Digital Commons Network^™

The Experience Of Hope For Adults With Cystic Fibrosis, Janet P. Tracy

Dissertations

In this highly technical biomedical era, advances in diagnosis and aggressive treatments have altered the survival age for many chronically ill people. What is the meaning of hope to people who have lived beyond their expected life span? The purpose of this study was to describe and interpret the meaning of hope in people who have beaten the odds of statistics. A Hermeutic-phenomenological design as informed by van Manen and influenced by Watson and Parse, guided and unfolded the meaning of hope for this population.

Chronically Ill Children's Mothers' Perceptions Of Environmental Variables, Anne Turner-Henson

Dissertations

Environments play a critical role in supporting families, ameliorating isolation, promoting group values, and providing resources (Garbarino, 1976). For families with a chronically ill child the role of the environment is of great importance in that child's successful development and socialization into a productive member of society. Previous research has documented the role of the environment in predicting child abuse and neglect; though little is known about the role of the environment for families with a chronically ill child. The purpose of this study was to examine the interaction of environmental variables on mothers' perceptions of the environment as supportive, …

Health Status And Psychological Well-Being In Elderly Women: The Self-System As Mediator, Susan M. Heidrich

Dissertations

The purpose of this research was to explain how elderly women manage to maintain high levels of psychological well-being despite losses associated with aging, especially loss of health, and to examine this process in young-old and old-old women. Two hundred and forty three community-dwelling elderly women completed surveys regarding demographic characteristics, their health status, and psychological functioning. The self-system was proposed as a mediator of the relationship between health status and psychological well-being, and a model was examined in which health status had a direct path to psychological well-being and an indirect path through the self-system. Three theoretical perspectives on …

Moderating Effects Of Cognitive Adaptability On Expressive Writing Outcomes Among Persons Infected With Human Immunodeficiency Virus, Lois J. Wagner

Dissertations

This study explored the effects of expressive writing on psychological well-being, health status, and adherence among persons with human immunodeficiency virus (HIV) infection. It further explored the moderating effects of cognitive adaptability on these outcomes. Thirty-seven participants were randomized to write weekly for 20 minutes on each of four days, either about stressful/traumatic life experiences (experimental) or trivial, non-emotional topics (control). Dependent measures obtained at baseline were repeated one month after writing. Higher cognitive adaptability (dispositional optimism coupled with perceived competence) was associated with improvements in positive affect, global sense of meaning, HIV-cognitive adaptability, HIV-quality of life, and HIV physical …

Perinatal Exposure To Hyper-Interleukin-6 Affects Neurodevelopment In The Mouse, Susan Brunssen

Dissertations

Pro-inflammatory cytokines, especially Interleukin (IL)-6, are elevated in the brains and serum of very premature infants in association with perinatal infectious and hypoxic/ischemic insults. To determine potential adverse effects of IL-6 on brain development, cross-fostered litters of male cd-1 mice were injected sub-cranially with hyper-IL-6 or vehicle at postnatal day (PND) 4 and examined for alterations in functional landmarks of CNS development.

Determinants Of Health Service Utilization: A Secondary Analysis Of The Comprehensive Multi-Level Nursing Practice Model For Rural Hispanics, Debra J. Mcginty

Dissertations

Rural Hispanic communities in America face socioeconomic barriers that are costly in terms of morbidity and mortality. Explication of the community qualities that influence healthcare utilization of rural Hispanic populations is critical to overcoming these socioeconomic barriers. Yet, empirical support for community concepts and relational links to explain healthcare utilization in rural Hispanic communities have not been addressed in the nursing literature. This study sought to improve understanding of the inner workings and coping mechanisms within the community. The study was a secondary analysis of data sets obtained from a larger study entitled Comprehensive Multi-Level Practice Model for Rural Hispanics …

Predictors And Outcomes Of Home Care Use In Urban Elders, Andrea B. Brassard

Dissertations

This study used longitudinal data from the Washington Heights-Inwood Columbia Aging Project (WHICAP), a random sample of 2128 Medicare beneficiaries, to examine predictors and outcomes of home care use. Predictors of home care were examined using Grabbe's (1992) Home Care Service Utilization Model. In this model, functional status is the pivotal predictor of home care use. Three other predictor categories were examined: individual factors, family variables, and policy/economic factors. Significant predictors of home care use, other than functional status, were increasing age, female sex, two or more (out of seven) reported medical conditions, hospitalization within the past year, living arrangement, …

Investigations Into Economic Class And Retention Rates Of Nursing Students, Angela D. Martindale

Dissertations

This quasi-experimental, quantitative design based on a grand theory developed for this study explores whether a course designed to allow students to investigate their own environment will affect retention rates of nursing students. A convenience sample of 11 participants were recruited to take the course and data from 185 students was provided for the control group. The course was taken over the Summer and the retention was measured at the beginning of the Fall semester (R1), the end of the Fall semester (R2) and then at the beginning of the Spring semester (R3). The study demonstrated that there was a …

Theory, Reality, Survival: An Organizational Analysis Of A Nurse-Managed Neighborhood Health Center, Sally P. Lundeen

Dissertations

The purpose of this study was to describe and analyze the development of Erie Family Health Center as a nurse-managed, community health center. Analysis focuses on those factors within the organization itself and in the external environment which facilitated or impeded agency survival and growth. The factors are identified and analyzed from the perspective of the nurse administrator. Erie Family Health Center, a limited service medical clinic, was developed into a multiple site, comprehensive, community health center between 1977 and 1985. Administrative and programmatic leadership was provided by master's prepared nurses. Factors contributing to the survival and growth of this …

The Effect Of Nurses' Use Of A Focused Protocol To Decrease Distractions During Medication Administration, Theresa M. Pape

Dissertations

Medication administration errors (MAE) are often the result of system problems that lead to patient injury, increased hospital costs and nurses being blamed for the incident. Contributing factors include distractions, lack of focus, poor communication, and failure to follow standard operating procedures during medication administration. A quasi-experimental study was conducted to measure the effect of two targeted interventions based on airline industry safety measures for decreasing nurses' distractions during medication administration.

Environmental Modification Strategies Used By Caregivers, Deborah H. Messecar

Dissertations

The purpose of this study was to describe the environmental modification strategies used by family caregivers of chronically ill older people. The specific aims of the study were to describe: (1) the environmental modification strategies that family caregivers used; (2) why environmental modification strategies were effective; and (3) how caregivers changed their environmental strategies over time. A qualitative design using the methods of data analysis recommended by Miles and Huberman (1994) guided the research.

Adult Daughters' Relationships With Their Institutionalized Mothers, Valerie Matthiesen

Dissertations

A qualitative research design using grounded theory methodology was used to study adult daughters' relationships during the transitional period following their mothers' institutionalization in a nursing home. The central question was: What characterized the relationship between adult daughters and their institutionalized mothers?

Optimism And Emotional Well-Being In Women With Breast Cancer: The Role Of Mediators, Ellyn E. Matthews

Dissertations

Diagnosis and treatment of breast cancer in women, with an estimated incidence of 182,800 new cases in the United States in 2000, is associated with psychological difficulties and diminished emotional well-being. The role of personal and social resources in maintaining emotional well-being is not adequately understood in women with breast cancer. The purpose of this research was to examine the relationships among the variables of optimism, emotional well-being, perceived social support, problem-focused coping, self-transcendence, and symptom distress. Optimism, or the tendency to believe that one will generally experience positive outcomes, is believed to influence emotional well-being. In addition, social support, …

Multiple Case Studies Using Positive Behavioral Interventions And Supports, Stacy Brouillette

Dissertations

Purpose: The purpose of this replicated multiple case study was to describe practices of the implementation process of a schoolwide positive behavioral interventions and supports (PBIS) approach at three purposely selected Washington state middle schools.

Methodology: A descriptive, qualitative, replicated multiple case study approach was selected for this study. Artifact reviews were conducted and an appropriate data collection tool was utilized to collect data. Observations of the sites where PBIS was being implemented were conducted with an appropriate observation tool to gather data. Interviews were conducted with qualitative questions asked. These data collection methods were then triangulated to find patterns …

Psychological Factors Related To Physical Activity In Adult Congenital Heart Disease, Tyler Pendleton

Dissertations

Adults with congenital heart disease (ACHD) are a new and growing medical population. While medical interventions previously focused on reducing rates of infant mortality, current research suggests increased risk of premature mortality in ACHD may be partially due to acquired cardiovascular disease. One lifestyle intervention to reduce acquired cardiovascular risk is physical activity. Physical activity has been supported in the research as a safe, efficacious, and tolerable intervention for many ACHD; however, most patients do not engage in recommended levels of physical activity. The purpose of this study was to investigate psychological factors related to physical activity in ACHD. Participants …

Effective Paraeducator Implementation Of Behavior Intervention Plans For Students With Autism Spectrum Disorder: An Exploration Of Training And Support Needs, Kristen Nottle-Powell

Dissertations

Purpose: The purpose of this convergent mixed methods study was to describe the training and support paraeducators who work with students with autism spectrum disorder received as they implemented behavior intervention plans based on the Browning-Wright, Mayer, and Saren model. Additionally, this study sought to describe the training and challenges experienced by paraeducators, as well as their training and support recommendations for paraeducators who work with students with autism spectrum disorder with a behavior intervention plan.

Methodology: A convergent mixed methods study was used to describe the training and support experiences, challenges, and recommendations, as described by paraeducators …

Theory Of Quality Of Life Of Stroke Survivors (Tqloss), Jenecia F. Fairfax

Dissertations

This study tested a theoretical model of quality of life of stroke survivors derived from King's conceptual framework for nursing. The model proposed that stroke survivors' perceptual integrity (cognition), social support, and perception of level of disability would predict their quality of life. In addition, the relative contribution of age, time since stroke, and number of strokes to the stroke survivor's quality of life was investigated.

Adolescent Victims' Experiences With Cyberbullying: A Grounded Theory Study, Melvina Sue Brandau

Dissertations

The purpose of this study was to construct a Grounded Theory that explains the processes involved in cyberbullying from the perspectives of those who have been victimized. A Constructivist Grounded Theory approach was used to explain the processes that occur as cyberbullying begins, unfolds, and ends, as well as to determine the methods that adolescent victims use to cope, and the context in which cyberbullying occurs.

The Relationship Between The Birth Of A Preterm Infant And The Vulnerable Child Syndrome Using Lessick's Vulnerability Model As A Theoretical Framework, Jean T. Martin

Dissertations

The primary purpose of this study was to explore the relationship between the birth of a preterm infant and the vulnerable child syndrome. The theoretical framework for the study was Lessick's Vulnerability Model for Nursing Practice. This model is based upon a person's individual factors interacting/correlating with environmental factors and the effects of these on health-illness behavior across the lifespan. A convenience sample of 57 parents of preterm infants, now three years of age, and 55 parents of full term infants, now three years of age, was drawn from a previous study of families' response to the birth of a …

Postpartum Hemorrhage Evidence-Based Registered Nurse Staff Education Project, Jessica Powell

Dissertations

Despite medical technology and research advances postpartum hemorrhages (PPH) continue to be a leading cause of morbidity and mortality for pregnant women, even in developed countries. One possible explanation for PPHs continuing to be a leading cause of maternal death is inconsistent recognition and timely treatment of women experiencing a PPH. This doctor of nursing practice project attempts to improve labor and delivery nurse knowledge through an educational intervention which will contribute to rapid identification and treatment of PPH. Knowledge change was demonstrated though change in pretest and posttest scores. The educational information and process was guided by adult learning …

Statistical Modeling Approaches And User-Centered Design For Nursing Decision Support Tools Predicting In-Hospital Cardiopulmonary Arrest, Alvin Dean Jeffery

Dissertations

This doctoral research explored strategies for the design and statistical development of probability-based nursing decision support tools within the clinical context of in-hospital cardiopulmonary arrest (IHCPA). IHCPA remains a harmful and costly event, and recent attempts to assist with early recognition via probability-based clinical decision support (PBCDS) tools have fallen short of improving patient outcomes. These shortcomings are due, in part, to the complex nature of PB-CDS tools with inadequate attention paid to important design elements during the early stages of the tools' construction.1 Failure to improve patient outcomes may also be a condition of the PB-CDS tools' underlying statistical …

An Investigation Of Parenting Competency And Sense Of Belonging In A Sample Of Mothers With And Without Mental Illness, Janet Salerno D'Arcangelo

Dissertations

Parenting competency among women with mental illness is a priority because maternal mental illness may pose difficulty in parenting and is associated with potentially adverse outcomes in children. (Weissman, Warner, Wickrmaratne, Moreau, & Olfson, 1997). Sense of belonging (SOB) (Hagerty, Lynch-Sauer, Patusky, Bouwsema, & Collier, 1992) is pertinent to the maternal-child relationship and possibly plays a role in parenting competency. This descriptive correlational study explored the relationship of sense of belonging and parenting competency in a sample of mothers. Research questions addressed descriptive and correlational data regarding the study variables, as well as possible moderating or mediating effects of sense …

El Corazon De La Cebolla: A Mini-Ethnographic Study Of Mexicana/O Symptom Interpretation And Management, Melody A. Weaver

Dissertations

The purpose of this urban mini-ethnographic qualitative study was to examine Mexicana/o symptom interpretation and management utilizing the Common Sense Model of Illness Representation as a guiding framework. Latina/os are a growing part of the population in the United States and are estimated to comprise 25% of the total population by the year 2050. The Latina/o population is diverse. Mexicana/os represent 68% of the Latina/o population in Utah. Despite growing numbers of Latina/os living within the borders of the United States, little work has been conducted that addresses the healthcare needs of this population. Research to date has focused on …

Health Status, Health Behavior, Multidimensional Health Locus-Of-Control And Factors In The Development Of Personal Control In Individuals With Rheumatoid Arthritis, Janice Ellis

Dissertations

This study was designed to expand understanding of perceived personal control, its relationship to perceived health and health behavior, and the development of personal control in the individual with rheumatoid arthritis. The theoretical framework for the study was Pender's Health Belief Model. Multidimensional Health Locus of Control, the Health Promoting Lifestyle Profile, Self-Evaluation of Health Status, physical and instrumental activities of daily living from the OARS Multidimensional Functional Assessment, and various demographics were measured for 67 subjects with rheumatoid arthritis.

Measuring Active Clinical Decision Support Influence On Nursing Research Utilization, Susan Cortez

Dissertations

The focus of the research was to test the effect of Clinical Decision support on nursing evidence-based practice. The research method was quantitative with a longitudinal cluster randomized design. The study measured the effect of active clinical decision support on oncology nursing evidence-based practice in four oncology clinics associated with an academic medical center. The quasi-experimental study design contained an intervention and control group. The study intervention was active clinical decision support in the form of evidence-based drop down boxes in the nursing electronic documentation system.

Relationships Among Self-Management Ability, Cognitive Function, And Sleep Quality In Advanced Heart Failure Intensive Care Unit Patients, Elizabeth Ann Edmiston

Dissertations

As the amount of people with heart failure and treatment complexity increases, many hospitals are implementing Advanced Heart Failure Intensive Care Unit (AHFICU). The success of this new model of care depends on understanding unique characteristics of patients including factors related to self-manage ability, cognitive function, and sleep quality. Nursing interventions can be implemented to meet the needs of this population. Therefore, the purpose of this study is to understand the relationships among sleep quality, cognitive function, and self-management ability at discharge in patients in AHFICU.

The Relationship Of Coping And Family Function To Outcomes Of Care In Families Of Tracheostomized Infants And Children, Judith A. Schmidt

Dissertations

The purpose of this study was to examine the relationship of parent coping and family function to outcome measures in terms of the rate of re-hospitalization, emergency physician utilization, and infection. Major questions included: (a) What coping behaviors do parents find most useful in dealing with the tracheostomized child? (b) How is coping related to family functioning? (c) Is there a relationship between outcome measures and family functioning or outcome measures and coping? (d) How do two measures of family functioning correlate over time? This descriptive, exploratory study examined the association of coping and family function to outcomes after discharge …

Self-Care Management Of African American Men With Type 2 Diabetes, Kevin Konstantinos

Dissertations

African American men are disproportionately affected by type 2 diabetes and have a 3 times higher rate of 3 serious complications of diabetes, including blindness, amputations, and end-stage renal disease, compared to other groups. The purpose of this project was to address the gap-in-practice disparity that exists in care of African American men with diabetes by providing one-on-one self-care management education in an outpatient clinic setting. The behavior change theories that supported the project intervention were Orem's self-care theory and Bandura's self-efficacy theory. Employing a quasi-experimental design, 33 participants between the ages of 40 and 65 were divided into an …

Selected Factors Affecting Nurse-Perceived Reciprocity In Nurse-Patient Relationships, Elnora P. Mendias

Dissertations

This exploratory study examined factors affecting nurse-perceived reciprocity in nurse-patient relationships of practicing public health nurses. The hypothesis was that there is a positive relationship between selected demographic (age), professional (years as RN, years in public health nursing), personal (career satisfaction, satisfaction with nurse-patient relationships), and contextual variables (work satisfaction, years with current employer, type of nursing care delivery system (team, primary, case management, functional, other), and satisfaction with workload) and nurse-perceived reciprocity in nurse-patient relationships.

Primary Care-Non-Profit Partnerships: Improving Ptsd Screening And Treatment Access For Veteran Patients, Nickolai Detert

Dissertations

Approximately 50% of 22 million American military veterans use civilian healthcare in addition to, or in lieu of, the Department of Veteran's Affairs health facilities. Studies find that theses veterans may have unidentified mental health needs and lack access to appropriate mental health services. Barriers to adequate mental health care include: (a) undisclosed veteran status; (b) stigma; (c) lack of cultural competency in civilian healthcare; and (d) an overall shortage of mental health services. With veteran post-traumatic stress disorder rates as high as 23%, we conducted a quality improvement project to improve veteran identification, mental health needs assessment, and access …