Medicine and Health Sciences Commons^™

An Integrated Review: Outpatient Care And Management Of Fever And Neutropenia Among The Pediatric Oncology Population, Sarkis Makarovich

DNP Qualifying Manuscripts

Abstract

In the pediatric population, comprehensive cancer treatment and its associated side effects significantly impact their physical and emotional well-being. Though chemotherapy drugs are valuable agents against cancer cells, they also damage healthy dividing cells, such as bone marrow, thus weakening the immune system. Febrile neutropenia (FN) and associated infections remain the most critical complications of the extensive chemotherapy regimen and can threaten life if not appropriately addressed. Appropriate primary evaluation and treatment of FN in children with cancer includes administering proper broad-spectrum antibiotics. Ongoing research has focused on improving quality of life (QoL); yet, FN has persisted as the …

Integrating Health-Related Quality Of Life And Evidence-Based Polycystic Ovarian Syndrome Management: A Quality Improvement Initiative, Kami Beveridge Wast

Doctor of Nursing Practice (DNP) Manuscripts

Polycystic Ovary Syndrome (PCOS) is a prevalent endocrine disorder affecting approximately 10% of women of reproductive age, characterized by symptoms such as irregular menstrual cycles, infertility, and metabolic issues (Fatemeh et al., 2021). Despite its prevalence, the management of PCOS remains challenging due to its manifestations and impact on quality of life. Current treatment paradigms often fail to adequately address the comprehensive needs of this patient population, highlighting a substantial gap in care.

Utilizing the Plan-Do-Study-Act (PDSA) methodology, this quality improvement (QI) project aimed to enhance the management of PCOS and improve the quality of life for patients in a …

The Impact Of Boxing Exercise On The Quality Of Life In People Living With Parkinson's Disease, Jen Baker

Master of Science in Nursing Final Projects

This integrative review aimed to explore the effects of boxing exercises on the quality of life (QOL) of people with Parkinson’s Disease (PwP). Boxing exercise programs are popular in the Parkinson’s Disease (PD) community. Decreasing motor symptoms tends to be a primary focus in exercise and PwP. However, non-motor symptoms are a side effect of PD that varies amongst individuals and can impact QOL. Understanding the effects of boxing, especially on non-motor QOL, can support practitioners when prescribing specific exercise modalities for PwP. An integrative review with the search of PUBMED, CINAHL, and MEDLINE was performed, and the methodology of …

Lvad Therapy Versus Medical Management In Heart Failure: An Integrative Review, Megan Cherry, Sandi Coker

Master of Science in Nursing Final Projects

Background: Advancements in technology have increased management options for heart failure (HF) patients. Options include guideline-directed medical therapy (GDMT), left ventricular assist device (LVAD) therapy, and/or heart transplant. Due to resource allocations, the most accessible options for many HF patients include GDMT and LVAD therapy. Authors of this integrative review (IR) sought to examine quality of life (QOL) and hospitalization rate outcomes among patients receiving GDMT versus LVAD therapy.

Methods: 417 articles were screened across multiple databases (CINAHL, Medline, ProQuest, Ovid, PubMed) for inclusion into the integrative review based on inclusion criteria: published within five years, peer-reviewed, written in English, …

Parents’ Emotional And Psychological Perspective Of Caring Children With Oncological Disorders: A Descriptive Qualitative Study, Ambreen Navroz Ali Salyani

Theses & Dissertations

Background: Childhood cancer has a profound effect on the emotional and psychological well-being of parents, yet often their own psychological health is overlooked as the primary focus while treating the child. These parents silently suffer from psychological distress while caring for their children. They use their own coping strategies to overcome the situation. However, limited studies have been carried out in low- and middle-income countries (LMIC) regarding parents’ emotional and psychological perspectives of caring their children with oncological disorder.
Purpose: The objective of this study was to explore the psychological perspectives that parents of children with cancer diagnosis, treatment, social …

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 …

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 …

Ovarian Cancer Survivorship Checklist, Emily Lott

Seton Hall University Dissertations and Theses (ETDs)

Background: The cancer survivorship population has been growing significantly in the last few years due to advancements in treatments such as immunotherapy, targeted medications and other types of chemotherapy. However, these survivors can have lifelong symptom burdens due to their diagnoses and adverse effects of their curative therapies. Symptoms are not always physical and can include emotional distress. Ovarian cancer patients in particular tend to have symptom complications because of their disease process. Symptoms include pain, constipation, neuropathy and fatigue. Ovarian cancer patients also experience a high level of cancer relapses. Early detection is key in cancer recurrences for patients …

Black American Men's Resiliency And Persistence To Grow Old: A Midwest Qualitative Study, Kimberly Ann Walker

Theses and Dissertations

AbstractAs Black American men continue to experience the highest premature morbidity and mortality, few studies have centered on the intersection of class (low-income) and race (middle-aged and older Black men) with multiple morbidity from a critical race approach in the Midwest region of the U.S. Middle-aged Black men have 31% higher death rate than their White counterparts. A qualitative study was conducted by a community health nurse in the spring of 2021 in a metropolitan city. Thirty-one, low-income Black American men were interviewed focusing on their understanding and perceptions of their complex comorbidities, symptom management for quality of life, short …

Symptom Experience Of Patients With Advanced Melanoma Undergoing Immune Checkpoint Inhibitor Therapy, Natalie Jackson-Carroll

Dissertations & Theses (Open Access)

Background: Immune checkpoint inhibitors (ICIs) are novel therapeutic agents utilized in the management of advanced melanoma. Though generally well-tolerated, patients receiving ICIs experience treatment-related toxicities at varying onset and intensity. Assessment and evaluation of these toxicities and their impact on a quality of life is essential to comprehensive cancer care. Patient-reported outcomes (PRO) contribute vital data to a clinical assessment, supporting clinicians in their ability to improve outcomes. To date, there is no melanoma-specific or ICI-specific PRO measure of symptom burden available.

Purpose: The purpose of this study was to describe the symptom experience from the patient's perspective and how …

Managing Menopausal Symptoms Through Exercise And Dietary Changes, Ae Rah Kang

Doctor of Nursing Practice Final Manuscripts

Background: The most critical aging stage for women is the menopausal transition period, which causes various symptoms such as hot flashes, night sweats, sleeping disturbance, and mood swings that lower women's quality of life. Menopausal symptoms that are not managed can exacerbate severe medical conditions such as cardiovascular disease, bone illnesses, neurological diseases, and psychosocial problems. As the first non-pharmacological treatment for menopausal syndrome, several studies have shown that regular exercise and diet control can potentially improve menopausal symptoms and the quality of life.

Purpose: This project aimed to examine the effect of improving the quality of life by reducing …

Improving Early Utilization Of Palliative Care Services To Impact Quality Of Life, April Mcdonald

Doctor of Nursing Practice Projects

Despite studies indicating the benefits of palliative care, many barriers remain that prevent individuals from accessing this specialty service. Palliative care needs improved utilization. The purpose of this quality improvement project was to improve the utilization of palliative services and increase general knowledge and confidence among nursing staff within one nursing home facility. In the intervention bundle, training was provided on the use of a Palliative Referral Flowchart and the Palliative Performance Scale (PPS) along with evidence-based materials made available to residents and families. Data was collected pre and post intervention. Knowledge was improved by 26 %. Confidence was improved …

Caffeine Usage And Effects On Quality Of Life, Clinical Performance, And Safety Among Nurses, Alexander Carl Yanga

Nursing | Senior Theses

Background: The purpose of this investigation is to examine the effects of caffeine consumption on the nurse’s quality of life. It also will explore the relationship between caffeine consumption, nurses' clinical performance, and patient safety. Nurses often endure long hours with demanding tasks to ensure client health and safety. Long work shifts and low margins for error can be taxing, which could result in fatigue, poorer sleep, and increased risk for mistakes. Caffeine is an accepted and effective option for combating fatigue and boosting alertness short term. Questions arise about whether caffeine is beneficial or if consumption causes a decrease …

Effectiveness Of Self-Care Education On The Perceived Quality Of Life In Adults With A Tracheostomy, Elizabeth A. Bonnet

DNP Projects

Background: A tracheostomy is an operative procedure performed to create a stable surgical airway for patients with respiratory compromise due to a variety of clinical reasons. Living with a tracheostomy has tremendous impact on the patient as they experience alterations in their ability to eat, speak, breathe normally, and care for themselves. There is also a potential negative impact to their quality of life. Under ideal circumstances, the tracheostomy is a planned event and education is given to the patient prior to the procedure in an effort to lessen the impact and prepare them to cope with the expected life …

Enhancing Quality Of Life For Ovarian Cancer Patients, Kelly Marie Liguori

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Ovarian cancer is associated with a delayed onset of symptoms and late diagnosis and therefore has increased morbidity and mortality (Momenimovahed et al., 2019). These patients face multiple health complications, frequent hospital admissions, and may suffer from an overall poor quality of life (Marks, 2020). Purpose: This project aimed to determine if implementing FACT-O, a patient-reported quality-of-life screening tool, led to increased pastoral care consults and patient-reported quality-of-life for ovarian cancer patients. Methods: Iowa Model of Evidence-Based Practice was used for this project. Upon admission to 3Tower at CMC Main during a 3-month period, all patients with ovarian …

Evaluating Mindfulness On Loneliness In An Older Adult Population, Jessica Tieskoetter

Dissertations

Problem: Loneliness is a widespread public health concern and has negatively impacted mortality and health outcomes among older adults. This quality improvement project’s purpose was to evaluate mindfulness on loneliness and quality of life among adults aged 65 years and older, participating in a weekly befriending socialization program.

Methods: A descriptive cohort design was utilized to assess loneliness pre-and post-implementation of a mindfulness telephone line over three months. A convenience sample of 22 older adults enrolled in a befriending socialization program was used. The Iowa Model of Evidence-Based Practice framework was applied to guide the implementation of a practice change …

Palliative Care Screening For Persons Living With Dementia In A Nursing Home, Shanika S. Pruitt

Dissertations

Problem: Dementia is rapidly increasing as the people of the world mature and life expectancy increases. As the world ages and the prevalence of dementia increases, nursing home placement will and is the most sought place for care of this population. Dementia is under recognized as a terminal illness and palliative care is underutilized for nursing home residents with advanced symptoms of dementia.

Methods: This quality improvement (QI) initiative utilized a prospective, descriptive design. The Palliative Care Screening for the Elderly tool was administered to a purposive sample of persons living with dementia residing in the nursing home. Qualitative data …

Utilization Of Remap Conversation Tool To Improve Advance Care Completion In The Home-Based Palliative Care Community Setting, Gwendolyn Starkey

Doctor of Nursing Practice Projects

Background: The World Health Organization and the American Society of Clinical Oncology guidelines endorses mandatory communication skills training in care goals for seriously ill patients (Back et al., 2019). In one survey of primary care providers (PCP), 68% reported no formal training to discuss advance care planning (Comer et al., 2020). Advance care planning is essential to manage chronic conditions in our growing aging population to provide the best patient care. This manuscript aimed to discuss best practices and techniques in advance care planning and optimize skills to provide patient-centered care conversations that honor patient wishes, reduce unwanted hospitalizations, and …

Long-Term Health Outcomes For Adult Women Who Experienced Sexual Assault, Jodie Flynn

Electronic Theses and Dissertations

The purpose of this study is to understand the impact of sexual assault pre- and post-sexual assault on health, health care experience, and health-related quality of life in adult women. Research identifying quality of life as a health outcome post-sexual assault is limited. No long-term studies to evaluate differences in health-related quality of life pre-and post-sexual assault have been conducted. In addition, only a few studies have investigated mental health changes over time. An exploration into self-perceived general health pre-and post-sexual assault and overall current quality of life needs to be conducted to determine improvements in health care services for …

Factors Affecting Quality Of Life And Asthma Control In Older Adults With Asthma., Karen Schuckmann

Electronic Theses and Dissertations

Introduction: Approximately 7.7 percent of adults over the age of 65 have asthma in the United States (U.S), further, the population of older adults in the U.S. will increase to 20% by 2030. Health Related Quality of Life is low for this age group and asthma is often misdiagnosed and undertreated creating a need for research to improve factors that influence Asthma Quality of Life. Aims: This study explored two aims. The first aim evaluates the relationship between medication numeracy and asthma self-management knowledge with asthma self-efficacy. The second aim evaluates medication numeracy, asthma self-management knowledge, asthma self-efficacy, and asthma …

Maternal-Fetal Attachment And Its Relationship To Quality Of Life In Pregnant Women With Diabetes, Cheryl Ann Angel

Dissertations

Background: Maternal-fetal attachment (MFA) is the bond between a mother and her unborn child during pregnancy. Pregnant women with diabetes are considered high-risk and their numbers are expected to increase as levels of obesity rise and women wait longer to have children. This researcher has observed health care providers instructing pregnant women with diabetes about diabetes self-management (DSM) activities such as “dietary management” and encouraging the women to make those changes for their baby. However, some women remained unable to successfully engage in DSM behaviors despite having exhibited signs of MFA, e.g., expressing “thoughts of the fetus” to health care …

Quality Of Life And Symptom Sharing Among Women With Athletic Urinary Incontinence, Hailey Stevens

Honors Theses and Capstones

Abstract

Introduction Women have a 2-3.5 times greater chance of urinary incontinence (UI) during exercise. Some high-impact activities are particularly provocative including gymnastics, trampoline, and volleyball. Athletic UI can cause frustration, worry, and embarrassment for women, negatively influencing their quality of life and sports performance. Methods This secondary analysis aimed to compare UI frequency with the amount of frustration, worry, and embarrassment (F/W/E) experienced by athletic and active women with UI. Data regarding the frequency of UI, management strategies, amount of F/W/E, and demographics from the Active Women’s Incontinence Screening Tool (AWIST) was analyzed. Data analysis was performed in Excel …

Improving Utilization Of Palliative Care For Heart Failure Patients, Devin Tilley

Doctor of Nursing Practice Projects

The purpose of this program was to educate providers regarding palliative care for heart failure patients. Palliative care is underutilized in conjunction with usual heart failure management despite proven benefits of decreased symptom burden, reduced hospitalizations, and improved overall quality of life. Provider education has the ability to improve provider knowledge of palliative care for heart failure patients. A brief education session was given to hospital providers in an acute care setting to evaluate the benefits of provider education on palliative care utilization for heart failure patients. Findings included improved provider confidence in referring heart failure patients to palliative care. …

Evaluating The Association Among Demographic, Disease, And Symptom Profiles And Quality Of Life In Connective Tissue Disease-Related Interstitial Disease, Lanier O'Hare

All ETDs from UAB

m

Connective tissue disease-related interstitial lung disease (CTD-ILD) results in an unrelenting symptom burden and may progress to death. The morbidity and mortality associated with CTD-ILD likely has a profound impact on individuals’ quality of life (QOL). Quality of life is a phenomenon that has yet to be sufficiently described in the literature on CTD-ILD. The factors associated with QOL in other chronic lung diseases have been described, but because of the different clinical and demographic characteristics of CTD-ILD, it is unknown if these same factors are associated with QOL in CTD-ILD. The purpose of this study was to examine …

Predicting Change In Quality Of Life In Patients With Advanced Cancer And Family Caregivers Using Gps Data, Kyungmi Lee

All ETDs from UAB

Patients with advanced cancer and their family caregivers often experience poor quality of life. Measuring patient and caregiver physical and mental quality of life is typically performed using participant reported outcome measures, especially validated questionnaires. However, this self-report approach has several limitations, including recall bias, respondent burden, and social desirability bias. One potential solution to these limitations may be to use passive data collected by personally owned smartphones (e.g., GPS data) to model and assess the quality of life in family caregivers and patients with advanced cancer. Yet, there is no evidence to date that passively collected smartphone data is …

Urinary Incontinence In The Pre-Menopausal Woman And Impact On Quality Of Life, Jacqueline Skene Kirk

Theses & Dissertations

Background

Urinary incontinence (UI) is a medical condition that plagues millions of women worldwide, negatively affecting their quality of life. UI is the involuntary release of urine or what women refer to as having “accidents.” Women suffering from UI often feel embarrassed and become socially isolated. The majority of studies in the literature focus on UI in postmenopausal women. However, very few studies explore the lived experience of living with UI as a premenopausal woman, who are at a time in their lives when they are involved in their careers, having intimate relationships with their partners, and are raising their …

Evaluating Loneliness In An Older Adult Population, Kelli Rowland

Dissertations

Problem: Loneliness and social isolation are severe burdens on global public health and can impair overall health outcomes. Unfortunately, both loneliness and social isolation are prevalent in the older adult population. The purpose of this quality improvement project was to evaluate loneliness in older adults enrolled in a weekly socialization program and its impact on loneliness.

Methods: A descriptive cohort design was utilized to analyze surveys completed three months apart. A convenience sample was used with older adults already enrolled in a weekly socialization program. The Iowa Model of Evidence-Based Practice was applied to evaluate and promote quality …

A Telehealth Palliative Care Objective Structured Clinical Examination, Lindsey Q. Mcintyre

Dissertations

Problem: Palliative care is a service focused on symptom management and improved quality of life for persons with serious or chronic illnesses and is widely underutilized. Although advanced practice registered nurses (APRNs) possess a unique skillset to contribute to palliative care, there is minimal reporting on palliative care training for this professional group. The purpose of this clinical scholarship project was to implement the End-of-Life Nursing Education Consortium (ELNEC) online training program for APRN students in the BSN-DNP program and evaluate its effect on student performance during a telehealth objective structured clinical examination (OSCE).

Methods: An observational, descriptive …

Get America Talking: Implementing Advanced Care Planning In Primary Care, Sasha Recht

Doctor of Nursing Practice Final Manuscripts

Advanced Care Planning (ACP) is an essential part of providing adequate care in the primary care setting. Discussing end of life with patients can be a tedious and uncomfortable conversation for many providers, however, its continued avoidance contributes to the stigma of end of life care and may also result in significant healthcare cost expenditure with the use of unwanted invasive treatments. All providers should engage in consistent advanced care planning in order to improve patient and provider communication, improve patient satisfaction, increase advanced directives on file, reduce the stigma of the topic, and improve quality of life.

Compassion Fatigue And Burnout During The Covid-19 Pandemic, Gabrielle Giamanco, Tyler Tanzyus

Doctor of Nursing Practice Projects

Abstract

The COVID-19 pandemic has pushed nurses to exhaustion while leaving them with compassion fatigue (CF) and burnout (BO). Compassion fatigue is secondary to traumatic stress and exposure, while burnout is the state of exhaustion of one’s ability to manage with their work and personal everyday stressors. This study aimed to determine whether a daily use of a meditation app could change quality of life indicators amongst front-line nurses affected by COVID-19. With the help of the ProQol assessment tool, along with a pre and post intervention surveys, participants’ awareness and personal experiences were evaluated. The study consisted of nurses …