Digital Commons Network^™

Constructive Solution Methodologies To The Capacitated Newsvendor Problem And Surrogate Extension, Pinyuan Shan

Dissertations

The newsvendor problem is a single-period stochastic model used to determine the order quantity of perishable product that maximizes/minimizes the profit/cost of the vendor under uncertain demand. The goal is to fmd an initial order quantity that can offset the impact of backlog or shortage caused by mismatch between the procurement amount and uncertain demand. If there are multiple products and substitution between them is feasible, overstocking and understocking can be further reduced and hence, the vendor's overall profit is improved compared to the standard problem. When there are one or more resource constraints, such as budget, volume or weight, …

A Description Of Cultural Humility As Perceived By Nursing Faculty In Baccalaureate Nursing Education, Linda Webster

Dissertations

In diverse populations, health inequities can exist, thereby contributing to health disparities. A lack of knowledge regarding unfamiliar cultural patterns and practices by health care providers can contribute to miscommunication and mistrust. The willingness to adopt the practices of self-awareness and self-reflection with critique is cultural humility. This concept may help to reduce health inequities and suboptimal health outcomes when a mutual respect for culture and diversity is present.

A foundational, qualitative descriptive study was proposed to investigate cultural humility as perceived by nursing faculty. The purpose of this study was to describe the concept of cultural humility from the …

Stress, Anxiety, And Depression: Role Of Campus Connectedness, Social Support, And Coping Among Nepalese Nursing Students, Priscilla Samson

Dissertations

High levels of stress, anxiety, and depression (SAD) can adversely influence physical health, psychological well-being, and academic and clinical performance of nursing students. Numerous studies have identified the factors associated with SAD; however, a paucity of empirical research addresses the relationship of SAD with campus connectedness (CC), perceived social support (PSS), and coping. The purpose of this quantitative cross-sectional study, guided by Lazarus and Folkman's theory of stress, coping, and adaptation, was to determine the prevalence of SAD and examine its relationship with CC, PSS, and coping among undergraduate nursing students of Nepal. Survey research was conducted using depression anxiety …

An Explanatory Sequential Study Of Cadet Commitment At The United States Air Force Academy, Justin Pendry

Dissertations

Character and leadership are the essence of the United States Air Force Academy (USAFA). USAFA’s mission is to develop leaders of character responsible for defending this nation. Our country has the most lethal Air Force this world has ever known. The men and women entrusted with protecting its citizens must be committed to the highest standards of ethical leadership. To accomplish this, USAFA provides a robust education and training program with extensive opportunities for cadet development. However, achieving USAFA’s vision of creating the nation’s best leaders of character relies upon cadet trust in the process and commitment to their development …

Using Visual Storytelling To Design Solutions-Based Approaches To Homelessness, Peggy Peattie

Dissertations

Despite millions of dollars spent over several decades on assistance programs, the nation’s homeless population has increased for the last four years in a row. The number of people reporting as homeless for the first time doubled in San Diego between June 2019 and June 2020. Trying to impose a one-size-fits-all model of care on a population comprised of unique individuals has resulted in many homeless opting for the street rather than subjugating themselves to rules they feel do not treat them with respect and dignity. Yet, the perspectives of homeless individuals are excluded from decision-making dialogue around policies and …

Preceptor Effectiveness As A Mediator Of Relationship Between Psychological Empowerment And Newly Registered Nurses' Intent To Stay, Deborah Taffe

Dissertations

The nursing profession is currently experiencing a nursing shortage that is projected to worsen. One in five newly licensed registered nurses (NLRNs) leaves the profession within the second year of practice (National Healthcare Retention and RN Staffing Report, 2018). Work empowerment has been shown to decrease turnover rates among nurses: However, the factors that mediate this concept have not been fully explored.

The purpose of this study was to investigate nurses' perceived preceptor effectiveness as a mediator of the relationship between psychological empowerment during the transition from an academic environment into practice and intent to stay in practice for NLRNs …

Night Shift Nurses' Perceptions On Fatigue Management Approaches: A Qualitative Case Study, Consuelo Nelson

Dissertations

The purpose of this study is to identify and understand the effects of working night shift to acquire insight into environmental, formative, and institutional constituents that may influence the development and utility of fatigue risk management approaches for nurses in acute care hospitals.

Simulated Clinical Experience: An Investigation Of Emotion Understanding And Management, Neena W. Jones

Dissertations

Many investigators have documented that lack of emotional intelligence (EI) in professional nursing correlates with patient dissatisfaction, negative patient outcomes, and litigation. However, much less information is available to nurse educators for an effective instructional strategy to increase EI skills, specifically emotion understanding and management (the most influential branches of EI) in nursing students. Grounded in the theory of EI and the theory of simulation, the purpose of this quantitative quasi experimental study was to introduce educational technology as a useful strategy for influencing EI in a convenience sample of 88 second semester students in a baccalaureate program. Research questions …

Exploration Of Gratitude In Cardiovascular Health: Mediators, Medication Adherence And Psychometrics, Lakeshia A. Cousin

Dissertations

The purpose of this dissertation was to explore the effect of gratitude on cardiovascular health outcomes using mediators, medication adherence, and psychometrics. The specific aims were to (1) establish the state of the science for gratitude and cardiovascular health outcomes via a state-of-the-science literature review, (2) explore mediators affecting gratitude and medication adherence using a structural equation model in patients with cardiovascular disease, and (3) analyze the psychometric properties of the Gratitude Questionnaire-6, a self-report questionnaire designed to assess individual differences to express dispositional gratitude, to provide evidence for the validity and reliability of the instrument in African Americans at …

Bedside Nurses' Perceptions Of Pursuing An Academic Career As Nursing Faculty, Suzanne L. Benfield

Dissertations

There is a nursing faculty shortage at a Mid-Atlantic associate degree nursing program. In response, program administrators have hired adjunct faculty with bachelor of science in nursing degrees (BSNs), hired full-time faculty with master of science in nursing degrees in areas other than education who also are not certified nurse educators, and reduced its minimum requirement for nursing faculty clinical experience. The nursing faculty shortage combined with the resulting gaps in practice are problematic because they may (a) negatively influence the program's ability to produce degreed nurses; (b) increase faculty workload; (c) decrease the quality of student education, which may …

International Students’ Perceived Support And Barriers Adapting To The New Cultural Experience In A Southern California University, Jeanette Ayala

Dissertations

Purpose: The purpose of this phenomenology study was to explore the lived experiences of international students’ perceptions regarding the types of support they received to adapt to a new culture experience and barriers to their successful adaptation to a new cultural experience while enrolled in a southern California university.

Methodology:

Qualitative research was the methodology used for this study because it was the approach best suited to gain a better understanding of the phenomena of international students’ lived experiences. The present study involved a qualitative design with a phenomenological inquiry approach. The technique of using semi-structured interviews is a method …

Relationship Between Aprn State Practice Authority Perceived Autonomy, Professionalism, And Interprofessional Team Function Among A National Sample Of Aprns In The U.S., Patricia R. Gilman

Dissertations

Healthcare that includes high performing interprofessional clinical teams (IPTs) is one recommended strategy to provide optimal quality and cost-effective care delivery. Highly functional IPTs are characterized by effective communication, trust, respect, collaboration, information-sharing, and conflict resolution and are more efficient than individual providers working alone. Internally, IPT members' relationships and understanding of both one's own professional identity and others' role and responsibilities are crucial to team functionality and effectiveness. Externally, factors including regulatory practice environments might influence the effectiveness and performance of both individual team members and the team overall. Inconsistencies between states' practice authority (SPA) for advanced practice nurses …

Decreasing Pre-Procedure Anxiety In School-Aged Patients In An Outpatient Surgery Setting Using A Video Prior To Anesthesia Induction, Michelle Charette

Dissertations

Anxiety occurs when a human feels a threat in response to a situation. Having surgery can heighten this psychological reaction, especially in pediatric patients undergoing anesthesia. Many children fear anesthesia for they do not understand what is expected of them nor what to expect when entering an operating room. When anxiety and fear are elevated, it can lead to behavioral changes, increases in postoperative pain, delays in wound healing, and postponement of discharge. Eliminating or reducing anxiety can result in positive outcomes for patients with pain, healing, and discharge. Literature supports the use of an educational video to aid in …

The Effectiveness Of Preoperative Preparation Program In Decreasing Parental Preoperative Anxiety, Thao L. Tran

Dissertations

This project aimed to examine the effectiveness of a preoperative preparation program (PPP) in decreasing parental anxiety. When children needed anesthesia to get outpatient procedures completed, the accompanying parents received verbal education about the process on the day of the procedure and were assisted by a support person during and after the child's induction anesthesia. Parental anxiety was measured using the State-Trait Anxiety Inventory (STAI) tool before preoperative preparation and after the induction of anesthesia to assess whether the PPP improved parents' anxiety levels. The parents' decreased anxiety score in post-intervention would suggest that the PPP can be effectively and …

Toward Enhancement Of Clinical Judgment And Critical Thinking Simulation In The Classroom, Roxie L. Barnes

Dissertations

Health-care systems are changing, thus changing the expectations and requirements for nursing students entering the profession (Kaddoura, 2011). Nursing education must address the changes and focus on the development of critical thinking and clinical reasoning. When students are unable to apply clinical reasoning or clinical judgment into practice, there is an increase in potential for negative patient outcomes (Jones, Passos-Neto, & Braghiroli, 2015). Case-based learning (CBL) and simulation-based learning (SBL) are both active learning methods that can enhance development of critical thinking, clinical reasoning, and clinical judgment (Forneris et al., 2015). The purpose is to compare the use of CBL …

Oral Medication Adherence, Attitude, And Quality Of Life In Older Adults With Cancer: The Impact Of Motivational Interviewing, Janelle Tipton

Dissertations

Oral medication adherence in the older adult with cancer, age 65 years and older, is a significant clinical problem. Adherence rates are estimated at only 50%, which can lead to suboptimal treatment efficacy, poor symptom control, and reduced survival. Patient attitudes and beliefs can improve oral medication adherence and quality of life, while reducing unnecessary emergency room visits, and hospitalizations. Motivational interviewing (MI) is a communication intervention that has been shown to improve oral medication adherence in persons with chronic illness, including cancer. The purpose of this evidence-based practice (EBP) project was to explore the influence of MI on adherence …

A Web-Based Learning Adaption Of The Ending Self-Stigma (Ess) Program, Shari Harding

Dissertations

The purpose of this practice project (SPP) was to implement and evaluate a web-based learning adaptation of the Ending Self Stigma (ESS) curriculum, a group-based program to reduce mental illness self-stigma. The literature currently supports group-based, psychoeducational, face-to-face interventions for self-stigma. This project adapted current evidence-based content to the web-based learning modality as an individual, technology-based, intervention. The intervention was evaluated using a mixed methods approach with a pre- and post-test design among adults receiving outpatient mental health services. The dependent variables of interest in this project were the self-stigma of mental illness and recovery orientation. This study found that …

The Student Voice: Experiences Of First-Generation, Adult, Latino Male Tutees Learning Within A Peer Tutoring Environment, Shawn M. Carney

Dissertations

Purpose: The purpose of this qualitative, single-site case study was to identify and describe the lived experiences of first-generation, adult, Latino male tutees utilizing peer tutoring services within the Solano Community College (SCC) learning assistance center (LAC), concerning readiness, challenge, support, and balance as they applied to motivation to learn and personal academic growth.

Methodology: Fifteen participants were selected through a purposeful sampling process, and data were collected and analyzed through semi-structured, open-ended interviews to develop common themes with tabulated results presented via frequency tables.

Findings: First-generation, Latino, male tutees (1) sought tutors who were confident in the subject matter, …

The Marginalization Of Social Studies In Missouri: An Analysis Of Elementary Instructional Time And High School Standardized Assessment Scores, Stephanie Lovette

Dissertations

Social studies education plays a vital role in an evolving American society. Through social studies, students are equipped with skills to become active and informed citizens in a democracy (National Council for Social Studies, 2017a). With the implementation of the No Child Left (NCLB) Act in 2001, educational reforms have increasingly emphasized student performance in mathematics, communication arts, and science (Libresco, 2015). As a result, instructional time has been drastically shifted to these subjects (Heafner & Fitchett, 2015). This mixed-methods study was conducted to explore the impact of NCLB and subsequent federal education policies on the marginalization of social studies …

The Impact Of Breathing Retraining Education On Adults With Asthma For Improving Quality Of Life, Symptom Control And Reducing Short-Acting Beta-Agonist Inhaler Use In A Primary Care Setting, Danny Barazi

Dissertations

Quality of life related to asthma is negatively impacted when asthma is uncontrolled, which is characterized by frequent symptoms and rescue inhaler use which lead to limitations in normal daily activities. The goals of asthma therapy include infrequent use of short-acting beta-agonist (SABA, rescue) inhalers, prevention of acute and chronic symptoms while maintaining normal activity levels. While these goals of therapy employ infrequent use of SABA inhalers as the primary metric of effective asthma symptom management, measuring quality of life is also recommended as an important outcome of therapy and an approach to promote self-management in patients with asthma. One …

The Effectiveness Of Nurse-Led Diabetes Self-Management Education Among Adults With Uncontrolled Type 2 Diabetes Mellitus, Consolata G. Oronsaye

Dissertations

Ample evidence has supported the efficacy of diabetes self-management education (DSME) in diabetes care. However, specific evidence that supports the effects of nurse-led DSME on glycemic control and prevention of diabetes complications remains limited. The purpose of this quantitative, quasi-experimental project was to determine if any, and to what extent a relationship existed between a nurse-led DSME intervention and the lowering of FBS levels to 100mg/dl or below, and the reports of improved self-efficacy among patients with poorly controlled T2DM at a primary care clinic located in an underserved community in Northwest, Texas. Theoretical support for the project was drawn …

Perinatal Experiences Of Childbearing Women With Physical Disabilities, Serah M. Nthenge

Dissertations

Purpose: The aim of this secondary qualitative analysis was two-fold: to explore perinatal experiences of 22 women with physical disabilities guided by the perinatal health framework of women with physical disabilities and; construct two perinatal life stories of childbearing women with physical disabilities.

Method: The study participants were 22 women with physical disabilities who, at the time of pregnancy, used a mobility device, and had given birth within the last 10 years. The principal investigator of the primary study interviewed all the participants.

Findings: Nine themes were identified in our study. All the participants reported both a lack of disability-specific …

Guided Reflective Writing And Student Clinical Judgment Development: A Descriptive Study Of Nursing Student And Faculty Perspectives, Tanya L. Smith

Dissertations

Literature supports guided reflection and clinical judgment development as key components to enhancing students' knowledge and preparation for complex nursing care. Faculty are challenged to prepare new nurses to enter the complex health care arena and often note problems in helping students transition classroom learning to clinical application. The National Council of State Boards of Nursing (NCSBN) recognizes and supports teaching clinical judgment in nursing curricula to better prepare nursing students for professional practice (2018).

Assessment Technologies Institute Test Results And Blended Experiences For Senior Community Health Nursing Students, Linda Lacomb-Williams

Dissertations

The purpose of the study was to examine the relationship between senior community health nursing students' ATI test scores and their clinical community health nursing experiences, either in-country or out-of-country. The ATI test results are a reliable predictor of whether the student will pass their nursing board exams (NCLEX-RN). The study also examined whether the two groups of students reported any similarities and differences in their sense of confidence or transcultural self-efficacy and conceptual knowledge and their clinical experiences.

ATI test scores were reviewed for the two groups. Focus groups were held to discuss any similarities or differences in the …

Cultural Practices, Knowledge, And Beliefs Of Newborn Care And Health-Seeking In Rural Zambia, Julie M. Buser

Dissertations

Decreasing newborn morbidity and mortality remains a serious global health challenge. For this reason, interventions like maternity waiting homes (MWHs) and the Saving Mothers, Giving Life (SMGL) initiative may improve maternal-newborn newborn health and delivery outcomes. The overarching goal of this dissertation was to explore and describe the cultural practices, knowledge, and beliefs of essential newborn care and health-seeking in the context of MWHs and the SMGL initiative in rural Zambia. Guided by the Ecological Systems Theory, this goal was met through three studies with the following aims: (1) Describe knowledge and beliefs of newborn care and illness from the …

The Association Of Patients' Analgesic Treatment Beliefs And Trade-Offs With Analgesic Adherence Behaviors Among Outpatients With Cancer Pain, William E. Rosa

Dissertations

Pain is one of the most burdensome symptoms for patients with cancer. Per cancer pain guidelines, opioids remain one of the primary modalities for managing moderate to severe cancer pain. Analgesic nonadherence is common among cancer patients despite unmanaged pain symptoms. We investigated how patients prioritized analgesic treatment beliefs for cancer pain and whether those beliefs predicted objective analgesic adherence behaviors.

Lived Experience Of Being An Obese Registered Nurse: A Phenomenological Inquiry, Trina Rodgers

Dissertations

Research has shown obesity is a significant problem affecting the general-public and is increasing in prevalence among health care providers. The purpose of this descriptive phenomenological study was to understand the lived experience of being obese as a registered nurse. One-on-one interviews with 15 registered nurses, who had a personal experience with being obese as a registered nurse, were conducted. Data were collected through in-depth interviews, which were taped and transcribed verbatim. The data analysis was conducted manually to gain the true essence of the participant's lived experiences. The responses were analyzed, coded, and themed using Colaizzi's method of data …

The Effect Of Treatment Modalities On Chronic Low Back Pain And Self-Transcendence, Grace Augustine

Dissertations

Chronic Low Back Pain (CLBP) is a common health problem that most people experience at some point in their lives. For the relief of pain, numerous studies have shown that pain medication causes several side effects and leads to mortality. This study focused on how an individual's choice of CLBP treatment modalities impacts utilization of the strategies of self-transcendence. Chronic low back pain prevalence shows a steady increase in the studies reviewed. Patients may improve in self-transcendence and well-being while they experience CLBP. Self-transcendence is a vital resource of well-being as people seek to manage CLBP.

Nursing Students' Perceptions Of Spiritual Well-Being, Academic Persistence And Academic Success, Mindy Barna

Dissertations

This qualitative phenomenological research study explores the perceptions and beliefs of undergraduate senior-level nursing students about spiritual well-being in relation to academic persistence and ultimately academic success as measured by timely graduation at a private women's university in the Midwest. By adding to the body of research and knowledge, nurse educators may better assist students to achieve academic success, which could potentially alleviate the national nursing shortage and decrease financial losses of academic institutions. Nine Bachelor of Science in Nursing (BSN) students at a private university in the Midwest participated in semi-structured, one-on-one interviews. Participants were in their senior year …

Psychometric Evaluation Of The Moral Comfort Questionnaire Among Hospital-Based Direct-Care Registered Nurses, Natalie Bermudez

Dissertations

Moral comfort, an emerging concept in nursing, is defined as an individual's feelings of ease with decisions and actions related to a moral dilemma. Moral comfort for nurses is the positive outcome of a moral situation or dilemma, while moral distress, a widely explored issue in nursing, is the negative outcome. However, nursing literature on the concept of moral comfort is limited. While several instruments to measure moral distress exist, an instrument to measure moral comfort was not found. The Moral Comfort Questionnaire (MCQ) was theoretically developed. The purpose of this study was psychometric evaluation of this new 35-item instrument.