Digital Commons Network^™

The Use Of High-Fidelity Simulation In Psychiatric And Mental Health Nursing Clinical Education, Bethany A. Murray

International Journal of Health Sciences Education

Background: High-fidelity simulation recreates real-life situations in a safe learning environment and encourages critical thinking in students. Published research in simulation in psychiatric/mental health nursing is sparse.

Methods: Four scenarios exemplifying drug or alcohol abuse utilizing the computerized, mannequin SimMan® were implemented. Students evaluated their learning experience following completion of the simulation via a 20-item, Likert-scale survey which included open-ended questions.

Results: Results were positive. Students rated all items on the survey as “agree” or “strongly agree” (Mean 4.77, SD=0.55).

Conclusions: High fidelity clinical education simulations are an effective means of facilitating student learning of psychiatric and mental health clinical …

Nursing Students' Attitude And Knowledge Of Alzheimer's Disease, Michelle Kimzey

Nursing Theses and Dissertations

As the population ages, nurses must be prepared to provide care for the large number of people with Alzheimer's disease (PWAD). Research is limited on nursing students and people with AD, whether nursing education prepares students to care for this population, or the best methods to educate students in an insightful and collaborative environment. The aim of this mixed methods design study was to determine the effects of educational experiences on nursing students' knowledge and attitudes towards people with AD. The qualitative piece identified factors that influenced and explained differences in nursing students' knowledge and attitudes surrounding the care of …

Examining The Association Of Medication Complexity With Health-Related Quality Of Life In Older Adults Receiving Community-Based Long Term Services And Supports, Claudia Ann Beck

Dissertations, Theses, and Capstone Projects

While the complexity of a medication regimen is a concern for all individuals, it is of significant concern for community-dwelling older adults who often require multiple medications to treat chronic health problems. Health related quality of life (HRQoL) has been identified as a key quality outcome measure when assessing care of older adults, particularly those with long-term care needs. Although the use of multiple medications has been widely explored in the literature, there is a paucity of data regarding the combination of several medication-related factors (number of active medications, therapeutic drug class, and medication regimen complexity) and HRQoL in older …

The Lived Experiences Of Nurses Caring For Dying Pediatric Patients, Danna Leigh Curcio

Dissertations, Theses, and Capstone Projects

The purpose of this research study was to explore the lived experiences of nurses caring for dying pediatric patients. Nurses and health care professionals may at times have difficulty adjusting and processing when life ends and this may have the potential to interfere with patient care. Reflection on past events and actions enable critical discovery of strategies to benefit both nurses and patients. The method for conducting this research study was from a qualitative phenomenological perspective exploring the lived experiences of nurses caring for dying pediatric patients. The philosophical underpinning of Merleau-Ponty (2008), in combination with the research method of …

"If She Can Do It, So Can I": An Ethnography Of A Supportive Living Environment For Women In The Criminal Justice System And Their Children, Regina Cardaci

Dissertations, Theses, and Capstone Projects

There are now more women in prisons and jails than at any time in United States history. A large number of these women will be returning to the community. Women returning to the community after release from prison or jail face numerous challenges to successful reentry, e.g., securing housing and employment. In addition, following separation and care of their children by others, women with children struggle to resume their roles as mother.

This dissertation is an exploration of a program that assists women transitioning from incarceration to the community. This program helps women by helping to develop job skills and …

Does End Of Life Terminology Influence Decisional Conflict In Surrogate Decision Makers?, Dawn Fairlie

Dissertations, Theses, and Capstone Projects

This study investigated the relationship between end of life terminologies and decisional conflict in surrogate decision makers using a convenience sample of 234 adults age 50 and older at active adult communities, and senior centers in New Jersey. Participants were randomized into two groups, and each received a vignette that was personalized. The vignettes varied only in the use of the words "Do Not Resuscitate (DNR)" and "Allow Natural Death (AND)". The Decisional Conflict Scale (DCS) was administered.

There was no difference in total DCS score based on AND and DNR versions. However, AND respondents perceived their decision as a …

The Lived Experience Of Young Adult Burn Survivors' Use Of Social Media, Marie S. Giordano

Dissertations, Theses, and Capstone Projects

The purpose of this phenomenological study was to illuminate the meaning of social media use by young adult burn survivors. Five females and four males, aged 20-25, who sustained burns > 25%, were interviewed. Van Manen's (1999) phenomenological methodology provided the framework for this study. The meaning of the context of the lived experience is described in the five essential themes of identity, connectivity, social support, making meaning, and privacy. These young adult burn survivors, having experienced the traumatic effects of a burn during adolescence, use social media as a way of expressing their identity, while being cautious about privacy. Part …

Patient Safety Culture And High Reliability Organizations, Jared D. Padgett

Walden Dissertations and Doctoral Studies

A 1999 evaluation of case studies performed by staff from the Institute of Medicine found that between 40,000 and 98,000 patients died from preventable errors, while 43,598 individuals died in car accidents that year. A 2011 report increased that estimate nearly 10 times. Widespread preventable patient harm still occurs despite an increase in healthcare regulations. High-reliability organization theory has contributed to improved safety and may potentially reverse this trend. This explorative single case study explored how the perceptions and experiences of nursing and respiratory staff affected the successful transition of a healthcare organization into a reliability-seeking organization. Fourteen participants from …

Predictors Of Health In Adult Child Caregivers Of Parent Stroke Survivors In China, Yuqin Pan

Loma Linda University Electronic Theses, Dissertations & Projects

Strokes are the leading cause of adult disability and death in China. The prevalence is 6 - 9% among adults over 65 in urban areas. It is estimated that currently there are more than 7.5 million stroke survivors with an annual increase of 2.5 million new cases. These stroke survivors are in great need of care during their rehabilitation. The tradition of filial piety involves adult children in caregiving to their parent stroke survivors; however, the caregiving responsibility becomes more challenging due to shrinking family size and modernization; thus caregiver health is often compromised. Data were collected by face-to-face interviews …

Creating A Healing Environment: Strategies Christian Nurses Use, Jane Bacon Pfeiffer

Loma Linda University Electronic Theses, Dissertations & Projects

Nursing metaparadigm concepts of nurse, person, environment, and health are the conceptual building blocks which provide direction to nursing research and knowledge development (Fawcett & Desnato-Madeya, 2013). Interaction of person, nurse and environment facilitate optimal outcomes yet, there remains a need for research on the paradigm concept of environment and creation of a healing environment in particular. (Meleis, 2010).

The purpose of this study was to explore the strategies Christian nurses used to create a healing environment and enhance well-being for non-end-of-life, hospitalized patients from admission forward. Specific aims included identifying nurses’ perspectives on (1) the strategies Christian nurses used …

The Association Of Health Literacy With Self-Care Agency In Older Adults In Jamaica, Heather F. Fletcher

Loma Linda University Electronic Theses, Dissertations & Projects

Older adults are the fastest growing segment of the population in Jamaica. With an increase from 10% (252,225) of the total Jamaican population in 1995 to 11% (279,051) in 2005, the rate is expected to rise to 25% by 2025. Thus, it will be critically important to understand factors that may contribute to health maintenance, disease prevention, and wellness promotion. Two such factors – not studied extensively in this country - are health literacy and self-care. The purposes of this study were to (a) generate health literacy profile data with the newly-developed Health Literacy Questionnaire for community-dwelling older adults in …

Individual, Disease, And Work-Related Factors Associated With Work Patterns, Presenteeism And Sick Pay Policy Of The Colorectal Cancer Survivor After Treatment, Kristin A. Roper

Graduate Doctoral Dissertations

Participation of colorectal cancer survivors (CRC) in the workforce has been described by clinicians, survivors, and researchers as a way to improve mood, quality of life (QOL), and survival. Maintaining self-esteem and financial independence have also been attributed to continued employment of the CRC survivor. The purpose of this cross-sectional survey was to describe patterns of employment of the CRC survivor and to examine the individual, disease, and work-related factors that influence presenteeism and perceived adequacy of sick pay (ASP) policy. The Conceptual Model of Nursing and Health Policy and the Pathways to Work Life Recovery guided the design, selection …

Factors Related To Academic Success Among Nursing Students: A Descriptive Correlational Research Study, Audrey M. Beauvais, Julie G. Stewart Dnp, Mph, Susan M. Denisco, John E. Beauvais

Nursing Faculty Publications

Background:The current rise in employment is improving forecasts for the future supply of registered nurses; however sizeable shortages are still projected. With the intention of improving academic success in nursing students, related factors need to be better understood.

Objectives: The purpose of the correlational study was to describe the relationship between emotional intelligence, psychological empowerment, resilience, spiritual well-being, and academic success in undergraduate and graduate nursing students.

Design/setting: A descriptive correlational design was utilized. The study was set in a private Catholic university.

Participants: There were 124 participants. There were 59% undergraduate and 41% graduate students.

Methods: Background data, in …

Patient Perceptions Of Patient-Empowering Nurse Behaviours, Patient Activation And Functional Health Status In Postsurgical Patients With Life-Threatening Long-Term Illnesses, Teresa Jerofke-Owen, Marianne E. Weiss, Olga Yakusheva

College of Nursing Faculty Research and Publications

Aim

To explore the trajectory of associations between the nursing care process of patient empowerment during postsurgical hospitalization and postdischarge patient self-management outcomes, specifically patient activation and functional health status.

Background

Patient-centred care models advocate for patient empowerment in long-term illness care. Postsurgical patients with life-threatening long-term illnesses frequently feel powerless, have unmet needs, decreased functional health status and high readmission rates; however, previous studies of patient empowerment have conceptualized empowerment as an outcome primarily in outpatient settings, with little attention paid to provider processes used to empower patients during hospitalizations.

Design

A non-experimental, prospective, correlational study.

Methods

This sample …

Psychometric Properties Of The Index Of Relocation Adjustment, Abir K. Bekhet, Jaclene Zauszniewski

College of Nursing Faculty Research and Publications

More and more American older adults are relocating to retirement communities, and they experience challenges in adjusting to new surroundings that may increase their depression and mortality. An instrument not previously tested in the United States, the Index of Relocation Adjustment (IRA), may help in early identification of poor relocation adjustment. This study examined the psychometric properties of the IRA using secondary data from a convenience sample of 104 older adults who relocated to 6 retirement communities in Northeast Ohio. Cronbach’s alpha was .86. The IRA was correlated with measures of positive cognitions (r = .48, p < .01) and relocation controllability (r = …

Strategies For Sustaining Self Used By Family Caregivers For Older Adults With Dementia, Margaret J. Bull

College of Nursing Faculty Research and Publications

The negative health consequences of caring for an older adult family member with dementia are well documented. However, not all family caregivers experience these negative health consequences. The purposes of this study were to describe strategies family caregivers use to help them continue to provide care for an older family member with dementia despite challenges and describe these family caregivers’ resilience and psychological distress. A mixed methods design was used with a narrative approach dominant and standardized scales for resilience and psychological distress used to enhance the description of the sample. Data were collected through telephone interviews with 18 family …

Bariatric Surgery Versus Lifestyle Interventions In Managing Obesity In Patients With Type Ii Diabetes: A Systematic Review, Leslie C. Nakaya, Mary Williams

Student Works

Obesity, with coexisting T2DM, is difficult to treat successfully for various reasons and carries enormous health risks and financial burdens. The purpose of this systematic review is to compare outcomes of conventional medical treatment to bariatric surgery for the treatment of T2DM, and determine which patients may be appropriate for referral. Data Sources: An electronic search of the literature was conducted to identify studies from 2008 to 2014 in the following databases: CINAHL, National Library of Medicine PubMed®/MEDLINE®, EBSCO, SciVerse®, Springer Link®, and the Cochrane library. Conclusions: Bariatric surgical options, even before weight loss occurs, positively affect glucose homeostasis and …

Quantitative Measurement Of Reciprocal Social Behavior Among Toddlers Aged 18 To 24, Rebecca Sarah Light-Pearlman

Dissertations

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that starts in early childhood. It is characterized by impairments in reciprocal social behavior, impaired language, and stereotypic behavior/restricted interests (Pine, Luby, Abbacchi, & Constantino, 2006). One in 68 children is affected by ASD (Centers for Disease Control and Prevention, 2014). The prevalence of ASD is rapidly increasing. New estimates show a 23% increase in the number of cases since 2009 and a 78% increase in case numbers since 2007 (CDC, 2013). The purposes of this project were to: (a) establish normative parameters of reciprocal social behaviors, among toddlers aged 18 to …

Acculturation, Self-Efficacy And Breastfeeding Behavior In A Sample Of Hispanic Women, Ivonne F. Hernandez

USF Tampa Graduate Theses and Dissertations

Breastfeeding confers immunological, physiological and psychological benefits for the infant and mother as well as social and economic benefits to the nation. The United States Department of Health and Human Servcies (HHS), Healthy People 2020 has established national objectives for the initiation and duration of breastfeeding at 82% initiation, 61% at six months and 34% at one year. In addition, they have set goals for exclusive breastfeeding at 3 months to be 46% and 25% at 6 months of infant's age. Currently breastfeeding initiation is at the highest recorded level of 76.9%, yet significant disparities exist (CDC, 2012). The purpose …

The Lived Experience Of Parental Bereavement, Christine Denhup

Seton Hall University Dissertations and Theses (ETDs)

The purpose of this manuscript is to present a Heideggerian hermeneutic phenomenological nursing research study on the phenomenon of parental bereavement. The aim of this study is to describe the lived experience of bereaved mothers and fathers who have experienced the death of a child due to cancer. Van Manen’s (1997) method guided this qualitative inquiry. New knowledge describing the meaning of the lived experience of parental bereavement promotes a better understanding of the phenomenon from the perspective of parents, fills a significant gap in the literature, and informs nursing research, education, and practice.

Impact Of Text Messaging On Diabetic Foot Self-Care Behaviors Using A Single-Case Design, Stephanie Charese Hills

Nursing Theses and Dissertations

Problem: The absence of diabetic foot self-care is one of the major reasons for the approximately 60,000 avoidable lower extremity amputations annually in the U.S. Providers have limited time during clinic visits to educate their patients and increase awareness. Innovative strategies beyond the clinical setting are necessary to reinforce self-care behaviors. Objective: The purpose of this study was to use an innovative design method to examine the impact of providing diabetic foot care education to patients via text messaging and to assess the effect on patient self-care behaviors and clinical outcomes. Methods: Quantitative research using a single case study design. …

Health, Health Perceptions, Healthcare Practices, And Influencing Factors Among Korean Immigrants Living In Rural Texas, Mary Beth Winton

Nursing Theses and Dissertations

The population of Asian immigrants in the United States increased 43.3% from 2000 to 2010. During the same period, Texas experienced an increase of Korean immigrants of over 47%. Despite the increase of Korean immigrants, only a minimal number of studies explored health and healthcare needs specific to this population. Furthermore, none of the studies addressed Korean immigrants living in rural Texas. Hence, an ethnographic study was conducted to examine the health and healthcare among Korean immigrants living in rural Texas. Face-to-face interviews were conducted and transcribed. Five major themes emerged which included acculturation, health and health perceptions, healthcare, relaxation …

Emergencies: Risk And Personal Preparedness Measures, Charleen C. Mcneill

Nursing Theses and Dissertations

Personal emergency preparedness efforts that increase the resiliency of individuals and communities and decrease the risk for poor outcomes after an emergency are increasingly of interest to health care leaders, policy makers, and governmental entities. The limited capacity for external aid to provide relief in the first 72 hours after an emergency dictates that individuals and communities become prepared to sustain themselves for this initial period. Failure to prepare for an emergency can result in a multitude of negative outcomes. Those who are economically vulnerable are particularly at risk, including a high risk for negative health outcomes. An initial review …

Validation Of The Transportation Burden Questionnaire Among Family Caregivers Of Older Adults, Bryant James Price

Dissertations

Because family caregivers provide a substantial amount of informal care to dependent loved ones, the potential burden such care may place on family members is an important area for clinical research and intervention. While the provision of transportation is recognized in the literature as a caregiving task and a component of global burden, few studies, to date, have addressed this as a distinct concern for measurement and intervention. The purpose of this study was to determine if an item set focused specifically on transportation burden would be additive to accepted global measures of burden in a volunteer sample of caregivers. …

Advantages And Limitations Of Anesthesia And Sedation Practices Used Among Acute Ischemic Stroke Patients During Endovascular Revascularization Therapy, Margaret Korzewski

Doctor of Nursing Practice (DNP) Projects

In order to safely and efficiently perform endovascular revascularization procedures among acute ischemic stroke (AIS) patients, general anesthesia or sedation is often required. However, anesthesia management during these procedures varies significantly worldwide and the procedural logistics have not been established yet. At some institutions AIS patients are intubated and paralyzed, while at other facilities, there is no routine protocol. In 2011 the University Hospital used “action nurses” (critical care float pool nurses) to provide pharmacological paralysis with sedation for intubated AIS patients under direct supervision of the neurointerventionalist. However, clinical outcomes among AIS patients undergoing endovascular procedures were poor. Exclusive …

Distress In Women With Ovarian Cancer, Judith Dellaripa

Theses and Dissertations

Clinicians and researchers know that women experience distress related to the diagnosis of and treatment for ovarian cancer. A review of the literature revealed that while there is interest in the topic, distress is inconsistently defined and measured. Women have been reported to have a variety of distress experiences including the challenges of late diagnosis and the treatment regimen, communication difficulties with healthcare providers, and concern about the effect of their diagnosis on their loved ones. Without information directly from women, assumptions predominate about what the experience is like and what they would find helpful from support persons. Women’s perceptions …

Effects Of An Apn-Led Amiodarone Clinic On Adherence To Recommended Monitoring Guidelines, Melissa Bartoszewicz

Evidence-Based Practice Project Reports

Evidence shows that patients receiving amiodarone therapy have not adhered to monitoring guidelines set forth by the Heart Rhythm Society. Uncertainty with responsibility for monitoring has led to the development of pharmacist-managed or multidisciplinary-managed outpatient amiodarone clinics. Some limitations have been identified in the pharmacist-managed outpatient clinics that may be overcome by advanced practice nurse (APN)-managed clinics. The purpose of this EBP project was to determine what effects an APN-led amiodarone clinic would have on adherence to amiodarone monitoring guidelines. Using the PICOT format, the clinical question was developed: Does enrollment in an amiodarone clinic compared with “usual care” change …

The Effect Of Shared Medical Appointments And Education On Hemoglobin A1c Levels, Gina L. Moore

Evidence-Based Practice Project Reports

Type II diabetes affects millions of people worldwide. Approximately 25.8 million or 8.3 percent of the United States (U.S.) population has type II diabetes. The number of adults in the United States developing diabetes has been projected to double by the year 2030 (World Health Organization, 2013). Diabetes is the leading cause of kidney failure and blindness, as well as the major cause of heart disease and stroke which is the 7th leading cause of death in the U.S. The purpose of this evidence-based project was to determine the effects of education during shared medical appointments with type II diabetic …

A Novel Psychotropic Risk Assessment To Enhance Medical Management Of Patients With Behavioral And Psychological Symptoms Of Dementia, Nancy C. Trego

Doctor of Nursing Practice (DNP) Projects

There is growing evidence and concern documenting the risks of antipsychotic use, and psychotropic medication burden in general, for older adults with behavioral and psychological symptoms of dementia (BPSD). Yet nearly 25 percent of all long term care residents take antipsychotics for behavioral disturbances associated with dementia as “off-label” use, despite their modest efficacy and FDA black box warnings (CMS, 2013). Expert consensus calls for non-pharmacological strategies as the first line treatment, yet some patients with BPSD may require a combination of non-pharmacological interventions and pharmacological treatments for symptom reduction (AGS, 2011). The relief of debilitating symptoms aims to improve …

Motivational Interviewing Education For San Mateo County’S Adolescent Healthcare Providers: Focus On Healthy Diet And Physical Activity, Emilie J. Gruhl

Doctor of Nursing Practice (DNP) Projects

Motivational interviewing has been endorsed by San Mateo County as an evidence-based effective form of behavior change counseling. Eighty percent of pediatric healthcare providers in San Mateo County have been trained in motivational interviewing, however 70% of the providers use it less than 50% of the time. The goal of this project was to reeducate the adolescent providers of San Mateo County in motivational interviewing with an emphasis on individualized training and feedback, directed toward healthy diet and exercise. Results of the quality improvement project showed an average 2.5-point increase in provider confidence on a zero to ten-point scale, and …