Social and Behavioral Sciences Commons^™

"I Stayed There The Whole Night": Exploring Caregivers' Experiences With The Healthcare System When Caring For A Parent At The End Of Life, Lillian Mehran

Dissertations and Theses

Background: In the United States, there are nearly 53 million individuals serving as caregivers to a loved one. Half of all caregivers are caring for a parent or parent-in-law, and 79% of caregivers are caring for a person aged 50 or older. In New York State, there are an estimated 4.1 million caregivers who collectively provide over 2.6 billion hours of unpaid care, with those caring for a person at the end of life providing twice as many hours of caregiving per week compared to other caregivers. The number of individuals requiring caregiving is expected to increase as a significant …

Treatment Disparities In Emergency Medical Services: The Influence Of Race/Ethnicity, Obesity, And English Proficiency, Jamie Kennel

Dissertations and Theses

Different treatment in healthcare settings provided to different social groups of people may lead to disparities in health, quality of life, and life span. Despite the critical role among healthcare services that Emergency Medical Services (EMS) provides disproportionately for marginalized communities, it remains unclear if and to what extent treatment disparities take place in the pre-hospital setting. Guided by the theoretical frameworks of social worth, aversive racism, and stigma, this study utilizes medical chart data from three different public and private datasets to investigate treatment disparities by Emergency Medical Service providers for racial minority, obese, and limited English proficiency patients. …

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 …

Activist Doctors: Explaining Physician Activism In The Oregon Movement For Single-Payer Healthcare, Jennifer Cullen Loomis

Dissertations and Theses

Changes in American healthcare over the last half century have created social and economic crises, presenting challenges for doctors and patients. The recently-implemented Patient Protection and Affordable Care Act is an incremental reform that does little to change the complex multi-payer financing characterizing American healthcare. There have been growing demands for more equitable financing arrangements, notably, a single-payer healthcare system in which medical care is financed through a single, non-profit payer and in which medical care is treated as a public good and medically-necessary care is available to everyone.

Nationally-representative surveys have demonstrated widespread physician support for single-payer legislation. Yet, …

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 …

Public Opinion And The Oregon Death With Dignity Act, Peggy Jo Ann Sandeen

Dissertations and Theses

Oregon voters legalized physician-assisted death in 1997 by passing the Oregon Death with Dignity Act. This law allowed terminally ill, mentally competent adult residents of the state to legally obtain a physician's prescription to hasten death under narrow sets of circumstances. The purpose of this study was twofold: to examine contemporary patterns of support for the law in Oregon and to explore how opinions have changed over time on the issue. This study examined patterns of public support among a random sample of registered Oregon voters for the state's death with dignity law, using a mixed mode (mail, online, and …

Understanding The Role Of Patient Activation In The Association Between Patient Socio-Economic Demographics And Patient Experience, Katsuya Oi

Dissertations and Theses

This study focuses on the association between patient characteristics, which include both demographic and contextual factors, and patients' experiences with health care. The pre-existing literature provides rich information about patients' various demographics related to patient experience. Despite the abundance of empirical evidence showing that patients' demographics do affect how they perceive their health care. However, there is little to no empirical knowledge explaining the significance of such factors. As the existing literature points out the need for taking into contextual factors such as patient's beliefs, attitudes, skills that are pertinent to dealing with health care, my study proposes patient activation …

Physicians Providing Alternative Medicine: Boundary Crossing And The Emergence Of Integrative Medicine, Richard Scott Lockwood

Dissertations and Theses

Integrative medicine (IM) has organized as a new area of specialization in mainstream healthcare. The development of IM is widely attributed to popular demand for the range of therapies known collectively as Complementary and Alternative Medicine (CAM). During the 1990's the rate of acceptance of CAM accelerated among consumers, professions, financing and education. The Medical Expenditure Panel Survey (MEPS) measured CAM utilization and professional service provision during the years 1996 and 1998, but never since. These surveys were unique because they specifically inquired as to whether CAM was provided by a physician, among other types of professionals. This dissertation defines …

Black Women's Health: A Content Analysis Of The Journal Of The American Medical Association, The American Journal Of Public Health, And The New England Journal Of Medicine (1989-1998), Tonia Marie Burkett

Dissertations and Theses

According to the National Vital Statistics Report (1998), Black women age 45-64 are ten times more likely than white women of the same age to die from diseases of the heart. They are five times more likely to die from diabetes. The goal of this study was to examine how articles published in leading medical journals between 1989 and 1998 accounted for such differences in health outcomes among Black and white women.

The explanatory content of the articles was analyzed and coded according to four types of attributions: genetic/biological, cultural/behavioral, structural/socioeconomic and alternative. Each type of explanation derives from different …

A Study Of Psoriasis : A Methodological Critique, Prudence Craig Ford, Roberta Jeanne Ford, Susan Swanson

Dissertations and Theses

According to the National Psoriasis Foundation (1976), psoriasis is a little known and poorly understood skin disease afflicting an estimated eight million victims in the United States. About fifteen thousand new cases of psoriasis are diagnosed each year. It affects men and women in equal numbers at any age, most often between the ages of fifteen and thirty-five.

Social Work Intervention And Patients' Utilization Of The Kaiser Health Care System, Pegi Sten, Liz Swint Young

Dissertations and Theses

This study was an analysis of social work practice in a medical setting: analyzing the work of a medical social worker in an outpatient clinic located in a metropolitan area. The primary purpose of this descriptive study was to evaluate the performance of a medical social worker in a Kaiser-Permanente outpatient clinic and to determine if there were possible associations between social work intervention and patient utilization of existing services offered by the Kaiser Health Care system, also referred to herein as Kaiser. Specifically, the study attempted to determine if there were quantitative changes in patient contacts, and utilization of …

Quality Of Life Assessment Of Chronic Hemodialysis Patients At The Artificial Kidney Unit Of Good Samaritan Hospital And Medical Center, Karen Jones Whittle, Michael Tripp, Bruce De Young

Dissertations and Theses

The purpose of this study was to evaluate certain factors that affect the quality of life experienced by the chronic hemodialysis patient population served by the Artificial Kidney Unit at Good Samaritan Hospital and Medical Center, Portland, Oregon. The intent of the study was to discover if there was a significant difference in quality of life between patients who dialyzed at home and patients at the Artificial Kidney Unit (center patients).

For the purposes of this study, House, Livingston and Swinburn’s definition of quality of life was used. Their definition states that quality of life is a function of the …

A Descriptive Study Of The Pragmatic Issues In Obtaining An Abortion Among Sixty-Five Women At Lovejoy Specialty Hospital, Portland, Oregon, Barbara E. Bordner, Wendy Green, Susie Milberg

Dissertations and Theses

In view of the current diversity of public opinion concerning the legalization of abortion in this country, it appears timely that a study of the pragmatic issues faced in obtaining an abortion be undertaken. The researchers see this as a step toward narrowing the lag between the enactment of the abortion law and the delivery of services that allow the right of abortion to be an accessible choice for women.

There has been a change in public opinion, regarding the right of abortion, only recently. In 1960, a public opinion poll showed that fewer than 15 percent of the population …

Motivational Factors Behind Repetitive Abortions, Kelly Osmont, Ellen Wolfford

Dissertations and Theses

This practicum intends to explore the motivational factors behind repeat abortions. The underlying assumptions of this study include: (1) women have abortions; (2) women have repeat abortions. Based on these assumptions, the two research questions are (1) are there significant factors in the causation of repeat abortions, and (2) what are the implications regarding the lack of information and service to women which have a direct relationship to repeat abortions.

The Utilization Of Preventive Health Care Services By Low Income Members Of A Comprehensive Prepaid Health Plan : The Impact Of Outreach Services, Linda Elmlund Mahoney

Dissertations and Theses

A reading of recent studies in preventative health care behavior recalls the proverb about the blind men and the elephant: each man is able to describe the part of the animal he is closest to, but none can see, and so none can put their diverse and often contradictory opinions together to come up with an accurate description of the whole elephant. Similarly, in preventative health care studies, each researcher or research group is able to observe the preventative health care utilization patterns of specific populations at particular times, but the conclusions reached are often based on less than complete …

A Study Of Ambulance Transportation In Relation To Public Welfare Policy, Gary Jules Lutz

Dissertations and Theses

This study examines the Public Welfare Medical Transportation Program with particular focus on ambulance transportation. It addresses the problems Public Welfare has in funding and administrating the program, looks at the components of the larger emergency medical care system and its relationship to Public Welfare, studies who, how, and why this service is being delivered, and makes recommendations for policy revision in respect to the larger emergency medical care system.

Two Delivery System Contexts For The Elderly:The "Institutional" Approach And The "Community" Approach., Mary Sarita Freer

Dissertations and Theses

Theoretically every society has some institutional means which seeks to prevent and alleviate personal misfortune and illness "Institutions are standardized solutions to collective problems." The increasing population rate of older persons, many of whom suffer from chronic diseases and disabilities, does pose a collective problem for society. Formerly, the "institutional" approach developed to address the needs of chronic aging patients and society. Today the "community" approach, by which community service agencies whose goal is to help older adults remain independent of total institutional care by supplying supportive services, is achieving recognition .

This thesis is an exploratory study to assess …

Medical-Social Needs In A Sample Population Of Elderly Post-Hospital Patients, Rose N. Cooper

Dissertations and Theses

The EPP Project was a descriptive and inferential study designed to determine the psychosocial and medical needs of elderly post-hospital dischargees.

The areas of need assessed were (1) living arrangements, (2) use of leisure time, (3) vocational adjustment, (4) financial functioning and (5) adjustment to illness.

The instrument adopted for the purpose of this study was an adaptation of a scheduled in the New York Study. The New York Study, described in The Elderly Ambulatory Patient: Nursing and Psychosocial Needs by Doris Schwartz, Barbara Henley and Leonard Zeitz was a long-range study of the needs of elderly clinic patients. The …