Browsing by Subject "disparities"

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Barriers to Care for Women Veterans with Post-Traumatic Disorder: Interface of Gender, Culture, Diagnosis, and Compensation
    (2018-12) Eggers, Thomasine
    This paper will specifically address processes that may create an arduous evidentiary burden that female veterans must meet in order to qualify for disability compensation benefits; notably more difficult burden of proof than their male counterparts (Schingle, 2009). Also addressed is the impact of cultural and gender competence and sensitivity on barriers to care for this particular subset of the veteran population. As women continue to serve in the military in increasing numbers, and as the roles expand to include those previously held by men, there is a great need for a better understanding of the stressors that women veterans face and how these stressors impact their lives and the lives of their families after deployment. Although MST affects both men and women, the foci of this work will be on women, as women are the majority of victims of sexual assault. If women are not diagnosed and compensated at similar rates as men -where warranted- this discrepancy can lead to poverty, drug and alcohol abuse, homelessness, despair, and even suicide. This paper will address gaps between the progress made at VHA so far, with suggestions for improving barriers to health care and mental health treatment for women.
  • Thumbnail Image
    Item
    A New Model for Acute Pain Management in Children: Examining Patient Characteristics and Potential Implications for Research and Practice
    (2021-05) Eull, Donna
    AbstractCurrent literature suggests that acute pain management in hospitalized children remains substandard, resulting in adverse physical, cognitive, and emotional effects for many children. Improvements to pediatric acute pain management require an updated conceptual model and validation of current assumptions from the literature. The purpose of the three studies in this dissertation was to advance the state of the science on acute pain management in hospitalized children through an updated conceptual model, a critical review of literature, and analysis of pain management data from a children's hospital. The new acute pain management model transforms the role of the nurse from gatekeeper to facilitator in genuine partnership with children and families. The critical review of the literature suggested that differences in medication type and frequency for acute pain are associated with children’s sex and race/ethnicity, however study limitations make it difficult to draw meaningful conclusions about potential disparities in acute pain management for children. Findings from a retrospective chart review suggested no differences by sex, race/ethnicity, or limited English proficiency (LEP) in the average number of pain assessments, medication by weight, or outcomes. The results from this study may indicate progress in the management of acute pain in hospitalized children, as children in this study demonstrated average pain intensity scores which typically indicate mild, well-controlled pain. Replication of this study in other hospitals is needed to determine organizational effects on pain outcomes. Future research should also focus on identifying the components needed to establish genuine partnerships with patients and families and the potential influence of parents on effective pain management.