Digital Commons Network^™

The Efficacy Of Analgesic Subdissociative Dose Ketamine In Trauma Casualties Treated By U.S. Military Special Operations Medical Professionals In A Prehospital Environment, Darin Schwartz

Theses & Dissertations

Research Focus. This study’s main objective was to determine the efficacy of sub-dissociative ketamine to reduce the pain of trauma casualties treated by U.S. military medical professionals in a prehospital environment evidenced by the 0–10 numeric rating scale (NRS) for pain. Research Methods. This quantitative study was accomplished using a pragmatic approach integrating social cognitive theory complemented by mixing methods using qualitative phenomenological influence through narrative inquiry. This exploratory retrospective, cross-sectional study, utilizing a quasi-experimental pretest-posttest design, used deidentified sample data (N = 47) for secondary analysis from U.S. Special Operations medical providers and were included in a casualty …

U.S. Army Physician Assistant Retention: A Latent Class Analysis, Robert Greener

Theses & Dissertations

Introduction: Retaining employees is crucial to the success of organizations. While significant effort has been made to model employee retention, models have been unable to significantly predict retention. The purpose of this quantitative, non-experimental, cross-sectional study was to develop an improved employee retention model which could be used as a practical guide to improve employee retention. Materials and Methods: The study analyzed a survey created, implemented, and collected by the Statistical Cell at the U.S. Army Center of Excellence. In September of 2020, all 864 active-duty PAs were sent a link to the survey and 290 completed the survey, …

Effect Of Protein, Fat, And Both Protein And Fat On The Glycemic Response Of A High Glycemic Index Meal, Muhammed Taai

Theses & Dissertations

Research Focus: Elevated blood glucose (BG) levels from a diet high in refined carbohydrates, even in the absence of diabetes, may increase the risk for chronic diseases including cardiovascular disease, type 2 diabetes, and obesity. The purpose of this study was to determine if supplementation of a high glycemic load breakfast with protein, fat, or a combination of the two attenuates the glycemic response in non-diabetic subjects.

Research Methods: Thirteen healthy adults, age 24.7±4y, BMI 25.1±4.5 completed four trials, having fasted 8-12h for this randomized, double-blind crossover study.

Fasting BG was measured, then subjects consumed 2 slices of white …

Affordable Care Act And Preventive Care Usage: A Mixed Method Analysis Of Cardiovascular Care, Brit Peek

Theses & Dissertations

It is a commonly held belief that access to health insurance affects the level of utilization of preventive care services, and thus plays a crucial role in the effective management of avoidable chronic illnesses, decreasing levels of premature mortality, and enabling individuals to live wholesome long lives. Based on this belief, among other goals, the Affordable Care Act (ACA) was designed to increase access to health insurance and related medical services for the population of the United States. This dissertation attempts to identify whether this belief is valid or not by testing whether the usage of preventive care changed between …

Preventive Healthcare Usage In The United States: Does Health Insurance Matter, Diane Rodriguez

Theses & Dissertations

The Centers for Disease Control in the United States has maintained that adults who avoid preventive care services are more likely to suffer from long term chronic diseases because they are not addressed or treated in a timely manner. Examining the effects of providing access to healthcare to uninsured adults and increasing preventive services can help in reducing chronic diseases and enable adults to live longer, healthier lives. The purpose of this study was to identify the relationship between the utilization of preventive health services and socioeconomic factors such as insurance status, race/ethnicity, household income, marital status, education, gender, age, …

Nursing Leaders’ Ethical Decision-Making About Professional Boundaries And Nurse-Patient Relationships: A Mixed Methods Explanatory Sequential Design, Pamela Scott

Theses & Dissertations

The purpose of this mixed methods explanatory sequential design study was to ascertain nursing leaders’ knowledge and skill in ethical decision-making when evaluating and managing professional nurse-patient relationship boundaries. It was also the purpose of this study to better understand nursing leaders’ perception of moral, cognitive, and organizational factors influencing their ethical decision-making in evaluating and managing professional nurse-patient relationships, with the intent of generating a theory grounded in the views of the participants as a final outcome of the study. The two theories, virtue ethics and self-efficacy comprise the ethicality construct of the conceptual framework explaining the nurse leaders’ …

Primary Care-Related Emergency Department Use, Tiffany Wetz

Theses & Dissertations

Primary care-related emergency department use has become a focal point in the United States considering health reform and changes made to the delivery model and reimbursement mechanisms. Emergency departments serve as critical access points within the United States delivery system because important medical resources are made available for all members within the community. However, a gap in the literature exists due to a lack of consensus regarding factors that influence emergency department use for primary care-related health needs. The purpose of this study was to understand the relationship between demographic, social, economic, geographic, and need factors that influenced use of …

Teaching And Learning Courageous Followership: An Action Research Study, Karen Walker Schwab

Theses & Dissertations

Followership has been shown to be a developmental stage of leadership. Yet, there is a lack of followership theory in the health-care context. The purpose of this qualitative action research study was to explore how introducing Chaleff’s dimensions of courageous followership influences the undergraduate nursing students’ views of the follower role and informs their nursing practice. Secondary research questions asked how knowledge of these dimensions influences the nursing students’ views while advocating, collaborating, and addressing lateral violence. Using purposeful sampling, 12 participants were recruited for this study. After attending a followership seminar, they completed online reflections and participated in individual …

Effect Of Postprandial Walking On The Glycemic Effect Of A Meal: Type I Diabetes, Samantha L. Hinojosa

Theses & Dissertations

This study was conducted to determine if 15 minutes of postprandial light walking has an effect on the glycemic response to a Boost® beverage in individuals with type 1 diabetes. Seven participants, 22.3 + 4.3 yrs, with type 1 diabetes completed the two days of data collection. On day 1, participants measured baseline fasting blood glucose (BG) with a glucometer, consumed a Boost® beverage, and sat quietly, repeating BG measurements 15, 30, 60, 90, and 120 minute. On day 2, participants repeated the protocol, but walked 15 minutes at a light pace (50-60% max HR) immediately after beverage consumption. The …

Quality Improvement Programs’ Contribution To Successful Clinical Practice Changes, Erika O. Bowen

Theses & Dissertations

There is a great deal of healthcare literature on the importance of QI programs and the significant contributions they make toward patient safety and patient satisfaction; however, documentation of outcome measures and predictors of success remains challenging. This study examined the experiences of physician participants who attended a state supported South Texas medical school’s CSE course to gain an understanding of QI education, demonstrate the need for formal QI education, and determine if a change in clinical practice occurred as a result of attending a structured QI course. Kirkpatrick’s (1967) four-level evaluation model was used as a framework to guide …

Duty Hour Limitations And Educational Outcomes: Perspectives From A Community Hospital-Based Family Medicine Residency Program, Maria Eliza Marquise

Theses & Dissertations

In 2003, the Accreditation Council for Graduate Medical Education and the American Osteopathic Association introduced new models that established limits on residents’ duty hours in training programs across the United States (Miulli & Valcore, 2010; Philibert & Taradejna, 2011); more stringent limitations were implemented in 2011. If these physician training programs decreased the time residents’ spent in a formal learning environment and utilized experiential learning as one teaching method, did the duty hour limitations affect the residents’ learning outcomes? The purpose of this ex post facto, quantitative study was to determine if there were differences in ITE (In-Training Examination) scores …

Mentoring, Job Satisfaction, Job Dissatisfaction, And Organizational Commitment Among Graduate Nurses, Abisola Adeyomibo Santos

Theses & Dissertations

Shortage of bedside nurses has been researched for a long time. Many researchers have referred to different shortage percentages, but the American Nurse Association stated that the shortage of bedside nurses would increase in the range of 29% to 36% by 2020. It is also reported that a large number of newly graduated, newly hired nurses leave within one year as compared to newly hired experienced nurses. The purpose of this correlational study was to evaluate the influence of mentoring, mediating job satisfaction, job dissatisfaction, and, therefore, organizational commitment, on nurses who completed the nurse residency program between January 2010 …

Fall Prevention Among Older Adults Living In The Community, Clarissa Silva Lopez

Theses & Dissertations

Older adults are within the fastest population growth rate in the United States, and as the population ages, the potential for falls increases (DHHS, 2011). This was a mixed-method explanatory study that investigated the perceptions of older adults regarding the usefulness, adequacy, and positive experience of fall information among older adults living in the community when received from healthcare professionals during physician’s office visits. The research questions were: 1. What is the relationship among perceptions of usefulness, adequacy, and positive experience of fall information among older adults? 2. Is there a difference in the perceptions of usefulness and adequacy among …

An Assessment Of The Relationship Between The Hospital Chief Executive Officer’S Leadership Behaviors And Hospital Success, Newton J. Courtney

Theses & Dissertations

The health care delivery system in the United States has received increased attention over the last 2 decades. Concerns of access, choice, cost, and quality have been in the forefront. This study was conducted to assess the leadership behaviors of hospitals’ chief executive officers and how they impact the performance of hospitals. Two instruments were used to collect the data for the study: the Multifactor Leadership Questionnaire (MLQ-5X; Avolio & Bass, 2004) and a demographics questionnaire. A correlational research design was used to measure the degree of association between variables related to hospital CEOs, the hospitals they represented and hospital …

Correlating Coworker Relations, Employee Involvement, And Leadership With Associate Commitment In Select Healthcare Companies Using A Mixed Sequential Explanatory Design, Kimberly Ann Lee

Theses & Dissertations

Increasing patient demands and decreasing reimbursement require better efficiency and effectiveness in health care systems and, subsequently, in health care teams. These environmental and societal factors are further complicated by the complex initiatives set forth by the Affordable Care Act (2010). In this study, the researcher sought to examine and identify the strongest variables of health care teaming and to explore resulting themes through the perception of groups of health care associates. This mixed sequential explanatory design first examined the relationships between coworker relations, employee involvement, and leadership with associate commitment and with each other. An existing database of associate …

Homelessness: Relationships Between Program Completion At A Transformational Shelter And Mental Illness, Substance Abuse, And Trauma, Richard T. Mccutcheon

Theses & Dissertations

Each and every evening many people do not have a home to return to. Solving the epidemic problem of homelessness is an ongoing pursuit. Analyzing issues related to homelessness will help solve the problem of homelessness for some individuals and families. Data was gathered, prioritized and analyzed to determine correlations and relationships between completion of a transformational shelter’s program and mental illness, substance abuse, and trauma. Demographic variables were assessed as well. A person is more likely to complete the program if they have a substance abuse issue. Females are more likely than males to complete the program. Program completion …

Self-Efficacy In Type 2 Diabetics, Joan M. Hyett

Theses & Dissertations

There are 1.2 million diagnosed diabetics in Texas, 10 % of whom live in Bexar County, Texas. Diabetes is rated as the fifth leading cause of death in the same county. In addition to the diagnosed cases, it is estimated that 125,000 adults in Bexar County have undiagnosed diabetes (Foy, 1999). Diabetic education may prevent complications in some individuals, but sometimes knowledge alone is not enough. Patients often lack motivation or self-confidence in their capacity for self- management of their diabetes. Diabetic educators are often faced with the challenge of not only educating but also motivating patients to be compliant …

Stress Experienced By Respite Care Workers And Family Caregivers When Caring For Alzheimer's Patients, Monica D. Minewiser

Theses & Dissertations

Changing demographics and cost containment in health care in caring for the Alzheimer's Disease (AD) patient has given birth to a growing need for respite care workers. The purpose of the study was to determine whether the stress level of a respite care worker who works with an AD patient in a noninstitutionalized setting on a daily basis will be significantly less than that of a family caregiver when caring for an AD patient. The Revised Memory and Behavior Problem Checklist (RMBPC) was the instrument used to measure stress. This is a questionnaire consisting of 24 questions and allows 5 …

The Effectiveness Of A Preoperative Patient Education Handbook In Decreasing Anxiety Of Veterans Undergoing Elective Surgery, Garletta White Steen

Theses & Dissertations

The purpose of this experimental, pretest/posttest study was to examine the effectiveness of a preoperative patient education handbook developed by postanesthesia care unit (PACU) nurses in decreasing state anxiety of veterans undergoing minor elective surgery. State anxiety was measured by the State Anxiety Scale of the State-Trait Anxiety Inventory, developed by Spielberger, Gorsuch, Luschene, Vagg, and Jacobs (1983). The population for the study was composed of veterans undergoing elective surgery in a hospital which is part of the South Texas Veterans Healthcare System. The sample consisted of 38 patients admitted to the hospital for a variety of minor elective surgeries. …

The Impact Of A Health Education Program On The Attitudes Of African-American Hypertensive Clients Regarding Adherence To A Prescribed Medical Regimen, Teresa Y. Mcpherson

Theses & Dissertations

This quasi-experimental study examined the effect of an educational program on the attitudes of hypertensive African-American clients regarding their adherence to a prescribed medical regimen.

Despite increased public awareness and improved treatment in hypertension, poorly controlled hypertension continues to be a significant problem especially among blacks and other minority populations in the United States (Shea, Misra, Ehlich, Field, & Francis, 1991). On the basis of different experiences, people may form different beliefs and, therefore different attitudes about the consequences of performing or not performing a behavior (Ajzen & Fishbein, 1980). Studies have indicated that a variety of factors such as …

Spirituality Among Terminally Ill Hospitalized Adults And Healthy Non-Hospitalized Adults In A Military Environment, Richard M. Holt

Theses & Dissertations

The purpose of this study was to identify whether or not terminally ill hospitalized adults indicated greater spirituality and well-being than healthy non-hospitalized adults. Reed's (1986b & 1987) studies are the bases for this treaty although this is not a replicate study. The conceptual framework of this research is founded on the developmental life-span, and energy field patterns (Rogers, 1980) impacting spirituality and well-being. It was hypothesized that terminally ill hospitalized adults indicate greater spirituality than healthy nonhospitalized adults in a military environment. A terminally ill and healthy adult group of N=30, (n=15 each) were selected for a convenience sample. …