Digital Commons Network^™

Oncology Nurses' Obstacles And Supportive Behaviors In End-Of-Life Care: Providing Vital Family Care, Renea L. Beckstrand, Joan Collette, Lynn Callister, Karlen E. (Beth) Luthy

Faculty Publications

Purpose/Objectives: To determine the impact of obstacles and supportive behaviors in end-of-life (EOL) care as perceived by hospital-based oncology nurses.

Design: A 69-item mailed survey.

Setting: National random sample.

Sample: 1,005 nurse members of the Oncology Nursing Society who had provided EOL care for patients with cancer.

Methods: Three mailings yielded 380 usable responses from 912 eligible respondents, resulting in a 42% return rate.

Main Research Variables: Size and frequency of EOL care obstacles and supportive behaviors for patients with cancer in a hospital setting.

Findings: Results of this research demonstrate the need for more EOL education and help in …

Evaluation Of The Clinical Integration Model For Hospital Care Delivery, Cheryl Mckay

Nursing Theses and Dissertations

Purpose: Two studies were used to evaluate whether introduction of the Clinical Integration Model (CIM) would decrease cost, length of stay (LOS), and mortality in two populations: a psychiatric in-patient population and congestive heart failure (CHF) patients. Objectives: 1. Evaluate reliability and validity of a process tool, the CareGraph, essential in the CIM. 2. Determine if there is a difference for LOS and cost between patients receiving care in the CIM and those receiving care in a traditional primary care delivery model in a psychiatric population; compare the same parameters as well as survival in the CHF population. Methods: Reliability …

Adoption Of A Heart Healthy Diet In Rural Eastern Kentucky, Kevin Luley

Kaleidoscope

No abstract provided.

The Influence Of Cognitive-Perceptual Variables On Patterns Of Change Over Time In Rural Midlife And Older Women's Healthy Eating., Bernice C, Yates, Carol H. Pullen, Jonathan Bruce Santo, Linda Boeckner, Patricia A. Hageman, Paul J. Dizona, Susan Noble Walker

Journal Articles: College of Nursing

Although studies demonstrate that dietary interventions for healthy adults can result in beneficial dietary changes, few studies examine when and how people change in response to these interventions, particularly in rural populations. The purpose of this study was to examine patterns of change over time in healthy eating behaviors in midlife and older women in response to a one-year health-promoting intervention, and to examine what predictors (perceived benefits, barriers, self-efficacy, and family support for healthy eating) influence the changes during the intervention and follow-up. Data for this secondary analysis were from the Wellness for Women community-based trial. Women (N = …

Breastfeeding Success Among Infants With Phenylketonuria, Sandra Banta-Wright, Kathleen C. Shelton, Nancy D. Lowe, Kathleen A. Knafl, Gayle M. Houck

Faculty Publications - College of Nursing

Breast milk is the nutrition of choice for human infants (American Academy of Pediatrics, 2005; American Association of Family Physicians, 2008; Association of Women’s Health Obstetric and Neonatal Nurses, 2005; Canadian Paediatric Society, 2005; U.S. Preventive Services Task Force, 2008; World Health Organization, 2009). The literature on the benefits of breast milk and breastfeeding for infants and mothers has established multiple positive outcomes for infants (Hoddinott, Tappin, & Wright, 2008; Horta, Bahl, Martines, & Victora, 2007; Ip et al., 2007). Breast milk has advantages for infants that distinguish it from standard commercial infant formulas. These advantages include growth factors, hormones, …

Pnpla3 Polymorphisms And Liver Aminotransferase Levels In A Mexican American Population, Quan Li, Hui-Qi Qu, Anne R. Rentfro, Megan L. Grove, S. Mirza, Yang Lu, Craig Hanis, Michael B. Fallon, Eric Boerwinkle, Susan P. Fisher-Hoch, Joseph B. Mccormick

School of Nursing Faculty Publications

Purpose: This study examined genetic associations of patatin-like phospholipase domain containing 3 gene (PNPLA3) polymorphisms and liver aminotransferases in an extensively documented, randomly recruited Mexican American population at high risk of liver disease.

Methods: Two single nucleotide polymorphisms (SNP) in the PNPLA3 gene (i.e., rs738409 and rs2281135) were genotyped in 1532 individuals. Population stratification was corrected by the genotyping of 103 ancestry informative markers (AIMs) for Mexican Americans.

Results: Both PNPLA3 SNPs showed highly significant association with alanine aminotransferase (ALT) levels, but was also, in males, associated with aspartate aminotransferase (AST) levels. Haplotypic association test of the two SNPs suggested …

Population-Based Risk Factors For Elevated Alanine Aminotransferase In A South Texas Mexican-American Population, Hui-Qi Qu, Quan Li, Megan L. Grove, Yang Lu, Jen-Jung Pan, Anne R. Rentfro, Perry E. Bickel, Michael B. Fallon, Craig L. Hanis, Eric Boerwinkle, Joseph B. Mccormick, Susan P. Fisher-Hoch

School of Nursing Faculty Publications

Background and aims: Elevated alanine aminotransferase (ALT >40 IU/mL) is a marker of liver injury but provides little insight into etiology. We aimed to identify and stratify risk factors associated with elevated ALT in a randomly selected population with a high prevalence of elevated ALT (39%), obesity (49%) and diabetes (30%).

Methods: Two machine learning methods, the support vector machine (SVM) and Bayesian logistic regression (BLR), were used to capture risk factors in a community cohort of 1532 adults from the Cameron County Hispanic Cohort (CCHC). A total of 28 predictor variables were used in the prediction models. The recently …

Parenting And Feeding Behaviors Associated With School-Aged African American And White Children, Michele Polfuss, Marilyn Frenn

College of Nursing Faculty Research and Publications

Pediatric obesity is multifactorial and difficult to treat. Parenting and feeding behaviors have been shown to influence a child’s weight status. Most prior studies have focused on preschool-aged White children. Additional complicating factors include parents’ inability to accurately identify their child’s abnormal weight status. Parenting and feeding behaviors used by 176 African American and White parents of school-age children were examined. Assessment included (a) identifying what behaviors were reported when parent expressed concern with child’s weight and (b) the relationship of these behaviors on child’s body mass index percentile (BMI%), considering ethnicity, socioeconomic status (SES), and parent’s body mass index …

Parenting And Feeding Behaviors Associated With School-Aged African American And White Children, Michele L. Polfuss, Marilyn Frenn

College of Nursing Faculty Research and Publications

Pediatric obesity is multifactorial and difficult to treat. Parenting and feeding behaviors have been shown to influence a child’s weight status. Most prior studies have focused on preschool-aged White children. Additional complicating factors include parents’ inability to accurately identify their child’s abnormal weight status. Parenting and feeding behaviors used by 176 African American and White parents of school-age children were examined. Assessment included (a) identifying what behaviors were reported when parent expressed concern with child’s weight and (b) the relationship of these behaviors on child’s body mass index percentile (BMI%), considering ethnicity, socioeconomic status (SES), and parent’s body mass index …

Case Study Of Parents Caring For A Child Having Type-1 Diabetes With Optimal Hga1c, Elizabeth Ciaccio Phd

Dissertations

Type 1 diabetes in school age children is a complex condition requiring continuous physical, nutritional, and therapeutic monitoring to prevent lifelong complications and maintain quality of life. In 2011, one in 400 children in the United States were affected by it. The purpose of this research study was to understand how parents achieve optimal HgA1c for their school age children with type-1 diabetes. Currently, there is very little research documenting how parents achieve this goal. Understanding this phenomenon more clearly can be used to inform future research, improve practice and provide information for development of effective health policy. Management of …

Effect Of Serum Vitamin D Levels On Cardiovascular Mortality And Cardiovascular Disease Risk, Aaron S. Bennion, Karlen E. Luthy, Donna S. Freeborn, Renea L. Beckstrand

Student Works

Vitamin D deficiency is prevalent across all geographic areas, age groups, and seasons and is increasing in incidence. Vitamin D receptors have been found to be present in almost every body cell and tissue. Clinical research has alluded to a preventive effect of vitamin D supplementation on cardiovascular disorders such as myocardial infarction, hypertension, and dyslipidemia. Furthermore, a low serum vitamin D level has been associated with an increased risk for cardiovascular disease. This paper examines the association between serum vitamin D levels and cardiovascular disease mortality and risk.

Relationship Of Demographic Characteristics And Bmi With Health Literacy In Pacific Islander Care-Giving Adults, Sharla E. Morgan

Theses and Dissertations

Purpose: Health literacy and obesity are major global issues. Vulnerable populations, such as those with low health literacy, have the highest rates of obesity. Native Hawaiian and other Pacific Islander (NHOPI) nations have the highest prevalence of obesity in the world. This study describes the relationship between health literacy and demographic variables in a sample of NHOPI caregiving adults. Methods: We conducted a correlational study of 364 NHOPI adults. Each was a caregiver of at least one NHOPI child. Data were collected at grocery stores and a preschool in two Hawaiian Islands (n=209) and at NHOPI events in Utah (n=155). …

Assessing The Feasibility And Perceptions Of Health Services For Refugees Of Resettlement Organizations, Heidi Jean Worabo

Dissertations

Background: Since 1975 the U.S. has resettled 2.6 million refugees who had to flee from their home countries. Many refugee resettlement organizations have developed different models of innovation to promote a smooth transition between previous foreign refugee camps to U.S. communities so that refugees swiftly become economically and socially self-sufficient. Providing refugees with health benefits and resources has been foremost priority upon arrival as they try to overcome health care barriers. Yet there is a lack of literature examining the impact of these health services and how they are perceived by the program recipients. Purpose: This scholarly project aimed to …

The Relationship Between Select Demographic Characteristics And Body Mass Index Among Native Hawaiian And Other Pacific Islander Caregiving Adults, Katrina Duncan

Theses and Dissertations

Purpose: Native Hawaiian and other Pacific Islanders (NHOPIs) have the highest prevalence of overweight and obesity in the world. This study identified the proportion of our NHOPI sample in each body mass index (BMI) category and explored relationships between demographic characteristics and BMI. Design: This descriptive correlational study included 364 NHOPI caregiver adults in Utah (n=155) and Hawaii (n=209). We gathered demographic information with a questionnaire. Height and weight were measured for BMI calculations. Results: According to the CDC's BMI categories, 84.3% of our sample was overweight (BMI=25.0-29.9) or obese (BMI ≥30). Participants in Utah had significantly higher BMIs than …

Resourcefulness Training Intervention: Assessing Critical Parameters From Relocated Older Adults’ Perspectives, Abir K. Bekhet, Jaclene Zauszniewski, Denise M. Matel-Anderson

College of Nursing Faculty Research and Publications

The population of American elders is increasing rapidly and relocation to retirement communities has been found to adversely affect their adjustment. This pilot study of 38 relocated elders evaluated, from elders’ perspectives, six critical parameters of a resourcefulness training (RT) intervention designed to help elders adjust to relocation. Within the context of Zauszniewski's theory of resourcefulness, a pre-/post-test design with random assignment to RT or to diversionary activities (DA) was used. Objective questionnaires measured demographic and relocation factors. An intervention evaluation questionnaire was designed and given to the relocated elders in order to assess the six critical parameters—necessity, acceptability, feasibility, …

Food Security In The Pine Ridge Indian Reservation: A Nursing Educational Module, Beth E. Grund

Theses and Graduate Projects

Assurance of food security has been a continuing goal of world nations for more than 60 years. The educational module that is the focus of this project is designed to increase the awareness of baccalaureate and post-graduate nurses about the health disparity of low food security as a social justice issue. International policy to detail the development of the concept of food security as a human right is examined and then contrasted with current national policy. Additional topics discussed are connections between low food security on health as well as a deficit in nurse knowledge. The educational module focuses on …

Exploring The Contribution Of General Self-Efficacy To The Use Of Self-Care Symptom Management Strategies By People Living With Hiv Infection, Inge B. Corless, Dean Wantland, Kenn M. Kirksey, Patrice K. Nicholas, Sarie Human, John Arudo, Maria Rosa, Yvette Cuca, Sue Willard, Mary Jane Hamilton, Carmen Portillo, Elizabeth Sefcik, Linda Robinson, Cathy Bain, Shanaz Moezzi, Mary Maryland, Emily Huang, William L. Holzemer

School of Nursing & Midwifery, East Africa

General self-efficacy (GSE), the expectation that one is able to perform a behavior successfully, may differentiate those who are able to successfully utilize self-care symptom management strategies (SCSMS). This subanalysis (n = 569) of an international 12 site longitudinal randomized controlled trial (RCT) (n = 775), investigated GSE as an important factor determining symptom burden, SCSMS, engagement with the provider, and medication adherence over time, and identified differences in those with high and low GSE ratings concerning these variables. Parametric and nonparametric repeated-measures tests were employed to assess GSE and the perceived effectiveness of SCSMS for anxiety, depression, diarrhea, fatigue, …

Commencement Program 2012, Loma Linda University

Commencement Programs

CONTENTS

1 | Message from the President

3 | 2012 Events of Commencement

5 | The Academic Procession

7 | Significance of Academic Regalia

9 The Good Samaritan

10 | University History Highlights

12 | Loma Linda University Song - "Healing Love"

13 | The Speakers

24 | The University Honorees

36 | The School Honorees

54 | The Program

• School of Medicine, 55
• School of Pharmacy, 72
• School of Dentistry, 79
• School of Science and Technology/School of Behavioral Health and School of Religion, 97
• School of Nursing, 109
• School of Allied Health Professions - Physical Therapy, 117
• School of …

Parenting Behaviors Of African American And Caucasian Families: Parent And Child Perceptions, Associations With Child Weight And Ability To Identify Abnormal Weight Status, Michele Polfuss, Marilyn Frenn

College of Nursing Faculty Research and Publications

This study examined the agreement between parent and child perceptions of parenting behaviors, the relationship of the behaviors with the child's weight status, and the ability of the parent to correctly identify weight status in 176 parent–child dyads (89 Caucasian and 87 African American). Correlational and regression analyses were used. Findings included moderate to weak correlations in child and parent assessments of parenting behaviors. Caucasian dyads had higher correlations than African American dyads. Most parents correctly identified their own and their child's weight status. Parents of overweight children used increased controlling behaviors, but the number of controlling behaviors decreased when …

Self-Tracking, Social Media And Personal Health Records For Patient Empowered Self-Care, C Paton, Margaret M. Hansen Edd, Msn, Rn, L Fernandez-Luque, Ays Lau

Nursing and Health Professions Faculty Research and Publications

Objectives: This paper explores the range of self-tracking devices and social media platforms used by the self-tracking community, and examines the implications of widespread adoption of these tools for scientific progress in health informatics. Methods: A literature review was performed to investigate the use of social media and self-tracking technologies in the health sector. An environmental scan identified a range of products and services which were used to exemplify three levels of self-tracking: self-experi- mentation, social sharing of data and patient controlled electronic health records. Results: There appears to be an increase in the use of self-tracking tools, particularly in …

Obesity Trends In Head Start Preschoolers, Anna Sanders

Honors Theses

The purpose of this natural comparative study is to see if changes in diet, education, and activity made in a South Mississippi Head Start (HS) preschool from Fall 2007 through Fall 2010 made any changes in the Body Mass Index (BMI) trends in two cohorts of low-income African American 3-year-olds. Cohort 1 BMI trends were measured in Fall 2006 and Spring 2007, before major HS changes in diet, education and activity were made (pre-treatment), and Cohort 2 was measured in Fall 2010 and Spring 2011, after major changes were made (post-treatment).

Barriers And Motivators For Influenza Vaccination Compliance Among Healthcare, Shelby Rogers

Honors Theses

The influenza vaccine is a topic of much debate and concern throughout the healthcare profession. This vaccination has been shown to drastically reduce the number of nosocomial infections of the flu among hospitalized patients. While many healthcare professionals are aware of the benefits of obtaining the influenza vaccination, many remain noncompliant to actually getting vaccinated. This research will use a form of evidence-based practice known as an integrative review of literature in order to determine the course of nursing action to implement regarding influenza vaccination that will best increase the rates of its compliance among health professionals. A number of …

Effect Of The Total Girl Wellness Program On Wellness Behaviors In Adolescent Females, Jenifer M. Chilton

Nursing Theses and Dissertations

Adolescent females perceive themselves to be healthy but research suggests this population engages in unhealthy and risky behaviors. Health habits established during youth transition into adulthood and may contribute to chronic diseases later in life. Guided by Bandura's Social Cognitive Theory (SCT), the purpose of this study was to test the effect of a comprehensive wellness intervention on overall wellness, physical fitness, and self-efficacy for health promoting behaviors in female adolescents. A multidisciplinary concept analysis of shame suggested components of shame can impact environment, personal factors, and behavior, the key concepts of SCT. An intervention based on SCT and titled …

Early Term Infant Care: Hospital Utilization And Breastfeeding Practices, Debra Craighead

Nursing Theses and Dissertations

Early term infants (ETI), with gestational ages from 37 to 38 weeks, have higher morbidity and mortality rates when compared with later term infant counterparts born at 39 to 41 weeks. Although this newly identified term infant subcategory is gaining attention, the immediate and long term health outcomes and care needs of ETI remain largely unexplored. The purpose of this research project was to examine the current research documenting ETI health and explore care practices that are currently utilized to promote ETI health. The original research study describes care practices used to promote health for ETIs born in Louisiana in …

The Use Of Provider Audit And Feedback On Improving Hypertension Control In The Type 2 Diabetic Population, Kara Painton

Evidence-Based Practice Project Reports

As the seventh leading cause of death, diabetes affects more than 25 million Americans and contributes to major cardiovascular diseases and complications (CDC, 2011). The cost of care for these Americans is astounding: $174 billion dollars was spent on diabetes care in 2007 (ADA, 2011). Furthermore, an estimated 75% of patients with type 2 diabetes have concomitant hypertension, and nearly one-half of these patients have uncontrolled hypertension (Thomas & Kodack, 2011; USDHHS, 2011). An initial chart audit at an outpatient, rural clinic in east central Illinois revealed that 90% of the type 2 diabetic population had concomitant hypertension, and only …

Chronic Kidney Disease Educational Sessions: Assessment Of Current Practices And Attendance Barriers And Facilitators, Della Connor

Nursing Theses and Dissertations

Chronic kidney disease (CKD) educational sessions, whether part of a multidisciplinary plan of care or separate entities, have been increasingly utilized over the last 20 years. Although literature reviews exist in which randomized controlled studies concerning CKD educational sessions are addressed, none of the studies reviewed specifically addressed the low attendance rates of CKD educational sessions. The purpose of this research was to describe current and recommended CKD (predialysis) educational interventions and outcomes in controlled and multidisciplinary studies, examine documented issues related to attendance, and determine barriers and facilitators that affect attendance at educational sessions for CKD patients.

The Meaning Of Parenteral Hydration To Family Caregivers And Patients With Advanced Cancer Receiving Hospice Care., Marlene Z. Cohen, Isabel Torres-Vigil, Beth E. Burbach, Allison De La Rosa, Eduardo Bruera

Journal Articles: College of Nursing

CONTEXT: In the U.S., patients with advanced cancer who are dehydrated or have decreased oral intake almost always receive parenteral hydration in acute care facilities but rarely in the hospice setting.

OBJECTIVES: To describe the meaning of hydration for terminally ill cancer patients in home hospice care and for their primary caregivers.

METHODS: Phenomenological interviews were conducted at two time points with 85 patients and 84 caregivers enrolled in a randomized, double-blind, controlled trial examining the efficacy of parenteral hydration in patients with advanced cancer receiving hospice care in the southern U.S. Transcripts were analyzed hermeneutically by the interdisciplinary research …

Ethanol Lock Therapy In The Treatment And Prevention Of Catheter-Related Bloodstream Infections, Breanna Anderson

HIM 1990-2015

Ethanol lock therapy is a novel technique that is being studied for its efficacy in eradicating catheter related bloodstream infections. A systematic review of interdisciplinary studies from CINAHL, Medline, Academic Search Premier, Biological Abstracts, and Web of Knowledge databases was performed. This meta-analysis examined the findings of thirty-five studies on ethanol lock therapy. Twenty-six of these studies compared ethanol to a placebo and nine studies performed a direct comparison of ethanol to other agents frequently used in antimicrobial lock technique. Ethanol lock therapy was shown to be effective as both a prophylactic therapy and as an active treatment in eradicating …

Elementary School Based Health Centers As Providers Of School Entry Health Exams: Do They Meet The Standards?, Roberta Bavin

UNLV Theses, Dissertations, Professional Papers, and Capstones

The health of today's children is crucial for the future of our society. There are many children without access to healthcare in these turbulent economic times; times that are increasingly uncertain as society maneuvers its way through the maze of healthcare reform. School based health centers (SBHCs) provide a safety net for children needing basic healthcare who are otherwise underserved. School entry health examinations (SEHE) are legal requirements in many states, and are a proven method for identifying health conditions early enough in a child's life that they can be corrected. Treating identified health conditions facilitates academic success for children, …

The Relationship Between Self-Efficacy And Fluid,And Dietary Compliance In Hemodialysis Patients, Ansy Paul John

UNLV Theses, Dissertations, Professional Papers, and Capstones

Patients with end-stage renal disease (ESRD) who receive hemodialysis often fail to follow a prescribed diet and fluid regimen, which undermines the effectiveness of care and leads to unpredictable disease progression and greater likelihood of complications. Non-adherence to dietary and fluid limitations compromises the outcomes of patients receiving hemodialysis. Noncompliance can lead to detrimental long-term outcomes including deterioration of the cardiovascular system, heart failure, hypertension, and pulmonary edema as well as short-term problems such as edema, itching, bone pain, and breathlessness.

Many studies have demonstrated that self-efficacy strategies are associated with improved dietary and fluid compliance among individuals receiving hemodialysis. …