Digital Commons Network^™

Inclusions Of Religious And Spiritual Diversity In Multicultural Training For Counseling Psychologists, Sandra M. Grissom

Theses and Dissertations

The present study examined the lived experiences of eleven professors teaching multicultural courses within AP A and APP IC accredited counseling psychology programs regarding the state of including religious and spiritual diversity. Data were extracted from individual interviews, copies of course syllabi, and participant follow-up contacts. Data were analyzed using grounded theory methodology. A total of eleven faculty were interviewed. Teaching careers ranged from 3 years to 30 years (M = 15 years, SD = 7. 78), with multicultural specific teaching experience ranging from 2 years to 28 years (M = 9 years, SD= 8.4). Race and ethnicity represented included …

Oncology Nurses' Impact Scores For Obstacles And Supportive Behaviors At The End Of Life, Joan M. Collett

Theses and Dissertations

Introduction: Oncology nurses provide end-of-life (EOL) care to their patients daily. Oncology nurses' perceptions regarding how to provide quality care to dying patients could be an important addition to the ongoing research on quality EOL care. The purpose of this study was to determine the impact of specific obstacle and supportive behaviors in EOL care as perceived by hospital-based oncology nurses. This study extended the work of Beckstrand, Moore, Callister, and Bond (2009).

Methods: A 69-item questionnaire adapted from previous studies (Beckstrand & Kirchhoff, 2005; Beckstrand, Smith, Heaston, & Bond, 2008) was sent to 1,000 nurses who were members of …

Impact Of Medicare Part D Coverage Gap On Beneficiaries' Adherence To Prescription Medications, Urvi Desai

Theses and Dissertations

INTRODUCTION: Medicare Part D provides prescription drug coverage to seniors through a benefit plan with a major deductible inserted in the middle. It is important to study the extent to which this structure affects seniors’ adherence to prescription medications. Therefore, this study had the following objectives: (1) To identify characteristics of beneficiaries reaching and not reaching the coverage gap, (2) To study the entry and exit times from the coverage gap, (3) To study the impact of a complete gap in coverage on beneficiaries’ adherence to prescription medications, (4) To study the impact of a partial gap in coverage on …

Using Advanced Practice Nurses As Care Managers For Community Dwelling Elders With Chronic Disease, Andrea J. Athmann-Luksik

Theses and Dissertations

This study looks at the evidence for using Advanced Practice Nurses (APN) as care managers for community-dwelling older adults with chronic disease. A literature review was conducted and twelve articles were reviewed to look at the potential for care management to (a) decrease resource utilization, (b) improve health outcomes, (c) improve quality of care, and ( d) decrease costs. It then summarizes the best practices of transitional and primary care management programs and how these best-practices could be implemented into a policy and procedure with protocols between a tribal IHS service unit and the associated Tribal Health Depart

Preventing The Spread Of Infections In Patients' Homes: What Is The Best Evidence?, Julie Ferry

Theses and Dissertations

Nurses need evidence-based practices to prevent the spread of infections in patients' homes. Nursing equipment must be cleaned and disinfected properly between patients and proper hand hygiene should be done to decrease health-care associated infections in the home and community setting. A review and synthesis of the most current literature was done by searching the Cumulative Index to Nursing and Allied Health literature (CINAHL), Cochrane Database, Google Scholar™ and Google™ databases. Key words include infection control, home visits, public health, cleaning, home health, equipment, disinfectants and combinations of those words. Tools were created for dissemination to nurses providing care in …

Spatial Parameters In Therapeutic Spaces: Design Of A Residential Treatment Facility For Eating Disorder Patients, Sarah Beth Basinger

Theses and Dissertations

Can the built environment positively influence the treatment of an eating disorder? Does the built environment play a role in the quality of care, the rehabilitation process and the lasting affects of treatment in eating disorders and if so, what role does it play? What are the important parameters to consider in designing such a space? Currently there are few facilities designed specifically for the treatment of this disorder. Of those facilities, there is a lack of research regarding the effects of the built environment. Therefore, the process of answering these questions must begin by assessing parameters in architectural precedents …

Examining California’S Assembly Bill 1629 And The Long-Term Care Reimbursement Act: Did Nursing Home Nurse Staffing Change?, Matthew Krauchunas

Theses and Dissertations

California’s elderly population over age 85 is estimated to grow 361% by the year 2050. Many of these elders are frail and highly dependent on caregivers making them more likely to need nursing home care. A 1998 United States Government Accountability Office report identified poor quality of care in California nursing homes. This report spurred multiple Assembly Bills in California designed to increase nursing home nurse staffing, change the state’s Medi-Cal reimbursement methodology, or both. The legislation culminated in Assembly Bill (AB) 1629, signed into law in September 2004, which included the Long-Term Care Reimbursement Act. This legislation changed the …

Honey In Healing: New Look At An Old Treatment, Tracy Jo Enger

Theses and Dissertations

Chronic wounds such as pressure ulcers continue to be a difficult problem to manage, especially in the elderly populations. They are costly in terms of pain, as well as medical resources. The initiative Healthy People 2010 has set a goal at reducing the number of chronic wounds, more specifically pressure ulcers, by 50% in nursing home residents. (Porth & Matfin, 2009). Researchers are diligently attempting to find new, innovative, and cost-effective ways to manage chronic wounds. One solution may actually be an old remedy; honey. The purpose of this work is to provide healthcare workers with a review of the …

Evaluation Of A Training Intervention For Personal Care Assistants And The Effect Of Age And Extrinsic Job Satisfaction: Changes In Career Commitment And Job Satisfaction, Jason Rachel

Theses and Dissertations

Home care is a vital component of the United States healthcare delivery system. The demand for home care has steadily increased over the past decade and it is projected that this increase will continue over the next several decades. Moreover, the utilization of Medicaid waiver home and community-based care services has expanded to provide an alternative to the more costly institutional placement. In order to meet this growing demand while maintaining the cost-savings, the system relies primarily on the minimally trained, healthcare paraprofessionals known as Personal Care Assistants (PCAs). The present study examined the career commitment and job satisfaction of …

Hospital Health Care Executives' Attitudes And Beliefs On The Impact That The Healthcare Providers And Systems Survey Has On Service Quality And Hospital Reimbursement, Patrick Flanagan Billiter

Theses and Dissertations

This study surveyed 314 hospital health care executives' attitudes and beliefs on the impact that the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey had on service quality levels and hospital reimbursements from Centers for Medicare and Medicaid Services (HCAHPS, 2008). Additionally, this study reviewed the increase in service quality levels as measured by HCAHPS since its inception in 2006. Consumers now have access to data that previously was unavailable to them. If consumers see that a hospital has higher HCAHPS scores than a competing hospital in the area, the hospital with the higher scores should attract more …

Predicting Healthcare Workforce Shortages : A Case Study Of A Midwestern Healthcare Facility, Linsey B. Stadstad

Theses and Dissertations

No abstract provided.

Assessing Economic And Hrql Burden Of Food Allergy And Anaphylaxis In The U.S., Dipen Patel

Theses and Dissertations

Background: Food allergy, an abnormal immunologic response to food protein, has an estimated prevalence of 6% in young children and 3.7% in adults in the U.S. The only proven therapy for food allergy is strict elimination of the offending allergens. As a result, caregivers and patients could experience constant anxiety and stress that affects their quality of life. Additionally, food allergy can lead to significant economic impact on the health care system, since severe reactions often lead to ED visits and hospitalizations. Objectives: The first major objective was to determine the economic burden of Food Allergy and Anaphylaxis (FAA) patients …

Understanding Nurses’ Experiences Of Providing End-Of-Life Care In The United States Hospital Setting, Susan Johnson

Theses and Dissertations

Nurses perform a vital role in the care of dying patients and their families. Hence, experiences of nurses are a meaningful source from which to advance holistic end-of-life care. In this study, a hermeneutic phenomenological perspective was used to explore the phenomenon of end-of-life nursing care. Details derived from a scientific exploration into the experiences of 13 registered nurses who provided care for patients and families at end-of-life in the inpatient hospital setting offer understandings regarding this important phenomenon. The hermeneutic phenomenological methods of Max van Manen guided data collection and analysis. Three main themes described the participants’ experience of …

The Lived Experience Of Faith Community Nurses Living The Call To Health Ministry, Deborah Mobley

Theses and Dissertations

Faith community nursing is one of the newest specialized practices of professional nursing. A faith community nurse is an actively registered professional nurse, who serves as a paid or volunteer staff member in a faith community. The faith community nurse promotes health and wholism of the faith community, its groups, families, and individual members. A faith community, as in a church, synagogue or mosque, is an organization of individuals and families who share common beliefs, values, religious doctrine, and faith practices that influence their lives. The faith community functions as a client system for the faith community nurse. The purpose …

Quality Of Life In Palliative Home Care: Education For Nurses, Lorene Gray

Theses and Dissertations

Palliative care has expanded beyond just caring for people at end-of-life to improving quality of life for all people living with serious, complex, and eventually terminal illnesses. Because of these changes, the need for palliative care services is increasing and nurses must be prepared to understand and provide care for this population. It has been difficult to develop quantifiable outcome measures to define the patients' perception of quality of life because of the difficulty conducting research at endof- life.

The purpose of this review of literature and subsequent independent study project is to better understand, identify and describe the quality …

Death Notification Skills, Secondary Stress, And Compassion Fatigue In A Level One Urban Trauma Center, Enid Virago

Theses and Dissertations

Abstract This quasi-experimental design study compared two small samples of Emergency medicine residents after one group had an educational intervention on death notification skills and the other did not. Comparisons were made on residents’ confidence in their communication, interpersonal skills and level of compassion fatigue/satisfaction and EM Residents’ level of Secondary Traumatic Stress after an event of patient death and subsequent notification of Secondary Patients. Residents were interviewed to gather recommendations for designing death notification curriculum. Over an eight month period, forty emergency medicine residents at two sites, control and intervention, completed surveys designed to provide quantitative data on self-confidence …

Nursing Home Organizational Characteristics And Utilization Of Cancer-Related Medical Services, Chun-Chieh Lin

Theses and Dissertations

Cancer is the second leading cause of death in the U.S and is more common among the elderly. Since frailty and other age related conditions put the elderly at risk for nursing home care, nursing homes may be the site of care and death for many elderly cancer patients. However, there is a large gap in knowledge concerning cancer treatment of elderly nursing home residents. Since residents rely heavily on their nursing facilities, nursing homes might influence them in their treatment decisions. After controlling for resident and nursing home market characteristics, this study applies Andersen’s Behavioral Model to examine whether …

The Impact Of A Coordinated Care Program On Uninsured, Chronically Ill Patients, Jennifer Neimeyer

Theses and Dissertations

This study explored how being enrolled in a program that both coordinates patient care and provides a medical home changes health care utilization for uninsured patients, more specifically those persons with chronic conditions, through the use of the Chronic Care Model and Andersen and Aday’s Behavioral Model for Access to Health Care. Uninsured patients typically seek out care in a fragmented manner, which may lead to ineffective and inefficient care, especially for conditions that may require ongoing treatment and monitoring such as chronic conditions. The methodology used to examine the relationship between the interaction of enrollment and chronic condition status …

Understanding Death Anxiety In Women With Gynecologic Cancer, Hana Kim

Theses and Dissertations

For most of us, thoughts about our own mortality are largely unconscious, an invisible backdrop to our daily living. However, when forced to face a potentially life threatening event, these otherwise underlying thoughts about human transience rise to consciousness. Given the seemingly inherent link between receiving a cancer diagnosis and developing an increased awareness of one’s own mortality, the present study sought to address the following research question, “What are the experiences and processes by which women with gynecologic cancer construct meaning and manage death anxiety in the face of their cancer diagnosis?” Based on an interpretive grounded theory paradigm, …

Design For Conspicuous Transit, Peter Bain

Theses and Dissertations

My creative project explores design for transit advocacy; aimed at shifting a car-dependent society into one where transit helps meet climate change, energy, and land-use challenges. It incorporates my research into aspects of designing for transit, an understanding of urbanism in Richmond and New York, and an appreciation of planning.

Student And Employer Perceptions Of Work-Based Learning In Rural Community Colleges In Mississippi, Shirley Ann King-Bailey

Theses and Dissertations

The general goal of work-based learning is to bridge the gap between the academic world and the labor market, providing those students with the skills they need to give employers the satisfaction they desire from well-trained, well-educated employees. Work-based learning, which includes work experience, structured training, and other workplace learning experiences appropriate to students’ career interests and linked to school curricula, provides the connection between students and employers. The sample consisted of 112 participants. 78 students and 34 employers involved in work-based learning at rural Mississippi community colleges specifically those students and employers involved in work-based learning hosted by Copiah …

A Longitudinal Examination Of How Hospital Provision Of Home Health Services Changed After The Implementation Of The Balanced Budget Act Of 1997: Does Ownership Matter?, Tiang-Hong Chou

Theses and Dissertations

By using a natural experiment approach and longitudinal national hospital data, this study sheds light on the objective functions of hospitals with different ownership forms by comparing their relative reductions in HH provision after the implementation of the BBA. The empirical findings reveal that for-profit hospitals behave differently as compared to public and private nonprofit hospitals, due to their different operational objectives. While the response of for-profit hospitals is consistent with the profit-maximizer model, both public and private nonprofit ownership types behave consistently in accordance with the model of two-good producers whose objective is to maximize market outputs for meeting …

Student And Faculty Perceptions Of Accelerated Nursing Programs On The Nursing Shortage In The Mississippi Delta, Sheba Jennings

Theses and Dissertations

The purpose of the study was to determine students’ and faculty members’perceptions of the accelerated nursing programs at two colleges in the Mississippi Delta, Coahoma and Mississippi Delta Community College. The study centered on whether the age, race or gender of the students affected their perceptions of program support, key issues and challenges, and program limitations. The study explored differences in faculty and students’ perceptions of the accelerated nursing program in regards to local support, nursing faculty, most complicated areas of the program (which were clinical and exams), and barriers. A quantitative research design was used for this study. The …

The Effect Of Caregiver Question Types On Disruptive Behavior In Dementia Patients, Cynthia I. Lofton

Theses and Dissertations

The purpose of this study was to determine if individuals in the later stages of dementia could benefit from their caregivers' use of language components that would assist them in gaining access to their emotional memories that had been developed throughout a lifetime of experiences. Participants in the study included 10 long-term care residents with a diagnosis of moderate-to-late stage dementia, probable Alzheimer's disease, and who were vocally disruptive. Thirty caregivers who interacted with the residents also participated in the study. The caregivers' responses to the vocally disruptive individuals were categorized as statements or questions. The language forms of caregiver …

Exploring The Reliability And Validity Of The Human Spirituality Scale Scores With Older Adults In Independent Living Facilities, Charles Joseph Landrum

Theses and Dissertations

This study sought to extend the findings of previous research about the construct of spirituality–as measured by the Human Spirituality Scale (HSS) developed by Wheat. To expand the research across the entire adult life span, the researcher pooled preexisting data (Wheat) from middle-aged adults with data he obtained from 236 older adults living in independent living facilities. He analyzed the pooled data from 502 adults, with an age range of 25 to 98. Using the pooled data set, the researcher divided the data into five age groupings. He conducted confirmatory factor analysis, of the model of spirituality developed by Wheat, …

Informal Caregivers Of Advanced Cancer Patients: The Impact Of Geographic Proximity On Social Support And Bereavement Adjustment, John Garland Cagle

Theses and Dissertations

This research explored the social and psychological needs of caregivers of advanced cancer patients, and their subsequent bereavement adjustment. The study focuses exclusively on informal caregivers who provide assistance to patients receiving hospice care for end-stage cancer. Those individuals living furthest from the dying care recipient, the long distance caregivers, were of particular interest. This study used a prospective design to explore how a caregiver's geographic proximity impacted their social support and bereavement adjustment. A 2 x 3 repeated measures design was used to gather data from caregivers before a patient's death (using a pre-death questionnaire) as well as after …

Assessment Of Seminary Education On End Of Life Issues, Stefan Hakon Pomrenke

Theses and Dissertations

Background: The US health care system faces increased costs from end of life (EOL) care. The intensive approach to EOL treatment with greater use of procedures in ICUs has led to decedent spending six times greater than that of survivors in the hospital. Experts in ICU and Palliative care fields have called for greater utilization of end of life planning and education. To date, EOL education has been dominated by the technologically driven medical field and the church has been under-utilized. The US population relies on clergy support for many mental health and EOL issues. Clergy report feeling uncomfortable in …

How Has The Three Strikes And You're Out Law Affected The Elderly Inmate Population Growth In The Department Of Correction System Since Its Passage? An Examination Of Washington And California, Deborah A. Smith

Theses and Dissertations

This public policy thesis is grounded Washington with Initiative Measure Number 593, later called RCW.9.94A.555, followed by California with Proposition 184, later called California's Penal Code 1170.12. This public policy thesis has explored ways in which Washington and California are now faced with a new growing trend of elderly inmate population. This public policy thesis looked at the different methods of trying to solve this problem. The type of research used for this thesis has been the illustrative case study for the data collection and analysis. This type of case study uses the Qualitative Method. The Qualitative Research Method demonstrates …

Working Toward A Definition Of Futile Care In The United States Health Care System, Michelle Fulp

Theses and Dissertations

While end-of-life and palliative care measures are difficult subjects to address, decision-making for patients and family members becomes more complicated when there is a lack of understanding of when care is appropriate or when it is futile in nature. To date, there is no one definition of what constitutes futile care that is used by health care providers as they counsel patients and family members regarding what is appropriate care at the end-of-life. In fact, the recent debate and media coverage surrounding the Terri Schiavo case in Florida has brought this issue to a national concern. Thus the purpose of …

The Assessment Of Problematic Barriers In Nurse Spiritual Caregiving And Implementing A Project To Overcome Them, Bonnie Engel

Theses and Dissertations

Understanding the spiritual dimension of human experience is paramount to nursing, because nursing is a holistic, practice-based discipline interested in the art of human concerns. In the past two decades, increased attention has centered on the relationship between health and spirituality (Harrison, 1993). Balance of the mind, body and soul are necessary for the maintenance of health (Brush, Daly, 2000). The purpose of this project is to examine via a needs assessment, the barriers that prevent the provision of a nurse's spiritual caregiving and based on these findings, implement a teaching project to reduce the barriers. Humans are spiritual beings. …