Disability-Related Factors And Perceived Stigma: A Closer Examination Of Suicidality In Individuals With Physical Disabilities, Lauren Khazem

Dissertations

Previous research has indicated an association between physical disability and suicidal ideation. However, the mechanisms contributing to the development of suicidal ideation in this population have remained largely unstudied within an empirically supported theoretical framework. The current study expands upon previous research by examining the relationship between different facets of physical disability and suicidal ideation intensity through the indirect effect of perceived stigmatization and interactions with mental states described within the Interpersonal Theory of Suicide, namely perceived burdensomeness and thwarted belongingness. Furthermore, this research aims to examine these potential relationships in a nonclinical sample of adults with physical disabilities ranging …

Gendered Racism And Risky Sexual Behavior Among African American College Women: A Moderated Mediation Study Of Psychological Distress, Alcohol Use, Safe Sex Practices, And Alcohol Protective Behavioral Strategies, Danielle P. Cottonham

Dissertations

Investigation of the effects of gender racism (i.e., discrimination based on race and gender) among African American college women is limited, which is concerning considering the impact this specific type of discrimination may have on mental health and coping behaviors among African American college women. African American students who have experienced racial discrimination and college women who have experienced sexual discrimination experience increased levels of psychological distress (i.e., symptoms of depression and anxiety). Further, harmful alcohol use is a common coping strategy for psychological distress among college students and has been linked to increased risky sexual behavior among African American …

A Content Analysis Of Flow And Music: Teaching, Performance, And Consumption, Lindsey Keay

Dissertations

Positive psychologist Csikszentmihalyi (2008) describes flow as a state of heightened concentration and arousal where a balance of skill and challenge cause someone to be so absorbed in a task that everything else seems to disappear. The result of the experience can be one of immense enjoyment and satisfaction. Musical activities lend themselves well to the flow experience due to the multifaceted tasks of listening, practicing, performing, or teaching music. With flow being an ideal creator of intrinsic motivation, music teachers and performers should consider flow and its implications for music making and music instruction.

The purpose of this study …

Mechanisms Driving Suicidal Ideation To Action: The Impact Of Rumination And Cardiovascular Reactivity On Momentary Fluctuations In Pain Tolerance And Persistence, Keyne Law

Dissertations

To prevent suicide, it is crucial to understand the mechanisms and processes associated with deaths by suicide. The capability for suicide is a critical factor that enables an individual to endure the physical pain necessary to make a lethal suicide attempt (Joiner, 2005; Klonsky & May, 2015). Few studies have examined whether the ability to tolerate and persist through pain are subject to momentary fluctuations during different emotional contexts. This study sought to directly compare the effects of sadness rumination and anger rumination on pain tolerance and pain persistence. Furthermore, this study aimed to examine the effect of heart rate …

The Role Of Critical Literacy In Challenging The Status Quo In Twentieth Century English Children’S Literature, Rene Fleischbein

Dissertations

Although many children’s literature critics focus on the two divides between instruction and delight and between the fantastic and the realist, this dissertation focuses on the occurrences in twentieth century English children’s fantasy of critical literacy, a mode of reading that challenges the status quo of society and gives voice to underrepresented and marginalized groups. Twentieth century English children’s literature is especially concerned with narrative structure and good storytelling rather than with what lessons might be learned from the texts, but lessons are there nonetheless. I examine the works of four authors, E. Nesbit, C. S. Lewis, Diana Wynne Jones, …

Adaptive Meshfree Methods For Partial Differential Equations, Jaeyoun Oh

Dissertations

There are many types of adaptive methods that have been developed with different algorithm schemes and definitions for solving Partial Differential Equations (PDE). Adaptive methods have been developed in mesh-based methods, and in recent years, they have been extended by using meshfree methods, such as the Radial Basis Function (RBF) collocation method and the Method of Fundamental Solutions (MFS). The purpose of this dissertation is to introduce an adaptive algorithm with a residual type of error estimator which has not been found in the literature for the adaptive MFS. Some modifications have been made in developing the algorithm schemes depending …

Towards Improving The Education Funding Policy In Oman: Lessons Learned From Other Oil Dependent Nations, Hamood Alshoaibi

Dissertations

The education system in Oman underwent tremendous development during the past four decades, however, the national economy dependency on oil threatens the sustainability of its education funding. This study aims to explore the relationship between education funding and oil price fluctuations in Qatar, U.A.E., and Oman from 1975 to 2015. Moreover, it aims to suggest new economic alternatives to diversify the education funding sources in Oman. This quantitative study, under the framework of Human Capital Theory, utilized descriptive and associational approaches to study the association between oil prices and education expenditures in the three countries. Multiple regression analyses showed that …

Family Care Partners Of Chronically Ill Older Adults: The Role Of Uncertainty In Illness, Jillian Pine

Dissertations

Abstract This study integrated research on family care partners of older adults and

research on uncertainty in chronic illness. Previous findings were extended by examining care partners of older adults with multiple chronic conditions and highlighting early-stage undiagnosed cognitive impairment as a uniquely unclear condition. Participants were 45 women assisting community-dwelling, earlier generation older adults with multiple chronic health conditions and a prognosis of more than six months. Online survey data were used to test the hypotheses that increased illness uncertainty would be associated with increased care partner-recipient relationship strain and increased care partner perceived stress. This study also hypothesized …

Impact Of Child And Family Teaming In A Child Welfare Agency, Madeline Roachell

Dissertations

Purpose. The purpose of this mixed-methods study was twofold, (1) to describe the family experiences of those who had a CFT and those who did not, and (2) to identify and describe the impact of child and family teams (CFTs) on reentry into foster care.

Methodology. The study used a mixed-methods approach collecting both quantitative and qualitative data. Quantitative data included archival data and an electronic survey. Qualitative data included in-depth interviews and narrative comments from the survey.

Findings. A careful analysis of the data resulted in nine major findings and three dominant themes. The dominant themes of the study …

Bariatric Surgery Regain And Long-Term Weight Loss Among Women: Self-Efficacy, Social Support And Health Promotion Lifestyle Behaviors, Raelene Z. Brooks

Dissertations

Although bariatric surgery appears to produce success in a short period of time immediately after surgery, weight regain over time in this population cannot be ignored. Understanding the relationship between potential psychosocial predicting post-surgical variables influencing bariatric surgery may prevent long-term weight regain. The purpose of this research is to examine self-efficacy, social support, and lifestyle habits and their relationship to long term weight loss and regain in women post bariatric surgery. Weight regain is observed as early as 18 months to 2 years after bariatric surgery. Patients face challenges sustaining the dramatic lifestyle changes required to ensure positive long-term …

Exploring The Quality Of The Leader-Follower Relationship And Its Effect On Followers’ Organizational Citizenship Behaviors In A Public-Service Organization, Kristina Zaragoza

Dissertations

Purpose: The purpose of this sequential, explanatory mixed-methods study was to identify and describe to what extent the quality of the leader-follower relationship, as perceived by followers, affects followers’ organizational citizenship behaviors in a public-service organization.

Methodology: A sequential mixed-methods study was the chosen design for this study. The first phase consisted of quantitative research in the form of a survey questionnaire that measured followers’ organizational citizenship behaviors. The researcher then conducted semistructured, face-to-face interviews that measured the quality of the leader-follower relationship.

Findings: Followers engage in organizational citizenship behaviors at a moderate to high level. Followers willingly assist co-workers …

Investigation Of Vaporization Enthalpies And Vapor Pressures Of Organic Compounds By Correlation Gas Chromatography, Carissa Nelson

Dissertations

Thermodynamic properties of organic compounds are useful to scientists and manufacturers in many areas of research and technology. This work focuses on measuring and reporting these properties on materials of commercial, environmental and scientific interest. Vaporization enthalpies and vapor pressures of several organic compounds have been studied using correlation gas chromatography (CGC) and are reported here as well as in recent publications. The CGC method allows for the indirect measurement of these properties in instances where these materials are available only in mixtures or in very small amounts.

The qualities of these measurements for any chosen target are directly related …

Optimizing The Involvement Of Women With Opioid Use Disorder In The Care Of Their Infants Experiencing Neonatal Abstinence Syndrome, Rebecca Boedeker

Dissertations

The incidence of opioid use disorder (OUD) has grown to epidemic proportions. Infants exposed to opioids inutero are likely to experience withdrawal symptoms during the hours and days immediately following birth, known as Neonatal Abstinence Syndrome (NAS). Research indicates maximizing non-pharmacologic, supportive management decreases Neonatal Intensive Care Unit (NICU) admissions, the length of stay, and the severity of NAS. The purpose of this project is to evaluate the effects of an antepartum consult designed to prepare mothers with OUD to participate in this nonpharmacologic care. The Women and Infants Substance Help (WISH) Center delivers prenatal care for women with OUD. …

Traumatic Brain Injuries: A Telehealth Alternative For Veterans, Jessica Dickman

Dissertations

Problem: Traumatic Brain Injuries (TBI) are known as the signature wound of veterans serving in Operation Enduring Freedom (OEF) and the Operation Iraqi Freedom (OIF). After the initial TBI diagnosis, outpatient TBI follow-up rates are reported to be approximately 9% less in the Veteran Healthcare Administration (VA) system when compared to the private sector. The purpose of this quality initiative was to decrease the rate of missed appointments among OEF/OIF veterans using a telehealth alternative.

Methods: The Plan-Do-Study-Act (PDSA) method was used to implement a consistent process for the telehealth visit option. A retrospective medical record review over the same …

Permanent Housing And On-Site Nursing Care: Effects On Homeless Individuals With Hiv And Other Cormorbidities, Lynelle Hinden

Dissertations

Abstract

Problem. Providing housing to otherwise homeless individuals who are HIV/AIDS-positive has been demonstrated to improve control of the disease. This was a healthcare quality initiative to review the viral load and Cluster of Differentiation Protein Four positive (CD4+) counts over time of residents in an urban housing facility for HIV/AIDS-positive individuals. Also, a nurse-run clinic was introduced for residents, especially those with comorbidities such as hypertension and diabetes.

Methods. A repeated measures design was utilized. Viral loads and CD4+ counts were retrospectively reviewed from facility records at entrance into and five-years later at the facility. Additionally, measurements of blood …

Assessment Of Nursing Knowledge Before And After Implementation Of Educational Intervention On Heart Failure, Sarah Scott

Dissertations

Purpose: The purpose of this study was to assess the knowledge of nursing staff on a cardiology unit before and after the implementation of heart failure specific education. Methods: Forty staff nurses on a cardiology unit at a single institution were given The Nurses Knowledge of Heart Failure Education Principles Survey (NKHFEP), a validated tool to assess nursing knowledge of heart failure. A series of four educational sessions were given to the same forty nurses. They were then given the NKHFEP survey a second time to assess change in knowledge post educational intervention. Results: The mean of Pre-education (M = …

Implementing The Cdcs Core Elements Of Outpatient Antibiotic Stewardship Program Into The Urgent Care, Deanna Powelson

Dissertations

Purpose: The inappropriate use of antibiotics has led to the development of antimicrobial

resistance which is a severe threat to the public and an increasing global problem. The

Centers for Disease Control and Prevention (CDC) estimates at least two million illnesses

and 23,000 deaths are caused by antibiotic-resistant bacteria in the United States (CDC,

2014). The purpose of this quality improvement (QI) project was to evaluate the

effectiveness of an antibiotic stewardship program (ASP) on urgent care providers'

prescribing on viral respiratory tract infections (RTIs) including the common cold,

pharyngitis, and bronchitis.

Methods: This QI project implemented the CDCs Core …

An Exploration Of Nicu Nursing Staff Perspective On The Change From Pod To Private Room Patient Care, Julie Nickles

Dissertations

Neonatal Intensive Care Units (NICU) are designed to care for critically ill newborns who require constant care. The design of the NICU may have an impact on not only the patient and their family but also the nursing staff. Historically neonatal intensive care have employed a cohort model of care. In this model multiple infants are in the same room or pod. With success of single room maternity care, the increased need for changes in neonatal care became apparent. Today, new parents desire extended contact with their extremely preterm and often very sick infant. This trend has led a standard …

Aligning With Patient-Centered Medical Home Standards: Depression Screening In Primary Care, Elizabeth Segura

Dissertations

Abstract

Problem: The Patient Centered Medical Home (PCMH) is a model of care that improves the quality and experience of care and decreases cost. Use of a validated depression screening tool for adult patients is a PCMH certification requirement. The purpose of this quality initiative was to obtain baseline data when a depression screening tool was utilized among adult patients in an internal medicine clinic within a Midwestern public health department.

Methods: This was a quality improvement project utilizing a descriptive and observational design. A retrospective medical record review was used to assess the rate of depression screening utilizing the …

Evaluation Of A Youth Emergency Room Enhancement Program For Behavioral Health, Anne Thatcher

Dissertations

Problem. Pediatric mental health complaints and subsequent hospitalizations have been steadily increasing. The Behavioral Health Network (BHN) developed an intensive outreach case management program aimed at reducing youth mental health emergency department (ED) visits and inpatient psychiatric admissions. The Youth Emergency Room Enhancement (YERE) program was a process improvement initiative to provide immediate case management to youth and caregivers for mental health care.

Methods. A Plan-Do-Study-Act (PDSA) method utilizing a retrospective case record review occurred over a six-month period. A convenience sample of youth aged 6-20 years presenting to one of eight healthcare facilities for either ED or inpatient hospitalization …

Assessing The Impact Of Practice Transition On Advance Practice Registered Nurse’S Job Stress And Job Satisfaction, Patricia E. Hendrickson

Dissertations

Problem

The impact of the transition to full practice authority (FPA) on job satisfaction and job stress has not been previously described in the literature.

Method

Job satisfaction, job stress, and practice transition stress data was collected from a sample of 33 Advance Practice Registered Nurses (APRN) working at the VA St Louis Health Care System using Misener Nurse Practitioner Job Satisfaction Survey (MNPJSS), National Institute of Occupational Safety and Health Generic Job Stress Questionnaire (NIOSH-GJSQ), and student-developed practice transition stress questionnaire during the initial phase of FPA transition.

Results

APRNs were minimally satisfied to satisfied. Job stress from work …

Nurse-Led Triage Clinic In An Hiv Supportive Housing Apartment Community, Sally Breen

Dissertations

Problem: HIV-positive persons living in supportive housing who were otherwise homeless are reported to have better health outcomes than those who remain homeless. This was a quality improvement project to obtain baseline information regarding the implementation of onsite nursing services for individuals and their families residing in an HIV-positive supportive housing apartment community in an urban Midwestern city. Methods: A nurse triage clinic was implemented in partnership with the Doorways organization. Two registered nurses staffed the clinic two days per week. Data was collected on demographics and clinic utilization over a nine-week period. Results: Of the apartment residents, N=95, the …

Aligning With Patient-Centered Medical Home Standards: Depression Screening In Women's Health, Charity Galgani

Dissertations

Problem: The Patient Centered Medical Home (PCMH) model of care improves health care quality and patient experience of care, and decreases costs. Depression screening is a requirement for becoming a PCMH. The purpose of this quality initiative was to obtain baseline data to describe depression screening rates among female adult patients receiving women’s health care within a Midwestern public health department seeking PCMH recognition.

Methods: The study utilized a descriptive, observational design and was guided by the Plan-Do-Study-Act framework. A retrospective medical record review was used to assess the rate of depression screening utilizing the PHQ-2 and PHQ-9 tools, and …

The Role Of Popular Culture In Preschool Children’S Emergent Writing/Composing: An Exploration Of The Writing Process And Tensions Surrounding One Preschool Writing Center, Stephanie Winters

Dissertations

Over the last several decades research has been conducted surrounding popular culture and children’s writing/composing. Much of this research focused on children in early elementary school classrooms. I discovered, when preparing for this project, that there was very little published research (written in English) surrounding preschool-aged children’s compositions (with or without the emphasis on popular culture), and what happens in the writing center. This study helps fill the gap in the research by documenting how preschool children in a mixed-age (ages three to five years) classroom, who attend a public school in an urban, Midwestern area, write/compose when given the …

Alternatives In Magnesium Sulfate Treatment Courses: An Investigation Of Physician Prescribing Behaviors, Erin Williams

Dissertations

Problem: The gold standard for managing preeclampsia in the postpartum patient is 24- hours of magnesium sulfate as this is the time the patient is most susceptible to experiencing a seizure (American College of Obstetricians & Gynecologists, 2013). However, these patients are at an increased risk for experiencing adverse health outcomes, as well as interruptions in maternal-infant bonding due to the mother requiring a higher level of care. Methods: A one group pretest-posttest design was conducted to gain a better understanding of the current practice while also assessing the willingness of physicians to change prescribing behavior after receiving the research-based …

Prophylactic Antibiotic Use In Female Patients With Pelvic Floor Reconstructive Surgery: A Retrospective Comparative Effectiveness Study, Courtney E. Turnbough

Dissertations

Problem: The purpose of this project was to determine the most effective prophylactic antibiotic to decrease the number of patients who have urinary tract infections (UTIs) after pelvic floor reconstructive surgery in a gynecological reconstructive surgery practice.

Methods: This was a retrospective chart review from 2015-2017 that included 732 subjects from a single practice. All patients underwent pelvic floor reconstructive surgery, with or without a midurethral sling placed. Patients also had a catheter and vaginal packing postoperatively. Patients who had a culture-proven UTI within the six-week postoperative period were noted.

Results: There were less UTIs (χ2 = 12.119, df = …

Measurements That Matter: Assessment & Management Of The Symptoms Of Chronic Illness Using The Integrated Palliative Outcome Scale (Ipos), Deborah Jeffery

Dissertations

ABSTRACT

Measurements that Matter: Assessment and Management of the Symptoms of Chronic Illness Using the Integrated Palliative Outcome Scale (IPOS)

Background: The mission of the Advanced Illness Management (AIM) program at the Visiting Nurse Association of Greater St. Louis (VNA) is to relieve the burden of serious illness by providing exceptional care to patients and families through symptom management. A validated symptom tool was needed for holistic assessment.

Purpose: This is a quality-improvement project aimed at enhancing symptom management in patients experiencing advanced illness in a community-based palliative care program. Provider use of the Integrated Palliative Outcome Scale (IPOS) as …

Implementation Of National Pediatric Guidelines To Prevent Chemotherapy Induced Nausea And Vomiting In Children With Cancer, Taryn Sandheinrich

Dissertations

Purpose: The purpose of this study was to assess the use of supplemental, as needed (prn) pharmacologic interventions for uncontrolled acute chemotherapy induced nausea and vomiting (CINV) in children with cancer after implementation of new pediatric CINV prophylaxis guidelines. Description of Project: A retrospective chart review was completed on forty-three children admitted to the hospital for chemotherapy during a 3 month period in 2017 to document the use of medications given for acute breakthrough CINV. The pre-implementation group received anti-emetics based on the institutional standard of care. A second retrospective chart review was completed on thirty-three children admitted to …

Implementing A Caps Simulation To Increase Nursing Education Practice Students’ Self-Awareness Of Attitudes And Beliefs About Poverty, Melissa Ehmke

Dissertations

Problem. The purpose of this project is to determine if college students who are currently in nursing school, will benefit from the addition of a poverty simulation to positively influence their self-awareness and individual-level beliefs and attitudes towards poverty, therefore being able to serve those in poverty fully and guide them to appropriate resources.

Methods. Bachelor of Science in Nursing (BSN) and Doctoral Nursing Practice (DNP) students participated in a three-hour Community Action Poverty Simulation (CAPS). A twenty-one item Attitude Toward Poverty Scale short form (ATPS) survey was completed pre and post-simulation participation.

Results. Significant improvements resulted in three of …

Evaluation Of Educating Registered Nurses Prior To Implementing New Evidence-Based Protocol: Enhanced Recovery After Surgery (Eras), Lisa Brooks

Dissertations

Evidence-based protocols promote standardization of care and patient safety. The inclusion of major stakeholders is imperative to the success of implementation of a new protocol. The “Enhanced Recovery After Surgery” (ERAS) protocol was implemented at the Veterans Administration Medical Center – St. Louis prior to formal education of direct-care registered nurses (RNs), a major stakeholder group. Due to the lack of knowledge, the RNs who were expected to implement and adhere to the ERAS protocol were not prepared and displayed a lack of confidence. Subsequently, an educational training intervention was designed and executed with thirty-five RN participants. Prior to this …