Medicine and Health Sciences Commons^™

Use Of Acupuncture As A Complementary Therapy For The Treatment Of Chronic Pain In The Veteran Population To Improve Outcomes: An Integrative Review, Tabitha T. Smithers

Doctoral Dissertations and Projects

Clinical care in patient management is progressive and should change as evidence-based practice research is available. Veterans’ experiences with pain related to their service-related injuries are unique. This pain can limit their ability to function in society successfully. Many of the patients continue to experience uncontrolled pain, as well as side effects from medications that have been prescribed. This integrative review focused on the use of acupuncture as a complementary therapy to improve pain and quality of life in the Veteran population. The review analyzes systematic reviews, randomized control trials, and additional levels of evidence from scholarly articles supporting the …

Lived Experiences: Growing Up With A Seriously Mentally Ill Parent, Deborah Lindell, Elliane Irani

Faculty Scholarship

Introduction: Individuals with serious mental illness often have persistent and disruptive symptoms. These can profoundly affect their children's lives, exposing them to adverse social and psychological conditions. Such conditions can result in traumatic lived experiences during childhood, which can carry over into adulthood, influencing their self-perceptions and shaping their attitudes toward themselves and society. To gain insights into this phenomenon, this study explored the lived experiences of adults who grew up with a parent with serious mental illness and their perceptions of their lives in adulthood. Design: This study used an interpretive phenomenological design. Methods: Participants were invited to voluntarily …

Continuity Of Care In The Post-Partum Period, Ashley Quezada

MSN Capstone Projects

Maternal mortality rates in the United States have been a growing concern over the past decade, with rates continuing to climb as recent studies have been published. The total maternal mortality rate in the United States in 2018 was 17.4 and has increased to 32.9 as of 2021, while other developed countries continue to decline (Hoyert, 2023). The maternal mortality rate is the number of deaths per 100,000 live births. More than 50% of pregnancy-related deaths in the United States occur after delivery, in the post-partum period (Melillo, 2020). The purpose of this report is to not only bring light …

Benchmark Study Of Early Palliative Care In End-Stage Liver Disease, Pebble Ward

MSN Capstone Projects

Patients with ESLD in general have high rates of healthcare utilization, resulting in more than 250,000 hospitalizations at $9.8 billion annually in the United States (Ufere et al., 2019). Liver disease is a rising cause of death worldwide, affecting younger people, but palliative care is largely absent for these patients (Kimball et al. 2018). Early readmissions are common for patients with ESLD and in the U.S. alone, over 25% of patients are readmitted within 30 days of their initial diagnosis, rates that now exceed those seen for patients with CHF and COPD (Ufere et al. 2019). Evidence shows that early …

Palliative Care And Quality Of Life Improvement: A Benchmark Study, Rebecca Daniels

MSN Capstone Projects

This project provides an overview of the standard and regular implementation of palliative care versus early implementation of palliative care in patients with chronic or terminal illnesses. Palliative care is an essential component of healthcare that focuses on improving the quality of life and providing support to patients through holistic elements to patients and their families facing chronic and terminal illnesses. With evidence-based research, many articles have been published with implementation of early palliative care showing improvement in patient and even caregiver quality of life. This project includes evidence gathered from mixed methods of systematic review of existing literature, randomized …

Differences In Symptom Severity And Quality Of Life Among Patients With Cancer Using Conventional Therapies With/Without Herbal Medicines In Uganda: A Cross-Sectional Study, John Baptist Asiimwe, Prakash B. Nagendrappa, Alfred Jatho, Maud M. Kamatenesi, Esther C. Atukunda

School of Nursing & Midwifery, East Africa

Objective:

Patients with cancer experience numerous symptoms related to cancer and treatment side effects that reduce their quality of life (QOL). Although herbal medicine (HM) is used to manage such symptoms by patients in sub-Saharan Africa, data on patients perceived clinical outcomes are limited. We compared differences in QOL and symptom severity between patients with cancer using HM plus conventional therapies (i.e., chemotherapy, hormonal therapy, radiotherapy, surgery) and those using conventional therapies alone.

Methods:

This cross-sectional study included patients with cancer aged >18 years who were consecutively sampled and completed a researcher-administered questionnaire between December 2022 and January 2023. Specifically, …

Palliative Care Early In The Care Continuum Among Patients With Serious Respiratory Illness An Official Ats/Aahpm/Hpna/Swhpn Policy Statement, Donald R. Sullivan, Anand S. Iyer, Susan Enguidanos, Christopher E. Cox, Morag Farquhar, Daisy J. A. Janssen, Kathleen O. Lindell, Richard A. Mularski, Natasha Smallwood, Alison E. Turnbull, Anne M. Wilkinson, Katherine R. Courtright, Matthew Maddocks, Mary Lynn Mcpherson, J. Daryl Thornton, Margaret L. Campbell, Tracy K. Fasolino, Patricia M. Fogelman, Larry Gershon, Thayer Gershon, Christiane Hartog, Judy Luther, Diane E. Meier, Judith E. Nelson, Elliot Rabinowitz, Cynda H. Rushton, Danetta H. Sloan, Erin K. Kross, Lynn F. Reinke

Research outputs 2022 to 2026

Background:

Patients with serious respiratory illness and their caregivers suffer considerable burdens, and palliative care is a fundamental right for anyone who needs it. However, the overwhelming majority of patients do not receive timely palliative care before the end of life, despite robust evidence for improved outcomes.

Goals:

This policy statement by the American Thoracic Society (ATS) and partnering societies advocates for improved integration of high-quality palliative care early in the care continuum for patients with serious respiratory illness and their caregivers and provides clinicians and policymakers with a framework to accomplish this.

Methods:

An international and interprofessional expert committee, …

Evaluation Of An Australian Neurological Nurse-Led Model Of Postdischarge Care, Judith Dianne Pugh, Kathleen Mccoy, Merrilee Needham, Leanne Jiang, Margaret Giles, Elizabeth Mckinnon, Kym Heine

Research outputs 2014 to 2021

Neurological disorders are a leading cause of disease burden worldwide, placing a heavy demand on health systems. This study evaluated the impacts and cost savings of a community-based nursing service providing supported discharge for neurological patients deemed high-risk for unplanned emergency department presentations and/or hospital readmissions. It focused on adult patients with stroke, epilepsy, migraine/headache or functional neurological disorders discharged from a Western Australian tertiary hospital. An observational design was used comprising prospective enrolment of patients receiving nurse-led supported discharge and follow-up (Neurocare), 21 August 2018 to 6 December 2019 (N = 81), and hospital administrative data, 1 February …

Examining How Congruence In And Satisfaction With Dyadic Care Type Appraisal Contribute To Quality Of Life In Heart Failure Care Dyads, Elliane Irani, Seunghee Margevicius

Faculty Scholarship

AIMS: Given the complexity of heart failure (HF) management, persons with HF and their informal caregivers often engage in dyadic illness management. It is unknown how congruent appraisal of dyadic HF care type is associated with dyadic health. Our aim was to examine how congruence in and satisfaction with appraisal of dyadic HF care type contribute to quality of life (QOL) for dyads. METHODS AND RESULTS: This is a secondary analysis of cross-sectional data on 275 HF care dyads (patients 45.1% female, caregivers 70.5% female). Congruent appraisal and satisfaction were assessed using the Dyadic Symptom Management Type instrument. Quality of …

Parent Health-Related Quality Of Life For Infants With Congenital Anomalies Receiving Neonatal Intensive Care, Krishna Acharya, Erin Rholl, Kathryn J. Malin, Margaret Malnory, Jonathan Leuthner, Steven R. Leuthner, Joanne Lagatta

College of Nursing Faculty Research and Publications

Objective

To examine factors associated with parent quality of life during and after neonatal intensive care unit (NICU) discharge among parents of infants with congenital anomalies admitted to the NICU.

Study design

This secondary analysis of 2 prospective cohort studies between 2016 and 2020 at a level IV NICU included parents of infants with major congenital anomalies receiving NICU care. The primary outcomes were parent health-related quality of life (HRQL) during the NICU stay and at 3 months post-NICU discharge.

Results

A total of 166 parent–infant dyads were enrolled in the study, 124 of which completed the 3-month follow-up interview. …

Dnp Final Report: Psychosocial Screening For Oncology Patients, Robyn V. Beard

DNP Final Reports

Background: Patients with cancer often face severe distress related to fear of death, body disfigurement, financial stress, and lack of support system. This distress may lead to physical and emotional symptoms that bring patients to seek care at emergency departments, delay care or make poor health choices, and increase utilization of prescription drugs. With the already over burdened healthcare system, addressing these psychosocial needs is vital to improving patients outcomes as well as improving healthcare expenditure. Purpose: The purpose of this evidence based practice project was to improve perceived quality of life for oncology patients through detailed screening and behavioural …

Neurological Patient And Informal Caregiver Quality Of Life, And Caregiver Burden: A Cross-Sectional Study Of Postdischarge Community Neurological Nursing Recipients, Judith Dianne Pugh, Kathleen Mccoy, Anne M. Williams, Catherine A. Pienaar, Brenda Bentley, Leanne Monterosso

Nursing Papers and Journal Articles

Background: Neurological conditions produce considerable disease burden.

Aims: To describe quality of life in patients with neurological conditions and informal caregivers receiving postdischarge generic community neurological nursing services, and caregiver burden.

Method: A descriptive cross-sectional design was used with researchers administering the WHOQOL-BREF Australian Version questionnaire and Zarit Burden Interview.

Results: Most patients and caregivers rated quality of life as 'Good'. The patients’ physical, psychological and environment domain scores, and caregivers’ physical domain scores, were below norms. Half of the caregivers experienced burden and 42% had risk for depression.

Conclusion: A heterogeneous group of patients with neurological conditions had …

Evidence-Based Individualized Discharge Educational Intervention For Coronary Artery Disease (Cad) Patients; A Benchmark Project, Sumita Thapa

MSN Capstone Projects

Coronary artery disease (CAD) is the leading cause of death worldwide, whereas, in the United States, 16,800,000 people are affected, resulting in 450,000 deaths annually. Patients’ perceptions of self-management related to treatment adherence, lifestyle modifications, and risk-factor management are significant indicators of outcomes following a cardiac event. To promote self-management in CAD patients, this benchmark project aims to determine the impact of individualized education interventions by establishing a standardized nurse-led educational intervention in the cardiac unit that emphasizes adherence to self-management and treatment regimen to improve quality of life and prevent rehospitalization due to worsening cardiac events. The evidence-based findings …

Palliative Care And Improving Quality Of Life With End Stage Renal Disease: An Integrative Review, Natoya Bender

Doctoral Dissertations and Projects

End-stage renal disease is a rising health care problem effecting greater than 10% of the US population. there are 700,000 patients in dialysis in the U.S who are characterized by multiple comorbidities and increasing, distressing symptom burden. The need for palliative care for patient with end-stage renal disease is becoming standard of care due to their complex medical needs and high symptom burden. The aim of this integrative review investigated the incorporation of palliative care will improve the quality-of-life of patients with end-stage renal disease once introduced in their care. While palliative care provides an ideal opportunity to assess the …

Chronic Disease Self-Management Support In Rural Areas: An Integrative Review, Karla A. Callahan

Doctoral Dissertations and Projects

Millions of Americans live with chronic health conditions which require careful attention and specific actions for optimal management. Chronic Disease Self-Management Education (CDSME) has been effectively utilized to improve health outcomes and quality of life for individuals with chronic disease, enhancing knowledge and self-efficacy. Traditional CDSME programs are less available for rural residents. An examination of successful CDSME programs highlights common interventions that yield success and may be utilized in a variety of settings. Self-management is more complex, but also more essential, for individuals with more than one chronic condition. Clinicians can provide individualized support for appropriate self-management techniques, thereby …

Exploring Canadian Children's Social Media Use, Digital Literacy, And Quality Of Life: Pilot Cross-Sectional Survey Study, Lorie Donelle, Danica Facca, Shauna Burke, Bradley Hiebert, Emma Bender, Stephen Ling

Nursing Publications

Background: Understanding social media use and digital literacy among young Canadian children is an increasing area of concern, given the importance of digital inclusion for full and informed participation in evolving educational, civic, corporate, social, and economic spaces. Objective: The aim of this study was to explore internet and social media knowledge as well as social media use among Canadian children aged between 6 and 10 years. Methods: We conducted interview surveys with 42 children aged between 6 and 10 years who participated in an after-school health promotion program in an urban community in Southwestern Ontario to understand their digital …

Youth And Parent Health-Related Quality Of Life And Association With Glycemic Outcomes In Preadolescents And Adolescents With Type 1 Diabetes, Joan P. Totka, Julia A. Snethen, Elizabeth D. Cox

College of Nursing Faculty Research and Publications

Introduction

We explored differences in Health-Related Quality of Life (HRQOL) and the youth's glycosylated hemoglobin (A1c) of preadolescent and adolescent youths with type 1 diabetes (T1D) by individual (age, sex, race) and family (socioeconomic status) factors, and associations between youths’ HRQOL, their parents’ HRQOL, and youth's A1c.

Method

Correlational secondary analysis of baseline data from a randomized controlled trial testing a developmental intervention for youths with T1D and their parents from two diabetes clinics.

Results

Better adolescent HRQOL was associated with better glycemic control. Better preadolescent HRQOL was associated with better parent HRQOL. Non-White adolescents had worse HRQOL than White …

Association Of Depression And Resilience With Fertility Quality Of Life Among Patients Presenting To The Infertility Centre For Treatment In Karachi, Pakistan, Shireen Shehzad Bhamani, Nida Zahid, Wajeeha Zahid, Salima Farooq, Saima Sachwani, Marilyn Chapman, Nargis Asad

School of Nursing & Midwifery

Background: In Pakistan there is a dire need to explore the quality of life in infertile males and females and its undesirable psychological outcomes. This, study aimed to compare the quality of life (QoL) of males and females visiting an infertility centre for treatment and to assess its association with resilience, depression, and other socio-demographic factors.
Methods: An Analytical Cross-Sectional study was conducted amongst infertile males and females at the Australian Concept Infertility Medical Centre (ACIMC), Karachi, Pakistan. The non-probability (purposive) sampling strategy was used to recruit the participants. The sample size was 668. Data was analysed using STATA version …

Advance Directives And Intensity Of Care Delivered To Hospitalized Older Adults At The End-Of-Life, Marsha Helen Tyacke, Jill L. Guttormson, Mauricio Garnier-Villarreal, Kathryn Schroeter, Wendy Peltier

College of Nursing Faculty Research and Publications

Background

Older adults prefer comfort over life-sustaining care. Decreased intensity of care is associated with improved quality of life at the end-of-life (EOL).

Objectives

This study explored the association between advance directives (ADs) and intensity of care in the acute care setting at the EOL for older adults.

Methods

A retrospective, correlational study of older adult decedents (N = 496) was conducted at an academic medical center. Regression analyses explored the association between ADs and intensity of care.

Results

Advance directives were not independently predictive of aggressive care but were independently associated with referrals to palliative care and hospice; however, …

A Quantitative Comparison Of Arm Activity Between Survivors Of Breast Cancer And Healthy Controls: Use Of Accelerometry, Mary Insana Fisher, Claire C. Davies, Timothy L. Uhl

Physical Therapy Faculty Publications

Purpose

Survivors of breast cancer (BC) on the non-dominant side have more persistent deficits than those with cancer on the dominant limb. What is not known is whether those with BC use their involved upper limbs more, less, or at the same level as women without BC. Accelerometer use offers a quantifiable method to measure activity levels of upper limbs. The purpose of this study was to quantify the activity levels of the non-dominant involved limb among survivors of BC and compare these values to their dominant limb, as well as the non-dominant limb of a control group.

Methods

Participants …

Nurse-Delivered Standardized Chemotherapy Education Intervention To Reduce Distress Among Older Adults In An Outpatient Setting, Michelle Viveiros

Doctor of Nursing Practice (DNP) Projects

Background/Review of Literature: A new cancer diagnosis is overwhelming and stressful. A multitude of information will be shared, and treatment initiated quickly. To prepare patients for chemotherapy, a comprehensive and systematic education program should be utilized. Combining written instructions and supportive material with nurse-led teaching sessions have been found to be most beneficial. Well prepared patients have been shown to have less anxiety, more confidence to handle adverse effects at home, and improved quality of life. Purpose: The quality improvement (QI) project purpose was to explore the effect of a nurse-delivered, enhanced education intervention on distress among older adults receiving …

Engaging Older Adults With Parkinson’S Disease In Physical Activity Using Technology: A Feasibility Study, Melinda Hermanns, Barbara K. Haas

Nursing Faculty Publications and Presentations

Parkinson’s disease (PD), a progressive neurodegenerative disorder, presents unique and daily challenges. Living with PD may limit one’s physical activity and negatively affect quality of life (QOL). No studies were identified that utilized online technology to promote health in this population. The purposes of this study were to (a) assess the feasibility of an intervention that requires wearing a physical activity tracker and participating in an online support group, and (b) examine the effect of this intervention on the self-efficacy for physical activity and QOL of older adults with PD. A 12-week longitudinal pretest/posttest design was used to assess physical …

Exploring Lived Experiences Of Married Pakistani Women Post-Mastectomy, Laila Hussain, Zeenatkhanu Kanji, Sharifa Bashir Lalani, Shabnam Moledina, Abida K. Sattar

School of Nursing & Midwifery

Objective: This qualitative descriptive exploratory study aimed to explore the lived experiences of married Pakistani women, 2 years post-mastectomy.
Methods: Twelve participants were recruited through purposive sampling from outpatient oncology clinic from a tertiary care hospital in Pakistan. Interviews were audio-taped and transcribed, and then themes and sub-themes were identified.
Results: Women verbalized a range of their experiences throughout the span from diagnosis to mastectomy. One over arching theme, quality of life and four main themes and their subthemes emerged from the data. Following are the themes; from history to diagnosis, worries, coping strategies, and recommendations.
Conclusions: The study findings …

Activities Of Daily Living, Peter F. Edemekong, Deb Bomgaars, Sukesh Sukumaran, Shoshana B. Levy

Faculty Work Comprehensive List

The activities of daily living (ADLs) is a term used to collectively describe fundamental skills that are required to independently care for oneself such as eating, bathing, and mobility. The term activities of daily living was first coined by Sidney Katz in 1950. ADL is used as an indicator of a person’s functional status. The inability to perform ADLs results in the dependence of other individuals and/or mechanical devices. The inability to accomplish essential activities of daily living may lead to unsafe conditions and poor quality of life. Measurement of an individual’s ADL is important as these are predictors of …

A Public Health Initiative To Support The Development Of A Trauma Informed Care Culture In A Community Organization That Provides Services To Individuals With Developmental And Intellectual Disabilities, Lisa Coenen

Doctor of Nursing Practice (DNP) Projects

Background: Trauma informed care (TIC) is a socio-ecological theoretical approach for universal practice focus to improve HRQOL and wellbeing outcomes. There is a gap in TIC system implementation for vulnerable populations, including the ID/DD population.

Purpose: The purpose of this project was to transfer knowledge to a newly created TIC work group on the use of an existing TIC system implementation tool to plan, develop, and measure the level of TIC systems culture in their community organization.

Methods: Knowledge transference through the utilization of a TIC systems implementation process map, TIC education, and the facilitation of a …

Effects Of Person-Centered Care At The Organizational-Level For People With Dementia. A Systematic Review, Lynette Chenoweth, Jane Stein-Parbury, Samuel Lapkin, Alex Wang, Zhixin Liu, Anna Williams

Nursing Papers and Journal Articles

The aim of the systematic review was to determine the effectiveness of organizational-level person-centered care for people living with dementia in relation to their quality of life, mood, neuropsychiatric symptoms and function. ALOIS, the Cochrane Dementia and Cognitive Improvement Group Specialised Register databases, were searched up to June 2018 using the terms dementia OR cognitive impairment OR Alzheimer AND non-pharmacological AND personhood OR person-centered care. Reviewed studies included randomized controlled trials (RCTs), cluster-randomized trials (CRTs) and quasi-experimental studies that compared outcomes of person-centered care and usual (non-person-centered) care, for people with a diagnosis of dementia. The search yielded 12 eligible …

What Predicts Regression From Pre-Diabetes To Normal Glucose Regulation Following A Primary Care Nurse-Delivered Dietary Intervention? A Study Protocol For A Prospective Cohort Study, Kirsten Coppell, Trish Freer, Sally Abel, Lisa Whitehead, David Tipene-Leach, Andrew R. Gray, Tony Merriman, Trudy Sullivan, Jeremy Krebs, Leigh Perreault

Research outputs 2014 to 2021

Introduction Pre-diabetes is a high-risk state for the development of type 2 diabetes mellitus (T2DM) and cardiovascular disease. Regression to normoglycaemia, even if transient, significantly reduces the risk of developing T2DM. The primary aim of this mixed-methods study is to determine if there are clinically relevant differences among those with pre-diabetes and excess weight who regress to normoglycaemia, those who have persistent pre-diabetes and those who progress to T2DM following participation in a 6-month primary care nurse-delivered pre-diabetes dietary intervention. Incidence of T2DM at 2 years will be examined.

Methods and analysis Four hundred participants with pre-diabetes (New Zealand definition …

Impact Of Tai Chi On Peripheral Neuropathy Revisited: A Mixed-Methods Study, Melinda Hermanns, Barbara K. Haas, Linda Rath, Brittany Murley, Arturo A. Arce-Esquivel, Joyce Ballard, Yong T. Wang

Nursing Faculty Publications and Presentations

Exercise may be beneficial to older persons living with peripheral neuropathy (PN), but maintaining an exercise program is challenging. After participating in a 12-week tai chi (TC) study, 12 participants requested classes continue. A mixed-methods design was used to explore long-term engagement of older persons with bilateral PN enrolled in a TC class for 18 months beyond the original 3-month study. Pre- and posttest measures of functional status and quality of life (QOL) were conducted. Focus groups were held after 18 months of twice-weekly classes. Psychosocial support was critical to participants’ long-term commitment to exercise. Participants reported, and objective assessments …

Treatment-Related Decisional Conflict, Quality Of Life, And Comorbidity In Older Adults With Cancer., Jeannette M. Kates

College of Nursing Faculty Papers & Presentations

Objective: The present study aims to examine the relationships between and among cancer treatment-related decisional conflict, quality of life, and comorbidity in older adults with cancer.

Methods: A convenience sample of 200 older adults was recruited from outpatient medical oncology and radiation oncology practices in the northeastern United States. A cross-sectional, descriptive, correlational study design was used employing a survey method. Survey instruments included the Decisional Conflict scale (DCS) (with five subscales, including informed, values clarity, support, uncertainty, and effective decision); Self-administered comorbidity questionnaire (SCQ); European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (including five function …

Factors Affecting Quality Of Life For Children With Asthma, Sheri K. Carey, Crystal M. Edds-Mcafee, Valerie Martinez, Kathy Thornton, Antonio P. Gutierrez

School of Nursing Faculty Presentations

BACKGROUND: In the U.S., asthma is the most common chronic illness in children under 18 years. An exploration of asthma admission rates in emergency departments indicated this was also the case for Southeast Georgia. Despite the availability of effective asthma treatments and interventions, asthma continues to severely impact children’s health-related QOL. PURPOSE: This exploratory study sought to assess quality of life (QOL) issues facing children with asthma and their caregivers. Specifically, this study aimed to 1) Determine the baseline QOL in children with asthma and their parents/caregivers, & 2) Determine what factors affect QOL for children with asthma and their …