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Mixed-Method Study Exploring International Students’ Career Readiness At A Four-Year Private University In The Midwest, Chloe Bonnand

Dissertations

This study explored international students’ career readiness in a four-year, private university in the Midwest. In order to measure career readiness, the researcher reviewed three factors: financial support, academic major, and country of origin. International students graduating in May 2018 received a survey from the researcher on career readiness. A total of 38 students completed the survey. The final question of the survey was an invitation to participate in an individual interview and/or a focus group. The qualitative data from the survey showed that financial support impacted international students’ career readiness. International students with financial support were more prepared to …

Increasing Patient Engagement In The Pre-Operative Patient Population, Toni Morris

Dissertations

The United States (U.S.) spends more revenue than any other industrialized nation on healthcare yet research indicates this does not equate to delivering the safest or most efficient quality patient care (Riehle & Hyrkas, 2012). Patients within the U.S. healthcare system have been the beneficiaries of cumbersome processes riddled with redundancy, waste, and discordant care (Institute of Medicine [IOM], 2001). Because of this data, healthcare reform to improve the quality and efficiency of patient care delivery has been the topic of debate over the past several decades, on both a national and global scale. Several organizations, coalitions, and groups have …

Early Identification And Intervention In Patients With Atrial Fibrillation Using An Implantable Cardiac Monitor To Significantly Improve Guideline-Based Anticoagulation Therapy In An Outpatient Cardiology Clinic, Lisa Alvarez

Dissertations

The purpose of this research was to (a) examine the demographics of patients receiving care in an outpatient cardiology clinic, (b) describe the relationship between the atrial fibrillation (AF) and other variables (e.g., BMI), (c) examine the frequency and the length of time to AF diagnosis in patients implanted with an implantable cardiac monitoring (ICM) device, (d) observe provider patterns of treatment with oral anticoagulants (OACs), and (e) investigate documented considerations to either diagnose or rule out OSA in a group of outpatient AF patients in a cardiology clinic.

Background: AF is largely undiagnosed but can cause major morbidity and …

Nursing Informatics And Hospital Decision-Making: The Use Of Information Generated By An Automated Patient Classification System, Mary L. Botter

Dissertations

Automated patient classification systems (PCS) are widely used throughout the United States. Their intended purpose is to generate information to be used in decision making by and for nurses and nursing services. Expenditures for this type of information technology are significant, yet no previous research had been conducted regarding the actual use of information generated by an automated PCS. Thus, the purpose of this research was to describe if, how, and why information obtained from an automated PCS is used in hospital decision making. A qualitative design was used for this organizational case study.

Interprofessional Healthcare Provider Education On Neonatal Abstinence Syndrome, Mary Puchalski

Dissertations

The rapidly increasing incidence of Neonatal Abstinence Syndrome (NAS) in the U.S. has been identified as a national healthcare crisis. An evidence-based practice change project, ";Interprofessional Healthcare Provider Education on NAS"; (IHPEN) was designed to implement a protocol to increase consistency in treatment for infants with NAS and provision of healthcare provider education to increase knowledge regarding NAS, as well as sensitivity to the signs and symptoms of withdrawal. The target population included all healthcare providers in the Neonatal Intensive Care Unit and Mother/Baby Unit of a large, urban, not-for-profit perinatal center. The project was developed in response to a …

Self-Reported Health Status And Health Determinants In Low Income Midlife Women Aged 40 To 64, Teresa L. Barry Hultquist

Dissertations

The purpose of this descriptive longitudinal study was to describe (a) self-reported health status, (b) the relationship between self-reported health status and individual, environmental, and system health determinants, and (c) changes over time in self-reported health status and health determinants in midlife low income women.

The Lived Experience Of Breastfeeding For Women With Perinatal Depression, Beth A. Pratt

Dissertations

Exclusive breastfeeding for at least 6 months provides numerous infant and maternal benefits. Yet mothers with risk factors, such as lower education, lower socioeconomic status, younger maternal age, planned cesarean birth, and anxiety and depression, are more likely to stop breastfeeding in the early postpartum period. Few studies have focused on perinatal depression as a risk factor for breastfeeding cessation. To tailor effective interventions, nurses must first understand the lived experience of breastfeeding for mothers at risk for perinatal depression. A descriptive phenomenological study was conducted to elucidate the experience of breastfeeding for mothers with perinatal depression. The study was …

Adolescent Motherhood: The Human Agency Perspective, Sharon L. Dormire

Dissertations

The purpose of this study was to develop and test a causal model a priori. The mediating influence of self-esteem in the relationship among the sociocultural variables of race, social status and family relationships, perception of motherhood, and pregnancy in adolescent females was examined. The Human Agency Model of Behavior developed by the researcher was used as a framework to explore interactions between the variables. In this model, the individual is shown as a self agent in determining behavior.

Spirituality In The Homebound Elderly, Mary Rosita Brennan

Dissertations

Spiritual care is a requirement of holistic nursing care. The spiritual dimension has been identified as a means for the elderly to cope with the problems of life that result from losses and longevity. The purpose of this descriptive study was to explore the role of spirituality in the homebound elderly and specifically to examine its relationship to Erikson's stage of integrity versus despair. One hypothesis was proposed: the achievement of integrity versus despair in the homebound elderly is positively related to the level of spirituality. The quantitative component incorporated three questionnaires (Demographic Data Form, Spirituality Assessment Guide, and Lifeview …

Developing An Explanatory Model For Cognitive Impairment In Mild Traumatic Brain Injury, Gayle H. Dasher

Dissertations

Nearly 2 million mild traumatic brain injuries occur annually and cognitive impairment is strongly associated with poor neurobehavioral performance. Identifying variables that influence the development of cognitive impairment could lead to the development of therapies designed to improve cognitive performance in at-risk populations. The theoretical framework used suggests that neurological factors, physical factors, psychological factors, objective cognitive deficits, and subjective cognitive deficits influence cognitive impairment. Specific aims were: (1) test the correlational relationships among the independent variables (neurological factors, physical factors, psychological factors, objective cognitive deficits, subjective cognitive deficits) and the dependent variable, cognitive impairment; and (2) develop a model …

Influences Of Nutritional Food Label Understanding On African American Women With Obesity, Cynthia Jean Hickman

Dissertations

Nutritional food label understanding (NFLU) in African American Women (AAW) is a philosophy that addresses obesity. Public health efforts have implemented nutritional and caloric information to packaged and restaurant foods to improve nutrient and calorie literacy. Research suggest NFLU might have a minimal effect on reducing obesity. However, it is not known how obese AAW born during the baby-boom era (51 to 64 years of age) perceive NFLU in relation to their dietary behaviors. The purpose of this phenomenological study was to understand the lived experience of obese AAW regarding NFLU from a cognitive and behavioral perspective.

Utilization Of Care Coordination Among Children With Special Needs In The 1994 National Health Interview Survey On Disability Phase Ii, Barbara J. Kruger

Dissertations

Care coordination helps families of children with special needs obtain a variety of services and manage communication among providers. Some families coordinate care themselves, while others receive assistance from professionals. Health care system changes are making these children less visible, and therefore at-risk for not receiving care coordination. A key question is how to identify families who need care coordination. Research about use of care coordination is sparse, and no generalizable method exists to identify which families require coordination. One aim of our study was to explore the differences among child and family factors and the use and need for …

Sociocultural, Physiologic, And Psychologic Variables That Influence Pain In The Fibromyalgia Patient, Linda Carol Hughes

Dissertations

It is estimated that fibromyalgia, a chronic condition in which pain occurs in 98% of the patients, can be found in 3- to 6-million American adults with females as the majority of those suffering. The purpose of this study was to determine variables that influence pain in women with fibromyalgia. The study's conceptual framework, based on Melzack and Casey (1968) and fibromyalgia literature, depicts the influence of three domains of variables on pain: sociocultural (i.e. age, education, ethnicity), physical (i.e. activity; comorbidity such as pelvic pain; flare-up; physical trauma; sleep-wake disturbance; fatigue; physical fitness) and psychologic (i.e. depression).

Qualitative Inquiry Of Nurse Educators Transitioning From Classroom To Online Teaching, Barbara C. Sinacori

Dissertations

In response to the Institute of Medicine (IOM) recommendations of meeting the goal of 80% of RNs prepared at the BSN level by 2020, an increase in graduates from RN-to-BSN completion programs must occur. One approach to meeting the IOM goal included recommending nursing schools offer defined academic pathways beyond articulation agreements and promote access for nurses to higher education. This goal can be met through online education, which is an effective way to reach students that are more diverse. Online education, however, requires a different pedagogy than the traditional classroom. Online education, defined as the educational process where the …

Experiences Of Homeless Vietnam Veterans In Deciding To Access Or Not Access Health Care, Susan K. Lee

Dissertations

Homeless Vietnam Veterans (HVV) report their health status as poor, indicating a multitude of health concerns, including physical and psychological problems, post-traumatic stress disorder (PTSD), and alcohol or drug dependencies. Prompt attention to health care may improve the prognosis; however, HVV tend to delay seeking medical attention. The purpose of this study was to explore the process utilized by HVV to make the decision to access or to not access health care services. According to inclusion criteria of the study, all participants served in the US military during the Vietnam War.

Understanding Interdisciplinary Communication And Collaboration Among Physicians, Nurses, And Unlicensed Assistive Personnel, Gwendolyn L. Lancaster

Dissertations

The negative impact of medical errors on patient safety poses a major problem for health care providers. Since physicians, nurses, and unlicensed assistive personnel (UAPs) each provide a portion of patient care, coordination of the various treatments and interventions provided is critical to prevent errors and fragmentation of care. The significance of this qualitative phenomenology study is that it can provide information to enhance interdisciplinary communication and collaboration among physicians, nurses and UAPs, thereby positively impacting patient care outcomes. Semi-structured face-to-face, privately held individual interviews were conducted to determine how physicians, nurses and UAPs view their roles and each other's …

A Qualitative Study Of Hope And The Environment Of Persons Living With Cancer, Lucia M. Tipton

Dissertations

The purpose of this naturalistic study was to explore and describe the impact of factors from the internal and external, human and non-human environments on the hoping process utilized by persons living with cancer. Given the nature of difficulties encountered by persons living with cancer, a sense of hopefulness is deemed to be especially important in managing life with this diagnosis. Using semi-structured interviewing and a purposive sample of fifteen persons living with cancer, positive and negative factors from the total environment were explored.

Nurses' Perceptions Of Collaborative Nurse-Physician Transfer Decision-Making As A Predictor Of Patient Outcomes In A Medical Intensive Care Unit, Linda W. Higgins

Dissertations

This prospective correlational study examined nurses' perceptions of collaborative nurse-physician transfer decision making as a predictor of patient outcomes in a medical intensive care unit (MICU), adjusting for risk.

The Meaning Of Health Among Midlife Russian-Speaking Women In The United States, Lenore K. Resick

Dissertations

This study sought to explore the meaning of health among midlife Russian-speaking women from the Former Soviet Union. A hermeneutic, phenomenologic, descriptive and interpretive design following the Utrecht School was used.

The Effects Of The Mother's Appraisal Of Her Employment Status On The Preterm Infant's Development At 3 Months, Joanne M. Youngblut

Dissertations

The issue of whether maternal employment has negative consequences for the child has been frequently studied, although with conflicting results. Only one study has been reported that examined the effects of maternal employment on preterm infants. With more mothers of children under 1 year of age in the labor force and with improvements in preterm infant care, it is important to examine the effects of maternal employment for this group. In addition, with the mixed results obtained in previous studies, it is important to explicate the process by which these effects might occur.

Outcome Evaluation Of An Interdisciplinary Care Model For Children With Cystic Fibrosis, Roberta P. Pawlak

Dissertations

Cystic Fibrosis (CF) is a life-limiting, autosomal recessive inherited disease that affects approximately 30,000 individuals in the United States. Health problems of children with CF tend to be complex, requiring specialty health services. Often children with CF are cared for in CF Care Centers, where an interdisciplinary care team addresses these needs. The Cystic Fibrosis Foundation (CFF) recommends specific Clinical Practice Guidelines be applied to all patients with CF. A major gap in the CF literature is evidence of guideline application results on health outcomes. The purpose of this study was to examine the influence of an interdisciplinary care model …

The Relationship Between Cognitive Development And Decision-Making Regarding Adolescent Sexual Activity: Instrument Development And Validation, Mary E. Auterman

Dissertations

The purpose of the study was to develop and validate an instrument which measures decision making in situations which may lead to sexual activity in adolescents, and the impact of cognitive development on that process. Several potential intervening variables were identified. Piaget's theory of cognitive development provided the theoretical basis for the study (Inhelder & Piaget, 1958). The study consisted of three phases: (1) development of the instruments to measure decision, the intervening variables, and cognitive development, (2) pilot testing the instruments, and (3) a construct validity study.

Widowhood: The First Anniversary Spousal Bereavement-Related Stress, Coping, And Well-Being In Older Women, Mary Elizabeth Minton

Dissertations

By 2020 approximately one million individuals will experience spousal bereavement annually, primarily older women. However, little is known about the survivor's well-being around the first year death anniversary. This study examined spousal bereavement-related stress, coping, and well-being in widows 65 years and older at months 11, 12, and 13 following the death of the spouse based on Lazarus and Folkman's transactional approach and Schaefer and Moos' model of life crises and transitions. Using a prospective, longitudinal, correlational design, data were collected from 47 widows.

The Role Of The Dorsolateral Pontine Tegmentum In Modulating Nociception, Judith Ann Paice

Dissertations

Compelling evidence exists for the role of supraspinal centers in the modulation of nociception. For example, numerous studies have established that stimulation of the spinally-projecting serotonergic neurons in the ventromedial medulla (VMM) inhibits nociception. Several sites within the brainstem are known to innervate the VMM, including the periaqueductal gray (PAG) as well as other sites. Experiments performed in our laboratory have demonstrated that some neurons in the dorsolateral pontine tegmentum (DLPT) have dense projections to the VMM and appear to modulate nociception. The purpose of this research was to investigate the anatomical and functional role of these projections from the …

A Grounded Theory Approach To Explore The Experience Of Involuntary Childlessness In Couples With Infertility, Taylor L. Grube

Dissertations

Couples who experience involuntary childlessness as a result of infertility are challenged to manage the biological, sociological, and psychological implications of the situation. Furthermore, they are confronted with a variety of options regarding infertility management and resolution of involuntary childlessness. Nurses play a key role in supporting couples as they manage infertility and involuntary childlessness. Since infertility and subsequent involuntary childlessness is a couple's experience, nursing care should aim to meet the needs of both partners. However, there is a lack of evidence to suggest how couples experience and manage this phenomenon. Therefore, the purpose of this study was to …

An Investigation Of The Ability Of The Minnesota Early Childhood Screening Program To Predict Educational Achievement In Third Grade Children, Martha Dewey Bergren

Dissertations

The ecological model assumes school, community, family, and friends shape child outcomes. Minnesota mandates comprehensive Early Childhood Screening (ECS) for preschool children including vision and hearing, and cognitive, language, motor, growth and speech, with optional screening for health, behavior, and life stresses. Children meeting federal criteria for special education programs are recommended for interventions. Children with less serious health and/or behavior problems or who lack sufficient resources may also be at risk for academic difficulties. The purpose of this study was to investigate the ability of family, health, development, behavior, and stress data collected at Minnesota ECS to predict grade …

An Analysis Of The Costs And Effects Of Three Levels Of Maternity Services In West Philadelphia, Ruth Ann Greenway Poliner

Dissertations

Due to high rates of low birthweight infants and inadequate prenatal care, two programs were implemented in West Philadelphia--Maternity Care Advocates and enriched Healthy Beginnings Plus (HBP). Using an observational design, an economic evaluation was performed comparing three groups of clients at two public health centers (N = 248): (a) basic maternity services (control), (b) basic services plus advocates (group A), and (c) basic services, advocates, and HBP (Group A+B; a midwifery practice).

Behavioral Indices Of Maternal Stress And Health Related Family Boundary Ambiguity In Pediatric Intensive Care, Bonnie L. Harbaugh

Dissertations

This study of mothers of children in Pediatric Intensive Care Units (PICU) created two measures, (a) Health Related Family Boundary Ambiguity (HRFBA:PICU), (b) Maternal Caretaking Behavior (MCOS:PICU), and explored relationships between Health Related Family Boundary Ambiguity (HRFBA), Caretaking Behaviors, and Stress (STAI; Spielberger, et al., 1983).

Baccalaureate Reentry Students: Effects Of Professional Support On Role Conflict And Role Transition, Ruth Naomi Grendell

Dissertations

An increasing number of registered nurses and other health care providers are entering upper division academic nursing programs to obtain the baccalaureate nursing degree. A path analytic model was developed to examine the interrelationships of multiple roles and focal role commitments, previous education, work experience, and role conflicts perceived by reentry adult students, and the influence of professional support in the subsequent transition to the professional role. Group differences between Registered Nurses (RNs) and military corpsmen were also investigated for the variables of importance.

Exploring Student Perceptions Of Retention Issues In A 3-Year Baccalaureate-Level Nursing Program, Rebecca L. Taulbee

Dissertations

The nursing shortage, a major concern for the United States, has a multitude of causative factors. Nursing education has been tasked with helping to decrease the shortage of qualified registered nurses. Poor retention of nursing students in higher education is impacting the number of qualified nurses entering the workforce. Nursing education has historically been a high attrition area due to the stress and rigor of the curriculum. The general problem is that a severe and worsening shortage of registered nurses is increasingly putting the health and well-being of society at risk. The purpose of this qualitative, multiple-case study was to …