Date of Award



© 2015 Peter Fifield

Document Type


Degree Name

Doctor of Education (EdD)



First Advisor

Carey Clark

Second Advisor

Michelle Collay

Third Advisor

Steven Arnault


Treating chronic illness is becoming increasingly team based, yet most team building concepts relate to the team as a dichotomous unit: the medical team and the patient. Patients are expected to be “engaged” and “activated” members of the team, yet there is a gap in knowledge regarding how patients most effectively integrate into the team. Exacerbating the complexity of patient as team member is the multifaceted, ever-changing mood state of patients with co-occurring medical and mental health conditions. The medical field is well aware of the correlations between mental health and chronic illnesses. The purpose of this study is to investigate, from the patient’s perspective, what factors influence the patient’s sense of connectedness to the patient’s care team and how these factors mediate the patient’s positive health behaviors relative to self-care. Findings from a mixed-methods approach showed that the level of perceived confidence relative to self-care of chronic illness was mediated by the presence of a mental health diagnosis. Mixed-methods data also showed that high levels of patient confidence relative to self-care of their chronic illness had no statistical connection to patient’s increased sense of connectedness to their care team.


Ed.D. Dissertation