Medicine and Health Sciences Commons^™

Feasibility Study Among Military Personnel With Traumatic Amputation During Military Combat Or Training, Michele (Shelly) R. Burdette-Taylor Phd, Msn, Rn-Bc, Cwcn, Cfcn

Dissertations

Military operations have resulted in a significant number of mangled extremities leading to traumatic amputations. Extremity injuries predominate, representing 50% to 70% of all injuries treated (Melcer, 2010). The majority of injuries sustained in Operation Endearing Freedom/Operation Iraqi Freedom (OEF/OIF) are combined penetrating, burn and blast injuries, traumatic amputation, and infections from the multi-drug resistant organism, Acinetobacter (Melcer, 2010). The purpose of this study was to measure the quality of well-being and impact of events in a group of adults who served in the U.S. armed forces and sustained the loss of one or more limbs during any combat or …

Evaluation Of Oncology Nurses' Knowledge, Practice Behaviors, And Confidence Specific To Chemotherapy Induced Peripheral Neuropathy, Rebecca Denise Mcallister

USF Tampa Graduate Theses and Dissertations

Chemotherapy induced peripheral neuropathy (CIPN) remains one of the most serious and challenging symptoms oncology nurses encounter in caring for patients receiving neurotoxic chemotherapy. CIPN is under-addressed, under-reported, and symptoms are minimized by healthcare providers, which adversely affect patient quality of life, physical function, and emotional well-being. There is an absence of research examining nurses’ knowledge and practice behaviors related to CIPN. The purpose of this study was to explore oncology nurses knowledge, practice behaviors, confidence, and the relationship between education, experience, and knowledge specific to CIPN.

Data was collected at Oncology Nursing Society (ONS) Chapter meetings throughout central and …

The Transition From Hospital To Home In Parents Of Pediatric Solid Organ Transplant Recipients, Stacee M. Lerret

Dissertations (1934 -)

Readiness for hospital discharge is an under-investigated topic in pediatric solid organ transplant. The immediate post-operative period and first few weeks after transplant are a critical time period where patients are at high risk for transplant-related complications.

A correlation design framed by Meleis' Transitions Theory were used to determine; (1) the influences of discharge teaching and care coordination on parent readiness for hospital discharge among parents of children who have experienced solid organ transplantation; and (2) the relationship of parent readiness for hospital discharge with coping, adherence difficulty, utilization of healthcare resources, and family impact in the first three weeks …

The Lived Experience Of Hispanic New Graduate Nurses In The United States, Esther Morales

Dissertations (1934 -)

There has been a significant increase in the Hispanic population in the United States that is not mirrored by representation of Hispanic registered nurses in the United States . Hispanic new graduate nurses enter nursing practice with few Hispanic role models and their story is not found in nursing literature. A qualitative study with a phenomenological philosophy and methodology was conducted to investigate the lived experience of seven Mexican American new graduate nurses, a subgroup of Hispanic nurses. Findings of this study were the seven themes: (a) being an employee; (b) an orientation with or without preceptors; (c) a transition; …

The Relationship And Effects Of Mindfulness On Comfort, Work Satisfaction, And Burnout Among Nurses Who Provide Direct Patient Care, Pamela Lichtenberg Heard

Dissertations

This study proposed to examine the problem of burnout in the nursing profession and ways to ameliorate burnout. Many burnout studies in the past focused on the problem and possible solutions that managers and/or hospital administrators could incorporate into their organization. The focus of this study is to evaluate ways that nurses can decrease their own propensity to burnout through the use of mindfulness. Therefore, this study examined burnout in a non-traditional manner. It is not assumed that others must assist nurses with decreasing their levels of burnout. Mindfulness is a means by which nurses can empower themselves to combat …

The Effect Of Using A Turn Clock To Cue Patient Repositioning For Pressure Ulcer Prevention In An Acute Care Setting, Julie Wiens

Master's Theses

Hospital-acquired pressure ulcers, a nursing care quality indicator, are becoming increasingly common in United States acute care facilities. In fiscal year 2007, the Centers for Medicare and Medicaid Services (CMS) recorded 257,412 “avoidable” Stage III and Stage IV pressure ulcers acquired in our nation’s hospitals on patients who were admitted to receive care for their primary diagnosis (CMS, 2007). Pressure ulcers are associated with pain and suffering, loss of function, increased length of stay, increased morbidity and mortality, and significant financial burden (Ayello & Lyder, 2008). In October 2008, the CMS discontinued payments for additional costs associated with pressure ulcers …

A Critical Reflection On Advanced Practice Nursing, Patricia Quinn Phd

Dissertations

Legitimation of the Nurse Practitioner (NP) and advanced practice nursing is explored using the framework of critical theory and the case study methodology of Yin. Three different cases are analyzed using classic themes of critical theory - oppression, alienation and ideology and false consciousness. Three publishable articles comprise this portfolio. First is "Looking for love (legitimation) in all the wrong places - A critique of Nurse Practitioner effectiveness literature". This article reviews the literature of NP effectiveness and offers an analysis of the failures and problems of these positivistic studies. Article two is "At least some of us are still …

Adn Program Benchmarking Using Standardized Exams For Assessment And Remediation, Amy J. Waters

Master's Theses

The purpose of this research investigation was to determine the correlational values between testing scores when utilizing the Assessment Technologies Institute™, LLC (ATI) standardized content exams during the third and fourth semesters of an associate degree nursing (ADN) program, and the sub-scale scores in the same content areas of the comprehensive final exam, the ATI RN-Predictor, taken during the final weeks of nursing school. The RN-Predictor is used to assess graduating students’ preparedness for the National Council Licensure Examination for Registered Nurses (NCLEX-RN®). A Level II, nonexperimental, correlational study design utilized convenience and retrospective sampling of academic variable data of …

Thai Patients' Experiences Of End-Stage Renal Disease: A Path Through An Unknown World, Chuleeporn Piyasut Phd

Dissertations

The purpose of the study was to explore how Thai end-stage renal disease (ESRD) patients manage the challenges of living with hemodialysis. The participants were Thai ESRD patients, who were receiving hemodialysis in one of the central provinces in Thailand. A grounded theory approach was employed in this study as it focuses on social processes grounded in individual experiences of participants in the study. The participants included 30 ESRD patients, aged 26-75, who had been undergoing hemodialysis from 6 months to 12 years. Individual in-depth interviews were audio-recorded and transcribed. Data were analyzed by using Atlas.ti. Data analysis revealed "a …

Breastfeeding And Mothers With Chronic Health Conditions, Blanche Landis Phd

Dissertations

Breastfeeding and Mothers with Chronic Health Conditions Breastfeeding may be most beneficial for women with specific chronic illness and may decrease the risk or prevent those illnesses from developing in their children. This study examined the initiation and duration rates of mothers identified as having asthma, hypertension, and diabetes; differences between the three groups in their efforts to breastfeed, and associations between determinants/outcomes of breastfeeding and behavioral beliefs, normative beliefs, and perceived control of mothers using Ajzen's Theory of Planned Behavior (TPB). A retrospective quantitative methodology was used to compare rates of initiation and duration, the differences between the three …

The Effect Of Shapedown On Habits And Self-Esteem For Overweight And Obese Children, Susan Bonnell Phd

Dissertations

Obesity in children is increased in the United States and globally which creates both physical and psychological health risks and co-morbidities affecting the development of positive self-esteem (Sinton & Birch, 2005; Whetstone, Morrissey, & Cummings, 2007). The development of poor self-esteem in children increases the risk of problem behaviors such as aggression, crime, teenage pregnancy, drug and alcohol use, tobacco use, and eating disorders (Brook et al., 2007). Treatment of childhood obesity is multifaceted, requiring behavioral and lifestyle changes for both child and family to achieve a healthy weight (De-Santis-Moniaci & Altshuler, 2007; Plourde, 2006; Ritchie, Crawford, Hoelscher, & Sothern, …

Battery And Abuse In The Elderly: A Forensic Analysis, Amy Y. Carney Phd, Mfs, Np

Dissertations

Elder abuse is a recognized social problem in the United States. First labeled as "granny battering" and originally studied under the umbrella of family violence, maltreatment of the elderly has received more funding and research in recent years. Multiple aspects of elder abuse have been examined in the literature including measures for detection, assessment, and documentation. Although studies have examined the circumstances surrounding abuse as well as theories of causation and characteristics of the abuser and the abused, studies of the relationship between the abuser and the abused are less well documented. The purpose of this research was to examine …

Application Of Systems Engineering Science To The Healthcare Environment, Jonathan Mack Phd, Msn, Anp, Rn

Dissertations

This Doctoral dissertation consists of a research portfolio examining the application of systems engineering techniques to the healthcare environment. The portfolio consists of three final publishable articles submitted to meet the program requirements for the, Doctor of Philosophy in Nursing degree from the University of San Diego, Hahn school of Nursing and Health Sciences. Article one is titled; "Use of a bed projection tool to predict ICU bed needs." This article describes the dissertation research study in which a bed projection tool was piloted on an ICU unit to determine the tool's ability to predict inpatient bed requirements. Article 2 …

Predictors Of Job Satisfaction And Burnout In Travel Nurses, Marcia Faller Phd, Msn, Rn

Dissertations

This study examined various individual and work environment characteristics and their influence as predictors of travel nurse job satisfaction and burnout. In addition it described travel nurses; a population of nurses that has not been previously studied. An explanatory sequential mixed methods design was used in order to take advantage of the exploratory nature of the qualitative portion in describing the attitudes and motivations of travel nurses in detail; and to further explain the findings from the quantitative portion of the study. The quantitative portion of the study used a descriptive correlational methodology with secondary data analysis of a cross-sectional …

Violence, Depression, Parental Stress, And Child Neglect Among High Risk Postpartum Women, Kristen D. Lambert Phd, Msn, Rn

Dissertations

The purpose of this study was to characterize a vulnerable population of postpartum women at risk for family violence and maladaptive outcomes and to determine the degree the identified attributes increase the risk of child neglect and psychological aggression. Lazarus' Appraisal Theory and Scaer's Traumatic Spectrum framework provided a conceptual basis to examine the interrelationships between intimate partner violence (IPV), depression, previous traumatic history, and child neglect. A descriptive correlation design using secondary analysis of longitudinal data collected for the Healthy Families San Diego Clinical Trial was used. Standardized measures including the CTS, CTS2, CTSPC, CES-D and PSI were administered …

The Impact Of A Clinical Mentor Program On Patient Outcomes, Cynthia M. Steckel Phd

Dissertations

The increasing complexity of patient care requires an expert nurse to navigate the hospital stay, yet today's workforce brings a declining supply of seasoned nurses, creating a patient need/nurse expertise gap. The clinical mentor role was developed to bridge this gap and create a safety net, using expert nurses, relieved of a patient assignment, to provide oversight for quality patient care. Results reported elsewhere showed improvements in failure to rescue and pressure ulcers six months before and after implementation. The purpose of this study was to examine the long-term impact of this new care model over the subsequent three years …

Accelerated Baccalaureate Nursing Students: Perceptions Of Success, Barbara B. Blozen

Seton Hall University Dissertations and Theses (ETDs)

Although there are a number of anecdotal reports on demographic characteristics and academic success of accelerated nursing students, few empirical studies have been undertaken to examine these students' success, despite this type of programs' existence for more than a decade, and only three studies have soughtto examine the perspective of the accelerated nursing student. Using Knowles' adult learning theory as a guiding framework, the purpose of this qualitative study was to explore, from the accelerated nursing students' perspective, the factors they reported as contributing to their success on the NCLEX-RN. This study also examined demographic characteristics of these accelerated students. …

Pushing Techniques Used By Midwives When Providing Second Stage Labor Care, Kathryn Osborne

Dissertations (1934 -)

A growing body of evidence suggests that spontaneous pushing during the second stage of labor results in better outcomes than directed pushing, which usually involves repeated use of the Valsalva maneuver. However, birth attendants in the United States (U.S.) continue to use directive methods when caring for women in the second stage of labor. This study used quantitative methods with the Theory of Diffusion of Innovations as a framework to identify and describe the practices used by certified nurse-midwives and certified midwives, practicing in the U.S., when caring for women in second stage labor. Data were gathered using a questionnaire …

Associate Degree Nursing Students' Thoughts, Feelings, And Experiences Of Short Study Abroad In A Low-Income Country, Cynthia Foronda

Dissertations (1934 -)

Associate Degree Nursing students are rarely offered opportunities to study abroad. Educational research about nursing students studying abroad is limited but suggests positive outcomes. Prior research has focused on graduate or baccalaureate students in developed and less developed countries, thus, the experience of studying abroad in a low-income country for the associate degree student is unknown. The purpose of this study was to describe the thoughts, feelings, and experiences of associate degree nursing students who participated in a short study abroad course in a low-income country. Ten students participated in phone interviews to share narratives two to six weeks following …

Neurodevelopmental Outcomes Of High Risk Infants, Lisa E. Miklush Phd, Msn, Rnc, Cns

Dissertations

Background: Infant developmental research has revealed amazing physical, cognitive, and social capacities of the human infant. Along with this knowledge is a growing appreciation of numerous factors that have the potential to impact the individual infant's developmental trajectory, either enhancing or compromising the eventual outcome. Enhanced understanding of those factors that shape infant developmental trajectories will provide an evidence base for the establishment of a supportive environment for the youngest members of society. Purpose: To determine the relationship between neurodevelopmental outcome and gestational age, birth weight, Apgar scores, NICU admission, infant gender, maternal depression, home environment, and parent-child interaction. Methodology: …

Shared Presence: Caring For A Dying Spouse, Lana Sue Mclouth Kanacki Phd, Ms, Rn

Dissertations

There is limited research on female spouses and their end-of-life experience with their dying husbands. The purpose of this study was to explore wives' perceptions of hospital and hospice care at their husbands' end-of-life. The grounded theory method was used for this study. Data were collected over thirteen months and then transcribed and coded for meaning. Participants were 25 elderly widows (62-103 years of age) with 19 husbands' deaths in a hospice setting and 6 in the hospital. They were widowed from 6 months to 10 years after the death of their spouses. They were good informants with excellent recollections …

Quality Of Life, Hope, Social Support, And Self-Care In Heart Failure Patients, Karen A. Mcgurk Phd, Mn, Rn

Dissertations

Heart failure is a significant, chronic health problem. Much is known about physiological factors related to this condition. Less is known about the psychosocial aspects that influence disease risk, progression, and treatment. The purpose of this study was to describe the relationships between quality of life, hope, social support, and self-care. A descriptive, correlational study was conducted. The participants were 65 heart failure patients who attended 2 military-based heart failure clinics. Quality of Life was measured using the Left Ventricular Dysfunction Questionnaire (LVD-36), Hope was measured using the Herth Hope Index (HUI), Social Support was measured using the Medical Outcomes …

Quality Of Life, Religious/Spiritual Coping, Demoralization And Depression In Heart Failure Patients, Terry Larsen Phd, Rn, Cns

Dissertations

Background: Research suggests that the heart failure (HF) population is particularly vulnerable to depression. Other factors may also affect quality of life such as religious/spiritual coping, and demoralization. Purpose: The purpose of this descriptive correlational study was to examine factors that predict health-related quality of life (HRQoL) in adults with heart failure. Specific Aims: (1) to examine level of religious/spiritual coping, spiritual distress, demoralization, depression and HRQoL among adults with heart failure; (2) to examine the relationships of religious/spiritual coping, spiritual distress demoralization, depression and selected demographic variables (age, gender, race/ethnicity and length of living with HF) with HRQoL. Methods: …

Tuberculosis Awareness And Public Opinion On Expanding Health Insurance Coverage, Belal A. Saadeh Phd, Msn, Rn

Dissertations

This quantitative descriptive cross-sectional study examined the effect of TB awareness and demographic variables on the level of support for expanding health insurance coverage for all residents, including undocumented immigrants. A modified 13-item tool developed by Morisky et al. (1990) was used to measure TB awareness; a single item created by the researcher assessed personal opinion regarding expansion of health insurance coverage; and a demographic questionnaire was used to collect data from 281 registered voters in San Diego County. The majority of San Diego County voters participating in the study supported at least some expansion of health insurance coverage. ANOVA …

Moral Distress And Avoidance Behavior In Nurses Working In Critical Care And Non-Critical Care Units, Mary Jo De Villers

Dissertations

Significance: Nurses facing impediments to what they perceive as moral practice may experience inner turmoil, frustration, and moral distress. These scenarios may culminate in resignation from employment at the individual level, increased attrition at the systems level, and poor patient outcomes, including increased morbidity and mortality.

Purpose: To explore the relationships between moral distress and avoidance thoughts and behavior between nurses currently practicing in critical care and non-critical care settings.

Methods: A descriptive cross-sectional comparative design was used. The sample was comprised of a randomized subset of 370 critical care nurses, a convenience sample of 87 nurses from a nursing …

Patients Safety Culture: A Baseline Assessment Of Nurses' Perceptions In A Saudi Arabia Hospital, Ahmad E. Aboshaiqah

Wayne State University Dissertations

ABSTRACT

PATIENT SAFETY CULTURE: A BASELINE ASSESSMENT OF NURSES' PERCEPTIONS IN A SAUDI ARABIA HOSPITAL

by

AHMAD E. ABOSHAIQAH

May 2010

Advisor: Dr. Stephen J. Cavanagh

Major: Nursing

Degree: Doctor of Philosophy

Patient safety (the avoidance and prevention of patient injuries or adverse events resulting from the processes of health care delivery) has become a major academic and public concern in healthcare. In order to promote and sustain a culture of safety in a healthcare organization, healthcare professionals stress the need to understand both individual and system contributions to error events. However, in Saudi Arabia, little is known about nurses' …

"A Cage Of Ovulating Females" : Mary Breckinridge And The Politics Of Contraception In Rural Appalachia, Dana Allen Johnson

Theses, Dissertations and Capstones

Mary Breckinridge and the Frontier Nursing Service have been the focus of intense scholarly effort over the last twenty years. Scholarship on Mary Breckinridge has centered on her healthcare reform work in Appalachia and its effects on the local residents and culture. This thesis examines the oral contraceptive trial that the FNS performed in Leslie County in the late 1950s and early 1960s. Although Breckinridge and the FNS maintained a restrictive contraceptive stance, they paradoxically permitted the contraceptive trial to be conducted on their patients in Leslie County. The decision to participate in the contraceptive trial resulted from a complex …

Health Promotion And Health Education: Nursing Students’ Perspectives, Kathleen Ann Halcomb

University of Kentucky Doctoral Dissertations

The purpose of this study was to determine student nurses’ perceptions of (1) the role of the nurse in health promotion, and (2) how the concept of health promotion is presented in nursing curricula. Research questions for this study included the following: 1) Can nursing students explain the difference between health education and health promotion? 2) What have nursing students been exposed to within their curriculum regarding health promotion? 3) What health promoting behaviors are nursing faculty role modeling as perceived by nursing students? 4) What is the role of the nurse in implementing health promotion as perceived by nursing …

A Program Evaluation Of A Nurse-Led Interdisciplinary Heart Failure Clinic, Victoria Lee Reis Savard

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Heart failure (HF) is a major health disparity that accounts for a vast number of hospitalizations as well as re-hospitalizations. In 2006. the estimated direct cost of HF in the United States (US) was 29.6 billion dollars (American Heart Association [AHA], 2005). HF is not only costly but it also accounts for approximately 287,000 deaths in the US each year (AHA). Significant improvements in patient outcomes are evident when patients are referred to HF clinics. From the literature it appears that referred clients have less frequent re-hospitalizations in addition to improved quality of life. Nurse-led outpatient HF clinics offer behavioral …

Dependability And Accuracy Of Clinical Performance In Nursing Examination Scores, Laurie Vanessa Nagelsmith

Legacy Theses & Dissertations (2009 - 2024)

The purpose of this study is to determine the dependability and accuracy of Clinical Performance in Nursing Examination (CPNE®) scores obtained from trained raters. Intraclass correlations were calculated to estimate interrater agreement. Accuracy of scores was determined by identifying percent accuracy for each scored element. Generalizability (G) coefficients were calculated to estimate sources of variance in CPNE scores. The population for the study is adjunct faculty at Excelsior College who agreed to participate in the study and are clinical examiners trained as raters for the CPNE