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The Relationship Between Race And Ethnicity And Serious Safety Events In Hospitalized Patients, Samantha Crandall

Dissertations

Purpose. This study explored the association between patient sociodemographic characteristics and the occurrence of serious safety events (SSE) in hospitalized patients. Specific aims were to describe among patients who have experienced an SSE: 1) patient sociodemographic variables (age, gender, race, ethnicity and language spoken), health insurance coverage, patient zip code, payer mix, site of care location, and severity of event; 2) the relationships between the select patient sociodemographic variables, health insurance coverage, patient zip code, payer mix, site of care location and SSE level of harm; and 3) what factors increase or decrease the odds of experiencing higher levels of …

A Phenomenological Qualitative Study To Discover The Attitudes And Perceptions Of Police Officers On The Legalization Of Recreational Cannabis And Crime, Izedomi Ayeni

Dissertations

Purpose: The purpose of this phenomenological qualitative study was to discover the attitudes and perceptions of police officers on the legalization of recreational cannabis and crime.

Methodology: This qualitative, phenomenological methodology employed the use of semi-structured interview questions consisting of open-ended questions to understand the lived experiences of Colorado Police and Sheriff Officers and their perspectives on the experiences with the legalization of cannabis and crime. The sample size of 16 officers was selected from the sampling frame, which included Denver Police officers and Larimer County Sheriff officers.

Findings: Analysis of the data from interviews resulted in the identification of …

Evidence Based Practice Improvement Project To Improve Influenza Vaccination Rate In Intercollegiate Athletes, Clifford W. Fawcett Iii

Dissertations

Influenza is a highly contagious, respiratory infection that affects between 19-26 million people in the United States annually and is associated with morbidity and mortality. Influenza spreads easily with rapid transmission especially in crowded areas. The Centers for Disease Control recommends the best prevention against influenza is the influenza vaccination. The Advisory Committee on Immunization Practices recommends annual influenza vaccination for all individuals greater than six months who do not have contraindications. Strong evidence supports the safety and efficacy of the influenza vaccine, yet the uptake of the vaccine is low across many populations, especially college students. Healthy People 2020 …

The Effect Of Using Virtual Manipulatives On Students’ Ability To Mentally Compare Proper Fractions, William Wilson Mcneary Iii

Dissertations

This study proposes a method to analyze the effects of the use of virtual fraction models (circle/bar/number line) on students’ ability to mentally compare proper fractions. Since developing a sense of magnitude with both whole numbers and rational numbers is highly correlated with improved performance on standardized assessments and improved performance in later algebra classes, special attention is directed to the bar and number line as they are linear representations.

The study used an experimental pretest/posttest group design by randomly assigning subjects within class sections to a control group (physical fraction circles) and treatment groups with seven different methods of …

Women’S Sexual Satisfaction In The Context Of Midlife Relationships: Examining An Ecological Model And Intergenerational Caregiving, Katherine M. Arenella

Dissertations

This study examined an ecological model of sexual satisfaction in midlife women in relationships, and paid particular attention to the role of intergenerational caregiving in predicting satisfaction. Participants were 1,411 midlife women in relationships who participated in the Midlife in the United States (MIDUS) national study. Using split samples for replication purposes, data from this survey were examined to test the hypothesis that an ecological model - including the macrosystem level variable of religiosity, the exosystem level variables of SES, social support, and parenthood, the mesosystem level variables of relationship satisfaction, affectual solidarity, relationship length, and sexual functioning, and the …

Older Adults' Implementation Of Discharge Instructions Following An Acute Care Hospital Stay, Brenda Miller

Dissertations

Discharge instructions are a self-care guide for patients after discharge from an acute care hospitalization. The discharge process starts on admission to the hospital and continues until discharged. Many patients rely on informal caregivers to provide support after a discharge. However, it is often unclear whether the patients or caregivers completely understand instructions provided during the discharge process. Key concepts related to how discharge instructions were implemented following discharge to home have been understudied from the patient's and informal caregivers' perspectives. Developing effective discharge instructions based on study findings may assist in reducing 30-day hospital readmission rates. This study was …

Moral Development And Public Health Nursing, Margaret Avila

Dissertations

Public health nurses (PHNs) have the opportunity and professional obligation to be at the forefront of the fight to eliminate health disparities based on the practice principle of social justice. The overall purpose of this descriptive study was to explore the stage of the moral development in a convenience sample of practicing public health nurses (PHNs) and the differences in moral development stage across selected demographic variables (age, gender, race/ethnicity, level of entry into professional nursing, highest level of education, years practicing as an RN, years practicing in a public health department, self-identified political views, primary language, and region of …

The Effect Of Induction Of Labor On The Odds Of Primary Cesarean Delivery, Susan Mcbride

Dissertations

The induction rate in the United States has more than doubled since 1989 to a high of 20.6% (Martin et al., 2003). The purpose of this study was to examine the effect of labor induction on the odds of primary cesarean delivery controlling for factors that confound or modify the effect with a database that provides size and scope. The study design was a retrospective, explanatory study design, using secondary data analysis with a database comprised of hospital discharge data, birth certificate data, AHA Annual Hospital Survey data, and neonatal intensive care survey data (N = 160,533 births).

An Analysis Of The Effects Of Content Coaching And Instructional Coaching On Teacher Practices, Victoria E. Daniels

Dissertations

The passage of the Every Student Succeeds Act increased professional development requirements, moving away from traditional methods of out-of-the-classroom professional development and toward more effective job-embedded professional development (Association for Supervision and Curriculum Development, 2016). The purpose of this study was to obtain the perceptions of teachers, coaches, and principals about the coaching programs in schools and the effect on instructional practice and student achievement. Simultaneously, the efficacy of job-embedded professional development and its direct correlation to Knight’s (2016) seven Partnership Principles were examined. Surveys were distributed to the participants who were third, fourth, and fifth-grade teachers, coaches, and principals …

Emergence Delirium In U.S. Military Combat Veterans, Jason M. Mcguire

Dissertations

This dissertation study examined the phenomenon of emergence delirium in U.S. military combat veterans. Emergence delirium is a post-anesthetic phenomenon that occurs immediately following emergence from general anesthesia and is characterized by agitation, confusion, and violent physical and/or verbal behavior. Clinical evidence suggests that emergence delirium is occurring with greater frequency among military personnel returning from conflict in the Middle East. This body of work is a culmination of three distinctive phases and is presented in three individual manuscripts.

Revalidation Of The Hung Postpartum Stress Scale, Chich-Hsiu Hung

Dissertations

The postpartum period, or puerperium, is a transitional and potentially stressful time during which women need to face both the new tasks of the maternal role and physiological changes in their bodies. Along with these adjustments are changes in the quality of social support needed by new mothers. These changes may trigger postpartum stress, which it may make it difficult for postpartum women to function effectively in their new maternal roles. Postpartum stress may also affect maternal health adversely during the postpartum period. The ability to identify postpartum stressors early in the course of childbearing could facilitate the development of …

The Participation Of Young Adults With Mild Intellectual Disabilities And Cerebral Palsy In The Decision To Receive Botox Treatment For Muscle Spasticity, John L. Belew

Dissertations

Background. While a large proportion of youth with intellectual disabilities (ID) live with chronic health conditions, it is unlikely that these individuals will be prepared to participate in health-related decisions. Purpose. This study examined the phenomenon of health-related decision-making among young adults with cerebral palsy and mild or borderline ID. The specific clinical context for the study was the decision to receive intramuscular injections of botulinum toxin type A (Botox) for skeletal muscle spasticity. Methods. A multicase methodology was used, based on a narrative approach.

Patient/Provider Concordance: Instrument Development, Amanda Jane Flagg

Dissertations

The purpose of this study was two-fold. The first was the establishment of a reliable and valid tool, the R-USLATCon scale that reflects degrees of concordance attitudes of both patients and health care providers established during a specific patient care episode that may or may not lead to planned adherence. Secondly, the purpose was to undertake a partial testing of a conceptual model, the patient and healthcare provider concordance model developed to specify concepts that are linked with concordance to predict adherence.

The design of this study was a descriptive correlational study used to assess the R-USLATCon scale's preliminary reliability …

The Experience Of Being Discharged From Hospice Alive As Perceived By Patients, Their Spouses, And Adult Children, Rebeka Bianca Campbell

Dissertations

Approximately 1.56 million patients received hospice care in 2009, and 243,000 individuals were discharged alive (NHPCO, 2010). There is a paucity of research describing the experiences of individuals discharged from hospice alive. The purpose of this transcendental phenomenological study was to explore the experiences of adult individuals with a life-limiting condition who were discharged from a hospice program due to decertification related to ineligibility or extended prognosis from the perspective of the individual and his or her adult family members. The study's research questions were: (a) how do participants perceive and describe the experience of being discharged alive from hospice, …

Using A Collaborative Center For Integrative Reviews And Evidence Summaries To Narrow The Education-Practice-Research Gap, Cecelia Lorayne Crawford

Dissertations

The overarching purpose of this dissertation project was to design a collaborative center for integrative reviews and evidence summaries (CCIRES) to advance the state of the art and science of nursing knowledge and narrow the education-practice-research gap. The CCIRES program was created as a web-based platform embedded in the Kaiser Permanente Southern California infrastructure. The specific purpose of this project was to implement CCIRES via that infrastructure, and evaluate the implementation, structures, processes, and usability of CCIRES.

The Lived Experience Of Chronic Pain In Nurse Educators, Moniaree Parker Jones

Dissertations

Pain is associated with a wide range of disease and injury, and is sometimes the disease itself. Millions suffer from chronic pain every year and the effects of pain lead to tremendous costs for healthcare, rehabilitation, and lost worker productivity, as well as the emotional, psychological, and financial burden it places on patients and their families. The nurse has a key role in effective pain management with the need for accurate assessment, prompt intervention, and evaluation of pain relief measures for positive patient outcomes. The purpose of the study was to explore the lived experience of chronic pain in nurse …

Current Care Practice Patterns For Type 2 Diabetics In A Primary Care Setting, Valencia C. Fleming

Dissertations

The two-fold purpose of this study was to compare health care provider current practice patterns for patients with Type 2 Diabetes in a primary care setting to the standards of care defined by the American Diabetes Association (ADA) and to establish baseline clinical outcomes for patients with Type 2 Diabetes. The study had a descriptive retrospective design that reviewed 250 charts of patients seen during the period of January 1, 2004 to December 31, 2004.

Providing Hospice Care For Children: An Organizational Study, Lisa C. Lindley

Dissertations

Background. Of the 54,000 children, who die in the US, many lack access to hospice care. As terminally ill children increasingly return home to die, little is known about the hospices that provide care for children and what factors may influence whether care is provided. Objective. To understand the institutional and resource factors that may influence the provision of hospice care for children, while controlling for organizational and market factors. Methods. This study used a retrospective, longitudinal design.

The Effects Of Therapeutic Back Massage On Psychophysiologic Variables And Immune Function In Spouses Of Cancer Patients, Linda M. Goodfellow-Kruth

Dissertations

Scant attention has been given to help spouses of cancer patients reduce stress associated with their partner's illness. Stress-induced immune function change may be the link between stress and illness. A significant decrease in natural killer cell activity (NKCA) and a high incidence of stress-related disorders, depression, loneliness, and marital disruption have been reported in spouses of cancer patients. Therapeutic back massage (TBM) is an intervention that may be beneficial in reducing stress in spouses of cancer patients. TBM is a systematic form of touch that manipulates soft tissues of the body to promote relaxation. Interventions that induce relaxation have …

Development Of A Program Proposal For A Nitrous Oxide Program In Pediatrics, Sarah Ann Oleson

Dissertations

When pediatric patients are admitted to the inpatient or outpatient hospital setting they potentially have to endure procedures that cause pain, fear, and anxiety which can have a lifelong impact on the child's response to future healthcare needs. The purpose of this project was to create a comprehensive program proposal for a nitrous oxide sedation program to minimize those perceptions towards medical procedures. The project utilized a systematic review of literature and secondary data to address the most important indicators for developing a comprehensive program proposal to present to the pediatric leadership team. Multiple studies have shown nitrous oxide having …

The Lived Experience Of Adolescent Females With Diabetes: A Phenomenological Approach, Jane K. Dickinson

Dissertations

The purpose of this study was to gain a better understanding of what it means for adolescent females to live with type 1 diabetes. The following research question was investigated: What is it like for adolescent females to live with type 1 diabetes?

The Effectiveness Of A Promotora-Led Intervention For Mexican Americans With Type 2 Diabetes, Josefina Lujan

Dissertations

The purpose of this randomized control repeated measures trial was to determine the effectiveness of a self-management intervention led by community lay workers called promotoras on the health outcomes of Mexican Americans with type 2 diabetes living in a major city on the Texas - Mexico border. The specific aims of this study, in relation to the intervention group participants, were to: (1) decrease the glycosylated hemoglobin (A1c) blood levels at the six-month assessment, (2) increase diabetes knowledge at the three and six-month assessments, and (3) strengthen the participants' beliefs in their ability to manage diabetes at the three and …

Development And Evaluation Of A Computer-Interpretable Guideline For Depression Screening And Initial Management In Primary Care, Jeeyae Choi

Dissertations

Clinical practice guidelines (CPGs) are designed to improve the quality of care by promoting proven interventions and consistency of care. The overall goal of this study was to develop a web-based decision support system (DSS) for depression screening and initial management that would be perceived as easy to use and potentially useful by system end-users (Advance Practice Nurses [APNs]). Translation of a CPG into a computer-interpretable guideline (CIG) is an essential step.

Nurse Perceptions Of Facility Influences On Older Adult Acute Care Falls, Patricia Brock

Dissertations

Health care and nursing sometimes seem at odds when determining what is best for patient care. This study examined registered nurse (RN) perceptions of the inability to apply expert specialized knowledge of falls prevention for older adults while maintaining professional nursing standards of care and safety and complying with health care and facility policies, procedures, and bureaucratic directives. Following methods of Institutional Ethnography (IE), the study considered how institutions influenced and organized RNs' work and social organization. The social life and organization of RNs arises in what they do and translate into their specialized knowledge. Within their particular settings and …

Qualitative Study: Understanding Mexican American Women's Experience In Intimate Partner Violence, Nora Montalvo-Liendo

Dissertations

The purpose of this qualitative study was to gain an understanding of the experiences of Mexican American women living with intimate partner abuse relevant to the process of disclosure of abuse. Limited research exists on the experiences of women who are of Mexican descent living with intimate partner abuse and their disclosure of abuse. Factors that influence disclosure for other populations are well articulated in the literature however, these factors have not been adequately verified in persons of Mexican descent.

The Experience Of African Students Studying Nursing In The United States In Relation To Their Use Of Critical Thinking, Donald L. Tyson

Dissertations

This qualitative study explores the critical thinking experiences of African nursing students enrolled in several universities in the U.S. Using a semi-structured interview approach, twelve African students discussed their experiences using and learning a western critical thinking approach, as well as described their educational experiences in Africa. Three major frameworks guided the study including van Manen's interpretive hermeneutical approach to qualitative research, the conceptual models of critical thinking described by Scheffer and Rubenfeld's (2000) nursing consensus statement and Barnett's (1997) description of criticality, and the African concept of Ubuntu.

Older Adult Caregiving In An Amish Community, Helen Mavis Farrar

Dissertations

The focus of this study is Amish experiences of older adult caregiving. As an ethnic and religious minority group, the population of Amish in North America is doubling every 18 to 20 years, increasing from an estimated 235,000 in 2008, to 282,000 in 2013 (Young Center for Anabaptist and Pietist Studies, 2013). Cultural values of the Amish include separation from mainstream society, avoidance of modern technology and an adherence to a rural, agrarian lifestyle according to scripture (Hurst & McConnell, 2010). In spite of sequestration from mainstream society, there is growing evidence that the Amish communities are increasingly seeking healthcare …

The Experience Of Viewing Self In The Mirror After A Mastectomy, Wyona M. Freysteinson

Dissertations

The purpose of this study was to talk with women who have had a mastectomy in order to discern the experience of viewing self in a mirror post-operatively. More specifically, the study sought to describe the experience from both a structural and a phenomenological perspective. The question guiding the study was: What is the experience of viewing self in the mirror after a mastectomy? Twelve women, who had a mastectomy 3-12 months prior to participation in the study, discussed their experiences of viewing self in mirror in audio-taped conversational interviews. A structural analysis was performed on each transcript, followed by …

The Biopsychosocial Model Of Metabolic Syndrome Among U.S. Adults, Jennifer L. Saylor

Dissertations

The Metabolic Syndrome (MetS) is a cluster of medical disorders (obesity, hypertension, dyslipidemia, and insulin/resistance/glucose intolerance) that characteristically occur together in individuals. The prevalence of MetS continues to increase in the U.S. and increases the risk of type 2 diabetes, cardiovascular disease (CVD), and mortality. Little research uses a theoretical model to identify direct or indirect contributions to MetS and predictors to MetS. Identifying the factors that influence MetS in a national sample is necessary to understand targets for intervention to prevent the MetS and its sequelae.

This study tested a hypothesized conceptual model of the biopsychosocial factors associated with …

The Life History Of Colice Caulfield Sayer And The Effects Of Generational Loss, Melissa Mcintire Sherrod

Dissertations

The study of the life history of Colice Caulfield Sayer explored the ways in which Colice's experiences changed the lives of her family and what was meaningful to them about these events. The purposes of the study were to provide an understanding of the effects of family experiences, to gain insight into the meaning of family loss and to demonstrate the use of qualitative interviewing to promote a deeper understanding of human behavior. Audiotaped, open-ended qualitative interviews with Colice's children and grandchildren provided individual interpretations of the generational effects of family loss. Through the inclusion of personal notes and poetry, …