rural health care professionals are an ever-increasing problem. The Affordable Care Act of 2010 sought to increase health care access by focusing on team-based care delivery. Thus, the need to educate health care students in the fundamentals of team-based practice has led to an increased emphasis on Interprofessional Education (IPE). While past research focused on urban IPE, a literature gap exists for the effects of a …

The Effects Of Frequency Of Social Interaction, Social Cohesion, Age, And The Built Environment On Walking, Gretchen Allison Luhr

Dissertations and Theses

The purpose of this dissertation was to explore, through a social ecological framework, the multifaceted effects of the neighborhood environment by investigating how dimensions of both the built environment and the neighborhood social context may interact to influence walking. Aesthetics, land use mix, crime, and pedestrian infrastructure were considered with respect to built environment walkability, and the neighborhood social context was conceptualized using measures of both social cohesion and social interaction with neighbors. This research used data from an Environmental Protection Agency (EPA)-funded study of 748 adults (18 years of age and older) residing in the Lents neighborhood in Portland, …

Understanding Neighborhood Satisfaction For Individuals With Psychiatric Disabilities: A Mixed Methods Study, Amy Leigh Shearer

Dissertations and Theses

Physical and social characteristics of neighborhoods are important to resident satisfaction for clinical and nonclinical populations. This study draws upon data collected from a sample of 172 individuals with psychiatric disabilities living in 16 supportive housing sites in the Portland, Oregon metropolitan area. Research questions explore the extent to which subjective and objective measures of neighborhood physical and social environments contribute to neighborhood satisfaction for this population. Mixed methods were employed to construct a detailed understanding of the factors that influence satisfaction with one's neighborhood of residence. Predictor variables were neighborhood social climate, neighborhood physical quality, perceptions of safety, crime …

Social Support And Depression Symptomatology Post Injury In Division 1 Athletes, Alyssa Catherine Tiedens

Dissertations and Theses

The way in which an athlete responds to the injury--emotionally, behaviorally, and cognitively--can significantly affect the athlete's mental health in a negative way if not handled appropriately. There are different forms of social support that are known to be helpful with coping during specific stages of injury. The purpose of this study was to examine the relationship between perceived levels of social support and depression symptomatology post injury in Division 1 collegiate athletes at Portland State University (PSU).

Participants were PSU student athletes (n=115). Variables: social support amount (SSQN), social support satisfaction (SSQS), and depression symptomatology (CESD-R) score. Selected injured …

Assessment Of A Mycorrhizal Fungi Application To Treat Stormwater In An Urban Bioswale, Alaina Diane Melville

Dissertations and Theses

This study assessed the effect of an application of mycorrhizal fungi to stormwater filter media on urban bioswale soil and stormwater in an infiltration-based bioswale aged 20 years with established vegetation. The study tested the use of commercially available general purpose biotic soil blend PermaMatrix^® BSP Foundation as a treatment to enhance Earthlite^™ stormwater filter media amelioration of zinc, copper, and phosphorus in an ecologically engineered structure designed to collect and infiltrate urban stormwater runoff before it entered the nearby Willamette River.

These results show that the application of PermaMatrix^® BSP Foundation biotic soil amendment to Earthlite …

Transgender Patients' Experiences Of Discrimination At Mental Health Clinics, Corrine Ann Stocking

Dissertations and Theses

The transgender population is makes up about 0.3% of the U.S. population (Gates 2011). The term transgender is both an identity and an umbrella term used to describe people who do not adhere to traditional gender norms (Institute of Medicine 2011). Transgender people experience many barriers to services, negative health outcomes, and discrimination (Fredrikson-Goldsen et al. 2013; Institute of Medicine 2011; Eliason et al. 2009; Hendricks & Testa 2012). Mental health clinics are an important site for understanding transgender peoples' experiences due to being a gatekeeper for other medical services and their role in helping transpeople with issues surrounding coming …

Thinking About Work At Home: Implications For Safety At Work, Frankie Guros

Dissertations and Theses

Safety at work is of the utmost importance to employees and the organizations they work for, and as such, it is a central issue for occupational health psychology. Although dramatic decreases in the number of worker injuries and fatalities have been observed over the last several decades, safety remains a principal concern for organizations. This is especially true in occupations in which employees face serious threats to their personal safety, such as correctional officers (COs). While a number of studies have identified workplace factors that contribute to worker safety, few have attempted to draw a link between employee nonwork experiences …

Mistrust: An Exploration Of African Americans' Attitudes And Perspectives Toward Healthcare, Adolfo Gabriel Cuevas

Dissertations and Theses

This dissertation explored mistrust through focus group discussions (study 1), responses to standardized laboratory vignettes (study 2), and survey questionnaires (study 3). In the first study, I found that African American community members (N=60) experienced perceived discrimination, medical mistrust, and poor communication in numerous and interrelated ways. For example, medical mistrust occurred when clinicians did not convey respect to patients, leaving patients to wonder whether their clinician's treatment was discriminatory or not. Based on these findings, I wanted to see whether these experiences of perceived discrimination and mistrust were related to other dimensions of Black experience, such as racial identity. …

Training And Application Of Correct Information Unit Analysis To Structured And Unstructured Discourse, Audrey Bretthauer Cohen

Dissertations and Theses

Correct Information Units (CIU) analysis is one of the few measures of discourse that attempts to quantify discourse as a function of communicating information efficiently. Though this analysis is used reliably as a research tool, most studies' apply CIUs to structured discourse tasks and do not specifically describe how raters are trained. If certified clinical speech-language pathologists can likewise reliably apply CIU analysis within clinical settings to unstructured discourse, such as the discourse of people with aphasia (PWA), it may allow clinicians to quantify the information communicated efficiently in clinical populations with discourse deficits. Purpose: The purpose of this study …

Latino Men Managing Hiv: An Appraisal Analysis Of Intersubjective Relations In The Discourse Of Five Research Interviews, Will Caston

Dissertations and Theses

Latino men, particularly those who have sex with other men, have been disproportionately affected by HIV/AIDS. Scholars have sought for nearly two decades to understand how various social and cultural factors in the Latino community exacerbate HIV risk among these men. Although following the advent of life-sustaining medications in 1996, HIV is often regarded as a manageable chronic illness, as opposed to a death sentence, scant attention has been devoted to how HIV-positive Latino men experience managing the illness. Among studies that have focused on HIV-positive persons' illness management, few Latino men have participated.

Using the Appraisal framework from Hallidayan …

A Cross-Sectional Study Of Student-Athlete Needs Satisfaction And Well-Being, Abigail M. Gunnink

Dissertations and Theses

Grounded in self-determination theory (Deci & Ryan, 2000), the purpose of this study was to examine (a) the effects of the social environment, as defined by the divisions of the Department of Athletics, on student-athletes' perceptions of basic needs satisfaction, (b) the effects of basic needs satisfaction on well-being, and (c) the effects of time demands, during in-season and off-season, on well-being, among student-athletes at Portland State University (PSU). Participants were student-athletes at PSU (n = 118). The participants completed a multi-section survey assessing basic needs satisfaction and well-being. Cumulative mean scores highlighted the satisfaction of the basic psychological needs …

Gender And Prescription Painkiller Misuse: Findings From The 2011 National Survey On Drug Use And Health, Robin Jo Clough

Dissertations and Theses

This study examines the effects of gender and social bonds on the experience of prescription painkiller misuse for men and women. The theoretical framework for the project is Travis Hirschi's social control theory (1969), and the social bond elements of attachment, commitment, involvement, and belief, which emphasizes the importance of these bonds in creating a "stake in conformity" for the individual, leading to acceptance of social norms and desistence from deviance. This theory, however, is relatively silent with regard to gender differences and was developed to examine delinquency in an all male sample of adolescents. The elements of this theory …

Participation, Information, Values, And Community Interests Within Health Impact Assessments, Nicole Iroz-Elardo

Dissertations and Theses

Health impact assessment (HIA) has emerged in the U.S. as one promising process to increase social and environmental justice through addressing health equity issues within planning. HIA practice is guided by values such as democracy and equity and grounded in broad social determinants of health. The most readily applied definition of democracy is problematic because it implies an element of direct, participatory engagement with the public. This is at odds with HIA practice that largely relies on stakeholder engagement strategies.

This dissertation critically examines the engagement strategies of three transportation planning HIA cases to more fully understand how the HIA …

Factors Influencing Youth Self-Perceptions Of Overweight And Obesity, Caitlin Helen Sommers

Dissertations and Theses

This study sought to examine whether participation in physical activity affects the ability to correctly classify body size, based on body mass index classifications. Secondarily, this study determined whether adolescents who incorrectly classified their body size overestimated or underestimated their size. Self-report data from the Youth Risk Behavior Surveillance Survey collected by the Centers for Disease Control and Prevention were analyzed. Logistic regression was performed to examine relationships between self-perception of body size and physical activity, television viewing time, computer/video game use, physical education class time, and extracurricular sports activities. Significance was set to p<0.05. Physical activity was the only statistically significant independent variable (p=0.058, OR = 1.060). Although physical activity was shown to be statistically significant, it did not appear to meaningfully increase the ability of youth to correctly classify body size. Secondary analysis showed that adolescents who incorrectly classified their body size were more likely to underestimate their body size. Females more frequently underestimated their body size (females=673; males=384).

Exploring The Effects Of Multi-Level Protective And Risk Factors On Child And Parenting Outcomes In Families Participating In Healthy Start/Healthy Families Oregon (Hs/Hfo), Peggy Nygren

Dissertations and Theses

While many studies focus on the links between multiple risk factors and negative outcomes such as child maltreatment, less is known about the influence of protective factors in the face of risks. The theoretical base of this study was a social ecological model of interactive influences including individual parent, family, and neighborhood level factors to predict outcomes. Protective Factor Index (PFI) and Risk Factor Index (RFI) predictors were developed to explore potential multi-level protective factor buffering effects on key child development and parenting outcomes. Participants were first time mothers enrolled in a randomized controlled study of the Healthy Start/ Healthy …

Work Stress Reactivity And Health Outcomes: A Study Of Nurses, Laurie Marie Jacobs

Dissertations and Theses

Negative events encountered in daily life influence individual well-being. Individuals vary in their reactivity to these events, the extent to which they are behaviorally, physiologically, and psychologically influenced by them (Almeida, 2005; Neupert, Almeida, & Charles, 2007). Reactivity to events in the form of changes in health behavior could represent either an attempt at coping (Cooper, Frone, Russell, & Mudar, 1995) or a stressor-related failure of self-control (Muraven & Baumeister, 2000). Such changes in behavior could have later effects on health.

Although a great deal of attention has been paid to both the immediate and long-term effects of stressors on …

Batterer Intervention Programs' Response To State Standards, Ashley Lynn Boal

Dissertations and Theses

The study of policy implementation has recently garnered research and federal attention highlighting the importance of implementation in achieving desired policy and program outcomes (Durlak & DuPre, 2008; Meyers, Durlak & Wandersman, 2012; National Institutes of Health, 2013). Psychology is one discipline that is well poised to guide the study of policy implementation as it can inform the creation, development, and outcomes associated with the introduction of a policy (Esses & Dovidio, 2011; Fischhoff, 1990). Given that batterer intervention programs (BIPs) have been developed to prevent future intimate partner violence (IPV) and improve victim safety, ensuring these programs have successfully …

The Impacts Of Change In Governance On Faculty And Staff At Higher Education Institutions: A Case Study Of Ohsu, Dana L. Director

Dissertations and Theses

In the early 1990s, Oregon Health and Science University leadership examined the political and economic landscape and determined it needed a new operational model to survive and thrive. In 1995 OHSU separated from the state higher education system and became a public corporation, with goals of increased efficiency, customer-focus, ability to attract world-class researchers and physicians, and salaries commensurate with an urban academic health center.

This research examines the internal impacts when universities undergo significant change, using OHSU's governance change as a case study. Central is the question: what effect(s) did OHSU's decision to become a unique public corporation have …

Bringing Functional Family Probation Services To The Community: A Qualitative Case Study, Denise Lynmarie Austin

Dissertations and Theses

In March 2011, Multnomah County's Juvenile Services Division (JSD) in Portland, Oregon implemented a new program model called Functional Family Probation Services, a case management model based on the principles of Functional Family Therapy. Under this model JSD Juvenile Court Counselors deliver Functional Family Probation Services to medium and high-risk youth on probation; both to the youth and their family in their home. This qualitative case study examined the extent to which the Juvenile Court Counselors and Community Justice Managers implemented Functional Family Probation Service's components and recorded their opinions regarding Functional Family Probation Services as a case management model. …

"Who Would Have Thought, With A Diagnosis Like This, I Would Be Happy?": Portraits Of Perceived Strengths And Resources In Early-Stage Dementia, Jutta Elisabeth Ataie

Dissertations and Theses

This study used photovoice methodology to explore how people with early-stage dementia use their perceived strength and resources to cope with the illness. Purposive sampling was used to recruit participants. Thirteen women and seven men age 57 to 90 (mean 73.4) with MMSE scores ranging from 20 to 28 (mean 25.6) participated in the project. Participants were provided with a disposable camera and invited to take photographs relevant to their well-being. The photographs provided the means for participants to take the lead in dialogue sessions about their coping response.

Grounded theory analysis revealed that initially, early-stage dementia precipitated a disruption …

Metaphor Use In Interpersonal Communication Of Body Perception In The Context Of Breast Cancer, Jennifer Mary Fillion

Dissertations and Theses

Female breast cancer patients are often confused, frustrated, and devastated by changes occurring in their bodies and the treatment process. Many women express frustration and concern with the inability to know what the next phases of their life will bring. Previous research also states that many women struggle to communicate with others about treatment as well as side effects. This research examined how woman are use metaphors to describe their experience with breast cancer, specifically throughout the treatment period related to body image struggles. I qualitatively conducted interviews with women who were either currently in treatment or just finishing. My …

The Historical, Political, Social, And Individual Factors That Have Influenced The Development Of Aging And Disability Resource Centers And Options Counseling, Sheryl Dejoy Elliott

Dissertations and Theses

This thesis reports on the perspectives and experiences of policymakers, advocates, agency supervisors, and experts in the field of gerontology, about the development of Aging and Disability Resource Centers (ADRC) programs and Options Counseling (OC). By examining the foundations upon which ADRCs and OC are built, this study sought to inform future research about the effectiveness of existing practice, increase understanding of best practices, and clarify whether these emerging services are accomplishing original goals.

ADRCs and OC intend to address long-term care issues and healthcare needs by providing a single entry point to the social service system. ADRCs offer information, …

International And Domestic Student Health-Information Seeking And Satisfaction, Stacy Theodora Austin

Dissertations and Theses

This study examines two groups -international and domestic students at Portland State University (PSU) - in terms of their motivations to seek university-health services, and their satisfaction with university-health services. The Theory of Motivated Information Management (W. A. Afifi & Weiner, 2004) served as the foundation for this study to examine the preferences of students in terms of the ways they seek information about their health concerns. Differences in international and domestic students' anxiety, efficacy, and satisfaction with physicians were supported. International students reported more anxiety than domestic students. Domestic students reported being more efficacious than international students when talking …

Exploring Four Barriers Experienced By African Americans In Healthcare: Perceived Discrimination, Medical Mistrust, Race Discordance, And Poor Communication, Adolfo Gabriel Cuevas

Dissertations and Theses

For many health conditions, African Americans bear a disproportionate burden of disease, injury, death, and disability compared to European Americans. African Americans also use health services less frequently than do European Americans and this underuse of services contributes to health disparities in the United States. Studies have shown that some disparities are present not as a result of poor access to care, but, to a certain extent, as a result of the experiences patients have at their doctors' offices. It is, therefore, essential to understand African American patients' perspectives and experiences with healthcare providers. Past studies have shown that four …

Empowerment In Community-Based Participatory Research With Persons With Developmental Disabilities: Perspectives Of Community Researchers, Erin Elizabeth Stack

Dissertations and Theses

Community-based participatory research (CBPR) is a research approach that benefits from the expertise of community members being involved in the research along all stages of a project (Israel et al., 2003). CBPR is often utilized with marginalized populations in order to amplify a community's voice on important issues in their lives (Bastida, Tseng, McKeever, & Jack, 2010; Minkler & Wallerstein, 2008). In the past, persons with disability have been excluded from research in order to protect them from exploitation. This practice of exclusion undermines opportunities for persons with disabilities to be independent and make decisions that are important for themselves …

Coping With Interpersonal Conflicts At Work: An Examination Of The Goodness Of Fit Hypothesis Among Nurses, Robert Randon Wright

Dissertations and Theses

Increasingly, evidence indicates that workplace interpersonal conflicts (WIC) are the most upsetting/troublesome daily work stressors (Sulsky & Smith, 2007), and within the context of nursing, WIC is a problem of high prevalence and intensity (Baltimore, 2006; Farrell, 1999). In relation to coping with stressors such as WIC, Lazarus and Folkman (1984) established the transactional model of stress and coping, where cognitive appraisals of the stressor (e.g., perceived control) are central to coping and classified all coping behaviors as either problem-focused or emotion-focused. They also proposed the "goodness of fit hypothesis", which predicts that problem-focused coping efforts used to cope with …

Euthanasia, The Ethics Of Patient Care And The Language Of Propaganda, Elizabeth Maria Krapf

Dissertations and Theses

This thesis is an examination of euthanasia, eugenics, the ethic of patient care, and linguistic propaganda in the Second World War. The examination of euthanasia discusses not only the history and involvement of the facility at Hadamar in Germany, but also discuss the current euthanasia debate. Euthanasia in World War II arose out of the Nazi desire to cleanse the Reich and was greatly influenced by the American eugenics movement of the early 20th century. Eugenics was built up to include anyone considered undesirable and unworthy of life and killed many thousands of people before the invasion of allied troops …

Nine Months, Esther Lim

Dissertations and Theses

This is a collection of short stories that traces a chronological movement through one family's experience of the mother's illness. Each piece in the collection is meant to be an independent, free-standing short story. Each story is different, told from distinctive points-of-view, angles, and voices. However, every story covers a span of time within the nine months of the family's experience, in the presented order, as part of a collective movement toward the core. All together, the pieces hope to reflect a mosaic of sorts--one that tells a story that cannot otherwise be told.