Digital Commons Network^™

High Risk Medication Regimens And Medication Related Predictors Of Hospital Readmission In Elderly Home Care Patients, Mary T. Dierich

Dissertations

Adverse drug events are a primary cause of hospitalization in the elderly. Nearly 70% of the $177.4 billion dollars spent on drug related morbidity and mortality in the U.S. is due to hospitalizations. Polypharmacy, inappropriate medications or medication regimen complexity have all been implicated as precursors to adverse drug events and as indicators of high risk medication regimens. Understanding the relationship between medication regimens and readmission is important when evaluating potential errors in administration, risk-benefit ratios, and readmission risk. However, due to definitional and measurement issues, the high risk medication regimen remains an elusive concept. This study characterizes medication regimens, …

Humanizing History: Empowering Educators To Navigate Difficult History Through Museum-Led Professional Development, Andrea Miskewicz

Dissertations

As museums increasingly serve as educational hubs, this research examines how teachers' participation in such programs contributes to their perceived efficacy for teaching topics of difficult history. Employing a mixed-methods approach, the study utilizes a survey with quantitative and qualitative measures to evaluate changes in teacher self-efficacy before and after a museum-led intervention. With a pre and posttest design, this study provides deeper insights into participants' experiences and challenges. Preliminary findings suggest museum-led professional development has a significant positive impact on teachers’ perceived self-efficacy, highlighting the resources and opportunities museums have available and the importance of humanizing history in social …

Using Evidenced-Based Practice To Increase Knowledge And Awareness Of Sexually Transmitted Infections, Amanda M. Brickey

Dissertations

The purpose of this quality improvement (QI) project is to increase the knowledge and intent to change practice through education on the importance in assessing sexual health history in patients at a federally qualified health center (FQHC) in Western Washington State by providing continuing education to primary care providers.

Settler Colonial Determinants Of Indigenous Health: Relationship Between Indigenous Women's Level Of Allostatic Load And High Blood Pressure During Pregnancy; A Secondary Analysis Of The Strong Heart Study, Nicole A. Thomas

Dissertations

There is a dearth of comprehensive literature relevant to the relationship between settler colonialism and health outcomes of Indigenous peoples residing in the United States (U.S.). Critical analysis of settler colonial determinants of Indigenous health will help to further shape discourse, research priorities, and policy relevant to Indigenous population health and disease distribution. This thesis will bring awareness to settler colonialism, propose relationships between settler colonialism and health outcomes, and identify specific settler colonial determinants of Indigenous health to help guide development and use of nursing theory. This dissertation argues that the structure of settler colonialism threatens and implicates the …

Neonatal Intensive Care Nurses' Perceptions Of Nurse Leader Behaviors And Their Impact On The Workplace Environment, Meggan R. Mcculley

Dissertations

Nursing leadership is a crucial component in today's healthcare organizations as nurses make up the largest profession in healthcare overall. Nurse leaders have the ability to affect the environment of the nurses' workplace in both positive and negative ways, thus impacting their Quality of Nurse Work Life (QNWL). QNWL is an indicator of nurse satisfaction within their workplace, and the ability of the nurse to make meaningful contributions to their home units and the organization. The purpose of this qualitative, interpretative phenomenological analysis (IPA) study was to describe what it meant to experience nursing leadership from the perspective of Level …

The Cultivation And Integration Of Cultural Humility And Cultural Competence In Lgbtiq+ Client Work: A Constructivist Grounded Theory Approach, Gon Ratanashevorn

Dissertations

Previous researchers have highlighted the lack of consistency and standards in LGBTIQ+ cultural competence trainings which may cause negative therapy experiences for LGBTIQ+ clients. This research empirically explored counselors’ (n = 12) process of the cultivation and integration of LGBTIQ+ cultural competence and cultural humility to inform training which leads to better services for LGBTIQ+ clients through constructivist grounded theory method. The theory of the life-long cultivation and integration of LGBTIQ+CC and cultural humility emerged with five categories: (1) motivation to do right by queer clients, (2) cultivating the right soil for queer folks, (3) walking the walk to …

Caring Behaviors Of Nursing Students And Their Attitudes Toward Older Adults, Jacquelyn D. Lambert-Davis

Dissertations

Caring is an emotion. It is a feeling of compassion and an understanding of the difficulties of others. Research indicates that caring behaviors and attitudes are an important part of the knowledge base for nursing students. Caring behaviors and attitudes are an important part of the knowledge base for nursing students in order to provide competent care for older adults. This descriptive cross-sectional study reports findings of caring attitudes and behaviors of nursing students using the Caring Dimensions Inventory (CDI). The purpose of this study was to examine the self reported attitudes and caring behaviors of nursing students toward older …

Development And Evaluation Of A Nurse Practitioner Directed Early Palliative Care Initiative And Its Impact On Goal-Concordant Care At A Cancer Center, Ashley V. Weinmann

Dissertations

Seriously ill patients often experience discordant care. Delivering high-quality healthcare requires effective communication to support goal-concordant care.

Pancreatic cancer has a 5-year survival rate of 12% with a high symptom burden. Pancreatic cancer patients often have unmet needs that lead to increased psychological, spiritual, social, and physical needs. Early integration of palliative care can provide high-quality communication and goal-concordant care. A retrospective analysis of MDACC's pancreatic patients found that 34% were referred to palliative care.

A Brief Self-Compassion Intervention For Survivors Of Sexual Trauma With Psychological Distress, Natalie Marie Hogue

Dissertations

Individuals who have experienced sexual trauma are at an increased risk of psychological disorders and psychological distress (Dworkin, 2020; Dworkin et al., 2017; Dworkin & Schumacher, 2018). Sexual trauma has one of the highest conditional risks for the development of posttraumatic stress disorder (Domino et al., 2020; Perrin et al., 2014). Experiential avoidance, shame, and posttraumatic cognitions are associated with psychological distress after experiencing sexual trauma (Bhuptani et al., 2019; Domino et al., 2020; Foa et al., 1999; Merwin et al., 2009). Established research suggests that self-compassion-based therapies can be effective in reducing psychological distress and treating a wide range …

Long Covid Patients: A Phenomenology Study Exploring Mental Health And Psychosocial Adaptation To Disability, Tonia Joy Lans

Dissertations

In the United States, approximately 1 in 13 long COVID patients experience adverse complications two to three years post-recovery (Centers for Disease Control and Prevention, 2022), including physical, psychological, and cognitive impairment, issues with daily functioning, and difficulties returning to work (del Rio et al., 2020; Greenhalgh et al., 2020; Ladds et al., 2020; Logue et al., 2021). Moreover, collective research has indicated the debilitating complications of long COVID often result in impaired mental health, chronic illness, and disability. While significant research efforts have started to accumulate data to understand and treat the physical and neuro-logical manifestations of this chronic …

The Fourth Wall Of Dialogue: A Co-Constructive Collaboration On Bipoc Student Sense Of Belonging In Higher Education, Valarie Lindsey

Dissertations

Black, Indigenous, People of Color (BIPOC) students’ sense of belonging (SOB) at higher education institutions has decreased over the last 30 years despite numerous initiatives aimed at increasing a sense of belonging for this group of students and addressing the challenges they face from various intersectionalities including cultural biases, gender marginalization, and racial subjectivities. Sense of belonging is often subjective in nature because it refers to an individual's lived experience, it is important for higher education institutions to tailor their Diversity, Equity, and Inclusive (DEI) initiatives to meet the needs of the students on their campus. This initiative should include …

Estimating And Applying Parameters Necessary To Plan Cluster Randomized Trials (Crts) And Multisite Cluster Randomized Trials (Mscrts), Dea Mulolli

Dissertations

Cluster randomized trials (CRTs) are commonly used to study the effectiveness of educational interventions. During the design phase of a study, it is critical for researchers to ensure their studies are adequately powered to detect meaningful treatment effects, including both main and moderator effects. Designing CRTs with adequate power to detect main and moderator effects requires accurate estimates of design parameters. This research aims to advance the literature on design parameters for power analyses, specifically focusing on empirical estimates of intraclass correlations (ICCs). The work consists of three research papers that examine the role of including the teacher level in …

A Microgenetic Learning Analysis Of Contextuality In Reasoning About Exponential Modeling, Elahe Allahyari

Dissertations

This work explores the complex cognitive processes students engage in when addressing contextual tasks requiring linear and exponential models. Grounded within Piagetian constructivism and the Knowledge in Pieces (KiP) epistemological perspective (diSessa, 1993, 2018), this empirical study in a clinical setting develops a Microgenetic Learning Analysis (MLA) of the reasoning of 14 students from an Algebra II course. It reveals the critical role of cognitive disequilibrium as an essential cognitive state for conceptual development and the process of reorganizing knowledge systems. The study uncovers the fluctuations in students’ reasoning patterns and the significant impact on students’ reasoning patterns of task-specific …

Infusing Values Into Written Exposure Therapy: A Comparison Study, Maegan Campbell

Dissertations

Written Exposure Therapy is a brief, efficacious intervention for the treatment of PTSD symptoms. The WET protocol calls for the infusion of values into therapeutic work, however, does not detail how to incorporate these values work into the highly scripted treatment. This study compared the standard WET protocol with WET infused with values. The study examined differences across the two conditions on seven variables (PTSD scores, depression scores, value importance and consistency, quality of life, psychological flexibility, customer satisfaction, and therapeutic alliance). The sample was largely homogenous in gender, ethnicity, sexuality, and reported index trauma. The sample was largely white …

Modeling Blue Mondays: A Preclinical Evaluation Of 3,4-Methylenedioxymethamphetamine Binge Dosing On Responding Maintained By A Progressive Ratio Schedule Of Food Reinforcement In Male Sprague-Dawley Rats, Candace Brenda Johnson

Dissertations

3,4-Methylenedioxymethamphetamine (MDMA) has been abused recreationally in the rave scene for decades. As pharmacotherapy research has progressed to develop alternative medications to treat trauma-related psychiatric symptoms, MDMA has become a prime candidate for medication-assisted psychotherapy in the treatment of PTSD and will soon be FDA approved for medicinal use. Despite convincing evidence for favorable clinical outcomes, this substance has been known to contribute to acute depressive states following excessive use. The sharp decrease in mood and cognitive impairment following MDMA use is colloquially termed Blue Mondays. Measuring lack of motivation or more broadly anhedonia through withdrawal of acute and chronic …

Brief Treatment For Ptsd: Promoting Trauma Recovery With A Five-Session Cognitive Processing Therapy Protocol, Sanela Kalakovic

Dissertations

Cognitive Processing Therapy (CPT) is a first-line treatment for trauma. CPT is traditionally administered over 12 sessions. This open clinical trial examined the feasibility and efficacy of a 5-session CPT protocol. The abbreviated protocol moves more quickly to the proposed therapeutic mechanism of action, cognitive restructuring, to alter unhelpful traumarelated thoughts and beliefs. The goal is to maintain efficacy while making therapy more efficient and thereby reducing barriers to trauma treatment. Using a repeated measures open clinical trial design (with embedded multiple baselines), 67 adults (M age = 43 years, 90% female, 79% White) with clinically significant post-traumatic stress disorder …

A Quantitative Analysis Of University Counselors And Student Affairs Personnel's Knowledge And Confidence In Working With Students With Autism Spectrum, Sandra Araiza Salazar

Dissertations

University counselors and student affairs personnel often find themselves unprepared to address the needs of undergraduate students with autism spectrum disorder. Many of these professionals are not receiving the proper training or education to prepare for the unique social, emotional, and academic needs of these neurodiverse students. Due to this trend, many university counselors and student affairs personnel may lack the necessary knowledge and confidence in serving this neurodiverse population. In this first-of-its-kind study, university counselors and student affairs personnel’s knowledge and confidence in working with undergraduate students with autism spectrum was analyzed. A nonrandom sample of university counselors and …

Drug Use And Harm Reduction: Community Readiness As Pathway To Well-Being And Reintegration, Lauretta Ekanem Omale

Dissertations

Drug abuse negatively impacts the life and well-being of those who use drugs; this harm often extends to their loved ones, communities, and society. One presumptive set of psychological explanations for drug abuse is an addictive personality, a psychological susceptibility resulting from challenging family relationships, inadequate reinforcement, the absence of healthy role models, conflicting parental expectations, and a lack of love and respect. Harm reduction is a public health approach that focuses on minimizing the harmful effects of drugs and reducing judgment. It aims to meet people where they are in life and provide judgment-free, empathetic, supportive, and needed medical …

Cooperative Pathways: Insights From Teacher Experiences On Improving Union And District Cooperation, Whitney Fink

Dissertations

This study involved an evaluation of teacher experiences within their districts, schools, and unions across the United States. The primary research question was: How are teachers currently experiencing the relationship between their unions, districts, and administrators and what opportunities exist to improve cooperation and shared ownership between those groups? The study used a mixed methods approach by gathering quantitative data in the form of a survey and qualitative data through open-ended responses on the survey as well as interviews with seven teachers. The results formed a general understanding of the current state of teacher experiences that was then applied to …

Persistence Of Female Faculty In Stem, Andrea Constantinou

Dissertations

The lack of women entering certain STEM fields impacts female representation in research faculty, teacher faculty, and leadership positions in higher education. Through a narrative inquiry methodology utilizing the theoretical paradigms of self-determination theory and relational autonomy, this study extended understanding of the factors that motivate persistence for women in certain STEM fields. While prior research focused on understanding the barriers to retention, this study sought to identify the factors motivating retention for women in certain STEM fields. The results of this study contribute to understanding the motivating factors that influence a woman’s persistence in STEM. The data gathered from …

Building Partnerships With Indigenous Communities, Andrea Plamondon

Dissertations

Non-indigenous researchers embark on research with indigenous communities with good intentions but can unintentionally continue to oppress. While existing research shows building partnerships with indigenous communities, requires researchers to work “with” not “for” communities and walk side-by-side, and to do so with reciprocity, respect, relevance, responsibility and reverence, this research study identified an iterative model to learn, follow, and emerge research relationships through ongoing connections and outlined the mindsets to consider and assess often. Ten non-indigenous researchers from the US and Canada shared their stories about building relationships with indigenous communities. Through their stories of successes and challenges, strengths and …

Undergraduate Student Sense Of Belonging And Edtech Tool Engagement: A Mixed Methods Exploration Of The Virtual Campus Experience, Veronica Wilson

Dissertations

The contemporary postsecondary learning experience is heavily mediated by educational technology (EdTech) tools and yet little is known about the ways in which these tools impact student engagement and sense of belonging, two indicators which are important to student persistence and graduation. Using Strayhorn’s (2023) critical socioecological sense of belonging framework, this convergent mixed methods study offers insights into these relationships by examining student engagement with EdTech and student sense of belonging and the impact of student traits on the relationship between EdTech and sense of belonging. This study was conducted at a private, broad access Hispanic-Serving Institution in the …

An Examination Of The Relationship Between Instructional Modality And Pedagogy Licensure Exam Scores In Post-Baccalaureate Educator Preparation Programs In Indiana, Kelly Eckel

Dissertations

The efficacy of the modality of instruction employed in higher education institutions has been a point of contention among students, faculty, administration, and other stakeholders in the educational realm. Since the COVID-19 pandemic, online and hybrid instruction has become a valued and desirable option for Educator Preparation Programs (EPPs) to offer for recruitment and retention purposes. The effectiveness of varying modalities in relation to teacher licensure exams has been limited in research and can serve as a critical quantitative measure for EPPs to assess. This longitudinal study examined the relationship between instructional modality and pedagogy teacher licensure exam scores in …

Understanding Latino Students' Perspectives On Their High School Experiences And Post-Graduation Options, Rubi Ortiz

Dissertations

Projections from the U.S. Department of Education National Center for Education Statistics indicate Latinos will constitute 30% of the school-aged population in the United States by the year 2030. Enhancing the quality of education for this demographic becomes increasingly crucial. Such improvements not only benefit Latino communities but also hold significant implications for the progress and future prosperity of our nation. The focus in this study was to understand Latino students’ perspectives on their high school experiences and post-graduation options, as well as to explore the influence of high school programming on their experiences. This qualitative study was conducted with …

Encendiendo La Intuición/Igniting Intuition: A Bilingual Reading Specialist's Lived Experiences And Reclaiming Of Literacies, Dora M. Guzmån

Dissertations

This autoethnography explores the researcher’s lived experiences as a first-generation Latina, bilingual reading specialist who developed biliteracy in English/Spanish from childhood through adulthood and how this ignited her cultural intuition. Framed by a critical, Chicana feminist lens, she analyzed her personal and professional biliteracy practices and cultural intuition to understand how she supported young bilingual readers. Qualitative data were collected retroactively and in-the-moment (e.g., voice/written reflective memos, journals). The study research focused on how her cultural intuition guided: a) her role and practice as a bilingual reading specialist; b) her role and practice as a bilingual literacy practitioner of bilingual …

Shake Ya Ass, But Watch Yourself: An Intersectional And Decolonial Approach To Exploring The Sexualization Of Female Recording Artists And The Empowerment Of Women In The United States, H.B. Rebeka

Dissertations

This dissertation, titled Shake Ya Ass, But Watch Yourself: An Intersectional and Decolonial Approach to Exploring the Sexualization of Female Recording Artists and the Empowerment of Women in the United States, critically examines the phenomenon of sexualization of women in the music industry and its impact on female empowerment. Through an intersectional and decolonial feminist lens, the study delves into the historical and socio-cultural contexts that shape the portrayal and perception of female recording artists in the United States.

The research traces the roots of feminism and the commodification of racial stereotypes through music, exploring how female empowerment has been …

A Program Evaluation Of The Necessary Attributes, Accommodations, And Resources Neurodivergent Students Require For Success In Higher Education, Barbara Muñoz

Dissertations

Without academic resources and accommodations, neurodivergent students with mild to moderate Learning Disabilities (LD) may be unable to navigate the academic challenges and rigor associated with college success. I used a mixed-methods research design to collect data from various stakeholders to determine the supports neurodivergent students with LD need to be successful in college. My findings indicated students need accommodations for their learning differences, access to assistive technology, access to counseling or mental health services, and access to specialized support personnel to be successful. I recommended a policy to ensure neurodivergent students and their caregivers are aware of post-secondary institutions …

A Convergent Parallel Mixed Methods Examination Of The Impact Of Graduate Student Loan Balances On Overall Quality Of Life Among Clinical Psychologists With Psyd Degrees, Lekai James

Dissertations

Graduate student loan debt in psychology, particularly for those with Doctorate in Psychology (PsyD) degrees in clinical psychology, is highly problematic. Previous research has shown that student loan debt negatively impacts quality of life (QOL) by affecting subjective well-being (SWB) and life satisfaction (LS). This study used a convergent parallel mixed method approach, guided by bottom-up spillover theory and Maslow’s hierarchy of needs, to explore the relationship between QOL and total graduate student loan balances, as well as the effects of income and monthly student loan payments on QOL among PsyD graduates. Participants (N = 16) completed a survey with …

Determining Factors For Improved Uptake Of Harm Reduction Services In The United States: A Study Of Inclusive, Culturally Sensitive Messaging, Lauretta Ekanem Omale

Dissertations

Harm reduction refers to public health policies and programs aimed at decreasing the adverse consequences associated with drug use. While harm reduction services (e.g., syringe exchange programs) can mitigate health risks, marginalized groups face barriers to service access and utilization, partially due to ineffective messaging approaches that fail to align with cultural values and experiences. A one-size-fits-all approach to messaging can negatively impact service utilization, health outcomes, and health disparities. Ineffective communication can lead to poor adherence to treatment, poorer health outcomes, and increased adverse events.

Culturally insensitive communication contributes to stigma, mistrust, and lack of perceived relevance, discouraging service …

Hear Their Voices: Black Male Student Perceptions Of Retention Initiatives At An Hsi In The Midwest, Joshua Watson

Dissertations

The enrollment of Black male students in colleges and universities over the last 30 years increased yet Black male retention rates have not increased proportionately to the enrollment rates of Black male students. Many colleges and universities recognized the importance of increasing Black male retention and invested millions of dollars in Black male retention initiatives, mentorship initiatives as well as hiring additional staff dedicated to Black male retention. Black male students use a variety of social support systems and coping strategies to persist in college despite facing economic, social, and political barriers to persistence. However, many Black male retention initiatives …