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Nurse Driven Enteral Nutrition Protocol For Mechanically Ventilated Patients, Deena Shewekah

DNP Projects

Introduction: Delayed enteral nutrition in critically ill patients increases the risk of complications and poor outcomes. Current evidence-based guidelines recommend initiation of enteral nutrition within 24-48 hours of intensive care unit (ICU) admission. The quality improvement (QI) project aim was to examine whether enteral nutrition was initiated within 24- 48 hours of mechanical ventilation after implementation of QI intervention in order to determine practice change.

Methods: The QI protocol was introduced to the Cardiovascular ICU (CVICU) at UK Chandler Hospital (UKHC) nurses via an education session. A post-education electronic survey identified the nurse’s understanding of the protocol. To identify nursing …

An Interprofessional Clinical Placement In A Primary Healthcare Setting: A Pilot Study, Christina Aggar, Beth Mozolic-Staunton, Renee Joyce Lovi, Maggie Scorey, Melissa Kemp, Tara Walker, Sian Lewis

Internet Journal of Allied Health Sciences and Practice

Purpose: Internationally, and in Australia, interprofessional education (IPE) is becoming typical in primary healthcare delivery and is core to delivering patient-centred care. It is essential that primary healthcare education develop interprofessional capacity in order to produce a skilled workforce. An IPE clinical placement for undergraduate health students was developed and piloted in primary healthcare settings. The aim of this study was to evaluate the impact of the IPE clinical placement in a primary healthcare setting on students’ perceptions of interprofessional education. Method: A pre-post placement validated questionnaire (n=19) indicated overall perceptions of IPE significantly increased over the course of …

Mennonite College Of Nursing Annual Report, Fiscal Year 2020, Judy Neubrander

Annual Reports - Mennonite College of Nursing

Annual report of the Mennonite College of Nursing at Illinois State University

Nutritional Strategies For Nurses In A Fast Paced Occupation, Zachary Christman

Department of Agronomy and Horticulture: Dissertations, Theses, and Student Research

The foundation of the medical system are the nurses and certified medical assistants. Their personal health condition affects how well diseases and other medical conditions are handled. This article will begin with an overview of the eating behavior of nurses. Three different interventions which have been shown effective in a fast paced workplace are presented in order to improve the health of nurses and certified medical assistants. The first intervention is organizational changes that would increase the amount of time nursing staff have to eat. The second is the use of a messenger bag delivery system to provide needed food, …

The Efficacy Of Cognitive Behavioral Therapy In The Treatment Of Adults With Obesity, Hallie M. Tiffany

All Graduate Theses, Dissertations, and Other Capstone Projects

Obesity is a complex condition increasing in prevalence and consequence throughout the United States and the world. Obesity is affected not only physiologically but by one’s psychological aspects of life. Obesity contributes to countless chronic health conditions and thus greatly impacts a person’s wellness. A literature review was conducted to identify the following if in obese adults the benefit of cognitive behavioral therapy for weight loss and/or maintenance. A total of 10 articles met inclusion criteria from searches from databases that included ProQuest, Medline, CINAHL, Cochrane, and PsycINFO as well as bibliography review. Level of evidence includes two articles that …

Nurse Practitioner-Led Education Program For Heart Failure Patients, Shay Felecia Clarke

Walden Dissertations and Doctoral Studies

Heart failure (HF) affects 5.7 million Americans and continues to be a leading cause of hospitalizations and deaths in the United States, posing an enormous burden on patients, families, and the health care system. Readmission rates for HF within 30 days post hospital discharge at small rural acute care facility in the southeast are consistently higher than the national average. The gap in nursing practice was the lack of up to date patient education postdischarge guidelines on HF for the socioeconomically disadvantaged, culturally diverse patient population located in this small rural town. The purpose of this project was to use …

A Provider Education Program Addressing Barriers To Diabetic Patients’ Self-Care, Henrietta O. Emokidi

Walden Dissertations and Doctoral Studies

Diabetes is the leading cause of death among American Indian/Alaskan Natives and the 7th leading cause of death in the United States. Type 2 diabetes (T2DM) affects 9% of the U.S. population and costs the United States an estimated $245 billion annually. The purpose of this project was to identify patients’ concerns related to their disease and to develop an education program for providers to address these concerns. The project was framed using Orem’s theory of self-care and the middle-range theory of self-care of chronic illness. Five providers in an underserved clinic in Alaska conducted assessments during a primary care …

Increasing Staff Knowledge On Obesity In Pediatric Patients With Asthma, Oluwakemi Taiwo

Walden Dissertations and Doctoral Studies

Asthma is a chronic life-long lung disease that contributes to morbidity and mortality around the world. The increased prevalence of asthma, particularly in children who are obese, inadequate assessment of obesity in pediatric patients, and a gap in staff knowledge regarding the Centers for Disease Control and Prevention (CDC) body mass index (BMI) percentiles resulted in a need for strategies to minimize this health concern. The purpose of this staff education project was to increase staff’s knowledge about identifying asthma patients who are clinically obese using the CDC BMI percentiles. The framework for the project was based on Knowles’s adult …

Educating Staff On The Benefits Of Vitamin D Therapy For Multiple Sclerosis, Cheniece Harris

Walden Dissertations and Doctoral Studies

Clinical competency is an important factor when delivering care to those with chronic conditions such as multiple sclerosis. Vitamin D therapy through diet, supplements, and sunlight may decrease physical complications. The gap in practice this doctoral project addressed is the lack of education provided to healthcare professionals to promote the benefits of vitamin D. The project examined whether registered nurses who are provided education on the benefits of vitamin D therapy can apply the knowledge into the plan of care for patients with MS within 6 months versus those provided no education. Paradigms and models that were used include the …

Nurse Directed Palliative Care Discussions In The Emergency Department, Shannon Lorince Landefeld

Walden Dissertations and Doctoral Studies

Emergency department (ED) nurses are in a unique position to discuss with patients who have life-limiting illnesses. However, due to lack of training, ED nurses are often reluctant to have these conversations. Although ED patients receive written information about advanced directives, there is a gap in practice with discussing palliative and end-of-life care, resulting in increased potential for patient isolation, inconsistencies in treatment modalities, and delayed opportunities for patient-centered goal setting. Therefore, the purpose of this project was to address what resources are available to guide evidence-based practice for ED nurses in a small inner city hospital to implement nurse-directed …

Barriers To Physical Activity Among Asian Indian Women In The United States, Anjana Mathews

Walden Dissertations and Doctoral Studies

Asian Indian women have a higher prevalence of cardio-metabolic diseases compared to women from other ethnicities and Asian Indian men in the United States. This is due to the lower level of physical activity behaviors among this population. The purpose of this study was to explore the perceived barriers to physical activity among Asian Indian women living in the United States. The theoretical framework that guided this study was Bandura’s social cognitive theory and the research design used was qualitative ethnographic approach. Participants were recruited from 2 Christian churches in Southern California using purposive and snowballing sampling strategies. Fifteen participants …

The Promotion Of Safety And Quality In Fall Prevention, Sheila J. Mercado

Walden Dissertations and Doctoral Studies

Falls in a hospital setting are considered one of the most frequent, preventable adverse events that need to be addressed through the creation of safer environments. Nurses play a key element in the prevention and management of injuries related to falls. The focus question for this quality improvement initiative (QII) was whether an evidence-based QII program could reduce falls in the inpatient population. The objective of the project was to improve the practices related to fall prevention to reduce the number of inpatients falls. The change model of Kotter and the Preventing Falls in Hospitals: A Toolkit for Improving Quality …

Nutritional Assessment Of Patients In The Intensive Care Unit, Jennifer Maureen Brown

Walden Dissertations and Doctoral Studies

Impaired nutrition is associated with prolonged hospitalization, poor patient outcomes, high mortality, and increased health costs. Nutritional assessment in intensive care unit (ICU) patients is important in recognition of changes in the patient’s nutritional status from admission to discharge and may promote early nutritional interventions by the health providers to prevent complications of poor nutrition. The purpose of this staff education doctoral project was to assess ICU nurses’ knowledge of nutritional assessment for critically-ill patients and to provide education on an assessment tool for patient nutritional assessment- the malnutrition universal screening tool (MUST). The guidelines from the American Society for …

Improving Glycemic Control For Post-Orthopedic Surgery Patients With Type 2 Diabetes, Allison Dale

Walden Dissertations and Doctoral Studies

Type 2 diabetes is a growing problem within the United States and a leading cause of mortality. The complications and comorbidities associated with type 2 diabetes cause a great financial and resource burden on the healthcare system, and cause negative mental and physical health outcomes for the individual living with it. The complications of poor glycemic control are especially notable following a surgical procedure that requires an inpatient stay. The practice problem for this project is glycemic control following an orthopedic surgery requiring hospitalization. To further analyze the practice problem and to create a clinical practice guideline a robust literature …

Systematic Review Of Family Nurse Practitioner Utilization Within School Environments, Luz Elena Zapien

Walden Dissertations and Doctoral Studies

The American Academy of Pediatrics and the Institute of Medicine recommend school health screening programs to detect problems that might interfere with a student’s education and general well-being, and many U.S. states require compliance with enrollment requirements such as updated immunizations and physical exams prior to attendance. In low-income areas, however, there is often a shortage of physicians available to meet the healthcare needs of the population. Family nurse practitioners (FNPs) can be utilized in school health settings to deliver health care services that support school attendance and the well-being of school students, yet little is known about their impact. …

Nursing Home Caregivers’ Knowledge Of Decubitus Ulcer Prevention Strategies, Shola Akinfiresoye

Walden Dissertations and Doctoral Studies

Decubitus ulcers (DUs) were a constant concern among the residents of the nursing home in this project. Prolonged immobility, sensory impairment, and urinary incontinence are some of the factors found in the literature as the causes of the disease. However, the lack of useful knowledge regarding evidence-based practices (EBPs) to prevent and treat DUs also contributed to the higher incidence rates at the nursing home. The purpose of this DNP- project was to evaluate the caregivers’ knowledge of EBPs to prevent and treat DUs at the facility. The IOWA Model of Evidence-Based Practice, which healthcare practitioners use to guide clinical …

Nurse Practitioner Approach To Care For Peripheral Vascular Disease, Jessica R. Wozniak

Walden Dissertations and Doctoral Studies

The Amputation Coalition indicates that there were approximately 2 million people with limb loss in the United States primarily caused by peripheral vascular disease in 2019. Those with amputation related to vascular disease have a 5-year mortality rate. The gap in clinical practice at the facility used for this project is that there were no comprehensive program guidelines for nurse practitioners and other health care professionals working with people who are at risk for vascular intervention or limb loss. The practice-focused question was answered that an interprofessional team did develop a prototype for a comprehensive peripheral vascular program that serves …

Perceptions On Maternal Mortality Among The Ekpeye Community, Theresa Tenim Ogide-Alaeze

Walden Dissertations and Doctoral Studies

In Africa, especially Nigeria, maternal mortality is a public health issue among women of childbearing age (WCBA). WCBA living in the Ekpeye community located in Rivers state in Nigeria are at high risk of maternal deaths during pregnancy and labor or delivery. Data were obtained through key informant interviews with 9 relatives, friends, and health workers. The purpose of the key informant interviews was to identify perceived barriers that result in high maternal deaths and facilitators seen as promoters to reduce pregnancy-related deaths. The participants identified 11 core themes as contributors to maternal death: (a) postpartum death, (b) financial insecurity, …

Staff Education Program For Nurses Caring For Patients With Medical Decline On A Geriatric Psychiatric Unit, Portia Denise Risper

Walden Dissertations and Doctoral Studies

AbstractElderly patients admitted to psychiatric units are a vulnerable population, some may have mental disorders, physical decline, cognitive challenges; along with other comorbidities in addition to their mental illness. However, their physical health needs may be overlooked due to the presenting behaviors mimicking mental health behaviors. The nurses working in the local hospital facility’s geri-psych unit failed to recognize signs and symptoms of physical decline in their severely mentally ill (SMI) patients. Not recognizing and reporting acute changes resulted in patients’ prolonged hospitalization, decreased quality of life, and increased cost to the facility. The purpose of this DNP project was …

Mortality Disparities Among Puerto Rican Infants In 2015, Maria Del Carmen Medina

Walden Dissertations and Doctoral Studies

There is a well-established disparity between infant mortality rates among women residing in rural areas in Puerto Rico in comparison with woman residing in urban areas of Puerto Rico. There is a significant amount of research that connects infant mortality to low birth weight, congenital malformations, and premature births. The purpose of this study was to determine infant mortality and its relationship with the geographical location of Puerto Rican mothers. The study also examined whether there is a relationship between infant mortality and the area of residence (rural/urban) of the mother, marital status, race, and education level of the mother. …

A Systematic Review Of Culturally Sensitive Strategies To Address Obesity Among Hispanic-American Pediatric Patients In The Primary Care Setting, Rachel Vurbeff

Walden Dissertations and Doctoral Studies

Obesity significantly increases morbidity and mortality, and its incidence amongHispanic-American children and adolescents exceeds that of any other ethnic group in the United States. Without proper intervention, these children and adolescents will experience the burden of costly comorbidities across the lifespan. Guided by Leininger’s theory of culture care diversity and universality, the purpose of this project was to identify evidence-based, culturally sensitive strategies to prevent and treat obesity among Hispanic-American pediatric patients in the primary care setting through a systematic review of the literature utilizing the Joanna Briggs Institute method. The practice-focused question that guided this review focused on finding …

Work Well: Promoting Health Behaviors And Self-Care Amongst Public School Faculty, Staff, & Administrators, Sherri Smith

Doctor of Nursing Practice Projects

Workplace wellness is a critical aspect within an organization. Failure to encourage and meet the wellness needs of staff can lead to increased absenteeism, decreased productivity, as well as increased stress levels. Improved workplace wellness in an academic setting has not only potential positive impact on employees but also the students they teach. Evidence shows that implementing wellness initiatives in academic settings has the potential to improve the overall wellbeing of teachers as well as students. Interventions include a Walkabout Challenge, a Caring Peer Group, and education. The interventions are an effort to improve self-care habits amongst faculty and staff …

Health Promotion And Cancer Screening Of Arab Americans, Lamyaa Alyaba

Dissertations

Introduction: Although Arab Americans represent one of the fastest-growing populations in the U.S., there is very little health data about their preventive health habits and health-promoting lifestyle, including cancer screening. Purpose: the purpose of this study is to examine the relationship between personal factors, health-promoting behaviors, and cancer-screening behaviors of Arab Americans while controlling for acculturation. Design: Pender's Health Promotion Model was the conceptual framework for the study. a cross-sectional correlational design explored the relationship between the study variables utilizing an online-based survey to collect data from Arab Americans. Multimodal recruitment was used to recruit a convenience sample of 287 …

Factors Associated With Diabetic Peripheral Neuropathy And Quality Of Life Among Type 2 Diabetes Patients In Saudi Arabia, Awatef Ibraheem

Dissertations

Evidence has suggested that diabetic peripheral neuropathy (DPN) is associated with decreased quality of life (QoL) and impaired physical and emotional health. About 82% of the diabetic population in Saudi Arabia show signs of DPN. However, it is under-recognized and undertreated. Further, DPN is linked to several clinical and metabolic risk factors. However, there is minimal evidence from Saudi Arabia on the impact of DPN on the individual's QoL. The aims of this current study were to (1) examine the impact of DPN symptoms on functioning, health perception, and QoL and (2) explore the biologic and individual factors associated with …

Enhancing Access To Parenting Services Using Digital Technology Supported Practices, Elaine Bennett, Wendy Simpson, Cathrine Fowler, Ailsa Munns, Jane Kohlhoff

Nursing Papers and Journal Articles

Background: Early parenting services (EPS) in Australia provide a range of expanding and rapidly changing services, including innovative digital technologies to improve service access for metropolitan and rural families.

Aim: This research aims to provide comprehensive information required for the planning, implementation and evaluation of the use of digital technologies for service delivery with parenting/child and family services in Australia and New Zealand in metropolitan and rural settings.

Methods: An interpretive descriptive approach was applied using semi-structured interviews from 23 EPS practitioners and managers in five sites.

Findings: These are presented as five main themes – preparing the way, practitioner …

ปัจจัยทำนายความเหนื่อยล้าของผู้ป่วยมะเร็งลำไส้ใหญ่และทวารหนักที่ได้รับยาเคมีบำบัด, สิริยา ชาลีเครือ

Chulalongkorn University Theses and Dissertations (Chula ETD)

การวิจัยครั้งนี้มีวัตถุประสงค์เพื่อศึกษาปัจจัยทำนายความเหนื่อยล้าของผู้ป่วยมะเร็งลำไส้ใหญ่และทวารหนักที่ได้รับยาเคมีบำบัด ได้แก่ ระยะของโรค ระดับฮีโมโกลบิน กิจกรรมทางกาย ภาวะโภชนาการ ความวิตกกังวล และการสนับสนุนทางสังคม กลุ่มตัวอย่าง คือ ผู้ป่วยโรคมะเร็งลำไส้ใหญ่และทวารหนักที่ได้รับการรักษาด้วยยาเคมีบำบัด อายุระหว่าง 18-59 ปี ทั้งเพศชายและเพศหญิง ในโรงพยาบาลระดับตติยภูมิ 3 แห่ง ในเขตกรุงเทพมหานคร จำนวน 136 คน คัดเลือกกลุ่มตัวอย่างแบบเฉพาะเจาะจงตามคุณสมบัติที่กำหนด เครื่องมือที่ใช้ในการเก็บรวบรวมข้อมูล ประกอบด้วย แบบบันทึกข้อมูลส่วนบุคคล แบบประเมินความเหนื่อยล้า แบบประเมินพฤติกรรมการปฏิบัติกิจกรรม แบบประเมินภาวะโภชนาการ แบบประเมินความวิตกกังวล และแบบวัดแรงสนับสนุนทางสังคม ซึ่งได้รับการตรวจสอบความตรงเชิงเนื้อหาจากผู้ทรงคุณวุฒิ และตรวจสอบความเที่ยงได้ค่าสัมประสิทธิ์แอลฟาครอนบาค เท่ากับ .91, .72, .70, .71 และ .90 ตามลำดับ วิเคราะห์ปัจจัยทำนายด้วยสถิติถดถอยพหุคูณแบบขั้นตอน ผลการวิจัยสรุปได้ดังนี้ 1. ผู้ป่วยมะเร็งลำไส้ใหญ่และทวารหนักที่ได้รับยาเคมีบำบัดส่วนใหญ่มีความเหนื่อยล้าระดับปานกลาง (Mean = 5.17, S.D. = .06) 2. กิจรรมทางกาย ภาวะโภชนาการ และระดับฮีโมโกลบิน มีความสัมพันธ์ทางลบกับความเหนื่อยล้าของผู้ป่วยมะเร็งลำไส้ใหญ่และทวารหนักที่ได้รับยาเคมีบำบัดได้อย่างมีนัยสำคัญทางสถิติที่ระดับ .05 (r = -.306, r = -.299 และ r = -.224 ตามลำดับ) 3. กิจกรรมทางกาย และภาวะโภชนาการ สามารถร่วมกันทำนายความเหนื่อยล้าของผู้ป่วยมะเร็งลำไส้ใหญ่และทวารหนักที่ได้รับยาเคมีบำบัดได้อย่างมีนัยสำคัญทางสถิติที่ระดับ .05 โดยมีอำนาจการทำนายได้ร้อยละ 19.9 นอกจากนี้ยังพบว่า กิจกรรมทางกายเป็นปัจจัยหลักในการทำนายความเหนื่อยล้า สามารถสร้างสมการพยากรณ์ในรูปคะแนนมาตรฐานได้ดังนี้ ( Zความเหนื่อยล้า) = -.331Zกิจกรรมทางกาย -.325Zภาวะโภชนาการ

ผลของการใช้โปรแกรมการป้องกันผิวหนังถูกทำลายจากเทปกา ทางการแพทย์ ต่อสภาพผิวหนังทารกเกิดก่อนกำหนด, กิติยา ตุนชัยภูมิ

Chulalongkorn University Theses and Dissertations (Chula ETD)

การวิจัยกึ่งทดลองเพื่อศึกษาผลของการใช้โปรแกรมการป้องกันผิวหนังถูกทำลายจากเทปกาวทางการแพทย์ต่อสภาพผิวหนังทารกเกิดก่อนกำหนด กลุ่มตัวอย่างคือทารกเกิดก่อนกำหนด อายุครรภ์ 28-36 สัปดาห์ 6 วัน ที่เข้ารับการรักษาในหอผู้ป่วยทารกใน โรงพยาบาลธรรมศาสตร์เฉลิมพระเกียรติ จำนวน 42 คน แบ่งเป็นกลุ่มควบคุมและกลุ่มทดลองอย่างละ 21 คน และพยาบาลประจำหอผู้ป่วยที่ผ่านการอบรมการใช้โปรแกรมฯ คัดเลือกกลุ่มตัวอย่างทารกเกิดก่อนกำหนดตามเกณฑ์ โดยจับคู่ให้มีอายุครรภ์ใกล้เคียงกัน +1 สัปดาห์ กลุ่มควบคุมได้รับการพยาบาลตามปกติ กลุ่มทดลองได้รับโปรแกรมการป้องกันผิวหนังถูกทำลายจากเทปกาวทางการแพทย์ เครื่องมือที่ใช้ในการวิจัยคือ โปรแกรมการป้องกันผิวหนังถูกทำลายจากเทปกาวทางการแพทย์ ที่พัฒนาขึ้นตามแนวคิดกระบวนการพยาบาลเพื่อให้การดูแลร่วมกับแนวทางความปลอดภัยกับผู้ป่วยจากการเกิดผิวหนังถูกทำลายจากเทปกาวทางการแพทย์ แบบวัดความรู้และแบบสังเกตการปฏิบัติตามโปรแกรมฯ ของพยาบาล และแบบประเมินสภาพผิวหนังทารกเกิดก่อนกำหนด มีค่าดัชนีความตรงตามเนื้อหาเท่ากับ 0.96 ถึง 1.00 แบบประเมินสภาพผิวหนังทารกเกิดก่อนกำหนดมีความเชื่อมั่นระหว่างผู้ประเมินเท่ากับ 0.93 วิเคราะห์ข้อมูลโดยใช้สถิติเชิงพรรณนาและสถิติการทดสอบ Mann-Whitney U test ผลการวิจัยสรุปได้ดังนี้ สภาพผิวหนังของทารกเกิดก่อนกำหนด กลุ่มที่ได้รับโปรแกรมการป้องกันผิวหนังถูกทำลายจากเทปกาวทางการแพทย์ ดีกว่ากลุ่มที่ได้รับการพยาบาลตามปกติ อย่างมีนัยสำคัญทางสถิติที่ระดับ .05 ผลการวิจัยนี้สนับสนุนว่า การใช้โปรแกรมการป้องกันผิวหนังถูกทำลายจากเทปกาวทางการแพทย์ ช่วยให้มีความคงอยู่ของสภาพผิวหนังที่ดีในทารกเกิดก่อนกำหนดที่ต้องติดเทปกาวทางการแพทย์

The Effect Of The Program Promoting Infection Prevention Behaviors In Family Caregivers Of Pre-School Age Children With Acute Lymphoblastic Leukemia: The Application Of Self-Care Deficit Nursing Theory, Su-Ari Lamtrakul

Chulalongkorn University Theses and Dissertations (Chula ETD)

This quasi-experimental, pretest-posttest design aimed to compare infection prevention behaviors (medication administration, infection control, and infection surveillance) between the family caregivers of preschool-age children with acute lymphoblastic leukemia (ALL) in the experimental group and the control group. This nursing program is based on the Self-Care Deficit theory, to enable dependent care agencies regarding infection prevention behaviors of family caregivers. The dependent care agency consisted of the ability to acquired knowledge, ability to make a decision, and ability to perform infection prevention behaviors. The sample was 45 family caregivers of preschool age children with ALL, 23 were an experimental group and …

Factors Related To Health-Related Quality Of Life In Patients With Acute Coronary Syndrome In West Java, Indonesia, Haerul Imam

Chulalongkorn University Theses and Dissertations (Chula ETD)

This descriptive study aimed to examine the relationship between age, self-efficacy, functional status, pain, dyspnea, social support, and health-related quality of life in patients with acute coronary syndrome in west java, Indonesia. The participants were 186 patients who has acute coronary syndrome or history of acute coronary syndrome visited cardiovascular outpatient clinic in the main national public hospital type A in west java province, Indonesia. The instruments used for data collection were Demographic Questionnaire, General Self-efficacy Scale, Seattle Angina Questionnaire, Rose Questionnaire for Angina, Rose Dyspnea Questionnaire, ENRICH Social Support, and MacNew Health Related Quality of life. These instruments were …

A Causal Model Of Functional Status Among Persons With Liver Cirrhosis, Surachai Maninet

Chulalongkorn University Theses and Dissertations (Chula ETD)

This cross-sectional correlation study aimed to develop and test a causal relationship among alcohol consumption, illness perception, social support, fatigue, and functional status among persons with liver cirrhosis. The hypothesized model was constructed based on the theory of unpleasant symptoms and the review of the literature. A stratified three-stage random sampling approach was utilized to recruit 400 persons with liver cirrhosis aged 40 years old and older who visited four hospitals from three regions of Thailand. Research instruments consisted of the demographic data form, Alcohol Use Disorders Identification Test Consumption, Brief Illness Perception Questionnaire, Multidimensional Scale of Perceived Social Support, …