Digital Commons Network^™

Impact Of Multiple Children On Parental Supervision Practices, Parental Developmental Competence, And Unintentional Injury Risk, Jennifer L. Taylor

Dissertations

Unintentional injury is the leading cause of childhood mortality and morbidity in the United States. The effects of injury on children, families and society encompass physical, mental, emotional, and financial consequences. The highest injury rates are among preschool age children, especially preschool children who have siblings. Child injury prevention strategies can reduce the rates of childhood unintentional injuries and minimize the burdens to children, families, and society created by these injuries. To design and implement effective child injury prevention strategies, further investigation is needed to understand the relationship between the variables influencing the occurrence of child injuries. The specific aim …

Chest Tube Dressings: A Comparison Of Different Methods, Susan Kathleen Blackburn Jones

Dissertations

This study is an experimental design with randomization comparing the use of standard gauze dressings (SGD) to transparent adhesive dressings (TAD) to cover chest tube insertion sites in post-operative patients who have undergone cardio-thoracic surgery. The study was conducted in a 400 bed, tertiary non-academic teaching hospital in the Midwestern United States. Seventy-nine patients were enrolled in the study; 39 received TAD and 40 received SGD. The non-inferiority margin was set at 15% in keeping with current recommendations (Kaul & Diamond, 2006). The TAD was found to be not inferior to the SGD with regards to the proportional differences in …

Call-Shift Fatigue And Use Of Countermeasures And Strategies By Certified Registered Nurse Anesthetists, Ramona M. Domen Phd, Crna

Dissertations

Purpose: The purpose of this study was to examine whether Certified Registered Nurse Anesthetists (CRNAs) experience fatigue during call and to assess their use of fatigue avoidance strategies (practices that prevent fatigue) and fatigue countermeasures (practices that decrease fatigue) to mitigate its effects. Method: Using a cross sectional descriptive survey design, data were collected from a randomly selected sample of 323 practicing CRNAs who worked call shifts. Data analysis: Data were analyzed using descriptive and multivariate statistics. Results: The sample was fairly evenly distributed with slightly more female respondents, 55% (n = 179). Fifty four percent worked a weekday call …

Women's Cognitive Appraisals Of Their Birth Experience As Predictive And Maintaining Factors Of Postpartum Posttraumatic Stress Symptom Severity, Lauren Carr Spooner

Dissertations

Empirical support has accumulated for evidence of posttraumatic stress symptoms following approximately 30% of childbirth experiences (Olde, van der Hart, Kleber, & van Son, 2006). Researchers have suggested that there is a complex relationship among predisposing, precipitating, and maintaining factors that impact postpartum PTSD (Slade, 2006). Anxiety, perception of support, and negative cognitions are such factors that have been shown to significantly correlate with PTSD symptoms (Foa & Rothbaum, 1998; Olde et al., 2006; Soet, Brack, & Dilorio, 2003), but have not been studied together in relation to PTSD associated with traumatic birth. The current study controlled for trait anxiety …

Nursing Students' Lived Experiences Surrounding Medication Administration, Sally Nan Morgan Phd

Dissertations

Medication errors are abounding and the complexity of medication administration creates an environment where health care providers are at risk for making errors. This environment includes nursing students learning medication administration. Coupled with a rigid, protocol-driven pedagogy, nursing students may be placed in a learning experience counterproductive to accuracy. Previous studies have focused on causes and perceptions of medication errors looking for the delineation between safe and unsafe practice. In doing so, past research may have narrowed the path of discovery needed to diminish medication errors. In addition, research regarding the lived experience of nursing students while they are learning …

Health Literacy And Health Promotion Behaviors Among Samoans, Katherine Tong Phd, Msn, Cfnp, Phn

Dissertations

Limited health literacy is associated with failure to engage in health promotion behaviors. Few studies examine this relationship among Samoans. This study used a cross-sectional correlational design to determine health literacy levels and their relationship to health promoting behaviors in a southern California Samoan population. Health literacy (Short form Test of Functional Health Literacy in Adults) and health promotion behaviors (Health Promotion Lifestyle Profile II) were measured in a convenience sample of 87 Samoans in southern California. Data analysis employed chi-square, t-test, and one- way ANOVA. Significant associations were found for health literacy and demographic characteristics of employment and marital …

Associations Among Perceived Benefits, Barriers, Cues, And Physical Activity In Thai Primary Students, Sireewat Ar-Yuwat Phd, Mph, Rn

Dissertations

The purpose of this study is to examine the relationships between perceived benefits, perceived barriers, and cues to action and levels of physical activity in Thai fourth grade students. The Health Belief Model was used as the theoretical framework of the study to investigate students' beliefs related to physical activity. The participants in this cross-sectional study were fourth grade students selected by a simple random sampling method. A sample of 123 students was recruited from primary schools in Muang district, Phitsanulok province. The sample schools were selected by stratified random sampling. For data collection, the study utilized two instruments: the …

A Retrospective Analysis Of Maternal And Child Outcomes Following An Obesity Intervention Program, Melinda S. Bender Phd

Dissertations

Background: One of the highest risk groups for childhood obesity and associated co-morbidities in the United States are low-income Hispanic preschool children. To reduce obesity, effective interventions are being sought to improve health behaviors among high risks groups. Objectives: To evaluate a subset of data from a larger 9-month promotora facilitated obesity intervention study. The aims were to determine: 1) pre- to post-program differences in health behaviors including: (a) children's consumption of high carbohydrate beverages (HCB); and (b) maternal walking, beliefs, knowledge, self-efficacy, and relationship building regarding nutrition and physical activity; and 2) which covariates were significant for change in …

Lived Experience: East African Somali Speaking Women Accessing The U.S. Healthcare System, Shukri Adam Phd

Dissertations

Access to prenatal healthcare for East African Somali Speaking Women (EASSW) who are immigrants to the U.S. has been dependent on the availability of a systematic healthcare treatment model. The purpose of this study was to explore EASSW's lived experiences in accessing prenatal healthcare services in the U.S. A descriptive, qualitative phenomenological approach informed by the work of Husserl was used to explore EASSW's experiences, views, and problems encountered while attempting to access prenatal healthcare services in the U.S. Fifteen EASSW of childbearing age (ages 18–45) were recruited for this study. All participants interviewed privately, beginning with a semi-structured, open-ended …

Cord Blood Collection In Pregnant Women For Stem Cell Research, Irene Carr Phd

Dissertations

Umbilical cord blood (UCB) stem cells form commonly banked types of human tissue. Confusion remains about sources of stem cells and their use. Birth is a once in a lifetime opportunity with 74 million births per year in the world and four million occur in the United States. Cord blood contains hematopoietic stem cells and pluripotent mesenchymal cells (Moise, 2005). There is a surge of interest in the clinical use and research investigation of umbilical cord blood for transplantation and regenerative medicine. Clinicians need increased awareness and education of options for private versus public donation and banking of cord blood …

Emergence Delirium In U.S. Military Combat Veterans, Jason M. Mcguire Phd, Crna

Dissertations

This dissertation study examined the phenomenon of emergence delirium in U.S. military combat veterans. Emergence delirium is a post-anesthetic phenomenon that occurs immediately following emergence from general anesthesia and is characterized by agitation, confusion, and violent physical and/or verbal behavior. Clinical evidence suggests that emergence delirium is occurring with greater frequency among military personnel returning from conflict in the Middle East. This body of work is a culmination of three distinctive phases and is presented in three individual manuscripts. The first manuscript, "Risk Factors for Emergence Delirium in U.S. Military Members," was published in the Journal of PeriAnesthesia Nursing with …

Nutritional Status And Clinical Outcomes Of Residents Admitted To A Nursing Home, Sheryl Nespor Phd

Dissertations

Purpose The purpose of this research study was to describe the nutritional status (well nourished, at risk for malnutrition, or malnourished) of residents admitted to nursing homes and adverse clinical outcomes in those residents after four weeks. Methodology A descriptive, correlational design utilizing medical record data was used to examine the relationship between nutritional status and adverse clinical outcomes of weight loss and pressure ulcers. Results The sample (n=69) was predominately Caucasian (90%) with 38% having one or more pressure ulcers on admission. Most of the residents were admitted from an acute care facility (97%) and were either malnourished or …

California School Nurse Survey, Rachel Van Niekerk Phd

Dissertations

The purpose of this study was to obtain evidence to support the assumption that school nurses have a positive effect on school attendance and medication administration practices and to hear the voice of the California school nurse. Data from this exploratory, descriptive study came from an online researcher developed survey consisting of both forced choice and open-ended questions completed by California school nurses representing the three major regions of California (Northern, Central, and Southern). The following three research questions guided the study: 1) What is the relationship between school and nurse factors on student outcomes? 2) How valued do California …

A Quantitative Inquiry Into Moral Distress And Psychological Empowerment In Critical Care Nurses Caring For Adults During End Of Life, Annette Marie Browning Phd, Rn, Cns

Dissertations

Background Critical care nurses care for many adults at end of life and it is known that these nurses can experience moral distress. Moral distress occurs when nurses are unable to perform what they believe is ethically correct. There has been speculation that psychological empowerment may ameliorate moral distress among critical care nurses. However, research has yet to examine the relationship between moral distress and psychological empowerment in the population of critical care nurses.

Objectives To describe the relationships between moral distress, psychological empowerment and select demographics in critical care nurses caring for patients at EOL.

Method Using a quantitative …

The Post Deployment Lived Experience Of U.S. Military Troops After Combat-Related Blast Exposure, Shirely A. Jett Phd

Dissertations

Blast-induced neurotrauma (BINT) is a newly emerging re-occurrence of an old combat-related injury in U.S. military troops returning from deployment in Afghanistan and Iraq. BINT is leading to a silent epidemic of symptomatic troops who face barriers to accessing healthcare and suffer debilitating symptoms in silence. The purpose of this hermeneutic phenomenological study was to discover the meaning of the lived experience of U.S. troops returning from Afghanistan and Iraq after combat-related blast exposure. Eleven service members and veterans ranging in age from 21 to over 30 years old participated in semi-structured face to face interviews. These service members and …

Examining Nursing Presence In The Acute Care Setting As An Indicator Of Patient Satisfaction With Nursing Care, Wendy Hansbrough Phd, Msn, Rn

Dissertations

Nursing presence is conceptualized as occurring within the nurse-patient relationship when the nurse acknowledges the uniqueness of the patient, within his or her context of being and chooses to intervene on the patient's behalf with a patient who allows the nurse into a reciprocal relationship. Nursing presence is described as occurring in varying levels and nurse expertise is suggested as one antecedent. Quantification of nursing presence would be useful in examination of nursing care outcomes, quality management and research. The Presence of Nursing Scale, PONS (Kostovich, 2002) was used in this study to test its reliability and determine its validity …

Mother-Son Connectedness, Substance Use, And Young Men's Criminal Justice System Involvement, Kim L. Moreno Phd

Dissertations

The relationship between a mother and her son and its influence on health and risk behaviors as a boy becomes a man has had little exploration. The purpose of this study was to examine the relationships between mother-son connectedness, substance use, serious delinquency, violent delinquency, and criminal justice system involvement in young men. This study uses data from The National Longitudinal Study of Adolescent Health (ADD Health), a school-based study of students in grades 7–12 in the United States. Multiple regression, ANOVA, and logistic regression were used to analyze independent and dependent variables. Results show a perception of connectedness, which …

Fibromyalgia Self-Care Management: Use Of Essential Oils, Regina Ann Sacco Izu Phd

Dissertations

Fibromyalgia is a female dominant chronic syndrome of diffuse muscle pain on palpation of at least 11 of 18 syndrome-associated tender points present for 3 months or longer. There is no cure. Self-care management involving multimodal integrative medicine approaches may increase treatment involvement resulting in a sense of control and pain relief. This embedded, single case study explored 'how' and 'why' an informant with fibromyalgia chose to initiate and continue self-care management using essential oils over several years to treat symptoms within context reality. Orem's Self-Care Deficit Model and the Principles of Integrative Medicine from the University of Arizona formed …

Compassionate Care, The Patient Perspective, Lori Burnell Phd

Dissertations

Professional mandates call for nurses to respond with compassion (e.g., American Nurses Association [ANA] Code of Ethics, International Council of Nurses [ICN]) and countless hospital mission and vision statements prominently display compassion as their fundamental purpose. As a component of healthcare and nursing models, however, defining characteristics and standards are inconsistent. Compassion as a means of establishing a connection on a spiritual level abounds in the literature (Buck, 2006; Grant, 2004; O'Brien, 2008; Schultz et al., 2007) and is documented as a nursing requirement (e.g., ANA, ICN); however, it remains virtually uncharted from the lens of the patient. Through interpretive …

Relationship Between Self-Stigma And Personal Empowerment Among People Who Have Severe Mental Illness, Diane Fischer Hickman Phd

Dissertations

The purpose of this study was to examine the relationship between self-stigma of mental illness and personal empowerment among people who have a severe mental illness. It had been hypothesized that self-stigma of mental illness and personal empowerment are at opposite end of a continuum. As such, individuals who perceive themselves in a stigmatized manner tend to reciprocally perceive themselves as being relatively powerless, rather than having a strong sense of personal empowerment. Likewise, individuals who perceive themselves as having a relatively strong sense of personal empowerment tend to experience a low degree of self-stigma. To test this hypothesis, a …

Improving Diabetic Outcomes With Caring Communication: Identifying Communication Patterning For The Human Diabetic, James R. Kennett Phd

Dissertations

Introduction. The purpose of this study was to identify the influence of caring communication for people living with diabetes (PLD) and the relationship to diabetic outcomes. Caring communication has not been studied for improving diabetic outcomes. Randomized control trials (RCTs) direct care, however people do not do what they told, they need to be included in their care. PLD need a voice to establish what is important to them. Incorporating medical, communication, and nursing science as multidisciplinary approach within a theoretical framework can be predictive diabetic outcomes. Methods. A correlational cross sectional survey design study was done. A sample of …

Spiritual Well-Being And Quality Of Life Among Persons With Paraplegia, Darlene Nelson Finocchiaro Phd, Msn, Rn, Crrn

Dissertations

With the advent of better emergency response and medical advances, the life expectancy of persons with spinal cord injury (SCI) is about 85% to 90% compared to that of non-disabled persons. Since SCI survivors are living well into their 70s, quality of life (QOL) is a major concern. The purpose of this study, informed by Ferrell and Grant's Quality of Life Model, was to examine relationships between spiritual well-being (SWB), existential well-being (EWB), religious spiritual well-being (RWB), depression, length of injury, age, gender, ethnicity, and QOL while living with paraplegia one year and longer. A descriptive, correlational, cross-sectional design, with …

A Retrospective Study Of Substance Use And Mental Health Disorders In A Sample Of Urban American Indian And Alaska Natives, Kathryn Aimee Fuller Phd

Dissertations

This retrospective study examined the prevalence of mental health disorders, co-occurring disorders (COD), and alcohol, tobacco, and other drug use (ATOD) among a sample of urban-dwelling adult American Indian and Alaska Natives (AI/ANs) seeking behavioral health services from one metropolitan Indian clinic in Southwestern United States. A descriptive quantitative design employed retrospective data from AI/AN subjects (N = 123) verified as tribally enrolled and receiving outpatient behavioral health services. Chart abstraction included patient demographics, substance use and mental health diagnoses, and ATOD scores from the Patient Health Questionnaire-9 (PHQ-9) and the Addiction Severity Index-NAV (ASI-NAV). The t-test compared gender differences …

Gestational Diabetes, Depression, And The Impact On Maternal Child Health Outcomes, Mary Alice Byrn

Dissertations

Antenatal depression occurs in about 20% of all pregnancies and gestational diabetes occurs in up to 14% of all pregnancies. Although there is sufficient information on (1) depression during pregnancy and (2) depression and diabetes, there is little information about depression and gestational diabetes. This comparative, longitudinal research study was done to better understand the relationship between gestational diabetes and depression. The study aims were the following: (1) to determine whether women with gestational diabetes had more depression than women without gestational diabetes, (2) to determine whether factors predictive of depression in pregnant women with gestational diabetes were different from …

A Salutogenic Framework To Understand Disparity In Breast Cancer Screening Behavior In African American Women, Regina Conway-Phillips

Dissertations

African American women (AAW) have the highest breast cancer mortality rate than any other racial or ethnic group. Limited access to care reduces mammography screening for AAW. Despite barriers, some AAW engage in breast cancer screening (BCS) behaviors like mammography. The salutogenic theory of health focuses on positive health behaviors and offers a framework to understand personal factors which allow some AAW to overcome adversity and engage in BCS. Sense of coherence (SOC) is central to salutogenic theory. Individuals with greater SOC utilize available resources to attain optimal health. This study: 1) Evaluated the contribution of SOC, social support and …

Community Assessment Of Cardiovascular Health And Risk Among People Of Mexican Descent In Berwyn, Illinois, Karen Ann Larimer

Dissertations

Background: Cardiovascular disease (CVD) is the number one cause of death in the United States and affects persons of all races and ethnicities. The number of persons of Mexican ethnicity has increased significantly in the United States, notably in the community of Berwyn, a suburb of Chicago, IL where according to the U.S. 2010 census 60% of the community is now of Mexican descent. The factors that contribute to CVD risk in persons of Mexican decent within this community must be understood before culturally appropriate risk reduction strategies are designed and implemented.

Purpose: The purpose of this community-based study is …

Acts-Hf: Attention, Cognition And Self-Care In Heart Failure, Catherine M. Murks

Dissertations

Background: Patients with heart failure (HF) are required to participate in self-care activities. This activities include taking prescribed medications, monitoring for symptoms, intervening appropriately and evaluating the response to the treatment. Cognitive impairment occurs relatively frequently in this population. Few studies have attempted to describe the nature of the relationship between self-care and cognitive impairment in this population.

Purpose:/ This study investigated the relationship between cognitive function and self-care ability in patients with HF. It also investigated the relationship between both self-care and cognitive function and subsequent hospital admission.

Methods:/ Participants were recruited from outpatient areas at two cardiology groups …

Spiritual Care In Advanced Practice Nursing, Barbara Baele Vincensi

Dissertations

Spiritual care has the potential to improve clients' health and quality of life. Since clients desire spiritual care from their health care providers as they age or as their health worsens, geriatric nurse practitioners (GNPs) were chosen to participate in this study. This cross-sectional, descriptive, survey design investigates the relationships and differences between practicing GNPs spiritual perspectives and their ability to assess clients' spiritual care needs (SCN) and provide specific spiritual care interventions (SCI). Differences and relationships were also investigated based on demographic variables of the GNPs. In addition, participants were asked to define spirituality in an open ended question. …

A Study To Determine The Influence Of Workload On Nursing Personnel, Supreeta G. Amin

Dissertations

The alarming number of adverse medical events and associated costs have placed immense importance toward the safety and health of both patients and medical personnel. A shrinking nurse workforce, an aging patient and nursing population coupled with a mismatch between hospital demands and the available nursing staff have created a situation detrimental to both patient and nursing personnel. Long working hours, working more than one job, low staffing ratios, high patient acuity, minimal social support, low experience level, complicated equipment, complex procedures and varying workload are some factors that may have a negative impact on the quality of care provided …

Working Together Toward A Common Goal: A Grounded Theory Of Nurse-Physician Collaboration, Lori Lynn Fewster-Thuente

Dissertations

Purpose: Effective collaboration has been identified as essential to quality patient care processes and outcomes. Yet, the conceptual and theoretical basis for understanding and practicing collaboration remains underdeveloped and imprecise. These factors may hamper the study of collaboration and therefore the optimization of care processes and outcomes. The purpose of this study was to understand the social processes associated with collaboration between nurses and physicians, with the intention of theory development.

Background: Collaboration, or a lack thereof, has been shown to impact both provider and patient satisfaction and outcomes. JCAHO now requires proof of collaboration for accreditation. Many organizations state …