Digital Commons Network^™

Research Nurses' Attitudes And Practices Regarding Communication Of Risks And Benefits During The Research Informed Consent Process, Lidia Lika Nusbaum

Dissertations

Many studies show that research participants frequently do not fully comprehend information regarding risks and benefits (R&B) associated with clinical trials even though this is a fundamental component of the research informed consent (IC) process, required by ethical and regulatory guidelines. Research nurses often take an active role in obtaining IC while explaining study details and verifying potential participants' understanding. Although there are published recommended strategies to enhance the IC communication process, particularly for R&B communication, there is a paucity of research focused on research nurses' perspectives about the process. This study addresses this gap in the literature and provides …

Developing And Maintaining Resilience In Charter School Executive Directors, Erika Vanderspek

Dissertations

Purpose: The purpose of this exploratory phenomenological study was to identify and describe the strategies used by charter school executive directors to develop and maintain personal resiliency based on Everly, Strouse, and McCormack’s (2015) five factors of personal resilience (active optimism, decisive action, moral compass, relentless tenacity, and interpersonal support).

Methodology: This exploratory phenomenological study identified and described the lived experiences of exemplary charter school executive directors in San Diego, Riverside, and Orange counties. Based on recommendations from expert entities who worked with the target population, the researcher used purposeful sampling to select eight exemplary charter school executive directors. The …

The Effects Of Career Commitment, Distress, And Persistence On Academic Success Among Undergraduate Baccalaureate Nursing Students, Kimberly D. Kennel

Dissertations

The ability of students, specifically in higher education environments, to persist is a critical determinant of academic success. Student success is especially precarious within programs of nursing, where curricula include clinical, laboratory, and didactic content. Identifying and describing the barriers and facilitators to nursing student persistence provides a blueprint to appropriately use financial and human resources as well as determine the effect student demographic variables has on desiring, attending, or benefiting from persistence interventions. The outcome of this study can guide the deployment of institutional resources to provide persistence-based interventions that are evidence-based. Framed by Tinto's Theory of Student Departure, …

Improving Pediatric Nurses Knowledge About Palliative Care Services, Marilia M. Rivera

Dissertations

Palliative care knowledge is important for nursing staff caring for children with life-threatening and debilitating illness because it can provide comfort-based interventions to optimize their quality of life. Nurses in pediatric settings can support the patient and family by providing education and evaluate patients who can benefit from palliative care services. If nurses do not have the palliative care education to support this comfort care process, the quality of life for children with life-threatening and debilitating illness may be affected. The purpose of this DNP project was to educate pediatric nurses about pediatric palliative care standards. The educational program resulted …

Constructing The Process Of Healthcare Decision-Making By Adolescent Athletes Post Sport-Related Concussion, Jeanette Faith Green

Dissertations

Sport-related concussion (SRC) is associated with short- and long-term health consequences. Current recommendations require immediate removal of an athlete suspected of injury, relying symptom self-reporting. Many SRC are unreported resulting in continued play despite symptoms, a risk for subsequent injury. The purpose of this dissertation was to explore influential factors and pivotal decision points within the process of health decision-making (DM) of adolescent athletes post-SRC. Twelve semistructured interviews were conducted with predominantly white high school athletes. Grounded theory methodology was used to examine salient concepts within athletes' DM process. Data were coded and analyzed using dimensional analysis with explanatory model …

The Correlation Between Peer Support And Quality Of Life Of Nurses, Kim Diane Rose Maryniak

Dissertations

Nurses can experience stress and perceived traumatic events during their career. This distress in the workplace can affect the quality of life of nurses. Exposure to perceived distressing events may lead to burnout, compassion fatigue, post-traumatic stress disorder, patient errors or poor outcomes, horizontal violence or even nurses leaving the profession. Peer support is a strategy which has been explored to increase defensive lines and improve coping. The purpose of this descriptive, correlational study was to examine if a relationship exists between the use of peer support, as conceptualized within the framework of the Neuman System Model, and the quality …

Qualitative Analysis Of Older Adults' Experiences With Sepsis, Rebecca D. Hancock

Dissertations

Atypical symptoms, multiple co-morbidities and a lack of public awareness make it difficult for older adults to know when to seek help for sepsis. Diagnosis delays contribute to older adults' higher sepsis mortality rates. This research describes patients' and caregivers' experiences with the symptom appraisal process, self-management strategies, provider-nurse-patient interactions, and barriers when seeking sepsis care.

Parental Self-Efficacy, Feeding Practices, And Weight Gain During Infancy: A Secondary Analysis, Jessica S. Bahorski

Dissertations

Mechanisms contributing to childhood obesity begin during early life, including infant feeding practices and an excessive rate of infant growth. Parental decisions regarding their infant contribute to these mechanisms. Parental self-efficacy (PSE) is the belief parents have in their ability to accomplish the tasks of parenting and is associated with infant outcomes. A high sense of PSE, breastfeeding self-efficacy, or self-efficacy for feeding has been found to be associated with healthy infant feeding practices. However, this research is limited in scope and has not been conducted in populations at greatest risk for childhood obesity such as low-income or African-American infants. …

Heart-Led Behaviors Of Exemplary Unified School District Superintendents, Sepideh Yeoh

Dissertations

Purpose: The purpose of this phenomenological study was to describe how exemplary K-12 school district superintendents lead from the heart using Mark Crowley’s four principles (building a highly engaged team, connecting on a personal level, maximizing employee potential, and valuing and honoring achievements) to accomplish extraordinary results in their organizations.

Methodology: This study utilized a qualitative phenomenological inquiry methodology to study the behaviors of eight exemplary K-12 school district superintendents in Southern California. Open-ended semistructured interviews were conducted utilizing a virtual platform. Responses from interviews in conjunction with observations and appropriate artifacts including, meeting agendas, memos, and newsletters provided …

Male Combat Veterans In Pre-Licensure Baccalaureate Nursing Programs: A Phenomenological Exploration, Kelly L. Dyar

Dissertations

There is recognized shortage of nurses in the United States which includes a lack of baccalaureate prepared nurses and lack of workforce diversity related to gender. Military veterans could be a recruitment source for the problems currently facing the nursing profession. However, both student veterans and male nursing students have experienced feelings of isolation, lower grade point averages, and higher rates of attrition. A scoping review of the literature revealed a lack of nursing education research literature related to veterans as nursing students. Therefore, the purpose of this study was to explore the lived experience of male combat veterans in …

How Exemplary Black Women Leaders Use Influence To Achieve Extraordinary Results, Catrena Elliott

Dissertations

Purpose: The purpose of this phenomenological study was to understand and describe how exemplary Black women business leaders (BWBL) influence employees through personal motivation, personal ability, social motivation, social ability, structural motivation, and structural ability.

Methodology: This phenomenological study research design identified and explored how 10 exemplary BWBL who have achieved extraordinary results influence employees through personal motivation, social motivation, structural motivation, personal ability, social ability, and structural ability. Participants were selected from exemplary BWBL in Southern California and Northern California who fulfilled the study’s requirements. Interviews, observations, and artifacts were used to gather data. To identify study findings, data …

Variables That Influence Student Nurse Progression During Sophomore Year In A Traditional Bsn Program, Connie Mcfadden-Chase

Dissertations

The purpose of this dissertation was to discover variables that influence student progression during the sophomore year in a traditional bachelor of science in nursing program. Research exists to identify factors that will predict the retention of students or will contribute to students' success. Tinto's model on student retention was the framework for this study with constructivist grounded theory as the methodology to unravel the data and discover new meanings. The results of the study align with Tinto's model and illustrates the importance of faculty and peer relationships in conjunction with guidance in navigating the particularities of nursing coursework and …

The Relationship Between The Perceptions Of Implicit Rationing Of Nursing Care And Emotionally Intelligent Leadership Style Among Direct-Care Nurses, Hazel Linda Blizzard

Dissertations

Implicit rationing of nursing care and emotionally intelligent leadership style of nurse managers has been found to contribute to patient outcomes. No studies had been done prior to this study to examine possible links between implicit rationing of nursing care and emotionally intelligent leadership style of nurse leaders on a hospital unit. The purpose of this cross-sectional survey design study was to examine relationships between amounts of perceived implicit rationing of nursing care and perceptions of emotionally intelligent leadership style of nurse leaders on the acute-care hospital unit.

The Lived Experience Of Newly Qualified Registered Nurse First Assistants (Rnfa) Who Have Transitioned To The Hospital Operating Room Setting: A Phenomenological Perspective, Susan Lynch

Dissertations

There is increased use of RNFAs as assistants to surgeons in surgery. It is estimated that RNFAs comprise as many as 54% of the non-physician assistants who provide patient care during the surgical event in the operating room setting (Patterson, 2012). There are research studies that focus on transitions of graduates from nursing programs but a lack of research on transitions of RNFAs to the surgical environment following education.

This qualitative interpretive hermeneutic phenomenological study explored the lived experience of newly qualified RNFAs who have transitioned to the hospital operating room surgical setting. The purpose of the study was to …

Handoff Communication Among Senior Nursing Students: A Phenomenological Study, Juanita Hanley-Gumbs

Dissertations

Despite discussions in health care regarding poor communication and its link to patient safety, it was revealed in the literature that many student nurses are inadequately prepared to conduct handoff communication. Student nurses have difficulty in this area due to limited or no experience with the handoff process, which jeopardizes patient safety. The purpose of this research study was to understand how senior nursing students make meaning of their lived experiences with handoff communication. The guiding research question for this study is: How do senior nursing students make meaning of their lived experiences with handoff communication during the change-of-shift report …

The Critical Factors Influencing The Attitudes And Behaviors Of Nurses Caring For Patients With Substance Use Disorders, Suzan Blacher

Dissertations

Nursing is known to be an ethical and caring practice discipline, yet there is some evidence that nurses may have negative attitudes and behaviors towards persons with substance use disorders. Few nurses realize these undesirable attitudes and behaviors negatively impact the very patients they are caring for (Can & Tanriverdi, 2015). These attitudes and behaviors are also considered unprofessional and may place nurses in violation of the Nursing Code of Ethics (American Nurses Association, 2015).

The purpose of this qualitative constructivist grounded theory study is to develop a middle-range theory explicating the process of nurses caring for Substance Use Disorder …

Understanding The Meaning Of The Lived Experience Of Adolescents In Treatment For Cancer, Dianne Fochtman

Dissertations

The increased intensity and complexity of cancer treatment has an impact on the lives of the adolescents undergoing such treatments. Living with cancer is a distinct experience for them which include physical, psychological, spiritual and social dimensions. The cancer experience comprises more than the measurement of symptom occurrence, frequency, duration and severity, or the ratings of quality of life. The meanings of the lived experience from the adolescent's perspective and self-report can give a more accurate, holistic picture of the nature and scope of the experience. Practitioners need to know and understand the meaning of the experience from the adolescent's …

Examination Of The Informed Consent Process As Experienced By Patients Who Underwent De Novo Transjugular Intrahepatic Portosystemic Shunt, Chemoembolization Or Radioembolization Procedure, Marsha A. Hughes-Gay

Dissertations

The purpose of this study is to examine the informed consent (IC) procedure as it was experienced by patients who had undergone a de novo transjugular intrahepatic portosystemic shunt (TIPS), chemoembolization (TACE), or radioembolization (TARE) procedure in an Interventional Radiology (IR) Department. The three main study aims and a fourth exploratory aim are as follows: (1) Describe how patients who underwent a de novo TIPS, TACE, or TARE procedure in an IR Department described the IC procedure; (2) Describe what information patients who underwent a de novo TIPS, TACE, or TARE procedure in an IR Department recalled being told during …

The Relationships Among Emotion Regulation, Role Stress, And Psychological Distress In Surrogate Decision Makers Of The Chronically Critically Ill Patients, Mary Njalian Variath

Dissertations

Advancement in technologies has contributed to patients surviving critical illness, but continuing to live with chronically critically ill conditions. A majority of such patients experience transient or persistent states of decisional impairment requiring family members or authorized surrogate decision makers to render treatment decisions. Abrupt transition to the surrogate decision maker role often evokes heightened stress. Research shows that emotion regulation can help manage situational stress.

To examine the associations among emotion regulation, role stress, and psychological distress in surrogate decision makers of chronically critically ill patients in intensive care units.

Exploring Health Literacy In The Acute Care Setting In A Rural Border Region, Shiloh A. Williams

Dissertations

Health literacy is important to ensuring patients have the necessary knowledge and skills needed to actively participate as a member of their own healthcare team. Patients with low health literacy are at increased risk for poor outcomes and limited participation in decisions affecting their health or treatment plan. Using the Social Ecological Model (SEM) as a framework, the purpose of this study was to determine the relationship between medical-surgical registered nurses, medical-surgical patients and the registered nurse's (RN) assessment of their patient's health literacy of those who live in a ruralborder region. The study's sample consisted of 84 pairs of …

Intervention Effects Of A Cognitive Behavioral Skills Building Program On Newly Licensed Registered Nurses, Marlene Sampson

Dissertations

The well-being of healthcare clinicians is considered a national crisis. Healthcare clinicians, including nurses, have higher rates of substance abuse, depression and suicide than the national average. Depression and poor health in nurses are linked to medical errors and patient dissatisfaction. Ninety-one percent of NLRNs report high stress levels resulting in stress-related illness, absenteeism and burnout. In 2017, the National Academy of Medicine launched the Action Collaborative on Clinician Well-being to develop evidence-based solutions to reduce this public health epidemic. The purpose of this study was to examine the effects of a Cognitive Behavioral Therapy (CBT)-based skills building program entitled …

Condom Use Among Urban African American Adolescent Females, Jaquetta M. Reeves

Dissertations

Sexually transmitted infections (STIs) are one of the most common global health problems, having a profound impact on sexual and reproductive health worldwide. The CDC estimates that approximately 20 million new infections occur each year in the U.S., and almost half of them are among adolescents age 15-24. Despite government initiatives on STI prevention programs for adolescents, there is dearth of knowledge regarding the lack of condom use among adolescent high school students, especially concerning African American females who live in urban areas.

The purpose of this research was to explore attitudes towards condoms, subjective norms and perceived behavioral control …

American Nursing Faculty's Experiences With International, Ell, And Esl Nursing Students In Bsn Degree Programs, Rosalynn Williams Thyssen

Dissertations

This basic qualitative dissertation research study addressed the question of how American nursing faculty describe their experiences with international, English language learner (ELL), and English as a second language (ESL) baccalaureate degree nursing students. There is a call to increase the number of diverse nursing graduates to meet the need of a globalized nursing profession.

The Impact Of Health Literacy, Culture And Psychological Factors On The Pap Testing Behaviors Of African Immigrant Women In The United States, Joycelyn Cudjoe

Dissertations

African immigrant (AI) women have low Pap testing rates. Limited health literacy is a barrier to cancer screening among racial/ethnic minority populations. Sources and types of health information can shape health literacy. However, how health literacy, sources and types of health information along with cultural and psychosocial correlates impact the Pap testing behaviors of AI women remains unknown.

To examine how sources and types of health information impact health literacy and health information exchange, and in turn, how health literacy, culture and psychosocial (cancer knowledge, self-efficacy, decisional balance, cultural beliefs) factors influence the Pap testing behaviors of AI women.

The Relationship Of The Work Environment To Compassion Satisfaction And Compassion Fatigue In Critical Care Nurses, Tara L. Sacco

Dissertations

Due to an increased demand for nurses and high attrition, a deficit of 260,000 nurses is expected by 2025. One contributing factor to the current shortage is nurses' exposure to unhealthy work environments. Nurses who work in such environments may be at higher risk for low levels of compassion satisfaction and high levels of compassion fatigue. Empirically, and when examined as separate constructs, the nurses' work environment, compassion satisfaction, and compassion fatigue have been linked to retention. Researchers have theorized that the nurses' work environment may promote the experience of compassion fatigue, while others have indicated that the positive aspects …

Acculturative Stress, Psychological Flexibility, And Cardiovascular Health Behaviors Among Second Generation Arab Americans In The Greater Washington Dc Region, Randa Merizian

Dissertations

Arab Americans are under-represented in cardiovascular (CV) research, but recent evidence reveals they are at disproportionate risk for poor CV health behaviors when compared to the overall United States of America population. The proposed study is designed to measure the impact of two factors, acculturative stress and psychological flexibility, on CV health behaviors among second generation Arab Americans in the Greater Washington DC region. The outcome variable will be measured using the CV Health Behaviors Questionnaire adapted from the American Heart Association Life's Simple 7 (LSS). Participants will be recruited from five local churches and mosques and George Mason University …

The Experiences And Expressions Of Compassion Among Critical Care Nurses, Mark S. Walker

Dissertations

Compassion is a core attribute of nursing practice and is associated with improved patient satisfaction and outcomes. For the last several decades, nurse researchers have been focused on the concept of compassion fatigue. Only recently has compassion appeared in nursing literature. Therefore, the purpose of this study was to explore the experiences and expressions of compassion among critical care nurses.

This dissertation includes a literature review of compassion within nursing education and practice, how it is currently defined, and a review of the empirical data. Next, two interpretative phenomenological qualitative studies were conducted. One study explored the experiences of compassion …

Exploring Mentoring Relationships Among Novice Nurse Faculty: A Grounded Theory, Katie Ruth Busby

Dissertations

The growing and aging population has created an increased demand for health care, resulting in a need for hundreds of thousands more nurses across the United States. As a result, additional nurse faculty are needed to teach the next generation of nurses. However, nurses who enter the faculty role in academia often come from various professional backgrounds with different educational preparation that may not equate to success with the tripartite faculty role of teaching, scholarship, and service. As a way to retain and develop novice faculty, mentoring relationships and programs are promoted as an intervention for career and psychosocial development …

Faculty Perceptions Of Nursing Student Retention In Community College Associate Degree Programs: A Qualitative Descriptive Study, Lauri Jones

Dissertations

Understanding the factors that influence nursing students to stay or leave a nursing program is vital to ensure our population has prepared nurses to care. Low student retention leads to fewer nurse graduates, negatively impacting the nursing shortage. Although several factors contribute to the nursing shortage, with many well beyond the influence of nursing education programs, student retention is a factor where nurse educators can play a pivotal role. Research indicates that students perceive faculty relationships as influential to their success, satisfaction and retention in education programs. However, a gap in the literature exists on faculty perspectives of student retention, …

Examining The Relationship Between Therapists’ Attachment-Related Characteristics And The Process And Outcome Of Psychotherapy, Char M. Houben

Dissertations

Although psychotherapy researchers have gleaned greater understanding about how client attachment classifications influence the outcome of psychotherapy, relatively few studies have investigated therapists’ effects and have yielded inconclusive results (Steel et al., 2018). In the current study, we investigated how therapist attachment affects changes in the working alliance and client psychological distress over a course of psychotherapy treatment. We evaluated attachment in a sample of 23 therapist trainees from a university-based training clinic in the U.S. with the recently validated, transcript-based Therapist Attunement Scales (TASc; Talia & Muzi, 2017), which measures attunement by moment-to-moment discursive markers from a single psychotherapy …