Digital Commons Network^™

Navigating The Change Of Life: The Menopausal Transition Of Thai Immigrant Women, Bulaporn Natipagon-Shah

Dissertations

Given that women continue to live more than three decades after menopause and their health and well being in later life are determined by quality of health during the menopausal transition, menopause has become an important issue in the healthcare arena. The growing number of immigrant women in the United States signifies a need for healthcare providers to develop cultural knowledge and sensitivity toward each immigrant group regarding the issue of menopause. The purpose of this qualitative study was to build a substantive grounded theory of the experiences of menopausal transition among Thai immigrant women in the United States.

Perceived Ease Of Use And Usefulness Of Podcasting In Nursing Skills Competence, Lisa Mesmer Barnes

Dissertations

This capstone project examined nursing students' technology acceptance of podcasting as a tool for nursing skill acquisition. Technology acceptance was determined by measuring the students' perceived competence of the skill along with the perceived usefulness and ease of use of the provided podcasts. A convenience sample of 49 first semester nursing students from an associate degree and practical nursing program participated in the project. Perceived competence of the three nursing skills: obtaining vital signs, inserting a Foley catheter, and performing a sterile dressing change was examined and compared from pre-podcast availability to post-podcast availability. The overall means of the nursing …

Distress After Preterm Birth: A Discourse Analysis Of Parents' Accounts And Photographs, Ira Kantrowitz-Gordon

Dissertations

Preterm birth is a distressing experience for parents. This distress may continue into early childhood, with negative consequences for parents' mental health and child development. The purpose of this study was to take an in-depth look at how parents formed their accounts of premature birth, postpartum distress, and lives as parents and partners. Discourse analysis of semi-structured interviews and photo-elicitation assignments were used to analyze the parents' experiences in the context of the couple relationship.

Dimensions Of Racial Identity As Predictors Of Physical Activity In Midlife African American Women, Elaine Clarista Hardy

Dissertations

Physical inactivity leads to serious health consequences, particularly for midlife African American (AA) women. Midlife African American (AA) women are less physically active and have higher obesity-related morbidity and mortality than midlife White women. Studies to examine these disparities typically view AAs as a homogeneous group, despite evidence of important within-group variance. Using a culturally-adapted identity-based motivational model, the purpose of this study was to determine whether dimensions of racial identity have differential influence on physical activity in midlife AA women.

The Relationship Between New Nurses Who Volunteer And The Caring Behavior New Nurses Exhibit In The Practice Setting, One Year Post Graduation, Nicolette Fiore-Lopez

Dissertations

Volunteering is engaged in by millions world-wide and nurses comprise a significant portion of those who provide their professional talents, unpaid, to the underserved in local, national and international efforts. Nurses who have engaged in volunteer activities anecdotally describe personally transforming experiences gained through their efforts and for many nurses volunteering becomes part of their professional mandate. Although many social disciplines have studied volunteering, to date there has been a paucity of research on nurses who volunteer. The purpose of this study was to describe the characteristics of novice nurses who volunteer and determine the influence of volunteering and associated …

Spirituality And Religiosity In Adolescents With Sickle Cell Disease: A Qualitative Study, Dora L. Clayton-Jones

Dissertations

Sickle cell disease (SCD) is a serious debilitating chronic illness and global health problem. Spirituality and religiosity have been shown to have positive correlations with their health outcomes. Research addressing the spiritual and religious needs of adolescents living with SCD is limited. The aim of this descriptive qualitative study was to examine how adolescents (Mage = 16.2 years) with SCD describe and experience spirituality and religiosity.

The Effect Of The Rapid Assessment For Adolescent Preventive Services (Raaps) In Improving The Style Of The Exchange Of Information And Balance Of Power During A Health Care Visit In A Pediatric Primary Care Setting, Brandi Snyder

Dissertations

It is estimated that more than 70% of illnesses, disabilities, and deaths among the adolescent population are related to adolescent high-risk behaviors. Adolescent high-risk behaviors include those that contribute to unintentional injuries and violence, sexual behaviors related to unintended pregnancies and sexually transmitted infections, alcohol and other drug use, tobacco use, unhealthy dietary behavior, and inadequate physical activity. Despite national recommendations, many providers remain reluctant to implement standardized screening tools that have been created to prevent and identify these behaviors. Studies have shown that a comprehensive preventative risk assessment, such as the Rapid Assessment of Adolescent Preventive Services (RAAPS) used …

Development Of A Clinical Nurse Leadership Orientation Program, Sunita Waddell

Dissertations

Nurses are often promoted or hired into leadership positions without the benefit of a formal orientation to their new leadership positions. The challenge of navigating the various expectations of the role of clinical nurse leader (CNL) such as fiscal ownership, staffing patterns, payroll, and disciplinary action process can be overwhelming. The lack of a formalized orientation process and an identified nurse leader to function as a mentor can contribute to the novice CNL feeling unsupported and overwhelmed. The purpose of this project was to identify, develop, and evaluate a CNL orientation manual, outline, and program for newly appointed CNLs. The …

Engagement Of Primary Stakeholders To Tailor A Comprehensive Transitional Care Model For Persons Who Have Experienced A Stroke And Their Caregivers, Lorre Laws

Dissertations

Stroke is the leading cause of disability in the US, affecting approximately 795,000 persons annually. Stroke care is delivered across multiple settings from hyperacute care in a hospital through chronic stroke management in the community. Considerable advancements have been made in the delivery of hyperacute and acute stroke care. Science and practice gaps exist in providing stroke transitional care across multiple providers and settings once an individual is discharged from an in-patient care facility to home.

Using a qualitative descriptive design, this study engaged and elicited descriptions from stroke survivors and caregivers affected by stroke to inform the refinement and …

Implementing An Early Mobility Protocol For Patients In Intensive Care Unit, Allison Nicole Crane

Dissertations

Limited mobility and prolonged bedrest were thought of as necessary to promote safety and hemodynamic stability in critically ill intensive care patients historically, but recent research does not support this idea. Newer research is suggesting that mobilizing critical ill patients in the intensive care unit can limit the negative effects of immobility and improve patient outcomes (Adler & Malone, 2012; Morris, et al., 2008; Perme & Chandrashekar, 2009; Perme, Lettvin, Throckmorton, Mitchell, Masud, 2011).

The objective of this clinical scholarly project is to educate the healthcare team about the importance of early mobility in the intensive care unit (ICU) patient …

Bone Health Education For Osteoporosis Risk Reduction In Premenopausal Women: A Quality Improvement Project, Gloria Jean Nichols

Dissertations

In the United States, about 8.5 million women live with osteoporosis. Osteoporosis is a debilitating systemic skeletal disorder characterized by low bone mass and reduced bone mineral density that occurs with the loss of estrogen. The mortality rate for this group is about 3 to 4 times higher than other women and as many as 1 in 3 experience a fracture. Guided by the Health Belief Model, this project evaluated how a bone health fact sheet impacts knowledge about osteoporosis and self-efficacy for preventative behavioral change in premenopausal women (age 40-58 years). The project also evaluated if an electronic medical …

La Maestra’S Circle Of Care: Studying The Impact Of An Integrated Service Model On The Health And Well-Being Of Vulnerable Populations, Zara Marselian

Dissertations

ABSTRACT

There is an urgent need to reform the health care delivery system in the United States, as recognized through current bipartisan efforts. Society’s vulnerable populations especially need health care reform as health care outcomes are the poorest among disadvantaged populations. Moreover, vulnerable populations are twice as likely to develop chronic diseases than the general population and they remain ill due to other contextual, societal factors affecting their ability to achieve health and well-being. This population is subjected to adverse life events that suggest a more comprehensive approach to health and well-being is called for.

The Circle of Care is …

Exploring Intergenerational Value Changes Across Three Generations Of Emirati Women Using Focused Ethnography, Ebtesam Ali Alteneiji

Dissertations

Intergenerational value change, influenced by technological advancements, economic development, formal education, and urbanization, becomes especially complex when it occurs in times of rapid changes, as in the case of the United Arab Emirates (UAE). Through the lens of social change and human development theory, heavily constructed in the Gemeinschaft/Gesellschaft paradigm, this focused ethnography explored the push and pull of traditional boundaries within a collectivist society and the necessary navigation of infused Westernized philosophies promoting individualism and autonomy. Participants in this study (N = 24) were members of 8 family triads of grandmothers, mothers, and daughters who represented 8 different …

The Relationship Between Race And Ethnicity And Serious Safety Events In Hospitalized Patients, Samantha Crandall

Dissertations

Purpose. This study explored the association between patient sociodemographic characteristics and the occurrence of serious safety events (SSE) in hospitalized patients. Specific aims were to describe among patients who have experienced an SSE: 1) patient sociodemographic variables (age, gender, race, ethnicity and language spoken), health insurance coverage, patient zip code, payer mix, site of care location, and severity of event; 2) the relationships between the select patient sociodemographic variables, health insurance coverage, patient zip code, payer mix, site of care location and SSE level of harm; and 3) what factors increase or decrease the odds of experiencing higher levels of …

Evidence Based Practice Improvement Project To Improve Influenza Vaccination Rate In Intercollegiate Athletes, Clifford W. Fawcett Iii

Dissertations

Influenza is a highly contagious, respiratory infection that affects between 19-26 million people in the United States annually and is associated with morbidity and mortality. Influenza spreads easily with rapid transmission especially in crowded areas. The Centers for Disease Control recommends the best prevention against influenza is the influenza vaccination. The Advisory Committee on Immunization Practices recommends annual influenza vaccination for all individuals greater than six months who do not have contraindications. Strong evidence supports the safety and efficacy of the influenza vaccine, yet the uptake of the vaccine is low across many populations, especially college students. Healthy People 2020 …

Women’S Sexual Satisfaction In The Context Of Midlife Relationships: Examining An Ecological Model And Intergenerational Caregiving, Katherine M. Arenella

Dissertations

This study examined an ecological model of sexual satisfaction in midlife women in relationships, and paid particular attention to the role of intergenerational caregiving in predicting satisfaction. Participants were 1,411 midlife women in relationships who participated in the Midlife in the United States (MIDUS) national study. Using split samples for replication purposes, data from this survey were examined to test the hypothesis that an ecological model - including the macrosystem level variable of religiosity, the exosystem level variables of SES, social support, and parenthood, the mesosystem level variables of relationship satisfaction, affectual solidarity, relationship length, and sexual functioning, and the …

Older Adults' Implementation Of Discharge Instructions Following An Acute Care Hospital Stay, Brenda Miller

Dissertations

Discharge instructions are a self-care guide for patients after discharge from an acute care hospitalization. The discharge process starts on admission to the hospital and continues until discharged. Many patients rely on informal caregivers to provide support after a discharge. However, it is often unclear whether the patients or caregivers completely understand instructions provided during the discharge process. Key concepts related to how discharge instructions were implemented following discharge to home have been understudied from the patient's and informal caregivers' perspectives. Developing effective discharge instructions based on study findings may assist in reducing 30-day hospital readmission rates. This study was …

Emergence Delirium In U.S. Military Combat Veterans, Jason M. Mcguire

Dissertations

This dissertation study examined the phenomenon of emergence delirium in U.S. military combat veterans. Emergence delirium is a post-anesthetic phenomenon that occurs immediately following emergence from general anesthesia and is characterized by agitation, confusion, and violent physical and/or verbal behavior. Clinical evidence suggests that emergence delirium is occurring with greater frequency among military personnel returning from conflict in the Middle East. This body of work is a culmination of three distinctive phases and is presented in three individual manuscripts.

Moral Development And Public Health Nursing, Margaret Avila

Dissertations

Public health nurses (PHNs) have the opportunity and professional obligation to be at the forefront of the fight to eliminate health disparities based on the practice principle of social justice. The overall purpose of this descriptive study was to explore the stage of the moral development in a convenience sample of practicing public health nurses (PHNs) and the differences in moral development stage across selected demographic variables (age, gender, race/ethnicity, level of entry into professional nursing, highest level of education, years practicing as an RN, years practicing in a public health department, self-identified political views, primary language, and region of …

Revalidation Of The Hung Postpartum Stress Scale, Chich-Hsiu Hung

Dissertations

The postpartum period, or puerperium, is a transitional and potentially stressful time during which women need to face both the new tasks of the maternal role and physiological changes in their bodies. Along with these adjustments are changes in the quality of social support needed by new mothers. These changes may trigger postpartum stress, which it may make it difficult for postpartum women to function effectively in their new maternal roles. Postpartum stress may also affect maternal health adversely during the postpartum period. The ability to identify postpartum stressors early in the course of childbearing could facilitate the development of …

The Effectiveness Of A Promotora-Led Intervention For Mexican Americans With Type 2 Diabetes, Josefina Lujan

Dissertations

The purpose of this randomized control repeated measures trial was to determine the effectiveness of a self-management intervention led by community lay workers called promotoras on the health outcomes of Mexican Americans with type 2 diabetes living in a major city on the Texas - Mexico border. The specific aims of this study, in relation to the intervention group participants, were to: (1) decrease the glycosylated hemoglobin (A1c) blood levels at the six-month assessment, (2) increase diabetes knowledge at the three and six-month assessments, and (3) strengthen the participants' beliefs in their ability to manage diabetes at the three and …

Nurse Perceptions Of Facility Influences On Older Adult Acute Care Falls, Patricia Brock

Dissertations

Health care and nursing sometimes seem at odds when determining what is best for patient care. This study examined registered nurse (RN) perceptions of the inability to apply expert specialized knowledge of falls prevention for older adults while maintaining professional nursing standards of care and safety and complying with health care and facility policies, procedures, and bureaucratic directives. Following methods of Institutional Ethnography (IE), the study considered how institutions influenced and organized RNs' work and social organization. The social life and organization of RNs arises in what they do and translate into their specialized knowledge. Within their particular settings and …

Perioperative Nurses Perceptions Of Moral Courage, Georgia A. Dinndorf-Hogenson

Dissertations

Threats to patient safety exist in perioperative nursing. Nurse appraisal of these threats and the likelihood to act with moral courage have not been documented.

This descriptive correlational study examined moral courage in response to threat to patient safety. The moral courage model is based on Lazarus and Folkman's theory of stress and coping. The Dillman, Smythe, and Christenson (2009) tailored design method was used to construct the Moral Courage Questionnaire for Nurses (MCQN) instrument. Moral courage frequency and intensity were explored relative to personal experience and institutional operating room environment.

The Effect Of High-Fidelity Simulation And Traditional Didactic Lecture On First Semester Junior Baccalaureate Nursing Students' Knowledge Acquisition, And Self-Confidence Using The Solomon-Four Group Research Design, Trudy Williams

Dissertations

Nurse educators are challenged with preparing nurses to practice in complex Health care settings. Nursing graduates often feel unprepared to meet the performance expectations placed on them by the Health care industry, displaying a lack of self-confidence and knowledge. The purpose of this study was to test the effectiveness of high-fidelity simulation (HFS) as a teaching pedagogy on first semester, junior baccalaureate nursing students (N = 98) enrolled at an HBCU in southeast Louisiana. More specifically, this study examined the effect of the independent variables, traditional didactic lecture and (an HFS-focused respiratory physical assessment scenario) intervention, on the dependent variables, …

Perceptions Of Future And Advance Care Planning For Japanese Women With Early Stage Gynecological And Breast Cancer, Yuki Asakura

Dissertations

Advance care planning (ACP) is the process that allows individuals to choose a path of care in the event that they are unable to make a decision for themselves. The concept of advance care planning is much broader than merely putting wishes in writing; however, misconceptions exist. The purpose of this study was to gain understanding of perceptions of Japanese women with early stage cancer about ACP. A theoretical model for ACP was developed from review of current knowledge. This study was significant to developing culturally sensitive intervention in supporting ACP in this Asian population. This study utilized ethnography guided …

Environmental And Personal Predictors Of Professional Behaviors Among Baccalaureate Nursing Students, Kae Rivers Livsey

Dissertations

This non-experimental, explanatory study utilized a comparative survey design to test a conceptual model developed by Milisa Manojlovich (2003), to examine whether proposed relationships between environmental and personal factors contributing to professional nursing practice behaviors are supported in baccalaureate nursing program settings.

Qualitative Study: Understanding Mexican American Women's Experience In Intimate Partner Violence, Nora Montalvo-Liendo

Dissertations

The purpose of this qualitative study was to gain an understanding of the experiences of Mexican American women living with intimate partner abuse relevant to the process of disclosure of abuse. Limited research exists on the experiences of women who are of Mexican descent living with intimate partner abuse and their disclosure of abuse. Factors that influence disclosure for other populations are well articulated in the literature however, these factors have not been adequately verified in persons of Mexican descent.

The Biopsychosocial Model Of Metabolic Syndrome Among U.S. Adults, Jennifer L. Saylor

Dissertations

The Metabolic Syndrome (MetS) is a cluster of medical disorders (obesity, hypertension, dyslipidemia, and insulin/resistance/glucose intolerance) that characteristically occur together in individuals. The prevalence of MetS continues to increase in the U.S. and increases the risk of type 2 diabetes, cardiovascular disease (CVD), and mortality. Little research uses a theoretical model to identify direct or indirect contributions to MetS and predictors to MetS. Identifying the factors that influence MetS in a national sample is necessary to understand targets for intervention to prevent the MetS and its sequelae.

This study tested a hypothesized conceptual model of the biopsychosocial factors associated with …

The Effects Of Therapeutic Back Massage On Psychophysiologic Variables And Immune Function In Spouses Of Cancer Patients, Linda M. Goodfellow-Kruth

Dissertations

Scant attention has been given to help spouses of cancer patients reduce stress associated with their partner's illness. Stress-induced immune function change may be the link between stress and illness. A significant decrease in natural killer cell activity (NKCA) and a high incidence of stress-related disorders, depression, loneliness, and marital disruption have been reported in spouses of cancer patients. Therapeutic back massage (TBM) is an intervention that may be beneficial in reducing stress in spouses of cancer patients. TBM is a systematic form of touch that manipulates soft tissues of the body to promote relaxation. Interventions that induce relaxation have …

The Lived Experience Of Chronic Pain In Nurse Educators, Moniaree Parker Jones

Dissertations

Pain is associated with a wide range of disease and injury, and is sometimes the disease itself. Millions suffer from chronic pain every year and the effects of pain lead to tremendous costs for healthcare, rehabilitation, and lost worker productivity, as well as the emotional, psychological, and financial burden it places on patients and their families. The nurse has a key role in effective pain management with the need for accurate assessment, prompt intervention, and evaluation of pain relief measures for positive patient outcomes. The purpose of the study was to explore the lived experience of chronic pain in nurse …