Medicine and Health Sciences Commons^™

Occupational Therapy In End-Of-Life Care, Shannon Sudrla

Student Capstone Papers

Patients at the end-of-life (EoL) experience functional decline in response to terminal illness and the active dying process, inhibiting participation and engagement in meaningful daily activities. Occupational therapy practitioners (OTP) are equipped to address patients’ occupational needs and desires despite their declining capacities; however, the absence of occupational therapy (OT) services in EoL care leaves patients’ occupational needs unmet, directly affecting their quality of life. The literature demonstrates the need for enhanced education and training among occupational therapy students (OTS) and practitioners to better prepare them to work with terminally ill patients who face progressive functional decline and imminent death. …

Enhancing Physician Perspectives Of Skilled Occupational Therapy Services For Patients With Rheumatoid Arthritis, Valerie S. Trinidad

Department of Occupational Therapy Entry-Level Capstone Projects

This Capstone Project, with a focus in research, sought to identify a relationship between self-reported functional performance and participation restriction as described by satisfaction with one’s execution or participation in a described occupation. A correlational study design was employed under the mentorship of Dr. Thomas Decker, EdD, OTD, OTR/L who oversaw all IRB processes, documentation, study development and deployment, as well as co-authored and provided mentorship for creation of a publishable manuscript of this project. The established Health Assessment Questionnaire Disability Index (HAQ-DI) and the newer Keele Assessment of Participation (KAP) were the two outcome measures of focus for surveying …

Utilization Of Remap Conversation Tool To Improve Advance Care Completion In The Home-Based Palliative Care Community Setting, Gwendolyn Starkey

Doctor of Nursing Practice Projects

Background: The World Health Organization and the American Society of Clinical Oncology guidelines endorses mandatory communication skills training in care goals for seriously ill patients (Back et al., 2019). In one survey of primary care providers (PCP), 68% reported no formal training to discuss advance care planning (Comer et al., 2020). Advance care planning is essential to manage chronic conditions in our growing aging population to provide the best patient care. This manuscript aimed to discuss best practices and techniques in advance care planning and optimize skills to provide patient-centered care conversations that honor patient wishes, reduce unwanted hospitalizations, and …

Analyzing The Relationship Between The Quality Of Life And Race Of Lung Cancer Survivors, Alina S. Wise

Honors Undergraduate Theses

Purpose: The relationship between racial disparities and the health-related quality of life (HRQoL) of lung cancer patients is not well understood. The purpose of this study was to quantify the overall HRQoL of lung cancer patients and compare differences in HRQoL among racial groups in the United States.

Methods: We analyzed data from the Behavioral Risk Factors Surveillance System (BRFSS), a population-based national cross-sectional study conducted by the Centers for Disease Control and Prevention. The BRFSS is conducted annually in all 50 states and collects information on demographics, health behaviors, health-related experiences, health conditions, use of medications, and use of …

The Impact Of Endometriosis-Associated Pelvic Pain On The Social And Academic Wellbeing Of Women Enrolled In University, Ava E. Bettencourt

Honors Undergraduate Theses

Background: Endometriosis, a medical condition in which endometrial tissue lining grows outside of the uterus, affects approximately 10-15 percent of women of reproductive age. While research has shown that symptoms of endometriosis negatively affect quality of life in women, few studies have examined the impact of this condition specifically in college students who may be overwhelmed with the stress of school, living independently, and managing the symptoms of their endometriosis. Purpose: To examine the impact of endometriosis on academic and psychosocial factors in university students. Methods: Four college females completed the Pain Self-Efficacy Questionnaire (PSEQ), a 10-item survey used to …

Improving Utilization Of Palliative Care For Heart Failure Patients, Devin Tilley

Doctor of Nursing Practice Projects

The purpose of this program was to educate providers regarding palliative care for heart failure patients. Palliative care is underutilized in conjunction with usual heart failure management despite proven benefits of decreased symptom burden, reduced hospitalizations, and improved overall quality of life. Provider education has the ability to improve provider knowledge of palliative care for heart failure patients. A brief education session was given to hospital providers in an acute care setting to evaluate the benefits of provider education on palliative care utilization for heart failure patients. Findings included improved provider confidence in referring heart failure patients to palliative care. …

Impact Of Provider Cultural Competency On Latino/Hispanic Patients During End-Of-Life And Hospice Care, Nicholle Nacionales

Theses and Graduate Projects

Background: Cultural competency in healthcare means delivering high quality care to patients with diverse beliefs, attitudes, values, and behaviors. Latinos/Hispanics are one of the fastest growing ethnic group and with an aging population, there is an increased need for providers to deliver culturally sensitive end-of-life and hospice care. Latino/Hispanic patients face many disparities that affect their quality of care which cultural competency aims to address. Purpose: The purpose of this literature review is to identify factors that affect Latino/Hispanic patient’s end-of-life and hospice care and how cultural competency of providers can influence management of their pain and quality of …

A Telehealth Palliative Care Objective Structured Clinical Examination, Lindsey Q. Mcintyre

Dissertations

Problem: Palliative care is a service focused on symptom management and improved quality of life for persons with serious or chronic illnesses and is widely underutilized. Although advanced practice registered nurses (APRNs) possess a unique skillset to contribute to palliative care, there is minimal reporting on palliative care training for this professional group. The purpose of this clinical scholarship project was to implement the End-of-Life Nursing Education Consortium (ELNEC) online training program for APRN students in the BSN-DNP program and evaluate its effect on student performance during a telehealth objective structured clinical examination (OSCE).

Methods: An observational, descriptive …

Get America Talking: Implementing Advanced Care Planning In Primary Care, Sasha Recht

Doctor of Nursing Practice Final Manuscripts

Advanced Care Planning (ACP) is an essential part of providing adequate care in the primary care setting. Discussing end of life with patients can be a tedious and uncomfortable conversation for many providers, however, its continued avoidance contributes to the stigma of end of life care and may also result in significant healthcare cost expenditure with the use of unwanted invasive treatments. All providers should engage in consistent advanced care planning in order to improve patient and provider communication, improve patient satisfaction, increase advanced directives on file, reduce the stigma of the topic, and improve quality of life.

Advance Care Planning And Palliative Care In Heart Failure: A Literature Review, Laura Dack

All Graduate Theses, Dissertations, and Other Capstone Projects

Despite advancing therapies, heart failure remains a progressive disease with high symptom burden. Advance care planning and palliative care assist in maximizing the quality of life for affected individuals. These interventions are supported by current heart failure guidelines yet application into practice is poor. The purpose of this literature review is to investigate the relationship between advance care planning and palliative care interventions on the quality of life of adults with heart failure. A search of the literature was completed between October 20^th, 2020 to November 10^th, 2020. Databases searched include Academic Search Premier, CINAHL Plus, …

Reducing Polypharmacy In Older Adults At End Of Life: The Outcome On Quality Of Life, Melissa Jenson

All Graduate Theses, Dissertations, and Other Capstone Projects

Background: Older adults at the end of life are commonly prescribed multiple medications which can lead to polypharmacy. Research has shown that optimizing medications through targeted deprescribing reduces inappropriate medications, reduces adverse effects and improves select outcomes. However, the impact of deprescribing remains uncertain--specifically whether this intervention improves quality of life (QOL). Objective: Explore polypharmacy in older adults at the end of life examining outcomes of deprescribing on the QOL. Methods: A systematic literature search using Academic Search Premier, CINAHL, Medline, JSTOR and Nursing and Allied Health Database was conducted between October 2020 to November 2020. Select articles …

Benefits Of Palliative Care In The Intensive Care Unit, Stephen Swenson, Stephen M. Swenson

Nursing Masters Papers

Abstract

The use of palliative care is often overlooked until the terminal phase of serious illness when life-prolonging interventions are deemed futile and death is considered imminent.

Alongside the well regarded Clinical Practice Guidelines for Quality Palliative Care (National Coalition for Hospice and Palliative Care, 2018), numerous critical care societies including the American Association of Critical-Care Nurses (Medina & Puntillo, 2006), American College of Critical Care Medicine (Davidson et al., 2008), American College of Chest Physicians (Selecky et al., 2005), American College of Surgeons (2017), and the American Thoracic Society (Lanken et al., 2007) have each published individual policies highlighting …

Optimizing Dry Skin Management Utilizing Np Led Phone Follow-Up, Christine Vazquez Bsn, Rn, Dnp - Fnp/Agnp Student

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this project is to evaluate the impact of a healthcare provider-led standardized dry skin protocol for outpatient geriatric patients to promote overall well-being and improve quality of life.

Background: Current literature supports using the dry skin protocol to help primary care teams identify patients that require xerosis cutis skin care, particularly of the lower extremities. The primary focus of this project will be timely detection of patients with the dry skin condition that will be identified with the standardized Overall Dry Skin (ODS) scale. When the patient meets the ODS criteria, a timely discussion will be …

Long Term Health Related Quality Of Life Following Uterine Fibroid Embolization At Aga Khan University Hospital, Nairobi, Michael Muthoka Kioko

Theses & Dissertations

Background: Uterine Fibroid Embolization (UFE) is one of the effective options available for treatment of symptomatic uterine fibroids with documented improvement in the quality of life and reduction in symptoms. Most of the studies have demonstrated an improvement in the quality of life over a short to intermediate period. We carried out this study to assess the long-term quality of life following uterine fibroid embolization in a predominantly black population. There are no identified studies locally or in Africa addressing this issue whereas studies done elsewhere indicate a probable increased fibroid disease burden among black women.

Objectives: Our objectives in …

Metabolic Control, Quality Of Life, And Body Image In Patients With Glycogen Storage Disease Type Ia, Alexa Bream

Dissertations & Theses (Open Access)

Glycogen storage disease is a group of inborn errors of metabolism, with type Ia being the most common form of the disorder. Glycogen storage disease type Ia (GSDIa) is a multisystemic condition in which individuals have various complications secondary to an inability to properly break down glycogen and to perform gluconeogenesis. Complex management is then necessary for patients and includes dietary modification, frequent cornstarch usage, and evaluation for additional complications such as hepatic adenomas, hypertriglyceridemia, and kidney disease. Previous studies have found lower scores in quality of life and body image in GSDIa patients; however, the specific factors influencing this …

Does Light Therapy Improve The Quality Of Life For People With Acne?, Montana W. Banks

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Does light therapy improve the quality of life for people with acne?”

STUDY DESIGN: A systematic review of three peer-reviewed primary studies published between the years of 2016 and 2018. All articles were published in the English language and in peer-reviewed journals.

DATA SOURCES: One pilot study, one multicenter, randomized, split-face control study and one single-blind, randomized, split-face study evaluating if light therapy can improve the quality of life (QOL) of people with acne. Sources were selected from PubMed and Cochrane based off of the relevance …

Does Stem Cell Injection Improve Quality Of Life In Patients With Cardiopathy Patients?, Shoua Shue Casillas

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not stem cell injections improve the quality of life in patients with cardiopathy.

STUDY DESIGN: Review of three randomized controlled trial (RCT) articles. All articles were published between 2012 – 2017 and were all printed in the English language.

DATA SOURCES: All three RCT articles were found through PubMed.

OUTCOMES MEASURED: One of the outcomes measured in each of the articles were improvement in quality of life in patients with cardiopathy. Among the three review articles, quality of life was measured using either the Kansas City Cardiomyopathy …

Impact Of Feeding Tube Status On Health Outcomes For Individuals With Oropharyngeal Cancer, Nedeljko Jovanovic

Electronic Thesis and Dissertation Repository

Abstract

This study investigated differences in outcomes related to health, swallowing, and quality of life (QoL) for individuals with oropharyngeal squamous cell carcinoma (OPSCC) receiving either radiotherapy (RT) alone, or concomitant chemoradiotherapy (CRT). Differences were assessed based on whether patients received a feeding tube (FT group) or not (NFT group). Measures including the Functional Oral Intake Scale (FOIS), Performance Status Scale for Head and Neck Cancer (PSS-HN), M.D. Anderson Dysphagia Inventory (MDADI), and weight were collected for 126 individuals at baseline, and at 3, 6, and 12 months post-treatment. Data were analyzed to identify potential prognostic differences between the groups, …

Symptom Clusters And Quality Of Life Trajectories In Breast Cancer Patients Before And After Chemotherapy, Gaurav Kumar

Capstone Experience

Context. Breast cancer patients experience multiple concurrent symptoms before and after chemotherapy (CTX). Physical and psychological symptoms may persist after treatment and reduce the quality of life (QOL) of survivors.

Objectives. Identify differences in prevalence and severity of symptoms at three times within 1- year of starting CTX; and identify symptom cluster and QOL trajectories over these times in breast cancer patients.

Methods. Symptoms were identified in breast cancer patients (N=219) before the start of CTX (baseline), 30 days after the last CTX, and 1-year after the first CTX. Hospital Anxiety and Depression Scale and Symptom Experience Scale …

A New Surgical Approach For O-C2 Fusion, Solving The Problem Of Dysphagia., M. Kathryn Mcclure

Electronic Theses and Dissertations

The fusion of the second cervical vertebrae to the occipital bone (O-C2 fusion) for head stabilization can result in postoperative dysphagia and dyspnea, negatively impacting the patient’s quality of life. Currently, the O-C2 angle is used for head placement, which may not place the head neutrally. We hypothesize that aligning the external auditory meatus with midline of the C2 will reduce oropharyngeal stenosis, reducing dysphagia. One male patient with poor swallow quality of life who required a revision of a previous O-C2 surgery was evaluated via videofluoroscopy and completed the standard swallow quality of life questionnaire (SWAL-QOL) before and after …

The Impact Of Advance Directives On The Intensity Of Care Received In The Acute Care Setting In Older Adults, Marsha Helen Tyacke

Dissertations (1934 -)

The proportion of older adults in the U.S. is rapidly increasing. One-third of Medicare expenditures occur in the final year of life, with nearly half resulting from acute exacerbations of chronic, progressive diseases(Riley & Lubitz, 2010). Older adults prefer comfort over life-sustaining care, and decreased intensity of care is associated with improved quality of life at the end-of-life (EOL). Advance directives (ADs) have been proposed as mechanisms to improve congruence between patient wishes and EOL care; however, the impact of ADs on care delivered in the acute care setting at the EOL for this population is unclear. A retrospective, correlation …

Minimizing The Impact Of Disease While Maximizing Quality Of Life: An Exploration Of Resilience In Head And Neck Cancer Survivors, Chelsea A. Macdonald

Electronic Thesis and Dissertation Repository

Introduction: Individuals with head and neck cancer (HNCa) face myriad biopsychosocial challenges. Even after treatment completion, these challenges may continue to cause diminished quality of life (QoL). Resilience may serve to minimize the impact of HNCa and, thus, maximize QoL. The purpose of this study was to identify resilience in HNCa survivors and explore its potential relationship with QoL.

Methods: Thirty-one HNCa survivors completed three validated, self-report questionnaires pertaining to the collection of resilience and QoL data. Descriptive, correlational, and observational analyses were performed.

Results: Resilience was identified in the HNCa survivors and a positive correlation was found between resilience …

Body Image And Quality Of Life Among Postsurgical Bariatric Patients, Amy Leigh White

Psychology Theses & Dissertations

In recent decades, bariatric surgery has become an increasingly popular intervention for the treatment of morbid obesity. Bariatric surgery leads to substantial improvements in physical health (e.g., weight loss, increased life expectancy) and psychological health (e.g., body image, quality of life). After bariatric surgery, many patients undergo subsequent surgical procedures to remove excess skin (“body contouring”), which are also associated with positive medical and psychological outcomes.

The present study sought to expand upon existing research into the psychosocial outcomes of bariatric surgery, investigate correlates of patients’ desire for body contouring, and determine whether presurgical motivations were associated with postsurgical outcomes. …

Is Preoperative Functional Status A Predictor Of Postoperative Mortality, Morbidity And Quality Of Life In Open Heart Patients?, A. Kate Macphedran

Dissertations

The very nature of mortality and morbidity surrounding cardiac surgery is complex with numerous risk factors involved and researchers have found functional status to be a stronger predictor of outcomes than the admitting diagnosis. Preoperative functional status, however, is not measured by any of the cardiac risk scores. Functional status can be objectively measured using validated outcome tools such as the Late-Life Function and Disability Instrument (LLFDI). In 3 studies, the impact and association of functional status changes over time was explored in patients who have undergone elective open heart surgery. Analyses in Study 1 demonstrated significantly improved functional status …

An Examination Of Quality Of Life Of Parents Of Adult Children Diagnosed With Autism Spectrum Disorder, Christina Noel Marsack

Wayne State University Dissertations

Previous research on parental caregivers has focused primarily on caregivers of individuals with intellectual and developmental disabilities, rather than focusing specifically on parents of adult children diagnosed with autism spectrum disorder (ASD). Most research on ASD has centered on parents of young children with this diagnosis, but not on parents of adult children with ASD. Understanding the experiences of parents caring for adult children with ASD is important given the increase in the prevalence of individuals with ASD and the lack of information regarding parents of adult children with ASD. A nonexperimental, quantitative, correlational design was used to examine effects …

Factors Influencing Resilience Among Haematological Cancer Survivors, Katherine S. Gallager

Theses: Doctorates and Masters

Haematological cancers in bone marrow (leukaemia) and the immune system (lymphomas or myeloma) represent the sixth most common adult tumour group in Australia. These cancers often develop without warning and require intensive treatment regimes that last on average eight months, but may continue for a lifetime depending on the diagnosis. Encouragingly, advancing cancer treatments, a key accomplishment of cancer research over the past 40 years, have resulted in a growing community of cancer survivors. Approximately two in three adults diagnosed with haematological cancer (HC) can now expect to survive more than five years. However, they must attempt to navigate the …

Impact Of Caregiving Role In The Quality Of Life Of Family Caregivers For Persons With Alzheimer's Disease, Supriya Sarkar

All Graduate Theses, Dissertations, and Other Capstone Projects

This study investigated quality of life of family caregivers of persons with Alzheimer's disease (AD). Caregiving is a strenuous and challenging job. Family caregivers experience poor quality of life after they take the role of caregiving which might be related to depression. Purpose of this study was to find if caregiving duration and depression has any role in affecting family caregivers' emotional, physical, and general health.

Data for this study were collected through electronic and mailed survey methods. The questionnaires completed by subjects: Medical Outcomes Study Short Form 36 (MOS-36) and Center for Epidemiologic Studies Depression Scale (CES-D). Descriptive statistics …

Relationships Between Parenting Self-Efficacy And Distress In Parents With And Without Cancer, Julie Marie Cessna

USF Tampa Graduate Theses and Dissertations

Despite the relatively large number of parents with cancer, relatively little is known about the extent to which having cancer affects the parenting experience. Qualitative studies have identified issues and concerns that create distress among parents with cancer, but quantitative studies have yet to be conducted. Studies demonstrate that parents with cancer experience psychological distress, and that parenting self-efficacy is related to psychological distress among parents without cancer. However, no study to date has examined the relationships between parenting self-efficacy and psychological distress among parents with cancer. This study sought to address these gaps in the literature by comparing parents …

Role Of Physical Exercise In Reducing Depression And Improving Mental Health In Cancer Survivors, Gregory Levin

Theses: Doctorates and Masters

Cancer survivors are more than twice as likely as the general population to suffer the debilitating effects of depression. This comorbid condition is associated with several negative consequences, such as reduction in compliance with cancer treatments, and hastened mortality. Recent research has examined the therapeutic effect of exercise on depression and reported excellent results of similar magnitude to those achieved with pharmacotherapy or psychological intervention. However, no research, to date, has examined the effectiveness of exercise on reducing depression in depressed cancer survivors. In order to address this important question this thesis reviewed previous literature in the area of cancer …

A Randomized Controlled Trial Comparing Arthroscopic Surgery To Conservative Management Of Femoroacetabular Impingement, Heather C. Klaus

Electronic Thesis and Dissertation Repository

OBJECTIVE: To determine whether patients with femoroacetabular impingement (FAI) who undergo arthroscopic hip surgery experience similar outcomes at two years post-operative with respect to physical function, pain, and health related quality of life, compared to similar patients who receive conservative management, including medication and physiotherapy. This thesis is an interim analysis of ten participants who are six-months post-randomization. METHODS: Participants were randomized to either operative treatment (6) or conservative treatment (4), and completed general and region specific quality of life questionnaires, including the Hip Outcome Score (HOS), Lower Extremity Functional Scale (LEFS), Modified Harris Hip Score (MHHS), Non-Arthritic Hip Score …