Theses and Dissertations at Montana State University (MSU)
Permanent URI for this collectionhttps://scholarworks.montana.edu/handle/1/733
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Item The effects of limiting access to abortion on domestic violence(Montana State University - Bozeman, College of Agriculture, 2020) Salemo, Katherine Marie; Chairperson, Graduate Committee: Isaac SwensenThis paper estimates the effect of access to abortion on the number of reported domestic violence victims using abortion clinic closures in the state of Texas that resulted from a statewide policy change. Results suggest that a decrease in access to abortion services causes a decrease in the number of reported intimate partner victims, though the evidence is weak. When analyzing the effects by relationship type, the results appear to be driven by victims with no legal ties to their offender, such as dating partners. The results indicate that a law enforcement agency that no longer has an abortion clinic within 100 miles reports 13.8% fewer dating partner victims. Because domestic violence crimes are vastly underreported and the data I use are exposed to this issue, the results could be due to a change in the frequency of the crime or a change in the decision to report the crime. This is the first paper to estimate this causal relationship, contributing to the literature by analyzing a policy that could have unintended impacts on victims of domestic violence.Item Breaking the cycle of adverse childhood experiences: a program evaluation(Montana State University - Bozeman, College of Nursing, 2019) McAnally, Jennifer Lyles; Chairperson, Graduate Committee: Dale MayerAdverse childhood experiences (ACEs) are specific types of childhood trauma, that, when experienced, have been found to have dose-response relationship to poor health outcomes later in life, namely, many of the leading causes of death in adults. ACEs include psychological, physical, or sexual abuse, witnessing violence against the mother, living with household members who were substance abusers, mentally ill or suicidal, or who are imprisoned. Recognizing a need for intervention to disrupt this ACE to illness trajectory, The American Academy of Pediatrics has called upon medical providers to address ACEs through screening and community-building. Since there is currently no guideline for how to address ACEs, the purpose of this scholarly project was to evaluate the Lewis and Clark County Health Department (L&CHD) ACE program for effectiveness and alignment with evidence-based practice. Using the Centers for Disease Control and Prevention manual titled Introduction to Program Evaluation for Public Health Programs (IPEPHP), an evaluation was completed. Steps included engaging stakeholders, describing the program, developing an evaluation plan, gathering credible evidence, and analyzing the evidence in order to develop conclusions and make recommendations. The L&CHD ACE program was found to be a largely progressive model that is consistent with most program goals and literature. Those who participated in the program tended to complete the program successfully, however, a majority of those who were referred to the ACE program either chose not to take advantage of the referral or declined to participate in the program. This finding was unexpected and warrants further inquiry. It appears that an integrated behavioral health model may be more effective for engaging potential participants, where they are able to initially meet with mental and behavioral health experts in the familiar primary care setting.Item Interventions for the prevention of opiate use disorder in patients with high adverse childhood experience scores in northern New Mexico: a qualitative project(Montana State University - Bozeman, College of Nursing, 2019) Clawson, Kendra Sweeney; Chairperson, Graduate Committee: Maria WinesAdverse childhood experiences (ACEs) are known to be associated with chronic disease, various disorders, and social-emotional challenges (Anda et al., 2008). Furthermore, illicit drug use has been indicated to be associated with ACE scores, in a dose-dependent relationship (Centers for Disease Control and Prevention, 2016a). This DNP project explored the experience of patients with opiate use disorder (OUD) in northern New Mexico, who had ACE scores of four or greater. The purpose of the project was to identify, via structured interviews, interventions the participants felt may have been significant in preventing their OUD. The project sought to specifically examine interventions as they relate to ACEs. The project gave a voice to those who have the lived experience of both ACEs and OUD, to synthesize strategies to address ACEs, and conceivably build resilience. In analyzing the participant responses, the most prominent themes identified were intentional communication, understanding the home environment, creating a safe space for the pediatric patient, referring to counseling, and providing increased education regarding opiates and mental health respectively. These approaches were compared to similar interventions in the literature, to synthesize recommendations to inform the practice of primary care providers, school nurses, and counselors who interact with children with high ACE scores in the northern New Mexico region (Felitti et al., 1998).Item The effects of abusive sibling conflict on self esteem(Montana State University - Bozeman, College of Education, Health & Human Development, 1990) Kannegaard, Mary ElizabethThe purpose of this study was to investigate the relationships between the acceptance and use of violence in the family environment, violent conflict between siblings, and self esteem. Acceptance and use of violence in the family environment was measured with the Family Violence Scale developed by Panos D. Bardis. The use of violent sibling conflict between siblings was assessed using the Conflict Tactics Scale developed by Murray Straus. Self esteem was measured using the Self Esteem Inventory which was developed by Stanley Coopersmith. Participant in the study were 150 college students at Montana State University. Volunteers were between 18 and 20 years of age with at least one sibling. Results indicated a significant relationship between the acceptance and use of violence in the home and violent conflict between siblings. A significant relationship was also found between violent sibling conflict and lower self esteem. In looking at male and female respondent separately it was found that violent sibling conflict was negatively related to the self esteem of male respondents and positively related to the self esteem of female respondents. Implications of this study were relevant for parents and professionals who work with families and/or children with problems stemming from low self esteem. The findings are also relevant to the prevention of child abuse.Item Writing a manuscript for publication : informing advanced practice nurses about routine screening for intimate partner violence in rural health care settings(Montana State University - Bozeman, College of Nursing, 2013) Moen-Leibrand, Jacqueline Helene; Chairperson, Graduate Committee: Patricia A. Holkup; Patricia A. Holkup, Laura Marx and Susan Raph were co-authors of the article 'Breaking barriers: intimate partner violence screening in the rural primary care setting' submitted to the journal 'The online journal of rural nursing and health care' which is contained within this thesis.Millions of women in the United States experience intimate partner violence (IPV) which can lead to devastating physical and psychological problems. Intimate partner violence is the leading cause of injury to women of childbearing years. Approximately 1200 women are murdered every year by their husband or boyfriend. Children who witness IPV are 3 times more likely to be abused than children who do not witness IPV. The economic burden to the individual and society as a whole are enormous. Despite endorsements by several health care and professional organizations, only 10% of healthcare providers screen for IPV routinely. The Centers for Disease Control and Prevention (CDC) estimates the costs of IPV to society are over 8 billion dollars each year. Advanced Practice Nurses (APNs) working in rural primary care settings face unique challenges to routine screening for IPV including geographical and social isolation, limited IPV resources, and a culture that values self-reliance and may normalize IPV. The purpose of this project is to write a manuscript that is suitable for publication which will identify strategies for the successful implementation of routine IPV screening in rural primary care settings.Item A description of employees' experiences working with rural programs for intimate partner violence(Montana State University - Bozeman, College of Nursing, 2013) Larkin, Julie Guthrie; Chairperson, Graduate Committee: Patricia A. HolkupIntimate partner violence (IPV), also known as domestic violence, is a problem that will affect over 25-35% of all women in their lifetime. People exposed to IPV are likely to sustain injury or develop serious long lasting mental or physical health problems. Rural women face specific issues including limited access to resources and a rural culture that may create difficulty for either leaving the abusive relationship or reducing the violence they face. Improved understanding of rural women's experiences will help health care providers increase the likelihood that these women will obtain the help and services they need. The purpose of this study was to explore: a) the experience of employees who work in rural programs supporting survivors of IPV and b) the employees' perspectives of rural women's experience of IPV. In this qualitative pilot study Giorgi's phenomenological research approach was used to conduct and analyze four face to face interviews. Major themes that emerged from the analysis included: a) the characteristics of the work; b) addressing IPV; c) the advocate's experience; and d) suggestions for change. Each of these themes contained sub-themes that more fully described the employees' experiences and perspectives of rural women's experience of IPV. Prominent sub-themes included the effects of: a) limited resources on the ability to address IPV survivors' needs; b) close-knit, geographically isolated rural communities on confidentiality and beliefs about IPV; c) the legal system on a survivor's ability to leave her partner; and d) working with this population on the employees' professional and personal lives. These results add to the body of knowledge about IPV. Previously unidentified areas of concern related to IPV in rural settings were revealed. Implications for nursing research, policy, practice, and education are discussed.Item Finding the faces of our mothers : every day feminism in Stephen King's 'Dolores Claiborne' and 'Gerald's game'(Montana State University - Bozeman, College of Letters & Science, 2006) Turnage, Rachel Anne; Chairperson, Graduate Committee: Robert BennettThe historical validity, feminist aspects, and social implications of Stephen King's Dolores Claiborne and Gerald's Game are analyzed to demonstrate how the novels reflect the nature of women's rights and struggles from the 1950's until the early 1990's. The patterns of survivor abuse stories are unearthed through both social science research and feminist literary criticism. By drawing connections between the two novels and their connection to the larger world of feminist issues, the argument is made that these and other popular novels are fruitful for cultural analysis because popular fiction reaches far more readers than academic texts and are thus able to initiate social change on a larger scale.