Implementing Universal Adult Depression Screening In A Rural Maine Free Medical Clinic, Karen Hussion

Doctor of Nursing Practice Scholarly Projects

Abstract

BACKGROUND: Depression in adults is a leading cause of disability, morbidity and mortality worldwide with an estimated prevalence of 20% in the US population. Despite estimates that one out of every five Americans suffers from depression, less than 50% of adult primary care patients with depression are identified, and less than 5% of all adult primary care patients are screened. To increase early detection and management of depression, the United States Protective Service Task Force (USPSTF) recommends routine depression screening for adults older than 18 years in primary care settings.

LOCAL PROBLEM: This project site was a rural, free, …

Factors Influencing Medication Adherence Among Adults Living With Diabetes And Comorbidities: A Qualitative Systematic Review, Kendall Gow, Amineh Qin, Lisa Whitehead

Research outputs 2022 to 2026

Purpose of review: Medication adherence plays an important role in improving health outcomes related to diabetes and comorbidity. The potential factors influencing medication adherence and how they contribute to health behaviors have not been synthesized to date. This review synthesized qualitative studies that identified factors influencing medication adherence among adults living with diabetes and comorbidity. Recent findings: Twenty-eight findings were extracted and synthesized into four themes: perceived support, lack of knowledge, medication issues, and the importance of routine. The findings highlight the factors that support medication adherence and areas that can be targeted to support and promote medication adherence. The …

How Does The Use Of Telemonitoring In Adult Patients With Uncontrolled Hypertension Improve Blood Pressure Control? An Integrative Review, Lucie Bakop

Doctoral Dissertations and Projects

Hypertension is an evolving problem worldwide and it constitutes a great risk for cardiovascular diseases. Despite the research and new drugs on the market to manage high blood pressure, hypertension remains the leading cause of disability-adjusted life and death worldwide. With many people suffering from hypertension around the world, and the burden of uncontrolled hypertension, it is imperative to find an intervention that can improve blood pressure control. To better target uncontrolled hypertension, the conventional method of management of high blood pressure based on in-person visits has shown some limitations and it must be combined with a contemporary approach that …

Implementation Of 3-Minute Diabetic Foot Exam For At Risk Diabetic Patients In Urban Primary Care Setting, Suzana Alvarez

DNP Projects

Background: Healthcare providers manage chronic health concerns by reducing the risk of diabetic complications among their patient population. In 2017, diabetes was the seventh leading cause of death in the United States and Connecticut. In Connecticut, there are 19,500 newly diagnosed diabetics and four Connecticut cities have higher occurrence of diabetes: Waterbury, New Britain, Hartford, and Bridgeport. Bridgeport Primary Care (BPC) had no policy or procedure in place to require the providers to complete a routine diabetic foot exam. The aim of this project was to promote and implement a tool to assist the BPC providers in evaluating adult …

Satisfaction And Effectiveness Of Opioid Pain Management Among Adults With Cystic Fibrosis: A Mixed Methods Study, Sarah Allgood, Jessica L. Zemlak, Elisabeth Dellon, Siddhartha G. Kapnadak, Jessica Goggin, Noah Lechtzin

College of Nursing Faculty Research and Publications

Background

Chronic pain is common among people living with cystic fibrosis (CF) and associated with worse clinical outcomes. Despite this, little is known about how pain is managed and how opioids are used to treat pain. The purpose of this convergent mixed methods study was to examine self-reported satisfaction and effectiveness of pain management strategies among a sample of adults with CF who are prescribed opioids.

Methods

We developed an online survey querying 4 domains - demographics, pain characteristics, pain communication, and management strategies. This was distributed nationally to adults with CF (n=48) via various online platforms. We obtained quantitative …

The Mediating/Moderating Role Of Cultural Context Factors On Self-Care Practices Among Those Living With Diabetes In Rural Appalachia, Brittany L. Smalls, Adebola Adegboyega, Ellen Combs, Matthew Rutledge, Philip M. Westgate, Md. Tofial Azam, Felipe De La Barra, Lovoria B. Williams, Nancy E. Schoenberg

Family and Community Medicine Faculty Publications

Background

The aim of this study was to examine whether cultural factors, such as religiosity and social support, mediate/moderate the relationship between personal/psychosocial factors and T2DM self-care in a rural Appalachian community.

Methods

Regression models were utilized to assess for mediation and moderation. Multilevel linear mixed effects models and GEE-type logistic regression models were fit for continuous (social support, self-care) and binary (religiosity) outcomes, respectively.

Results

The results indicated that cultural context factors (religiosity and social support) can mediate/moderate the relationship between psychosocial factors and T2DM self-care. Specifically, after adjusting for demographic variables, the findings suggested that social support may …

Continuous Glucose Monitoring, Type 2 Diabetes And Hemoglobin A1c: An Integrative Review, Kimberly Dawn Fairchild

Doctoral Dissertations and Projects

Continuous glucose monitors (CGMs) are used to measure a patient’s glucose levels every few minutes around the clock. According to the National Institute of Diabetes and Digestive and Kidney Disease (NIDDK), CGMs are mostly used by Type 1 Diabetes Mellitus patients, but research has shown that Type 2 DM patients can benefit from them as well (Ida et al., 2019; NIDDK, 2017). Glucose levels can change over hours or days, and seeing the trends by using a CGM will help patients make more informed decisions about the food they eat and how much they exercise, and the type and amount …

The Prediction Of Behavioral Health Outcomes In Adults With Sickle Cell Disease Using The Chronic Disease Outcomes Triad Model, Lisa G. Fryar

FIU Electronic Theses and Dissertations

The lifelong experience of acute and chronic pain associated with sickle cell disease (SCD) not only has damaging physiological sequelae, but it also can negatively impact affected persons psychologically and socioculturally. These triad of SCD sequelae have an inter-relational and interactional mind-body-social connection that impact the behaviors of adults with SCD. These physiological, psychological, and sociocultural domains comprise the triadic sequelae.

The purpose of this study was to investigate the inter-relational and interactional mind-body-social relationship of the triadic sequelae in SCD as predictors of behavioral health outcomes (i.e., sickle cell fatalism, perceived sickle cell prejudice, and SCD self-efficacy) based on …

Falls Prevention Among Older Adults At A Nursing Home In A Northern Suburban Of Perth In Western Australia, Horatius Musembi, Deborah Sundin

School of Nursing & Midwifery, East Africa

The objective was to identify factors leading to falls and determine the role of nurses and carers play in falls prevention. A retrospective audit of the performance of nurses and carers regarding falls prevention among older adults was used. Residents who had a fall during July 2015 (n=25) were identified using purposeful sampling. Data for this study were collected from the files of these residents. Data analysis was done by using the Fisher exact test which was appropriate for the collected data. Residents aged 85-89 years had the most falls (32%); however, one resident who fell five times in the …

Using Mobile Health To Improve Mild Depression Outcomes In Adult Primary Care, Michele Marek

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Mild depression is a common patient complaint in primary care, potentially impairing role function in multiple dimensions, with risk for escalation to severe Major Depressive Disorder (MDD), a chronic, recurring illness with multiple comorbidities at high emotional and economic cost to individuals, families, and society. Barriers to care include lack of access to Mental Health Specialists, financial constraints and stigma, all of which can cause escalation of symptoms to the point of disability and are magnified in underserved populations.

Purpose: The primary goal of this quality improvement (QI) project was to improve depression symptoms using the evidence-based mobile …

The Role Of Spirituality And Religiosity In Persons Living With Sickle Cell Disease, Dora L. Clayton-Jones, Kristin Haglund

College of Nursing Faculty Research and Publications

Purpose: Sickle cell disease (SCD) is a serious debilitating chronic illness, affecting approximately 90,000 Americans and millions globally. Spirituality and religiosity (S/R) may ease the burden faced by persons living with SCD. The purpose of this study was to examine the role of S/R in adolescents and adults living with SCD in the research literature.

Method: The electronic databases Cumulative Index to Nursing and Allied Health Literature, Health Source Nursing/Academic, ProQuest Health Module, PsycINFO, Medline, PubMed, and the American Theological Library Association were searched from January 1995 to December 2014.

Findings: Of the 89 studies retrieved, 11 articles between 2001 …

Vaccination Perceptions Of Urban School Employees, Janelle L. B. Macintosh, Karlen E. Luthy, Katreena C. Merrill, Renea L. Beckstrand, Lacey M. Eden, Emily L. Wright

Faculty Publications

The purpose of this study was to explore public school employee perceptions regarding vaccinations. Employees from 1 urban school district in Utah responded to the School Employees' Perception of Immunizations Questionnaire. Lack of perceived efficacy was the most common explanation for lack of seasonal influenza vaccine. Being unsure of need was the most common reason participants were unvaccinated for measles, mumps, and rubella. The most common reason for rejecting a mandatory vaccine policy was a perceived violation of personal freedoms. Nurse practitioners can positively influence the health of public school employees by ensuring they are properly vaccinated.

A Review Of The Evidence: Prewarming Adults Prior To General Anesthesia In The Prevention Of Unplanned Perioperative Hypothermia, Paige F. Wrigley

Senior Honors Theses

Unplanned perioperative hypothermia (UPH), a common event in the surgical setting, is associated with many adverse patient outcomes. In current perioperative practice, patient core temperature is monitored and active warming interventions are implemented during the intraoperative and postoperative phases in response to UPH. The literature suggests preoperative warming of patients as a proactive measure may be more effective in the prevention of UPH. In the form of an integrative review, this thesis seeks to address the research question: For adult patients undergoing general anesthesia, how does preoperative warming compared to no preoperative warming affect UPH incidence? A database search yields …

Shared Care Dyadic Intervention: Outcome Patterns For Heart Failure Care Partners, Margaret Sebern, Aimee Woda

College of Nursing Faculty Research and Publications

Up to half of heart failure (HF) patients are readmitted to hospitals within 6 months of discharge. Many readmissions are linked to inadequate self-care or family support. To improve care, practitioners may need to intervene with both the HF patient and family caregiver. Despite the recognition that family interventions improve patient outcomes, there is a lack of evidence to support dyadic interventions in HF. Thus, the purpose of this study was to test the Shared Care Dyadic Intervention (SCDI) designed to improve self-care in HF. The theoretical base of the SCDI was a construct called Shared Care. Shared Care represents …

Type B: Congnitive/Attitudinal Characteristics, Stress Reactivity, And Health Status, Sandra Thomas

Faculty Publications and Other Works -- Nursing

Little is known about the Type B behavior pattern which is allegedly antithetical to the coronary-prone Type A pattern. The purpose of this study was to develop a descriptive profile of individuals in middle adulthood who exhibit the Type B pattern. Cognitive/attitudinal characteristics, stress reactivity, and health status were examined in 98 adults. The results indicated that Type Bs had better general health than Type As, fewer days ill during the past year, fewer physician visits, fewer hospitalizations, fewer surgical procedures, and fewer prescription medications. Type Bs were more likely than Type As to hold internal locus of control beliefs, …