Medicine and Health Sciences Commons^™

Identifying The Complexity Of Bipolar Disorder, Brandie Marie Stiles

Dissertations

Bipolar disorder is a complex illness that is difficult to correctly diagnosis and treat. Experts estimate that a correct diagnosis and treatment for bipolar disorder may be delayed for up to 7-10 years after symptoms become problematic. The primary purpose of this study was to identify the complexity of diagnosing bipolar disorder, including diagnostic patterns, recommended treatment, and patient response. A focused ethnography, including in-depth interviews and a retrospective chart review, were completed to answer the research questions: 1) What is the nature of the experience of receiving a diagnosis of bipolar disorder? 2) What are the diagnostic and treatment …

Implementation Of Sleep Assessment Questionnaire In College Health And Counseling Visits: A Quality Improvement Pilot, Sarah Ruth Jackson

Dissertations

Sleep deprivation or sub-optimal sleep hygiene in college students has profound implications. Decreased cognitive performance, increased depression or mood concerns, higher rates of usage of alcohol or marijuana to compensate for poor sleep are all interconnected. The American College Health Survey (2011) results indicated that students do not receive support or education on the importance of sleep habits from their schools or medical providers. This DNP project explored two areas of interest. The first was a change in patient interview protocol as a quality improvement project in UMSL University Health, Wellness, Counseling & Disability Access Services (UHWC&DAS). The second area …

Faculty-To-Faculty Incivility As Perceived By Nursing Faculty, Melinda Lofton Sills

Dissertations

The purpose of this research was to determine the perceived presence of workplace incivility among nursing faculty in associate, baccalaureate, and graduate nursing programs and whether there was a significant difference between workplace incivility behaviors, occurrence of incivility, extent of incivility, and engagement of incivility among the three groups. A convenience sample of faculty from nursing programs accredited by Accreditation Commission for Education in Nursing and Commission of Collegiate Nursing Education in Alabama, Arkansas, Florida, Louisiana, and Tennessee completed the Incivility in Nursing Education-Revised (INE-R) survey. The final sample included 169 nursing faculty.

Based on the results of the study …

Group Empowerment Capacity And Capability In Associate Degree Schools Of Nursing In The United States, Christy Lee Savell

Dissertations

The purpose of conducting this research was to determine the perception of group empowerment capacity (EC) and group empowerment capability (E) among faculty and administrators in associate degree nursing programs (ADN) in the United States (U.S.), whether there was a significant difference in the scores of EC and E between the two groups and if there was a significant relationship between the mediating variables and EC. The study was conducted online with administrators and faculty of ADN programs throughout the United States (U.S.). Information letters with questionnaire links were sent to all members of the Organization of Associate Degree Nurses …

Improving Veteran Access To Heart Failure Specialty Care: A Change Model Project, Mark Bird Whelchel

Dissertations

Background: Many Veterans Health Administration (VHA) facilities have cardiac services, but not all VHA centers offer heart failure care. Viable alternative models exist to traditional outpatient treatment by physicians, such as Tele-medicine consultations, the use of nurse practitioner run clinics, and the use of models such as Specialty Care Access Network-Extension for Community (SCAN-ECHO) and site specific contracted physician services models. These have the potential to improve Veteran access to care. Objective: The purpose of this change project was to conduct a needs assessment survey, in joint effort with the Hershey Medical Center Heart and Vascular Institute, to identify barriers …

Health Literacy As A Moderator In The Relationship Between Diabetes Knowledge And Diabetes Outcomes, Jameshyia Ballard Thompson

Dissertations

The purpose of this research was to determine if health literacy was a moderator in the relationship between diabetes knowledge and diabetes outcomes, and explore the relationship between diabetes knowledge and health literacy. The target population included adults living in Mississippi with a diagnosis of diabetes at any point in life. A pilot study was performed to determine if the Functional Communicative Critical Health Literacy scales (FCCHL) and the Spoken Knowledge in Low Literacy in Diabetes scale (SKILLD) were appropriate for use in a population of adults in Mississippi with a diagnosis of diabetes. Participants for the pilot study were …

The Lived Experience Of Urban Plus-Sized Black Women In A Midwestern City, Jolene Johnson Lynn

Dissertations

ABSTRACT Obesity among adults in the United States is a significant problem of growing proportions. Black women have a higher rate of obesity than other women but there is a paucity of research about the experiences and perspectives of plus-sized Black women. The purpose of this phenomenological study was to explore the experience of plus-sized Black women living in an urban area. Ten participants were interviewed guided by open-ended interview questions. All interviews were audiotaped and transcribed verbatim. Colaizzi’s (1978) phenomenological method was used to identify themes within the data. Data analysis resulted in three themes: the meaning of plus-size, …

Examining The Barriers And Facilitators Of Breastfeeding Duration Among Active-Duty Military Mothers, Andrea Lynn Farwell

Dissertations

Abstract Objective: To describe breastfeeding duration, as well as barriers and facilitators experienced, by active-duty women in the United States military. Design: A cross-sectional design guided the study. Setting: The setting was a social media site offering breastfeeding education and support for military mothers. Participants: The sample included 292 mothers who reported having a baby, initiating breastfeeding postpartum, and returning to work while serving active-duty in the United States within the last five years. Methods: An investigator-designed Qualtrics survey with multiple choice, Likert, and open-ended questions was used. Analysis procedures focused on descriptive statistics, chi-square, and logistic regression. Content analysis …

Body Image And Anthropometric Measurements In Bariatric Surgery Patients, Julie Ann Varns

Dissertations

Purpose: The purpose of this study was to explore body image and anthropometric (body mass index) measurements in bariatric surgery patients over three months. Conceptual framework: The dimensions of body image are body attitude, Appearance Evaluation, body checking, body space, body size, and Appearance Orientation. Body attitude is affective distress related to one’s weight, shape, size, and fatness. Appearance Evaluation is feelings of satisfaction or dissatisfaction with one’s looks. Body checking is the repeated scrutiny of one’s body size, shape, and weight. Perceived body space is the amount of space individuals perceive their bodies to occupy. Perceived body size is …

Simulation Learning And Transfer To The Clinical Environment In Undergraduate Nursing Students, David A. Miles

Dissertations

Simulation learning is an integral component of many undergraduate nursing programs throughout the country. Experiential learning through simulation allows students to improve their cognitive, affective, and psychomotor skills. Some clinical experiences lack significant practice of clinical skills for students; including the inability to assume the role of the nurse. A recent literature review revealed a need to advance the understanding of simulation learning and transfer; with many questions still remaining unanswered. The aim of this study was to conceptualize the process by which simulation learning transfers to the clinical environment in undergraduate nursing students. Twenty-five, fourth-year traditional nursing students, who …

The Relationship Between Light Exposure And Fatigue And Mood In The Patient Undergoing Bone Marrow Transplant, Kimberly S. Anderson-Drevs

Dissertations

Exposure to light is known to produce changes within the human body. It has demonstrated ability to produce changes in the circadian rhythm and the sleep wake cycle and to change the production and secretion of melatonin and corticosteroids. The bulk of research is related to the use of bright light therapy (BLT) for certain depressive disorders. The literature does not provide a standard of care for BLT administration dose or schedule. This study intended to define any relationship between natural and ambient light with a hospitalized patient’s mood and/or fatigue level. Further it aimed to relate cumulative light levels …

Restoring Trust: A Grounded Theory Study Of Cyberbullying Among Young Women, Nancy H. Camp

Dissertations

Cyberbullying is a global and national public health issue with the potential to affect the healthy social and emotional development of adolescents and young adults. There has been an 80% increase in social media use in 18-29 year olds between 2004 and 2014 (Gahagen, Vaterlaus, & Frost, 2016). In a study of 14-24 year olds (MTV/AP, 2011), 76% identified cyberbullying as a serious problem, with more than 56% reporting they have experienced cyberbullying. Cyberbullying research has been conducted predominantly with adolescents (ages 11-18 years), however scant research has been conducted with older adolescents and young adults (ages 18-30 years). This …

What Is The Process Of Relational Work Of The Nurse?, Daniela Terrizzi Defrino

Dissertations

The process of how nurses work in relationships to accomplish their work is presented in this dissertation. This study has made the relational work process of nurses explicit. While research demonstrates that increased nurse staffing is associated with better patient outcomes and with nurses experiencing less burnout and job dissatisfaction, the process is not explored in the empirical literature.

The research question was: “What is the process of relational work of the nurse?” Data collection and analysis conformed to the process of classical grounded theory. Interviews were face to face with 23 registered nurses working as direct care staff nurses …

Expectations And Quality Of Life During The Antepartum And Postpartum Period, Mary Kathryn Adams

Dissertations

During pregnancy, women frequently anticipate birth and motherhood with unrealistic images and expectations which are formed by personal experience and society’s portrayal of motherhood (e.g., books and movies). How these expectations impact the postpartum period for women has not been well studied. However, research has identified a link between maternal expectations, reality, and negative emotional responses. When expectations are met, the experience of motherhood may be a positive one. However, when these expectations are not met, the potential for negative emotional responses may be greater. The postpartum period is a significant period of adjustment, and depression occurs in about 13%–19% …

Use Of Video Games In Patients' Self-Management Of Pain: A Feasibility Study, Janet Donnelly Phd(C), Rn-Bc, Acns-Bc, Pccn

Dissertations

Background: Pain affects more than 75 million Americans and is the primary reason people seek medical attention. Pain is a common cause of disability and diminished quality of life. While anecdotal evidence exists regarding nurses’ use of distraction therapy activities in pain management, little empirical research data is available.

Purpose: To examine the effects of video game use (VGU) on pain perception, pain interference perception and perceived self-efficacy in pain management in adult inpatients.

Conceptual Model: The conceptual model is based on Self-efficacy Theory (Bandura, 1995). The antecedents of the concept of distraction therapy with use of VGs in patients’ …

Avoiding Hospital-Acquired Conditions: A Qualitative Analysis Of Early Top Performers, Tammy Doolittle

Dissertations

Preventable medical errors in hospitals cost our nation an estimated 180,000 annual deaths and tens of billions of dollars. The Patient Protection and Affordable Care Act mandated improvements in quality and patient safety. The Centers for Medicare and Medicaid Services, acting on these imperatives initiated legislation-mandated programs halting reimbursement to hospitals for specific hospital-acquired conditions (HAC) coined as Never Events. To date, studies have focused on quantifying incidence of specific HAC and assessing policy impact without correlating findings to actual outcome performance. The purpose of this study was to develop an understanding of organizational, contextual, process, and other factors occurring …

School Nurse Perceptions And Decisions About Children Self-Carrying Inhalers In School, Lisa Anne Dominguez Jaurigue

Dissertations

Every state in the United States has passed legislation allowing students to self-carry rescue inhalers in the school setting. Many organizations are stakeholders in respiratory issues, school health issues, and pediatric issues, recommending the support of this practice. Students’ ability to self-carrying rescue inhalers in the school setting has been impacted by school nurse perceptions and decision-making. This study addressed the questions: (a) What are school nurse perceptions and attitudes in regard to children self-carrying inhalers in the school setting? (b) How do school nurses decide whether children can self-carry inhalers in the school setting? and, (c) Are school districts …

Symptom Experience And Influenza-Like Illness In A Military Population, Monique Bouvier

Dissertations

AIMS: The primary objective of this study was to identify if symptom presentation expressed over the course of an influenza-like illness (ILI) can predict virus type by use of unsupervised machine learning. The secondary objective was to describe clinical characteristics of strain specific coronavirus. Finally, examine the psychometric properties of the Canadian Acute Respiratory Illness and Flu Scale (CARIFS).

BACKGROUND: ILI outbreaks have been a significant source of non-battle injury among military personnel. Many different viruses cause ILI, and it is difficult to determine which virus is causing the illness. Recent studies have examined the etiology and epidemiology of ILIs. …

Exploring The Lived Experience Of Male-To-Female Transgender Youth Accessing Trans-Related Healthcare In Los Angeles, Marcel Fomotar

Dissertations

Background: According to the National Institutes of Health (NIH) (2015), LGBTI individuals delay healthcare treatment because they fear stigmatization or because they believe many healthcare professionals lack knowledge and experience working with LGBTI individuals. The phenomenon of living as a transgender person and accessing trans-related healthcare is understudied.

Aim: To explore the perceived meaning of accessing transgender-related healthcare among transgender youth.

Method: A phenomenological qualitative design grounded on Husserl’s descriptive phenomenology was used to explore the ascribed meaning associated to accessing trans-related healthcare services among transyouth as they experienced and perceived it. A purposive and thematic sample of Male-to-Female transyouth …

In-Hospital Factors Associated With Supplementation Among Healthy, Full-Term, Breastfed Infants, Jodi Kae O'Brien

Dissertations

Background: Formula supplementation of healthy, term, breastfed infants born to mothers who plan to exclusively breastfeed persists at high rates, in spite of global reduction efforts. The identification of modifiable risk factors for supplementation and effective nursing care for successful breastfeeding is understudied.

Purpose: This study aimed to better understand the obstetrical, hospital, and nursing factors associated with supplementation during the hospital stay. The aims were: (1) examine the relationships between aspects of hospital care of infants who are supplemented compared to infants exclusively breastfed and (2) determine what in-hospital risk factors increase the odds of formula supplementation among a …

Access And Barriers To Care During Transition From Active Duty To Veteran Status In Veterans With Diabetes: A Look At Health Literacy, Change, And Ongoing Diabetes Self-Management Education, Mark R. Malebranche

Dissertations

Background and Rationale: Transition from active duty to veteran status may be a challenging time, especially for veterans with diabetes. These veterans face multiple changes that can cause distress. Most veterans with diabetes have type 2 diabetes, however a diagnosis of type 1 diabetes on active duty is cause for discharge for active duty.

Purposes and Aims: The purpose of this study was to describe the transition experience of veterans diagnosed with diabetes while on active duty from active duty to veteran status. The study describes barriers and facilitators to healthcare and diabetes self-care management. The four aims of the …

Transitions To Assisted Living Within A Continuing Care Retirement Community, Judith H. Scott

Dissertations

Purpose/Aims: The purpose of this study was to explore the lived experience of older single women who moved from their independent homes to the assisted living setting, both situated within a Continuing Care Retirement Community (CCRC).

Rationale: Anecdotally, CCRC transitions have been viewed as either one dreaded possible step toward the end of life or a supportive place to open a new chapter in older adults’ lives. However, no studies have actually examined this experience among older single women, who comprise a large proportion of people making this transition.

Background: Older adults move to assisted living within a CCRC when …

A Grounded Theory Approach To Healthy Work Environment: Its Impact On Nurses, Patient Safety, And Significance In Healthcare Settings, Nicole Sevilla-Zeigen

Dissertations

A healthy working environment has been an area of interest for occupation health providers. There is anticipation that a safe working environment improves patient safety, which is associated with reduction in clinical nurse errors. Issues with medication errors and poor working environment pose a greater risk to patient safety. The aim of this qualitative study was to provide a broad understanding on nurses’ perceptions on the processes that influence a healthy working environment and the impacts of a healthy working environment on patient safety. An interpretive grounded theory methodology was used in this study to evaluate nurses’ perceptions in acute …

The Effect Of Organizational Commitment, Organizational Based Self Esteem And Work Engagement On Nurses' Perception Of Medication Errors, Vanessa V. Wertheim

Dissertations

Background: Organizations rely on the accurate reporting of medication errors or omissions by bedside nurses to improve the medication delivery system in order to prevent further errors from occurring in the future. In a time where nurses are managing more complex patients with shorter lengths of stay, full engagement in the role is essential. Literature from other disciplines suggests that many factors can influence work engagement (Chughtai & Buckley, 2011; Schaufeli, Salanova, González-Romá & Bakker, 2002; Schaufeli & Bakker, 2003). Two of these factors include organizational commitment and organizational-based self-esteem (Allen & Meyer, 1990; Bowling, Eschleman, Wang, Kirkendall & Alarcon, …