Health Services Research Commons^™

Exploring The Lived Experience Of Self-Care In Young Adults With Type 2 Diabetes, Holly Berry-Price

Electronic Theses and Dissertations

Introduction

The prevalence of prediabetes in adults aged 18 or older was as high as 38% between 2017-2020. Youth-onset T2DM is a more aggressive phenotype than T2DM that occurs later in life. Young adults with T2DM have poorer health outcomes, lose an average of 15 years of life, all resulting in significant economic burden impacting the person. Current self-management interventions do not improve health outcomes in young adults with T2DM.

Purpose

The purpose of this research was to explore the self-care experiences of young adults living with T2DM.

Methods

Existential hermeneutic phenomenology informed the research. Inclusion criteria as follows: adults …

Reimagining Equitable Care: Simulation-Based Education And The Dismantling Of Implicit Bias And Stigma Of Vulnerable Populations In Hospitals, Vanessa Smith

Nursing | Senior Theses

Background: Simulation-based education consists of using high-fidelity mannequins and equipment to provide a safe space for healthcare professionals to practice crucial skills within healthcare. Used within hospitals and schools, simulation most commonly surrounds practicing hands-on skills such as central line insertion, IV insertion, Ultrasound-guided procedures, code blue response, etc. However, a large portion of healthcare that is overlooked is tackling issues within patient-provider relationships. Simulation can help dismantle the negative behaviors and feelings providers push onto patients through the use of standardized patients and role-playing. By using these methods, simulation can reduce providers’ personal implicit biases and the stigma associated …

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 …

Building Up Cal Poly Global Brigades Student Group: Reflections On Designing And Implementing One Undergraduate-Led Community Info Session, Caroline Nicole Smith, Jafra D. Thomas

Kinesiology and Public Health

Intro: Global Brigades, an international non-profit organization, trains college students and other pre-professionals in community-based health promotion by mobilizing community service trips around the world, which are taught and led by local community groups. Cal Poly’s Global Brigades student group was founded in 2018, and thus far, they have carried out three annual, medically-focused brigades to Honduras (two in-person, one virtual).

Purpose: The aim of this report is to present the findings of one experiential senior project to promote Cal Poly’s Global Brigades student group^[1] (conducted January to March 2023).

Methods: The student designed material for …

Examining The Feasibility Of Integrating An Alcohol Detoxification Protocol Within Primary Care, Emily A. Miller, Dnpc, Bsn, Rn

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Purpose: Medically supervised, in-home alcohol detoxification is safe, efficacious, cost-effective, and satisfying for patients. However, it remains underutilized within primary care practices. This feasibility study aimed to examine clinician perceptions of adopting a standardized outpatient alcohol detoxification protocol at a rural primary care clinic where no internal protocol exists.

Methods: An ambulatory alcohol detoxification protocol was created using the American Society of Addiction Medicine guideline on alcohol withdrawal management and presented to 38 providers and 11 nurses. Twelve participants (six providers and six nurses) completed a modified version of the Implementation Process Assessment Tool. The instrument measured stakeholder perceptions of …

Gender Differences In Administration Of Tpa In Treatment Of Ischemic Stroke, Christina Annerino

CURE Proceedings

As medicine and pharmacology advance through the years, new life-saving treatments are studied or discovered every day, and a medical emergency is no longer a death sentence. Even with conditions as serious as ischemic stroke, there is hope for survival and rehabilitation with the ‘clot-busting’ drug, tissue plasminogen activator, colloquially known as ‘tPA’. tPA is a thrombolytic agent, a substance that acts on fibrin in clots to dissolve them so they can no longer cause ischemia in blood vessels that results in a stroke. (Vega, 2022). tPA is an extremely effective treatment for ischemic stroke, demonstrated in 2013 by a …

Blind Spot: Implicit Bias In Health Care And Its Awareness Among Nursing Students At The University Of Southern Mississippi, Debora Skaliks

Doctoral Projects

While prejudice and bias are eminent topics in our society, implicit bias or unconscious bias is not as easily detected. Even though implicit bias may be a familiar concept to many, numerous healthcare workers frequently do not recognize the extent of harm such biases can impose on patients' health and outcomes. The Blind Spot DNP project exposed in this research paper explores the relentless question of the correlation between implicit bias awareness, implicit bias education, and its impact on health care. This Doctor of Nursing Project (DNP) project aimed to analyze whether implicit bias education and testing could increase unconscious …

The Clinical Healthcare Provided To Homeless Communities Across The United States: A Literature Review, Saylor Sisemore

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Homelessness has become a global public health concern as it results in poorer physical and mental health than age-matched people living in permanent housing (Ortiz & Roser, 2017). The area that comprises Northwest Arkansas (NWA), like other areas of the United States experiencing rapid growth, has seen a marked increase in the number of people experiencing homelessness in recent years. The homeless population is one of the most vulnerable and underserved groups of individuals in NWA and beyond. Public health nursing as a discipline is dedicated to providing compassionate care and exceptional service for all members of communities, with special …

Is Trauma Informed Care Practiced In Public Std Clinics In New York State, Antonia Brewer

Electronic Theses and Dissertations

Introduction: Sexually transmitted diseases (STDs) are increasing in the United States and often result in long-term adverse health outcomes. New York State (NYS) local health departments (LHDs) provide public STD clinics for high risk populations also found to have high rates of violence. This study examined if/how trauma informed care (TIC) is implemented in these settings. The study sample were LHD STD Program Directors in NYS.

Method: A convergent parallel mixed methods study design was used which included an online survey and follow up interviews. Survey data were analyzed using univariate statistics and conventional content analysis was used to analyze …

Emergency Care For Youth Who Experience Suicidality And Identify As Lesbian Gay Bisexual Transgender Queer/Questioning (Lgbtq+): An Interpretive Phenomenology, Theresa Schultz

Electronic Theses and Dissertations

Purpose: Suicide is a leading cause of death in children; youth who identify as LGBTQ+ are at an exponentially higher risk of suicide. The purpose of this study was to explore the lived experiences of young adults who identify as LGBTQ+ and sought emergency care for suicidality when they were adolescents.

Methods: Heideggerian hermeneutics phenomenology is the research method used in this study. Youth, ages 18-25 years, who identify as LGBTQ+ and sought emergency treatment for suicidality when they were adolescents (13-17 years) were recruited to participate;fifteen youth enrolled. Individuals ranged in age from 20 to 25 years. Participants described …

Health Disparities In Adults With Developmental And Intellectual Disabilities, Tulsi Patel

Nursing | Senior Theses

This paper reviews literature pertaining to the treatment of people with developmental disabilities. It will emphasize the inadequacies of health care in this population. The literature that will be discussed focuses on disparities in care via proxy, sociodemographic and clinical factors associated with disparities, assessing the needs of this population, the prevalence of disabilities in rural and urban settings, and the comparison of health disparities between adults with and without developmental disabilities.

For the purpose of this paper, a few terms will be defined. Developmental disabilities (DD) will be defined as “a group of conditions due to an impairment in …

Belmont University Covid Surveillance And Containment: An Evaluation Of Program Effectiveness, Morgan A. Lambrecht

DNP Scholarly Projects

In the early days of the Coronavirus (COVID) pandemic, members of university communities faced elevated risk of contracting COVID because they live and work in congregate settings, with shared living and dining arrangements. By the Fall 2020 semester, with limited information regarding the transmission of COVID, a quick, but comprehensive strategy was needed to allow students to return to university campuses, while maintaining a safe environment for students, faculty, and staff. The purpose of this project was to determine the effectiveness of the COVID surveillance and containment measures implemented in the 2020/2021 academic year for the residential campus community at …

The Effect Of Provider-Patient Racial Concordance On Student Health Services, Sophia B. Gilliam

Senior Theses

Objective: This research aimed to evaluate the effect of provider-patient racial concordance on perceived care received by University of South Carolina students at Student Health Services.

Methods: A total of 173 students at the University of South Carolina Columbia campus who have received care from Student Health Services within the past 2 years participated in the study. Participants were questioned about their experience with Student Health Services using an adaptation of the CAHPS® Clinician & Group Survey Version 3.0. Independent samples t-tests and descriptive analyses were used for comparisons between the 25 non-white respondents and a randomly selected proportionate group …

The Relationship Between Collective Nursing Knowledge And Nurse Turnover: An Application Of Nursing Intellectual Capital Theory, Pamela Russman-Chambers

Doctorate of Nursing Science Dissertations

The value of a healthcare organization is vested in the expertise, intellect, and wisdom of employees. Nursing knowledge resides both within the individual nurse and the collective knowledge embedded in organizational structures and practice environments. Healthcare organizations rely on their ability to utilize this knowledge to deliver high-quality care to patients. Hospitals wanting to gain a competitive advantage and achieve financial stability must be adept at acquiring, cultivating, and using the nursing knowledge stocks of the organization. When this knowledge can be utilized to mitigate healthcare issues and improve patients' health, this collective knowledge or intellectual capital is often the …

The Association Of Demographics, Social And Personal/Family Characteristics With Treatment Utilization Among Young Adults With Opioid Use Disorder In The United States, Marva L. Frederick

Dissertations, Theses, and Capstone Projects

Background

Opioid use disorder is a life-threatening medical condition and an ongoing public health problem in the United States. Treatment is necessary to combat opioid use disorder and to minimize the health-associated problems. Opioid use disorder is treatable with life-extending medications. Studies that examined treatment utilization among young adults with opioid use disorder in the United States was scarce. This study investigated the characteristics posited in the Andersen Behavioral Model of health utilization which may be associated with treatment utilization, among young adults with opioid use disorder in the United States. The urgency posed by the continuing opioid crisis in …

Improving Identification Of Seniors At Risk Tool Adherence To Identify Emergency Department Readmissions In Older Adults, Joy Gao

Doctor of Nursing Practice Final Manuscripts

The purpose of this evidence-based project (EBP) is to improve the emergency department (E.D.) staff adherence in completing the Identifying Seniors at Risk (ISAR) screening tool. The specific aim is to improve electronic health record (EHR) data collection to enhance the identification of older adults that are frequent utilizers of the E.D. at a local community hospital in Southern California. Based upon the most recent National Hospital Ambulatory Medical Care Survey, patients ages 65 and older make up 32% of all E.D. admissions. These patients also represent 50% of the moderate to severely ill patients seen in the E.D. …

The Associations Of Chronic Stress, Social Support, Health Behaviors And Metabolic Syndrome Among Hispanic Women, Edna Esquer

Dissertations

The Associations of Chronic Stress, Social Support, Health Behaviors and Metabolic Syndrome Among Hispanic Women

Background: Metabolic syndrome (MetS) prevalence is 25% among Mexican American women 30 – 49 years of age, compared to 22% among non-Hispanic Whites in the United States. Little is known about the additional contributions of chronic stress, social support and health behaviors to the development of MetS among this population.

Purpose: Describe the associations between chronic stress, social support, and health behaviors and the presence of MetS in Hispanic women living in an underserved community.

Methods: A retrospective cohort study design. The Adult Treatment Panel …

Examination Of Access, Utilization, And Barriers To Care Among Special Populations In The United States, Jed R. Hansen

Theses & Dissertations

Utilizing healthcare services is a complex phenomenon in the United States. While system-level barriers and facilitators of care, along with individual consumer choices, are known to affect access and subsequent use of services, the interaction among the factors that lead to utilization remains unknown. Examining access and utilization of healthcare services using a consumer framework incorporating both access barriers and facilitators and consumer-level dimensions that affect choice in seeking care may inform access and utilization research. The purposes of this dissertation were 1) to explore the presence of facilitators and barriers to care in ambulatory healthcare locations for non-emergent care …

Access To Healthcare For The Hispanic/Latino Population, Rebecca Loritz

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background: The U.S. Hispanic/Latino population faces significant barriers to accessing healthcare. The most common barriers Latinos face are language barriers, cost barriers, immigration statuses, insurance coverage barriers, transportation barriers, health literacy and education barriers, as well as lack of access to healthcare providers. These barriers impact not only their ability to access healthcare but also the quality of healthcare they receive.

Purpose: To synthesize the existing literature evaluating that identifies barriers to healthcare.

Methods: CINAHL and PubMed were systematically searched, along with a manual internet search for journal articles that studied access to care issues for the Latino population in …

Syphilis Screening Among Primary Care Providers, Sarah Christian, Nikki Franklin, Seth Stuart, Casey Tramel, Sereka Walker

MSN Research Projects

Syphilis is a sexually transmitted infection (STI) that can cause lesions on various mucosal areas of the body on an infected individual. If the disease is left untreated, syphilis can progress and affect an individual’s cardiovascular, neurological, and immune systems. The STI rates are on the rise across the United States, especially in the state of Mississippi. Because of the increase in syphilis rates in Mississippi, the researchers developed this study. The purpose of this study is to determine if primary care providers (PCPs) are knowledgeable and screening according to the guidelines of the Early and Periodic Screening, Diagnostic, and …

Knowledge Of The 2017 American Heart Association Hypertension Guidelines, Kelsey Creel, Kristan Kelly, Linda Turner

MSN Research Projects

The primary purpose of this project was to determine the knowledge of nurse practitioners in Mississippi regarding the 2017 American Heart Association Hypertension Guidelines. Following approval by the Institutional Review Board (IRB), the researchers utilized a descriptive, quantitative survey design to evaluate the knowledge of Mississippi nurse practitioners of the 2017 American Heart Association Hypertension Guidelines in regards to diagnosis and management of hypertension. Utilizing social media, the researchers targeted specific Facebook sites for nurse practitioners who practice in the state of Mississippi. Data was gathered through SurveyMonkey using a questionnaire. The data gathered from the completed questionnaires were then …

Implementation Of The 2017 Aha Guidelines By Primary Care Providers In Managing Elevated Blood Pressure A Modifiable Risk Factor Of Stroke, Chelsi Archie, Chelsea Bullock, Nekesha Johnson, Elizabeth Lishman

MSN Research Projects

Elevated blood pressure is a condition in which systolic blood pressure is 120-129 mmHg and diastolic blood pressure is less than 80 mmHg, according to the CDC (2020), which points out that elevated blood pressure often leads to hypertension. In 2017, The American Heart Association (AHA) released guidelines to aid providers in the early detection and management of hypertension. These guidelines integrate nonpharmacological and pharmacological therapies. The nonpharmacological therapies include following a heart-healthy diet, weight loss, sodium restriction, limitation of alcohol and tobacco consumption, and increased physical activity (AHA, 2018). Hypertension, “the silent killer” is one of the major causes …

Bystanders’ Perspectives On The Provision Of Informal, Hospital-Based Care To Bedridden Patients With Cancer In Sri Lanka, B. Sunil S. De Silva

Nursing ETDs

Due to the nursing shortage in Sri Lanka, patients need informal caregivers, known as bystanders, to help provide patient care. This study described bystanders’ perspectives on informal, hospital-based care to bedridden patients with cancer in Sri Lanka. In this qualitative descriptive study, 17 bystanders at Apeksa/Cancer Hospital, Sri Lanka, were recruited using snowballing sampling. Data were collected through telephone interviews and analyzed using content and thematic analyses. Findings showed that paid and unpaid bystanders cover all caregiving tasks with minimum interaction with nurses. Unpaid bystanders described the need for same-sex bystanders and additional help with patients’ mobilization and specialized care. …

Improving Clinicians’ Access To Patient Education And Va Resource Information, Ella Bermudez

Doctor of Nursing Practice (DNP) Projects

Abstract

Problem: In a western US Veterans Administration (VA) hospital system, patient education materials are provider-specific, not standardized, and not located in a central, readily available location.

Context: How does a patient education tool affect the clinicians' delivery of health education in increasing health literacy compared to written information alone in the US veteran population? An integrated literature review was performed using Cochrane, Joanna Briggs Institute (JBI), Scopus, CINAHL, and PubMed databases to address the PICOT question above and determine the impact of patient education tools on health literacy and patient engagement. The literature recommended improving patient education for better …

Nursing Students’ Knowledge And Attitudes About Pain Management And Opioids, Hedieh Hatami Sirjani

Health Services Research Dissertations

Statement of the problem: healthcare professionals’ knowledge of using opioids for pain management safely is critical in preventing opioid abuse and overdose. Undergraduate curricula of health professional schools, including undergraduate nursing programs, need to improve and adopt a comprehensive education regarding this issue.

Method: the first project was a systematic analysis of the literature regarding the educational interventions’ impact on healthcare professional knowledge and practice behavior regarding prescription opioids. The second project was a qualitative study of nursing students to explore their experience, self-efficacy, and knowledge of prescription opioid use for pain management and whether they feel the need for …

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 …

Investigating The Impact Of The Nursing Practice Environment (Npe) On Central Line-Associated Bloodstream Infections (Clabsi) Among Older Adults In The Intensive Care Unit (Icu), Kristen A. Cribbs

Dissertations and Theses

Background: Health care–associated infections, resulting from treatment received for medical or surgical conditions in a health care setting, represent a critical public health and patient safety issue, exacting substantial medical, social, and economic costs. The costliest among the leading causes of preventable health care-associated infections is central-line associated bloodstream infections (CLABSI), to which older adults (age 65 years and older) are particularly susceptible, especially during intensive care unit (ICU) stays. A rich body of research has empirically linked the quality of the nursing practice environment (NPE) in hospitals to both positive and negative patient outcomes; yet, surprisingly few studies have …

Dnp Project: Improving No-Show Rates In Primary Care, Mai-Linh T. Nguyen, Sarah M. Kuzara

Doctor of Nursing Practice Projects

Abstract

This paper explores the factors that contribute to no-show rates in the primary care setting and effective interventions to improve no-show rates. The average no-show rate in the primary care setting is 23%, (Dantas, Fleck, Olivaria, & Humacher 2018). In 2018, the no-show rate at the WeCare Clinic was 50-60%. A literature review was conducted to gather information regarding why patients choose to no-show their appointments, the common causes of high no-show rates, and effective interventions found to decrease no-show rates. We investigated the primary causes of a high no-show rate at the WeCare Clinic by interviewing staff and …

The Effect Of The Timing Of A Hospice Referral And The Perceived Quality Of Care By The Family, Caitlin Tran

Nursing | Senior Theses

Hospice care is a specialized type of palliative care for patients with a time-limiting illness. Despite its benefits, hospice remains underutilized. A key reason behind the underutilization are untimely referrals, often made during the last weeks or days of the patient’s life. The purpose of this paper is to investigate the existing barriers towards hospice that play into late referrals and its effect on patient/family satisfaction. This information will be examined to propose a pilot research study for further exploration.

Health Care Access And Utilization By U.S. Farmworkers, Genesis Bojorquez

Dissertations

Background: Agriculture industry has the highest fatality rate among all United States industries. Farmworkers experience high rates of occupational injury, illness, and mortality, yet have limited access to health care. Implementation of the Patient Protection and Affordable Care Act (ACA) of 2010 increased health care accessibility and broadened farmworker eligibility for health insurance, yet no study has measured the impact of the ACA upon U.S. farmworkers.

Purpose: The purpose of this research was to examine health care access and health care services utilization among U.S. farmworkers following the implementation of the ACA in 2010.

Specific Aims:

1. Apply the …