Digital Commons Network^™

Increasing Breast Cancer Screenings Of African American Black Women, Marlene A. Griggs-Warner

Dissertations

Research shows that African American Black women have a high breast cancer mortality rate due to lack of breast cancer screenings. This quality improvement (QI) project evaluated if culturally-appropriate materials/education increased breast cancer screening rates of African American Black women living in a community in the southern portion of NJ. Kurt Lewin's theory of change encouraged African American Black women to change to healthier lifestyles by encouraging breast cancer screenings. Research also shows that the use of culturally-appropriate tools in clinical settings can improve patient outcomes for this population. Leininger's theory of culture care promoted clinical awareness of the African …

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.

Nurse Perception Of Technology Integration, Adrian D. Hordon

Dissertations

With the increase in technological advancements integrated into hospitals, physician offices, and nursing programs, there is concern regarding the imposition on the clinical foundation of nursing as a human improvement profession during the implementation of technology advancements. Technology can potentially serve as a distraction and even a false feedback loop for improved care, causing an impact on the fundamental quality of patient care. Mobile technology advancement such as Electronic Health Record (EHR) charting and smartphone use in the clinical nurse setting provides both prospects and challenges that have not been widely researched. This dissertation proposal examines registered nurse survey results, …

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.

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.

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 …

Identifying Motivation Toward Healthy Behavior In Overweight And Obese Pregnant Women, Heather Lynn Watson

Dissertations

Excessive weight gain in overweight and obese pregnant women may result in long-term maternal and child health implications. Current interventions reflect minimal effectiveness toward achievement of appropriate weight gain in this population. Although not specific to examination of motivation towards dietary and exercise behaviors in pregnant overweight and obese women, the literature supports that motivation represents a factor impacting diet and exercise health behavior modification. This study examined the predictive value of basic psychological needs (autonomy, competence, relatedness), healthcare climate, attitude toward weight gain, and BMI on motivation towards healthy dietary and exercise behaviors and the mediation effect of healthcare …

Effects Of Evidence-Based Relaxation Techniques On Nurse-Patient Communication, Deborah Samuel

Dissertations

Occupational stress in nursing leads to poor patient and staff satisfaction making it essential to address stress among nursing staff and improving patient satisfaction. The purpose of this quantitative quasi-experimental quality improvement (QI) project was to determine to what degree evidence-based relaxation techniques, including music, deep-breathing, progressive muscle relaxation and guided imagery, using the transactional model would reduce stress levels among nursing staff and improve nurse-patient communication on a medical-surgical unit in a community hospital. Lazarus and Folkman's theory of stress and coping best explains stress levels and the need for alternate solutions. Data to evaluate stress levels was collected …

Nurses' Attitudes And Perceptions Regarding Their Role In Incorporating Prayer In Practice, Sonia H. Wisdom

Dissertations

The nurses' role in praying is not clearly defined. Scientific evidence to guide nurses praying in practice is lacking resulting in inconsistencies as nurses develop individualized strategies from personal frameworks in meeting the patient's spiritual needs. This descriptive study was conducted with a self-selected sample of 2,688 registered nurses licensed with the Florida Board of Nursing to explore nurses' attitudes and perceptions to their role in praying in practice. The four reliable subscales extracted by factor analysis were attitudes to prayer, role perception, relevant activities, and challenges in praying. All subscales showed that nurses hold positive perspectives and support their …

Exercise To Reduce Chemotherapy-Induced Peripheral Nephropathy: A Pilot Rct, Grace A. Kanzawa-Lee

Dissertations

Oxaliplatin-induced peripheral neuropathy (OIPN) occurs in 85-95% of patients receiving FOLFOX or FOLFIRINOX, oxaliplatin-based chemotherapy for invasive gastrointestinal (GI) cancers. Persistent OIPN can impair long-term quality of life (QOL). No OIPN cures are known. Aerobic physical activity (PA) may reduce OIPN by enhancing circulation and re-distributing neurotoxic oxaliplatin away from vulnerable neurons. However, no trials have evaluated solely aerobic exercise for OIPN. This dissertation reports the results of a 1) literature review on exercise for chemotherapy-induced peripheral neuropathy, and 2) pilot randomized controlled trial (RCT) of brisk walking for OIPN in FOLFOX/FOLFIRINOX-receiving GI cancer survivors. The "MI-Walk Intervention" - an …

Baccalaureate Nursing Students' Attitudes Toward End Of Life Care: The Impact Of Simulation-Based Learning, Kristin M. Sagedy

Dissertations

All nurses may be obliged to care for patients at the end of life. Baccalaureate nursing education should prepare nurses to provide this care, but best practice for end of life care education has not been established. Nurses are not adequately prepared to care for dying patients and grieving families. This research study explored the effectiveness of low-fidelity simulation-based learning (SBL) activities on improving baccalaureate nursing students' attitudes toward end of life care. Junior-level baccalaureate nursing students participated in this quasi-experimental study. A standardized tool assessed students' attitudes toward end of life care before and after the SBL activities. While …

The_Instaprep_Project: A Social Marketing Intervention On Instagram To Increase Oral Hiv Prophylaxis In Black Men Who Have Sex With Men, James Q. Simmons

Dissertations

Incidence of HIV diagnoses is higher in Black men who have sex with men (BMSM) than any other socio-demographic population in the United States. BMSM account for 26% of all new HIV diagnoses in the U.S. yet make up an estimated 1% of the U.S population. In 2017, Centers for Disease Control and Prevention (CDC) predicted 50% of BMSM would be diagnosed with HIV in their lifetime. Oral HIV pre-exposure prophylactic (PrEP) medications developed to prevent sexual transmission of HIV are 95-99% effective. However, Blacks represent only 10% of PrEP prescriptions. Targeted Social Marketing initiatives on Instagram need to be …

Preferred Instructional Methods Of Millennial Nursing Students: A Qualitative Study, Brooke Mcatee

Dissertations

The continuing nursing shortage requires nurse educators to understand the best ways students learn to maximize student success and retention. Millennial generation students are currently the majority in the associate degree nursing classroom; therefore, identifying the instructional methods that enhance this generation's learning can influence student success, retention, and preparation for the workforce. The literature reviewed offered conflicting findings, identifying differing instructional methods that enhanced millennial students' learning processes. The purpose of this basic qualitative research study was to determine what instructional methods millennial students identified as aiding in their learning within an associate degree nursing program. An additional research …

The Long-Term Multidimensional Impact Of Persistent Multisite Pain On Physical And Psychological Disability, And Mortality In Community-Dwelling Older Adults, Saurja Thapa

Dissertations

Persistent multisite pain is highly prevalent, affecting 25-43% of community-dwelling older adults. Although existing evidence suggests that persistent multisite pain is associated with physical and psychological disability, studies use a cross-sectional assessment approach that overlooks pain duration or persistence. This study aimed to estimate the persistence of multisite pain and the proportion of incident multisite pain and examine the association between persistent multisite pain and physical (ADL and IADL) and psychological disability (depression and anxiety) at 18 months and six years. Also, the association between baseline persistent multisite pain and mortality was assessed.

Identifying Transfer Of Care Gaps: Electronic Health Record Capture Of Perioperative Handoff Communications, Sharon Giarrizzo-Wilson

Dissertations

Transitions in patient care are held together by interdisciplinary handoff communications intended to coordinate the patient's ongoing care requirements. Patients with complexity in care encumber the transfer of care process requiring a higher level of care coordination between the interdisciplinary team (Coleman, 2003; Naylor et al., 2004). While the literature is abundant on the characteristics and quality of handoff communications, it is limited on the requirements of what data is necessary for ongoing care following transfer communications (Galatzan & Carrington, 2018).

Preliminary Efficacy Of A Nurse Led Brief Intervention Quasi-Experimental Pilot Study For Individuals Presenting To The Emergency Department With Risk For Alcohol Use Disorder, Felipe Gutierrez

Dissertations

The purpose of this study was to assess preliminary efficacy of screening for alcohol use and brief interventions (BIs) on patients who present to the emergency department (ED) at-risk for alcohol use disorder (AUD) utilizing established nurse navigators. This is the first study to assess the initial efficacy of a BI to reduce alcohol use in at-risk patients utilizing nurse navigators in the ED who were not bedside nurses.

Utilization Of A Clinical Decision Support System To Increase Chlamydia Screening Rates In Sexually Active Young Women: A Quality Improvement Project, Raine Martin

Dissertations

The objective of this Doctor of Nursing Practice (DNP) scholarly project was to implement an evidence-based intervention, the clinical decision support system (CDSS), and include education to promote increased routine chlamydia screening practices in an outpatient clinic. An additional objective was to assess CDSS usability using the System Usability Scale (SUS) to evaluate for project sustainability. The project design was a quasi-experimental study with post-implementation data collection with a comparison of norms of baseline chlamydia screening from the prior year. The project was completed over eight weeks. The project was implemented at a family health clinic located in a southcentral …

Effectiveness Of The Nurse-Practitioner-Driven Enteral Nutrition Protocol, Jho Mary Tangcora

Dissertations

The delay in initiating enteral feeding (EF) in the critical care unit is known to cause malnutrition which may lead to poor patient outcomes. The purpose of this quasi-experimental quantitative project was to determine if the nurse practitioner (NP)-driven enteral nutrition protocol recommended by the Society of Critical Care Medicine (SCCM) and the American Society for Parenteral and Enteral Nutrition (ASPEN) will psychologically empower the NP toward reducing the delay on initiating EF and lowering the length of stay (LOS) of adult patients an intensive care unit in urban California over four weeks. This project utilized the theoretical foundation of …

Compassion Satisfaction, Burnout, And Intent To Stay Among Nurse Leaders, Lisa D. Surby

Dissertations

Nurses in leadership roles have a substantial influence on the quality of the work environment and on safety, quality, and patient outcomes. However, compassion satisfaction (CS) and burnout (BO) have historically been understudied, and evidence is lacking regarding the existence of a relationship between CS, BO, and intent to stay among nurse leaders. The purpose of this cross-sectional descriptive study, guided by Stamm's theory of CS and compassion fatigue (CF), was to determine if there was a relationship between CS and BO and intent to stay among nurse leaders. An anonymous online survey was conducted using the Professional Quality of …

Espoused Versus Operationalized Organizational Values: A Case Study Of Values Integration, Erik Dees

Dissertations

At the start of the 21^st century, corporate America found itself confronted by a series of scandals about powerful business leaders unethically exploiting the system and their own organizations. Among the most familiar of these scandals is the one involving the former energy and commodities services corporation, Enron. Illegal accounting practices in that organization resulted both in the dissolution of that organization and in passage of the 2002 Sarbanes-Oxley Act, which placed greater demands on corporate accounting practices.

Enron’s maleficence deeply affected its more than 20,000 employees through job loss and the evaporation of retirement benefits. Enron leaders’ widely …

Teachers Attitudes Regarding Adverse Childhood Experiences, Trauma-Informed Educational Practices, And Student Resiliency, Alyson Reynolds Kohl

Dissertations

Purpose: The purpose of this convergent parallel design mixed methods case study was to determine how training on Adverse Childhood Experiences and Trauma-Informed Educational Practice affected the attitudes of teachers, in Shasta County’s Enterprise Elementary School District (EESD), regarding students who had experienced Adverse Childhood Experiences (ACE). A further purpose of this study was to understand if teachers in EESD perceived training in ACE and Trauma-Informed Educational Practices (TIEP) was effective in changing their classroom practices to support the resiliency of students who had experienced ACEs.

Methodology: The methods for this research included: an online survey, The Attitudes Regarding Trauma-Informed …

Retention, Structural Empowerment, And Dialysis Nursing: Integrating Kanter's Theory And The Refined Nurse Worklife Model, Richard C. Scepura

Dissertations

During this two-phase project, factors that dialysis nurses experience contributing to stress, retention, and the intentions of staying were examined. The theoretical frameworks of Kanter's Theory of Structural Empowerment (KTSE) and The Refined Nurse Worklife Model (NWLM) were utilized in the creation of a learning module regarding structural empowerment. In phase one this was reviewed by an expert dialysis nurse focus group from seven different states with experience in dialysis from seven to forty years. During phase one, the expert panel gave high-frequency domain input including access to support, resources, and the need for strong leadership. The module was adjusted …

Investigation Of A Checklist To Reduce Medication Errors Among Pre-Licensure Baccalaureate Nursing Students, Mary Agoglia

Dissertations

This experimental pilot study was aimed at the development of a quality standard to facilitate medication administration error detection, prevention, and reporting among pre-licensure baccalaureate nursing students. Based on both the literature review and peer review, sequential steps of the medication administration process were identified, bundled, and anchored in the mnemonic, C-MATCH-REASON, to form a new inquiry-based paper checklist that pairs clinical reasoning with rule adherence. The Checklist (independent variable), for nursing student utilization, was accompanied by an error tracking instrument (Observation Form) for nursing faculty (raters) to measure medication errors committed, recovered, and reported. Reason's (1990) error theory was …

Clinical Factors That Influence Nurse Responsiveness In Activating Rapid Response Services, James Tormey

Dissertations

This study advances the understanding of essential clinical knowledge skillsets that nurses need to identify and respond to early signs of patient deterioration. The identification of critical thinking and assessment skills that nurses require may support professional practice through improved nursing education curriculum or additions of necessary critical care skillsets. The purpose of this study, which was framed by Benner's novice-to-expert model, was to identify and measure critical thinking skills that influence a nurse's ability to detect deterioration in patients and call the rapid response system (RRS). The research questions addressed the relationship between a nurse's clinical or reasoning skill …

Ensemble Data Fitting For Bathymetric Models Informed By Nominal Data, Samantha Zambo

Dissertations

Due to the difficulty and expense of collecting bathymetric data, modeling is the primary tool to produce detailed maps of the ocean floor. Current modeling practices typically utilize only one interpolator; the industry standard is splines-in-tension.

In this dissertation we introduce a new nominal-informed ensemble interpolator designed to improve modeling accuracy in regions of sparse data. The method is guided by a priori domain knowledge provided by artificially intelligent classifiers. We recast such geomorphological classifications, such as ‘seamount’ or ‘ridge’, as nominal data which we utilize as foundational shapes in an expanded ordinary least squares regression-based algorithm. To our knowledge …

Boosting Degree Attainment: A Mixed Methods Examination Of An Adult Degree Completion Initiative, Hannah Harrison

Dissertations

Higher education has increased its focus to national degree attainment, especially among adults who have some college education (Hardin, 2008; Nettles, 2017). Research from these entities identifies future economic growth and the strength of the United States economy requires a more highly educated society (Carnevale & Rose, 2014). As a result, Federal and institutional initiatives seek ways to increase the retention rates of current students while also incentivizing students to return to school to complete their degrees (Markle, 2015). A review of the related literature identified economic and social benefits exist for individuals who obtain a postsecondary degree (Chan, 2016). …

Doping Of Conjugated Polymers: Preparation, Characterization And Device Fabrication, Kan Tang

Dissertations

Semiconducting conjugated polymers (CPs) as emerging materials for advanced electronic applications such as sensors, OPVs, and OEFTs has become an intriguing research topic in the past decades. It opens a new avenue of “flexible” electronics, which has shown great potential in next-generation electronic devices.

However, due to the nature of CP materials and related solution processing techniques, unlike almost perfectly crystalline silicon materials, CPs in the solid-state often exhibit much lower crystallinity if it is not complete amorphous, which severely hinder the electronic property and optical property of the materials. The crystallinity of CPs in a film is often uniquely …

The Perceived Absence Of African American Women In Leadership Positions In Public Four-Year Predominantly White Institutions Of Higher Education In Mississippi, Tonya Neely

Dissertations

There is a perceived absence of African American women in leadership positions in predominantly White institutions of higher education. This research study explored the experiences of African American women in leadership positions at predominantly White institutions of higher education in Mississippi. The themes that emerged from the published literature that were explored in this research study were barriers, mentorship, leadership, and copying strategies. A mixed methods research approach was used to complete this research study using semi-structured interviews and an online Qualtrics survey to capture the experiences of the study participants. The results of this research study support the narrative …

Identification Of Cultural Differences And Their Effects On International Relations: A Novel Approach, Stephen W. Jones

Dissertations

International Relations suffers from underspecified treatments of culture that risk reifying, essentializing, or ignoring the effects of cultural differences in the conduct of relationships between states. Following a review of the development of the culture concept, this interpretivist, epistemologically critical realist, dissertation introduces intercultural adaptive frameshifting from the intercultural communication literature. To assess whether culture has effect within an epistemic community, four frameworks are evaluated within a non-IR field (global Christian reasoning). Speech act theory is used to assess meaningful affect through illocutionary and/or perlocutionary divergence based on cultural difference.

Following the findings that such cultural differences do in fact …