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Sociology

2017

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Full-Text Articles in Nursing

Simulation As A Multidisciplinary Team Approach In Health Care Programs In An Urban University Setting, Geraldine Fike, Dawn Blue, Guillermo Escalante, Phoebe (Yeon) S. Kim, Jose A. Munoz Dec 2017

Simulation As A Multidisciplinary Team Approach In Health Care Programs In An Urban University Setting, Geraldine Fike, Dawn Blue, Guillermo Escalante, Phoebe (Yeon) S. Kim, Jose A. Munoz

Health Science and Human Ecology Faculty Publications

The poster provided here showcases results from a simulation study that began in the Spring Quarter of 2017 at CSU San Bernardino. The results presented here are based on four simulations conducted on campus in our nursing lab space. We incorporated the participation of 44 students in our study.

Patients are cared for by a nurse and multidisciplinary teams which may include physical therapists, social workers, and public health workers; however, students in health care programs usually will not experience necessary scenarios developing needed skills. Although needed skills are learned within the walls of the university they remain in a …


An Exploration Of Dementia Friendly Communities From The Perspective Of Persons Living With Dementia, Catherine Hebert Dec 2017

An Exploration Of Dementia Friendly Communities From The Perspective Of Persons Living With Dementia, Catherine Hebert

Electronic Theses and Dissertations

The growing global prevalence of dementia coupled with a shift in public perception from a hopeless disease to the possibility of living well with dementia has led to the formation of dementia friendly communities (DFC). DFCs are a new phenomenon in the United States, with a gap in knowledge on input from people living with dementia (PLWD). This study investigated DFCs from the perspective of PLWD in Western North Carolina, with the following research questions:

  1. How are interactions and relationships experienced by persons living with dementia in the community?
  2. How is community engagement experienced by PLWD?
  3. To what extent and …


Predictors Of Cognitive Function Among Cognitively Impaired Older African Americans Living In Congregate Residential Settings, Zyra Daffodil Apugan Nov 2017

Predictors Of Cognitive Function Among Cognitively Impaired Older African Americans Living In Congregate Residential Settings, Zyra Daffodil Apugan

Dissertations

The purpose of this secondary data analysis was to identify potential psychosocial predictors of cognition, including social support, depression, and functional activity, among older African Americans, ≥ 65 years, with a diagnosis of Alzheimer’s disease and living in congregate residential settings. Guided by the main effect model of social support, this study used existing data from the National Alzheimer’s Coordinating Center Uniform Data Set, an NIH-funded multicenter study. Results showed that on average, the participants (n=56) were 81.7 years of age with 13.8 years of education. All, but six, were married. Bivariate Pearson correlations indicate a moderately strong negative relationship …


Strategies For Delivering Sexual Health Education To Adolescents With Autism Spectrum Disorders: An Integrative Review Of The Literature, Megan Harris Nov 2017

Strategies For Delivering Sexual Health Education To Adolescents With Autism Spectrum Disorders: An Integrative Review Of The Literature, Megan Harris

Grace Peterson Nursing Research Colloquium

Autism spectrum disorder (ASD) is a neurobiological condition leading to cognitive and social deficits within individuals on the spectrum. Adolescence is a time of intense physical and psychosocial changes that prove difficult for youth with ASDs. As families work through this transition they try to navigate teaching sexual health to their adolescent with an ASD. Teaching should be done to promote health, healthy relationships, and to prevent victimization. Yet, parents report that they lack the knowledge and support to complete this task. The purpose of this literature review was to synthesize research on strategies for teaching sexual health education to …


Why Women Suffer Domestic Violence In Silence: Web-Based Responses To A Blog, Salima Farooq, Tazeen Saeed Ali, Yasmin Parpio, Nasreen Lalani, Muecke Marjorie Nov 2017

Why Women Suffer Domestic Violence In Silence: Web-Based Responses To A Blog, Salima Farooq, Tazeen Saeed Ali, Yasmin Parpio, Nasreen Lalani, Muecke Marjorie

School of Nursing & Midwifery

Background & Aim: Domestic violence (DV) is a global socio-cultural concern faced by a majority of women. DV has a negative impact on women’s social, physical, and psychological wellbeing. Objective was to explore perceptions regarding contributing factors to domestic violence among women.
Methods & Materials: A qualitative descriptive exploratory method was applied for the study. Purposive sampling was used to select participants through emails to respond to the web based blog created for the study. 41 worldwide participants shared their perceptions through the blogs in the study. The data were collected using a web-based discussion forum on the Urban Women …


“I Feel Like I’M Drawing Strength From It”: Lived Experiences Of Filipino Elderly Participating In Craft-Making, Sharon B. Cajayon, Romeo Luis A. Macabasag, Norilyn Limchanco, Vanessa O. Umali, Ellayza N. Blas, Michelle S. Angulo, Cristine Joy A. Breguera, Nikka Angela A. De Guzman, Sheila N. Malapi, Emmalyn E. Quibote Oct 2017

“I Feel Like I’M Drawing Strength From It”: Lived Experiences Of Filipino Elderly Participating In Craft-Making, Sharon B. Cajayon, Romeo Luis A. Macabasag, Norilyn Limchanco, Vanessa O. Umali, Ellayza N. Blas, Michelle S. Angulo, Cristine Joy A. Breguera, Nikka Angela A. De Guzman, Sheila N. Malapi, Emmalyn E. Quibote

The Qualitative Report

In this phenomenological study, we offer an insightful understanding of the lived experiences of seven (7) Filipino elderly participating in craft-making. We purposively selected the key informants from a municipality in the province of Bulacan, Philippines. The transcribed data gathered through a semi-structured in-depth interview was analyzed using Colaizzi’s approach. Six themes describing the lived experiences emerged: “Fostering friendship,” “Flourishing health,” “Furthering service,” “Facing aging with acceptance,” “Finding felicity and self-fulfillment,” “Feelings of belongingness and security.” Just like the sun, the elderly’s participation in craft-making serves as a nourishment for them. This exploration speaks to understanding the potential of craft-making …


When The Health System Fails You: Maternal Care Under Kenya’S 2017 Nurses' Strike, Tessa Coughtrey-Davenport Oct 2017

When The Health System Fails You: Maternal Care Under Kenya’S 2017 Nurses' Strike, Tessa Coughtrey-Davenport

Independent Study Project (ISP) Collection

This study focuses on the 2017 nurses’ strike and how the crippling of the public health system impacted maternal care in Kisumu, Kenya. Kenya has one of the highest maternal mortality ratios in the world, and there have been many efforts to reduce this, such as delivery with a Skilled Birth Attendant and attending antenatal care visits, all of which are centered around a functioning health system. The research team used a combination of interviews with key populations and analysis of service delivery data at local health centers to evaluate the effects of the strike on maternal care. The study …


The Mediating Effects Of Positive Thinking And Social Support On Suicide Resilience Among Undergraduate Students, Denise Marie Matel-Anderson Oct 2017

The Mediating Effects Of Positive Thinking And Social Support On Suicide Resilience Among Undergraduate Students, Denise Marie Matel-Anderson

Dissertations (1934 -)

Suicide has been the 2nd leading cause of death for 18-24-year-olds in the US since 2011. The stress experienced by undergraduate college students has the potential to increase ones’ risk for suicide. Resilience theory was used as a theoretical framework to examine the interplay between risk and protective factors. A cross-sectional and correlational design was used to assess the mediating effects of positive thinking and/or social support on suicide resilience in 131 college students 18-24 years old who completed an online survey. An indirect effect of self-esteem on suicide resilience was found through positive thinking and social support indicating that …


Evaluating The Role Of Community Advisory Boards: With Persons Who Inject Drugs In Photovoice Research, Nicole Pallas Aug 2017

Evaluating The Role Of Community Advisory Boards: With Persons Who Inject Drugs In Photovoice Research, Nicole Pallas

Grace Peterson Nursing Research Colloquium

Background: The use of community advisory boards (CABs) is a source of leadership in community-based participatory research (CBPR); however, not all researchers have incorporated CABs, and others have restricted CAB involvement for feasibility purposes. Although there is literature about utilizing CABs in a variety of CBPR studies, less is known about the challenges and successes of working with persons who inject drugs (PWIDs) as CAB members in photovoice methodology, as well as their perceptions throughout the process.

Objectives: The purpose of this qualitative study was to investigate the role CABs play in photovoice research while determining PWIDs’ capacity to fulfill …


Understanding The Blogging Practices Of Women Undergoing In Vitro Fertilization (Ivf): A Discourse Analysis Of Women’S Ivf Blogs, Elizabeth Orr, Susan M. Jack, Wendy Sword, Sandra Ireland, Lois Ostolosky Aug 2017

Understanding The Blogging Practices Of Women Undergoing In Vitro Fertilization (Ivf): A Discourse Analysis Of Women’S Ivf Blogs, Elizabeth Orr, Susan M. Jack, Wendy Sword, Sandra Ireland, Lois Ostolosky

The Qualitative Report

Infertility and its associated treatments, including in vitro fertilization (IVF), can have a profound impact on the emotional health and well-being of women desiring to become mothers. Researchers have measured the impact of infertility and described the experience of infertility and its treatment, leaving the rich descriptions of the IVF experience as captured in women’s blogs to be explored. This discourse analysis describes the blogging practices of women undergoing IVF, exploring both the content and function of the IVF blog discourse. Data were collected from the text of seven women’s blogs (n=1,149 blog posts) and resulted in four main functions …


The Public Health Harms Of Pornography: The Brain, Erectile Dysfunction, And Sexual Violence, John D. Foubert Jul 2017

The Public Health Harms Of Pornography: The Brain, Erectile Dysfunction, And Sexual Violence, John D. Foubert

Dignity: A Journal of Analysis of Exploitation and Violence

No abstract provided.


Gadgets And Grieving: A Chronological Analysis On The Ways In Which Advancements In Medical Technologies Have Altered The Grieving Process, Grace Mcnair Jun 2017

Gadgets And Grieving: A Chronological Analysis On The Ways In Which Advancements In Medical Technologies Have Altered The Grieving Process, Grace Mcnair

Dialogue & Nexus

Since the 1940s, both end-of-life care and advancements in medical technologies have expanded exponentially. This article explores the advancements in medical technologies and how these have altered the way that Western society grieves death. With the capabilities to prolong life, the family, the patient, and the medical team, all grieve the end of life in different ways. This article provides a chronological analysis of palliative care, hospice care, and various medical advancements. These changes in medicine are then paralleled with alterations in the bereavement process. This article explores historical narratives of Western society’s transformation of grief through the lens of …


A Descriptive Study Of The Elderly In California Substance Abuse Treatment Programs, David Berenschot Jun 2017

A Descriptive Study Of The Elderly In California Substance Abuse Treatment Programs, David Berenschot

Electronic Theses, Projects, and Dissertations

As gerontologists may know, there are a great deal of studies and a variety of academic literature on the misuse of alcohol and prescription medication amongst the elderly population. While there is a plethora of information on alcohol and prescription misuse, there is little reported data about the prevalence of other substance misuse experienced by this population. This study aims to help to fill that gap in the data by using quantitative methods to describe the scope of substance abuse of individuals 55-years or older. This study utilizes data from the Treatment Data Set Admission (TEDS-A). The TEDS-A is a …


Combating Workplace Violence: An Evidence Based Initiative, Diana L. Giordano May 2017

Combating Workplace Violence: An Evidence Based Initiative, Diana L. Giordano

Evidence-Based Practice Project Reports

Patient/visitor violence against healthcare (HC) employees is a type of workplace violence (WPV) and considered a dangerous hazard within HC occupations (Bureau of Labor Statistics, 2015). Lack of recognition of the true incidence and underreporting of WPV may contribute to a false sense of security within a HC facility (HCF). Therefore, fully addressing the problem may be met with administrative resistance, resulting in poor employee perceptions of support and commitment for a zero-violence environment. A retrospective analysis was conducted on the HCF’s online incident reports, security request calls, and data from a previously deployed WPV employee survey. The emergency department …


The Application Of Grounded Theory: An Example From Nursing Workforce Research, Latoya J. Lewis-Pierre 4572586, Joann Kovacich, Linda Amankwaa May 2017

The Application Of Grounded Theory: An Example From Nursing Workforce Research, Latoya J. Lewis-Pierre 4572586, Joann Kovacich, Linda Amankwaa

The Qualitative Report

The application of grounded theory was the conduit to theory development in this study. The intent was to explore nurse manager, educator, preceptor, and new graduates’ perceptions of workplace readiness for new graduates entering an Intensive Care Unit. Research participants were drawn from five different ICUs: Medical, Coronary Care, Surgical, Neuroscience, and Trauma. One-on-one interviews were conducted to collect participants’ perspectives on readiness to practice in the ICU. Using grounded theory, four themes emerged giving rise to the novice nurse embracing the ICU theory (NNEIT). Reflections on the type of grounded theory used, reasons for the selection, challenges faced in …


The Emotional Cost Of Caring: Compassion Fatigue Experienced By Nurse Staff On An Inpatient Geriatric Behavioral Health Unit, Susan Annette Campbell May 2017

The Emotional Cost Of Caring: Compassion Fatigue Experienced By Nurse Staff On An Inpatient Geriatric Behavioral Health Unit, Susan Annette Campbell

Theses and Dissertations from 2017

Purpose: Research studies on the prevalence of compassion fatigue (CF) in nursing have been conducted in various clinical settings. There has been limited empirical research conducted on nurses working within the geriatric behavioral health setting, which can present increased nursing challenges related to the chronic health problems of aging coupled with acute behavioral health crises. The purpose of this quantitative, descriptive research study was to identify the prevalence of CF in RN and LPN staff within an inpatient geriatric behavioral health unit setting in two comparably sized hospitals. Design/Methods: An electronic survey design (consisting of demographics and the ProQOL v. …


Analyzing Organizational Commitment And The Effect On Job Turnover In Nurse Residents, Cory D. Church Apr 2017

Analyzing Organizational Commitment And The Effect On Job Turnover In Nurse Residents, Cory D. Church

Nursing Theses and Dissertations

This dissertation is an exploration of psychosocial concepts related to the experiences of a vital health human resource, newly licensed registered nurses. Newly licensed registered nurses are at risk for leaving their first job within the first year due to the difficulty of transitioning to practice. The pressure to gain competence and deliver quality care, all while navigating the workplace environment, can impact their commitment to an organization and the profession. The reader will notice these concepts threaded throughout the dissertation. While these concepts are explored in other nursing workforce populations, the researcher determined a gap in the research on …


Grounded Theory And The Conundrum Of Literature Review: Framework For Novice Researchers, Mohamed T. El Hussein, Andrea Kennedy, Brent Oliver Apr 2017

Grounded Theory And The Conundrum Of Literature Review: Framework For Novice Researchers, Mohamed T. El Hussein, Andrea Kennedy, Brent Oliver

The Qualitative Report

The issue of the literature review remains a conundrum and a controversy within the discourse on grounded theory methodology. Grounded theory researchers are expected to minimize preconceptions to ensure the concept of interest is grounded in data, yet at the same time are required to evaluate existing literature to support institutional ethics and scientific review of the research proposal. In addressing this dilemma, we espouse that literature review in grounded theory should comprise a multistage nonlinear approach to the literature and introduce a framework for novice grounded theory researchers. This framework offers a reflexive, dynamic and integrative process for conducting …


Improving Lgbt Cultural Competence In Senior Nursing Students, Hallie Orgel Apr 2017

Improving Lgbt Cultural Competence In Senior Nursing Students, Hallie Orgel

Evidence-Based Practice Project Reports

LGBT (lesbian, gay, bisexual, transgender) health care is considered a national priority by The Institute of Medicine (IOM, 2011) and HealthyPeople 2020 (2013). The shortage of LGBT culturally competent health care providers is a top contributor to the oppression and discrimination affecting LGBT health (2013). The purpose of the evidence-based practice (EBP) project was to improve the cultural competence of nursing students by improving their knowledge, attitudes, and skills in working with the LBGT population. A multi-method intervention was provided to seniors in a baccalaureate program. The project took place at a private Midwestern university and utilized a pretest/post-test design. …


Opening Up About Birth: An Autoethnographic Account Of Prolonged Labour, Petra B. Elias Feb 2017

Opening Up About Birth: An Autoethnographic Account Of Prolonged Labour, Petra B. Elias

The Qualitative Report

A woman’s first pregnancy can be both emotionally exciting and daunting. There are many changes to make, but there is little emotional support to adjust to the role, the focus being on the physical process which is most often managed medically (Spear, 2008; Zasloff, Schytt, & Waldenström, 2007) though warnings about what could occur are not routinely told (Kaitz, 2007, pp. 720-721). This paper presents an autoethnographic story of first time pregnancy and the unfolding labour. The methodology of autoethnography is a useful tool for conveying stories of lived experience at a level of detail often previously unrecorded, evoking for …


Improving Patient Safety Through High Reliability Organizations, Jared Padgett, Kenneth Gossett, Roger Mayer, Wen-Wen Chien, Freda Turner Feb 2017

Improving Patient Safety Through High Reliability Organizations, Jared Padgett, Kenneth Gossett, Roger Mayer, Wen-Wen Chien, Freda Turner

The Qualitative Report

Preventable medical errors result in the loss of 200,000 lives per year with associated financial and operational burdens on organizations and society. Widespread preventable patient harm occurs despite increases in healthcare regulations. High reliability organization theory contributes to improved safety and may potentially reverse this trend. This single case study explored the introduction of a safety culture and subsequent improvements in patient safety in a reliability-seeking organization. Fourteen participants from a subacute nursing facility were selected using purposeful sampling criterion. Data were collected through participant interviews, document reviews, and group observation. Five themes emerged from an analysis of collected data …


Warmth And Competence Traits: Perceptions Of Female And Male Nurse Stereotypes, Randolph E. Gross Feb 2017

Warmth And Competence Traits: Perceptions Of Female And Male Nurse Stereotypes, Randolph E. Gross

Dissertations, Theses, and Capstone Projects

A nursing shortage looms ahead; 1.03 million new nurses will be needed by 2022 to meet society's healthcare needs. A major barrier to recruitment of women and men are nurse stereotypes. The literature suggests four female and four male stereotypes exist; however, no quantitative research exists that explores perceptions of non-nursing undergraduate students. Approximately, 90% of college students do not consider nursing as a career option, and 72% have misconceptions of what nurses do in reality.

According to social cognitive theory's Stereotype Content Model (SCM), perceptions are viewed through a combination of two dimensions: warmth and competence. The author devised …


Religious/Spiritual Coping In Older African American Women, Danice B. Greer, Willie M. Abel Jan 2017

Religious/Spiritual Coping In Older African American Women, Danice B. Greer, Willie M. Abel

The Qualitative Report

The purpose of this study was to identify religious/spiritual coping behaviors of African American women with hypertension (HTN) and explore how religious/spiritual coping influences adherence to high blood pressure (HBP) therapy in older African American women. A mixed-method research design guided this study. Twenty African American women with primary HTN were enrolled in this study using a mixed methods concurrent triangulation design. Data collection included physiologic, descriptive, and sociodemographic data. Adherence was measured using the Hill-Bone Compliance to High Blood Pressure Therapy scale (Kim, Hill, Bone, & Levine, 2000), and religious/spiritual coping was evaluated with the Brief Religious/Spiritual Coping scale. …


The Use Of Physical Restraints In Long-Term Care In Spain: A Multi-Center Cross-Sectional Study, Gabriel J. Estévez-Guerra, Emilio Fariña-López, Eduardo Núñez-González, Manuel Gandoy-Crego, Fernando Calvo-Francés, Elizabeth Capezuti Jan 2017

The Use Of Physical Restraints In Long-Term Care In Spain: A Multi-Center Cross-Sectional Study, Gabriel J. Estévez-Guerra, Emilio Fariña-López, Eduardo Núñez-González, Manuel Gandoy-Crego, Fernando Calvo-Francés, Elizabeth Capezuti

Publications and Research

Background: Physical restraint is a procedure used frequently in long-term care. It is a controversial practice because its use is associated with numerous complications and also affects freedom and individual autonomy. The objective of this study was to examine the use of physical restraint of long-term care residents with the ability to move voluntarily.

Methods: We conducted a cross-sectional observational and correlational multi-center study. Nine centers agreed to participate. Of the 1,200 people present at the time of data collection, those without voluntary movement or in the facility for less than a month were excluded. Thus, the final sample was …


Developing Morally Sensitive Policy In The Nicu: Donation After Circulatory Determination Of Death, Michael Van Manen, Nicole Kain Jan 2017

Developing Morally Sensitive Policy In The Nicu: Donation After Circulatory Determination Of Death, Michael Van Manen, Nicole Kain

The Qualitative Report

Policy development is an important activity for the practice of healthcare. Policies, after all, may cultivate common practices and ensure that best available evidence is employed in clinical decision making. Qualitative research and individuals with expertise in qualitative research methods have much to offer policy makers. We were confronted with the situation of developing policy for donation after circulatory death (DCD) for our newborn intensive care program. Due the moral-ethical complexities surrounding DCD, and the limited experience with DCD in this context, we approached policy development from an iterative design perspective employing qualitative methods. We describe our experience in employing …


Professional Nursing Value Development In Nursing Students Who Participate In International Service Learning, Heather Ferrillo Jan 2017

Professional Nursing Value Development In Nursing Students Who Participate In International Service Learning, Heather Ferrillo

Nursing Faculty Publications

Background: International Service Learning (ISL) is becoming widely used in nursing education as a means to provide global learning opportunities. Concrete outcomes for these experiences have not been clearly supported in previous research. Determining if ISL experience facilitate the development of Professional Nursing Values (PNV) can support the use of ISL as a viable pedagogy. Purpose: The purpose of the study was to determine if there were a difference in PNV development in students who participate in ISL as part of their clinical experiences compared to those who do not. The hypothesis was that there was a difference in the …


The Impact Of Nursing Staff Ratios On Falls Rates In Skilled Nursing Facilities, Akudo Okeorji Jan 2017

The Impact Of Nursing Staff Ratios On Falls Rates In Skilled Nursing Facilities, Akudo Okeorji

Walden Dissertations and Doctoral Studies

Falls and complications from falls are a common problem among adults aged 65 years and older. About 60% of older adults fall every year, causing injuries, hospitalization, nursing home placement, and even death. Most studies on falls among skilled nursing facility (SNF) residents focus on fall preventive measures that fail to include staffing variables such as nursing hours. Although researchers have examined the relationship between nursing staff and patient outcomes in hospital settings, similar studies have not occurred in long-term care facilities. The purpose of this retrospective longitudinal study was to determine whether a correlation exists between nursing staff hours …


Chinese Nursing Students At Australian Universities: A Narrative Inquiry Into Their Motivation, Learning Experience, And Future Career Planning, Carol Chungfeng Wang Jan 2017

Chinese Nursing Students At Australian Universities: A Narrative Inquiry Into Their Motivation, Learning Experience, And Future Career Planning, Carol Chungfeng Wang

Theses: Doctorates and Masters

This study presents a narrative inquiry of Chinese nursing students at Australian universities in order to examine these students’ motivations, learning experiences and future career planning. Australia seeks to attract international nursing students from China to maintain its economic advantage and alleviate its projected nursing shortage. In contrast, China desperately needs its best and brightest citizens who have trained abroad as nurses to return to China in order to cope with its current challenges in the healthcare system and nursing education. Little is known about the underlying factors that motivate Chinese nursing students to study in Australia, these students’ learning …


Quality Improvement Initiative To Reduce Fall Risk In The Snf, Ramona C. Lancaster Jan 2017

Quality Improvement Initiative To Reduce Fall Risk In The Snf, Ramona C. Lancaster

Walden Dissertations and Doctoral Studies

Residents who fall in SNF either sustain significant decline to quality of life or die from their injuries. The average fall costs about $34,000 per incident. On average, 19.8% of residents fall at least once per month. The purpose of this project was to assess, identify, and advance nursing practice to decrease falls by evaluating current facility standard of practice, fall policy, procedures, and protocol. The objective was to create actions that would close the communication gap between clinicians and residents. This project encourages clinicians to intertwine resident feedback and strategies into the plan of care to help reduce fall …


Staffing Standards And Care Outcomes In For-Profit And Not-For-Profit Religious-Based Nursing Homes, Ara Omobola Omotowa Jan 2017

Staffing Standards And Care Outcomes In For-Profit And Not-For-Profit Religious-Based Nursing Homes, Ara Omobola Omotowa

Walden Dissertations and Doctoral Studies

Vulnerable older adults residing in nursing homes continue to experience poor care outcomes due to nurse staffing levels that are below the levels required for maintaining their well-being. Studies have shown that patient care outcomes in nursing homes are related to nurse staffing standards/levels, which are affected by profit maximization on adherence to registered nurses and licensed nurse staffing standards. The purpose of this descriptive study was to determine if there was a relationship between adherence to staffing standards and care outcomes in for-profit (FP) and not-for-profit religious-based (NFPRB) nursing homes using the profit maximization theory. Research questions focused on …