Exploring Functional Health Literacy In Older Adults With Age-Related Macular Degeneration, Jennifer K. Fortuna

Dissertations

This three-paper dissertation explores functional health literacy (i.e., the ability to access, process and understand health information) in older adults with vision loss caused by age-related macular degeneration (AMD). This research builds scholarship that explores the unique patient education needs of older adults with AMD. The specific aims of this research are to: (1) explore associations between functional health literacy and severity of visual impairment; (2) determine the general readability, suitability and comprehensibility of online patient education materials (PEMs) designed for older adults with AMD; and, (3) assess the overall quality of one PEM that has been simplified based on …

Training Practitioners On The Effects Of Psychotropic Medication Via A Web-Based Platform, Anita Li

Dissertations

Many individuals diagnosed with autism spectrum disorders (ASD) receive multiple therapeutic services in an attempt to supplement behavioral therapy. These services include pharmacological interventions. Two drugs, risperidone (Risperdal) and aripiprazole (Abilify), are FDA-approved to treat “irritability” in children with ASD. Research shows that the effects of risperidone and aripiprazole on irritability varies greatly across treated individuals. Therefore, individualized monitoring and evaluation must be conducted to provide the physician with data to determine if the medication is resulting in desired changes and effects. Certified behavior analysts are trained in data collection and experience high levels of contact with individuals diagnosed with …

Exploration Of Physician Attitudes About Self-Care And Personal Mental Health: Possible Barriers To Physician Well Being, Candich Farrar

Dissertations

The present study was designed to examine physicians’ mental health, attitudes, and behaviors toward self-care and the utilization of mental health services. As the medical field can be very demanding and exhausting, it is believed that many physicians suffer from mental illnesses such as anxiety and depression. However, it was theorized that many physicians do not engage in adequate self-care regimes or seek support and suppress their symptoms, which may further exacerbate their illnesses. A thorough literature review was performed to explore the following: possible barriers to physicians seeking mental health services to address high rates of mental illnesses, physicians …

Anticonvulsant And Procognitive Effect Of Nonimidazole Histamine H3r Receptor Antagonists /Inverse Agonists In Experimental Animal Models, Alaa Imad Alachkar

Dissertations

Epilepsy is a common chronic neurological disorder accompanied by cognitive impairment. Available antiepileptic drugs (AEDs) have not been reported to have ameliorative effects on epilepsy-associated memory impairment. The potential of histamine H3 receptors (H3R) in several neuropsychiatric diseases, including epilepsy and Alzheimer’s disease, is well recognized. In this study, a series of H3R antagonists (1-16) were screened for their in vivo anticonvulsant effect in several acute-induced seizures in rats. Moreover, the procognitive effect of the most promising H3R antagonist was investigated in dizocilpine (DIZ)-induced amnesic effect applying several behavioral memory tests. Furthermore, the most promising H3R antagonist was assessed for …

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 …

Veteran Specific Risk Factors For Delirium, Allison Perkins

Dissertations

Purpose/Aims: This study explored the relationships between military characteristics such as combat experience, mental health issues such as post-traumatic stress disorder (PTSD), traumatic brain injury (TBI), depression, anxiety and substance use disorder (SUD), physical comorbidities such as coronary artery disease (CAD), other risk factors, and delirium diagnosis among hospitalized veterans.

Background: Delirium is a common disorder experienced by 25% of all hospitalized adults 65 years and older. No published studies to date have examined whether combat, TBI and PTSD are associated with the incidence of delirium in the hospitalized veteran.

Methods: A retrospective cross-sectional cohort design with a sample size …

Barriers And Facilitators To Opioid Use Treatment And Recovery Services During Pregnancy, Loralie Woods

Dissertations

Purpose: To identify barriers and facilitators to opioid use treatment and recovery services among pregnant and nonpregnant women who misuse opioids.

Background: Over 130 Americans die daily after overdosing on opioids. Women have not been immune from opioid use disorders (OUDs), with a 4-fold increase from 1999-2010. The prevalence of opioid use among pregnant women increased from 1.5 per 1,000 hospital deliveries to 6.5. Although the annual National Surveys on Drug Use and Health (NSDUH) has provided information on risk factors for OUD related to socioeconomic and demographic factors, no studies using this data have identified barriers to opioid use …

Frailty And Post-Operative Outcomes In Adult Hip Fracture Patients, Melissa Yager

Dissertations

Abstract

Background/ Purpose: The majority of adult hip fracture patients never return to their pre-fracture functional level and have a poor quality of life (Kistler, Nicholas, Kates, & Friedman, 2015; Pioli et al., 2016; Sheehan et al., 2018). The prevalence of frailty in adult hip fracture patients is estimated at 51%. Frail patients with hip fractures are twice as likely to have a complication (Kistler et al., 2015). Extant studies have examined frailty and hip fractures independently, nonetheless, a gap in the literature exists with few investigations of the connection between frailty and post-operative outcomes after hip fracture. The purpose …

Skin And Soft Tissue Infections In The Emergency Department, Nicole Martinez

Dissertations

Background/Purpose: Skin and soft tissue infections (SSTI) represent a diverse group of infections varying in clinical presentation and degree of severity. The International Classification of Diseases codes for patients presenting with cellulitis or abscess account for $5.5 billion in annual health care costs and 1.4% of all hospital admissions nationally. Data are needed to inform admission and management decisions. The purpose of this study is to examine relationships among sociodemographic, physical examination findings, and treatment modality and management in patients with SSTIs.

Theoretical/Conceptual Framework: Web of Causation Theoretical Framework explores multiple causative factors treated with equal prominence, thus …

Pain And Spiritual Distress At End Of Life, Kathryn Lee Robinson

Dissertations

Purpose: The purpose of this study is to examine the relationship between unmanaged pain and spiritual distress in adults newly admitted to hospice.

Background/Rationale: Current evidence supports the presence of a positive relationship between increased physical pain and spiritual distress for those with advanced cancer and/or receiving palliative care services. Nonetheless, spiritual distress remains a relatively understudied area; anecdotally, assessment and management of physical symptoms often take precedence over interventions for spiritual distress in patients at end of life (EOL) on hospice. Research is needed to examine the relationships between physical pain, spiritual distress, and other relevant variables specific to …

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 …

The Relationship Between Race And Ethnicity And Serious Safety Events In Hospitalized Patients, Samantha Crandall

Dissertations

Purpose. This study explored the association between patient sociodemographic characteristics and the occurrence of serious safety events (SSE) in hospitalized patients. Specific aims were to describe among patients who have experienced an SSE: 1) patient sociodemographic variables (age, gender, race, ethnicity and language spoken), health insurance coverage, patient zip code, payer mix, site of care location, and severity of event; 2) the relationships between the select patient sociodemographic variables, health insurance coverage, patient zip code, payer mix, site of care location and SSE level of harm; and 3) what factors increase or decrease the odds of experiencing higher levels of …

An Examination Of The Night Burn Clinic Transition To Nurse Practitioner Coverage, Kevin J. Maxwell Dnp, Fnp-Bc

Dissertations

Background/Significance: Burns are dynamic, evolving wounds requiring prompt attention and treatment (Morgan et al., 2018). Many studies have been conducted comparing physician outcomes to those of APNs showing no difference (McCleery, Christensen, Peterson, Humphrey, & Helfand, 2011; Naylor & Kurtzman, 2010; Pioro et al., 2001; Roche, Gardner, & Jack, 2017; Spetz, Skillman, & Andrilla, 2017). Time delays which allow for progression of the injury have a negative impact on patient outcomes. Any pathway allowing for quicker review of the burn by a burn specialist should be welcomed (Kelly et al., 2013). APNs can augment physician efforts and expand access to …

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 …

Impulsivity As A Trait Predictor In Baccalaureate Nursing Students, Jennifer Bertucci

Dissertations

Impulsive personality traits have been linked to pathological decision making in individuals who possess the trait. Impulsive pathological decision making may include acts of aggression, divergence, risky behavior, lack of self-care, etc. The purpose of this study was to examine impulsive personality traits among nursing students. Traditional students are defined by the following characteristics: earns a high school diploma, enrolls full time immediately after finishing high school, are financially dependent on parents, and either do not work during the school year or works part-time (the exception to the rule) (Choy, 2002). A non-traditional nursing student is defined as students who …

Establishment Of Organoids From Gastric Stem Cells And Their Use To Study The Role Of Aryl-Hydrocarbon Receptors, Shakila Afroz Taleb

Dissertations

Stem cells are powerful tools in different aspects of biomedical and translational research, including disease modelling, drug testing, and tissue engineering for regenerative medicine. However, isolation and culture of organ-specific stem cells are challenging tasks. Therefore, the biological features of many adult stem cells are not well studied and their involvement in the development of cancer is still controversial. Some immortal stem cell lines have been established and used as an alternative to studying features of organ-specific stem cells. The ability to grow cells in a scaffold-free, three-dimensional (3D) model system that mimics in vivo conditions would help in revealing …

Consumer Assessment Of Healthcare Providers And Systems In A Psychiatry Practice, Treacy Williams

Dissertations

Problem: Patient-centered care improves healthcare. Patient surveys are instruments used to assess the patient’s experience and is essential to providing patient-centered care. The aim of this quality improvement initiative was to assess patient perceptions of care delivered by nurse practitioner (NP) providers in a psychiatric mental health practice.

Methods: An observational, descriptive design with a customized Consumer Assessment of Health Care Providers and Systems (CAHPS) survey administered in an outpatient psychiatric mental health practice for six weeks. A structure, process, outcomes framework was used. The structure of study was care delivered by the NP, the process of interest was communication …

A Descriptive Phenomenological Study Of Body Art Patients And Their Health Care Experience, Lacee Kaufmann

Dissertations

This study aimed to update dated research by exploring the relationships between patients with body art (tattoos and body piercings) and their interaction with health care providers. This creates a current description of the body art patient’s health care experience. Previous research indicates that body art has been associated with risk taking and deviant behaviors and these behaviors have been used to justify why people with body art are negatively perceived. If the presence of body art and the associated behavior are viewed as a threat to normalcy, then Stangor and Crandall’s theory (2000) suggests that stigma may surround 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 ( …

Emotional Intelligence Methods Utilized By Successful Major League Baseball Closers To Perform Successfully In High Pressure Situations, Joshua Rosenthal

Dissertations

Purpose: The purpose of this qualitative case study is to understand the similarities that exist in the descriptions of emotional intelligence methods utilized by retired successful Major League Baseball closers to appraise, express, regulate, and utilize their emotions to perform successfully in high pressure situations.

Methodology: The dissertation was a qualitative case study. Twelve of the top 50 retired save leaders in Major League Baseball were interviewed to understand the similarities in the descriptions of emotional intelligence methods used to perform successfully in high pressure situations. This study attempted to understand what exactly elite closers did to utilize emotional intelligence …

Impact Of Meaningful Recognition On Work Environment Perception Of Critical Care Nurses, Kristin Meinershagen

Dissertations

Problem: Absence of nursing staff recognition can lead to compassion fatigue, burnout, job dissatisfaction, and increased turnover rate resulting in high costs for hospitals. Meaningful recognition has been found to decrease compassion fatigue and reduce burnout. A meaningful recognition program was implemented over a 3-month period for staff nurses in an Intensive Care Unit (ICU) at a large midwestern, metropolitan hospital to determine its effect on nurse’s perception of work environment and turnover rate in the ICU.

Methods: This was an observational, descriptive, cohort design utilizing the AACN Healthy Work EnvironmentSurvey instrument for assessing results before and after implementation …

Dominican Nursing Students’ Self-Reported Mastery Of International Nursing Competencies, Wady Ramirez

Dissertations

The Dominican health care system has many challenges to meet the legal and the population’s health care expectations (La Hoz, 2018; United States Agency for International Development, 2013). The purpose of this study was to evaluate how well Dominican nursing students, who have completed their internship but not yet defended their final career project, assessed themselves against a set of international nursing competencies. In addition, the purpose was to explore any differences in their self-assessments based on whether these students completed their internship at public health care centers or not. Finally, the goal was to determine to what extent do …

The Epidemiology And Burden Of Cardiometabolic Risk Factors In A Young Emirati Population, Fatima Abobakr Hussein Mezhal

Dissertations

The United Arab Emirates (UAE) has experienced rapid economic growth that was paralleled by a drastic rise in non-communicable diseases (NCDs); primarily cardiovascular diseases (CVDs), which account for 40% of mortality in UAE. CVDs have complex etiology, interplay, and accumulation of many risk factors. Understanding the clustering and interrelationships between common risk factors like obesity, deglycation, dyslipidemia, hypertension and central obesity, and the associations with social and lifestyle determinants are warranted. The study aimed to estimate the burden of cardiometabolic risk factors (CRFs), their interrelationship, and their associations with other social and lifestyle determinants in a young Emirati population. Data …

Anxiety, Attributions, And Marital Quality: A Mediation Model, Tara Vossenkemper

Dissertations

Marital quality plays a significant role in the physical and mental health of many people. The purpose of this study was to examine anxiety, attributions, and marital quality in a sample of females. The first two hypotheses aimed to assess the relationship between anxiety and marital quality, and the relationship between attributions and marital quality. The primary research question aimed to assess attributions as a mediator in the relationship between anxiety and marital quality. Participants (N = 358) completed a demographic questionnaire, the Quality Marriage Index (QMI; Norton, 1983), the Marital Adjustment Test (MAT; Locke & Wallace, 1959), the …

How Do Student Nurses Of English Language Learner Populations Experience Nclex-Rn Style Questions?, Shawne Manies

Dissertations

The purpose of this qualitative study was to explore how student nurses of English Language Learner (ELL) populations experienced National Council Licensure Examination for Registered Nurses (NCLEX-RN) style questions. Evidence has suggested difficulty in improving the nation’s diversified nursing workforce, resulting in concerns over minority nurse representation. Student nurses of ELL populations are more likely than non-English language learner student nurses to be out of sequence or released from a nursing program. The extant literature has shown that this population of students struggle with NCLEX-RN style questions and that they have significantly lower pass rates than their English-speaking counterparts. Literature …

A Meta-Synthesis Of The American And The European Standards For The Accreditation Of Counseling Training Programs, Natalia Zapolsky

Dissertations

The purpose of this qualitative study was to explore how the European Standards for the accreditation of counseling training programs compare to CACREP standards and to each other. The differences and commonalities between standards have been defined through a meta-synthesis of integrated findings from a large body of inter-related qualitative studies and reinterpretation of the synthesized data.

This qualitative meta-synthesis research was intended to contribute to the process of counseling globalization by exploring the unique cultural features and aspects of the European and the U.S. accrediting systems for counseling training programs. This research revealed 1) the commonly recognized areas that …

Treatments For Cancer Given Orally: Patients' Perceptions Of Distress Due To Financial Toxicity, Ellen Carr

Dissertations

Purpose/Aims: For adult participants who have received or are receiving treatment for hematologic and solid tumor malignancies given orally, this study describes the relationship between participants’ experience of financial toxicity (FT), the participants’ perception of distress associated with FT, and participants’ self-identified adherence to prescribed treatments in the context of FT.

Background: FT has emerged as an additional source of distress for cancer patients. The costs of treatments given orally can be prohibitively expensive for patients. Therefore, these patients may experience considerable distress and may not adhere to treatments as prescribed.

Method: Descriptive cross-sectional correlational design study of a sample …

Health Promotion And Cancer Screening Of Arab Americans, Lamyaa Alyaba

Dissertations

Introduction: Although Arab Americans represent one of the fastest-growing populations in the U.S., there is very little health data about their preventive health habits and health-promoting lifestyle, including cancer screening. Purpose: the purpose of this study is to examine the relationship between personal factors, health-promoting behaviors, and cancer-screening behaviors of Arab Americans while controlling for acculturation. Design: Pender's Health Promotion Model was the conceptual framework for the study. a cross-sectional correlational design explored the relationship between the study variables utilizing an online-based survey to collect data from Arab Americans. Multimodal recruitment was used to recruit a convenience sample of 287 …

Pediatric Providers' Perceptions Of Their Role In Early Detection Of Postpartum Depression, Laura Aime De La Pena

Dissertations

The birth of a child is usually a happy occasion in a woman's life. It is also often a time of overwhelming anxiety, stress and hormonal changes. Postpartum depression (PPD) could occur during the first year of childbirth in approximately 10-20% of mothers (Waldrop, Ledford, Perry, & Beeber, 2017). PPD is the most common maternal health problem within the first year after childbirth (the American College of Obstetricians and Gynecologists, 2018). Recognition of mothers who are at risk for PPD allows health professionals to initiate care that can prevent further problems for the mother, infant, and the rest of their …

The Situational Context Of Safety Culture From The Perspective Of Medical-Surgical Staff Nurses And Nurse Leaders In A Hospital, Lisa Harton

Dissertations

People enter into healthcare facilities to maintain or restore health; however, often times those seeking health are harmed during the process by avoidable medical errors. Since the Institute of Medicine report on patient harm, safety culture continues to be the largest barrier in realizing safer patient care. Staff nurses' comprise the largest component of the health care workforce in hospitals and consistently have the lowest perceptions of a safety culture. Leaders who play a key role in creating and sustaining a safety culture consistently have the most favorable perception of safety culture. The development of a safety culture and safer …