ABSTRACTPurpose: The overarching purpose of this thesis, which includes a literature review and creative applied project, is to explore the primary catalysts for the pervasive homeless complex within the scope of male adults and to implement effective solutions discovered within the research-based literature. The specific goal within this thesis timeline was to develop, offer, and evaluate a creative outlet for homeless male adults to facilitate them in feeling connected to others, ease the feeling of depression, and aid in being better understood. Background: Homelessness is a pervasive form of social exclusion. Annually, 1.6 million people utilize transitional housing programs or shelters in the United States (Parker et al, 2016). The thesis identifies three underlying behavioral and psychological factors that contribute to and exacerbate existing problems inextricably intertwined with homelessness. These factors are depression, social isolation, and addiction. The existing literature argues that by integrating artistic expression on a regular basis, homelessness may not only be prevented to an extent, it may also serve as a positive influence to fully re-integrate the population into society. The literature substantiates the need for structured activities. Methods/Approach/Process: This applied project developed a concise lesson on mindfulness and gratitude, crafted to associate intentional meaning behind the art class. The two-time class at a single local site included an ice breaker activity, square stitched keychains, painting a pocket-sized gratitude stone and a reflective mental health worksheet. A four-question hard copy post-session questionnaire was distributed to the participants at the end of each class to evaluate its impact from participants’ perspectives.

Results: The feedback of the shelter’s male participants suggested that the desired outcome of this applied project was achieved. The lecture and creative art class garnished positive responses from all participants. Every participant conveyed feeling a sense of ease, enjoyment and belonging while actively engaging and participating in the Art Class. Conclusion: The development and implementation of the two-time creative outlet for homeless male adults within a single local site helped participants to feel connected, eased the feeling of depression and aided in being better understood.

Most patients with limited English proficiency do not receive adequate interpretation services during their hospitalization. Research has established an association between patients who have limited English proficiency and poor health outcomes. There is very little research about barriers to using professional interpreting services in the critical care setting. This quantitative study surveyed 69 registered nurses working in 6 critical care units at a Northern California academic medical center. The aim was to identify what adult critical care nurses perceive as barriers to using professional interpretation services. Most answers to Likert questions regarding what inhibited use of interpreters clustered in the middle of the survey, or between “A Little” to “A Moderate Amount”. The factor with the highest percentage of “A Moderate Amount” (44.93%) answers was the “Patient is able to speak some English,” consistent with the observation of “getting by,” which is using a less qualified but more readily accessible means of interpretation (the patient, patient’s family, or other staff). The factors “Desire of a family member to interpret,” “Desire to use an unqualified staff member,” and “The patient declares some English proficiency” standout as the factors garnering the most responses of “A great deal” or “A lot,” a cluster of responses also consistent with the “getting by” phenomenon. Though nurses responded they preferred in-person interpreters, which is the profession’s gold standard, they overwhelmingly used video interpretation, indicating that the latter mode was more easily accessible. Themes that emerged in response to open-ended questions regarding additional obstacles specific to the ICU setting that inhibited the use of interpreters include delirium, sedation, and intubation, all which made communication challenging. Isolation status, COVID-19 status, rapidly deteriorating clinical status, and prioritizing patient safety were also obstacles to interpreter use. The findings suggest critical care nurses should receive training regarding all modalities of interpretation services and highlight the need for restructuring how nurses provide adequate means of communication for patients who are critically ill and have limited English proficiency.

The purpose of this phenomenological study is to determine how cultural views impact Fijian Indian women’s perception of IPV. The first objective of this study identifies themes in Fijian Indian women’s perspectives regarding IPV. The second objective of this study determines the impact these themes have on Fijian Indian women. The lifetime economic cost for Intimate Partner Violence (IPV) in the United States (U.S.) is 3.6 trillion dollars. Studies show that South Asian women are at a higher risk for experiencing IPV in the U.S. Fijian Indian women are part of the diverse South Asian diaspora; however, there is no published data on the experience Fijian Indian women have had with IPV. Ten Fijian Indian women, 18 years of age and older, who reside in California, were recruited through social media platforms. Data were collected through a semi-structured interview which took place either face-to-face or via zoom call. Results reveal that within the Fijian Indian community, women report a silencing and normalizing of the IPV experience. Contributing factors to this silencing and normalizing include familism/collectivism, shame and judgment, patriarchy/traditional gender roles, generational gap/learned behavior, and Hinduism’s gender hierarchy. When it comes to seeking help for IPV, women are more inclined to seek help within the family than from outside the family. According to these interviewees, health care providers and law enforcement end up being their last choice. Health care providers must understand the cultural nuances of the Fijian Indian community to provide holistic, patient-centered care, especially when it comes to providing care to a victim of IPV.