How Korean Couples Construct Marital Relationships: A Qualitative Study

Kang, Young Joo Loma Linda University ProQuest Dissertations & The 2019 해외박사(DDOD)

소속기관이 구독 중이 아닌 경우 오후 4시부터 익일 오전 9시까지 원문보기가 가능합니다.

With increased economic and employment opportunities for women, South Korean couples are challenged by division of labor in the family. This qualitative study examined how marital partners maintain their relationships in light of rapid social change. The study employed social constructionism and feminist theory as conceptual frameworks. Through social constructionism, I sought to understand the interactive roles marital partners perform as they attempt to balance family needs and responsibilities within the context of evolving gender ideas. Feminist theory provided an additional lens to further understand the nuances of partners’ beliefs and expectations about their own gender and that of their partners. Transcriptions were made of the recorded couples’ conjoint interviews and analyzed using grounded theory methodology. Some couples adopted patterns of their parents with wives automatically assuming responsibility for childcare. Other couples adopted traditional gender-based decisions regarding distribution of household responsibilities, but were not necessarily influenced by parental patterns. Dual-career couples used mutual decision-making regarding household responsibilities. For these couples, mutual formation of goals led to sharing of childcare and household responsibilities with neither partner dedicated to a fixed area of responsibility. The results from this study will deepen family therapists’ understanding of the different roles Korean partners perform as they balance advice from parents amidst social and cultural influences to their marital relationships. This study helps therapists untangle relationship problems by examining the intergenerational gender messages partners bring to their relationships. Understanding Korean couples’ issues will assist therapists develop marital and premarital programs.

Association of Nurses' Sanctification of Work with Work-Related Outcomes and Patient Satisfaction

Ada, Hazel M Loma Linda University ProQuest Dissertations & The 2019 해외박사(DDOD)

소속기관이 구독 중이 아닌 경우 오후 4시부터 익일 오전 9시까지 원문보기가 가능합니다.

Nurses working in hospitals face many intrinsic stressors, including widespread job dissatisfaction, burnout, and frustration. These challenges, in turn, may affect patient care. Nursing often attracts individuals who wish to serve others, and some may find the expression of spirituality on the job helpful in finding meaning, satisfaction, and value in their work (Kociszewski, 2004).Sanctification of work (SoW) is a promising facet of spirituality defined by researchers as an individual’s experience of their work as a manifestation of God or sacred qualities that affects their effectiveness and engagement on the job (Walker, Jones, Wuensch, Aziz, and Cope, 2008). In the field of nursing, with its emphasis on positive outcomes and patient satisfaction, a study of sanctification of work could prove useful in improving the nursing environment, and thus, work-related outcomes. Thus far, little attention has been paid to how spirituality may influence nursing work-related outcomes and patient satisfaction. There is a need for further knowledge about sanctification as a facet of spirituality and its association with these important factors. This study sought to determine if sanctification of work was associated with job burnout, and other work outcomes such as employee engagement, organizational commitment, turnover intention, and job satisfaction. In addition, the study also explored whether nurses’ sanctification of work was associated with patient satisfaction, since there were no empirical studies on that area. A quantitative, descriptive, cross-sectional, correlational research design was used to describe and measure the association between sanctification of work and work-related outcomes, patient satisfaction, and demographic factors. A group of 463 licensed and unlicensed nursing personnel participated in the study, conducted in a not-for-profit, faith-based teaching hospital in the Los Angeles area. A sample size of 435 achieved 80% power to detect an R² of 0.02 attributed to 1 independent variable(s) using an F-Test with a significance level (alpha) of 0.05. The variables tested are adjusted for an additional 15 independent variable(s) with an R² of 0.10 and 20% non-response rate. Participants answered an 82-item questionnaire comprised of several previously established scales and demographic items, including The Duke University Religion Index (DUREL), the Sanctification of Work Scale, The Maslach Burnout Index, the Overall Job Satisfaction Scale, and the Employee Engagement Scale, among others. Patient satisfaction was measured using data from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. Of the 463 participants of this study, 60% were Catholics, 81% were female, and nearly 45% had worked at least 5 years in the organization. The mean age of the participants is 42. Participants on average rated sanctification of work as a 5.7 on a 7-point scale. The linear regression results indicated that sanctification of work is a significant predictor of employee engagement, organizational commitment, and job satisfaction. In addition, females are more likely to perceive work as sanctified than male respondents. The study may influence nursing practice and nursing education. Study findings could help healthcare organizations promote positive patient experiences and inform nursing leadership decision making in recruitment and retention. Educators might also learn how to teach nursing students and nurses about the importance of sanctification of work, and consider adding the concept of sanctification to nursing curriculum and program frameworks.

The Formulation of a RBANS Effort Supplement

Goldberg, Joshua Seth Loma Linda University ProQuest Dissertations & The 2019 해외박사(DDOD)

소속기관이 구독 중이 아닌 경우 오후 4시부터 익일 오전 9시까지 원문보기가 가능합니다.

Assessment of effort detection is an essential component of a neuropsychological evaluation to ensure results of testing are valid indicators of an individual’s true level of cognitive functioning. Effort detection in the initial screening process provides neuropsychologists information regarding patients’ test engagement prior to administering longer testing batteries. Two effort measures are embedded in the Repeatable Battery for Assessment of Neuropsychological Status (RBANS), a neuropsychological screening assessment, but both have demonstrated elevated false positive rates for classifying individuals with memory impairment as those putting forth poor effort. These embedded measures rely on cut-off scores on digit span and memory subtests. In contrast, this RBANS Effort Supplement (RES) utilizes several forced-choice subtests, reflective of current research emphasizing the importance of multiple methods of effort detection; subtests in this measure included list learning forced-choice, figure copy forced-choice, picture naming forced-choice, a coding task, and a story recognition component utilized for face validity of memory assessment. Fifty-nine participants were recruited from an outpatient neuropsychology facility in conjunction with 14 poor effort simulators; each participant was administered the RBANS, the RES, and the Dot Counting Test (DCT). Results supported the RES’ reliability at the individual decision-making level. Validity analyses demonstrated that the RES exhibited strong convergent validity with established effort detection measures and that individuals putting for poor effort scored significantly lower on the RES than individuals who put forth adequate effort, as delineated by the established DCT cutoff score of 17. In summary, the RES was shown to be a valid indicator of effort detection. Clinical implications of the RES include reduction of time and costs involved in neuropsychological assessment.

Relationship Between Balance and Physical Activity in Subjects with Non-Specific Chronic Low Back Pain

Alsufiany, Muhsen B Loma Linda University ProQuest Dissertations & The 2019 해외박사(DDOD)

소속기관이 구독 중이 아닌 경우 오후 4시부터 익일 오전 9시까지 원문보기가 가능합니다.

Most research on sedentary lifestyle has focused on pain and disability outcomes, while neuromuscular outcomes (postural control and strength) have received less attention. The objective of the present study was to determine whether low level of physical activity is negatively associated with measures of lower body muscular strength and postural control in subjects with and without non-specific chronic low back pain (NSCLBP).Twenty-four subjects with NSCLBP (28.8±5.9 years) and 24 age, gender, and Body Mass Index (BMI) matched healthy controls participated in the study. Subjects were sub-classified into four subgroups based on their level of physical activity using the International Physical Activity Questionnaire Short Form (IPAQ-SF) – (Group A: Non- active, NSCLBP; Group B: Active NSCLBP; Group C: Non-active healthy control; and Group D: Active healthy control). Each subgroup consisted of 12 subjects, 6 males and 6 females. Following a familiarization session, assessments of hip muscular strength and postural control were performed. Peak force of hip extensors, flexors, abductors, and external rotators was assessed using a handheld dynamometer. Postural control was assessed using computerized posturography and the Y Balance Test.There was no significant group by physical activity interaction for strength and static and dynamic postural control, except for static control during left single leg stance with eyes closed (p=0.029). However, there was a significant difference in strength, static and dynamic postural control by physical activity level (p<0.05). Postural control and peak force of the hip muscles strength were significantly associated with physical activity level (r ranged from 0.50-0.66, p < 0.001 and r ranged from 0.40-0.59, p < 0.05, respectively).Postural control and hip strength were independently related to physical activity behavior. The present results suggest that sedentary behavior may be an important risk factor for impaired postural control and hip muscles strength, and that physical fitness is vital to neuromuscular outcomes.

Task Analysis of SERT: Exploring the Efficacy of Feminist Therapy

Donihoo, Gregory B Loma Linda University ProQuest Dissertations & The 2019 해외박사(DDOD)

소속기관이 구독 중이 아닌 경우 오후 4시부터 익일 오전 9시까지 원문보기가 가능합니다.

Feminist theorists have begun to view gendered power as a core component of relational distress (Knudson-Martin & Mahoney, 2009; Moradi, 2012). Leading couples toward equality is a social justice ethic and is arguably a stand-alone clinical outcome (Evans, Kincade, Marbley, & Seem, 2005; Fitzgerald & Betz, 1994). Leading couples toward mutual support brings relational stability and long-term relationship satisfaction in both men and women (Acitelli & Antonucci, 1994; Buunk & Mutsaers, 1999; Mahoney & Knudson-Martin, 2009; Sprecher, 2001). SERT [Socio-emotional Relationship Therapy] was designed to integrate feminist theory as a core component to bringing power change in couples (Knudson-Martin & Huenergardt, 2010). This research utilized task analysis to locate the tasks of therapists guiding couples toward mutual attunement and shared relational responsibility. The study discovered that therapists who were successful in reaching the outcome resolution would first attune to male clients, then direct those men toward relational language and mindsets, invite the female client’s perspective and finally guide an enactment of this new and mutually supportive process with the couple. This study gives clarity on the process of implementing SERT which can guide the training process of new feminist therapists.

Does Self-Evaluation and Education in Students Change Attitudes and Beliefs Towards Weight Stigma?

Garcia, Henry A Loma Linda University ProQuest Dissertations & The 2019 해외박사(DDOD)

소속기관이 구독 중이 아닌 경우 오후 4시부터 익일 오전 9시까지 원문보기가 가능합니다.

The current state of global ensures physical therapists will encounter patients that are overweight/obese in all clinical settings, which makes them exceptionally positioned to promote lifestyle modifications to their patients. Unfortunately, weight stigma is highly prevalent among health care providers. Weight stigma has been shown to have adverse effects on patients. The purpose of this study is to measure weight bias in the doctor of physical therapy (DPT) students. Elicit change in obesity stigma in DPT students by way of self-evaluation while enrolled in a course Aspects of Health Promotion (AHP). Methods: Sixty students enrolled in AHP course participated in a blood draw, self-evaluation assignments, and a lifestyle change assignment involving a lifestyle journaling. The Nutritional, Exercise and Weight Management (NEW) Attitudes Scale taken at three distinct times. Baseline at the beginning of fall quarter, baseline to 6 months after the AHP course, and at 12 months the following year when returning from their clinical affiliation. Correlation between NEW Attitudes Scale score and lipid profile revealed students with triglyceride levels > 150 mg/dL showed no significant improvement in their attitudes on weight stigma. In contrast, students with triglyceride levels < 150 mg/dL, showed a significant change of improved score in their attitudes and beliefs on weight stigma P = .000. Measuring HbA1c, hs-CRP, and HDL levels in students, all showed a significant change of improved score at six months. Barriers to lifestyle change identified by the DPT students ranked highest barriers to least barriers as time management (60%), motivation (28%), illness/pain (10%) and media (3%) respectively. Total cohort attitudes and beliefs showed a significant change in improved scores from baseline to 12 months, which included the AHP course and their clinical affiliation. In conclusion, healthier lipid panel, as well as hs-CRP and HbA1c correlated in improved attitudes and beliefs, barriers to lifestyle changes correlated with patients with type 2 diabetes, cancer, and senior citizens. Recommendations are to encourage a healthy lifestyle while students are in graduate work preparing to enter the health care field to lower negative bias towards the overweight and obese population.

An Empirical Examination of Doctoral Training Models in Clinical Psychology in the United States

Dautenhahn, Katherine E Loma Linda University ProQuest Dissertations & The 2018 해외박사(DDOD)

소속기관이 구독 중이 아닌 경우 오후 4시부터 익일 오전 9시까지 원문보기가 가능합니다.

Since as early as 1908, psychology as a discipline has grappled with how to integrate research and practice into the field’s professional identity. To further define the area of expertise of a psychologist, three main models of clinical training have been proposed: the scientist-practitioner model, the practitioner-scholar model, and the clinical scientist model. Despite clinical psychology’s universal claim for empirical moorings, the debate about the foundation of training in clinical psychology has remained primarily theoretical. The purpose of this study is to expand upon the limited research exploring the differences between training models to empirically determine which factors significantly predicted training models. To answer this question, a series of logistic regressions were run to determine if training models could be predicted by program admission criteria, faculty modeling, structural factors, differences in epistemological stance, and student factors. Results indicated admission criteria, faculty modeling, and structural factors significantly predicted training models. Results and implications for future research and clinical practice are discussed.

Resilience and Complicated Grief

Bishop, Leslie Loma Linda University ProQuest Dissertations & The 2018 해외박사(DDOD)

소속기관이 구독 중이 아닌 경우 오후 4시부터 익일 오전 9시까지 원문보기가 가능합니다.

This study surveyed 155 family members or caregivers of patients who had died between twelve and thirty months prior to this study. These patients had been on hospice at the time of their death. The purpose of the study was to assess the prevalence of hospice defined risk factors for complicated grief. Medical records provided patient demographics information and a verbal (telephone) survey was used to measure the following risk factors: lack of social support, lack of expression of faith, lack of adequate coping skills, multiple losses, substance use, and relationship to the person who died. Descriptive statistics were used to assess the prevalence of risk factors and linear regression was used to evaluate the potential of risk factors to predict complicated grief. Results indicated that coping skills were a highly significant predictor of complicated grief. To a lesser extent, the gender of the patient was also a significant predictor of complicated grief. Pragmatic, clinical and theoretical implications of these results are discussed.

Adverse Childhood Experiences, Cognitive Ability, and Psychosocial Functioning

Mathis, Maleia Loma Linda University ProQuest Dissertations & The 2019 해외박사(DDOD)

소속기관이 구독 중이 아닌 경우 오후 4시부터 익일 오전 9시까지 원문보기가 가능합니다.

Inflammation, Depression and Non-Adherence Correlates in Persons on Hemodialysis

Fulmer, Kathleen Loma Linda University ProQuest Dissertations & The 2019 해외박사(DDOD)

소속기관이 구독 중이 아닌 경우 오후 4시부터 익일 오전 9시까지 원문보기가 가능합니다.

The hemodialysis patient is at risk for a high inflammatory state as evidenced by the elevation of the pro-inflammatory cytokine, interleukin-6 which has been linked to lower serotonin levels and development of depression. The biological and psychological stress of living with End Stage Renal Disease on hemodialysis increases the risk for depression which is the leading psychological disorder affecting these patients which is also under-diagnosed and under-treated. The phenomenon of depression can manifest itself in the maladaptive behavior of non-adherence which has been associated with increased mortality, morbidity and decreased quality of life for the hemodialysis patient. The purpose of this study is to determine if there is relationship between inflammation, depression and non-adherence among persons in End Stage Renal Disease on hemodialysis. Prior studies have shown a link between inflammation and depression and depression and non-adherence, but little is known about the possible relationship between inflammation and non-adherence with depression as a mediating factor. Establishing this relationship may build a framework upon which to develop future interventional studies to understand the links between the phenomena and approaches towards addressing non-adherence in the hemodialysis population. This study examined the relationship between inflammation, depression, and non-adherence in Hemodialysis (HD) patients. A total of 67 subjects on HD at least three times a week, 3 hours per treatment with a minimal vintage of 12 months were included. Interleukin-6, a twelve- month average of phosphorous and potassium levels, intradialytic weight gains (IDWG) and number of missed/shortened treatments, Beck Depression Inventory II (BDI-II) scores, and End Stage Renal Disease Adherence Questionnaire (ESRD-AQ) scores were collected. Depression prevalence was 48%. There were significant relationships between IL-6 and BDI-II scores (p=0.001); BDI-II as a predictor of IDWG(p=0.048); Il-6 and IDWG, ESRD-AQ total and Diet, Medication and Treatment score percentages (p=0.002-0.05). IL-6 was not a significant predictor of IDWG with BDI-II scores as a mediating factor.