Digital Commons Network^™

Preceptor Effectiveness As A Mediator Of Relationship Between Psychological Empowerment And Newly Registered Nurses' Intent To Stay, Deborah Taffe

Dissertations

The nursing profession is currently experiencing a nursing shortage that is projected to worsen. One in five newly licensed registered nurses (NLRNs) leaves the profession within the second year of practice (National Healthcare Retention and RN Staffing Report, 2018). Work empowerment has been shown to decrease turnover rates among nurses: However, the factors that mediate this concept have not been fully explored.

The purpose of this study was to investigate nurses' perceived preceptor effectiveness as a mediator of the relationship between psychological empowerment during the transition from an academic environment into practice and intent to stay in practice for NLRNs …

A Model To Facilitate Transformative Learning In Learner Nurses At Nursing Education Institutions, Tebogo A. Tsimane

Dissertations

Transformative learning is a learner-centered process of learning that actively engages learners in self-examination and critical reflection on assumptions and results in the development of competence and self-confidence in new roles and relationships that bring about change in specific environments, rather than rote learners who are inherently deficient, lacking change attributes such as clinical reasoning and judgment.

The purpose of the study is to describe and evaluate a model with guidelines to facilitate transformative learning in nursing education institutions. A qualitative, exploratory, descriptive and contextual research design for theory generation was used. The study was conducted in four phases. Phase …

Simulated Clinical Experience: An Investigation Of Emotion Understanding And Management, Neena W. Jones

Dissertations

Many investigators have documented that lack of emotional intelligence (EI) in professional nursing correlates with patient dissatisfaction, negative patient outcomes, and litigation. However, much less information is available to nurse educators for an effective instructional strategy to increase EI skills, specifically emotion understanding and management (the most influential branches of EI) in nursing students. Grounded in the theory of EI and the theory of simulation, the purpose of this quantitative quasi experimental study was to introduce educational technology as a useful strategy for influencing EI in a convenience sample of 88 second semester students in a baccalaureate program. Research questions …

International Students’ Perceived Support And Barriers Adapting To The New Cultural Experience In A Southern California University, Jeanette Ayala

Dissertations

Purpose: The purpose of this phenomenology study was to explore the lived experiences of international students’ perceptions regarding the types of support they received to adapt to a new culture experience and barriers to their successful adaptation to a new cultural experience while enrolled in a southern California university.

Methodology:

Qualitative research was the methodology used for this study because it was the approach best suited to gain a better understanding of the phenomena of international students’ lived experiences. The present study involved a qualitative design with a phenomenological inquiry approach. The technique of using semi-structured interviews is a method …

Relationship Between Aprn State Practice Authority Perceived Autonomy, Professionalism, And Interprofessional Team Function Among A National Sample Of Aprns In The U.S., Patricia R. Gilman

Dissertations

Healthcare that includes high performing interprofessional clinical teams (IPTs) is one recommended strategy to provide optimal quality and cost-effective care delivery. Highly functional IPTs are characterized by effective communication, trust, respect, collaboration, information-sharing, and conflict resolution and are more efficient than individual providers working alone. Internally, IPT members' relationships and understanding of both one's own professional identity and others' role and responsibilities are crucial to team functionality and effectiveness. Externally, factors including regulatory practice environments might influence the effectiveness and performance of both individual team members and the team overall. Inconsistencies between states' practice authority (SPA) for advanced practice nurses …

The Impact Of Technology Centered Instruction And Implementation Measures On Student Performance, Daniel Kania

Dissertations

This study was conducted to compare the impact of technology-centered instructional methods on student performance in literacy to the impact of non-digital instructional practices. Additionally, this research was designed to identify specific program implementation measures used during the implementation of the prevailing instructional method and identify what link existed between these measures and the performance of students. The researcher examined quantitative and qualitative data obtained from both public data sources and from a survey administered to teachers in eight school districts in Missouri. The participants responded to questions that provided the researcher with quantitative and qualitative data to be used …

Decreasing Pre-Procedure Anxiety In School-Aged Patients In An Outpatient Surgery Setting Using A Video Prior To Anesthesia Induction, Michelle Charette

Dissertations

Anxiety occurs when a human feels a threat in response to a situation. Having surgery can heighten this psychological reaction, especially in pediatric patients undergoing anesthesia. Many children fear anesthesia for they do not understand what is expected of them nor what to expect when entering an operating room. When anxiety and fear are elevated, it can lead to behavioral changes, increases in postoperative pain, delays in wound healing, and postponement of discharge. Eliminating or reducing anxiety can result in positive outcomes for patients with pain, healing, and discharge. Literature supports the use of an educational video to aid in …

Effects Of Neuraxial Anesthesia On Readiness For Ambulation Following Total Knee Arthroplasty, James Thomas Papesca

Dissertations

Total knee arthroplasty (TKA) is the most commonly performed inpatient surgical procedure within the USA and is estimated to reach 3.48 million procedures annually by 2030. An aging population with multiple health conditions coupled with value-based care initiatives focusing on the trend toward outpatient care and patient satisfaction, has prompted healthcare providers to develop and implement an anesthetic approach to enhance TKA outcomes. The American Association of Hip and Knee Surgeons acknowledges the movement toward outpatient TKAs emphasizing minimal complications and maximizing patient safety. A review of current literature identifies causative factors delaying hospital discharge following TKA ranging from postoperative …

The Effectiveness Of Preoperative Preparation Program In Decreasing Parental Preoperative Anxiety, Thao L. Tran

Dissertations

This project aimed to examine the effectiveness of a preoperative preparation program (PPP) in decreasing parental anxiety. When children needed anesthesia to get outpatient procedures completed, the accompanying parents received verbal education about the process on the day of the procedure and were assisted by a support person during and after the child's induction anesthesia. Parental anxiety was measured using the State-Trait Anxiety Inventory (STAI) tool before preoperative preparation and after the induction of anesthesia to assess whether the PPP improved parents' anxiety levels. The parents' decreased anxiety score in post-intervention would suggest that the PPP can be effectively and …

Toward Enhancement Of Clinical Judgment And Critical Thinking Simulation In The Classroom, Roxie L. Barnes

Dissertations

Health-care systems are changing, thus changing the expectations and requirements for nursing students entering the profession (Kaddoura, 2011). Nursing education must address the changes and focus on the development of critical thinking and clinical reasoning. When students are unable to apply clinical reasoning or clinical judgment into practice, there is an increase in potential for negative patient outcomes (Jones, Passos-Neto, & Braghiroli, 2015). Case-based learning (CBL) and simulation-based learning (SBL) are both active learning methods that can enhance development of critical thinking, clinical reasoning, and clinical judgment (Forneris et al., 2015). The purpose is to compare the use of CBL …

Oral Medication Adherence, Attitude, And Quality Of Life In Older Adults With Cancer: The Impact Of Motivational Interviewing, Janelle Tipton

Dissertations

Oral medication adherence in the older adult with cancer, age 65 years and older, is a significant clinical problem. Adherence rates are estimated at only 50%, which can lead to suboptimal treatment efficacy, poor symptom control, and reduced survival. Patient attitudes and beliefs can improve oral medication adherence and quality of life, while reducing unnecessary emergency room visits, and hospitalizations. Motivational interviewing (MI) is a communication intervention that has been shown to improve oral medication adherence in persons with chronic illness, including cancer. The purpose of this evidence-based practice (EBP) project was to explore the influence of MI on adherence …

A Web-Based Learning Adaption Of The Ending Self-Stigma (Ess) Program, Shari Harding

Dissertations

The purpose of this practice project (SPP) was to implement and evaluate a web-based learning adaptation of the Ending Self Stigma (ESS) curriculum, a group-based program to reduce mental illness self-stigma. The literature currently supports group-based, psychoeducational, face-to-face interventions for self-stigma. This project adapted current evidence-based content to the web-based learning modality as an individual, technology-based, intervention. The intervention was evaluated using a mixed methods approach with a pre- and post-test design among adults receiving outpatient mental health services. The dependent variables of interest in this project were the self-stigma of mental illness and recovery orientation. This study found that …

The Student Voice: Experiences Of First-Generation, Adult, Latino Male Tutees Learning Within A Peer Tutoring Environment, Shawn M. Carney

Dissertations

Purpose: The purpose of this qualitative, single-site case study was to identify and describe the lived experiences of first-generation, adult, Latino male tutees utilizing peer tutoring services within the Solano Community College (SCC) learning assistance center (LAC), concerning readiness, challenge, support, and balance as they applied to motivation to learn and personal academic growth.

Methodology: Fifteen participants were selected through a purposeful sampling process, and data were collected and analyzed through semi-structured, open-ended interviews to develop common themes with tabulated results presented via frequency tables.

Findings: First-generation, Latino, male tutees (1) sought tutors who were confident in the subject matter, …

The Marginalization Of Social Studies In Missouri: An Analysis Of Elementary Instructional Time And High School Standardized Assessment Scores, Stephanie Lovette

Dissertations

Social studies education plays a vital role in an evolving American society. Through social studies, students are equipped with skills to become active and informed citizens in a democracy (National Council for Social Studies, 2017a). With the implementation of the No Child Left (NCLB) Act in 2001, educational reforms have increasingly emphasized student performance in mathematics, communication arts, and science (Libresco, 2015). As a result, instructional time has been drastically shifted to these subjects (Heafner & Fitchett, 2015). This mixed-methods study was conducted to explore the impact of NCLB and subsequent federal education policies on the marginalization of social studies …

Relationship Between Perceptions Of Home Discharge Readiness And Parental Health Literacy (Phl) Of Nicu Parents Of Black Preterm Infants, Mia K. Waldron

Dissertations

The United States (U.S.) ranks last among western nations in overall infant mortality rates and ranks second highest in rates of preterm birth among the same nation group (MacDorman, Matthews, Mohangoo & Zeitlin, 2014). The U.S. infant mortality data show that Black infants have the highest incidence among all groups (Ely, Driscoll & Matthews, 2018; Murphy, Xu, Kochanek & Arias, 2018). Infants born prematurely are among those at highest risk for infant death with Black women delivering premature infants at rates higher than all other U.S. groups (Ely, Driscoll & Matthews, 2018; Murphy, Xu, Kochanek & Arias, 2018; Xu, Murphy, …

The Impact Of Breathing Retraining Education On Adults With Asthma For Improving Quality Of Life, Symptom Control And Reducing Short-Acting Beta-Agonist Inhaler Use In A Primary Care Setting, Danny Barazi

Dissertations

Quality of life related to asthma is negatively impacted when asthma is uncontrolled, which is characterized by frequent symptoms and rescue inhaler use which lead to limitations in normal daily activities. The goals of asthma therapy include infrequent use of short-acting beta-agonist (SABA, rescue) inhalers, prevention of acute and chronic symptoms while maintaining normal activity levels. While these goals of therapy employ infrequent use of SABA inhalers as the primary metric of effective asthma symptom management, measuring quality of life is also recommended as an important outcome of therapy and an approach to promote self-management in patients with asthma. One …

Communication Technology Within Community Colleges, Nicole Dunne

Dissertations

Purpose: The purpose of this mixed methods study was to explore and describe the communication technologies that community college students perceive are effective ways to receive information from their college. A secondary purpose was to explore and describe communication technology channels students perceive would be effective ways to receive information from their college that are not being used.

Methodology: This mixed methods research design used quantitative and qualitative data to inform the research questions in relation to community college students’ perception of communication technology effectiveness. The study was a sequential mixed methods study; the quantitative survey results helped to inform …

Perinatal Experiences Of Childbearing Women With Physical Disabilities, Serah M. Nthenge

Dissertations

Purpose: The aim of this secondary qualitative analysis was two-fold: to explore perinatal experiences of 22 women with physical disabilities guided by the perinatal health framework of women with physical disabilities and; construct two perinatal life stories of childbearing women with physical disabilities.

Method: The study participants were 22 women with physical disabilities who, at the time of pregnancy, used a mobility device, and had given birth within the last 10 years. The principal investigator of the primary study interviewed all the participants.

Findings: Nine themes were identified in our study. All the participants reported both a lack of disability-specific …

Community College Esl And English Composition Faculty Collaboration, Lynn Hovde

Dissertations

Purpose. The purpose of this study was to examine the collaboration between ESL and English composition instructors at the community college level using the Kolb and Gray (2005) collaboration leadership model in the areas of common mission, collective responsibility, necessary resources, respective and supportive climate, awareness of group process, creativity, and capacity to deal with conflict. A secondary purpose was to explore barriers to collaboration and describe what strategies and practices could improve collaboration.

Methodology. An explanatory sequential mixed method study was chosen because it offered a multifaceted and in-depth view of current practice, which allowed for a …

Guided Reflective Writing And Student Clinical Judgment Development: A Descriptive Study Of Nursing Student And Faculty Perspectives, Tanya L. Smith

Dissertations

Literature supports guided reflection and clinical judgment development as key components to enhancing students' knowledge and preparation for complex nursing care. Faculty are challenged to prepare new nurses to enter the complex health care arena and often note problems in helping students transition classroom learning to clinical application. The National Council of State Boards of Nursing (NCSBN) recognizes and supports teaching clinical judgment in nursing curricula to better prepare nursing students for professional practice (2018).

Assessment Technologies Institute Test Results And Blended Experiences For Senior Community Health Nursing Students, Linda Lacomb-Williams

Dissertations

The purpose of the study was to examine the relationship between senior community health nursing students' ATI test scores and their clinical community health nursing experiences, either in-country or out-of-country. The ATI test results are a reliable predictor of whether the student will pass their nursing board exams (NCLEX-RN). The study also examined whether the two groups of students reported any similarities and differences in their sense of confidence or transcultural self-efficacy and conceptual knowledge and their clinical experiences.

ATI test scores were reviewed for the two groups. Focus groups were held to discuss any similarities or differences in the …

The Use Of Flexible Seating In The Elementary Classroom, Pamela Erin Swofford

Dissertations

The purpose of this study was to examine the use of flexible seating in southwest Missouri classrooms. Four research questions guided the study based on the conceptual framework of Eric Jensen. The work of Jensen (2005) was selected as the conceptual framework due to his focus on the use of movement and how it impacts the brain. The research population consisted of 119 school districts from 25 counties in southwest Missouri. Participants in the study included elementary principals and classroom teachers in the first through fourth grades. Of the participants, 107 teachers completed a survey specific to the use of …

The Association Of Patients' Analgesic Treatment Beliefs And Trade-Offs With Analgesic Adherence Behaviors Among Outpatients With Cancer Pain, William E. Rosa

Dissertations

Pain is one of the most burdensome symptoms for patients with cancer. Per cancer pain guidelines, opioids remain one of the primary modalities for managing moderate to severe cancer pain. Analgesic nonadherence is common among cancer patients despite unmanaged pain symptoms. We investigated how patients prioritized analgesic treatment beliefs for cancer pain and whether those beliefs predicted objective analgesic adherence behaviors.

Increasing Breast Cancer Screenings Of African American Black Women, Marlene A. Griggs-Warner

Dissertations

Research shows that African American Black women have a high breast cancer mortality rate due to lack of breast cancer screenings. This quality improvement (QI) project evaluated if culturally-appropriate materials/education increased breast cancer screening rates of African American Black women living in a community in the southern portion of NJ. Kurt Lewin's theory of change encouraged African American Black women to change to healthier lifestyles by encouraging breast cancer screenings. Research also shows that the use of culturally-appropriate tools in clinical settings can improve patient outcomes for this population. Leininger's theory of culture care promoted clinical awareness of the African …

Lived Experience Of Being An Obese Registered Nurse: A Phenomenological Inquiry, Trina Rodgers

Dissertations

Research has shown obesity is a significant problem affecting the general-public and is increasing in prevalence among health care providers. The purpose of this descriptive phenomenological study was to understand the lived experience of being obese as a registered nurse. One-on-one interviews with 15 registered nurses, who had a personal experience with being obese as a registered nurse, were conducted. Data were collected through in-depth interviews, which were taped and transcribed verbatim. The data analysis was conducted manually to gain the true essence of the participant's lived experiences. The responses were analyzed, coded, and themed using Colaizzi's method of data …

Nurse Perception Of Technology Integration, Adrian D. Hordon

Dissertations

With the increase in technological advancements integrated into hospitals, physician offices, and nursing programs, there is concern regarding the imposition on the clinical foundation of nursing as a human improvement profession during the implementation of technology advancements. Technology can potentially serve as a distraction and even a false feedback loop for improved care, causing an impact on the fundamental quality of patient care. Mobile technology advancement such as Electronic Health Record (EHR) charting and smartphone use in the clinical nurse setting provides both prospects and challenges that have not been widely researched. This dissertation proposal examines registered nurse survey results, …

The Effect Of Treatment Modalities On Chronic Low Back Pain And Self-Transcendence, Grace Augustine

Dissertations

Chronic Low Back Pain (CLBP) is a common health problem that most people experience at some point in their lives. For the relief of pain, numerous studies have shown that pain medication causes several side effects and leads to mortality. This study focused on how an individual's choice of CLBP treatment modalities impacts utilization of the strategies of self-transcendence. Chronic low back pain prevalence shows a steady increase in the studies reviewed. Patients may improve in self-transcendence and well-being while they experience CLBP. Self-transcendence is a vital resource of well-being as people seek to manage CLBP.

Nursing Students' Perceptions Of Spiritual Well-Being, Academic Persistence And Academic Success, Mindy Barna

Dissertations

This qualitative phenomenological research study explores the perceptions and beliefs of undergraduate senior-level nursing students about spiritual well-being in relation to academic persistence and ultimately academic success as measured by timely graduation at a private women's university in the Midwest. By adding to the body of research and knowledge, nurse educators may better assist students to achieve academic success, which could potentially alleviate the national nursing shortage and decrease financial losses of academic institutions. Nine Bachelor of Science in Nursing (BSN) students at a private university in the Midwest participated in semi-structured, one-on-one interviews. Participants were in their senior year …

Psychometric Evaluation Of The Moral Comfort Questionnaire Among Hospital-Based Direct-Care Registered Nurses, Natalie Bermudez

Dissertations

Moral comfort, an emerging concept in nursing, is defined as an individual's feelings of ease with decisions and actions related to a moral dilemma. Moral comfort for nurses is the positive outcome of a moral situation or dilemma, while moral distress, a widely explored issue in nursing, is the negative outcome. However, nursing literature on the concept of moral comfort is limited. While several instruments to measure moral distress exist, an instrument to measure moral comfort was not found. The Moral Comfort Questionnaire (MCQ) was theoretically developed. The purpose of this study was psychometric evaluation of this new 35-item instrument.

Effects Of Evidence-Based Relaxation Techniques On Nurse-Patient Communication, Deborah Samuel

Dissertations

Occupational stress in nursing leads to poor patient and staff satisfaction making it essential to address stress among nursing staff and improving patient satisfaction. The purpose of this quantitative quasi-experimental quality improvement (QI) project was to determine to what degree evidence-based relaxation techniques, including music, deep-breathing, progressive muscle relaxation and guided imagery, using the transactional model would reduce stress levels among nursing staff and improve nurse-patient communication on a medical-surgical unit in a community hospital. Lazarus and Folkman's theory of stress and coping best explains stress levels and the need for alternate solutions. Data to evaluate stress levels was collected …