Date on Master's Thesis/Doctoral Dissertation

12-2025

Document Type

Doctoral Dissertation

Degree Name

Ph. D.

Department

Nursing

Degree Program

Nursing, PhD

Committee Chair

Hardin-Fanning, Frances

Committee Member

Nash, Whitney

Committee Member

Anderson, Debra

Committee Member

Buchino, Susan

Author's Keywords

Patient activation; psychological capital; case management; permanent supportive housing

Abstract

This dissertation explores patient engagement with health, or patient activation, in the formerly homeless population housed in Permanent Supportive Housing (PSH) and receiving case management support. Research is limited on patient activation in PSH residents; consequently, there is minimal understanding of factors contributing to one’s attitudes and behavior towards health care in this group. Psychological Capital refers to the components of hope, self-efficacy, resilience, and optimism. Research in other marginalized groups indicates increasing psychological capital may improve health behaviors. Case management provides support to PSH residents and forms of social support have been associated with improved health outcomes. Applying the Neuman Systems Model to the exploration of psychological capital and case management support to patient activation provides baseline data for these factors in the sample of 68 PSH residents in a Midwest city. In this study, higher psychological capital predicts higher patient activation, whereas case management support was not significantly associated with patient activation. Therefore, the modifiable state-like factor psychological capital has a role in predicting patient activation level. This is an area of potentially low-cost intervention to improve patient engagement with their health and thus impact long-term health outcomes.

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