Medicine and Health Sciences Commons^™

Exploring Factors That Influence The Choice To Retire From Driving In Older Adults, Debra J. Jenkins

Theses and Dissertations

No

Integration And Impact Of Stress Management And Resiliency Training (Smart) In A Nurse Residency Program: A Feasibility Study, Sherry Chesak

Theses and Dissertations

Nursing is recognized widely as a highly stressful profession, and the time of orientation is identified as the most stressful time in a nurse's career. Innovative strategies are needed to assist new registered nurses in the management and prevention of stress as a result of transitioning into the complex and challenging healthcare environment. The purpose of this study was to assess the feasibility and impact of integrating a Stress Management and Resiliency Training (SMART) program within a nurse residency program for new nurses at an academic medical center. Additional aims were to assess the effects of the program on participants' …

Representing And Retrieving Patients' Falls Risk Factors And Risk For Falls Among Adults In Acute Care Through The Electronic Health Record, Jann Pfaff

Theses and Dissertations

Defining fall risk factors and predicting fall risk status among patients in acute care has been a topic of research for decades. With increasing pressure on hospitals to provide quality care and prevent hospital-acquired conditions, the search for effective fall prevention interventions continues. Hundreds of risk factors for falls in acute care have been described in the literature. However, due to variations in the terms utilized to represent each fall risk factor, an effort to compare findings across settings and replicate research is hampered. As the expectations for the effective use of electronic health records increase, an opportunity exists to …

The Experiences Of Women Entering Methadone Treatment For Opioid Use: An Interpretive Phenomenological Inquiry, Melissa Mae Rubio

Theses and Dissertations

The United States is facing a momentous public health problem of prescription and illicit opioid use among women. Traditionally in health literature women have received less attention than men and this is especially true with regard to drug use. In terms of recovery from opioid use, treatment centers that use methadone as a pharmaceutical replacement for illicit opioids have been present in the US for decades, and women have been enrolling in treatment since its inception. However, there is little in the literature about the characteristics of these women, why they choose methadone treatment, and what their experiences are while …

Trends In Work-Related Injury Rates And The Associated Incurred Costs In Long-Term Care Centers, Darcie Lange Olson

Theses and Dissertations

Background. Nursing assistants, working in long-term care facilities, have consistently been among the top occupational groups experiencing work-related musculoskeletal injuries. These injuries have been attributed the physical demands of lifting and moving the individuals in their care. Great strides in research have identified successful risk reduction strategies such as the implementation safe patient handling and mobility programs. The benefits of these programs have been advocated over the last two decades, but the rate of injuries among nursing assistants continues to be more than double the national average for all other industries. The purpose of this study was to investigate the …

New Graduate Nurses' Experiences Of Transition During Orientation Into Critical Care, Mari Beth St Clair

Theses and Dissertations

The concept of new graduate nurses working in critical care for some healthcare systems remains a fairly new concept. Often new graduate nurses begin their orientation in critical care with minimal to no critical care experience. Orientation for the new graduate nurses can be challenging as for years new graduate nurses were not allowed to work in critical care until they had a minimum of one year of nursing experience. Currently new graduate nurses beginning employment in critical care are faced with revisiting basic nursing and learning critical care nursing at the same time. In order for critical care units …

Simulation Design Characteristics: Perspectives Held By Nurse Educators And Nursing Students, Jane Brekke Paige

Theses and Dissertations

Simulation based learning (SBL) is pedagogical method poised to innovate nursing educational approaches. Yet, despite a growing body of research into SBL, limited investigation exists regarding assumptions and beliefs that underpin SBL pedagogy. Even though key simulation design characteristics exist, the particular methods nurse educators use to operationalize simulation design characteristics and how these choices are viewed from the perspective of nursing students is unknown. Without understanding what motivates educators to design simulations as they do, it is difficult to interpret the evidence that exists to support chosen methods. Through the exploration of perspectives (points-of-view), underlying beliefs can be uncovered. …

Communication During Palliative Care And End Of Life: Perceptions Of Experienced Pediatric Oncology Nurses, Kathleen Montgomery

Theses and Dissertations

Advances in cancer and supportive therapy have led to improved outcomes for children with cancer. Despite progress, children still die from complications of cancer therapy or their disease. Communication during palliative care and end of life is essential to successful navigation through the end of life continuum. Nurse communication during palliative care and end of life is a phenomenon with limited research, and it is unclear how the level of nursing experience influences the perspectives of nurses communicating during end of life. The purpose of this dissertation study was to describe the commonalities of nurses' experiences of communicating palliative care …

Perceived Needs And Coping Resources Of Newly Hired Nurses In Transition, Catherine A. Schmitt

Theses and Dissertations

Newly hired nurses who do not transition well often leave their first nursing position or nursing prematurely, at great cost to themselves, the profession, the hiring organization and patients. The purpose of this secondary analysis study was to better understand the experience of new graduate nurses (NGNs) and experienced nurses as each group transitions to a new setting in nursing practice and the contribution the preceptor role plays in that transition. Schlossberg's Transition Theory was the framework that guided the study. The original data were collected from 118 newly hired nurses who were predominantly female and Caucasian with the majority …

A Measure Of Nephrology Nurse Perceptions Toward Advance Care Planning: Validation Of The Nephrn Perceptions Toward Advance Care Planning Instrument, Mary S. Haras

Theses and Dissertations

This dissertation is a report of a three-phase quantitative research study that included the development and testing of an instrument to examine the perceptions of nephrology nurses toward advance care planning for persons with chronic kidney disease. Phase 1 began with the identification of the dimensions of advance care planning and creation of an item pool for the instrument. The instrument was distributed to five content experts for evaluation and comments of inclusiveness to measure perceptions toward advance care planning. In Phase 2 the item pool was pilot tested in a convenience sample of 50 nephrology nurses. Exploratory factor analysis …

Personal Characteristics And Learning Preference In End-Of-Life Decision Making Of Chronically Ill Community Dwelling Elders, Leigh Ann Bonney

Theses and Dissertations

Leigh Ann Bonney, RN, MSN; Susan Kossman, RN, PhD; MyoungJin Kim, PhD; Wendy Woith, PhD, Caroline Mallory, PhD

Illinois State University, Mennonite College of Nursing

Personal Characteristics and Learning Preference in End-of-Life Decision Making of

Chronically Ill Community Dwelling Elders

Purpose and Background: Clear decision-making (DM) about end-of-life [EOL] contributes to a good death This requires knowledge of life-sustaining treatment with lack of knowledge contributing to feelings of decisional conflict Decision aids can increase knowledge, but elders' preferred learning methods are unknown. Identifying characteristics associated with preferred learning method and decisional conflict can help nurses tailor information to assist in …

Predictors Of Cooperative And Externalizing Behaviors In Siblings Of Children With Disabilities, Christine Rae Platt

Theses and Dissertations

Objective: To examine whether caregiver burden, parenting style, and sibling relationships in families raising a child with a disability (CWD) predict cooperative and externalizing behaviors in typically-developing sibling (TDS). Methods: This correlational study included 189 families raising both a CWD and a TDS. Mothers and fathers completed self-report questionnaires on caregiver burden, sibling relationships, parenting style, and TDS cooperative and externalizing behaviors. Results: Authoritative parenting was positively associated with cooperative behaviors, whereas authoritarian parenting was positively associated with externalizing behaviors. Hierarchical regression revealed caregiver burden was a significant predictor of cooperative and externalizing behaviors; however, when parenting style was added …

The Impact Of Cancer Caregiving On Cancer Caregivers: Stories Of Lives In Transition, Cynthia Marie Steinwedel

Theses and Dissertations

The purpose of the study was to examine the impact of cancer caregiving on primary caregivers, exploring their personal narratives looking back on the entire experience from diagnosis, through treatment, and beyond. Caregiving is associated with exacerbation of stress-related disorders such as hypertension and heart disease and may also be associated with increased mortality rates. Transitions theory served as the conceptual framework for the study. Eleven adult caregivers, pre-retirement age, each participated in two semi-structured interviews. Caregivers were recruited from a community cancer resource center and were purposively selected to achieve maximum variation in terms of outcome of cancer treatment. …

Reading Comprehension And Nursing Education: A Missing Variable Associated With Nursing Student Attrition?, Debra L. Lajoie

Theses and Dissertations

ABSTRACT

READING COMPREHENSION AND NURSING EDUCATION:

A MISSING VARIABLE ASSOCIATED WITH

STUDENT ATTRITION?

by

Debra L. Lajoie, MSN

The University of Wisconsin-Milwaukee

December, 2013

Under the Supervision of Susan Dean-Baar, PhD, RN, FAAN

The goals of nursing faculty and administrators are to select students most capable of completing the nursing program and to provide academic support needed for program completion. However, despite stronger entrance requirements, educators are still baffled by the persistent attrition from nursing education programs. The purpose of this study was to describe and compare the level of reading comprehension of two groups of students, a pre-nursing student …

Raising Children With Type 1 Diabetes And Celiac Disease: Parental Experiences, Kerri Louise Erickson

Theses and Dissertations

The purpose of this qualitative descriptive study was to examine parental experiences and challenges raising children with both T1DM and CD. Twenty-six families, including 30 parents (25 mothers, 4 fathers, and one custodial grandmother), participated in a 30-60 minute audio-recorded interview designed to explore parental experiences raising children with both T1DM and CD. Participants were asked IRB approved open-ended questions about their experiences raising a child with both diseases. Direct quotations best representing categories/sub-categories were identified through selective coding. Analysis revealed seven main themes: Six themes parents are concerned about, including (a) their child's health complications, b) the challenges of …

Breastfeeding Influencing Factors In Thai Adolescent Mothers, Supannee Kanhadilok

Theses and Dissertations

Background: Breastfeeding is well established as the optimal method for ensuring healthy infant nutrition. However, many adolescents remain unaware of the role of breastfeeding. Adolescent mothers continue to have the lowest rate of breastfeeding in many countries including Thailand, with only 17% of Thai adolescent mothers continuing to breastfed at 6 months postpartum. Objective: Examine factors influencing breastfeeding behaviors in adolescent mothers, particularly those in Thailand. Methods: This dissertation project involved two research studies focusing on breastfeeding influencing factors in adolescent mothers. The first study was an integrative review of 22 articles published in 2000-2012. The findings revealed that personal …

Predictors Of Agitation In The Critically Ill, Ruth Burk

Theses and Dissertations

BACKGROUND: Agitation is a common complication in the intensive care unit (ICU) manifested in behavior and actions that range from simple apprehension or anxiety to frankly combative behavior.5 Agitation is associated with significant adverse outcomes.1-3 Studies report up to 71% of ICU patients have some degree of agitation during their ICU stay and that agitation is observed 32% of the time.3;4 Potential causes of agitation in critically ill patients are numerous; however, data about factors that predict agitation are limited. OBJECTIVE: The specific aim of this study was to identify predictors of agitation on admission to the ICU as well …

Predictors Of Mexican American Nursing Student Academic Success, Belva J. Gonzalez

Theses and Dissertations

The shortage of nurses in the United States has been an ongoing concern. The need to meet the overall demand for qualified nurses is compounded by the lack of minority representation in nursing. While there are disparities in the representation of all racial/ethnic groups in nursing the lack of Hispanic nurses is of special concern. Hispanic's in the United States, at 16 percent of the total population, constitutes the nation's largest racial/ethnic minority (U.S. Census 2010). Within the Hispanic population those of Mexican American ancestry account for 63 percent of the total population. To address the health needs of America's …

Gay Men And The Intentional Pursuit Of Hiv, Thomas James Loveless

Theses and Dissertations

Hidden deep within the gay male underground lives a small population of gay men who imagined the intentional pursuit of HIV as a means to some end. In terms of nursing care for such marginalized pockets of gay men, most nurses are unaware of their existence or lack sufficient knowledge and compassion to care for this population. Bug chaser is a metaphor used to describe the gay men who intentionally sought the bug--HIV infection. Essential to caring for these men is first discovering them, and then understanding them.

The purpose of this narrative study was to understand the life experiences …

Relationships Of Contextual Supports And Barriers In Choice Behavior For Associate Degree And Diploma Registered Nurses, Sandra Lynn Nash

Theses and Dissertations

Currently, the majority of practicing registered nurses (RN) are associate degree in nursing (ADN) or diploma prepared, and the majority of ADN and diploma RNs do not return to school to get a BSN. Yet, there is increasing evidence that the educational level of a RN makes a difference in patient outcomes; having BSN RNs in a facility improves patient outcomes. Very little is known about effective strategies for ADN and diploma RNs to return to school. The Social Cognitive Career Theory (SCCT) contains a choice behavior model that could explain some of the supports or barriers for a RN …

The Historical Influence Of Politics And Society On Women's Experiences Of Abortion, Sandra Ruth Schumacher

Theses and Dissertations

One out of every three women in the United States will experience abortion (Guttmacher Institute, 2008). The purposes of this feminist qualitative research were to: 1) examine historically the context of legal abortion in the United States, 2) describe and explore women's experiences of abortion and 3) better understand the historical impact of the sociopolitical climate on women's perceptions of their abortion experiences. An historical review of political, legislative, and social contexts surrounding legal abortion revealed an increasingly hostile environment toward women seeking abortion since 1973. By challenging existing abortion laws in state and federal courts, anti-abortion legislators have removed …

Management Of The Medically Fragile Child In The K- Fifth Grade Classroom Setting, Mandy M. Cranney

Theses and Dissertations

The aim of this focused project was to explore perceptions and identify needs of teachers of medically fragile children (MFC), in the grade setting, with the hope of designing educational modules to be utilized as supportive measures by the teachers for the classroom setting. The focused project consisted of an extensive literature review of medical fragility in school age children as well as a literature review of teachers' perceptions and needs identified in the past. Nola Pender's Health Promotion Model served as the conceptual framework in designing the study. Two focus groups were conducted among grade teachers enrolled in Masters …

A Comparative Effectiveness Study Of Continuous Positive Airway Pressure (Cpap) Related Skin Breakdown When Using Different Nasal Interfaces In The Extremely Low Birth Weight (Elbw) Neonate, Katherine Newnam

Theses and Dissertations

Nasal continuous positive airway pressure (CPAP) is reportedly superior to mechanical ventilation in the neonatal population by reducing bronchopulmonary dysplasia (BPD). The neonate is vulnerable to injury secondary to immature physiological systems and skin structures and the current CPAP devices place constant pressure on nares, nasal septum and forehead, increasing injury risk. Through the framework of comparative effectiveness research an examination of nasal interfaces currently used during neonatal CPAP was conducted in an effort to provide scientifically supported recommendations and improve clinical outcomes. The primary aim of this study was to determine differences in the frequency, severity and specific types …

Rural School Employees' Awareness And Perceptions Of Adult Vaccinations: A District-Wide Study, Eli Gary Thornton

Theses and Dissertations

As key members of the school environment, it is important for school employees to be vaccinated. Employees are in direct contact with children in close quarters for long periods of time and such an environment can easily serve as an outbreak center for vaccine-preventable communicable diseases such as measles. Despite the fact that most school employees believe vaccines are safe and effective and many school employees report they are up-to-date with their vaccines, a closer examination reveals discrepancy between belief and behavior. As a vaccine advocate, the school nurse can be influential in providing adult vaccination education for school employees, …

Caregiver Burden And Sibling Relationships In Families Raising Children With Disabilities, Diane W. Allred

Theses and Dissertations

The purpose of this study was to examine sibling relationships and caregiver burden in families raising children with disabilities (CWD). In order to determine (a) are there differences in caregiver burden according to parent gender and types of disability (b) are there differences in sibling relationships according to parent gender and type of disability and (c) is there a relationship between caregiver burden and sibling relationships after controlling for CWD and sibling gender and age, and type of disability? After IRB approval, 166 families living in the west and raising typically developing children (TDC) or a CWD participated. Disabilities included …

Vaccination Perceptions And Barriers Of School Employees: A Pilot Study, Kim Cranney Houle

Theses and Dissertations

Schools are group settings where vaccine-preventable diseases can spread quickly, especially if vaccination rates are suboptimal. Vaccination of school children has been the subject of many studies; however, data are lacking regarding the vaccination status, vaccination perceptions, and potential barriers to vaccination for school employees. Method: A questionnaire was developed to measure school employees' perceptions,awareness of current vaccination status, and potential barriers to vaccinations. This study included a convenience sample of 277 employees from a small urban school district located in central Utah. Results: Adult vaccination knowledge is lacking in the school employee population, with over half believing they were …

Prevention Of Skin Breakdown In The Pediatric Intensive Care Unit, Lydia H. Palmer

Theses and Dissertations

Skin breakdown occurs when one or more layers of the skin have been disrupted (McLane et al., 2004; National Pressure Ulcer Advisory Panel, 2007). While some literature uses the terms skin breakdown and pressure ulcer interchangeably, these are actually two distinct conditions and pressure ulcers are encompassed in the definition of skin breakdown (Kuller, 2001; Lund, 1999; Suddaby et al., 2006). The consequences of skin breakdown in the pediatric population can include increased cost of treatment, infection, increased morbidity and mortality as well as psychological consequences from resulting alopecia or scarring (Schindler, 2010; Willock & Maylor, 2004). Development of skin …

A Pilot Intervention To Engage Nurses To Lead Transformation Of The Workplace, Molly Patton

Theses and Dissertations

The often toxic work environment in which nurses practice contributes to decreased well-being, job dissatisfaction, and poor retention rates, while negatively impacting quality and patient safety. Most leadership programs and resources target nurses in formal leadership positions and are exclusive of the bedside nurse. The purpose of this research utilization project was to determine immediate and short-term outcomes of an educational leadership workshop for nurses, including intent to change the work environment and subsequent action to change the work environment. The goal was to develop, deliver, and evaluate an evidence-based educational intervention to empower nurses at all levels of care …

Best Practice Guideline For Managing Interstitial Cystitis In Adult Women, Amanda Thomas Langford

Theses and Dissertations

Interstitial cystitis/painful bladder syndrome (IC/PBS) is a chronic disease characterized by symptoms of urinary urgency, frequency, bladder pain, and chronic pelvic pain in the absence of known pathology. Selection of appropriate treatments depended on the severity of the patient's symptoms and patient's preference. This review found that it is important for providers and patients to set realistic goals for symptom improvement when starting a new treatment.

The purposes of this project was to 1) conduct a substantive literature review on treatment guidelines for IC/PBS, 2) analyze the literature for comparing oral pharmacological interventions and behavioral interventions for IC/PBS, and 3) …

The Use Of Ultrasound As An Adjunct To X-Ray For The Localization And Removal Of Soft Tissue Foreign Bodies In An Urgent Care Setting, Stacy Lane Merritt

Theses and Dissertations

Embedded soft tissue foreign bodies are common complaints of patients presenting to rural urgent care centers. The removal of soft tissue foreign bodies present challenges for the healthcare provider when objects are radiolucent and cannot be identified on readily available diagnostic imaging modalities such as plain radiographs (X-rays). Ultrasound has been introduced in the literature as a useful adjunct to X-rays for the localization and removal of soft tissue foreign bodies. The purpose of this research utilization project was to report the use of bedside ultrasound by healthcare providers as an adjunct to X-ray for the localization and removal of …