The purpose of this exploratory study, using grounded theory methodology, was to investigate the impact of institutionalization on the elderly nursing home resident's sense of connectedness with valued attachments. The five female subjects who participated in the study ranged in age from 76 to 92 years. Their lengths of stay at the facility ranged from two months to three years and six months. Data collection and analysis involved interviewing the subjects and comparing and contrasting their responses. This resulted in the identification of a core process labeled Integrating the Experience of Institutionalization. This core process incorporated the subjects' cognitive appraisal of conditions and contingencies related to their past and present lives and involved coping strategies and consequences. The findings of this study were viewed from a developmental perspective in light of the universal need of the elderly individual for integration. This study has implications for nursing research, education and practice.

The purpose of this study was to determine if a difference existed between a sample of fraternity residents and a sample of dormitory residents in the level of self-disclosure present in their same-sex friendships. Of additional import was whether or not self-disclosure, directed toward different target persons, varied according to the age of the discloser, the identity of the target person, and the reported closeness of the discloser to his father. A modified version of Sidney M. Jourard's Self-Disclosure Questionnaire was utilized to measure present levels of self-disclosure. Findings indicated there was a significant difference in self-disclosure with same-sex friends between the sample of fraternity residents and the sample of dormitory residents. Moreover, significant differences were found in the mean level of self-disclosure as it related to the identity of the target person, and to the reported closeness of the discloser to his father.

The purpose of this study was to explore the lived experience of smokers hospitalized on a tobacco free psychiatric unit through the research methodology of phenomenology. The sample consisted of 3 participants: a 44 year old Caucasian female, a 36 year old Caucasian male, and a 38 year old Caucasian female. Interviews were audiotaped and analyzed using an adaptation of Colaizzi's eight-step procedure. Results included these Theme Categories: The Psychological Experience of Smoking Abstinence; The Physiological Experience of Smoking Abstinence; The Socio-Cultural Experience of Smoking and Its Abstinence; Spiritual Aspects of Smoking; How Do I Deal with Smoking Abstinence?; What about Smoking Cessation?; and Persisting Perceptions of a Tobacco Free Psychiatric Hospitalization. The essential structure of the lived experience of smokers hospitalized on a tobacco free psychiatric unit was formulated from the data.

This study examines the development, organization, and implementation process of an intersectoral work insertion program (ISWIP) that is implemented through the collaboration of six stakeholders from different sectors of the community, including health and employment. The research objective is approached by case study methodology whereby the main methods of inquiry are documentation collection, participant observation, and semi-structured interviews. An innovative program logic model is developed that illustrates key components of using an intersectoral approach: leadership, sharing resources, and serving interests. The study demonstrates the relevance of local development to the social integration of individuals with mental illness. It also provides insight into the challenging nature of collaboration; obstacles such as negotiating roles, maintaining interests, and dealing with unforeseen consequences can be sources of frustration and tension among participants. Communication, attitude, and stakeholder involvement, are mediating factors in overcoming conflicts, reducing tension, and promoting successful collaboration.

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<p> Depression and abnormal salivary cortisol levels have been related to poor health outcomes for both mothers and their children. However, few studies have examined whether protective factors, such as optimism, resilience, or coping styles are associated with depression and cortisol during pregnancy. The current study examined whether these protective factors were associated with depressive symptomology (current and lifetime depression) and salivary cortisol patterns among 100 low-income pregnant women. Hierarchical regression analyses found that: (a) greater levels of optimism and resilience were associated with lower levels of depression (<i>R²</i> = .17 to .46, <i>p</i> &lt; .05); (b) women low in resilience reported more depressive symptoms when using more positive reinterpretation coping (<i>R²</i> = .36, <i>p</i> &lt; .05); and (c) women high in resilience reported more depressive symptoms when using more avoidance coping (<i>R²</i> = .20, <i> p</i> &lt; .05). Results suggest that coping processes may be important in understanding the mental and physical experience of depression.</p>

<p> Rural West Virginia has a very high percentage of older adults. The age-related disease of Alzheimer&rsquo;s threatens the health of older Appalachians, yet research on Alzheimer&rsquo;s disease (AD) in this population is scarce. In order to improve screening rates for cognitive impairment, Appalachians need to understand their vulnerability. The first step would be to assess their knowledge about AD but a suitable AD knowledge test has not been developed. The purpose of this study was to test the reliability and validity of a new measure of knowledge about AD that is culturally congruent, and to examine factors that may predict AD knowledge in this rural population. A correlational descriptive study was conducted with 240 participants from four samples of older adults in south central rural Appalachian West Virginia using surveys and face-to-face interviews. Results from tests for stability, reliability including Rasch modeling, discrimination and point biserial indices, and concurrent, divergent, and construct validity were favorable. Findings were that although more diversity in test item difficulty is needed, the test discriminated well between persons with higher and lower levels of education [<i>F</i>(2, 226) = 170.51, <i>p</i> = .001]. Using multiple regression, the predictors of AD knowledge included caregiver status, miles from a healthcare provider, gender, and education; (<i>R</i>²=.05, F(4,187) = 2.65, <i>p</i> =. 04). Only years of education accounted for a significant proportion of unique variance in predicting the total BKAD score (<i>t</i> = 2.14, <i>p</i> =. 03). Implications include the need for further tool refinement, testing for health literacy, coordination with recent statewide efforts to educate the public regarding AD, and community based participatory research in designing culturally effective education programs that will ultimately increase screening and detection of Alzheimer&rsquo;s disease in rural populations.</p>

<p> This thesis examines how the current psychological collective conceptualizes, addresses, and makes clinical use of the wounded healer archetype as it occurs in and influences the vocation of psychotherapy. The universal, historic significance of the wounded healer archetype is explored as well as its manifestation in the psychotherapist, the degree to which the therapist&rsquo;s wounds define countertransference, and the effect on client therapy outcome. Research on the psychological community&rsquo;s recognition and encouragement of exploration of the psychotherapist&rsquo;s woundedness is included. A heuristic approach applied to unraveling the mythological wounded healer archetype finds that it may dwell in the psyche of any human. The author concludes that wounded healers who&mdash;for myriad unpredictable reasons&mdash;follow the vocation of psychotherapy may benefit the psychological community by understanding the clinical and neuroscientific evidence suggesting that their own wounds underwrite countertransference and can be accessed and used as a potent tool in their practice.</p>

As Canada, and particularly metropolitan cities like Montreal, becomes increasingly diverse, it is important to explore and understand the culture and needs of immigrant communities. This Masters thesis focuses on the mental health of South Asian immigrant women in Montreal, Quebec. This original research is a qualitative descriptive study based on in-depth interviews with nine women from India and Pakistan. The interviews focus on the intersection of gender and culture with post-migration experiences, help-seeking patterns and coping strategies for distress in South Asian women. The women's narratives provide pertinent information for researchers and practitioners that could be applicable to the design of future research, outreach, health promotion, and models of care on mental health. The following four chapters provide a thorough discussion of the methodology, findings and conclusions.

<p> Research has shown that people with mental illness who seek treatment from mental health services have improved quality of life. The objective of the study was to evaluate the influence of stigma on people with mental illness, and how stigma can affect the person's decision to seek treatment for his or her mental condition.</p><p> The objected was assessed using secondary data from the 2009 Adult California Health Interview Survey. The initial filtering of the respondents was unable to be performed because Human Subjects Protection laws protect sensitive information from being released in public use data files. I redeveloped my study, focusing primarily on the association between respondents with feelings of depression and whether or not they have health insurance coverage for mental health services.</p><p> The results of the analysis proved to be statistically significant, which led to speculation that, even with mental health insurance coverage, the low rates of mental health service utilization was most likely attributed to the impact of stigma. Future research should be conducted on the effects of primary care mental health integration, and how this increased parity impacts the utilization of mental health treatment options.</p>