Digital Commons Network^™

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

Dissertations

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

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

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

Dissertations

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

Selected Factors Affecting Nurse-Perceived Reciprocity In Nurse-Patient Relationships, Elnora P. Mendias

Dissertations

This exploratory study examined factors affecting nurse-perceived reciprocity in nurse-patient relationships of practicing public health nurses. The hypothesis was that there is a positive relationship between selected demographic (age), professional (years as RN, years in public health nursing), personal (career satisfaction, satisfaction with nurse-patient relationships), and contextual variables (work satisfaction, years with current employer, type of nursing care delivery system (team, primary, case management, functional, other), and satisfaction with workload) and nurse-perceived reciprocity in nurse-patient relationships.

Self-Care Management Of African American Men With Type 2 Diabetes, Kevin Konstantinos

Dissertations

African American men are disproportionately affected by type 2 diabetes and have a 3 times higher rate of 3 serious complications of diabetes, including blindness, amputations, and end-stage renal disease, compared to other groups. The purpose of this project was to address the gap-in-practice disparity that exists in care of African American men with diabetes by providing one-on-one self-care management education in an outpatient clinic setting. The behavior change theories that supported the project intervention were Orem's self-care theory and Bandura's self-efficacy theory. Employing a quasi-experimental design, 33 participants between the ages of 40 and 65 were divided into an …

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

Dissertations

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

Statistical Modeling Approaches And User-Centered Design For Nursing Decision Support Tools Predicting In-Hospital Cardiopulmonary Arrest, Alvin Dean Jeffery

Dissertations

This doctoral research explored strategies for the design and statistical development of probability-based nursing decision support tools within the clinical context of in-hospital cardiopulmonary arrest (IHCPA). IHCPA remains a harmful and costly event, and recent attempts to assist with early recognition via probability-based clinical decision support (PBCDS) tools have fallen short of improving patient outcomes. These shortcomings are due, in part, to the complex nature of PB-CDS tools with inadequate attention paid to important design elements during the early stages of the tools' construction.1 Failure to improve patient outcomes may also be a condition of the PB-CDS tools' underlying statistical …

Health Status, Health Behavior, Multidimensional Health Locus-Of-Control And Factors In The Development Of Personal Control In Individuals With Rheumatoid Arthritis, Janice Ellis

Dissertations

This study was designed to expand understanding of perceived personal control, its relationship to perceived health and health behavior, and the development of personal control in the individual with rheumatoid arthritis. The theoretical framework for the study was Pender's Health Belief Model. Multidimensional Health Locus of Control, the Health Promoting Lifestyle Profile, Self-Evaluation of Health Status, physical and instrumental activities of daily living from the OARS Multidimensional Functional Assessment, and various demographics were measured for 67 subjects with rheumatoid arthritis.

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

Dissertations

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

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

Dissertations

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

Adolescent Victims' Experiences With Cyberbullying: A Grounded Theory Study, Melvina Sue Brandau

Dissertations

The purpose of this study was to construct a Grounded Theory that explains the processes involved in cyberbullying from the perspectives of those who have been victimized. A Constructivist Grounded Theory approach was used to explain the processes that occur as cyberbullying begins, unfolds, and ends, as well as to determine the methods that adolescent victims use to cope, and the context in which cyberbullying occurs.

An Investigation Of The Relationship Between The Magnitude Of Life Stress, Appraisal Of Adjustment To Life Stress And The Occurrence Of Conception Among Women Of Childbearing Age, Marianne T. Roncoli

Dissertations

The purpose of this investigation was to explore the relationship between life stress and conception. Previously, it had been reported that women who were pregnant sustained life stress equal to or greater than people who sustained serious illness. This investigator attempted to prospectively establish what had been retrospectively found and to make a theoretical contribution to the understanding of the relationship between life stress and health status. Prior to this investigation empirical evidence suggested that the occurrence of life stress may be causally related to the onset of pregnancy. A pathway of life stress to illness reported in the literature …

The Relationship Between The Birth Of A Preterm Infant And The Vulnerable Child Syndrome Using Lessick's Vulnerability Model As A Theoretical Framework, Jean T. Martin

Dissertations

The primary purpose of this study was to explore the relationship between the birth of a preterm infant and the vulnerable child syndrome. The theoretical framework for the study was Lessick's Vulnerability Model for Nursing Practice. This model is based upon a person's individual factors interacting/correlating with environmental factors and the effects of these on health-illness behavior across the lifespan. A convenience sample of 57 parents of preterm infants, now three years of age, and 55 parents of full term infants, now three years of age, was drawn from a previous study of families' response to the birth of a …

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

Dissertations

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

El Corazon De La Cebolla: A Mini-Ethnographic Study Of Mexicana/O Symptom Interpretation And Management, Melody A. Weaver

Dissertations

The purpose of this urban mini-ethnographic qualitative study was to examine Mexicana/o symptom interpretation and management utilizing the Common Sense Model of Illness Representation as a guiding framework. Latina/os are a growing part of the population in the United States and are estimated to comprise 25% of the total population by the year 2050. The Latina/o population is diverse. Mexicana/os represent 68% of the Latina/o population in Utah. Despite growing numbers of Latina/os living within the borders of the United States, little work has been conducted that addresses the healthcare needs of this population. Research to date has focused on …

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

Dissertations

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

Training Practitioners On The Effects Of Psychotropic Medication Via A Web-Based Platform, Anita Li

Dissertations

Many individuals diagnosed with autism spectrum disorders (ASD) receive multiple therapeutic services in an attempt to supplement behavioral therapy. These services include pharmacological interventions. Two drugs, risperidone (Risperdal) and aripiprazole (Abilify), are FDA-approved to treat “irritability” in children with ASD. Research shows that the effects of risperidone and aripiprazole on irritability varies greatly across treated individuals. Therefore, individualized monitoring and evaluation must be conducted to provide the physician with data to determine if the medication is resulting in desired changes and effects. Certified behavior analysts are trained in data collection and experience high levels of contact with individuals diagnosed with …

Pinch Span And Force: Normative Data, Requirements For Functional Tasks And Life Roles, And The Influence Of Carpometacarpal Joint Osteoarthritis, Nancy Hock

Dissertations

The three studies that form this dissertation build knowledge related to functional pinch. Study 1 provides normative data for the Baseline® 5-Position Hydraulic Pinch Meter, which may be used in clinical practice. The data collected in this study demonstrate the relationship between lateral pinch strength and age and reveal that strength decreases with age in both males and females. Through examination of the lateral pinch force produced at the 5 different pinch spans, it was found that the strongest lateral pinch strength was produced at 4-5 cm of pinch span. This information can be used by clinicians as they modify …

Collateral Consequences: The Experiences Of Black Women With Incarcerated Loved Ones, Keiondra Jné Grace

Dissertations

A wealth of research exists that considers the causes of mass incarceration, particularly how it has shaped crime narratives and the life courses of Black men and Black women that experience imprisonment. Scholars have also explored the collateral consequences of incarceration for families and communities in general, but mentioning that Black families and communities in particular are disproportionately impacted by mass incarceration. Despite the documented impact of incarceration on families, and the acknowledgement of the toll mass incarceration has on Black communities—the social cost of mass incarceration in the lives of Black women whom have not experienced incarcerated is yet …

Exploring Functional Health Literacy In Older Adults With Age-Related Macular Degeneration, Jennifer K. Fortuna

Dissertations

This three-paper dissertation explores functional health literacy (i.e., the ability to access, process and understand health information) in older adults with vision loss caused by age-related macular degeneration (AMD). This research builds scholarship that explores the unique patient education needs of older adults with AMD. The specific aims of this research are to: (1) explore associations between functional health literacy and severity of visual impairment; (2) determine the general readability, suitability and comprehensibility of online patient education materials (PEMs) designed for older adults with AMD; and, (3) assess the overall quality of one PEM that has been simplified based on …

The Effects Of Character Education Programs On School Climate And Student Discipline In Grades 6-8 Through The Eyes Of Substitute Teachers, Javier Lozano

Dissertations

This research study used surveys and one on one interviews conducted with substitute teachers to investigate whether character education programs in a middle school setting can be observed having a noticeable impact on school culture and climate. The study observed findings through the lens and perspectives of substitute teachers to see if guest teachers reported a significant difference in their experience between schools of character versus schools that did not practice character initiatives. The study investigated this Research Question through exploring four topics: 1) how substitute teachers described schools that are actively involved in character education versus those schools that …

Social-Ecological And Protective Factor Approach To Managing Parental Incarceration, Jacquelyn Harris

Dissertations

Mass imprisonment does not only impact the incarcerated individual; it also affects approximately five million children in the United States. Researchers identified and compare the impact of parental incarceration on child development. They acknowledged the protective factors across the lifecycle from a social-ecological perspective and specifically related to parental incarceration. The comprehensive literature review inspired an innovative model, the social-ecological and protective factor approach to managing parental incarceration. The primary goal of this model is to combat the detrimental effects of parental incarceration by identifying protective factors across the lifecycle and throughout the microsystem, mesosystem, and exosystem. This model is …

Bridging The Gap: Understanding Non-Offending Parental Responses To Their Children's Sexual Abuse., Jennifer Latreill, Psy.D.

Dissertations

The parental response to children's disclosure of childhood sexual abuse (CSA) is the most critical and important factor regarding the child's post trauma trajectory and overall trauma resolution. Understanding parental responses and the factors that prompt acceptance versus disbelief among the non-offending parent (NOP) is vital to children's success following disclosure given the weight of the NOPs response and its impact on long-term consequences of CSA. This literature review provides a comprehensive summary of what may deter the NOP from recognizing intrafamilial sexual abuse, factors that may contribute to the NOPs disbelief following disclosure, and possible clinical implications of such …

Increasing Odds: The Impact Of Casino Gaming Size, Location, And Economic Stream Style Differences On County Revenue In Pennsylvania, Brandon W. Koch

Dissertations

As county administrators seek new revenue streams, casino gaming becomes a valuable local revenue production mechanism. Recently, Pennsylvania has been vastly successful with developing a conunercial casino market. The American Gaming Association in 2017 found that Pennsylvania has the largest sole commercial casino industry and highest effective tax rate in the United States. The case study of the Pennsylvania gaming industry is utilized to investigate plannable casino born factor impacts on county revenue. State and local regulations dictate the method and location (plannable factors) of permitted casino gaming via quotas and licensure. Casino born factors created as a result of …

Food Insecurity: A Closer Look At How Households Cope With Food Insecurity And How This Phenomenon Affects Their Overall Health, Burak O. Tan

Dissertations

This study focused on the lived experiences of low-income households who coped with food insecurity and explored their worldview on the health impacts of battling with this phenomenon in the Grand Rapids Metropolitan Statistical Area (MSA). While the main research question focused on how low-income households coped with food insecurity, the following were the focus of the research analysis and served as the empirically testable framework: a) addressing the impact of poverty on affordability of nutritious food, b) addressing the impact of food deserts on accessibility and availability of nutritious food, c) addressing the coping strategies used to battle food …

Occupational Therapy As Part Of A Team-Based Approach In Primary Care Settings, Lydia Royeen

Dissertations

The purpose of this project was to study issues related to occupational therapists integrating into primary care settings, as part of a team-based approach and to best meet the needs of the clients.

This is a mixed methods study that examined quantitative and qualitative data for members of the primary care team and occupational therapists working in primary care clinics. The Team Climate Inventory-14 (Kivimaki & Elovainio, 1999) was selected as the quantitative measure because it examines themes related to team functioning, which include vision, participative safety, task orientation, and mutual support. Participants completed a semi-structured interview that examined themes …

An Integrated Approach (Remote Sensing, Hydrogeology, Gis, And Statistical Modeling) To Identify The Distribution Of Shallow Groundwater Occurrences Over Southwest Saudi Arabia, Fahad Khudier Alshehri

Dissertations

Identifying shallow (near-surface) groundwater in arid and hyper-arid areas has significant societal benefits, yet it is a costly operation when traditional methods (geophysics and drilling) are applied over large domains. In this study, we developed and successfully applied methodologies that rely heavily on readily available temporal, visible and near-infrared, radar, and thermal remote sensing data sets and field data, as well as statistical approaches to map the distribution of shallow (1–5 m deep) groundwater occurrences in Al Qunfudah Province, Saudi Arabia and to identify the factors controlling their development. A four-fold approach was adopted: (1) constructing a digital database to …

The Effects Of Low Dose Lysergic Acid Diethylamide Administration In A Rodent Model Of Delay Discounting, Robert J. Kohler

Dissertations

The resurgence of Lysergic Acid Diethylamide (LSD) as a therapeutic tool requires a revival in research, both basic and clinical, to bridge gaps in knowledge left from a previous generation of work. Currently, no study has been published with the intent of establishing optimal microdose concentrations of LSD in an animal model. In the present study, rats were administered a range of LSD doses to quantify potential augmentations in choice behavior in a rodent model of delay discounting. In the first experiment, rats were administered LSD (20 or 40 μg/kg, i.p.) or saline at the start of terminal baseline training …

Methods For Improving Quality Of Care Within Acute And Post-Acute Settings, Kelly L. Vankoevering

Dissertations

According to the Centers for Medicare and Medicaid (CMS), over the next 7 years, U.S. national healthcare spending is projected to grow at an average of 5.7% per year, up from 4.8% in 2019. Additionally, personal health care cost is expected to increase by 2.7% per year. As a result, there have been increased efforts among healthcare systems and hospital organizations to improve quality of care while decreasing healthcare cost. The research reported in this dissertation builds upon the existing literature regarding interventions to improve hospital performance and quality metrics. Two of the most researched and effective strategies for improving …

Adjustment Issues As Students Transition From High School To The Dominican Republic's First Community College, Alexandra Julia Garcia Munoz

Dissertations

The vision statement of the first community college in the Dominican Republic (DR) notes that it is “an institution of higher technical level aimed at offering opportunities for development, forming competent, ethical and innovative professionals through a relevant curriculum assuming a solidarity integration with business and social sectors" (Instituto Tecnico Superior Comunitario [ITSC], 2012, para. 1). Each day, the institution tries to help individuals achieve their lifelong dreams by providing a quality education so that graduates may benefit economically, socially, and personally, and reach a better quality of life that expands those benefits to their community, country and the whole …

What Role Does The African American Church Play When Meeting The Mental Health Needs Of Its African American Parishioners?, Lisa Sutton

Dissertations

Abstract

This study will focus on understanding the role played by the church in meeting the mental health needs of its African American parishioners. The goal is to understand the ways that African American communities hold faith, position themselves within the church, and the outside world, with a specific focus on issues of trust, which have emerged based on historical and structural violence that has debilitated the health of our community. The study examines attitudes and perceptions of church leadership and members around their caring for parishioners with mental health issues. The hope is that the data will help construct …