Digital Commons Network^™

Evolving An Ecological Way Of Thinking: Social Interactions And The Construction Of Environmentally Sustainable Behaviors In Adolescents During Expeditionary Learning, Jennifer Fruend

Dissertations

The people around us - as well as the methodical progression of education through content - often shape our relationship to the world. Currently, Earth is at a crossroads, which requires humans to act and live more sustainably with an intentional environmental ethos, whether for literal survival or for slowing Earth’s resource degradation. Situated within the models of ecological contributors such as Aldo Leopold, transformational experiences, particularly when processed with self-reflection, writing, and social interaction, can change behaviors and priorities in individuals. Additionally, by recognizing the place of social learning components in expeditionary, informal, or adventure-based education settings, the potential …

Policy Alternatives That Provide California School Districts With The Policy Options Necessary To Develop Facilities To Enhance Student Learning Opportunities And Optimize Financial Resources, Brett Mitchell

Dissertations

Purpose: The purpose of this study was to develop policy alternatives by the years 2019 to 2025 that would assist state policy makers, legislators, and advocates in adding definition to California school facility development and funding.

Methodology: This study involved descriptive statistics using a Delphi study method. Within the theoretical framework established for policy analysis, this Delphi study was inclusive of the knowledge and expertise of an expert panel that was nominated through peers. The Delphi panel consisted of 24 experts knowledgeable about statewide school facilities policy in California. The Delphi study was comprised of 3 rounds of electronic questionnaires …

Mental Health Nurses' Imagination, Power, And Empathy: A Descriptive Study Using Rogerian Nursing Science, Maureen B. Doyle

Dissertations

The researcher developed a perspective on empathy derived from Rogers' (1970, 1994) Science of Unitary Human Beings. Building on Barrett's (1983) Rogerian theory of power as knowing participation in change, the researcher proposed that empathy and power would change relative to each other and relative to the creative manifestation of human imagination. Using a descriptive correlational design, three hypotheses predicting that empathy, power, and imagination would each be related positively to one another were tested.

The Relationship Between Two Types Of Artificial Lighting And Restlessness As Manifested By Level Of Activation And Motor Activity In The Elderly, Ann F. Kolanowski

Dissertations

The researcher's purpose in this study was to investigate a proposed relationship between the spectral power distribution of two different fluorescent lights and two measures of restlessness, motor activity and level of activation. Motor activity was measured using Down's and Fitzpatrick's (1926) Motor Activity Rating Scale. Level of activation was measured using Hoskins (1978) alternate forms of Thayer's Activation-Deactivation Adjective Check List. The spectral power distribution of fluorescent lights was selected as a stimulus which might induce restlessness because different colors are known to have different arousing potentials. A General Electric Chroma 50 lamp provided broad spectrum fluorescent lighting. This …

Patterns Of Fatigue And Factors Influencing Fatigue During Adjuvant Breast Cancer Chemotherapy, Ann M. Berger

Dissertations

Women beginning adjuvant chemotherapy for breast cancer seek information from health professionals regarding fatigue, but knowledge regarding this distressing symptom is currently limited. The purposes of this study were to describe the patterns of fatigue and of factors influencing fatigue across the first three cycles of chemotherapy and to determine the extent to which health and functional status, chemotherapy protocol, physical activity behaviors, activity/rest cycles, nutrition behaviors and status, stress management behaviors, interpersonal relations behaviors, symptom distress and reaction to the diagnosis of cancer explain fatigue at each treatment and predict fatigue at the mid-point of the first three chemotherapy …

Food, Body Weight, And Health Among Adolescents In The Digital Age: An Explorative Study From A Health Promotion Perspectives, Christopher Bjorn Holmberg

Dissertations

The overall aim of this thesis was to explore adolescents' relationship with food, body weight, and health communication in online digital media, as well as how adolescents experience participating in a health promotion intervention regarding food and physical activity habits. Health promotion as a research area served three purposes: to inform the research questions, to direct the data collection, and to identify implications from the research findings. The four included studies explored how adolescents portray food in a widely used image-sharing application, why and how adolescents in treatment for obesity engaged with online health-related information, and how these adolescents experienced …

Self-Selected Distraction For Acute Procedural Pain In Adolescents: An Intervention Feasibility Study, Debra A. Jeffs

Dissertations

This feasibility study evaluated all phases of the planned main study. The study tested the effect of self-selected distraction on acute pain perception in adolescents undergoing allergy skin testing. Distraction is a cognitive-behavioral nonpharmacologic nursing intervention used to divert attention from painful stimuli, which is supported by the gate control theory and distraction framework. A developmental model of adolescence provided a framework for testing self-selected distraction with adolescents for whom choice and control are important developmental concerns.

What is the effect of distraction on acute procedural pain perception in adolescents? Specifically, what is the effect of self-selected distraction, rather than …

Early Outcomes From Mild Traumatic Brain Injury From Child And Proxy Perspectives, Pamela Pieper

Dissertations

Approximately 70-90% of traumatic brain injuries are mild, with a worldwide incidence greater than 600 per 100,000 people. Previous studies of health-related quality of life (HRQoL) after a mild traumatic brain injury (mTBI) have not included child perspectives or children discharged from the Emergency Department.

This study evaluates, from perspectives of children and their proxies, whether children who have sustained an mTBI return to pre-injury levels of HRQoL by 1-month post-injury and whether their HRQoL is different from that of mild non-brain injured or uninjured children at either time point. It also compares child/proxy dyad ratings of the child's HRQoL.

Fleet Mental Health: A Discourse Analysis Of Navy Leaders' Attitudes About Mental Health Problems, Richard J. Westphal

Dissertations

Mental disorders are a significant source of medical and occupational morbidity for active duty military members. The majority of military personnel believe that using mental health services will cause career harm, and over 81% of those with mental health problems do not seek treatment. The literature suggests that stigma and fear of negative career impact are significant barriers to the use of mental health services. Military members have indicated that concern about leaders' attitudes is a barrier to seeking help. The attitude of military leaders is important because those leaders have authority over both subordinates' careers and their access to …

Effectiveness Of Experiential Learning Strategies, Debra L. Fowler

Dissertations

The aim of this experimental study was to determine if Baccalaureate of Science in Nursing (BSN) students who complete a service learning (SL) assignment within a nursing course score significantly higher on the Nursing Professional Values Scale—Revised (NPVS-R) compared to an attention control group of BSN students in the same nursing course.

Clinical Decision-Making Among Nursing Students: An Interpretive Study, Ann Hanson White

Dissertations

Clinical decision making has been identified as one of the most important contributions made by the professional nurse in the care of patients. Yet as a discipline, we continue to question what factors influence the development of clinical decision making skills. The purpose of this study was to identify how nursing students learn clinical decision making. Heideggerian phenomenology and hermeneutical analysis provided the framework and method for the study.

Experienced Engagement In Appreciative Advising Of Adjunct Professors In Community College Education, Margaret Kenrick

Dissertations

Purpose: The purpose of this explanatory sequential mixed-methods study was to identify what Appreciative Advising strategies were used by adjunct professors to engage community-college students when participating in Appreciative Advising. The study was also designed to describe the experiences of the adjunct professors as they implemented the strategies of Appreciative Advising with students. In addition, it was the purpose of this study to describe the benefits and challenges adjunct professors experienced when participating in Appreciative Advising. Finally, this study sought to describe the impact to teaching practices experienced by adjunct professors who participated in Appreciative Advising.

Methodology: This study used …

Mixed-Method Study Exploring International Students’ Career Readiness At A Four-Year Private University In The Midwest, Chloe Bonnand

Dissertations

This study explored international students’ career readiness in a four-year, private university in the Midwest. In order to measure career readiness, the researcher reviewed three factors: financial support, academic major, and country of origin. International students graduating in May 2018 received a survey from the researcher on career readiness. A total of 38 students completed the survey. The final question of the survey was an invitation to participate in an individual interview and/or a focus group. The qualitative data from the survey showed that financial support impacted international students’ career readiness. International students with financial support were more prepared to …

Increasing Patient Engagement In The Pre-Operative Patient Population, Toni Morris

Dissertations

The United States (U.S.) spends more revenue than any other industrialized nation on healthcare yet research indicates this does not equate to delivering the safest or most efficient quality patient care (Riehle & Hyrkas, 2012). Patients within the U.S. healthcare system have been the beneficiaries of cumbersome processes riddled with redundancy, waste, and discordant care (Institute of Medicine [IOM], 2001). Because of this data, healthcare reform to improve the quality and efficiency of patient care delivery has been the topic of debate over the past several decades, on both a national and global scale. Several organizations, coalitions, and groups have …

Early Identification And Intervention In Patients With Atrial Fibrillation Using An Implantable Cardiac Monitor To Significantly Improve Guideline-Based Anticoagulation Therapy In An Outpatient Cardiology Clinic, Lisa Alvarez

Dissertations

The purpose of this research was to (a) examine the demographics of patients receiving care in an outpatient cardiology clinic, (b) describe the relationship between the atrial fibrillation (AF) and other variables (e.g., BMI), (c) examine the frequency and the length of time to AF diagnosis in patients implanted with an implantable cardiac monitoring (ICM) device, (d) observe provider patterns of treatment with oral anticoagulants (OACs), and (e) investigate documented considerations to either diagnose or rule out OSA in a group of outpatient AF patients in a cardiology clinic.

Background: AF is largely undiagnosed but can cause major morbidity and …

Interprofessional Healthcare Provider Education On Neonatal Abstinence Syndrome, Mary Puchalski

Dissertations

The rapidly increasing incidence of Neonatal Abstinence Syndrome (NAS) in the U.S. has been identified as a national healthcare crisis. An evidence-based practice change project, ";Interprofessional Healthcare Provider Education on NAS"; (IHPEN) was designed to implement a protocol to increase consistency in treatment for infants with NAS and provision of healthcare provider education to increase knowledge regarding NAS, as well as sensitivity to the signs and symptoms of withdrawal. The target population included all healthcare providers in the Neonatal Intensive Care Unit and Mother/Baby Unit of a large, urban, not-for-profit perinatal center. The project was developed in response to a …

Self-Reported Health Status And Health Determinants In Low Income Midlife Women Aged 40 To 64, Teresa L. Barry Hultquist

Dissertations

The purpose of this descriptive longitudinal study was to describe (a) self-reported health status, (b) the relationship between self-reported health status and individual, environmental, and system health determinants, and (c) changes over time in self-reported health status and health determinants in midlife low income women.

The Lived Experience Of Breastfeeding For Women With Perinatal Depression, Beth A. Pratt

Dissertations

Exclusive breastfeeding for at least 6 months provides numerous infant and maternal benefits. Yet mothers with risk factors, such as lower education, lower socioeconomic status, younger maternal age, planned cesarean birth, and anxiety and depression, are more likely to stop breastfeeding in the early postpartum period. Few studies have focused on perinatal depression as a risk factor for breastfeeding cessation. To tailor effective interventions, nurses must first understand the lived experience of breastfeeding for mothers at risk for perinatal depression. A descriptive phenomenological study was conducted to elucidate the experience of breastfeeding for mothers with perinatal depression. The study was …

Adolescent Motherhood: The Human Agency Perspective, Sharon L. Dormire

Dissertations

The purpose of this study was to develop and test a causal model a priori. The mediating influence of self-esteem in the relationship among the sociocultural variables of race, social status and family relationships, perception of motherhood, and pregnancy in adolescent females was examined. The Human Agency Model of Behavior developed by the researcher was used as a framework to explore interactions between the variables. In this model, the individual is shown as a self agent in determining behavior.

Spirituality In The Homebound Elderly, Mary Rosita Brennan

Dissertations

Spiritual care is a requirement of holistic nursing care. The spiritual dimension has been identified as a means for the elderly to cope with the problems of life that result from losses and longevity. The purpose of this descriptive study was to explore the role of spirituality in the homebound elderly and specifically to examine its relationship to Erikson's stage of integrity versus despair. One hypothesis was proposed: the achievement of integrity versus despair in the homebound elderly is positively related to the level of spirituality. The quantitative component incorporated three questionnaires (Demographic Data Form, Spirituality Assessment Guide, and Lifeview …

Developing An Explanatory Model For Cognitive Impairment In Mild Traumatic Brain Injury, Gayle H. Dasher

Dissertations

Nearly 2 million mild traumatic brain injuries occur annually and cognitive impairment is strongly associated with poor neurobehavioral performance. Identifying variables that influence the development of cognitive impairment could lead to the development of therapies designed to improve cognitive performance in at-risk populations. The theoretical framework used suggests that neurological factors, physical factors, psychological factors, objective cognitive deficits, and subjective cognitive deficits influence cognitive impairment. Specific aims were: (1) test the correlational relationships among the independent variables (neurological factors, physical factors, psychological factors, objective cognitive deficits, subjective cognitive deficits) and the dependent variable, cognitive impairment; and (2) develop a model …

Influences Of Nutritional Food Label Understanding On African American Women With Obesity, Cynthia Jean Hickman

Dissertations

Nutritional food label understanding (NFLU) in African American Women (AAW) is a philosophy that addresses obesity. Public health efforts have implemented nutritional and caloric information to packaged and restaurant foods to improve nutrient and calorie literacy. Research suggest NFLU might have a minimal effect on reducing obesity. However, it is not known how obese AAW born during the baby-boom era (51 to 64 years of age) perceive NFLU in relation to their dietary behaviors. The purpose of this phenomenological study was to understand the lived experience of obese AAW regarding NFLU from a cognitive and behavioral perspective.

Utilization Of Care Coordination Among Children With Special Needs In The 1994 National Health Interview Survey On Disability Phase Ii, Barbara J. Kruger

Dissertations

Care coordination helps families of children with special needs obtain a variety of services and manage communication among providers. Some families coordinate care themselves, while others receive assistance from professionals. Health care system changes are making these children less visible, and therefore at-risk for not receiving care coordination. A key question is how to identify families who need care coordination. Research about use of care coordination is sparse, and no generalizable method exists to identify which families require coordination. One aim of our study was to explore the differences among child and family factors and the use and need for …

Sociocultural, Physiologic, And Psychologic Variables That Influence Pain In The Fibromyalgia Patient, Linda Carol Hughes

Dissertations

It is estimated that fibromyalgia, a chronic condition in which pain occurs in 98% of the patients, can be found in 3- to 6-million American adults with females as the majority of those suffering. The purpose of this study was to determine variables that influence pain in women with fibromyalgia. The study's conceptual framework, based on Melzack and Casey (1968) and fibromyalgia literature, depicts the influence of three domains of variables on pain: sociocultural (i.e. age, education, ethnicity), physical (i.e. activity; comorbidity such as pelvic pain; flare-up; physical trauma; sleep-wake disturbance; fatigue; physical fitness) and psychologic (i.e. depression).

Qualitative Inquiry Of Nurse Educators Transitioning From Classroom To Online Teaching, Barbara C. Sinacori

Dissertations

In response to the Institute of Medicine (IOM) recommendations of meeting the goal of 80% of RNs prepared at the BSN level by 2020, an increase in graduates from RN-to-BSN completion programs must occur. One approach to meeting the IOM goal included recommending nursing schools offer defined academic pathways beyond articulation agreements and promote access for nurses to higher education. This goal can be met through online education, which is an effective way to reach students that are more diverse. Online education, however, requires a different pedagogy than the traditional classroom. Online education, defined as the educational process where the …

Experiences Of Homeless Vietnam Veterans In Deciding To Access Or Not Access Health Care, Susan K. Lee

Dissertations

Homeless Vietnam Veterans (HVV) report their health status as poor, indicating a multitude of health concerns, including physical and psychological problems, post-traumatic stress disorder (PTSD), and alcohol or drug dependencies. Prompt attention to health care may improve the prognosis; however, HVV tend to delay seeking medical attention. The purpose of this study was to explore the process utilized by HVV to make the decision to access or to not access health care services. According to inclusion criteria of the study, all participants served in the US military during the Vietnam War.

Understanding Interdisciplinary Communication And Collaboration Among Physicians, Nurses, And Unlicensed Assistive Personnel, Gwendolyn L. Lancaster

Dissertations

The negative impact of medical errors on patient safety poses a major problem for health care providers. Since physicians, nurses, and unlicensed assistive personnel (UAPs) each provide a portion of patient care, coordination of the various treatments and interventions provided is critical to prevent errors and fragmentation of care. The significance of this qualitative phenomenology study is that it can provide information to enhance interdisciplinary communication and collaboration among physicians, nurses and UAPs, thereby positively impacting patient care outcomes. Semi-structured face-to-face, privately held individual interviews were conducted to determine how physicians, nurses and UAPs view their roles and each other's …

A Qualitative Study Of Hope And The Environment Of Persons Living With Cancer, Lucia M. Tipton

Dissertations

The purpose of this naturalistic study was to explore and describe the impact of factors from the internal and external, human and non-human environments on the hoping process utilized by persons living with cancer. Given the nature of difficulties encountered by persons living with cancer, a sense of hopefulness is deemed to be especially important in managing life with this diagnosis. Using semi-structured interviewing and a purposive sample of fifteen persons living with cancer, positive and negative factors from the total environment were explored.

Nurses' Perceptions Of Collaborative Nurse-Physician Transfer Decision-Making As A Predictor Of Patient Outcomes In A Medical Intensive Care Unit, Linda W. Higgins

Dissertations

This prospective correlational study examined nurses' perceptions of collaborative nurse-physician transfer decision making as a predictor of patient outcomes in a medical intensive care unit (MICU), adjusting for risk.

The Meaning Of Health Among Midlife Russian-Speaking Women In The United States, Lenore K. Resick

Dissertations

This study sought to explore the meaning of health among midlife Russian-speaking women from the Former Soviet Union. A hermeneutic, phenomenologic, descriptive and interpretive design following the Utrecht School was used.