Medicine and Health Sciences Commons^™

Sleep Loss And Its Health Impact Among Family Caregivers Of Persons With A Primary Malignant Brain Tumor, Jean Pawl

Nursing Dissertations (PhD)

Sleep impairments for caregivers are multifactorial. Assumptions are that caregivers of those with primary malignant brain tumors (PMBT) are similar to caregivers of persons with dementia as cognitive impairments are present at diagnosis. The shorter trajectory of PMBTs and rapid deterioration of recipients’ health may influence sleep in caregivers of persons with a PMBT. The purposes of this study were to use a sleep impairment model to characterize caregiver sleep using objective and subjective measures, and to examine sleep loss effects on psychosocial and physiologic health outcomes.

A secondary data analysis using baseline data from a larger study of mind-body …

Social Ecology Of Adherence To Hypertension Treatment In Latino Migrant And Seasonal Farmworkers, Eleanor M. Hall

Nursing Dissertations (PhD)

The prevalence of hypertension (HTN) is high in Latinos (Latino/Latina) Americans due to social and ecological factors. Increased migration of Latino migrant/seasonal farmworkers (MSFW) to the U.S. augments the social, economic, environmental, and psychosocial factors associated with health and illness. Bronfenbrenner’s Ecological Systems Theory was used to guide this study. The purposes of this cross-sectional, correlational study were to explore Latino MSFWs’ adherence to HTN treatment (medication adherence, blood pressure [BP] self-care, and BP control) and to examine the influence of BP knowledge, perceived stress, acculturation, health literacy, and health care access (HCA) on adherence to HTN treatment.

A total …

The Experiences Of Obese African American Women And Their Utilization Of Preventive Healthcare Services, Winsome Beverly Stephenson

Nursing Dissertations (PhD)

Obesity is associated with higher death rates from breast and gynecological cancers. African American women(AAW) are more likely to be diagnosed with these cancers at later stages and have lower survival rates than Caucasian women. African American women are also disproportionately affected by obesity. Studies suggest that the healthcare experiences of obese women (primarily stigmatization), may contribute to their decisions to utilize healthcare services. However, these studies have largely comprised Caucasian women; there remains a paucity of studies addressing this issue in AAW. The purpose of this study was to explore the healthcare experiences of obese AAW and their utilization …

Perceived Susceptibility Of Cardiovascular Disease As A Moderator Of Relationships Between Perceived Severity And Cardiovascular Health Promoting Behaviors Among Female Registered Nurses, Deborah Mcclendon

Nursing Dissertations (PhD)

Significance: Morbidity and mortality related to CVD among women in the U.S. and most developed countries surpasses that of all cancers combined (AHA, 2008). Yet, CVD in women remains understudied, yielding low awareness among women and healthcare providers. The purpose of this study was to examine whether the relationship between health beliefs related to perceived cardiovascular disease (CVD) severity and health promoting behaviors were different in women with high self perception of CVD susceptibility versus women with low self perception of CVD susceptibility.

Methods: This study used a descriptive, correlational design. A convenience sample (N = 220) included female registered …

Perceived Health Status, Source Of Care And Health Outcomes Of Individuals With Self-Reported Mental Disorders, Rita Marie W. Lumansoc Dr.

Nursing Dissertations (PhD)

In Healthy People 2010, mental health is listed as a major public health concern as evidenced by an alarming increase in the number of individuals who suffer from mental disorders. Mental disorders are a treatable public health condition. However, health disparities in the treatment of mental disorders are evident. The purpose of this study was to examine factors that affected health outcomes of persons with mental disorders. Two specific aims were addressed: Aim 1: to examine the relationships of population characteristics (predisposing factors and enabling resources), health behaviors (health services use and health practice); and health outcomes (physical health status …

Factors Influencing Female Caregivers' Appraisals Of Their Preschoolers' Behaviors, Sallie P. Coke

Nursing Dissertations (PhD)

Children with psychologically vulnerable caregivers may be at risk for being labeled as having behavior problems when typical behaviors are viewed by their caregivers as problematic. Research examining the accuracy of the caregivers’ perceptions of children’s behaviors is limited. The purpose of this study was to use the Resiliency Model of Family Stress, Adjustment, and Adaptation to explore family and female caregiver factors associated with appraisals of children’s behaviors, the extent to which these appraisals may be distorted and children’s level of risk of having behavioral problems.

A cross-sectional, correlational design was used. Data were collected from female caregivers of …

The Experiences Of Medically Fragile Adolescents Who Require Respiratory Assistance, Regena Spratling

Nursing Dissertations (PhD)

The population of medically fragile adolescents has grown in recent decades because of the sequelae of prematurity, injuries, and chronic or terminal illnesses. Medically fragile adolescents who require respiratory assistance are part of this unique population with challenges in their daily lives, yet as nurses, we know little about their experiences and the best approaches to use in caring for them. The purpose of this study was to explore the experiences of medically fragile adolescents who require respiratory assistance.

Interpretive phenomenology was used to describe and interpret the experience of 11 medically fragile adolescents who required respiratory assistance. The adolescents …

Factors That Influence Smoking Cessation In Women Following An Invasive Cardiovascular Procedure, Leslie C. Moore

Nursing Dissertations (PhD)

Women smokers with heart disease (HD) are at increased risk for negative health effects. At the time of invasive cardiovascular (CV) interventions is a critical opportunity to make lifestyle changes to reduce future CV interventions. The purposes of this study guided by the Health Belief Model were to determine which factors predict smoking cessation (SC) in women following an invasive CV procedure and to explore assistance received with SC.

A correlational, prospective design was used. Data were collected from women smokers at the time of an invasive CV intervention and three months later. Instruments measured commitment to stop smoking, perceived …

Personal Factors, Perceptions, Influences And Their Relationship With Adherence Behaviors In Patients With Diabetes, Glenn E. Hagerstrom

Nursing Dissertations (PhD)

Problem and significance: Adherence to health-promoting behaviors in a diabetes self-care regimen is essential for individuals with diabetes and can assist providers and individuals with diabetes management. The purpose of this research was to explore the relationship between personal factors (age, length of diabetes diagnosis, perceived health status, weight), perceived barriers to action (number of barrier days), interpersonal influences (social support), situational influences (depressive symptoms), and patient adherence to health-promoting behaviors (blood glucose monitoring, diet, and exercise) and health outcomes ( A1c and body mass index) in a diabetes self-care regimen.

Methods: A descriptive correlational analysis was performed using baseline …

The Relationship Of Personal Characteristics, Behavorial Capability, Environmental Factors, And Hypertension Medication Adherence In African American Adults With Metabolic Syndrome, Karen Andrea Armstrong

Nursing Dissertations (PhD)

Disparities in medication adherence (MA) associated with African American (AA) adults may be related to a dynamic interplay between personal factors, behavioral capability, and environmental factors. The purpose of the study was to examine this relationship in AA adults with metabolic syndrome (MetS). A cross-sectional, correlational analysis was conducted from baseline data from a larger intervention study. Constructs from the Social Cognitive Theory were used to predict MA. The sample of 91 AA adults with MetS was primarily middle-aged (age range 45-70 years old; M 53, SD 6.3), female (79%), relatively well-educated, and married. Despite being on antihypertensive medications, 53% …

The Effects Of Pattern Recognition Based Simulation Scenarios On Symptom Recognition Of Myocardial Infarction, Critical Thinking, Clinical Decision-Making, And Clinical Judgment In Nursing Students, Susan A. Walsh

Nursing Dissertations (PhD)

In the United States nearly 1 million annual new and recurrent myocardial infarctions (MI) occur with 10% of patients hospitalized with MI having unrecognized ischemic symptoms. Inexperienced nurses are expected to accurately interpret cardiac symptom cues, possibly without ever having experienced care of patients with MI, yet have been shown to be less able to classify symptom cues and reach accurate conclusions than experienced nurses. The purpose of this study was to test an educational intervention using theories of pattern recognition to develop CT in MI and improve nursing students’ clinical decision-making and clinical judgment using high fidelity patient simulation. …

Understanding The Health Beliefs Of First Time Mothers Who Request An Elective Cesarean Versus Mothers Who Request A Vaginal Delivery, Deborah T. Macmillan

Nursing Dissertations (PhD)

Little is known about how the decision for elective cesarean section comes about in the clinical environment. A prospective longitudinal study based on the Health Belief Model was conducted about first time mothers’ decision making processes and their health beliefs which led to their satisfaction with their decision about their mode of delivery. A convenience sample of 144 nulliparous women with singleton pregnancies and no medical indications requiring a cesarean delivery were recruited using internet based informational notices and with flyers. Women (n = 127) planning a vaginal delivery (VDMR) represented 88.2% of the sample and women (n = 17) …

Invisible Motherhood: A Heideggerain Hermeneutical Analysis Of Motherhood Among Three Generations Of African American Women, Katherine Ferrell Fouquier

Nursing Dissertations (PhD)

The mothering role of African American women has largely been ignored in the literature. Contemporary research on the construct of becoming a mother has focused on upper middle class, White women who are partnered. When African American women are included in research, they are often poor, single, teenage mothers and their experiences have not been described within the context of the African American worldview. Hermeneutic phenomenology from an afrocentric feminist perspective is the methodological approach used in this study to provide insight, analysis, and understanding of the experiences of three generations of African American women in the transition to motherhood. …

Nurses' Experiences With The Disclosure Of Errors To Patients, Debbie Greene

Nursing Dissertations (PhD)

The 1999 Institute of Medicine report, To Err is Human, raised awareness about the multitude of errors that occur in healthcare. Frequently, errors are not disclosed to patients or their families. While several studies have examined patient and physician perspectives on disclosure, limited research on nurse perspectives exist. In hospitals, nurses are often the last line of defense before errors reach the patient. Because nurses are often present when errors occur, nurses’ experiences with disclosure are integral to understanding the issues that surround the disclosure of errors. The purpose of this study was to gain an understanding of nurse experiences …

The Relationship Betwen Perceived Wellness And Stages Of Change For Exercise Among Rural African American Women, Imani Carolyn Goodwin

Nursing Dissertations (PhD)

Cardiovascular disease (CVD) is the leading cause of death among women in the US, and African American women (AAW) have a disproportionately high rate of deaths from CVD. Physical inactivity plays a major role in CVD development. It has been reported that some rural women have low rates of physical activity; 39% of White women and 57% of women of color are reported to be physically inactive. Rural AAW have a high mortality and morbidity rate related to CVD and a high rate of physical inactivity. The purpose of this study was to describe rural AAW’s perception of wellness in …

Clinical Decision-Making Of Nurses Regarding Elder Abuse, Diana J. Meeks-Sjostrom

Nursing Dissertations (PhD)

A descriptive correlational design based on an adapted model of Donabedian’s Structure, Process, Outcome model and Benner’s Novice to Expert theory was used to examine the clinical decision-making of nurses regarding elder abuse. The relationship of the nurses applied knowledge (assessment cues) of elder abuse; demographic questions (e.g. years of experience as a Registered Nurse (RN) and their clinical level of practice status), the use of intuition in nursing practice; and clinical decision outcomes (interventions) for patients in cases of suspected elder abuse was examined. A convenience sample of RNs who worked in the emergency department (ED) in three acute …

A Study About Older African American Spousal Caregivers Of Persons With Alzheimer's Disease, Lillian D. Parker

Nursing Dissertations (PhD)

The purpose of this descriptive correlational study was threefold: (a) to assess the relationships between boundary ambiguity, spirituality, marital relationship quality, and caregiver strain and depression among older African American spousal caregivers of persons with Alzheimer’s Disease (AD); (b) to identify which variables are the best predictors of caregiver strain; and (c) to identify which variables are the best predictors of depression. The sample consisted of 25 female and 15 male spouses, who were ages 60 to 87. The data were analyzed using descriptive statistics, Pearson correlation coefficients, and multiple regression. Marital relationship quality was correlated with the two dependent …

Prostate Cancer Screening Patterns Among African American Men In The Rural South, Joann Simon Oliver

Nursing Dissertations (PhD)

Prostate cancer is the most commonly diagnosed cancer and the second leading cause of cancer death among men in the United States. In African American men, the disease is typically detected at a more advanced stage and mortality is twice the rate of Caucasian men. However, African American men are less likely to participate in prostate cancer screening. The purpose of this descriptive study was to assess the relationship between health beliefs, knowledge, and selected demographic variables (age, income and education) and a man’s decision to participate in prostate cancer screening among African American men dwelling in rural communities. The …

Understanding Teen Pregnancy Through The Younger Sister's Voice: A Focused Ethnography, Bonnie J. Simmons

Nursing Dissertations (PhD)

Each year in the United States between 800,000 and 900,000 adolescents, aged 19 or younger, become pregnant. Over one-half of these pregnancies end in a live birth. Several studies have shown that the younger sisters of adolescent mothers have teenage childbearing rates two to six times higher than childbearing rates of women in the general population. The purpose of this focused ethnography was to gain a better understanding of the influences of a pregnant and parenting adolescent on her younger sister. Purposeful sampling was used to recruit younger sisters of parenting teens. Fifteen (15) African American females, ranging in age …

Illness Representations, Emotional Distress, Coping Strategies, And Coping Efficacy As Predictors Of Patient Outcomes For Type 2 Diabetes, Patricia Lynn Hart

Nursing Dissertations (PhD)

Diabetes mellitus affects 20.8 million Americans in the United States and is the fifth leading cause of death in the United States. Acute and chronic disease-related complications can have a devastating effect on the life of individuals with Type 2 diabetes. Reduction in acute and chronic complications can be best achieved by individuals’ adhering to appropriate lifestyle changes and maintaining tight glycemic control through a process of self-regulation. Self-regulation treatment decisions and lifestyle behavioral changes can be influenced by physiological and psychosocial factors. The purpose of this study was to examine the relationship between illness representations, emotional distress, coping strategies, …

Factors Influencing Surrogate End-Of-Life Healthcare Decision-Making For A Family Member With Alzheimer's Disease, Sharlene Toney

Nursing Dissertations (PhD)

Alzheimer’s disease (AD), a chronic terminal disease, progressively impairs cognitive function resulting in deterioration of intellect, memory, and personality. With disease progression, the surrogate decision-maker becomes more involved in intervention choices and end-of-life (EOL) care, which may or may not be based on patients’ wishes or best practice guidelines. Yet surrogate decision outcomes involve important issues of medical futility, quality of life and death. The purpose of this study was to examine factors that influence surrogate health care decision-making for a family member during the terminal stage of AD. A descriptive, predictive design was used to address the research questions: …

Maternal Confidence Of First-Time Mothers During Their Child's Infancy, Kendra Russell

Nursing Dissertations (PhD)

Motherhood is a rewarding, but challenging experience. Mothers are expected to balance parenting with multiple roles including employment. How mothers adjust is influenced by their confidence in their role, their mental health, the social support from their partner, family, and friends, and their perceptions of their infants (Mercer, 1995). Maternal confidence has been identified in the literature as an essential variable in the adaptation to motherhood and to the maternal role (Mercer, 1986; Walker, Crain, & Thompson, 1986). Low maternal confidence delays the transitioning into the maternal role/identity as well as limits the satisfaction in the mothering role (Mercer, 1986). …