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Pressure Ulcers And Prevention Among Pediatric Patients And Factors Associated With Their Occurrence In Acute Care Hospitals, Ivy J. Razmus

Dissertations

Pressure ulcers are a health-care concern for all patient populations; however, younger patients, including infants, have different etiologies associated with pressure ulcer development. The influence of hospital, unit, and nursing factors on hospital-acquired pressure ulcers (HAPU) rates have not been evaluated in pediatric patients. Comparative data for pediatric patients is necessary for hospitals to improve the care related to prevention and treatment of pediatric pressure ulcers.

The purpose of this study was to describe (a) the pressure ulcer prevalence rate and the rate of HAPU in pediatric patients; (b) the frequency of patient pressure ulcer risk assessment and prevention …

Hypertonic Lower Extremities In Infants: Correlation To Motor Function Scores At Thirteen Months Of Age, Susan Jean Brillhart

Dissertations

Exploring a large data set, hypertonicity of the lower extremities has been incidentally identified as occurring in one out of every five infants, whether term or preterm. This retrospective, longitudinal, descriptive, quantitative study examined data from 463 functionally and structurally normal infants and identified infants that were considered to be hypertonic at either hospital discharge and at one month of corrected gestational age to determine what their motor capabilities were at 13 months of age. Understanding the correlation will assist in determining whether early intervention is indicated for these infants. Multiple statistical analyses revealed no correlation between hypertonicity as a …

Using Second-Transitionary Phase Cognitive Factors To Predict Adherence To A Walking Routine, Donna B. Konradi

Dissertations

The purpose of the study was to test a regression model designed to predict adherence to a walking for exercise routine. An extension of the Second-Transitionary (Adherence) phase of the Natural History of Exercise Model, referred to as the Natural History of Walking for Exercise Model (NHWEM) was the organizing framework.

The Impact Of The Interim Payment System On Ohio Home Healthcare Agencies, Abigail A. Gerding

Dissertations

In order to decrease the escalating costs of home care and extend the solvency of the Medicare trust fund, major changes in home care reimbursement were mandated by the Balanced Budget Act of 1997. The Interim Payment System, required by the Balanced Budget Act, altered the method of payment for home healthcare agencies from a retrospective cost-based system to a per-episode aggregate limit as home healthcare agencies prepared for a Prospective Payment system to be implemented by October of 2000. This study examined the impact of the Interim Payment System on home healthcare agencies across Ohio. As a retrospective, explanatory …

The Experience Of Cognitive Change In Women With Breast Cancer Following Chemotherapy, Mary Louise Kanaskie

Dissertations

Change in cognitive function is one side effect of chemotherapy that has been reported in some breast cancer survivors. Alarming reports indicate that between 16 to 50 percent of women receiving chemotherapy for breast cancer experience symptoms of cognitive impairment. These symptoms include subtle changes in memory, concentration, and some higher order processes that include psychomotor speed and executive functioning. In addition, it has been reported that these symptoms may persist even years after completion of treatment. Research is limited that has explored the lived experience of the phenomenon of chemotherapy-related cognitive change in breast cancer survivors.

The purpose of …

Implementing A Depression Screening And Referral Program In An African American Church Community, Mary S. Garner

Dissertations

The purpose of this quality improvement project was to launch a depression screening and stigma reduction program in a nondenominational church that serves mainly African Americans. Potential links between stigma, such as beliefs related to mental illness, and how education can influence help-seeking and health literacy among ministerial leaders were identified.

Influence Of The Economy On Teen And Adult Birth Patterns In Oklahoma 1980 Through 1995: A Time Series Analysis, Sandra Kay Cesario

Dissertations

Influence of the economy on birth patterns was examined separately for teen and adult women. Competing theories and conceptual frameworks currently exist to describe the cyclic patterns found in reproductive behavior and their relationships to economic condition. Pro-cyclic models suggest a lagged positive association between economic conditions and numbers of births whereas counter-cyclic models indicate that a negative or inverse relationship exists. Three distinct problems were addressed in this study. First, the competing economic models was addressed. Second, this study of daily and weekly births to allow greater sensitivity in testing the relationship of an economic variable number and timing …

Parenting A Lone Twin: When One Twin Dies, Kelly L. Grady

Dissertations

Parents who simultaneously grieve the loss of one twin and nurture the surviving twin experience a paradox of grief and joy. The acute grief of losing a twin coincides with a critical time in the development of the parental role and relationship with the surviving twin. Very few researchers have addressed the unique parenting situation in which one twin infant dies. The aim of this qualitative descriptive study was to describe the experience of parents who lose one twin in utero, at birth, or in the neonatal period. The study question was "What is the parenting experience of mothers and …

The Relationship Between The Nurses' Work Environment And Patient And Nurse Outcomes, Nancy Theresa Blake

Dissertations

Medical errors cost the United States over $50 billion annually. Healthy work environments (HWE) can reduce medical errors and decrease Registered Nurse (RN) turnover. Three of the variables that impact the work environments are communication, collaboration and leadership. The Joint Commission stated that communication failures are the leading cause of harm to patients in hospitals today. With an estimated shortage of 260,000 nurses identified in the year 2025, nurse leaders need to be creative and do what they can to improve the work environment. The purpose of this research study was to determine the relationship between HWEs, patient outcomes and …

Self-Regulation And Exercise Maintenance In Older Women, Joanne K. Schneider

Dissertations

The purpose of this study was to examine factors that influence exercise maintenance in an older population using the self-regulation of exercise maintenance model which focuses on the individual's personal meaning or interpretations of exercise. This study was the second of two phases. The aims of Phase I, the preliminary descriptive phase, were to identify qualitative descriptors of episode-specific interpretations of exercise in women, 60 years of age and older, immediately after an exercise episode. These qualitative descriptors were used to develop an instrument to measure episode-specific interpretations of exercise for the present study, Phase II. In Phase II, instruments …

Traumatic Events, Social Support, And Self-Efficacy: Correlates Of Health Perceptions Among Adolescents, Kerry H. Cheever

Dissertations

The relationship between traumatic events and health perceptions among adolescents is poorly understood. While social support and self-efficacy protect adults from the adverse effects of trauma, the nature of this relationship among adolescents is not clear. The Adolescent Trauma Conceptual Model provides a useful framework to examine these complex interrelationships. The purpose of this research is to examine the relationship between traumatic events such as violent life events, non-violent life events, a natural disaster, and war, and health perceptions in an adolescent population. Additionally, the protective effects of social support and self-efficacy upon these traumatic events and health perceptions is …

Effect Of Heparin Injectate Volume On Pain And Bruising Using The Roy Model, Pamela S. Stewart Fahs

Dissertations

This quasi-experimental study examined the effect of heparin injectate volume on pain and bruising using the Roy model. The study was undertaken to provide nurses with information on responses produced by two injectate volumes.

Perceived Control And Adaptation In Elderly Caregivers, Margaret I. Wallhagen

Dissertations

This study examined the mediating effects of perceived control on the adaptation of elderly caregivers. Perceived control, or the perception that salient or valued aspects of one's life are manageable, was hypothesized as mediating between: (a) the subjective and objective contexts of caregiving and caregiver adaptation and (b) the subjective and objective demands of caregiving and caregiver adaptation. Adaptation was measured as life satisfaction, depression, and subjective symptoms of stress. Objective measures of stress were measured as urinary cortisol, norepinephrine, and epinephrine.

A Secondary Analysis Of Mammography And Pap Screening Among Women With Diabetes, Janet G. Marshall

Dissertations

Using a national database for secondary analysis, the purpose of this investigation was to determine if women with diabetes have different patterns of screening for breast and cervical cancer than women of the general population; and, if so, identify the determinants of the screening pattern. The PRECEDE Model was the organizing framework for this investigation of the complex issues related to cancer screening. The 12 states utilizing the optional women's health module for the 2003 Behavioral Risk Factor Surveillance System (BRFSS) was downloaded into STATA Software.

Exit Exam Testing, Stress, And Test Anxiety In Prelicensure Nursing Education, Lisa D. Brodersen

Dissertations

Knowledge acquisition in nursing education is commonly assessed with tests, also called exams, or examinations. Because of their impact on course grades and academic success, tests are a substantial source of anxiety and stress for nursing students and the central unifying theme of this three-manuscript dissertation. There are two high-stakes tests that are particularly important in nursing education: the exit exam and the licensure exam. The exit exam identifies deficiencies in nursing knowledge and clinical judgment and quantifies students' probability of passing the licensure exam, which is the final test of competency for nursing practice. The first manuscript resulted from …

Shipboard Nursing On Aircraft Carriers: The Lived Experience Of Twelve Navy Nurses, Catherine Wilson Cox

Dissertations

The purpose of this study, was to describe the lived experience of shipboard nursing on aircraft carriers. As of Spring 2001, the Navy had twelve aircraft carriers in operation. Each carrier's medical department includes just one Navy nurse assigned to directly care for over 5,500 personnel. Currently, there is no research that describes what it is like to be the only nurse available to a patient population in the thousands. Using the principles of phenomenology, twelve Navy nurses previously stationed aboard aircraft carriers were interviewed to explore their experience as ships' nurses.

Deciding To Withhold/Withdraw Life-Sustaining Treatments From Incompetent Adults Following Unanticipated, Catastrophic Illnesses: A Phenomenological Study Of Surrogate Decision Makers' Experiences, Carolyn M. Hayes

Dissertations

The purpose of this study was to describe the experience and meaning of having made a decision to withhold and/or withdraw life-sustaining treatments from an adult who was rendered incompetent following an unanticipated, catastrophic illness.

The Effect Of Social Support On Women's Perception Of Perimenstrual Changes, Gwen G. Morse

Dissertations

The unidimensional approach that has dominated research on premenstrual syndrome (PMS) has been remiss in visualizing the diversity of factors that may be involved in women's menstrual cycle experiences. Traditional menstrual cycle research reflects a stereotypic negative bias that does not encompass the complexity of the phenomena. For example, even though, the majority of menstrual cycle literature has focused on negative changes during the perimenstruum, some women report positive changes. This research represents an endeavor of a unique nursing intervention aimed at reframing perceptions of menstrual cycle experiences for the purpose of diminishing perimenstrual impairment. The intervention was a health …

A Mother's Lived Experience During An Acute Episodic Hospitalization Of A Child With A Chronic Condition: A Case Study, Arleen N. Steckel

Dissertations

Chronic conditions affect approximately 31% of children less than 18 years of age of which 2% have severe conditions. Advances in medical and surgical technologies have created and maintained this growing population of children. Many of these medically fragile children have an unknown life expectancy and face a future that is uncertain and unpredictable. Caring for such a child is a difficult and challenging job. Children with chronic conditions who become hospitalized with an acute episodic illness may stress the mother even more. The purpose of this case study was to investigate a mother's perceptions of her experience during the …

Development Of The Woman Abuse Screening Tool, Wendy K. Taylor

Dissertations

Researchers reported that 25%-33% of female trauma victims had injuries caused by battering. More than one million women per year seek medical care for injuries caused by battering. Of those who seek medical care, only one in ten is officially identified as a battered woman. Women are routinely screened for a variety of problems, conditions, or medical disorders, but violence is not included. An important issue related to identifying battered women is the lack of an appropriate comprehensive screening tool. The purpose of this study was threefold: (a) determine whether using a comprehensive abuse screening tool results in an increased …

Managing My Pregnancy: A Grounded Theory Of Pregnancy And Childbearing Beliefs And Practices Of Women Of Mexican Descent, Lorena Consuelo Guerrero

Dissertations

Examples of pregnancy-specific health beliefs and practices of Hispanic women are found in the medical literature, but the findings regarding the beliefs and practices are often outdated, limited, mostly curative in nature, and are often dismissed as benign cultural practices of a mainly homogeneous cultural group. Hispanic women incorporate both conventional and biomedical practices with traditional medicine/complementary and alternative medicine in their treatment of illnesses. The findings from this study served to illustrate current pregnancy-specific health beliefs and practices of pregnant Hispanic women of Mexican origin. The purpose of this study was to gain an understanding of the pregnancy-specific health …

Hiv Informal Caregiving: Role Responsibilities And The Effects Of Case Management, Nancy R. Reynolds

Dissertations

The purpose of this study was to describe how HIV informal caregivers experience the social and biophysical dimensions of the HIV illness process and develop a supportive and sustaining environment. The specific aims of this project were to: (1) explore the role responsibilities of HIV/AIDS informal caregivers over the course of HIV illness; and (2) describe the effect of a case management model on HIV/AIDS informal caregivers' health/well-being and satisfaction with formal services. A prospective design was used to facilitate exploration of the emergent nature of the caregiving role. Data was gathered in 32 indepth interviews with 20 subjects who …

A Silent Epidemic With No Voice: Alzheimer's Education In An African American Midwest Community, Sandra D. Fields

Dissertations

Alzheimer’s disease is a growing crisis in this country, particularly in the African American community. Despite this awareness by the health care community and educational programs offered about the disease, a deficit in research assessing the impact of these programs exists. Consequently, the purpose of this study is to analyze the key criterion relative to the educational programs about Alzheimer’s offered by local organizations and the impact they have on a Midwest African American community.

According to research regarding Alzheimer’s disease, African Americans continue to go undiagnosed and untreated. The literature review in this study explores the synergy of three …

Basic Knowledge In Critical Care: A Comparison Of Experienced And Newly Graduated Nurses Augmented With An Examination Of Newly Graduated Nurses? Experience Making Clinical Judgments, Lynn L. Wiles

Dissertations

Newly graduated nurses (NGNs) are thrust into roles that some purport they are inadequately prepared to handle. Studies found that 4% of NGNs were comfortable with their skills, it took up to one year to feel competent and confident, and NGNs feel shocked, unprepared, and overwhelmed. The purpose of this mixed method study was to investigate the basic knowledge (BK) of NGNs working in the critical care (CC) setting and compare it to the BK of experienced nurses and to understand the experience of NGNs as they made clinical judgments. Triangulation linked the experiences of NGNs as they made clinical …

The Use Of Ice For Pain Associated With Chest Tube Removal, Jenny L. Sauls

Dissertations

The purpose of this experimental study was to ascertain whether the application of ice would decrease pain before, during, and after chest tube removal (CTR) in adults who have undergone cardiothoracic surgery.

Rural Daughter/Daughter-In-Law Caregivers' Interactional Patterns, Sharon P. Ridgeway

Dissertations

Daughters/daughters-in-law who care for a parent with a dementing illness at home are at risk for physical, psychological, and social problems. Also, their parent care recipient runs a higher risk of institutionalization, In order to intervene in this dynamic, a multidimensional, subjective perspective is required. However, literature is sparse regarding a multidimensional subjective perspective of rural daughter/daughter-in-law caregivers' patterns of interaction within the context of caring for a parent with a dementing illness. The purpose of this research was to identify the multidimensional patterns of person-environment interaction.

The Lived Experience Of Women Who Quit Assisted Reproductive Technology Without The Birth Of A Live Child And Remained Childless, Linda L. Millenbach

Dissertations

The purpose of this study was to describe the experience of women who quit assisted reproductive technology (ART) without the birth of alive child and remained childless.

Barriers To Student Connectedness And Engagement: How Socioeconomic Status Affects Student Involvement, Dominic M. Manola

Dissertations

Today, as students prepare for post-secondary opportunities, a greater and greater emphasis is placed on the importance of engaging learners both in and out of the classroom. While many students are inclined to get involved, there is a growing number of young people who face barriers that prevent them from connecting and engaging in the high school experience. Importantly, socioeconomic status plays a key role in determining how engaged a student may be, as well as serving as a key identifier in what must be addressed to ensure more young people get involved in their academic and co-curricular learning. This …

Minority Students In Stem Careers In The U.S. – The Role Of Ap Calculus, Kendall Coleman

Dissertations

“The number of native-born S&E [science and engineering] graduates entering the workforce is likely to decline unless the nation intervenes to improve success in educating S&E students from all demographic groups, especially those that have been underrepresented in S&E careers” (National Science Board [NSB], 2003, p. 13). More than a decade ago, the National Science Board (NSB) sounded an alarm regarding the projected decline in native-born science and engineering graduates with the aim of driving strategic fundamental changes. There is limited evidence that the NSB’s prognostication is actively being addressed. Approximately 81% percent of all full-time graduate students in U.S. …

Developmental And Sex Modulated Neurological Alterations In Autism Spectrum Disorder, Azeezat Azeez

Dissertations

Autism Spectrum Disorder (ASD) was first described in 1943 by Dr. Leo Kranner in a case study published in The Nervous Child. It is a neurodevelopment disorder, with a range of clinical symptoms. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), used by clinicians to diagnose mental disorders, a child needs to have persistent social deficits, language impairments, and repetitive behaviors, that cannot be explained by neurological damage or intellectual disability. It is known that children diagnosed with ASD are often are developmentally delayed therefore alterations in the typical developmental trajectory should be a major factor in …