<p> The unique nature, challenges, and demands of rural counseling has been linked to higher rates of burnout and turnover among rural counselors in comparison to their urban and suburban counterparts. The current study examined the relationship between burnout and selected variables among professional counselors working in rural settings. A review of the literature indicated that multiple relationships, confidentiality, competence and training, lower compensation, lack of privacy, and personal and professional isolation were the variables most frequently identified as problematic for rural counselors. Data from 127 respondents were analyzed using multiple regression models. Individually, the independent variables were significant predictors of burnout, however, only confidentiality, lower compensation, lack of privacy, and personal and professional isolation were significant predictors in the multiple regression models.</p>

This descriptive study used the Diagnostic Content Validity (DCV) and the Clinical Diagnostic Validation (CDV) models proposed by Fehring (1986) to clinically identify and validate the defining characteristics for Alteration in Tissue Perfusion: Peripheral. The Peripheral Vascular Assessment Tool (PVAT) was designed as the data collection tool; the DCV of the PVAT was 0.75. Twenty subjects, 18 years old and older, were selected from a population who were admitted as in-patients in one rural southwestern hospital. Data were collected through patient interviews, independent nurse assessment, and review of medical records. The CDV score for the validated tool was 0.62. No major defining characteristics and six minor defining characteristics were clinically validated. Differences in defining characteristics were found in the subjects with arterial occlusive disease and those with venous occlusive disease. Findings are applicable to nursing practice and research.

Introduction: Non-milk extrinsic sugar {NMES} intake among children in Scotland fails to meet dietary recommendations, which is likely to contribute to dental decay and weight gain. Children's physical activity, which contributes to energy balance, also fails to meet recommended targets. Aim: To develop and evaluate a classroom based educational intervention to improve knowledge of NMES and energy balance in children aged 10-12 years. Methods: Following development of an intervention, consisting of two educational sessions, one on NMES and one on physical activity and energy balance, a cluster-randomised trial was conducted with 268 children in 15 primary schools {8 controls}. Children completed questionnaires to assess their knowledge of NMES and energy balance and levels of physical activity at baseline and 4, 10 and 34 weeks post intervention. Intake of NMES was assessed at baseline, and at weeks 10 and 34 using a food frequency questionnaire. After the intervention, focus groups were conducted to explore children's views and opinions of NMES and the educational sessions. Results: At baseline children had limited knowledge of NMES. Post intervention, the intervention group had a significantly higher knowledge than the control group, but this declined by 34 weeks. Knowledge of energy balance between the groups was not significantly different post intervention. No changes in NMES intake or physical activity were observed post intervention. Focus groups highlighted that children did not consider health to be a priority for dietary choice. They thought it was important to learn about NMES, but were disinclined to reduce their intakes. Conclusions: Despite improved knowledge of N MES and the health consequences of excess consumption, children are unlikely to change dietary behaviour when it requires over-riding their taste preferences. Education helps children to understand healthy lifestyle behaviours, but following this, environmental changes may be necessary to facilitate behaviour change.

The purpose of this study was to determine what benefits have accrued as a result of five years of participation in mandatory continuing education by Florida respiratory care practitioners. The study also assessed the differences in characteristics between respiratory care practitioners who perceived benefits from participation in mandatory continuing education and those who did not; and it determined the perceptions of respiratory care practitioners regarding the effectiveness and accessibility of continuing education offerings since the implementation of mandatory continuing education. / A self-administered questionnaire was mailed to a stratified random sample of 300 respiratory care practitioners throughout the state of Florida. After initial and follow-up mailings, 81% were returned (N = 243). Results of the study indicated that the typical respondent may be described as a married female, 30 to 39 years old, held the CRTT credential, was employed full-time in a hospital as a staff respiratory care practitioner, had been employed for five to ten years, and completed an associate's degree in respiratory therapy. / Professional benefits were cited by the majority of the respondents over personal and educational benefits. Utilizing pre-determined criteria, the respondents were divided into two groups, "Benefitors" (38.7%) and "Non-benefitors" (61.3%). Significant differences were determined between the groups utilizing the Chi-square test of significance on the variables of sex, job position, and participation behavior. A discriminant analysis employed between the two groups yielded non-significant canonical discriminant functions. Comments made by the respondents regarding the effectiveness of the continuing education mandate were also reported. / Source: Dissertation Abstracts International, Volume: 51-09, Section: A, page: 2960. / Major Professor: Clyde F. Maurice. / Thesis (Ph.D.)--The Florida State University, 1990.

The purposes of this study are fourfold: (1) to examine job satisfaction among academic department chairpersons/division directors in four allied health disciplines in colleges and universities, (2) to identify factors that influence job satisfaction among chairpersons/division directors of baccalaureate and associate degree allied health academic department, (3) to identify differences in characteristics of academic department chairpersons/division directors which would influence job satisfaction, and (4) to determine the feasibility of the use of Maslow's hierarchy of needs theory in determining their job satisfaction. / The population consisted of allied health academic department chairpersons/division directors from 155 Medical Record Administration programs, 65 Occupational Therapy programs, 257 Radiologic technology programs, and 273 Respiratory Therapy (Respiratory Care) programs (n = 750). / The research method employed in this study was the survey method using a self-administered questionnaire. The questionnaire consist of two instruments: the Job Descriptive Index (JDI), Smith et. al. (1969) and Porter's needs fulfillment instrument, Porter, (1961). The data were collected through self-administered questionnaires. One hundred eighty-eight questionnaires were mailed with a return rate of 67% with 64% usable. / The results of this study indicated the following: (1) with the respect to the total sample; while not statistically significant for every job characteristic, the results generally indicated that higher ratings in job characteristics tended to be positively related to higher ratings in satisfaction with the work, (2) there was no significant difference between the means (at the.05 level) of the independent variables of discipline, formal academic preparation, classification of schools, type of institution, academic position, first administrative position, race (White/Non-White), and gender with the dependent variable of job satisfaction. However, there was a statistically significant difference between the means (p =.05) of those educationally prepared and those unprepared for the academic position and the subscale promotion for the JDI, (3) the needs categories most often reported as unsatisfied were the high level needs of autonomy and self-actualization, and (4) overall, most respondents indicated they would probably remain in the position for the next five years. / Finally, information derived from this study can be utilized to improve selection, retention, and self-motivation of allied health academic department chairpersons/division directors. This will contribute to the improvement of allied health education, and thus, the quality of care delivered by graduates of baccalaureate and associate degree programs in the allied health sciences. / Source: Dissertation Abstracts International, Volume: 52-08, Section: A, page: 2763. / Major Professor: Allan Tucker. / Thesis (Ph.D.)--The Florida State University, 1991.

The purpose of this research was to discover concepts and hypotheses related to nurse participation in patient education at the bedside. Naturalistic inquiry was used to explore patient education practices in one community hospital in South Florida. For nine months the researcher worked alongside nurses in the process of conducting fieldwork. Ethnographic methods of participant observation, informant interviewing, document analysis, and journal writing amassed a body of descriptions from which a theoretical model of the dynamics of nurse participation in patient education took form. / The emergent model is a comprehensive, hypothetical framework that includes four sets of variables: (1) Situational variables, including physical (fixtures, messages, and educational resources) and social (patients, doctors, peers, and management). (2) Intrapersonal variables, composing a hypothetical profile of the nurse as defined by the presence of three extremes of contrast (task versus process orientation, role clarity versus role ambiguity, and patient dependence versus patient independence). (3) Valuational variables, operationalized as nurse perceptions of the value of content to doctors and to patients. (4) Participatory variables, defined by four alternative roles (initiator, teacher, reinforcer, and facilitator). / Early in the research it became apparent that patient education is not a singular phenomenon but a complex of roles that nurses assume in helping patients learn. The emergence of a model, built incrementally from data derived from practice, serves as a tool for the development of theoretical hypotheses and research questions too numerous to state in a single study. More than forty hypotheses which have implications for both decision-making in practice (including legal, economic, and academic concerns) and the advancement of theory are given. / Important areas for future study include the development of measurement instruments for the above-mentioned sets of variables, verification of the hypotheses set forth, and testing of the model as a decision-making and theory-building tool. / Source: Dissertation Abstracts International, Volume: 48-12, Section: B, page: 3532. / Thesis (Educat.D.)--The Florida State University, 1987.

<p> Legislative advocacy efforts are increasingly becoming part of a counselor&rsquo;s professional identity, yet scholarly literature lacks studies about experiences of counseling students involved in legislative advocacy for the counseling profession. The purpose of this study was to gain an understanding of the meaning counseling students ascribe to their involvement in legislative advocacy for the counseling profession. Astin&rsquo;s student involvement theory was the conceptual framework utilized to explore the lived experiences of counseling graduate students and recent graduates who participated in a 4-day long American Counseling Association Institute for Leadership Training on legislative advocacy and leadership or in professional legislative advocacy at the state level. Convenient and snowball sampling yielded 8 participants who engaged in semistructured interviews. Using interpretative phenomenological analysis, the data were analyzed to identify essential themes. Thematic analysis was conducted by hand using literature-based codes and lean coding as well as NVivo software. Themes included awareness, faculty mentor, involvement, incorporating legislative advocacy into the curriculum, lack of confidence, student learning and personal development, legislative culture, motivation, student obstacles to professional legislative advocacy, and problems in working with other professions. Findings may be useful for counselor educators seeking to integrate professional legislative advocacy into the counseling curriculum. Implementing a professional legislative advocacy approach into the counseling curriculum might contribute to counselor students&rsquo; developing a propensity for leadership, advocacy, and professional legislative advocacy beyond graduation.</p><p>

Purpose This study assessed ETSU dental hygiene students’ perceptions and attitudes toward their careers after graduation in relation to underserved populations’ lack of access to dental care and nontraditional roles for dental hygienists. Methods A voluntary simple survey was used to assess the following: dental hygiene students’ exposure to and knowledge about underserved populations and nontraditional roles for dental hygienists, students’ favor or opposition toward these nontraditional roles, students’ interest in nontraditional roles, and students’ perceived preparedness to work outside of a traditional dental office in nontraditional roles to provide care for underserved populations. The survey data was aggregated and analyzed within the general context of the ETSU Dental Hygiene Program, and differences in responses based upon student classification were investigated using an independent samples t test. Results Between classes, a significant difference was seen in the responses for seven questions, all of which addressed either students’ knowledge about underserved populations and corresponding solutions to the lack of access to care or students’ perceived preparedness for nontraditional roles after graduation. The majority of the dental hygiene students responded as being in favor or completely in favor of expanded or nontraditional roles for dental hygienists and as being interested or highly interested in functioning in such roles. However, 88.89% of participants reported that they were either likely or highly likely to choose private practice as their primary place of employment. Conclusion The senior dental hygiene students both possess higher levels of knowledge about underserved populations and nontraditional roles for dental hygienists and feel more prepared to function in nontraditional roles after graduation than do the junior dental hygiene students. The program could consider focus areas, such as the reason for students’ high interest in nontraditional roles and simultaneous high likelihood to work primarily in private practice and ways to address this discrepancy.

Doctor of Philosophy (PhD) / Effective clinical reasoning and its communication are essential to health professional practice, especially in the current health care climate. Increasing litigation leading to legal requirements for comprehensive, relevant and appropriate information exchange between health professionals and patients (including their caregivers) and the drive for active consumer involvement are two key factors that underline the importance of clear communication and collaborative decision making. Health professionals are accountable for their decisions and service provision to various stakeholders, including patients, health sector managers, policy-makers and colleagues. An important aspect of this accountability is the ability to clearly articulate and justify management decisions. Considerable research across the health disciplines has investigated the nature of clinical reasoning and its relationship with knowledge and expertise. However, physiotherapy research literature to date has not specifically addressed the interaction between communication and clinical reasoning in practice, neither has it explored modes and patterns of learning that facilitate the acquisition of this complex skill. The purpose of this research was to contribute to the profession’s knowledge base a greater understanding of how experienced physiotherapists having learned to reason, then learn to communicate their clinical reasoning with patients and with novice physiotherapists. Informed by the interpretive paradigm, a hermeneutic phenomenological research study was conducted using multiple methods of data collection including observation, written reflective exercises and repeated semi-structured interviews. Data were analysed using phenomenological and hermeneutic strategies involving in-depth, iterative reading and interpretation to identify themes in the data. Twelve physiotherapists with clinical and supervisory experience were recruited from the areas of cardiopulmonary, musculoskeletal and neurological physiotherapy to participate in this study. Participants’ learning journeys were diverse, although certain factors and episodes of learning were common or similar. Participation with colleagues, peers and students, where the participants felt supported and guided in their learning, was a powerful way to learn to reason and to communicate reasoning. Experiential learning strategies, such as guidance, observation, discussion and feedback were found to be effective in enhancing learning of clinical reasoning and its communication. The cultural and environmental context created and supported by the practice community (which includes health professionals, patients and caregivers) was found to influence the participants’ learning of clinical reasoning and its communication. Participants reported various incidents that raised their awareness of their reasoning and communication abilities, such as teaching students on clinical placements, and informal discussions with peers about patients; these were linked with periods of steep learning of both abilities. Findings from this research present learning to reason and to communicate reasoning as journeys of professional socialisation that evolve through higher education and in the workplace. A key finding that supports this view is that clinical reasoning and its communication are embedded in the context of professional practice and therefore are best learned in this context of becoming, and developing as, a member of the profession. Communication of clinical reasoning was found to be both an inherent part of reasoning and an essential and complementary skill necessary for sound reasoning, that was embedded in the contextual demands of the task and situation. In this way clinical reasoning and its communication are intertwined and should be learned concurrently. The learning and teaching of clinical reasoning and its communication should be synergistic and integrated; contextual, meaningful and reflexive.

Thesis (Ph. D.)--Syracuse University, 2009. / "Publication number: AAT 3381584."