Thesis (M.S.)--University of Michigan, 1977.

Thesis (M.S.)--University of Michigan, 1977.

Thesis (M.S.)--University of Michigan, 1971.

Thesis (M.S.)--University of Michigan, 1971.

<p> Today&rsquo;s emerging patient centered health movement is focused not on a specific condition or demographic, but rather on shifting the balance of power and enabling access to information to drive decision-making in healthcare. This takes place through electronic health records as well as more generalized sources. The uptake of social media is contributing to an innovation in patient centered healthcare: information and support on a global scale is coming not only from the formal healthcare system, but also within online social networks. Today, through computer-mediated interactions, patients are not only seeking information, they are curating and sharing information. Subsequently, patients are also creating information, establishing a novel ecosystem of engagement that has the potential to disrupt the current healthcare system. </p><p> This dissertation explores an online health community, BCSM (which stands for &ldquo;breast cancer social media&rdquo;), established using Twitter, a largely public and searchable social media platform. Drawing primarily from social network theory, disruptive innovation, and ecological systems theory, this research identifies essential characteristics within the community that may inform future development and support for patient centered healthcare. To conduct this research, a blended approach of netnography &ndash; referring to the approach of ethnography applied to the study of online cultures and communities &ndash; and in-depth interviews with BCSM participants were employed. </p><p> Data collected via interviews and tweets using the hashtag #bcsm provide evidence of clinical support, emotional support, information sharing, and knowledge translation. Underpinning this activity is the opportunity to associate not only with peers, but also with individuals of varying roles (including patients, providers, advocates, researchers, and caregivers). As evidenced by the data collected, educational opportunities flow in both directions. </p><p> This work contributes to the larger corpus of health-related literature in the identification and naming of a significant community element that has seen little focused attention: cross-peer engagement, a term used to highlight the interaction amongst individuals of differing status, ability, or rank. This research also documents the formation of microspurs, defined as relationships that form as a result of community participation. These come in many forms and range from expanding a personal support network to participation in federal policy work. Findings suggest that the future of healthcare will not revolve around hospitals and bounded systems. Instead, patients will demand an expanded set of entry points for health information sharing, knowledge transfer, condition management, and general support.</p>

<p> There is an increasing demand for more baccalaureate- and graduate-prepared registered nurses in the United States, to face the healthcare challenges of the 21st century. As a strategy to meet this need, educational institutions are expanding electronic learning in nursing education; however, technology acceptance in education continues to be a concern for educational institutions. In this context, the goal of the study was to investigate factors that potentially influence registered nurses&rsquo; intentions to adopt e-learning systems. A theoretical model was used to determine whether perceived value, attitude toward e-learning systems, and resistance to change influence registered nurses&rsquo; intentions to use e-learning systems. </p><p> A web-based survey was used to assess the effect of the aforementioned constructs on registered nurses&rsquo; intentions to use e-learning systems. The web-survey instrument was developed as a multi-item questionnaire using Likert-type scales. A 35-item survey instrument was developed using previously validated measurable items. The target population of this study was registered nurses in South Florida. The sample for this study was 323 (over 21% response rate) registered nurses at two hospitals in South Florida. </p><p> Multivariate analysis was conducted using structural equation modeling and robust standard errors with the Satorra-Bentler adjustment. The results revealed that perceived value, attitude toward e-learning systems, and resistance to change influence registered nurses&rsquo; intentions to use e-learning systems. Findings from this investigation may be of interest to educational institutions preparing to make investments in e-learning systems. The information provided in the study will allow administrators in higher educational institutions to make decisions on ways to address the challenges that may be affecting e-learning acceptance by registered nurses.</p>

<p> The purpose of this study was to compare and contrast four age cohorts to determine: (a) if they have any preexisting knowledge about The Blue Zones Power 9 lessons for longevity, (b) if they are currently practicing any of the Power 9 lessons, and (c) to what extent they intend to adopt all or some of the Power 9 lessons in the future. The Transtheoretical Model of Behavior Change (DiClemente &amp; Prochaska, 1982) guided exploration of the respondents&rsquo; adoption of the Power 9 lessons. There were four significant findings in this study. Physical activity and stress relief had similar results in that both the youngest and oldest age cohorts&rsquo; expressed higher frequencies than the two middle age cohorts. Wine consumption and adoption/intention to adopt the Power 9 also had similar results, demonstrating that as age increased, so did the frequency of wine consumption and adoption/intention to adopt the Power 9.</p>

<p> Employee job satisfaction is an ongoing concern in the field of social work. High caseloads, low compensation, and the lack of job security are sources of job dissatisfaction for novice and seasoned social workers in managed care settings. Specifically, the purpose was to determine if there is a correlation between high caseloads, the lack of job security, and low compensation and job dissatisfaction among novice (<i>n</i> = 24) managed care social workers and seasoned (<i>n</i> = 86) social workers in Texas and the surrounding areas. The emphasis of these factors, if not recognized and addressed through interventions by health care administrators, can lead to novice or seasoned managed care social workers&rsquo; dissatisfaction and within their position and careers with an ending result of desirable professional leaving the field of social work. Herzberg&rsquo;s two-factor theory guided the study. The independent variables were selected for use in a multiple regression analysis at the .05 level of significance. No correlation was found between high caseloads and job dissatisfaction among novice social workers or between low compensation and job dissatisfaction among novice and seasoned social workers. High caseloads were correlated with job dissatisfaction among seasoned social workers. A correlation was found between the lack of job security and job dissatisfaction between novice and seasoned social workers. The research study collected data used in sealing the gap in the health care community by providing valuable information and directions for health care administrators to focus on in an attempt to reduce turnover, increase productivity, and improve the quality of patient care.</p>

<p> Self care is more than a requirement for life. Working in a high stress hospital environment lends itself to having many personal and professional stressors that go beyond medical professionals job requirements. The purpose of this study was to explore how hospitals support medical staff through self care programs. Data was collected through semi-structured interviews of five medical professionals who work in various specialties. Results of this study indicated that self care was represented in various unstructured formats. Additionally, this study demonstrates the need for more support in the medical field to allow for more opportunities for self care to take place. Furthermore, this analysis of self care explains the importance of this practice to be implemented by medical professionals as it helps to reduce the high rates of burnout and compassion fatigue.</p><p>

Quality rating and improvement systems (QRIS) are a state-level policy designed to assess and improve quality in early childhood education and care through rating systems and financial incentives. Current research suggests that QRIS are not meeting their stated goals of increasing access to quality care and improving child outcomes. This report investigates concepts of quality in QRIS by critically analyzing their use of standardized quality measurement scales. It uses postmodern perspectives and cultural relativism theory to argue for an alternate conceptualization of quality that incorporate community context and multiple perspectives. Finally, this report proposes alternative policies that could be used to promote ongoing conversations about quality within a community context. / text