Medicine and Health Commons^™

Our Bodies, Our Stories: Mental And Physical Self Connection As A Protective Factor In Sexual And Gender Minorities, Emerson A. Todd

Electronic Theses and Dissertations

The mind and body connection has been actively examined in neuroscience and developmental psychology backgrounds. Sociological theorists posit ways that individuals develop a sense of self through mind, body, and the social world. While research on the connection between the mind and body in disabled and aging populations is common, less is known of the everyday impact of these connections for other minority populations. The present study uses mixed-methods research to explore the relationship between mind and body and the impacts on internal and social life. The quantitative aspect of the study found significant relationships between physical and mental health …

Self-Reported Health Among Sexual Minorities In The United States, Christopher Burton

Electronic Theses and Dissertations

Previous literature on LGBTQ+ people (lesbian, gay, bisexual, transgender, queer/questioning, and other sexual minorities) reports that this community experiences greater health problems than heterosexuals. LGBTQ+ people experience higher rates of chronic conditions, STIs, addiction, poor mental health, and cancer, which highlights the importance of capturing data regarding health. A growing concern is that social surveys fail to find meaningful ways to gather gender and sexuality data to understand possible health disparities for LGBTQ+ people. This study uses data from the General Social Survey to examine the physical and mental health outcomes of LGB people compared to straight people in a …

A Qualitative Analysis Of End-Of-Life Healthcare In Tennessee: Politics, Principles, And Perceptions, Erin Mauck

Electronic Theses and Dissertations

The unprecedented growth of the aging population in Tennessee is a significant demographic trend that highlights the necessity for healthcare policy that tackles end-of-life issues. This study examined the perceived quality of end-of-life healthcare in Tennessee, areas that are in need of improvement, policies that have the potential to influence improvements, and the role of politics in end-of-life healthcare policy. It also assessed the support for end-of-life healthcare policy that would advance quality of care and expand end-of-life choices for Tennesseans, while evaluating the policy-making process that legislators employ.

For this study, data were collected using semi-structured, in-depth interviews with …

Correlates Between Childhood Trauma And Reproductive Health Behaviors Among Women In Appalachia, Haley Metcalf

Electronic Theses and Dissertations

The lasting effects of childhood trauma into adulthood have been well corroborated by research from a variety of sources. Previous research has found a vast number of psychological, behavioral, and health related outcomes that are negatively affected by victimization in childhood. This piece strives to assess the correlates between childhood trauma and adult reproductive behavior and well-being for women living in Appalachia. The NCIPC has found that residents of Appalachia are at higher risks for both experiencing childhood traumas and poor health outcomes (2017). To create long-term positive reproductive health behaviors among Appalachian women, it is essential to examine how …

Lovie: The Story Of A Southern Midwife And An Unlikely Friendship By Lisa Yarger (Review), Rebecca Adkins Fletcher

ETSU Faculty Works

No abstract provided.

Women And Healthcare In Appalachia: Impeding Circumstance And The Role Of Technology, Ashley Cano

Electronic Theses and Dissertations

For decades, healthcare access and quality in central and southern Appalachia have trailed the rest of the country. Entrenched poverty and low educational attainment compound healthcare problems. This study examines the healthcare obstacles women encounter in southern and central Appalachia and analyzes how technology use, such as Internet searching and social media affect women’s healthcare decisions. Data were analyzed from four focus groups conducted with women from the region. Results indicate that seeing a physician or not did not influence women’s propensity to search the Internet for health-related information or to seek support through social media sites. Additionally, women reported …

From Quackery To Control: Perceptions Of Complementary And Alternative Medicine From Users With Mental Health Disorders, Rachael Welsh Allen

Electronic Theses and Dissertations

This study is an investigation into why people with depression and anxiety use complementary and alternative medicines at higher rates than the general population. The study examines perceptions of mental illness and meanings assigned to depression and anxiety, others’ perceptions of mental illness, and experiences with conventional medicine. All participants were using complementary and alternative medicine at the time of the study; their reasons for CAM use as well as how CAM affected perceptions of their illness were main research questions. I conducted three focus groups with individuals diagnosed with depression who were using complementary and alternative medicine as forms …

Rural Appalachian Health Care Providers' Perceived Barriers To Intimate Partner Violence Screening In Primary Care, Jamie Tedder

Electronic Theses and Dissertations

Intimate Partner Violence (IPV) is a major problem in the United States. There are many health concerns associated with IPV (e.g. chronic pain, gynecological problems), leading researchers to examine the detection and management of IPV in primary care settings. However, a disproportionate amount of this research has focused on the detection and management of IPV in urban primary care clinics, with the detection and management of IPV in rural primary care being largely understudied. The current study addresses this gap in the literature by describing the screening practices and barriers to screening reported by rural providers as well as differences …

Free Clinics And The Uninsured: The Need For Remote Area Medical In Central Appalachia After Health Reform., James W. Watson

Electronic Theses and Dissertations

In 2008, the election of President Barack Obama brought health care to the forefront of national discussions and led to the passage of the Patient Protection and Affordable Care Act (ACA). The legislation changed the rules of health care delivery in the United States, but the ACA did not do one fundamental thing: It did not end the need for many of the nation's most needy patients to seek free medical care from groups such as Remote Area Medical (RAM).

A mobile clinic, RAM brings together volunteer dentists, physicians, nurses, and other professionals as well as support staff for multi-day …

Rural Parents Mental Health Service Delivery Preferences: Overcoming Barriers To Care., Jeffrey H. Ellison

Electronic Theses and Dissertations

Unique barriers prevent parents in rural areas from seeking mental health services for their children. The implementation of innovative models of service delivery may reduce these barriers' impact on rural parents' treatment seeking.

The purpose of this study was to determine: 1) parents' willingness to use innovative service delivery models; 2) barriers that parents perceive to seeking treatment in each of the 4 service delivery models, and; 3) the relationship between perceived barriers and willingness to seek help in the context of 4 service delivery models.

Surveys were distributed to parents of children attending school in several counties in rural …

"Knowing Where I Am At": The Experience Of Self-Monitoring Blood Glucose For People With Non-Insulin-Requiring Type 2 Diabetes., Dana Elisabeth Brackney

Electronic Theses and Dissertations

Eleven participants living with non-insulin-requiring Type 2 Diabetes (T2DM) discussed their self-monitoring blood glucose (SMBG) experience. All had been recently diagnosed (< 2 years) and treated for diabetes with a self-regulating SMBG guideline for primary care practice. Their digitally-recorded interviews and photographed logbooks were analyzed thematically and interpreted through the lens of numeracy literature to answer 2 questions: 1. What is the meaning of SMBG among people with non-insulinrequiring T2DM? 2. How do people with non-insulin-requiring T2DM perceive the function of SMBG in diabetes self-management? The meanings of SMBG were patient competence, "It is easy, just a little pin prick"; patient control, "I can control it. It doesn't control me"; and patient security, "It is not that way anymore." Three periods of lived time were observed: Diagnosis "The numbers say I have diabetes"; "I just can't figure out why it does that"; and Routine "I make my numbers." Prominent numeracy functions emerged by time period. During Diagnosis primary numeracy functions included comparing SMBG results to target values. Participants expressed this experience as, "I am some kind of O.K." During applied numeracy functions included taking medication correctly. SMBG readings were experienced as a clue to the diabetes mystery, sometimes confusing the participants, "I just don't …

Family Income, Maternal Marital Status, Maternal Employment, And The Development Of Overweight And Obesity During Childhood., Shaoqing Gong

Electronic Theses and Dissertations

This study examined the longitudinal associations of family income level, maternal marital status, and maternal employment with body mass measurements and the development of overweight and obesity. Multiple linear and logistic regressions were used to assess the effects of the exposure variables on weight status with simultaneous adjustment for the exposure variables and the covariates. Key findings include: Children in families with incomes below the poverty line at child's 24 or 54 months of age were at a higher risk of becoming overweight and obese at child's third grade than children in families with incomes above the poverty line; longer …

Surviving Cancer In Appalachia: A Qualitative Study Of Family Cancer Communication And Changing Personal Identities Through The Cancer Journey., Kathryn L. Duvall

Electronic Theses and Dissertations

The Appalachian region is known for its beautiful mountains, close-knit communities, and health care disparities including higher rates of cancer and premature mortality. Being diagnosed with cancer in the region may present a unique experience for survivors in regards to family cancer communication and changing personal identities. In a multiphasic study, the stories of 29 female Appalachian cancer survivors were collected through either a day-long modified story circle event (n=26) or an in-depth interview (n=3). Qualitative content analysis was used to identify emergent themes in the data. The analysis revealed 5 types of family cancer communication and five barriers to …

Police Stress: An Examination Of The Effects Of Stress And Coping Strategies., Derrick Kenwright

Electronic Theses and Dissertations

How police officers deal with stress greatly affects how they carry out their daily lives and how they treat family and friends. In this study 2 police departments were issued surveys to see how the police officers experienced stress. Questions on the survey asked the officers about the sources of stress, sources of support, and which methods they used to alleviate the stress. The surveys were given to the respective departments over a period of 2 months, and 132 surveys were returned. The statistical analysis performed showed danger was a factor when examining stress. Administration support was found to be …

Evaluating Satisfaction And Benefit Of Nutrition Counseling Provided By A Registered Dietitian Among Cancer Patients Receiving Radiation Therapy., Bethany A. Stuart

Electronic Theses and Dissertations

The purpose of this study was to determine if patients with cancer receiving radiation therapy were satisfied with the nutrition counseling they were receiving and if they obtained any benefit. Radiation increases the risk for side effects such as taste changes, chewing/swallowing problems, constipation, diarrhea, nausea, and vomiting. When these side effects are present, a decrease in food and fluid intake occurs, which leads to weight loss, increased risk of morbidity and mortality, as well as decreased quality of life. Subjects were recruited from a regional cancer treatment facility and a survey was administered to those who met criteria. Subjects …

The Impact And Efficacy Of Diabetes Education Programs Among Adults., Mireille Hamdan

Electronic Theses and Dissertations

The purpose of this study was to measure the impact of diabetes education classes in increasing knowledge and promoting healthy lifestyle behaviors. Thirty-three subjects participated in the classes between October 2004 and October 2005. Only six subjects agreed to participate in this study. Changes in knowledge after the classes were measured by a survey test one year following the completion of classes. Survey responses were analyzed using percentages. Subject's Hgb A1C and weights were also collected to measure the direct impact of education on participants' blood glucose management. Overall, participants were very knowledgeable of diabetes symptoms, complications, carbohydrate counting, and …

Evaluation Of An Elementary School Wellness Concept In Rural East Tennessee., Audrey Lynn Taylor

Electronic Theses and Dissertations

Parents of elementary school children in the small, rural area of Unicoi County, TN were surveyed to determine their attitudes toward health, nutrition, and Unicoi County Schools' Wellness Policy. Elementary school classrooms were randomly chosen to receive surveys for the children's parents to return by mail. Data were compiled and analyzed using SPSS software. Over 99% of parents stated that nutrition education in schools was important, and 96% stated schools played an important role in their child's health. The assessment provided meaningful data and laid groundwork for future nutrition education programs. The research showed rural, lower-income parents are supportive of …

Prenatal And Postnatal Nutrition And Lactation Consulting: A Feasibility Study., Marissa Blake Beale

Electronic Theses and Dissertations

The purpose of this study was to evaluate the feasibility of a prenatal and postnatal nutrition and lactation consulting facility in either of two locations in the Tidewater region of Virginia, Virginia Beach or Williamsburg. Experts in nutrition and lactation, a registered dietitian and licensed lactation consultant, would be the ideal means of providing adequate nutritional and lactation advice for the mother and infant to foster healthy, optimal pregnancy outcomes and lactation success. A web-based search for adequate data on the demographic sketches of the two cities was done to develop an understanding of meeting the needs of the target …

Etsu Medical Residents' Clinical Information Behaviors, Skills, Training, And Resource Use., Richard Wallace

Electronic Theses and Dissertations

Information is a powerful tool for enabling physicians to provide quality healthcare for their patients. Information use in the clinic is a skill that must be learned. If medical residency programs fail to impart this skill, then patients will suffer.

The residents of the ETSU Quillen College of Medicine were surveyed as to their use of clinical information. Of the 217 residents of the 2005-2006 class who were surveyed, 105 returned the survey for a return rate of 48%. The clinical faculty was also surveyed in order to measure the responses of the residents against that of their instructors.

ETSU …

Assessing Perceptions Toward Implementation Of The Nutrition Care Process Among Registered Dietitians In Northeast Tennessee., Jessica Lee Gourley

Electronic Theses and Dissertations

The purpose of this study was to survey registered dietitians in Northeast Tennessee to determine attitudes toward implementation of the nutrition care process prior to and following education about the nutrition care process and/or implementation of the nutrition care process in their respective healthcare facilities. Approximately 100 registered dietitians were involved in the study. Data were collected through electronic submission and written inquiries. The findings of the study identified that there was a need for further research regarding implementation of the nutrition care process and that negative attitudes, opinions, and barriers were broken down by education, implementation, and exposure to …

Wellness And Nutrition Education Program To Promote Improve Nutritional Practices And Decreased Body Mass In Individuals Working In A Health Care Setting., Jessica Brown Bandy

Electronic Theses and Dissertations

The purpose of this study was to determine whether a wellness and nutrition education program directed at employees of a health care facility would result in changes in weight, waist and hip circumference, BMI, and nutritional practices. Nine participants completed the five week program including final weight, measurements and post-program survey to determine nutritional practices. All participants attended weekly group classes with topics related to nutrition, physical activity, and behavior changes. Changes in weight, anthropometric measurements, and BMI were calculated. Changes in nutritional practices were analyzed using Minitab statistical software. There were improvements made in weight, anthropometric measurements, and BMI …

Parenting, Home Environment, And Child Obesity: A Survey Of Parents And Children Attending A Pediatric Clinic., Amit Ravindra Bodhani

Electronic Theses and Dissertations

Data were collected from 60 parents of children 5-11 years of age to describe the parental and family factors and explore the associations of these factors with children's Body Mass Index (BMI) percentiles. Mother's made up 81.7% of the sample. Whites/Caucasians comprised 88.3% of the sample. Males comprised 51.6% of the child participants while females comprised 48.3%. Among the child participants, 38.3% had BMI equal to or greater than the 95th percentile, and 6.7% had BMI 85th to less than 95th percentile. Concerns about child weight (r_s = 0.582), pressure to eat (r_s = -0.433), and monitoring (r …

Physician Communication Behaviors That Elicit Patient Trust., Linda E. Bambino

Electronic Theses and Dissertations

The general relationship between the physician and the patient is one where communication is used to establish and maintain what will likely become a long-term partnership. Health communication research indicates that physicians who have apt communication skills in the patient-physician relationship develop a platform of trust behaviors. The physician communication behaviors perceived to elicit trust reported by patients are; comfort/caring, agency, competence, compassion and honesty. The objective of the research project was to assess patient perceptions of previously determined physician communication behaviors that predict patient trust through individual surveys (N=162) between foreign-born international medical graduates and American-born non-IMG resident physicians. …

A Perceptual Study Of The Impact Of Athletic Programs In Selected Community Colleges In The State Of Tennessee., Lee Martin Cigliano

Electronic Theses and Dissertations

The purpose of the study was to examine the economic, institutional, and human impact of athletic programs at community colleges in the Tennessee Board of Regents community college system to determine how the athletic programs affects the benefits, or lack of benefits, for students, the institutions, and the communities.

Sixteen participants were interviewed: two presidents, two athletic directors, four coaches, and eight student-athletes. The student-athletes represented four different sports and came from a variety of educational backgrounds and academic standing. The primary benefits perceived for the institutions and the student-athletes were the impact on missions, enrollment, educational and athletic opportunities, …