Digital Commons Network^™

Attention-Deficit Hyperactivity Disorder: Improving Outcomes Through Early Identification, Tina Lusk

Dissertations

Problem: Failure to identify and treat attention-deficit hyperactivity disorder (ADHD) is associated with academic underachievement, social difficulties, negative physical and mental health effects. Evidence suggests approximately 3% of a broad-based population sample and roughly 13% of an at-risk population are undiagnosed despite significant symptomology (Downey & Zun, 2018; Madsen et al., 2018; Okumura et al., 2019). The United States (U.S.) has no structured screening system for ADHD. Consequently, children receive no referral for diagnosis or treatment to mitigate its effects.

Methods: The Institute for Healthcare Improvement (IHI) Model for Evidence-Based Practice using the Plan Do Study Act (PDSA) cycle guided …

Self-Care Practices In Doctoral Nursing Students And Effects On Educational Experience, Megan Lutman

Dissertations

Problem: Doctoral nursing students are often faced with stressors on top of their schooling, one of which is continuing to work while pursuing their education. This in combination with normal life stressors can be challenging. The purpose of this project was to survey doctoral nursing students on what their current self-care practices.

Methods: An exploratory needs assessment project was created to gather data from Doctor of Nursing practice (DNP) and Doctor of Philosophy (PhD) nursing students in an urban, mid-sized, Midwestern, public university to identify current self-care practices, barriers to self-care, preference of self-care practices, and the impact these …

Evaluation Of A Substance Abuse Screening Tool In The Pediatric Emergency Room, Jody Sims

Dissertations

Abstract

Background: Substance abuse among adolescents is one of the most serious social health problems in the United States. The prevalence of alcohol use in adolescents is as high as 80%, while opioid overdose deaths among adolescents have risen by greater than 50% in the last 10 years. Alcohol, tobacco, and other substance use has also increased among youth and is not being properly evaluated in the pediatric hospital setting. The purpose of this project was to evaluate the use of a substance abuse screening tool with SBIRT trained staff in the pediatric emergency room setting.

Methods: The CRAFFT substance …

Improving Pediatric Asthma Outcomes Through Pictorial Asthma Action Plans, Julia Donovan

Dissertations

Problem: Asthma is the leading chronic disease of children and the leading cause of childhood emergency department (ED) visits, hospitalizations, and missed school days. Asthma action plans (AAPs), including photographs or pictures of asthma medications, symptoms, triggers, and devices, have improved parents’ understanding of their child’s asthma and have increased their comfort level in caring for their child.

Methods: An interventional pre-post study with a mixed-method research design, at a large, urban, primary care pediatric clinic with two locations, evaluated the effectiveness of a pictorial AAP on a child’s asthma control. A pictorial AAP was provided, and a childhood asthma …

Extubation Readiness Test In A Pediatric Cardiac Intensive Care Unit, Mary K. Holyoke

Dissertations

Extubation Readiness Test in a Pediatric Cardiac Intensive Care Unit

Abstract

Problem: The lack of standard extubation readiness tests (ERTs), that are practiced in pediatric ICUs to monitor extubation readiness, clinicians have the difficult task of weighing the risk versus benefit of extubation. ERTs can aid clinicians in deciphering patients ready to be successfully extubated and have shown to decrease length of mechanical ventilation and decrease extubation failures.

Methods: The quality improvement (QI) project utilized a descriptive observational design to assess the effects of the implementation of an ERT in a pediatric cardiac ICU. This project used a convenience sample …

Self-Care, Resilience, Self-Compassion, And Burnout In Doctoral Nursing Students: An Exploratory Needs Assessment, Logan Justice

Dissertations

Abstract

Problem: In the United States, one in three nurses experience symptoms of burnout, and doctoral nursing students are additionally challenged to juggle multiple school, work, and life demands (Reith, 2018; Woo et al., 2020). The purpose of this project was to explore the current self-care practices of doctoral nursing students to understand how self-care relates to resilience and burnout.

Methods: This exploratory needs assessment utilized a convenience sample of Doctor of Nursing practice (DNP) and Doctor of Philosophy (PhD) nursing students at a medium sized midwestern university. An electronic data collection survey was constructed to assess student self-care practices, …

Effect Of Confusion Assessment Scores On Identifying Delirium In Intensive Care Patients, Kayla Jacobs

Dissertations

Delirium in intensive care unit (ICU) patients can lead to increased length of stay in the hospital, increased risk of complications, increased polypharmacy, family distress and increased rate of mortality (Vasilevskis et al., 2018). Research has shown that addressing modifiable risk factors can improve survival rate by up to 15%, and routine screening for delirium in ICU patients leads to decreased patient anxiety, reduced in-hospital mortality, early recognition, and treatment of delirium (Krewulak et al., 2021 ; Vasilevskis et al., 2018). This quality improvement project used evidence-based intervention to increase accurate documentation of the confusion assessment method in the ICU …

Physical And Psychological Effects Of Qigong Exercise In Community-Dwelling Older Adults: An Exploratory Study, Pei-Shiun Chang

Dissertations

Older adults need exercise programs that correspond to age-related changes. Qigong exercise, a type of Chinese traditional medicine exercise, is a gentle low-impact exercise and is safe for older adults. Qigong interventions have resulted in improved psychological well-being, muscle strength, flexibility and balance in Asian adults with chronic conditions. However, little data are available on the effects of Qigong exercise on older adults' health in the United States. The purpose of the study was to explore feasibility, adherence, and preliminary efficacy of an 8-week Qigong exercise intervention in community-dwelling older adults in the United States.

Determinants Of Spiritual Well-Being In Adults Newly Diagnosed With Heart Failure: Primary Palliative Care Applied, Valerie Joy Smith

Dissertations

Guided by Roy's Adaptation Model (Roy, 2009) and using a descriptive, correlational, comparative design, sociodemographic characteristics (age, gender, race, marital status, income), coping, primary palliative care (PPC, spiritual needs, social support, decision-making [DM] engagement, psychological support, PPC information and education provision, goals of care discussion, and care coordination across settings and times), spiritual well-being (SWB), and advance directive (AD) completion in response to living with a HF diagnosis within the previous 12 months were described and the potential relationships and differences between the variables explored.

Spirituality, Religiosity, And Perceived Ability To Provide Spiritual Care In Nursing Students, Shannon O'Connell-Persaud

Dissertations

The objective of this study was to explore nursing students' spirituality, religiosity, and perceived ability to provide spiritual care.

Exploring The Lived Experience And Meaning Of Resilience For Nurses: A Descriptive Phenomenological Inquiry, London Draper Lowe

Dissertations

Using descriptive phenomenological investigation, this study shed light on the phenomenon of resilience for nurses in high acuity clinical settings. The purpose of this study was to explore, understand, and describe experiences of resilience by nurses in the clinical setting who demonstrate characteristics of resilience and investigate the meaning these experiences held for them. Another purpose for this study was to increase the knowledge base that nurses and nurse educators have regarding resilience including what factors contribute to the emergence and maintenance of resilience.

Development And Psychometric Performance Of The Family Willingness For Caregiving Scale (Fwcs), Cindy A. Wilk

Dissertations

Family members and close friends of ICU patients receiving mechanical ventilation often sit helpless at the bedside. Participation in care of their loved one may improve adaptation to the stressful situation and better prepare them for caregiving after discharge. The primary aim of this study was to develop and test the psychometric properties of the Family Willingness for Caregiving Scale (FWCS). The impetus for scale development was the lack of a valid instrument to measure caregiver willingness of family members for the ICU patient. The Facilitated Sensemaking Model (FSM) and adapted Psychosocial Assessment Model (PAM) provided the theoretical foundation for …

Effectiveness Of Simulation-Based Case Studies In Undergraduate Nursing Students, Kesha T. Becnel

Dissertations

An ever-changing healthcare landscape requires today's nurses to have a solid foundation in knowledge and clinical judgment to provide safe care to patients. Nurse educators must implement teaching strategies that help develop the knowledge and clinical judgment that nursing students will need upon graduation and entry into healthcare. Simulation-based experiences have been shown to help develop clinical judgment when used as part of a clinical practicum. However, few studies have examined the effectiveness of simulation-based experiences as a classroom teaching strategy.

Debriefing For Meaningful Learning: Fostering Development Of Clinical Reasoning Through Simulation, Kristina Thomas Dreifuerst

Dissertations

There is a critical need for faculty, a shortage of clinical sites, and an emphasis on quality and safety initiatives that drive increasing use of simulation in nursing education. Debriefing is an essential component of simulation, yet faculty are not consistently prepared to facilitate it such that meaningful learning, demonstrated through clinical reasoning, occurs from the experience. The purpose of this exploratory, quasi-experimental, pre-test-post-test study was to discover the effect of the use of a simulation teaching strategy, Debriefing for Meaningful Learning (DML), on the development of clinical reasoning in nursing students.

Nursing Faculty Care Expressions, Patterns, And Practices Related To Teaching Culture Care, Sandra J. Mixer

Dissertations

The purpose of this ethnonursing research study was to discover the care expressions, patterns, and practices of nursing faculty related to teaching culture care within the environmental context of urban and rural baccalaureate nursing programs in the Southeastern United States. The goal of the study was to discover faculty caring that facilitated teaching nursing students to provide culturally congruent and competent care. Four major themes with universal and diverse patterns which supported the themes were discovered. The themes were faculty care as embedded in Christian religious values, beliefs, and practices; faculty teaching culture care without an organizing conceptual framework; faculty …

Family Dining: Food And Drink In The Sopranos – A Gastrocritical Approach, Lisa Davies

Dissertations

This thesis uses gastrocriticism to explore food and drink in the 86 episodes of the long-form narrative HBO television series The Sopranos. Gastrocriticism is an emerging branch of literary criticism that draws on scholarship from a range of disciplines such as sociology, anthropology and cultural studies. A deeper understanding of the series was gained by using a structured framework of enquiry to explore narrative, setting, characterisation and genre through the lens of food and foodways. The Sopranos is a story of an Italian-American crime family and food is abundant in the series and bound up with the identity of …

Student Engagement And The Impact Of Successful Completion In A Virtual Alternative Program, Nicole Almiria Davis

Dissertations

The focus of this study was to examine the correlation between student engagement and successful completion of online alternative courses during the summer session from June 2022 through July 2022. The research questions focused on the difference in engagement levels between students who completed the course and those who did not complete the course. The study was motivated by the growing importance of alternative online programming in education. This study also aimed to fill gaps in existing research that failed to directly connect student engagement to the success of online programs. The findings provide valuable insights for school leaders, teachers, …

Hippocampal Volume And The Detection Of Mild Cognitive Impairment In An Older Adult Population: Assessing Performance On Cognitive Screeners Administered In-Person And Electronically, Kristen Fabrizi

Dissertations

The present study investigated how performance on in-person and electronic neuropsychological assessment measures predicted subcortical hippocampal volume and cognitive decline consistent with mild cognitive impairment. It was hypothesized that the Montreal Cognitive Assessment would display better predictive strength than the Cogstate Brief Battery when evaluating subcortical hippocampal volume measured via structural magnetic resonance imaging. It was further hypothesized that the Montreal Cognitive Assessment would be more sensitive to predicting group membership to the diagnostic classification of mild cognitive impairment compared to the Cogstate Brief Battery. The sample included 445 older adult participants selected from the Alzheimer’s Disease Neuroimaging Initiative 3. …

Foster Parent Knowledge And The Need For Information - Sharing Technology, Amy Lynne Averbuch

Dissertations

In 2023, the United States child welfare system suffers from disorganization, role ambiguity, and deficient transparency. With 12 contempt of court strikes for the system’s Director in 2022, it is clear why child welfare actors are unable to successfully perform. Foster parents, a key stakeholder in the proper care of children, report being unable to successfully perform because they are raising children with significant needs and trauma while having to locate and navigate child welfare system laws, policies, and procedures on their own. The purpose of this research project was to 1 ) identify whether foster parents know who is …

Psychological Needs Satisfaction In Teaching: A Mixed Methods Analysis On The Impact Of Evaluation Systems On Teacher Intrinsic Motivational Outcomes Using Self-Determination Theory, Matt Gaglio

Dissertations

The purpose of this study is to examine the relationships between psychological need satisfaction, motivational regulators, and intrinsic motivational outcomes regarding teacher evaluation systems related to the self-determination theory. The study consisted of 144 participants from two school districts and 18 school buildings. Confirmatory factor analysis and structural equation modeling showed that psychological need satisfaction positively predicted autonomous motivation and in turn, positively predicted enjoyment and pressure, while also negatively predicting value. Psychological need satisfaction also negatively predicted controlled motivation with autonomy and competence, but positively predicted relatedness. Controlled motivation positively predicted enjoyment, but negatively predicted pressure and value. Twenty …

Does Convenience Come With A Price? The Impact Of Remote Testimony On Expert Credibility And Decision-Making, Ashley Jones

Dissertations

Legal cases involving expert testimony, especially by forensic mental health professionals, is increasingly relying on remote testimony to reduce associated costs and increase availability of such services. There is some evidence to show that expert testimony delivered via videoconference (VC) is comparable to expert testimony delivered in person; however, the most compelling evidence for this claim is unpublished. Other evidence across disciplines showed relative comparability between VC and in-person modalities across various types of outcomes. Based on both unpublished and published findings, this study tested the hypothesis that minimal differences in measures of expert credibility, efficacy, and weight assigned to …

Racial Differences In The Strong Black Woman Schema And Its Relationship To Health Behaviors And Perseverance, Raegan Bishop

Dissertations

Black women face a number of poor health outcomes, with 50% of Black women 20 years and older suffering from cardiovascular disease, and a diabetes incidence rate that is almost double that of White women. Health behaviors like physical activity, diet, and stress management can assist in reducing the onset and worsening of these diseases. However, Black women are less likely to engage in these behaviors compared to women of other races. Additionally, even when Black women do engage in positive health behaviors, they see fewer positive results than White women. One potential influencer in the complex relationship that Black …

Baccalaureate Nursing Students' Experiences With Online Case-Based Learning (Cbl) During The Covid-19 Pandemic, Jessica Verplaetse

Dissertations

In spring 2020, in-person learning for nursing students was canceled in response to the Covid-19 pandemic. All courses, including clinical courses, abruptly transitioned to online formats. A significant gap in the literature exists regarding baccalaureate (BSN) nursing students' experiences with online learning during this timeframe. The purpose of this basic qualitative study was to explore BSN students' experiences with online learning during the spring 2020 semester.

Out Of The Briar Patch: Diffusion And Sustainability Of Nurse-Managed Practice, Linda Campbell

Dissertations

Community-based nurse-managed practice (CBNMP) offers local populations the opportunity to contract directly with professional nurses for primary health care services. Despite provision of high quality care below the average cost of primary care providers, an estimated 21 percent decline in the number of academic CBNMPs was documented between 1989 and 1998.

A multiple case study was conducted to address the overall research question: What factors are believed to facilitate or hinder the innovation development process of CBNMP in prevalent practice contexts? A model synthesizing concepts from the Theory of Diffusion of Innovations and the Theory of Community as Partner was …

Online Education: Benefits And Challenges For Refugee Students, Roza Badritdinova

Dissertations

ABSTRACT

Currently, only 3% of refugees are pursuing higher education opportunities compared to the 37% higher education participation rate globally. There is an urgent need for quality academic work to leave behind the endless descriptive accounts of refugee life and move toward identifying effective strategies and successful solutions that could facilitate the integration of refugees into higher education. Technology has proffered some hope in providing access to public education for marginalized populations. This study looked specifically at how one online education organization attempts to address refugee education and multiple barriers that prevent the majority of the world’s university-age refugee youth …

Vicarious Learning And Perceived Self-Efficacy Among Pre-Licensure Nursing Students During Pediatric End-Of-Life Situations, Stephanie Clark

Dissertations

Despite decades of acknowledgement among nursing academics and organizations, end-of-life (EOL) nursing education is significantly lacking. Insufficient EOL care education leaves nursing students feeling ill-prepared to adequately care for clients and their loved ones at EOL. Though the literature reveals a recent increase in didactic and simulation-related EOL education sporadically being integrated into nursing curricula, minimal research addresses important topics of pediatric EOL care and provision of therapeutic communication, considered critical to EOL care. End-of-life clinical experiences, particularly in pediatrics, are limited for pre-licensure nursing students. Though effective, simulations can be costly and timely to execute, are restricted by limited …

Sociodemographic And Health-Related Risks For Loneliness And Outcome Differences By Loneliness Status In A Sample Of Older U.S. Adults, Laurie A. Theeke

Dissertations

Loneliness is a prevalent problem for older adults and has been shown to be associated with negative physical, psychological, and social variables. There has been limited research focusing on the relationship of loneliness to health. There is a gap in the literature when it comes to understanding how the problem of loneliness relates to the health of older adults in the United States.

The purpose of this study was to address this gap in the literature through the testing of two models, the first model represented the postulated risks for loneliness and the second model represented the postulated outcomes for …

The Relationships Between And Among Parental Perceptions Of Family-Centered Care, Parental Beliefs, And Parental Stress In The Pediatric Intensive Care Unit, Kelly Keefe-Marcoux

Dissertations

Children hospitalized for critical care require increasingly complex and technical care, which can be very stressful for parents. Awareness of the importance of parents' role while their child is receiving critical care is vital to deliver care within a family-centered philosophy that is mutually beneficial to parents and nurses. This descriptive correlational study examined the relationships between and among parental perception of Family-Centered Care (FCC) nursing practices, parental beliefs regarding their role and their hospitalized child, and parental stress during their child's admission to the Pediatric Intensive Care Unit (PICU). This study utilized the Family-Centered Care theoretical framework to examine …

Claiming Health: Mammography-Screening Decision Making Of Older, Urban African-American Women, Barbara A. Fowler

Dissertations

There have been few researchers in nursing and the behavioral sciences that examined the social contexts and processes that may influence mammography-screening decision making of older, urban, lower-income AA women. Researchers, public health officials, and nurses in education and clinical practice may use the findings of this study to increase use of mammography screening. Grounded Theory (GT) research methods were used to develop, expand, and verify the basic social psychological process (BSP) and interrelated concepts emerging from the data, and understand the potential influences of related factors on mammography-screening decision making in this group of AA women.

The Association Between Pelvic Floor Dysfunction And Mental Health In Natal Females With A Focus On Native American Populations, Lexxie Gramke

Dissertations

Purpose

Over half of natal females in the United States suffer from pelvic floor dysfunction (PFD). PFD can increase risk of mental health sequelae; however, no studies have been conducted examining the association between mental health and PFD in the Native American (NA) population. This dissertation aims to evaluate the association between PFD, with a focus on overactive bladder (OAB), and mental health in females with specific attention to NAs.

Methodology

A current state of the science review examined the literature for associations between OAB with depression and anxiety in females. Utilizing this literature review, a theoretical model was constructed …