Medicine and Health Commons^™

Exploring The Experience Of Embodiment Of Diverse Leaders, Susan Lynn Flaming Yeats

Dissertations

The experience of embodiment is a complex phenomenon that spans a range of feelings: a sense of connection to one's physical body, a sense of capability to accomplish certain physical acts, an attunement to self-care behaviors, a connection to desire, and inhabiting the body as a subjective site (Piran, 2016). This can be a complicated experience for leaders who hold multiple intersecting identities (Hill et al., 2016). As new medical therapies promise radical weight loss possibilities, the experience of embodiment has taken on a new layer of complexity (Giorgis, 2024). For fat leaders who are also women of color, sexual …

Reclaiming Healing Spaces: A Phenomenological Study On The Transformative Power Of Outdoor Therapy From The Lived Experiences Of Black Clinicians Working With Black Clients, Lynn Murphy

Dissertations

This phenomenological study involved assessing the experiences of Black therapists who engaged Black clients in outdoor therapeutic contexts. The study was founded on the existing literature that shows the quality of the therapeutic relationship is pivotal for client retention and the Western standards that have historically favored treatment within indoor environments. To contextualize this research, a comprehensive literature review was commenced, covering topics such as the decolonization of therapy, the historical and present-day relationship between Blacks and the outdoors in the United States, sedentary lifestyles, the psychological benefits of time spent in nature, various types of outdoor therapy, and the …

The Association Between Emotional Intelligence, Empathy, And Social Determinants Of Health Among Accelerated Bachelor Of Science In Nursing Students: A Multi-State Cross-Sectional Descriptive Study, Kwanza Thomas

Dissertations

This study investigated the association between emotional intelligence (managing and understanding), empathy, and social determinants of health (SDOH) among accelerated Bachelor of Science in Nursing (ABSN) students. Despite the exponential increase in ABSN programs in the United States, little is known about the association between these variables among this nursing student population. A cross-sectional, correlational descriptive design was used to survey 104 students completing ABSN programs in Georgia, Mississippi, Philadelphia, and Texas. Participants self-reported their socioeconomic and programmatic characteristics using a researcher-developed questionnaire. Emotional intelligence (managing and understanding) was measured using two instruments, including the Situational Test of Emotional Management …

The Development Of The Holistic Pastoral Wellbeing Assessment: A Mixed Methods Study, Timothy Captain

Dissertations

Some pastors are clearly in crisis. Research has indicated that clergy struggle to cope with the stressors of their profession. While pastoral work is overtly spiritual in nature, day-to-day tasks include interactions with God, themselves, congregants, and the world at large. Without multi-dimensional tools to consider their wellbeing, specifically assessments that reflect their worldview and role, pastors may remain unaware of dangerously low levels of wellbeing until they reach a place of crisis. Therefore, in this mixed methods study, the Holistic Pastoral Wellbeing Assessment (HPWA) was developed and tested to offer a validated, useful tool for pastors and those who …

Life Matters, Marina Fischer

Dissertations

Problem: One of the challenges facing many primary care providers is managing hypertension. Hypertension contributes to cardiovascular disease events. Consequently, the high occurrence of hypertension related visits signifies a clinical practice gap in hypertension management resulting in substandard blood pressure outcomes. The purpose of this clinical scholarship project was to assess the difference of pre and post Quality of Life Scale (QOLS) scores in a hypertensive population.

Methods: This quality improvement project used a longitudinal, observational design with prospective data collection. The sample included newly diagnosed hypertensive adults ages 21 to 64 years old. The sample was administered the World …

Barriers And Facilitators To Opioid Use Treatment And Recovery Services During Pregnancy, Loralie Woods

Dissertations

Purpose: To identify barriers and facilitators to opioid use treatment and recovery services among pregnant and nonpregnant women who misuse opioids.

Background: Over 130 Americans die daily after overdosing on opioids. Women have not been immune from opioid use disorders (OUDs), with a 4-fold increase from 1999-2010. The prevalence of opioid use among pregnant women increased from 1.5 per 1,000 hospital deliveries to 6.5. Although the annual National Surveys on Drug Use and Health (NSDUH) has provided information on risk factors for OUD related to socioeconomic and demographic factors, no studies using this data have identified barriers to opioid use …

Medical Cannabis And Recreational Marijuana: Patient Perceptions, Stigma, And Gender During A Time Of Emerging Legalization, Matt Reid

Dissertations

Marijuana’s status as an illegal drug has been redefined over the previous three decades. Despite Michigan and 32 other states having comprehensive medical cannabis programs, both academics and laypeople commonly present the medicalization of marijuana as an intermediary phase or proxy for fully legalized recreational use. While some evidence exists to support this position, this framework marginalizes the struggles and experiences of patients who have found relief through their therapeutic use of cannabis. As such, the goal of this study is to re-center the voices of cannabis patients in academic conversations of cannabis as medicine.

My study is unique in …

Improving Access To Mental Health Care With Nurse Practitioners, Jessica Whelan

Dissertations

Problem: Over 40% of those with mental illness are untreated since the supply of psychiatrists does not meet the demand. The psychiatric mental health nurse practitioner (PMHNP) may be an adjunct in providing those services. The purpose of this quality assurance study was to evaluate outcomes of care between a PMHNP and a psychiatrist (medical doctor [MD]).

Methods: An observational, descriptive design with a retrospective medical record review of adult patients over a six-month period in a suburban, Midwestern, privately owned psychiatric practice.

Results: A total of 787 individual patients encountered at least one visit (N=787) although 3,679 …

Exploring The Homeless Persons Perception Of Living In A Long-Term Care Facility, Janice Woods

Dissertations

Objective:The purpose of this study was to explore the lived experiences of homeless persons admitted to a nursing home facility. Originally, the study was to explore their understanding of and their experience with advance health care planning; coincidently, the participants were more open to their experience of living in a long-term care facility.

Method:A convenience sample of 13 participants (12 male, 1 female) at four long-term care facilities in Southern California were interviewed about their perception of advanced health care planning, including the physician’s orders for life sustaining treatment (POLST); a consent form required in all nursing homes. …

How Professional Physical Therapist Education Programs Develop Cultural Competence Within Their Students: An Exploratory Concurrent Mixed Methods Study, Dustin E. Domingo

Dissertations

Purpose: The purpose of this exploratory concurrent mixed methods study was to describe experiences that shape the factors of cultural intelligence (CQ) as perceived by students of professional physical therapist education programs. In addition, it was the purpose of this study to determine whether any particular factor of cultural intelligence influenced one’s overall cultural competence according to the cultural competence continuum by Cross et al. (1989).

Methodology: Students in a professional physical therapist education program completed a questionnaire, which included Likert scale questions, open ended questions, and a 37-item self-assessment based on the expanded cultural intelligence scale by Van Dyne …

The Influence Of Stressful Life Events On The Development Of Type 2 Diabetes, Joshua Minks

Dissertations

This study examined the relationship between distress and the development of Type 2 diabetes mellitus (T2DM) in the presence of established risk factors. Distress secondary to mental health disparities, stressful life events, and work conditions has been shown to promote insulin resistance and the development of T2DM.

Subjects (N=79) diagnosed with T2DM within the previous six months were recruited from SSM Health Centers and VA Medical Centers in the greater St. Louis area. They completed the Recent Life Changes Questionnaire, ENRICHD Social Support Instrument, and a demographic survey and analyses were conducted to determine differences between the veteran …

The Predictors Of Juvenile Recidivism: Testimonies Of Adult Students 18 Years And Older Exiting From Alternative Education, La Toshia Palmer

Dissertations

Purpose: The purpose of this descriptive, qualitative study was to identify and describe the importance of the predictors of juvenile recidivism and the effectiveness of efforts to prevent/avoid juvenile recidivism as perceived by previously detained, arrested, convicted, and/or incarcerated adult students 18 years of age and older exiting from alternative education in Northern California. A second purpose was to explore the types of support provided by alternative schools and the perceived importance of the support to avoid recidivism according to adult students 18 years of age and older exiting from alternative education.

Methodology: This qualitative, descriptive research design identified …

Experiences Of Former Participants In Teen Advocates For Sexual Health (Tash), Celeste Nicholas

Dissertations

This qualitative study explores the experiences of former participants in a Planned Parenthood youth development and sex education program, Teen Advocates for Sexual Health (TASH). Phenomenologically-based interviews centered the question, “What did it mean to participate in TASH?” Chapter 1 introduces the study context and synthesizes foundational literature from the fields of sex education, public health, critical pedagogy, civic engagement, youth development, and youth organizing. Chapters 2-4 each contain complete manuscripts, representing three complementary analytic approaches to a common data set and inviting multiple audiences. Chapter 2 addresses sex educators in describing TASH’s “rights-based” sex education model. Research questions included: …

Negotiating Diabetes: Professional Diabetes Care Work In The U.S., Melissa Marie Gesbeck

Dissertations

The rising incidence of diabetes mellitus (types 1 and 2) transcends national borders, creating a global pandemic. The U.S. leads the world in diabetes prevalence, despite its wealth and access to sophisticated medical technologies. Within health care, there is an increasing focus on lifestyle and behavioral interventions that research suggests may be the key to reversing this trend, but thus far their effectiveness in practice is uneven at best. In order to gain a better understanding of the other factors involved in professional diabetes care work that might support or inhibit effective diabetes management, this research treats diabetes as a …

Influence Of Resources, Resource Loss, And Coping Response On Food Management Practices And Food Security, Simone Perette Camel

Dissertations

Food insecurity has been associated with compromised health and wellness. Current literature regarding coping strategies and practices employed by the food insecure often describes food management and acquisition practices, and/or the riskiness of these practices. Material and personal resources such as income, time, self-efficacy, and social support have been identified as predictors or influencers of food security status. In this study, the Conservation of Resources theory was used to conceptualize resources and resource loss as they relate to food practices and food security. It was hypothesized that the level of resources would influence food security status and the adaptive food …

Three Essays On Social Health Insurance In Developing Countries: The Case Study Of Ghana, Stephen Ofori Abrokwah

Dissertations

More than 2 billion people live in developing countries with health systems constrained by inequitable access and inadequate funding. The World Health Organization estimates that more than 150 million of these people suffer financial breakdown every year having to make unexpected out-of-pocket expenditures for emergency care.

To improve health and reduce the financial burden on households, a number of developing countries, including Ghana, Colombia, and Peru, have recently introduced social health insurance programs which are heavily subsidized. The dissertation is a collection of three essays looking at how individual health care choices changed as a result of the availability of …

Perceptions Of Workplace Bullying Among Practicing Registered Nurses, Crystal Regina Threadgill

Dissertations

Workplace bullying (WPB) is a social and organizational problem. Within the health care arena, employees, particularly registered nurses, are at risk. WPB has several adverse effects and has been cited in the literature as closely associated with burnout and nurses leaving their positions. This quantitative study examined workplace bullying among practicing registered and its relationship with burnout and nurses’ intent to leave their current position.

The surveys utilized were the Negative Acts Questionnaires-Revised (NAQ-R), Maslach Burnout Inventory Survey, Intention to Turnover Scale and a demographic survey. Of the surveys distributed, a total of 185 were returned from one selected hospital …

Understanding The Behavior And Attitude Of Professional Athletes In Saudi Arabia Toward Dietary Supplements, Sulaiman O. Aljaloud

Dissertations

A dietary supplement is defined as a product taken orally that contains a "dietary ingredient" (vitamins, minerals, herbs, amino acids, enzymes, etc.), and is intended to supplement one's diet. Dietary supplements include plant extracts and concentrates from foods. Supplements help provide required nutrients to fulfill nutritional levels for daily training or competitive performance, and can help remedy nutritional deficiencies. Therefore, it is important that sports professionals have a thorough knowledge of these supplement products. However, athletes need to be informed about the use and possible benefits, side effects, and risks associated with the use of dietary supplements. Four objectives guided …

Society In Crisis: A Critical Perspective On Health Care And Distribution Ofhealth Status In The United States, Curtis D. Hosier

Dissertations

This research examines U. S. health status both internationally and domestically utilizing indicators infant mortality, life expectancy at birth, and maternal mortality data as comparison. This research compares U.S. health status data with OECD country data to ascertain U.S. rankings internationally. Also, this research examines the distribution of health status within and between sex, class, and racial groups in the U.S. to further the discussion that health status is unequally distributed in the United States. This research found the U.S. ranked in the lowest quartile in each of the health status variables examined internationally. This research found inequalities exist in …

Development Of An Instrument To Identify The Virtues Of Expert Nursing Practice: ‘Byrd’S Nurses Ethical Sensitivity Test’ (Byrd’S Nest), Lisa Marie Byrd

Dissertations

The purpose of this research was to develop and analyze the psychometric properties of Byrd’s Nurse’s Ethical Sensitivity Test (Byrd’s NEST). An instrument to evaluate nurses’ ethical sensitivity in practice by examining choices of action in ethical dilemmas based on nursing virtues: compassion, fidelity to trust, moral courage, justice, self-confidence, resilience, practical reasoning, and integrity (Benner, Tanner, & Chelsa, 1996; Volbrecht, 2002). Benner’s theory of skill acquisition-novice to expert was the theoretical framework for this research which surveyed for correlations between a nurse’s ethical sensitivity and educational level, years of experience, certification, and work setting. Until now, there have been …

Amish Childbearing Beliefs And Practices And The Implications For Nurse-Midwives As Servant-Leader Care Providers, Victoria L. Wickwire

Dissertations

Problem. The knowledge, beliefs, and practices associated with childbearing among Amish women from their perspective are not widely known. The available research on Amish childbearing health practices does indicate that these women are at high risk for problems during the childbearing period. This indication, coupled with both a general mistrust of outsiders and the Amish separateness from society at large, creates opportunities for misunderstandings. These misunderstandings in turn have created challenges for care providers outside the Amish culture who are seeking research-based knowledge about what constitutes culturally congruent childbearing care from the Amish woman's perspective. It is unknown how …

The Link Between Smoking And Body Weight Among Adolescents, Tracey Barnett

Dissertations

Trends in smoking rates among adolescents indicate that white females generally smoke more than their adolescent counterparts, the only substance in which this occurs. Another trend in which white females far outnumber any other adolescent group is eating disorders. This study was conducted to assess the relationship between cigarette smoking and perception of weight among adolescents. A logistic regression model was constructed to test the relationship using the Adolescent Health Public Dataset. For females, there was a link between cigarette smoking and perception of overweight which was not found among the males. Similarly, white females had a significantly higher rate …

Binge Drinking And Salutogenesis: Sense Of Coherence, Stress, Religiousness And Spirituality, Jeanne C . Debruyn

Dissertations

No abstract provided.

Coping With Chronic Fatigue, Susan Lynne Jensen

Dissertations

The purpose of this study was to examine sense of coherence in those individuals diagnosed with chronic fatigue syndrome (CFS), and to explore its relationship to age, gender, work status, duration of illness, fatigue and functional ability/ disability in this population.

This study used a combined methods approach, using both qualitative and quantitative methods. A sample of thirty individuals diagnosed with chronic fatigue syndrome was surveyed by means of a self-administered questionnaire, including Antonovsky’s 13-item shortened Sense of Coherence (SOC) scale. A subset of 12 participants participated in the qualitative portion of the study, and answered specific questions regarding their …

Social Factors Related To Recovery After Hip Fracture, Debra Lindstrom Hazel

Dissertations

Objectives. The relationship between social variables and performance of instrumental activities of daily living (IADL) was examined in participants three to nine months after they experienced a hip fracture. All participants were over the age of 60 and living in their own homes before and after their hip fractures.

Method. This study employed both qualitative and quantitative methods. There were 19 participants in the quantitative portion of the study that compared three subjectively rated questionnaires with an objectively rated IADL scale. The independent variable, subjective scales were: (1) Antonovsky’s “Orientation to Life” Scale, which measures the sense of coherence, (2) …

The Effects Of Organizational Culture On Quality Of Life For Older Veterans, Michelle Diane Stone

Dissertations

The organizational culture in a Veteran's Administration Medical Center (VAMC) was described using triangulated methods which included both secondary quantitative survey data, and internal documentary data sources. The initial survey data collected, from staff and elder veterans revealed an overall positive perception from both samples regarding the quality of life for elder veterans living on extended care wards. The study investigated the extent to which the VAMC's organizational culture affected these perceptions of quality of life.

Documentary data were collected from a variety of VAMC sources regarding behaviors, ideologies, leadership trends, mechanisms of control, and the formal organizational structure. A …

A Comparative Study Of Primary Preventive Behaviors And Secondary Preventive Behaviors Among Michigan Adults, Jing Chang

Dissertations

Many researchers have documented the range and extent of the health preventive behaviors. However, previous studies have generally focused on either the contact with medical professionals (secondary preventive care) or compliance with their recommendations (primary preventive care). Some have treated the two types of behaviors as one and related them to social demographic characteristics and socio-structural conditions (e.g., access to medical service). There have been very few studies that have compared the two sets of preventive behaviors. This study takes a first step to explore the correlates of secondary preventive activities and compare them with the correlates of primary preventive …

The Impact Of Third Party Reimbursement On Occupational Therapy And Vision Rehabilitation Services: A Comparative Case Study, Tiehan Liu

Dissertations

This is a comparative case study of occupational therapy and vision rehabilitation services. The purpose of this study is to describe how environmental forces, especially third party reimbursement, shape occupational therapy in terms of organizational form, setting, procedure of services and documentation process. The study will further examine the current external and internal conditions under which vision rehabilitation professionals may develop third party payment, especially Medicare and Medicaid. Based on environment theories and the experience of occupational therapy, the potential impact of such reimbursement on vision rehabilitation services is discussed.

Three forms of data were used in this study: (1) …

Caring For Dementing And Nondementing Chronically Ill Elderly In Belgium: Modeling Salutogenic And Pathogenic Processes, Timothy John Gallagher

Dissertations

The predominant model in the study of stress and disease has been identified as the pathogenic orientation. The underlying assumption of this orientation is that stress is, by nature, disease causing. An alternative model is the salutogenic orientation (Antonovsky, 1979). Researchers using the salutogenic approach are concerned with explaining the origins of health. In the present study, a sample of Flemish caregivers {N = 126) to persons with chronic dementing and nondementing disorders is examined in order to detail how sense of coherence (a measure of personality disposition), the nature of patient pathology, demographic characteristics, coping resources, and perceived negative …

Performance And Satisfaction Ratings By Nurses, Supervisors, And Patients In Jordanian Government And Private Hospitals, Diab Mousa Al-Badayneh

Dissertations

This is a study of performance and satisfaction ratings by supervisors, patients, and nurses in the Jordanian government and private hospitals. Comparisons of total performance ratings scores as well as individual performance items were made between (a) registered nurses vs. supervisors and registered nurses vs. patients within government and private hospitals and in all hospitals combined^ (b) combined as well as separate ratings of registered nurses, supervisors, and patients between government and private hospitals; and (c) total performance ratings scores only between registered nurses vs. supervisors and registered nurses vs. patients within each hospital. Comparisons of total satisfaction ratings scores …