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An Intersectional Perspective On Stigma As A Barrier To Effective Hiv Self-Management And Treatment For Hiv-Infected African American Women, Kimberly Adams Tufts

Ellmer School of Nursing Faculty Publications

Among those who are HIV-infected and striving to live well with HIV, African American women have poorer health outcomes and represent a higher portion of those women who die from HIV-related causes. Those health inequalities have been associated with the presence of social determinants of health such as stigma. This analytical review asserts that stigmas precipitated by gender, race, and class in the context of HIV-related stigma constitute substantial barriers to active engagement in HIV self-management, care, and treatment for HIV-infected African American women. The utility of the intersectionality framework for analyzing how these various stigmas interact to create unique …

Nclex-Rn Predictor Test Scores And Nclex-Rn Success, Annie Ruth Grant

Walden Dissertations and Doctoral Studies

Health care professionals and nurse educators are concerned about increasing percentage of first time test takers failing the NCLEX-RN exam. The purpose of this retrospective study was to examine predictive accuracy of the Assessment Technologies Institute (ATI) RN Comprehensive Predictor for passing or failing the NCLEX-RN exam in a cohort of nursing students (N = 195). South Eastern Technical College in South Carolina is in jeopardy of losing accreditation for their nursing program because of the low percentage of first time test takers failing. The college's pass rate on the NCLEX-RN exam has been below the national and state averages …

Attitude, Subjective Norm, And Perceived Behavioral Control As Indicators For Nurse Educators’ Intention To Use Critical Thinking Teaching Strategies: A Structural Equation Model Analysis, Angerlita Yolanda Smith

Dissertations

Problem

Deficiencies in new nursing graduates’ ability to use critical thinking skills have been documented. Researchers have found that the continued use of traditional teaching methods and less student-centered approaches for critical thinking development has contributed to this problem. This particular issue has evoked much concern for institutions and organizations involved with the safe delivery of patient care. The purpose of this study was to examine (a) the relationship between the factors educator characteristics, attitude, subjective norm and perceived behavioral control in a hypothesized model that may influence nurse educators’ intention to use instructional methods that promote critical thinking in …

A Culturally Appropriate Cognitive Assessment Screening For Bhutanese Refugees, Holly Milligan

Master's Theses and Capstones

Background: As the incidence of cognitive impairment continues to rise, timely and accuratediagnoses are essential. Aim: The aim of this quality improvement project was to evaluate the standard cognitiveassessment screening for Bhutanese refugees in a medical home, and compare an alternative,validated, and potentially more culturally appropriate tool. Also, an assessment of provider,nurse and interpreter satisfaction with the two tools was performed. Method: Mixed methods including qualitative observations and quantitative satisfaction surveysrelated to the implementation of a culturally appropriate cognitive assessment tool. Results: When assessed with the standard tool, all 10 people screened positive for cognitiveimpairment. However, when using the alternative …

Be Seen And Heard Being Clean: A Patient-Centered Approach To Hand Hygiene At Concord Hospital, Ashley Pinkham

Master's Theses and Capstones

Background: Regular hand washing is recognized as the most effective means to combat the spread of infectious illness; however hand washing behavior amongst health care workers (HCW’s) is inconsistent. Furthermore, measurement of hand washing behavior is subject to bias.

Aim: This quality improvement project aimed to remove the Hawthorne effect and improve the behavior of HH at Concord Hospital.

Methods: A quasi-experimental, pre-posttest design was used to evaluate HH rates on a 32 bed med-surge unit at Concord Hospital. Baseline data was collected for 30 days by asking patients if they had seen or heard staff cleaning their hands. Using …

Chronic Care Model Staff Education And Adherence With End-Stage Renal Disease Patients, Emilia K. Addo

Walden Dissertations and Doctoral Studies

The management and treatment of chronic diseases, such as end-stage renal disease, is often unproductive because of patients' poor adherence to treatment. The chronic care model toolkit is an Agency for Healthcare Research and Quality supported framework, associated with improved outcomes in patients living with chronic disease. The purpose of this project was to develop and plan an educational program using the chronic care model toolkit for the interdisciplinary clinical staff of a renal hemodialysis center. The goal of this project was to adapt team building between patients and their clinicians through the use of the chronic care model in …

The Health And Health Behaviours Of Australian Metropolitan Nurses: An Exploratory Study, L. Perry, R. Gallagher, Christine Duffield

Research outputs 2014 to 2021

Background: Nurses make up the largest component of the health workforce and provide the majority of patient care. Most health education is delivered by nurses, who also serve as healthy living and behavioural role models. Anything that diminishes their health status can impact their credibility as role models, their availability and ability to deliver quality care, and is potentially disadvantageous for the health of the population. Study aims were to investigate nurses' overall health and the presence of chronic disease; to describe nurses' health-related behaviours and to compare them to those of the general population, with both groups matched by …

Tumor Growth Increases Neuroinflammation, Fatigue And Depressive-Like Behavior Prior To Alterations In Muscle Function, Diana M. Norden, Sabahattin Bicer, Yvonne Clark, Runfeng Jing, Christopher J. Henry, Loren E. Wold, Peter J. Reiser, Jonathan P. Godbout, Donna O. Mccarthy

College of Nursing Faculty Research and Publications

Cancer patients frequently suffer from fatigue, a complex syndrome associated with loss of muscle mass, weakness, and depressed mood. Cancer-related fatigue (CRF) can be present at the time of diagnosis, during treatment, and persists for years after treatment. CRF negatively influences quality of life, limits functional independence, and is associated with decreased survival in patients with incurable disease. Currently there are no effective treatments to reduce CRF. The aim of this study was to use a mouse model of tumor growth and discriminate between two main components of fatigue: loss of muscle mass/function and altered mood/motivation. Here we show that …

Antenatal Clinic: Using Ethnographic Methods To Listen To The Voices Of Pregnant Adolescents, Deborah Ireson

Theses: Doctorates and Masters

Aim: This research aims to explore the motivating reasons and external influences that affect pregnant adolescents’ reasons for attending an antenatal clinic. Background: Pregnancy during adolescence has been researched from perceived ‘poor’ decision making during pregnancy and postnatal perspectives involving high-risk outcomes for mother and baby. Antenatal clinic attendance by pregnant adolescents is often characterised by late and infrequent attendance, limiting midwifery contact with this inexperienced group. Gaps in the literature exist where the real-time voices of pregnant adolescents offer their current experiences of antenatal clinic as a relevant means to inform midwifery practice.

Research design: Using ethnographic methods, this …

Early Screening And Identification Of Preschool Children Affected By Serious Emotional Disorders, Cathy Renee Robey-Williams

Theses and Dissertations

Mental illness has surpassed physical health problems as the leading cause for morbidity and mortality in American children. National prevalence of serious emotional disorders in the 0-5 age group has ranged from 9.5% to 14.2%. Of the 15 million children affected by mental illness, less than 20- 25% receive any treatment. Nationwide, early screening, identification, and treatment of preschoolers with emotional or behavioral disorders have become a critical priority in order to reduce the increasing burden of healthcare costs for mental illness and psychiatric care. The purpose of this study was to test the feasibility of a screening process for …

Effect Of A Workplace Walking Initiative To Decrease Telehealth Nurses' Fatigue, Rae Ann Heissenbuttel

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Abstract

Background: Fatigue has been a common problem in the nursing profession. To date, most of the research regarding nurse fatigue has focused on nurses working in hospitals. Minimal research has been completed examining fatigue among nurses working in the telehealth environment and the effects of an evidence-based workplace initiative to decrease fatigue.

Aim: The aim of this translational project was to describe the overall self-reported health and fatigue for a group of telehealth nurses and to evaluate the effectiveness of the American Heart Association’s (AHA) walking program in improving overall health status and decreasing fatigue in telehealth …

Implementation Of Food Insecurity Screening In Clinical Setting, Florence Ngozi Soba

Doctor of Nursing Practice (DNP) Projects

This project used the Stetler model of research utilization framework to apply evidence-based findings to clinical settings screening adults with type II diabetes mellitus (T2DM) and low incomes for food insecurity. The project involved the review and critical appraisal of research studies and translation of research-based knowledge into a protocol for the Peach Tree Clinic with respect to the impact of food insecurity on diabetes outcomes in adults with T2DM and low incomes who were at risk of food insecurity. In addition, the proportion of screened at-risk patients who received nutritional counseling was calculated. The proportion of patients with T2DM …

Avoiding 30-Day Readmissions Of Acute Mi Patients Utilizing Cardiac Rehabilitation, Patricia T. Forsberg

Doctor of Nursing Practice (DNP) Projects

A significant number of Acute Myocardial Infarction (AMI) patients were readmitted to an urban San Francisco Medical Center within 5-7 days post discharge this year. Two of the main identified causes were symptom management issues and medication instructions, both of which are part of the discharge instructions. It’s not surprising that 80% of all discharge teaching is forgotten by patients by the time they hit the parking lot. With the recommended timeframe for post discharge follow up appointments at 48 to 72 hours post discharge and as those appointments are not typically available within the recommended timeframe, patients are more …

The Significance Of Timing Of Patient Daily Weights And The Barriers, Ann Pan

Master's Projects and Capstones

Background. Current unit practice is that patient daily weights are obtained in the afternoon or evenings. However, patient weights in the afternoon and evenings are not accurate dry weights. According to evidenced based research, to obtain an accurate patient daily weight, patients should be weighed every morning, after their first void and before they eat breakfast.

Purpose. The focus of the study was to compare the current practices of obtaining daily weights in the afternoon and evenings, compared to the evidenced based practice recommended in the literature.

Method. Through interviews and surveys with staff, the barriers to obtaining patient weights …

Minimizing Avoidable Interruptions During Medication Administration, Jaleel Anne Arnado

Master's Projects and Capstones

The objective of this CNL Internship Project is to improve patient outcomes and nurse satisfaction by minimizing the avoidable interruptions that occur during medication administration. The microsystem is a pediatric and adult medical-surgical overflow unit at a large, urban teaching hospital in Northern California. A series of surveys for nurses and patients and observations of medication administrations were conducted to assess barriers during mediation administration. It was determined phone calls interrupt a nurse the most during medication administration. Interruptions leave the medication administration process vulnerable to errors because it disrupts the nurse’s workflow and thought process. Because most pediatric medication …

Onsite Integrative Clinics: Acupuncture, Positive Patient Outcomes, And Frequency Of Provider Office Visits, Sherry Shoemaker Phd

Dissertations

Purpose and Aims. There is limited information about outcomes of care, resource utilization, and associated costs for patients who receive acupuncture in integrative health settings. The purpose of this study was to address this gap through the following aims: To examine: (1) changes in patient pain levels pre/post acupuncture treatments; (2) relationships between receiving acupuncture treatments (number of treatments, length of time, select demographic factors, (age, gender), pain level pre and post acupuncture treatments; (3) relationships between number of treatments, length of time, age, gender, pain level (pre/post acupuncture treatments) and provider visits (pre/post acupuncture treatments); and (4) relationship between …

Evidence-Based Change In Practice: Development And Implementation Of Type Ii Diabetic Flow Sheet, Kathryn Grimleybaker

Doctor of Nursing Practice (DNP) Projects

Ten percent of the National Health Service annual budget goes to treat complications from diabetes (Lancet, 2010). The American Diabetes Association® (ADA, 2013) estimated that diabetics in the United States incur $176 billion annually in direct medical costs for treatment with hospitalization being the main component of the expenditures. California has the largest population of diabetics and the highest annual cost at $27.6 billion (ADA, 2013). The Healthcare Cost and Utilization Project (HCUP, 2008) found that the average cost of hospitalization in 2008 for a patient with diabetes was $10,937 in contrast to $8,746 for a patient without diabetes. The …

The Development Of Prolonged Weaning Guidelines To Facilitate Ventilatory Liberation, Jamie Jordan Rrt-Accs, Kenneth Miller Med, Rrt-Nps, Angela Lutz Bs, Rrt-Nps, Vanessa Ribaudo-Kaufman Md, Cindy Umbrell Msn, Rn, Cns, Ccrn, Donald J. Butz Rn, Cnrn

Patient Care Services / Nursing

No abstract provided.

A Descriptive Mixed-Methods Study Examining Resilience And Transitioning To Adulthood Among Emerging Adults With Disabilities, Jennifer E. Mannino

Theses & Dissertations

Transitioning to adulthood is not without challenges. The move away from family influence towards independence and self-determination is filled with uncertainty. As emerging adults (18-29) transition to adulthood they will encounter various challenges related to their new adult roles (Arnett & Tanner, 2005; Jensen & Arnett, 2012). Increased challenges and vulnerabilities in transitioning are evident among emerging adults with disabilities because they face additional challenges related to their disability over and above what all others of this developmental stage experience (Betz & Redcay, 2002; Blomquist, 2007; Faux & Nehring, 2010; King, Baldwin, Currie & Evans, 2005; Murray, 2003; National Research …

The Human Microbiome: The Brain-Gut Axis And Its Role In Immunity, Vanessa Moser

Graduate Research Projects

No abstract provided.

A Comparison Of A Social Support Physical Activity Intervention In Weight Management Among Post-Partum Latinas, Colleen Keller, Barbara Ainsworth, Kathryn Records, Michael Todd, Michael Belyea, Sonia Vega-López, Paska Permana, Dean Coonrod, Allison Nagle-Williams

Nursing Faculty Works

Background Weight gain during the childbearing years and failure to lose pregnancy weight after birth contribute to the development of obesity in postpartum Latinas. Methods Madres para la Salud [Mothers for Health] was a 12-month, randomized controlled trial exploring a social support intervention with moderate-intensity physical activity (PA) seeking to effect changes in body fat, fat tissue inflammation, and depression symptoms in sedentary postpartum Latinas. This report describes the efficacy of the Madres intervention. Results The results show that while social support increased during the active intervention delivery, it declined to pre-intervention levels by the end of the intervention. There …

Food Choices And Practices During Pregnancy Of Immigrant Women With High-Risk Pregnancies In Canada: A Pilot Study, Gina M A. Higginbottom, Helen Vallianatos, Joan Forgeron, Donna Gibbons, Fabiana Mamede, Rubina Barolia

School of Nursing & Midwifery

Background: Immigrant women may be regarded as a vulnerable population with respect to access and navigation of maternity care services. They may encounter difficulties when accessing culturally safe and appropriate maternity care, which may be further exacerbated by language difficulties and discriminatory practices or attitudes. The project aimed to understand ethnocultural food and health practices and how these intersect in a particular social context of cultural adaptation and adjustment in order to improve the care-giving capacities of health practitioners working in multicultural perinatal clinics.
Methods: This four-phase study employed a case study design allowing for multiple means of data collection …

Predictors Of Lifestyle Behaviors, Trust Of Health Care Provider, And Utilization Of Health Services Among Adolescents Living In A Rural Area., Heather Karolyne Hardin

Electronic Theses and Dissertations

Background: Adolescents have elevated morbidity and mortality rates associated with risk-taking behaviors, but utilize health services at low levels. There is little evidence concerning health behavior, trust of health care provider, or utilization of health services among adolescents living in rural areas. Purpose: The purpose of this study was to examine individual characteristic variables and determine the extent to which these variables influence lifestyle behaviors, trust of health care provider (HCP), and utilization of health services among adolescents attending public high school in rural Indiana. Methods: This study used a cross-sectional, quantitative design. Instruments used in this study were …

A Qualitative Study Evaluating Bedside Reporting And The Impact On Nurse Satisfaction And Communication Barriers With Washington Regional Medical Center, Win Szeto, Sarah Wren, Molly Milborn

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Nursing care occurs on a continuum that involves transferring the responsibility of a patient’s care from one nurse to another during shift change. Hand-off reports are a vital part of the communication cycle to ensure safe and effective care. Studies have shown bedside reporting increases patient and nurse satisfaction as well as the nurse-patient relationship (Agency for Healthcare Research and Quality, 2013b). The aim of this study was to educate nurses on the importance of bedside reporting and to implement a standardized hand-off. This study was evaluated through two measures. The first measure involved a survey/interview on nurses' perception before …

Motivational Interviewing To Enhance Weight Loss And Eating Self-Efficacy In Overweight And Obese Adults, Theresa K. Buchanan Dr.

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Greater than six in ten adults in the United States are overweight or obese which can lead to cardiovascular disease, Type II Diabetes, joint injury and some forms of cancer, costing billions of healthcare dollars each year. Weight loss is difficult, as is maintaining weight loss. The purpose of this project is to investigate if use of the evidenced based (EB) intervention, motivational interviewing (MI), will enhance weight loss and eating self-efficacy (ESE) in overweight and obese adults seeking weight loss at a weight loss clinic over the course of eight weeks. Participants who received MI in addition to current …

Use Of Complementary Therapies By Individuals With Or At Risk For Cardiovascular Disease And Diabetes: Results Of The 2007 National Health Interview Survey, Katrina Michelle Embrey

Dissertations, Theses and Capstone Projects (Full IR Collection)

Costly, debilitating and largely preventable, cardiovascular disease (CVD) and diabetes mellitus (DM) place a heavy disease burden of high morbidity, mortality, and rising health care costs on people of the United States. With mortality reports from the two diseases of over 600,000 per year and costs in excess of $176 billion, identifying alternatives to traditional models of care must be considered. Complementary and alternative medicine (CAM) therefore becomes a viable option for prevention and treatment. Using secondary data analysis of the 2007 National Health Interview Survey, the aim of the current study was to determine whether CAM use was associated …

Hemoglobin A1c And The Diagnosis Of Diabetes And Prediabetes In Children And Adolescents, Jennifer Mcguire Hitt

Theses and Dissertations (ETD)

Although the American Diabetes Association (ADA) adopted the use of the glycated hemoglobin (A1C) test as a method of diabetes and prediabetes diagnosis, the ADA has not developed firm guidelines concerning the use of the A1C test in children and adolescents, as research has not validated thresholds in this group. Diabetes and prediabetes are diseases influenced by multiple factors, including race and ethnicity, age, vitamin D deficiency, and body mass index (BMI). The purpose of this study was to determine the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the A1C test compared to the gold …

Nicu Culture Of Care For Infants With Neonatal Abstinence Syndrome: A Focused Ethnography, Monica M. Nelson

Electronic Theses and Dissertations

Purpose: The purpose of this ethnographic study was to describe the culture of care and nonpharmacological nursing interventions performed by NICU nurses for infants with NAS. Background: Infants with NAS are increasingly being cared for in the inpatient hospital setting by NICU nurses. Interventions used for the care of premature and sick infants in the NICU may or may not be the exact interventions that should be used for the care of the fragile infant with NAS. Research studies on the nonpharmacological nursing care of infants with NAS encompass 5 main areas of practice: environment, adequate rest and sleep, feeding, …

Inflammation And Its Role In Our Health: Can A Plant-Based Diet Prevent Disease?, Leeanne Coffman

Graduate Research Projects

No abstract provided.

Chronic Conditions In Elders In Assisted Living Facilities: Associations With Daily Functioning, Self-Assessed Health, And Depressive Symptoms, Abir K. Bekhet, Jaclene A. Zauszniewski

College of Nursing Faculty Research and Publications

Background

The increasing life expectancy of older adults has prompted an increase in chronic conditions that may interfere with their daily living and impact physical and mental health.

Objectives

This study examined associations between commonly reported chronic conditions, daily functioning, self-assessed health, and depressive symptoms of elders.

Methods/Design

A secondary analysis of existing data from 314 elderly residents of 29 facilities was conducted.

Results

The most frequently reported conditions were arthritis (64%), hypertension (47%), and heart problems (35%). Elders who reported having all three of these most frequently reported conditions differed significantly from those who reported none or one of …