Medicine and Health Sciences Commons^™

Leadership Practices Of Supervisory Employees: An Exploration Of Current Practices At A Southeastern Veterans Affairs Medical Center, Melissa M. Zimmerman

Electronic Theses and Dissertations

As the nation’s healthcare system moves through the 21^st century, unprecedented changes are occurring on both a local and global stage. Healthcare organizations are faced with creating and implementing leadership strategies to enhance the overall patient experience. When coupled with the need to ensure increased nurse job satisfaction, improved cost-effectiveness and healthy organizational cultures with fiscally sound budgets, improvement work has led efforts to ensure effective leadership techniques are used across an agency.

This task may be viewed as commonplace for some organizations, while others may perceive this process as a complete paradigm shift from historical practices related to …

Effects Of A Text Message-Based Motivational Interviewing Intervention On Cigarette Smoking In College Students., Anna Jorayeva

Electronic Theses and Dissertations

Purpose: The purpose of this dissertation was to examine the effects of a novel text message-based motivational interviewing intervention on cigarette smoking behavior in college students. Three manuscripts comprised this dissertation and included: a state of the science review of motivational interviewing and text message-based smoking behavior interventions in adolescents and young adults; a critical review and analysis of instruments used to measure nicotine dependence in young adults; and a quasi-experimental study testing the effects of a novel text message-based motivational interviewing intervention on cigarette smoking behavior in college students. Background: Cigarette smoking is the number one preventable cause of …

Psychometric Testing Of The Presence Of Nursing Scale: Measurability Of Patient Perceptions Of Nursing Presence Capability Of Nurses In An Academic Medical Center, Rebecca L. Turpin

Electronic Theses and Dissertations

Introduction: Nursing presence occurs when nurses expend themselves on the behalf of a unique patient. This phenomenon requires further research to develop instruments. The Presence of Nursing Scale (PONS) measures the patient’s perspective (Kostovich, 2012). Psychometric testing of PONS-Revised using exploratory factor analysis is warranted to further develop a reliable and valid measure of nursing presence. Contextual workplace variables need exploration in inpatient settings for correlation with nursing presence.

Method(s): A convenience sample of 122 adult inpatients from ten acute-care nursing units in a Southeastern Magnet hospital were surveyed to conduct the first psychometric testing of this revised instrument using …

To Foster A Culture Of Curiosity: A Hermeneutic Study Of The Experienced Nurse Educator And Student Intellectual Curiosity In The Online Learning Environment, Bedelia H. Russell

Electronic Theses and Dissertations

Skills of inquiry are essential outcomes from a baccalaureate nursing education. Students who demonstrate intellectual curiosity can develop effective skills of inquiry. Nurse educators must place emphasis on teaching and learning strategies which engage student intellectual curiosity. However, the concept of intellectual curiosity is not well-studied across multiple contexts of teaching and learning environments within nursing education. In addition, there is little known about the experienced nurse educator and the meaning of student intellectual curiosity across multiple teaching and learning environments. With the increased emphasis on online teaching and learning in nursing education as a solution for expanding student access …

Factors Associated With Self-Care Behavior In Persons With Heart Failure., Mohammed Munther Al-Hammouri

Electronic Theses and Dissertations

Introduction: Heart failure is a serious illness that mostly affects the elderly. It is characterized by progressive deterioration of the heart muscle and affects the quality of life of those living with it. The progression of the illness has been shown to be slower with appropriate self-care. Several studies examined predictors of self-care extensively. The results were inconsistent and usually explained a small fraction of the variance in self-care in persons with heart failure, and they usually overlooked some potential predictors that could be related to self-care in person with heart failure. Purpose: The purpose of this study was to …

Factors That Influence Classroom Participation Of Junior- And Senior-Level Nursing Students, Mary Tedesco-Schneck

Electronic Theses and Dissertations

The healthcare system is dynamic and complex and requires innovative problem-solving to address inherent challenges and incorporate new knowledge and technology that may impact care. Nurses, as healthcare providers, need to be creative problem-solvers; hence nursing faculty must provide students with a foundation for problem-solving skills during their formative academic years. These skills may be enhanced through pedagogies that foster active learning supported by classroom participation. Feminist pedagogy reforms the faculty/student relationship and empowers students to be active participants in learning.

The purpose of this study situated in feminist pedagogy was to determine factors that influence classroom participation of junior-and …

A Hermeneutic Phenomenological Study Of The Lived Experience Of Adult Female Sexual Assault Survivors, Ann N. Hellman

Electronic Theses and Dissertations

Sexual assault is an international problem affecting hundreds of thousands of women each year. Significant psychological, physical, and financial consequences result from sexual assault. The prevalence of sexual assault suggests that nurses frequently encounter survivors yet minimal literature exists focusing on how nurses should adjust their care to meet the needs of this population.

The phenomenon of sexual assault has been widely studied from multiple perspectives and across disciplines. Likewise, studies of spiritual and religious beliefs and practices and their impact at the end-of-life and in disease, grief, and loss are extensive in nursing literature. However, a nominal number of …

Psychological And Sociocultural Influences Of Current And Historical Intimate Partner Violence In Pregnancy, Cindy D. Phillips

Electronic Theses and Dissertations

The Centers for Disease Control and Prevention (CDC) estimates that 1.5 million women are victims of intimate partner violence (IPV) each year, and 324,000 of these women are pregnant (2013). Research on the predictability of certain factors and their relationship to current and historical IPV is limited. In order to better understand IPV as it related to a sample of 1,016 Appalachian pregnant women selected for the Tennessee Interventions for Pregnant Smokers (TIPS), it was important to evaluate various influences that may predict the prevalence of IPV in this population when compared to the State of Tennessee and the U.S. …

Identification Of Predictors And Moderators Of Weight-Related Behaviors In College Students., Heather Owens

Electronic Theses and Dissertations

College students are at increased risk for weight-gain and obesity compared to their non-student peers. Although many studies have confirmed these findings, few address the underlying causes of weight-related behaviors in college students. Associations between sleep behaviors (sleep duration and sleep quality), stress and weight-related behaviors (physical activity and food choices) have been identified, but studies have not adequately explored these associations among college students. Further, the influence of bioecological determinants of health cannot be overlooked when addressing health-related behaviors in diverse populations. The purpose of this dissertation was to explore factors impacting sleep behaviors and weight-related behaviors in college …

Predicting Nclex-Rn Performance : An Exploration Of Student Demographics, Pre-Program Factors, And Nursing Program Factors., Heather Davis Mitchell

Electronic Theses and Dissertations

Nursing programs are experiencing a decline in National Council Licensure Examination for Registered Nurses (NCLEX-RN) pass rates among graduates. While researchers have attempted to identify predictors of performance on the NCLEX-RN, identification of predictors remains elusive. Although the literature is replete with studies exploring NCLEX-RN predictors, prediction under the new 2013 NCLEX test plan and passing standards is not well established. Considering the ever-evolving diversity in students, combined with recent changes in the NCLEX-RN, further exploration of predictors of performance is warranted. Using a correlational design, the study sought to identify the predictors of NCLEX-RN performance for Bachelors of Science …

Positive Deviance, Contraceptive Self-Efficacy And Social Desirability In Sexually Active Adolescent Females : A Mixed Methods Approach., Ashley D. Miller

Electronic Theses and Dissertations

Unintended pregnancy is an issue that impacts women of all ages, ethnicities, and socioeconomic statuses. It also impacts the child that results and the society in which they live. In the United States, adolescents experience unintended pregnancy more than adolescents in other countries. The purpose of this dissertation was to explore the factors that contribute to successful contraceptive use among adolescent females (ages 13-18) seeking reproductive health services at a local family planning clinic. The theoretical framework of contraceptive self-efficacy (CSE) was used to frame this understanding. The exploration was conducted in three ways: a critical review of the literature …

An Evaluation Of Anxiety Following Substance Abuse Withdrawal And Assessment Of Somatic Treatments Presently Available With A Focus On Cranial Electrotherapy Stimulation, Janet Hutchison

Electronic Theses and Dissertations

Addictive disorders/substance use disorders (SUDS) affect almost everyone in the United States, either directly or indirectly. The cost of substance abuse to the social and economic structure in the United States is huge. Anxiety is one of the most frequently mentioned symptoms which lead to relapse during the early weeks of recovery due to neurohormonal changes in the limbic system as well as cortisol production which occur during this time. Present research in the treatment of anxiety in substance abuse and long term recovery is focused on genetics and pharmaceuticals, however most pharmaceuticals produce sedation. Additional therapies in early recovery, …

Determining The Relationship Among Change Fatigue, Resilience, And Job Satisfaction Of Hospital Staff Nurses, Robin Brown

Electronic Theses and Dissertations

Purpose: The purpose of the study was to determine if there is a relationship among change fatigue, resilience, and job satisfaction of hospital staff nurses and if differences exist between novice and experienced staff nurses.

Background: Healthcare is typified by change. Organizational changes have a negative impact on nurses and the effects of organizational change are being overlooked and under researched. Change fatigue is a result of constant organizational change and has not been researched with nurses.

Methods: The study utilized a descriptive correlational design. Participants completed an online survey, using three tools: Change Fatigue Scale, Connor-Davidson Resilience Scale (CD-RISC), …

Preschool Attendance: A Parental And Teacher Perspective Of Barriers And Behaviors Using Grounded Theory Research, Anne Meoli

Electronic Theses and Dissertations

Background: Preschool children from single-parent households with lower socioeconomic status (SES) are absent from preschool at rates higher than any other group. Some children are chronically absent, missing more than 10% of the school year. The phenomenon of preschool attendance related to behaviors, practices, and parental decision making associated with health and illness in lower SES households has not been previously studied using grounded theory methodology. Aim: The purpose of this study was to explore decision making related to supporting attendance in a preschool of 67 children (aged 3 to 4 years) with primarily low-income, single parents and preschool teachers …

The Nurse As A Family Caregiver: Their Experience, Their Story, Julie A. Hansen

Electronic Theses and Dissertations

The purpose of this qualitative narrative research study was to explore and bring more attention to the Registered Nurse in the role of informal caregiver to family members. These caregivers are responsible for the care of parents, spouses, and children. The stories shared in this study are not isolated experiences as more and more nurses are placed in the caregiver role outside of their formal professional role. The number of caregiver roles are expected to increase with the increasing numbers of baby boomers and improved life expectancy.

Perceived Readiness To Transition To Adult Health Care For Youth With Cystic Fibrosis And Congruence With Their Caregivers' Views, Valerie Lapp

Electronic Theses and Dissertations

Youth with cystic fibrosis must gradually assume considerable self-care management skills in order to optimize longevity and quality of life, and healthcare providers and caregivers play a role in youth gradually assuming these skills. The purpose of this study was to determine how youth with cystic fibrosis perceive their self-care management skills required for transition to adult healthcare, the relationship between age and skill acquisition, youth and caregiver congruence on perceived transition readiness, and frequency of transition discussion with provider. In this descriptive, correlational, cross-sectional design, 58 youth ages 14-22 rated their skill ability in managing cystic fibrosis using the …

Evaluating Moral Distress, Moral Distress Residue And Moral Courage In Oncology Nurses, Lolita Melhado

Electronic Theses and Dissertations

Purpose: To examine relationships between moral distress, moral distress residue, and moral courage and to determine which nurse characteristics are predictive of moral distress and moral courage. Methods: The study used a mixed methods cross-sectional correlation design and qualitative content analysis to investigate oncology nurses' characteristics and relationships between moral distress, moral distress residue, and moral courage. A convenience sample of 187 oncology nurses working in inpatient and outpatient settings was recruited through the national Oncology Nursing Society in the Southeastern United States. Hamric's 21-item Moral Distress Scale-Revised (MDS-R) and Sekerka et al. 15-item Professional Moral Courage Scale (PMCS) supplemented …

Prehabilitation (Prehab): Prevention In Motion, Billie Russell

Electronic Theses and Dissertations

Cardiovascular disease is the leading cause of death for U.S. adults. It adds greater than $100 billion to U.S. health care costs annually. Rates of morbidity, mortality, and economic burden of the disease could be dramatically reduced with improvements in sedentary behaviors among adults with coronary artery disease (CAD). A regular commitment to moderate physical activity can reduce ischemic heart events up to 50%. Although the benefits of physical activity are well-known for individuals with coronary artery disease, an estimated 70% of this population remains relatively sedentary. Hospital-based cardiac rehabilitation programs are the single secondary prevention option offered to improve …

Pilot Study Of The Effects Of Heart Rate Variability Biofeedback On Perceived Stress, Perceived Coping Ability, And Resilience In Accelerated Baccalaureate Nursing Students, Andrea J. Harmelink

Electronic Theses and Dissertations

Objective. The purpose of this quasi-experimental randomized controlled two-group pilot study was to test the effectiveness of a Heart Rate Variability Biofeedback (HRVB) intervention on accelerated baccalaureate nursing (ABN) students’ perceived stress, perceived coping ability, and resilience over four weeks during an academic term of ABN coursework. This study was guided by Lazarus and Folkman’s Transactional Theory of Stress and Coping, with a focus on primary appraisal.
Background. ABN students report higher perceived stress and anxiety compared with nursing students in traditional four-year nursing programs due to the compressed and fast-paced format of the ABN curriculum. Qualitative data points to …

The Learning Experiences Of Immigrants Who Are Graduates Of An Entry-Level Baccalaureate Nursing Program In Minnesota, Marcia L. Scherer

Electronic Theses and Dissertations

The United States faces an immigrant population explosion with more foreignborn residents compared to any country in the world. Each immigrant enters with individual and cultural health beliefs and, as they seek health care, often prefers to receive care from someone who understands and supports their cultural beliefs and customs. Nurses comprise the largest segment of healthcare providers. Within this population of nurses, the number of ethnically diverse nurses continues to stagnate at astoundingly low levels. The literature reviewed neglected to identify interviewing immigrants separate from ethnically diverse nursing students. Understanding the immigrant’s nursing education experiences is essential to addressing …

Relationship Between Self-Care Agency, Self-Care Practices, And Body Mass Index Among Nursing Professionals, Takara Schomberg

Electronic Theses and Dissertations

Purpose: The purpose of this study is to investigate the relationship between self-care agency (SCA), self-care practices (SCP), and Body Mass Index (BMI) among Registered Nurses (RNs) living in an urban South Dakota county. These specific constructs and their relationships have not been researched among nursing professionals. Methods: This study used a non-experimental, predictive correlational approach based on Orem’s Self-Care Deficit Theory to quantify the relationship between self-care agency and self-care practices and subsequently body mass index (BMI) among nursing professionals. A tracked but anonymous online survey was sent by email via QuestionPro to 210 nursing professionals selected using systematic …

Depression Outcomes In Care Coordination, Primary Care And Psychiatry Patients After Pharmacogenetic Testing, Julie Kittelsrud

Electronic Theses and Dissertations

Objective. The purpose of the study is to compare the outcomes of patient activation before and after pharmacogenetic care in a coordinated care population. The process of pharmacogenetic care includes the patient’s acknowledgment of medication changes which are based on their genetic profile. This study will be framed by Dorothea Orem’s Self-Care Theory and Davies and Conley’s framework of genetic influences in prescribing anti psychotropic therapy.

Background. Understanding patient’s behavioral reactions to pharmacogenetic care in terms of patient activation is important to understanding patient’s health outcomes. No published studies were identified in literature reviews conducted by this author which …