Medicine and Health Sciences Commons^™

Implementation Of Lymphedema Education Toolkit For Nurse Coordinators, Heather Gee

Master's Projects and Capstones

Problem: Lymphedema is a chronic condition that develops secondary to cancer treatments such as chemotherapy, radiation, and surgical removal of affected lymph nodes. This swelling in patient’s limbs can cause discomfort and limit mobility, however lymphedema is often not detected until later stages, delaying treatment and patient education.

Context: This quality improvement project was conducted at Hospital S Women’s Cancer Center, an outpatient center specializing in advanced treatments for breast and gynecological cancers. This center has a multidisciplinary team focusing on both the medical and surgical aspects of oncology treatment.

Interventions: An evidence-based lymphedema education toolkit was created for nurse …

Physiotherapists Description Of Patient-Centered Care, And Barriers And Facilitators Experienced To Implementation, Maclean Jordan

Electronic Thesis and Dissertation Repository

Patient-centered care (PCC) is a growing standard for healthcare delivery due to the benefits to patient autonomy. Lacking a cohesive definition in the physiotherapy literature, it is also lacking in implementation. Employing interpretive description with semi-structured interviews, the goal was to understand how physiotherapists drawn from private for-profit clinics in Canada describe PCC, and barriers and facilitators to providing it. Results included requiring person-centered communication in PCC, seeing Health holistically, centering the patient in care, and being a skill that becomes clearer with practice experience. Barriers included: lack of practitioner reflexivity, patient not desiring self-directed care, and limited access to …

Traditional Chinese Medicine And The Argument For Future Application In The United States, Kylie Nicole Frohlich

Graduate Student Theses, Dissertations, & Professional Papers

No abstract provided.

The Role Of Patient And Rehabilitation Factors In The Recovery Of Home And Family Work Roles Following Distal Radius Fracture, Sheena Saju Philip Ms.

Electronic Thesis and Dissertation Repository

Background: Distal radius fracture (DRF) is a common upper extremity fracture that causes significant impairment and leads to difficulties in fulfilling important life roles such as indoor and outdoor cleaning, meal preparation, grocery shopping, caring for others, and earning and managing family income. However, clinicians do not routinely address home and family life roles after a DRF. Patient and rehabilitation factors are crucial in addressing home and family work roles (HFWRs). The HFWR questionnaire consists of tasks that are typically performed at home.

Objective: The overarching objective of this thesis is to explore the role of patient and rehabilitation …

Exploring The Experience Of Sexuality And Gender During The Healthcare Transition Of The Youth With Cerebral Palsy, Umma Salma

Electronic Thesis and Dissertation Repository

Background: Transition from the pediatric to adult health care system is an important phase of healthcare for youth with cerebral palsy (CP). Sexuality and gender are two very important components of health that are mostly ignored in the healthcare transition process. It is possible that health care providers only see a client’s disability, and therefore, key aspects of sexuality and gender diversity may be ignored, or deemed irrelevant as a result of their disability status. Therefore, the purpose of our study is to explore how gender and sexuality may influence the experience of health care transition for youth with cerebral …

Chronic Lower Back Pain Among Women In India: Evidence-Based Approach To Risk Factors And Interventions, Aelita Matosova

Master's Projects and Capstones

Chronic lower back pain (CLBP) is a prevalent issue worldwide, affecting about 1.71 billion people, with a significant proportion being women. CLBP is a major health concern in India, particularly among women, which were 80% reported experiencing this condition. Several factors, such as personal beliefs, sociocultural norms, restricted healthcare access, repetitive movements, and psychological aspects, contribute to this high prevalence leading to severe health and economic implications, including reduced work productivity and income. Although there have been several reports on prevalence and risk factors of CLBP, to our knowledge, there has not been enough work focusing on evidence-based interventions to …

An Exploratory Study Of Ergonomics In College Students, Wesley Ryan Tinker

Murray State Theses and Dissertations

Abstract

This study aimed to examine the relationship between poor ergonomic conditions and student physiological discrepancies. This examination provided great insight into students’ daily experiences and concerns for their futures. The methodology used for this study was quantitative as two source data sets were collected and analyzed. The tool REBA was used to measure the specific body angles while students sat working. A survey yielded great results, giving the students an opportunity to subjectively choose options.

This exploratory study allowed the researcher to use quantitative data to answer this study’s research questions. The research questions asked from this study were …

What Could Go Wrong? Patient And Hospital Characteristics Associated With Pediatric Quality Of Inpatient Care And Pediatric Adverse Events, Michael H. Samawi

Electronic Theses and Dissertations

This study aims to analyze associations between hospital and patient characteristics with pediatric adverse events (PAE) in the inpatient hospital setting, utilizing the framework of pediatric quality indicators (PDIs) from the Agency for Healthcare Research and Quality (AHRQ) indicators. Three PDIs were identified and utilized for this purpose: NQI 03 Neonatal Blood Stream Infection, PDI 09 Postoperative Respiratory Failure, and PDI 10 Postoperative Sepsis. The data used for the study is based on an analysis of discharge data from the Healthcare Cost and Utilization Project (HCUP) Kid’s Inpatient Databases (KID) for the year 2019. The findings contribute to the growing …

Multimodal Approach To Chronic Pain Management And Prevention Of Opioid Use Disorder, Hannah Elston

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background. Chronic pain (CP) is a major public health problem that affects one-third of the population and can interfere with the activities of daily life and cause decreased quality of life. Patients with CP have been increasingly prescribed opioids, contributing to the rise in the opioid epidemic. Due to the long-term nature of CP, the use of opioids as the sole treatment for CP can cause tolerance and increased dosages overtime which can lead to addiction and potentially overdose. Therefore, CP treatment should include multimodal approaches to treatment to prevent opioid misuse, opioid use disorder (OUD), and overdose. Multimodal treatments …

Association Between Arthritis And Yoga Among Veterans, Anupreet Arora

UNLV Theses, Dissertations, Professional Papers, and Capstones

Yoga is a state of complete mindfulness and self-realization with an inwardly drawn focus, a state of mind – body integration in which there is a harmony between form and action. Yoga can help us treat a myriad of chronic health conditions like obesity, heart diseases, diabetes, depression, gastrointestinal problems, asthma, hypertension, chronic low back pain, and arthritis to name a few. Arthritis is a frequent, debilitating chronic disease which can cripple an individual if allowed to progress unchecked. In 2021, the prevalence of arthritis in USA was around 24% with a projection of 37% by 2030. Prevalence of arthritis …

The Double Burden Of Intra-Household Malnutrition Among Mother–Child Dyads In South Africa, Puveshni Crozier

Walden Dissertations and Doctoral Studies

Household-level double burden of malnutrition (HL-DBM) challenges traditional South African vertical malnutrition programs. Research has associated a household with an overweight/obese mother of reproductive age and her under 5-year-old child with signs of undernutrition (wasting, stunting, or thinness) with socioeconomic levels, maternal characteristics, features of the household, and child’s demographics. Grounded in the social determinants of health conceptual framework, this study aimed to investigate the determinants of HL-DBM in South Africa across the reproductive-child health continuum. Using the representative 2017 Wave 5 South African National Income Dynamics Study survey secondary data, a total sample of 314 homes met this non-experimental …

The Outcome Of Stroke Education And Management On Cerebrovascular Accident Patients In Bermuda, Antoinette Simone Dyer

Walden Dissertations and Doctoral Studies

AbstractIncidence of cardiovascular accident (CVA), also referred to as a stroke, has increased in Bermuda. Understanding key contributing factors is necessary to reduce incidences that are associated with this disease process. This dissertation examined the outcome of stroke education and management on CVA patients in Bermuda. The health belief model, incorporating a reflection of the public health framework, guided the analysis of a quantitative dataset obtained through Bermuda Hospitals Board’s Neurology Department. A cross-sectional study design was used to sample 253 stroke patients over a 2-year period (2019 -2021). The Wilcox test was employed to compare two groups – stroke …

Faculty Perspectives On Quality Of Online Courses In Health Education And Promotion Programs, Dana Wawrzyniec

Walden Dissertations and Doctoral Studies

The need to make quick transitions online due to COVID-19 challenged many Health Education and Promotion (HEP) faculty to identify how to create quality online HEP courses. A review of the literature identified the need for qualitative research on the quality of online courses from the faculty’s perspective. The purpose of this general qualitative study was to explore the perceptions and experiences of HEP faculty at multiple universities, in terms of the organization and facilitation of their online courses, communication between instructor and student, and assessment of students. The community of inquiry (COI) framework, which evaluates the teaching, social, and …

The Utilization Of Physical Literacy To Understand Physical Activity In Individuals With A History Of Anterior Cruciate Ligament Reconstruction, Rachel Renee Kleis

Theses and Dissertations--Rehabilitation Sciences

Injury to the anterior cruciate ligament (ACL) is common in physically active populations. Anterior cruciate ligament reconstruction (ACLR) is commonly performed after injury in order to restore joint stability and knee function and return patients to desired levels of physical activity. However, not everyone will return to their pre-injury levels of sport after surgery and recent evidence reveals that individuals with a history of ACLR are less likely to meet the recommended physical activity guidelines. Specifically, previous literature has reported that individuals with a history of ACLR take fewer daily steps and participate in less moderate-to-vigorous physical activity compared to …

Feasibility Of Delivering Fall Prevention Intervention For People With Intellectual Disability In Group-Homes, Poram Choi

Theses and Dissertations

Adults with intellectual disability (ID) have a higher rate of falls than the general population, and changing health behaviors through exercise program could enhance health and reduce falls in this population. However, the feasibility study of fall prevention based on the theoretical framework for adults with ID has not been explored to date. This study examined the feasibility of a home-based exercise intervention for people with ID living in a residential setting. We provided an 8 week intervention consisting of a training workshop for support workers and sessions for adults with ID devoted to behavior reward, education about fall prevention …

Minimizing Musculoskeletal Injury Risk In Health Care Professionals With Education On Safe Patient Handling, Aubrey Graves

Honors College Theses

Introduction: Nursing is a high-risk occupation for musculoskeletal injuries due to the strenuous activity of patient handling. These tasks include, assisting a patient in bed, moving a patient from the bed to a wheelchair, and assisting with walking. These work-related tasks can create a large amount of stress on the body, especially the back if proper technique is not utilized and/or if excessive loads are applied. The purpose of this study is to examine if teaching proper body mechanics and the dangers of not performing the tasks properly is an effective way of reducing musculoskeletal injuries.

Methods: The NUR 202 …

Falls Screening In Community- Dwelling Older Adults, Hadi Kooshiar

Electronic Thesis and Dissertation Repository

Falls screening can prevent falls and their consequences. The two studies of this thesis aimed to identify the accuracy of falls screening tools and explore patient preferences and empirical validity of the self-rated Falls Risk Questionnaire (FRQ). The first study, Systematic Literature Review, found the Toulouse-St. Louis University Mini Falls Assessment and the Activities-specific Balance Confidence scale Hindi version emerged as accurate tools for predicting falls in the target population. The second study determined most of respondents, 36%, had no preference between Activities Specific Balance Confidence 6 items (ABC-6) or FRQ. The Bland & Altman approach revealed a degree of …

The Role And Importance Of Social Support During Recovery Following Distal Radius Fracture, Ogheneruona Mi Idoghor Ikpen

Electronic Thesis and Dissertation Repository

This thesis explored how social support changes with time and differs across genders within 1-year post distal radius fracture (DRF). It also examines the effect of social support on the patient-rated wrist evaluation (PRWE) score and health-related quality of life (HRQoL) of DRF patients at 3 months post-fracture. In this cohort study, patient-reported social support (emotional/informational, tangible, affectionate and positive social interaction) was measured using the Medical Outcomes Study (MOS) social support survey, and HRQoL was measured using the 36-Item Short-Form Survey (SF-36). Social support significantly decreased at 3 months in comparison to baseline, 6 months and 1 year (with …

Exploring Experiences Of Parents Of A Child With Medical Complexity: A Case Study Approach, Vanessa Rocchese

Electronic Thesis and Dissertation Repository

Parents of children with medical complexity (CMC) have the unique experience of also being their child’s health care provider (HCP). This cross-sectional, qualitative single-case study sought to 1) examine experiences of parental caregivers of CMC whilst navigating healthcare and social systems; and 2) examine influences of urban/rural settings on parental caregiver experiences. An online demographic survey and semi-structured telephone interviews were utilized with two families, one urban (n=1) and one rural (n=2). A thematic analysis was undertaken using both intersectionality and the Conceptual Model of Health-Related Quality of Life-(HRQoL) as frameworks to explore findings. This study revealed that challenges in …

Health Concerns Of Adolescents And Adults With Spina Bifida, Jessica A. Starowicz

Electronic Thesis and Dissertation Repository

The Transitional and Lifelong Care (TLC) program is a multidisciplinary clinical service providing comprehensive, coordinated care to adolescents and adults with spina bifida (SB). This study sought to identify the most common health concerns among this population at initial consultation and identify patient factors related to these concerns to ultimately improve health care delivery. A retrospective chart review was performed. Descriptive analyses were completed and associations between concerns and patient factors were determined using Spearman’s rho correlation coefficients. A multiple linear regression was performed to estimate the relationship between patient factors and total number of concerns reported. Ninety-four patient charts …

The Assessment Of Clinical Reasoning In Preceptors Across The Athletic Training Profession, Gary Wayne Cohen Jr.

Health Services Research Dissertations

Clinical reasoning (CR) is defined as a complex multi-factorial metacognitive process for diagnosis formulation. Clinical reasoning begins as a student and develops over a career. Students are typically taught an analytical approach defined as hypothetico-deductive reasoning (HDR). Expert clinicians use a non-analytical approach defined as the Knowledge Based Model (KBM) of CR. It is accepted that clinicians use the KBM with cases that they have more experience to streamline the evaluation process. Unfortunately, because of the nuance of CR there have been limited investigations within athletic training to evaluate CR outside of the student population.

The overarching purpose of this …

Using Mindfulness To Decrease Stress In College Students, Saska Pavlovic

Evidence-Based Practice Project Reports

The prevalence of stress is increasing in colleges, where students are experiencing anxiety at an alarming rate, with anxiety being the topic most discussed in university counseling centers. The purpose of this evidence-based practice project was to determine the effect of mindfulness exercises on college students’ perceived stress. The Stetler Model guided the project development and implementation. The literature search revealed that best practice included mindfulness exercises through a combination of face-to-face instruction and remote online audio meditation for a duration of eight weeks. For this project, 56 undergraduate students (health care-leadership, health-science, and nursing majors) enrolled in a health …

Rurality As A Moderator Of Perception Of Need For Medical Care And Patient Satisfaction, Kyndal Grammer

Electronic Theses and Dissertations

Many individuals experience barriers to accessing medical care, especially in rural areas. Some barriers are attitudinal and represent perceptions of quality care. Patient satisfaction and perceived need for medical care are two such attitudinal barriers related to health care utilization, yet the relationship between these variables has not been explored. Using data from an online survey, the current study examined the association between these variables, and further, whether rurality status moderated this association. Results indicated a significant correlation between patient satisfaction and perception of need. Although the overall moderation model was significant, perception of need was not significantly associated with …

Hip And Pelvic Floor Strength And Mobility In Women With And Without Urgency And Frequency Predominant Lower Urinary Tract Symptoms, Stefanie N. Foster

Arts & Sciences Electronic Theses and Dissertations

Urgency and frequency are common lower urinary tract symptoms (LUTS) in women and are accompanied by substantial activity and participation restrictions. Medical management begins with ruling out organ pathologies, typically followed by fluid intake and timed voiding often combined with pharmacologic management, and may progress to nerve stimulation, botulinum injections, or surgery where indicated. Despite abundant management options for urgency and frequency predominant LUTS (UF-LUTS) and high financial burden, patients often experience only partial relief from medical treatments for LUTS. While a great deal of literature exists to inform pharmacologic and surgical care of patients with UF-LUTS, less is known …

Parental Educational And Engagement Through Positioning And Play, Gaile E. Seay

Occupational Therapy Doctorate Capstone Projects

Background: This project is to increase the confidence of parents/caregivers via education about their infants that may not otherwise be provided by other health care professionals. This project also provides early intervention to the infants in efforts to facilitate their maximum development through proper positioning for sleeping and play. Purpose: The purpose of this project was a parental education class for parents/primary caregivers of babies ages 0-6 months. They were educated about their child’s development, and how to engage their baby through play and positioning for optimal cognitive, communication, and social-emotional development. This class and project sought to enhance parents’ …

Bystanders’ Perspectives On The Provision Of Informal, Hospital-Based Care To Bedridden Patients With Cancer In Sri Lanka, B. Sunil S. De Silva

Nursing ETDs

Due to the nursing shortage in Sri Lanka, patients need informal caregivers, known as bystanders, to help provide patient care. This study described bystanders’ perspectives on informal, hospital-based care to bedridden patients with cancer in Sri Lanka. In this qualitative descriptive study, 17 bystanders at Apeksa/Cancer Hospital, Sri Lanka, were recruited using snowballing sampling. Data were collected through telephone interviews and analyzed using content and thematic analyses. Findings showed that paid and unpaid bystanders cover all caregiving tasks with minimum interaction with nurses. Unpaid bystanders described the need for same-sex bystanders and additional help with patients’ mobilization and specialized care. …

Unit Cost Analysis Of Acute Respiratory Infection (Ari) Clinic For Covid-19 Screening At Bangbuathong Hospital, Nonthaburi, Thailand, Tharit Mongkol

Chulalongkorn University Theses and Dissertations (Chula ETD)

The COVID-19 outbreak has affected the services of all hospitals in Thailand, especially making their financial position at risk of bankruptcy. Although managing the cost of health care services for COVID-19 effectively can help reduce that risk, but very few researches has been done and analyzed on these issues. This study aimed to identify the unit cost and cost recovery of Acute Respiratory Infection (ARI) clinic for COVID-19 screening at Bangbuathong Hospital. This research was a descriptive study by retrospective data collection from hospital recorded and database of costs of ARI clinic between March to May 2021, which was the …

Academic Center Tiered Operating Room Strategy (Action): Comparing A High Efficiency Or To The Conventional Or, Moaz Bin Yunus Chohan

Electronic Thesis and Dissertation Repository

Canadian healthcare system is under immense economic pressure. In an attempt to resolve the problem, outpatient surgical services were offered to patients presenting with orthopaedic surgical complaints. An observational cohort study was carried out, comparing the conventional surgical setup to the newly designed high-efficiency setup that provided similar care, with a significantly lower operating cost. A total of 200 patients were enrolled in the study. Standardized and unstandardized questionnaires were used to evaluate pre-operative and post-operative patient data that reflected quality of life outcomes. Data was collected at enrolment and during post-operative follow-ups of up to 6 months. Results indicate …

Critical Illness Survivors’ Perceptions Of Their Recovery: An Interpretive Phenomenological Inquiry, Kelly Calkins

Theses and Dissertations

Surviving critical illness with its physical, cognitive, and psychosocial morbidities is a growing clinical and research challenge and an important public health concern. Currently, there are few interventions for survivors of critical illness after hospital discharge. Potential interventions include rehabilitation services, Intensive Care Unit (ICU) diaries and ICU follow-up clinics, however, most survivors do not have access to these post-hospital interventions.

The purpose of this study is to gain a better understanding of how critical illness survivors experience their recovery, interventions they use, and what they perceive as facilitators and barriers to their recovery. A better understanding of these factors, …

Prognostic Predictive Model To Estimate The Risk Of Multiple Chronic Diseases: Constructing Copulas Using Electronic Medical Record Data, Jason E. Black

Electronic Thesis and Dissertation Repository

Introduction: Multimorbidity, the presence of two or more chronic diseases in an individual, is a pressing medical condition. Novel prevention methods are required to reduce the incidence of multimorbidity. Prognostic predictive models estimate a patient’s risk of developing chronic disease. This thesis developed a single predictive model for three diseases associated with multimorbidity: diabetes, hypertension, and osteoarthritis.

Methods: Univariate logistic regression models were constructed, followed by an analysis of the dependence that existed using copulas. All analyses were based on data from the Canadian Primary Care Sentinel Surveillance Network.

Results: All univariate models were highly predictive, as demonstrated by their …