Medicine and Health Sciences Commons^™

La Maestra’S Circle Of Care: Studying The Impact Of An Integrated Service Model On The Health And Well-Being Of Vulnerable Populations, Zara Marselian

Dissertations

ABSTRACT

There is an urgent need to reform the health care delivery system in the United States, as recognized through current bipartisan efforts. Society’s vulnerable populations especially need health care reform as health care outcomes are the poorest among disadvantaged populations. Moreover, vulnerable populations are twice as likely to develop chronic diseases than the general population and they remain ill due to other contextual, societal factors affecting their ability to achieve health and well-being. This population is subjected to adverse life events that suggest a more comprehensive approach to health and well-being is called for.

The Circle of Care is …

Health Care Access And Utilization By U.S. Farmworkers, Genesis Bojorquez

Dissertations

Background: Agriculture industry has the highest fatality rate among all United States industries. Farmworkers experience high rates of occupational injury, illness, and mortality, yet have limited access to health care. Implementation of the Patient Protection and Affordable Care Act (ACA) of 2010 increased health care accessibility and broadened farmworker eligibility for health insurance, yet no study has measured the impact of the ACA upon U.S. farmworkers.

Purpose: The purpose of this research was to examine health care access and health care services utilization among U.S. farmworkers following the implementation of the ACA in 2010.

Specific Aims:

1. Apply the …

Oxygen Consumption In Sepsis, Julie Graham

Dissertations

Background: Sepsis is a life-threatening condition that can lead to septic shock and death. With over 300,000 annual cases (AHRQ, 2011) costing a staggering $1.5 billion (Health Care Utilization Project Brief #185), the importance of sepsis is becoming clear. However, some basic biological mechanisms are poorly understood. Study Purpose: This study investigated the relationships between select demographics, resting energy expenditure (REE), serum lactate, SOFA score mortality index, oxygen consumption [by way of measuring net oxygen consumed, (V02) and net carbon dioxide produced (VC02)], and sepsis. Specific Aims: Aims were to describe 1) patient demographics, serum lactate, SOFA score mortality index, …

The Health Of Human Trafficking Victims In San Diego, California: A Retrospective Study, Noelle Lipkin Leveque

Dissertations

Background/Purposes/ Aims: Human trafficking (HT) is a threat to human rights globally. Studies indicate between 28% and 87% of HT victims encountered a health care professional during their trafficking period. Nonetheless, little is known about the health care needs of victims of HT. The purpose of this study was to examine the health care needs of a self-identified group of trafficked women in San Diego County, California.

Conceptual Basis: The Model of Human Trafficking and Health by Zimmerman et al. (2011) was used to identify multiple determinates of health following the trafficking period including demographic factors (age at assessment, age …

Use Of Video Games In Patients' Self-Management Of Pain: A Feasibility Study, Janet Donnelly Phd(C), Rn-Bc, Acns-Bc, Pccn

Dissertations

Background: Pain affects more than 75 million Americans and is the primary reason people seek medical attention. Pain is a common cause of disability and diminished quality of life. While anecdotal evidence exists regarding nurses’ use of distraction therapy activities in pain management, little empirical research data is available.

Purpose: To examine the effects of video game use (VGU) on pain perception, pain interference perception and perceived self-efficacy in pain management in adult inpatients.

Conceptual Model: The conceptual model is based on Self-efficacy Theory (Bandura, 1995). The antecedents of the concept of distraction therapy with use of VGs in patients’ …

Pain Management In Triage And Reducing Percentage Of Left Without Being Seen In An Overcrowded Ed, Christina Ballejos-Campos Phd

Dissertations

Although in most emergency rooms, the patient is seen first by a highly trained triage nurse, the ED physician is trained to determine if the patient can safely leave the ED prior to in-depth exam, treatment and diagnosis. The goal is to keep the left without being seen by a physician percentage low, since a high number would indicate poor quality, additionally patients who present with pain, and then leave the ED prior to being seen can pose a greater risk. This study examined the association of nurse-initiated triage pain protocol on the LWOBS percentage rate of patients who present …

Health Literacy And Health Promotion Behaviors Among Samoans, Katherine Tong Phd, Msn, Cfnp, Phn

Dissertations

Limited health literacy is associated with failure to engage in health promotion behaviors. Few studies examine this relationship among Samoans. This study used a cross-sectional correlational design to determine health literacy levels and their relationship to health promoting behaviors in a southern California Samoan population. Health literacy (Short form Test of Functional Health Literacy in Adults) and health promotion behaviors (Health Promotion Lifestyle Profile II) were measured in a convenience sample of 87 Samoans in southern California. Data analysis employed chi-square, t-test, and one- way ANOVA. Significant associations were found for health literacy and demographic characteristics of employment and marital …

California School Nurse Survey, Rachel Van Niekerk Phd

Dissertations

The purpose of this study was to obtain evidence to support the assumption that school nurses have a positive effect on school attendance and medication administration practices and to hear the voice of the California school nurse. Data from this exploratory, descriptive study came from an online researcher developed survey consisting of both forced choice and open-ended questions completed by California school nurses representing the three major regions of California (Northern, Central, and Southern). The following three research questions guided the study: 1) What is the relationship between school and nurse factors on student outcomes? 2) How valued do California …

Mother-Son Connectedness, Substance Use, And Young Men's Criminal Justice System Involvement, Kim L. Moreno Phd

Dissertations

The relationship between a mother and her son and its influence on health and risk behaviors as a boy becomes a man has had little exploration. The purpose of this study was to examine the relationships between mother-son connectedness, substance use, serious delinquency, violent delinquency, and criminal justice system involvement in young men. This study uses data from The National Longitudinal Study of Adolescent Health (ADD Health), a school-based study of students in grades 7–12 in the United States. Multiple regression, ANOVA, and logistic regression were used to analyze independent and dependent variables. Results show a perception of connectedness, which …

Relationship Between Self-Stigma And Personal Empowerment Among People Who Have Severe Mental Illness, Diane Fischer Hickman Phd

Dissertations

The purpose of this study was to examine the relationship between self-stigma of mental illness and personal empowerment among people who have a severe mental illness. It had been hypothesized that self-stigma of mental illness and personal empowerment are at opposite end of a continuum. As such, individuals who perceive themselves in a stigmatized manner tend to reciprocally perceive themselves as being relatively powerless, rather than having a strong sense of personal empowerment. Likewise, individuals who perceive themselves as having a relatively strong sense of personal empowerment tend to experience a low degree of self-stigma. To test this hypothesis, a …

Improving Diabetic Outcomes With Caring Communication: Identifying Communication Patterning For The Human Diabetic, James R. Kennett Phd

Dissertations

Introduction. The purpose of this study was to identify the influence of caring communication for people living with diabetes (PLD) and the relationship to diabetic outcomes. Caring communication has not been studied for improving diabetic outcomes. Randomized control trials (RCTs) direct care, however people do not do what they told, they need to be included in their care. PLD need a voice to establish what is important to them. Incorporating medical, communication, and nursing science as multidisciplinary approach within a theoretical framework can be predictive diabetic outcomes. Methods. A correlational cross sectional survey design study was done. A sample of …

Breastfeeding And Mothers With Chronic Health Conditions, Blanche Landis Phd

Dissertations

Breastfeeding and Mothers with Chronic Health Conditions Breastfeeding may be most beneficial for women with specific chronic illness and may decrease the risk or prevent those illnesses from developing in their children. This study examined the initiation and duration rates of mothers identified as having asthma, hypertension, and diabetes; differences between the three groups in their efforts to breastfeed, and associations between determinants/outcomes of breastfeeding and behavioral beliefs, normative beliefs, and perceived control of mothers using Ajzen's Theory of Planned Behavior (TPB). A retrospective quantitative methodology was used to compare rates of initiation and duration, the differences between the three …

Tuberculosis Awareness And Public Opinion On Expanding Health Insurance Coverage, Belal A. Saadeh Phd, Msn, Rn

Dissertations

This quantitative descriptive cross-sectional study examined the effect of TB awareness and demographic variables on the level of support for expanding health insurance coverage for all residents, including undocumented immigrants. A modified 13-item tool developed by Morisky et al. (1990) was used to measure TB awareness; a single item created by the researcher assessed personal opinion regarding expansion of health insurance coverage; and a demographic questionnaire was used to collect data from 281 registered voters in San Diego County. The majority of San Diego County voters participating in the study supported at least some expansion of health insurance coverage. ANOVA …

Psychometric Testing Of The Information-Motivation-Behavioral Skills Model Of Behavior Change Questionnaire In Mexican-Americans With Diabetes Type 2, Beverley Brownell Phd

Dissertations

Background: The most successful diabetes self-management (DSM) programs focus on changing previously established behavior patterns. To develop focused and culturally appropriate self-management programs, health care providers need valid and reliable assessment tools. Purpose: To test the reliability and content and construct validity of an instrument developed to assess diabetes knowledge, motivation, and adherence to medical regimes. The Information-Motivation-Behavioral (IMB) Skills Diabetes scale was tested with 83 Mexican-American adults with type 2 diabetes from a community in Orange County, CA. Methodology: A cross-sectional correlational study design was conducted with 64 female and 19 male Mexican-American adults diagnosed diabetes type 2 patients. …

The Contemporary Perspective Of Wellness Through The Voices Of The Kūpuna, Anne P. Odell Phd

Dissertations

Few studies successfully explain the decline of Hawaiian health, nor provide enough insight to the cultural determinants that affect Hawaiian wellness. For over two hundred years, Hawaiians have been influenced by a changing landscape mostly imposed upon Hawaiians and Hawaiian lands as a consequence of being conquered by powerful Western cultures. This grounded theory study utilized video elicitation and focus group methodologies to examine the perspective of wellness in a group of Hawaiian elders known as kūpuna. Following the viewing of a documentary film designed to elicit culturally based memories, a series of interview questions were asked to foster group …

Navy Nurses' Experiences During Operation Unified Assistance Aboard The Usns Mercy: A Grounded Theory Study, Angelica L.C. Almonte Phd

Dissertations

On December 26, 2004, the most powerful earthquake in 40 years erupted under the Indian Ocean triggering a deadly tsunami that devastated 11 Asian and African countries and killed more than 280,000. The US Navy responded through Operation Unified Assistance (OUA). In a historic first on the hospital ship USNS MERCY, the U.S. Navy deployed one team with members from the Navy, the U.S Public Health Service, a non-government organization (NGO), and a civilian mariner crew to provide humanitarian aid. Despite these efforts, there is a dearth of scholarly research work published on nurses' experiences during the disaster. The purpose …

Nurse Practitioner Adoption Of Clinical Innovations, Rhoberta Jones Haley Phd

Dissertations

Adoption of clinical innovations by Nurse Practitioners (NP) is a complex phenomenon, rooted in personal values and influenced by challenges within health care environments. When clinical innovations are adopted or rejected by NPs, this decision has meaning for patients, NPs, health care agencies, and society. The decision controls the opportunity for patients to access a clinical innovation that could reduce morbidity and mortality, save money, and provide satisfaction related to the health care encounter. The purpose of the study was to increase knowledge about NP adoption of clinical innovations, particularly emotionally-laden clinical innovations. The lines of inquiry focused on what …

Healthcare Encounters Of Formerly Incarcerated Women: A Grounded Theory Study, Karen Sue Hoyt Phd

Dissertations

The adult correctional population in the United States soared to nearly 7 million people (Bureau of Justice Statistics [BJS], 2005). Over 2 million individuals were housed in prisons or jails in the United States. Nearly 7 percent (6.9%) were women (BJS, 2005). Recent trends in the adult correctional population suggest that there has been a stark increase in the number of formerly incarcerated women in the United States. The purpose of this research was to explore how formerly incarcerated women perceived their healthcare encounters. The aims of this study were to answer the following questions. How did formerly incarcerated women …

Role Perceptions Of School Nurses Who Work With Medically Fragile Students, Cay Chapman Casey Phd

Dissertations

In 1999, the Supreme Court ruled that school districts were financially responsible to provide related services including nursing services, to medically fragile students. This decision applied to children attending public schools who have complex health problems and are tracheostomy dependent. The purpose of this grounded theory study was to explore role perceptions of eighteen school nurses caring for these children in classrooms. Six dimensions emerged from the data: Promoting Family/Nurse Connections, Adapting the Environment, Claiming Authority, “Standing Out There”, Striking a Balance and Experiencing Success. Promoting Family/Nurse Connections emerged as the central perspective, essential to implementing a plan of care. …

Comparison Of Health Promotion Behaviors And Performance On The Navy Physical Readiness Test Among Active Duty Shipboard Personnel With And Without Anterior Knee Pain, Robin Theresa Mckenzie Phd, Msn, Rn

Dissertations

Health promotion is the number one health priority of the nation, yet, health promoting behaviors (HPB) are rarely part of the management plan for persons with anterior knee pain (AKP). In an active duty military population, AKP can interfere with performance on the required, semi-annual physical readiness test (PRT). The purpose of this descriptive, comparative study was to compare the relationships among HPB, AKP and performance on the PRT between two groups of active duty Navy shipboard personnel (those with AKP and those without AKP). Pender's (1996) Health Promotion Model (HPM) served as the theoretical framework. Subjects completed demographic and …

Factors Associated With Women's Decisions To Obtain Routine Cervical Cancer Screening In A Prepaid Health Care System, Vicki Debaca Dnsc

Dissertations

The focus of this research study was to explore the factors affecting women's decisions to participate in preventive cervical cancer screening using a conceptual model proposed by Cummings, Becker, and Maile (1980). This descriptive-comparative study investigated the effect between the components of this model (age, education level, race, general barriers, psychological barriers, evaluation of health care, threat of illness, knowledge, social network) and the outcome variable of intent to participate in cervical cancer screening examinations. This study also examined whether there were differences in the predictor variables between two groups of women: those that have had a recent Pap examination …