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Staffing Patterns Before And After Mandated Nurse-To-Patient Ratios In California's Hospitals, Teresa D. Serratt

Dissertations

This study identifies and describes changes in nurse staffing that may have occurred as a result of the enactment of nurse-to-patient ratios and whether these changes were associated with particular hospital characteristics, controlling for market factors and population factors.

Development And Testing Of A Measure Of Patient Satisfaction With Nursing Care, Lee A. Schmidt

Dissertations

The purpose of this research was to test an empirically derived measure of patient satisfaction with nursing care. Existing measures of this important phenomenon lack adequate validity and a strong theoretical base. A grounded theory study was completed with patients discharged from medical surgical units of a tertiary care facility.

Cultural Competence And Racist Attitudes Of Direct Patient Care Registered Nurses In A Midwestern State, Linda Kay Hardy

Dissertations

Racism has been implicated as one of the causes of health disparities in non-White population groups in the United States. The purpose of this study was to explore and describe cultural competence and racist attitudes of direct patient care registered nurses (DPC RNs) in a Midwestern state. The researcher hypothesized that racist attitudes impacted cultural competence, compromised the nurse-patient interaction, and potentially led to less than optimal patient outcomes. Critical Social Theory and Leininger's Theory of Culture Care Diversity and Universality served as the framework for this quantitative, descriptive correlational dissertation research. Cultural competence was measured with the Cultural Competence …

Teaching The Spiritual Dimension Of Nursing Care: A Survey Of Associate Degree Nursing Programs In The Southeast United States, Nancy L. Labine

Dissertations

Spirituality is a subject which is often neglected in nursing education. The purpose of this study was to determine associate degree nursing faculty's perception of their ability to teach the spiritual dimension in the delivery of nursing care. The study explored whether faculty have received training related to spiritual care, how and where nursing programs integrate spirituality education into the curriculum, nursing faculty's understanding of the terms spirituality and spiritual care, and faculty members perception of whether they receive sufficient support and guidance in teaching related to spirituality and spiritual care. Survey research was used in this study.

Variables That May Affect Physical Activity Levels In African American Females With Type 2 Diabetes, Melanie K. Samardzija

Dissertations

Type 2 diabetes continues to pose a significant health challenge for the United States. The incidence and prevalence rates for type 2 diabetes are higher for certain at risk populations such as African American females. Personal behaviors including high-fat, high-caloric diets and physical inactivity result in obesity and insulin resistance that are associated with type 2 diabetes. Physical inactivity is particularly common in African American females, and this places them at an increased risk for the development of type 2 diabetes. Certain variables have been shown to influence physical activity. The purpose of this study was to examine how selected …

Stories, Ethics And The Interpretation Of Meaning: Bearing Witness To Mothers' Stories Of Their Neonatal Intensive Care Unit Experience, Angela C. Blackburn

Dissertations

This study grounded in narrative perspectives was conducted to uncover mothers' experience of having a baby in the Neonatal Intensive Care Unit (NICU). The purpose of this study was to describe and interpret mothers NICU experiences, and to sensitize health care professionals about the importance of mothers' personal experience stories. The NICU experience began with mothers' birth experience or the incident that led up to her infant requiring care in the NICU and her experience extended beyond the NICU with future concerns about the health and wellbeing of her baby.

Deliberate Practice Using Simulation To Improve Clinical Competency And Confidence, Sharon Lacue

Dissertations

Bridging the gap between classroom learning and nursing practice is an ongoing concern in nursing education. Multiple studies have found that students who are provided the knowledge, skills and modeling behavior, in addition to an expectation of efficacy, have an increase in their confidence of acquired skills and thus an increase in self-confidence and competence. However, patients in acute care settings have increasingly complex medical problems, which often leave nursing students with minimal hands-on care for their assigned patient. The purpose of this study was to examine the effect of deliberate practice, using a repeated simulated clinical experience, on student …

The Paradox Of Respect And Risk: Six Lakota Adolescents Speak, Mary J. Isaacson

Dissertations

Adolescence is a time of turbulence as young people stretch parental boundaries, seeking where they fit in society. For many American Indian adolescents this time involves the initiation of dangerous high-risk behaviors. Potential causes posed for this are: loss of identity, loss of cultural values and traditions, lack of positive role modeling and feelings of hopelessness. Survey research has been the predominant method of data collection. Very few studies of Native American youth use storytelling, even though stories are a part of many Indian cultures. The primary purpose of this study was to describe the phenomena of respect and risk …

Contributions Of Three Nursing Leaders To The Development Of Registered Nursing Education In Jamaica, 1946-1986, Hermi Hyacinth Hewitt

Dissertations

The historical research design is used to document the contributions that Misses Ruth Nita Barrow, Gertrude Hildegarde Swaby and Julie Symes made in advancing the status of professional nursing education in Jamaica, between 1946 and 1986. Their roles in the Jamaica General Trained Nurses Association and the General Nursing Council of Jamaica in obtaining registration for nurses' education in Jamaica, reciprocal agreement with England and Wales and professional recognition from the International Council of Nurses are discussed. Since nearly two decades of Barrow, Swaby and Symes' contributions to professional nursing's development occurred while Jamaica was a British colony, the economic, …

Factors Influencing End-Of-Life Decisions Regarding The Living Will And Durable Power Of Attorney: An Application Of Roy's Adaptation Model, Weihua Zhang

Dissertations

Modern technology offers extraordinary life-saving opportunities that were not imaginable in old times. However, it also takes us to a new frontier where the challenge of life-saving becomes death-prolonging. More than a decade after the Patient Self-Determination Act which guarantees the individual's legal right to decide the end-of-life care, the utilization of this right has seen no significant increase. The purpose of this quantitative study was to identify the variables that influence the decision-making responses related to Advance Directives (ADs). A path model applying Roy's Adaptation Model was developed for the study. Publicly accessible data collected for the Longitudinal Study …

Psychometric Evaluation Of A New Pressure Ulcer Skin Risk Assessment Scale For The Pediatric Burn Patient, Mary D. Gordon

Dissertations

Prevention of pressure ulcers is a primary goal in nursing practice, and achievement implies excellence in clinical care. One component of prevention is to understand the risk for pressure ulcer development. The benefit of knowing risk is to initiate pressure ulcer preventive interventions. Pressure ulcers are a significant problem in the pediatric burn patient population. Unfortunately, no skin risk assessment scale exist that capture the unique risk indices of the burn injury, thus the Pressure Ulcer Skin Risk Assessment Scale (PrUSRAS) was developed. The purpose of this study was to evaluate the validity, reliability and predictability of scores from the …

Siblings Of Children With Down Syndrome: Voices Heard, Kimberlee A. Sutter

Dissertations

The purpose of this study was to explore the meanings of the relationship of school-age siblings of brothers or sisters with Down syndrome in order to gain a greater understanding of the lived experience from the view point of the school-age sibling. Sibling spend more time together than any other family subsystem and siblings actively shape one another's lives and prepare each other for future experiences. With children with Down syndrome living into their 60's, the question regarding the sibling relationship is becoming an important focus due to the possible demands on the sibling to care for the individual with …

Acculturation And Health Status Among Hispanic American Elders, Charles P. Buscemi

Dissertations

Hispanic Americans are at risk for health-related problems. Disparities in diseases such as diabetes and obesity, access to health services and health insurance have placed Hispanic Americans at a disadvantage. Sociocultural factors such as acculturation and its relationship to health requires further development. This study was a secondary analysis of a parent study titled Culture Bias in Testing Expressive Ability in Dementia (Tappen, Williams, Loewenstein, Rosselli, Touhy, & Morgan, 2000). The primary purpose of this dissertation was to identify the relationship between acculturation and health in Hispanic American elders. Specific aims were (1) identify the relationship between acculturation and cigarette …

Nurses, Philanthropies, And Governments: The Public Mission Of Chilean Nursing 1900-1945, Jeannine M. Uribe

Dissertations

This dissertation examines the role of nurses in Chile during the transformation of the health care system from charitable benevolence to duty of the state. The first secular nurses trained to assist physicians in 1902 and were educated, middle class women. The Constitution of 1925 made public health a state responsibility and created a middle class bureaucracy. A U.S. model of public health nursing started in Chile in 1927. In 1941, the International Health Division of the Rockefeller Foundation was invited to improve public health and to build the public health leadership of physicians and nurses in Chile. A demonstration …

Factors Associated With Peer Violence Among Elementary, Middle And High School Students, Tracy J. Perron

Dissertations

The purpose of this study was to examine the relationships among perceived school climate, self-reported psychosomatic symptoms, visits to the school nurse for reported psychosomatic symptoms and reports of bullying behaviors among students' grades 3-12. In the study self-reported bullying behaviors were proposed to predict psychosomatic complaints at the school health office. Negatively perceived school climate was proposed to predict bullying behaviors. Lastly, the combination of bullying and negative school climate were proposed to predict psychosomatic complaints. The final convenience sample of 222 students, ages 8-18 years, was obtained from one elementary school, one middle school and one high school …

The Impact Of Debriefing Sessions Following Viewing Of Recorded High Fidelity Simulation Scenarios On Knowledge Acquisition, Self-Confidence, And Satisfaction: A Quasi-Experimental Study, Kristen D. Zulkosky

Dissertations

The role of the nurse educator is complex and it is imperative that educators design pertinent learning activities including implementation of innovative teaching strategies while using the latest pedagogical techniques, and evaluating that learning occurred. This study utilized a quantitative, quasi-experimental, comparison group, crossover design and compared teaching strategies using simulation in the classroom. The purpose of the study was to determine if fourth semester Associate of Science in Nursing students who participated in debriefing sessions after watching recorded high-fidelity simulation scenarios in a nursing class obtained higher examination scores than those who received the same content through traditional lecture …

How Perioperative Nurses Define, Attribute Causes Of, And React To Intraoperative Nursing Errors, Robin R. Chard

Dissertations

Errors in nursing practice are a growing concern in healthcare posing a threat to patient safety. Practitioners have been hesitant to come forward and report errors because of negative ramifications in the workplace. Few studies have approached error management through the eyes of the clinician or have studied how nurses cope or change their practice after committing an error. Studies on nursing errors have traditionally used floor/unit nurses as the sample population. This study used an often unseen and highly specialized group known as perioperative or operating room registered nurses. This study was a descriptive, correlational design using a survey …

Brokering Student Well-Being: Understanding The Work Of School Health Administrators, Samantha Blackburn

Dissertations

Despite a well-documented need for school health programs (SHPs) among school children who have chronic conditions, require medically complex interventions at school, or experience socio-emotional health issues, there is little school health funding in California. There is limited research on the role of those who manage SHPs.

This qualitative study investigated the work of a selected group of school health administrators (SHAs) in California. Study aims were to explore SHA job pathways and responsibilities, the contextual factors influencing their work, and how they get their work done given limited funding for SHPs.

Deciding To Engage In Advance Care Planning: A Comparison Of Participants' Experiences, Karen Joy Vander Laan

Dissertations

Advance care planning (ACP) is a dynamic decision-making process that assists people to construct and communicate their preferences for end of life care. Two decades of research have shown that when preferences are not known, undesirable outcomes may occur for individuals and other surrogate decision-makers. Barriers to advance planning can be addressed through educational programs, especially through existing community-based groups. The purpose of this study was to examine internal and external influences within the decision-making context that may affect individuals' decisions to engage and re-engage in ACP. The Decision Process Model for Advance Care Planning provided the conceptual framework for …

The Lived Experience Of Non-Degreed Learners From A Time Modified Traditional Baccalaureate In Nursing Program, Stephanie S. Deboor

Dissertations

The purpose of this phenomenological inquiry was to describe, interpret, and gain a deeper understanding of how non-degreed, traditional baccalaureate nursing students experience education in a Time Modified Traditional Program of study.

Structural And Psychological Empowerment Of Community/Public Health Nurses, Linda C. Royer

Dissertations

This descriptive, non-experimental study examines the perceptions Community/Public Health Nurses (C/PHNs) have about the work they do and about their workplace when questioned about organizational factors that potentially lead to a sense of empowerment and commitment.

Hemodynamic Changes Associated With Manual And Automated Lateral Rotation In Mechanically Ventilated Intensive Care Patients, Shannan K. Hamlin

Dissertations

Objective: To investigate hemodynamic responses to lateral rotation. Design: Time-series within a randomized controlled trial pilot study.

Predictors Of Success On The National Council Licensure Examination For Registered Nurses (Nclex-Rn) In A Traditional Baccalaureate Nursing Program: A Descriptive Study, Ana Stoehr

Dissertations

A major issue for most nursing programs is how to produce graduates who will be successful in the program and on the NCLEX-RN. Providing an optimal undergraduate education is made more difficult by issues such as limited clinical space for students' experiences, and the nursing shortage, which increases the pressure on nursing programs to accept more students and graduate all admitted students. It is imperative that nursing programs accept those applicants who are most likely to graduate, and in a timely manner. This study examined variables that have been suggested as predictors of success on the NCLEX-RN.

Missionary Nurse Dorothy Davis Cook, 1940-1972: "Mother Of Swazi Nurses", Susan E. Elliott

Dissertations

Dramatically absent from nursing's historical knowledge and professional recognition are the lives, roles, contributions, and legacies of Christian faith-based nurses. The purpose of this study was to investigate the ministry and service of Sister Tutor Dorothy Davis Cook, Church of the Nazarene missionary nurse in the African country of Swaziland 1940 to 1972. The multi-dimensional, multi-task expanded roles manifested in her integration of Christian missionary and nurse were explored and her legacy identified.

Trying Something New: Understanding The Common Practices Of Reforming Nursing Education, Martha M. Scheckel

Dissertations

What are the common reforming practices of teachers when they reform nursing education? How is cultivating thinking an important reforming practice in nursing education that moves beyond teaching "critical thinking?" Do the Concernful Practices of Schooling Learning Teaching reveal reforming practices that illuminate engendering community as central to creating and sustaining innovation? This interpretive phenomenological and Heideggerian hermeneutical study describes two themes (common practices) of reforming nursing education: Cultivating Thinking and Enacting the Concernful Practices: Making Visible How Innovation Arises. A pattern, Unlearning and Becoming, one of the Concernful Practices, was of central importance in this study. It describes how …

The Relationship Of Self-Efficacy, Social Support, Self-Esteem, And Hope With Sex Related Health Promotion Behaviors In Hiv-Infected And Uninfected Women, Shirley Mae Timmons

Dissertations

The Sex Related Health Promotion Behaviors Model (SRHPBM), suggesting a positive relationship between self-efficacy, social support, self esteem, hope, and sex related health promotion behaviors, was used in this descriptive study to guide the investigation of five research questions: (1& 2) are variables in the (SRHPBM), (self-efficacy, hope, social support, self esteem) significantly associated with sex related health promotion behaviors in HIV+ and HIV- women? (3 & 4) are there significant differences in self-efficacy, social support, self esteem, hope, and sex related health promotion behaviors in HIV+ and HIV- women and (5) Do self-efficacy, social support, self esteem, and hope …

Relationships Among Nurses' Professional Identity, Career Satisfaction, Occupational Commitment, And Intent To Stay, Sheila M. Sharbaugh

Dissertations

The shortage of registered nurses (RNs) in the United States continues to be of major concern in the healthcare industry. This shortage is expected to intensify as the current workforce ages, the general population ages, and the need for healthcare grows. It has become increasingly important to investigate the factors that contribute to nurses' commitment to the profession of nursing and intent to stay in the profession. The first purpose of the study was to describe RNs' professional identity, career satisfaction, and occupational commitment and intent to stay. The second purpose was to discover how the professional identity of nurses, …

An Emergency Department Patient's Perception Of Safety, Paul R. Clark

Dissertations

Because the patient's perception of safety in the healthcare system has not been adequately examined, the purpose of this study was to discover an Emergency Department patient's perception of safety so as to add an element currently absent in safe patient care provision.

The Lived Experience Of Non-English And Limited English Speaking Hispanic Persons Associated With A Past In-Patient Hospitalization In The United States: A Phenomenological Study, Jana Goodwin

Dissertations

The Hispanic population in the United States faces many challenges such as differences in language, culture, education, and socioeconomics. Research findings suggest that poor acculturation, language barriers and healthcare provider biases are associated with decreased access to care, lack of insurance or underinsurance, underutilization of services, feelings of isolation and powerlessness, which may lead to poor health outcomes. This hermeneutical phenomenological study explored the lived experience of non-English and limited English speaking Hispanic persons associated with past in-patient hospitalization in the United States.

United States Resident, Jordanian And Palestinian Women's Participation In Breast Cancer Screening, Lina N. Kawar

Dissertations

Breast cancer is a threatening disease to women worldwide. Breast cancer screening (BCS) is a key to early detection and reduced mortality. Factors predicting women's participation in BCS have been well studied in the United States (US), including among major US racial and ethnic minority groups. Factors predicting participation in BCS among immigrant ethnic groups, such as Arab women, are less well studied, especially cultural factors that may be barriers to BCS. The purposes of this cross-sectional, predictive, correlational study were to: (1) describe US resident-Jordanian and Palestinian women's psychological variables (feelings, attitudes, and habits) toward participation in BCS, (2) …