Medicine and Health Sciences Commons^™

The Correlation Of Size Of Core Network And Frequency Of Contacts With Agitation And Positive Affect In Elderly With Dementia, Amal Ali Al Ghassani

Theses and Dissertations

In the country of Oman, care needs of older adults are primarily provided by family members in the home. The study was guided by socioemotional selectivity theory, the environmental vulnerability hypothesis, and the need-driven dementia-compromised behavior theories. The central premise was that the size of the person’s activities of daily living (ADL) core network and frequency of contact with the ADL core network would predict agitation and affect. A smaller core network with a higher frequency of contact may be better at identifying and treating the person’s unmet needs. A secondary premise was that the emotional closeness of the core …

Evaluation Of Student Competence In Simulation Following A Prebriefing Activity: A Pilot Study, Sarah Black Beman

Theses and Dissertations

Background: Simulation-based learning (SBL) shows promise to potentially improve clinical competence in nursing education. The efficacy of evidence-based prebriefing activities and valid and reliable systems to evaluate those strategies is a gap in the literature. Preliminary evidence shows that prebriefing can improve participant outcomes. The goal of this pilot study was to compare the outcome of clinical competence for prelicensure nursing students based on assignment to one of the following prebriefing activities: standard, careplan, or concept mapping. Methods: This is a quasi-experimental double-blind, posttest only, comparison-group design, pilot study. The participants were from an associate degree professional nursing program. Out …

Feasibility Of A Social Emotional Parenting Curriculum Applied In An Early Head Start Home Visitation Program With Mexican Immigrant Families, Patricia J. Ealy

Theses and Dissertations

Early social-emotional development is influenced by the experiences of the child especially the parent-child interaction and relationship. Influences on the parent’s ability to provide nurturing enriched parenting experiences include the parent’s past encounters with how they were parented. The Building Early Emotional Skills curriculum (BEES) has a component of self-awareness exercises that assist parents to understand personal parenting behaviors and attitudes. The BEES framework is an infant mental health model with a specific focus on early social emotional development. Curricula related specifically to early child social-emotional development based on an infant mental health model is limited in the literature. However, …

Exploring Resiliency And Family Functioning For Families Of Premature Infants, Karen Schnackel Gralton

Theses and Dissertations

The impact of a premature birth on a family is a crisis requiring a process of adjustment and adaptation. The Resiliency Model of Family Stress, Adjustment and Adaptation (RMFAA) describe this process for families and was the conceptual framework for the current study. A modified model of the RMFAA was used to explore family resiliency for Non-Hispanic Black (NHB) and Non-Hispanic White (NHW) families of premature infants through the identification of protective and recovery factors. The aims of the current study explored the association between protective and recovery factors and family functioning.

Biological mothers of premature infants (< 37 weeks gestational age) and one other family member, who identified as either NHB or NHW were recruited in five separate Level III or IV neonatal intensive care units. Fifty-five NHW (N = 110) and 24 NHB (N = 48) families completed five scales that assessed their use of protective and recovery factors and their perception of family functioning. Mean scores for family functioning indicated that most family members viewed themselves as functioning effectively at that point in time.

Specific demographic …

Relationships Among Climate Of Care, Nursing Family Care And Family Well-Being In Intensive Care Units, Natalie Susan Mcandrew

Theses and Dissertations

Family inclusion in health care delivery is vital for family well-being. However, intensive care (ICU) nurses experiencing frequent ethical conflict, low levels of organizational support and high levels of burnout may not be able to adequately care for families. The purpose of this study was to explore the relationships among variables related to the climate of care, nursing family care and family well-being in the ICU setting. A conceptual model derived from nursing, family, and organizational theories guided the study.

A cross-sectional, correlational design was used with a convenience sample of nurses (n= 115) and family members (n = 44) …

Parental Attitudes Of Immunization In Children With Special Healthcare Needs: A Qualitative Study, Maren Topham

Theses and Dissertations

Background and Purpose: Just over 15% of children under 18 years of age in the UnitedStates, or approximately 11.2 million children, are estimated to have special healthcare needs.Although children with special healthcare needs (CSHCN) make up a small percentage of thepediatric population, they account for over one third of pediatric medical care. Parental attitudesregarding immunization play a significant role in vaccination rates among children. The purposeof this research is to explore parental attitudes regarding immunization of CSHCN.Methods: This qualitative study focused on parental perceptions and beliefs aboutimmunizations for CSHCN. Sixteen participants, who were parents of CSHCN from onepediatric specialty care …

Social Capital And Hospital Readmission Of Older Adults, Sheryl Emmerling

Theses and Dissertations

This dissertation is comprised of three manuscripts exploring the concept of social capital and hospital readmission of older adults. The first manuscript provides a review of the literature evaluating studies that measure the relationship between social capital and health, healthy behaviors, and access to and utilization of healthcare resources. Further research focusing on testing various types of individual social capital and their relationship to key outcomes including hospital readmission is needed.

The second manuscript is a description of the Social Capital and Health Framework that can serve as an outline for assisting nurses and other healthcare providers to consider older …

Influence Of Expectations Of Aging On Older Women’S Use Of Dietary Supplements Using The Health Promotion Theory, Barbara Emily Hekel

Theses and Dissertations

The use of vitamins, minerals and herbal supplements by older adults is increasing and changing. There are concerns about supplement quality, safety, and vitamin D overuse. Little is known about supplement use by nursing home residents and about factors that influence older women to use supplements. The current study describes the supplement use of 247 nursing home residents and 110 independent living women 65 years or older in the Midwestern United States. A secondary analysis of 247 medication administration records describes the prevalence of vitamin, mineral, and herbal supplement use of nursing home residents. Using the health promotion theory, the …

State Requirements For Childhood Vaccination Exemption Forms In The United States, Katherine Elizabeth Hill

Theses and Dissertations

In the United States, children must be vaccinated in order to attend school, although parents also have the right to request a vaccine exemption. The type of vaccine exemption varies by state but can include exemption for religious, philosophical, medical, and temporary medical reasons. The purpose of this research was to identify the use of provider signature requirements and fees in states during the vaccine exemption process. A questionnaire was sent to immunization managers in the 50 United States, District of Columbia, the United States Indian Health Service, and eight United States territories. The managers were asked if their states …

The Supervision Of School Nurses In New Jersey: Parallel Needs, Actions, And Impacts On Student Care, Lee-Ann Halbert

Theses and Dissertations

New Jersey Certified School Nurses (NJ-CSNs) practice in an environment of parallel needs and actions where the primary goal is the education of the students in the building, yet the health and safety of each student are paramount. The research presented here evaluates how the supervision provided to the NJ-CSNs affects their clinical practice and other areas of decision-making in the school setting. This mixed methods research study of 557 NJ-CSNs reveals that school nurses who are supervised by an educator whose background includes being a registered nurse are better able to provide the optimal support for the nurses, and …

Critical Care Nurses' Experiences Of Family Behaviors As Obstacles In End-Of-Life Care, Caitlin Brook Mallory

Theses and Dissertations

Background: Critical care nurses (CCNs) frequently provide end-of-life care for critically ill patients. CCNs may face many obstacles while trying to provide quality EOL care. Some research focusing on obstacles CCNs face while trying to provide quality EOL care has been published; however, research focusing on family behavior obstacles is limited. Research focusing on family behavior as an EOL care obstacle may provide additional insight and improvement in care. Objective: What are the predominant themes noted when CCNs share their experiences of common obstacles, relating to families in providing EOL care? Methods: A random geographically dispersed sample of 2,000 members …

Parents Advising Parents: Raising A Child With Type 1 Diabetes, Becky Jean Rasmuson

Theses and Dissertations

Background and Purpose: Children diagnosed with Type 1 Diabetes face significant challenges in the day to day management of their disease. Parents play an important role in supporting children at every stage of their lives and helping them transition to independence in the management of T1D. The purpose of this study was to learn from parents who have raised their children with T1D to adulthood and identify strategies for parents who are currently raising a child with T1D. Methods: Using a biographical method, a qualitative design, two in-depth interviews with open-ended prompts were completed with purposively selected parents of children …

Opioid Prescription And Use After Laparoscopic Cholecystectomy, Valynn Christina Haslam

Theses and Dissertations

Background: Opioid abuse has become a serious public health issue. While adequate pain management is an ethical responsibility for health care providers, responsible stewardship of controlled substances is of equal concern. Opioids are often prescribed for treatment of acute pain post-operatively. The purpose of this study is to examine opioid prescription practices and use of opioids after laparoscopic cholecystectomy. Methods: A convenience sample of 42 patients scheduled for laparoscopic cholecystectomy were enrolled in the study. Using a descriptive study design, patients were interviewed by phone 6-10 days post-operatively using a scripted questionnaire. The average number of excess prescribed opioid medication …

Patient Web Portal Use Among Women With Gestational Diabetes, Megan Anderson

Theses and Dissertations

Background: The prevalence of gestational diabetes mellitus (GDM) continues to increase. Research suggests that adverse maternal and newborn outcomes increase in relation to the mother’s elevated blood glucose levels. Diabetes researchers discuss that utilizing information technology for self-management, particularly Internet-based modes of delivery, may result in individual improvements in diabetes outcomes. Scant research exists on the use of Internet-based tools such as patient web portals (PWPs) for GDM self-management and outcomes.

Purpose: The purpose of this study was to examine PWP use in women with GDM. Specific aims of this study included: 1) compare the characteristics of nonusers and users …

Influence Of Health Beliefs On Diabetes Self-Care In Saudi Adults, Moudi Albargawi

Theses and Dissertations

The prevalence of Diabetes Mellitus Type 2 (DMT2) has increased among the adult population in Saudi Arabia. Many Saudi adults with DMT2 fail to follow the recommended daily self-care activities, increasing their risk for diabetes-related complications. Findings in the literature show that people’s health beliefs influence their self-care behaviors. However, limited studies were found to examine the association between the health beliefs of Saudi adults with DMT2 and their diabetes self-care. Therefore, the aim of this dissertation study was to examine the relationship between the health beliefs of adults in Saudi Arabia with DMT2 and their reported adherence to their …

Patient Acuity As A Predictor Of Length Of Hospital Stay And Discharge Disposition After Open Colorectal Surgery, Martha Kimpton Badger

Theses and Dissertations

Major areas of concern within the US healthcare system today include the quality and cost of healthcare. Open colorectal surgery patients have a higher prevalence of prolonged length of hospital stay (LOS) than most other types of surgery patients and are likely to be discharged to home care or other healthcare settings (DHCS), both of which contribute to increased costs. The ability to predict which patients are at risk for these outcomes early after open colorectal surgery could prompt nursing interventions aimed at improving quality of care and reducing healthcare costs. Radwin and Fawcett’s Refined Quality Health Outcomes Model served …

Maternal Abo Blood Phenotype And Factors Associated With Preeclampsia Subtype, Adriane Burgess

Theses and Dissertations

Preeclampsia affects 3-8% of all pregnancies and is a global issue that significantly effects the short and long-term health of women and neonates. The pathophysiology of preeclampsia remains unclear and there seems to be two distinct subtypes, early and late onset. Each subtype may have a unique pathophysiology and set of risk factors. Preeclampsia is linked to long-term risk of cardiovascular disease in previously affected women. Subsequently, risk factors shared between preeclampsia and cardiovascular disease should be explored. The main aim of this study was to determine the strength of association between maternal ABO blood type and preeclampsia subtype. This …

Improving Research Participants' Understanding Of Informed Consent, Debra Jean Gillespie

Theses and Dissertations

ABSTRACT

IMPROVING RESEARCH PARTICIPANTS’ UNDERSTANDING

OF INFORMED CONSENT

by

Debra J. Gillespie

The University of Wisconsin-Milwaukee, 2017

Under the Supervision of Professor Rachel Schiffman

Twenty-five to sixty percent of research participants are unable to understand important information during the research consenting process. This lack of comprehension may unintentionally expose research participants to potential harm. The purpose of this study was to test the teach back method of communication as an intervention to improve research participants’ understanding of informed consent. The Shannon Weaver Communication model was the theoretical framework supporting this study. The pre-intervention sample (control group) of 18 participants enrolled …

Exploring Factors Influencing Health Promoting Behaviors Among Latino Immigrants, Martin Joseph Mikell

Theses and Dissertations

Latinos immigrants may experience stress during acculturation to the U. S., which can influence their ability to engage in health-promoting behaviors, such as dietary intake and physical activity. Dietary intake and physical activity influence the prevention or development of pre-diabetes/Type 2 Diabetes (T2DM). The immigrant’s ability to perform health-promoting behaviors can also be influenced by their perceptions of self-efficacy to engage in health-promoting behaviors. Limited information is available in the literature on effective strategies for decreasing stress during the acculturation process of Latino immigrants, while also increasing self-efficacy on health-promoting behaviors. The purpose of this study was to explore the …

Factors Associated With Unmet Respite Care Needs In Families Of Children With Autism Spectrum Disorder, Kim E. Whitmore

Theses and Dissertations

Background. One in sixty-eight children have Autism Spectrum Disorder (ASD). To optimize outcomes to families through use of respite care, we examined the prevalence of unmet respite care needs and associated factors in families of children with ASD, compared to families of children with special healthcare needs (CSHCN) without ASD.

Design. An exploratory secondary analysis of the 2009-2010 National Survey of Children with Special Healthcare Needs (NS-CSHCN) was conducted using a non-experimental, descriptive, correlational design. The NS-CSHCN is a national cross-sectional telephone survey of 40,242 US households. The final sample included parents of children age 2-18 years old with ASD …

Exploring The Costs And Values Of The Household Model In Long Term Care, Mark Alan Proffitt

Theses and Dissertations

As part of the culture change movement in long term care, nursing homes are transforming into person centered living settings that reject the previous medical emphasis that dominated the industry. The household model is one approach to achieve this goal by systemically altering the traditional nursing home’s organization, routines and physical setting with an emphasis on recreating familiar, domestic places for its residents. The household model is hallmarked by three key characteristics: 1) the creation of a smaller functional group of residents within the nursing home that is delineated by the environment (24 residents or less) with the 2) intent …

Development Of An Effective International Medical Disaster Relief Team: A Qualitative Descriptive Study, Nicolette Broby

Theses and Dissertations

Natural and manmade disasters are occurring at an unprecedented rate. Injuries and sickness are among the most widespread types of suffering caused by disasters, making medical aid essential. However, medical response depends on multiple factors to be timely and effective. The process of building a competent international medical disaster relief organization is complex, yet many well-intentioned, charitable organizations react hastily after a disaster, sending medical teams without truly understanding what an effective response requires. Consequently, in their genuine effort to help, they may end up hindering the response effort more than helping. Meanwhile, successful organizations implement principles conducive to an …

The Nicotine Content Of A Sample Of E-Cigarette Liquid Manufactured In The United States, Barrett H. Raymond

Theses and Dissertations

Background: Use of electronic cigarettes (EC) has dramatically increased in the United States since 2010 with a forecasted growth of 37% between 2014 and 2019. There is little research on e-liquid nicotine concentration from domestic manufacturers. However, limited research outside of the U.S. found wide inconsistencies between the labeled concentration of nicotine in e-liquids and the actual nicotine concentration. Methods: The seven most popular online manufacturers or distributors were identified. E-liquid samples of the five most popular flavors from each manufacturer were purchased in nicotine concentrations of 0 mg/ml and 18 mg/ml. Of the samples purchased (n=70), all were labeled …

Smoking Behavior In Arab Americans: Acculturation And Health Beliefs, Roula Ghadban

Theses and Dissertations

Background: Arab Americans, a growing population in the U.S., tend to have high rates of smoking and low rates of smoking cessation. Arab Americans and their families are at a high risk for poor health outcomes related to smoking.

Objective: The purpose of this study is to better understand the smoking behaviors of Arabs in the U.S., using the two publishable manuscripts format. The first manuscript is a systematic review of the literature exploring the smoking behavior, prevalence and use among Arab Americans and examining studies addressing the effect of acculturation on this behavior. The second manuscript is a cross-sectional …

A Biobehavioral Approach To Examining Moral Distress In Critical Care Nurses, Marian Altman

Theses and Dissertations

Moral distress is a complex and challenging problem that may cause negative biopsycohosical and professional outcomes for critical care nurses. The purpose of this work was to explore the relationship between the ethical climate of the work environment and moral distress as experienced by critical care nurses; and to explore relationships among mediators of stress (nurse characteristics e.g. education (BSN, nonBSN), years certified as a critical care nurse, and tolerance of ambiguity) and their relationship with perceived stress, moral distress, health status and salivary alpha amylase. A descriptive correlational cross-sectional design was used for this pilot study of 100 critical …

Influence Of Contextual Factors And Self Efficacy On Self- Management In Parents Of Children With Cystic Fibrosis, Erin B. Booth

Theses and Dissertations

Cystic Fibrosis, a life threatening autosomal recessive genetic disease, is characterized by a defective gene resulting in the production of thick mucus that obstructs the lungs and pancreas. CF requires intensive management performed at the home. An initial pilot study was performed to describe knowledge of CF related diabetes (CFRD) in adults with CF. The findings of this study, which demonstrated that adults with CF lacked sufficient knowledge about CFRD confirmed the need to explore additional factors of self-management guided by a theoretical framework. The second study presented in this dissertation used the Individual and Family Self-Management Theory (IFSMT) to …

Simulation-Based Interprofessional Education In A Rural Setting, Ann D. Scott

Theses and Dissertations

The purpose of this project was to examine the feasibility and acceptability of a simulation-based IPE experience for pre-licensure nursing, pharmacy, and medical students on a rurally-located campus. Using a mixed-methods, explanatory sequential approach, this project: 1) examined the feasibility of implementing a simulation-based IPE experience using telehealth tools; and 2) evaluated student perceptions of inter-professional teamwork, roles and responsibilities, and patient outcomes for collaborative practice, both pre- and post-scenario.

Quantitative data were analyzed using SPSS. Results revealed 94% agreed/strongly agreed the IPE experience resembled a real-life situation. 100% of nursing/medical students and 80% of the pharmacy students indicated they …

Losing Weight With Five A’S (5 A’S): Assess, Advise, Agree, Assist, Arrange Framework And Motivational Interviewing (Mi) For Health Behavior Change Counseling, Jacqueline Baer

Theses and Dissertations

According to the Centers for Disease Control and Prevention (CDC), obesity has reached epidemic levels and has associated with increased risk of morbidity and mortality rates. The increasing prevalence of obesity is a major public health concern. Researchers calculate that health care costs are 44% higher among moderately and severely obese older persons than for persons at normal weights. Seventy-five percent of African American (AA) women are overweight and obese according to data from the CDC and The State of Obesity: Better Policies for a Healthier America. Compared to any other racial ethnic group, AA women are more likely to …

Evaluation, Treatment, And Education In The Hospice Setting By Initiating A Formalized Pain Card, Alyssa M. Soprano

Theses and Dissertations

The purpose of this DNP quality improvement project was to evaluate the use of a formalized pain card that Nurse Practitioners could use to assist clients and caregivers in making the decisions necessary for safe and effective pain management with improving outcomes by using the Brief Pain Inventory Form for measuring: 1) decreased pain, 2) increased pain, 3) pain relief. The appraised evidence suggested that there was a need for a policy standard for patients to notify when pain is unrelieved despite exhausting all other efforts to control pain (Glowacki, 2015). Forty-one (n=41) hospice patients were surveyed pre and post …

Barriers To The Use Of Guardrails On Iv Smart Pumps, Ivory Williams

Theses and Dissertations

Medication errors involving hospitalized patients have been an evolving challenge for decades. Moreover, errors related to intravenous (IV) medication administration continue to rise in hospitals despite implemented policies governing the use of Guardrails™ for safe IV medication infusion via smart pump technology. An organizational investigation was performed to identify barriers to the use of Guardrails™ among nursing staff. From 2015 through 2017, multiple interventions that aimed to identify barriers and increase nurses’ use of the safety features on IV smart pumps were implemented in the hopes of reaching a compliance goal of 90-100%. This quality improvement project assesses Guardrails™ compliance …