Medicine and Health Sciences Commons^™

Perceived Power By Nurse Managers In Dialysis Units: A Qualitative Case Study, Janie Griner

Dissertations

Nurses comprise the largest workforce in health care but lack power despite their numbers. Nurses have suffered short-staffing, burnout, job dissatisfaction, unsafe work settings, and cumbersome technology for decades. The dialysis nurse manager is an important component of the dialysis unit and plays a role in the retention and recruitment of nurses. Using a case study approach this qualitative, thematic analysis described dialysis nurse managers’ perception of power in dialysis units. A review of the current research revealed a gap involving dialysis nurse managers’ perception of power in the dialysis unit. The following research question was developed: • How do …

Perceptions Of Stress In Community Clinic Nurses During The Covid-19 Pandemic, Jomeka Smith

Dissertations

The COVID-19 pandemic is one of the largest healthcare crises that has affected the entire healthcare industry. Community health nurses in the front-line roles are greatly threatened by the COVID-19 pandemic that has decimated healthcare systems. The well-being of nurses is vital to perform their full potential of adequate patient care. Increased demands and pandemic related stressors can increase the risk of mental health problems. Nurses work in a variety of healthcare settings, however, the expectations, the fear of the unknown, and changes in demands have largely contributed to the unprecedented stressors that accompany nurses in clinical settings. Stress among …

The Leadership Experience Of Academic Chief Nurse Administrators In The State Of Georgia During The Covid-19 Pandemic Upon Return To Campus After Full Virtual Instruction: A Qualitative Study, Susie Jonassen

Dissertations

The impact of the COVID-19 global pandemic has been rated as the highest factor of intent to leave the profession in nurses serving in a leadership role. During the pandemic, crisis leadership swept across academia partly because nursing academia was not prepared for the rapid transition to virtual instruction. The reopening of nursing programs, while pandemic restrictions were still required, caused unprecedented disruptions and stress for academic leaders. One-third of nursing faculty anticipate retirement within the next two years. With the present burnout and shortage of nursing academia leaders, there was a need to explore the lived experience of academic …

The Effects Of Mindfulness And Exercise On Symptoms Of Parkinson’S Disease: A Systematic Review, Collin Tyler Garner

Dissertations

Parkinson’s Disease (PD) is the second most common neurodegenerative disease affecting which affects motor control, emotional regulation, cognition, and sleep through degradation of dopaminergic neurons. As of 2019, PD affects approximately 8.5 million individuals worldwide, with prevalence estimated to increase to between 8.7 and 9.3 million by 2030. The primary therapeutic approach to PD management is pharmaceutical, relying on dopamine replacement therapy. However, recent research has identified promising complementary therapies such as exercise and mindfulness training.

This review was conducted to compile and present evidence related to the efficacy of exercise, mindfulness, and combined exercise and mindfulness protocols as complementary …

An Analogue Study Of Expected Working Alliance And Hope With Victims Of Military Sexual Trauma Among Civilian And Military-Oriented Therapists, Alishia D. Salyer

Dissertations

Victims of military sexual trauma (MST) face unique challenges as they pursue mental health treatment and supportive care. Understanding what factors impact potential treatment outcomes is critical in aiding in their recovery (Castro et al., 2015; Kroviak, 2020). Although a substantial amount of research has been conducted to evaluate prevalence and client factors associated with treating victims of MST (Teit et al., 2015; Turchik & Wilson, 2010), little is known about therapists’ factors including therapists’ expectations working with such clients. The purpose of this study was to examine the relationships between therapist type (military-affiliated versus civilian), therapist gender, client gender, …

Chronic Stressors, Obesity Pathogenesis, And The Moderating Effect Of Internalized Weight Stigma; A Quantitative, Illinois Study, Karyn Byrne

Dissertations

The obesity epidemic is a ‘wicked’ problem with a complex web of determinants and outcomes. While generally higher for minoritized populations, prevalence rates manifest in surprising, nonlinear patterns. There is no consensus regarding treatment protocols or mitigation efforts, except that current efforts remain largely ineffective. Much research evidence that a profusion of determinants of health support obesity pathogenesis through various physiological processes and mechanisms, including the allostatic load, mitochondria functioning, the gut microbiome, and epigenetics. Intervening to support markers of the allostatic load (immunity, inflammation, and metabolic health) may provide a more effective treatment outcomes than traditional approaches, which tend …

Binding Interactions Of Biologically Relevant Molecules Studied Using Surface-Modified And Nanostructured Surfaces, Palak Sondhi

Dissertations

This research focuses on the field of surface nanobioscience, wherein different nanosurfaces that will be used as working electrodes in the electrochemical cell are manufactured and surface modified to understand the critical binding interactions between biologically significant molecules like proteins, carbohydrates, small drug molecules, and glycoproteins. This research is essential if we are to determine whether a synthetic molecule can serve as a therapeutic candidate or diagnose a disease in its early stages. In order to fully understand the binding interactions, the study begins with defining some of the fundamental concepts, principles, and analytical tools for biosensing.

Afterwards, we addressed …

Targeting Loneliness In Older Adults With Weekly Socialization, Tanja Johnson

Dissertations

Problem: Loneliness related to social isolation among the older adult population has become an increasing health concern with few interventions available for the general population. Loneliness has been directly associated with depression, poorer physical health outcomes, and overall quality of life.

Methods: The purpose of this study is to evaluate loneliness in the older adult population residing in a senior living community in an urban area in Missouri. Weekly one-on-one socialization, ranging from 45-60 minutes, will be implemented over 6 weeks, with pre and post-intervention screening for loneliness with the 28-item Visit-A-Bit (VAB) screening tool. Approval was received by both …

Risk And Protective Factors To Well-Being In Foster Care Youth Prescribed Psychotropic Medication In A Wraparound Program Of Care, Ann Reali Stratton

Dissertations

Background: Youth in foster care are prescribed psychotropic medications at higher rates and are more likely to experience disruptions to their medical care. Wraparound models of care have been shown to improve outcomes for youths on psychotropic medications, however, these methods have proved difficult to replicate in the foster care population. Government policies have called for better oversight in the foster care population and in response programs have been implemented, however, there remains little research for these programs. Objective: This research will evaluate the characteristics of foster care youth as they enter a Wraparound model of care and the predictive …

Lost In Interpretation: The Lived Experience Of Nurse Interpreters In The Clinical Setting, Byron Batz

Dissertations

The use of language interpreters in the health care setting constitutes a vital part of provider-patient communication but remains a relatively unexplored phenomenon. Registered nurses (RNs) are often called upon to serve as interpreters when linguistically diverse patients constitute a large segment of the patient population. That RNs serve simultaneously in an interpreter role – in addition to clinical and advocacy roles – is a complex facet of contemporary nursing practice in a diverse U.S. culture. The purpose of this qualitative descriptive study was to examine the lived experience of RNs serving as interpreters in health care institutions in Southern …

The Caregiver Of The Child With Cerebral Palsy: The Unnoticed Victim, Taylor Tusinski

Dissertations

The purpose of this study was to better understand the overall quality of life (QoL) in the primary caregiver who provides care to the child or adolescent, aged 0-17 with mild, moderate, or severe Cerebral Palsy (CP). This study aligned with a nonexperimental or observational design and examined the severity level of CP and the QoL in the mother and/or father.

For research question 1, regression results indicated that the overall model did not significantly predict the mother’s and father’s QoL [R² = .000, R² _adj = -.012, F(1,80) = .003, p = .957]. Regression results indicated that …

The Effects Of Mindfulness On Depression In Dialysis Patients, Nakeia Saddler

Dissertations

Abstract

Problem: Depression is a prevailing global health issue and a typical complication of dialysis patients. This quality improvement project's purpose was to evaluate mindfulness on depression in dialysis patients, aged 18-93, who are on dialysis and participated in a mindfulness program over three months.

Methods: A descriptive, prospective, and retrospective design was used to assess depression pre- and post-implementation of a mindfulness telephone line over three months. A convenience sample of twenty adults aged 18-83 who use this hemodialysis center on Monday, Wednesday, and Friday was utilized. The Iowa Model is the framework selected to guide the implementation of …

The Influence Of Attachment Styles And Mental Health Symptoms On Marital Satisfaction Among Deployed Us Army Soldiers, Leo Mora

Dissertations

Since 2002, changes in the frequency, duration, and nature of military campaigns overseas have piqued efforts to understand the effects of deployment on the mental health of DoD service members, especially married Army soldiers. However, few studies have examined the influence of attachment styles on the emotional health of combat veterans and the wartime impact they have also imparted to their spouses. Thus, in the context of military deployments, this study examines how secure/insecure attachment styles, posttraumatic stress (PTS), and depressive symptoms significantly influence married soldiers and their perceptions of marital satisfaction. In addition, this study also examines pre-existent, internalized, …

The Relationship Among Emotional Intelligence, Coping Strategies, And Occupational Burnout For Child Protective Service Workers, Yvette Longoria

Dissertations

There are low retention rates of child protective service caseworkers and this impacts the quality of care of the families served. The purpose of this study was to examine the relationship between emotional intelligence, coping strategies and occupational burnout for CPS caseworkers. In addition, examining the relationship between education type, education level, and caseload size as it relates to emotional intelligence, coping strategies, and occupational burnout among child protective caseworkers. The theoretical framework utilized was the Transactional Theory of Stress and Coping. A convenience sampling was used to collect participants employed as FBSS or CVS caseworkers at Texas Department of …

What Covid-19 Tweets Reveal About Risk Perception And Safety Preventative Measures And Behaviors Two Years Into A Pandemic, Elizabeth Vargas

Dissertations

The purpose of this study was to examine individuals Covid-19 risk perceptions two years into a long running pandemic. Data was collected analyzing risk perception and safety preventative measures to understand how individuals communicated risk in a health crisis that lasts more than two years. 116,401 tweets were collected from March 7-18, 2022, and analyzed utilizing a qualitative content analysis design. Four main classes were identified from the data which looked at how individuals perceived risk, how individuals determined risk from information that was shared, what preventative measures individuals were utilizing, and how individuals were living after the SARS-CoV-2 pandemic …

Experiences Of Counselors Who Assist Women In Midlife Who Display Depressive Symptoms: A Transcendental Phenomenological Study, Carla Pestana

Dissertations

In this dissertation, I present a transcendental phenomenological study conducted with 12 counselors who worked with women in midlife who displayed depressive symptoms. The purpose of this study was to understand the lived experiences, clinical and personal, of licensed professional counselors (LPCs) who worked with women in midlife who displayed depressive symptoms. Through the study, I sought to recognize the essence and themes that emerged from these LPCs who worked with this population. Moreover, this study was designed to obtain a better understanding of how these LPCs managed their feelings and thoughts, how they helped when working with these women, …

Internet Pornography Use, Loneliness, And Adult Attachment Patterns Among Asian Indian Young Adults: An Explanatory Sequential Mixed Methods Design, Anish Baby

Dissertations

Internet pornography consumption among Asian Indian Americans, an ethnic minority group, is largely underrepresented in current scholarly literature despite their growing population in the United States. The purpose of this research was threefold: (a) to measure the prevalence of internet pornography use among Asian Indian American young adults and adults; (b) to explore the relationship between internet pornography use, loneliness, and attachment patterns; and (c) to describe the lived experience of problematic porn consumers. Using an explanatory sequential mixed methods design, I conducted this study in two distinct phases: quantitative followed by qualitative. In the quantitative phase, I employed an …

Seminarians In The Person-Of-The-Therapist (Pott) Training : A Phenomenological Study, Tomichan Moonnanappillil

Dissertations

This dissertation presented a transcendental phenomenological study conducted among eight seminarians in one of the theological schools in Southern Texas, who attended the personof-the- therapist (POTT) training program during the fall semester of 2019. This study aimed to examine seminarian participants' experiences in POTT training, their influence on their selfawareness, and their impact on their emotional maturity and the ability to make responsible life choices. The study was guided by an existential-humanistic philosophical orientation as an overarching theoretical orientation with the subjective epistemological worldview and socialconstructionism paradigm. Findings indicated POTT training positively impacted seminarian participants' human formation, which was foundational …

Inviting The Outside In: Nature's Contribution To Counselor Wellness, Naomi Medina

Dissertations

The positive influence of nature on client wellness and psychological health (BonhamCorcoran et al., 2022) is well reflected in the emergence of nature-based counseling interventions such as wilderness therapy, walk talk therapy, and horticulture therapy, among other counseling modalities that involve aspects of the natural world (Lewis et al., 2022). This suggests that the inclusion of nature within the counseling session could also contribute to the wellness of the counselor. The purpose of this research was to determine the extent to which presence of nature contributes to counselor wellness and which of the five senses may play a greater role …

Lived Experiences Of School Counselors Working In Conjoint Roles In A Multisystem Framework To Address The Mental Health Needs Of Students, Angela Sampson

Dissertations

The purpose of this phenomenological qualitative study was to explore the lived experiences of school counselors working in conjoint roles as social–emotional leaders and mental health professionals (MHPs) to address the mental health needs of students through multisystem collaboratives (MSCs) and school-based systems of mental health care (SBSMHC).

The role of the school counselor has expanded into becoming a social–emotional leader and school MHP advocating for comprehensive social–emotional learning and the “school-linked” movement that coalesced their exclusive professional proficiency with both school-based and community resources working to enhance initiatives for student psychosocial development in ways that would increase student assets …

Apoe Risk Disclosure: A Review Of Positive And Negative Outcome, Stacey Rowcliffe

Dissertations

Two of this century’s most significant healthcare challenges are Alzheimer’s disease and mild cognitive impairment, with 40 million people suffering from the diseases. In fact, a conservative estimate projects that both conditions will double every 20 years until 2050. Alzheimer’s disease involves memory impairment, disorientation, confusion, and various problematic behaviors. Presently, no prevention method or cure has been discovered for Alzheimer’s. Mild cognitive impairment typically includes problems with memory, language, thinking, and judgment beyond those typical of one’s age. Usually, these symptoms do not interfere with daily activities but do not improve and have been linked with a risk of …

Predictors Of Chronic Traumatic Encephalopathy In Nfl Players: A Meta Analysis Review, Eisha Vora

Dissertations

Chronic traumatic encephalopathy (CTE) is a progressive neurodegenerative disease that emerges as a result of repetitive mild traumatic brain injury and has been studied within athletes of all sports. Repetitive blows to the brain are associated with many pathological changes and an emergence of tau pathology, all of which can lead to presentation with cognitive dysfunction, behavioral changes, and further motor decline in the later stages. After passing the inclusion criteria, a meta-analysis comprising four articles was computed using Comprehensive Meta-Analysis Version 3. Two hypotheses were examined: (a) the earlier the age of exposure to football, the greater the likelihood …

Computational And Experimental Investigation Of Elemental Sulfur And Polysulfide, Jyoti Sharma

Dissertations

Petroleum processing results in the generation of significant quantities of elemental sulfur (S₈), leading to a surplus of sulfur worldwide. Despite its abundance and low cost, the use of sulfur in value-added organic compound synthesis is limited due to its unpredictable and misunderstood reactivity. This dissertation aims to address this issue by tackling it from two angles. Firstly, by utilizing Density Functional Theory (DFT) calculations, the reactivity of sulfur in the presence of nucleophiles is studied. This facilitates the identification of organic polysulfide intermediates that can be generated under different conditions, as well as the corresponding reactivity for …

Atrial Fibrillation Management In Hispanic Adults, Tania Borja

Dissertations

Background: Research has found atrial fibrillation (AF) to be the primary or a contributing cause of death on 183,321 death certificates, and an underlying cause of death for 26,535 Americans in 2019. Findings indicate an increased AF diagnosis in White people compared to racial and ethnic minorities, contrasting widespread findings of increased prevalence of cardiovascular disease and ischemic strokes in minorities. Significant disparities—by race and socioeconomic status in disease distribution and access to testing and lifesaving treatments—have been documented, specifically associated with social determinants of health (SDOH); i.e., the conditions in which people are born, grow, live, work, and age. …

The Impact Of Social Determinants Of Health And Acculturation On Quality Of Life In Older Chinese American Adults With Chronic Pain: A Quantitative Study, Chi Lam

Dissertations

Despite a rapid increase in the older Chinese American adult population, there are very few research studies examining the impact of social determinants of health and acculturation on the quality of life in older Chinese American adults. The purpose of the study was to determine the impact of social determinants of health and acculturation on quality of life in older Chinese American adults with chronic pain. This quantitative, descriptive correlational study utilized Madeleine Leininger’s Transcultural Theory as its theoretical framework. Two research questions guided this study: (1) Was there a difference in the quality of life in older Chinese American …

Effects Of A Self-Forgiveness Intervention On Recovery From Substance Use Disorders, Michael Saltzman

Dissertations

Previous research has highlighted the relationship between shame, guilt, and problematic substance use (Gueta, 2013; Luoma et al., 2019; McGaffin et al., 2013; Rahim & Patton, 2015). Self-forgiveness has been associated with positive outcomes for individuals in recovery with substance use disorders (SUDs), though only one prior study has explored the effects of a selfforgiveness intervention for individuals in treatment (Scherer et al., 2011). This study examines the effects of a self-forgiveness intervention on state shame and guilt, state self-forgiveness, and drug avoidance self-efficacy, and it is the first intervention study to focus on self-forgiveness for individuals with SUDs receiving …

A Review Of The Role Of Anxiety In Diagnosis Of Children And Adolescents With Autism Spectrum Disorder: A Paradigm Shift In Conceptualization And Diagnosis, Evan Wahlquist

Dissertations

Early evidence of co-occurring anxiety symptoms in children and adolescents with autism spectrum disorder (ASD) dates back to the first descriptions of ASD by Leo Kanner (1943) and Hans Asperger (Frith & Mira, 1992). While current research has identified anxiety disorders as one of the most prevalent co-occurring disorders in children and adolescents with ASD, little is known about the nature of the relationship between these disorders. In an effort to explain these high prevalence rates, recent research has started to investigate the relationship between these two disorders. To join these efforts, this clinical research project explored the role of …

Allied Health Faculty Members’ Perspective On Interprofessional Collaborative Practice: A Hermeneutic Phenomenological Study, Prajakta Khare-Ranade, Margaret Newsham Beckley, Mary Geders Falcetti

Dissertations

A framework for interprofessional collaborative practice (IPCP) was developed by the World Health Organization (WHO) (WHO, 2010) in response to the need to address the complicated conditions that exist in today’s health systems. Much of the focus of today’s health service delivery is predicated on the social determinants of health (Barzansky et al., 2019), which refer to the environmental conditions associated with where people are born, live, go to school, work, play, age, and worship that have an impact on health, function, quality of life, and risks (Healthy People 2030, n.d.). IPCP is thought to be the only approach effective …

Vaccine Hesitancy, Provider Time, And Decision To Vaccinate, Kenneth Shackelford

Dissertations

Problem: To date, there is a significant gap in the literature involving studies evaluating the time healthcare providers spend educating vaccine-hesitant caregivers about the necessity for their child’s immunizations. Due to alarming resurgence rates of vaccine-preventable diseases in children, this project aimed to answer the following question: In vaccine-hesitant caregivers of newborns through six months of age, what is the effect of provider discussion time on vaccine administration (item) at well-child visits during the child’s first six months of life?

Methods: Using a descriptive observation design, pre-collected data on provider discussion time and vaccine administration was evaluated retrospectively from …

Implementation Of A Vestibular Disorder Screening Tool In An Urgent Care, Kathleen A. Probst

Dissertations

Implementation of a Vestibular Disorder Screening Tool in an Urgent Care

Kathleen A. Probst

M.S.N., University of Missouri-Columbia, 2007

B.S.N., University of Missouri-Columbia, 2004

A Dissertation Submitted to The Graduate School at the University of Missouri-St. Louis in partial fulfillment of the requirements for the degree

Doctor of Nursing Practice

August 2023

Advisory Committee

Susan Dean-Baar, PhD, RN, CENP, FAAN

Chairperson

Jennifer Vines, DNP, MSN, RN

Troy Dinkel, MD

Copyright, Kathleen A. Probst, 2023

Abstract

Problem: Vestibular disorders disrupt everyday living and can cause reduced quality of life. Guidelines developed to screen for vestibular disorders are not efficient to use …