Medicine and Health Sciences Commons^™

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 …

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 practice. The concept …

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 mental health training …

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 consider …

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 …

Employees Support As A Determinant Of Merger Success: Exploring The Organizational Context And Its Interventions During Post-Merger Integration, Abdulla Humaid Saif Aljarwan Alshamsi

Dissertations

Mergers is an extreme form of organizational change, which usually has an adverse impact on the merging organizations employees’ wellbeing. In literature it was argued that organizational integration after merger, which is referred to as Post-Merger Integration (PMI) is usually resisted by employees, which is considered as a major contributor to the high failure rates of mergers. It was further argued that employees’ resistance toward integration is attributed to stress, uncertainty, ambiguity and lack of clarity on the changes that merger and integration initiate. Therefore, PMI activities were assumed to psychologically traumatize employees and jeopardize their sense of belonging, attachment, …

Acculturation, Psychological Well-Being And Substance Use Behaviors In Asian Indian Americans, Sonia Y. Amin

Dissertations

The American population is becoming more diversified with increases in the number of immigrants and refugees entering the country. These new Americans bring distinct cultural values, traditions, and worldviews. With this diversity, an important need has arisen to better understand the interplay of culture, physical, and mental health concerns that affect specific racial and ethnic populations. This increase in knowledge and awareness will aid in the development and provision of culturally-sensitive mental health services. The stress of immigration and the multifaceted sociocultural and psychological adaptations involved in adjusting to living in a new country with a Eurocentric dominant culture can …

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 adult …

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 descriptive, correlational …

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 how …

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 …

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

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 …

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

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

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 …

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 collect demographical, …

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 = …

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 …

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 …

Development And Validation Of A Food Frequency Questionnaire For The Adult Emirati Population For Use In Epidemiological Studies, Najoua El Mesmoudi

Dissertations

No abstract provided.

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. In this …

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.

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 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

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

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 are …

Chronic Pain, Sleep Disruption, And Work Performance In The Military, Jeffrey Ransom

Dissertations

Abstract

Background and Significance: Managing pain is a challenge for many organizations, including the U.S. military. The added complication of managing sleep disruption compounds the issue. Examining pain and sleep disruption in the context of work performance within the military is critical to understanding the impact of these conditions on our nation’s fighting forces.

Purpose: Examine the associations of chronic pain and sleep disruption in the context of work performance among active duty military service members.

Research Aims: 1) Describe sociodemographic characteristics, military service characteristics, clinical characteristics, and work performance of active duty service members, 2) Examine relationships between these …

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 …}

Risk And Protective Factors For Psychological Distress Following A Morally Injurious Event In Combat Veterans, Aaron Keating

Dissertations

Morally injurious events have been shown to increase the likelihood of experiencing anxiety, depressive, and posttraumatic stress symptoms of combat veterans. Research has found that guilt and shame are associated with higher levels of symptomology following morally injurious events. Similarly, individuals who are high in trait proneness to guilt and shame may be at higher risk for developing symptoms following a morally injurious event; however, no research to date has examined this possibility. In addition, acts that go against what one considers morally right bring about cognitive dissonance which then leads to anxiety. In order to reduce anxiety caused by …