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In a healthcare system already struggling with burnout among its professionals, the COVID-19 pandemic presented a barrage of personal and occupational strife to US healthcare workers. Structural and everyday discrimination contributed to the health inequities of people of color in the US, exacerbated by COVID-19-related racism and xenophobia. There is

In a healthcare system already struggling with burnout among its professionals, the COVID-19 pandemic presented a barrage of personal and occupational strife to US healthcare workers. Structural and everyday discrimination contributed to the health inequities of people of color in the US, exacerbated by COVID-19-related racism and xenophobia. There is little research regarding the effects of COVID-19 and related and/or concurring discrimination upon minority nursing staff, despite their importance in supporting the diverse American patient population with culturally competent, tireless care amid the pandemic. This cross-sectional survey study aimed to examine 1) the relationships between discrimination, social support, resilience, and quality of life among minority nursing staff in the US during COVID-19, and 2) the differences of discrimination, social support resilience, and quality of life among minority nursing staff between different racial/ethnic groups during COVID-19. The sample (n = 514) included Black/African American (n = 161, 31.4%), Latinx/Hispanic (n = 131, 25.5%), Asian (n = 87, 17%), Native American/Alaskan Native (n = 69, 13.5%), and Pacific Islander (n = 65, 12.7%) nursing staff from 47 US states. The multiple regression results showed that witnessing discrimination was associated with a lower quality of life score, while higher social support and resilience scores were associated with higher quality of life scores across all racial groups. Furthermore, while participants from all racial groups witnessed and experienced discrimination, Hispanic/Latinx nursing staff experienced discrimination most commonly, alongside having lowest quality of life and highest resilience scores. Native American/Alaskan Native nursing staff had similarly high discrimination and low quality of life, although low resilience scores. Our findings suggest that minority nursing staff who have higher COVID-19 morbidity and mortality rates (Hispanic/Latinx, Native American/Alaskan Native) were left more vulnerable to negative effects from discrimination. Hispanic/Latinx nursing staff reported a relatively higher resilience score than all other groups, potentially attributed to the positive effects of biculturality in the workplace, however, the low average quality of life score suggests a simultaneous erosion of well-being. Compared to all other groups, Native American and Alaskan Native nursing staff’s low resilience and quality of life scores suggest a potential compounding effect of historical trauma affecting their well-being, especially in contrast to Hispanic/Latinx nursing staff. This study has broader implications for research on the lasting effects of COVID-19 on minority healthcare workers’ and communities’ well-being, especially regarding Hispanic/Latinx and Native American/Alaskan Native nursing staff.

ContributorsLaufer, Annika Noreen (Author) / Chen, Angela (Thesis director) / Fries, Kathleen (Committee member) / Edson College of Nursing and Health Innovation (Contributor) / Barrett, The Honors College (Contributor)
Created2021-05
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Female infertility can present a significant challenge to quality of life. To date, few, if any investigations have explored the process by which women adapt to premature ovarian insufficiency (POI), a specific type of infertility, over time. The current investigation proposed a bi-dimensional, multi-factor, model of adjustment characterized by the

Female infertility can present a significant challenge to quality of life. To date, few, if any investigations have explored the process by which women adapt to premature ovarian insufficiency (POI), a specific type of infertility, over time. The current investigation proposed a bi-dimensional, multi-factor, model of adjustment characterized by the identification of six latent factors representing personal attributes (resilience resources and vulnerability), coping (adaptive and maladaptive) and outcomes (distress and wellbeing). Measures were collected over the period of one year; personal attributes were assessed at Time 1, coping at Time 2 and outcomes at Time 3. It was hypothesized that coping factors would mediate associations between personal attributes and outcomes. Confirmatory Factor Analysis (CFA), simple regressions and single mediator models were utilized to test study hypotheses. Overall, with the exception of coping, the factor structure was consistent with predictions. Two empirically derived coping factors, and a single standalone strategy, avoidance, emerged. The first factor, labeled "approach coping" was comprised of strategies directly addressing the experience of infertility. The second was comprised of strategies indicative of "letting go /moving on." Only avoidance significantly mediated the association between vulnerability and distress.
ContributorsDriscoll, Mary (Author) / Davis, Mary C. (Thesis advisor) / Aiken, Leona S. (Committee member) / Luecken, Linda J. (Committee member) / Zautra, Alex J. (Committee member) / Arizona State University (Publisher)
Created2011
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Description
Fibromyalgia (FM) is a chronic pain condition characterized by debilitating fatigue. This study examined the dynamic relation between interpersonal enjoyment and fatigue in 102 partnered and 74 unpartnered women with FM. Participants provided three daily ratings for 21 days. They rated their fatigue in late morning and at the end

Fibromyalgia (FM) is a chronic pain condition characterized by debilitating fatigue. This study examined the dynamic relation between interpersonal enjoyment and fatigue in 102 partnered and 74 unpartnered women with FM. Participants provided three daily ratings for 21 days. They rated their fatigue in late morning and at the end of the day. Both partnered and unpartnered participants reported their interpersonal enjoyment in the combined familial, friendship, and work domains (COMBINED domain) in the afternoon. Additionally, partnered participants reported their interpersonal enjoyment in the spousal domain. The study was guided by three hypotheses at the within-person level, based on daily diaries: (1) elevated late morning fatigue would predict diminished afternoon interpersonal enjoyment; (2) diminished interpersonal enjoyment would predict elevated end-of-day fatigue; (3) interpersonal enjoyment would mediate the late morning to end-of-day fatigue relationship. In cross-level models, the study explored whether individual differences (between-person) in late morning fatigue and afternoon interpersonal enjoyment would moderate within-person relations from late morning fatigue to afternoon interpersonal enjoyment, and from afternoon interpersonal enjoyment to end-of-day fatigue. Furthermore, it explored whether the hypothesized relationships at the within-person level would also emerge at the between-person level (between-person mediation models). Multilevel structural equation modeling and multilevel modeling were employed for model testing, separately for partnered and unpartnered participants. Within-person mediation models supported that on high fatigue mornings, afternoon interpersonal enjoyment was dampened in the spousal and combined domains in partnered and unpartnered samples. Moreover, low afternoon interpersonal enjoyment in both the spousal and combined domains predicted elevated end-of-day fatigue. Afternoon interpersonal enjoyment mediated the relationship of late morning to end-of-day fatigue in the combined domain but in not the spousal domain. Cross-level moderation analyses showed that individual differences in afternoon spousal enjoyment moderated the day-to-day relation between afternoon spousal enjoyment and end-of-day fatigue. Finally, the mediational chain was not observed at the between-person level. These findings suggest that preserving interpersonal enjoyment in non-spousal relations limits within-day increases in FM fatigue. They highlight the importance of examining domain-specificity in interpersonal enjoyment when studying fatigue, and suggest that targeting enjoyment in social relations may improve the efficacy of existing treatments.
ContributorsYeung, Wan (Author) / Aiken, Leona S. (Thesis advisor) / Davis, Mary C. (Thesis advisor) / Mackinnon, David P (Committee member) / Zautra, Alex J (Committee member) / Arizona State University (Publisher)
Created2013
Description

This research aimed to examine college students’ perceived racial discrimination, mental health, and differences of these variables by US citizenship to promote healthier mental health practices within Asian college students. Mental disorders are a leading cause of suicidal ideation, which is the fourth leading cause of death among teenagers and

This research aimed to examine college students’ perceived racial discrimination, mental health, and differences of these variables by US citizenship to promote healthier mental health practices within Asian college students. Mental disorders are a leading cause of suicidal ideation, which is the fourth leading cause of death among teenagers and young adults, becoming a global phenomenon. The rate of mental health problems, including anxiety and depression, have steadily increased in a decade, with higher rates among racial and ethnic minorities. More than half of adults with serious mental illnesses haven't received treatments, with minorities being more likely to delay or fail seeking mental health treatments due to cultural and structural barriers such as cultural stigma, racial discrimination, acculturation, and language, making it more difficult to address the inaccessibility to high mental health care services, especially for Asians. The findings of this study suggest that, compared to international students, domestic students have greater mental health service seeking intention, received worse racial discrimination (subject to slurs and suspiciousness) and worse mental health since Covid-19, and determined language concordance between patient and healthcare provider is important. International students have more negative beliefs towards the difficulties of treatment and care of mental illnesses and determined ethnicity concordance between patient and healthcare provider is important. The findings provide preliminary insight to acknowledge the differences between domestic and international students in their perceived racial discrimination and mental health. Furthermore, based on findings the issue can be addressed by implementing a mixed-method approach on collecting disaggregated data among this population, removing language and stigmatic barriers to mental health services by education, and promoting cultural competency among mental health workers.

ContributorsNguyen, Evie (Author) / Chen, Angela (Thesis director) / Han, SeungYong (Committee member) / Barrett, The Honors College (Contributor) / School of Molecular Sciences (Contributor)
Created2023-05
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Secondary traumatic stress (STS) is the natural, consequent behaviors and emotions that result from the individual’s knowledge about traumatizing events experienced by another. Psychiatric registered nurses (RN), due to the nature of their jobs, are frequently exposed to significant amount of secondary trauma during nurse-patient interactions. Secondary traumatic stress impacts

Secondary traumatic stress (STS) is the natural, consequent behaviors and emotions that result from the individual’s knowledge about traumatizing events experienced by another. Psychiatric registered nurses (RN), due to the nature of their jobs, are frequently exposed to significant amount of secondary trauma during nurse-patient interactions. Secondary traumatic stress impacts the physical and emotional health of the nurse, compromises patient outcomes and organizational success. Evidence acknowledges the significant extent of secondary traumatic stress among nurses and is insistent on the necessity for effective interventions to mitigate the impacts of secondary trauma on healthcare professionals. A review of literature suggests that knowledge is a protective factor against secondary traumatic stress, and that nurse resilience also moderates the effects of secondary trauma and other work related stressors. These findings have led to the initiation of an evidence-based project that seeks to assess the efficacy of a resilience-oriented educational intervention in decreasing secondary traumatic stress scores and improving resilience among hospital-based psychiatric registered nurses. This project was guided by the Theory of Cognitive Appraisal and Rosswurm and Larabee’s model for evidence-based practice. Results from this project, despite being non-statistically significant, showed a decrease in STS scores from time-point zero (T0) to time-point one (T1) and increased resilience scores from time-point one (T1) to time-point two (T2), and from time-point zero (T0) to time-point two (T2). This project highlighted a deficit in knowledge of concepts of ST, STS and resilience among psychiatry RNs and inspired an open discussion on STS and other types of work-related stress among psychiatry RNs.
Created2021-04-28