Health and Medical Administration Commons^™

Reconnecting The Mind And Body: A Pilot Study Of Developing Compassion For Persistent Pain, Sarah L. Parry Dr, Zoey Malpus Dr

Patient Experience Journal

As an alternative to the more typical cognitive behavioural approach to pain management, a novel pain management group based on the principles of compassionate mind training was developed for a particular sub-group of patients. Participants were patients of a community pain clinic, who were invited to participate in this alternative approach to pain management. The eight-week Compassion in Pain Groups included psychoeducation around persistent pain, the underlying principles of compassionate mind training, practical exercises such as diaphragmatic breathing, followed by a series of compassionate imagery exercises and group discussions. Both quantitative and qualitative analyses were undertaken to gain further insights …

Experiences Of Communication Barriers Between Physicians And Immigrant Patients: A Systematic Review And Thematic Synthesis, Salim Ahmed, Sonya Lee, Nusrat Shommu, Nahid Rumana, Tanvir Turin

Patient Experience Journal

Frequent immigration of peoples from outside often challenges various systems of any country; healthcare sector is the most confronted one. One of the most prominent reasons for this confrontation is communication gap between physicians and immigrant patients. In this systematic narrative review, we studied existing literature on physician-immigrant patient communication. We systematically searched the repositories of literature and followed some criteria to select literature. We selected 32 literatures for information extraction. Three themes emerged from the synthesis: Physicians’ viewpoint about communication barrier with their immigrant patients, Immigrant patients’ viewpoint about the communication barrier with their physicians, and Interpreter as a …

Improving Nursing Attitudes Toward Suicide Prevention In The Emergency Department: The Implementation Of An Adolescent Suicide Risk Screening Tool, Julie A. Simpson

Evidence-Based Practice Project Reports

The Center for Disease Control ranked suicide as the second leading cause of death for American adolescents (2015). This crisis of adolescent suicide warrants evaluation and improvement of current suicide prevention practices. The Emergency Department (ED) offers 24-hour services and may be the only organized healthcare for utilized by some individuals. Nurses are the front-line provider of care in the ED and this role offers opportunity to identify an adolescent with increased suicide risk. The purpose of this EBP project is to evaluate nursing attitudes toward suicide prevention by implementing the best practice screening tool for adolescent suicide risk assessment. …

Need Vs. Supply Analysis Of The New Haven Public Bus System, Stan Mathis

Yale Day of Data

ABSTRACT:

The aim of the study was to assess how well the public transportation system of New Haven County was matched to the public transit need using publicly available geospatial datasets from state and federal sources. Geospatial bus stop data was extracted from public State of Connecticut data sets. Census tract geography was extracted from US Census TIGER files while census tract aggregated household vehicle access data was queried from the American Community Survey data access server. A census tract’s Need was defined as percentage of households reporting access to zero vehicles; its supply was defined as the number of …

Repealing The Aca Without A Replacement — The Risks To American Health Care, Barack Obama

United States Public Health Resources

Health care policy often shifts when the country’s leadership changes. That was true when I took office, and it will likely be true with President-elect Donald Trump. I am proud that my administration’s work, through the Affordable Care Act (ACA) and other policies, helped millions more Americans know the security of health care in a system that is more effective and efficient. At the same time, there is more work to do to ensure that all Americans have access to high-quality, affordable health care. What the past 8 years have taught us is that health care reform requires an evidence-based, …

Associations Of Suicidal Ideation With Opioid/Prescription Drug Use, Violence, Food Insecurity, And Community Factors Among New Hampshire High School Students, Emily R. Carbonara, Semra Aytur

Honors Theses and Capstones

Purpose: Suicide is the second leading cause of death for New Hampshire (NH) youth. Evidence-based public health emphasizes the use of data for translating research into practice/policy. We utilized data from the Youth Risk Behavior Survey (YRBS) to support community-academic partnerships and inform suicide prevention interventions. Methods: Data from the 2011 NH YRBS, a cross-sectional survey of 9th-12th grade students, were analyzed. Gender-stratified, adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated using logistic regression models (SAS 9.4, ProcSuveylogistic) to evaluate associations between suicidal ideation (seriously considering attempting suicide within the past 12 months), violence (e.g., physical bullying, …

Emergency Department Use Among Asian Adults Living In The United States: Results From The National Health Interview Survey (2006 – 2013), Kathleen M. Sullivan, James Davis, Angela Sy

Asian/Pacific Island Nursing Journal

This paper presents secondary analyses of the National Health Interview Survey data focused on emergency department (ED) utilization among Asian adults residing in the United States. National Health Interview Survey data provided from survey years 2006-2013 was pooled and disaggregated by single-race Asian ethnic subgroups (Filipino, Chinese, Asian Indian, other Asian). We explored trends in reports of an ED visit over the survey years for the purpose of determining whether reports of an ED visit increased or decreased over survey years. We also explored background/biologic, environment, access to care, and behavior factors and their associations with having an ED visit. …

Vicarious Trauma Coping And Self-Care Practices Among Trauma Therapists., Annette Zaccari

Walden Dissertations and Doctoral Studies

Therapists who specialize in trauma therapy are indirectly exposed traumatic events presented by clients within the therapeutic relationship. The potential consequences for trauma therapists may be the risk of vicarious trauma. Effective coping and self-care are essential in the practice of trauma work. The research question for this study is: Do coping skills and self-care practices in trauma therapists moderate the disruptive effect of vicarious trauma on the fulfillment of their psychological needs (trust/dependence and control)? The purpose of this research study was to examine quantitatively, the role of trauma therapists' beliefs in the effectiveness of coping skills and time …

Psychological Resilience In Correctional Officers: The Role Of Demographics, Manuel Chapa Villarreal

Walden Dissertations and Doctoral Studies

Correctional officers occupy an important societal role in maintaining safety and assisting in the rehabilitation of inmates; however, both their performance and mental health are highly susceptible to fatigue because of working in a high stress environment. This study investigated the relationship between correctional officers' demographic factors (level of education, marital status, gender, and race/ethnicity) and their psychological resilience. The Connor-Davidson Resilience Scale 10 (CD-RISC-10) was used to measure correctional officers' resilience when responding and or coping with stress. This study utilized the stress-vulnerability model as a framework to investigate protective factors against and risk factors for psychopathological symptoms. Participants …

Evaluating The Impact Of Integrated Care On Service Utilization In Serious Mental Illness, Heidi C. Waters

Walden Dissertations and Doctoral Studies

Serious mental illness (SMI) affects 5% of the United States population and is associated with increased morbidity and mortality. Use of high-cost healthcare services is common, including hospitalizations and emergency department (ED) visits. Integrating behavioral and physical healthcare may improve care for consumers with SMI, but prior research findings have been mixed. This quantitative retrospective cohort study addressed the impact of integrated care on physical health and ambulatory care sensitive (ACS) utilization via a program evaluation of an integrated health clinic (IHC) at a community mental health center (CMHC). The research questions assessed whether there was a predictive relationship between …

Tobacco Use, Cessation, And Locus Of Control Among College Students, Bernard Ambe

Electronic Theses and Dissertations

ABSTRACT

The purpose of this study was to (a) determine the locus of control among American college students (b) determine if tobacco use or cessation correlate with any demographic variables to better understand the efficacy of tobacco interventions and help design an intervention most effective in the prominent LOC of college students.

The Global Adult Tobacco Survey (GATS) was modified for the purposes of this study and used to determine demographic factors and tobacco usage status. The modified GATS survey also included the LOC questionnaire which yielded the data. Seventy-four responses were recorded. The mean locus of control scores were …

A Qualitative Analysis Of The Health Informatics Role In Addressing The Public Health Crisis Of Addiction And Overall Effectiveness Of Treatment, Daniel Del Toro

Applied Research Projects

In recent years, the implementation of Health Information Management (HIM) data systems has had significant positive impacts in nearly all aspects of both health and healthcare delivery. However, during this time, there has also been a dramatic increase in the demand for addiction and mental health treatment. The rising number of individuals requiring mental health treatment for addiction has resulted in its declaration as an urgent public health epidemic by the Department of Health and Human Services. The all-encompassing effects of addiction are prevalent in all areas of society, seen in the form of across-the-board rising healthcare costs, addiction related …

Strategic Community Healthcare Management, Stephanie Penrod

Master's Projects and Capstones

Federally Qualified Health Centers(FQHC) and Community Health Centers are growing with the Affordable Care Act. This paper introduces literature that supports the need for Community Health Centers and management of low income patients with chronic illnesses. This paper also reviews the fieldwork experience at a FQHC. It reviews the goals, project, methods and findings of the fieldwork. This paper also elaborates on the scope of the project and a quality improvement report for the FQHC in observation. It discusses the future potential implementation of the recommendations and the benefits for both employees and patients. This paper concludes with follow up …

Using The Theory Of Planned Behavior To Predict Executives’ Intentions To Hire Psychologists In Federally Qualified Health Centers, Robert M. Tolliver

Electronic Theses and Dissertations

Health psychologists with training in integrated care are ideal candidates to work in Federally Qualified Health Centers (FQHCs). However, despite the large documented need for more behavioral health providers in FQHCs, psychologists are underrepresented in this setting compared to other behavioral health professions. The purpose of this study was to: 1) examine the specific beliefs that are most relevant to executives’ intentions to hire psychologists, 2) determine how executives’ perceived control over hiring psychologists varies by several demographic variables, and 3) examine how well the Theory of Planned Behavior (TPB) predicts executives’ intentions to hire psychologists. Method: Executives (N …

Nebraska Sex Trafficking Survivors Speak – A Qualitative Research Study, Shireen S. Rajaram, Sriyani Tidball

College of Journalism and Mass Communications: Faculty Publications

This exploratory, qualitative research study was conducted by researchers Dr. Shireen S. Rajaram in the College of Public Health at University of Nebraska Medical Center (UNMC) and Ms. Sriyani Tidball in the College of Journalism and Mass Communication at the University of Nebraska at Lincoln (UNL), and was funded by the Women’s Fund of Omaha. The purpose of this study was to document the perspectives of adult women survivors of sex trafficking about the “3Ps” paradigm: to identify strategies to prevent sex trafficking, provide protection and support for survivors and prosecution of the perpetrators to reduce the demand for sex …

An Analysis Of Women’S Access To Acute Opioid Detoxification Services In Maine: Identifying The Barriers To Treatment, Karen E. Conley

Muskie School Capstones and Dissertations

The lack of treatment facilities and services for opioid use disorder in Maine, combined with an increased prevalence of addiction, creates a potential for health inequity between men and women that may be intensified by barriers in access to care. This capstone study utilized detoxification screening inquiry forms and data obtained from the Milestone Foundation’s acute opioid detoxification program to assess and categorize barriers to access by gender. A barriers model was developed based on existing literature and was to identify potential associations among and between the known barriers to accessing treatment. Barriers were described as internally or externally based, …

Local Health Departments’ Level Of Engagement In Population Mental Health Promotion, Jonathan Purtle, Ann C. Klassen, Jennifer Kolker, Rachel M. Peters, James W. Buehler

Frontiers in Public Health Services and Systems Research

Background: Mental health conditions are highly prevalent in the U.S. and are associated with physical health problems. Federal initiatives recognize mental health as a public health priority, and local health departments (LHDs) have been identified as partners to promote population mental health. Little is known, however, about the extent to which LHDs address mental health or how LHD officials perceive mental health as a public health concern.

Purpose: To describe the cumulative level of LHDs’ engagement in activities to address population mental health and explore how LHD officials perceive their roles in promoting it.

Methods: Module 2 of the 2013 …

Client Satisfaction Survey For Hiv/Aids Dental Care Services: An Example From Rural Texas, H. Stephen Cooper Ph.D., Lcsw, Freddie L. Avant Ph.D., Lmsw-Ap, Acsw, C-Ssws, Kim L. Rich-Rice Ph.D., Lmsw-Ipr

Journal of Human Services: Training, Research, and Practice

The challenges to examining client satisfaction are demonstrated through an evaluation of dental services provided by a regional service provider to people living with HIV/AIDS. The process of developing and administering a measure of client satisfaction is discussed. Forty-one of 350 (11.7%) dental clients chose to participate. Quantitative and qualitative data suggests that overall participants are satisfied with services. Identified concerns included a lack of specialized dental, medical, mental health, and case management services. Implications of the study for service delivery, future evaluations, and rural social work practice are addressed.

The Impact Of Ciwa-Ar Tool On Healthcare Professionals, Laronda Tinsley

Applied Research Projects

Alcohol is one of the most abused substances worldwide. The regular consumption of alcohol can lead to dependency which depresses the central nervous system. Consequently, when a heavy drinker is no longer consuming alcohol, the central nervous system is no longer suppressed and may go into a hyperexcitable state known as alcohol withdrawal syndrome (AWS). Symptoms can vary from mild to life threatening. Patients who experience alcohol withdrawal symptoms often have a more complicated hospitalization, an extended length of stay, and increased utilization of intensive care and medical services. The Clinical Institute Withdrawal Assessment of Alcohol Scale-revised (CIWA-Ar) is a …

Predictive Factors Of Patient Satisfaction With Pharmacy Services In South Korea: A Cross-Sectional Study Of National Level Data, Sunkyung Lee, Onyeka P. Godwin, Kyungah Kim, Euni Lee

Pharmacy Faculty Articles and Research

Objectives
Patient satisfaction has emerged as a prerequisite to improving patients’ health behaviors leading to better health care outcomes. This study was to identify predictive determinants for patient satisfaction with pharmacy services using national-level data.

Methods
A cross-sectional evaluation was conducted using 2008 Korean National Health and Nutrition Examination Survey (KNHANES) data. To assess the predictive factors for patient satisfaction with pharmacy services, an ordinal logistic regression model was conducted adjusting for patient characteristics, clinical comorbidities, and perception of health.

Results
A total of 9,744 people, a representative sample of 48.2 million Koreans, participated in the 2008 KNHANES, of whom …

Mental Health Clinical Managers And Their Multicultural Leadership Practices, Christie Marie Melonson

Theses & Dissertations

There is a general recognition that the United States has historically failed to provide adequate mental health services to ethnic minorities. The American Counseling Association has mandated multicultural competence of counseling professionals in today’s context of dramatic demographic change. Despite numerous studies on practitioners, organizations, models, and interventions geared toward minorities, disparities in access, usage, and outcomes in still exist. Simultaneously, counseling fields have emphasized leadership development as a key factor in improving services, yet training or research on leadership remains scarce. In response to these conditions, this basic interpretive qualitative study focused on exploring clinical managers’ perceptions of their …

Awareness And Utilization Of The Ohio Automated Rx Reporting System By Physician Assistants, Julia Cathleen Rose

All Theses And Dissertations

Chronic pain has become a public health epidemic. As pain complaints increase, so does the potential for drug abuse/misuse. Prescription drug monitoring programs (PDMPs) are active in 49 of the 50 states to assist providers in recognizing drug abuse/misuse. There is no clear standardization of who utilizes the PDMP and how. Little is still known about the ways PDMP results are incorporated into clinical decision making, what barriers exist, and how providers may or may not alter their prescribing plans based on the results. Laws surrounding prescribing practices and use of the Ohio Automated Rx Reporting System (OARRS) are constantly …

The Effect Of Education On Compassion Fatigue As Experienced By Staff Nurses, Kathryn L. Zehr

Evidence-Based Practice Project Reports

Historically, nursing has been perceived as a highly rewarding profession. Yet, due to the increasing complexity of today’s healthcare, nurses are faced with greater challenges in their work environments. Registered nurses who work in tertiary care settings are exposed to disturbing patient situations including trauma, death, abuse, or chronic disease. Joinson (1992) described this experience as compassion fatigue and symptoms include headaches, short attention span, or fatigue. A review of literature has identified that nurses should be educated about risk factors and coping strategies to combat compassion fatigue. Guided by the Model for Evidence-Based Practice Change and Jean Watson’s Theory …

Talking Mirrors: Experiences Of Older Transgender Adults And Culturally Competent Mental Healthcare Profes-Sionals With Talk Therapy In The Netherlands, Kate Cieplicki

Independent Study Project (ISP) Collection

Historically, both the general population and mental healthcare providers specifically have misunderstood the transgender identity as pathological and unnatural. Despite persistent ignorance in the mental healthcare field about the background and needs of transgender adults, a psychoanalytic evaluation is required by the gender clinic for a transgender individual to begin the gender transition process in the Netherlands. This requirement creates a degree of tension and mistrust between the transgender individual and the mental healthcare field. Such discomfort is unfortunate because statistically transgender adults face more mental health problems than their cisgender peers, likely because of the stress that comes from …

Perceived Barriers To Utilizing Maternal And Neonatal Health Services In Contracted-Out Versus Government-Managed Health Facilities In The Rural Districts Of Pakistan, Atif Riaz, Shehla Zaidi, Asif Raza Khowaja

Community Health Sciences

Background: A number of developing countries have contracted out public health facilities to the Non-Government Organizations (NGOs) in order to improve service utilization. However, there is a paucity of in-depth qualitative information on barriers to access services as a result of contracting from service users’ perspective. The objective of this study was to explore perceived barriers to utilizing Maternal and Neonatal Health (MNH) services, in health facilities contracted out by government to NGO for service provision versus in those which are managed by government (non-contracted).

Methods: A community-based qualitative exploratory study was conducted between April to September 2012 at two …

Cost Of Primary Health Care In Pakistan, Muhammad Ashar Malik, Wahid Gul, Saleem Per Waiz Iqbal, Farina Abrejo

Community Health Sciences

Background: Detailed cost analysis is an important tool for review of health policy and reforms. We provide an estimate of cost of service and its detailed breakup on out-door patient visits (OPV) to basic health units (BHU) in Pakistan.

Method: Six BHUs were randomly selected from each of the five districts in Khyber Pukhtonkhawa (KPK) and two agencies in Federally Administered Tribal Areas (FATA) of Pakistan for this study. Actual expenditure data and utilization data in the year 2005 –06 of 42 BHUs was collected from selected district health offices in KPK and FATA. Costs were estimated for outpatient visits …

The Role Of Occupational Therapy In Primary Care, Priti Patel

Occupational Therapy Doctorate Capstone Projects

The Capstone Project is focused on communicating, influencing and educating other health care professionals regarding the role of occupational therapy in the future model of primary care delivery initiated by the adoption of the Affordable Care Act and the Triple Aim Initiative. Currently, primary care, the largest health care platform in United States, is not inclusive of occupational therapy services. Occupational therapists have the scope, knowledge and understanding to be part of the redesigned team model of primary care. Educating those currently working in primary care about adding occupational therapy services can have a significant impact on the profession of …

Mental Health Therapists' Attitudes On Adoption Of Evidence-Based Practices And Organizational Culture, Jennifer Guerguis

Walden Dissertations and Doctoral Studies

Evidence-based practice (EBP) in mental health was initiated in the United States due to state legislation. The EBP implementation process is complex due to multiple factors related to organizational culture. Mental health agencies implementing EBP processes can expect significant personnel changes due to higher turnover rates, which may have a negative effect on the quality of services. The purpose of this study was to investigate the relationship between providers' attitudes toward the adoption of EBPs and organizational culture. The theoretical framework for this study was organizational culture theory and the Denison organizational culture model. This correlational and predictive study examined …

Health Information Exchanges And Patient Portals In Behavioral Health, Christine Peterson

Applied Research Projects

We live in an electronic world. Technology is everywhere, including in our healthcare system. With the advent on the electronic health record and the push to meet Meaningful Use, many healthcare organizations have already started using patient portals and sharing information among providers via health information exchanges. There have been roadblocks to successful implantation of patient portals and health information exchanges, one of which is how to handle behavioral health information and would these new technologies be accepted by patients with mental health diagnoses

Development And Mental Health Care Services: A Case Study At Rtccd, Hanoi, Michelle Lafortune

Independent Study Project (ISP) Collection

Vietnam’s rapid development since 1986 has had both positive and negative impacts on Vietnam’s mental health services. A health system was put into place and is expanding to overcome many challenges. Conversely, development has also brought with it new amenities and technologies that, in some cases, are being abused – one such is example is video games. As Vietnam deals with disturbing violent video game related episodes, parents and community members are searching for answers. This study project focuses on understanding the mental health care system in Vietnam and its current growth and advances. Three weeks were spent in Hanoi, …