Medicine and Health Sciences Commons^™

Servant Leadership Towards Cultural Competency And Critical Thinking: A Mixed Methods Study In Zambia, Jill Marie Brown

Occupational Therapy Program Student Theses, Dissertations and Capstones

There is a paucity of occupational therapy literature related to the professional development process that occurs when students participate in immersive, international servant leadership experiences in developing countries. A scarcity of literature exists on how such culturally rich experiences can influence the development of the participating students’ dispositional critical thinking and cultural competency skill sets. This mixed methods study depicts how a 3-week servant leadership experience in Zambia, Africa, measured the acquisition of dispositional critical thinking and cultural competency skill sets in novice to experienced occupational therapy students. Moreover, this study infuses a constructivist grounded theory approach to uncover a …

Harnessing Nature For Occupational Therapy: Interventions And Health Promotion, Gina Ferra Kaplanis

Occupational Therapy Program Student Theses, Dissertations and Capstones

Literature is beginning to emerge which states that participation in natural environments can be restorative, provide much needed physical activity and assist with health promotion and prevention of illness. Theories such as Attention Restoration Theory (Kaplan, 1995) and Biophilia Hypothesis (Wilson, 1993) support the benefits for participation in natural outdoor environments. Health benefits of participation in nature including accessing Vitamin D, improving balance, attention restoration, reduced myopia, stress reduction are widely present in literature. Despite the health benefits of participation in nature, occupational therapists rarely complete interventions in the natural environment. Principles of adult learning and occupational adaptation were used …

Practice Makes The Deficiency Of Global Motion Detection In People With Pattern-Related Visual Stress More Apparent, Jana Wegrzyn

Student Theses, Dissertations and Capstones

Pattern-related visual stress (PRVS) refers to the perceptual difficulties experienced by some individuals when exposed to high contrast striped patterns. People with PRVS were reported to have reduced sensitivity to global motion at baseline testing and the difference disappears at a second estimate. The present study was to investigate the effect of practice on global motion threshold in adults with and without PRVS. Methods: A total of 101 subjects were recruited and the Wilkins & Evans Pattern Glare Test was used to determine if a subject had PRVS. The threshold to detect global motion was measured with a random dot …

A Clinical Documentation Practice Improvement To Increase Insurance Reimbursement, Allison R. Hamilton

Student Theses, Dissertations and Capstones

Background: The National Institute Mental Health (2015) estimated there were about 44.7 million people diagnosed with a serious mental illness and 62.9% of those diagnosed were without mental health services. The loss of services was due to unemployment, reoccurring hospitalization, inabilities to care for themselves, and lack of participation in societal norms (World Health Organization [WHO], 2014). According to Insel (2011/2015), the U.S. cost of mental healthcare was an estimated $57.5 billion in 2006. This cost was not due to actual care but associated with the economic burden of job loss and the excessive use of community resources. The Affordable …

Improved Use Of Interact To Decrease 30-Day Readmissions From A Skilled Nursing Facility, Folasade Omobowale Adewunmi

Student Theses, Dissertations and Capstones

Background: The rising cost of health care in relation to rehospitalizations continues to be a challenge. Medicare 30-day readmissions have an annual estimated cost of $17.4 billion. Irrespective of these costs and the continued improvement in the quality of care, skilled nursing facilities (SNF) still face high readmission rates. Purpose: The purpose of this quality improvement project was to enhance SNF care processes by improving the utilization of the electronic medical record software program “INTERACT” to increase early identification and treatments of patients to minimize 30-day hospital readmissions. Theoretical Framework: The theory of planned behavior by Icek Azjen was used. …

Implementing A Culturally Sensitive Intervention For Haitian Patients Non-Adhering To Hypertensive Medications, Guilaine Gabriel-Percinthe

Student Theses, Dissertations and Capstones

Background: The pervasiveness of hypertension (HTN), morbidity, and mortality in Haitians immigrants are frightening. Nonadherence with hypertensive medications, disease management, lifestyle modifications, and cultural and spiritual beliefs, including prayer; faith healing; use of herbal teas; and a diet that is deficient in potassium, rich in sodium, high in fat, cholesterol, and carbohydrates result in increased prevalence of HTN and disability in the Haitian community. Purpose: The purpose of this quality improvement project was to examine the existing system for adherence to hypertensive medications, standardized clinical practice guidelines, identify patients at risk for nonadherence to hypertensive medications, disease management, medical follow-up, …

Lived Experience Of Post-Licensure Nurses In A Perioperative Clinical Rotation, Amy Stahley

Student Theses, Dissertations and Capstones

A projected deficit in the perioperative workforce of 32,000 perioperative nurses retiring by 2024, creates an inability to meet the nursing needs of the United States population. The need for experienced perioperative nurses has been increasing while the availability of nurses with perioperative education has been decreasing. The purpose of this phenomenological study was to explore the lived experience of post-licensure nurses who participated in a perioperative clinical rotation within their baccalaureate nursing program and did that experiential experience affect the recruitment and employment for perioperative nursing to halt the impending shortage. The integrations of Kolb’s experiential learning theory and …

Use Of Evidence-Based Test Development In Pre-Licensure Nursing Programs: A Descriptive Study Of Faculty Beliefs, Attitudes And Values, Richild Berrick

Student Theses, Dissertations and Capstones

Background: Effective testing in pre-licensure nursing programs is a challenge in nursing education. Implementing evidence-based test development is essential to successful assessment of students’ competence and preparation for licensure. Purpose: Identifying the beliefs, attitudes and values of nursing faculty will contribute to the use of best practices in student assessments, ultimately contributing to increased retention of competent students and increasing the workforce within the healthcare industry. Theoretical Framework: This study is based on Rokeach’s theory of beliefs, attitudes and values. Methods: A quantitative descriptive research methodology was used in this study using survey data collection. A purposive, non-probability, convenience sample …

Thrust Joint Manipulation To The Cervical Spine In Participants With A Primary Complaint Of Temporomandibular Disorder (Tmd): A Randomized Clinical Trial, Breanna C. Reynolds

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: Temporomandibular disorder (TMD) is a common and costly problem often leading to chronic pain. There exists moderate evidence for physical therapy (PT) interventions in the management of TMD. A known relationship between TMD and the cervical spine exists with some evidence to support cervical intervention treatments. Cervical spine thrust joint manipulation (TJM) is an effective PT intervention explored in a limited fashion for this population. Objectives: To determine the immediate and short term (1 and 4 week) effects of cervical TJM on pain, dysfunction, and perception of change in individuals with a primary complaint of TMD. Methods: In this …

Cognitive Load Theory Principles Applied To Simulation Instructional Design For Novice Health Professional Learners, Susan M. Grieve

Department of Physical Therapy Student Theses, Dissertations and Capstones

While the body of evidence supporting the use of simulation-based learning in the education of health professionals is growing, howor why simulation-based learning works is not yet understood. There is a clear need for evidence, grounded in contemporary educational theory, to clarify the features of simulation instructional design that optimize learning outcomes and efficiency in health care professional students.

Cognitive Load Theory (CLT) is a theoretical framework focused on a learner’s working memory capacity. One principle of CLT is example based learning. While this principle has been applied in both traditional classroom and laboratory settings, and has shown positive …

Trigger Point Dry Needling, Manual Therapy And Exercise Versus Manual Therapy And Exercise For The Management Of Achilles Tendinopathy: A Feasibility Study, Alex Michael Koszalinski

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: The effect of trigger point dry needling (TDN) on myofascial trigger points (MTP) in Achilles tendinopathy are unknown. Objectives: To determine the feasibility of a large randomized controlled trial (RCT) to compare the effects of TDN to exercise in a patient population with Achilles tendinopathy. Methods: This single-factor, pretest-posttest control group design included 22 subjects between the ages of 24 and 65 years with Achilles tendinopathy. Subjects were randomly assigned to either a control group (MT+Ex) or experimental group (TDN+MT+Ex). Subjects in both groups completed 8 physical therapy treatment sessions over 4 weeks. The intervention for the TDN+MT+Ex group …

Effects Of Generic Group-Based Versus Personalized Individual-Based Exercise Programs On Balance, Gait, And Functional Performance Of Older Adults With Mild Balance Dysfunction And Living In Residential Care Facilities - A Randomized Controlled Trial, Varatharajan Lingam

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background and Purpose: To investigate the effect of an individualized exercise program versus a generic group-based exercise program on balance, gait, and functional performance of older adults categorized as having mild balance dysfunction and living in residential care facilities. Methods: Single blind randomized control design. One hundred-twenty residents fulfilled screening criteria for mild balance dysfunction based on the BioSwayTM balance and the Multi-Directional Reach Test (MDRT) primary outcome measures. Secondary assessment was completed using the Modified Physical Performance Test (PPT), hand-held dynamometer (lower-limb muscle strength testing), and gait speed analysis. Sixty subjects received individualized treatment from physical therapists (8 weeks). …

Effectiveness Of A Manual Therapy Approach In Treatment Of Patients With Lumbar Spinal Stenosis, Haitham Ramadan

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: The use of manual therapy for the management of lumbar spinal stenosis (LSS) has not been adequately systematically reviewed in an attempt to determine its effectiveness on patients with LSS. The lack of evidence in support ofcommonly used conservative interventions continues to result in a lack of clarity regarding what interventions should be used to manage patients with LSS. Objective: To use a randomized comparative trial to compare the functional clinical outcomes achieved by patients with LSS receiving two different physical therapy interventions. Methods: In this randomized controlled trial, a total of40 participants diagnosed with LSS were randomized into …

Integrative Molecular Pathological Epidemiology Of Congenital And Infant Acute Leukemia, Heather Elizabeth Williams

Health Sciences Program Student Theses, Dissertations and Capstones

Congenital and infant acute leukemia remain one of the most puzzling clinical issues in pediatric hematology-oncology. There is a paucity of studies focused on these rare, aggressive, acute leukemias; specifically, there is little study on the differences in disease in the youngest of infants less than 1 year of age unlike the numerous studies of the disease in older children. The United States National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) cancer population registry program has been integral for a plethora of clinical population and pathology research studies for numerous diseases in the last 40 years and has an …

Chinese Immigrants With Non-Insulin-Dependent Diabetes Mellitus: Nutritional Self-Management Approach, Winnie Manlai Wong

Student Theses, Dissertations and Capstones

Background: Chinese immigrants (CIs) with non-insulin dependent diabetes mellitus (NIDDM) generally have poor control in their diet regimen. Due to the variation in body mass, physiology, and cultural differences as compare with the general American population, special attention must be conducted in treating diabetes in Cis, emphasizing culturally sensitive care and nutrition therapy that acknowledge the differences. Purpose: The purpose of this project was to assess cultural challenges in self-management for CIs living with non-insulin dependent diabetes mellitus and evaluate the effectiveness of a diabetic nutritional self-management guide tailored to this population. Theoretical Framework: Havelock’s theory of change is a …

Comprehensive Occupational Therapy In A Breast Cancer Program, Nicole Renee Scheiman

Occupational Therapy Program Student Theses, Dissertations and Capstones

The purpose of this capstone project is to develop an evidenced-based, innovative, and comprehensive occupational therapy evaluation and intervention protocol for breast cancer care. The contents of this paper will include an introduction into the current care provided to survivors, literature review on best practice in breast cancer care, outline of the procedures completed to discover what best practice care should be, results of these procedures, discussion of the results, and conclusion with proposed program and recommendations for further investigation. The concern investigated is the inconsistencies in care provided to survivors from the time of diagnosis throughout their lifespan or …

Fine Motor Skills And The Occupations Of Young Adults With Multiple Sclerosis, Mary Squillace

Occupational Therapy Program Student Theses, Dissertations and Capstones

Objective: Multiple sclerosis (MS) is one of the most common neurological diseases affecting adults of working age, and those of younger ages of onset have been increasingly recognized. Twenty-seven percent of people with MS (PwMS) are age 30 years old or younger. The burden of MS for young adults puts them at risk for poorer outcomes regarding their education, family planning, vocation, and social skills as they transition to adulthood. Fine motor (FM) skill impairment might impede performance within the daily occupations of young adults who are transitioning into adulthood. Few studies focus on the occupations and occupational performance of …

Enhancing Collaboration Regarding Long-Term Therapy Planning For Children With Chronic Conditions Using Participatory Action Research, Victoria Ann Mcquiddy

Occupational Therapy Program Student Theses, Dissertations and Capstones

Children with chronic conditions often participate in therapy, but there is little information about how often or for how long therapy services should be provided. Participatory action research (PAR) methods were utilized in this study and, therefore, involved both parents and occupational and physical therapists throughout the study. Parental interviews were conducted to understand parent perception of self-management and how parents felt their child’s therapist was doing or could do to facilitate self-management, particularly as it related to discharge planning or having their child take a break from ongoing therapy. Through analysis of parent interviews completed by the therapist team …

Assessing Beliefs, Attitudes, And Perceived Risks Of Hiv As Predictors Of Hiv Testing Behavior Among Seniors In The Coachella Valley, California, Gillian Sealy

Health Sciences Program Student Theses, Dissertations and Capstones

According to the Centers for Disease Control and Prevention (CDC) (2017), at the end of 2014, approximately 428,724 people 50 years or older were diagnosed and living with HIV in the United States. A contributing factor to the high incidence of HIV in this population is unknown HIV/AIDS serostatus (Fenton, 2007). The U.S. Department of Health and Human Services (2018), terms serostatus as the state of having or not having detectable antibodies against a specific antigen (https://aidsinfo.nih.gov/understanding-hiv-aids/glossary/1632/serostatus). Contributing to the lack of knowledge about HIV serostatus, is that those over 50 are less likely to be tested for HIV even …

Interpretive Phenomenological Analysis: Exploring The Experiences Of Eye Bank Coordinators When Approaching Families Of Decedents For Eye Donation, Concetta Triglia

Health Sciences Program Student Theses, Dissertations and Capstones

This dissertation was used to addresses a group of individuals who work as eye bank coordinators. These individuals call families and approach them for eye donations from a loved one who has just passed away. An interpretative phenomenological analysis (IPA) was used to explain the lived experience of eye bank coordinators who call families for consent of eye tissue. The focus was to understand the dedication of the coordinators to giving the gift of sight and exploring the positive and negative experiences of eye bank coordinators. IPA is used for a keen understanding of eye bank coordinators, and the investigator …

Lose To Win: Fighting Obesity In The Workplace, Latoya Dotson

Student Theses, Dissertations and Capstones

Background: Obesity is a significant healthcare problem in modern American society. It has led to decreased longevity of employees and decreased productivity in day-to-day duties of healthcare workers. There are more negative attributes to obesity than positive, regardless of the race affected. One of the leading causes of death in 2012 was cardiovascular disease. Due to poor dietary choices, the promotion of sedentary lifestyle has led to complications of obesity such as high blood pressure and diabetes. Major improvements can be made within a community that acknowledges the risks of obesity and seeks to implement preventive programs. Increasing one’s physical …

Implementation Of The Essential Competencies For Evidence-Based Practice In Baccalaureate Nursing Education, Elizabeth Whorley

Student Theses, Dissertations and Capstones

Integrating evidence-based practice into healthcare education has been a recommendation for the past 16 years. Despite this, barriers still exist with the utilization of evidence-based practice. The purpose of this study was to describe the current state of EBP scholarship in the curriculum of baccalaureate pre-licensure nursing programs. Essential Competencies for Evidence-Based Practice in Nursing (Stevens, 2009) was utilized to measure the state of EBP scholarship. The research question stated: how is evidence-based practice scholarship addressed within baccalaureate pre-licensure nursing programs? The research design was guided by Rogers’ diffusion of innovations theoretical framework and the star model of knowledge transformation …

Senior Nursing Students' Knowledge, Attitudes, And Perceived Competency About Older Adults, Deborah Denise Brabham

Student Theses, Dissertations and Capstones

Background: Nurses entering the workforce may have limited education in gerontological nursing. Therefore, many nurses are unprepared to provide quality care to older adults. An unprepared nursing workforce could negatively influence older adults’ health outcomes and care experience. Purpose: To determine differences in senior nursing students’ knowledge, attitudes, and perceived competency about older adults based on enrollment in a bachelor of science in nursing degree (BSN), associate’s degree nursing (ADN), and practical nursing (PN) program that offers geriatric content in curricula. Theoretical Framework: Bandura’s social cognitive theory, triadic reciprocal determinism model provided the theoretical framework. Methods: A non-experimental, descriptive survey …

Effect Of Three Different Contamination Removal Methods On Bond Strength Of Ceramic To Enamel Contaminated With Aluminum Chloride And Ferric Sulfate, Cesar Gonzalez

Student Theses, Dissertations and Capstones

Background: The need to control moisture and contamination is crucial in adhesive dentistry, especially when rubber dam isolation is not feasible. Hemostatic contamination can negatively affect adhesion to tooth substrate. To achieve better outcomes, hemostatic agents should be rinsed off properly using a method that will remove the contamination and will not affect the μ-SBS. Objective: To evaluate and compare the effect of three different aluminum chloride and ferric sulfate contamination removal methods on the μ-SBS of lithium disilicate glass-ceramic bonded to enamel and to compare the type of fracture between samples. Material and Methods: Lithium disilicate blocks (IPS e.max …

Effect Of Air-Abrasion Preparation On Shear Bond Strength Of Orthodontic Brackets To Enamel Surface, Elliott Katz

Student Theses, Dissertations and Capstones

Introduction: An optimal orthodontic bonding system must minimize damage to the enamel during conditioning, have enough bond strength to prevent bracket de-bonding during treatment, and allow bracket removal at treatment completion, such that minimal damage is inflicted to the tooth.1 Pumice followed by acid etching has been the standard for many years; however, Groman Inc. (Margate, FL, USA) has stated that using their air-abrasion product will result in a tripling of bond strength. This method claims a three-fold increase in bond strength compared to traditional acid etching techniques by substituting air-abrasion using the EtchMaster® (Groman Inc., Margate, FL) 50 μm …

Influence Of A Post-­Graduate Physical Therapy Residency Program On Clinical Reasoning, Professional Development, And Career Advancement In Nairobi, Kenya, Shala Cunningham

Department of Physical Therapy Student Theses, Dissertations and Capstones

Problem Statement

Residency programs that emphasize clinical reasoning and manual therapy can provide a means to optimize the outcomes of physical therapy without the need for or access to expensive equipment. The residency format of continuing education could allow physical therapists in developing countries access to specialty training and ongoing mentorship. However, there are limited studies that investigate the influence of residency training on the progression of clinical reasoning, professional development, and career advancement.

Purpose

The purpose of this study was threefold. The first objective was to describe the outcome of a post-graduate orthopaedic manual therapy residency program on development …

Effect Of Individual Height And Testing Methods On Outcome Of The Forward Functional Reach Test, Jill Elaine Heitzman

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: With falls a leading cause of injuries among those over age 65, early recognition of risk is imperative to reduce rising rates. The Forward Functional Reach test (FFRT) (Duncan et al., 1990) is frequently used to identify fall risk, however, the variability in cut values found in the research may be related to height and reach strategies.

Purpose: The purpose of this study was to determine if FFRT is affected by an individual’s height and if bilateral reach to height ratio could more accurately identify fall risk.

Methods: Sixty-six participants (60 and older) were recruited from a senior center …

Use Of A Telerehabilitation Delivery System For Fall Risk Screening, Robert W. Nithman

Department of Physical Therapy Student Theses, Dissertations and Capstones

Problem: The Centers for Disease Control and Prevention indicates that falls are the “leading cause of injury death and the most common cause of nonfatal injuries and hospital admission for trauma among people ages 65 and older.”1 Falls can have significant economic consequences to the individual and payer sources. To address these consequences, telerehabilitation was hypothesized to be a suitable supplement for fall screening efforts. Several sources concluded that support for synchronous telerehab was underdeveloped in the literature. Purpose: The purpose of this study was to explore the acceptability, feasibility, reliability, and validity of telehealth-delivered fall screening among community-dwelling older …

Predictors Of Shoulder Injuries In Female Collegiate Swimmers, Eric Lee Lippincott

Department of Physical Therapy Student Theses, Dissertations and Capstones

Competitive swimmers frequently injure their shoulders. The risk factors for shoulder injuries in competitive swimmers have not been clearly identified. The primary purposes of this study were to describe the characteristics of female collegiate swimmers at the onset of a swim season, identify the risk factors of shoulder injury in female collegiate swimmers, characterize the swim volume of female collegiate swimmers, and determine if swim volume is a predictor of shoulder injury.

A prospective longitudinal cohort multi-center design was utilized. Female collegiate swimmers [n=53, mean age=19.3+/– 1.2] from four NCAA Division II universities were recruited to participate in this study. …

Diagnostic Musculoskeletal Imaging: How Physical Therapists Utilize Imaging In Clinical Decision-Making, Hilmir Agustsson

Department of Physical Therapy Student Theses, Dissertations and Capstones

This qualitative study describes how physical therapist experts in musculoskeletal disorders evaluate and interpret imaging studies and how they employ imaging in clinical decision-making. The informants are physical therapists who are certified orthopedic clinical specialists (OCS) and/or fellows of the American Academy of Orthopaedic Manual Physical Therapists (AAOMPT). The study employed web conferencing to display patient cases, record screen-capture videos, and to conduct interviews. Informants were observed and their activity video-captured as they evaluated imaging studies and, afterwards, interviews were employed to explore the processes they utilized to evaluate and interpret the images and to discuss imaging-related clinical decision-making, including …