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The Effects Of Historical Alcohol Use On Neuropsychological Functioning In Older Adults Following A Traumatic Brain Injury, Ryan Sever

Dissertations

The present study aimed to determine the effects of alcohol abuse and dependence in long term functioning of older adults who have experienced a moderate to severe traumatic brain injury. The research question being answered in the current study was if a history of alcohol abuse or dependence would worsen neuropsychological functioning in older adults who experienced at least one moderate to severe traumatic brain injury. Participants of the study were selected from the more extensive database provided by the Brain Aging in Vietnam War Veterans (DOD-ADNI) database. All participants were Vietnam War veterans between the ages of 61 and …

Social Support And Relationship Expectations In Mothers Of Sick And Well Newborns, Sherrilyn D. Coffman

Dissertations

The purpose of the study was to investigate if social support and fulfillment of relationship expectations were related to personal outcomes and quality of relationships for mothers of sick and well newborns. The study tested Levitt's model of close relationships and drew upon Kahn's and Antonucci's work in social support. Emphasis was placed on two support figures: the person identified by the mother as the closest or most important in her network, and one nurse, perceived by the mother as closest or most important in that role.

The Risks Of Methemoglobinemia With The Use Of Two Antimicrobials In Low Birth Weight Infants, Denise J. Poirier Maguire

Dissertations

The purpose of this study was to determine the degree of risk of methemoglobinemia and extent of skin breakdown when 0.5% chlorhexidine was used as a topical antimicrobial in a population of low birth weight (LBW) infants.

Collaborative Practice By Nurse Practitioners And Physicians In Long-Term Care Homes: A Mixed Methods Study, Faith C. Donald

Dissertations

To understand how nurse practitioners (NPs) and physicians (MDs) collaborate with one another to provide resident care in Ontario long-term care homes (LTCHs).

Breast Cancer Risk Perception, Knowledge, Attitudes, Beliefs And Screening Behaviors Of Chamorro Women In Guam, Teofila P. Cruz

Dissertations

Breast cancer is a serious public health issue in Guam and in the world. Chamorro women in Guam have the highest incidence and mortality rates of breast cancer among other ethnic groups of women living in Guam. Early detection reduces breast cancer morbidity and mortality. Little is known regarding factors associated with Chamorro women's breast cancer screening behaviors.

This qualitative descriptive study was designed to obtain a straight forward description of perspectives and insights of Chamorro women in Guam ages 45 - 65 years, about their breast cancer risk perception, knowledge, attitudes, beliefs and breast cancer screening behaviors.

Predictors Of Distress During The Breast Diagnostic Period, Mariann Mayhew Harding

Dissertations

Breast cancer is the most common cancer diagnosed in women and the leading cause of cancer deaths among women worldwide (Warner, 2011). Mortality from breast cancer in the United States has been decreasing in part due to advances in therapy and the detection of the disease at earlier stages. As a result, more than 1.6 million U.S. women will undergo a breast biopsy in 2013 with approximately 232,340 of these being diagnosed with cancer. Although distress in women undergoing a breast diagnostic evaluation has been recognized as having the potential to alter treatment outcomes in those diagnosed with cancer, few …

Congruence Of Illness Representation Between Older Adult Heart Failure Patients And Their Spouses Or Partners And Its Relationship To Adherence Behavior, Ola H. Fox

Dissertations

Intentional nonadherence to prescribed treatment has been documented as a leading contributor to the deleterious outcomes observed for many heart failure patients. Investigation of adherence from the perspective of the patient and spouse/partner offers a different approach to the complexities of intentional nonadherence. The purpose of this study was to examine the relationship between patients' and spouse/partners' illness representations or perceptions of the symptoms, cause, time-line, consequences, and control of heart failure and the patients' adherence behavior.

The Effect Of Mirthful Laughter On Stress And Natural Killer Cell Cytotoxicity, Mary P. Bennett

Dissertations

A survey of local cancer patients revealed that humor was a frequently used complementary therapy which helped them cope with stress. Introductory research has suggested that humor can decrease the perception of stress and perhaps improve the immune system's response to disease causing agents. However, there are a very limited number of rigorous intervention studies which document these effects. Using psychoneuroimmunology as a framework, the effect of mirthful laughter on stress and natural killer (NK) cell cytotoxicity was measured. Since the beneficial effect of laughter on NK activity has limited documentation in healthy males and no documentation in females, a …

Managing Personal Integrity: A Grounded Theory Of Elderly People Surviving Hospitalization, Cynthia S. Jacelon

Dissertations

The goal of this grounded theory research was to develop a substantive theory of the social processes engaged in by elderly people while in the hospital. The derived theory is entitled Managing Personal Integrity. Within the theory, Personal Integrity is defined as a dynamic, intrinsic quality of the self which has properties composed of physical and psychological attributes.

Towards A Context-Sensitive Theory Of Nursing Ethics: Classification And Comparison Of Nurses' Narratives From Four Time Periods (1934, 1979, 1989, And 1995), Judith Marlene Wilkinson

Dissertations

This two-phase, descriptive study used qualitative content analysis of nurses' narratives from 1934, 1979, 1989 and 1995 to determine whether the Wilkinson bifocal model of moral problem construction could account for all the different kinds of moral problems nurses described.

Hospital Discharge Preparation For Homeward Bound Elderly, Diane Storer Brown

Dissertations

Hospital discharge planning (DCP) for the elderly is a research priority. Within the cost conscious healthcare environment, there is concern about short hospitalizations and responsibility shifts to patients for continued health care. While Health Maintenance Organizations (HMO) provide care for many elderly, there is no research on DCP outcomes for elderly HMO patients. The purpose of this study was to explore outcomes of DCP for elderly medical patients, satisfaction, service utilization, and relationships among the hospital environment, patients, and discharge outcomes. This study utilized a descriptive correlational design within an HMO hospital.

Correlates Of Desire For Children Among Black Women With And Without Hiv Infection, Yvonne Wesley

Dissertations

HIV infection poses a threat to women, children and society in general. Public health officials recommend that women with HIV avoid pregnancy, however these recommendations do not consider women's desire to bear children. Many authors suggest that desire for children, especially among Black women with HIV, is related to sense of self. This study examined whether there is a relationship among self-esteem, self-efficacy and desire for children, and compared these relationships between 52 Black women with HIV infection (mean age 34) and 46 Black women without HIV infection (mean age 31).

A Construct Validity Study: Accountability For Nursing Care, George D. Velianoff

Dissertations

The purposes of this study were to: (1) expand upon the pilot study by Velianoff (1983) to define more precisely professional accountability in providing nursing care, (2) to test the construct validity of a tool developed to measure the constructs, and (3) contribute to a better understanding of accountability in nursing. The theoretical and conceptual bases of the study included: (1) Velianoff's (1983) pilot study, (2) French and Ravens (1960) Social Bases of Power, (3) Hirschman's (1970) Exit, Voice and Loyalty model, and (4) Rotter's (1954) Social Learning theory dealing with Locus of Control. Four hypotheses were tested.

Gaining A Voice: A Study Of The Breastfeeding Experiences Of A Select Group Of Educated, Low-Income, Minority Women Supported By Peer Counselors, Maryanne Phyllis Locklin

Dissertations

This grounded theory study describes the experiences of a small select group of educated, low-income, culturally diverse women who were supported by peer counselors/breastfeeding advocates in their communities as they attempted to breastfeed. The study explores their issues and concerns. In-depth interview data from seventeen women (ten African-American and seven Latina) were analyzed, using constant comparative analysis. Findings from the study indicated that the perception of successful breastfeeding can have an empowering effect on women when support for their endeavors are gender--and culturally--appropriate, The five themes that emerged as primary descriptors of the experience were Making the Discovering, Seeking a …

The Perspectives Of The Woman/Nurse/Executive Working In The Managed Care Environment Of Southern California, Cheryl L. Brandi

Dissertations

The purpose of this study was to explore the perspectives of the woman/nurse/executive working in the managed care environment of Southern California. This research was extremely timely because (a) Southern California leads the nation in managed care market penetration, (b) changes in health care financing have resulted in a prolific expansion of nurse executive responsibilities, and (c) nurse executive experiences regarding increased responsibilities have not been researched. Role expansion impacts both male and female nurse executives, but female nurse executives must confront the dilemma of functioning in administrative domains which have been largely dominated by men. Knowledge about their experiences …

Predictors Of Glove Use By Health Care Workers, Pamela F. Levin

Dissertations

The primary aim of this study was to identify predictors of health care workers' glove use related to protective behavior. The self-protection model, an adaptation of Ajzen's theory of planned behavior, investigated the health care workers' intention to wear gloves and glove use behavior when there was potential for blood exposure. This study also ascertained if glove use varied by field of employment, geographical region, or type of work setting. A cross-sectional survey approach was used with a stratified-random sample of nurses and laboratory workers from a large midwestern state.

A Comparison Of The Nursing Costs Associated With The Implementation Of The Mandated Nurse-To-Patient Ratios In California, Shelly C. Wells

Dissertations

Nurse executives are challenged to provide adequate nurse staffing to prevent adverse patient outcomes, promote patient satisfaction and enhance nurses' job satisfaction. Historically, nurse staffing strategies have involved the use of patient classification systems, the use of time studies to predict staffing numbers and the best guesses of the nurse administrators. Collective bargaining units moved to include staffing ceilings or nurse-to-patient ratios to address staffing needs in hospitals. In 1999, the state of California signed AB394 into law requiring the implementation of mandated minimum nurse-to-patient ratios. The California Department of Health Services estimated that the mandated nurse-to-patient ratios would cost …

Addressing The Theory-Practice Gap Relative To Teacher-Perceived Knowledge Of Effective Instructional Strategies, Laura Danielle O’Quinn

Dissertations

In the field of education, a theory-practice gap occurs when research is not applied with fidelity by practicing teachers in the classroom (Ford, 2018). Student achievement is negatively impacted when teachers do not implement research-based practices consistently (Stronge, 2018). This study involved an investigation into teacher perceptions of research-based instructional strategies as a possible cause of the theorypractice gap in education. Data were collected through a mixed-methods study involving an online survey and teacher focus group interviews. The online survey was used to measure teachers’ accuracy identifying the impact level of selected research-based instructional strategies from Hattie’s (2009) meta-analysis. Survey …

Development And Testing Of A Scale To Measure Self-Efficacy For Pelvic Muscle Exercises In Women With Urinary Incontinence, Barbara S. Broome

Dissertations

The purpose of this methodological study was to: (1) develop a scale that can be used to measure perceived self-efficacy for pelvic muscle exercises; and, (2) test the scale for reliability and validity in a group of women with incontinence. The 23 item scale incorporated items from self-efficacy expectation and outcome expectation, the two domains of self-efficacy theory as they relate to urinary incontinence.

Breastfeeding Self-Efficacy In Women Of African Descent, Deborah Elaine Mccarter

Dissertations

Black women (women of African descent) have the lowest rate and duration of breastfeeding compared to other racial groups. Breastfeeding self-efficacy, defined as a mother's belief that she will be able to organize and carry out the actions necessary to breastfeeding her infant, has been shown to predict breastfeeding pattern and duration, but has not been studied in black women. The purpose of this study was to examine the relationship between breastfeeding self-efficacy and duration and pattern of breastfeeding. Black women (N = 155) with full-term infants who were planning to breastfeed were recruited from a large urban teaching hospital …

Self-Efficacy, Social Support, Therapeutic Support And The Initiation And Duration Of Breastfeeding In Adolescent Mothers, Deborah L. Birk

Dissertations

This longitudinal investigation examines self-efficacy, social support and therapeutic support as predictors of initiation and duration of breastfeeding in adolescent mothers. It proposes that prenatal levels of self-efficacy, social support and therapeutic support are significant predictors of breastfeeding initiation in adolescent mothers. It also proposes that postpartum levels of these variables are significant predictors of the number of days breastfeeding after delivery in adolescent mothers.

Factors That Contribute To Anticipated Turnover Among Civilian Registered Nurses Employed In United States Army Hospitals, Carol Ann Huebner

Dissertations

In this study, selected factors believed to influence anticipated turnover among civilian registered nurses employed in Army hospitals were examined. Based on a theoretical model developed from existing models of nursing turnover, independent variables were clustered into three groups: individual factors (age, education, tenure, kinship responsibility); growth need strength, initial expectations of tenure, and career intentions; and perceptions of contextual factors (workload, group cohesion, instrumental communication, job characteristics, external and internal labor market, and pay satisfaction). The theoretical model proposed that independent variables influenced the dependent variable which was anticipated turnover, either directly or indirectly through job satisfaction.

Hypertonic Lower Extremities In Infants: Correlation To Motor Function Scores At Thirteen Months Of Age, Susan Jean Brillhart

Dissertations

Exploring a large data set, hypertonicity of the lower extremities has been incidentally identified as occurring in one out of every five infants, whether term or preterm. This retrospective, longitudinal, descriptive, quantitative study examined data from 463 functionally and structurally normal infants and identified infants that were considered to be hypertonic at either hospital discharge and at one month of corrected gestational age to determine what their motor capabilities were at 13 months of age. Understanding the correlation will assist in determining whether early intervention is indicated for these infants. Multiple statistical analyses revealed no correlation between hypertonicity as a …

Understanding Reflection From The Perspective Of Baccalaureate Nursing Students, Deborah A. Greenawald

Dissertations

Across the nation, nurse educators are seeking to meet the needs of students with diverse learning characteristics within increasingly complex academic and clinical environments. One teaching-learning strategy that has been used is reflection; however, there is a notable lack of consensus among educators and researchers about the specific nature of reflection. The purpose of this study was to describe reflection from the perspective of baccalaureate nursing students. A review of the literature provided the context for the study, and was organized into four sections: Historical Perspectives, Models and Definitions of Reflection; Reflection in Nursing Practice; Reflection in Nursing Education; and …

Sex, Drugs, And Religion: A Multi-Ethnic Analysis Of Health Behaviors, Attitudes, And Perceptions Of Childbearing Women, Robin L. Page

Dissertations

Maternal health behaviors such as substance use and sexual promiscuity can put the health of mothers and their offspring at risk. Sociodemographic factors such as low socioeconomic status are also found to correlate with health risks for childbearing women. Hispanic women—especially those less-acculturated—often have sociodemographic risk factors present, but have paradoxically positive pregnancy outcomes. Healthy behaviors in addition to religiosity have been hypothesized to contribute to such positive outcomes. Past studies offer support for the positive influence of religion on healthy behaviors. The purpose of this study was to investigate the patterns and predictors of healthy behaviors and well-being of …

Collective Self-Esteem And Attitudes Toward Collaboration As Predictors To Collaborative Practice Behaviors Used By Registered Nurses And Physicians In Acute Care Hospitals, Karen D. Bankston

Dissertations

Beginning in 2000, the Institute of Medicine clearly established the importance of fostering interdisciplinary collaboration and teamwork with regard to improving patient care quality and safety in acute care hospitals. IOM documents also presented evidence of the positive impact that interdisciplinary collaboration and teamwork can have on other key dimensions of organizational performance. Interdisciplinary collaboration represents a significant issue confronting hospital and nursing executives, deans of colleges of nursing and medicine and practicing nurses and physicians. The aim of this study was to examine the extent to which collective self-esteem and attitudes toward collaboration were predictors to nurse-to-nurse, nurse-to-physician and …

Community Nursing Support For Schizophrenic Clients, Lora Humphrey-Beebe

Dissertations

Decreasing hospital stays necessitate various community supports for persons with schizophrenia. However, there is little research on the effectiveness of community-based nursing interventions for this population. A true experimental, post test only design was used to evaluate the effectiveness of a telephone nursing intervention in increasing community survival, and decreasing the number and length of stay of rehospitalizations for persons with schizophrenia.

Patterns Of Symptom Distress During The Initial Treatment Period In Three Children With Cancer, Sharron Lee Docherty

Dissertations

Childhood cancer treatment can be extremely aggressive and has been found to be more distressing and painful than the disease itself. This distress is a direct response to the symptoms caused by the side effects of treatment such as nausea, vomiting, retching, fatigue, anorexia, pain, stress, mood disturbances, and sleep alterations. Some children appear to adapt and cope well, whereas others are particularly susceptible to the physical intensity of the treatment symptoms and show physical, emotional, and behavioral manifestations of marked symptom distress. The ability to identify the symptom distress vulnerable child may be an important aspect of childhood cancer …

The Impact Of The Interim Payment System On Ohio Home Healthcare Agencies, Abigail A. Gerding

Dissertations

In order to decrease the escalating costs of home care and extend the solvency of the Medicare trust fund, major changes in home care reimbursement were mandated by the Balanced Budget Act of 1997. The Interim Payment System, required by the Balanced Budget Act, altered the method of payment for home healthcare agencies from a retrospective cost-based system to a per-episode aggregate limit as home healthcare agencies prepared for a Prospective Payment system to be implemented by October of 2000. This study examined the impact of the Interim Payment System on home healthcare agencies across Ohio. As a retrospective, explanatory …

Using Second-Transitionary Phase Cognitive Factors To Predict Adherence To A Walking Routine, Donna B. Konradi

Dissertations

The purpose of the study was to test a regression model designed to predict adherence to a walking for exercise routine. An extension of the Second-Transitionary (Adherence) phase of the Natural History of Exercise Model, referred to as the Natural History of Walking for Exercise Model (NHWEM) was the organizing framework.