Medicine and Health Sciences Commons^™

Bridging The Gap With Old Order Amish: A Cultural Brokering Model Based On Culture Care Theory, Sharon M. Mcgill

Theses and Graduate Projects

The Old Order Amish people have chosen to live a humble lifestyle consistent with their cultural beliefs and values. This lifestyle guides the Amish people in utilizing home based care (generic care) for their everyday health need.s and professional care (Western medical- care) to meet their needs during a health crisis. In fact many Old Order Amish seek professional care as the last resort. The purpose of this protect is to develop a model of advanced transcultural nursing practice that bridges the gaps between the Old Order Amish generic care practices and Western professional health care practices - This model …

A Comparison Of An Individually Tailored And A Standardized Asthma Self-Management Education Program, Judy Ann Shackelford

Dissertations

Asthma is one of the most prevalent chronic diseases in the United States (Centers for Disease Control [CDC], 2003). According to the CDC (2003), prevalence of asthma continues to rise in epidemic proportions and is very costly. While asthma cannot be prevented or cured, it can be controlled to improve quality of life. Self-management is key to controlling asthma (CDC, 2003; National Heart, Lung, and Blood Institute [NHLBI], 2002). State of the science for asthma self-management establishes that health care costs decrease for self-management intervention groups (Lindberg et al, 2002; Thoonen et al, 2003). Education is essential to support asthma …

Missouri Ozark Women's Experiences Of Living With Postpartum Depression Symptoms, Nathalie B. Williams

Dissertations

Depression is a serious complication of the postpartum period that affects not only women but their children and families as well. Rural women are of particular concern because of the significant barriers to health care that they experience as a result of isolation, poverty, traditional beliefs, and a lack of accessible and adequate health related services. A review of the literature to identify evidence based nursing interventions that focused on primary and secondary prevention of postpartum depression revealed few interventions and there were no studies identified that targeted or even included women living in rural areas of the United States. …

Leadership Competencies In Today's Complex Healthcare Environment, Judy Moseley

Theses and Graduate Projects

The increasingly diverse, multicultural population in the United States is offering significant challenges to nurses to provide culturally competent care. If the provision of the best possible care for all patients is the goal, nurse leaders must have the expertise and skill to lead staff through the complex problems of organizations. Nurses must possess the ability to generate solutions consistent with the organization's mission and with sensitivity to the needs of a diverse patient population. Through the interconnected processes of teaching and practice, an innovative Master of Arts in Nursing program that emphasizes transcultural nursing practice experience for leaders was …

Perceptions Of Dyspnea, Physical Activity, And Functional Status In Obese Women, Donna Althea Jewell

Dissertations

PURPOSE: King's Theory of Goal Attainment guided this study exploring the physical sensation of dyspnea that obese women feel and how it affects their functioning. BACKGROUND AND SIGNIFICANCE: Obesity prevalence has doubled since 1980. Current research is investigating how to reduce prevalence and examining obesity's impact on the respiratory system. Little research was found that investigated the impact obesity has on routine activities because of dyspena and function and whether physical activity has a mitigating effect. METHODS: A comparative descriptive research design was used. A survey of dyspnea felt during routine activities was created; IRB approval to survey community-dwelling women …

Nursing In Hell: The Experience Of Providing Care During And After Hurricane Katrina, Marti L. Jordan-Welch

Doctoral Dissertations

Hurricane Katrina, a Category Four hurricane, made landfall on August 29, 2005, along the Gulf Coast of Mississippi and Louisiana. The strength and the extent of winds resulted in the worst destruction and the largest storm surge in the history of the United States. Within hours after the hurricane hit, the earthen levees in New Orleans were breached and 80% of the city became submerged in up to 20 feet of water. Health care workers and patients were stranded in hospitals, where they experienced extreme environmental conditions. The death toll was reported at, 1836 persons, and the damage was estimated …

Influence Of Stroke Clinical Pathway On Documentation, Shannon Sternberg

All Theses

The purpose of this study was to determine whether the implementation of a stroke clinical pathway could improve compliance with documentation of specific quality measures for patients admitted with the diagnosis of acute ischemic stroke, hemorrhagic stroke, or transient ischemic attack. The study used the ten standardized performance measures for stroke identified by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and integrated documentation of those measures into a stroke clinical pathway consisting of physician order sets, an interdisciplinary plan of care, and a patient/family education flow sheet. The American Stroke Association's Get with the Guidelines - Stroke (GWTG-Stroke) …

Perceived Organizational Support And Ethical Work Climates As Predictors Of Turnover Intention Of Licensed Nurses In Skilled Nursing Facilities, Anna A. Filipova

Dissertations

The purpose of this study was twofold: (1) to replicate Victor and Cullen's (1987; 1988) studies to confirm whether ethical climates (ECs) arise in skilled nursing facilities (SNFs), and whether organizations and groups within organizations have identifiable ECs; and (2) to test a model that examines the effects of ECs and perceived organizational support (POS) on licensed nurses' turnover intention (TOI) through job satisfaction (JS) and organizational commitment (OC).

A cross-sectional survey design was implemented. Three hundred and fifty nine freestanding SNFs were selected in a midwestern state. While a total of 110 facilities (31%) agreed to participate, responses were …

Cardiopulmonary Predicators Of Dysfunctional Ventilator Weaning Response After Coronary Artery Bypass Graft, Annapoorna Mary

Theses and Dissertations (ETD)

Although the majority of coronary artery bypass graft (CABG) surgery patients are extubated within 6 to 8 hours following surgery, 20% to 40% of patients remain intubated 12 hours after surgery due to dysfunctional ventilator weaning response (DVWR). DVWR associated with increased morbidity and mortality (30% to 43%) following CABG surgery. Finding significant antecedence to predict DVWR could help to identify and prevent the complications from DVWR after CABG surgery. Literature review revealed that there is an association between cardiopulmonary indicators (CPI) and DVWR after CABG surgery. Cardiopulmonary indicators are the selected hemodynamic parameters that have an association with DVWR. …

Graduate Project To Explore Factors Affecting Completion Of Final Degree Requirements For A Master Degree In Nursing, Sharon Gentile

Theses and Graduate Projects

The purpose of this project was to explore issues that influence Master Degree completion as perceived by graduate nursing students, using focus groups. All eight graduate nursing student participants recently completed structured coursework, but had not submitted a final paper or project. Margaret Newman's Health as an Expanding Consciousness Nursing Theory was applied as the conceptual framework used to process the information obtained. Dialogue between moderator and participants occurred during accompaniment enabling valuable information to be elicited, and participants' personal clarification of concerns; therefore establishing praxis. Issues emerged related to adult learners seeking defined expectations and effective relationships with advisors. …

Profiling The Quality Of End Of Life Care, Catherine Murton

All Theses

ABSTRACT
Despite increased national debate regarding quality of life and quality of care at the end of life, patients in the United States continue to die primarily in hospitals experiencing a myriad of distressing symptoms, leaving caregivers and healthcare professionals wondering if caring for the dying will ever change in this country. There are alternatives available, but it is necessary to assess current conditions for dying patients in order to change the status quo in end of life care. Profiling how patients experience the last few months of life, as well as their terminal hospital stay, is a starting point …

Becoming Tied: A Theory Of Adolescent Maternal-Infant Interaction, Melinda K. Sprinkle Collins

Doctoral Dissertations

The purpose of this study was to describe the interaction that occurs between adolescent mothers and their newborns while situated together in the immediate postpartum period. The researcher sought to determine: 1) What are the interactive process (es) that occur between adolescent mothers and their newborns while situated together in the immediate postpartum period, 2) What categories emerge from the adolescents’ descriptions of the mother infant situation?, and 3) How do the emergent categories relate?

Ten primiparous adolescent mothers age 17 years or less were purposively sampled to participate in this qualitative Grounded Theory study. Face to face interviews about …

Comeback Of Appalachian Female Stroke Survivors: The Interrelationships Of Cognition, Function, Self-Concept, Interpersonal, And Social Relationships., Patricia Mckenzie Vanhook

Electronic Theses and Dissertations

The purpose of this descriptive correlational study was to examine the comeback phase of the Trajectory of Chronic Illness Management for Appalachian women stroke survivors. This study predicted comeback as a relationship between physical healing, biographical reengagement, and psychological coming to terms that was mediated by rehabilitation.

The concepts were evaluated through investigation of function and cognitive abilities, self-assessment of recovery, health rating, ability to control life, relationship changes, physical and mental health, and limitations of activities due to poor physical or mental health. Data were collected using, the Stroke Impact Scale (3.0) (Duncan, Bode, Lia, & Perera, 2003), the …

Parental Decision Making In The Administration Of Stimulant Medication For Their Latency Age Children With Attention Deficit Hyperactivity Disorder (Adhd), Randye Kay Phd, Msn, Rn

Dissertations

The purpose of this study was to examine parental decision making in the administration of stimulant medication to their latency age children with Attention Deficit Hyperactivity Disorder (ADHD). Research has shown that psychostimulants, used to treat ADHD are effective for 75-90% of children (US Department of Health and Human Services, 2001), however children do not take their medication from 20-65% of the time. A qualitative study using a type of grounded theory, dimensional analysis (Schatzman, 1991), was conducted to study the experiences of fourteen parents whose children began medication treatment between the ages of 5 and 12. Semi stuctured, audiotaped …

Phlebitis Rates In Trauma Patients: Peripheral Intravenous Catheters Started In Or Outside The Emergency Department, Ligia J. Zarate

Theses and Dissertations

Ligia J. Zarate College of Nursing Master of Science Peripheral catheter-related phlebitis is the inflammation of a superficial vein that can lead to infection or thrombus formation if untreated. About 150 million peripheral intravenous catheters (PIVC) are inserted in the United States each year with phlebitis rates reported between 5% and 70%. Many PIVCs are started on trauma patients, but the rate of phlebitis in trauma patients whether the PIVC is started outside the emergency department (ED) or inside the ED is unknown. Therefore, the purpose of this pilot study was to determine phlebitis rates in trauma patients when PIVC's …

Families Moving Forward: Homeless Women With Children Transitioning To Independent Living, Kristin Elizabeth Hoyt Phd

Dissertations

Family homelessness is one of the most profound and disturbing social problems of the 21st century and is projected to remain an ongoing issue for the United States in upcoming years. The fastest growing segment in the homeless population continues to be families, specifically single women with children. One intervention to the problem of homeless women with children is by providing them with transitional housing, a step beyond the familiar short-term emergency shelter. Transitional housing typically shelters families for up to 2 years. During this extended stay, women participate in programs designed to assist them with addiction, mental health, domestic …

Transcultural Nursing Care Journey To Ecuador: Designing A Transcultural Education Course For Registered Nurses, Debra S. Zaffke

Theses and Graduate Projects

This paper describes an educational program for Registered Nurses to learn transcultural nursing care while in Ecuador. The program is based on Leininger's Culture Care Diversity and Universality nursing theory. The project framework is based on her Sunrise Enabler to Discover Culture Care. The Observation-Participation-Reflection enabler from Leininger's ethnonursing research methods is utilized as a technique to learn about the people and lifeways of Ecuador and it serves as a reliable tool to tease out information that relates to the general principles of transcultural care nursing. The paper outlines the necessity of transcultrual nursing education for practicing nurses, the scope …

Evaluation Of Student Perceived Self-Efficacy With The Implementation Of A Problem-Based Learning Module, Joel David Romero

Master's Projects

To facilitate the graduation of competent registered nurses, healthcare educators must create learning environments that foster content expertise, problem solving, collaboration, and refined learning skills. Although countless teaching strategies are in existence today, problem-based learning (PBL) has revealed noteworthy potential in healthcare education. In PBL, complex, reality-based problems are used as motivation for students to identify salient concepts, gather data, and ultimately work through posed problems. Considerable evidence supports the use of PBL as a method to promote learning, though examining knowledge alone cannot always assess actual behavioral performance. To ascertain the likelihood learned concepts would be utilized in practice, …

Waiting For The Other Shoe To Drop: The Lived Experience Of Hope For Mothers Of Premature Infants In The Neonatal Intensive Care Unit, Kristina Maria Plaas

Doctoral Dissertations

The purpose of this study was to describe the lived experience of hope for mothers of premature infants in the Neonatal Intensive Care Unit (NICU). This study was grounded in the existential-phenomenologic philosophy of Merleau-Ponty. A purposive sample of six mothers of infants born between 23 ½ and 31 weeks gestation were interviewed by the researcher 10 months to 2 ½ years after birth. Mothers were asked to think back to when their infant was in the NICU and tell about a specific time when they were aware of hope. Interviews were transcribed verbatim and analyzed following a hermeneutic process …

Why Am I Still Here, You Ask? A Phenomenological Study Of The Lived Experience Of Nurse Managers, Wendy Carlton Shea-Messler

Doctoral Dissertations

Fewer people are entering the profession of nursing. There is already a shortage of nurses, yet, many abandon the bedside for lucrative ways to practice their art and for respected positions less inhibited by bureaucratic initiatives. A significant percentage of nurses will soon retire, further diminishing the number of experienced caregivers.

Good nurses require great leaders. A primary goal of organizations is to retain and recruit effective nurse managers. This study provides insight to the needs of nurse managers and aspects that keep them from leaving their jobs. The purpose of this study was to gain a differentiated understanding of …

An Analysis Of Providers' Practices Regarding Smoking Cessation, Laurie Fowler

MSN Research Projects

Clinical guidelines are the basis of any primary care setting. They were developed in order to give the healthcare provider access to information regarding screening, assistance, and management of certain ailments. Smoking cessation education is among the many clinical guidelines. Smoking is also among the modifiable risk factors for many diseases, including heart disease and cancer. A nonexperimental, ex post facto chart review was used to evaluate if healthcare professionals provided and documented smoking cessation education. A random sample o f (N=200) patients’ charts were selected at a clinic site in Northeast Mississippi. The purpose o f the study was …

Gastric Myoelectrical Activity In Patients With Diabetes, Sandra Luberata Holmes

Theses and Dissertations (ETD)

This descriptive, correlational study investigated the associations among gastric myoelectrical activity (GMA), upper gastrointestinal (GI) symptoms, and glucose control. The study also attempted to determine whether any relationship existed between upper GI symptoms, glucose control, age, or length of diagnosis and pattern of GMA identified using electrogastrography (EGG). A total of 25 persons participated in the study. The sample was comprised of 7 healthy controls, 5 patients diagnosed with type 1 diabetes, and 13 patients diagnosed with type 2 diabetes. Electrogastrography was performed for 30 minutes in the fasting state and continued at 30-minute intervals for a total of 1-1/2 …

Health Barriers, Health Perceptions, And Cardiovascular Risk Factors Of Adolescent Black American Males, Desmarie Jackson Decuir

Theses and Dissertations (ETD)

Area of Investigation: Cardiovascular (CV) diseases are the leading cause of death among Black American adult males. Health behaviors that contribute to CV disease are probably learned during adolescence yet few researchers have studied the factors that influence health promotion behaviors in adolescent Black American males. This study described the health barriers, health perceptions (health self-efficacy and health status), and CV risk factors reported by and the influence of these variables on health promotion behaviors of a sample of Black American adolescent males without known CV disease.

Methods and Procedures: A descriptive correlation study design was used to …

Parental Perceptions Of The Management Of Childern With Type 1 Diabetes At School: A Broader Perspective, Claudia Wilde

Master's Projects

The purpose of this study was to examine parental perceptions related to the care and management of children with Type 1 diabetes at school. Parents of elementary and middle school-age children with Type 1 diabetes completed a survey questionnaire, which included one open-ended question. The questionnaire was developed by the researchers based on original questionnaires by Nabors, Lehmkuhl, Christos, and Andreone (2003) and Lewis, Powers, Goodenough and Poth (2003 ). Permission to use and modify the questionnaires was provided by Nabors and Poth. Results from this study showed a split in parental satisfaction regarding care provided by school personnel in …

Morbidity And Mortality Ofvery Low Birth Weight Infant Graduates Of A Level Three Neonatal Intensive Care Unit, Maria Cortes

Master's Projects

Purpose: To describe the morbidity and mortality of very low birth weight (VLBW) infant graduates of a level three neonatal intensive care unit (NICU) in a medically underserved population. Design: A retrospective chart analysis of 181 live born infants at a regional tertiary center between 2004-2006. Sample: Infants born with a birth weight of 425-1489 grams and gestational age of23-40 weeks (n=127). Main outcome variable: Descriptive statistics were used to describe the incidence of associated VLB W morbidities presenting after discharge along with hospital readmissions and mortality rates. Results: VLBW infants discharged from the NICU had chronic lung disease (24.4%), …

The Lived Experience Of Wives And Husbands With Coronary Heart Disease, Patricia A. Bradley Phd

Dissertations

The purpose of this feminist hermeneutic study was to discover the meaning of living in the community with a husband who has coronary heart disease (CHD). Ten women, aged 47-74 who were married from 4 to 55 years, participated in unstructured face to face interviews. The women were interviewed 6 to 18 months after their husbands were diagnosed with medically or surgically treated CHD. Audio recorded transcribed interview data were analyzed to identify the essential themes and sub-themes. Texts were interpreted guided by hermeneutic phenomenology (Gadamer 1960/1989; 1976) and van Manen's (1990) research activities. A feminist lens was applied to …

Transition To Nursing Home Of Korean-American Elders, Myungja Kim Hahm Phd

Dissertations

The purpose of this study was to explore factors affecting Korean-American (KA) elders during the transition to nursing homes in the first month following admission. The three aims of this proposed study were (1) to explore culture specific factors that affect KA elders' perspectives during the transitional period to a nursing home, (2) to identify thoughts and feelings of KA elders about their admission into a nursing home, (3) to describe the adjustment process associated with admission to a nursing home. A grounded theory design was utilized to explore KA elders' perceptions/experiences associated with adjustment to a nursing home. Open-ended, …

Screening For Postpartum Depression At Well-Baby Visits, Suzanne Mello

Master's Projects

Objective: To assess the prevalence of postpartum depression among mothers who attend first-year well-baby visits. Methods: A convenience sample of 33 women was screened during first year well-baby visits using the Edinburgh Postpartum Depression Scale (EPDS) at three pediatric offices in Northern California. Measures included demographic data, history of depression, tobacco use, strength of support system, breast/bottle feeding, and child's health. EPDS scores were collected to calculate the prevalence of postpartum depression. Results: The EPDS was administered to 33 women at first year well-baby visits. Thirty-two were completed. Sixty-six percent of women had scores < 10 indicating no depression. Thirty-four percent reported scores of>=l 0 during the postpartum year …

Barriers To Mammograms Among Women Who Are Homeless, Lucinda M. Ramirez

Master's Projects

Purpose: The purpose of the study was to identify barriers to mammogram screening among women who are homeless. Knowing the barriers to mammogram screening will be useful to advanced practice nurses for it provides insight to understanding the perceived susceptibility, benefits, and barriers of women potentially amendable to intervention. Data sources: A descriptive survey was used with a convenience sample of 41 women who were homeless, between the ages of 20-70 years, and agreed to participate in this study. The research was conducted at two homeless shelters in an urban county in Northern California. Findings: Findings reflected positive perceptions recognizing …

Cultural Self-Efficacy Of Graduating Baccalaureate Nursing Students In A State Funded University In The Silicon Valley, Lihua Liu

Master's Projects

The purpose of the study was to examine the level of cultural self-efficacy of graduating baccalaureate nursing students, who care for diverse populations, in a state funded university in the Silicon Valley, California. The level of cultural self-efficacy was measured using Bernal and Froman's Cultural Self-Efficacy Scale (CSES). A convenience sample of 48 nursing students completed an 8-item demographic questionnaire and a 26-item CSES. The subjects of this study were found to have an increased level of cultural confidence in comparison with previous studies. This study suggests nurse educators continue to incorporate cultural concepts and skills in the nursing curriculum.