Social and Behavioral Sciences Commons^™

Pathways To Patient-Provider Conflict In Nigeria: A Structural Equation Model Of Expectations, Communication, Trust, And Organizational Constraints, Akaninyene O. Unaam, Christie Divine Akwaowo, Edidiong A. Unaam

Patient Experience Journal

Objective: This study empirically investigated the drivers of patient-provider conflict and tested a conceptual model linking treatment expectations, communication, trust, and organizational constraints to conflict intensity in Nigerian tertiary care. Methods: A cross-sectional survey of 400 patients (response rate 82.3%) and 150 healthcare providers (response rate 71.2%) from three Nigerian tertiary hospitals was conducted using stratified random sampling. Validated, culturally adapted scales measured unrealistic treatment expectations, communication barriers, organizational constraints, trust, and conflict intensity. Data were analyzed using Structural Equation Modeling (SEM) with maximum likelihood estimation and bootstrapping for mediation testing. Multi-group confirmatory factor analysis established measurement invariance across samples. …

Centering Community Voices To Address Healthcare Inequities In Underserved Utah Populations, Karishma Shah, Jazmine Abril, May Shaaban, Silvia Soule, Sonia Sehgal, Rawad Farhat, Jeannette Villalta, Oreta Tupola, Valentine Mukundente, Cathy Wolfsfeld, Ivana Holiday, Walter Watchman, Carrie Olvera, Lauren Gleave, Kamaile Tripp, Alexander Sperber, Rita Osborn

Patient Experience Journal

Persistent disparities in health outcomes across the United States are often driven by systemic inequities and social determinants of health. In Utah, these inequities are particularly pronounced among racially, ethnically, and geographically underserved populations. Community healthcare workers (CHWs) who share lived experiences with these communities are uniquely positioned to bridge the gap between patients and a fragmented healthcare system. This study aimed to explore how underserved communities in Utah perceive and interact with the healthcare system, centering their lived experiences to inform more equitable care models. We conducted eight focus groups with 73 participants from six medically underserved communities: African …

Caring But Still Hurting: Uninsured Patients' Illness And Healthcare Experiences At A U.S. Free Clinic, Danaya Amornnimit, Eda G. Christensen, Adelaida Salmeron, Kian Robison, Sofia Ampudia Arroyo, Jessica Benelli, Brenda Spearman, Akiko Kamimura

Patient Experience Journal

While free clinics provide essential healthcare to socioeconomically disadvantaged populations, patients' lived experiences in these settings remain underexplored. This qualitative study examined how uninsured patients at a U.S.-based free clinic perceive their illness experiences and interactions with healthcare providers. From October to December 2024, semi-structured interviews were conducted with 21 adult patients (ages 18–72; M = 49.14), most of whom were non–U.S.-born and primarily Spanish-speaking. Participants described illness as entangled with emotional distress, social isolation, stigma, and disruptions to identity and family roles—revealing a psychological burden that extends beyond physical symptoms. These findings highlight the need to integrate psychosocial and …

From Drifting To Anchored: How Online Health Communities Can Transform Care For Complex Chronic Illness, Mads Eggerding

Patient Experience Journal

This personal narrative recounts a 25-year diagnostic odyssey with Ehlers-Danlos syndrome, defined by medical fragmentation, dismissed symptoms, and profound isolation. It illustrates how Online Health Communities (OHCs) bridged the chasm between lived experience and a clinical system ill-equipped for complex chronic illness. For patients like me, these digital forums provide the peer validation, practical knowledge, and self-advocacy tools necessary to navigate a disjointed healthcare landscape. For providers, this story underscores a critical opportunity: proactive, non-judgmental engagement with OHCs is not a threat to expertise but a foundational strategy for patient-centered care. By acknowledging and constructively partnering with these patient-led spaces, …

Secondary Infertility: A Personal Story Of Loss And Grief, Ben Hughes

Patient Experience Journal

An increasing number of people worldwide are experiencing fertility and this trend is reflected in the data from the United Kingdom. However, most research focuses on the experiences of women and so the male perspective is largely missing from the literature. This narrative is an account of my personal journey of secondary infertility. Presenting a male perspective of infertility provides a point of view which is rarely explored and is about a topic which feels largely a societal taboo. I chart how infertility has changed me, what it has meant to me through my years of trying to come to …

When Hope Meets Harm: A Story Of Trust, Pain, And Consent In Intimate Care, Sharon I. Choe, Erin Foster

Patient Experience Journal

Transparent communication is key to building and maintaining strong patient-provider relationships. In this article, I interviewed a patient who shared her experience undergoing treatment for a chronic vulvar condition and the consequences that followed. She described a painful procedure for which she felt unprepared and later realized she had not been educated about the need for ongoing care. Years later, this gap in understanding contributed to irreversible disease progression. After re-establishing care with a dermatologist she felt comfortable confiding in, the patient expressed a desire for her story to be shared. This narrative presents her experience as she shared it …

Ai As A Physician Companion In Enhancing Trust In Healthcare, Saria Gouher

Patient Experience Journal

Trust remains a fundamental pillar of the physician–patient relationship, ensuring care that is safe, evidence-based, and grounded in shared decision-making; however, the increasing use of artificial intelligence tools such as ChatGPT has introduced a new dynamic in how patients interpret symptoms and seek medical advice. This narrative describes a clinical encounter involving an elderly patient with multiple myeloma whose caregiver used ChatGPT to evaluate new-onset slurred speech suggestive of stroke, resulting in an urgent recommendation driven by incomplete clinical information. Through comprehensive history-taking, physical examination, and careful review of the Artificial Intelligence (AI)-generated response, the physician reassured the caregiver, contextualized …

Building Trust In The Absence Of Certainty: Community As Trust In Action, Jennifer A. Owens

Patient Experience Journal

This personal narrative explores how trust is experienced and sustained in the context of serious illness, where uncertainty is persistent and control is limited. Drawing on the lived experience of caregiving for a child with an undiagnosed congenital diaphragmatic hernia (CDH), this personal narrative examines how trust emerges not as a matter of belief or individual choice, but as something recognized through the actions of others.

Rebuilding Trust After Bondi Beach: Healing Patients, Protecting Caregivers, And The Sacred Work Of Care, Anne Marie Hadley

Patient Experience Journal

The Bondi Beach tragedy of December 14, 2025 profoundly disrupted Australia's collective sense of safety, belonging, and trust. Beyond the immediate loss of life and injury, such events exert lasting impacts on healthcare systems and the people who work within them. This article explores how trust can be rebuilt not only for patients and communities, but also for caregivers themselves. Drawing on trauma-informed care, psychological safety, and human experience design, it examines the often-overlooked dimensions of staff safety, the essential role of pastoral care and chaplaincy, and the particular vulnerabilities experienced by faith-based caregivers during periods of social fracture and …

Supporting The Human Experience: Why Compassion Outperforms Empathy In Care Delivery, Katelyn Carey

Patient Experience Journal

Healthcare professionals are often taught that empathy, defined as imagining oneself in the emotional experience of another, is essential to providing excellent care. Yet in high-stress, high-stakes clinical environments, the very tool given to increase patient and employee connection can contribute to disengagement, burnout, and diminished resiliency. This research review article examines the longstanding conflation of empathy and compassion in healthcare and argues that the distinction between the two is not merely semantic but critical to provider well-being and patient outcomes. Drawing on research from neuroscience, psychology, and communication studies, the piece outlines how emotional, perspective-taking empathy activates the brain's …

Racial Concordance And The Assumption Of Trust: Why Engagement Is Often Mistaken For Partnership In The Care Of Black Men, Samantha Faith Calhoun, Lacretia Carroll, Y'Esha Williams-Click, Kola Brown

Patient Experience Journal

Race concordance between patients and clinicians is frequently promoted as a strategy to improve trust and engagement for Black men in healthcare. Evidence suggests that encounters with Black male clinicians often increase patient comfort and observable engagement; however, engagement alone does not necessarily reflect trust. Drawing on professional experience as a nurse and researcher working with Black men, and on prior research examining shared decision-making preferences among Black men with hypertension in the U.S. Mid-South, this Personal Narrative examines how race-concordant encounters may rely on presumed trust, leading clinicians to advance diagnosis and treatment planning without adequate co-construction of care. …

Building Or Breaking Trust In Healthcare Through Patient And Family Engagement In Research And Service Design: The Need For Authentic Engagement Practices, Lisa D. Hawke, Hajar Seiyad, Shoshana Hauer, Charlotte Munro, Natasha Y. Sheikhan

Patient Experience Journal

Trust in the healthcare system is an important driver of public health, but is sometimes lacking among individuals and communities. Patient and family engagement in research and service development is one proposed means of influencing trust. Patients and families can be engaged authentically and meaningfully as partners in the conduct of research and the development of healthcare services. When engagement is conducted following best practices, patients and families have the opportunity to build strong mutual relationships with project leads, hold a share of the power in the discipline, and exercise choice to influence the research and service development agenda. These …

Co-Designing Trust: Patient Experience, Relationships, And The Design Of Care, Toni Land

Patient Experience Journal

Trust can have a positive or negative impact on patients, families, and community healthcare experience. Although important, it is often treated as something soft and intangible rather than something intentionally measured and designed. Currently, healthcare organizations collect and report patient experience data related to communication, courtesy, respect, and responsiveness. But these measures do not capture the specific behaviors that influence whether trust builds or whether it stalls. This commentary explores trust as a foundational behavioral and environmental element in healthcare and challenges that improving trust requires more than good intentions; it requires bringing voices to the table through co-design. Starting …

A Modern Playbook For Trust Across The Health Ecosystem, Erin O'Malley

Patient Experience Journal

Public trust in health care delivery, public health, and biomedical innovation is at a historic low. While many place the blame on the COVID-19 pandemic and the proliferation of social media, the reality is that distrust is a deeply rooted structural challenge that has plagued the U.S. for centuries. It is tied to historical movements for medical freedom and centuries of systemic discrimination and earned mistrust among minoritized communities. Today, this crisis is compounded by a lack of shared values and facts and the rising dominance of tribal identity over objective science. The Coalition for Trust in Health & Science …

Healing The Social Covenant: Rebuilding Trust And Re-Humanizing Healthcare, Cynda Hylton Rushton

Patient Experience Journal

Violence against healthcare workers continues to escalate despite substantial investments in security measures, workplace violence prevention programs, and legislative protections. Although these interventions are necessary, they have not produced sustained improvements in workforce safety or retention, suggesting that workplace violence is more than a behavioral or security problem. This commentary argues that it also reflects a deeper erosion of trust within healthcare. Drawing on evidence linking workplace violence to burnout, moral injury, psychological distress, and turnover intention among nurses, we propose that repairing trust is essential to sustaining the workforce and healthcare.Building on our earlier work, Rebuilding a Foundation of …

Trust: Why A Commitment To Human Experience Matters, Jason A. Wolf

Patient Experience Journal

Trust is one of the most essential elements in our overall human existence. It is a critical part of our human experience, one that reaches well beyond the boundaries of healthcare. Trust is the element that holds society together. It emerges in the relationship of one human being connecting with another human being, and it reaches to the engagements people have with organizations, institutions, and systems as well. Trust, while hard to hold, is ever present. It is a powerful force that guides our way of being, our interactions, our choices, even if we ourselves are not directly conscious of …

The Registered Dietitian Nutritionist’S Implementation Of Dysphagia Screening In Clinical Practice: A Commentary, Nicole Wiksten, Holly Estes-Doetsch, Laura C. Boucher, Sarah Rusnak, Kristen M. Roberts

Journal of Dietetic Education

Background: The Accreditation Council for Education in Nutrition and Dietetics (ACEND) amended the competencies for the future education model (FEM) in dietetic education to include competency 3.6 stating that the Registered Dietitian Nutritionist (RDN) must be able to "Initiate and conduct bedside swallow screenings". There is no clear process for RDNs to implement dysphagia screening in practice or academia. The aim of this review is to inform clinicians and educators on current literature discussing current RDN and speech language pathology approaches to dysphagia screening and to provide a proposed curriculum for implementation of competency 3.6 in clinical practice and academia.

Assessing And Addressing Cultural Competence And Cultural Humility In Dietetic Education, Zoe Duran, Nicholas Slagel, Lisa Caldwell, Katie Kage

Journal of Dietetic Education

Limited theory-informed, dietetic-specific resources are available to guide the development, evaluation, and refinement of culturally competent (CC) curricula. This pilot study used a mixed-methods, theory-informed approach to evaluate CC integration within an undergraduate dietetics curriculum and examine the applicability of existing CC self-assessment tools for dietetic students. A senior-level undergraduate community nutrition curriculum was evaluated using the Tool for Assessing Cultural Competence Training (TACCT), guided by the Campinha-Bacote Model of Cultural Competence in Healthcare Delivery. James Banks’ Model of Multicultural Curriculum Reform was then applied to refine curricular content and learning activities. In addition, 74 students enrolled in a didactic …

Virtual Reality: The Future Of Didactic And Experiential Education For Nutrition And Dietetics, Michael Holik, Dexter Richardson

Journal of Dietetic Education

The integration of virtual reality (VR) into nutrition and dietetics education provides an innovative answer to challenges in accessing experiential learning. This study examined student perceptions of immersive VR experiences designed to simulate hospital foodservice operations and nutrition counseling sessions, guided by the Diffusion of Innovation Theory (DOI). A quasi-experimental design involved 55 participants who engaged with 360° VR modules featuring interactive elements, avatars representing key healthcare roles, and embedded critical-thinking questions. Results demonstrated strong support for VR’s educational value across DOI’s five key attributes: relative advantage, compatibility, complexity, trialability, and observability. Participants reported enhanced understanding of registered dietitian roles, …

Editors' Message, Volume 4, Issue 2, Diana Cuy Castellanos, M Elizabeth (Beth) Miller

Journal of Dietetic Education

In this edition, you will find research on the use of virtual reality in experiential food service learning, instruments to assess cultural competency and humility in dietetic students, and tools for measuring empathy—an area of growing importance in dietetic pedagogy. Additionally, this issue explores the inclusion of disability-related curricula in education programs and features a commentary on RDNs implementing swallow screenings within clinical practice, highlighting how this procedure falls within an RDN’s scope of practice when supported by proper training and demonstrated competency.

Cover, Table Of Contents, About The Journal

Journal of Dietetic Education

No abstract provided.

How Philip K. Dick Used The Unreliable Narrator To Transport Unwitting Acolytes, Michael Barros, Jordi Smith

Dialogue: The Interdisciplinary Journal of Popular Culture and Pedagogy

This essay examines the use of the unreliable narrator to transport the reader into narrative worlds, specifically in Philip K. Dick's fiction. By exploring the phenomenon of narrative transportation and the role of emotions in engagement with fiction, we argue that Dick's use of the unreliable narrator significantly engages and transports readers into his narrative worlds. Subsequently, we contend that his belief in the fundamental reality of those worlds is effectively positioning himself as a gatekeeper and mediator between the narrative world and the real world, which sets him, in his mind, as a prophet, using fiction as a tool …

A Case For Societal Provenance: Marguerite Harper As Told By The Men She Represented, V. Emily Cranwell Deinert

Journal of Contemporary Archival Studies

This paper argues for making societal provenance the grounding framework for archival descriptive standards to ensure that important voices already present in archives are no longer buried. This study reclaims from archival obscurity the career of literary agent Marguerite E. Harper to illustrate the need for this expansion. Harper proves strikingly absent from some of the archives for the authors she represented. Likely an unwitting omission from archivists that uncritically accepted the narratives of these male authors, Harper’s erasure provides a potent example of the ways that archival descriptive standards may unintentionally further silence historically marginalized voices within archives. The …

An Architecture Of Vanishing: Toward A Protocol Of Archival Disappearance, Edgardo Civallero

Journal of Contemporary Archival Studies

This article rethinks the preservationist reflex that equates archival care with permanence. Drawing on post- and decolonial theory, it provincializes endurance as a historically situated ideal and foregrounds global traditions where disappearance, opacity, and cyclical renewal structure memory. It reframes vanishing as custodianship rather than neglect, introducing a taxonomy of protocols of epistemic disappearance—temporal, spatial, relational, semantic, and material—and a grammar of vanishing that operationalizes them as design tools. Extending to institutions, it outlines seasonal, dismantling, shadow, and nomadic archives as forms that measure success by their capacity to end well. A concluding framework articulates five principles—vanishing as care, duration …

Media Emotion Regulation And Executive Function In Childhood: Associations With Respiratory Sinus Arrhythmia, Lara M. Almeida

Theses and Dissertations

Media emotion regulation (MER), or the use of media to help children manage emotions, may influence children's development by shaping opportunities for practicing self-regulatory skills. Guided by the Dynamic, Relational, Ecological Approach to Media Effects Research (DREAMER) model, this study examined longitudinal associations between MER and executive functioning (EF) in early childhood and explored whether respiratory sinus arrhythmia (RSA), a physiological index of regulation, predicted developmental changes. Participants included 175 parent-child dyads assessed across two annual waves when children were approximately 4 and 5 years old. Structural equation modeling was used to test bidirectional associations between MER and EF while …

A Systematic Review Of Posttraumatic Stress Disorder Among Hispanic Immigrants In The United States, Rashel Acireale

Theses and Dissertations

This study systematically reviews the literature on posttraumatic stress disorder (PTSD) among Hispanic immigrants in the United States, a population exposed to cumulative trauma across the migration process. Stressors may occur before, during, and after migration and include violence, family separation, dangerous travel conditions, discrimination, and fear of deportation. Despite these risks, findings on PTSD prevalence remain mixed, and Hispanic immigrants are underrepresented in clinical research and culturally informed interventions. This review examines sample representation, types and timing of trauma, PTSD measurement approaches, and the inclusion of cultural and contextual factors such as acculturation and immigration-related stress. It also evaluates …

Emotion-Attention Relationships In Anxiety: A Multimodal Psychophysiological Network Analysis, Kyle O'Brien

Clinical Psychology Dissertations

Anxiety has long been associated with changes in attention processing, emotional salience detection, and emotional affect. Traditional methods of measuring anxiety frequently utilize self-report symptom measures, behavioral performance measures, and psychophysiological indicators. The current study integrates behavioral accuracy, self-report measures of psychological distress and well-being, and event-related potential markers of attention processing into an exploratory multimodal psychological network analyses to identify meaningful patterns across these indicators. The final sample of nonpatients included 36 anxious (low depression) and 24 control (low anxiety and depression) participants who completed an Emotion Attention Blink task while EEG data were collected to assess early, more …

This Platform Combines Multiple Learning Resources. That Creates Some Challenges., Janice Schuster

Library Faculty and Staff papers

No abstract provided.

Integrating Matrescence Into Birth Worker Practice: A Practice Improvement Project, Kelsey B. Green

Doctor of Nursing Practice (DNP) Projects

Background: Perinatal mood and anxiety disorders (PMADs) affect 20–25% of mothers worldwide and are a leading cause of maternal complications. Stigma, fragmented care, and limited provider training leave families vulnerable, while birth workers offer trusted, continuous support.

Problem: Birth workers' maternal mental health (MMH) training is minimal and often excludes matrescence, the developmental transition to motherhood, limiting their ability to distinguish normal adjustment from clinical PMADs and delaying intervention.

Methods: A single-group, pre-/post-test design evaluated a matrescence-informed workshop at Roots Community Health's 2nd Annual Symposium. Anonymous surveys measured knowledge, attitudes, and confidence, analyzed with Mann–Whitney U, Wilcoxon signed-rank tests, and …

When Everyone Is A Librarian: Examining Job Titles And Responsibilities In California School Libraries, Mary Ann Harlan, Jeffrey Mattison, Jodi Hwang

Learning Hub

School libraries in California are staffed by a wide range of personnel, including credentialed Teacher Librarians (TLs) and paraprofessional staff working under a variety of job titles. Analysis of responses from the California School Library Survey revealed substantial variation in self-reported library staff titles, raising questions about the relationship between job titles, job descriptions, and professional responsibilities. This study examined the titles used by individuals working in California school libraries as paraprofessionals and analyzed corresponding job descriptions to determine whether distinctions exist between professional standards and descriptions and paraprofessional duties. Using survey data from the 2022–2023 California School Library Survey, …