Digital Commons Network^™

Development Of An Instrument Measuring Existential Authenticity, Misty M. Richmond

Dissertations

The purpose of this study was to develop an instrument to measure existential authenticity in adults. Existential authenticity was defined as awareness of the existential givens in the human experience as defined by Irvin Yalom. This construct is theorized as the goal of existential psychotherapy, which is a meaning-centered psychotherapy aligned with the purpose of providing clients with the tools to cope with life's negativities and live a meaningful life. Many diagnostic conditions, including depression, psychological trauma, and anxiety, are conceptualized as amenable to the benefits of existential psychotherapy and the journey towards existential authenticity.

A Comparative Study Of Student Achievement And Teacher Perceptions Between Differently Structured Special Education School Districts, Leigha Wetter

Dissertations

In order to provide recommendations for special education service organization practices, the researcher investigated student achievement and teacher perceptions of differently structured special education school districts that collaborated with a special school district to provide special education services and schools that provided their own special education services. Through evaluating the varying school districts, this study aimed to address possible best practices within the structuring of the organizations to increase student achievement for students with special needs. In order to evaluate the organization of the school districts, the researcher analyzed the student achievement of special education students at the elementary and …

A Delphi Study Of Actions Needed For Active Shooter Preparedness To Lower The Number Of Casualties And Injuries During Active Shooter Incidents At K-12 Schools, Michael Maley

Dissertations

Purpose: The purpose of this Delphi study was to identify specific actions that experts perceive are needed for active shooter preparedness for educational facilities, to lower the active shooter incident casualties and injuries in the U.S. K-12 schools. The study also examined the degree of importance for the identified specific actions needed for active shooter preparedness at educational facilities and those actions most likely to be implemented.

Methodology: The research design for this study is utilizing the Delphi technique that provides a systematic process in collecting data of opinions from a panel of experts. The Delphi study includes collecting …

Personality Type, Self-Efficacy, And Learning Style Preference: A Quantitative Study Of Ninth-Grade Students In Missouri, Katie Lee Mock

Dissertations

Personality types, learning style preferences, and self-efficacy domains of ninth-grade students in southwest Missouri were explored in this study. The study was conducted to shed light on needs assessments used to identify learner differences due to the rise of mixed-ability classrooms. Five selected schools participated in the study during the 2019-2020 school year. The Big Five Personality survey was used to identify the dominant personality type of each participant: openness, conscientiousness, extroversion, agreeableness, or neuroticism. The Self-Efficacy Questionnaire for Children (SEQ-C) was used to identify the dominant self-efficacy domain for each participant: academic, social, or emotional. The Thinking and Learning …

Perceptual Differences Between Lighthouse Team Members And Non-Lighthouse Team Members Regarding School Attendance, Classroom Discipline, And School Climate In Leader In Me Schools, Nina J. Henson

Dissertations

The Leader in Me is a school approach with a focus on socioemotional education adopted by over 3,000 schools across the globe (Soutter, 2018, p.8). As culture continues to change with technology and new social aspects, character education programs must continue to adapt as well to support student needs within schools (Rocco, 2018). This quantitative study was designed to identify differences in perceptions of Lighthouse Team members and Non-Lighthouse Team members about how the Leader in Me impacts student attendance, classroom discipline, and school culture. Surveys were sent to educators in 22 schools in southern Missouri who had implemented the …

Exclusionary Beliefs, Multicultural Ideology, Empathy, And Perceived Threat: A Comprehensive Model Of Anti-Immigrant Prejudice, Reigna El-Yashruti

Dissertations

Despite the increased movement of people across national borders, anti-immigrant sentiment continues to pose challenges to immigrant mental health and disrupt intergroup relations. In the USA, where over 14% of the population is comprised of foreign-born individuals, immigrants continue to face prejudice from both the public and political administration. Intergroup Threat Theory (ITT) explains this prejudice as stemming from the perception that the out-group poses a threat to the cultural purity, economic stability, or physical safety of the in-group. Traits that promote group exclusion, such as perceived group superiority (i.e. Right-Wing Authoritarianism; RWA, Social Dominance Orientation; SDO, cultural dominance; CD) …

A Comparison Of The Effectiveness, Efficiency, And Post-Training Outcomes Of Traditional Behavioral Skills Training And Asynchronous Remote Training, Dani Pizzella

Dissertations

While applied behavior analysis (ABA) is the most commonly recommended therapy for individuals with Autism spectrum disorders (New York State Department of Health, 1999; Surgeon General, 1999), there is a significant lack of board certified behavior analysts (BCBAs; Bethune & Kiser, 2017; Maglione, Kadiyala, Kress, Hastings, & OʹHanlon, 2016). Telehealth may help to increase the availability of training in behavior analytic procedures, however, BCBAs have been slow to adopt remote training measures (Tomlinson, Gore, & McGill, 2018). This may be due to the in-vivo training requirements of common behavior analytic training procedures. This research compares traditional, face-to-face behavioral skills training …

Bridging The Gap In Primary Care Of Inflammatory Bowel Disease (Ibd) Patients, Deanna Dial

Dissertations

Abstract

Problem. Patients in rural or medically underserved areas (MUAs) with inflammatory bowel disease (IBD) have limited access to primary care preventative services, making them even less likely to obtain preventative care, placing them at even greater risk for adverse health outcomes.

Methods. A two-phase retrospective chart review utilizing a convenience sample of patients diagnosed with IBD from a privately-owned gastroenterology office to evaluate the effectiveness of increasing preventative screenings for IBD patients. The first review included 53 patients seen from January to April 2019. A preventative screening

evaluation tool (PSET) was developed based on literature recommendations, including the American …

Screening For Delirium In The Emergency Department, Melissa Minks

Dissertations

Abstract

Delirium is a problem for many older adults who are acutely ill. Delirium often comes on suddenly, can be severe, and is often difficult to diagnose, especially in the presence of dementia. Missed delirium has a mortality rate of 30.8% and costs millions. What is the purpose of this study?

Methods The 4A’s Test screening instrument was implemented and evaluated in the Emergency Department of a rural Midwestern hospital from May 1, 2019 through August 31, 2019.

Results There were 122 participants in the study with 61 in each cohort. In 2018, three (5%) were diagnosed with delirium without …

The Effectiveness Of Multiple-Choice Test Items In Assessing The Clinical Judgement Abilities Of Prelicensure Registered Nursing Students, Tracy D. Holt

Dissertations

The purpose of this study was to evaluate the effectiveness of multiple-choice questions in assessing the clinical judgment abilities of prelicensure registered nursing students. Nurse educators are responsible for ensuring fairness in testing and evaluating the development of clinical judgment abilities of students throughout the nursing program of study. This study compared multiple-choice test items developed using the current NCSBN® NCLEX-RN test item writing guidelines to multiple-choice test items developed using the new guidelines proposed by the NCSBN® Next Gen NCLEX-RN® project.

A Mixed- Methods Study Investigating The Perceptions Of Culture Among Faculty, Staff, Adjunct Instructors, And Administrators In A Four-Year, Private, Midwestern University, Amanda J. Price

Dissertations

This mixed-methods study investigated the different perspectives between faculty, staff, adjunct instructors, and administrators utilizing the Competing Values Framework developed by Cameron & Quinn (2011). The quantitative portion of this study analyzed how each employee type viewed the institution’s current culture and how these perceptions were similar or dissimilar to the preferred culture. The qualitative portion, on the other hand, aimed at understanding each group’s viewpoints on the university’s ability to achieve its mission and purpose, adapt and change, clearly communicate, and to effectively lead. These insights were necessary for the researcher to gain insight into the institution’s culture beyond …

Evaluation Of Sleep Hygiene Checklist For Delirium In An Intensive Care Unit, Ying Wei

Dissertations

Abstract

Problem: Delirium is a severe complication brought on by sleep deprivation that could increase mortality and prolong intensive care unit (ICU) stays in critically ill patients. This project aimed to develop and implement a sleep hygiene checklist to decrease the incidence of delirium in a Medical Intensive Care Unit (MICU).

Methods: This study used a pre-post design to compare the incidence of delirium pre-and post-implementation of the sleep hygiene checklist. Forty-four patients and thirty-six patients were recruited for the pre-and post-intervention groups, respectively.

Results: The result of this study demonstrated use of a sleep hygiene checklist could decrease the …

Evaluation Of A Type 2 Diabetes Mellitus Care Coordination Program, Carrie Smith

Dissertations

Abstract

Purpose: This Quality Improvement (QI) project evaluated the impact of an existing Diabetes Care Coordination (DCC) program at an urban clinic for clients with no health insurance in the Midwest. Diabetes related indicators of those enrolled in the DCC program and client reported barriers were documented over a 19 month period.

Sample: Clients included were 18 years and older, with no insurance, having the diagnosis of Type 2 diabetes mellitus, and were enrolled in the DCC program within the first six months of the program's initiation.

Methods: A retrospective chart review of 24 clients recording diabetes related outcome indicators …

The Development Of Science Identity In Undergraduate Stem Majors: A Case Study Of Urban High School Students, Charles Mcwilliams, Benjamin Nims, Kathleen Dwyer

Dissertations

The STEM fields, science, technology, engineering, and mathematics, face a significant challenge: the underrepresentation of women and minority racial groups entering STEM degree programs and careers. Addressing this STEM gap requires more than quality curriculum and educational supports; there is a need to understand the social psychological processes that influence students’ perceptions, motivation, and interest in STEM. The concept of science identity has been posed as a research perspective to understand participation and persistence in STEM. Enacting a science identity may include describing oneself as a scientist, having a high sense of self-efficacy to do scientific work, displaying an interest …

Optimizing The Effectiveness Of Peripheral Intravenous Catheters, Carrie Kollar

Dissertations

Problem Hospitalized adult patients require more than one short peripheral catheter (SPC) to complete the prescribed intravenous (IV) therapy due to catheter failure and the practice of resiting. The purpose of this quality improvement initiative was to increase the rate of SPCs remaining in situ for the entire duration of the IV therapy for hospitalized adult patients.

Methods Application of an engineered securement device (ESD), an educational program pertaining to modifiable risk factors, and changing the practice to removal upon clinical indication were methods utilized to reduce the number of SPC insertions and catheter failures. This study was conducted at …

Path Dependence In Geographic Crime Patterns, Theodore Lentz

Dissertations

This dissertation argues that status quo bias in crime location choice has substantial effects on geographic crime patterns. Offenders often re-select prior crime locations when they commit crimes. Mainstream theories argue this is because such locations are objectively more suitable for crime and thereby attract offending behavior at higher rates. I contend that locational suitability is only one consideration and that offenders may re-select a location that has been established as a status quo option, despite availability of more optimal alternatives. When individuals re-select prior crime locations, crimes will increasingly concentrate and create hotspots that are stable over time and …

A Phenomenology Study Of Possible External And Internal Factors Relating T Women’S Under-Representation In Leadership In Large Chinese Media Organizations In Beijing City, Xiaoxue Xiang

Dissertations

The purpose of this study is to gain a better understanding of possible factors that contribute to the underrepresentation of women in leadership positions in Chinese media through their lived experience. The 10 participants in this study were from large media organizations in Beijing. The results of this study indicate Balancing work and family and Chinese traditional culture can be considered as the external possible factors of the barriers women leaders encountered in Beijing large media organizations; the negative influence of traditional culture on Chinese women, which refers to women’s low self-evaluation and negative self-awareness, can be taken as the …

Cultural Homelessness, Self-Esteem, And Skin Color Satisfaction Among Latinxs, Josephine M. Almanzar

Dissertations

This study explored feelings of cultural homelessness, self-esteem, and skin color satisfaction among Latinxs. A close interest was placed in examining responses of participants who identified as racially Black or Afro-Latinx. Through an electronic survey, the study aimed to answer the four research questions: (1) Is there a correlation between cultural homelessness, self-esteem, and skin color satisfaction; (2) Do participants of different self-perceived skin colors differ in self-esteem, cultural homelessness, and skin color satisfaction; (3) Does age moderate the relationship between self-perceived skin color and self-esteem; and (4) Does age moderate the relationship between self-perceived skin color and cultural homelessness. …

Exploring The Impact Of Insecure Attachment Styles In Couple Adjustment Through The Lens Of Cluster B Pathology, Laura Bonnemort

Dissertations

The current body of research literature appears to lack adequate studies focused on individuals who possess an insecure attachment, potential cluster B personality pathology, and who are engaged in couple discord. The following clinical research project explored how insecure attachments impact the trajectory of both cluster B pathology and adult couples’ relationship discord. Studies reviewed included adults diagnosed with mood disorders, personality pathology, and those engaged in couples therapy due to dissatisfaction and discord. Developing an insecure attachment in childhood appears to place adults at risk for higher rates of personality pathology and risky romantic relationships fraught with discord. Evidence-based …

Improving Transitional Care In Rural Health Using A Standardized Discharge Time-Out Process, Lori Koethe

Dissertations

The process for transitioning patients from hospital to home is complex and fraught with opportunity for error. Increasingly, hospitals are tasked with regulatory, safety, and public expectation burdens to ensure that safe, effective transitions from hospital are well-planned, well-communicated and collaborative.

Transitional care processes are well documented in large, academic medical centers. Little evidence exists within the rural healthcare community. We sought to determine if the implementation of a discharge time-out could improve patient satisfaction and identify and correct errors prior to discharge.

Participation In Sporting Activities As A Mechanism For Enhancing Science Instruction, Erin Roades

Dissertations

ABSTRACT

After students have taken years of science classes, they still believe science content is disconnected to the “real” world or to their lives. Teaching without attention to relevance results in decreased motivation for learning and negative attitudes toward science. An instructional method incorporating physical, sport-related activities was used to develop relevance and enhance achievement in science compared to typical/traditional science instructional methods. In the typical method, science lessons consisted of front-loading science content through direct instruction followed by a laboratory activity to confirm lesson content. The experimental teaching strategy used was “Relevance Integration for Teaching Science using Sports Exploration” …

Investigations Into Economic Class And Retention Rates Of Nursing Students, Angela D. Martindale

Dissertations

This quasi-experimental, quantitative design based on a grand theory developed for this study explores whether a course designed to allow students to investigate their own environment will affect retention rates of nursing students. A convenience sample of 11 participants were recruited to take the course and data from 185 students was provided for the control group. The course was taken over the Summer and the retention was measured at the beginning of the Fall semester (R1), the end of the Fall semester (R2) and then at the beginning of the Spring semester (R3). The study demonstrated that there was a …

Multiple Case Studies Using Positive Behavioral Interventions And Supports, Stacy Brouillette

Dissertations

Purpose: The purpose of this replicated multiple case study was to describe practices of the implementation process of a schoolwide positive behavioral interventions and supports (PBIS) approach at three purposely selected Washington state middle schools.

Methodology: A descriptive, qualitative, replicated multiple case study approach was selected for this study. Artifact reviews were conducted and an appropriate data collection tool was utilized to collect data. Observations of the sites where PBIS was being implemented were conducted with an appropriate observation tool to gather data. Interviews were conducted with qualitative questions asked. These data collection methods were then triangulated to find patterns …

Psychological Factors Related To Physical Activity In Adult Congenital Heart Disease, Tyler Pendleton

Dissertations

Adults with congenital heart disease (ACHD) are a new and growing medical population. While medical interventions previously focused on reducing rates of infant mortality, current research suggests increased risk of premature mortality in ACHD may be partially due to acquired cardiovascular disease. One lifestyle intervention to reduce acquired cardiovascular risk is physical activity. Physical activity has been supported in the research as a safe, efficacious, and tolerable intervention for many ACHD; however, most patients do not engage in recommended levels of physical activity. The purpose of this study was to investigate psychological factors related to physical activity in ACHD. Participants …

Effective Paraeducator Implementation Of Behavior Intervention Plans For Students With Autism Spectrum Disorder: An Exploration Of Training And Support Needs, Kristen Nottle-Powell

Dissertations

Purpose: The purpose of this convergent mixed methods study was to describe the training and support paraeducators who work with students with autism spectrum disorder received as they implemented behavior intervention plans based on the Browning-Wright, Mayer, and Saren model. Additionally, this study sought to describe the training and challenges experienced by paraeducators, as well as their training and support recommendations for paraeducators who work with students with autism spectrum disorder with a behavior intervention plan.

Methodology: A convergent mixed methods study was used to describe the training and support experiences, challenges, and recommendations, as described by paraeducators …

Primary Care-Non-Profit Partnerships: Improving Ptsd Screening And Treatment Access For Veteran Patients, Nickolai Detert

Dissertations

Approximately 50% of 22 million American military veterans use civilian healthcare in addition to, or in lieu of, the Department of Veteran's Affairs health facilities. Studies find that theses veterans may have unidentified mental health needs and lack access to appropriate mental health services. Barriers to adequate mental health care include: (a) undisclosed veteran status; (b) stigma; (c) lack of cultural competency in civilian healthcare; and (d) an overall shortage of mental health services. With veteran post-traumatic stress disorder rates as high as 23%, we conducted a quality improvement project to improve veteran identification, mental health needs assessment, and access …

Postpartum Hemorrhage Evidence-Based Registered Nurse Staff Education Project, Jessica Powell

Dissertations

Despite medical technology and research advances postpartum hemorrhages (PPH) continue to be a leading cause of morbidity and mortality for pregnant women, even in developed countries. One possible explanation for PPHs continuing to be a leading cause of maternal death is inconsistent recognition and timely treatment of women experiencing a PPH. This doctor of nursing practice project attempts to improve labor and delivery nurse knowledge through an educational intervention which will contribute to rapid identification and treatment of PPH. Knowledge change was demonstrated though change in pretest and posttest scores. The educational information and process was guided by adult learning …

Measuring Active Clinical Decision Support Influence On Nursing Research Utilization, Susan Cortez

Dissertations

The focus of the research was to test the effect of Clinical Decision support on nursing evidence-based practice. The research method was quantitative with a longitudinal cluster randomized design. The study measured the effect of active clinical decision support on oncology nursing evidence-based practice in four oncology clinics associated with an academic medical center. The quasi-experimental study design contained an intervention and control group. The study intervention was active clinical decision support in the form of evidence-based drop down boxes in the nursing electronic documentation system.

Relationships Among Self-Management Ability, Cognitive Function, And Sleep Quality In Advanced Heart Failure Intensive Care Unit Patients, Elizabeth Ann Edmiston

Dissertations

As the amount of people with heart failure and treatment complexity increases, many hospitals are implementing Advanced Heart Failure Intensive Care Unit (AHFICU). The success of this new model of care depends on understanding unique characteristics of patients including factors related to self-manage ability, cognitive function, and sleep quality. Nursing interventions can be implemented to meet the needs of this population. Therefore, the purpose of this study is to understand the relationships among sleep quality, cognitive function, and self-management ability at discharge in patients in AHFICU.

Neurobiological Mechanisms Of Cognitive Processing Therapy For Post-Traumatic Stress Disorder: A Brain Network Approach, Tessa Vuper

Dissertations

Psychotherapy research is increasingly targeting both psychological and neurobiological mechanisms of therapeutic change. This trend is evident in and applicable to post-traumatic stress disorder (PTSD) treatment research given the high nonresponse rate of individuals with PTSD who undergo cognitive-behavioral therapy (CBT). A review of the literature investigating neurobiological mechanisms of CBT in PTSD reveals inconsistent results that fail to fully support dual process or learning models of CBT effects in the brain. However, network-based models of psychopathology provide a new framework from which to understand both mental disorder symptoms and therapeutic mechanisms. The current study investigated a) whether brain networks …