In sixth grade, I did an art project where I painted a self-portrait. I decided to paint myself looking in a mirror. On the right-hand side of the canvas was the back of my head. On the left-hand side was a reflection of my face looking back at me in the mirror. During one session with my art teacher, she looked at my painting and paused before asking, “what happened?” She paused again before continuing that at one point the painting was on the right track, implying since that point, something had gone terribly wrong. I mean what was looking back at me in the mirror was quite scary. It was a girl with sharp, angry brows who was grimacing like that emoji with clenched teeth. By the end of the project the painting only got uglier and unfortunately lived in my family’s home for years to come. My mom once told me that “interesting” isn’t necessarily a good thing. It was said right after I proudly shared with her that I received a certificate that read, “Most Interesting Art Project” for a paper doll I made to look like myself in eighth grade. Since that subtle comment, I’ve always been careful about how I choose and use words. I didn’t dare challenge my mom’s comment. Instead, I recall being mad at my art teacher. How could she call my paper doll interesting! What did she mean by that? I’ve always been better with paper than paint and I knew that unlike my self-portrait that I had painted two years prior, this doll I constructed, complete with my ponytail and 空手着 (karate uniform) actually looked like me! It’s been over a decade since these two “art incidents” but oddly enough these stories are quite telling about my current self-perception. This is the power of storytelling. Not only does it help me to connect with people beyond small talk but writing and reflecting on my past has helped me understand who I am now. Today I am an educator, supervisor of students, and a young professional in higher education. More than titles or positions I hold, I find meaning in the relationships I build with my colleagues, students, mentors, and community. What I have learned and hope to share to all educators, staff, students, and leaders by way of writing this thesis is the value and necessity of exploring, unlearning, and challenging yourself to understand who you are, how you are who you are, and why you are who you are. While recognizing that I have changed and will continue to change through growth, learning, and time, I find security at this intersection of past and future where I am present in this self. As someone who is empathetic, I am sensitive to other people’s feelings and emotions. With context, I attempt to understand how someone else may feel still while recognizing I may never truly know their experience. On the contrary, I’ve discovered that to be empathetic with my own self is quite challenging! This insight has created inner chaos and has helped me understand how I do and don’t process my own feelings and emotions regularly. As someone who has made it a priority to serve others, I am fueled by keeping busy as a way to have a purpose in all of my actions. I want to be useful. Through this grind, I’ve lost a sense of who I am and valuing myself beyond my work and what I am capable of. I don’t believe this is a unique experience. I have taken responsibility for burning out and running on empty. I am shifting gears. I have taken this opportunity to write my own experiences in hopes that there is something to be learned from it for anyone who has ever taken on too much, has run away from themselves, or been uncomfortable with who they are.

Spirituality and nursing have been intertwined from the beginning of the profession; however, there is little evidence that clearly defines spiritual nursing care and no standardized practices that can be included in the routine preoperative plan of care for patients undergoing invasive surgical procedures. The purpose of this project was to conduct a systematic review of the literature to define spiritual care and identify specific spiritual nursing care interventions. The biopsychosocial model, Narayanasamy's transcultural care practice model, and Watson's theory of human caring provided the theoretical framework for the project. MEDLINE, PubMed, Wiley online library, SCIENCE, WOS, Cochrane, and SciELO databases were searched for the literature review. Keywords and phrases used included spirituality, spiritual nursing care, holistic health practices, inpatient, hospital, and preoperative care. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) II tool was used for data analysis. Interventions found in the literature to be supportive of spirituality included healing presence; providing effective communication; praying with the patient and family or facilitating other religious rituals; using the therapeutic self to be with the patient; listening to and exploring the patients' spiritual perspectives; and showing support and empathy through patient-centered caring, nurturing spirituality, and creating a healing environment. Employing these nursing actions might promote positive social change by contributing to a sense of well-being as patients find meaning and purpose in their illness and life overall, which will promote improved surgical outcomes and better patient satisfaction with care.

During the past few decades, holistic education has increasingly emerged in academia. However, limited research has been conducted on how holistic education impacts instructional practices in real life situations like the well-being of cancer patients. The purpose of this qualitative study was to explore how a holistic education program impacts instructional practices designed to improve the well-being of cancer patients. The conceptual framework was based on transformative learning theory and learner-centered teaching. This single case study was conducted at a non-profit cancer center in the Western United States which emphasizes multiple dimensions of well-being for cancer patients, including holistic education. Participants included four instructors at the center. Data were collected from individual interviews with these instructors, reflective journals that they maintained, and documents and archival records related to the center and its education programs. Data analysis involved line-by-line coding and categorization to identify patterns and themes. Results revealed that holistic education improves the knowledge, comfort, self-efficacy, and empowerment of cancer patients. Results indicated that it would be useful to conduct more studies to explore the impact of holistic instructional practices on patients with cancer. This study contributes to social change by providing instructors and health professionals with a deeper understanding of holistic instruction and how it can be used to improve whole-person healing.

Collective efficacy, time urgency, and health literacy have been a focus of research since the 1970s. Researchers have demonstrated that these factors influence health and decision making. However, researchers have yet to establish how these factors may be connected to the achievement of policy aims that impact holistic or environmental health. This study utilized the health belief model, social cognitive theory, time urgency theory, health education and promotion theory, Bronfenbrenner's ecological systems theory, and the Meikirch model. The purpose of this quantitative study was to determine if the factors of collective efficacy, perceived time urgency, perceived health literacy, ethnicity, age, gender, perceived financial strain, and/or educational level are associated with the perception of the likelihood of reaching 100% renewable energy in North Hawaii County (Hawaii Island) by the year 2045, referred to as REHI45. A sample of 136 residents of North Hawaii County completed a survey to measure these factors. A multiple linear regression analysis was run to test relationships among the variables. Results revealed that collective efficacy, perceived time urgency, and perceived health literacy were significantly associated with the perceived likelihood of REHI45. These findings may inform the design of intervention programs and/or preventative measures to promote overall long-term health and positive social change in North Hawaii County. Individuals, organizations, institutions, cultures, and societies may benefit from the results of this study through its ability to raise awareness of factors that influence the perceived likelihood of achieving REHI45.

Improved health indicators, mental and physical health outcomes, and sustainable lifestyle practices have been found among yoga practitioners. The purpose of this study was to examine the impact of mixed styles of yoga practice on the health and behaviors of yoga practitioners. The relationship between yoga and body mass index (BMI), self-reported disease diagnosis, participation in other types of physical activity, adoption of healthy and sustainable lifestyle and dietary behaviors, perceived improvements in medical conditions that yoga was used to treat, quality of life resulting from yoga practice, and the reasons for beginning and continuing yoga were observed and tested in this study. Participants (N = 383) were adult yoga practitioners who were recruited using systematic sampling in Facebook social media. Data were analyzed using multiple linear regression, ANOVA, McNemar Chi square, and Spearman's correlation. Mean BMI for all yoga styles were in the normal range; however, ashtanga yoga was a significant predictor of low BMI. Self-reported disease diagnosis was significantly lower after beginning yoga practice. The majority of participants also engaged in other types of physical activity and adopted many healthy lifestyle practices. However, general/hatha and other styles of yoga were associated with adopting a greater number of other physical activities and general/hatha, ashtanga, and yoga therapy styles were associated with adopting a greater number of healthy and sustainable lifestyle and dietary behaviors. Medical conditions that yoga was used to treat and quality of life were perceived to be improved as a result of yoga practice. Results of this study confirm previous research findings that demonstrate numerous positive health outcomes from yoga practice.

The purpose of this dissertation was to expand the understanding of youth in psychiatric residential treatment facilities by using psychosocial indicators to develop subgroup profiles. Additionally, differences in treatment outcomes between subgroups and the extent to which within-treatment factors accounted for observed differences in treatment outcomes between subgroups were examined. Data were extracted from the case records of 447 youth who were served in psychiatric residential treatment facilities over a seven year span of time. A latent class analysis was used to identify and describe subgroups. A series of multivariate regression analyses were used to examine group differences in functional impairment at discharge. Next, a path analysis was used to determine if there were differences in average change in functional impairment from admission to discharge between subgroups and to test within treatment factors as potential mediators of group differences. Finally, a logistic regression was used to determine if there were differences between groups in the probability of discharging to a community-based placement or discharging to another congregate care facility. The latent class analysis revealed four distinct subgroups of youth. The analyses of treatment outcomes revealed statistically significant differences in the level of functional impairment at discharge and average change in impairment between groups. Results from the path model of indirect effects supported that within treatment factors accounted for a statistically significant proportion of the observed difference in change between groups. No differences were found in discharge placement outcomes between groups. Implications for future research, practice and policies focused on youth in residential treatment are discussed.

"Motivation" is the force that drives an individual to perform a certain action. Abraham Maslow (1908-1970), an American psychologist profoundly influenced by the existential and teleological paradigms, expounded a motivation theory that remains precise and replicable, as well as applicable to other spheres of study, including the humanities. Indeed, psychology experts and non-specialists are by and large familiar with Maslow's Pyramid of Human Needs. Moreover, despite the abundance of literary criticism that utilizes Freudian-based theory to analyze the motivations of literary characters, critics have largely neglected the use of other paradigms, including Maslow's. In this thesis, I use Maslow's texts as support for identifying the motivations of women characters who dress as men in Shakespeare's dramas. I also simultaneously employ Maslow's theory to illuminate the parallels in these characters' motivations and the varying need levels that Maslow develops in his hierarchy. After a comprehensive review of the literary criticism that addresses the dramatic motif of cross-dressing in early modern England and an extensive explanation of the history of motivation theory up to and including that of Abraham Maslow, I treat the following plays by William Shakespeare: The Two Gentlemen of Verona, As You Like It, and The Merchant of Venice in conjunction with Maslow's Pyramid of Human Needs. Through this analysis, I demonstrate that Julia cross-dresses to satisfy needs on the level of Love/Belonging; Rosalind cross-dresses for reasons that correspond to the Safety level, then to the Esteem level; and Portia demonstrates motivations that correspond to Maslow's Love/Belonging and Esteem levels.

This study aims to deconstruct current conceptions about animal-assisted interventions by investigating relationships between human beings and birds of prey. Interactions between birds of prey, or “raptors,” provide novel cases from which to reexamine failed attempts to provide empirical data in support of alternative therapies. Previous research addressing the efficacy of animal-assisted interventions is simply not robust enough to be considered a feasible treatment option by medical professionals. By extension, models of self-regulation in psychology are often presented using reductionist models and oversimplified therapeutic outcomes. Taken together, raptor-human relationships help to highlight the shortcomings of each, as well as potential solutions towards developing comprehensive frameworks for measuring efficacy of multispecies interactions. This study was conducted at a small nature park in Largo, FL where a number of native raptor species are housed, cared for, and trained each day by volunteers. These volunteers made up the sample size for this study with forty participants (n = 40) between the ages of eighteen and seventy five. Drawing on both my own experiences as a raptor handler, as well as the qualitative data collected from volunteers, I employed a neuroanthropological approach to reveal underlying dynamics of the program via a two-stage research plan. Stage 1 of the study addresses the Raptor Program itself in facilitating human-animal interactions. Stage 2 addresses the mechanisms at play during firsthand encounters with birds of prey. Findings suggest that programmatic and regulatory drivers within the program must operate together, often simultaneously, for an animal-assisted intervention organization to be successful. Further, this study calls for the ongoing development of novel methodological approaches in future research to determine the efficacy of animal-assisted interventions at large.

In order to understand the intricate processes involved in second language teacher development, in the last decade studies in second language teacher education (SLTE) have addressed the need to explore pre-service teachers’ beliefs and emotions jointly as they occur in their contexts of teaching. SLTE researchers have referred to the importance of helping pre-service teachers verbalize their beliefs and try to understand and regulate their emotions as they can serve to explain what, how, and why pre-service teachers do what they do during their practicum experience. In addition, considering future teachers will be passing on their beliefs, values, and ways of behaving and feeling to future generations, SLTE should offer pre-service teachers with models of teaching that will help form ethical, reflective, and emotionally intelligent professionals capable of transforming society. The clamor for peace in today’s world and the globalized nature of the English language emphasize the need to embrace practices in SLTE intended to foster peace. In Argentina (the context of the present study) such practices carry particular relevance, as it is expected from the Ministry of Education that the teaching of foreign languages at primary and high school level serve as tools to promote societal peace. Given the importance of exploring pre-service teachers’ beliefs together with emotions, and on the importance of providing them with holistic approaches to teaching aimed at expanding peace, this study examines pre-service teachers’ beliefs and emotions about an innovative intervention involving the language of peace throughout their practicum semester in an Argentine setting. More specifically, through multiple case studies and narrative approaches, this study investigates four pre-service teachers’ beliefs and emotions regarding peace and the implementation of multidimensional peace language activities (MPLAs) before, during, and after their Practicum I course. In addition, it aims at comparing participants’ beliefs and emotions with their actions as reflected in their lesson plans and in-school teaching experience. Finally, it traces pre-service teachers’ transformation of beliefs and emotions throughout the course, and examines the ways in which reflection facilitates teacher development. Multiple sources were used for data collection, including semi-structured interviews, journal entries, field-notes from classroom observations, lesson plans, and narrative frames. The thematic and content analysis of the data revealed that in general participants believed the MPLA intervention in the practicum (a) gave participants meaningful English exposure, (b) changed their understanding of peace and enhanced their ability to teach peace in EFL classrooms, and (c) led to a more transformative practicum experience. By embodying multidimensional peace the participants were able to become conscious of their beliefs, emotions, and actions regarding the inclusion of MPLAs and understand their teaching practices better, thereby allowing themselves to develop as teachers and peacebuilders. However, it was noted that two pre-service teachers were not able to include as many MPLAs as they had desired, due to contextual factors and previous learning experiences, among other aspects. Limitations of the study are addressed, as well as research and pedagogical implications for the field of SLTE that relate to the need to incorporate holistic, experiential, and contemplative approaches intended to cultivate multidimensional peace.

The overall goal of the thesis was to investigate the nature of the healthy human self and the process of achieving health. This was undertaken by reviewing established self-theory and presenting a summary of each theory and its position with regard to self-composition, self-agency and the nature of the healthy self. An inclusive self-theory was then developed, congruent with reviewed literature, which positioned spirituality as the essential core of self. From the foundational Spiritual Theory of Self and the findings of the first study in this thesis, the Health Change Process Theory was developed to explain and predict how people achieve sustainable health. Three subsequent studies resulted in the construction and testing of a quantitative measure which enabled scientific investigation of the nature of the healthy self and the process of achieving health. Method The methodology of the four studies in this thesis was based on the instrumental approach which posits that, while there are procedural differences between qualitative and quantitative methodologies, philosophically speaking, there is no fundamental difference as they are both equally applicable and valuable. Consequently, the methodology judged to be the most appropriate instrument to investigate each study's topic of inquiry was chosen rather than allegiance to either qualitative or quantitative methodology. The first study was qualitative, as it investigated the definition of health and the process by which it was achieved from the perspective of 30 people with chronic musculoskeletal impairments. The findings from this study provided the theoretical basis for the three subsequent questionnaire development and validation studies. The second study used qualitative methodology with 59 participants to identify participant-generated items used in a new quantitative holistic health questionnaire and then employed quantitative methods to perform preliminary tests of the reliability and validity of this measure. The third study used quantitative methods with 233 participants to evaluate more robustly the reliability, content and concurrent validity of the original developmental measure and another, behaviourally-orientated assessment instrument, which used the identical item content but re-framed in the past tense. The fourth study employed qualitative and quantitative methods with 205 participants to evaluate the clinical validity of the scale found to possess reliability and validity in the previous investigation. Results The critical review of self-theory concluded with the development of the Spiritual Theory of Self. The initial study supported this theory as a robust explanation and predictor of the determinants of a healthy self. Furthermore, the findings of this study and a review of relevant literature concluded with the development of a Health Change Process Theory, which was based on the Spiritual Theory of Self. The Health Change Process Theory explains and predicts the process by which a healthy self develops. The subsequent questionnaire development and validation studies sought to provide a quantitative holistic assessment tool, congruent with the Health Change Process Theory, and found the 28-item QE Health Scale (QEHS) to be a reliable and valid measure of holistic health. These results also demonstrated that the Health Change Process Theory and the underpinning Spiritual Theory of Self were robust. With regard to clinical application, the QEHS was found to aid assessment, therapeutic intervention, a client-centred holistic approach to healthcare and evidenced-based practice. The Patient Profile, derived from QEHS responses, provided a tool that enabled theory to be applied to practice by identifying the key indicator personal attributes determining holistic health status. Conclusion The research results demonstrated that the Spiritual Theory of Self and the Health Change Process Theory provide valid explanations of the constructs that enable people with musculoskeletal disorders to remain otherwise healthy with such conditions. Furthermore, the relationship between the findings and established self-theories suggest that the Spiritual Theory of Self and the Health Change Process Theory may advance knowledge of the predictors and interventions that enable all people to undertake a health-enhancing process of change when confronted with adversity. The QEHS and associated Patient Profile were found to be reliable and valid tools that facilitated assessment and enhancement of the holistic health status for people with musculoskeletal impairments. These tools identified barriers to achievement of holistic health, predicted by the Health Change Process Theory; facilitated the therapeutic process through a focus on issues meaningful to those receiving healthcare; aided treatment decision making; and enabled quantitative evidence-based evaluation of the efficacy of interventions. Moreover, the overall results have advanced psychological knowledge with implications for all fields of psychology involved in the study of people. The evidence of the research undertaken provides a basis for promoting knowledge and research of chronic healthcare delivery and a spiritually based conception of self and health. The QEHS and associated theories provide a tool and basis for investigations where people are experiencing traumatic, irreversible crises. However, the initial aims of further research should be to refine the QEHS and the associated Patient Profile to enable the use of theory and the QEHS across a diverse range of research populations and to investigate the applicability of these to facilitate the maintenance or achievement of a healthy self.