Digital Commons Network^™

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 …

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 …

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 …

Perceptions Of Associate Degree Nursing Students Regarding The Effects Of Pervious Work Experiences On Their Academic Progress, Latifah Davis

Dissertations

The purpose of this basic qualitative study was to explore how ADN nursing students eligible to graduate, with prior or concurrent healthcare work experience, describe their academic experiences and progress in an associate nursing degree program. The theoretical framework was Kolb's (1984) experiential learning theory and Knowles's (1980) adult learning theory. ADN students from three community colleges in the South Atlantic region of the United States were asked ten questions via face-to-face and telephone interviews. Three themes arose from the data analysis, valued work experience, financial obligations, and faculty support. All students verbalized that future nursing students should have some …

The Effectiveness Of Nurse-Led Diabetes Self-Management Education Among Adults With Uncontrolled Type 2 Diabetes Mellitus, Consolata G. Oronsaye

Dissertations

Ample evidence has supported the efficacy of diabetes self-management education (DSME) in diabetes care. However, specific evidence that supports the effects of nurse-led DSME on glycemic control and prevention of diabetes complications remains limited. The purpose of this quantitative, quasi-experimental project was to determine if any, and to what extent a relationship existed between a nurse-led DSME intervention and the lowering of FBS levels to 100mg/dl or below, and the reports of improved self-efficacy among patients with poorly controlled T2DM at a primary care clinic located in an underserved community in Northwest, Texas. Theoretical support for the project was drawn …

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 …

Contributing Factors To Diaper Dermatitis In The Nicu, Media S. Esser

Dissertations

Purpose: Describe the prevalence of diaper dermatitis (DD) and clinical characteristics of the infants in the Neonatal Intensive Care Unit (NICU) that develop DD. Explore the relationships between clinical characteristics and the development of DD.

Design: Retrospective, exploratory, descriptive study

Setting: Level IV NICU in an urban community in Southeast Wisconsin.

Participants: A convenience sample of 611 infants who were born and admitted to the NICU within 12 hours of life and discharged from the same NICU. A final total of 537 infants remained after exclusion criteria were met.

Methods: Data were collected from the participant's electronic health records from …

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 …

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 …

Baccalaureate Nursing Students' Attitudes Toward End Of Life Care: The Impact Of Simulation-Based Learning, Kristin M. Sagedy

Dissertations

All nurses may be obliged to care for patients at the end of life. Baccalaureate nursing education should prepare nurses to provide this care, but best practice for end of life care education has not been established. Nurses are not adequately prepared to care for dying patients and grieving families. This research study explored the effectiveness of low-fidelity simulation-based learning (SBL) activities on improving baccalaureate nursing students' attitudes toward end of life care. Junior-level baccalaureate nursing students participated in this quasi-experimental study. A standardized tool assessed students' attitudes toward end of life care before and after the SBL activities. While …

Identifying Transfer Of Care Gaps: Electronic Health Record Capture Of Perioperative Handoff Communications, Sharon Giarrizzo-Wilson

Dissertations

Transitions in patient care are held together by interdisciplinary handoff communications intended to coordinate the patient's ongoing care requirements. Patients with complexity in care encumber the transfer of care process requiring a higher level of care coordination between the interdisciplinary team (Coleman, 2003; Naylor et al., 2004). While the literature is abundant on the characteristics and quality of handoff communications, it is limited on the requirements of what data is necessary for ongoing care following transfer communications (Galatzan & Carrington, 2018).

Preliminary Efficacy Of A Nurse Led Brief Intervention Quasi-Experimental Pilot Study For Individuals Presenting To The Emergency Department With Risk For Alcohol Use Disorder, Felipe Gutierrez

Dissertations

The purpose of this study was to assess preliminary efficacy of screening for alcohol use and brief interventions (BIs) on patients who present to the emergency department (ED) at-risk for alcohol use disorder (AUD) utilizing established nurse navigators. This is the first study to assess the initial efficacy of a BI to reduce alcohol use in at-risk patients utilizing nurse navigators in the ED who were not bedside nurses.

Utilization Of A Clinical Decision Support System To Increase Chlamydia Screening Rates In Sexually Active Young Women: A Quality Improvement Project, Raine Martin

Dissertations

The objective of this Doctor of Nursing Practice (DNP) scholarly project was to implement an evidence-based intervention, the clinical decision support system (CDSS), and include education to promote increased routine chlamydia screening practices in an outpatient clinic. An additional objective was to assess CDSS usability using the System Usability Scale (SUS) to evaluate for project sustainability. The project design was a quasi-experimental study with post-implementation data collection with a comparison of norms of baseline chlamydia screening from the prior year. The project was completed over eight weeks. The project was implemented at a family health clinic located in a southcentral …

Clinical Factors That Influence Nurse Responsiveness In Activating Rapid Response Services, James Tormey

Dissertations

This study advances the understanding of essential clinical knowledge skillsets that nurses need to identify and respond to early signs of patient deterioration. The identification of critical thinking and assessment skills that nurses require may support professional practice through improved nursing education curriculum or additions of necessary critical care skillsets. The purpose of this study, which was framed by Benner's novice-to-expert model, was to identify and measure critical thinking skills that influence a nurse's ability to detect deterioration in patients and call the rapid response system (RRS). The research questions addressed the relationship between a nurse's clinical or reasoning skill …

Identification Of Cultural Differences And Their Effects On International Relations: A Novel Approach, Stephen W. Jones

Dissertations

International Relations suffers from underspecified treatments of culture that risk reifying, essentializing, or ignoring the effects of cultural differences in the conduct of relationships between states. Following a review of the development of the culture concept, this interpretivist, epistemologically critical realist, dissertation introduces intercultural adaptive frameshifting from the intercultural communication literature. To assess whether culture has effect within an epistemic community, four frameworks are evaluated within a non-IR field (global Christian reasoning). Speech act theory is used to assess meaningful affect through illocutionary and/or perlocutionary divergence based on cultural difference.

Following the findings that such cultural differences do in fact …

This Was The World And I Was King: Land And Identity In Scottish Children's Literature Of The Golden Age, Rodney Fierce

Dissertations

This dissertation focuses on Scottish cultural identity and its erasure in nineteenth-century British children’s literature as successful Scottish authors became known as British authors, and British children’s literature was canonized as the genre’s first Golden Age. Specifically, it explores the ways that Catherine Sinclair, George MacDonald, R. M. Ballantyne, Robert Louis Stevenson, J. M. Barrie, and Helen Bannerman—six popular nineteenth-century Scottish authors—maintain a sense of Scottishness in their adventure fiction. By reading the texts in the historical context of the authors’ biographies, I demonstrate that the land in their works and the benevolent colonizers allowed to control it in some …

Mobbing And Job Satisfaction Among Registered Nurses In Mississippi, Brenda Collins

Dissertations

The incidences of mobbing or workplace bullying are a common occurrence among nurses. The practice has been associated with overwhelming and long-standing comprising emotional, psychosomatic, and psychosocial distress. Mobbing (workplace bullying) impacts the target, those close to them, and the organization in which they work. The experience of mobbing produces affective reactions in the target. Affective experiences on the job can impact job satisfaction within organizations. Job satisfaction plays an essential role in sustaining an adequate nursing workforce. Subsequently, some nurses become frustrated and opt for resigning or early retirement when they are no longer satisfied with the culture or …

When You Play The Game Of Drones, You Win Or You Die: Examining The Role Of U.S. Drone Strikes In U.S. And English Language Allies Newspapers From 2008-2019, Melissa Aho

Dissertations

In the years following the terrorist attacks on September 11, 2001, the United States ramped up its usage of drones and drone strikes around the world. Spanning three United States’ presidents, drone strikes became a regular feature in the US military arsenal. While American newspaper media and citizens have been very pro-drone, global citizens view drones in a far more negative light. This study examines US military drone strikes and English-speaking allied newspapers in Australia, Canada, New Zealand, and the United Kingdom and evaluates if coverage remains positive or negative depending on the newspaper’s conservative or liberal leanings from 2008–2019. …

"Ain’T I A Woman?”: The Intersectional Representation Of Black Women Professional Leaders Above The Concrete Ceiling In Scandal And How To Get Away With Murder, Jessica Love

Dissertations

This dissertation investigates the politics of re-presentation of the two Black leading characters in Shonda Rhimes’s televised series, Scandal (Olivia Pope) and How to Get Away with Murder (Annalise Keating). This textual analysis explores how the characters are re-represented as leaders at the intersections of race, class, gender, and sexuality using Kimberlé Crenshaw’s (1989) theory of intersectionality. This study also imposes Patricia Hill Collins’s (2005) matrix of domination to explicate how the hegemonic structure of the concrete ceiling conditions their identities and exertion of power in the workplace. To do this, the researcher investigated cultural workplace expectations tied to notions …

Gender And Cross-Cultural Invariance Of Attitudes Toward Statistics Among Non-Stem Undergraduate Students, Mihili Edirisooriya

Dissertations

Because of the wide usage of statistics in almost every field, many universities have incorporated statistics into their undergraduate and graduate curricula. Students taking statistics have often reported negative experiences and an aversion to statistics. Non-STEM students have often reported negative attitudes toward statistics (Chew & Dillon, 2014; Keeley et al., 2008). Researchers have used qualitative and quantitative approaches to measure attitudes toward statistics. The Survey of Attitudes Toward Statistics-36 (SATS-36) scale has been the most widely accepted measure to investigate attitudes toward statistics. Any psychometrically sound measurement instrument requires invariance across groups in its usage. Otherwise, measurement biases could …

Honor And Duty: The Collegiate Education Of A Yeoman Farmer’S Son In Antebellum Mississippi, David Taylor

Dissertations

This endeavor reviews the mindsets and ideologies emerging from the South in the era known as "King Cotton," a time which predated the American Civil War and in which cotton was the primary export of the South. It is historically relevant to Higher Education in that it views this mindset through the eyes of young, white, single males and in particular, one male, a student of Mississippi College in Clinton, Mississippi. This description will focus on the years from 1850 to 1860 and this male population. This in no way degrades or neglects the contribution or inclusion of women in …

Estimating School-Level Effects Of Mandatory Student Grade Retention Policies Using Latent Growth Curve Modeling, Matthew Koziol

Dissertations

Mandatory grade retention for poor-performing readers has been a disputed practice for decades. Since the early-2000s, state-level mandatory grade retention policies have proliferated. In 18 states and Washington, D.C. mandatory grade retention exists for students in the third grade who fail an end-of-year standardized reading exam. These policies are based on research that suggests students who do not read by the third-grade are at much greater risk of dropping out of school prior to receiving a high-school degree. Mandatory grade retention policies use a gatekeeper mechanism at the end of the third grade to ensure that students who are not …

Doing More With Less: A Quantitative Analysis Of Mindfulness, Meditation, Sustainable Consumption Awareness And Practice Among University Undergraduates, Teresa Van Horn

Dissertations

ABSTRACT

Climate change, overconsumption, air, and water pollution continue to be pressing issues for society. Given the significant impact of overconsumption, the search for strategies to promote more sustainable behavior has become a topic for investigation. Universities are uniquely positioned to help students work toward sustainable solutions. This research explored the role of mindfulness in university students' sustainable consumption awareness and practice as there are gaps in the literature concerning definitions, constructs, and research regarding mindfulness and sustainable consumption.

To address these disparities, this research used stepwise regression analysis to investigate the extent to which mindfulness and select demographic measures …

Personal Data Privacy And Protective Federal Legislation: An Exploration Of Constituent Position On The Need For Legislation To Control Data Reliant Organizations Collecting And Monetizing Internet-Obtained Personal Data, Giovanni De Meo

Dissertations

In the past twenty years, the business of online personal data collection has grown at the same rapid pace as the internet itself, fostering a multibillion-dollar personal data collection and commercialization industry. Unlike many other large industries, there has been no major federal legislation enacted to monitor or control the activities of organizations dealing in this flourishing industry. The combination of these factors together with the lack of prior research encouraged this research designed to understand how much voters know about this topic and whether there is interest in seeing legislation enacted to protect individual personal data privacy.

To address …

Reproducing The Status Quo In The Middle School English Classroom: A Critical Examination Of Literacy Learning Via Personalized Learning Technology, Michele Mcconnell

Dissertations

Personalized learning technology (PL Tech) is a growing educational reform movement supported by federal grant dollars. As a bourgeoning educational movement, no research has been conducted to explore the potential effects of such structures in supporting student literacy learning. Additionally, current education reform research often lacks the perspective of the students experiencing the reform. Therefore, this study sought to examine the lived experiences of middle school students using PL Tech to understand what structural and cultural arrangements influenced students’ literacy learning.

Portraiture, a qualitative methodology, was employed to conduct the study at a charter school in Fresno, California implementing PL …

A Qualitative Exploration Of The Patient Care Experience As Perceived By Hispanic Patients Receiving Care At A Safety-Net Facility, Silvinia Cuizon

Dissertations

Purpose: The purpose of this study was to understand how English- and Spanish-speaking Hispanic patients seeking kidney and liver transplant care at a safety-net facility perceive and interpret the care experience with the goal of generating a grounded theory model to guide care delivery and improve perception of care for this population.

Background/Rationale: The patient experience is the current federally mandated hospital quality indicator that measures the range of interactions patients have with their hospital admission, which has fiscal and clinical implications for the delivery of care. Many safety-net health care delivery systems, which primarily serve traditionally underserved populations, and …

Exploring Generational Difference Of Acculturation, Ethnic Identity And Racial Identity In Liberian Immigrants And Their Children Living In The United States, Breezie J. Gibson

Dissertations

Prior literature on immigrants has focused on the impact of acculturation for groups such as Asians and Hispanic or Latinx immigrants (Orjiako & So, 2014; Sall, 2019). Compared to these two groups, the literature on Black immigrants’ experience of acculturation is scarce. In addition to the minimum visibility of Black immigrants in the acculturation literature, there is also limited knowledge relating to differences in the ethnic identity and racial identity of Black immigrants because these immigrants are often grouped monolithically with minimum attention to their diverse countries of origin. Understanding the influence of acculturation, ethnicity, and race is important because …

Contingent Reinforcement And Instructed Generalization In A Laboratory Analog Of Functional Analytic Psychotherapy: A Mixed Within-Group, Between-Group Design, Rebecca Rausch

Dissertations

Functional Analytic Psychotherapy emphasizes using social interactions in the therapeutic relationship to enhance interpersonal outcomes. The proposed mechanism of action in FAP is reinforcement provided by the therapist responding contingently to client improvements as they occur in session. The result is a stronger therapeutic relationship and improved social relating in daily life. Generalization is expected due to functional similarities inherent in interpersonal interactions and explicit attempts to link in-session learning to clients’ life via verbal descriptions and homework. The present study was a laboratory-based analog of the proposed processes occurring in FAP.

Using a modified fast friends’ procedure (FFP) and …

An Examination Of Types Of Health Insurance And The Reported Prevalence Of Autism In The United States, Jennifer L. Thompson

Dissertations

The prevalence of Autism Spectrum Disorders continues to rise despite barriers of changes to diagnostic criteria and lack of insurance coverage. Increases in prevalence affect costs associated with a disorder since cost of health care services are often estimated based on utilization of services. This can also affect an individual’s ability to access to health care services. To equitably distribute autism services to individuals an accurate estimation of the true prevalence of autism is needed.

Access to health care can be influenced by the type of insurance coverage a person holds. Other factors, such as socio-economic status, ethnicity, location of …