Scholars have utilized the Minority Stress Model to explore external and internal stressors, coping mechanisms, social support and mental health outcomes for sexually marginalized populations. However, scarce studies examine Latinx sexually marginalized experiences and associations within the model. Thus, the goal of this study was to integrate sexually marginalized Latinx experiences in the Minority Stress Model. The theoretical frameworks utilized were Minority Stress Theory, Intersectionality and Experiential Theory rooted in the Couple and Family Therapy field. First, an explanation of the Minority Stress Model, influences of prominent Latinx cultural factors (i.e., tradition, familism, gender, and acculturation) in model processes, and a proposed Latinx Minority Stress Model is provided. Further, clinical implications are discussed through intersectional multicultural competency and Experiential Theory techniques. Second, a quantitative study with a sample comprised of 76 Latinx lesbian women in romantic relationships will be discussed. Regression analysis indicated that participants with family closeness and positive romantic relationship quality reported lower internalized heterosexism (i.e., internal stress). Additionally, higher internalized heterosexism outcomes predicted higher reports of anxiety and depression. Positive relationship quality perception also statistically mediated internalized heterosexist thoughts and depression. Implications for clinical work are discussed using Experiential Theory. Finally, research and clinical implications are examined through an integration of the proposed Latinx Minority Stress Model and quantitative analysis results. Limitations and future directions are discussed.

This qualitative research study explores the correlation between socioeconomic status and factors of psychotherapy dropout among college students who have prematurely terminated therapy while attending college. Twelve female-identifying college students were interviewed in a semi-structured design. It was predicted that socioeconomic status moderates the impact of financial and logistical barriers to access, mental health stigma, and perceived lack of socioeconomic status competency among practitioners on the decision to leave therapy prematurely, such that these factors have an amplified effect for students coming from lower socioeconomic status backgrounds. Findings indicate that logistical barriers to access are experienced across the socioeconomic spectrum, but with low socioeconomic students having fewer treatment options and an additional step of securing external funding. Results pertaining to identity competency did not indicate a socioeconomic status moderation or the specific need for socioeconomic status competence. Stigma was not found to be related to dropout. Other results are discussed. Further research should apply the present findings and recommendations to intervention-based pilot programs to investigate ways in which dropout can be reduced.

Bereavement is an experience that most people will encounter multiple times across their lifetime. Some people who experience grief are going to seek support in this process from a therapist. The NASW Code of Ethics suggests that social workers only practice in fields in which they are competent. This study will look at the self-perceived grief competency of master’s level therapists. Demographic data and a survey designed to measure the competency of a master’s level therapist was utilized to collect data to measure the self-perceived grief competency. Data collected was analyzed using descriptive statistics, one-way between groups ANOVA, and correlation analysis. The results of this study were mixed. Overall, there was no significant difference between MSWs, MFT and other therapists in their grief experience. However, among other significant findings, years in the field is associated with higher levels of training and experience. Further research will be needed to better assess for preparedness. However, findings suggest the importance of training social workers to adequately meet the needs of grieving individuals in lieu of years of experience.

This study focused on social work students’ views on the integration of religion in social work. This study allowed students to gain knowledge and insight on the importance of discussing religion with clients. The study examined social worker students’ experiences during their involvement in the social work program which looked into how prepared they were in situations where religion was necessary to discuss with clients and other outcomes. Qualitative interviews were conducted with ten participants who discussed their experiences in internships during their involvement within the social work program. Participants were in different years in the BASW and MSW program and were from various ethnicity, age, gender, and specializations. Main findings were that participants believed religion plays a huge role in clients’ everyday lives and that the social work program is not teaching students how to discuss religion with clients during their internships. Another finding was that a few social work students were not prepared to discuss clients’ religious practices. Agency employers also discouraged social work students from discussing clients’ religious practice. This study enhances the social work profession and allow social workers to better service diverse and cultural clients by highlighting the importance of religion in some clients’ lives. The social work profession can improve the quality of service that is given to clients that have a religious practice and can be assessed for appropriate services based on their individual needs. Social work students can learn to integrate this topic into their assessments.

Hospital readmissions within 30 days of discharge result in significant multimillion-€dollar penalties to thousands of Medicare-€eligible hospitals throughout the United States and are indicators of suboptimal patient healthcare leading to less than ideal health outcomes for previously hospitalized patients. The purpose of this correlation study was to examine the relationship between medication reconciliation, nursing workforce competency, timely and effective care, and Medicare-€eligible hospital 30-€day readmission rates. The sample of 269 hospitals came from the population of Medicare-€eligible hospitals throughout the United States. Complexity theory and the general model of readmission were theoretical frameworks grounding this study. Secondary data were from publicly available governmental databases. The reporting of the F statistic resulted in rejection of the null hypothesis in this study, based on evidence of the existence of a significant correlation between the variables. Findings shows a statistically significant relationship between nursing workforce competency, timely and effective care, and Medicare-€eligible hospital 30-€day readmission rates. Medication reconciliation, as measured in this study, was not a significant predictor of 30-€day readmission rates. Implications of this study for positive social change include an understanding of factors related to hospital 30-€day readmission rates to help leaders take action to enhance patient care, reduce inpatient care expenses, and decrease Medicare-€imposed hospital penalties.

The purpose of this project was to evaluate the impact of a quality improvement strategy to implement an RN clinical learning and development specialist (CLDS) with the intent to reduce high turnover in novice nurses and low nurse engagement. The CLDS served as expert, role-model, coach, and mentor. Benner'€™s model of novice-to-expert was used as the conceptual framework to monitor progression of nurses mentored by the CLDS. The Institute for Healthcare Improvement model for improvement was reviewed to assess the effectiveness of the CLDS on turnover rates and nurse engagement. At the time of program evaluation, the CLDS role had been operational at the project site for 8 months in inpatient and perioperative service lines. An analysis of turnover rate by headcount of 1510 RNs within the practice environment was completed. The change from the preintervention period to the postintervention period was statistically significantly lower. A nonparametric test to compare the monthly rates was used (z = -2.613; p = .005). To evaluate nurse engagement, the practice environment scale was deployed to all RN nurse residents from 9/2018 through 3/2019. A total of 166 surveys were deployed. There were 86 responses; 62 respondents were RNs with an assigned CLDS. There were no statistically significant differences in the scores between these 2 groups. The social impact of this project is important to share with nursing and operational leadership as an intervention to reduce RN turnover across healthcare settings, specifically in acute care practice areas. The issues of RN turnover and satisfaction with the practice environment are relevant across organization types and settings.

Thesis (M.Dev.) --University of Limpopo, 2007. / This study sets out to explore the challenges faced by grade 9 educators in the implementation of Outcomes-Based Education (OBE) in Maleboho East Circuit in Limpopo Province in view of the role played by this new education approach in the government’s agenda for social transformation. The study is mainly exploratory in design and has been undertaken within a qualitative framework. Thus, the study does not purport to come with explanations of cause and effect relations. It only explores the challenges that impact on successful implementation of the OBE approach. The research results show that the OBE approach is not effectively implemented in schools, due to inadequate teacher training, limited or little support to educators in their classroom practice, overcrowded classes and poor working conditions of educators. There is a need for a multi-dimensional approach that aims to address not only deficiencies in training, but also to impact on the attitudinal changes of educators. / N/A

There is no widely accepted tool to assess an orthopedic surgeon’s technical skill in the operating room. With changes in surgical education, simulators are being investigated for learning and assessing technical skills, but a link between the actual operating room is needed to ensure they are effective. Hip fracture surgery is a good starting point to develop these measures because hip fractures are common and fixation is a difficult task. Resident orthopedic surgeons wore a head-mounted video camera during hip fracture surgery. Data collected included: duration, number of x-ray images, the supervising surgeon intervention, and tip-apex distance (TAD, a measure of how accurate the implant is placed). To determine the reliability of these measurements, four raters performed them for two cases. Ten raters measured the tip-apex distance (TAD) on 7 cases. These performance metrics for 15 cases were compared to experience of the residents, both point in residency and number of previous cases. A composite performance score was computed using the four metrics. The metrics were also compared to two practicing surgeons’ assessment of skill. The inter-rater reliability of the performance metrics was high (0.97-0.99) showing these measures are consistent between different raters and useful for assessment. There was a significant relationship between resident experience and the metrics of duration and TAD. Expert opinion was related to duration. These metrics provide objective assessment of resident technical performance in the operating room by a non-expert, an important step towards competency based education. Their validity is shown with correlation to surgical experience.

The purpose of this study was to investigate how well rehabilitation counselor trainees in CORE accredited rehabilitation counseling programs are prepared to advocate clients. In order to seek an answer to this research question, this study (a) measured the rehabilitation counselor trainees' self-reported preparedness to advocate for their clients, (b) assessed the rehabilitation counselor educators' perceptions of their students' preparedness to advocate for their clients, (c) explored the relationship between rehabilitation counselor trainees' self-reported preparedness to advocate for their clients and their educational experiences as well as their demographic information, (d) investigated whether there was a significant difference between rehabilitation counselor educators' perception of their students' preparedness to advocate for their clients and the rehabilitation counselor trainees' self-reported preparedness. The results indicated that rehabilitation counseling students developed advocacy competencies in some areas. However, it was also found that rehabilitation counseling students have lower advocacy competencies in the community and public level domains than in the individual level. Rehabilitation counseling students reported that rehabilitation counseling course work and their prior experiences with persons with disabilities were most substantial factors in the process of developing advocacy competencies.

A team's performance in any sport can be predicted by many factors. Some of these factors include team collective efficacy, team cohesiveness, and coaching competency. Currently, there is little research investigating the relationships among teams' beliefs about their capabilities, their level of cohesion, and their perceptions of coaching competency on overall sport performance. The purpose of this study was to document the relationship among collective efficacy, cohesion, and coaching on sport performance in a sample of university athletes. The objectives of this study were to identify the level of cohesion, collective efficacy, and perceptions of coaching competency by each athletic team at the university, and to identify the relationships among each of these variables in regard to sport performance. Participants were 163 collegiate athletes involved in eight sports at Utah State University during the 2005-2006 academic year. Correlational analysis revealed significant positive relationships with collective efficacy, cohesion, and coaching competency. Multi-level modeling and linear regression analyses revealed that collective efficacy was a significant predictor of win/loss percentage, whereas some aspects of cohesion and coaching competency were seen as predictors of collective efficacy.