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Full-Text Articles in Medicine and Health Sciences

Respecting The Spectrum: Creating A Gender Inclusive Structured Diagnostic Intake Interview, Natalia Andino-Rivera Jun 2021

Respecting The Spectrum: Creating A Gender Inclusive Structured Diagnostic Intake Interview, Natalia Andino-Rivera

Dissertations

Transgender and nonbinary (TNB) people, more than ever, are in need of and actively seeking out services in order to cope with the reality of being transgender in the United States. This includes requiring assistance from local and federal governmental systems that do not provide protections for equal housing, workplace discrimination, and healthcare provisions, much less hate crime investigation and prosecution. In 2011, 75% of transgender people were or had been in therapy in the past, with a further 14% intending to participate in therapy in the future. Recently, the newly elected President Joseph Biden issued an executive order (EO ...


Positive Symptoms Of Schizophrenia And Suicide: A Systematic Review Of Gender, Race/Ethnicity, And Premorbid Iq Variables, Susan Diann Paschall Jun 2021

Positive Symptoms Of Schizophrenia And Suicide: A Systematic Review Of Gender, Race/Ethnicity, And Premorbid Iq Variables, Susan Diann Paschall

Dissertations

Schizophrenia is an exceptionally debilitating mental disorder. Its effects permeate all facets of psychosocial functioning and it is associated with premature mortality. As such, suicide is of clinical concern. Positive symptoms such as hallucinations and delusions may influence the risk of suicide among individuals diagnosed with schizophrenia, but additional research is necessary, as the limited literature on this topic is dated and includes heterogeneous results. Early recognition of and intervention for suicide risk factors, such as the presence of positive symptoms of psychosis, may reduce mortality rates for individuals with schizophrenia. The present literature review examined the role of gender ...


Strategies Exemplary Mental Health Leaders Use To Stay Grounded While Working With Veterans, Audrey Dangtuw Apr 2021

Strategies Exemplary Mental Health Leaders Use To Stay Grounded While Working With Veterans, Audrey Dangtuw

Dissertations

Purpose. The purpose of this explanatory mixed method study was to identify and describe what exemplary mental health leaders in Puget Sound area mental health facilities serving veterans do to maintain their physical, emotional, intellectual, social, vocational, and spiritual health based on the six dimensions of Rosen's (2014) healthy leader model.

Methodology. An explanatory mixed methods approach was selected to allow the triangulation of data to increase the validity of the findings. The study analyzed quantitative surveys to identify how exemplary mental health leaders rate their use of grounded leadership strategies and qualitative semi-structured interviews to identify strategies exemplary ...


A Sequential Explanatory Mixed Methods Study Of Chief Nurse Executives On Creating A Culture Of Inclusiveness, Toloue Aria Jan 2021

A Sequential Explanatory Mixed Methods Study Of Chief Nurse Executives On Creating A Culture Of Inclusiveness, Toloue Aria

Dissertations

Purpose: The purpose of this sequential explanatory mixed methods study was to identify and describe the leadership strategies that exemplary chief nurse executives use in inpatient acute care hospitals located in Southern California to create an organizational culture of inclusiveness using Kennedy’s (2008) 5 leadership qualities of cultural differences.

Methodology: A sequential mixed methods research design was selected to answer this study’s research questions. The researcher was a part of a thematic group of 10 peer researchers and 7 faculty advisors. Through purposeful sampling, the researcher selected 18 exemplary chief nurse executives for survey data collection using instrumentations ...


Coping Skills, Emotional Intelligence, Attachment, And Resilience On Post-Traumatic Stress Disorder In Private Sector Emergency Medical Technicians, Brenda-Joyce Gonzales Orozco Markert-Green Jan 2021

Coping Skills, Emotional Intelligence, Attachment, And Resilience On Post-Traumatic Stress Disorder In Private Sector Emergency Medical Technicians, Brenda-Joyce Gonzales Orozco Markert-Green

Dissertations

Problem

Private sector Emergency Medical Technicians (EMTs) are first responders who respond to traumatic incident scenes along with firefighters and police officers. However, news agencies and the public do not acknowledge private sector EMTs with the same vigor or accolade as public sector EMTs, nor are the risks to life, health, and mental well-being recognized among this population. Thus, the research literature has been sparse regarding how private sector EMTs experience PTSD, and what unique risk factors and needs may be present.

Purpose Statement

The purpose of this study was to examine the relationship between PTSD symptoms and coping skills ...


Baccalaureate Nursing Students' Lived Experiences Of A Leadership Role During Clinical Practicum, Gisela E. Schmidt Jan 2021

Baccalaureate Nursing Students' Lived Experiences Of A Leadership Role During Clinical Practicum, Gisela E. Schmidt

Dissertations

Problem

Leadership is an essential component of professional nursing practice used in many aspects of the Registered Nurse (RN) role. Baccalaureate nursing (BN) programs have the responsibility of preparing graduating nursing students with leadership orientation and practice. Excellent professional preparation of RNs starts with their education during nursing school. The fast-paced and high-demand healthcare environment needs RNs who can be accountable for patient care that enables excellent patient outcomes and sound patient-centered care. Taking this into consideration, nursing educators are in a special position to promote nursing education which prepares their students with leadership education and training. The purpose of ...


Childbirth And Control Behind Bars: A Descriptive Qualitative Analysis Of The Maternal Perception Of Control In Women Who Have Given Birth While Incarcerated, Lorin Raines Dec 2020

Childbirth And Control Behind Bars: A Descriptive Qualitative Analysis Of The Maternal Perception Of Control In Women Who Have Given Birth While Incarcerated, Lorin Raines

Dissertations

The perception of control during childbirth has been widely studied in various setting and groups. Many factors have been found to aid or impede the perception of control for birthing women. Significance of that perception of control during childbirth has also been measured in past studies. This descriptive qualitative study advances the knowledge of the perception of control during childbirth and examines a population that has thus far been excluded. Four previously incarcerated women participated in semi-structured interviews about their experience of giving birth while incarcerated and their perception of control during that time. The women were from diverse backgrounds ...


A Phenomenological Study Of Faculty Members’ Experiences With Attempting To Integrate Religion And Spirituality Into Counseling Psychology Doctoral Training, Theresa M. Nutten Dec 2020

A Phenomenological Study Of Faculty Members’ Experiences With Attempting To Integrate Religion And Spirituality Into Counseling Psychology Doctoral Training, Theresa M. Nutten

Dissertations

Religion and spirituality (R/S) are two of several multicultural variables salient to some clients seeking counseling, therefore psychologists are expected to be sensitive to and respectful of R/S in professional duties (APA, 2017a; APA, 2017b). However, research has shown that the integration of topics of R/S into the training of psychology graduate students has been minimal at best (Brawer et al., 2002, Hage et al., 2006, Saunders et al., 2014; Schafer et al., 2011; Schulte et al., 2002; Vogel et al., 2013). There are potential logistical and personal barriers to the inclusion of religion and spirituality into ...


Cardiac Electrophysiology: Exploring Racial And Gender Outcomes Of Treatment Of Paroxysmal And Persistent Atrial Fibrillation Using Sotalol And Dofetilide, Nicole Lanette Bradford-Love Dec 2020

Cardiac Electrophysiology: Exploring Racial And Gender Outcomes Of Treatment Of Paroxysmal And Persistent Atrial Fibrillation Using Sotalol And Dofetilide, Nicole Lanette Bradford-Love

Dissertations

Purpose

The purpose of this study is to explore the association between gender and racial lines in the conversion and sustainment of normal sinus rhythm (NSR) from paroxysmal atrial fibrillation (PAF) and persistent atrial fibrillation using the anti-arrhythmic drugs (AADs) sotalol and dofetilide.

Methods

A secondary data analysis was performed to assess the relationships of the independent and dependent variables listed above. Using SPSS v. 24 descriptive statistics were obtained and initially evaluated for accuracy with histograms. A cross-tabulation frequency table was produced to determine the number of variables that fell into each dependent category. Following this, the frequencies were ...


A Signal Detection Framework For Evaluating The Effects Of Feedback On Stroke Recognition, Jordan D. Bailey Dec 2020

A Signal Detection Framework For Evaluating The Effects Of Feedback On Stroke Recognition, Jordan D. Bailey

Dissertations

The impact of stroke on the lives of individuals and the healthcare system is considerable. Damage from stroke can be reduced if the treatment is administered at the appropriate time so early recognition is essential. One problem is that strokes present in a variety of ways that sometimes do not fit into the Facial drooping, Arm weakness, Speech difficulties and Time (FAST; American Heart Association, 2019) acronym. Signal detection is one way to measure decision making under conditions of uncertainty (e.g., discriminating stroke symptoms and risk factors from other symptoms, and non-risk factors). The methodology also allows us to ...


Utilization Of Asthma Guidelines In Primary Care, Kate R. Miller Nov 2020

Utilization Of Asthma Guidelines In Primary Care, Kate R. Miller

Dissertations

Background: Chronic lower respiratory disease, including asthma, is the fourth leading cause of death in the U.S. Financially, asthma accounts for approximately 54 billion dollars in healthcare spending annually. The National Heart Lung and Blood Institute [NHLBI] established guidelines to reduce impairment and to reduce future asthma attacks.

Purpose: This Quality Improvement (QI) pilot implemented the Asthma Control Test (ACT) and the Asthma Action Plan (AAP) per NHLBI guidelines. This project aimed to increase provider use of the ACT and AAP to 50% in patients with a diagnosis of asthma over one month.

Methods: A convenience sample of six ...


Community Health Nurse Educators And Disaster Nursing Education, Jody Spiess Nov 2020

Community Health Nurse Educators And Disaster Nursing Education, Jody Spiess

Dissertations

Abstract

The world is struggling with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic and the need for disaster nursing education has never been more clear. Recently, the American Nurses Association reported that of the over 32,000 nurses surveyed; only 11% felt well prepared to care for a COVID-19 patient (ANA, 2020). Community health nurse educators are tasked with educating future nurses on disasters, yet, little is known about this population’s perceived competence in disaster preparedness. The purpose of this study is to describe community health nurse educators' perceived competence in disaster preparedness.

The study is a ...


Demystifying First-Time Mothers’ Postpartum Mental Health: A Phenomenological Study Of The Transition To Becoming A Mother, Megan Dooley Hussmann Nov 2020

Demystifying First-Time Mothers’ Postpartum Mental Health: A Phenomenological Study Of The Transition To Becoming A Mother, Megan Dooley Hussmann

Dissertations

Becoming a mother is a significant life event that can greatly impact maternal mental health. Understanding maternal mental health is an important interdisciplinary goal because it could lead to mother’s receiving better care and support from both mental health and medical professionals. Seven first-time mothers with a baby under the age of one were interviewed for a phenomenological qualitative study, which investigated first-time mothers’ postpartum mental health experiences. This study was guided by two research questions: How do new mothers experience their postpartum mental health in comparison to how they experienced their mental health before having their baby, and ...


Implementing A Three-Minute Foot Exam For Diabetic Patients In Primary Care, Emilee Laster Nov 2020

Implementing A Three-Minute Foot Exam For Diabetic Patients In Primary Care, Emilee Laster

Dissertations

Problem- One in four U.S. Veterans have Diabetes Mellitus, and one in four U.S. Veterans with diabetes will develop a diabetic foot complication. There is currently no protocol for healthcare providers to perform foot screenings on diabetic patients at each visit. Utilizing a foot screening at each visit for high risk diabetic patients may help to recognize problems sooner, making treatment easier and less aggressive.

Methods- This quality improvement initiative was a retrospective and prospective record review before and after evidence based three-minute foot exams were implemented. A convenience sample of 50 patient medical records were reviewed to ...


Improvement In Primary Care Identification Of Trauma Symptoms Of Foster Care Children, Crystal Lucas Nov 2020

Improvement In Primary Care Identification Of Trauma Symptoms Of Foster Care Children, Crystal Lucas

Dissertations

Introduction: Exposure to adverse childhood events (ACEs) is common in foster children. Primary care providers are ideally positioned to advocate for foster care children through early identification and treatment of trauma-related symptoms and diagnoses during routine well-child assessments.

Purpose: This quality improvement project sought to institute a standardized trauma assessment instrument, the Childhood Behavioral Checklist (CBCL), to determine if there was an increase in the identification of trauma-related symptoms and diagnoses along with an increase in the rate of referral to mental health care (MHC).

Method: This quality improvement project used a descriptive, observational design to complete retrospective and prospective ...


Missed Appointment Rates And The Implication On Primary Care Practice, Kelly Martin Nov 2020

Missed Appointment Rates And The Implication On Primary Care Practice, Kelly Martin

Dissertations

Problem: Missed appointments cost primary care facilities money and resources through lack of utilization. When patients fail to attend their scheduled appointment the providers are non-productive when they could be seeing other patients that are potentially moved to other days, sending patients to other providers, or worse sending patients to the prompt care or the Emergency Department for care. The missed appointment rate at Office A Primary Care is approximately ten percent, while Office B has a nearly 11% missed appointment rate. Both facilities make reminder calls to patients the day before their appointments to remind them of their appointment ...


Comorbidity And Quality Of Life Of Hiv-Positive Adults Living In Supportive Housing, Rose Sharp Nov 2020

Comorbidity And Quality Of Life Of Hiv-Positive Adults Living In Supportive Housing, Rose Sharp

Dissertations

Problem: Life expectancy for people living with HIV significantly increased with widespread use of antiretroviral therapy, resulting in population increases in comorbidity prevalence. The increased burden of living with both HIV and comorbidities lowers health-related quality of life (HRQoL).

Methods: Using a descriptive, correlational, cross-sectional design, a convenience sample of HIV-positive adults was selected from seven supportive housing communities. Comorbidities were assessed using a modified Self-Administered Comorbidity Questionnaire, and HRQoL using the Patient-Reported Outcome Measurement Information System Scale v1.2 – Global Health.

Results: A sample of 17 (N = 17) adults reported a mean of 4.2 (SD = 2.8) comorbidities ...


Sustainability Of An Outpatient Antibiotic Stewardship Program, Kristin Smith Nov 2020

Sustainability Of An Outpatient Antibiotic Stewardship Program, Kristin Smith

Dissertations

Abstract

Problem: Antibiotic stewardship is an effort to evaluate and improve the use of antibiotics by providers and patients. Antibiotic stewardship programs (ASPs) promote the appropriate use of antibiotics. There is increasing evidence that supports the use of antibiotic stewardship programs in reducing antibiotic prescribing rates while continuing to maintain safe patient care. Research supports approaches with multiple interventions and ongoing commitment to antibiotic stewardship. However, information regarding long-term sustainability of antibiotic stewardship programs is lacking. The purpose of this quality assurance project was to assess long-term sustainability of a previously implemented ASP promoting appropriate prescribing of antibiotics for the ...


Tailoring Violence Prevention Programming To A Critical Care Area, Jaime Campbell Nov 2020

Tailoring Violence Prevention Programming To A Critical Care Area, Jaime Campbell

Dissertations

Abstract

Problem: Rising rates of violence in health care environments signal a need for health care workers, specifically frontline nurses, to be trained in effective de-escalation management skills. Since January 2017, there has been an increase in the number of patients categorized as aggressive with more violent patient events taking place at a selected midwestern hospital facility in the critical care department, particularly the intensive care and transitional care units.

Methods: Using a pre-post design, this project compared nurses’ verbal de-escalation skills using the English Modified De-escalating Aggressive Behaviour Scale (EMDABS) to determine effectiveness of de-escalation strategies in simulated scenarios ...


Effect Of Standardized Nurse Teaching On Patient Experience Using Cahps®, Julie Hake Nov 2020

Effect Of Standardized Nurse Teaching On Patient Experience Using Cahps®, Julie Hake

Dissertations

Abstract

Purpose: This quality improvement (QI) project aimed to determine if a standardized nurse teaching approach improved patient understanding of diagnosis and treatment as it relates to women diagnosed with a pelvic floor disorder (PFD) after receiving a standardized nurse education (SNE) session in an urban tertiary care Urogynecology practice.

Methods: Females aged 18 and older with a newly diagnosed PFD and prescribed PFPT for the first time who agreed to receive the SNE and complete the CAHPS® survey were included in the project. Patient perception of PFPT was assessed via phone interview utilizing the Consumer Assessment of Healthcare Providers ...


Screening And Referring For Postpartum Depression In Pediatric Primary Care, Melissa Harkins Nov 2020

Screening And Referring For Postpartum Depression In Pediatric Primary Care, Melissa Harkins

Dissertations

Problem

Postpartum depression (PPD) can lead to increased risk of child abuse, delays in infant development, and increased medical costs (Earls et al., 2019). The American Academy of Pediatrics (AAP) recommends all mothers of infants 0-6 months be screened for PPD during well-child visits. Despite these recommendations, many pediatric offices have no PPD screening process.

Methods

This quality improvement project utilized a standardized tool to screen mothers of infants 0-6 months for PPD during their infants’ well-child visits. Mothers who screened positive for PPD were offered referrals to treatment resources and given the opportunity to participate in two follow-up telephone ...


Diet Behaviors, Physical Activity, And Sociodemographic Factors In A Sample Of Racially Diverse Adults: A Secondary Analysis Of Nhanes (2017-2018) Data, Fatemeh Choupani Nov 2020

Diet Behaviors, Physical Activity, And Sociodemographic Factors In A Sample Of Racially Diverse Adults: A Secondary Analysis Of Nhanes (2017-2018) Data, Fatemeh Choupani

Dissertations

Background: The prevalence of obesity is increasing among adults in the United States and is related to a high risk to health. Obesity has been linked to lifestyle behaviors such as diet behaviors and physical activity.

Purpose: This study aimed to determine if an association exits between foods prepared outside of the home, walking or biking, vigorous/moderate recreational activities, sociodemographic factors and the outcomes, body mass index, percentage of body fat, and waist circumference.

Method: A secondary analysis was conducted using data from 3942 adults from the U.S. aged 20 years, as recorded in the National Health and ...


The Experience Of Early Mobility After One Week Of Hospital-Acquired Deconditioning, Lila S. Moersch Nov 2020

The Experience Of Early Mobility After One Week Of Hospital-Acquired Deconditioning, Lila S. Moersch

Dissertations

Abstract

Older adults who are hospitalized spend most of their time in bed. Prolonged bed rest and immobility in older adults may result in deconditioning of the muscles, leading to a loss of muscle mass and strength. The loss of muscle mass results in weakness and reduced physiological functioning post-hospital discharge. Immobility is especially problematic in older adults who naturally lose muscle mass and strength due to the aging process. Older adults who experience weakness post-hospital discharge face challenges with mobility. The purpose of this study was to describe the early mobility experiences of adults who are 60 years old ...


The Impact Of Medicare Insurance Plans Upon Healthcare Services Utilization Considering Patients' Characteristics And Their Access To Medical Care, Steven Stout Oct 2020

The Impact Of Medicare Insurance Plans Upon Healthcare Services Utilization Considering Patients' Characteristics And Their Access To Medical Care, Steven Stout

Dissertations

The annual average cost of healthcare for services utilization by a Medicare beneficiary is projected to grow from about $10,000 to over $16,000 by 2023. As an ongoing initiative to address this trend, the federal government contracts with private insurance companies and other entities, called Medicare Advantage Organizations (MAOs), to develop and administer alternative health insurance plans designed to contain service utilization and costs. One feature of some Medicare Advantage plans is the presence of risk-bearing contracts with primary care physician organizations that voluntarily accept financial responsibility for the overall cost of care for patients attributed to them ...


Traits Of Character That Facilitate Formation Of Exemplary Nurses In Bachelor Of Science Nursing Programs, Jean Marks Oct 2020

Traits Of Character That Facilitate Formation Of Exemplary Nurses In Bachelor Of Science Nursing Programs, Jean Marks

Dissertations

Constructivist grounded theory methods were applied in this study to explore traits of character that facilitate the formation of exemplary nurses in Bachelor of Science Nursing (BSN) programs. Interest in this study was prompted by a desire to examine attributes beyond academics alone that contribute to the formation of excellent nurses. The intent was to promote clarity in describing these attributes for further scholarly discussion.

Framing this study was Aristotle’s doctrine of the golden mean (Aristotle, 350 B.C.E./1934). Operational definitions consistent with this doctrine were created for the concepts of character, character traits, and exemplary nursing ...


Empowering Nurses Of Minority In The Face Of Incivility And Bullying: Through The Lens Of Phenomenology, Corrine Floyd Oct 2020

Empowering Nurses Of Minority In The Face Of Incivility And Bullying: Through The Lens Of Phenomenology, Corrine Floyd

Dissertations

Abstract

Up to 85% of nurses have reported exposure to incivility in the workplace (Hunt & Marini, 2012). The often-subtle nature of incivility toward nurses in a minority population may partially explain why it remains a problem. Healthcare organizations realize the need for civility to counter the high turnover rate, staff shortages, and low job satisfaction reported by nurses, but lack understanding of how nurses of a minority population perceive incivility and bullying. This study aimed to answer the research question how do nurses with minority representation experience incivility and bullying versus empowerment in the workplace? A descriptive phenomenological design used ...


Comparison Study: Trauma-Focused Cognitive Behavioral Therapy And Acceptance And Commitment Therapy For Trauma, Colleen Marie Kirsch Hiltz White Oct 2020

Comparison Study: Trauma-Focused Cognitive Behavioral Therapy And Acceptance And Commitment Therapy For Trauma, Colleen Marie Kirsch Hiltz White

Dissertations

There is a need for more evidenced based treatments for adolescents with trauma related disorders. Currently, Trauma Focused Cognitive Behavioral Therapy (TF CBT) is the gold standard, but clients and clinician need the ability to choose between effective treatments. This study completed a direct comparison between six weeks of treatment in Acceptance and Commitment Therapy for Trauma and TF CBT via telehealth during the COVID-19 pandemic. Treatments were measured using the Clinician Administered PTSD Scale and the Child PTSD Symptom Scale. Both treatments were found to be effective in reducing trauma related symptoms in two 12-year-old females.


The Relationship Among Perfectionism, Perceived Stress, And Coping In Baccalaureate Nursing Students, Amanda Finley Sep 2020

The Relationship Among Perfectionism, Perceived Stress, And Coping In Baccalaureate Nursing Students, Amanda Finley

Dissertations

Perfectionism in nursing students is an understudied problem that may affect student and workforce success. Perfectionism has been linked to increased stress and less effective coping styles, as well as depression, anxiety and other psychological alterations. However, it has rarely been studied in nursing students. Studying perfectionism in this population is important because it may increase the likelihood that new nurses will struggle with the stress of practice and it could be a significant factor in early career attrition. The purpose of this descriptive, correlational study was to gain a better understanding of the incidence of perfectionism in a nursing ...


Life After Menopause: Quality Of Life In Women Diagnosed With Polycystic Ovarian Syndrome After The Childbearing Years, Katelyn Baker Sep 2020

Life After Menopause: Quality Of Life In Women Diagnosed With Polycystic Ovarian Syndrome After The Childbearing Years, Katelyn Baker

Dissertations

Very little research has been conducted in regards to what happens after a woman diagnosed with PCOS is menopausal or post menopausal. This study researched the quality of life in women with PCOS before and after menopause in an attempt to compare the two groups.


Can A Brief Online Intervention Change Low-Income Caregivers’ Reported Use Of Spanking? A Randomized Controlled Trial, Hilary L. Richardson Aug 2020

Can A Brief Online Intervention Change Low-Income Caregivers’ Reported Use Of Spanking? A Randomized Controlled Trial, Hilary L. Richardson

Dissertations

Spanking is commonly used by parents (64-94%) in the United States as a strategy for managing undesirable child behaviors. Research has found that the use of spanking is particularly high among young mothers, low-income parents, and African American families. Decades of literature on the use of spanking has identified abundant detrimental outcomes for children such as increased externalizing behaviors, decreased long-term compliance, and less guilt following misbehavior, as well as serious outcomes in adulthood such as depressed mood and alcohol/drug use. There is also a risk for spanking to escalate to physical abuse. Thus, safer, more effective discipline strategies ...