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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 …

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 …

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 …

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.

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.

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 …

Delineating The Exocytic Fusion Machinery Required For Mast Cell Exocytosis, Pratikshya Adhikari

Dissertations

Mast cells undergo exocytosis to release a wide array of inflammatory mediators by utilizing membrane fusion proteins-SNAREs (soluble-N-ethyl-maleimide sensitive factor attachment protein receptor) along with essential regulatory Munc18 and Munc13 proteins. Accumulating evidence in mast cell biology suggests the existence of distinct pools of mast cell mediators. However, the precise mechanism underlying the release of each mast cell mediator is not clear. To determine whether different exocytic machineries are required for differential mediator release, I used reconstitution to investigate the differential role of Munc18s in fusion machinery regulation. Munc18a and Munc18c stimulated VAMP2 and VAMP3-mediated lipid mixing, whereas Munc18b only …

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 …

How Intensive Care Unit Nurses Conceive Of Personal And Professional Risk When Exercising Clinical Autonomy, William Albert Randall

Dissertations

Nurses are often encouraged to work to their fullest potential, including exercising clinical autonomy--a factor known to decrease morbidity and mortality. Nonetheless, nurses endure historical, societal, and professional barriers to be respected and independent. In the intensive care unit (ICU), critically ill, often unstable patients require nurses to respond quickly and adapt to each unique situation, which may mean migrating outside of formal rules, norms, and policies, or "rule-bending." However, as inherent subordinates of hospital administrators and physicians, rule-bending, no matter how well-intended, necessary, or benign, often cause nurses to function in a grey zone of vulnerability and risk.

I …

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.

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 …

Moderate-Intensity Risk Reduction Counseling And Acquisition Of Sexually Transmitted Infection, Cindy M. Farina

Dissertations

Sexually transmitted infections (STIs) are a public health problem in the United States, with adolescents and young adults to age 25 bearing a disproportionate burden of infection. Risk reduction counseling (RRC) as a strategy to decrease STI incidence has been a focus of scholars. Research examining RRC efficacy has suggested that RRC is effective for 6 to 12 months after treatment. However, study samples have varied by age, ethnicity, race, gender, and geographic location. Whether RRC is effective for more than 1 year is unknown. The purpose of this post hoc chi-square study was to examine the efficacy of moderate-intensity …

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 …

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 …

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 …

Health Information Security And Privacy: A Social Science Exploration Of Nurses' Knowledge And Risk Behaviors With Security And Privacy Issues Focusing On Mobile Device Usage, Keith Richard Weiner

Dissertations

This dissertation examines characteristics related to cybersecurity practices of new nurses a year following graduation from nursing school where they may have been prepared to work in environments with EHRs. The study will explore their understanding of cybersecurity as it relates to use and protection of the sources of information in the EHRs, and their own personal risk behaviors with mobile technologies that may put them at risk to outside hacking or misuse of information. The questions that drive the study are the associations with nurses' knowledge of information system security, risk behaviors specifically with mobile device use, and their …

Preceptor Education Program Impact On Implementation Of The Preceptor Role, Nancy Bohnarczyk

Dissertations

The purpose of this mixed methods study was to identify potential benefits and gaps in an academic-based preceptor education program offered to long-term care facilities in New Jersey. Preceptors are experienced nurses who provide guidance, support and instruction to new nurses transitioning from student to professional. Through an online survey and individual interviews, preceptors who participated in the program reflected on to what extent and in what ways the program impacted their understanding of key concepts critical to the preceptor role, as well as their ability to effectively apply these concepts in the work setting. Informed by Rogers' Diffusion of …

Thermomechanics Of Semiconducting Polymers And Their Morphological Phenomena, Luke Galuska

Dissertations

In contrast to conventional silicon-based electronics, semiconducting polymers show great promise for emerging applications in soft, flexible, and ductile electronic technologies. This is due to their polymeric nature, tailorable structure, and sub-100 nm device thickness. Despite this mechanical novelty, there remains a poor understanding of their structure-property-processing relationships, which has hindered growth within the field. This dissertation elucidates these relationships through investigation of their thermomechanics, and morphological phenomena. This was accomplished through the following projects:

1) To demonstrate the impact of backbone rigidity on semiconducting polymer thermomechanics, we varied the backbone rigidity of an NDI-based polymer by inserting flexible methylene …

Sleep Loss And Its Health Impact Among Family Caregivers Of Persons With A Primary Malignant Brain Tumor, Jean D. Pawl

Dissertations

Sleep impairments for caregivers are multifactorial. Assumptions are that caregivers of those with primary malignant brain tumors (PMBT) are similar to caregivers of persons with dementia as cognitive impairments are present at diagnosis. The shorter trajectory of PMBTs and rapid deterioration of recipients' health may influence sleep in caregivers of persons with a PMBT. The purposes of this study were to use a sleep impairment model to characterize caregiver sleep using objective and subjective measures, and to examine sleep loss effects on psychosocial and physiologic health outcomes.

A secondary data analysis using baseline data from a larger study of mind-body …

Factors And Processes That Influence E-Professionalism Among Pre-Licensure Baccalaureate Nursing Students When Utilizing Social Media, Julie Skrabal

Dissertations

There is limited research related to nursing students' social media use. Because of this, there was a need to further explore how they were using social media and their ability to maintain e-professionalism. This study discovered that pre-licensure baccalaureate nursing students are actively using multiple social media accounts on a daily basis. Nursing is considered a trusted and respected profession, therefore, nursing students are held to a high professional standard. This includes maintaining privacy boundaries when managing professional and personal information during social media use.

The purpose of this grounded theory study was to explore the processes pre-licensure baccalaureate nursing …

Comparing Top Industry Demands For Talent To General Studies Curriculum For Competitive Job Acquisition, Gregory Sansone

Dissertations

University General Studies degrees are rapidly increasing in enrollment, driven by an increased focus on college completion. Yet, non-traditional, non-science, technology, engineering, and math (STEM) degrees are perceived as less competitive in the job market upon graduation. This study finds that students predominantly acquire skills in three areas, analysis, critical thinking, and communication, regardless of courses taken. Variability in salary suggests that the degree was not a factor in the graduates’ ability for wage earning. Through a combination of skills outcomes for external job postings, natural language processing on course syllabi outcomes, General Studies graduates’ course records, and a survey …

Frequent Top Leadership Transitions And Their Effect On Followers: The Moderating Roles Of Followership Characteristics And Organizational Culture, William Butler

Dissertations

Modern for-profit, large businesses are often organized as a collection of business units, with each unit having a top leader responsible for the unit’s results. While there is much literature about CEO transitions, there is scant literature about leadership transitions at an individual business unit level. Moreover, there is no literature concerning frequent leadership transitions at this level. This study developed and validated a new measure to assess employee perceptions of top leadership transition frequency. To measure employee reactions to perceived top leadership transition frequency, the EVLN scale was utilized. This study identified that employee Exit or Neglect are likely …

The Color Of Conduct: A S.I.S.T.A.'S Tale Of Race, Housing, And Higher Education, Natasha Gibson-Winston

Dissertations

S.I.S.T.A., suffering in silence to be acknowledged, is an acronym that symbolizes the hidden voices of Black women in higher education and abroad. This study examined the experiences of a graduate student woman of color impacted by university housing policies and practices as a judicial student conduct officer at a historically white institution. Using autoethnography as a methodology, grounded in critical race theory (CRT) as a theoretical framework, this qualitative study aims to highlight the ways Black women can and have been harmed in predominantly white spaces and processes within higher education. The application of the aforementioned frameworks found the …

Applications Of Simulation Analysis To Generate Reference Points And Evaluate Management Control Rules In Three Eastern Us Fisheries, Laura Solinger

Dissertations

Myriad sources of uncertainty are characteristic of or impact all commercial and recreational fisheries, contributing uncertainty to the determination of stock status. In the face of these uncertainties, fisheries managers tend to reserve fishery resources from the management targets to allow for variability. Simulation analysis is a useful tool to complement and extend formal stock assessment models to better inform managers of the risk that a management strategy results in an overfished stock or overfishing occurs over some period of time. Three examples of simulation analysis are presented to address risk-tolerance and development of management thresholds for three commercially important …

Academic Nurse Educator Attitudes Regarding Their Role Educating Ethnically And Racially Diverse Nursing Students: A Focused Ethnography, Melissa Lillian Weir

Dissertations

The purpose of this research was to explore academic nurse educator attitudes, specifically beliefs and values, regarding their role educating ethnically and racially diverse students through the lens of culturally relevant pedagogy. Focused ethnography methodology was applied through all phases of this research. Interviews with 14 academic nurse educators provided insight into a subculture of nursing. Themes that emerged from data analysis included strengths perspective, teacher-student relationships, diversity as an asset, crucial or difficult conversations, and ethnicity and race setting the narrative. In addition, assimilation and white privilege were discussed due to compelling and varied responses from participants.

Engaging Experts: Overcoming Trust In Risky Environments, Cynthia Goodwin-Sak

Dissertations

In business-to-business sales environments, sellers may choose to bring their go-to expert to a customer meeting, even when there is an expert available who may be more skilled in the product being discussed. The purpose of this study is to identify if an intervention of data, trust transference, ingroup identity, or a combination, influence the choice of expert a salesperson engages for a customer meeting. We tested this question through a series of vignettes and hierarchical linear modeling. The sample came from a US-based technology company, and salespeople in the United States.

We found that trust transference influenced both choice …

Graduate Nurse's Perspective Of Simulation To Address The Theory-Practice Gap In Nursing, Joset E. Brown

Dissertations

Graduate nurses are being employed to provide care in high acuity care areas, and this becomes a problem of significance as the literature suggests that graduate nurse's experience a deficit in integrating theoretical concepts in the clinical environment, described as the theory-practice gap; which can result in a risk to patient safety and the potential for negative outcomes. Cognitive constructivism was the conceptual framework that guided this study. A qualitative phenomenological design was used to explore the lived experiences of 13 graduate nurses employed at a community hospital in northern New Jersey. After recruiting the participants through purposive sampling, semi …