Digital Commons Network^™

Social Factors That Exacerbate Features Of Borderline Personality Disorder In Young Adult Women Between 25 And 35 Years Of Age Living In The Commonwealth Of Puerto Rico, Erika M. Carrasquillo

Dissertations

The high prevalence of BPD hospitalizations, unsuccessful treatments, poor social awareness, suicide attempts and complete suicides were motivating forces for this research study. The aim was to uncover pertinent social factors that exacerbate BPD in the lives of individuals with this affliction and therefore find ways to combat this disease. Since most of the individuals affected by this disease are female, the present research was focused on uncovering factors that increased the likelihood of BPD factors in women between the ages of 25-35 years. Borderline personality disorder is often viewed as difficult to treat. However, recent research shows that BPD …

Influences Of Social Relationships, Illness Characteristics, And Personality On Chronic Pain And Depression, Julia Faucett

Dissertations

Subjects with myofascial pain disorders (n = 67) and arthritis (n = 84) were studied to examine the contribution of personality traits and social relationships to their complaints of pain and depression. Structured interviews using standardized questionnaires provided information about personality traits, supportive and conflictual aspects of social network and family relationships, pain-specific responses of the significant other, depression, and affective and sensory pain. Interpersonal conflict and pain-specific punishing responses of the significant other were found to contribute significantly to pain and depression.

Relationship Among Subjective Mental Workload, Experience, And Education Of Cardiovascular Critical Care Registered Nurses, Andrea Crawford Gregg

Dissertations

Subjective mental workload was introduced for study in nursing emanating from a concern among nurses that current measures of nursing workload fail to capture the cognitive demands of patient care. Subjective mental workload is conceptually based on attention load, or the amount of attention that is required versus amount available to cognitively process work information. Information processing theory suggested a relationship between past learning and subjective mental workload; that is, as work becomes more familiar, subjective mental workload decreases. Subjective mental workload had been measured in other populations, but had not been studied in nursing. The purposes of the study …

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 …

Psychological And Immunological Correlates Of Surviving Breast Cancer: Influence Of Children, Susan M. Bauer-Wu

Dissertations

Positive outcomes, such as greater meaning in life, have been identified in cancer survivors. A pilot study identified that presence or absence of children may be an important contributor to the observed high variances on measures of personal meaning, perceived stress, and psychological distress in breast cancer survivors; in addition, significant relationships among these variables were found. Based on pilot study findings and using an integration of existential, stress-coping, and psychoneuroimmunology perspectives, the purpose of this study was to identify differences between women with a history of breast cancer who have children and those who do not on measures of …

Development And Evaluation Of An Instrument To Measure Parental Trust In Nurses, Janet K. Graves

Dissertations

The purpose of this study was to develop and test an instrument to measure parents' trust in nurses. The conceptual framework for the Parental Trust in Nurses Scale (P-TINS) included four dimensions of parental trust--generalized trust, trust in the imagined nurse, trust based on previous experience with nurses, and situation-specific trust, and a closely related construct--perception of risk. Content validity was enhanced by basing the 40 items of the Likert-type, sixth-grade level scale on parents interviews and qualitative studies and by ratings of parent and nurse content experts.

Nursing Workforce Issues: Nursing Student Enrollment And Faculty Trends In The State Of Maryland, Virginia S. Pichler

Dissertations

The United States is experiencing a nursing shortage unlike any previous shortage. The nursing workforce is aging at a greater rate than the general workforce. Nursing school enrollments are not predicted to meet the demands created by older nurses leaving practice and increasing health care complexity. The purpose of this study was to identify potential disparities in the registered nurse workforce by collecting information about nursing schools and programs, nursing faculty, faculty hiring projections, nursing students and enrollment projections.

Role Of Municipal Governance In Stabilizing Mature Inner Suburbs: A Study Of Five St. Louis Municipalities 1970-2015, Napoleon Williams Iii

Dissertations

This study explores the role of municipal governance in municipal-level stabilization of inner suburbs in St. Louis County, Missouri. The data, from 1970 to 2015, include a robust collection of official government archives collected from five municipalities in St. Louis County, historical documents, city-state-national statistical data, and related materials. Interviews of 25 stakeholders were conducted and data were analyzed based on the community power structure framework.

I outline five mature St. Louis inner suburbs’ evolution in municipal-level conditions from 1970 to 2015, and I detail the role each suburbs’ municipal governance played in the evolution of municipal-level conditions. I conclude, …

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) …

Supporting Hope In Midlife Cancer Survivors: Intervention Workshop, Clare Marie Butt

Dissertations

Cancer patients lack information and support needed to make the transition to survivorship. This problem was addressed by testing a psycho-educational group intervention, the Mid-Life Directions Workshop, for its effect on hope and quality of life in midlife cancer survivors.

Factors Related To Self-Care Agency And Self-Care Practices Of Obese Adolescents, Kathy S. James

Dissertations

Identification of factors that influence obese adolescents' health behaviors is necessary if obese adolescents are to benefit from therapeutic interventions. The purpose of this descriptive-correlational study was to identify the relationships between selected basic conditioning factors (BCFs)--perceived health status (PHS), perceived self-efficacy (PSE), family satisfaction (FS), and life events (LE)--and the self-care agency (SCA) and self-care practices (SCP) among obese adolescents. The relative predictive strength of each BCF in relation to the outcome variables was also explored. Orem's self-care theory provided the conceptual framework for this study.

A Study Of Health Locus Of Control, Self-Efficacy, Health Promotion Behaviors, And Environmental Factors Related To The Self-Report Of The Avoidance Of Environmental Tobacco Smoke In Young Adults, Angela M. Martinelli

Dissertations

Environmental Tobacco Smoke (ETS) is a source of preventable diseases. Currently, 3.1 million adolescents smoke cigarettes. Despite the prevalence of smoking in young people and the health consequences of ETS, research has not adequately addressed the avoidance of ETS. This study identified and described factors which influence the avoidance of ETS in young adults. Pender's Health Promotion Model provided the research framework. Predictor variables included demographic characteristics, biological characteristics, situational factors, self-efficacy, control of health, and health promotion behaviors.

Primary Prevention Emphasis And Self-Reported Health Behaviors Of Nursing Students, Ronda E. Yoder

Dissertations

The current climate of healthcare reform demands an increased curricular emphasis on primary prevention, yet the relationship between the level of curricular emphasis on primary prevention and the health behaviors of nursing students has not been established. The purpose of the study was to determine if there is a difference in the self-reported health behaviors of nursing students enrolled in baccalaureate nursing programs ranked as having high and low levels of emphasis on primary prevention. Neuman's systems model was the conceptual framework for the study.

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 …

Explaining Relationships Between Stress And Resilience In Pharmacy Students, Rebecca Jones

Dissertations

ABSTRACT

Stress is a growing issue on college campuses, and students in a professional pharmacy program may be at an even greater risk for associated problems. The purpose of this study was to gain information about resilience and its relationship with stress, high-risk behaviors, and grade point averages (GPAs) in students who just completed their first professional (P1) year of a pharmacy program. The research questions for this study were: 1) What is the relationship between levels of stress and level of resilience in these pharmacy students, 2) What is the relationship between high-risk behaviors and level of resilience?, and …

Utilizing Mindfulness-Based Exercises To Reduce Anxiety Severity Scores According To The Gad-7, Kelly Calhoun

Dissertations

Abstract

Problem: Generalized anxiety disorder (GAD) affects thousands of Americans every year. Mindfulness, a practice of bringing oneself into the present moment, has been shown to impact anxiety symptoms positively.

Objective: This prospective observational correlational study utilized mindfulness-based exercises to help decrease anxiety severity according to the generalized anxiety disorder-7 (GAD-7) in an outpatient psychiatric practice.

Methods: Participants practiced mindfulness exercises for two months. The GAD-7 was completed three times to monitor symptom severity. Two participant satisfaction surveys were completed to determine whether participants felt the exercises were beneficial for decreasing their anxiety.

Results: A repeated measures ANOVA was used …

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 …

Effects Of Genetic Testing On Clinical Outcomes Of Patients With Obsessive Compulsive Disorder, Jessica Higlen

Dissertations

Problem: The National Institute for Mental Health (NIMH) reports that only 1.2% of adults suffer from OCD, but over 50% are severe (Obsessive Compulsive Disorder (OCD), n.d.). Meier et al. (2016), found that patients with OCD faced a 40% higher chance of early mortality. Individuals with psychiatric conditions are more at risk for poor physical health, poor education, economic struggles and crime (Mental Health by the Numbers, 2019). Emergency departments claim tens of millions of visits per year related to psychiatric issues resulting in billions in costs each year (Mental Health by the Numbers, 2019). Genetic testing is becoming a …

Diversity In Pre-Nursing Majors And Nursing Program Applicants, Christel Fehr

Dissertations

Problem: The population of the US has become increasingly ethnically diverse. This diversity has not been reflected in the nursing workforce with approximately 70% being Caucasian and 85% being female, resulting in a disparity in healthcare delivery by minorities. The purpose of this project was to perform an analysis of race, ethnicity, and gender diversity in undergraduate nursing applicants at a rural midwestern university.

Method: A retrospective review of nursing applications, enrollment reports, and graduation rates were examined for three academic years.

Results: 326 students (N=326) applied to the nursing program from Fall 2016 through Spring 2019. Of …

Nurse Practitioner Student Confidence And Competence In Common Women's Health Diagnostic Procedures, Jessica Cowan

Dissertations

Problem: In areas with limited health resources, such as Guatemala, cost-effective and reliable methods for sexually transmitted infection and cervical cancer screenings are needed. The purpose of this Quality Improvement (QI) project was to develop standardized training in Vaginal Wet Mount (VWM) preparation and cervical cancer screening using Visual Inspection with Acetic Acid (VIA) for Nurse Practitioner students who traveled to Guatemala for a week-long global immersion experience.

Methods: This was a QI project with a prospective descriptive design utilizing a purposive sample of 10 University of Missouri-St. Louis Nurse Practitioner students who traveled to Guatemala on medical mission trip …

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 …

Evaluation Of Mcgeer Criteria For Uti Determination In A Nursing Home, Julie Rehagen

Dissertations

Problem: Urinary tract infection (UTI) is one of the most complex and challenging medical diagnoses to make in the long-term care (LTC) population. The unnecessary treatment of a UTI can increase cost of care and the likelihood of multi-drug resistant organisms.

Methods: The McGeer criteria which focuses on UTI in the LTC population was utilized to complete a quality improvement initiative. A descriptive cohort project utilizing retrospective and prospective data was completed to determine if an implemented McGeer criteria protocol improved the avoidable treatment of asymptomatic bacteriuria (ASB).

Results: Before implementation of the protocol, 62.5% of residents were unnecessarily treated …

Adolescent Resilience Following Parental Death In Childhood And Its Relationship To Parental Attachment And Coping, Marjorie M. Heinzer

Dissertations

Adolescent resilience following loss has been linked with supportive social relationships and coping. Retrospective studies have found that parental death during childhood has been a risk factor for serious mental health problems in adolescence. However, health care professionals and researchers have also reported positive outcomes of increased competency, self-worth, and health in other adolescents. These adolescents have demonstrated resilience, the dynamic ability or strength that enables persons to adjust readily to loss and to mobilize resources. The purpose of this study was to investigate the relationships among parental attachment to the surviving parent, adaptive coping, and resilience of adolescents following …

Comparison Of Nursing Student Academic Achievement And Satisfaction Based On Face-To-Face Interaction Versus Distance Education In Teaching Therapeutic Crisis Management Techniques, Jennifer S. Graber

Dissertations

Nursing education today is very different with advances in science and technology. Nurse educators are using distance education in an effort to offer students the ability to practice varying skills in a safe non-threatening environment. This quasi-experimental, post-hoc causal comparative study had a two group post-test only design. There were two conditions: face-to-face classroom delivery of course content and distance education with online course content. The study was designed to compare effectiveness of distance education and face-to-face interaction through reviewing test grades and class grades. Additionally students were asked to rate their satisfaction of the different modalities.

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.

Antecedents Of Three-Year-Old Child Health Status, Candice C. Bowman

Dissertations

This study sought to assess a set of factors that were proposed to influence child health status at 3 years of age. The sample (N=4940) was drawn from the 1988 National Maternal Infant Health Survey and the 1991 Longitudinal Follow-up, conducted by the National Center for Health Statistics. Only mothers who gave birth to live, singleton infants in 1988 and whose children were still alive and living with them in 1991 were used in the analysis (N=4940). Relationships were specified between the following latent variables: maternal social advantage to birth outcomes and from birth outcomes to child health status, measured …

A Theory-Based, Web-Mediated Physical Activity Intervention For College Women, Lynne L. Ornes

Dissertations

Physical inactivity increases the risk for heart disease, type 2 diabetes, and obesity. Females, more than males, become increasingly inactive as they age. The primary aim was to develop and measure the effect of a theory-based, Web-delivered, physical activity intervention on walking behavior in college-aged women. The secondary aim was to perform a process evaluation to determine the efficacy of the intervention and explore potential mediating variables that explain changes in health behavior.

Baroreflex Sensitivity During Positional Changes In Patients With Traumatic Brain Injury, Norma D. Mcnair

Dissertations

Traumatic brain injury (TBI) affects 1.7 million Americans annually leading to significant morbidity and health care costs. An important cause of morbidity in TBI is secondary brain injury due to abnormal cerebrovascular autoregulation (CA). Standard measures of CA are not amenable to use outside of the intensive care unit (ICU) and patients continue to be at risk for secondary brain injury post- ICU. Baroreflex sensitivity (BRS) is a non-invasive assessment of autonomic tone that may be useful in evaluating CA. Evaluation of BRS and its relation to CA has not been examined in patients with TBI and predictors of CA …

Knowledge And Health Beliefs About Breast Cancer Screening Among Rural Palestinian Women: Pilot Study, Hanan Saca-Hazboun

Dissertations

Breast cancer is the most frequent type of cancer among women and the risk increases with age, with an estimated 1.67 million new cases in 2012 and a 25% incidence of all cancers in women in both developed and developing countries. It is the most frequent cause of cancer death in women in less developed regions (324,000 deaths, 14.3% of total), (Ferlay, Soerjomataram, Dikshit, Eser, Mathers, Rebelo, et al., 2015). Breast cancer is diagnosed at advanced stages of the disease in women who reside in the developing countries of the Eastern Mediterranean region (Jemal, Bray, Center, Ferlay, Ward, & Forman, …

A Strategic Plan To Thread Genomics Competencies Into Undergraduate Curriculum, Holly Mathis

Dissertations

Problem: Genomics in undergraduate nursing education has experienced slow adoption in the United States. Various approaches have been proposed but do not address barriers to successful implementation.

Methods: A strategic plan was developed to increase the amount of genetics and genomic content in the curriculum of an undergraduate nursing program. A gap analysis was performed on the curriculum revealing a paucity of content. A SWOT analysis informed the strategic plan, which included a faculty education program using the ANA/ISONG’s Essentials of Genetic and Genomic Nursing: Competencies, Curricula Guidelines and Outcome Indicators (2^nd ed.) (2009) as a foundation.

Results: Faculty …