Department of Conflict Resolution Studies Theses and Dissertations

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Date of Award

2025

Document Type

Dissertation - NSU Access Only

Degree Name

Doctor of Philosophy

Department

Halmos College of Arts and Sciences - Department of Conflict Resolution Studies

First Advisor

Elena Bastidas

Second Advisor

Robin Cooper

Third Advisor

Ismael Muvingi

Keywords

adolescents, advocacy, arts-based narrative inquiry, bias, care delivery, communication, community-based care, comprehensive care, conflict resolution, culturally sensitive healthcare, equity-focused care, healthcare access, healthcare justice, healthcare quality, healthcare systems, lived experiences, narrative reflection, psychosocial care providers, psychosocial factors, rural communities, sickle cell disease, Social Capacity Theory, supportive relationships, Systems Theory, systemic barriers, underserved populations, virtual interviews, visuo-textual analysis, young adults

Abstract

This qualitative, arts-based narrative inquiry explores the barriers and challenges to comprehensive care experienced by adolescents and young adult patients with sickle cell disease (SCD) in rural southeastern U.S. communities, incorporating perspectives from both patients and psychosocial care providers. Utilizing Social Capacity Theory and Systems Theory as theoretical frameworks, this study examines the psychosocial, structural, and systemic factors influencing healthcare access, quality, and justice. Data were collected through virtual interviews that integrated visual art creation and narrative reflection, enabling rich visuo-textual analysis of lived experiences. The findings reveal overlapping themes of systemic barriers, bias, isolation, and the critical role of supportive relationships and advocacy in care delivery. Divergences between patient and provider perspectives highlight the complexity of navigating rural sickle cell care. This study underscores the emotional toll on both groups and emphasizes the importance of conflict resolution approaches to enhance communication, trust, and collaboration within healthcare systems. The results inform recommendations for community-based, equity focused care models aimed at improving outcomes for this underserved population and advancing sustainable, culturally sensitive healthcare practices in rural settings.

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