Doctor of Education, Ashland University, 2020, College of Education

This dissertation researches Adverse Childhood Experiences (ACEs) and how teachers use their own experiences in their classrooms. Recent researchers have concluded that the prevalence of childhood trauma and can cause increased, long-term effects on individuals (Connor, Ford, Arnsten & Greene, 2015; Edwards, Anda, Felitti, & Dube, 2004; Edwards, Holden, Felitti, & Anda, 2003; Felitti, 2002; Felitti, Anda, Nordenberg, Williamson, Spits, Edwards, Koss, et al., 1998; Kalmakis & Chandler, 2014; Whitfield, 1998). Recent studies noted that children who experience at least one ACE are more likely to exhibit difficulties in their education (Duplechain, Reigner, & Packard, 2008; Forster, Gower, Borowsky, & McMorris, 2017), behavior (Hunt, Slack, & Berger, 2017) and physical health (Felitti, 2002). However, this study thoughtfully researches classroom teachers who have positive ACE scores (N≥1) and how they manage and use these experiences to inform a classroom culture of trauma-informed care. This dissertation uses Felitti et al.'s original ACE work (1998) as well as Finkelhor, Shattuck, Turner and Hamby's (2015) revised ACE questionnaire as a framework for the inquiry and descent into research.

Committee: Judy Alston PhD (Committee Chair); James Olive-Liebhart PhD (Committee Member); Allison Dickey EdD (Committee Member) Subjects: Education; Teaching

PHD, Kent State University, 2018, College of Education, Health and Human Services / School of Teaching, Learning and Curriculum Studies

This naturalistic inquiry study explored and interpreted the phenomenon of decision-making of three practicing experienced teachers and how their pivotal lived experiences influence their teacher decisions and practices. The teachers, who had lived or were living through pivotal life events while teaching, were interviewed in a series of four in-depth interviews, including reflecting on and interpreting life artifacts as representations of their experiences. Analysis through two stages, naturalistic inquiry and interpretative phenomenology approaches, showed that their pivotal lived experiences enter the classroom and influence their existing practice and various forms of decisions; academic, social-personal, humanistic, time and philosophical. The findings show that these teachers engage in reflecting on their practices but do not think about the processes or influences on their decisions. While reflecting and co-interpreting, they made meaning of their experiences and showed that life experiences orient them to their lifeworlds in physical and philosophical ways within the crafted spaces of teaching. Decisions reflected those orientations, and dispositions and philosophies emerged and were directly connected to the experience of experiencing life. The findings showed that training, previous beliefs and orientations of these teachers are not the only guiding forces in how they make decisions; pivotal lived experiences influence how they form their identities, develop their worldviews and social perceptions, promote social justice and empathy in the classroom, and how the culture and environment of their teaching world and teaching spaces are crafted by their decision-making, influenced by what is experienced outside of the teaching world.

Committee: Alicia R. Crowe (Committee Chair) Subjects: Education Philosophy; Educational Theory; Teaching

Psy. D., Antioch University, 2024, Antioch Seattle: Clinical Psychology

Although there have been some studies that explore the lived experiences of adults with non-epileptic seizures, there have been limited studies that examine the lived experiences of adolescents and emerging adults with non-epileptic seizures. This qualitative study explored the experiences of emerging adults who had been diagnosed with non-epileptic seizures during adolescence. The study focused on specific interventions utilized in therapy that they found helpful, highlighted what their experiences were throughout their daily lives, and what treatment recommendations were provided. The research will also help guide parents, clinicians, and individuals with NES towards treatment recommendations. Eight participants completed an in-depth, semi-structured qualitative interview. The seven major themes that emerged included the following: Insights into Effective Interventions Learned in Therapy, Mixed Emotions, Complexities of the Family Relationship, Support and Strain in Peer Relationships, Stigma, Experiences in the School Settings, and Therapeutic Experiences and Recommendations.

Committee: Bill Heusler (Committee Chair); Michelle Kim (Committee Member); Dana Waters (Committee Member) Subjects: Clinical Psychology; Psychology; Psychotherapy; Therapy

Master of Fine Arts, The Ohio State University, 2024, Design

The pandemic and the emergence of Long Covid symptoms have highlighted the critical importance of patient involvement and participation in healthcare. Individuals living with Long Covid, researchers, and healthcare providers have come together to understand the condition and address its challenges, which is uncommon in the traditionally hierarchical healthcare system. Despite these efforts, many voices and concerns remain unheard, revealing gaps in data, research pathways, empathy, and understanding. This isolation has driven some patients to seek a more active role in the healthcare setting. Learning from the stories and experiences of people living with Long Covid and extending it to Diabetes, this research aims to make these voices and stories more visible to the healthcare mainstream. By amplifying patients' voices and needs, the project seeks to foster collaboration among the researchers, patients, and providers silos in healthcare, enabling a better mutual understanding and ultimately creating a more equitable healthcare future. The study explores the integration of exploratory design research methods within a healthcare system that is currently focused on evidence-based research. By concentrating on the conditions of Diabetes and Long Covid, the research involves three key groups: patients, providers, and researchers. These groups represent the main silos in healthcare, whose collaboration could lead to improved patient outcomes and experiences. In-depth interviews were conducted to understand their current participation and collaboration efforts within the existing healthcare system. Based on the analysis of these interviews, a provocative potential solution, or 'provotype,' was designed to create a deeper understanding of the different groups' needs and behaviors. A series of surveys was conducted to gather feedback and initiate a dialogue in this space, leading to conclusions and future steps based on this feedback. One of the main findings is the crea (open full item for complete abstract)

Committee: Elizabeth Sanders (Advisor); Shadrick Addy (Committee Member); Yvette Shen (Committee Member) Subjects: Design; Health Care

Doctor of Education , University of Dayton, 2024, Educational Administration

International schools experience administrative turnover approximately every 3.7 years. This turnover can create challenges for staff members, particularly the locally hired staff who have been with the school for a significant amount of time. These individuals are the backbone of international schools due to their longevity employed with the school. Carrying immense historical knowledge and critical information regarding the school, community, and strategic planning, they are affected most by high administrative turnover. Additionally, beyond the daily task of academic support, these individuals help acculturate the expatriate staff, who are also transitional. This dissertation examined the extent to which high administrator turnover affects the experiences of locally hired staff and the practical strategies used to mitigate the impact experienced during administrative turnover. This qualitative action research study investigated the impact of administrative turnover on locally hired staff. During the study, semi-structured interviews were completed using a phenomenological design to explore the lived experiences of six locally hired staff who worked at an American international school for more than ten years. Based on the framework of intercultural competency theory, this research identified five key themes: the impact of leadership and organizational changes, system and standardization, empowerment and contributions of local staff, cultural responsiveness and integration, and growth and development of the school environment. These themes led to the proposal of two action-based objectives. The objectives involved leveraging the expertise and knowledge of locally hired staff by forming a task force to establish a unified framework that promotes cultural sensitivity, inclusivity, equity, and standardization of practices among locally hired staff.

Committee: James Olive (Committee Chair); Joshua Garrett (Committee Member); Matthew Witenstein (Committee Member) Subjects: Educational Leadership

Doctor of Philosophy (PhD), Ohio University, 2022, Counselor Education (Education)

The dissertation investigated the experiences of six counselors located in the Midwestern region of the USA and how their experiences influence intervention strategies when providing support for GBV (Gender-Based Violence) survivors. The purpose of the study was to explore the counselors' experiences and to see how these affect the strategies that they use. The hermeneutical phenomenological approach was used as a methodology, with six participant counselors who were from agencies and shelters that house gender-based violence survivors. The researcher recruited the participants using convenience sampling and snowballing strategies, and analyzed data from semi-structured interviews, fieldnotes, and document analysis, using the Bronfenbrenner Model as the conceptual framework. The data analysis yielded seven main themes: experience of counselors, interventions for GBV, negative impacts of therapy on counselors, counselors' needs in GBV work, coping strategies for counselors, types of abuse in clients, and the effects of covid on GBV work. Implications for these findings on counselor educators, clinical supervisors and future research within the mental health field are discussed.

Committee: Dr. Bilal Urkmez (Advisor) Subjects: Counseling Education

MFA, Kent State University, 2022, College of the Arts / School of Art

This thesis examines a path of discovery and self-reflection of my early life in Georgia and my travels around countries like France, Portugal, Vienna, Spain, and Greece. The title, A Delicate, Wistful, Young Woman… Walks Slowly Down the Path, is a direct reference to this journey. Through research, readings, art historical references, processes, materials, and concepts my artistic practice became process-based and I developed a greater interaction and reaction with the outside environment. I explore my studio practice indoors and outdoors as a complete process of integrating materiality, aesthetic sensibility, and process. In this body of work, the figures are not alone or detached from the picture plane, rather, they are shown fully succumbing to their environment. Their visceral and effortless quality arrests and engages the viewer by creating a visual and textural pentimento. The goal of this body of work is to engulf the audience as well as me as the maker. As I went through the process and engaged with nature, my studio practice, and my sensibilities I was able to capture a journey of change, protection, and liberation.

Committee: Shawn Powell (Advisor); Eli Kessler (Committee Member); Gianna Commito (Committee Member); John-Michael Warner (Committee Member) Subjects: Fine Arts

Master of Science, The Ohio State University, 2022, Health and Rehabilitation Sciences

Background: Food insecurity is a persistent public health issue that affects 10.5% of households in the U.S. The United States Department of Agriculture monitors food insecurity using the Household Food Security Survey Module (HFSSM). There is growing concern that it may not capture the true extent of food insecurity nor reflect the lived realities of households across the food security spectrum, particularly in rural areas. Study Objective: To explore whether the HFSSM reflects the lived realities and conceptualizations of food security among adults with varying food security experiences. Methodology and Data: A study recruitment postcard was mailed to all residential addresses in the Athens County region of Appalachian Ohio in late June 2020. Adult recipients were invited to complete an initial survey with quarterly follow-up for one year. Surveys included a demographic questionnaire and the HFSSM. Based on HFSSM-based trajectories of household food security over study time points, a purposively selected sub-sample of respondents were invited for in-depth semi-structured interviews (n=16) conducted in May-June 2021. Interviews were audio-recorded and transcribed verbatim. Using NVivo (Version 12), template analysis was employed to identify themes through a process employing both a priori codes (based on HFSSM constructs) and emergent codes. The codebook went through six iterations based on a series of consensus-building discussions among three co-authors until saturation was reached and no new codes emerged. Two researchers coded a subset of interviews to check codebook clarity and ensure interrater reliability. Results: Interviewed adults represented households experiencing consistent food security (n=7), transient insecurity (n=5), and persistent insecurity (n=4) across time points. Households with a history of food insecurity characterize their experiences in ways that largely converge with the HFSSM measure, including skipping meals, reducing meal size, (open full item for complete abstract)

Committee: Jennifer Garner (Advisor); Claire Bollinger (Committee Member); Michelle Kaiser (Committee Member); Colleen Spees (Committee Member) Subjects: Health Sciences; Nutrition; Public Health

Doctor of Philosophy (PhD), Ohio University, 2020, Communication Studies (Communication)

This qualitative study highlights rich and compelling insights into how individuals living with disability identities are treated negatively as a result of their physical differences. To understand what it means to be disabled in The Gambia, this study obtained different viewpoints of how individuals make sense of their disability identities by examining the perceptions of individuals living with disabilities, the family members of persons with disabilities, and employees of a disability NGO known as The Gambia Organization of the Visually Impaired (GOVI). The results of the study suggest that people with disabilities in The Gambia can be differentiated into three main categories. These include (1) individuals who rely on the community's goodwill for sustenance, and as a result of their dependency, feel profoundly devalued by society; (2) Folks with disabilities who are employed, self-reliant, and economically independent and therefore have the choice to defy and/or dispute the social structures that limit and discriminate against them; and (3) individuals who are assertive, embrace their disabilities, and portray themselves as resilient as a result of the positive support obtained from family members and people close to them.

Committee: John W. Smith Dr. (Advisor) Subjects: Communication

PhD, University of Cincinnati, 2018, Education, Criminal Justice, and Human Services: Educational Studies

This qualitative study featured three case studies exploring the lived experiences of international students on the campus of an urban, comprehensive university in the Midwest. The study aimed to answer two questions: (1) What is the lived experience of three international students on the campus of an urban, public, comprehensive university in the Midwest? (2) What sociopolitical influences affected these students' literacy, learning, and life experiences while in the USA? Data were collected through phenomenological, in-depth interviewing, university website documents and handbooks, and official U.S. government websites. The interviews were analyzed using the constant comparative method of Bogden and Biklen (1982). The cases were constructed by reading the transcripts several times and finding themes that emerged from the data. University documents and U.S. websites helped triangulate the data. The themes developed were (1) the impact of cultural influences, with two sub-themes of culture influences from home and cultural influences from chosen culture, (2) positive experiences, (3) negative experiences, (4) relationships, and (5) barriers. Analysis of the data showed that all three participants struggled in their interactions with domestic students. None of the participants took advantage of the social or cultural offerings of the university. The participants did experience discrimination and harassment to varying degrees. They insulated themselves from domestic students and from sociopolitical issues. This study was significant in two ways. First, many studies completed on international students feature homogeneous groups. This study featured as broad a geographical sample as possible. The second way this study was significant was the focus on sociopolitical changes and how those changes affect international students. None of the literature reviewed featured this focus. The study ends with implications for a variety of groups and suggestions for (open full item for complete abstract)

Committee: Holly Johnson Ph.D. (Committee Chair); Mary Benedetti Ed.D. (Committee Member); Emilie Camp Ph.D. (Committee Member) Subjects: Higher Education

Doctor of Education, Ashland University, 2018, College of Education

The underrepresentation of the African American female superintendent is disappointing and calls into question the reasoning behind such despairing amounts. In order to address that issue, one must examine the history of the African American female superintendent, recognize the barriers that she faces, and inquire about her lived experiences. The purpose of this study was to examine the lived experiences of African American female superintendents. The research answers the question of what are the lived experiences of African American female superintendents in the state of Ohio with an emphasis on their career paths, barriers, perspectives and successes. Black Feminist Theory and Critical Race Theory represent the theoretical frameworks for the research. The qualitative approach to this research was a phenomenological case study. Data for this case study were collected from four current African American superintendents in the state of Ohio. The participant presented a variety of reasons why she felt there are so few African American female superintendents in the state Ohio. The lived experiences of the participants in this study expounded the strategies necessary for overcoming barriers, facing challenges, or striving for success.

Committee: Judy Alston PhD (Committee Chair); James Olive PhD (Committee Member); Tanzeah Sharpe EdD (Committee Member) Subjects: African American Studies; African Americans; Educational Leadership; Gender Studies

Ph.D., Antioch University, 2017, Leadership and Change

This research focused on the lived experiences of fourteen military caregiving wives whose husbands were wounded, ill, or injured in a post-9/11 combat theater of war. All wives in this study had been vetted by and appointed to the Elizabeth Dole Military Caregiving Fellows Program and were either actively involved in the Fellowship or had become recent alumni of the two-year commitment at the time of this study. The purpose of this study was to provide a platform for their voices, understand their hopes, struggles, successes, and failures, and to give honor to their stories of military caregiving through the qualitative methodology of narrative inquiry. The stories as data were analyzed in two distinct ways. The first was using a plot analysis that exposed the story lines of the caregivers from the moment of their husbands' final deployment home to the present day, ranging from three to 13 years post onset. Using eight plot line elements, the arc of the story lines revealed one continuous story that was consistent among all caregivers, yet highly nuanced and unique. Thematic analysis was conducted as the second way of looking at the data. Moving dynamically along the flow of the story line, topical themes and their subthemes deepened the understanding and sense making the caregivers expressed at each stage of their evolution, providing the thematic road map of each journey. It was within this roadmap that a holistic picture emerged of the wives' journey through the emergent themes beginning with hope, to their own unraveling, to disillusionment with self, other, and the system, to the factors that eventually allowed them to turn toward a more empowered self, and finally, to the paradigm shift that ultimately allowed for transformative, inspired action. This dissertation is accompanied by the author's MP4 video introduction. The electronic version of this dissertation is available in open access at AURA: Antioch University Repository and Archive, http://aur (open full item for complete abstract)

Committee: Elizabeth Holloway PhD (Committee Chair); Tony Lingham PhD (Committee Member); Deborah Johnson Hayes PsyD, LCSW, MPH (Committee Member) Subjects: Families and Family Life; Mental Health; Military Studies; Psychology

Doctor of Education (EdD), Ohio University, 2017, Educational Administration (Education)

This qualitative phenomenological case study examined the influence of female leaders' perceptions of peace and globality on leadership styles and organizational development practices in two voluntary organizations. They are Young Women's Christian Association of Tokyo (YWCA-Tokyo) and Young Women's Christian Association of Japan (YWCA-Japan), affiliated to the World Young Women's Christian Association (World YWCA). Three methods were used: interview, observation, and document analysis. Outlined by YWCA-Japan's experiences of World War II, the interviewed leaders first highlighted the essentiality of sincere apology. Their perceptions of peace stressed committed reconciliation based on multiangled learning, the voice of civil societies, kyousei or co-living based on diversity, collaboration and trust, and the development of belonging and worth. Peace goes beyond an absence of war. Their perspectives on globality included philosophy that goes beyond national boundaries, the local-global dualism, and the objective look of the Earth and human behaviors. Findings revealed the influence of peace and globality perceptions on lived experiences, leadership styles, and organizational practices: structure, system, culture and climate.

Committee: Emmanuel Jean Francois (Committee Chair); Barbara Trube (Committee Co-Chair); Diane Ciekawy (Committee Member); Dwan Robinson (Committee Member) Subjects: Educational Leadership

Master of Arts, The Ohio State University, 2017, Art

There is a relationship between lived experience and the documentation of lived experience. This relationship is complicated. It leaves me curious. I am exploring the image's role in explaining events, its role in addressing narrative, how it aims to regenerate experience, how it acts as a desired conduit for something much greater, and how it can be used to translate these complicated charges. I am engaged in questions surrounding time, memory, sentimentality, nostalgia, loss, sincerity, narrative, and connection.

Committee: Dani Leventhal (Committee Chair); Paulsen Kris (Committee Member); Thorne Jared (Committee Member) Subjects: Art Criticism

Doctor of Education (EdD), Ohio University, 2016, Educational Administration (Education)

The superintendency is the most male-dominated position in education (Alston, 2000; Brunner, 2000). Statistical data report disproportionality in the number of African American women who have obtained superintendency. Women, particularly African American women, have continued to obtain certification and fulfill degree requirements, yet often do not ascend to the position of superintendency (Glass & Franceschini, 2007). This research study focuses on the phenomenon of the underrepresentation of African American women in the position of superintendency. This qualitative study examined the lived experiences of six African American females in the role of K-12 public superintendent. Three research questions guided the study and were centered around the participants' perceptions of superintendency, the impact of race and gender on their role and strategies for the aspiring superintendent. The study was conducted through the use of semi-structured interviews with African American women superintendents in the United States. Bandura's theory, critical race theory and Black feminist thought were utilized as frameworks to better understand participants' lived experiences as superintendents. The results of the study yielded three emergent themes: (a) stereotypes, (b) positionality and (c) mentorship relationships. Through the voices of study participants, their experiences as public school superintendents provide a comprehensive perspective for aspiring superintendents, hiring consultants, school boards, educational leadership programs and policy makers.

Committee: Yegan Pillay (Advisor) Subjects: African Americans

EdD, University of Cincinnati, 2012, Education, Criminal Justice, and Human Services: Urban Educational Leadership

According to Bennis (2003), “True leaders are not born, but made, and usually self-made” (p. 33). The purpose of this study was to identify and examine what factors influenced and limited the opportunities of African American females to obtain and maintain leadership roles in administrative positions at urban schools and the value of supporting diversity in leadership. This researcher believed that AA female leaders rely on their own personal-lived experiences to develop a leadership style that compliments how she handles the day-to-day protocols of her demanding and volatile job. Additionally, research and experiences about AA female leadership is scare and in dire need of more attention (Allen, Jacobson, & Lomotey, 1995; Alston, 2005; Bloom & Erlandson, 2003; Dillard, 1995, Hill-Collins, 2000). AA female leaders appear to be in a sphere of pressured situations based on social, economic, political, and moral concerns that collectively challenge the way she develops her educational environment in order to create a didactic environment that becomes an effective, successful, and high-achieving academic setting for the students, teachers, and staff. This research study examined the leadership style of a small subset of three (3) AA female elementary principals, ranging from ages 35-43, in a large urban school district. This study utilized a qualitative approach and was situated in an epistemology of Black Feminist Theory and Transformational Leadership that investigated how gender, race, age, personal-lived experiences, mentors, culture, spirituality, and other social inequalities might affect their leadership decisions and influence their urban educational experiences.

Committee: James Koschoreck PhD (Committee Chair); Michael Dantley EdD (Committee Member); Vanessa Allen-brown PhD (Committee Member); Lanthan Camblin PhD (Committee Member) Subjects: Educational Leadership

EdD, University of Cincinnati, 2008, Education : Literacy

A teacher's lived experiences are important in shaping her subsequent practices in the classroom. Teachers must look at the connections between those experiences, their identities, and classroom practice. The foundation for my research is built on history's record of education's effects on Black people. My own identities, the tenets of culturally relevant pedagogy, my efforts to attain classroom praxis, and an autoethnographic account of my lived experiences and how they have shaped my pedagogy, lend structure to both the project and this narrative. This research offers a critical reflection from a Black feminist perspective as a prelude to creating a classroom where students are taught using culturally relevant pedagogical strategies.By incorporating each of these elements, I have been able to identify myself as a woman, a feminist, and a scholar. Within this frame, I am free to explore, to learn, and to grow with the students in my care. Together, we are able to learn from one another (as advocated by culturally relevant pedagogy) and to examine ourselves and our experiences critically (as advocated by Black Feminist Theory). Additionally, this offers me both an opportunity and an incentive to examine myself – my identities, my classroom praxis, and the confluence of those present elements with my lived experiences in what is termed Reflexive Culturally Relevant Pedagogy (RCRP): truly, it offers me an opportunity to achieve a better teaching identity and a better self.

Committee: Chester Laine PhD (Committee Chair); Mary Ann Pitman (Committee Member); Mark Gooden (Committee Member); Deborah Hicks (Committee Member); Helen Meyer (Committee Member) Subjects: Education; Literacy

Doctor of Philosophy, The Ohio State University, 2010, Social Work

Multiple health and psychosocial needs are associated with the Human Immunodeficiency Virus (HIV) infection and Acquired Immunodeficiency Disease Syndrome (AIDS). Persons living with these medical conditions are in need of assistance in many areas of their lives. Therefore, case management services are utilized to support most of this population. Although several studies have reviewed case management service delivery, most of these studies focus on conceptualization of case management and clients' outcomes rather than the actual practice of case management. Yet, within the health and social service delivery system, case managers play crucial roles in assisting the diverse needs of persons living with HIV/AIDS (PLWHA). This research, therefore, was done to explore the perceptions and lived experiences of social work case managers offering services to PLWHA. Qualitative research methods in a grounded theory approach were used to collect data through semi-structured interviews with thirteen adult social work case managers of the Ryan White Care Program in one public health setting, one hospital, and two community based organizations in a metropolitan area of a Midwest state. Themes that emerged from the analysis of data were: 1) defining the role of the case manager; 2) challenges with clients; 3) challenges with formal organizations; 4) recommendations for improving case management service delivery; and lastly, 5) satisfaction and rewards of the job. The results have implications for improvement of case management service to PLWHA.

Committee: Bette A. Speziale Ph.D (Committee Chair); Curtis Carla Ph.D (Committee Member); Randi Love Ph.d (Committee Member) Subjects: Social Work

Master of Arts (MA), Ohio University, 2005, Sociology (Arts and Sciences)

This research is an adaptation of Sharon Hays' study of the real lives of low income single mothers. While Hays' study took place in an urban area, the current study was completed in a rural locale. Hays' research demonstrates that we need to look past stereotypes and cultural misconceptions, about the poor in America, if we are to learn how to effectively help single mothers overcome poverty, make ends meet, and provide a better life for their children and themselves. The goal of this study was to build upon Hays' research by gaining a broader and more complete understanding of the real lives of all single mothers through the examining of the life experiences of rural Appalachian single mothers, an often invisible group of single mothers. This research suggest that (1) stereotypes of Appalachian single mothers are hindering the development of effective and appropriate poverty policy, (2) Appalachian single mothers face regional specific obstacles to making ends meet, and (3) there are differences in the single mother population that spatial inequality cannot account for which needs to be addressed in poverty policy.

Committee: Debra Henderson (Advisor) Subjects: Sociology, Public and Social Welfare

Master of Science (MS), University of Toledo, 2006, Nurse Educator

The purpose of this study was to discover the lived experience of women with first-time myocardial infarction. Van Manen's (1990) phenomenological method of human science guided the data collection and analysis. Watson's (1979, 1985, 1988, 1999) nursing theory was the conceptual framework. Three themes emerged and are synthesized in an exhaustive description of the phenomenon. Exhaustive Formalized Description of Phenomenon Loss and disharmony of the old self or pre-myocardial infarction elicited the process of grief as a coping response. Integration of experiences promotes change and restoration of harmony as a new integrated self is developed and sustained. Intentional caring transactions foster the integration of experience, change, and self-healing that promotes self-knowledge and inner strength to make choices in health-illness decisions.

Committee: Joanne Ehrmin (Advisor) Subjects: Health Sciences, Nursing