Medicine and Health Sciences Commons^™

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 …

The Assessment Of Co2 Exposures, Workload Demands, And Musculoskeletal Disorder Risk On Heart Rate For Select Craft Brewery Job Tasks, David L. Huizen

Dissertations

Americans have embraced craft beer, and the ensuing demand has resulted in an ever-increasing number of craft breweries opening over the past 20 years. Craft brewers are generally small employers and, as such, lack the resources necessary to address the safety and health of their employees adequately. Brewers face many safety and health hazards in their work environment. These hazards include exposures to carbon dioxide (CO₂), workload demand, and MSD risk. It is essential to evaluate these hazards in craft breweries as they handle carbon dioxide (CO₂) differently than large breweries by having the CO_{2 …}

Nanocarbon Modification Of Membranes For Enhanced Water Desalination And Water Treatment, Worawit Intrchom

Dissertations

Water scarcity is foreseen to be one of the great global issues in the coming decades. The challenges are not only in providing water supply to cope with the growing public demand, but recovering clean water to natural resources. Clean water supply, from brackish and seawater is attractive. Membrane distillation (MD) is an emerging thermal membrane-based process that has been used for desalination and other pollutant separations from water. MD can be operated at low temperature, so low-grade energy sources are a good alternative heat source for MD. High salt rejection and low membrane fouling also make MD interesting for …

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 …

Increasing Patient Adherence To Gestational Weight Gain Goals In Pregnancy, Annie Vining

Dissertations

Abstract

Problem: The inability to maintain healthy weight gain during pregnancy may contribute to multiple pregnancy-related complications. Nutritional education and support may improve nutrition and vitamin consumption, and recommendations for healthy gestational weight gains have been published. However, pregnant women have reported minimal advice regarding healthy weight gain during pregnancy. A personalized, nutritional counseling program was initiated in a Midwestern, suburban OB-GYN private practice.

Methods: A quality improvement descriptive, correlational design was used. A cohort of pregnant women first trimester through six-weeks postpartum received individual counseling and face-to-face interaction at an office visit each trimester.

Results: Twenty ( …

Improving Access To Mental Health Care With Nurse Practitioners, Jessica Whelan

Dissertations

Problem: Over 40% of those with mental illness are untreated since the supply of psychiatrists does not meet the demand. The psychiatric mental health nurse practitioner (PMHNP) may be an adjunct in providing those services. The purpose of this quality assurance study was to evaluate outcomes of care between a PMHNP and a psychiatrist (medical doctor [MD]).

Methods: An observational, descriptive design with a retrospective medical record review of adult patients over a six-month period in a suburban, Midwestern, privately owned psychiatric practice.

Results: A total of 787 individual patients encountered at least one visit (N=787) although 3,679 …

The Diffusion Of Telehealth: System-Level Conditions For Successful Adoption, Danika Tynes

Dissertations

Telehealth is a promising advancement in health care, though there are certain conditions under which telehealth has a greater chance of success. This research sought to further the understanding of what conditions compel the success of telehealth adoption at the systems level applying Diffusion of Innovations (DoI) theory. System-level indicators were selected to represent four components of DoI theory (relative advantage, compatibility, complexity, and observability) and regressed on 5 types of Telehealth (Teleradiology, Teledermatology, Telepathology, Telepsychology, and Remote Monitoring) using multiple logistic regression.

Analyses included data from 84 states leveraging data from the World Health Organization, World Bank, ICT Index, …

Same-Sex Sexual Coercion Among Women: The Impact Of Minority Stress On Perpetration And Victimization Experiences Of Women Of Diverse Sexual Identities, Allison Kirschbaum

Dissertations

The purpose of the current study was to investigate women’s experiences with same-sex sexual coercion perpetration and victimization. Specifically, I sought to explore the role that the stress of living as a sexual minority plays in these experiences as well as to determine whether the psychological variables of perceived powerlessness, psychological distress, social support, and alcohol use mediate the relationship between minority stress and perpetration and victimization experiences. Data were collected online from self-identified women and individuals assigned female at birth who reported experiencing genital sexual contact with another woman (N=339). Of the cisgender women in the sample, 31.6% reported …

A Vaccine Administration Training Program To Increase Adolescent Vaccination Rates, Claire Jensen

Dissertations

Abstract

Immunizations have been proven to control life-threatening diseases. Often Registered Nurses (RNs) administer vaccines but are unsure how to discuss vaccines with vaccine hesitant patients. Missouri’s adolescent vaccination rates are below its neighboring states. This initiative’s purpose was to increase adolescent vaccine administrations at a Missouri County Health Department (MCHD).

This quality improvement initiative had an observational, cross-sectional, descriptive design. RNs employed at three MCHD clinics attended an adolescent vaccine administration training program (VAT) and completed pre-/post-tests regarding the Advisory Council on Immunization Practices recommendations. Medical record reviews from March 1-April 30, 2018 and March 1-April 30, 2019 compared …

A Behavioral Weight Loss Program For Low-Income Adults With Obesity And Hiv, Sophai Thach

Dissertations

Problem: Obesity, having a body mass index (BMI) of 30 kg/m² or greater, increases the risk for cardiovascular disease. For people living with HIV (PLWH), this increases their risk for myocardial infarctions by 50% and causes this life-threatening event to occur at a younger age compared to those who are not diagnosed with HIV.

Methods: With obesity disproportionately affecting people with low income, this study aims to evaluate the effects of a 12-week behavioral weight loss program that utilizes journaling as a self-monitoring tool, weekly educational classes, and individualized goal-setting on PLWH with obesity who live in …

The Lived Experience Of Discharged And Readmitted African Americans With Chronic Obstructive Pulmonary Disease To A Safety-Net Hospital, Kiiyonna Jones

Dissertations

Background:Chronic Obstructive Pulmonary Disease (COPD) is a debilitating respiratory disease that negatively affects the quality of life of those affected and has been a major contributor to the continuous rise in healthcare cost in the Unites States (Guarascio, Ray, Finch, & Self, 2013; National Heart Lung and Blood Institute, 2009; Shavelle, Paculdo, Kush, Mannino, & Straus, 2009; Scott, Smith, Sullivan, & Mahajan, 2001). In 2014, Centers for Medicare & Medicaid Services (CMS) identified COPD as an applicable condition to the Hospital Readmissions Reduction Program, which penalizes healthcare organizations having readmissions higher than the national average. COPD is the second …

G.I. Jane Fem Etran Goes Corporate: An Exploration Of Post-9/11 Female Combat Veterans Transitioning To A Civilian Career, Tumona Austin

Dissertations

Purpose: The purpose of this multiple-case study was to explore the experiences of post- 9/11 female combat veterans transitioning from military service to civilian careers, using the Schlossberg transition model factors of situation, self, social support, and strategies.

Methodology: This multiple-case study identified and interviewed post-9/11 female combat veterans transitioning from active-duty to civilian career. Respondents were purposively chosen based on specific criteria and expert panel recommendations.

Findings: Examination of case-study interview data and artifacts from the 3 post-9/11 female combat veterans indicated nine major findings:

1. The factor of situation clearly outweighed the other Schlossberg factors in impact.

2. …

A Collaborative Perspectives Approach For Understanding Effective Care Coordination In Autism Spectrum Disorder, Rachel Severs

Dissertations

Autism spectrum disorder (ASD) is a neurodevelopmental disorder that causes significant impairment in social and communication areas. The severity of the disorder can often result in a substantial degree and amount of service access and expenditures relating to a child’s needs. This study examined the experiences of how family caregivers and service providers of children with ASD view service delivery using a basic qualitative research design. For the study, 10 participants (five family caregivers and five service providers) were enrolled and interviewed. Interview data were collected and coded to produce a qualitative analysis of the experiences of these individuals who …

Redefining Burnout: Exploring Common Conceptualizations And The Neurophysiology Of Chronic Stress To Establish An Integrated Allostatic Model, Danny A. Guzzi

Dissertations

Burnout is a widely researched stress-related phenomenon associated with numerous adverse outcomes for employees and organizations. Unfortunately, burnout is not well understood and research to this point has been flawed due to a lack of consensus on the definition, dimensionality, and context of the construct. Prevalent conceptualizations of burnout have been criticized for being arbitrarily developed without solid theoretical foundation and for failing to clearly distinguish burnout from depression or other work-related conditions such as compassion fatigue, secondary traumatization, and vicarious traumatization. The current project first examines relevant literature to identify commonalities among prevalent burnout conceptualizations. Then relevant stress research …

Adventist Healthcare: A Qualitative Study Of 19th Century Founding Governing Principles In 21st Century Adventist Hospitals, Cesiah Yareth Pimentel Melendez

Dissertations

Problem and Purpose

Founding values and principles can help organizations stay focused on fulfilling their mission. This is especially true in faith-based organizations that seek to continue their founding principles as a governing commitment to their core identity. This study identified Adventist healthcare founding principles in Ellen G. White's early health visions and explored how Adventist healthcare leaders perceived these principles as governing principles applied to current Adventist healthcare practices.

Conceptual Framework and Research Design

Two metaphors and three areas of literature review guided my approach of this qualitative study of Adventist healthcare founding principles. My first metaphor of DNA …

Evaluating The Kentucky Association Of Extension 4-H Agents Annual Conference Using The Re-Aim Framework, Michael Elijah Wilson

Dissertations

The Reach, Effectiveness, Adoption, Implementation, and Maintenance (REAIM) evaluation framework, as first introduced by Glasgow, Vogt, and Boles (1999), offers a straightforward method for evaluating Extension related programs. In this study, the RE-AIM framework is used to evaluate the Kentucky Association of 4-H Extension Agents (KAE4-HA) annual conference by examining pre-existing organizational data and records that include the results from KAE4-HA post-conference surveys that had never been reviewed as part of a comprehensive program evaluation.

This dissertation is divided into five chapters. Chapter I provides an overview of the study. Chapter II reviews the history of Extension in Kentucky, program …

Permanent Housing And On-Site Nursing Care: Effects On Homeless Individuals With Hiv And Other Cormorbidities, Lynelle Hinden

Dissertations

Abstract

Problem. Providing housing to otherwise homeless individuals who are HIV/AIDS-positive has been demonstrated to improve control of the disease. This was a healthcare quality initiative to review the viral load and Cluster of Differentiation Protein Four positive (CD4+) counts over time of residents in an urban housing facility for HIV/AIDS-positive individuals. Also, a nurse-run clinic was introduced for residents, especially those with comorbidities such as hypertension and diabetes.

Methods. A repeated measures design was utilized. Viral loads and CD4+ counts were retrospectively reviewed from facility records at entrance into and five-years later at the facility. Additionally, measurements of blood …

Implementing The Cdcs Core Elements Of Outpatient Antibiotic Stewardship Program Into The Urgent Care, Deanna Powelson

Dissertations

Purpose: The inappropriate use of antibiotics has led to the development of antimicrobial

resistance which is a severe threat to the public and an increasing global problem. The

Centers for Disease Control and Prevention (CDC) estimates at least two million illnesses

and 23,000 deaths are caused by antibiotic-resistant bacteria in the United States (CDC,

2014). The purpose of this quality improvement (QI) project was to evaluate the

effectiveness of an antibiotic stewardship program (ASP) on urgent care providers'

prescribing on viral respiratory tract infections (RTIs) including the common cold,

pharyngitis, and bronchitis.

Methods: This QI project implemented the CDCs Core …

The Predictors Of Juvenile Recidivism: Testimonies Of Adult Students 18 Years And Older Exiting From Alternative Education, La Toshia Palmer

Dissertations

Purpose: The purpose of this descriptive, qualitative study was to identify and describe the importance of the predictors of juvenile recidivism and the effectiveness of efforts to prevent/avoid juvenile recidivism as perceived by previously detained, arrested, convicted, and/or incarcerated adult students 18 years of age and older exiting from alternative education in Northern California. A second purpose was to explore the types of support provided by alternative schools and the perceived importance of the support to avoid recidivism according to adult students 18 years of age and older exiting from alternative education.

Methodology: This qualitative, descriptive research design identified …

Diabetes Prevention Program: Exploring Spirituality And Spiritual Interventions On Outcomes, Sharon E. Plutko Long

Dissertations

Purpose

The purpose of this study is to explore a relationship between a modified Diabetes Prevention Program (DPP) for adults with pre-diabetes (pre-DM) or type-2 DM with variables of spirituality and religiosity (S/R) to illuminate the potential religion-health connection based in changes in participant weight, body mass index (BMI) and physical activity. A secondary purpose is identifying spiritual interventions used by faith-based DPP coaches in a group setting.

Methods

A mixed-methods study was conducted with 34 DPP participants and 11 DPP coaches who completed the core section (weeks 1-26) of DPP courses held in Macomb Country, Michigan. Independent variables are …

Estimating The Prevalence Of Hepatitis C In Sub-Saharan Africa, William Howard Adams

Dissertations

Hepatitis C (HCV) is a virus transmitted via contact with contaminated products such as razor-blades or by engaging in high-risk activities (i.e., such as sexual or injecting drug-use activities). Today, there are an estimated 115 million people world-wide living with HCV. Despite recent advancements in antiviral treatments that can ameliorate (or even cure) HCV, treatment remains laborious and costly and is often unavailable in resource-poor areas such as Sub-Saharan Africa (SSA). The primary aim of this study was to estimate the prevalence of HCV in SSA.

A meta-analysis was conducted on the HCV epidemic in SSA. A literature search for …

Evaluation Instruction In Council On Education For Public Health Accredited Master Of Public Health Schools And Programs, Kristin Ann Hobson

Dissertations

Despite the increasing role of evaluation in public health practice and research (Association of Schools and Programs of Public Health [ASPH], 2006; Institute of Medicine [IOM], 1998; Public Health Functions Steering Committee, 2008; United States Government Accountability Office [GAO], 2012), as well as Henry and Mark’s (2003) assertion of a need for systematic evidence on evaluation training and education, the literature continues to lack studies on evaluation instruction in Council on Education for Public Health (CEPH)-accredited Master of Public Health (MPH) schools and programs. As such, this study explored evaluation instruction in CEPH-accredited MPH schools and programs in the following …

Implementation Of The National Asthma Guidelines In A Residential Pediatric Clinic, Patricia A. Foster-Staples

Dissertations

Abstract

Purpose: Foster care children admitted to residential facilities are a unique and vulnerable group, many presenting with undiagnosed or poorly managed asthma. The alarming rate of residents admitted to a particular residential primary care clinic with a diagnosis of asthma led to the project question: “Based on record reviews, does staff education about the importance of utilizing the national guidelines for asthma education influence the implementation of such guidelines in a residential pediatric clinic?” The purpose of this quality improvement project was to implement a systematic process to influence practice change. The project was conducted over a period …

The Influence Of Culture On The Use Of Healthcare Services By Refugees In Southcentral Kentucky: A Mixed Study, Chika N. Ejike

Dissertations

The world as a global village has become a ubiquitous trope in the popular discourse, and Bowling Green, Kentucky, with its substantial immigrant population, may be considered an exemplar of this idealized community. It has become an ideal location for research regarding the challenges faced by immigrants. Due to the diverse cultural identities of the refugee/immigrant population, it is particularly well suited for studies into complex culturally dependent healthcare utilization patterns.

The central research question for the study was as follows: What are the healthcare-seeking behavioral patterns (as influenced by culture) among refugees at their nearest healthcare facilities? This mixed …

The Effectiveness Of Combined Appointments And Influenza Immunization Rates In A Rural Wic Population, Lisa L. Sitler

Dissertations

Purpose: The purpose of this descriptive retrospective study was to examine predictors and barriers to influenza immunizations receipt in a low-income WIC population.

Method: A quality improvement project was conducted in October 2010 in which 129 caregivers of children having WIC appointments were randomly assigned to receive (a) influenza immunizations at the time of the WIC visit or (b) educational materials and a later immunization. Caregivers completed a survey about their perceptions of influenza immunizations. Tanahashi’s access to care model (1978) was used to identify predictors (acceptability, accessibility, availability, and effectiveness) of influenza immunizations.

Analysis: In analysis …

Exploring Factors Impacting Veterans' Hypertension Control, Jian Hua Liu

Dissertations

Exploring factors impacting veterans’ hypertension (HTN) control is essential in reducing the common cardiovascular disease event of stroke, heart attack, chronic kidney disease and mortality. The purpose of this study was to describe multidimensional factors impacting veterans’ HTN control. Utilizing a descriptive, exploratory, cross-sectional, retrospective, convenience sampling research design, 331 electronic medical records in a VA dashboard data set were reviewed for men and women veterans between the age 24 and 98 years (M=62, SD=13) in a Southern California Veterans Affair primary care clinic from October 17, 2014 through October 17, 2016. Data were analyzed by univariate, bivariate and multivariate …

Epidemiology Of White Spot Syndrome Virus In The Daggerblade Grass Shrimp (Palaemonetes Pugio) And The Gulf Sand Fiddler Crab (Uca Panacea), Muhammad

Dissertations

Ever since the first outbreaks of White spot syndrome virus (WSSV), which causes White Spot Disease (WSD), in Asia in the early 1990s, the pathogen has been a major constraint to the profitability of the shrimp aquaculture industry across the globe. WSSV has a broad host range and is routinely detected in wild decapod crustaceans. In the present study, two common species in the tidal salt marsh along the northern coast of the Gulf of Mexico, the daggerblade grass shrimp (Palaemonetes pugio) and the Gulf sand fiddler crab (Uca panacea), were investigated for their role as …

An Examination Of African Americans' Utilization Of Health Care, Brittany Powell

Dissertations

The study examined the relationship between perceptions of discrimination, social support, quality of health care received, and utilization of health care services among African Americans. Data was analyzed from 99 African American respondents that completed either an online or paper questionnaire. The responses demonstrated significant relationships existed between discrimination and quality of health care as well as social support and utilization of health care. Results concluded that the more discrimination one perceives, the lower quality of health care they are to expect, and therefore they are less likely to utilize services. However, the data also reflected that even in the …

Health Literacy As A Moderator In The Relationship Between Diabetes Knowledge And Diabetes Outcomes, Jameshyia Ballard Thompson

Dissertations

The purpose of this research was to determine if health literacy was a moderator in the relationship between diabetes knowledge and diabetes outcomes, and explore the relationship between diabetes knowledge and health literacy. The target population included adults living in Mississippi with a diagnosis of diabetes at any point in life. A pilot study was performed to determine if the Functional Communicative Critical Health Literacy scales (FCCHL) and the Spoken Knowledge in Low Literacy in Diabetes scale (SKILLD) were appropriate for use in a population of adults in Mississippi with a diagnosis of diabetes. Participants for the pilot study were …