Digital Commons Network^™

A Constructivist Grounded Theory Of Spiritual Competencies Development In Counseling Supervision, Emmanuel Javert Nnadozie

Dissertations

Developing religious and spiritual competencies is paramount in the training of counselors to become effective in addressing clients’ religious and spiritual issues in counseling. Clinical supervision in practicum and internship courses is key to the development of these competencies, but questions as to how best they might be infused in counselor training remained. The purpose of the study was to create an explanatory theory of the process of the development of religious and spiritual competencies in clinical supervision. Utilizing grounded theory, experts in the field of supervision and spirituality were interviewed. The ways paradigm was used as a sensitizing concept …

Intimate Partner Violence Education For Pregnant And Postpartum Adolescents And Young Adults, Tatiana Filajdic

Dissertations

Abstract

Problem The commencement of intimate partner violence (IPV) often begins with relationships during adolescence and young adulthood; hence, young age is a risk factor. Young adult females, pregnant and post-partum adolescents are at high risk of experiencing intimate partner violence (IPV).

Methods A prospective, descriptive design evaluating the impact of three IPV education sessions offered over a three-month period at a non-profit shelter specific for young adult, pregnant and post-partum adolescents.

Results Twelve participants attended the sessions (N=12), and seven (n=7, 61.5%) of shelter residents attended at least one IPV education session. A two-proportion z …

Factor Structure And Construct Validity Of A Hospital Survey On Patient Safety Culture Survey Using Exploratory Factor Analysis, Maureen Falcone

Dissertations

Abstract

Objective: The purpose is to explore the underlying factor structure of the Hospital Survey on Patient Safety Culture Survey (HSOPS^®), to evaluate correlations between the factors, and to extend past work by further estimating its construct validity in a large sample.

Methods: A secondary data analysis using EFA and the AHRQ HSOPS^® database (December 2017 to October 2020), from nurses who shared their perceptions about hospital cultures of safety in the reporting of adverse events. Data were collected from 191,977 hospital nurse respondents in 320 U.S. hospitals.

Results: EFA obtained six factors with an eigenvalue >1 …

Factors Associated With Household Contacts' Tuberculosis Testing And Evaluation, Elvy G. Barroso

Dissertations

Contact investigation (CI) is one of the core elements of tuberculosis (TB) control. It is intended to achieve early identification of contacts who may have been exposed to a patient with infectious active TB and contacts who may benefit from treatment for latent tuberculosis infection (LTBI). LTBI is an infection in which the Mycobacterium tuberculosis organisms cause no signs and symptoms but the infection can be reactivated and develop into full-blown active TB disease. Failure to be identified as a contact is the primary reason for disease development in more than half of TB patients, thus a complete and timely …

Exploring Psychological And Situational Factors That Influence Female College Students' Participation In Oral Sex, Margaret Bergeron

Dissertations

Although sexually transmitted infections (STI) are not officially reported via the route of transmission, the CDC (2016) reports that individuals who provide fellatio have the highest risk of oral transmission of a STI. Therefore, females who engage in fellatio are at risk for acquiring a STI. The majority of research studies on young adult heterosexual female sexual activities primarily focus on vaginal sex and the associated risks of pregnancy and sexually transmitted infections. Limited research exists on the oral sex behaviors of female college students and their understanding of the risk for contracting an STI through fellatio. The purpose of …

The Lived Experience Of Being A Caregiver For A Family Member Dependent Upon Hemodialysis, Christine Kearney Turner

Dissertations

An identified gap in the literature exists regarding studies using an inductive approach that allow caregivers to describe the lived experience of caring for family members dependent upon hemodialysis for managing end stage kidney disease. This study used a purposive sample of six caregiver participants, male and female, with an average age of 36 using a descriptive, phenomenological approach designed to share experiences of providing care to a family member dependent on hemodialysis. The representative sample was recruited from a mid-sized hospital in the mid-Atlantic region of the United States. The investigator conducted face-to-face, semistructured interviews with participants. Using the …

The Effect Of Self-Management Support Interventions For Adults With Mild Traumatic Brain Injury And Family Caregivers, Ann Thaiudom

Dissertations

Purpose: This study aimed to examine the effect of a self-management support program for individuals with mild traumatic brain injury (mTBI) and their family caregivers.

Design: The study design was a two-group randomized control trial.

Method: A total of 73 mTBI patients and their primary family caregivers were randomly assigned to either the intervention group (n=36) receiving the self-management support program plus usual care or the control group (n=37) receiving only usual care. The self-management program was developed based on the Individual and Family Self-management theory, and relevant clinical practice guidelines. The program consisted of self-management support assessment at …

Leaders Of Change: An Exploration Of Relationships Between International School Administrators’ Mindsets And Their Preferred Leadership Styles, Joe Brogan

Dissertations

At the heart of educational leadership is the ability to manage change. Leaders who can successfully manage change invariably will be more effective. This is especially true in the often-transient world of international schools, where change happens frequently in response to evolving internal and external environments.

K-12 international schools that use the English language as the medium of instruction have proliferated since the end of the Cold War. There has been exponential growth, especially in China, India, and other developed and developing nations. The quality of leadership in these schools is extremely important to stakeholders, especially students, and, consequently, it …

Advanced Nursing Education: Critical Factors That Influence Diploma And Associate Degree Nurses To Advance, Rose L. Mcghie-Anderson

Dissertations

Advanced nursing education needs to be pursued along the continuum of the nursing career path. This education process is indispensable to the role of the nurse as educator, manager, nurse leader, and researcher who will effect policy changes and assume leadership roles as revolutionary thinkers in addition to implementing paradigmatic shifts.

This grounded theory study sought to unearth the critical factors that motivate nurses to advance academically. The study aimed to gain an understanding of the social processes associated with the decision of diploma and associate degree nurses to advance their nursing education.

Clinical Nursing Faculty Perceptions Of Undergraduate Baccalaureate Nursing Student Stress In The Clinical Environment, Catherine A. Stubin

Dissertations

High stress levels are experienced by student nurses throughout their professional education, with the chaotic ever-changing clinical environment being a predominant source of stress. Clinical nursing faculty have a critical role to recognize the stress their students experience in the clinical environment and understand its significance.

A qualitative descriptive design was used to provide a rich description of clinical nursing faculty perceptions of undergraduate baccalaureate nursing student clinical stress. A purposive sample of 14 clinical nursing faculty with at least 4 semesters of clinical nursing faculty experience from accredited, generic baccalaureate nursing programs in the Northeast region of the United …

Emotional Responses And Mother-Infant Interactions Of Mothers With Early-Preterm, Late-Preterm, And Full-Term Infants In Malawi, Kaboni Whitney Gondwe

Dissertations

Malawi has the highest preterm birth rate in the world and preterm birth contribute to more than one-third of the neonatal deaths annually. Malawi is also faced with limited resources, both human and material. The lack of incubators led to the adoption of Kangaroo Mother Care (KMC) as routine care for preterm infants. Families also provide support, physical and emotional during this entire period. Evidence from developed countries has shown that preterm birth contributes to maternal emotional distress (depressive, anxiety, and posttraumatic stress symptoms and maternal worry about child's health) and fewer maternal and infant interactive behaviors. The majority of …

The Relationship Between Nursing Unit Culture And The Use Of Evidence-Based Practice Among Nurses In Hospitals, Jin Jun

Dissertations

Evidence-based practice (EBP) has been the gold standard for clinical practice. However, the use of EBP by healthcare providers, including nurses, has remained at suboptimal rates. Though researchers have examined various factors that influence nurses' use of EBP, studies of more complex organizational factors are limited. Nursing unit culture, which encompasses unique shared values, beliefs, and assumptions, may be one of the driving forces in determining nurses' behavior, leading to variation in the use of EBP. The purpose of this study was to examine the association between nursing unit culture and the use of EBP among nurses in hospitals under …

An Examination Of Summer Melt For Trio Talent Search And Upward Bound Alumni, Jasmine D. Clay, Jasmine C. Lewis

Dissertations

College access programs provide middle and high school students with essential skills to prepare them for a successful transition to postsecondary education. TRIO Talent Search (TS) and Upward Bound (UB) are federally funded programs established to strengthen the likelihood that students from underserved groups will graduate high school and pursue higher education. Both programs offer support to low-income and first-generation students to ensure equitable access to higher education. While these programs offer a holistic approach to student development, including personal and professional support, some students from underserved groups experience challenges during the summer months that prevent them from enrolling in …

Predictors Of Early Rehospitalization Among African American And Caucasian Women Hospitalized With Heart Failure, Carolyn B. Sue-Ling

Dissertations

Heart Failure remains a complex clinical syndrome that affects all races and backgrounds. Periodically individuals with a heart failure diagnosis will require hospitalization during the course of the disease progression. Consequently, early and repeated rehospitalizations for acute exacerbations presents additional social and economic difficulties. Prior research demonstrated that elderly African-American and Caucasian women account for a large proportion of the population at risk for future heart failure hospitalizations along with readmissions within 60 days of discharge. Unfortunately, the literature remains unpredictable or largely non-existent regarding the unique associations between risk predictors for heart failure and early (31 to 60-day) heart …

Improving Postpartum Hypertension Discharge Education: A Pilot Project, Kathryn Barth

Dissertations

Problem: Hypertensive disorders of pregnancy (HDP) are a leading cause of maternal morbidity, mortality, and postpartum readmission. Several evidence-based algorithms and protocols have been implemented in the inpatient setting to treat severe blood pressure and prevent complications. However, there remains an opportunity to improve the postpartum care transition and discharge education for patients with these conditions in an attempt to decrease 30-day postpartum hypertension readmissions.

Methods: This pilot project utilized a descriptive design and took place on a postpartum unit at a Midwest metropolitan high-risk obstetrical teaching hospital. Interventions included patient-specific discharge education, distribution of a home blood pressure …

Liquid Biopsies For Type 2 Diabetes Mellitus: Biomarkers For Disease Risk And Diagnosis, Stephanie Chidester

Dissertations

Background: Type 2 diabetes mellitus (T2DM) has reached epidemic proportions in the United States. There is a critical need for earlier and more effective screening and diagnostic tools. Innovative liquid biopsy technologies may play a key role in meeting this need. Liquid biopsies are a non-invasive, adjunctive tool for determining diagnosis, prognosis, and therapeutic response. This dissertation focuses on two potential applications of liquid biopsy technologies to T2DM: (1) epigenome-wide association studies to identify epigenetic markers of risk for T2DM, and (2) extracellular vesicle (EV)-based biomarker studies to identify and detect markers associated with T2DM development and progression. Dissertation studies: …

Quality Improvement: Improving Type 2 Diabetes Self-Management And A1c Levels In Older Adult Veterans Using An Automated Message System, Danielle Brunson

Dissertations

Background: Diabetes mellitus is prevalent among the US population; particularly type 2 diabetes. As the population ages, the number of adults 65 years of age or older with diabetes is increasing. Diabetes is also common among U.S. veterans. Approximately 25% of U.S. Department of VA patients have diabetes. Evidence demonstrated a prevalence of diabetes among older veterans. Innovative approaches to improve diabetes care and health outcomes for veterans are needed.

Aim: This quality improvement (QI) project examined the use of a unidirectional automated text message system (Annie) to improve self-management behaviors of veterans with Type 2 diabetes, as evidenced by …

Postpartum Patient Teaching Success: Implications From Nursing And Patient Perspectives, Dawn Day

Dissertations

A recent examination of postpartum patient satisfaction scores in an inner-city hospital revealed decreased satisfaction of discharge teaching practices. Guided by Knowles' model of andragogy and Donabedian's model of structure-process-outcome, the purpose of this study was to gain an understanding of how the structure and process of discharge teaching practices impact successful postpartum teaching. This mixed-method, concurrent study examined the structure, process, and outcome of postpartum patient discharge teaching practices. A convenience sample was used to obtain 138 patient surveys, observations of 15 nurses completing discharge teaching, and 15 face-to-face patient interviews. Data analysis included the use of Spearman's rho, …

Breastfeeding Intention And Initiation Among Rural, Low-Income Native Americans And African American Adolescent Mothers In North Carolina: Testing The Theory Of Planned Behavior, Cynthia H. Herndon

Dissertations

Infant feeding practices can greatly impact a child's life with far reaching implications based upon decisions a mother makes for her newborn. Breastfeeding is the preferred method of infant feeding because of its association with health benefits to both the mother and child. The prevalence of breastfeeding among rural, low income, disadvantaged groups to include Native American (NA) and African American (AA) adolescent mothers is low. NAs and AAs bear a disproportionate burden of illness and health risks compared to other races and ethnic groups in the United States. Breastfeeding is a targeted public health strategy to improve the health …

Minimizing Workplace Violence By Initiating An Evidence-Based Community Meeting, Olivia Gabrielle Foster

Dissertations

Problem: Workplace violence (WPV) in healthcare has become an epidemic demanding change. WPV is three to four times higher in the healthcare industry compared to other workplaces. For this project, WPV will be defined as any act of physical violence from a patient to a staff member. Community meetings are one evidence-based approach to decreasing WPV in psychiatric inpatient hospitals. Methods: This descriptive observational project compared data before and after implementing a targeted WPV community meeting, including unit rules, staff and patient expectations, a definition of WPV, and medication options available to reduce anxiety and irritability. This project …

Certified Clinical Nurse Leaders Not Hired Into The Formal Role: Job Title Survey And Systematic Review, Jacqueline Alexander Clavo-Hall

Dissertations

The purpose of this study is to answer the following questions: (1) To what extent do NHA CNLs report engaging in CNL competency-based activities in their current positions? (2) Does NHA CNLs' engagement in CNL competency-based activities vary by job titles? (3) What roles were certified CNLs enacting if they were not hired into officially titled CNL roles?

The Knowledge And Attitudes Of Oncology Nurses On Advance Directives, Bailey Nettles

Dissertations

Advances in healthcare technology has changed how healthcare professionals care for patients, increasing the importance of Advance Directives (ADs). ADs are legal documents describing patient end-of-life care wishes. Despite the usefulness of ADs, particularly in oncology settings, most patients do not have one.

This qualitative content analysis study examined knowledge and attitudes of ADs among oncology nurses to obtain a better understanding of ADs. Literature on ADs and nurses is dominated by quantitative research. This study addresses knowledge gaps best filled by qualitative methods.

Ten experienced oncology nurses answered eleven open-ended questions using online video conference interviews. The eleven questions …

An Examination Of Medical Resident Practices Regarding Patient Communication About Infant Safe Sleep Practices, Summer Samir Chahin

Dissertations

Infant mortality is a significant public health concern in the United States, particularly because of the large racial disparities in death rates. In particular, Black infants die at a rate twice that of white infants (Center for Disease Control, 2016). Sleep-related deaths are one of the most preventable causes of infant mortality. In Kalamazoo, Black and multi-racial infants account for the majority (3 out of 4) of sleep-related deaths (Sleep-Related Infant Deaths in Kalamazoo County Fact Sheet, 2017). To reduce sleep-related deaths, the American Academy of Pediatrics published recommendations for safe sleep practices (American Academy of Pediatrics, 2016).

Unfortunately, caregivers …

A Mixed-Method Study On The Online Learner Readiness Questionnaire Instrument At A Midwest University, Sky Toland

Dissertations

Online learning readiness is a field of study that has emerged and become increasingly relevant over the past two decades. Several instruments have been developed and used to measure readiness for online learning in college students. The Online Learner Readiness Questionnaire, or OLRQ, sought to measure student readiness for online asynchronous learning through a 30-question instrument. The OLRQ generated feedback for students, based on their answers; this feedback was designed to address both strengths and areas of deficiency, giving specific guidance on how to strengthen these areas. Literature in this field typically fell under the larger umbrella of online and …

The Effect Of Preschool And Kindergarten Participation On Later Achievement Of Language-Minority Student, Xin Li

Dissertations

Evidence has suggested that preschool and kindergarten experiences affect the cognitive and social-emotion development of language-minority students (LMS). This quantitative study aims to illustrate the LMS’ preschool and kindergarten experience by investigating the preschool and kindergarten experience, family environment, and school environment. Longitudinal data from the U.S. nationwide Early Childhood Longitudinal Study, Kindergarten (ECLS-K), was used to apply a hierarchical linear model (HLM). Due to a gap in the literature regarding how school and family environments influence the holistic development of LMS, this study explores whether and how preschool and kindergarten experiences are associated with LMS’ cognitive and socioemotional outcomes …

Predictors Of First-Time National Board Passage For Respiratory Therapists, Jennifer Kay Riggs

Dissertations

Respiratory therapists fulfill a vital role that saves and improves lives. To achieve recognition for their knowledge, unique skills, and dedication to clinical excellence, they must pass a series of national board exams. Achieving credentials from the National Board of Respiratory Care (NBRC) is a challenge, a true testament to the skills and strengths required for excellence in the profession. The problem prompting this study is the number of respiratory graduates who are not passing the Therapist Multiple Choice (TMC) exam on their first attempt. The goal of respiratory programs is to prepare graduates for success on the TMC exam …

Delegitimizing Animal Rights And Environmental Activism: A Critical Discourse Analysis Of “Eco-Terrorism” In Congress And The Federal Courts, Joshua Varnell

Dissertations

Research on eco-terrorism has focused attention on many areas, from the analysis of the language used in specific pieces of legislation targeting animal rights and environmental activists, like the Animal Enterprise Protection Act, and the Animal Enterprise Terrorism Act, to the appropriateness of labeling individuals and groups eco-terrorist and/or terrorist given their non-violent stance and direct action campaigns which target property not people, and to law enforcement responses to those labeled eco-terrorist (Del Gandio and Nocella II 2014; Lovitz 2007; Carson, LaFree, and Dugan 2012; Loadenthal 2013b, 2014). The eco-terrorist discourse produces images of animal rights and environmental activists as …

Encouraging Activism In Secondary English: Reading And Writing For Social Justice, Elisabeth Spinner

Dissertations

This dissertation presents researched backed, social justice oriented teaching strategies secondary English teachers can implement to encourage their students to think critically and take action on issues that matter to them. Foundational to this research is critical inquiry which encourages students to not read or listen to information passively, but rather to investigate, critique, explore, and ask questions of what they are reading. This approach is necessary when encouraging students to dispel myths and stereotypes, understand questions of rights and justice, and find the right way to be involved. The English classroom is an ideal place for students to do …

The Manufacturing And Engineering Partnership Program: An Examination Of A Partnership Between Manufacturing And Cte, Laura Schoenborn-Preuss

Dissertations

Manufacturing is struggling to find people to fill open positions in the various career opportunities they represent. The skills gap or skills needed by manufacturers has caused challenges in filling those open positions. Adding to this dilemma is that student interest in these careers has reduced, with the focus being on obtaining college degrees right out of high school. Due to these changes, manufacturing and education are partnering in ways to increase student interest and fill open positions.

This study is looking to better understand one such partnership and how the activities students’ experience influence their career decision making. The …

Generation Status, Ethnic Identity, Colonial Mentality, And Enculturation In Filipino Americans, Kamille Patricia Urmaza La Rosa

Dissertations

Filipino Americans’ psychological experiences pertaining to their generation status, ethnic identity, enculturation, and colonial mentality are rarely studied in counseling psychology due to inconsistent disaggregation of Asian American and Pacific Islander (AA&PI) data (Agbayani-Siewert, 2004; Espiritu, 2003; Nadal et al., 2010; Okamura, 2013). Literature suggests that the study of these constructs related to their mental health can guide more culturally informed care for this historically excluded population (David & Nadal, 2013; Nadal, 2020). The current study used an exploratory design to test six research hypotheses and accomplish the following: examine relationships between the constructs, investigate intergenerational differences, validate a measure …