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Medicine and Health Sciences

Theses/Dissertations

2016

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Exploring The Lived Experiences Of Daughters/ Daughters-In-Law Providing Primary Informal Care To Their Mothers/ Mothers-In-Law With Dementia, Sarah Macfarlane Dec 2016

Exploring The Lived Experiences Of Daughters/ Daughters-In-Law Providing Primary Informal Care To Their Mothers/ Mothers-In-Law With Dementia, Sarah Macfarlane

Theses and Dissertations (Comprehensive)

Abstract

Objective

As the senior population in Canada rises, more middle aged residents of Canada will find themselves taking on a caregiving role, often times for a parent with dementia. This research examines the lived experiences of daughters/daughters-in-law providing primary informal care to their mothers/mothers-in-law with dementia in order to understand the motivations, effects, and transitions within caregiving relationships.

Methods

Phenomenology was the theoretical orientation used to guide this research and captured individuals’ lived experiences. Background questionnaires were administered initially, followed by one-on-one semi-structured interviews which were transcribed verbatim upon completion for data analysis. Field notes, member checks, and triangulation …


Dichotic Listening Test Performance In Children, Kairn Stetler Kelley Dec 2016

Dichotic Listening Test Performance In Children, Kairn Stetler Kelley

Graduate College Dissertations and Theses

Dichotic tests evaluate binaural integration through simultaneous presentation of different stimuli to each ear of a listener who has normal hearing sensitivity in both ears. Dichotic listening deficits may lead to problems with language, communication, reading, or academic performance. If accurately identified, dichotic deficits may be treatable with listening training or managed with accommodation. However, it is not clear which of several commercially-available dichotic test recordings are best for audiologists to use when assessing binaural integration in children. Literature review revealed limited evidence of reliability, accuracy, usefulness, or value for dichotic tests applied to children. Of 11 dichotic tests identified, …


Stroke Outreach In The Lao Community, Noor A. Dythavon Dec 2016

Stroke Outreach In The Lao Community, Noor A. Dythavon

Master's Projects and Capstones

CNL Abstract

A community health needs assessment for the service area prompted concern regarding access to quality healthcare for non-English speaking Southeast Asians (SEA) in the area. Goals of an initial investigation and subsequent implementation of sustainable stroke health fairs for non-English speaking communities were evaluated to assess primary healthcare concerns that the SEA community face and to suggest long-term solutions to these issues. Initial investigation required researching population-specific minority health statistics to quantify the prevalence of chronic diseases and conditions which were prioritized in terms of needs versus disparities. Research came from evidence base practice guidelines and personal concern …


Exploring Knowledge, Beliefs And Practices Of Radon Gas Exposure Among Public Health Workers, Paschal Nwako Dec 2016

Exploring Knowledge, Beliefs And Practices Of Radon Gas Exposure Among Public Health Workers, Paschal Nwako

Seton Hall University Dissertations and Theses (ETDs)

Radon gas exposure is the highest cause of lung cancer among people that never smoked in the United States. People exposed to elevated levels of radon had a higher risk of developing lung cancer. Achieving the long term goal of the Indoor Radon Abatement Act (IRAA) of 1988 require a combined efforts of government agencies. Public health workers are change agents and their role in protecting and improving the health of their communities are well documented. This study created and utilized a multi question survey, the Public Health Workers Radon Assessment Instrument (PHWRAI) to explore knowledge, beliefs, personal and professional …


Sexual Behavior And Substance Use Among Women Across The Spectrum Of Sexual Orientation, Margaret M. Wolff Dec 2016

Sexual Behavior And Substance Use Among Women Across The Spectrum Of Sexual Orientation, Margaret M. Wolff

Dissertations and Theses

Background: Compared to non-sexual minority women, sexual minority women are at greater risk for substance use and abuse, sexual risk behaviors, and unplanned teen pregnancy; few studies measure differing associations by sexual orientation (e.g., identity, behavior, attraction) or discordance (e.g., heterosexually-identified women with female partners) components. Minority stress may explain sexual minority women’s health disparities; thus, as U.S. policies evolve to reflect growing acceptance of all sexual minorities, research should examine sexual minority women’s health risk behaviors using multidimensional constructs of sexual orientation.

Methods: Using the female sample of the 2002-2013 National Survey of Family Growth (Aims 1-2 n=25,523; …


Feasibility Study For Rural Health Clinic, Cynthia A. Noble Dec 2016

Feasibility Study For Rural Health Clinic, Cynthia A. Noble

Doctor of Nursing Practice Scholarly Project

An Abstract of the Scholarly Project by

Cindy Noble

The purpose of this study was to determine the feasibility of a rural health clinic in the Adair, Oklahoma area. A mixed-mode survey was sent to 2,890 households within a certain zip code for the Adair community and surrounding area. A link for the survey was also included so the survey could be accessed on line. The total number of surveys returned was 88. The respondents of the survey did show a willingness to use healthcare clinic if one were available in Adair, Oklahoma. The surveying also showed that the majority …


Using Community Health Workers In Collaboration With Nurse Case Managers In Effecting Change In Quality Of Life For Heart Failure Patients, Patra Hull Reed Dec 2016

Using Community Health Workers In Collaboration With Nurse Case Managers In Effecting Change In Quality Of Life For Heart Failure Patients, Patra Hull Reed

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

This project was designed to evaluate the effectiveness in improving the quality of life among heart failure patients with the addition of the role of Community Health Worker (CHW) to a current continuum case management model. The study also addressed the increased need for more appropriate and cost-effective chronic care management for heart failure patients. Hospitals and healthcare systems are being challenged to find innovative ways to decrease readmissions, decrease unnecessary emergency room visits, increase patient adherence, and manage chronic disease, all improving the patient’s overall quality of life. Studies show that approximately 76% of heart failure patients have a …


Self-Care Practices For Dance/Movement Therapy Student Interns: A Multifaceted Toolbox, Stephanie N. Terrell Dec 2016

Self-Care Practices For Dance/Movement Therapy Student Interns: A Multifaceted Toolbox, Stephanie N. Terrell

Creative Arts Therapies Theses

The purpose of this project was to create tools for self-care practices that help second year dance/movement therapy (DMT) students at Columbia College Chicago cope with possible risks encountered within clinical practice. The importance of developing effective self-care habits for practitioners in therapeutic professions is emphasized in literature, and it is encouraged that this self-care practice is developed during a student’s graduate training experience. Literature in the areas of therapists’ self-care practices, counselor development, burnout, compassion fatigue, countertransference, somatic countertransference, therapist distress, and vicarious traumatization are reviewed. A product development methodology was used, the Eight Stage-Gate Process for New Product …


Being In Relationship: The Experience Of A Female Dance/Movement Therapy Intern On A Male Residential Unit For Sexually Problematic Behaviors, Krista Tyner Dec 2016

Being In Relationship: The Experience Of A Female Dance/Movement Therapy Intern On A Male Residential Unit For Sexually Problematic Behaviors, Krista Tyner

Creative Arts Therapies Theses

This study serves to explore the experience of a female dance/movement therapy intern working with males on a residential unit for sexually problematic behaviors. It enlightened me on how it was to be in relationship with them, through both a mind and body therapeutic lens. It addresses stereotypes and preconceived notions pertaining to this population. The questions attempted to be answered were as follows: How is it to be in relationship with males who are on a residential unit for sexually problematic behavior, as a female dance/movement therapy intern? How do I experience male/female relationships, gender, and sexuality on the …


Implementing Post-Hospital Interprofessional Care Team Visits To Improve Transitions Of Care And Decrease Hospital Readmission Rates, Stacy M. Baldwin Dec 2016

Implementing Post-Hospital Interprofessional Care Team Visits To Improve Transitions Of Care And Decrease Hospital Readmission Rates, Stacy M. Baldwin

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

Background: Today’s healthcare climate is comprised of a population of patients who are more complex, presenting with multiple comorbidities, and requiring frequent hospitalizations. It is imperative for acute care and primary care landscapes to bridge silos and form collaborative relationships to ensure safe and effective transitions of care from hospital to home. An interprofessional, post hospital follow-up clinic is one approach that can be utilized to improve transitions of care and decrease preventable hospital readmissions.

Purpose: The purpose of the project's discharge clinic was to improve transitions of care and decrease thirty day hospital readmission rates. The primary objective of …


Segregation Or Integration: Exploring The Interprofessional Collaboration Of The Sexual Assault Response Team-A Pilot Study, Phyllis E. Adams Dec 2016

Segregation Or Integration: Exploring The Interprofessional Collaboration Of The Sexual Assault Response Team-A Pilot Study, Phyllis E. Adams

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

The Sexual Assault Response Team (SART) has been functioning since the early 1970’s with little research on the dynamics of the members’ interprofessional collaboration practice. A current gap in the literature is research specific to the assimilation of the disciplines within the SART and the collaborative practice of the SART. The purpose of this project study is to clarify the 12 subscales of Interprofessional Collaborative Practice (motivation, role expectations, personality style, professional power, group leadership, communication, coping, social support, organizational culture, organizational aims, organizational domain, and organizational environment) and explore how each profession perceives these subscales. The sample participants were …


Improving Provider Compliance Of The Naepp 2007 Asthma Guidelines Through The Electronic Health Record (Ehr) In A Pediatric Primary Care Practice, Tiffany L. Kidd Dec 2016

Improving Provider Compliance Of The Naepp 2007 Asthma Guidelines Through The Electronic Health Record (Ehr) In A Pediatric Primary Care Practice, Tiffany L. Kidd

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

The Expert Panel Report -3 (EPR3) NAEPP 2007 evidence-based clinical asthma guidelines were developed to provide evidence-based high-quality patient care that leads to improved outcomes. A literature review showed that healthcare providers do not routinely follow the asthma guidelines. The purpose of this project was to develop and implement an evidence-based asthma electronic health record (EHR) template in a pediatric office to improve provider compliance to the guidelines resulting in improved outcomes for children with asthma. The study was conducted over a period of four months from January - April 2016. An EHR asthma protocol template and training for providers …


Hemostatic Responses To Exercise In A Polycythemia Vera Patient, Allison M. Huschke Dec 2016

Hemostatic Responses To Exercise In A Polycythemia Vera Patient, Allison M. Huschke

Senior Honors Projects, 2010-2019

PURPOSE: To assess the hemostatic responses to exercise in a patient with Polycythemia Vera (PV). METHODS: Six female runners (≥15 miles/week) completed a maximal treadmill test. One subject had PV while the other five subjects made up the comparison group. Blood samples were taken before and within two minutes after exercise. VO2max was also recorded. RESULTS: Pre-exercise Factor VIII and tPA-antigen were similar in the PV subject and comparison group. Factor VIII and tPA-antigen increased dramatically in the PV subject (+100%, +1000%) in relation to the comparison group (+22.9 ± 8.7%, +108 ± 78%) after exercise. Pre-exercise PAI-1 was lower …


Tobacco Use, Cessation, And Locus Of Control Among College Students, Bernard Ambe Dec 2016

Tobacco Use, Cessation, And Locus Of Control Among College Students, Bernard Ambe

Electronic Theses and Dissertations

ABSTRACT

The purpose of this study was to (a) determine the locus of control among American college students (b) determine if tobacco use or cessation correlate with any demographic variables to better understand the efficacy of tobacco interventions and help design an intervention most effective in the prominent LOC of college students.

The Global Adult Tobacco Survey (GATS) was modified for the purposes of this study and used to determine demographic factors and tobacco usage status. The modified GATS survey also included the LOC questionnaire which yielded the data. Seventy-four responses were recorded. The mean locus of control scores were …


Burnout In Radiation Therapy: Examining The Six Leading Influences, Gina C. Passmore Dec 2016

Burnout In Radiation Therapy: Examining The Six Leading Influences, Gina C. Passmore

All Theses And Dissertations

Recent studies are highlighting the dangers of burnout amongst healthcare workers, including radiation therapists. Since burnout is associated with an increase in medical errors (Sanchez-Reilly, 2013), it affects both the well-being of the patient and patient satisfaction scores, which are important to a hospital’s reputation. Burnout has a positive correlation with job dissatisfaction and increased employee turnover, making it both a financial and quality issue. Organizations acknowledge that burnout leads to unhappy employees, and unhappy employees are less likely to be engaged in their work, thereby not producing the best “products” (Sehlen, 2009). By examining which components seem to be …


Ihss: Repackaging Consumer Information, Deloras N. Puran Dec 2016

Ihss: Repackaging Consumer Information, Deloras N. Puran

Master's Projects and Capstones

Currently, qualified Californians with disabilities and aging individuals can receive consumer-directed care through the IHSS program. Despite the strong demand for the program, new consumers are still struggling to begin their service after enrollment.

This study assisted San Francisco In Home Supportive Services Public Authority to understand how new consumers can navigate the IHSS program services after enrollment. Focus group and semi-structured in-depth interviews were conducted to gather feedback from consumers regarding what type of information would they need after enrollment, and how would they want to receive the information. Based on the feedback, written and virtual deliverables were designed …


Identification And Intervention For Action Planning Deficits In Children With Hemiplegic Cerebral Palsy, Swati M. Surkar Dec 2016

Identification And Intervention For Action Planning Deficits In Children With Hemiplegic Cerebral Palsy, Swati M. Surkar

Theses & Dissertations

The primary purpose of this investigation was to describe and quantify action-planning deficits during goal-directed movements in children with hemiplegic cerebral palsy (HCP). Three specific topics were addressed: brain activation, kinematics, and the use of visual input. First, we assessed prefrontal cortex (PFC) activation during complex goal-directed actions in children with HCP. The outcome suggested that children with HCP have higher PFC activation than age matched typically developing (TD) children during action planning, potentially due to the difficulty in allocating attentional resources for simultaneously processing the cognitive (i.e., attention, memory, information processing) and motor demands of the goal-directed task. Reduced …


Self-Disclosure Among Male Survivors Of Child Sexual Abuse: Service Providers’ Perspective, Marudan Sivagurunathan Dec 2016

Self-Disclosure Among Male Survivors Of Child Sexual Abuse: Service Providers’ Perspective, Marudan Sivagurunathan

Electronic Thesis and Dissertation Repository

Previous research regarding child sexual abuse (CSA) indicates significant gender differences in disclosure rates: specifically, males are less likely to disclose their child sexual abuse in comparison to females. CSA can have lasting impact on a child’s emotional, physical, and psychological wellbeing. Trauma studies show support and early intervention is necessary for CSA survivors to re-establish a sense of safety and to experience better quality of life. Service providers play a key role in providing care and support for male CSA survivors. However, little is known about service providers, who work with male CSA survivors, and their perceptions and attitudes …


Behavioral Care For Children In Urban And Rural Integrated Primary Care, David I. Taylor Dec 2016

Behavioral Care For Children In Urban And Rural Integrated Primary Care, David I. Taylor

Theses & Dissertations

Mental, emotional, and behavioral issues in children are a significant concern for the children, their families, and society. Despite the existence of evidence-based treatments, the success of behavioral healthcare to meet the needs of these families will require high quality communication and relationships across a wide range of stakeholders. Integration of care represents a patient-centered strategy to unify these stakeholders into a single cohesive care team. The purpose of this dissertation is to define the behavioral healthcare team in integrated primary care for children in terms of the functional roles involved and to evaluate the quality of relationships and communications …


Educational Needs Of Nurses For Wound Care, Stephanie Adee Dec 2016

Educational Needs Of Nurses For Wound Care, Stephanie Adee

Doctor of Nursing Practice Scholarly Project

The purpose of this study was to conduct a needs assessment of registered nurses’ knowledge base and attitudes toward wound care and to be able to customize a wound assessment tool to meet those needs. The visual assessment is an essential part of wound care and performing accurate assessments can lead to making the correct diagnosis, starting appropriate treatment timely, and discharging patients sooner. There are over five million patients suffering from chronic wounds and more cases are added yearly. The nurses need a tool to assist them in their daily assessments. This study utilized an anonymous survey of 23 …


Improving Provider Knowledge In The Evaluation, Diagnosis, And Treatment Of Adhd, Amanda L. Swink Dec 2016

Improving Provider Knowledge In The Evaluation, Diagnosis, And Treatment Of Adhd, Amanda L. Swink

Doctor of Nursing Practice Scholarly Project

Pediatric diagnosis of attention deficit hyperactivity disorder (ADHD) is on the rise with an increasing financial burden to the healthcare system and the patient (Center for Disease Control, 2015). This study sought to determine if an educational intervention would increase the knowledge of primary care providers in respect to ADHD clinical practice guidelines and the diagnosis and treatment of pediatric patients. An initial online survey was administered to primary care nurse practitioners in an attempt to determine their knowledge level, provider feelings and current practices in regards to pediatric ADHD in this region. Approximately four weeks after the online survey, …


Diabetes Self-Management Education: A Rural Health Development, Ashleigh A. Heter Dec 2016

Diabetes Self-Management Education: A Rural Health Development, Ashleigh A. Heter

Doctor of Nursing Practice Scholarly Project

The purpose of this Scholarly Project was to explore the need for a Diabetes Self-Management Education (DSME) Program in a rural health community in Southeast, Kansas (SEK). Statistics in Crawford County reveal that 10% of the population has been diagnosed with type 2 Diabetes Mellitus (T2DM) and a rising number of patients that are classified as obese. Without serious interventions many of these patients will develop T2DM. DSME programs provide essential skills and resources for patients to maintain glycemic control and reduce risks associated with this life-long disease. This study utilized data from fifty T2DM patients in the SEK area. …


Creating Healthy Urban Environments: Commercial Landscaping, Preference And Public Health, Mary Leibe Dec 2016

Creating Healthy Urban Environments: Commercial Landscaping, Preference And Public Health, Mary Leibe

University of New Orleans Theses and Dissertations

Landscape development[1] can provide many benefits, including the reduction of stormwater runoff and the creation of habitats for wildlife. It can also provide health benefits. Researchers, such as Roger Ulrich and Rita Berto have demonstrated that views of trees and other vegetation are associated with lower blood pressure and reduced recovery times in hospitals and that environments with more natural elements may lessen mental fatigue (R. Ulrich 1984) and (Berto 2005).

As rebuilding in New Orleans continues 11 years after Hurricane Katrina, landscape development has been limited or lacking, especially in the redevelopment of commercial properties. Two prominent reasons …


Inside The Juvenile Justice System, Megan Phalon Dec 2016

Inside The Juvenile Justice System, Megan Phalon

Master's Projects and Capstones

The United States of America is known for freedom and integrity and being a nation that stands for justice and equality for all. Within the United States there are systems in place to better the people and communities in order to provide safety and order. However, just as any nation, there is a struggle with violent behavior and tendencies among adults and adolescents. Within the last three decades, the United States has created a correctional system that specifically targets adolescents, and that acknowledges the differences between adult and juvenile development and deviant behavior. Within this literature review, academic databases were …


Mental Health Workout: Lifting Stigma, Jeremy Bambery Dec 2016

Mental Health Workout: Lifting Stigma, Jeremy Bambery

Master's Projects and Capstones

Mental illness affects one out of every five Americans between the ages 13-18, and it is estimated that two-thirds of these individuals will not seek treatment due to the stigma associated with having a mental illness or mental health issue (National Alliance on Mental Illness). Access to information and the ability to talk openly without fear will aid in creating a stigma free future. The goal of this project is to supply high school students in the San Francisco Bay Area with information regarding the stigma associated with mental health and mental illness via videos that will be used as …


Increasing Patient Satisfaction And Decreasing Hospital Readmission Due To Deep Venous Thrombosis By Providing Anticoagulation Education For Orthopedic Patients, Margaret Gniewosz Dec 2016

Increasing Patient Satisfaction And Decreasing Hospital Readmission Due To Deep Venous Thrombosis By Providing Anticoagulation Education For Orthopedic Patients, Margaret Gniewosz

Master's Projects and Capstones

Abstract

Improving Process on Oral Anticoagulant Education for Orthopedic Patients

The aim of this project is to improve anticoagulation education for orthopedic patients to increase patient satisfaction. The microsystem for this project is a medical-surgical (MS), 50-bed unit in a medium size hospital. Because orthopedic patients are at high risk to develop DVT postoperatively, proper anticoagulants and anticoagulation education is an important aspect of patient care. By implementing a well-designed and easy-to-read patient handout on anticoagulants with instructional script for nurses will empower patients to achieve higher level of anticoagulant knowledge and in result, increase patient satisfaction. A preliminary round …


Vitamin D, Calcium And Blood Pressure In The U.S., Sarah Bean Dec 2016

Vitamin D, Calcium And Blood Pressure In The U.S., Sarah Bean

Master's Projects and Capstones

Vitamin D and calcium have received increased attention for their potential roles in improving cardiovascular health. The active form of vitamin D, 1,25-hydroxyvitamin D (25[OH]D), may influence blood pressure by increasing gastrointestinal calcium absorption. The objectives of this study were to first examine the association between blood pressure and blood serum 25(OH)D levels, and then explore the interaction between 25(OH)D, calcium intake, and blood pressure. Cross-sectional analysis featured 24,844 U.S. adults aged 20-80 years from three cycles of the National Health and Examination Survey (NHANES 2001-2006). Linear regression models were used to determine the adjusted association of 25(OH)D categories with …


The Development, Implementation, And Evaluation Of A Transgender Health Resource Bundle, Lovejeet Kaur Dec 2016

The Development, Implementation, And Evaluation Of A Transgender Health Resource Bundle, Lovejeet Kaur

Doctor of Nursing Practice (DNP) Projects

Transgender populations experience disproportionate social and health disparities that can negatively impact quality of life. Healthcare barriers due to gender based discrimination and lack of medical insurance and culturally competent providers contribute to low levels of access to preventative health care screenings, resulting in sub-optimal health outcomes. The unique health circumstances of transgender individuals have been understudied in the literature. As a result clinicians are often under-informed of their specific health maintenance needs and screening guidelines. To help address this disparity, a Doctor of Nursing Practice (DNP) student at the University of San Francisco facilitated the collaborative assessment, development, implementation …


Nursing Student Work-Study Internship: Partnering To Bridge The Education-To-Practice Gap, Jonalyn M. Wallace Dec 2016

Nursing Student Work-Study Internship: Partnering To Bridge The Education-To-Practice Gap, Jonalyn M. Wallace

Doctor of Nursing Practice (DNP) Projects

Abstract

Discussed for decades, the need for transitional experiences bridging educational and practice settings gained momentum in the mid-1970s with the release of Kramer’s groundbreaking book Reality Shock: Why Nurses Leave Nursing. Nursing student internship programs were developed in the 1970s as one effort to address this issue. The Northern California Region of Kaiser Permanente partners with five universities to conduct the Nursing Student Work-Study Internship Program (WSP). The program provides senior level nursing students with a paid internship in clinical practice settings, working under the supervision of RN preceptors. The aim of the program is to improve the …


Exploration Of Factors Affecting Nurse Faculty Use Or Resistance To Online Education, Lisa M. Harless Dec 2016

Exploration Of Factors Affecting Nurse Faculty Use Or Resistance To Online Education, Lisa M. Harless

Nursing Theses and Dissertations

The substantial increase in online nursing program enrollment demands that nurse educators be adept in the delivery of online education; however, a significant challenge exists in how to deliver practice-based nursing education in the online environment. Teaching online requires a change in the traditional role of the educator accompanied by the effective use of online learning technologies. Some studies suggest that faculties remain pessimistic to online delivery of education and do not participate, yet few objectively examine variables that influence resistance or use. Included in this dissertation are two manuscripts. The first manuscript defines resistance and addresses prominent concerns associated …