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Temporal And Functional Cortical Aspects Related To Mirror Visual Feedback During Target-Directed Movement In Healthy And Stroke Individuals, Maryam Rohafza

Dissertations

Stroke is the leading cause of disability in the United States (American Heart Association, American Stroke Association) affecting 800,000 individuals annually (i.e., one person every 45 seconds). Therapy for stroke often uses repetitive task practice, which is difficult to perform for patients due to impairment. Mirror visual feedback (MVF) based rehabilitation uses the effect of observing the mirror reflection of volitional movement of one limb, to activate visuomotor brain areas that process movement of the opposite limb. In persons with hemiplegia due to stroke, exercising the less affected limb while observing its reflection, perceived by them as the motion of …

Adult Ambulatory Care Visits For Illness-Related Complaints In The United States, 1995/1996, Ann M. Williamson

Dissertations

The purpose of this study was to describe the characteristics of a subset (illness-related complaints) of adult ambulatory care visits during 1995 and 1996 to physician offices (MDO), emergency departments (ED), and outpatient departments (OPD), using a nationally representative sample. Additionally, visits for selected illness conditions (chest pain, abdominal pain, asthma, and depression), visits resulting in hospital admission, and visits occurring in the ED were analyzed using logistic regression to construct utilization profiles.

Seeking Life Balance: The Perceptions Of Health Of Cambodian Women In Resettlement, Olivia Catolico

Dissertations

This grounded theory study was an inquiry into the perceptions of health of Cambodian women in resettlement and the conditions that influenced their perceptions. Few studies of Cambodian women who escaped political conflict exist. Cambodian women were among the waves of Southeast Asian refugees who have resettled in the United States. The sequelae of significant life trauma upon the health of Cambodian women in resettlement have received little attention in the nursing literature. There is less information about their perceptions of health in resettlement as their beliefs about health and illness causation contrast with those of Western health care providers.

The Relationship Between Health Locus Of Control, Perceived Self-Efficacy, Hardiness, And Recovery In Schizophrenia, Anne W. Bender

Dissertations

Approximately 1 out of 100 persons in the United States will be diagnosed as schizophrenic at some point in their lives. As an illness with onset in late adolescence or early young adulthood, schizophrenia has been described as having a homogeneous course of long-term chronicity. Recent literature has delineated more heterogeneity of outcome, but studies identifying factors related to recovery have been sparse. Using as a theoretical framework the stress-vulnerability model of schizophrenia, and concepts from social learning theory and existential psychology, this study examined the relationship between health locus of control, perceived self-efficacy, hardiness, and recovery, and which would …

Exploration Of The Decision-Making Process To Access And Utilize Healthcare In Women Veterans, Corinne A. Lee

Dissertations

Previous research described the barriers that women veterans (WVs) encounter during their decision-making to access and utilize healthcare services (Hamilton et al. 2013; Haskell, 2011& Washington et al. 2011).The decision-making process for accessing and utilizing healthcare in VA and non-VA health systems by women veterans is not described in the literature. Using a grounded theory approach (Strauss et al., 1998) and embedding the Decisional Conflict Scale(DCS) to assess for decisional conflict, this study explored how and why women veterans decide to access and utilize healthcare.

The Influence Of Behavioral Cues On Immunization Practices Of Elders, Lynn A. Chilton

Dissertations

A quasi-experimental intervention study was designed to compare the influence of behavioral cues on immunization practices of elders. Elders also were surveyed to determine immunization practices related to influenza and pneumonia and to ascertain reasons for under-immunization among this age group. The Neuman Systems Model and the Health Belief Model were used as conceptual frameworks to guide the study. Data were collected utilizing a Demographic Survey (DS) and an Immunization Survey (IS).

Information Retrieval Of Self-Care And Dependent-Care Agents Using Netwellness, A Consumer Health Information Network, Linda C. Rieg

Dissertations

Since the earliest times a major focus of nursing has been to provide health care information to those in their care. The purpose of this exploratory study was to investigate information retrieval of consumers using NetWellness ®, a community health information network. Using Orem's Self-Care Deficit Nursing Theory, six research questions were developed. These questions were designed to determine if there were any differences in information retrieval based on whether the participants were self-care agents or dependent-care agents, or whether differences were based on basic conditioning factors identified as age, gender, race, household income and educational levels. In addition questions …

An Investigation Of The Relationship Between Time Preference And Developmental Stage In The Lives Of Adult Females, Karen E. Forbes

Dissertations

Research has been conducted documenting the occurrence of biological rhythms in all aspects of life. Researchers have shown that an individual's time preference for morningness or eveningness parallels some biological rhythms. Others have shown that biological rhythms are stable across the life span. Preliminary studies have been conducted on adult developmental stages. These studies have shown that adults, like children, travel through distinct stages. This study arose when many women reported being an evening type when they were young adults, but changed to being a morning type when they had children. This study was designed to investigate whether a woman's …

The Effects Of Pattern Recognition Based Simulation Scenarios On Symptom Recognition Of Myocardial Infarction, Critical Thinking, Clinical Decision-Making, And Clinical Judgment In Nursing Students, Susan A. Walsh

Dissertations

In the United States nearly 1 million annual new and recurrent myocardial infarctions (MI) occur with 10% of patients hospitalized with MI having unrecognized ischemic symptoms. Inexperienced nurses are expected to accurately interpret cardiac symptom cues, possibly without ever having experienced care of patients with MI, yet have been shown to be less able to classify symptom cues and reach accurate conclusions than experienced nurses. The purpose of this study was to test an educational intervention using theories of pattern recognition to develop CT in MI and improve nursing students' clinical decision-making and clinical judgment using high fidelity patient simulation. …

Transitioning From Hospital To Home: An Evidence-Based Approach In Heart Failure Patients, Donna G. Flynn

Dissertations

Heart Failure (HF) is a complex syndrome affecting millions of Americans and is considered to be a major public health threat. It is responsible for $33.2 billion dollars in healthcare spending annually. The Center for Medicare and Medicaid Services (CMS) will no longer reimburse hospitals for readmissions within 30 days of hospital discharge for a primary diagnosis of HF. Patients diagnosed with HF often receive care from multiple practitioners across multiple settings. Crucial information is frequently lost when patients transition from one care site to another. This evidence-based practice project examined the effect of an evidence-based bundle to provide a …

Quality Of Life, Self-Transcendence, Illness Distress, And Fatigue In Live Transplant Recipients, Kathy A. Baker

Dissertations

This cross sectional study described the relationship between quality of life (QOL) and self-transcendence (ST) in liver transplant recipients. Self-transcendence is a dynamic process reflecting spiritual growth and maturity and a broadening of personal perspective during challenging life experiences. Illness distress, fatigue, age, gender, marital status, education, and time-since-transplant were also investigated relative to QOL.

The Moral Certainty Or Uncertainty Of Nurses Regarding End-Of-Life Treatment Decisions, Mary Ellen Wurzbach

Dissertations

Much has been written about the importance of decision-making in nursing ethics, but few research studies have been completed which examine nurses' ethical decision-making. In order to address this absence of research, two concepts that are integral to nurses' ethical decision-making were analyzed: moral certainty and moral uncertainty. These concepts were studied in the context of the issue of withholding or withdrawing artificial nutrition and hydration. This issue was chosen as an exemplar of issues about which nurses feel morally certain or uncertain. The research questions addressed by this research were: (a) Are nurses morally certain or uncertain about whether …

Kids These Days: Increasing Youth Engagement In Community Heritage And Social Justice Through The Implementation Of A Youth Participatory Empowerment Model, Melanie Canaday-Talley, Lindsay Clemens, Amanda J. Dworak Rowland, Mary Gillis, Curlinda Mitchell Blacksheep, Jancarlos Jose Romero

Dissertations

The purpose of this co-authored, qualitative, action research study was to examine how to empower youth to become active participants in their communities. Citizen engagement in community and public life is vital to a healthy democracy and young people have a unique place in community citizenry, but are often dismissed or excluded from decision-making. The research team developed a model, the Youth Participatory Empowerment Model (YPEM), to guide youth through a process of identifying and engaging a community heritage or social justice need in their community. The team assembled a guidebook of activities to engage groups in difficult self, group, …

The Use Of The Re-Engineered Discharge (Red) Toolkit On Patients Undergoing A Hip Or Knee Joint Replacement Or Revision, Kathleen Mitchell

Dissertations

Discharge planning plays a crucial role in the transition of care. Despite the expenditures dedicated towards discharge planning, organizations struggle with reducing 30-day readmission rates, improving patient satisfaction scores, and length of stay. Poorly coordinated care transitions account for nearly one-fifth of Medicare readmissions within 30 days' post discharge. It is estimated that more than 75% of these are preventable at an estimated cost savings of $12 billion per year. The evidence-based practice improvement project instituted a discharge planning process using the Re-Engineered Discharge (RED) Toolkit on patients undergoing a hip or knee joint replacement or revision. The RED Toolkit …

Nurse Family Member Perceptions Of Patient Death And Nursing Care After Withdrawal Of Life-Sustaining Treatment, Deena Drake

Dissertations

Purpose/Aims: This pilot study explored nurse family member perceptions of nursing care and patient quality of death and dying during and after withdrawal of life-sustaining treatment within Intensive Care Units (ICU).

Rationale: Past research that examined physician, nurse, and family member experiences of End-of-Life (EOL) care within the ICU found significant differences between the three groups.

Background: Approximately 500,000 people die within an ICU each year in the United States. End-of-Life and Palliative Care programs focused primarily on physician interventions to improve quality of EOL care have had little impact on family member perceptions of quality of care or patient …

Patient Perception Of Fall Risk And High Fall Risk Screening Scores, Nicole D. Pena

Dissertations

Purpose: The purpose of the study was to describe the relationship between patient

perception of fall risk and high fall risk screening scores.

Background: Despite mandated government regulations and multiple hospital

interventions, falls are the most prevalent adverse event among hospitalized patients and

are the leading driver of health care costs, amounting to over $30 billion each year with

projections to double by 2030. Recently, perception was identified as a major component

in preventing falls. A dearth of research examines the relationship between a patient’s

perceived risk for falls and standardized fall screening scores.

Methods: A descriptive correlational design with …

Perinatal Mood And Anxiety Disorders, Stigma, And Social Support Among Postpartum Women, Ellen K. Fleischman

Dissertations

Purpose/Aims: The purpose of this descriptive, correlational, cross-sectional study was to examine the relationships among perinatal mood and anxiety disorder (PMAD) symptomatology, select demographics, stigma of mental illness, and social support, among inpatient postpartum women. Rationale: PMADs affect as many as 21% of childbearing women, yet these disorders are identified and treated less than half the time. There is a gap in the literature regarding the relationships among stigma, social support, and PMADs in postpartum women.

Conceptual Basis/Background: Despite recommendations from professional organizations, screening for PMADs is not consistently completed using a valid, reliable instrument. Stigma contributes to the low …

Patient’S Utilization Of Health Information Technologies For Disease Self-Management, Mahmoud Hamzeh Altawalbih

Dissertations

Background: The rapid growth of Health Information Technologies (HITs) provides

patients with greater opportunity to take control over their health. HITs utilization has

been proven to be a critical component of disease self-management and can result in

positive outcomes. Its widespread adoption and utilization is still relatively low among

patients with chronic disease. It is important to understand the factors that may impact

HITs utilization, such as the perceived Task-Technology Fit (TTF). A very limited

number of studies have examined the relationship between HITs utilization and the

perceived fit between task and technology in the context of TTF theory.

Aims/ …

Adult Postoperative Open-Heart Patients: Anemia And 30-Day Hospital Readmission, Lindsey Ryan

Dissertations

Background. In 2013 alone, more than 4% (3.9 million) of patients discharged from a hospital were readmitted. Anemia following a surgical procedure is associated with early hospital readmission.

Purpose/Aims. The following were specific aims of this dissertation:

• Aim 1. To develop an operational definition of the term condition-based maintenance as applied to health care and discuss the applicability and effectiveness of condition-based maintenance within health care.
• Aim 2. To identify the number of adult patients undergoing elective open-heart surgery with preoperative anemia.
• Aim 3. To examine the relationship between preoperative anemia, sociodemographics, and 30-day hospital readmission rates among postoperative open-heart …

The Lived Experience Of Discharged And Readmitted African Americans With Chronic Obstructive Pulmonary Disease To A Safety-Net Hospital, Kiiyonna Jones

Dissertations

Background:Chronic Obstructive Pulmonary Disease (COPD) is a debilitating respiratory disease that negatively affects the quality of life of those affected and has been a major contributor to the continuous rise in healthcare cost in the Unites States (Guarascio, Ray, Finch, & Self, 2013; National Heart Lung and Blood Institute, 2009; Shavelle, Paculdo, Kush, Mannino, & Straus, 2009; Scott, Smith, Sullivan, & Mahajan, 2001). In 2014, Centers for Medicare & Medicaid Services (CMS) identified COPD as an applicable condition to the Hospital Readmissions Reduction Program, which penalizes healthcare organizations having readmissions higher than the national average. COPD is the second …

Delirium In Long Term Care Rehabilitation Residents: A Correlational Retrospective Study, Rebecca Lerma-Kjonegaard

Dissertations

Abstract Background: Delirium is associated with devastating outcomes, cognitive loss,

decreased function and an increase risk of mortality which affects patients and places a heavy burden on family and the healthcare system. The purpose of this study was to describe the relationship between select demographics, clinical characteristics, CHART- DEL-derived delirium diagnosis and ICD-10 coded discharge delirium diagnoses among Long Term Care (LTC) rehabilitation residents.

Method: A retrospective correlational design from174 LTC rehabilitation residents age 65 years or older using EMR and hard copy charts. The setting was a Southern California community hospital-based 100-bed LTC. Abstracted data included demographic characteristics (age, …

Prenatal Care Education For Women Experiencing Unplanned Pregnancy, Sharon T. Heskitt

Dissertations

This project suggested that the Prenatal Care Education Module (PCEM), a series of three brief videos lasting a total of ten minutes, may be an effective way to educate women experiencing an unplanned pregnancy about the importance of prenatal care for themselves and their babies. To assess the effect of the PCEM, the Brief Pregnancy Perception Questionnaire (B-PPQ), a tool adapted from the Brief Illness Perception Questionnaire (B-IPQ) (Broadbent, Petrie, Main & Weinman, 2006) was employed. The B-PPQ assessed participants' health care needs, their understanding of pregnancy, their emotional response to pregnancy, and current contact with a prenatal health care …

Variables Affecting Quality Of Life And Adherence In Adults With Type 2 Diabetes, Michele L. Poradzisz

Dissertations

The purpose of this two-phase mixed methods study was to examine the influence of selected variables on quality of life (QOL) and adherence to diabetes regimen in a convenience sample of adults with Type 2 diabetes. Participants were all clients of the same American Diabetes Association-recognized diabetes center and had previously received comprehensive diabetes education.

Impact Of Managed Care On Health Care Delivery Practices As Perceived By Health Care Administrators And Practitioners, Mari F. Tietze

Dissertations

Managed care has had a significant impact on many components of the U.S. health care delivery system such as cost effectiveness, access to care, and quality of care. These changes have affected how administrators and practitioners perceive the impact of managed care on health care delivery practices. The problem of this study was to explore whether health care administrators and practitioners perceive the impact of managed care on health care delivery practices differently and to explore which organizational variables explain the difference. A descriptive, cross-sectional survey design was used for the target population of administrator and practitioner health care professionals …

Elements Of A Decision Support System For Chief Nurse Executives, Amy J. Barton

Dissertations

The objective of this nursing informatics research was to identify data elements for a decision support system (DSS). The specific purposes were to (a) prioritize issues for strategic planning decisions that are expected to involve chief nurse executives during the next 10 years; (b) determine the information required to reduce uncertainty in making strategic decisions; and (c) translate the information required for strategic decisions into specific data elements to be included in a DSS. The methodology employed was a modification of the Policy Delphi using two rounds with a national sample of 240 nurse executives. The questionnaire consisted of 20 …

Predictors Of Nurse Adoption Of A Computerized Information System As An Innovation, Carol A. Romano

Dissertations

Computerized information systems are viewed as innovations in the health care delivery system and are used by nurses to support the management of clinical and administrative information. The development, implementation and use of computerized information systems are viewed as predictable activities in the future health care environment. Adoption of these innovations is critical to the achievement of improved information management. Nurses are challenged to direct these activities to achieve efficiency, effectiveness and productivity in the delivery of health care services. The adoption of information systems is envisioned as a vehicle to enhance and improve the quality of information and ultimately …

Toward A Theory Of Home Health Care Nursing Practice, Leslie J. Neal-Boylan

Dissertations

Current theories of home health nursing practice in the United States are not based on research. The purpose of this study was to build a substantive theory of home health nursing practice using a qualitative methodology. A grounded theory study of 26 home health nurses practicing in the tri-state area of Virginia, Washington, D.C., and Maryland was conducted to explore how home health nurses define their practice. The nurse participants varied in nursing background, level of education, home health nursing experience, age, race, position within the organization, and the type of organization that employed them. Unstructured interviews that were audiotaped …

The Relationship Of Leadership Patterns To Usage Patterns And Suitability Of Information Technology For Decision-Making Of Nursing And Non-Nursing Academic Administrators In Higher Education, Martha J. Morrow

Dissertations

This dissertation describes the relationship of leadership patterns to computer usage patterns and the suitability of information technology for decision making among academic administrators in higher education in the Nursing departments and Arts and Science Departments of universities in the United States and its provinces.

Increasing Parental Competency By Demonstration Of Newborn Behavioral Characteristics, Mary Jane Hamilton

Dissertations

The purpose of this study was to investigate the question: Does an explanation, demonstration, and return demonstration of the Infant Behavioral Assessment Record by a nurse and new parents increase maternal and paternal observed and perceived parental competence?

Relationships Between Pressure Ulcer Risk Potential, Nursing Interventions, And Pressure Ulcer Presence, Suzanne S. Prevost

Dissertations

The development of pressure ulcers is a common and expensive problem within acute care hospitals. Nurses are expected to identify patients at risk for pressure ulcers and provide preventative interventions accordingly. The purpose of this descriptive correlational study was to identify what preventative nursing interventions were being used, and to examine relationships between pressure ulcer risk, nursing interventions, and pressure ulcer presence in two acute care facilities. Bloch's (1975) Framework for the Evaluation of Nursing Care and Braden's (1987) Conceptual Schema for the Development of Pressure Sores provided the conceptual framework for the study.