Medicine and Health Sciences Commons^™

Dnp Final Project Report.Docx, Cherry Nelson

Cherry Nelson

Cervical Screening: Assessing Patient Anxiety, Janette Jones

Janette S. Jones

Severe stress reactions in female patients presenting for annual pelvic examination may occur for a variety of reasons, including previous sexual assault, post-traumatic stress disorder, and /or intimate partner violence. The clinician's approach to care delivery is critical for establishing trusting relationships with female patients exhibiting these types of reactions. A case study is used to describe assessment and communication techniques to improve care delivery.

Annual Examination And The Overly Anxious Patient, Janette Jones

Janette S. Jones

Varying degrees of nervousness may be found in patients presenting for gynecologic examination. It is the clinician's role to distinguish typical (expected) anxiety from that which is considered excessive. Extreme stress reactions may occur from a variety of reasons including prior sexual assault, post-traumatic stress disorder, and/or intimate partner violence. Approach to care delivery is critical for establishing a trusting relationship. Case study format will be used to discuss stress-reducing techniques during annual examinations.

Social Script Ipad Application Versus Usual Care Before Undergoing Medical Imaging: Two Case Studies Of Children With Autism, Norah Johnson, Octavia Bree

Norah L Johnson

Autism spectrum disorders (ASDs) are neurodevelopmental disorders of socialization, communication, and repetitive behaviors. Children with ASD have underlying anxiety leading to challenging behaviors in unfamiliar situations. The anxiety impacts timely completion of an imaging procedure. The purpose of the case study was to describe the process of the social script intervention delivered using the iPad application on parent and child anxiety, child behaviors, and imaging procedure length between two parent and child dyads. The case study of two parent-child dyads demonstrated the process for comparing the social script intervention iPad app for preparing for imaging versus usual care. Parent anxiety …

Effect Of A Social Script Ipad Application For Children With Autism Going To Imaging, Norah Johnson, Octavia Bree, Erin Lalley, Kelly Rettler, Pam Grande, Md Gani, Sheikh Ahamed

Norah L Johnson

This randomized controlled trial feasibility study tested the effectiveness of an iPad® application (app) social script intervention for children with autism spectrum disorder (ASD) going to imaging and their parent (n = 32 parent/child dyads). Parents of the children exposed to the app (n = 16) had lower state anxiety compared to the parents whose children were not exposed to the app (n = 16) (effect size 0.33). Children exposed to the app had fewer externalized challenging behaviors than the control group (effect size 0.56). The results demonstrate feasibility and efficacy of the intervention. Further study of the iPad app …

Multinational Validation Of Anxiety, Hopelessness, And Ineffective Airway Clearance, Richard Fehring, Teresa Fadden, Madeline Wake

Richard J Fehring

The effective use of nursing diagnosis internationally depends in part on incorporating language and cultural difference into the common language of nursing. International validation studies can provide a basis for this effort. This study tested three diagnoses—anxiety, hopelessness, and ineffective airway clearance—through multinational validation. The Diagnostic Content Validity (DCV) model was used to collect data from critical care nurses in six countries. Defining characteristics rated as critical (> .80) by the total sample were dyspnea for ineffective airway clearance and panic and nervousness for anxiety. No critical defining characteristics for hopelessness were identified. DCV ratios for all defining characteristics are …

Proactive Policy Planning For Unexpected Student Distress During Simulation, Janet Willhaus, Mitzi Averette, Michael Gates, Janet Jackson, Susan Windnagel

Janet Willhaus

Stress reactions resulting from participation in simulation scenarios are seldom reported in the literature but are often informally discussed by simulation faculty seeking guidance to manage the occurrences. Although simulation faculty members often describe events where a single learner’s distress interrupted learning for all involved, no examples of policies to plan for this kind of occurrence are available in the simulation literature. This article offers suggested best practices for identifying and assisting students who exhibit uncontrolled stress in simulation and includes a sample policy for planning.

Multiple Dimensions Of The Symptom Experience In Patients With Advanced Cancer And Their Impact On Quality Of Life, Stephanie Gilbertson-White

Stephanie Gilbertson-White

Many people with advanced cancer experience multiple severe symptoms as their disease progresses such as pain, sleep problems, fatigue, and depression. These symptoms can be a result of the cancer itself, cancer treatment or an interaction of the two. The studies reported in this dissertation uses the patients' own responses to survey questions to describe the multiple dimensions of the symptom experience; the factors that predict the total number of symptoms; as well as the optimal cutpoint between a low and a high number of symptoms and the between group differences in patient outcomes (i.e., depression, anxiety, quality-of-life).

Determination Of Cutpoints For Low And High Number Of Symptoms In Patients With Advanced Cancer, Stephanie Gilbertson-White, B. Aouizerat, T. Jahan, S. Paul, C. West, K. Schumacher, M. Dodd, M. Rabow, A. Abu Raddaha, C. Miaskowski

Stephanie Gilbertson-White

While patients with advanced cancer experience a wide range of symptoms, no work has been done to determine an optimal cutpoint for a low versus a high number of symptoms. Analytic approaches that established clinically meaningful cutpoints for the severity of cancer pain and fatigue provided the foundation for this study. The purpose of this study was to determine the optimal cutpoint for low and high numbers of symptoms using a range of potential cutpoints and to determine if those cutpoints distinguished between the two symptom groups on demographic and clinical characteristics and depression, anxiety, and quality of life (QOL). …

Predictors Of Topical Anesthetic Effectiveness In Children, Charmaine Kleiber, D. Schutte, Ann Mccarthy, M. Floria-Santos, J. Murray, Kirsten Hanrahan

Kirsten M. Hanrahan

Some children report significant pain with peripheral intravenous catheter (IV) insertion, despite the appropriate use of topical lidocaine anesthetics. This analysis of data from an existing study identified factors related to variation in topical anesthetic effectiveness used for IV insertion. The children (n = 218) in this investigation were 4 to 10 years old and undergoing a scheduled IV insertion. Inclusion criteria were (1) topical anesthetic was used according to manufacturer's recommendations, (2) DNA material was available, and (3) child completed a self-report measure of pain intensity (Oucher scale). Low pain phenotype was defined as a pain intensity score of …

Predictors Of Topical Anesthetic Effectiveness In Children, Charmaine Kleiber, D. Schutte, Ann Mccarthy, M. Floria-Santos, J. Murray, Kirsten Hanrahan

Ann Marie McCarthy

Some children report significant pain with peripheral intravenous catheter (IV) insertion, despite the appropriate use of topical lidocaine anesthetics. This analysis of data from an existing study identified factors related to variation in topical anesthetic effectiveness used for IV insertion. The children (n = 218) in this investigation were 4 to 10 years old and undergoing a scheduled IV insertion. Inclusion criteria were (1) topical anesthetic was used according to manufacturer's recommendations, (2) DNA material was available, and (3) child completed a self-report measure of pain intensity (Oucher scale). Low pain phenotype was defined as a pain intensity score of …

Physiological And Psychological Correlates Of Fatigue In Hiv/Aids, Kenneth D. Phillips, R.L. Sowell, M. Rojas, A. Tavakoli

Kenneth D. Phillips

Fatigue is a frequent symptom reported by persons living with HIV disease and one that affects all aspects of quality of life. To improve quality of care of persons with HIV disease, it is important to address all factors that contribute to fatigue. The purpose of this study was to determine the associations of physiological, psychological, and sociological factors with fatigue in an HIV-infected population. With Piper’s integrated fatigue model guiding selection, factors examined in this study were hemoglobin, hematocrit, CD4+ cell count, HIV-RNA viral load, total sleep time, sleep quality, daytime sleepiness, HIV-related symptoms, anxiety, depression, and perceived stress. …

Nursing Management Of Anxiety In Hiv Infection, Kenneth D. Phillips, J. Morrow

Kenneth D. Phillips

Anxiety is a universal problem for individuals with AIDS because the disease creates uncertainty and disruptions in every aspect of their lives. Nurses have a wide variety of holistic interventions to help persons living with AIDS (PLWAs) manage anxiety. Orem’s self-care theory of nursing provides a framework for assessing, diagnosing, planning, implementing, and evaluating nursing care for an HIV-infected person experiencing anxiety. This article presents an overview of anxiety, the nature of anxiety in HIV-infected individuals, and psychological, pharmacological, and holistic interventions to assist the client in self-care of anxiety.