Medicine and Health Sciences Commons^™

Soothability And Growth In Preterm Neonates, Holly Johanna Diesel

Dissertations

This proposal seeks to understand the relationship between soothability, weight gain and length of hospital stay in premature infants when the infants receive a simple, non-invasive treatment to help them cope with the noxious environment of the special care nursery. Thousands of premature infants are born every year in the United States, and the numbers are increasing. Prematurity is the leading cause of mortality in infants. Despite numerous technological and medical advances in treatment and care, premature infants still have difficulty adapting to life outside the uterus as a result of immature nervous systems and significant differences in the pre …

Rx For Change: Nurses' Response To A Smoking Cessation Intervention, Laura Louise Bisch Ochoa

Dissertations

Problem: An evaluation of a smoking cessation educational intervention for direct care RNs. Design: A randomized controlled trial. Methods: The study was conducted at a large Midwestern academic medical center. Direct care Registered nurses (dcRN’s) employed at least .7 FTE and spending 80% of their time in direct patient care on general medicine or general surgery units were recruited. Recruitment occurred between April and May, 2009. Outcome data was abstracted from charts of patients receiving care from the intervention group. Interventions: Participants were randomized to either ‘Rx for Change’ which was a training program regarding tobacco cessation or to a …

A Head Injury Teaching Module For Pre-Hospital Assessment: Using The Four Score, Chris A. Wolf

Theses and Graduate Projects

The purpose of this project is to create a teaching module and evaluation tool for a United States Air Force Aeromedical Evacuation Squadron for the pre-hospital assessment of patients with head injuries using the FOUR Score assessment scale. Specifically, this project integrates theory, relevant literature, and reflection on service to and caring for others. Information from published literature supports the development and implementation of a new assessment tool, such as the FOUR Score, to assess patients who have suffered a head injury. Ultimately, a teaching module is presented, described, and evaluated, along with potential questions to be addressed in the …

Brad: A Model Of Caring For Persons With Frontotemporal Dementia, Jennifer Mcguire

Theses and Graduate Projects

Frontotemporal dementia (FTD) is caused by u progressive degeneration of the frontal and temporal lobes of the brain (Boxer & Miller, 2005), This degeneration causes profound alterations in personality, social behavior, and language skills. FTD is particularly devastating due to the fact that it commonly affects people during mid-life or earlier. Evidence has shown that caregivers face higher rates of burden, distress and isolation when providing care for someone with FTD than other forms of dementia (de Vugt, Riedijk, Aalten, Tibben, van Swieten, & Verhey,2006; Kumamoto, Arai, Hashimoto, Ikeda, Mizuno, & Washio, 2004). The Behavioral Recognition, Assessment and Delivery (BRAD) …

Strengthening Nurse/Physician Collaborative Relationships To Promote Patient Safety, Julie Lynch Weegman

Theses and Graduate Projects

The purpose of this project is to identify implementable best practices that promote effective nurse physician collaboration in the hospital setting at the unit level for strengthening the culture of patient safety. These best practices will be shared with nurses and physicians at a workshop using the methods of powerpoint presentation and appreciative inquiry. The goal for this workshop is to inspire nurses and physicians to spread the seeds of collaborative practice throughout the organization through the path of shared governance.

A Nursing Educational Program For Recognizing And Managing Emotional Labor, Kathleen Kuzelka

Theses and Graduate Projects

The purpose of this project is to develop a one hour learning module on emotional labor for all staff that will enable them to recognize and manage emotional labor for themselves and their coworkers in their daily work. This project presents the concept of emotional labor and emotional labor in nursing. A one hour learning module is described. The presentation of this module is discussed. There is discussion of the implications of emotional labor for nursing research, nursing practice and nursing education.

Cardiovascular Reactivity To Forgiveness In Females, Carolyn Mccrocklin

Theses and Dissertations

Empirical evidence exists directly relating forgiveness to physiological markers of cardiovascular health based on the manner in which individuals respond to interpersonal offenses. Extant literature has identified the harmful effects of stress in cardiovascular disease and health in general and unforgiveness has been identified as a stressor with potential implications for cardiac health. Understanding cardiac response to the stress of unforgiveness may have favorable implications for heart disease prevention and treatment in women and may prove to be beneficial in reducing allostatic load.

Building Community Among Older Oromo Women Struggling With Sadness In A Large Urban Setting, Fatuma Kotile

Theses and Graduate Projects

Older Oromo women who immigrated to the United States in the early 1990s have experienced several stressful life events including war, famine, acculturation, harsh northern climate, a new language (English), and multiple experiences different from those in their native country, Ethiopia. Coping with these new experiences, correlates with a high level of depressive symptoms that Oromo people call "sadness." The purpose of this project is to create and describe a transcultural model of nursing practice in community that aims to decrease sadness among older Oromo women by promoting community building and healthy life choices in the midst of change. A …

Developing A Community Clinic To Address The Health Needs As Experienced By A Small Rural Village In Sierra Leone, Doris K. Acton

Theses and Graduate Projects

Developing countries experience a disproportionate amount of health care inequities due to extreme poverty, lack of education, minimal resources and marginalization from health care services. Additionally, barriers such as access, availability and affordability prevent people from seeking care. Development of community based clinics can help to address the health disparities that the people of these countries often experience. Utilizing Madeleine Leininger's Culture Care Theory and the Sunrise Enabler provide a framework on which to develop clinics and health care programs in ways that are culturally congruent and acceptable. This paper addresses the health needs of Manonkoh, a small village in …

Effect Of The Interactive Computerized Information For Surrogates Icu Program In Increasing The Understanding Of Informed Consent And The Knowledge Of Genetic And Genomics Research, Ann Kathleen Shelton

Dissertations

Background: A significant and growing number of clinical research studies conducted in Intensive Care Units (ICUs) today have some genetic and genomics component. Surrogates approached to authorize participation in clinical research for a loved-one in the ICU may not be prepared to make informed decisions. A model of stewardship of genetic and genomics research was used as a framework for this study. Purpose: The purpose of this investigation was to examine the effect of an educational program, the Interactive Computerized Information for Surrogates (ICIS) ICU Education Program in assisting surrogates to (1) increase their understanding of the process of informed …

Small Windows Of Hope: Understanding The Meaning Of Fatigue Experienced By Cancer Patients, Lois Starnes Doane

Doctoral Dissertations

The purpose of the study was to describe the experience of early stage breast cancer women who were living with cancer-related fatigue. Using a phenomenological approach based on the work of Merleau-Ponty, the researcher completed six interviews in which women described the experience of being tired each day.

Interviews were transcribed verbatim and analyzed using a hermeneutical approach developed by Pollio and applied to nursing research by Thomas. Each interview was examined within the context of all the interviews to identify themes noted in all transcriptions. Dealing with the prevailing and profound fatigue that entrenched these women‟s lives was overwhelming. …

The Current Practice Of Nursing Clinical Simulation Debriefing: A Multiple Case Study, Maria L. Overstreet

Doctoral Dissertations

Experts have identified simulation debriefing as the crucial or pivotal point to learning (Baldwin, 2007; Gaba, Howard, Fish, Smith, & Sowb, 2001), and the “heart and soul” of simulation (Rall, Manser, & Howard, 2000, p. 517). No research studies exist that support how best to perform this crucial activity, particularly as it relates to nursing clinical simulation (NCS) debriefing.

My aim in this study was to explore and describe the current practice of NCS debriefing. I studied the phenomenon as it naturally occurred, a group exercise, and interaction between the educator, student, and environment. The research question was the following: …

Can We Get Nurses To Stay? A Qualitative Study To Evaluate The Effectiveness Of A Formal Mentoring Program In An Acute Care Health System, Eileen M. Willits

Dissertations

This qualitative phenomenological case study was designed to investigate the affect that a formal mentoring program had on job satisfaction including a nurse's intent to stay with their current employer and their intent to stay in the nursing profession. The research was intended to determine whether mentoring programs could be used to help avoid the affect of the upcoming predicted nursing shortage in the acute care hospital.

The findings were based on the results of a sample of twelve nurses who had voluntarily signed up to take part in a formal mentoring program sponsored by the staff development department of …

Is Parenting Style Related To Overweight In Mexican Or Mexican-American Preschoolers?, Darlene Mcpherson-Ventura Phd

Dissertations

The prevalence of childhood overweight (OW) continues to rise and children from low-income, Mexican or Mexican-American families are disproportionately affected. The preschool years have been identified as a critical period for excessive weight gain and during this time children respond to parental cues as they form their early eating habits. Certain parenting styles have been associated with improved health outcomes in children. The purpose of this study was to evaluate the relationship of parenting styles and feeding practices to the Mexican or Mexican-American preschool child's risk of overweight. Interdependence Theory was used to inform this study to understand the interaction …

Function And Pain In Community-Dwelling, Adult Mid-Southerners With Limb Loss, Cecile B. Evans

Theses and Dissertations (ETD)

Background: Limb loss affects about 1 in 190 people in the US. Risk factors for limb loss include diabetes, obesity, smoking, minority race, and poverty, which are all common in the Mid-South population. Function is impaired by limb loss, and pain associated with limb loss may further impair function.

Purpose: Describe the function, pain, health status, and demographics of community-dwelling, adult Mid-Southerners with limb loss. Estimate the relationship between function and pain, health status, and demographics of community-dwelling, adult Mid-Southerners with limb loss. Estimate the joint influences on function by pain, health status, and demographics of community-dwelling, adult Mid-Southerners with …

A Pilot Study Of Organizational Performance, Performance Barriers And Faculty Engagement In The Nursing Education Unit, Yolanda Chapman Turner

Dissertations

This pilot study was driven by the problem of market disequilibrium and the subsequent overarching desire to identify and describe principles and processes taken by nursing education units to optimize market equilibrium for nursing service in response to cyclical market demands. Given the complexities of market responsiveness in conjunction with changes in healthcare delivery, health economics, population demographics, higher education and other contextual factors, it is essential for nursing education as a whole to be in a position to respond to demand. The purpose of this study was to investigate organizational performance, performance barriers and faculty engagement in the nursing …

Giving End Of Life Care To Persons With Intellectual Disabilities: A Model Of Support For Community Based Caregivers, Emily K. Gress

Theses and Graduate Projects

Persons with intellectual disabilities are living longer lives, often outliving family caregivers, and experiencing chronic illnesses known to the general aging population. Ultimately, this translates to a need for end of life care. Hospice care seeks to provide individualized physical, emotional, and spiritual support to assist persons and their families in attaining the highest quality of life in the face of a life limiting illness. Hospice services have been underutilized for persons with intellectual disabilities and little has been studied about end of life care provided by community based residential caregivers. The purpose of this project is to use Margaret …

Invisible Motherhood: A Heideggerain Hermeneutical Analysis Of Motherhood Among Three Generations Of African American Women, Katherine Ferrell Fouquier

Nursing Dissertations (PhD)

The mothering role of African American women has largely been ignored in the literature. Contemporary research on the construct of becoming a mother has focused on upper middle class, White women who are partnered. When African American women are included in research, they are often poor, single, teenage mothers and their experiences have not been described within the context of the African American worldview. Hermeneutic phenomenology from an afrocentric feminist perspective is the methodological approach used in this study to provide insight, analysis, and understanding of the experiences of three generations of African American women in the transition to motherhood. …

Contextual Factors Influencing The Acute Care Registered Nurse's Response To Clinical Alarms, Kathleen Mary Stacy Phd

Dissertations

Nurses are faced with a multitude of clinical alarms on a daily basis. There is an inherent expectation that upon hearing an alarm the nurse will immediately respond to assess the situation and initiate appropriate action to correct the problem. Yet this does not always occur. Issues with alarm responsiveness can pose a serious threat to patient safety. The purpose of this qualitative study was to develop a broader understanding of the contextual factors that influenced the acute care nurse's response to clinical alarms. This study used an interpretive phenomenological methodology to study the lived experiences of the nurses who …

Oncology Nurses' Perceptions Of Self-Compassion: A Pilot Study, Miriam R. Lindell

Theses and Graduate Projects

Oncology nurses face extraordinary stressors in their work. If this stress becomes prolonged, these nurses are at risk for burnout and compassion fatigue. One effective way for nurses to manage stress is to care for themselves, body, mind, and spirit. The concept of self-compassion reflects a meaningful approach to self-care. This pilot study explored the perception'of self-compassion by hospital based oncology nurses. A convenience sample of 37 oncology nurses was surveyed using four demographic questions and the Self-Compassion Scale by Kristin Neff. The results demonstrated positive correlation between years of nursing experience and years of oncology nursing experience with common …

Nurses' Experiences With The Disclosure Of Errors To Patients, Debbie Greene

Nursing Dissertations (PhD)

The 1999 Institute of Medicine report, To Err is Human, raised awareness about the multitude of errors that occur in healthcare. Frequently, errors are not disclosed to patients or their families. While several studies have examined patient and physician perspectives on disclosure, limited research on nurse perspectives exist. In hospitals, nurses are often the last line of defense before errors reach the patient. Because nurses are often present when errors occur, nurses’ experiences with disclosure are integral to understanding the issues that surround the disclosure of errors. The purpose of this study was to gain an understanding of nurse experiences …

Transformational Nursing Simulation: Bringing Life To Inanimate Objects For The Purpose Of Educating And Re-Igniting Passion, Pamela A. Torkkola

Theses and Graduate Projects

A transformational nursing simulation program that incorporates a holistic approach in caring for the caregiver is the focus for a Master's Field Project paper. As an alternative to the construction of a generic nursing simulation center that is limited to the education of knowledge and skills, a larger vision centered in Margaret Newman's nursing theory, Health as Expanding Consciousness is proposed. Business models, an incremental approach and practical suggestions are offered in support of healthcare organizations working toward a Center for Nursing Arts and Sciences in times of economic challenge.

Exploring The Stress Response In New Army Nurses, Laureen Otto

Theses and Dissertations

The study of stress is limited in professional nursing, but it is nearly non-existent in professional military nursing. The purpose of this study was to explore the relationships among psychological, environmental, biological and demographic factors of stress in new Army nurses during the Army Medical Department’s 8-week Officer Basic Leadership Course (OBLC). Using a descriptive prospective, correlational repeated measures design, 33 study participants completed two psychological stress measures (Perceived Stress Scale [PSS] and the Impact of Event Scale – Revised[IES-R]), an environmental measure (Life Experiences Survey [LES]), a biologic measure (salivary cortisol) and a demographic questionnaire at three different time …

Nurses' Spiritual Care Practices: Assessment, Type, Frequency, And Correlates, Iris Mamier

Loma Linda University Electronic Theses, Dissertations & Projects

This descriptive, correlational study described the type, frequency, and correlates of nurses' spiritual care practices (quantitative) and their experiences with the sacred at work (qualitative). A convenience sample of 554 (24%) of the Registered Nurses employed at a western United States faith-based tertiary care health system participated in this online survey. Nurses' spiritual care practices were assessed using the 17-item Nurses' Spiritual Care Practice Questionnaire (NSCQ). Factorial validity and reliability of the pilot NSCQ were established. Spiritual care practices most frequently endorsed were assessing patients' spiritual beliefs pertaining to health and listening to patients' stories of illness and their spiritual …

The Relationship Betwen Perceived Wellness And Stages Of Change For Exercise Among Rural African American Women, Imani Carolyn Goodwin

Nursing Dissertations (PhD)

Cardiovascular disease (CVD) is the leading cause of death among women in the US, and African American women (AAW) have a disproportionately high rate of deaths from CVD. Physical inactivity plays a major role in CVD development. It has been reported that some rural women have low rates of physical activity; 39% of White women and 57% of women of color are reported to be physically inactive. Rural AAW have a high mortality and morbidity rate related to CVD and a high rate of physical inactivity. The purpose of this study was to describe rural AAW’s perception of wellness in …

Perceptions Among Students In Online Health Related Courses - A Pilot Study, Kathy Sullivan

Master's Projects

Given the proliferation of online courses in university education, continuous evaluation is imperative to ensure quality. This study utilized a quantitative descriptive design using a questionnaire to explore the perceived adequacy and acceptance of distance learning in undergraduate health related courses. Questions were designed to elicit students' reactions to teaching methods, course content, and how the format influenced their learning. Overall, acceptance of online courses is high. Most of the students were willing to take another online course in the future. Respondents felt that online courses offer more flexibility, encourage both independent and critical thinking skills, and that the course …

Situational Awareness In Multi-Casualty Incidents: Theory Development From The Field, Steven T. Busby

Doctoral Dissertations

The purpose of this study was to understand the process of situational awareness (SA) in multi-casualty incidents (MCI). This study is significant because SA provides information on which critical decisions are made during emergency events. The literature concerning SA is mostly drawn from the domains of aviation, military operations and business and not nursing. Current conceptual and theoretical development is insufficient for application to the domain of MCI. MCI occur daily across the United States, yet a literature review revealed no studies involving SA in MCI. Limited issues that are possibly related to SA in MCI have been researched such …

"I Am A Living History": A Qualitative Descriptive Study Of Atomic Bomb Survivors, Amy Knowles

Doctoral Dissertations

Never has the world experienced such extreme desecration as with the atomic bombings of Hiroshima and Nagasaki, Japan, in August 1945. This magnitude of destruction serves as the foundation for this disaster research. Although significant quantitative research has been completed about medical effects following radiation, the literature lacks qualitative exploration from a holistic health perspective. The purpose of this study was to explore the experience of atomic bomb survivors from Hiroshima and Nagasaki. From ethnographic data and interviews with eight survivors who currently reside in the United States, a thematic structure was developed that depicts the essential elements of the …

Knowledge, Attitudes, And Job Satisfaction In Long-Term Care: A Comparison Between Licensed Nurses And Nursing Assistants, Lynne Almand

Student Dissertations & Theses

Knowledge, attitudes, and job satisfaction of long-term care workers were examined to determine if a relationship existed between these factors and if differences existed between licensed nurses and nursing assistants. Participants included 36 nurses and 60 assistants from five nursing homes in the Midland/Odessa area. Results indicated that nurses had significantly more positive attitudes toward (t(94) = -5.72, p<.05) and increased knowledge of older adults (t(94) = 2.71, p<.05) than assistants. In addition, more positive attitudes were significantly associated with more knowledge of the elderly (r(96) = -0.36, p<.05) as well as increased levels of job satisfaction (r(96) = -0.53, p<.05).

Nursing Faculty Experiences And Perceptions Of The Implementation Process To A Learner-Centered Teaching Philosophy: A Case Study, Sharon L. Colley

Dissertations

This study explores nursing faculty's experiences with and perceptions of, their school of nursing's change to a learner-centered teaching philosophy. The primary research goals are to determine faculty perceptions of what learner-centered approaches they are utilizing in their classes, what change conditions they perceive as significant to the implementation process, and how they perceive the overall faculty progress and unity toward the goal of adopting a learner-centered teaching philosophy. Using the theoretical frameworks of Carl Rogers and Donald Ely, a case study approach is used to examine the faculties' use of five key concepts associated with the learner-centered philosophy, as …