Digital Commons Network^™

Assessment Of Cancer-Related Fatigue In Breast Cancer Survivors, Meagan Walker

Walden Dissertations and Doctoral Studies

Cancer-related fatigue (CRF) is a persistent and debilitating problem for many breast cancer survivors. Although many CRF measurement tools are available, no consensus exists on the most appropriate tool to use for breast cancer survivors. The purpose of this project was to identify the best method of assessing CRF in breast cancer survivors. The practice-focused question inquired about the most appropriate way to assess fatigue in breast cancer survivors. The central concepts of the project were CRF and cancer survivorship. This project was informed by the theory of health as expanding consciousness and Mishel's theory of uncertainty in illness. The …

Religious Coping And Ptsd Symptom Management Among African Americans: A Clergy Perspective, Barbra Talley

Walden Dissertations and Doctoral Studies

Data indicated that although African Americans reported fewer occurrences of traumatic events than that of their racial/ethnic counterparts, however, the degree of traumatic events experienced by African Americans tends to be more serious and violent in nature. More so, lower recovery outcomes associated with PTSD among African Americans have been attributed to varying factors, such as financial restrictions, strained health care access, ineffective coping strategies as well as a mistrust of medical and clinical approaches, thus leading African Americans to seek faith-based approaches. This phenomenological study investigated clergy perspectives on religious coping constructs relative to the management of PTSD symptoms. …

Faith Leaders' Experiences On Health Counseling Provided To Their Congregation, Latangee Degrace Dickens

Walden Dissertations and Doctoral Studies

Numerous faith-based organizations (FBOs), denominations, and religious groups are represented in the United States. Faith leaders have the responsibility of addressing the spiritual needs of the congregation; however, the health needs of parishioners may be a point of discussion faith leaders should address. Communities surrounding FBOs may have limited health care services, lack transportation, and have serious health issues. The purpose of this phenomenological qualitative study was to explore the experiences of faith leaders on giving health counseling to their congregation. Faith leaders play an essential role in providing health counseling on various health topics to their congregation and community. …

Developing A Practice-Based Research Agenda For Grief And Bereavement Care, Ashton Hay, Christopher W. Hall, Margaret Sealey, Elizabeth Lobb, Lauren J. Breen

Medical Papers and Journal Articles

We aimed to identify practitioners’ perspectives on current research priorities in grief and bereavement care. Grief and bereavement care providers were invited to participate in a three-phase Delphi study to create expert consensus on the top priorities for grief and bereavement research. A total of 140 participants completed Phase 1, 84 completed Phase 2, and 70 completed Phase 3. These top 10 research priorities form the basis of a practice-based research agenda for grief and bereavement care to enable researchers to respond to key issues in grief and bereavement care that will ultimately improve the lives of bereaved people.

Patients’ And Caregivers’ Contested Perspectives On Spiritual Care For Those Affected By Advanced Illnesses: A Qualitative Descriptive Study, Clare O'Callaghan, Joanne Brooker, William De Silva, David Glenister, Adelaide Melia, Xavier Symons, David Kissane, Natasha Michael

Medical Papers and Journal Articles

Context; Spiritual care refers to practices and rituals addressing spiritual/religious concerns. It supports coping with loss and finding hope, meaning, and peace. Although integral to palliative care, its implementation is challenging.

Objective: To understand an Australian cohort of patients’ and caregivers’ perspectives about experiencing and optimizing spiritual care in the context of advanced illness.

Methods: Patients and caregivers of patients with #12 month prognosis were recruited from a broader spiritual study via criterion sampling and agreed to opt-in interviews. Participants from an Australian, metropolitan health service received a spiritual care definition and were interviewed. Transcripts were analyzed using qualitative description. …

'Through The Eyes Of The Dying' - Identifying Who May Benefit From Bereavement Follow-Up: A Qualitative Study, Jane L. Phillips, Elizabeth A. Lobb, Francis Bellemore, Terrence Hays, David C. Currow

Medical Papers and Journal Articles

Introduction: Bereavement support is an integral element of palliative care. Emerging evidence stipulates that bereavement support should be reserved for those most at risk of poor outcomes. While this evidence makes identifying those at risk of experiencing a complex bereavement a necessary first step, it has been difficult to arrive at a consensus as to whom that should be.

Aim: To explore whether palliative care in-patients with advanced disease are concerned about the bereavement needs of others and, if so, is it their next-of-kin.

Design: A qualitative study using semi-structured interviews, and thematic analysis using a constant comparative method.

Setting/participants: …

Self-Concealment, Perceived Discrimination, And African American Treatment Choices For Major Depression, Danita Morales Ramos

Walden Dissertations and Doctoral Studies

African Americans have a higher proclivity to depression than other ethnic groups in the United States and also have a greater propensity to avoid seeking professional mental health treatment. The available research has shown that racial and cultural barriers such as perceived discrimination and self-concealment are the primary factors that negatively affect African Americans' attitudes toward mental health itself and mental health treatment. Perceived discrimination and self-concealment may also negatively affect whether African Americans seek help for depression and from whom, but further investigation was needed. The quantitative survey study provided answers to which factors influence whether and where African …

Non-Pharmacological Solutions To Sleep And Circadian Rhythm Disruption: Voiced Bedside Experiences Of Hospice And End-Oflife Staff Caregivers, Rana Sagha Zadeh, Elizabeth Capezuti, Paul Eshelman, Nicole Woody, Jennifer Tiffany, Ana C. Krieger

Publications and Research

Background: Sleep disturbance is a significant issue, particularly for patients with advanced terminal illness. Currently, there are no practice-based recommended approaches for managing sleep and circadian disruptions in this population. To address this gap, a cross-sectional focus group study was performed engaging 32 staff members at four hospices/end-of-life programs in three demographically diverse counties in New York State.

Methods: Participants responded to structured open-ended questions. Responses were transcribed and subjected to qualitative content analysis. The themes and recommendations for improved practice that emerged were tabulated using Atlas TI qualitative software.

Results: This report details the experiences of hospice and end-of-life …

Transitioning With Grace: Improving Quality Of Life For Comfort Care Patients In The Intensive Care Unit, Melissa Ashley

Doctor of Nursing Practice Projects

The primary aim of this project was to develop and execute a standard protocol of interventions for comfort care patients on a medical intensive care unit. Staff at a 15 bed MICU at a Midwest urban teaching hospital from June 1 until August 11, 2018 were trained to execute a standardized protocol of interventions for comfort care patients. Seventeen MICU patients who transitioned to comfort care were offered a standardized set of evidence-based interventions, after staff attended educational in-services on providing high quality end of life (EOL) care. Checklists were used to determine intervention compliance. Pre-project and post-project surveys were …

Cost Of Caring: The Effects Of Euthanasia On Animal Shelter Workers, Kim L. Nguyen-Finn

Theses and Dissertations

This mixed-methods study focuses on animal shelter workers, a population that has often been overlooked in research and clinical practice, and the emotional strains of the task of euthanasia. The effects of employment in a kill or no-kill shelter, participation in euthanasia, and number of years employed on mental health issues of substance abuse, anxiety, depression, secondary traumatic stress, and burnout were examined. A three-way MANOVA was run to test the hypothesis that there is a cell effect among the type of shelter employed in, participation in euthanasia, and years of experience on mental health, which was not supported by …

2018 Celebration Of Scholarship, Creativity And Engagement, Eastern Illinois University

Programs

Scholarship, creativity, innovation, and the many forms of collaborative engagement that shape faculty life and student learning are central to the mission of Eastern Illinois University. For that reason, our faculty, department chairs, college deans, the provost, and the entire campus community celebrate the achievements and outstanding contributions of our colleagues and students to their disciplines and professions every year.

And, as the following pages illustrate, faculty engaged in continuing scholarly and creative activities provide outstanding mentoring experiences for our undergraduate and graduate students.

In addition to recognizing faculty performances, shows, publications, grants and other professional efforts, the University will …

Adventure-Based Therapy: Couple Intimacy With Christian Spirituality, Edward Boyer

Electronic Theses and Dissertations

Adventure-Based Therapy (ABT) models have been used for many years in the United States and beyond, primarily in adolescent and young adult populations. This project seeks to explore the experiences of couples on an ABT trip. Couples were asked to share their lived experiences as it pertains to marital intimacy, nature, and Christian spirituality. Seven themes emerged as the interviews were transcribed and confirmed by the couples: appreciation for nature, building community, care shown by partner, connecting with God outdoors, leaving technology, preparation together, and shared activity. These themes form the backbone of potential new outcomes as couples’ work is …

Leadership Rounding In The Intensive Care Unit To Improve Satisfaction, Stephanie Laborde

Master's Projects and Capstones

A mid-sized hospital in Alameda County would like to increase its Hospital Consumer Assessment of Healthcare Providers and System (HCAHPS) scores by improving the patient care experience. The specific aim for this project is that by August 2018, the implementation of daily leadership rounding in the ICU will result in an increase of patient satisfaction HCAHPS scores by 5%. The project team used the Plan-Do-Study-Act cycle to guide the implementation of leadership rounding. Leadership rounding was conducted daily over a 10-week period by the project team, which consisted of the floor manager and clinical nurse leader (CNL) student. The project …

Kematangan Emosi Remaja Pelaku Bullying, Siti Maryam, Fatmawati Fatmawati

Jurnal Kajian Bimbingan dan Konseling

In recent year, there is a number of news in the mass media on violence in the school, including bullying. The high number of juvenile delinquency is the result of a lack of ability to control emotions in an acceptable way, causing the individual to easily engage the group's influence to perform negative behavior, including bullying behavior. From the above explanation, we interested to examine more deeply how the emotional maturity in adolescents bully in Junior High School 9 Banda Aceh. This study was done through quantitave method by using using the Emotional Maturity scale developed by Katkovsky and Gorlow. …

Life Or Death And Other False Dichotomies: A Theology Of Hospice, Kayla Stock

School of Theology and Seminary Graduate Papers/Theses

Feelings of fear and failure are often ascribed to death and dying; hospice offers a new way forward. This paper considers fear of death from a personal and evolutionary psychological perspective, then branching into the ways fear of death and death anxiety are made manifest in the health care system. Within the health care system, in particular the biomedical model of health care, death is construed as the enemy, the ultimate mark of failure. In one sense, death is fundamentally unknown, and is therefore naturally fear-inducing. Simultaneously, death is also both singularly and universally knowable; it is the only thing …

Facilitating Emotional Regulation In Adults With Developmental Disabilities Through Person-Centered Play Therapy, Otis Kemutambah

Honors Theses

Adults with developmental disabilities may employ maladaptive behaviors that stem from limited opportunities to interact with their community and non-nurturing interactions within their environment. This literature review explores the effects of play on maladaptive behaviors and provides a rationale that supports the use of PCPT to improve this population’s emotional regulation skills. More specifically, the sources indicate that activities containing exercise and games, improves the emotional regulation skills of this population. Based on the presented information, created cost effective activities will potentially improve these skills amongst adults with developmental disabilities. These activities that adhere to PCPT are basketball, water basketball, …

Policy Addressing Family Presence During Resuscitation, Crystal Emanuel-Hayes

Walden Dissertations and Doctoral Studies

When hospitals became the primary care setting for very ill patients, visiting hours and restrictions related to family presence during resuscitation (FPDR) became common. During medical crises that occur in hospital settings, families are separated from loved ones because family members may impair resuscitation efforts or such efforts might psychologically traumatize family members. Various national health care organizations have endorsed family presence during resuscitation; however, practices preventing family presence persist. This project used evidence from the peer-reviewed literature to develop a healthcare institution policy that addresses family presence during resuscitation. Theories, concepts, and models that guided this DNP project included: …

Chaplaincy Inclusion In Hospital Interdisciplinary Teams And Its Impact On Chaplains' Well-Being, Chike Nzegwu

Walden Dissertations and Doctoral Studies

Healthcare providers may impede the delivery of spiritual and emotional support to

patients and their families by healthcare professional chaplains if they misunderstand how to effectively use chaplains, who often prefer to be engaged sooner than they are. This issue prevents highly trained, board-certified professional chaplains from providing services, thereby impacting the quality of patient care. The purpose of this phenomenological study was to examine, through the lived experiences of professional chaplains, the extent to which chaplains feel that others perceive them as valued members of an interdisciplinary team (IDT), as well as to determine how team inclusion may impact …

Patient Navigation Program In Oncolgy Clinical Practice, Mercy George

Walden Dissertations and Doctoral Studies

Cancer diagnoses affect millions of people in the United States each year. Today, cancer patients face many challenges when trying to navigate the complex healthcare system. Patient navigation programs were developed to address and overcome barriers patients may face as they make their way through the healthcare system. The purpose of this project was to provide an analysis and discussion of the current published literature to provide evidence for improving care coordination and patient satisfaction in the oncology clinical setting with a patient navigator program. The practice-focused question for this project asked if a patient navigator program for adult cancer …

Development Of A Professional Practice Competency For Undergraduate Nursing Students At A Private Catholic University In Western Australia: A Mixed-Method Study, Christine Adams

Theses

This research investigating professional student nursing practice occurred at a private Catholic university in Western Australia. The objects of this university articulate the provision of education in the context of Catholic faith and values. The objects are further expressed through the university’s 10 graduate attributes, which every student should have achieved by graduation. These attributes aim to foster and grow the qualities of ethical practice, interpersonal skills, professionalism, specialist knowledge and skills to support local and global communities. Suggested university strategies for attaining these attributes include undertaking high-quality work-integrated learning and building strong and mutually beneficial relationships with industry partners …

How Is Chaplaincy Marginalised-By Our Faith Communities And By Our Institutions And Can We Change It?, Jeffrey Cohen

Medical Papers and Journal Articles

This paper reviews the issues confronting chaplaincy/spiritual care in the 21st century. It looks at how faith communities are changing their view of chaplaincy as well how institutions respond. The paper looks at two qualitative studies and what can be learned from them in confronting the questions raised at the beginning. It concludes with the question of how the evidence base can be expanded to make chaplaincy/spiritual care more relevant over the next few years.

International Medical Electives In Selected African Countries: A Phenomenological Study On Host Experience, Elspeth Fotheringham, Pippa Craig, Elina Tor

Medical Papers and Journal Articles

Objectives: To explore the host experience on international medical electives at a selection of hospitals in low- and middle-income countries in Africa. Outcomes of the study may inform and improve the preparation of global health curriculum, pre-elective training and debriefing for international medical electives.

Methods: A descriptive phenomenological study was undertaken, involving semi-structured interviews with ten elective hosts at seven study sites in three African countries. Purposive convenience sampling augmented by snowballing was utilised to recruit study participants. The data were thematically analysed and interpreted with reflexivity to generate an accurate aggregate of the experience of participants in hosting international …

Cultural Considerations At End Of Life In A Geriatric Inpatient Rehabilitiation Setting, Melissa J. Bloomer, Mari Botti, Fiona Runacres, Peter Poon, Jakqui Barnfield, Alison M. Hutchinson

Medical Papers and Journal Articles

Aim: To explore the impact of cultural factors on the provision of end-of-life care in a geriatric inpatient rehabilitation setting.

Background: Australia’s ageing population is now also one of the most culturally diverse. Individuals from culturally and linguistically diverse backgrounds may have specific care needs at the end of life according to various aspects of their culture.

Design: A mixed method approach using a retrospective audit of existing hospital databases, deceased patients’ medical records, and in-depth interviews with clinicians.

Findings: Patients’ and families’ cultural needs were not always recognised or facilitated in end-of-life care, resulting in missed opportunities to tailor …

'Death Is Difficult In Any Language': A Qualitative Study Of Palliative Care Professionals' Experiences When Providing End-Of-Life Care To Patients From Culturally And Linguistically Diverse Backgrounds, Anna Green, Natalia Jerzmanowska, Marguerite Green, Elizabeth Lobb

Medical Papers and Journal Articles

Background: Ethnic minority patients have unique challenges in accessing health services. These include language difficulties, unfamiliarity with the health system, lower rates of cancer screening and survival, higher rates of reported side effects from cancer treatment and poorer quality of life. Little is known about this patient group when transitioning to palliative care.

Aim: To elicit the experiences of palliative care health professionals when providing care for patients from culturally and linguistically diverse backgrounds which differ from mainstream Australian language and culture.

Design: An emergent qualitative design, informed by theoretical and procedural direction from grounded theory research.

Setting/participants: Four focus …

Identifying Systems Barriers That May Prevent Bereavement Service Access To Bereaved Carers: A Report From An Australian Specialist Palliative Care Service, Jane Phillips, Elizabeth A. Lobb, Paula Mohacsi, Nicole Heneka, David Currow

Medical Papers and Journal Articles

Background: Bereavement follow up is an integral element of palliative care. However, little is known about the systems that link bereavement services with bereaved carers.

Aim: To map how effectively a specialist palliative care service linked bereavement service to bereaved carers.

Methodology: A retrospective medical audit, using process mapping was undertaken within one Australian specialist palliative care service to identify the systems that linked bereavement services to a consecutive cohort of palliative care decedents (n=60) next of kin.

Results: Bereavement records were located for 80% of decedents. Nearly all (98%) had a nominated next of kin, with just over half …

Culturally And Linguistically Diverse Palliative Care Patients' Journeys At The End-Of-Life, Anna Green, Natalia Jerzmanowska, Marguerite Green, Elizabeth Lobb

Medical Papers and Journal Articles

Objective: To understand the clinical and psychosocial journey of culturally and linguistically diverse (CALD) palliative care patients.

Method: This study was conducted at a subacute hospital with a specialist palliative care unit and a community palliative care service in a metropolitan region of New South Wales, Australia. Medical records of 100 deceased patients from CALD backgrounds over a 12-month period from 2014 to 2015 were recorded on a data mining tool. The cohort had transitioned to either community or inpatient palliative care services with a life-limiting illness. We used descriptive statistical analyses to identify the patients’ end-of-life journeys in the …

Using New And Innovative Technologies To Assess Clinical Stage In Early Intervention Youth Mental Health Services: Evaluation Study, Laura Ospina-Pinillos, Tracey A. Davenport, Frank Iorfino, Ashleigh Tickell, Shane Cross, Elizabeth M. Scott, Ian B. Hickie

Medical Papers and Journal Articles

Background: Globally there is increasing recognition that new strategies are required to reduce disability due to common mental health problems. As 75% of mental health and substance use disorders emerge during the teenage or early adulthood years, these strategies need to be readily accessible to young people. When considering how to provide such services at scale, new and innovative technologies show promise in augmenting traditional clinic-based services.

Objective: The aim of this study was to test new and innovative technologies to assess clinical stage in early intervention youth mental health services using a prototypic online system known as the Mental …

Patient Reported Outcomes Of Pastoral Care In A Hospital Setting, Elizabeth A. Lobb, Susanne Schmidt, Natalia Jerzmanowska, Ashley M. Swing, Safrina Thristiawati

Medical Papers and Journal Articles

This study aimed to establish whether Pastoral Care (PC) visits were an effective component of a hospitalized patient’s overall health experience. Outcomes of PC visits were reported by 369 patients in 7 sites across Australia. The patient reported outcomes of PC visits included: the patients felt they could be honest with themselves, with a sense of peace, a better perspective of their illness, less anxiety, and felt more in control. Five factors of the PC visit significantly related to higher patient’s overall outcomes: (a) having more Pastoral Care visits (p < 0.5 0 R 0.778, CI 0.17–1.38); (b) the patient was able to talk about what was on their mind (p < 0.01, OR1.48, CI 0.58–2.37); (c) they had something to be hopeful about (p < 0.01 OR1.18, CI 0.51–1.85); 4); the visit focused on decisions about the patient’s health care (p < 0.05, OR0.70, CI 0.05–1.35); and (d) a belief in God/Higher Being (p < 0.01, OR 1.01, CI 0.43–1.71).

'What’S On Your Mind?' The Only Necessary Question In Spiritual Care, Austyn Snowden, Elizabeth Anne Lobb, Susanne Schmidt, Ashley M. Swing, Pamela Logan, Catherine Macfarlane

Medical Papers and Journal Articles

Around the world, chaplains provide specialist spiritual care for people with complex healthcare needs. If the nature of chaplain interventions was better understood then multidisciplinary colleagues could both improve their own skills in spiritual care and better understand when to refer people to chaplains. A survey was constructed to establish what aspects of the chaplain/patient relationship were most important for patients in Scotland and Australia. Outcomes were measured with the Scottish Patient Reported Outcome Measure (Scottish PROM©). Results from 610 respondents showed the strongest correlation was between ‘being able to talk about what is on my mind’ and the Scottish …

Addressing Spiritual Care Needs In Primary Care, Olayinka Akerele-Olufidipe

Walden Dissertations and Doctoral Studies

This DNP project focused on the spiritual aspects of care that are often neglected in the outpatient setting. Most patients value their spiritual health and believe that it is just as important as their mental and physical health. The purpose of this project was to improve the overall spiritual care provided to patients, their families, and/or caregivers in times when they were experiencing spiritual distress. This quality improvement (QI) project was designed to determine whether embedding a chaplain in an outpatient clinic instead of providing a pamphlet about chaplain services increases patient satisfaction. Secondary analysis of the data in this …