Frailty And Post-Operative Outcomes In Adult Hip Fracture Patients, Melissa Yager

Dissertations

Abstract

Background/ Purpose: The majority of adult hip fracture patients never return to their pre-fracture functional level and have a poor quality of life (Kistler, Nicholas, Kates, & Friedman, 2015; Pioli et al., 2016; Sheehan et al., 2018). The prevalence of frailty in adult hip fracture patients is estimated at 51%. Frail patients with hip fractures are twice as likely to have a complication (Kistler et al., 2015). Extant studies have examined frailty and hip fractures independently, nonetheless, a gap in the literature exists with few investigations of the connection between frailty and post-operative outcomes after hip fracture. The purpose …

Skin And Soft Tissue Infections In The Emergency Department, Nicole Martinez

Dissertations

Background/Purpose: Skin and soft tissue infections (SSTI) represent a diverse group of infections varying in clinical presentation and degree of severity. The International Classification of Diseases codes for patients presenting with cellulitis or abscess account for $5.5 billion in annual health care costs and 1.4% of all hospital admissions nationally. Data are needed to inform admission and management decisions. The purpose of this study is to examine relationships among sociodemographic, physical examination findings, and treatment modality and management in patients with SSTIs.

Theoretical/Conceptual Framework: Web of Causation Theoretical Framework explores multiple causative factors treated with equal prominence, thus …

Barriers And Facilitators To Opioid Use Treatment And Recovery Services During Pregnancy, Loralie Woods

Dissertations

Purpose: To identify barriers and facilitators to opioid use treatment and recovery services among pregnant and nonpregnant women who misuse opioids.

Background: Over 130 Americans die daily after overdosing on opioids. Women have not been immune from opioid use disorders (OUDs), with a 4-fold increase from 1999-2010. The prevalence of opioid use among pregnant women increased from 1.5 per 1,000 hospital deliveries to 6.5. Although the annual National Surveys on Drug Use and Health (NSDUH) has provided information on risk factors for OUD related to socioeconomic and demographic factors, no studies using this data have identified barriers to opioid use …

Pain And Spiritual Distress At End Of Life, Kathryn Lee Robinson

Dissertations

Purpose: The purpose of this study is to examine the relationship between unmanaged pain and spiritual distress in adults newly admitted to hospice.

Background/Rationale: Current evidence supports the presence of a positive relationship between increased physical pain and spiritual distress for those with advanced cancer and/or receiving palliative care services. Nonetheless, spiritual distress remains a relatively understudied area; anecdotally, assessment and management of physical symptoms often take precedence over interventions for spiritual distress in patients at end of life (EOL) on hospice. Research is needed to examine the relationships between physical pain, spiritual distress, and other relevant variables specific to …

African American Females Holding Executive Administrative Positions At California Community Colleges: A Phenomenological Study Of Cultural Influences And Opportunities, Daria Reynolds

Dissertations

Purpose: The purpose of this phenomenological study was to explore the lived

experiences of African American female presidents, vice presidents, deans, associate deans, and directors serving at a California community college (CCC) and to explore what African American cultural influences or other opportunities contributed to their becoming administrators.

Methodology: This phenomenological study explores the lived experiences of African American female administrators of CCCs. This study highlighted the essence of those lived experiences. The respondents were chosen based on specific criteria. The researcher then conducted structured web-conference interviews that described the essence of the lived experiences of the 10 African American …

Interagency Collaboration In Local Partnership Agreements: A Qualitative Case Study Identifying And Describing The Perception Of Preparedness Of Transition Specialists Working In Workability I Projects, Barbara Boyd

Dissertations

Purpose: The purpose of this qualitative case study was to identify and describe the preparedness of transition specialists working in WorkAbility I (WAI) projects as perceived by transition specialists using Kohler’s Taxonomy for Collaborative Transition Programming. In addition, its purpose is to explore the perceptions of transition specialists regarding interagency collaboration in local partnership agreements (LPAs).

Methodology: This qualitative case study identified and described WAI transition specialists’ perception of transition programming and interagency collaboration. It employed the use of semi-structured interview questions consisting of open-ended questions. Using this methodology promoted the extraction of high quality information from the transition specialists. …

The Role Of Socioeconomic Status And Prior Industry Exposure On The Attitudes, Career Goals, And Career Decision Self-Efficacy Of Undergraduates Studying Hospitality And Tourism Management, Laura Mckenzie Shroder

Dissertations

The hospitality and tourism industry struggles with high employee turnover, and many hospitality management students graduate and subsequently leave or choose not to enter the industry. Scholars have found it beneficial to study students’ industry attitudes, career goals, demographics, and career decision self-efficacy to further understand how these variables influence students’ perceptions, engagement, and retention. This quantitative study measured these variables as well as prior industry exposure, which is based on the Social Cognitive Career Theory. Results of an online survey of hospitality students in the Western United States (n = 315; response rate 79.9%) suggested that students’ prior industry …

Leadership Adapted: Towards An Understanding Of How Western-Developed Leadership Theories Are Translated And Practiced In The Modern Arab Middle East, Derek R. Olson

Dissertations

The purpose of this study is to understand how western-developed leadership theories are translated and practiced in the Modern Arab Middle East (MAME). Over the past century the notion of leadership has progressed through phases of understanding, definition, and practice. This evolution continues today and is no longer contained to the academic and practice-oriented institutions of North America and Europe. Through western-styled educational institutions and professional industries, western-developed leadership theories have stretched around the globe, including the MAME. While this is known, what is much less understood is how these theories are adopted and adapted. This study’s objective is to …

The Impact Of The Language Of Instruction On Second-Grade Latinx Emergent Bilinguals’ Understanding Of Place Value In Two Spanish-English Transitional Bilingual Classrooms: An Exploratory Study, Angela Maria Rengifo

Dissertations

The relationship between mathematics learning and the language of instruction in bilingual settings has been observed and analyzed widely in educational research. As Latinx Emergent Bilingual students start developing their mathematics knowledge and skills in elementary classrooms, the role that language plays in the process has been studied as a key aspect of classroom practice. A convergent parallel mixed-method approach was used to examine fourteen second-grade Latinx Emergent Bilingual students’ understanding of the concept of place value and whether this process was related to the language of instruction chosen in each of the two Spanish-English transitional bilingual classrooms. Findings from …

Developing Teachers Technological, Pedagogical, And Content Knowledge (Tpack) Through Design Thinking And Community Of Practice, Jennifer Gee Huei Wang

Dissertations

Current professional development programs have been ineffective in developing teachers’ technological, pedagogical, and content knowledge (TPaCK). Development of teachers’ TPaCK is fundamental for 21st-century student-learning. After a series of professional development workshops with the design thinking process, this study examined whether and how the self-selected K-5 teachers in a suburban elementary school in California demonstrated TPaCK in the integration of instructional technologies when they engage in a community of practice (CoP) structured around design thinking. Data was collected by online TPaCK surveys, exit slips after the CoP, audio recordings and field notes from the CoP and focus group interview. This …

Understanding The Barriers, Bridges And Bases To Inclusion Instruction For Secondary Students With Mild To Moderate Disabilities, Angela Renee Lyte Crowther

Dissertations

Inclusion is the practice of educating students with disabilities and students without disabilities in the same learning environment. For secondary students with mild/moderate disabilities, inclusion is rooted in the philosophical mindset of social justice, equity, and legislation. Inclusion is a complex and sometimes controversial topic few educational systems want to tackle. The purpose of this multi-method research was to gather and analyze secondary site administrators' and teachers’ opinions on the barriers, bridges, and bases needed for the furtherance of inclusion practices and the elimination of the segregated classrooms for students with mild-moderate disabilities. A plethora of research on this topic …

Expanding And Improving High-Quality Early Care And Education In California: Is There Alignment Between Policymakers And The Public?, Heidi Schmidt Emberling

Dissertations

Although there is widespread agreement about the life-long benefits of high-quality childcare and preschool, access for all children in California is limited. The negative effects of this inadequate landscape are borne predominantly by children living in poverty, and middle-income families who do not qualify for subsidies and cannot afford full-fee care. This mixed-methods study examines specific factors that impede expansion and improvement of childcare/preschool in California, from the perspective of five diverse policymakers. Findings reveal a variety of policy solutions in the areas of funding, teacher workforce, quality of care, policy development, and public perception of the importance of high-quality …

Examining The Effects Of A Peer-Mediated Social Skills Intervention On The Prosocial Behaviors Of Elementary Students With Emotional And Behavioral Disorders, Prabhjot Singh

Dissertations

Students with Emotional and Behavioral Disorders represent part of the population of students who receive special education services, and the social skill deficits that they present makes it so that they are less likely to pass their classes and more likely to drop out of school than their typical peers. The social skill deficits of these students often lead to a variety of negative factors including poor relationships and academic achievement. The purpose of this study was to examine the effects of a peer-mediated social skills intervention on fourth and fifth grade students in a public-school setting. The current study …

Navy Seals - Crossing Cultures: Cross-Cultural Competence And Decision Styles, Robert Newson

Dissertations

U.S. military cross-cultural competence is currently deficient, as Special Operations Forces (SOF) personnel assessments fail to explicitly consider aspects related to cross-cultural competence and lack processes specifically tailored to cross-cultural personnel assignments. Researchers, however, have identified eleven attributes that contribute to military cross-cultural competence; this study uses these attributes to explore whether decision styles and demographics correlate with cross-cultural competence. Building on existing work on the attributes of military cross-cultural competence (defined in this study as the ability to quickly and accurately assess, then effectively act, in a culturally complex environment to achieve mission results), I first examined the attribute …

A Mixed Methods Study Identifying And Describing Factors To Promote Psychological Safety In Middle School Professional Learning Communities: Making The Bread Rise, William Cloo

Dissertations

Purpose: The purpose of this mixed methods explanatory study was to identify and describe factors of risk-taking behavior among Riverside County Professional Learning Community (PLC) middle school teachers. It elicited teacher perspectives of a psychologically safe PLC that promotes risk-taking. Additionally, it sought to identify factors that increase psychological safety in a PLC.

Methodology: This mixed methods study uses a sequential explanatory 2-step process to produce results. The quantitative-qualitative study started with a quantitative survey that collected and analyzed numerical data on levels of risk among the population. Qualitative interviews provided context and further explanation on the methods to foster …

Spirituality And Religiosity In Adolescents With Sickle Cell Disease: A Qualitative Study, Dora L. Clayton-Jones

Dissertations

Sickle cell disease (SCD) is a serious debilitating chronic illness and global health problem. Spirituality and religiosity have been shown to have positive correlations with their health outcomes. Research addressing the spiritual and religious needs of adolescents living with SCD is limited. The aim of this descriptive qualitative study was to examine how adolescents (Mage = 16.2 years) with SCD describe and experience spirituality and religiosity.

Navigating The Change Of Life: The Menopausal Transition Of Thai Immigrant Women, Bulaporn Natipagon-Shah

Dissertations

Given that women continue to live more than three decades after menopause and their health and well being in later life are determined by quality of health during the menopausal transition, menopause has become an important issue in the healthcare arena. The growing number of immigrant women in the United States signifies a need for healthcare providers to develop cultural knowledge and sensitivity toward each immigrant group regarding the issue of menopause. The purpose of this qualitative study was to build a substantive grounded theory of the experiences of menopausal transition among Thai immigrant women in the United States.

Engagement Of Primary Stakeholders To Tailor A Comprehensive Transitional Care Model For Persons Who Have Experienced A Stroke And Their Caregivers, Lorre Laws

Dissertations

Stroke is the leading cause of disability in the US, affecting approximately 795,000 persons annually. Stroke care is delivered across multiple settings from hyperacute care in a hospital through chronic stroke management in the community. Considerable advancements have been made in the delivery of hyperacute and acute stroke care. Science and practice gaps exist in providing stroke transitional care across multiple providers and settings once an individual is discharged from an in-patient care facility to home.

Using a qualitative descriptive design, this study engaged and elicited descriptions from stroke survivors and caregivers affected by stroke to inform the refinement and …

The Effect Of The Rapid Assessment For Adolescent Preventive Services (Raaps) In Improving The Style Of The Exchange Of Information And Balance Of Power During A Health Care Visit In A Pediatric Primary Care Setting, Brandi Snyder

Dissertations

It is estimated that more than 70% of illnesses, disabilities, and deaths among the adolescent population are related to adolescent high-risk behaviors. Adolescent high-risk behaviors include those that contribute to unintentional injuries and violence, sexual behaviors related to unintended pregnancies and sexually transmitted infections, alcohol and other drug use, tobacco use, unhealthy dietary behavior, and inadequate physical activity. Despite national recommendations, many providers remain reluctant to implement standardized screening tools that have been created to prevent and identify these behaviors. Studies have shown that a comprehensive preventative risk assessment, such as the Rapid Assessment of Adolescent Preventive Services (RAAPS) used …

Dimensions Of Racial Identity As Predictors Of Physical Activity In Midlife African American Women, Elaine Clarista Hardy

Dissertations

Physical inactivity leads to serious health consequences, particularly for midlife African American (AA) women. Midlife African American (AA) women are less physically active and have higher obesity-related morbidity and mortality than midlife White women. Studies to examine these disparities typically view AAs as a homogeneous group, despite evidence of important within-group variance. Using a culturally-adapted identity-based motivational model, the purpose of this study was to determine whether dimensions of racial identity have differential influence on physical activity in midlife AA women.

Implementing An Early Mobility Protocol For Patients In Intensive Care Unit, Allison Nicole Crane

Dissertations

Limited mobility and prolonged bedrest were thought of as necessary to promote safety and hemodynamic stability in critically ill intensive care patients historically, but recent research does not support this idea. Newer research is suggesting that mobilizing critical ill patients in the intensive care unit can limit the negative effects of immobility and improve patient outcomes (Adler & Malone, 2012; Morris, et al., 2008; Perme & Chandrashekar, 2009; Perme, Lettvin, Throckmorton, Mitchell, Masud, 2011).

The objective of this clinical scholarly project is to educate the healthcare team about the importance of early mobility in the intensive care unit (ICU) patient …

Perceived Ease Of Use And Usefulness Of Podcasting In Nursing Skills Competence, Lisa Mesmer Barnes

Dissertations

This capstone project examined nursing students' technology acceptance of podcasting as a tool for nursing skill acquisition. Technology acceptance was determined by measuring the students' perceived competence of the skill along with the perceived usefulness and ease of use of the provided podcasts. A convenience sample of 49 first semester nursing students from an associate degree and practical nursing program participated in the project. Perceived competence of the three nursing skills: obtaining vital signs, inserting a Foley catheter, and performing a sterile dressing change was examined and compared from pre-podcast availability to post-podcast availability. The overall means of the nursing …

Distress After Preterm Birth: A Discourse Analysis Of Parents' Accounts And Photographs, Ira Kantrowitz-Gordon

Dissertations

Preterm birth is a distressing experience for parents. This distress may continue into early childhood, with negative consequences for parents' mental health and child development. The purpose of this study was to take an in-depth look at how parents formed their accounts of premature birth, postpartum distress, and lives as parents and partners. Discourse analysis of semi-structured interviews and photo-elicitation assignments were used to analyze the parents' experiences in the context of the couple relationship.

Development Of A Clinical Nurse Leadership Orientation Program, Sunita Waddell

Dissertations

Nurses are often promoted or hired into leadership positions without the benefit of a formal orientation to their new leadership positions. The challenge of navigating the various expectations of the role of clinical nurse leader (CNL) such as fiscal ownership, staffing patterns, payroll, and disciplinary action process can be overwhelming. The lack of a formalized orientation process and an identified nurse leader to function as a mentor can contribute to the novice CNL feeling unsupported and overwhelmed. The purpose of this project was to identify, develop, and evaluate a CNL orientation manual, outline, and program for newly appointed CNLs. The …

Motivation To Learn, Learner Independence, Intellectual Curiosity And Self-Directed Learning Readiness Of Prelicensure Sophomore Baccalaureate Nursing Students, Maria Grandinetti

Dissertations

Attrition is a major concern in schools of nursing, and research shows that it is most prevalent in baccalaureate nursing students as they first encounter their initial nursing and core science courses. Many nursing students are confronted with these challenging courses as they enter their sophomore year in 4-year baccalaureate nursing schools. Nurse educators anticipate that sophomore students have the potential to be self-directed learners; and have the initiative to independently identify and implement resources and strategies for learning. A concept analysis of self-directed learning readiness identified motivation to learn, learner independence, and intellectual curiosity as the primary antecedents of …

Bone Health Education For Osteoporosis Risk Reduction In Premenopausal Women: A Quality Improvement Project, Gloria Jean Nichols

Dissertations

In the United States, about 8.5 million women live with osteoporosis. Osteoporosis is a debilitating systemic skeletal disorder characterized by low bone mass and reduced bone mineral density that occurs with the loss of estrogen. The mortality rate for this group is about 3 to 4 times higher than other women and as many as 1 in 3 experience a fracture. Guided by the Health Belief Model, this project evaluated how a bone health fact sheet impacts knowledge about osteoporosis and self-efficacy for preventative behavioral change in premenopausal women (age 40-58 years). The project also evaluated if an electronic medical …

The Relationship Between New Nurses Who Volunteer And The Caring Behavior New Nurses Exhibit In The Practice Setting, One Year Post Graduation, Nicolette Fiore-Lopez

Dissertations

Volunteering is engaged in by millions world-wide and nurses comprise a significant portion of those who provide their professional talents, unpaid, to the underserved in local, national and international efforts. Nurses who have engaged in volunteer activities anecdotally describe personally transforming experiences gained through their efforts and for many nurses volunteering becomes part of their professional mandate. Although many social disciplines have studied volunteering, to date there has been a paucity of research on nurses who volunteer. The purpose of this study was to describe the characteristics of novice nurses who volunteer and determine the influence of volunteering and associated …

Exploring Intergenerational Value Changes Across Three Generations Of Emirati Women Using Focused Ethnography, Ebtesam Ali Alteneiji

Dissertations

Intergenerational value change, influenced by technological advancements, economic development, formal education, and urbanization, becomes especially complex when it occurs in times of rapid changes, as in the case of the United Arab Emirates (UAE). Through the lens of social change and human development theory, heavily constructed in the Gemeinschaft/Gesellschaft paradigm, this focused ethnography explored the push and pull of traditional boundaries within a collectivist society and the necessary navigation of infused Westernized philosophies promoting individualism and autonomy. Participants in this study (N = 24) were members of 8 family triads of grandmothers, mothers, and daughters who represented 8 different …

An Examination Of Gaming Environments In Dungeons And Dragons Groups, Joe Lasley

Dissertations

Tabletop Role-Playing Games (TRPG) like Dungeons & Dragons are unique phenomena within the topics of game-based learning and gamification of leadership development. Games in general are used for both game-based learning (learning from playing games) and as sources of inspiration for gamification: the application of game design elements in non-game contexts like business or education. Many potential benefits of playing TRPGs have been observed including transformative experiences linked to collective creativity. Knowing more about the transformative potential of TRPGs can inform facilitation of creative learning environments and guide the use of TRPGs for leadership development.

The concept of a holding …

La Maestra’S Circle Of Care: Studying The Impact Of An Integrated Service Model On The Health And Well-Being Of Vulnerable Populations, Zara Marselian

Dissertations

ABSTRACT

There is an urgent need to reform the health care delivery system in the United States, as recognized through current bipartisan efforts. Society’s vulnerable populations especially need health care reform as health care outcomes are the poorest among disadvantaged populations. Moreover, vulnerable populations are twice as likely to develop chronic diseases than the general population and they remain ill due to other contextual, societal factors affecting their ability to achieve health and well-being. This population is subjected to adverse life events that suggest a more comprehensive approach to health and well-being is called for.

The Circle of Care is …