Digital Commons Network^™

Gottman Processes And Couple Outcomes While Navigating Infertility, Clayton Brigance

Dissertations

Infertility remains one of the most difficult relational contexts for couples. However, some research suggests that some couples actually increase their overall satisfaction in their relationship through infertility due to a deeply shared emotional experience. To the knowledge of the author of this dissertation, no studies exist which explain how couples arrive at their relational outcomes through the experience of infertility. These studies within this dissertation add to the present literature by explaining how couples may arrive at their relational outcome through the lens of Gottman Method Couple Therapy (GMCT). For both studies presented here, 902 participants were recruited through …

Level 2 And Level 3 Patients In A 5-Level Triage System: Factors Related To Acuity Assignment And Trajectory Of The Emergency Department Experience, Roxanne O. Garbez

Dissertations

Clinical decision making in the emergency department (ED) can have a significant impact on patient safety and health care outcomes. One type of clinical decision making is the process of emergency department triage. Within the context of the 5-level Emergency Severity Index triage system, it is not known what factors influence patient assignment by the triage nurse to ESI acuity levels 2 and 3. To increase the validity of patient assignment to levels 2 and 3, more explicit criteria are needed.

Purposes: (1) Describe factors that influence triage nurse assignment of patients to level 2 and level 3; (2) Examine …

The Effect Of Student Perception Of Parent Involvement And Socioeconomic Status On Academic Intrinsic Motivation, Pallavi Aggarwal, Taylor Lawson Smith

Dissertations

Many teachers struggle to help students become intrinsically motivated in their school work. Research has shown that students who are intrinsically motivated tend to have higher academic achievement than students who are not (Mendoza, 2012). There are many factors that contribute to students’ intrinsic motivation. Building on existing research, the relationship between perceived parental involvement and students’ intrinsic motivation, as well as the relationship of perceived socioeconomic status and intrinsic motivation was investigated. A mixed methods research approach was used to determine a) the relationship between perceived parent involvement and students’ intrinsic motivation, b) the relationship between perceived socioeconomic status …

A Study Of Nurses' Experiences With Behaviors That Compromise A Healthy Work Environment In The Hospital Setting, Connie K. Schultz

Dissertations

The existence of disruptive behaviors in the hospital setting has been shown to affect the communication and collaboration between healthcare professionals. This study explored nurses' experiences with behaviors that compromise a healthy work environment. The data collection was accomplished through semi-structured interviews and review of organizational documents. The results of the analysis concluded that there existed a low incidence of disruptive behaviors in the selected organization. Themes were determined that reflected inconsistencies in the nurses' practice environment that contributed to the presence of disruptive behaviors. Inconsistency in communication and collaboration, in holding colleagues accountable, and the lack of visibility of …

A Composite Cognition Instrument For Nursing Care Of Combat Casualties, Patricia Frohock Hanes

Dissertations

In the course of caring for military and civilian combat casualties, military nurses must make rapid, accurate decisions. When developing methods to teach nurses essential content for combat casualty care, it is important to understand the cognitive and learning processes involved in acquiring that knowledge. Measures to examine how military nurses think and learn have significance, especially when applied to the high-stress, high-stakes practice arena of combat causality care. Use of these measures in evaluating educational strategies will help answer the need for better deployment readiness for military nurses.

The Experience Of The Expectant Mother Following A Diagnosis Of A Fetal Anomaly, Janet A. Tucker

Dissertations

The experience of pregnancy complicated by a fetal anomaly diagnosis is comprised of many concepts: uncertainty, information needs, stress and anxiety, waiting, decision-making dilemmas, isolation, fragmented health care, multiple losses and grief, foreknowledge, acceptance and adaptation. There is great variance in what is understood about each concept. The purpose of this study was to explore uncertainty and waiting among expectant mothers from the time period of a prenatal diagnosis of a fetal anomaly through the post-partum period.

Impacting African American Student Achievement In The Middle School Stem Classroom By Teaching Mathematics Through Arts Integration And Design Thinking, Robert Lippert, Tjuannia R. Seals

Dissertations

Middle school is a transitional period in which many students experience content-specific teachers, travel between classrooms, and explore extracurricular activity options for the first time. Historically, African American middle school students have not fared well in Science, Technology, Engineering, and Mathematics (STEM) on standardized assessments, performing significantly below their Caucasian counterparts in mathematics and science. From the beginning of their academic careers, a lack of access to quality teachers, excessive use of direct instruction strategies, and a lack of resources in their school communities, contribute to their overall apathy towards the subject matter and factor into their underperformance. As a …

The Neuroendovascular Procedures In The Cath Lab: An Educational Intervention, Jolly M. Kuruvilla

Dissertations

Stroke is the fifth leading cause of death and a major cause of disability. Catheter-based therapies for acute ischemic and hemorrhagic stroke have emerged as the latest model of care for patients experiencing stroke. Catheterization laboratories are now performing neuroendovascular procedures such as thrombectomy and embolization for stroke; it is critical that nurses assist with cardiac catheterization be proficient in neuroendovascular procedures. The project began with a clinical question: Among nurses practicing in a cath lab, will there be a difference in knowledge level and clinical competencies in preparing and monitoring patients for thrombectomy and embolization (neuroendovascular procedures) before and …

Perceptions Of Undergraduate Nursing Students On Racism And Racial Disparities In Maternal Health, Monika Costa

Dissertations

The United States has persistent racial inequities in maternal health, with African American women experiencing the highest maternal mortality and morbidity (Centers for Disease Control and Prevention, 2020). Structural inequities, racism, implicit and explicit biases, and discrimination contribute to disparities in maternal health outcomes in the United States (Alshusen et al., 2016; Davis, 2019; Institute of Medicine, 2003, Liese et al., 2019, National Academies of Sciences, Engineering, and Medicine, 2020). In recent years, racial discrimination and bias have been important topics of discussion. However, very little research has been done about nursing curricular preparedness to address implicit bias and racism …

Knowing Nursing Error: Understanding Nursing Error Through Nurses' Error Experiences, Suzanne Edgett Collins

Dissertations

Although it is recognized that significant under-reporting of nursing error exists, little is known about how nurses learn to recognize and manage nursing error in the clinical setting. Knowledge of this process is a necessary prerequisite to understanding and reducing nursing error, as well as increasing the reporting of error.

Grounded theory methodology in the tradition of Strauss and Corbin (1998) was selected for inquiry into the process through which nurses learn to recognize and manage nursing error over the course of their careers. The sample consisted of 24 nurses from the RN to BSN, MSN, and Ph.D. programs at …

The Effects Of Simulation On Nursing Student Knowledge, Attitudes, And Clinical Preparedness In The Care Of Transgender Clients, Julie Cartney

Dissertations

Nationally, nursing education provides extremely limited coverage of LGBTQIA+ topics and as a result, nursing students lack clinical confidence and knowledge to assess and intervene effectively in this marginalized population. Despite national health goals and organizational calls for health equity, transgender persons continue to experience significant healthcare disparities and barriers in accessing quality health care.

The purpose of this project was to determine if the incorporation of a simulation scenario that features the care of transgender patient would have a positive effect on the knowledge, attitudes, and clinical preparedness of practical nursing students.

Predicting Heart Failure Readmission Using Home Health Clinical Indices, Jamie Murphy

Dissertations

Heart failure is the most rapidly growing cardiovascular disease in the U. S. (Boxer et al., 2010) and is the most common cause for hospital readmission (Fang et al., 2008; Heidenreich et al., 2013; Jencks et al., 2009) with a 30-day readmission rate of 24.8% (Centers for Medicare and Medicaid, 2012). Currently, many heart failure patients are discharged quickly from the hospital without adequate skills and knowledge to perform self-care tasks. Moreover, home health nurses provide the same care for all heart failure patients and have limited knowledge on what clinical health indicators might affect readmission. As a result, home …

A Phenomenological Study On The Informal Learning Experiences Of Female Mid-Level Administrators, Kathryn L. Curameng

Dissertations

Purpose: The purpose of this phenomenological study is to identify and describe the informal leadership development experiences of female mid-level administrators in private nonprofit higher education.

Methodology: This phenomenological study identifies and describes the informal leadership development experiences of female mid-level administrators in private nonprofit higher education institutions in California. Respondents were selected based on specific criteria and recommendations of a sponsor. The researcher collected data through semi-structured interviews and observations of participants.

Findings: Examination of the qualitative data from interviews with 16 female mid-level administrators working in private nonprofit higher education yielded nine major findings. These included 2 unexpected …

Student Nurses' Perception Of Preceptors' Authentic Leadership Effect On Self-Efficacy, Venise D. Bryan

Dissertations

The study examined the relationship between final year nursing students' perceptions of preceptor authentic leadership and self-efficacy. Nursing students are required to engage in a preceptorship experience at the end of their nursing education for socialisation into the profession and learning consolidation to facilitate optimum transition from student to nurse. Unfortunately, preceptorship has been identified as the most stressful experience that nursing students engage in and poor relations with clinical staff and low competence beliefs to nurse have led to attrition after graduation. To date, a limited number of studies have examined preceptors' leadership style, particularly authentic leadership and student …

Differences Of Weekend Versus Weekdays, Nurse-To-Patient Staffing Ratios, Patient Diagnosis, And Direct Patient Care Time, Deborah F. Behan

Dissertations

The purpose of this study was to determine differences in time spent providing direct nursing care time on weekends versus weekdays, nurse-to-patient ratios, medical-surgical nursing units, and weekend versus weekday patient diagnoses. Specific aims were (a) determine differences in nurse-to-patient staffing ratios and direct care time on medical-surgical inpatient units in an acute care hospital, (b) determine differences in direct nursing care time on 24 hour weekend shifts versus 24 hour weekday shifts on medical-surgical inpatient units in an acute care hospital, (c) determine differences in direct care time on two medical-surgical inpatient units in an acute care hospital, and …

The Influence Of Knowledge And Value On Nursing Students' Quality Of Supportive Feedback To Peers, Joni L. Tornwall

Dissertations

Peer review in nursing is an expectation of every registered nurse in the workplace, and it is essential to accountability and self-regulation of practice in the nursing discipline. However, the literature reveals that professional nurses and nursing students feel peer review is not their responsibility. Research has shown that they state they do not have time to do it, and they feel unprepared for and anxious about the process of providing good feedback to peers. Academic nursing programs should be teaching future nurses to participate in peer review and recognize its value to professional nursing practice. Training in peer review …

Simulation Usage As A Partial Replacement Of Traditional Clinical: A Study Of Administrator And Faculty Perceptions In Practical Nursing Programs In Pennsylvania, Cynthia A. Cornelius

Dissertations

There has been a significant amount of research regarding simulation use in nursing education; however, there is limited research available regarding the replacement of traditional clinical with simulated clinical. This research included a mixed-method design formulated to determine Pennsylvania Practical Nursing Programs' current simulation usage and Pennsylvania Practical Nursing Directors', Assistant Administrators', and Faculty Members' perceptions regarding replacing a portion of traditional clinical with simulated clinical. An 18-item electronic questionnaire was delivered to 309 potential respondents via the Qualtrics electronic survey distribution system, with 191 responding.

Women's Lives After An Induced Abortion: A Phenomenological Study Of The Long-Term Post Abortion Experience, Rosanna Formanek Hess

Dissertations

Most previous research investigations on the post abortion experience studied women up to two years post abortion. The findings of many of these short-term studies indicate that 5-20% of women have severe psychiatric distress two years after the abortion. Little is known about the long-term effects of an abortion in women who experienced the event.

The purpose of this study was to explore the abortion experience in women who had a legal, elective, first trimester, induced abortion > 5 years before the interview. The main objective of the study was to learn how each woman was affected by the abortion and …

Influence Of Leadership Styles On Expatriate Nurses' Professional Integration In The Uae, Emmah Ncube

Dissertations

Transnational nurse migration has evoked a growing interest in the phenomenon of professional integration of expatriate nurses into their host societies. Despite research connecting employee and organizational outcomes such as job satisfaction and organizational citizenship behavior to the quality of leadership styles, there remains a lack of research linking professional integration of expatriate nurses to nurse leadership styles in the UAE. The purpose of this grounded theory study was to develop a theory that would explain how nurse leadership styles and behaviors impacted the professional integration of expatriate nurses into the multicultural work environment of the UAE. The research questions …

Faculty Caring Behaviors: A Quantitative Examination From The Ethnically Diverse Student's Perspective, Donna M. Hedges

Dissertations

The increase in patient ethnic diversity in the health care environment has not been mirrored by an increase in ethnic diversity within the nursing profession. There is a need for increased focus on the retention of ethnically diverse nursing students in order to meet the needs of an ethnically diverse patient population. The quality of caring demonstrated by faculty in the faculty - student relationship can have significant influence on the student's successful completion of the nursing program. Faculty understanding of how ethnically diverse students perceive caring faculty behaviors may assist faculty to mitigate attrition of these students. The purpose …

Impact Of Telecommuter Status, Manager Leadership Style, Structural Empowerment And Job Satisfaction On Managed Care Nurses' Level Of Engagement, Jessica Varghese

Dissertations

The work environment impacts nurses' level of work engagement. Nurses are working outside of traditional hospital settings and moving into industries such as the managed care arena. This impacts the way work is experienced as many practices such as telecommuting are more prevalent in the managed care setting. The purpose of this study is to understand the effects of telecommuter status, manager leadership style, structural empowerment, and job satisfaction, on nurses' level of engagement in the managed care workplace setting..

Hospital Nursing Organization And Outcomes For Surgical Oncology Patients, Christopher R. Friese

Dissertations

As interest in the relationship between the organization of nursing care and patient outcomes grows, concerns exist that the quality of care for cancer patients is unequal. This study examined the association between the organization of hospital nursing care and outcomes for surgical oncology patients. Building upon an existing research program, data on cancer diagnosis, stage and length of illness were appended to a database which included patient discharge abstracts, hospital structure characteristics, and nurse reports of staffing, practice environment and educational preparation. The Practice Environment Scale of the Nursing Work Index (PES-NWI) measured the practice environment and classified hospitals …

Influence Of Learning Style And Learning Flexibility On Clinical Judgment Of Prelicensure Nursing Students Within A Human Patient Computer Simulation Environment, Elizabeth Sharon Robison

Dissertations

Nursing education is experiencing a transition in how students are exposed to clinical situations. Technology, specifically human patient computer simulation, is replacing human exposure in clinical education (Nehring, 2010b). Kaakinen and Arwood (2009) discuss the need to apply learning theories to instructional designs involving simulation for successful learner-centered outcomes. Developing effective teaching strategies using technology to support enhancing student performance outcomes requires a paradigm shift from traditional, clinical-based models.

The purpose of this study was to begin to close research gaps and support development of evidence-based practice in implementing simulation by examining prelicensure nursing students' learning styles and flexibilities relative …

The Impact Of Using Relevant Context On Student Comprehension And Attitude In A Collegiate Introductory Statistics Unit On Probability, Ryan F. Rzeszutko, Jennifer L. Petrie, Dwayne T. James

Dissertations

The typical collegiate introductory statistics course poses significant challenges for students. Many do not fully comprehend key course skills, and it is common for students to exit the class with a neutral or negative attitude toward statistics. To measure the impact of using relevant contextual examples as an instructional strategy during a probability unit, in-class activities were designed to align with areas of interest for participants as identified by a student interest inventory. It was hypothesized that the use of relevant context would create a significant difference in the comprehension or attitude of students enrolled in an introductory statistics course …

Transition Experiences Of Novice Mid-Level Academic Nurse Leaders From Educators To Administrators, Joana Velasquez

Dissertations

The shortage of academic nurse leaders (ANLs) is imminent and creates a crisis for the nursing profession. Nurse educators commonly assume leadership roles with minimal preparation and training. However, few research studies have explored the transition of nursing faculty to ANLs. Consequently, several aspects of transitioning from educator to administrator have remained unknown. The purpose of this generic qualitative research was to explore the experiences of novice mid-level ANLs who transitioned from educators to academic administrators, identify the facilitators and barriers to the transition process, and describe the indicators of a successful role transition. The primary research question that guided …

Probing Amyloid-Beta Protein Structure And Dynamics With A Selective Antibody, Shikha Grover

Dissertations

Alzheimer’s disease (AD) is a progressive neurodegenerative disorder. The AD brain is characterized by significant neuronal loss and accumulation of insoluble fibrillar amyloid-β protein (Aβ) plaques and tau protein neurofibrillary tangles in the brain. However, over the last decade, many studies have shown that the neurodegenerative effect of Aβ may in fact be caused by various soluble oligomeric forms as opposed to the insoluble fibrils. Furthermore, the data suggest that a pre-fibrillar aggregated form, termed protofibrils, mediates direct neurotoxicity, and triggers a robust neuroinflammatory response.

Antibodies targeting the various conformation of Aβ are important therapeutic agents to prevent the progression …

The Relationship Between Staff Nurses' Perceptions Of Nurse Manager Caring Behaviors And Their Perception Of Exposure To Workplace Bullying Within Multiple Healthcare Settings, Lynda D. Olender

Dissertations

This study examined the relationship between staff nurses' perception of nurse manager caring behaviors and their perceived exposure to workplace bullying within multiple healthcare settings. It was based on the theoretical position that caring promotes reciprocal caring and healing for each other and for the larger universe as informed by Watson's theory of human caring (1979, 2006, 2008). Results indicated a statistically significant, negative, linear relationship between the CFS-CM and the NAQ-R (r = -.534, p < .001), meaning that as staff nurses' perceptions of their nurse manager caring increased, their perception of exposure to negative acts (meeting the definition of workplace bullying) significantly decreased. The sample consisted of primarily older, more experienced, staff nurses who worked 10 years or longer within their work environment. Data analysis also revealed that staff nurses who were females and those who worked in Medical/Surgical settings were significantly more likely to perceive their managers as caring (p < .05 respectively) and that a high workload significantly influenced the staff nurses perception of exposure to workplace bullying (p < .05). In view of the predicted nursing shortages as baby-boomer nurses retire at the same time the demand for health care is rising (AACN, 2009), these findings highlight the importance of caring leadership for the health and availability of nurses at the bedside, and may lead to shifting work priorities for nurse managers. Study findings may also foster the design and implementation of a caring curriculum and caring competencies applicable for the nurse managers' role either within nursing academic or clinical settings.

South Asian Low Sodium Study (Salt): A Multi-Method Approach, Salima Hemani

Dissertations

Hypertension (HTN) is prevalent in South Asian Canadians (SAC), and dietary sodium is the primary contributing factor. The overall goal of the South Asian Low-sodium sTudy (SALT) is to describe contextual factors and determine the feasibility of implementing a six-week low sodium community-based dietary intervention to improve outcomes in SAC with stage one HTN.

SALT is a multi-method study consisting of a pilot randomized controlled trial (RCT) and a cross-sectional survey. Following ethics approval, participants with stage one HTN were randomized to a usual care group or an intervention group. Participants in the usual care group received the HTN Canada …

The Role Of County Offices Of Education In Supporting District Superintendent Effectiveness, Carol Tomeo

Dissertations

Purpose: The purpose of this parallel comparative Delphi study was to first identify the services provided by the County Office of Education (COE) to district superintendents that ensured their successful job performance from the perspective of both county superintendents/designees and district superintendents. Additionally, it sought to rate the importance of the identified services, identify the best methods of providing those services, and identify the rationale for each service provider method from both perspectives. The final purpose was to compare the results from both groups to determine alignment and efficacy.

Methodology: This study used a parallel comparative Delphi method that consisted …

A Phenomenological Study: The Perceived Impact Of The Intersectional Barriers Created By Gender And Race On African American Female's Advancement To A K-12 Central Office Leadership Position, Mariyon Thompson

Dissertations

Purpose: This phenomenological study aimed to explore the perceived impact of the intersectional barriers created by gender and race on African American females' advancement to a K-12 central office leadership position. The second purpose of this study was to identify strategies African American females leverage to overcome barriers due to intersectionality while advancing to a K-12 central office leadership position.

Methodology: This qualitative research study employed a phenomenological approach to describe the lived experiences of eight African American women leaders employed in K-12 central office leadership positions in San Bernardino and Riverside counties. Data collection included an interview protocol of …