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An exploratory qualitative study was conducted using a grounded theory approach (Charmaz, 2006) to examine the subjective experiences of mindfulness. Semi-structured interviews were conducted with 10 individuals who practice mindfulness on a regular basis. Data analysis revealed domains related to the experience, conditions, strategies and consequences related to the practice

An exploratory qualitative study was conducted using a grounded theory approach (Charmaz, 2006) to examine the subjective experiences of mindfulness. Semi-structured interviews were conducted with 10 individuals who practice mindfulness on a regular basis. Data analysis revealed domains related to the experience, conditions, strategies and consequences related to the practice of mindfulness. The following main themes emerged: subjective experience, mechanism of practice, use of metaphors, contextual influences, and shift in perception. An emerging theoretical model related to the experience of mindfulness is also proposed. Implications, limitations and suggestions for future research are discussed.
ContributorsMejia, Araceli (Author) / Kurpius, Sharon (Thesis advisor) / Arciniega, Miguel (Committee member) / Kinnier, Richard (Committee member) / Arizona State University (Publisher)
Created2013
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This study addressed the questions: What is the experience of mindfulness by yoga masters? How can such experiences inform the counseling intervention of mindfulness? In a qualitative study, individuals who held the minimum credentials E-RYT 200 (i.e., Experienced Registered Yoga Teacher 200 Hour) were interviewed. The verbatim interviews were analyzed

This study addressed the questions: What is the experience of mindfulness by yoga masters? How can such experiences inform the counseling intervention of mindfulness? In a qualitative study, individuals who held the minimum credentials E-RYT 200 (i.e., Experienced Registered Yoga Teacher 200 Hour) were interviewed. The verbatim interviews were analyzed using the phenomenological approach. Two categories of themes emerged describing mindfulness as a state of being and a practice of awareness. The common themes describing mindfulness as a state of being include: conscious awareness, feeling bliss, the present moment, interconnectedness, and compassionate evolution. The common themes describing mindfulness as a practice of awareness include: waking the body, balanced practice, the power of pranayama, refining abilities, obstacles to awareness, a holistic practice, and external supports. The results of this study suggest that mindfulness is multifaceted and ephemeral; however, with regular practice it becomes more consistently maintained. As a practice of awareness, mindfulness develops through a hierarchy of techniques moving from the external to the internal including both self and other. Discussion focuses on how these experiences can be applied in counseling interventions.
ContributorsBeyer, Gina (Author) / Kinnier, Richard (Thesis advisor) / Glidden-Tracey, Cynthia (Committee member) / Hutchinson, Joel (Committee member) / Arizona State University (Publisher)
Created2012
Description
Significance Background: Human papilloma virus (HPV) is the most common sexually transmitted infection, affecting 79 million Americans today and an additional 14 million Americans becoming infected with HPV each year. HPV infection may lead to the development of genital warts and several types of cancers including both cervical and oropharyngeal

Significance Background: Human papilloma virus (HPV) is the most common sexually transmitted infection, affecting 79 million Americans today and an additional 14 million Americans becoming infected with HPV each year. HPV infection may lead to the development of genital warts and several types of cancers including both cervical and oropharyngeal cancers. The promotion of currently available HPV vaccines is important to prevent HPV transmission and reduce the prevalence of the comorbidities associated with infection. Promotion to Vietnamese-Americans in particular is important because of the increased rates of cervical cancers seen in this population. As Vietnamese-American mothers often act as the primary healthcare decision maker for their children, they were chosen as the target population for this intervention. Purpose: This study aims to (1) develop personal digital stories about HPV and HPV vaccination among Vietnamese women with adolescent children who are vaccinated against HPV; and (2) share these stories with a group of Vietnamese American mothers and assess the effect of the stories in changing the attitudes, beliefs, and intention to vaccinate for HPV. Methods: This study used a two-step process to design, implement, and evaluate digital stories to improve Vietnamese mothers' attitudes, beliefs, and intention to vaccinate their adolescent children against HPV. The first step was a formative research design to develop the digital stories. The second step was quasi-experimental with a pre and posttest design to evaluate the effect of the stories. Results: The first phase has produced two digital stories which will be screened recruitment has been completed for phase two. Content analysis showed the importance of community resources, the desire to protect children, a history of familial and/or personal cancer, concerns about side effects, and the influence of healthcare providers as themes in both stories. Recruitment efforts are underway to recruit eligible Vietnamese mothers to assess the effect of these stories. Data collection is ongoing. Conclusions and lessons learned: The project has yielded two digital stories and recruitment for phase two is underway. This project has been successful in obtaining IRB approval, recruiting phase one participants, holding a digital storytelling workshop, designing the phase two survey, and beginning data collection efforts. The phase two recruitment has been challenging and will necessitate a change in strategy to find participants.
Created2017-05
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Description
The purpose of this phenomenological study was to explore the cultural, social, environmental, and gender factors that may influence physical activity (PA) in older Mexican American (MA) men living in Tucson, Arizona. The Mexican origin population is the fastest growing Hispanic subgroup in our nation, increasing from 20.6 million in

The purpose of this phenomenological study was to explore the cultural, social, environmental, and gender factors that may influence physical activity (PA) in older Mexican American (MA) men living in Tucson, Arizona. The Mexican origin population is the fastest growing Hispanic subgroup in our nation, increasing from 20.6 million in the year 2000 to 31.8 million in 2010. Arizona has the sixth largest Hispanic population in the United States and the Mexican origin population accounts for 91% of Arizona's Hispanics. Despite the fast growing Mexican population, there are a limited number of studies that examine MAs and PA. There are even fewer interventions created to foster PA among older (≥65 years old) MA men. Fourteen individual interviews were conducted with older MA men living in Tucson, Arizona. Data was collected, organized, and analyzed according to the methodologies of Clark Moustakas and the Social Ecology Model for Health Promotion framework. Six themes emerged which reflected the older MA male's perception of health, masculinity, and physical activity: a) Retirement promotes self-care behaviors, b) Women, health care providers, and the Internet are important in promoting health, c) Aging changes physical activity, d) I take care of myself, e) Physical activity is a personal choice and lifestyle, and f) I learn and make adjustments as needed. Themes were used to create textural and structural descriptions of their experiences. Descriptions were formed into the essence of the phenomenon. The results of this study increase our understanding of health, masculinity, and physical activity in older MA men. This research will inform the development of an evidence-based PA intervention to promote cardiovascular (CV) health in older MA men that may be implemented in a variety of community-based settings.
ContributorsDowling, Evangeline M (Author) / Hooker, Steven (Thesis advisor) / Grando, Victoria (Committee member) / Der Ananian, Cheryl (Committee member) / Larkey, Linda (Committee member) / Arizona State University (Publisher)
Created2015
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Description
Cancer survivors engaged in either six-week Internet-delivered mindfulness training or a usual-care control and were compared on the following outcome battery: The Hospital Anxiety and Depression Scale, the Profile of Mood States, the Pittsburgh Sleep Quality Index, and the Fatigue Symptom Inventory. Assessments were conducted before and after treatment and

Cancer survivors engaged in either six-week Internet-delivered mindfulness training or a usual-care control and were compared on the following outcome battery: The Hospital Anxiety and Depression Scale, the Profile of Mood States, the Pittsburgh Sleep Quality Index, and the Fatigue Symptom Inventory. Assessments were conducted before and after treatment and intervention compliance was monitored. Mindfulness treatments were delivered at a time and on a computer of the participants’ choosing. Multivariate analysis indicated that mindfulness training produced significant benefits on all measures (p < .05). Online mindfulness instruction represents a widely-accessible, cost-effective intervention for reducing psychological distress and its behavioral manifestations in cancer survivors, especially those who are unable to participate in in-person training.
ContributorsMesser, David, Ph.D (Author) / Horan, John J (Thesis advisor) / Homer, Judith (Committee member) / Larkey, Linda (Committee member) / Arizona State University (Publisher)
Created2017
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Description
The aim of this review is to explore the effects of mindfulness-based interventions on Registered Nurse's rate of burnout and stress. Particularly focusing on the mitigation and decrease of burnout. Burnout is a multifaceted, complex issue that has become engrained in the culture of nursing and a widespread epidemic. Burnout

The aim of this review is to explore the effects of mindfulness-based interventions on Registered Nurse's rate of burnout and stress. Particularly focusing on the mitigation and decrease of burnout. Burnout is a multifaceted, complex issue that has become engrained in the culture of nursing and a widespread epidemic. Burnout has detrimental effects for the quality of life of the nurse, patient outcomes, interprofessional collaboration, and nursing practice. A systematic literature review incorporating qualitative data and analyzing the quantitative data was conducted. Studies on the effects of mindfulness-based interventions for nurses relating to burnout published between January 2008 and May 2018 were identified through a systematic search in electronic databases: CINHAL, Cochrane, Embase, Medline, PsycInfo, and PubMed. Gray literature was searched through Scopus and clinical trials were explored through clincialtrials.gov. Data analysis was based on 8 data points that were extracted from the research. A total of 17 articles were selected for inclusion in the systematic literature review. There were several different types of studies including single group intervention study, randomized control trial interventions studies, mixed model, quasi-experimental studies with controls, and a non-randomized controlled comparison. All relied on self-reporting scales and questionnaire for quantitative pre-post intervention changes. Overall, the 10 of the 17 studies found that there was a statistically significant decrease in burnout rates and an increase in mindfulness post intervention. Several other factors improved in a number of studies such as quality of life, decreased stress, increased sense of personal accomplishment, and decreased emotional exhaustion. There were also indications of an improvement in the individual's holistic well-being (e.g. inner state of calmness, awareness and enthusiasm) relating to improved mindfulness levels in 12 of the studies. Based on the results of this systematic review, mindfulness may be considered a potentially effective intervention for decreasing nurse burnout and mitigating future burnout. This intervention could be useful in a number of contexts including on-site and off-site programs with institutional support. Future research should explore longitudinal outcomes of mindfulness practice, symptom focused outcome measures, and multi-modal studies.
ContributorsGeurtz, Heidi Frances (Author) / Larkey, Linda (Thesis director) / Costello, Jennifer (Committee member) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor) / Barrett, The Honors College (Contributor)
Created2018-12
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Description
Background: Unmanaged stress is a major contributing factor to the development of disease in both men and women. Middle-aged adults (40-64) have some of the highest stress of all age groups and the use of meditation may provide relief for conditions such as stress. A smartphone application (app) may hel

Background: Unmanaged stress is a major contributing factor to the development of disease in both men and women. Middle-aged adults (40-64) have some of the highest stress of all age groups and the use of meditation may provide relief for conditions such as stress. A smartphone application (app) may help limit the magnitude of the perceived challenges of meditation. The purpose of this study is to determine the feasibility of a consumer-based meditation app (i.e., Calm) to reduce stress in middle-aged adults who self-report elevated stress. The preliminary effects of Calm on stress and health outcomes related to stress were explored as well as the preliminary effects of Calm on mindfulness and coping behaviors for stress were explored.

Methods: Adults were recruited to a 4-week app-based health and well-being study. Participants were randomized into either a mindfulness meditation (i.e. Calm) group or a health education (POD) control group. Participants were asked to participate at least 10 minutes per day. Assessments were conducted for stress, anxiety, depression, mindfulness, physical activity, eating habits, and coping behaviors at pre- and post-intervention and voluntary phone interviews were held post-intervention. App usage data were collected subjectively through weekly participation logs and through objective app usage data provided by Calm.

Results: Eighty-three participants were enrolled into the study and 60 completed the intervention and were analyzed. Feasibility and demand benchmarks were met with 96% of participants satisfied with the intervention and 93% found it enjoyable, appropriate, and useful. There was a 70% adherence (minutes/week) to the meditation intervention. Recruitment of men into the intervention group was 38.1% and retention of men was 81.3%. Significant changes were not observed in stress, anxiety, depression, or mindfulness, physical activity, eating habits, and coping behaviors.

Conclusion: The findings of this study support the feasibility of a 4-week, mobile app-based mindfulness meditation intervention (i.e. Calm) in middle-aged adults. These finding do not demonstrate preliminary efficacy of Calm to reduce stress, anxiety, and depression or improvement of mindfulness, physical activity, eating habits, or coping behaviors among middle-aged adults who report elevated stress. These results can be applied for improved design of future studies.
ContributorsLaird, Breanne Michelle (Author) / Huberty, Jennifer (Thesis advisor) / O'Rourke, Holly (Committee member) / Larkey, Linda (Committee member) / Arizona State University (Publisher)
Created2020
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Description
Harm to patients remains high in US hospitals despite significant progress to improve the quality of care in our health systems. Leadership, a culture of patient safety, and a climate conducive to innovation in patient care are necessary to advance positive patient safety outcomes. Yet, little is known about how

Harm to patients remains high in US hospitals despite significant progress to improve the quality of care in our health systems. Leadership, a culture of patient safety, and a climate conducive to innovation in patient care are necessary to advance positive patient safety outcomes. Yet, little is known about how leadership can impact patient safety within a climate of innovation. This study examines the effects of transformational and transactional leadership (singularly and with transactional augmenting transformational leadership) as related to nurses’ perception of patient safety, how communication elements of a culture of patient safety may strengthen that relationship, and how the mediating role of team innovation climate may help explain the relationship between transformational and transactional leadership and nurses’ perception of patient safety. The variables were measured using three validated and reliable survey instruments: The Multifactor Leadership Questionnaire (MLQ Form 5X), the Team Climate Inventory-short (TCI), the Agency for Healthcare Research and Quality (AHRQ) Hospital Survey on Patient Safety Culture. A convenience sample of all staff registered nurses (N=952) from the single academic medical center with direct patient care responsibility was surveyed via e-mail for this research. A total of 210 surveys were returned, 157 met inclusion criteria for a response rate of 16%. Transformational leadership had a statistically significant relationship with patient safety perception, while the relationship of transactional leadership with patient safety perceptions was not significant. The results of the regression analysis that tested the effect of communication elements of a culture of patient safety on the relationship between transactional and transformational leadership and patient safety perception were not significant. Transformational leadership was significantly related with team innovation climate after controlling the effect of transactional leadership supporting the augmentation effect. Mediation analysis showed that team innovation climate had a significant mediating effect on the relationship between transformational leadership and patient safety perception. Team innovation climate had a significant mediating effect on the relationship between managers’ transformational leadership and patient safety perception after controlling for transactional leadership supporting the augmentation effect. This is the first study known to test the augmentation of transformational leadership related to patient safety and the role of team innovation climate.
ContributorsYounger, Samuel (Author) / Larkey, Linda (Thesis advisor) / Porter O'Grady, Timothy (Committee member) / Lamb, Gerri (Committee member) / Arizona State University (Publisher)
Created2019
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Description

The purpose of this study was to determine the feasibility of a mindfulness-based intervention among pregnant women (12-20 weeks’ gestation) using a mobile meditation app, Calm. This study involved 100 participants who were recruited nationally due to the COVID-19 pandemic. This study was reviewed and approved by the Institutional Review

The purpose of this study was to determine the feasibility of a mindfulness-based intervention among pregnant women (12-20 weeks’ gestation) using a mobile meditation app, Calm. This study involved 100 participants who were recruited nationally due to the COVID-19 pandemic. This study was reviewed and approved by the Institutional Review Board of Arizona State University (STUDY STUDY00010467). All participants were provided an informed consent document and provided electronic consent prior to enrollment and participation in this study. This study was a randomized, controlled trial (trial registration: ClinicalTrials.gov NCT04264910). Participants randomized to the intervention group were asked to participate in a minimum of 10 minutes of daily meditation using a mindfulness meditation mobile app (i.e., Calm) for the duration of their pregnancy. Participants randomized to the standard of care control group were given access to the app after they gave birth. Both the intervention and control groups were administered surveys that measured feasibility outcomes, perceived stress, mindfulness, self-compassion, impact from COVID-19, pregnancy-related anxiety, depression, emotional regulation, sleep, and childbirth experience at four time points: baseline (12-20 weeks gestation), midline (24 weeks gestation), postintervention (36 weeks gestation), and follow-up survey (3-5 weeks postpartum). Data is currently being analyzed for publication.

ContributorsLister, Haily (Author) / Huberty, Jennifer (Thesis director) / Larkey, Linda (Committee member) / School of Mathematical and Natural Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2021-05
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Description

Polypharmacy among psychiatric patients is a concerning trend. From 2007-2010, 58.2% of women and 41.8% of men reported taking five or more prescription drugs within the last 30 days (CDC, 2014). Negative outcomes include prescription drug abuse, side effects, interactions, treatment failure, patient dissatisfaction, and lack of treatment control. The

Polypharmacy among psychiatric patients is a concerning trend. From 2007-2010, 58.2% of women and 41.8% of men reported taking five or more prescription drugs within the last 30 days (CDC, 2014). Negative outcomes include prescription drug abuse, side effects, interactions, treatment failure, patient dissatisfaction, and lack of treatment control. The associated practice challenges have led to the following PICOT question. In persons with mental health issues receiving care at an outpatient mental health clinic, does engaging in mindfulness practice versus no mindfulness practice change polypharmacy use over a 3-month period?

The project purpose was to evaluate the effectiveness of Insight Timer mobile mindfulness app at helping patients self-manage distressing symptoms and reduce polypharmacy. Over three weeks, mental health clinic nurse practitioners (NPs) voluntarily recruited patients (n=12) over age 18 using as needed prescriptions (PRNs), and agreed to use Insight Timer mobile mindfulness app for adjunct symptom management. Consenting participants downloaded the mobile app, and completed a brief questionnaire measuring PRN use at the start of app use, and PRN use at their next visit. A Wilcoxon signed-rank test indicated a 10-week mindfulness app trial did not significantly lower total PRN doses compared with pre-app dosing (Z = -.534, p = .593). Paired t-tests revealed no significant change in pre (M = 65.17, SD = 28.64) versus post (M = 67.75, SD = 20.22) OQ45 life functionality results (t(11) = -.420, p = .683) (d = .121) as a result of app use.

Clinically relevant results illustrated 83.33% of participants taking greater than nine PRN doses over the study period used the app six times or more in place of medication. High PRN users employed the app frequently in place of medication regardless of total PRN doses taken. Practice implications and sustainability recommendations include incorporating mobile app use in treatment plans for high PRN users and educating NP’s on the tangible benefits of mindfulness apps in reducing polypharmacy and easing symptom distress on an ongoing basis.
Keywords: mindfulness, mhealth, mobile apps, mobile smart phone, online, RCT, behavior change, polypharmacy.

ContributorsPierce, Albert (Author) / Guthery, Ann (Thesis advisor)
Created2019-04-29