Dissertations / Theses on the topic 'Mental health; rural; mixed methods'
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Cochrane, Carrissa. "A mixed-methods study of mindfulness in LGBTQ+ youth." Thesis, California State University, Long Beach, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10260407.
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LGBTQ+ youth are at increased risk of experiencing stress, sadness, and dissatisfaction with life. A mixed-methods study was designed to examine the effects of mindfulness training on perceived stress and life satisfaction in LGBTQ+ youth. Quantitative pre- and post-test data were collected using the Mindful Attention Awareness Scale-Adolescents and Goal Attainment Scaling. Qualitative data were collected via focus group at the conclusion of the mindfulness training. Results indicate that mindfulness training may be effective in reducing stress, increasing life satisfaction, and increasing coping skills in LGBTQ+ youth. School-based mental health service providers may find the group format of mindfulness training an effective use of time and resources.
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Wang, Chia Wen. "Cyberbullying and mental health among Taiwanese high school students: a mixed methods study." Kyoto University, 2020. http://hdl.handle.net/2433/253211.
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Ndayizigiye, Melino. "Assessment of Barriers of Contraceptive Use in Rural Burundi: A Mixed Methods Study." Thesis, Harvard University, 2014. http://nrs.harvard.edu/urn-3:HUL.InstRepos:13041361.
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Burundi’s high maternal and child mortality is caused in part by the high fertility rate, prompted by low rate of contraceptive use. Available sources report a contraceptive use of 18% among married women, but this excludes unmarried sexually active women. This study employed mixed methods to understand rates of contraceptive use in rural Burundi. We first assessed availability and uptake of contraceptives in 39 health clinics in the rural districts of Rumonge and Bururi. We selected sites with different utilization rates and conducted individual interviews and focus group discussions. 56 individuals participated including women, men, facility managers and community leaders.
Uptake of family planning averaged 2.96%. Greater uptake was positively associated with the number of health professionals engaged and trained in family planning service provision as well as the number of different types of contraceptives available. Uptake was inversely associated with duration of stockouts and number of contraceptives stocked out. Qualitative data pointed to scarce resources, sociocultural factors, fear of disclosure and side effects, partner’s disapproval, and lack of information on modern contraceptives as explanations of low uptake. Interventions would need to take into account one or more of these factors in order to improve uptake of family planning
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Nash, Michael. "A mixed methods approach to exploring mental health nurses' diabetes education and skills needs." Thesis, Middlesex University, 2014. http://eprints.mdx.ac.uk/13468/.
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Diabetes is emerging as a clinical practice and educational concern in mental healthcare. However, there is little research into the diabetes education and skills needs of practitioners such as Mental Health Nurses. Furthermore, there is very little research into Mental Health Service Users experiences of diabetes or diabetes care and how these could be used to enhance the education and training of Mental Health Nurses in this area. This research project used a mixed methods research approach to explore Mental Health Nurses diabetes education and skills needs from the view of both Mental Health Nurses and Mental Health Service Users. A quantitative Training Needs Analysis survey was undertaken in 2008 with a sample of 220 Mental Health Nurses regarding their diabetes care education and skills needs. 146 responded giving a response rate of 66%. The results of this survey where used to develop a qualitative interview schedule to explore the experiences of diabetes care of a purposive sample of seven Mental Health Service Users in 2011 and how these experiences could be used to inform Mental Health Nurses diabetes education and training. This study found that diabetes care is becoming a frequent care activity for Mental Health Nurses. While the sample reported prior training in diabetes care, this was predominantly in the period of student nurse training. This has an implication for the currency of clinical skills and knowledge. Mental Health Nurses reported varying levels of general and specific knowledge of diabetes. They also reported varying levels of confidence in aspects of diabetes care such as recognising symptoms of diabetes, knowledge of local diabetes services and liaison with local diabetes services. There was a recognition that further training was required and the sample reported high levels of motivation to attend training and retain diabetes care as an area of Mental Health Nursing practice. Mental Health Service Users reported negative experiences of diabetes care. This consisted of stigma, diagnostic overshadowing, a splitting of mental and physical health and low levels of confidence in Mental Health Nurses ability to provide diabetes care. Service Users broadly agreed with Mental Health Nurses expressed training needs but felt that education and training on stigma and how this can be a barrier to diabetes care is a priority area for education. This study recommends that Mental Health Service Users experiences of physical illness, in this instance diabetes, should be a foundation part of any training and education of Mental Health Nurses in this area. This is because these experiences can promote critical reflection on practice and encourage professionals to reflect on negative attitudes that may be an unwitting barrier to care. It also recommends that service users are more involved in identifying education and training needs so that education is responsive not only to the needs of nurses and Higher Education Institutions, but service users also.
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Burdock, Matthew. "Burnout in secure forensic mental health services for young people : a mixed methods approach." Thesis, University of Southampton, 2016. https://eprints.soton.ac.uk/402565/.
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Occupational burnout is highly prevalent in mental health services and has a deleterious effect upon the psychological wellbeing of staff. Few studies have explored burnout in inpatient settings; those that have do not address the possible systemic impact. This study aimed to explore burnout and emotional reactions to behaviour that challenges in a secure forensic mental health service for young people; a specialised environment in which severe and frequent incidences of aggression and violence occur. Following a systematic review of burnout literature pertaining to inpatient mental health services, an empirical study was conducted using a convergent parallel mixed method design. Forty three staff members were recruited to the quantitative strand and ten were recruited to the qualitative strand. Emotional Reactions to Challenging Behaviour Scale (ERCBS) and Maslach Burnout Inventory (MBI) instruments were used. A significant moderate positive correlation was found between emotional exhaustion and negative emotional reactions to behaviour that challenges. This relationship was mediated by general self-efficacy, which buffered the effect of emotional exhaustion on negative responses to behaviour that challenges; responses found to be detrimental to the relational environment. ‘Young People Blame Themselves’ was explored as a relational barrier and maintaining factor in occupational burnout. In ‘You Want Someone You Recognise’ and ‘We Lack That Consistency’ a high ratio of agency staff and a lack of operational consistency were identified as occupational stressors. Emotional exhaustion is associated with negative emotional reaction to challenging behaviour. Interventions should be targeted towards developing staff self-efficacy, through the use of reflective practice and ecological changes that enhance team-working and feelings of safety on the ward. When on the ward, staff should be mindful of young people’s predisposition towards attribution bias. Future studies need to give greater consideration to systemic outcomes associated with burnout.
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Sanderson, Victoria. "Post-Secondary Students with Symptoms of Psychosis: A Mixed-Methods Systematic Review." Thesis, Université d'Ottawa / University of Ottawa, 2019. http://hdl.handle.net/10393/39788.
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The purpose of this thesis was to synthesize evidence on symptoms of psychosis in post-secondary students, including participant characteristics, prevalence, risk factors, interventions, and reported experiences. The design was a mixed-methods systematic review, modeled on the Joanna Briggs Institute and PRISMA guidelines, with all standard systematic review procedures followed. A search in nine databases yielded 26 (published between 2006 and 2018) articles for inclusion. Data were analyzed according to objectives and reported using synthesis tables and narrative summaries. Average age of participants was 21 years and most identified as female and Caucasian. Prevalence of psychosis across the included studies was inconclusive. Risk factors associated with symptoms of psychosis included substance use, depression, and younger age. There were five interventions with mixed results and three studies about experiences. While five promising interventions exist, inadequate testing and replication limits confidence in their effectiveness. There is a notable deficit in qualitative evidence exploring the experiences of students with symptoms of psychosis.
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Bishop, James. "The Potential of Misdiagnosis of High IQ Youth by Practicing Mental Health Professionals: A Mixed Methods Study." Thesis, University of North Texas, 2017. https://digital.library.unt.edu/ark:/67531/metadc1062851/.
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The difficulty of distinguishing between genuine disorder and characteristics that can be attributed to high IQ increases the likelihood of diagnostic error by mental health practitioners. This mixed methods study explores the possibility of misdiagnosis of high IQ youth by mental health professionals. Participants were private practice mental health professionals who read case study vignettes illustrating high IQ youth exhibiting characteristics associated with their population. Participants then completed a survey and provided an assessment of the hypothetical client. In the study, 59% of participants were unable to recognize behavioral characteristics associated with high IQ youth unless suggested to them, and 95% of participants were unable to recognize emotional characteristics associated with high IQ youth unless suggested. The results of this study provide much-needed empirical exploration of the concern for misdiagnosis of high IQ youth and inform clinical practice and education.
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Rajo, Erika. "A Mixed Methods Study Examining Parent Impressions of a Psychoeducational Program on Common Issues During Childhood." Thesis, Pepperdine University, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10601119.
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The rate of youth suffering from untreated emotional and behavioral problems has risen in recent years. Various barriers to treatment utilization of youth and their families have been identified in the literature, including logistical factors (i.e. transportation, lack of child care), financial barriers, as well as system barriers (i.e. limited knowledge of mental health difficulties among parents of young children). Parents/caregivers are often the primary gatekeepers to treatment for children suffering from mental health problems. Additionally, psychoeducational programs have increasingly gained support as an effective evidence-based practice that may bolster treatment utilization among youth. A psychoeducational program for parents of school-aged children was developed to teach empirically-based strategies for managing common childhood problems and to help parents understand when and how to refer to professional services. A mixed methods study was conducted as a means to gain teacher impressions of the program’s effectiveness in disseminating evidence-based home strategies that can be used by parents to manage common childhood problems. Qualitative data analysis procedures based on grounded theory were undertaken to code collected data from narrative interviews. Major themes that emerged included importance of parent psychoeducation, need for social skills training, need for effective discipline techniques, preference for modular training, and scheduling with consideration for parental time constraints. Quantitative data analysis revealed that usefulness of behavioral interventions received the highest average rating between very much and extremely (M = 4.67, SD = 0.52) from participants, while knowledge increase post program overview had a medium level impact between somewhat and very much (M = 3.83, SD = 0.98). Limitations, strengths, and recommendations for future directions are discussed.
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Lewis, Eliza Grug. "A mixed methods study of mental health and wellbeing in different UK undergraduate student populations." Thesis, Royal Veterinary College (University of London), 2015. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.701656.
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Austin, Jason Paul. "Getting Them In: An Exploratory Mixed-Methods Study with Implications towards Marketing Marriage and Family Therapy." Diss., Virginia Tech, 2015. http://hdl.handle.net/10919/79484.
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The purpose of this sequential exploratory mixed methods study was to develop and test a theory of planned behavior questionnaire that includes both direct and belief-based measures for seeking professional help from a MFT for participants and their spouses during times of relationship distress. To complete this goal, three focus groups (N = 24) were conducted to elicit the salient behavioral, normative, and control beliefs associated with seeking professional help from a MFT for participants and their spouses during times of relationship distress. The data was member checked and then analyzed using thematic analysis.
Next, two quantitative measures were constructed, one using the salient beliefs elicited during the focus groups and the second using general questions that assessed participants' overall attitude, perceived norm, and perceived behavioral control. Both measures were placed online pilot tested (N = 102) using Qualtrics panels. The results suggest that the measures were accurate predictors of behavioral intention. The main stage then used both measures to assess the predictive ability of the elicited beliefs.
The results also suggest that the beliefs accurately predicted participants' behavioral intentions for seeking professional help from a MFT for them and their spouses during times of relationship distress. The results also indicate that an intervention could be used to encourage troubled individuals, couples, and families to seek professional help from a MFT when experiencing relational issues.Ph. D.
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Grueber, Arno. "Outcomes and experiences of participants of the Activity Based Experience (ABE) Programme at Richmond Services Limited: a mixed methods study." Thesis, University of Canterbury. School of Health Sciences, 2013. http://hdl.handle.net/10092/9120.
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Objectives: Evidence suggests that physical activity reduces symptoms of clinical anxiety and depression, however, very little research has been published about service user’s experiences with physical activity interventions. The ABE Programme is a client-centred, individualised physical activity intervention for people with mental illness delivered by non-government organisation Richmond Services Limited. The objectives of this study were to investigate service users’ outcomes, experiences, barriers to physical activity and contributing factors for physical activity adherence, to make recommendations for health policy, community development, service improvements and further research.
Methods: An explanatory concurrent mixed methods design was applied: for the quantitative component a simple quasi-experimental reversal study to analyse participants’ physical (blood pressure, body weight), mental (self-esteem, mental well-being) measures, physical activity level and smoking status; for the qualitative component a descriptive study conducting semi-structured interviews with participants of the programme.
Results: Thirty assessment results were available for the quantitative data analysis. Self-esteem, mental well-being and physical activity levels showed significant improvements, whereas physical measurements and smoking status showed no changes. Thirteen interviews were conducted. Qualitative findings reinforced and enhanced quantitative results. Participants’ experiences were physical, psychological and social. Support was important to overcome barriers. Multiple factors contributed to maintaining physical activity. Clients made suggestions related to the support, structure and contents of the programme.
Conclusions: The ABE Programme contributes to the improvements of participants’ mental and physical well-being. Professional support is crucial. Improvements are recommended regarding follow-up support, group activities and evidence-based physical activity adherence methods. Emphasis for policy should be on early intervention, collaboration between services and physical activity promotion approaches on multiple levels. Further research is recommended, for example, to develop efficient and cost-effective physical activity adherence approaches. Future research could include single subject studies, surveys and focus groups studies within Richmond and across the wider mental health sector.
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Calhoun, Melissa Dawn. "Food Insecurity in Urban and Rural Settings: A Mixed Methods Analysis of Risk Factors and Health." Thèse, Université d'Ottawa / University of Ottawa, 2013. http://hdl.handle.net/10393/26235.
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Food insecurity exists when access to safe, nutritionally adequate foods is limited or uncertain, or when acquisition of these foods occurs in socially unacceptable ways (Anderson, 1990). Considerable research has focused on identifying the risk factors for and potential consequences of household food insecurity; however, few studies have investigated whether and how place of residence might influence household food insecurity. To address this gap in the literature, a mixed methods approach was used to explore the connections between risk factors, household food insecurity, and health in urban and rural settings. This dissertation comprised three studies. In the first study, secondary data were used to identify the household factors that increased the risk for household food insecurity and to examine whether place of residence moderated these relationships. Significant associations were found between household sociodemographics and household food insecurity. In addition, rural households were more likely to report household food insecurity. Although most moderation models were non-significant, a moderation effect was found for educational attainment: secondary school graduation increased the risk for household food insecurity in urban households, yet it was protective in rural households. In the second study, secondary data were used to examine the relationship between household food insecurity and poor general, physical, and mental health, and to test for a moderation effect of place of residence. In the main effects models, household food insecurity was associated with an increased likelihood of poor health on all measures. There was no evidence of urban-rural differences in these relationships. In the third study, qualitative data were used to explore household food insecurity from the perspective of urban and rural residents in Eastern Ontario. Findings revealed that urban and rural residents described similar conditions, processes, and consequences of household food insecurity; however, the unique features of the urban and rural settings influenced how people managed these experiences. In particular, certain aspects of the rural settings added to the complexity of managing household food insecurity. Overall, the results of this dissertation suggest that the urban-rural context, although important, is secondary to the primary contribution of low economic and social resources in household food insecurity.
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Warner, Joanne Norma. "The meaning of risk in mental health : a study of social work practice using mixed methods." Thesis, Royal Holloway, University of London, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.404884.
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Wallace, Richard L., Nakia J. Woodward, and Travis Clamon. "A Mixed-Methods Analysis of a Library-Based Hand-Held Intervention with Rural Clinicians." Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etsu-works/3816.
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Background: The East Tennessee State University Quillen College of Medicine Library has participated for several years in projects to provide rural clinicians with health information resources.
Objectives: To determine whether a strategy of hand‐held devices with a best‐evidence point‐of‐care disease tool and a drug database paired with access to a medical library for full‐text articles and training to use the tools would be an affordable way to meet the information needs of rural underserved clinicians.
Methods: This study is a mixed‐methods methodology. The first project was evaluated using a randomised controlled trial (RCT) methodology. The second was evaluated qualitatively using interviews and focus groups.
Results: The quantitative findings discovered that clinicians equipped with a hand‐held device with evidence‐based software more frequently found answers to clinical questions, found answers more quickly, were more satisfied with information they found and use expensive resources such as continuing medical education, online databases and textbooks less than the group that did not have access to online technology. Qualitative results supported the quantitative findings. Conclusion: Librarians can implement a three‐pronged strategy of the secondary literature via a hand‐held, the primary literature via Loansome Doc and quality training to meet basic information needs of rural clinicians.
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Weaver, Lindy L. "Yoga for Anxiety Reduction in Children and Adolescents: A Mixed Methods Effectiveness Study." The Ohio State University, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=osu1437737562.
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Cato, Mary Louise. "Nursing Student Anxiety in Simulation Settings: A Mixed Methods Study." PDXScholar, 2013. https://pdxscholar.library.pdx.edu/open_access_etds/1035.
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The use of simulation as a clinical learning activity is growing in nursing programs across the country. Using simulation, educators can provide students with a realistic patient situation using mannequins or actors as patients in a simulated environment. Students can practice multiple aspects of patient care without the risk of making mistakes with real patients, and faculty can reinforce course objectives and evaluate student learning. Because of the technology, the environment, and the methods by which simulation is implemented, it may cause anxiety in learners, which may interfere with the learning process. Anxious students may miss an opportunity for learning valuable aspects of nursing care that are reinforced in simulation.
This paper will describe a study of the student perspective on simulation, particularly related to the anxiety experienced by many learners. Nursing students in a baccalaureate program who participate in simulation in their clinical courses were recruited for the study, which consisted of a survey and a focus group. Participants were asked to rate nineteen aspects of simulation in regards to the feelings they elicit, from confidence to anxiety. The survey, completed by 73 of the 178 eligible participants, also included open-ended questions in which students could elaborate on their responses. A focus group was held after the survey, during which nine volunteer participants were asked further questions about their feelings and reactions in simulation, specifically as related to their effect on learning. During a facilitated discussion, they also offered suggestions for interventions that they believed would decrease their anxiety and improve the learning environment in simulation.
After an analysis of the data, a "comfort-stretch-panic" model (Palethorpe & Wilson, 2011) emerged as a useful framework for understanding the student perspective. Students in the "stretch" zone, in which they perceived a manageable amount of stress, were motivated to perform and experienced optimal learning from the simulation session. The student suggestions for interventions which would aid their learning may be useful for transitioning them into the "stretch" zone, and should be considered as potential tools in simulation practice.
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McCloskey, Rebecca Jane. "Adverse Childhood Experiences, Postpartum Health, and Breastfeeding: A Mixed Methods Study." The Ohio State University, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=osu1586539670575903.
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Waples, Patricia Ann. "Coming to an understanding : mainstream pupils' perceptions of mental health problems." Thesis, University of Hertfordshire, 2010. http://hdl.handle.net/2299/4189.
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With the introduction of the UK Government’s inclusive ideology in the late 20th century, increased pressure was put on schools serving adolescent psychiatric units to support their pupils to return to mainstream education. However, there is a perception that a factor that makes the transition process difficult is the attitude of mainstream pupils towards their peers with mental health problems. The purpose of this research was to explore mainstream pupils’ perceptions of mental health problems and the extent to which their understandings might lead to stigmatising attitudes. A theoretical perspective encompassing the ideas of social constructionism, interpretavism and symbolic interactionism, combined with a linguistic based approach, underpinned the development of an empathetic methodological approach to researching sensitive topics with adolescents. The research involved collecting data using a sequence of questionnaires, individual interviews and group interviews with pupils in three secondary schools within socially diverse communities. The questionnaire was presented in comic booklet form and included such techniques as cartoons, vignettes, and adapted familiarity and social distance scales. This dissertation reveals ways in which young people create their personal constructs around mental health and the complexities of the nature of stigma. It also highlights the implications that these findings have for staff and pupils involved in the transition process and for the development of practice in this field.
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Sharma, Sheetal. "Measuring what works : a mixed-methods evaluation of women's groups on maternal health uptake in rural Nepal." Thesis, Bournemouth University, 2017. http://eprints.bournemouth.ac.uk/29899/.
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Background: There is a need for more studies that analyse evaluation methods in the context of maternal health promotion. These should assess the effectiveness of health promotion interventions on health outcomes, factors contributing to impact, and transferability. This thesis reports on an evaluation of one such intervention in Nepal targeting rural women to promote maternal health. Methods: A mixed-methods approach was used where, first, a Difference-in- Difference (DiD) estimation assessed the effects of the intervention on selected outcome variables while controlling for: 1) a constructed wealth index; and 2) women’s socio-economic characteristics in a five-year controlled, non-randomised, repeated cross-sectional study of a community-based health promotion intervention targeting maternal health in Nepal. Second, the qualitative data were analysed to explore the knowledge, attitudes, and beliefs of women post-intervention. Finally, the financial data were analysed to identify resources needed and estimate the cost of the health promotion intervention. Results: After five years, women in the intervention area were more likely to seek antenatal care at least once, to take iron/folic acid, and to attend postnatal care. The intervention did not influence women’s place of birth or likelihood of receiving care from a skilled birth attendant. However, it did improve attendance for the recommended four antenatal visits for the first two and a half years. The qualitative findings helped explain some of the changes or lack thereof, where in the intervention area women were perceived, by the researcher, as empowered, confident, and the family as supportive. The cost of providing the health promotion intervention per group/woman and the evaluation process consisted of only 10% of the total programme cost. Conclusion: This is the first community-based health promotion intervention that has demonstrated a greater impact during pregnancy (i.e., uptake of antenatal care) than around birth (i.e., changes in delivery care). Other factors, not easily resolved through health promotion interventions, may influence birth outcomes, such as financial liquidity or geographical constraints. The evaluation showed that using mixed methods provided valuable information that would not have been extracted through one method alone. While DiD is a precise tool for measurement, the qualitative research provided insight into why the intervention had an impact in pregnancy but not at birth.
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Galeano, Richard. "Understanding the health of operational personnel in an ambulance service: A mixed methods study." Thesis, Queensland University of Technology, 2019. https://eprints.qut.edu.au/134241/2/Richard_Galeano_Thesis%5B1%5D.pdf.
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This mixed methods study was designed to review the health of ambulance operational personnel and to better understand the complex relationship between the organisation of the work and the working and organisational environment in which the work is done. The study found that the physical and mental health of ambulance operational personnel is worse than the Australian population due to the interplay of long working hours, shift work and a perceived lack of support. Ambulance services need to take a lead role in designing health support approaches that may better protect the health and wellbeing of ambulance operational personnel.
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Austin, Sarah Joyce. "A mixed methods exploration of the role of friends and identity in multiracial adolescent girls' mental health." Thesis, University College London (University of London), 2018. http://discovery.ucl.ac.uk/10055768/.
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This thesis used mixed methods to explore how peers and friends influence the ethnic identity and mental health of multiracial adolescent girls. This drew upon social identity theory and ecological theory to understand why multiracial girls may have different outcomes to their monoracial peers, and which factors in their environment can promote their identity and wellbeing. Educational Psychologists (EPs) have a key role in supporting positive mental health for all children and young people. The multiracial population in the UK is growing. Historically multiracial groups have been overlooked in UK research, although some national studies show multiracial adolescents may be at greater risk of poor mental health. Little research has explored the role of friends and peers in multiracial adolescent mental health, despite the robust findings that peers become more important during adolescence. In an ethnically diverse Local Authority in London, 109 mid-adolescent girls (mean age 13.9) from diverse ethnic groups took part in a questionnaire measuring ethnic identity, self-esteem, socio-emotional functioning, peer discrimination, friendship support and interethnic friendships. 12 multiracial girls with one black/multiracial and one white parent took part in semi-structured interviews. The multiracial girls in this sample reported lower self-esteem and lower perceived friendship support than their monoracial peers. Multiracial girls held less positive feelings about their ethnic group (affirmation) than their BAME (black, Asian, minority ethnic) monoracial peers. Affirmation only predicted self-esteem when friendship support was included in the model. Many multiracial girls felt positively about their ethnic group, but this was not always accepted by their peers and some experienced identity invalidation and exclusion. Friends were important for validating identity and emotional support. The family emerged as important for providing cultural knowledge and identity validation. This thesis highlights the importance of friendships and the peer context in multiracial adolescent mental health and informs EP practice.
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Nic, a. Bháird C. "Multidisciplinary team meetings in community mental health care : a mixed-methods investigation of their functions and organisation." Thesis, University College London (University of London), 2015. http://discovery.ucl.ac.uk/1471491/.
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Background Community mental health teams are a central means of delivering specialist mental health care in England. Weekly multidisciplinary team (MDT) meetings are assumed to improve the quality of care by incorporating diverse professional perspectives into care planning. However, these meetings are resource-intensive and there has been little investigation of their operational procedures or their impact. Aim The aim of this PhD is to examine the functions and organisation of MDT meetings in community mental health care, and to identify current challenges to effectiveness and opportunities for improvement. Method A mixed-methods investigation was conducted to examine current practice and stakeholder views in six community-based mental health teams: three general community mental health teams, two memory clinics and one early intervention psychosis service. This involved non-participant observation of 109 MDT meetings; quantitative data on 3,213 MDT case discussions from 181 MDT meetings; and semi-structured interviews with 35 practitioners and patients. Results MDT meetings were perceived to serve a wide variety of functions, ranging from care planning to peer support. However, many practitioners believed that their meetings were poorly managed and lacked clarity of purpose. Teams varied in terms of which patients were discussed, the time dedicated to each discussion, multidisciplinary representation, and operational procedures. Several challenges made it difficult for teams to capitalise on their multidisciplinary diversity, including conflicting models of care, ambiguous leadership, and a struggle to balance profession-specific and generic keyworker roles. Practitioners' ability to implement agreed MDT care plans was limited by a lack of patient involvement, inadequate resources, administrative requirements, and organisational instability. Conclusions A wide range of factors mediate the potential for MDT meetings to benefit patients. The findings highlight the importance of critical reflection on the purpose and organisation of MDT meetings to ensure that they are a valuable use of practitioner time.
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Shearer, Amy Leigh. "Understanding Neighborhood Satisfaction for Individuals with Psychiatric Disabilities: a Mixed Methods Study." PDXScholar, 2016. http://pdxscholar.library.pdx.edu/open_access_etds/3119.
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Physical and social characteristics of neighborhoods are important to resident satisfaction for clinical and nonclinical populations. This study draws upon data collected from a sample of 172 individuals with psychiatric disabilities living in 16 supportive housing sites in the Portland, Oregon metropolitan area. Research questions explore the extent to which subjective and objective measures of neighborhood physical and social environments contribute to neighborhood satisfaction for this population. Mixed methods were employed to construct a detailed understanding of the factors that influence satisfaction with one's neighborhood of residence. Predictor variables were neighborhood social climate, neighborhood physical quality, perceptions of safety, crime reports, neighborhood diversity, and WalkScore data. This study found that aspects of the social environment collectively accounted for more variance in neighborhood satisfaction than physical environmental variables; further, subjective assessments of the environment were more predictive of neighborhood satisfaction than objective indicators. Qualitative data were collected on aspects of the neighborhood that residents liked and disliked. These data were analyzed using thematic content analysis to contextualize quantitative findings. Findings provide important information regarding neighborhood features that contribute to or detract from neighborhood satisfaction among individuals with psychiatric disabilities. Supportive housing programs aiming to improve residents' well-being and increase residential tenure may consider looking to features of the neighborhood that most impact resident experiences.
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Wingate, Emily J. "Classroom Support and Students’ Subjective Well-Being: A Mixed-Methods Investigation." Scholar Commons, 2018. http://scholarcommons.usf.edu/etd/7249.
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In line with the positive psychology movement and the dual factor model of mental health, professionals are increasingly compelled to consider not only mechanisms through which mental distress can be alleviated, but also pathways through which students’ wellness can be fostered. While research in this area has primarily focused on positive indicators of adults’ and adolescents’ mental health, there is a need to address those factors that contribute to the wellness of elementary-aged youth. Participants in the current study included 179 fourth and fifth grade students from an elementary school located in a southeastern state. For this secondary analysis, a mixed methods approach with an explanatory design was adopted to investigate both the quantitative relationship between school social support variables (i.e., Teacher-Student Relations, Teacher Support, Classmate Support) and students’ subjective well-being (SWB; i.e., happiness), as well as qualitative responses of students and teachers regarding displays of support and care in the classroom. Results provide support for the existence of a relationship between Classmate and Teacher Support and elementary students’ subjective well-being, with student perceptions of Instrumental and Emotional Classmate Support and Teacher Emotional Support as unique contributors to student subjective well-being. Qualitative results supplement quantitative findings by highlighting the salience of forms of Instrumental and Emotional Support in discussions of both Teacher and Classmate Support and care. These findings add to the current knowledge base on how building supportive relationships may be incorporated in prevention efforts aimed at fostering a positive school climate and enhancing students’ complete mental health.
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Nash, Panya R. "A Mixed methods study of access and utilization of faith-based mental health support services for African-American consumers and their families." DigitalCommons@Robert W. Woodruff Library, Atlanta University Center, 2009. http://digitalcommons.auctr.edu/dissertations/70.
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The purpose of this study is to detail the availability and use of faith-based mental health services in Fulton County, Georgia. Specifically, this study examines mental health service availability and use patterns that influence African-American's use and with satisfaction with urban mental health services. What emerged from the mixed methods study that consisted of a survey, GIs map, and illustrative case study was a preference for culturally relevant mental health services but a disparity between service availability and accessibility. According to the results from the case study, the first hypothesis supports that consumers (and service providers) in the sample believe that faith-based organizations (FBO's) are more culturally sensitive to their needs. However, the second hypothesis, that FBO's increase access and utilization of mental health services to African American consumers and their families, are equivocal. According to data from the survey and GIs mapping, FBO's provision of mental health services is fragmented within and between FBO's and county-level systems of care. Finally, while GIs analyses confirm that FBO's are geographically closer to each other than local Fulton County mental health service providers; the survey results show that FBO's rarely share resources. FBO's provide referrals to county-level systems of care, but specific numbers of individuals that are referred by the sample population remains unknown. The study concludes with a discussion of the implications for social work policy, practice, and research.
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Zhang, Nan. "Parental migration, care-giving practices and left-behind children's nutritional health in rural China : a mixed-methods approach." Thesis, University of Manchester, 2016. https://www.research.manchester.ac.uk/portal/en/theses/parental-migration-caregiving-practices-and-leftbehind-childrens-nutritional-health-in-rural-china-a-mixedmethods-approach(e902bf74-1d86-4395-b088-5529265f7941).html.
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China’s rural-urban migration has resulted in 61 million children living apart from their parent(s) in rural communities. Previous studies have failed to examine the long-term effects of parental migration on left-behind children’s nutritional health, and have not examined the gender differences (of parents and children) in those associations. This research uses a mixed-methods design that incorporates quantitative and qualitative techniques to explore links between parental migration, care-giving arrangements and left-behind children’s nutritional health in rural China. The quantitative analyses draw on a longitudinal dataset – the China Health and Nutrition Survey (CHNS) (1997, 2000, 2004, 2006, and 2009) to examine the relationships between children’s nutritional outcomes and different patterns of parental migration including being left behind in different stages of childhood, and being left behind by the father or the mother. The qualitative component consists of analyses of interviews with 32 caregivers (21 grandparents, 9 mothers, and 2 uncles/aunts), and children’s diaries (26 children aged 6-12, 21 left-behind children and 5 non-left-behind children) to explore the care-giving practices for left-behind children from the perspectives of a group of children and their caregivers in rural northern central China. Results of the quantitative analyses show negative associations between parental migration, especially maternal migration, and left-behind children’s nutritional outcomes indicated by anthropometric measures and macronutrient intakes, and this is particularly true for boys left behind during early life in rural China. The qualitative findings highlight the importance of socio-cultural factors, since there seems to be a paradox of intergenerational obligations for boys in a culture where sons are more valued than daughters. This is because parents migrate to save for their sons’ adult lives, reducing the remittances sent to support their sons who stay behind. There is less pressure to save for daughters’ adult lives and so more potential for remittances to support their nutrition. The research also recognizes the importance of grandparents as carers, and their experiences and beliefs about healthy eating for children. Grandparents, particularly on the paternal side, are expected to fulfil social obligations to care for left-behind grandchildren even without immediate financial returns. Inadequate financial support from the migrant parents of left-behind boys in rural China, in particular boys cared for by paternal grandparents, may result in greater risk of poor nutrition during the early childhood. This potentially renders such left-behind boys vulnerable to developmental delays. These findings are important for policy-makers to develop effective interventions to improve left-behind children’s nutritional well-being in rural China.
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Leighton-Herrmann, Ellyn. "A Mixed-Methods Examination of Racial Differences in Females' Perceptions and Experiences of Sexual Objectification." VCU Scholars Compass, 2014. http://scholarscompass.vcu.edu/etd/3485.
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Sexual objectification has become a pervasive problem, negatively affecting the mental and physical health of many women. Understanding the influence of visual media, social-support networks and social interactions on young women's health is essential to addressing issues related to objectification. We do not have an in-depth understanding of how Black and White young adult women make meaning of objectification. Further, the existing literature suggests that experiences of objectification are likely different for Black and White women. The current research employed two studies, one qualitative and one quantitative, to address these particular gaps. Study 1 used focus groups to assess young Black and White women’s attitudes and experiences related to objectification. Four focus groups were conducted with university students, two with White women (N=11) and two with Black women (N=17). Results indicated that sexual objectification is a complex and unfortunate reality in the women’s daily lives; driven by the media, men and even other women. Participants’ immediate responses to objectifying experiences are multi-faceted and the potential consequences of long-term exposure can be detrimental to a woman’s well-being. Racial differences arose in relation to standards of beauty as well as examples of and reactions to objectifying experiences. Study 2 study assessed two different models of sexual objectification for White and Black women. Female, undergraduate and graduate students completed an online questionnaire about sources of objectification; 155 White women and 173 Black women were included in the analyses. The results suggest there are significant relationships between certain sociocultural sources of objectification, body image preoccupation and the associated consequences of depression, eating disturbances. Skin color dissatisfaction was an additional negative outcome for Black participants. The models for Black and White participants were not equivalent. Understanding how women experience sexual objectification and racial differences has implications for how objectification and related outcomes are measured. This information also has implications for developing appropriately tailored programming related to the objectification and psychological well-being of women. The information from these studies can hopefully be used to inform individuals of the risks associated with sexual objectification, as well as develop educational programs on college campuses.
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Rheault, Haunnah. "Examining the chronic disease health literacy of First Nations Australians: A mixed methods study." Thesis, Queensland University of Technology, 2022. https://eprints.qut.edu.au/228618/8/Haunnah%20Rheault%20Thesis.pdf.
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Chronic disease is the most significant contributor to the mortality gap between Australia’s First Nations people and the overall Australian population. This study explored chronic disease self-management and health literacy in First Nations adults living in remote Queensland. Key findings were poor communication by healthcare providers coupled with limited health literacy abilities of individuals were the major barriers to active engagement with managing chronic disease. Providing a supportive health literacy environment and the provision of appropriate health information delivered in a cultural safe way using clinical yarning, may assist with closing the gap in First Nations people.
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Hughes-Morley, Adwoa. "What are effective methods to recruit research participants into mental health trials?" Thesis, University of Manchester, 2017. https://www.research.manchester.ac.uk/portal/en/theses/what-are-effective-methods-to-recruit-research-participants-into-mental-health-trials(00c200de-b35f-4389-b9a4-afdfb9205453).html.
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Background: There is a great need for effective treatments for mental health problems. Randomised controlled trials are the gold standard for evaluating treatments, however recruitment into trials is challenging, highlighting a clear need for evidence-based recruitment strategies. This thesis aimed to systematically develop a recruitment intervention and evaluate its effectiveness for improving the recruitment of participants into mental health trials. Methods: A mixed-methods approach, adopting the Medical Research Council’s complex interventions framework: 1) a systematic review to identify the evidence base and describe the factors affecting recruitment into depression trials; 2) a qualitative study to understand patients’ decision-making process in declining to enrol in a depression trial; 3) development of a recruitment intervention, using Participatory Design methods; and 4) evaluation of the recruitment intervention, using a randomised controlled trial, embedded in an ongoing mental health trial (the EQUIP trial). The primary outcome was the proportion of participants enrolled in EQUIP. Results: From the systematic review, a conceptual framework of factors influencing the decision to participate was developed, which highlighted that the decision to enrol involves a judgement between risk and reward. Findings suggested that patient and public involvement in research (PPIR) might be advertised to potential participants to reduce such perceived risk. The qualitative study found positive views of trials. Interviewees’ decision making resembled a four-stage process; in each stage they either decided to decline or progressed to the next stage. In Stage 1, those with an established position of declining trials opted out – they are termed ‘prior decliners’. In Stage 2, those who opted out after judging themselves ineligible are termed ‘self-excluders’. In Stage 3, those who decided they did not need the trial therapy and opted out are termed ‘treatment decliners’. In Stage 4, those who opted out after judging that disadvantages outweighed advantages are termed ‘trial decliners’. While ‘prior decliners’ are unlikely to respond to trial recruitment initiatives, the factors leading others to decline are amenable to amelioration as they do not arise from a rejection of trials. We recruited a host mental health trial (EQUIP), and worked with key stakeholders, including mental health service users and carers, to develop an intervention using a leaflet to advertise the nature and function of the PPIR in EQUIP to potential trial participants. 34 community mental health teams were randomised and 8182 patients invited. For the primary outcome, 4% of patients in the PPIR group were enrolled versus 5.3% of the control group. The intervention was not effective for improving recruitment rates (adjusted OR= 0.75, 95% CI= 0.53 to 1.07, p=0.113). Conclusions: This thesis reports the largest ever trial to evaluate the impact of a recruitment intervention. It also reports the largest trial of a PPIR intervention and makes a contribution to the evidence base on trial recruitment as well as to that assessing the impact of PPIR. Two further embedded trials are underway to evaluate the effectiveness of different versions of the recruitment intervention in different trial contexts and patient populations. This will also allow the results to be pooled to generate a more precise estimate of effect; to evaluate the impact of the intervention on trial retention; and to explore patient experiences of receiving the intervention.
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Patrick, Lauren. "The Effects of Participation in a Grief Choir on Perceived Grief, Coping, Energy, Social Support, and Health among Bereaved Adults| A Mixed Methods Randomized Control Study." Thesis, Temple University, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10259965.
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The purpose of the current study was to test the effects of participation in a treatment grief choir vs. standard care grief group (verbal) on bereaved persons’ perceived grief, coping, energy, social support and health and to examine the experiences of those participating in both groups. In this mixed-methods study, the results from the qualitative phenomenological focus groups were used for explaining and interpreting the findings of the Randomized Control Trial (RCT). Within the RCT, five people completed the treatment grief choir and four completed the standard care grief group ( N=9). A repeated-measures ANOVA was employed to detect any statistical significance among the adult grievers. A significant within-subjects effect was found in both groups for the Numeric Rating Scale (NRS) start-of-session grief, NRS end-of- session grief, Hogan Grief Reaction Checklist (HGRC), and NRS end-of-session coping measures. These results indicate that both groups showed significant improvement over time in these areas. A between-subjects effect was found for the NRS end-of-session grief and for the Multidimensional Scale of Perceived Social Support (MSPSS) with the standard care grief group scoring significantly better over time than the treatment grief choir. Finally, one interaction effect was found for the NRS end-of-session health scores at week sixteen, with a significant gain for the standard care grief group.
For the qualitative portion of this study, five members of the treatment grief choir and three of the four members from the standard care grief group participated in separate focus group interviews. A seventeen-step analysis of the interview data was employed to discover meaningful descriptions and experiences while maintaining validity and integrity of the process. The following categories emerged from the analysis of the treatment grief choir interview: The Grief Choir Did Help; Songs were Important in Grief; Making Musical Connections Helped; Interactions with Grievers were Valued; The Music Therapists Influenced the Experience; and Gained Insights about Grief. The following categories emerged from the standard care grief group: Standard Care Did Help; Timing and Composition of Group Mattered; Standard Care was a Complex Experience; and The Experience of Being in Research. Recommendations for future grief choirs and standard care grief groups are discussed.
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Wainwright, Verity. "The pathways to offending and mental health needs of ex-armed forces personnel in prison : a mixed methods study." Thesis, University of Manchester, 2017. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.713625.
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Background: Ex-armed forces personnel constitute 3.5% of the prison population in England and Wales but we know little about why some former service personnel end up in prison. Furthermore, understanding what the mental health needs of this group are and how to meet them will inform service delivery and offending prevention strategies. Therefore, this study aimed to assess the mental health needs, and explore the pathways to offending, of ex-armed forces personnel in prison. Methods: A mixed methods design was used. A researcher administered questionnaire collected demographic information; details of pre-service; military experience; circumstances post-armed forces; and a detailed assessment of mental health of 105 male ex-armed forces personnel in prison. Their healthcare and offending records were accessed to record any formal mental health diagnoses and details of previous offending. Two studies made up the qualitative arm of the study: study 1 used semi-structured interviews (n = 20) to explore the pathways to offending of ex-armed forces personnel in prison from their perspective and study 2 employed semi-structured interviews with prisoners (n = 10) and a focus group with professionals (n = 5) to explore the service needs and treatment barriers of former service personnel in prison. Results: Of 105 participants, 40 (38%) screened positively for a current common mental health (CCMH) problem (i.e. depression, anxiety or post-traumatic stress disorder [PTSD]) and a high prevalence of alcohol misuse was assessed (n = 59, 56%). Over half of the sample were serving their first custodial sentence (n = 58, 55%). Violent offences were the most common index offence (n = 34, 32%) and the majority of the sample had previous convictions recorded (n = 70, 71%). Participants considered their pathways to offending as complex and incorporating pre-service, military service and post-service factors. Perceived influences on offending included mental health and substance misuse problems, impulsivity and problem solving difficulties. Prison was considered an opportunity to access help and staff having military awareness was thought to encourage help-seeking. However, stigma and previous negative experiences were perceived to make asking for help difficult and the variability in support across the prison estate was considered a barrier to support by all. Discussion: The findings of this study add to the literature and our knowledge of ex-armed forces personnel in prison. The study found that the mental health needs of the group are largely similar to the general prison population but that potential nuances exist regarding alcohol misuse and PTSD. The pathways to offending of the group are complex and are influenced by a number of factors in veterans' lives. Based on the findings of the study implications and directions for future work are discussed.
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Strachan, Jennifer Claire. "'Facing choices' : a mixed-methods approach to patients' experience of care and discharge in an inpatient mental health unit." Thesis, University of Edinburgh, 2012. http://hdl.handle.net/1842/6451.
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Objectives: This thesis addresses patients’ conceptualising of the experience of admission to and discharge from an inpatient mental health unit, and the role of measurable psychosocial constructs in this conceptualisation. Design: An embedded mixed-methods design was employed. Themes developed using thematic analysis were compared and contrasted with standardised assessment ratings. Methods: Twelve adult patients of an acute mental health unit took part in two separate interviews about their experience of admission and discharge, and completed standardised measures of anxiety and depression, social support, attachment style and illness beliefs. Interview data were analysed using social constructionist thematic analysis. Relationships between participants’ contribution to constructed themes and their responses to standardised assessments were discussed in the context of extant literature. Results: A total of fourteen themes were constructed, organised around a central theme of choices, planning and decision making. Many themes were comparable to existing constructs in attachment theory and the literature addressing illness appraisal, including mentalisation, the safe haven, internal working models, self as illness and shame. Standardised assessments supported and enhanced these interpretations. Conclusions: Understanding of the process and adaptation to the inpatient experience can be enhanced by reference to the concepts of attachment theory and social cognition. Incorporation of these concepts into current care practices and future service development may improve the inpatient experience.
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Dewey, Elizabeth. "A mixed methods feasibility study of group-based acceptance and commitment therapy with older people with mental health difficulties." Thesis, University of Glasgow, 2018. http://theses.gla.ac.uk/30802/.
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Background: CBT has mixed findings for older people with mental health difficulties and has been described as no more efficacious than relaxation training for anxiety. Due to the types of difficulties associated with old age that cannot be changed, such as chronic health conditions and experiences of bereavement and retirement, a more acceptance-based approach, such as Acceptance and Commitment Therapy (ACT) could be more suitable; however, there are few clinical trials with ACT and older people. Objectives: This feasibility study used mixed methods to explore the acceptability and feasibility of delivering ACT groups to inpatient and outpatient older people. Method/Results: 14 participants were recruited, nine of these completed the group (defined as attending four of six sessions) and eight were interviewed. Results suggested that 12 weeks after the last session, completers’ anxiety and cognitive fusion scores significantly decreased. Interviews suggested that ACT was acceptable to participants. Conclusions: ACT is both a feasible and acceptable transdiagnostic intervention for older people in an outpatient setting. Preliminary quantitative analysis suggested the intervention reduced anxiety and cognitive fusion; however, this should be measured in future intervention studies with higher participant numbers. Qualitative analysis suggested older people engaged with ACT because of the focus on visual material and that it seemed to increase their perspective taking and self-efficacy. The latter needs to be explored quantitatively.
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McEntee, Louise. "A mixed methods approach to examining teachers' perceptions of their role in promoting mental health in Irish primary schools." Thesis, University of Bristol, 2014. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.685043.
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Children who are mentally healthy have the ability to develop empathy and self-awareness. They can manage their feelings, are motivated, and have good social skills. Research suggests that the school is an important location for the promotion of mental health in children. However, very little is known about how teachers in Ireland feel about taking on the role of mental health promotion. Methodology: A mixed methods approach was adopted to examine this issue within one county in the west of Ireland. Questionnaires were distributed to all of the primary schools in the county. These were then analysed using SPSS. Based on these findings, four teachers were interviewed to gain a fuller understanding of some of the issues raised. The interviews were analysed using thematic analysis. Findings: The findings suggest that, for the most part, teachers agree that mental health promotion is a part of their role. They are more likely to feel this way if they also feel that they are capable of promoting mental health, if their school has a supportive ethos, and if they believe that mental health promotion is important. In general, teachers felt that they had not received enough training in mental health promotion. As such, this was a source of some stress and can have an impact on the teachers' own well-being. These results are discussed in relation to previous research and government policy, in addition to the possible implications at a local and national level and to EP practice.
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Planner, Claire. "Collaborative care for severe mental illness : a mixed-methods exploration of potential to improve healthcare delivery and health outcomes." Thesis, University of Manchester, 2015. https://www.research.manchester.ac.uk/portal/en/theses/collaborative-care-for-severe-mental-illness-a-mixedmethods-exploration-of-potential-to-improve-healthcare-delivery-and-health-outcomes(8baf9c66-c32c-42d2-b201-7e9a4a66c667).html.
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Background: People with severe mental illness die up to 20 years earlier and are more likely to have co-morbid physical illness and poorer health outcomes than a comparative population without these conditions. International and National policy has emphasised the need to integrate healthcare delivery across the primary and secondary care settings to improve healthcare for this population and collaborative care is one approach to integrating services. Collaborative care is considered a ‘complex intervention’ because it includes a number of different elements. Research suggests that collaborative care can improve symptoms of depression when compared to usual care. The evidence for collaborative care for severe mental illness has, to date, not been reviewed systematically. Aim: The aim of this thesis is to establish whether collaborative care is effective and if it can be implemented within routine clinical practice to improve the health and healthcare of people with severe mental illness. MethodsA mixed methods approach and triangulated design was used to explore the current context in which services are provided (studies 1 and 2), review evidence to determine the effectiveness of collaborative care for severe mental illness (study 3) and identify the factors that could facilitate or hinder the implementation of collaborative care through application of Normalization Process Theory (study 4). These studies combined constitute the development stage of the Medical Research Council’s complex intervention development framework. Results: An estimated 31% of people with severe mental illness are seen only in primary care. Yet primary care and cross-boundary continuity is poor for this group. Examining consultation rate patterns demonstrated that rates are increasing over time and at a faster rate since the introduction of the Quality and Outcomes Framework. These findings point to the pivotal role of primary care in the context of severe mental illness. One randomized controlled trial of collaborative care for veterans with bipolar disorder (306 participants) indicated effectiveness in terms of reduced psychiatric admissions and quality of life; however, risk of bias was high. Stakeholders ‘buy-in’ to the core aims of collaborative care but there are notable factors which could hinder implementation within a UK NHS context. Conclusion:The findings from this thesis demonstrate how a mixed- methods approach can be used to inform the development of a complex intervention based on rigorous methods designed to provide complementary data. Findings are synthesised in a series of recommendations to inform the development and testing of collaborative care for severe mental illness.
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Hancock, Kate. "Stories and stats: a mixed methods study of staff and male prisoner patient experiences of prison based mental health services." Thesis, Curtin University, 2009. http://hdl.handle.net/20.500.11937/180.
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One consequence of the deinstitutionalisation of psychiatric care and increase in community care is the rising number of mentally ill people in prison populations where there are insufficient mental health professionals and services to address the treatment and rehabilitation needs of psychiatrically unwell prisoner patients. People with mental illness are over-represented in prison populations, and the provision of mental health services is a difficult task in an environment where discipline and safety take precedence over health treatment. This research investigated attitudes, perceptions, and experiences of prisoners, health professionals, and correctional staff in relation to mental illness and mental health service provison across eight prisons in Western Australia. The research aimed to gain a deeper understanding of experiences within prisons. Perceptions, attitudes and experiences of participants were explored using a mixed methods approach; both qualitative and quantitative methods were employed to gather information in a ‘two phase sequential design’ (QUAL/QUAN) (Creswell and Plano Clark 2007). The Phase One key informant interviews (n=17), and the key themes identified in the literature review, informed the development of the Phase Two quantitative survey questionnaires (n=168). These Phases acted as two different ways of exploring the research questions.One consequence of the deinstitutionalisation of psychiatric care and increase in community care is the rising number of mentally ill people in prison populations where there are insufficient mental health professionals and services to address the treatment and rehabilitation needs of psychiatrically unwell prisoner patients. People with mental illness are over-represented in prison populations, and the provision of mental health services is a difficult task in an environment where discipline and safety take precedence over health treatment. This research investigated attitudes, perceptions, and experiences of prisoners, health professionals, and correctional staff in relation to mental illness and mental health service provison across eight prisons in Western Australia. The research aimed to gain a deeper understanding of experiences within prisons. Perceptions, attitudes and experiences of participants were explored using a mixed methods approach; both qualitative and quantitative methods were employed to gather information in a ‘two phase sequential design’ (QUAL/QUAN) (Creswell and Plano Clark 2007). The Phase One key informant interviews (n=17), and the key themes identified in the literature review, informed the development of the Phase Two quantitative survey questionnaires (n=168). These Phases acted as two different ways of exploring the research questions.
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Nair, Manisha. "Effect of the Mahatma Gandhi National Rural Guarantee Act on infant malnutrition : a mixed methods study in Rajasthan, India." Thesis, University of Oxford, 2013. http://ora.ox.ac.uk/objects/uuid:1e6100e1-1499-48b6-8b89-5880b37fe95f.
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Background Malnutrition is a major risk factor of infant mortality in India. Policies targeting poverty and food insecurity may reduce infant malnutrition. The Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA), a wage-for employment policy of the Indian Government, targets deprivation and food insecurity in rural households. MGNREGA could prevent infant malnutrition by improving household food security or increase the risk of malnutrition by reducing the time devoted to infant care if mothers are employed. This study analyzed the effect and the pathways of effect of households' and mothers' participation in MGNREGA on infant malnutrition. Methods A community based mixed methods study using cross-sectional survey and focus group discussions (FGDs) was conducted in Dungarpur district of Rajasthan, India. Cross-sectional study included 528 households with 1,056 participants who were infants 1 to <12 months and their mothers/caregivers. Selected households were divided into MGNREGA-households and non-MGNREGA-households based on participation in MGNREGA between August-2010 and September-20ll. Anthropometric indicators of infant malnutrition-underweight, stunting, and wasting (WHO criteria) were the outcomes. Eleven FGDs with 62 mothers were conducted. Results Of 528 households, 281 participated in MGNREGA (53%). Mothers were employed in 51 (18%) households. Prevalence of wasting was 39%, stunting 24%, and underweight 50%. Households participating in MGNREGA were less likely to have wasted infants (OR 0' 57, 95% Cl 0•37-0'89; p=O'014) and underweight infants (OR 0'48,95% Cl 0•30-0'76; p=0'002) than non-participating households. Stunting did not differ significantly between groups. Although MGNREGA reduced starvation, it did not confer food security to the participating households because of lower than standard wages and delayed payments. Results from path analysis did not support an effect through household food security and infant feeding, but suggested a pathway of effect through birth-weight. Mothers' employment had no significant effect on the outcomes in the cross-sectional study, but the qualitative study indicated that it could compromise infant feeding and care. Conclusion Participation in MGNREGA was associated with reduced infant malnutrition possibly mediated indirectly via improved birth-weight rather than improved infant feeding. Providing child care facilities at worksites could mitigate the negative effects of mother's participation in MGNREGA. Further, improving mothers' knowledge of appropriate feeding practices in conjunction with providing employment (to address deprivation and food insecurity) is key in the efforts to reduce infant malnutrition.
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Savocchia, Mathilda. "Reviving Mending to Benefit the Individual, Community & Industry: A Mixed Methods Study." Kent State University / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=kent1628556618882235.
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Teeley, Aubriana M. "Knitting as an Adjunctive Treatment for Substance Use Disorder: A Mixed Methods Multiple Case Study." Antioch University / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=antioch1541530708768503.
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Townsend, Lisa Dawn. "The Conceptual Adequacy of the Drug Attitude Inventory For Measuring Youth Attitudes Toward Psychotropic Medications: A Mixed Methods Evaluation." online version, 2008. http://rave.ohiolink.edu/etdc/view.cgi?acc%5Fnum=case1216162396.
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O'Connell, Nicola. "Functional neurological disorder in acute stroke and mental health services : a mixed methods assessment of experiences, prevalence, associated clinical factors, and treatment." Thesis, King's College London (University of London), 2018. https://kclpure.kcl.ac.uk/portal/en/theses/functional-neurological-disorder-in-acute-stroke-and-mental-health-services(c6f40fea-3c02-40ac-aed3-2f662107589d).html.
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Functional neurological disorders (FND) present as neurological disease for which no organic cause can be found. These disorders are common, debilitating, and patients can present to a range of medical services. Little is known of the prevalence of patients with functional symptoms presenting to stroke settings, their experience once admitted to stroke wards, the demographic and clinical features of functional motor disorder (FMD) patients treated in psychiatric settings, or their response to psychological treatment. This thesis addresses this paucity of evidence. A systematic review and meta-analysis found functional stroke patients consistently present to stroke settings, constituting 1.7% (95% CI: 1.3% - 2.2%) of all patients with suspected stroke, with weakness the most commonly presenting functional symptom. A qualitative study using in-depth interviews with 14 hyper acute stroke clinicians, found participants named a range of potential causes of functional stroke presentations, but many felt unsure in how to discuss a functional diagnosis with patients. In a survey of 120 staff in hyper acute stroke wards in England, 90% of clinicians stated they do not believe there are clear guidelines on how to manage functional patients and 95.8% believed further research is necessary. A qualitative study involving interviews with 30 patients with functional stroke symptoms at one hyper acute stroke ward found many reported strong negative emotions in response to their admission and while on the ward, many believed they had had a stroke. Two months after discharge, many patients were uncertain about the cause of their admission and 40% experienced residual physical symptoms. Many expressed a desire for a more detailed explanation about the potential cause of their symptoms. A case-control study of 322 FMD patients found the disorder more commonly affects women, patients more frequently work in social or health care settings, patients often have carers or are themselves carers, and more frequently have comorbid physical and functional disorders when compared to a random sample of psychiatric patients from South London and the Maudsley NHS Trust. We found no association between experience of childhood sexual or physical abuse and an FMD diagnosis; however tentative evidence suggests patients experience precipitating events that could be defined as ‘disruptions to interpersonal relationships’. Finally, our case-control cognitive behavioural therapy (CBT) study indicates that both FMD patients and patients with organic disease respond to outpatient CBT. Half of the FMD group saw improvements in their physical symptoms, and measures of psychological distress and depression showed significant clinical improvement between first and last treatment sessions. Dropout rates from treatment were comparable between FMD and control patients. We conclude that functional disorder symptoms occur in multiple medical settings and present to newly established hyper acute stroke wards. A lack of understanding amongst clinicians about the nature of FND coupled with increasing financial pressure on the health service may serve to entrench patients’ symptoms, and worsen experiences in medical settings. Within mental health services, FMD appears to have distinct epidemiological characteristics but the fragmentation of neurological and mental health services mean patients are often under-served and lack continuity of care.
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Price, Jenson. "Examining the Feasibility and Acceptability of a Telehealth Behaviour Change Intervention for Rural-Living Young Adult Cancer Survivors." Thesis, Université d'Ottawa / University of Ottawa, 2019. http://hdl.handle.net/10393/39561.
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Regular physical activity (PA) participation and fruit and vegetable (FV) consumption confers numerous positive health outcomes for cancer survivors, including prevention of cancer recurrence, second primary cancers, and other non-communicable chronic diseases. Rural-living young adult cancer survivors (YAs) possess unique barriers and concerns that influence their ability to participate in traditional face-to-face behaviour change interventions. Few researchers have explored alternative means for delivering behaviour change interventions grounded in theory utilizing a mixed-methods approach to assess processes of change and behavioural outcomes. To fill this gap and provide recommendations for future interventions and services focused on positive health behaviours in this population, the objective of the research presented in this thesis was to explore the feasibility and acceptability of a 12-week theory-based telehealth behaviour change intervention aiming to improve PA and FV consumption using a single-arm, mixed methods pilot trial. Over a 7-month period, 14 YAs self-referred. Of these 14, 5 were eligible and consented to participate with 3 completing the study. Retention to the study was 73% and adherence to the health coaching program ranged from 66.67-100% with a 40% attrition rate. Inquiry into the acceptability of the intervention offered insight into participants experiences, which was summarized within five themes: (1) the more time the better, (2) the human factor, (3) supporting access, (4) influencing the basic psychological needs, and (5) finding motivation. Collectively, the findings suggest the methods used require minor modifications before being deemed feasible despite the general acceptability of the intervention. Importantly, they highlight the necessity of more expansive recruitment strategies and a need to explore participants’ underlying intentions for participating in behaviour change interventions. Further, recommendations are made based on the findings to improve this style of intervention, including testing stepped down models of support because it may help some YAs maintain behaviour change post-intervention.
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Lampman, Michelle Ann. "Assessment of the relationship between rural location and performance of Patient-Centered Medical Home processes among veterans health administration primary care clinics: an explanatory sequential mixed methods study." Diss., University of Iowa, 2016. https://ir.uiowa.edu/etd/3125.
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The Patient-Centered Medical Home (PCMH) is a new model for primary care delivery intended to improve the care experience for both patients and providers, improve the health of populations, and reduce health care costs. Adopting the PCMH model into practice requires considerable investment of time and resources which often act as barriers for many small primary care practices; especially in rural areas. Few studies have examined performance of the PCMH model in rural clinics that have successfully implemented the model. It is important to obtain a comprehensive understanding of how context from the surrounding environment relates to implementation and performance of the model and whether there are differences between rural and urban primary care clinics.
This study used a sequential explanatory mixed methods approach to assess differences in performance of the Patient Aligned Care Team (PACT) model between rural and urban primary care clinics within the Veterans Health Administration (VHA). Generalized Estimating Equations with repeated measures were used to estimate associations between rurality and five process-oriented endpoints among a national sample of 891 VHA primary care clinics. Results indicate that, after adjusting for patient characteristics and clinic structural capacity, clinics located in large rural or small/isolated rural areas demonstrated difficulty with enhancing access through use of non-traditional encounters (i.e. telephone visits, group visits, or secured messaging) and facilitating care coordination through post-discharge follow-up compared to urban clinics. Findings also suggest that rural clinics were more likely to struggle to meet system-wide performance standards for these same two PACT-related processes than their urban counterparts.
A multiple-case study of five VHA primary care clinics was conducted to obtain a contextual understanding of the relationships between rurality and performance of PACT processes from the perspective of primary care staff engaged in PACT implementation. A comparison of the experiences of staff across the five cases revealed cross-cutting themes that are important to understanding the implementation and performance of PACT-related processes within these clinics. These themes included: both rural and urban clinics experience distance-related barriers; patient preferences and behavior impact performance of PACT-related processes; and primary care clinics experience frequent change. Findings from this qualitative assessment highlight the importance of understanding the unique context and circumstances experienced by each clinic and how they relate to performance and implementation of the PACT model. Insights gained through the qualitative assessment revealed that performance of PACT is influenced by complex relationships with both internal and external context. Combination of both quantitative and qualitative methods provided a more comprehensive understanding of these relationships beyond what could have been learned from a solitary assessment of standardized metrics by gaining additional context directly from the voices of those engaged in PACT care delivery.
Identifying differences in PACT performance between rural and urban clinics calls attention to the possibility of unique advantages and challenges for PACTs delivering care to rural patients which need further exploration. Findings from this study contribute to the current understanding of PCMH implementation in rural settings by moving beyond the barriers related to structural capacity to performance of processes aligned with PCMH principles. More widespread implementation of PCMH will require additional attention to the complex relationships between the PCMH and surrounding context in order for primary care practices to successfully implement the model.
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White, Ivet Resna. "Exploring the perception of African Caribbeans in choosing a career as a counselling psychologist : a mixed methods approach." Thesis, University of Wolverhampton, 2015. http://hdl.handle.net/2436/579935.
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This mixed method study explored the perceptions of African Caribbeans towards choosing careers as counselling psychologists. 131 (N = 131) African Caribbeans aged 16-55 contributed to this study. Firstly, an online and paper survey questionnaire was designed and administered to (N =121) participants. This comprised of (N = 41) parents; (N = 41) undergraduate psychology students and (N = 39) 16-18 year olds. An ANOVA Test indicated a significant effect between participatory groups. Semi structured interviews were carried out to explore these identified differences. 4 parents; 4 16-18 year olds; and 2 undergraduate psychology students were interviewed. Qualitative data was analysed using Braun & Clarke (2006) thematic analysis. Themes identified as significant across all groups were centred around participants’ perception of psychology; interest or otherwise in studying psychology and choosing it as a career option; knowledge about counselling psychology and choosing it as a career; the participants’ experiences of school; the attraction of particular careers such as sports and music for 16-18 year olds when compared to counselling psychology; the importance of support; attitudes towards mental health and the importance of having role models from the community that are counselling psychologists. Recommendations for the Division of Counselling Psychology, BPS, training and future research are outlined.
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Holehouse, Rosanna. "Implementing smoking cessation interventions in community mental health settings : exploring nurses' readiness to change, perceived barriers and overall perceptions using a mixed methods design." Thesis, University of British Columbia, 2007. http://hdl.handle.net/2429/31865.
Full textAbstract:
Tobacco use is deeply entrenched in the culture of psychiatry. Historically, nurses condoned smoking and at times even encouraged it. Despite the vast research examining smoking cessation interventions for the general public, little is known about the barriers health care professionals face while working in community mental health settings and their 'readiness' to change in regards to implementing smoking cessation interventions into their practice. This study is part of a growing body of research examining tobacco in the context of mental illness. A mixed methods research design was utilized for this project. The first phase of the study consisted of the analysis of a self-report questionnaire completed by 282 health care providers working within the community mental health field in the Greater Vancouver area. The Transtheoretical Model: Stages of Change Method was applied to this largely untapped source of health providers to determine their 'readiness' to a) talk to clients about their smoking habits, and b) provide smoking cessation support to their clients. The second phase consisted of a focused
ethnographic design in which semi-structured in-depth interviews were conducted with 13 community mental health nurses.
This first Canadian investigation of community mental health nurses' 'readiness' to implement smoking cessation interventions into their practice revealed that the majority of nurses were in the preparation stage for both a) talking to clients about their smoking and b) providing smoking cessation support to their clients. Barriers to providing smoking cessation included lack of knowledge, time and appropriate resources. The ethnographic profile of the sociocultural and organizational context of community mental health nursing revealed the structure of the nursing subculture within the mental health teams (Brokers, Conductors, and Connectors) and highlighted the impact of these roles on nurses' readiness to change. Findings from both phases of the study were synthesized and results indicate a need for 1) the development of smoking cessation interventions specifically tailored to community mental health nurses' roles, 2) the incorporation of smoking cessation intervention education into the community mental health workplace, and 3) placing equal emphasis on the role and value of mental health nursing in undergraduate nursing programs.Applied Science, Faculty of
Nursing, School of
Graduate
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Lim, M. S. M. "Validation of a Vietnamese Mental Health Recovery Scale (VRS) in a community sample of Vietnamese refugees living in the UK : a mixed methods study." Thesis, University College London (University of London), 2016. http://discovery.ucl.ac.uk/1520993/.
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Overview Two studies and a critical reflection are presented in this thesis. In Chapter 1, a systematic review of the links between a Psychological Sense of Community (PSC) and subjective wellbeing, social relationships and community structures are investigated. Data from 20 East and Southeast (E/SE) Asian studies were explored using meta-analytic methods. This revealed medium to large effects in all categories investigated. Of particular significance was how relationship quality associated with a stronger PSC than social support, and strong community management was associated with a stronger PSC than residential features. In Chapter 2, a psychometric validation study of a Vietnamese Mental Health Recovery Scale (VRS) is presented. Thirteen Vietnamese refugees recruited from a Vietnamese mental health charity were interviewed in two focus groups. In consultation with an expert professional panel (n = 7), and guidance from existing recovery scales, these qualitative themes informed the content and wording of the VRS items. Forty-eight further service users from the same charity completed the VRS. This procedure validated a 15-item VRS that measured recovery processes such as meaningful social roles and interactions, self-management of problems, and spiritual attitudes and living. Total scores on the scale predicted self-rated wellbeing, fewer mental health symptoms, and lower professional ratings of general life functioning. In Chapter 3, the present research is critically discussed from a community and cultural psychology perspective. In particular, the social circumstances of E/SE Asia, and the social philosophies of the region such as Confucianism, Daoism and Buddhism, are reviewed.
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Chu, Tsz Lun. "The Roles of Coaches, Peers, and Parents in High School Athletes' Motivational Processes: A Mixed-Methods Study." Thesis, University of North Texas, 2018. https://digital.library.unt.edu/ark:/67531/metadc1248411/.
Full textAbstract:
Grounded in self-determination theory and achievement goal theory, the purpose of this mixed-methods study was to examine the underlying motivational processes from social environments created by coaches, peers, and parents to motivational outcomes in high school athletes, with an emphasis on the relative influence of social agents in basic psychological needs (i.e., autonomy, competence, and relatedness). The quantitative part of this study tested a hierarchical model of high school sport motivation in a final sample of 311 student athletes (204 boys, 107 girls) using structural equation modeling: social factors (coach-, peer-, and parent-created motivational climates) -> psychological mediators (need satisfaction and frustration) -> types of motivation (autonomous motivation, controlled motivation, and amotivation) -> consequences (subjective vitality, athlete burnout, and intention to drop out). Invariance across gender and across team type (varsity vs. non-varsity) was also tested. Adequate model fits were achieved in separate "brighter side" and "darker side" models across the overall sample, gender, and team type. The follow-up qualitative part of this study explored "how" beyond "what" coaches, peers, and parents contribute to the social environments, need frustration, and negative motivational outcomes in sport in a subsample of 37 student athletes (24 boys, 13 girls) who reported high amotivation/burnout and higher than average dropout intentions in the quantitative survey. Content analysis and observation were conducted to interpret the focus group interview data among athletes across gender and team type. The results of both quantitative and qualitative parts were integrated and compared to summarize the roles of coaches, peers, and parents in the "brighter and darker sides" of athletic experience in high school athletes.
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Magers, Megan. "A Mixed-Methods Approach to Examining the Memphis Crisis Intervention Team (CIT) Model: An exploratory study of program effectiveness and institutionalization processes." Doctoral diss., University of Central Florida, 2013. http://digital.library.ucf.edu/cdm/ref/collection/ETD/id/5811.
Full textAbstract:
The present study utilized a mixed-methods strategy to examine the effectiveness, diffusion, and institutionalization of the Memphis Crisis Intervention Team (CIT) model. To evaluate the effectiveness of the training component of the CIT model, a panel research design was employed in which a sample of 179 law enforcement officers and 100 correctional officers in nine Florida counties were surveyed on the first day of training (pretest), the last day of training (posttest), and one month following their completion of CIT training (follow-up). These surveys measured the extent to which CIT training achieved several officer-level objectives, including increased knowledge of mental illness and the mental health referral process, improved self-efficacy when responding to mental health crises, and enhanced perceptions of verbal de-escalation skills, mental health services in the community, and the mental health referral process. The results of these surveys revealed officers experienced a statistically significant increase on every measure of training effectiveness between the pretest and posttest data collection points. However, a significant decline was found among the 117 officers that responded to the follow-up survey on the measures associated with self-efficacy and perceptions of verbal de-escalation, which points to a measurable decay in the effectiveness of the training in the intermediate timeframe with regard to these two measures. To examine the extent to which the diffusion of the CIT model resembles a social movement in the field of criminal justice and to explore the impact of CIT institutionalization on the organizational structure of criminal justice agencies, an online survey was distributed to 33 representatives of law enforcement and correctional agencies known to participate in the CIT program in the nine Florida counties in which officers were surveyed. The results of this survey indicate interagency communication and external pressure from mental health providers and advocates largely contribute to the decision of criminal justice agencies to adopt the CIT model. In addition, the findings of this survey suggest criminal justice agencies modify their organizational structure in a number of different ways to internalize and institutionalize the CIT model. By coupling a training program evaluation with an assessment of diffusion and institutionalization, this study makes a unique contribution to organizational and evidence-based literature.Ph.D.
Doctorate
Dean's Office, Health and Public Affairs
Health and Public Affairs
Public Affairs; Criminal Justice
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Nielsen, Sarah Kaye. "A Mixed-Methods Study Examining the Effectiveness of Psychosocial Occupational Therapy Preparation for Therapists Working with Children in Schools." Diss., North Dakota State University, 2011. https://hdl.handle.net/10365/29770.
Full textAbstract:
This mixed-methods research study was conducted for the purpose of examining school-based occupational therapists' child psychosocial knowledge and attitudes, along with how therapists developed this knowledge and attitudes. Using a phenomenological qualitative approach, the study addressed the following broad research question: What meaning do school-based occupational therapists give to their experience in developing child psychosocial knowledge? Using a quantitative approach, a survey instrument was used to answer the following questions: (a) What level of child psychosocial knowledge
and attitudes do school-based occupational therapists possess? (b) How do the following variables impact child psychosocial knowledge and attitudes: (1) level of education, (2) academic course content, (3) participation in mental health fieldwork, (4) application of psychosocial knowledge in non-mental health fieldwork, (5) professional practice experiences, and ( 6) continuing education experiences. Snowball sampling was used to select 11 school-based occupational therapists for the phenomenological portion of the design. Data were analyzed using Giorgi and Giorgi's (2008) method of phenomenological analysis. Random sampling was used to select 1,000 school-based therapists who were mailed the Occupational Therapy Child Mental Health Questionnaire based upon The Teacher Mental Health Opinion Inventory (Morris, 2002). The response was N = 630. Data were analyzed using descriptive statistics and analysis of association. Using the mixed-methods triangulation convergence model, where both quantitative and qualitative data were collected at the same time and the results converged during interpretation by comparing and contrasting them, the following conclusions were made: (a) school-based occupational therapists possess and use child psychosocial knowledge: however. they do not believe it is sufficient; (b) school-based occupational therapists have a difficult time articulating psychosocial knowledge; however. through case descriptions they are able to give many examples of psychosocial knowledge they use in practice; (c) school-based occupational therapists believe that holistic, occupation-based, and client-centered practice, along with additional psychosocial intervention strategics, help them
maintain a positive attitude toward children with emotional disturbance; (d) school-based occupational therapists experience tension when attempting to apply their holistic, occupation-based, and client-centered practice in an environment that is typically focused on students changing to meet the environmental demands; (e) due to the constraints of the educational system and the IEP, school-based occupational therapists practice holistically by incorporating psychosocial knowledge in a hidden fashion; (f) school-based occupational therapists believe that mental health fieldwork and rich experiences with
individuals who have mental illness is important to developing a comfort level with people who have mental illness; (g) school-based occupational therapists do not readily connect the learning from adult mental health fieldwork that they apply in their school-based practices.
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Savard, Jedidiah S. "Reducing Adolescent Anger and Aggression with Biofeedback: A Mixed-Methods Multiple Case Study." Antioch University / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=antioch1499119177225382.
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