Digital Commons Network^™

Matrescence: An Emerging Concept For Birth Worker Practice, Kelsey B. Green

DNP Qualifying Manuscripts

The maternal mental health (MMH) crisis, affecting up to 25% of birthing individuals, is exacerbated by significant gaps in perinatal support. While birth workers are uniquely positioned to provide care, they often lack specialized training beyond basic screening checklists to address the complex transition to motherhood, defined as matrescence. This clinical innovation proposal outlines a matrescence-informed educational curriculum, guided by the Comprehensive Model of Mental Health during the Perinatal Period. The intervention is designed to build tangible, implementable skills, training birth workers to: (1) operationalize matrescence as a psychoeducational tool to normalize distress; (2) use clinical differentiation to distinguish the …

Evaluating Fall Prevention Outcomes: Fall Rates, Staff Fall Knowledge, And Perceptions On Safety Culture, Priscilla Greco

Student Scholarly Projects

Practice Problem: The practice problem addressed in this project was the elevated fall rates on a 46-bed medical–surgical unit with a reported sentinel fall event, prompting the need to evaluate the current fall prevention program.

PICOT: The PICOT question that guided this project was: In nursing staff on a medical–surgical unit (P), how does the implementation of an evidence-based fall prevention program evaluation using AHRQ tools (I), compared with no formal program evaluation (C), influence staff knowledge, perceptions of safety culture, and fall rates (O) over 8-weeks (T)?

Evidence: Evidence supporting this project emphasized that structured staff education, strong communication, …

Potential Adverse Effects On Lifestyle And Food Intake Pattern In Night Shift Workers, Stacie L. Coleman

Electronic Theses, Projects, and Dissertations

Abstract

Night shift work is prevalent in healthcare and other industries, yet its effects on lifestyle factors such as food intake, sleep quality, and mental health remain underexplored. This study investigates the impact of night shift schedules on nurses’ wellness, focusing on eating patterns, sleep, physical activity, and mood. A sample of 13 nurses were divided into two shift groups: day (n=5) and night (n=8); and they completed a questionnaire to assess the variables related to their behavior, food choices, eating habits, sleep patterns.

The results of previous research studies indicate that night shift nurses are more likely to adopt …

Systemic Racism In Canadian Healthcare: A Policy And Equity Analysis, Kola Adegoke, Abimbola Adegoke, Deborah Dawodu, Temitope Kayode

Health & Biomedical Sciences Faculty Publications

Background: In Canadian healthcare, systemic racism subverts commitment to universal coverage by building inequities into the system of governance, regulation, and clinical practice. Although racial disparities have been documented, little attention has been paid to how institutional structures perpetuate these inequities.

Objective: This study critically examines the organizational aspects of racism in the Canadian healthcare system. It aims to identify structural obstacles faced by racialized patients and foreign-trained physicians and to provide policy recommendations grounded in evidence.

Methods: The authors employed a narrative review framework for qualitative analysis of documents. Public inquiries (eg, Truth and Reconciliation Commission and Viens Report), …

Exploring Workplace Mental Health And Counseling Needs In Open University Staff: A Mixed-Methods Study, Pathanin Sangaroon, Oranuch Kanjanaprakorn, Araya Prasertchai, Worrawit Nakpan

Journal of Health Research

Background: Workplace mental health is a growing concern in higher education, especially in open and distance learning (ODL) settings, where staff face unique stressors. This study examines the mental health and counseling needs of academic and support staff at Sukhothai Thammathirat Open University (STOU), Thailand, using a biopsychosocial lens.

Methods: An explanatory sequential mixed-methods design was used. In the quantitative phase, 332 staff completed a questionnaire on mental health and biopsychosocial factors. Twelve participants then took part in interviews to explore their experiences and counseling preferences. Quantitative data were analyzed using stepwise regression, and qualitative data through thematic analysis. …

Spatial-Temporal Variation Of Diarrhea Among Children Under 5 Years Old Between 2010-2020 In Rwanda, Amans Ntakarutimana Dr., Patrick A. Tschida Dr., Elias Nyandwi Dr.

Journal of Social, Behavioral, and Health Sciences

We used secondary data from the Rwanda Demographic and Health Surveys of 2010, 2015, and 2020 to assess the spatial-temporal variation of diarrhea among children under 5 years old between the years 2010 and 2020 in Rwanda. Stratified descriptive statistics, pairwise comparisons, and logistic regression designs were used for data analysis in SPSS. A statistically significant variation of diarrhea among children under 5 years old was observed across districts, regions, and urban–rural areas but not at the national level between 2010–2020. Some districts of the Western region, including Nyabihu (OR = 2.5), Ngororero (OR = 2.3), and Karongi …

Evidence-Based Best Practices For Diabetes Education And Self-Care In Appalachia: A Literature Review, Angela J. Occidental, Inga M. Zadvinskis, Jacqueline Hoying

Journal of Appalachian Health

Introduction: The Appalachian Region has a higher prevalence of type 2 diabetes mellitus (T2DM) and associated adverse health outcomes. Although numerous papers report best practices for diabetes care and education, a clinician-friendly, synthesized summary of best practices tailored to Appalachian cultural preferences is lacking.

Purpose: This paper uses the Melnyk & Fineout-Overholt evidence-based framework to identify the best practices for T2DM care and education for Appalachian residents.

Methods: A comprehensive literature search using the databases CINAHL, Academic Search Complete, and PubMed was guided by a PICOT question. Quality appraisals were completed for fifty-two articles; thirty papers were selected to synthesize …

Person-Centered Trauma-Informed Care (Pctic): A Training Needs Assessment For Home And Community-Based Services In West Virginia, Ranjita Misra, A. Brianna Sheppard, Natalie Wilson, Megan C. Govindan, Matthew Myers, Amanda Acord-Vira, Steven Wheeler, Heather Henderson, Christena Ross, Laura Cooper, Rachel A. Goff

Journal of Appalachian Health

Introduction: Person-centered, trauma-informed care (PCTIC) is a combined, holistic service model promoting the well-being and empowerment of trauma survivors.

Purpose: This study examined the PCTIC knowledge, skills, and abilities needed by West Virginia (WV) Medicaid Home and Community-Based Services (HCBS) direct service professionals (DSPs) to serve clients that may have experienced trauma.

Methods: Semi-structured interviews were conducted with diverse stakeholders (n = 32) from 19 organizations that provide HCBS services in all 55 counties. Interviews focused on identifying current training, needs and knowledge gaps, and priority areas for additional PCTIC training. ATLAS.ti software was used to manage and code. Validity …

Has Regional Hospital Autonomy Achieved Its Goals? Lessons Learned From Indonesia: A Systematic Review, Masyitoh Basabih, Indriaswari Widhakuswara

Kesmas

This study examined the impact of hospital autonomy implementation on the performance of regional public hospitals in Indonesia, particularly in terms of efficiency, effectiveness, and governance. A systematic review of 32 peer-reviewed studies published between June 12 and September 6, 2023, was conducted using Garba Rujukan Digital and Google Scholar, following PRISMA guidelines. Studies addressing financial performance, service outcomes, and challenges related to implementing autonomy were included. The findings indicated that while autonomy led to improvements in infrastructure, service types, visit volumes, and hospital revenues, it had only a marginal impact on improving key health performance outcomes, such as service …

Predictors Of Healthcare Providers' Readiness For Health System Transformation In Saudi Arabia, Ahmed Ali Alasiri

Health Services Research Dissertations

The healthcare system in Saudi Arabia is undergoing significant health reform to warrant sustainable welfare provision. Privatization or public-private partnerships (PPPs) were introduced in 2021 and outlined the vision for the health system for 2023. The planned initiatives aim to be comprehensive and effectively reach individuals and society, including citizens, noncitizens, and visitors. This dissertation seeks to study and explore privatization, the role of healthcare providers, and their capacity to adapt to the transformation of the healthcare system. To achieve this ambitious goal, several interrelated projects have been undertaken. The first project was a systematic review aimed at studying the …

A Workplace Posture Initiative To Reduce Work-Related Musculoskeletal Disorders, Carrie Isaac

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Work-related musculoskeletal disorders (WRMSDs) are a leading cause of occupational injury and discomfort in industrial workplaces. Although an ergonomic program existed at the project site, a formalized process to detect postural misalignments early had not been established. Relying on employee self-reporting, delayed intervention, and limited opportunities to prevent injuries before they progress.

Aim of the Project: A proactive posture screening program using PostureScreen® was implemented to identify postural deviations that could contribute to WRMSDs. Emphasis was placed on supporting employees through early awareness of posture-related issues and evaluation of alignment improvements following individualized intervention.

Review of the Evidence: Evidence …

Increasing Colorectal Cancer Screening Rates For Patients Without Insurance, Andrea F. Day

Doctor of Nursing Practice Projects

Background: Colorectal cancer is a leading cause of cancer-related death in the United States (U.S.), ranking as second most prevalent overall. Despite many initiatives, screening rates remain low, especially among clinic patients without insurance. The lack of an evidence-based screening protocol exacerbates these issues and increases the risk of advanced cancer and death. Initial data showed that 0% of patients were screened according to recommended guidelines.

Purpose: The project implemented a standard screening protocol to increase colorectal cancer screening rates in a rural Alabama free clinic for patients ages 45-64 lacking insurance.

Project Design: This quality improvement …

Implementation Outcomes And Associated Constructs From The Consolidated Framework For Implementation Research Among Churches Trained Online To Implement Faith, Activity, And Nutrition In A National Implementation Study, Sara Wilcox Phd, Ruth P. Saunders Phd, Andrew T. Kaczynski Ph.D., Caroline Rudisill Ph.D., Msc, Ye Sil Kim Phd, Jasmin Parker-Brown, Kelsey R. Day

Faculty Publications

Churches hold promise for reaching populations with high rates of chronic disease, yet few faith-based large-scale implementation studies exist. The study purpose was to examine 12-month implementation outcomes and associated Consolidated Framework for Implementation Research (CFIR) constructs after converting in-person training to online for an evidence-based intervention designed to improve church organizational practices related to physical activity (PA) and healthy eating (HE). US churches recruited from 2020 to 2022 participated in eight online lessons prior to implementation. Each church’s coordinator completed an online baseline and 12-month survey assessing church practices for PA/HE components targeted in the Faith, Activity, and Nutrition …

Leading Change For Transgender And Gender Diverse Healthcare: Assessing Organizational Readiness, Braxten Lovett

Dissertations

Background: Transgender and gender-diverse (TGD) individuals face persistent stigma and systemic discrimination across multiple societal domains, with healthcare settings—intended as safe spaces—often being among the most harmful. Despite increased visibility of TGD populations and growing research on their health inequities, inclusive healthcare remains insufficiently addressed by many healthcare leaders, adding to the urgency to advance equitable, inclusive care. Additionally, structural cisnormativity and binary gender frameworks continue to perpetuate misinformation, erasure, and health disparities. Addressing these entrenched barriers requires systemic reform rooted in cultural humility, inclusive practices, and a commitment to dismantling cisnormative bias within healthcare delivery and policy. This study …

Stress And Burnout Among Icu Nurses, Jaspreet Kaur

2025 Spring Honors Capstone Projects - Archive

Burnout is a significant occupational hazard for Intensive Care Unit (ICU) nurses. High patient acuity, staffing shortages, and long shift hours increase stress and diminish well-being among nurses, affecting patient care outcomes. This study examined the prevalence of stress and burnout among ICU nurses to identify contributing factors and potential interventions. An anonymous online survey was conducted among 110 ICU nurses, utilizing the Maslach Burnout Inventory (MBI) and the Perceived Stress Scale(PSS). Findings revealed that 42.5% of nurses reported high emotional exhaustion, while 37.5% felt they had little to no control at work. The most frequently cited workplace stressors were …

The Relationship Of Peer Recovery Support Specialists And Recovery Of Perinatal Women With A Substance Use Disorder, Mary C. Talbot

Health, Human Performance and Recreation Undergraduate Honors Theses

Introduction: Substance use in pregnant and postpartum women is a growing issue in the United States. Drug use while pregnant can lead to birth defects, stillbirths, and problems providing positive parenting to their children. Many women with substance use disorders (SUD) feel extreme shame and stigma related to their substance use and have trouble accessing recovery-related treatment and other services. Peer recovery support treatment uses the lived experiences of individuals in current recovery from SUD to facilitate and support recovery in others. Purpose: The purpose of this review was to evaluate the impact of peer recovery support specialists on the …

Improving Oral Hygiene Practices In A Long-Term Care Setting For Individuals With Advanced Dementia: A Quality Improvement Initiative, Rachel L. Mcinerney

Capstone Experience: Master of Public Health

This quality improvement project utilized the Plan-Do-Study-Act framework to enhance oral hygiene practices in a long-term care setting for individuals with advanced dementia. Advanced dementia often leads to significant oral health challenges due to the individuals’ inability to communicate needs or independently manage oral care. Poor oral hygiene results in pain, systemic infections, and reduced quality of life. The project aimed to identify and address barriers to effective oral care delivery by focusing on organizational factors such as leadership, training, and caregiver support. This capstone paper provides insights into the quality improvement initiative’s aims, background, and methodology, while emphasizing its …

Evaluating The Nebraska Medical Center's Repatriation Of Inter-Hospital Transfers, Natalie Crump

Capstone Experience: Master of Public Health

Background: Bed capacity challenges at large academic medical centers delay the transfer of rural patients, negatively impacting their safety and quality of care. Repatriating inter-hospital transfer (IHT) patients to referral facilities upon completing specialized care can improve tertiary hospital bed capacity and community hospital financial sustainability.

Objectives: This project aims to identify the barriers and facilitators to successful IHT repatriation and the process and outcome variables influenced by the Nebraska Medical Center’s reverse transfer program.

Study Design: A retrospective observational cohort study was conducted to identify barriers and facilitators of NM’s IHT repatriation program.

Methods: Descriptive and comparative analyses of …

A Qualitative Study: Patients' Expectation Of Private Hospitals, Sarah Jada, Jessy Jacob, Ahmad Nasrallah

Patient Experience Journal

Objectives: This study was conducted to explore patients' expectations and perceptions of private healthcare facilities, understand the key factors influencing their choice of such facilities, also identify elements that enhance patient satisfaction and loyalty, enabling the development of actionable recommendations to improve patient-centered care in private healthcare settings. Method: A qualitative study using thematic analysis was conducted with 29 patients from various nationalities and backgrounds who received services in private hospitals in Kuwait, including Dar Al Shifa Hospital. Insights were gathered through semi-structured interviews. Results: The study delved into the significant correlation between patients' experience of their healthcare encounters and …

The Readiness For Integrated Primary Health Care (Ilp) At Puskesmas Pamulang In Tangerang Selatan City, Firda Safitri Rachmaningsih, Kurnia Sari

Journal of Indonesian Health Policy and Administration

. Integrated primary healthcare (ILP) is part of the transformation of primary healthcare aimed at improving access to quality healthcare. This study aims to analyze the readiness of Pusat Kesehatan Masyarakat (Puskesmas) and their networks to implement ILP. This research used a qualitative approach, focusing on a case study of a Puskesmas in an urban setting, specifically in the operational area of Puskesmas Pamulang in South Tangerang. Data collection methods include in-depth interviews, observations, and document reviews. This research adopts the conceptual framework of PHC monitoring based on WHO and Weiner's theory of organizational change readiness. The research findings indicate …

Benefits, Challenges, And Strategies For Increasing Women Coaches In Elite Sport: The Trail To Gold (T2g) Initiative In U.S. Cross-Country Skiing, Anika Anna Angriman, Lynda B. Ransdell, Shelley Lucas, Nicole Lavoi

International Journal of Physical Activity and Health

Despite tremendous growth in sport participation of girls and women following Title IX in 1972, women’s participation as sport coaches did not follow the same trajectory. In fact, women remain significantly underrepresented in sport coaching. Research highlights ongoing barriers within the sport industry's patriarchal structure, and although strategies have been proposed to improve women’s representation, the lack of progress over the past two decades indicates limited effectiveness. A better approach is essential to address this issue across individual, interpersonal, organizational, and societal levels. The purpose of this study is to interview participants within the U.S. cross-country skiing program, Trail to …

Burnout In The Emergency Room: Corrective Measures Vs. The Absence Of Solutions, Zane Walters, Zachary Woodall

Theses, Dissertations and Capstones

Introduction: Physician burnout has become an increasingly prevalent and critical issue in healthcare systems worldwide, particularly among emergency room physicians who face high-stress, high-demand working conditions. Burnout manifests as emotional exhaustion, depersonalization, and a diminished sense of personal accomplishment, leading to negative outcomes for physicians’ mental health, job satisfaction, and overall career longevity. This phenomenon not only threatens the well-being of physicians but also compromises patient care quality and contributes to costly turnover within healthcare organizations.

Purpose of the Study: The aim of this study was to systematically investigate the impact of burnout interventions on emergency room physicians. …

Improving Knowledge And Confidence Of Family Nurse Practitioners In Offering The Hpv Vaccine, Leni Terano Fisher

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Abstract

Introduction

Despite the recommendations of the United States Advisory Committee on Immunization Practices, HPV immunization lags behind other routine vaccines by up to 31%. Although there are many reasons for the low vaccine rate, provider hesitancy and lack of confidence significantly contribute to suboptimal HPV vaccine uptake.

Objectives

This project aimed to utilize evidence-driven interventions to increase family nurse practitioners' (FNPs) knowledge and confidence in offering the HPV vaccine.

Methods

Participants were given pre- and post-questionnaire surveys. The Wilcoxon Rank Test was used to compare, quantify, and measure the results of the eight-week data collection.

Results

The subjects were …

A Quality Improvement Approach To Reducing Post-Surgical Acute Care Falls, Tiffany C. Mitchell

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Inpatient falls remain one of the most preventable adverse events in hospitals. Falls result in serious injuries and increasing healthcare costs. This quality improvement project evaluates the implementation of Fall TIPS to reduce fall incidence and promote sustainable safety practices.

Readiness To The Privatization Of The Health System In Saudi Arabia: Translation And Factor Analysis Of Readiness To Organizational Change (Roc) Scale, Ahmed Ali Alasiri, Qi Zhang

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background

The Kingdom of Saudi Arabia (KSA) began a major transformation as a part of version 2030 for its health system. These reform initiatives aim to privatize health services and improve efficiency. Despite this meaningful change, there is a knowledge gap in how healthcare providers prepare for or perceive this shift. Specifically, there has been a lack of validation of Arabic instruments that gauge the individual readiness to this change. This study bridges the gap by localizing and validating the Readiness to Organizational Change scale (ROC) to provide empirical evidence and to understand adaptability for the KSA context.

Method

The …

Supports For Mental Well-Being Valued By Healthcare Workers: Qualitative Analysis Of Data From A Canadian Cohort Of Healthcare Workers During The Covid-19 Pandemic, Shannon Marie Ruzycki, Anil Adisesh, Quentin Durand-Moreau, France Labrèche, Tanis Zadunayski, Erica Stroud, Nicola Cherry

Études primaires

A prospective cohort of 4964 HCWs from four Canadian provinces was established early in the COVID-19 pandemic. Participants were invited to comment about workplace mental health supports at three time points. We performed a thematic content analysis of responses from 1738 participants using the Social Support Behaviour Code framework to categorize barriers to support as informational, tangible, emotional, social, or expressing esteem. Themes were synthesized into suggestions for healthcare organizations to prepare for future crises. Formal and informal peer support, workplace mental health supports, and one-on-one counseling were most often mentioned as valued. Analysis suggested that workplace social networks as …

Evolution Of Stressors For Healthcare Workers Over The Covid-19 Pandemic, F. Labrèche, Q. Durand-Moreau, A. Adisesh, J.-M. Galarneau, Shannon Ruzycki, Tanis Zadunayski, Nicola Cherry

Études primaires

Background:

Many studies have documented exposure to psychosocial factors in healthcare workers (HCWs) during the COVID-19 pandemic. Few have done it prospectively with open-ended questions.

Aims:

To describe the evolution of stress factors reported by HCWs during the pandemic.

Methods:

A prospective cohort of 4964 HCWs (physicians, nurses, healthcare aides, personal support workers), from four Canadian provinces, received four online questionnaires between the springs 2020 and 2022. Responses to an open-ended question on stressful events were coded into 25 stressors. Multilevel logistic regressions assessed trends in stressors, and the effect of gender, occupation, and age.

Results:

In 2020, 91% of …

Journey To Well-Being: An Exploration Of Thrivership Post-Domestic Violence, Kader Gumus

Antioch University Dissertations & Theses

Domestic violence profoundly affects multiple facets of a survivor’s life. While most existing literature on survivorship addresses the immediate aftermath of domestic violence, this study delves into the extended process following the trauma of abuse to attain “thrivership,” a new concept in the scholarly and practice literature that emphasizes enduring well-being and flourishing. This dissertation examines the journeys from surviving to thriving for 13 women who transformed themselves and their lives to achieve well-being after traumatic domestic violence. Bronfenbrenner’s ecological systems theory was applied to examine the multiple layers of environmental influences on an individual’s development, including the micro, meso, …

Priorities To Care Within The Military Health System: A Mixed Methods Study On Military Spouse Access To Care During Covid-19 On Okinawa, Elayne L. Wilson

Theses & Dissertations

Military spouses in Okinawa experienced denial of care at military treatment facilities and off base Japanese healthcare facilities during the COVID-19 pandemic. Over two years of travel restrictions further contributed to difficulties accessing healthcare while stationed on the island with their active-duty spouse. This study examined the implications of a priority-based access system through the TRICARE program implemented due to limited resources during COVID-19 and its impact on military spouses in a scarce medical resource environment. This concurrent mixed-methods research used a survey tool developed by Community First Hawaii to quantify access to healthcare and in-depth interviews to further explore …

Msw Portfolio, Andrea E. Anderson

Graduate Student Portfolios, Professional Papers, and Capstone Projects

The portfolio narrative includes a brief introduction to my academic journey including field related work. The ten social work competencies are used as a guide while I reflect on the required appendices, theoretical frameworks and orientation to practice throughout the narrative.