Medicine and Health Sciences Commons^™

Feasibility Study Among Military Personnel With Traumatic Amputation During Military Combat Or Training, Michele (Shelly) R. Burdette-Taylor Phd, Msn, Rn-Bc, Cwcn, Cfcn

Dissertations

Military operations have resulted in a significant number of mangled extremities leading to traumatic amputations. Extremity injuries predominate, representing 50% to 70% of all injuries treated (Melcer, 2010). The majority of injuries sustained in Operation Endearing Freedom/Operation Iraqi Freedom (OEF/OIF) are combined penetrating, burn and blast injuries, traumatic amputation, and infections from the multi-drug resistant organism, Acinetobacter (Melcer, 2010). The purpose of this study was to measure the quality of well-being and impact of events in a group of adults who served in the U.S. armed forces and sustained the loss of one or more limbs during any combat or …

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. …

Shrouded In Stigma: A Heuristic Study Of Living With Hiv, Neal Stacy Rosenburg

Dissertations

HIV-related stigma is a serious hindrance to addressing the recruitment, maintenance, and follow-up nursing care of HIV-infected persons. This study was anchored within the heuristic research model, which engaged both the researcher and participants in a dialogical and aesthetic manner to unveil the stigma of HIV. The close proximity of the researcher and study participants revealed the most visceral, emotional, and self-reflective nature of gathering data, while maintaining the integrity and rigor of a qualitative study. The purpose of this heuristic study was to examine the lived experiences of HIV-infected individuals relating to internalized stigma within an existential context. This …

The Cultivation And Practice Of Spiritual Care Expertise In An Inpatient Palliative Care Setting, Gail Elaine Pittroff

Dissertations

Caregivers involved in palliative care seek to understand problems and challenges at end of life through research to determine the best care for patients and their families. Spiritual care is a key component of quality end of life care, yet there is a paucity of research on spiritual care in inpatient settings at end of life in nursing literature. The purpose of this study was to examine the personhood and spiritual care practices of inpatient palliative nurse consultants. This study describes expert nurse’s experience of delivering spiritual care for patients and families at end of life in inpatient palliative care …

Mother-Infant Synchrony During Infant Feeding, Barbara Reyna

Theses and Dissertations

MOTHER-INFANT SYNCHRONY DURING INFANT FEEDING By Barbara A. Reyna, PhD A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University. Virginia Commonwealth University, 2010. Major Director: Rita H. Pickler, PhD Endowed Nursing Alumni Professor Department of Family and Community Health Nursing, School of Nursing Synchrony between a mother and her infant is fundamental to their developing relationship. Feeding is an essential activity that provides an opportunity for interaction between a mother and her infant and may lead to synchronous interaction. The purpose this study was to develop and test a …

Awareness Cultivation: Designing A Transcultural Patient Family Advisory Council, Lisa G. Peterson

Theses and Graduate Projects

This project explores the rationale that supports designing and implementing a transcultural patient family advisory council (PFAC) at a large academic center in the Midwest where eight disease-diagnosis based PFAC's already exist. Potential pitfalls and obstacles that could interfere with such a council being successful will also be reviewed. In addition, Madeline Leininger's theory of Culture Care Diversity and Universality is applied to add support to this effort. Specifically, the stranger to trusted friend enabler explains how having such a committee can foster mutually beneficial relationships that demonstrate a change in culture and attitudes at this traditional physician-lead institution.

Replicating Success: Developing An Educational Process For Improving Nursing Accuracy When Using A Patient Classification System, Dewey M. Moulton

Theses and Graduate Projects

The use of patient classification systems (PCS), within hospitals has been and still is utilized primarily for determining staffing requirements, based upon the projected needs of the patient. Since its conception in the 1950's, health care management has worked to develop a system that accurately depicts those needs to provide good patient care. Recently, a major tertiary health care center located in the Midwest region of the United States implemented a revised patient classification system within its acute care setting. Nurses were provided various levels of education regarding its use. Because of this, accuracy by nurses using the patient classification …

Caring Beyond Constraint: A Nursing Model Of Presence In A Time Limited Procedural Practice, Laura Becker

Theses and Graduate Projects

The purpose of this paper is to support the value of maintaining presence within a time limited procedural practice. Specifically, it presents the significance of a nursing presence model based on Jean Watson's human caring theory within an outpatient procedural endoscopy unit which has high patient volumes and time limited processes. It describes the process for developing a care model of nursing presence and methods used to integrate this model into practice. It also includes an evaluation of the methods to determine themes and make comparisons to determine effectiveness of theory integration into nursing practice.

The Mother's Perspective: Understanding More About The Health Care Needs Of The Preschool Child With Autism, Margaret W. Bultas

Dissertations

Background Information: The prevalence of autism spectrum disorders (ASD) has dramatically risen over the last decades. It is known that children with ASD visit health care providers (HCP) more frequently than typically developing peers. Given behavioral and medical complexities of these children, mothers may experience barriers in this process. Purpose: The purpose of this study was to gain a better understanding of mothers’ experiences of taking their children to the HCP. Aims of this study were to reveal mothers’ concerns related to these experiences, examine resources and barriers affecting the quality of the visit, and discover more about the effect …

Spermatogenesis: Laser Microdissection Optimization, Deborah Ann Hansen

Dissertations

Studies link paternal environmental exposures to pesticides, herbicides, and radiation to adverse reproductive outcomes such as developmental delays, malignancies, and structural birth defects. To date, 900 children of Vietnam veterans with presumed Agent Orange exposure receive VA presumptive service connected benefits because these children have Spina Bifida. To date, there are limited data to explain the underlying causal mechanisms whereby paternal environmental exposures result in adverse reproductive events. Laser microdissection (LMD) is the only technology that allows the isolation of cell subpopulations from complex tissues such as the testes without disturbing the cell’s bimolecular signature. LMD is essential in the …

Thinking Differently: Developing A Fall Risk Assessment For The Emergency Department Setting, Carissa K. Fauks

Theses and Graduate Projects

When a patient falls in the hospital it ends up being costly for both the patient and the hospital. Having an awareness of risk factors that lead to an increase in patient falls becomes very important for all nursing staff. However, the contributing factors are not the same for every department in a hospital. The focus of this proposal is the development of a fall assessment that is specific to the emergency department. Age, cognition, elimination, physical mobility, and medications were the risk factors determined to be most important after a review of the literature. Once the fall assessment scale …

Facial Expression Discriminates Between Pain And Absence Of Pain In The Non-Communicative, Critically Ill Adult Patient, Mamoona Arif-Rahu

Theses and Dissertations

BACKGROUND: Pain assessment is a significant challenge in critically ill adults, especially those unable to communicate their pain level. At present there is no universally accepted pain scale for use in the non-communicative (cognitively impaired, sedated, paralyzed or mechanically ventilated) patient. Facial expressions are considered among the most reflexive and automatic nonverbal indices of pain. The facial expression component of pain assessment tools include a variety of facial descriptors (wincing, frowning, grimacing, smile/relaxed) with inconsistent pain intensity ratings or checklists of behaviors. The lack of consistent facial expression description and quantification of pain intensity makes standardization of pain evaluation difficult. …

Student Persistence In Associate Degree Nursing Programs At Mississippi Community Colleges, Kathryn Lee Fleming

Dissertations

The purpose of this study was to examine factors of student persistence and attrition in addition to strategies that may help students persist in associate degree nursing programs at community colleges. Data were collected from nursing students enrolled in first-year associate degree nursing programs at participating Mississippi community colleges and analyzed using multiple regression and repeated measures ANOVAs. Tinto’s Classic Model and Bean & Metzner’s Nontraditional Model of Student Attrition were utilized in this study. This mixed methods convenience sample yielded 564 participants, and the results were as follows: environmental factors and demographic factors of student persistence were found to …

Characterizing Dietary Intake And Physical Activity Affecting Weight Gain In Kidney Transplant Recipients, Connie Klopfenstein Cupples

Theses and Dissertations (ETD)

Weight gain following kidney transplant is a significant problem with 50 to 90% of kidney transplant recipients gaining weight. Potential factors leading to weight gain following kidney transplantation have been thought to include a change in lifestyle such asdietary intake and physical activity, along with the use of immunosuppressant medications to preserve the newly implanted organ. Other influences affecting weight gain include genetic determinates such as age, gender and race. There is little data to confirm which of these factors may indeed lead to weight gain and obesity. The purpose of this study was to examine dietary intake and physical …

Infection Risk Along U.S. Highways? The Case Of A ‘Truckchaser’ Cruising For Truckers, Mona Shattell, Yorghos Apostolopoulos, Sevil Sönmez, Richard Rothenberg, Rose Weitz, John Smith

Mona Shattell

This article explores potential infection risks linked with trucker cruising along U.S. highways. Specifically, the article delineates the settings and social organization of trucker cruising, examines the structure of sex partnerships of truckers and cruisers, and delves into the unique database of one truckchaser who recorded 4,162 sex interactions with 2,499 different truckers during a 13-year period. Concurrent sexual partnerships of bisexual and particularly straight-identified truckers hold increased potential for amplifying infection risk as they enable pathogens to operate as bridges along disparate geographies, demographies, and epidemiologies.

Recent Accelerated Second-Degree Baccalaureate Graduates’ Perceptions Of Educational Preparation, Susan Candelaria

UNLV Theses, Dissertations, Professional Papers, and Capstones

As of 2008, the U.S. Department of Labor is predicting a need for greater than one million new registered nurses by the year 2016 (American Associations of Colleges of Nursing [AACN], 2008). One way that nursing schools around the country are dealing with this issue is through the creation of accelerated second-degree programs for non-nursing graduates.

The purpose of this descriptive study was to examine the perceptions of educational preparation of accelerated second-degree baccalaureate graduates, who have been out of school for at least one year, but no longer than four years. The sample consisted of 54 graduates from an …

Coronary Heart Disease Knowledge And Risk Factors Among Filipino-Americans Connected To Primary Care Services, Alona N. Dalusung-Angosta

Nursing Faculty Publications

Coronary heart disease (CHD) is the leading cause of death of Filipino-Americans (FAs). Despite the growing numbers of FAs in the United States, little is known about their CHD knowledge and risk factors.

The purposes of this study were to examine the baseline knowledge and risk factors of CHD among FAs and to describe the relationships between knowledge, sociodemographic, and socioeconomic characteristic variables of FAs between the ages of 35-75 years.

The study sample consisted of 120 FAs (N = 120) who were connected to primary care services. Data were collected from three primary care clinics in Las Vegas, …

Chhs December/January E-Newsletter, Dr. John Bonaguro, Dean, Vashon S. Wells, Editor, College Of Health And Human Services

College of Health & Human Services Publications

No abstract provided.

Direct Care Workers Perceptions And Practices Related To Quality Of Life In Long Term Care, Karen M. Kinyon

Dissertations

The focus of this case study was to discover how DCWs define success in their practice and what institutional and individual factors contribute to their successful practices. It describes how DCWs perceive quality of life for NH residents and how their practices reflect quality of life indicators. The conceptual model for which this research is based on was developed around the concepts that individual and institutional factors contribute to the successful practices of direct care workers; and, how these DCWs perceive quality of life influences how they practice to promote quality of life for nursing home residents. Using a case …

Near Miss Reporting: An Educational Program, William Strub

Nursing Masters

In October 2007, the Medicare system contemplated future introduction of a new policy, which would no longer pay for eight preventable medical errors. With this potential new change in policy it becomes increasingly more important for health care institutions to monitor (track) medical errors and determine what measures can be taken proactively to prevent the occurrence of errors. The errors that might not be financially reimbursed under Medicare in the future include: - Sponges and/or surgical tools left in patients after surgery - Treatment of problems arising from air embolisms or incompatible blood transfusions - Treatment of bedsores developed while …

Treatment Outcomes From The Tdc: A Look At Smoking Cessation Among Patients With Co-Occurring Disorders, Chizimuzo T.C. Okoli

Chizimuzo T.C. Okoli

Summary of Key Findings •Smoking abstinence at end of program:

–Intent to treat analysis: 32.2%(83/258) –Among program completers: 41.3%(83/201)

•Significant predictors of abstinence : –Having an alcohol, heroin (or other opioid) or marijuana use history was a significant predictor of being less likely to quit smoking when compared to having no history of substance use disorder. –Having a lower CO level at program enrolment was a significant predictor of being more likely to quit –Attending the TDC program for a longer duration was a significant predictor of being more likely to quit.

Stamping Out Electrosurgery Smoke, Kay Ball

Nursing Faculty Scholarship

Did you know that perioperative nurses have twice the incidence of some respiratory problems as compared to the general population? This information surprised me too when the data from my doctoral research revealed this startling and unsettling fact.....What are we breathing in the OR?

Using No-Show Modeling To Improve Clinic Performance, Laura P. Sands, Joanne K Daggy, Mark Lawley, Deanna Willis, Debra Thayer, Christopher Suelzer, Po-Ching C. Delaurentis, Ayten Turkan, Santanu Chakraborty

School of Nursing Faculty Publications

‘No-shows’ or missed appointments result in under-utilized clinic capacity. We develop a logistic regression model using electronic medical records to estimate patients’ no-show probabilities and illustrate the use of the estimates in creating clinic schedules that maximize clinic capacity utilization while maintaining small patient waiting times and clinic overtime costs. This study used information on scheduled outpatient appointments collected over a three-year period at a Veterans Affairs medical center. The call-in process for 400 clinic days was simulated and for each day two schedules were created: the traditional method that assigned one patient per appointment slot, and the proposed method …

Energy Webs And Nursing Praxis: Patterning In The Lived Experience Of Type 2 Diabetes, Karen Marcus Glasenapp

Doctor of Nursing Practice Projects

Diabetes is an illness best described as costly, complex, chronic, and epidemic in the United States, affecting nearly 24 million children and adults; 90% of who have type 2 diabetes (Centers for Disease Control and Prevention, 2008). On average, every 20 seconds in the United States, an individual 20 years of age and older receives a diagnosis of diabetes; yet, an estimated 6 million people with the disease remain undiagnosed (American Diabetes Association, 2010b). The financial burden of this disease, the inconsistent effectiveness of well-intentioned diabetes programs to educate and actualize change behavior, and the limited resources of millions of …

Mission Trip To Guatemala A Life-Changing Experience For Nursing Students, Eileen Yost

Eileen Yost

The weeklong mission, which was the department’s second to the impoverished Central American country of Guatemala, took place in the areas surrounding the city of Antigua and centered on providing obstetrical care.

Application Of A Judgment Model Toward Measurement Of Clinical Judgment In Senior Nursing Students, Tiwaporn Pongmarutai

UNLV Theses, Dissertations, Professional Papers, and Capstones

Clinical judgment, defined as “the application of the nurse’s knowledge and experience in making decisions about client care” (The National Council of State Boards of Nursing, 2005, p. 2), has been recognized as a vital and essential skill for healthcare providers when caring for clients. Undisputedly, nurses represent the largest component of the healthcare profession and, therefore, play a major role in ensuring quality patient care in the United States. Although the concept of clinical judgment in nursing has been discussed for more than three decades, and in spite of numerous efforts to improve student clinical judgment, the recent literature …

Ua61/1 Wku Nursing Class 2010, Wku Nursing

WKU Archives Records

Members of the 2010 nursing class: Laura Abernathy, Michelle Allison, Jana Anderson, Tanya Atkinson, Denise Bunner, Mollie Carter, Jared Crocker, Brittany Davidson, Laura Deaton, Drew Frey, Erin Garner, Brian Gaskins, Angie Gipson, Brianna Glover-Motley, Jeanette Granese, Jennifer Green, Lindsay Green, Erick Greer, Crystal Heady, Myranda Holder, Kelly Irvin, Katherine Kerr, Dawn Kimberlin, Wendi King, Amanda Lamb, Jody Lee, Angela Legge, Rebecca Lock, Tiffany McMinoway, Joe Middleton, Sherry Moore, Amber Nagornay, Renae Neldlinger, Laura Nuestro, Blair Ramsey, Heather Rasmussen, Lora Ray, Justin Reed, Kristin Richardson, Jacqui Rock, Regina Salai, Shelby Scillian, Sydney Scillian, Michael Sticar(?), Rachel Sither, Amanda Smith-Gaspar, Sarah Somers, …

Further Validation Of The Body-Mind-Spirit Wellness Behavior And Characteristic Inventory For College Students, Nicole Mareno, Kathy Shadle James

Faculty and Research Publications

Health promotion is a vital component of college health programs. College health professionals are challenged to find cost-effective, comprehensive measures to assess wellness and risk behaviors. Hettler’s 1979 Six Dimension of Wellness Model guided this inquiry. Physical, emotional, intellectual, occupational, social, and spiritual wellness dimensions were measured by the Body-Mind-Spirit Wellness Behavior and Characteristic Inventory (BMS-WBCI). This study aimed to further validate the BMS-WBCI by reporting reliability as internal consistency of the scale when used to measure wellness in a sample of college students. A descriptive cross-sectional design was utilized. A convenience sample of 106 college students from a small, …