Digital Commons Network^™

Neuroimaging In Headache Patients: The Sensitivity Of Computerized Tomography (Ct) In Missed Stroke Diagnosis, Elizabeth C. Heetderks-Fong

Dissertations

Stroke is the leading cause of disability in the US, costing $34 billion a year and affecting 800,000 patients. Early detection and treatment is the best way to improve outcomes. Yet, 12.5% of strokes are discharged from the ED within the prior 30 days, with headache the most common diagnosis. Neuroimaging, ideally, would catch an impending stroke, but head CT has variable sensitivity based on onset of symptoms and there are both Federal and provider-led (including Choosing Wisely and the American College of Radiology Appropriateness Criteria (ACR-AC) initiatives to reduce overuse of imaging.

This study examined variation in ED treatment …

An Evidence-Based Evaluation Tool To Assist Healthcare Providers In Their Assessment Of Effective Mhealth Applications For The Management Of Chronic Health Conditions, Sara Belle Donevant

Dissertations

Mobile health (mHealth) apps are considered a viable option to improve chronic disease management. Healthcare providers are now recommending mHealth apps for patient use to assist in managing chronic diseases. However, healthcare providers may have difficulty locating effective, evidence-based mHealth apps for patients as there are currently over 325,000 available health apps (Research2Guidance, 2017). Limited evaluation tools are available to assist healthcare providers in this process. Therefore, our goal was to develop an online mHealth evaluation tool to assist healthcare providers in the selection of evidence-based mHealth apps.

After creating a comprehensive pool of mHealth features, healthcare providers provided feedback …

Career And Technical Education Students Advancing To Higher Education Through Faculty Mentoring, Joneane P. Davis

Dissertations

Purpose: The purpose of this phenomenological study was to identify and describe the career technical education (CTE) mentoring experiences of adult learners who completed an allied health certification and subsequently went on to pursue higher education such as a bachelor’s degree, from the lens of Zachary’s four phase mentoring model.

Methodology: Semi-structured interviews were conducted with adult former CTE learners who advanced to higher education. Through purposeful sampling, 10 participants were selected to participate in the interviews. The interviews were recorded and the recordings transcribed. The data were coded and analyzed for common themes.

Findings: The data …

Barriers, Enablers, And Strategies Influencing Female Leaders' Career Advancement In The Nuclear Industry, Anesa Davis

Dissertations

Women entering science, technology, engineering, and math (STEM) occupations increased by 19% between 1970 and 2019, but at 74% of the STEM workforce, men still dominate the field (Martinez & Christnacht, 2021). In the nuclear industry, this disparity is most apparent with few women holding leadership roles within nuclear organizations (Kovaleski, 2014; Gaspar & Dubertrand, 2019). While research suggests that companies with women leaders in the manager level through the board level excel in organizational performance (Catalyst, 2007), a problem exists for women when trying to promote to leadership positions, especially to the C-suite in STEM fields (Warner, 2014).

Findings …

Examining The Relationship Between Perceptions Of Service Quality, Student Satisfaction, And Intention To Persist At Higher Education Institutions, Denise Hardesty

Dissertations

The importance of customer service quality in business industries has long been understood and studied, but to a lesser extent in higher education. The usage and application of the term customer service in higher education has been debated by those in academia. Using a correlational research design, this quantitative, descriptive study was conducted at a two-year community college and a four-year public university. A modified version of the Perceived Service Quality (PSQ) instrument was used to survey full-time, undergraduate students at each institution to examine perceptions of service quality and whether those perceptions impact a student’s decision to return the …

Comparison Of Counselor Job Satisfaction By Setting: Agency, Private Practice And Online, Leeanne Cravey

Dissertations

To answer the research question – “What intrinsic and extrinsic factors increase job satisfaction in private practice, online counseling, and agency practice?” – a survey was administered to assess demographic information and to rate 25 intrinsic and extrinsic components of job satisfaction. Individual components of job satisfaction with the strongest correlation to overall job satisfaction were identified, for the entire study sample and within the three different work settings (agency practice, private practice, and online practice). Due to the small sample sizes of demographic and work setting groups, no correlations with individual components of job satisfaction were statistically significant (all …

The Utility Of The Test Of Everyday Attention For Children (Tea-Ch) For Attention-Related Referrals, Ewelina Lakomy

Dissertations

The Test of Everyday Attention for Children (TEA-Ch) is a commonly used, UK-normed test to assess diverse attentional capacities in children and adolescents. Currently, there is insufficient evidence for the diagnostic utility of the TEA-Ch with ADHD in a U.S. population. The focus in this study was to investigate the relationship between the TEA-Ch scores test authors found to be most sensitive to ADHD in UK samples as well as the relationship of TEA-Ch scores to other measures typically used in the diagnosis of ADHD, including rating scales. Archival and prospective analyses of 121 subjects with mixed-clinical/ADHD diagnoses (ages 6–16; …

Two For The Price Of One! A Study Of Persistence Of Adult Education Students Pursuing A High School Equivalency Credentiial And A Study Of The Researcher's Experience Conducting That Study., Jacqueline Lynch

Dissertations

This two-in-one study was an exploration of persistence. The quantitative study explored the relationship between the self-efficacy and persistence of adult learners pursuing a high school equivalency credential. Bandura’s theory of self-efficacy and Lewin’s Force Field Analysis offered an effective framework for considering this relationship. The findings of this study were statistically insignificant due to the low response rate.

The second study, a qualitative study, was added to understand my experience trying to gather data during the quantitative study and to explore the implications of data collection, sharing, and use in the adult education field. Resource Dependence Theory (RDT) and …

Estimation Of Odds Ratio In 2 X 2 Contingency Tables With Small Cell Counts, Guohao Zhu

Dissertations

This study is focusing on properties of estimators of odds ratio or its logarithm in case of 2x2 tables with small counts. The odds ratio represents the odds that an outcome of interest will occur given a particular exposure, compared to the odds of the outcome occurring in the absence of that exposure. Both parameters are often used to quantify the strength of association of two binary variables and are common measurements reported in case-control, cohort, and cross-sectional studies.

Because of their wide applicability, both parameters, odds ratio, and its logarithm, have been intensively studied in the literature. However, most …

Examining Media Dependency And Parasocial Relationship On Protective Action Behaviors During Covid-19, Amy Hyman

Dissertations

The COVID-19 pandemic illuminated the significant role that mass media plays in disseminating messages to the public during disasters and public health crises. Information disseminated during a disaster influences individuals’ decision-making process regarding protective actions, or mitigation behaviors. This study examined the relationship between media dependency theory, parasocial relationship, and media effects (cognitive, affective and behavioral) during the COVID-19 pandemic. A quantitative approach was used with a convenience sample. The sample focused on residents in the state of Arkansas and specific generational cohorts. The results found that the generational cohorts had different media preferences during the height of …

Impact Of Counselor Wellness On Positive And Negative Consequences Of Covid-19 Shared Trauma, Monique Rahman

Dissertations

This study sought to explore how the shared trauma of the COVID-19 pandemic has impacted Texan counselors both positively and negatively, as well as the mediating or moderating effect of counselor wellness. Negative consequences of stress such as secondary traumatic stress, burnout and compassion fatigue were explored, but also positive consequences such as compassion satisfaction and post-traumatic growth. Measures such as the Five Factor Wellness Inventory (FFWEL), the Shared traumatic and Professional Posttraumatic Growth Inventory (STPPGI), and the Professional Quality of Life Measure (ProQOL) will be utilized in addition to demographic questions and COVID-19 stress related questions mirroring Park et …

Soliton Based All-Optical Data Processing In Waveguides, Amaria Javed

Dissertations

The growing demand for higher data processing speed and capacity motivates the replacement of the current electronic data processing by optical data processing in analogy with the successful replacement of electronic data communication by optical data communication. In a quest to achieve comprehensive optical data processing we aim at using solitons in waveguide arrays to perform all-optical data processing operations. Solitons are special nonlinear waves appreciated for their ability to conserve their shape and velocity before and after scattering. They are observed naturally in diverse fields of science, namely, nonlinear physics, mathematics, hydrodynamics, biophysics, and quantum field theory, etc. with …

The Evaluation Of Graduate Nurses' Performance Gaps In Blood Administration, Vanessa M. Schott

Dissertations

New nurse graduates are expected to help relieve the current and pending massive nursing shortage anticipated in the nursing field (Goode, Reid Ponte, & Sullivan Havens, 2016). However, there is a discrepancy between evaluations of new graduate readiness and the expectation to provide competent complex care. Ninety percent of undergraduate nursing education leaders feel new graduate nurses are prepared to practice, yet 90% of hospital nurse administrators disagree. When graduate nurses participating in nurse residency programs perform self-assessments on procedural readiness, emergency management and blood product administration/transfusion are frequently in the top three skills/procedures they feel uncomfortable performing independently. Yet …

The Lived Experience Of Becoming A Professional Nurse For Associate Degree Nursing Graduates: A Phenomenological Study, Jean L. Hershey

Dissertations

This qualitative study used a hermeneutic phenomenological design to investigate the lived experience of becoming a professional nurse for associate degree nursing graduates. The study looked specifically at the process of acquiring a professional identity for associate degree nursing graduates. The theoretical frameworks of structural functionalism and reference group theory provided the lens which guided the study. Structural functionalism is a sociological perspective describing how groups reproduce themselves by creating members whose behaviors and values correspond to the established group norms. A reference group is the social group which an individual uses to define attitudes, beliefs, and values which the …

The Female Overactive Bladder In Our Beverage-Centered Society: An Evolutionary Perspective, Sarah Becker Hortsch

Dissertations

Over recent decades, chronic disease has trended upwards, associated with the mismatch between our modern nutritional environment and our paleolithic genome. The beverage industry has exploded in sync with chronic conditions, including bladder symptomatology. This dissertation uses the logic and paradigm of evolutionary medicine to examine the modern beverage culture as a cause of the current high overactive bladder prevalence rates (17-31%, age dependent). A natural experiment exemplar concludes the dissertation with proof of concept that societal-wide influences to hyper-hydrate by drinking beyond thirst influences non-pathological changes to bladder state. The study is a secondary analysis with main outcome measure …

Determining The Needs Of Fathers Of Premature Neonates, Linda Ann Merritt

Dissertations

In order to practice true family-centered care in the NICU setting, a nurse needs to understand the perceptions and concerns of both parents of the neonate. Although research is emerging on fathers' perceptions and experiences, researchers have not examined fathers' needs with respect to sociodemographic factors and gestational age of neonates. The purpose of this study was to determine the needs of NICU fathers and if these needs differed based on sociodemographic factors and gestational age of neonates.

The Role Social Capital Plays In The Psychological Capital Of Registered Nurses Experiencing Second Victim Syndrome, Teresa-Lynn Hinkley

Dissertations

This study used an ex-post facto survey for data collection and structural equation modeling for data analysis to explore the combined relationship of psychological capital and social capital on the severity of second victim syndrome experienced by registered nurses. Specifically, this study sought to answer the following research question "To what extent does the relationship between psychological capital and social capital combine to predict the severity of SVS experienced by registered nurses following a precipitating event?" A second research question, aimed at explicating the relationships between the subconstructs of the three constructs of interest was "What are the relationships between …

Hypoglycemia Management In The Tnpatient Setting: Protocol Education For The Registered Nurse, Sarah Firmin

Dissertations

Hypoglycemia in the hospital setting is associated with increased mortality, morbidity, and an increased length of stay. In the clinical setting for this quality improvement project, there is an emergency standing order for the presentation of hypoglycemia. The purpose of the order is to direct the registered nurse to utilize specific measures when patient presentations are emergent. The literature review for this project provided an overview of quality improvement projects which had a focus on the care of patients with hypoglycemia. This project had the following specific aims: nurse knowledge related to diabetes and the treatment of hypoglycemia will increase, …

Predictors Of Quality Of Life In Thai Adults With Early-Stage Chronic Kidney Disease, Warissara Sorat

Dissertations

The incidence and prevalence of chronic kidney disease (CKD) are increasing worldwide. Persons with CKD constitute a large population with a high prevalence of morbidity and mortality in Thailand. Treatment of CKD generally involves a multidisciplinary team and requires a comprehensive assessment and aggressive treatment plan to improve the health status of persons with CKD to slow the disease progression. This study aimed to examine factors that influence quality of life among Thai adults with early-stage CKD and test the constructs of a complex model identifying individual and family factors, knowledge, depression, and self-efficacy related to self-management behavior and quality …

Impact Of End-Of-Life Education On Nurses' Moral Distress, Jenniffer L. Mullen

Dissertations

Moral distress is a state of concern or anxiety that occurs when there is a correct action to take but an individual's ability to take that action is constrained in some way. Nurses, especially those who work in intensive care units (ICUs), may struggle with moral distress due to feelings of futility when caring for end-of-life patients. The purpose of this 1-group pretest–posttest quasi-experimental study, guided by Lazarus's theory of stress, coping, and adaptation, was to determine whether End-of-Life Nursing Education Consortium (ELNEC) education reduces moral distress in ICU nurses caring for end-of-life patients. A revised Moral Distress Survey (MDS-R …

Electronic Health Record Instruction In First-Semester Nursing Students: A Comparative Study, Angela R. Ruckdeschel

Dissertations

The use of health information technology has been shown to have positive effects on patient outcomes and provider efficiency. New nurses make more than half of the 7 million lifethreatening medication errors that occur each year, and electronic health records (EHRs) have been shown to significantly reduce these errors. Nurses now are expected to enter practice with a solid foundation in health information technology and the use of the EHR. Unfortunately, the vast majority of nursing schools do not specifically train their students in effective EHR utilization. Academic EHRs (AEHRs) are software packages with learning features that can be incorporated …

The Impact Of Adverse Childhood Experiences And Forgiveness On Nurses' Capacity For Compassion Satisfaction, Anne D. Troy

Dissertations

The objective of this study was to examine the relationship between Adverse Childhood Experiences (ACEs), forgiveness and compassion satisfaction in nurses. In addition, the study sought to determine the impact of forgiveness, as a moderator on the relationship of adverse childhood experiences and compassion satisfaction. Lastly, this study explored which demographic characteristics serve as predictors of forgiveness and compassion satisfaction in a select population of nurses.

Quality Remediation Programs Lead To Successful Learning, Katherine T. Ralph

Dissertations

The mission of nursing programs is to prepare as many students as possible to pass the first-time attempt on the National Council Licensure Examination- RN (NCLEX-RN®). If a school's first-time pass rate drops below 80%, the school is at risk of being closed by the State Board of Nursing. Furthermore, a student's ability to work as a registered nurse (RN) depends on passing the NCLEX-RN®, and the overall impact on our nation's health due to the current nursing shortage.

The purpose of this study was to examine the policies and strategies used in nursing programs to increase NCLEX-RN® first-time attempt …

Preparing Nursing Students To Respond To Disasters: Faculty Perspectives, Melissa Jayne Freshwater

Dissertations

This mixed methods study explored emergency preparedness and disaster response in the concept-based learning curriculum adopted by the Alabama Community College System (ACCS) in 2016. The concept-based curriculum employs active learning in lieu of the traditional lecture-style teaching methods.

This study addressed the problem that educators may be unfamiliar with this content and are unsure how to present this material to students. The purpose of this study was to gain insight on teaching methodologies, to better prepare nursing students on this content.

Kolb's 1984 Experiential Learning Theory was the framework that parallels closely with this curriculum. Kolb emphasizes four stages …

Bedside Counseling For Medical Inpatients Who Misuse Alcohol, Lise Anne Cooper

Dissertations

This dissertation addresses the process and results of a program implemented to motivate patients that are admitted to a medical center with diagnoses of alcohol misuse to seek addiction recovery. The primary research question is: How does bedside addiction counseling reduce the patient's number of readmissions and length of stay? This is a comparative, interventional mixed methods study. This study also examines the methods used to identify the inpatients at the medical center that are admitted with alcohol misuse, and how that identification process initiates treatment.

Measuring Knowledge And Behavior After An Educational Program On Air Pollution As A Health Risk Reduction Strategy, Mary Eileen Guerin Kloster

Dissertations

Potential exposure to indoor and outdoor air pollution must be considered as part of an overall health risk reduction strategy. Toxicants identified in outdoor air pollution, fine particulate matter (PM2.5), and photochemical ozone cause a systemic inflammatory response to the heart and lungs after exposure. Inside the home, health issues from exposure to carbon monoxide (CO), PM2.5, nitrogen dioxide (NO2), and volatile organic compounds (VOC) are intensified when the home is sealed with the windows and doors closed. This explanatory study sought to promote health by teaching participants about strategies to reduce risks related to indoor and outdoor effects of …

Celiac Disease: Examination Of Executive Function And Social Phobia Among Female College-Aged Students, Jacqueline M. Arnone

Dissertations

This study compares traditional age female college students (18-25) diagnosed with celiac disease (CD) to age matched controls on measurements of executive function (EF) and social phobia (SP). Although previous research in this area has been mixed, a preponderance of the evidence from these studies suggests that CD impacts cognitive functioning as a whole; executive functioning in particular. However, most of the literature in this area focuses on age groups outside of the normal traditional college age range. No research to date has examined executive functioning or social phobia among 18-25-year-old female college students with CD. Bronfenbrenner's Bio-Ecological Systems Theory …

Family Dementia Caregivers' Perceptions Of The Virtual Dementia Tour®: A Changed Reality, Candace Currie Harrington

Dissertations

Family dementia caregiving involves many challenges that often lead to stress and frustration. A subjective understanding of the daily struggles associated with dementia is not possible unless one has the disease; therefore, the family dementia caregiver's perception of dementia might be incongruent with their family member's lived experience.

The Virtual Dementia Tour® (VDT) provides a vicarious first-person perspective for six of the most common symptoms of dementia. Although extensive evidence supports the use of the Virtual Dementia Tour® in the healthcare profession and education, no research studies were found investigating the Virtual Dementia Tour® with family dementia caregivers.

Nurses Caring For Birth Tourism Families In Neonatal Intensive Care Units: A Phenomenological Inquiry, Tamara Lacroix

Dissertations

Birth tourism families plan their birthing experience that includes purchasing a maternity care package, traveling internationally to a preferred destination, and the delivery of a healthy newborn in an expected short hospital stay. However, some families admit a premature or ill infant into a South Florida neonatal intensive care unit. When admitted into this setting, neonatal nurses are unique in providing quality nursing care to birth tourism infants and their parents as a family unit. There remains a gap in nursing research in understanding neonatal nurses' lived experience caring for birth tourism families in the neonatal intensive care unit.

The …

Dispositional Mindfulness In Senior-Level Nursing Students: Examining The Relationship To Situation Awareness And Clinical Outcomes, Deborah L. Struth

Dissertations

Experts in the study of ergonomics and human performance factors have described the 'collective mindfulness' of nurses as a critical element to the attainment of highly reliable safety within patient care delivery. Little research exists related to the construct of mindfulness and its impact on safe nursing practice and situation awareness by the nurse.