Health and Medical Administration Commons^™

Narratives Of Men Living With Systemic Lupus Erythematosus, Kimberly Vandermark Lynch

Walden Dissertations and Doctoral Studies

While systemic lupus erythematosus (SLE) has been traditionally viewed as a woman's disease, SLE impacts men as well. Although most research on SLE has concentrated on how it affected women, little is known about how it impacts men. The purpose of this phenomenological study was to examine how men who live with SLE perceive its psychological impact. Using the lens of the biopsychological theory, common themes were examined pertaining to how men with SLE perceive the impact that SLE has on their cognitive and emotional functioning. Data were collected via interviews with 9 men with SLE, and the data were …

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 …

Influences Of Provider-Patient Communication On Health Literacy And Public Policy Relevant Outcomes, Rachel Carla Cartwright-Vanzant

Walden Dissertations and Doctoral Studies

Several artifacts of federal policy address the connection between health literacy of patients and health outcomes. These laws include The Plain Writing Act, Health Information Technology for Economic and Clinical Health, and the Health Insurance Portability and Accountability Act. Even with this policy structure, little is known about how nurses' knowledge of health literacy may influence patient understanding of medical information and health outcomes. Using Knowles' principles of effective communication, the purpose of this mixed-methods study was to concurrently examine the relationship between nurse knowledge of health literacy and communication techniques used by nurses to identify any causal relationships in …

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 …

Facilitating Environmental Enrichment In Senior Care Activities With Professional Development, Celia Mary Ross

Walden Dissertations and Doctoral Studies

There is little known about the current state of professional development and continuing education practices for empowering activity professionals to better enhance environmental enrichment in long term care. The purpose of this qualitative study was to explore the activity professional's perceived role and best strategies for professional development to enrich the long-term care environment. The study used social cognitive theory as its theoretical framework to develop research questions focused on the views of activity professionals concerning professional development and continuing education to support care for long-term care residents. Using a narrative approach, 9 activity professionals were recruited through networking at …

Practicing Sacred Encounters: A Narrative Analysis Of Relational, Spiritual, And Nursing Leadership, Margaret Woodrow Mark

Antioch University Dissertations & Theses

This research examined one large health system that has, through a stated mission outcome that every encounter is a sacred encounter, sought to enhance relationships occurring within the health care environment. Seeking to understand the lived experience of sacred encounters through the lens of nurse leaders in one acute care hospital settings this study examined how nurse leaders experienced their leadership role in realizing sacred encounters. Participants were defined as nurse leaders from one hospital setting and included nurse managers, directors and one vice president. A narrative thematic analysis framed by situational analysis was the method of inquiry. Data was …

Exploring Job Satisfaction And Preceptorship Capacity Among Applied Epidemiologists, Jessica C. Arrazola

College of Graduate Studies: Theses & Dissertations

Job satisfaction is important to consider when developing strategies for recruitment and retention. The Public Health Workforce Interests and Needs Survey (PH WINS) conducted in 2014 was the first nationally representative assessment of the state public health workforce. Prior to this assessment, the job satisfaction of state agency public health workers and preceptor capacity had not been measured. This study fills the current research gaps by studying the job satisfaction among the applied epidemiology workforce, identifying factors influencing job satisfaction, and the describing the preceptorship capacity among epidemiologists. This research is based on the 2014 PH WINS data. The analysis …

Racial And Ethnic Differences In Receipt Of Immediate Breast Reconstruction Surgery: Do Hospital Characteristics Matter?, Jaya Shankar Khushalani

Theses and Dissertations

Immediate Breast Reconstruction Surgery (IBRS) is associated with better quality of life among women who undergo a mastectomy. Despite insurance coverage for IBRS, utilization of IBRS remains low. Data from publicly available sources for 2010-2012 are used to examine the association between hospital characteristics receipt of IBRS by patients. Minority-serving status, low bed size, for-profit ownership, non-teaching status, high competition, low density of plastic surgeons in the market and non-metropolitan location are associated with lower likelihood of receipt of IBRS.

Racial and ethnic minorities are less likely to receive IBRS. A mixed effects logistic regression model with interactions between Black/Hispanic …

Researchers', Stakeholders', And Investors' Perceptions Of U.S. Stem Cell Research Policy, Dorothy King-Moore

Walden Dissertations and Doctoral Studies

Federal support and funding for human embryonic stem cell (hESC) research in the United States lags behind stem cell programs in many countries because of the divisive debate over hESC research and the continually evolving federal policies that have hindered research efforts. The purpose of this phenomenological study was to explore the perceptions of stem cell researchers, stakeholders, and investors in the United States about the effects of the current federal stem cell policy on stem cell research in the United States, the moral disagreement with stem cell research, and their recommendations to improve stem cell research policy in the …

Relationship Between Health Care Costs And Type Of Insurance, Macey Buker

Walden Dissertations and Doctoral Studies

Continued escalation in health care expenditures in the United States has led to an unsustainable model that consumes almost 20% of GDP. Policymakers have recognized the need for industry reform and have taken action through the passage of the Affordable Care Act (ACA). The purpose of this quantitative, longitudinal study was to examine the relationship between the type of health insurance and health care costs. Mechanism theory and game theory provided the theoretical framework. The analysis of secondary data from the Healthcare Cost and Utilization Project included a sample of 1,956,790-inpatient hospital stays from 2007 to 2014. Results of one-way …

Policing The Mentally Ill In Coronado, Ca, Jennifer Susan Ayres

Walden Dissertations and Doctoral Studies

The growing number of individuals suffering from mental illnesses and their inability to access intervention methods has adverse effects on the criminal justice system. These impairments increase the likelihood that police officers will have negative attitudes about persons with mental illnesses. This study sought to understand whether police officers' empathy, education, experience outside of work as well as on the job, and officers' training in the field of mental health all related to police officers' attitudes relating to persons with mental illness. The purpose of this study was to expand the body of knowledge and determine how factors such as …

Initial Findings Of A Medicare Annual Wellness Visit Program, Hesper B. Nowatzki

Walden Dissertations and Doctoral Studies

Despite the emphasis of benefits on preventive health, many older adults are not receiving the recommended age specific, evidence based screenings and vaccinations. The Medicare Annual Wellness Visit (AWV) is designed to address modifiable risk factors with aging adults and close gaps in care not captured in routine office visits. Although a free Medicare benefit to patients, and a reimbursable service to health care providers, participation in the AWV is low nationwide. The purpose of the project is to introduce an AWV program to a rural health clinic in Northwest Illinois that has a population consisting of over 25% of …

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 …

Impact Of A Student-Scheduled Child Care Program On Parents' Educational Goals, Barbara Carter

Administrative Issues Journal

The purpose of this study is to examine what, if any, impact a Student-scheduled Child Care (SSCC) program had on the families of students completing their higher education goals at a college in the southwestern region of the United States. Student completion rate is a concern for most college and university administrators. Research conducted by the Gates foundation determined that over three quarters of former students surveyed felt that they would have graduated if the college or university had offered child care (Johnson, Ott, & DuPont, 2011). This correlational and descriptive research study revealed what student families thought about the …

Advanced Placement U.S. History And The Application Of Social Justice, Katherine A. Curry, Lou L. Sabina, Jon Loffi

Administrative Issues Journal

Recent changes to Advanced Placement U.S. History have sparked a national debate concerning goals and purposes of college level history courses. Critics suggest that the revisions result in a national curriculum that promotes a revisionist history perspective. Defenders claim that revisions are an important step in preparing students for 21st century citizenship. This document analysis identifies key differences between the 2010 and 2014 AP U.S. History frameworks and considers changes made in 2015 by College Board in response to the national debate. The challenges of applying a social justice lens to curriculum are discussed, and suggestions are made concerning the …

Administrative Issues Journal: Table Of Contents And Letter From The Editor, Jared F. Edwards

Administrative Issues Journal

No abstract provided.

Planning A Library Leadership Retreat On The Cheap: Case Study And Analysis, Stewart Brower

Administrative Issues Journal

Staying ahead of the pitch: an old baseball metaphor that means to anticipate where the ball is going to go so that the batter can score a hit. But to anticipate changes in a field as robust and challenging as information sciences, reflection and contemplation are often key to good planning. With simple day-to-day management of libraries already being a full-time task, true leadership and planning often comes with a real, physical break from the workplace and daily routines. With this in mind, the leadership retreat should be employed by librarians to give themselves the luxury of deep reflection, camaraderie, …

Police Attitudes And Professionalism, Joseph Loftus, Keith Price

Administrative Issues Journal

This quantitative study utilized Richard H. Hall's attitudinal attributes of a professional using a Likert scale. The survey was administered to officers in two similar mid-sized police departments. The first agency had 650 officers, while the second had 350 officers. Agency One requires all applicants to possess a bachelor's degree, while Agency Two does not have this requirement. It was hypothesized that the officers with a bachelor's degree would possess an enhanced attitudinal level of professionalism over those without. It was also hypothesized that officers belonging to an agency that requires a bachelor's degree will have an enhanced attitudinal level …

Motivating Adult Learners: Exploring The Emergence Of Adult Business Students In An East Texas University, Douglas Luke, Madeline Justice

Administrative Issues Journal

Adult enrollment in higher education institutions has grown significantly during the last decade, with students aged 25 and older attending 4-year institutions at higher rates than before. In the 21st century, few can improve their socioeconomic status or advance professionally without higher education. Colleges and universities must consider this diverse student population by identifying new modes of motivation for students to pursue degrees at 4-year institutions. Research suggests that universities focus on the new learners of higher education: nontraditional students who are motivated by their desire to learn and advance professionally. This study examined motivational factors and patterns of students …

Transforming High School Counseling: Counselors' Roles, Practices, And Expectations For Students' Success, Wei-Cheng J. Mau, Jiaqi Li, Kimberly Hoetmer

Administrative Issues Journal

This study examined the current roles and practices of American high school counselors in relation to the ASCA National Model. Expectations for student success by high school counselors were also examined and compared to those of teachers' and school administrators'. A nationally representative sample of 852 lead counselors from 944 high schools was surveyed as part of the High School Longitudinal Study: 2009-2012. Findings are examined in the light of the National Model and advocated practices.

Latina Titans: A Journey Of Inspiration, Velma D. Menchaca, Shirley J. Mills, Filomena Leo

Administrative Issues Journal

This qualitative research examined the journey of renowned female leadership in higher education. Two top level Latina administrators of universities were interviewed extensively to discover their journey to leadership. The theoretical framework used was Latina critical race theory, feminist theory, and counter-storytelling. Themes that surfaced were strong supportive mother, fervent faith, humble beginnings, mentors, intelligence, and challenges not obstacles. These guiding themes serve as a path for Latinas who aspire to higher educational leadership positions.

Cheating In Online Courses For Financial Aid Fraud In The U.S., Robert S. Owen

Administrative Issues Journal

This manuscript reviews issues that differentiate traditional academic cheating from course misconduct that is motivated by a desire to defraud financial aid services in the U.S. Past research on college student cheating has assumed that cheaters are driven by an incentive to obtain undeserved grades in college in order to ultimately obtain a degree. However, researchers on academic dishonesty, professors, and college administrators might not realize that online class members can include virtual "straw" students who are puppets of a financial aid fraud ring leader. Cheating behaviors of straw students differ from cheating behaviors of actual, legitimate students. This has …

Envisioning Mechanisms For Success: Evaluation Of Ebcd At Cheo, Kristina Rohde, Mireille Brosseau, Diane Gagnon, Jennifer Schellinck, Christine Kouri

Patient Experience Journal

To advance patient engagement (PE) and more comprehensively involve patients, families, and staff in quality improvement (QI) at the Children’s Hospital of Eastern Ontario (CHEO), the Experience Based Co-Design (EBCD) approach was piloted. Set against the backdrop of envisioning factors that would facilitate success, an evaluation was designed to assess five domains: strengthening of mutual understanding, collaboration, and partnerships between patients/families and staff; a greater involvement of patients, families, and staff in QI; satisfaction with the process; the ability of EBCD to generate clear and useful data to ascertain the patient/family and staff experience; and the ability of EBCD to …

Patient Advisors: How To Implement A Process For Involvement At All Levels Of Governance In A Healthcare Organization, Marie-Pascale Pomey, Edith Morin, Catherine Neault, Veronique Biron, Lise Houle, Louise Lavigueur, Guy Bouvette, Nicole St-Pierre, Martin Beaumont

Patient Experience Journal

Patient involvement at the operational (clinical care and services), tactical (management), and strategic (board of directors and executive management) levels of establishments is increasingly sought after. To address this specific challenge, a Canadian healthcare organization, the Centre intégré universitaire de santé et de services sociaux de la Mauricie-et-du-Centre-du-Québec, has developed an integrated strategy based on three principles: (1) shared leadership between a patient and a manager to build the strategy; (2) a clear process for recruiting, training, and coaching patient advisors (PA) so that they can participate in decision-making at the various levels of governance of the establishment; and (3) …

Using Patient Value Statements To Develop A Culture Of Patient-Centred Care: A Case Study Of An Ontario, Canada Hospital, Erica Bridge, Madelyn P. Law, Miya Narushima

Patient Experience Journal

Patient-centred care (PCC) is not a new concept; however, in recent years it has garnered increasing attention in the research literature and clinical practice. PCC in clinical practice has been found to improve clinical outcomes, resource allocation, and the patient experience. In response to the need for PCC and quality in healthcare, the Ontario, Canada government developed the Excellent Care for All Act (ECFAA) in 2010. The ECFAA imposes six obligations to Ontario hospitals, one of which is developing and publishing a Patient Declaration of Values (PDoV). The purpose of this study was to explore how a leading patient-centred Ontario …

Creating A Common Trajectory: Shared Decision Making And Distributed Cognition In Medical Consultations, Katherine D. Lippa, Valerie L. Shalin

Patient Experience Journal

The growing literature on shared decision making and patient centered care emphasizes the patient’s role in clinical care, but research on clinical reasoning almost exclusively addresses physician cognition. In this article, we suggest clinical cognition is distributed between physicians and patients and assess how distributed clinical cognition functions during interactions between medical professionals and patients with Multiple Sclerosis (MS). A combination of cognitive task analysis and discourse analysis reveals the distribution of clinical reasoning between 24 patients and 3 medical professionals engaged in MS management. Findings suggest that cognition was distributed between patients and physicians in all major tasks except …

Improving The Patient Experience Through A Commit To Sit Service Excellence Initiative, Cari D. Lidgett

Patient Experience Journal

Effective communication between nurses and patients positively impacts patient care, outcomes, and the patient experience.While in the hospital, patients receive information from multiple caregivers and are often overwhelmed and confused. Nurses make up the majority of interactions with patients and are in an ideal position to improve the patient experience from the front lines. The purpose of implementing the Commit to Sit service excellence initiative was to positively impact the patient’s perception of nurse communication by nurses sitting with their patients during each shift. Outcomes were measured by the overall nurse communication composite on the Press Ganey survey, as well …

Beyond Patient-Centered Care: Enhancing The Patient Experience In Mental Health Services Through Patient-Perspective Care, Timothy A. Carey Prof

Patient Experience Journal

Delivering mental health services as patient-centered care has been an international priority for more than 50 years. Despite its longevity there is still not widespread agreement regarding how it should be defined or how it should guide the delivery of services. Generally, though, prioritizing the patient’s values and preferences seem to be at the core of this particular approach. It is not clear, however, that services attend to patient values and preferences as closely as they should. Terms such as “treatment resistant” and “noncompliant” seem to belie an attitude where the therapist’s opinion is privileged rather than the patients. To …

Why Do They Do That?: Looking Beyond Typical Reasons For Non-Urgent Ed Use Among Medicaid Patients, Cynthia J. Sieck, Jennifer L. Hefner, Randy Wexler, Chris A. Taylor, Ann S. Mcalearney

Patient Experience Journal

Barriers to accessing primary care, including lack of transportation and inadequate appointment times, are common reasons for non-urgent emergency department (ED) use yet even when these barriers are addressed, the problem persists. This study explored non-urgent ED use by Medicaid enrollees through interviews with patients and providers and sought to identify themes beyond the commonly mentioned logistical and access issues. Qualitative interviews with 23 Medicaid enrollees and 31 PCP and ED providers utilizing a semi-structured interview guide focused on reasons for seeking care in the ED and issues associated with PCP appointments. We identified overlap as well as surprising differences …

Uninsured Free Clinic Patients’ Experiences And Perceptions Of Healthcare Services, Community Resources, And The Patient Protection And Affordable Care Act, Akiko Kamimura, Jeanie Ashby, Ha Trinh, Liana Prudencio, Anthony Mills, Jennifer Tabler, Maziar Nourian, Fattima Ahmed, Justine Reel

Patient Experience Journal

Free clinics provide free or reduced fee healthcare to individuals who lack access to primary care and are socio-economically disadvantaged. There has been a paucity of free clinic research with the few studies employing a quantitative design. The purpose of this study is to conduct an in-depth qualitative exploration of free clinic patients’ experience and perceptions of healthcare services, community resources, and the Patient Protection and Affordable Care Act (ACA). Free clinic adult patients (n=35) participated in four focus groups between June and July 2014 (one Spanish group in June, and two English groups and one Spanish group in July) …