Thesis (Ph. D.)--Texas State University-San Marcos, 2006. / Vita. Appendices: leaves 287-319. Includes bibliographical references (leaves 320-330).

Thesis (M.Nurs.)--Washington State University, May 2007. / Includes bibliographical references (p. 35-39).

Thesis (M.Sc.)--Saint Mary's University, 2008. / Includes abstract and appendices. Supervisor: Mark Fleming. Includes bibliographical references (leaves 60-68).

Thesis (Ph. D.)--University of Washington, 2000. / Vita. Includes bibliographical references (leaves 109-114).

<p> The growth in the older adult population will result in an increasing number of individuals with functional and cognitive limitations. The demand for nursing home administrators will grow proportionately with the aging population and the need for effective leadership within nursing homes is and will continue to be imperative as the population ages. Identifying top-rated nursing homes that provide quality care is essential to understanding the operations of successful long-term care facilities. Nursing home administrators (NHAs) are tasked with leading and directing provision of skilled, intermediate and rehabilitation care on a 24-hour basis while ensuring high quality operations. Identifying the character strengths of nursing home administrators who lead exemplary nursing homes may benefit other nursing home leaders who lead lower rated or underperforming facilities. In this qualitative study, 19 nursing home administrators who lead exemplary facilities across Indiana completed the Value in Action Inventory Strengths (VIA-IS) questionnaire and engaged in face-to-face interviews. Analysis of the interview data via NVivo indicated how the use of character strengths is crucial to effective leadership within long-term care. Creativity, fairness, bravery, perspective, and judgment were identified by a majority of study participants as essential to decisionmaking and problem solving, especially in a heavily regulated environment. Humor, hope, courage, and spirituality were acknowledged as contributing to a positive and optimistic environment. Humor, hope, courage, and spirituality were also noted as coping mechanisms when faced with stress and adversity. Honesty, kindness, love, teamwork, and gratitude were emphasized by the study participants as essential to relationship development and formation of trust with staff, residents, and families. This study allowed participants the opportunity to reflect on their own character strengths and leadership both personally and professionally. This reflection resulted in increased self-awareness and appreciation of their staff, residents, and roles as nursing home administrators. </p><p>

<p> In 2004, the Institute of Medicine (IOM) called for academic health centers (AHCs) to adapt and change through collaboration between their many separate groups of healthcare professionals. Research on collaboration in healthcare organizations to date has concentrated on how collaboration impacts patient care and organizational efficiency. Research has not focused on whether collaboration among healthcare professionals, influences learning for individuals or the organization. Socio-cultural learning theory, which takes into account the individual, the organization and the larger system, emphasizes that &ldquo;collaborative learning&rdquo; is an important component of the learning process. It also emphasizes that problem solving facilitates the development of insights and solutions. On this basis, the link between collaboration and learning needs to be explored. This research focused on exploring the association between collaboration and learning as perceived by clinician educators and other healthcare professionals with whom they have collaborated in AHCs. In-depth interviews were conducted with 21 healthcare professionals who had participated in collaborative activities in the past 18 months, and who had familiarity with relational coordination (RC) as a framework for collaboration. Interview questions elicited interviewee descriptions of positive and challenging collaboration experiences. Data were analyzed using an inductive analysis approach and coded to identify implicit and explicit learning outcomes from those experiences. Findings indicated that all participants had extensive experience of informal collaboration with professional colleagues and learning resulting from their collaboration experiences. Four categories of learning outcomes were identified; process and quality improvement, professional relationships with colleagues, emotional awareness, and growth in technical and adaptive knowledge and skills. The majority of learning outcomes in each of the four categories were implicit, indicating that participants did not recognize the learning that was occurring through their participation in collaborative activities. Learning appears as a currently invisible outcome of collaboration as described by the participants in this study. Further research is needed to determine the potential value of the learning for the individual and the institution.</p><p>

M.Tech. (Radiography (Diagnostic)) / In order to meet the needs of the country South African radiographers need to become multi skilled radiographers. Empowering diagnostic radiographers with pattern recognition skills to enable them to comment on images could address the problem in many South African departments where a shortage of radiologists’ results in delayed reports or no reports to referring doctors. The research assessed the ability of qualified diagnostic radiographers in two Gauteng Government Hospital’s to apply pattern recognition and provide a comment on a radiograph after training in musculoskeletal pattern recognition. The study employed a pre- and post-test model with an intervention which comprised training of radiographers in musculoskeletal pattern recognition. The post- test results showed a significant improvement in the accuracy of identifying abnormal images and the comments provided were more complete than before training. Thus the intervention was successful in improving the ability of the radiographers to recognize normal and abnormal images, however, the training would need to be more extensive for an accurate comment to be provided on musculoskeletal images.

We used the results from two large scale cardiovascular investigations as a platform for examining ways in which psychological response style measures could improve the prediction of cardiovascular health outcomes. Of particular focus was the long-standing conceptual controversy over whether response styles are better treated as confounds to the self-report of stress-related personality characteristics or as separate personality traits. Study 1 consisted of a 3-year prospective study of ambulatory blood pressure levels in a healthy adult sample of males and females (N=T25). Study 2 comprised a pharmacological treatment study among ischemic heart disease patients (N=95). Questionnaire batteries completed in each study included self-report measures of depression, anger expression, daily stress, and hostility, along with self-deception and impression management response style scales. In each study, we investigated direct relationships between the response style measures and cardiovascular outcomes, moderator relationships between response style x psychological risk factor interactions and cardiovascular endpoints, and finally between the psychological risk factors and cardiovascular measures after statistically extracting response style variance from the p sychological risk factor scores. Results most strongly supported the main effects model. Higher self-deception scores predicted elevated 3-year diastolic and systolic blood pressure means in study 1, and poorer treatment outcomes in study 2. In both investigations these relationships proved stable after controlling for baseline cardiovascular standing. Importantly, efforts to statistically control for response style effects within the psychological risk factors did not improve predictive power with these measures. The above findings favor efforts to treat response styles as potentially independent psychological contributors to cardiovascular health outcomes, and support ongoing attempts to identify biobehavioral mechanisms through which personality dispositions may impact the appearance or progression of disease. / Arts, Faculty of / Psychology, Department of / Graduate

Career burnout, defined by feelings of high emotional exhaustion, depersonalization, and low personal accomplishment, is prevalent amongst clinicians. A literature search established mindfulness-based interventions are growing in popularity to reduce or prevent burnout in healthcare. One type of mindfulness-based intervention is Mindfulness Based Stress Reduction (MBSR) programming. MBSR, an eight-week course, has been shown to reduce stress and improve quality of life and self-compassion. Our research aims to investigate the current burnout landscape in the field of medicine, and evaluate the effects of a MBSR variant course on clinician burnout and professional fulfillment at Boston Medical Center (BMC). Through the creation and execution of an eight-week MBSR variant course, Mindfulness Training for BMC Clinicians: A Program for Stress Reduction, Vitality, and Professional Development, we surveyed clinicians before the course, after the completion of the course, and two months after the completion of the course. The surveys were used to collect quantitative and qualitative data; we employed mixed methods analysis to statistically evaluate these data. The survey results were used to calculate numerical professional fulfillment and burnout scores for each clinician. Changes in scores were evaluated over time. These data suggest participants' professional fulfillment increased and burnout decreased from baseline measures to post-intervention measures, and results were sustained two months after the course was completed. Likewise, our qualitative data revealed approximately two-thirds of participants remarked having greater value on self-care. The vast majority of participants plan on continuing their mindfulness practice after the course and would recommend the MBSR variant course to their colleagues. Mindfulness based interventions show promise in increasing professional fulfillment and alleviating aspects of career burnout in clinicians at Boston Medical Center (BMC). Continuation of our pilot course will allow our team to increase our sample size and continue to evaluate and modify methods to best serve clinicians and other hospital employees in the efforts to increase their overall wellbeing.

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