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A Model Of Patient Satisfaction And Behavioral Intention In Managed Care, Diane Sturdy Greeneich Dnsc, Ms, Rn

Dissertations

Determination of patient outcomes associated with new and return business is a primary objective of the managed care marketplace. Identification of variables which contribute to both positive and negative patient experience in managed care systems is crucial to their effectiveness. The purpose of this study was to test the functional relationships between the variables of nurse practitioner attributes and behaviors, patient perceptions of the managed care system, and outcomes of patient satisfaction and intention to return to and recommend the managed care system. Functional relationships were measured with the Patient Satisfaction Semantic Differential (Greeneich and Long, 1992), and the Service …

A History Of The Concept Of Creativity In Western Nursing: A Cultural Feminist Perspective, Karen K. Fritz Dnsc, Ms, Ba, Rn

Dissertations

Using historical methodology, this study examined the concept of creativity in Western nursing from a cultural feminist perspective. An exploration of the concept was accomplished by means of a review emanating from the English literature of Western nursing and its allied disciplines of education and psychology. Two distinct views of creativity were delineated--the classical and the contemporary. The classical understanding required the completion of a major product or attainment in order for creativity to be ascribed. In contrast, the contemporary view was that of a novel, unrestrained thought process. It required no creative work or attainment for its ascription. The …

Care Of Aging Parents: The Experiences Of Middle-Aged Filipino Women, Carmen B. Toledo Galang Dnsc, Msn, Rn

Dissertations

The purpose of this study was to examine and analyze parent care as experienced by middle-aged Filipino women, particularly those who have resided in the United States for over 20 years. There is little information known about this topic; therefore, a grounded theory study design was utilized. Open-ended, semi-structured interviews of 29 Filipino women were conducted in English and/or Tagalog, and at times a combination of both languages. Data were transcribed verbatim from the audio-recorded interviews and analyzed using a constant comparative method of analytic induction. Field notes were kept and patterns of observation were analyzed according to their significance. …

Illness Impact And Adjustment To Parkinson's Disease: Before And After Treatment With Tolcapone, Mickie D. Welsh Dnsc, Rn

Dissertations

There is evidence that adjustment to chronic illnesses such as Parkinson's disease (PD) may be affected by psychological factors especially how patients appraise and cope with the stress of their illness. There has been limited research available examining the role of illness impact or appraisal in adjustment to chronic illness. No studies were found dealing with the interrelationship of illness impact, adjustment and pharmacological treatment. The purpose of this study was to determine whether the quality of life (as conceptualized by impact of illness and adjustment) was improved by treatment with tolcapone in persons with Parkinson's disease. This study was …

Patient Perceptions Of Quality: The Influence Of Value And Beneficence, Rebecca H. Waldon

Theses and Dissertations (ETD)

The influence of patient values and patient perception of benefits on patient perceptions of quality have not been extensively investigated, even though patient and provider perceptions of quality have been widely studied. Refocusing quality assessment and improvement to include factors that influence patient perceptions of quality is necessary for humanitarian and economic reasons. The health care patient has certain expectations of health care. These expectations are based on the value the patient places on the services. Value is a predictor of patient-perception of quality. The relative worth of patient goals may also be related to patient perceptions of quality. If …

Effects Of Family Stress, Family Social Support, And Family Balance On Maternal Adaptation In Post Birth Families, Constance H. Blake Hansen Dnsc, Mn, Rn

Dissertations

The purpose of this study was to describe the effects of perinatal family stress, family social support, and family balance on post birth maternal adaptation. The birth of a new infant is a transitional event that causes stress to the individuals within the family and the family as a unit. The childbearing woman has been identified as the core of the expanding family. Her adaptive level is critical to the integration of the new infant into the family unit. Stress and support are important variables in maternal adaptation, yet the specific relationship of these variables as they relate to the …

Sociolinguistic Dimensions Of Nurse Practitioner Practice: A Question Of Power, Merrily J. Allen Dnsc, Mn, Rn

Dissertations

Ethnographic methods were used to examine the sociolinguistic dimensions of female nurse practitioner interactions with female patients. The purpose was to provide a contextual account of the discursive practices used by the nurse practitioners during routine office visits with female patients. Direction for this research was provided by my concern about power inherent in professional-client dyadic relationships. Data collection methods included formal and informal interviews, participant observation and audio taping nurse-patient encounters. Nine nurse practitioners and 26 patients participated in the study in both private and public ambulatory care settings. Data analysis yielded two concurrent story lines which I labeled …

Occupational Stress Among Nurse Administrators In General Hospitals In Tennessee, Ruby T. Davis

Electronic Theses and Dissertations

The purpose of this study was to determine the level of occupational stress among nurse administrators and to identify the types of strategies used by nurse administrators to deal with or manage occupational stress. The study examined the relationship between selected demographic variables, occupational stress, and strategies. The research design included five research questions along with seven null hypotheses testing the relationship between occupational stress and demographic variables--age, gender, marital status, years of professional nursing experience, years as a nurse administrator, educational attainment, and hospital bed capacity. There were seven additional hypotheses testing the relationship between the same demographic variables …

Being Pregnant And Using Drugs: A Retrospective Phenomenological Inquiry, Merry A. Armstrong Dnsc, Msn

Dissertations

Qualitative methodology was employed to conduct a phenomenological inquiry describing the structure of the experience of being pregnant and using drugs. The purpose of the study was to explore the nature of women's experience and perception of the interaction, relationship, and intersection of contextual phenomena of lifestyle, pregnancy, and substance abuse. Data gathering and analysis was accomplished using guidelines provided by Spiegelberg and Van Manen. Eleven mothers voluntarily participating in a recovery program described their prior experience of being addicted and pregnant during 2 conversations with the researcher. Through transcript analysis of the first audio-taped interview, major and minor themes …

How Latinas Come To Know About Aids And Aids Prevention, Patricia Walker Caudle Dnsc, Mnsc, Fnp, Rnc

Dissertations

By the year 2000, Latinos will become the largest minority group in the United States. Acquired Immunodeficiency Syndrome (AIDS) is occurring at a disproportionately high rate among Latinos. As care-giver and health decision-maker in the family, the Latina needs to know about AIDS and AIDS prevention. This research identified and offers an explanation of how the Latina comes to know about AIDS and AIDS prevention within the context of the family and the Latino culture. Grounded theory methodology was used to explore the complex socialization patterns within the Latino community that affect how the Latina perceives HIV/AIDS. Data were collected …

Factors Influencing A Battered Woman's Perception Of Controllability In Violent Intimate Relationships, Patricia Ann Chin Dnsc, Msn, Rn

Dissertations

Despite the fact that domestic violence has been the focus of empirical investigation for more than twenty years, little is known about the phenomenon. While the available body of knowledge provides a sketchy picture of the abused woman and her abuser, and helps to dispel many of the myths surrounding spousal abuse, it provides very little insight into the dynamics of wife abuse. This study, based upon a foundation of the Reformulated Learned Helplessness Theory, was designed to explore the nature of the relationships among concepts that have been identified within the context of battering, and that were thought to …

An Analysis Of The Values Influencing Neonatal Nurses' Perceptions And Behaviors In Selected Ethical Dilemmas, Deborah A. Raines

Theses and Dissertations

The purpose of this research was to identify the values influencing the nurse's perception and choice of behavior in a hypothetical clinical situation. The theoretical framework was Rokeach's (1973) Theory on the Nature of Human Values and Value Systems. A descriptive study using a mailed survey was conducted on a random sample of 331 members of the National Association of Neonatal Nurses. Data on individual nurses' values, perception of information and behavioral choices were collected with an investigator developed questionnaire, consisting of a values scale (alpha =.82) and an information scale and choice alternatives related to three hypothetical vignettes: a …

Baccalaureate Reentry Students: Effects Of Professional Support On Role Conflict And Role Transition, Ruth N. Grendell Dnsc, Msn, Rn

Dissertations

An increasing number of registered nurses and other health care providers are entering upper division academic nursing programs to obtain the baccalaureate nursing degree. A path analytic model was developed to examine the interrelationships of multiple roles and focal role commitments, previous education, work experience, and role conflicts perceived by reentry adult students, and the influence of professional support in the subsequent transition to the professional role. Group differences between Registered Nurses (RNs) and military corpsmen were also investigated for the variables of importance. A sample of 206 RNs and 37 U.S. Navy corpsmen (from a current population of 96) …

Elders Caring For Elders: Risk Of Abuse And Neglect?, Marjorie F. Bendik Dnsc, Msn, Rn

Dissertations

This study was designed to examine the phenomena of mood disturbance and associated potential to abuse in an elderly caregiver population. The data from which the results were obtained came from structured interviews, using quantitative measures, with 110 men and women caregivers aged 55 and over, living at home and caring for another physically or mentally ill elder (usually a spouse or other relative) who was living with them. A causal model was developed to examine the effects of locus of control, social support, physical health, stress perception, and coping efficacy on total mood disturbance and potential to abuse. Standardized …

The Moral Reasoning Of Nurse Practitioners, Diane C. Viens Dnsc, Ms, Fnp, Rnc

Dissertations

The purpose of this phenomenological study was to identify the moral dilemmas experienced by nurse practitioners in their clinical practice and to describe the essential features of moral reasoning utilized by the nurse practitioners to resolve the moral dilemma. The participants in the study were ten female volunteers who were currently employed as NPs in a variety of settings. Unstructured interviews were conducted with the participants and the qualitative data was analyzed using a nine step process. Five essential features of moral reasoning emerged through the process of data analysis: values, elements in the contextual framework for moral reasoning, influencing …

A Model Of Organizational Commitment In Staff Nurses, Donna Burgener Adams Dnsc

Dissertations

The purpose of this study was to describe and explain the impact of work stress, sex role organization, and organizational tenure on self-esteem and work satisfaction, and ultimately, on the organizational commitment of registered nurses. An eclectic framework was utilized which incorporated organizational and personal variables. The correlational design resulted in a temporally ordered causal recursive model with linkages supported by a literature review. Past research has demonstrated less organizationally committed nurses more prone to leave their positions, and high turnover is detrimental to patient care as well as costly to the health care system. The sample consisted of 143 …

Factors Related To Body Image Appraisal Associated With Receiving Treatment For A Malignant Brain Tumor, Ruth Ann Mulnard Dnsc

Dissertations

Within a stress-coping-adaptation framework, a path analytic model was hypothesized to explain the interrelationships among the variables of gender, age, duration of illness, steroid dosage, social support, perceived health status limitations, and coping skills, and their subsequent effect on body image appraisal in the population of subjects undergoing treatment for a malignant brain tumor. The many potential changes in physical appearance and functional abilities, including the loss of hair, the onset of Cushing's syndrome and varied physical disabilities, may cause devastating alterations in body image, requiring tremendous coping skills for adaptation in these individuals. One hundred and ten subjects were …

Self-Preserving: Patterns Guiding The Experience Of Interpersonal Conflict For Female Nursing Faculty, Kathleen L. Harr Dnsc, Msn, Rn, C

Dissertations

The purpose of this study was to identify a substantive theory to explain and predict interpersonal conflict as it is experienced by nursing faculty. Gaining an understanding of this process may assist faculty and administrators of nursing education programs in dealing with interpersonal conflict in more constructive and helpful ways. It may also provide the basis for further development of formal theory and the potential for theory testing. The grounded theory method described by Glaser and Strauss (1967) and Glaser (1978) guided data collection and analysis. The sample was comprised of 18 full-time nursing faculty members from the field site …

Well-Being Of Elderly Women: Rural-Urban Differences, Betty J. Gale Dnsc, Ms, Rn

Dissertations

Using a stress-coping theoretical framework, this path analytic study examined the effects of hardiness, self-esteem, social support, and stress on coping, service utilization, and well-being of elderly women. Fifty-five rural and fifty-five urban females living in the community comprised the sample whose mean age was 75 years. The overall level of well-being of these women was high. Hardiness was associated with greater social support and well-being. Self-esteem was related to lower stress. Hardiness and self-esteem were also associated with decreased use of emotion-focused coping. Stress had a positive relationship with service utilization and a negative relationship with well-being. Problem-focused coping …

The Nurse Manager: An Ethnography Of Hospital-Based First-Line Nurse Managers Practicing In An Expanded Role, Sally Everson-Bates Dnsc, Ma, Rn

Dissertations

The behaviors, beliefs and values that characterize everyday practice of first-line nurse managers role were analyzed. Ethnographic field research techniques were used including nine months of observation and in-depth interviews with practicing nurse managers. After reviewing historical events that shaped the role of the nurse manager, the role was then placed within the economic, social and health care context of the 1970's and 80's. Research and anecdotal descriptions of the manager role of the past twenty years were also explored. Research was conducted in two voluntary acute care, multi-service hospitals. One manager was observed intensively for two months to develop …

The Everyday Life Experiences Of Three To Six-Year-Old Children With Comforting Possessions, Susan H. Harris Dnsc

Dissertations

The purpose of this study was to explore the phenomenon of comforting possessions in order to develop descriptive theory based on the perceptions, beliefs, values, symbolic meanings, and feelings of young children regarding comforting possessions. Using ethnographic methods, children with comforting possessions were observed extensively in a preschool setting (n = 10). Two of these children were later interviewed with a parent present. In addition, 17 other children were interviewed in the home or preschool setting with a parent present for a total study sample of 27 children. Several major patterns were supported by the data derived from these two …

A Model Of Registered Nurse Intent To Stay In Southern California Childrens' Hospitals, Linda Diann Urden Dnsc, Mn, Rn, Cna

Dissertations

The purpose of this study was to examine the interrelationships of professional image, organizational climate or domains thereof, professional commitment, organizational commitment, position satisfaction, and the influence of these variables on intent to stay employed. The path analytic model of intent to stay was temporally ordered and proposed that professional image and organizational climate affect intent to stay through professional commitment, organizational commitment, and position satisfaction. Subjects (n = 232) were both male and female registered nurses who worked per diem, part-time, or full-time on all shifts. They held clinical positions, delivered direct care, and had been employed in one …

Multiple Role Women And Their Spouses: Variables Effecting Family Functioning, Julie C. Novak Dnsc, Cpnp, Ma, Rn

Dissertations

The purpose of this study was to examine the effect of age, education, perceived child care support, social support, role conflict, coping and marital adjustment on family functioning as experienced by multiple role women and their spouses. The family has long been recognized as the most important contextual influence in human growth and development. Nurses have been working with families for generations, especially in community and mental health nursing. It is only in the last decade, however, that there has been an increasing interest in family research among nurses reflected in a trend away from individual-focused studies and toward a …

Ariel - Volume 3 Number 8, Terry Burt, Paul Bialas, Eugenia Miller, Glenn Nye, Kodwo J. Abaidoo, Robert Breckenridge, Jr., Michael Leo

Ariel

Editors

Richard J. Bonanno

Robin A. Edwards

Associate Editors

Steven Ager

Tom Williams

Lay-out Editor

Eugenia Miller

Contributing Editors

Paul Bialas

Robert Breckenridge

David Jacoby

Mike LeWitt

Terry Burt

Michael Leo

Editors Emeritus

Delvyn C. Case, Jr.

Paul M. Fernhoff

Types Of Behavior During Labor And Delivery And Scores On The Minnesota Multiphasic Personality Inventory, Bette Gloria Winthers

University of the Pacific Theses and Dissertations

Purpose of the Study

The thesis of this study is that personality characteristics can be shown as factors in the variation of behavior which occurs during labor and childbirth. It is felt that if personality traits can be measured by a standard device they will correlate with various types of behavior expressed during labor. The Minnesota Multiphasic Personality Inventory is one instrument which tests all of the more important phases of personality. This test was chosen as the device to be used in this study to determine the personality traits of the women involved. Therefore, the purpose of this study …