Digital Commons Network^™

Using The Home Health Oasis To Promote Advance Care Planning Among Community-Dwelling, Frail Older Adults, Suzanne S. Sullivan

Dissertations

Despite an aging population with increasing proportions of frailty and decline, the rates of documented Advance care plans (ACP), meant to align goals for care with the level of treatment at end-of-life (EOL), are low (~30-40%). Patients expect clinicians to raise the question about serious illness goals for care when the time is right, however, there are a number of barriers to the initiation of these difficult conversations including provider bias and uncertainty. A review of the literature indicates that there are few prognostic indices available for use to identify the right time to initiate EOL conversations based on risk …

A Fundamental Cause Approach To Intimate Partner Violence In Marginalized Populations, Nicholas S. Metheny

Dissertations

Intimate Partner Violence (IPV) is a serious public health concern that transcends partnership types and societies, affecting approximately one-third of women worldwide. Men in same-sex relationships likely experience violence at similar rates. This dissertation takes a fundamental cause approach to social-ecological and minority stress theories, arguing that structural forces are the root causes of violence in two target populations: women residing in low- and middle-income countries (LMIC) and Indigenous men who have sex with men (MSM) in the United States. Consisting of eight chapters, four of which are empirical studies, this body of work creates new knowledge surrounding how social …

A Secondary Analysis To Inform A Clinical Decision Rule For Predicting Skull Fracture And Intracranial Injury In Children Under Age Two, Elizabeth L. Stone

Dissertations

The purpose of the current study was to identify the variables associated with the risk of closed head injury (CHI) in children under age two with suspected minor head injuries based on age-appropriate, or near age-appropriate, mental status on exam, as defined by a Glascow Coma Score (GCS) of 15 or 14, respectively. The goal was to propose a set of variables that, when considered together, have a high degree of predictive accuracy in identifying CHI in this population. This set of variables could eventually be used to inform a clinical decision rule which may help triage nurses make acuity …

It Can Be Lonely At The Top, But It Doesn’T Have To Be: Workplace Loneliness As Experienced By Senior Leaders And Potential Coping Strategies, Kristen Prince

Dissertations

Workplace loneliness is a topic of growing interest among scholars and practitioners, in part because of the known impacts of loneliness on individuals’ well-being and performance. Recent literature has suggested that senior leaders may be vulnerable to feelings of workplace loneliness but lacks a thorough depiction of how leaders experience and cope with the feelings. This qualitative study explores the lived experiences and perspectives of senior leaders through interviews with 26 leaders and seven close confidants who provide a nuanced understanding of how senior leaders experience workplace loneliness and offer insight on mitigating these feelings. The findings suggest that the …

A Comparison Between Unit-Based Education And Centralized Education Among Staff Nurses, Marilyn J. Campbell

Dissertations

Educating staff nurses is pivotal in the evolving healthcare environment. Two staff development models used in the healthcare setting are unit-based and centralized. Unit-based education is a staff development model that places educators on individual units. These educators direct the educational development of staff nurses on their assigned units. Centralized education meets generalized learning needs and provides nursing departments with scheduled education sessions or impromptu meetings regarding changes to policies and procedures. In addition, centralized educators are assigned to address the learning needs of the nurses on several units with universal orientation (Cummings & McCaskey, 1992), coordinate and implement intravenous …

Implementation Of Evidence-Based Hourly Rounding To Improve Fall Rates Of Adult Patients On A Medical-Surgical Nursing Unit, David W. Smith

Dissertations

Patient falls remain a safety concern for all healthcare organizations and despite current evidence-based processes available for implementation there was a gap at the project site in adopting one. Therefore, the purpose of this quantitative quasi-experimental quality improvement project was to determine if the implementation of the Studer Group's Hourly Rounding tools would impact patient fall rates among adult patients in an urban medical-surgical unit in Florida over thirty-days. Orlando's deliberate nursing process theory was utilized as a theoretical framework for this project. A total of 304 patients were included in the project with the pre-intervention group of n=140 …

Project Poppseed: A Mixed-Methods Exploration Of Parents' Lived Experiences With Anencephaly, Shandeigh N. Berry

Dissertations

One in four women who experience perinatal loss develop intense grief. Adverse outcomes of intense grief include depression, anxiety, posttraumatic stress disorder, substance abuse, suicidal ideation, obesity, hypertension, and diabetes. Congenital anomalies such as anencephaly are the leading cause of perinatal mortality in the United States. The purpose of this study was to identify the impact of common experiential themes on perinatal grief intensity by exploring parents' lived experiences with a pregnancy complicated by anencephaly.

Perceived Factors Impacting Teachers’ Pedagogical Decision-Making Pertaining To The Use Of Pbl In The Classroom: A Dissertation, Amanda Slaughter

Dissertations

There is a consistent body of research evidence citing the potential of Problem-Based Learning (PBL) as a viable instructional tool to raise student engagement with challenging content (Saye & Brush, 2017; Strutchens and Martin, 2017; Wynn, 2015). According to the National Council for the Social Studies, “The primary purpose of social studies is to help young people develop the ability to make informed and reasoned decisions for the public good as citizens of a culturally diverse, democratic society in an interdependent world” (NCSS, accessed 2023, March 1, para. 2). Scholars like Engle (1960) called for instructional strategies that raised the …

Elucidating Enterococcal Mechanisms Underlying Recurrent Urinary Tract Infections, Baylie Hochstedler-Kramer

Dissertations

Urinary tract infection (UTI) is one of the most common bacterial infections globally and can lead to life-threatening complications. UTI disproportionately affects females, with the majority of females being treated for at least one UTI in their lifetime. Of the females who develop UTI in their lifetime, almost one third will develop recurrence within six months after initial treatment and many will struggle with UTI recurrence for long spans of their lives. Although recurrent UTI has previously been attributed to persistence of Escherichia coli, recent studies utilizing more sensitive detection methods have shown Enterococcus faecalis is strongly associated with recurrent …

An Interpreted Journey Of Professional Growth Among Female Baccalaureate Nursing Students: A Hermeneutic Study Of Mindfulness Practices, Lorraine Santangelo

Dissertations

Nursing literature reveals that stress is a leading factor contributing to nursing student attrition, new nurses leaving the profession, and the reduction of positive formation of professional identity during prelicensure education and transition into professional practice, which jeopardizes the growth and replacement needs of the future nursing workforce. Despite extensive quantitative research suggesting mindfulness practices decreases stress and anxiety among college students, nursing students, and nurses, a paucity of qualitative studies exist to inform on the meaning of this experience from the nursing student perspective. Nursing literature also suggests that stress management techniques, cultivating awareness of personal values, and a …

Exploring Multilevel Factors Associated With Dual-Method Contraceptive Use Among Adolescent And Young Adult Women, Lauren Holt

Dissertations

Sexually transmitted infections (STIs) continue to rise in the US, and adolescent and young adult women (AYAW) between ages 18 and 24 have some of the highest STI rates in the country. Further, AYAW who use prescribed contraceptives (commonly referred to as birth control) are less likely to use condoms and more likely to be diagnosed with an STI than non-prescribed contraceptive users. The purpose of this dissertation is to understand multilevel factors contributing to condom use decision-making and STI risk perception analysis among AYAW who use prescribed contraceptives. Data was using qualitative research methods in two separate studies. In …

Impact Of Gamification On Engagement Of Prelicensure Nursing Students: Faculty Perceptions, Elizabeth A. Lucas

Dissertations

The United States is facing a current and worsening nursing workforce shortage which poses a threat to today's healthcare structure. Strategies to combat this shortage by increasing the number of qualified applicants admitted to nursing programs each year have been implemented. In addition to increasing the number of students admitted each year, work must be done to better support those nursing students to make it to graduation. A method that can help is through achieving student engagement which has been linked to improved critical thinking, learning, and grades. One teaching strategy that has the potential to increase student engagement is …

The Lived Experiences Of Clinical Staff Nurses Who Provide Care For Transgender Patients In Florida, Twanna L. Crockam

Dissertations

Historically, transgender patients have experienced challenging interactions with healthcare providers. As a result, many transgender patients refuse to seek medical attention for a broad spectrum of healthcare needs. Although the transgender population has gained attention, a lack of research exists of clinical staff nurses' lived experiences providing care for transgender patients.

The purpose of this qualitative hermeneutic phenomenological inquiry was to uncover and understand the experiences of clinical staff nurses when providing care for transgender patients in Florida. The research question was this: "What is the lived experience of clinical staff nurses who provide care for transgender patients in Florida?"

Physical Activity Self-Efficacy And Text Message Intervention Among Northeast Louisiana Women With Cardiovascular Disease, Sherrie Roberson

Dissertations

Rural women are less likely to meet the recommended physical activity guidelines, which leads to poor health outcomes such as cardiovascular disease (CVD). Adherence to physical activity is critical in preventing CVD and recurring cardiac events. Heart disease is one of Louisiana's major diseases. In Louisiana, women ages 55 to 64 had the highest risk factors for CVD and heart attack. The purpose of this study was to examine the impact of a 6-week text messaging intervention on the effects of physical activity and physical activity self-efficacy among Northeast Louisiana women with cardiovascular disease. A randomized controlled trial with a …

A Comparison Study Of Vocational Factors Influencing Academic Satisfaction For Marginalized And Majority Students, Sara Driver

Dissertations

Marginalized college students experience increased rates of discrimination resulting in poorer academic outcomes whereas majority students are often afforded more privilege and access to resources allowing them to be more successful (Bardhardt et al., 2017; Milkman et al., 2015; Hanson, 2021). Psychology of Working Theory (PWT; Duffy et al., 2016) posits that experiences of discrimination and marginalization can negatively impact the chances for one to be successful in the world of work. PWT argues that decent work is a desired outcome by marginalized individuals and research confirms that securing future decent work is important to marginalized college students (Ma et …

History Education: Learning History From Community College Students’ Perspectives, Mylinh V. Pham

Dissertations

Given the current political climate of division, the study of history is important now more than ever, but the value of the study of history has been marginalized. This study used student focus groups to understand ways in which history could be taught in such a way that its importance is emphasized through relevance and connection to current social and political issues and through student-centered learning. This study also determined how history could help students evaluate and think critically about historical content. This study drew on the experiences of community college students who have taken a higher education history course …

Leading With An Intercultural Mindset: Leadership Development Programs For International Students, Keri A. Toma Loehrer

Dissertations

This mixed methods study explored co-curricular student leadership development programs that included intercultural learning and were designed for international students studying at higher education institutions in the United States. The study aimed to better understand: (a) common program characteristics; (b) program administrator perceptions; and (c) the international student experience. Data was collected in a two-phase explanatory sequential design, involving surveys and semi-structured interviews. Six main content areas across all programs were identified: (a) diversity, equity, and inclusion (DEI); (b) global engagement; (c) intercultural learning; (d) leadership development; (e) personal and professional development; and (f) supporting the international community. Administrators generally …

Teacher And Student Perspectives Of Technology Use In Elementary School Classrooms, Anthony Oskar Alvarado

Dissertations

This study explored student and teacher perspectives of technology use at Franklin Elementary School in South San José, CA, using qualitative, quantitative, and observational methods, including interviews, observations, and surveys. Thirteen teachers responded to a survey on educational technology use. Among this group, eleven provided interviews, and nine invited classroom observations from 1st through 6th grades. Additionally, sixty-nine 3rd to 6th-grade students were surveyed about their views on technology use. The study found that technology use in teaching is widespread and integral, not just an add-on. Observations and teacher interviews showed high engagement and interest in technology tools, primarily supporting …

Exploring Factors Influencing Health Promoting Behaviors Among Latino Immigrants, Martin J. Mikell

Dissertations

Latino immigrants may experience stress during acculturation to the U. S., which can influence their ability to engage in health-promoting behaviors, such as dietary intake and physical activity. Dietary intake and physical activity influence the prevention or development of pre-diabetes/Type 2 Diabetes (T2DM). The immigrant's ability to perform health-promoting behaviors can also be influenced by their perceptions of self-efficacy to engage in health-promoting behaviors. Limited information is available in the literature on effective strategies for decreasing stress during the acculturation process of Latino immigrants, while also increasing self-efficacy in health-promoting behaviors. The purpose of this study was to explore the …

Con Respeto Y Dignidad: Transforming Educational Experiences For Students Of Color By Addressing Disproportionate Discipline Practices, Selene Munoz

Dissertations

Discipline practices wield significant influence over the social dynamics within educational settings and profoundly impact students’ ability to attain academic and social gains crucial for their success. The racialization of school discipline has been linked to negative effects on student’s academic trajectories and life outcomes. Consequently, school administrators can play a crucial role in effecting cultural change within their organizations to support disciplinary practices that uphold students’ educational dignity. This study looked at the strategies employed by secondary level administrators to shift their school cultures aimed at addressing disproportionate disciplinary practices. Using a mixed methods approach, this study draws upon …

Loss Of Resources And Depressive Symptoms After Traumatic Injury, Elizabeth Van Horn

Dissertations

Unintentional traumatic injury is a significant public health problem in the United States. Each year trauma patients sustain loss of physical function, temporary or permanent disability, and additional losses in personal, social, financial, and occupational realms. Loss of resources after injury may contribute to the occurrence of depressive symptoms in trauma patients, which may negatively affect recovery outcomes. The purpose of this research study was to test a model of trauma-related variables that may influence the occurrence of depressive symptoms after traumatic injury. The model developed for this study was based on the Conservation of Resources (COR) model. In applying …

High-Fidelity Simulation: Methods To Decrease Stress And Anxiety In Prelicensure Nursing Students, Barbara L. Biddle

Dissertations

The purpose of this dissertation literature review was to discuss causes of and methods to reduce stress and anxiety among prelicensure student nurses before and during a simulation so that learning through simulation prepares students to care for patients safely. This literature review focused on the history of simulation in training, feelings of anxiety and stress among nursing students, theories pertinent to nursing simulation, prelicensure students' views and outcomes in simulations, and the research measures that helped reduce stress and anxiety during simulation training.

Best Practices In Academic Nurse Educator Role Transition: A Multiple-Case Study, Joelle L. Wolf

Dissertations

Healthcare is facing a crisis related to a shortage of nurses. One of the most alarming factors regarding this shortage is the lack of academic nurse educators (ANE). The problem addressed in this study was the shortage of ANEs due to obstacles in the role transition process. The theoretical framework used was the nurse educator transition theory which connected well with this study as this theory focuses on stages of ANE role transition. Two research questions were used that identified perceptions of best practices in role transition of ANEs and best strategies in retention. Participants were early-career ANEs with 1 …

Radiating Excellence: Leadership Styles In Nuclear Power That Influence Operators Towards Industry Best Practices, Joshua Copeland

Dissertations

Poor leadership is the root cause for the three most significant accidents in the nuclear industry. The purpose of this research was to determine the best leadership characteristics of operating supervisors at nuclear plants that could help prevent future accidents from happening. Operating supervisors are the leaders that have the greatest impact on how safe the nuclear plant is operating. A mixed method approach was used, where the quantitative study surveyed 77 supervisors about their leadership style and how well they influence standards adherence, and the qualitative study interviewed 11 subordinates of supervisors to determine how supervision helps them follow …

Development And Structural Origin Of Stretchable Semiconducting Polymers And Composites, Yunfei Wang

Dissertations

Stretchable semiconductors are pivotal in advancing wearable and implantable electronics, with those boasting both high stretchability and self-healing capabilities being especially significant for a myriad of wearable applications. In this dissertation, we developed an extremely soft, highly stretchable, and self-healing elastomer based on H-bonding crosslinked amide-functionalized polyisobutylene (PIB-amide). When blended with a high-performance conjugated diketopyrrolopyrrole (DPP-T) polymer, the composite exhibits unprecedented stretchability, exceptionally low elastic modulus, and an innate ability to self-heal at room temperature.

The morphology of conjugated polymer/elastomer semiconducting composites have significant impacts on electrical and mechanical properties Further investigations focused on manipulating the phase separation size in …

The Pedagogical Impact Of Injury Through The Experiences Of Three Professional Trombonists, Caleb Owenby

Dissertations

As the stigma surrounding performance-related injuries in the brass community is slowly lifting, more musicians are openly seeking assistance for injuries, more musicians are willing to share their experiences with injury, and the musical community is becoming more knowledgeable in the realm of musician health. This research is aimed at preventing future dysfunctions in brass players, offering avenues of recovery for musicians currently experiencing an injury, and examining the current state of trombone pedagogy through the experiences of three performing trombonists.

Megumi Kanda, Colin Williams, and David Vining are professional trombonists and educators who have experienced an embouchure dysfunction or …

Factors Influencing Teacher Retention In K-12 Public Schools In Rural Hawai’I As Perceived By K-12 Public School Teachers, Celeste Akiu

Dissertations

Purpose. This qualitative study aimed to identify and describe the factors influencing teacher retention in K-12 public schools in rural Hawai’i, as perceived by K-12 public school teachers examined within the framework of Mason and Matas’ (2015) conceptualization of four capital factors: human, social, structural, and positive psychological. Methodology. This qualitative study intended to identify factors that influenced teachers in rural Hawai’ian communities to remain in the profession. Convenience purposeful sampling was used to identify the nine teachers who participated in this study. The Four Capital Framework for Teacher Retention was used to guide the questions used in the interviews, …

Localized Hermite Method Of Approximate Particular Solutions, Kwesi Acheampong

Dissertations

A localized Hermite method of approximate particular solutions (LHMAPS) is presented in this dissertation. This method is designed to improve the accuracy of the localized method of approximate particular solutions (LMAPS) for solving partial differential equations. LMAPS is a strong-form method that defines local radial basis function approximations to the solution values at a group of collocation points before applying the differential operator to this approximation function. Based on the LMAPS's local scheme, LHMAPS seeks Hermite-type local approximations based on both function values and derivatives. Numerical experiments validate the superior accuracy of the proposed method to the LMAPS by solving …

Elevating Commodity Polymers To Advanced Applications In Polymer Photonics And Polymer-Derived Porous Materials, Mark Robertson

Dissertations

Since the inception of synthetic polymers, polymer-derived materials have permeated into essentially all aspects of our daily lives. The most commonly thought of examples of polymer materials involve single-use, disposable products to increase shelf lives of perishable items, act as personal protective equipment, or provide some degree of convenience for the consumer. However, as we have furthered our understanding of polymer chemistry and polymer physics to develop increasingly sophisticated polymer systems, polymer materials have been employed in incredibly advanced applications. These include solid electrolytes for energy storage, matrices for aerospace grade carbon fiber-reinforced composites, membranes for liquid and gas separations, …

Development And Evaluation Of An Instrument For Exploring Achievement Emotions Of General Chemistry Students: General Chemistry Achievement Emotions Questionnaire, Alexander Graves

Dissertations

General Chemistry, a course that is required for many STEM degree programs, is often perceived as a difficult and stress-inducing course by students. One aspect of a student’s course experiences that can be measured are achievement emotions. Emotions that students can experience that can affect and are affected by academic performance are called achievement emotions. Achievement emotions, such as anxiety, have been extensively studied in recent years in relation to student performance and retention in different courses. Instruments that have been developed to measure achievement emotions in broad academic settings. However, achievement emotions have been determined to be domain-specific, meaning …