Medicine and Health Sciences Commons^™

Environmental Barriers And Supports To Participation For Individuals With Disabilities: An Evidence-Based Practice Project, Ali M. Grinde, Ella V. Johnson, Anya H. Larson, Jordan A. Mills, Gretta N. Obeid, Bridgett N. Tegen, Julie D. Bass

Graduate Occupational Therapy Research and Projects

This Evidence-Based Practice (EBP) project considered the following question: What environmental supports and barriers influence participation for individuals with disabilities and are there disparities, inequalities, or inequities between disabled and non-disabled groups?

Utilization Of Nurse Practitioners In States With Full Practice Authority: Does Geography Matter?, Jana Zwilling

Theses & Dissertations

Background: Over 80 million Americans reside in or are part of a population designated as Health Professional Shortage Areas (HPSAs). Of the primary medical HPSA areas designated in the U.S., 66.74% are located in rural or partially rural areas (HRSA, 2020). To combat this shortage, 23* states and Washington, D.C. have enacted full practice authority laws for nurse practitioners (NP). Over 60% of NPs work in communities of less than 250,000.

Problem: The variability and extent of utilization of NPs in states with full practice authority (FPA) is unknown. To ensure access to quality healthcare, nurse practitioners need to be …

Multidisciplinary Team Approach Effect On Pediatric Severe Asthma, Lila Kertz

Dissertations

Problem. Children with severe asthma are more likely to be non-adherent with their prescribed medications, often related to barriers. A holistic assessment of these patients has been suggested, but is not typically performed in most pediatric asthma clinics. The purpose of this project was to evaluate the effects of severe pediatric asthma clinic services designed to perform holistic assessments and provide comprehensive care.

Methods. An observational, descriptive design was used to evaluate the Severe Asthma Clinic for Kids (SACK) created in 2013 using a retrospective database review. A convenience sample of data collected on all children treated in the clinic …

Increasing Long-Term Care Employee Influenza Compliance Through An Educational Approach, Shyandrea H. Brazil

Doctor of Nursing Practice Projects

Influenza (flu) is a highly contagious respiratory illness caused by several influenza viruses (Centers for Disease Control, 2019). The CDC estimates that there have been approximately 42.9 million flu incidents, 20.1 million flu medical visits, 647,000 flu related hospitalizations and 61,200 deaths from October 1, 2018 through May 4, 2019. Individuals who contract this illness may have symptoms varying from mild to severe. This project focused on the elderly population because these individuals fall into the high-risk category. Individuals 65 and older are more likely to experience flu-related complications, which could ultimately lead to hospitalizations and in some cases, death. …

Motivators And Barriers Associated With Intent To Complete A Bsn For Hispanic Associate Degree Nurses, Marissa Jimenez

Nursing Theses and Dissertations

Hispanics who are registered nurses (RNs) are more likely to enter the nursing profession through an associate degree nursing program and are less likely than any other racial/ethnic groups to complete advanced degrees. The purpose of this study is to explain the relationship between motivators and barriers associated with the intent to complete a bachelor’s degree in nursing (BSN) for Hispanic associate degree nurses (ADNs). The research question for this study was, “how much variance in intent to complete a BSN do Hispanic associate degree nurses attribute to motivators and barriers to returning to school for RN to BSN?”

Ajzen’s …

Exploration Of Physician Attitudes About Self-Care And Personal Mental Health: Possible Barriers To Physician Well Being, Candich Farrar

Dissertations

The present study was designed to examine physicians’ mental health, attitudes, and behaviors toward self-care and the utilization of mental health services. As the medical field can be very demanding and exhausting, it is believed that many physicians suffer from mental illnesses such as anxiety and depression. However, it was theorized that many physicians do not engage in adequate self-care regimes or seek support and suppress their symptoms, which may further exacerbate their illnesses. A thorough literature review was performed to explore the following: possible barriers to physicians seeking mental health services to address high rates of mental illnesses, physicians …

Barriers And Facilitators To Opioid Use Treatment And Recovery Services During Pregnancy, Loralie Woods

Dissertations

Purpose: To identify barriers and facilitators to opioid use treatment and recovery services among pregnant and nonpregnant women who misuse opioids.

Background: Over 130 Americans die daily after overdosing on opioids. Women have not been immune from opioid use disorders (OUDs), with a 4-fold increase from 1999-2010. The prevalence of opioid use among pregnant women increased from 1.5 per 1,000 hospital deliveries to 6.5. Although the annual National Surveys on Drug Use and Health (NSDUH) has provided information on risk factors for OUD related to socioeconomic and demographic factors, no studies using this data have identified barriers to opioid use …

Recruiting And Retaining Np Preceptors, Angelica Renteria

DNP Qualifying Manuscripts

It is estimated that by 2020, the shortage of primary care providers will reach over 20,000. This has led to a surge of nurse practitioner (NP) programs across the nation. Recruiting and retaining preceptors is of paramount importance. Barriers and incentives to precepting must be identified in order to maximize teaching capacity. More effective ways of training NP students (NPs) need to be explored to capitalize on the time preceptors invest with students. The adoption of the OMP teaching model may facilitate training for the preceptor and improve the learning of NPs due to its simplicity and efficiency.

Neonatal Health Outcomes And Access To Care, Riki Desjarlais

Nursing | Senior Theses

This paper will review existing research regarding the importance of prenatal healthcare. The research included covers the barriers existing to pregnant mothers and the consequences these barriers pose for mothers and babies with prenatal care that is unobtainable or undesired. This paper will also review current interventions that have provided under-served mothers with the resources they need to better ensure a healthy pregnancy and delivery. Research analyzing mother’s attitudes and beliefs regarding prenatal care will be addressed in addition to how these beliefs may attribute to the health outcomes of their babies. Finally, this paper will include my own research …

Perceptions Of Help-Seeking Likelihood For Depression: Examining The Relative Predictive Value Of Ethnicity And Barriers To Care, Linda Esperanza Guzman

Graduate Theses and Dissertations

Latinx and non-Latinx White adults 18 years of age and older experience depression at proportional rates. However, Latinxs seek specialized care for depression at lower rates than non-Latinx Whites, suggesting these groups experience barriers in accessing care differently. This study sought to test the theoretical steps of help-seeking as informed by the Gaining Access and Treatment Equity model (GATE model; Bridges, 2018). According to the GATE model, successful help-seeking means navigating a series of barriers: sequentially, these are perceived need, attitudinal barriers, and structural barriers. Participants (N = 987) were either Latinx (n = 437) or non-Latinx White (n = …

The Effect Of The Timing Of A Hospice Referral And The Perceived Quality Of Care By The Family, Caitlin Tran

Nursing | Senior Theses

Hospice care is a specialized type of palliative care for patients with a time-limiting illness. Despite its benefits, hospice remains underutilized. A key reason behind the underutilization are untimely referrals, often made during the last weeks or days of the patient’s life. The purpose of this paper is to investigate the existing barriers towards hospice that play into late referrals and its effect on patient/family satisfaction. This information will be examined to propose a pilot research study for further exploration.

Improving Medication Adherence In African American Adult Females With Hypertension, Donald Welch

Doctoral Projects

The World Health Organization (WHO) reported that adherence among patients with chronic diseases averages nearly 50% in developed countries (Lam & Fresco, 2015). Medication non-adherence is recognized as a significant public health issue that leads to poor health outcomes and added healthcare costs. Multiple African American adult females with hypertension have a high prevalence of non-adhering to their treatment plan. Numerous factors lead to poor medication adherence, including socioeconomic factors, therapy-related factors, patients-related factors, condition-related factors, and health system/healthcare team-related factors (Lam & Fresco, 2015). Medication adherence can lead to a decreased risk of adverse outcomes such as stroke and …

Home Assessment Modifications For Individuals With Autism Spectrum Disorder And Sensory Processing Disorder, Danielle Stelbasky

OTD Capstone Projects

Based off of the identified needs of individuals with Autism Spectrum Disorder, the goals of this project were to investigate and implement modifications in homes due to specific challenges these individuals face. Coinciding with Tucker's House Agency mission and vision, and incorporating the PEO model as a guideline, Tucker's House staff and EC student created projects to enhance occupational performance in individuals with ASD by reducing environmental barriers in their home.

Community Of Immunity: A Process Improvement To Increase Influenza Vaccination Uptake, Macy Ball

DNP Scholarly Projects

Background & Review of Evidence: Annual flu vaccination has been recommended for everyone over the age of six months (National Foundation for Infectious Disease [NFID], 2016). A low flu vaccination rate among college students living in a residential community poses the risk for spreading a highly-contagious respiratory illness caused by the virus. Students have the ability to spread the disease to everyone around them in their dormitories, classrooms, shared restrooms and via social gatherings (NFID, 2016). College students who contract the flu virus experience approximately eight or more days of the illness (NFID, 2016).

Purpose: The purpose of …

School Nurses' Role During Disease Outbreak, Christina Rickenbach

Theses and Dissertations

Background and Purpose: School nurses have the critical task of overseeing the health and wellness of school-aged students. Utah is 1 of 17 states which allow parents to exempt their children from vaccines. The most common parental reason for exempting children from vaccines is personal choice. With the number of students without vaccinations on the rise, school nurses are tasked with responsibilities related to the spread of vaccine-preventable diseases. However, few studies have explored the role of school nurses in managing a disease outbreak. Therefore, the purpose of this study was to 1) explore the responsibilities of Utah school nurses …

Lived Experiences Of African American Nursing Students In An Associate Degree Nursing Program, Monique Renee Merritt

Walden Dissertations and Doctoral Studies

Despite recognition of the barriers that African American nursing students encounter while pursuing nursing education, leaders of U.S. nursing programs continue to struggle to retain these students and promote their degree completion. Poor retention and lack of completion contributes to the unequal representation of African American nurses in the U.S. healthcare workforce compared to the overall population. The purpose of this qualitative study was to examine the experiences that helped to promote African American nursing students’ success or served as barriers to successful completion of an Associate Degree Nursing program. Tinto’s integration model was used as the theoretical framework. Semistructured …

Barriers In Cancer Related Experiences: Where Can Ots Fill In The Gaps, Zoe Hoberman-Kelly

OT Student Capstones

Over the last two decades, oncology has made vast improvements in the treatment and management of cancer. Medical advancements in diagnostic imaging, treatment agents and improved surgical techniques have transformed the effectiveness of cancer delivery and care. However treatment related obstacles and health concerns of survivors trails behind that of the treatment for the actual cancer. The literature identified a growing need for increased psychosocial and self-management services to help provide a more cohesive spectrum of care. The inclusion of occupational therapy services within the cancer care continuum can strengthen functional practice and help treat physical and psychosocial barriers. This …

Barriers To Reporting Workplace Violence In Emergency Departments: A Systematic Review, Kari Gaston

Walden Dissertations and Doctoral Studies

Underreporting of workplace violence by emergency department (ED) nurses is a global practice concern. When workplace violence is not reported, the breadth of the issue is not reflected in the data, which is necessary to support legislative action, regulatory requirements, and organizational changes to prevent violence. The purpose of this systematic review of literature was to appraise and synthesize evidence regarding ED nurses’ barriers to reporting workplace violence. The practice-focused question addressed the barriers to reporting workplace violence according to emergency nurses. The theory of planned behavior was the theoretical framework for this project. Melnyk and Fineout-Overholt’s critical appraisal of …

Rural Practical Nursing Students' And Faculty Members' Perceptions Of Supports And Barriers To Success, Amy J. Randall-Mcsorley

Walden Dissertations and Doctoral Studies

Practical nursing program students at a rural vocational school (RCC) in the midwestern United States were graduating at a low rate that was putting the school at risk to not meet accreditation standards set by the Council on Occupational Education. The purpose of this study was to explore the perceptions of practical nursing program students and faculty at RCC about institutional, situational, and dispositional supports and barriers students faced toward graduation. The conceptual framework, Cross’s model of barriers to adult learning, was used to identify institutional, situational, and dispositional supports and barriers. A bounded case study design was employed to …

Systematic Review: Barriers To Primary Care For The Transgender Individual, Charles David Mccormick

Walden Dissertations and Doctoral Studies

Representing a diverse group, the transgender community defies conventional norms expected by society resulting in discrimination and denial of essential goods and services necessary to maintain personal health, safety, and well being. The identification of the barriers to primary care faced by the transgender individual has the potential to reduce healthcare disparities and improve the compliance with national screening and treatment guidelines. The purpose of this project was to examine available literature incorporating the systematic review method to determine the barriers to primary care faced by the transgender individual. Using Leininger’s transcultural nursing theory to guide the process to determine …

Perceptions Of Academic Success Of English As A Second Language Nursing Students, Jean Lansang

Walden Dissertations and Doctoral Studies

Hispanic or Latino and Asian communities represent two of the rapid-growing ethnicities who seek healthcare in the United States. However, the U.S. nursing workforce does not reflect the ethnic or cultural makeup of the patient population. The purpose of this study was to examine the lived experiences of Asian and Hispanic or Latino English as a second language (ESL) nursing students and learn the barriers and facilitators they experienced in their nursing program. A qualitative phenomenological approach underpinned by the social-ecological model and the Cummins language acquisition model was used for the study. Face-to-face interviews were conducted with 7 Asian …

Nursing Administration And Faculty Perceptions Of Their Self-Efficacy With Active Learning Methods, Lindsey Ann Helm

Walden Dissertations and Doctoral Studies

A lack of active teaching was identified in a small, rural college in a midwestern state, resulting in negative course evaluations that referenced students’ learning preferences as not being met. This qualitative case study was aligned with Bandura’s theory of self-efficacy to explore the perceptions of nursing administrators and nursing faculty about their teaching methods and self-efficacy regarding the implementation of active learning strategies. A purposeful sampling method was used to select a total of 8 participants: 6 nursing faculty and 2 nursing administrators. Selection criteria included nurse educators and administrators who had worked at the college within the last …

Nurse Educator Perceptions Of Using Simulation For Evaluation Of Nursing Competencies, Angela Elizabeth Horton

Walden Dissertations and Doctoral Studies

Over the past 10 years, simulation technology has been increasingly used in clinical settings to evaluate nursing competencies and ensure safe patient care. However, not all simulation laboratories are used consistently by hospital nursing education departments to support learning. The purpose of this qualitative case study, framed by constructivist theory, was to identify nurse educators’ perceptions of the value of using simulation to evaluate nurse competence. Research questions addressed how nurse educators decided what teaching methods to use when evaluating nursing competencies. The participant sample included 8 nurse educators responsible for the education of new and practicing nurses in the …

Improving The Relationship Between Emergency Nurses And The Behavioral Health Patient, Alea Bundy

Master of Science in Nursing Theses and Projects

There is an increasing number of behavioral health patients entering through the emergency department for behavioral health treatment and crisis intervention every day. Workplace violence against nurses has also increased leaving some nurses feeling anxious and fearful of interactions with behavioral health patients. The increase of behavioral health patients and unstable situations have created a gap in communications and has strained the nurse patient relationship yielding poor patient outcomes. The purpose of this project is to educate nurses on the care of the behavioral health patients and improve nurse-patient relationships for better outcomes for the patient. The framework for this …

Mental Health Professional Perceptions Of Barriers To Fidelity For Empirically- Supported Treatments, Chris Streidl

Walden Dissertations and Doctoral Studies

It is estimated that one in five adults in the United State of America experience mental illness in a given year. When mental health organizations implement empirically-supported treatments but fail to maintain them, it can result in individuals not being provided the services that they need. The purpose of this study was to identify perceived barriers to maintaining fidelity for empirically-supported mental health treatments. The study utilized a quantitative cross-sectional correlational research design (N = 154) and the Perception of Barriers Scale (PBS) was developed to measure perceived barriers to maintaining fidelity for empirically-supported treatments. Bandura’s social cognitive theory as …

Assessing The Percieved Barriers To Early Detection, Treatment, And Management Of Cervical Cancer Among Ghanaian Women, Angela D. Blackwell

Electronic Theses and Dissertations

Introduction: The purpose of this study was to assess the perceived barriers and strategies for improvement of timely detection, treatment, and management of cervical cancer among Ghanaian women in a tertiary hospital setting. Methods: Sixty semi-structured interviews, comprised of thirty-five cervical cancer patients and twenty-five healthcare professionals who provide cervical cancer care, were conducted. Two focus groups were conducted, including four healthcare professionals and another with two healthcare professionals—the data were analyzed using NVivo 12. A theoretical thematic analysis was utilized to identify common themes and sub-themes that arose from the participant interviews. The social-ecological model framework was employed to …

Impact Of Coaching By Extension Professionals On Rural Wellness Coalition Success, Taylor Willhite

Electronic Theses and Dissertations

Objective: To quantitatively assess coaches perceived confidence in coaching rural wellness coalitions and to qualitatively determine barriers and facilitators to success in coaching rural wellness coalitions.
Design: A mixed methods design was utilized with quantitative (scorecard) and qualitative (key informant interviews) methodologies.
Setting: Six rural South Dakota wellness coalitions.
Participants: Extension wellness coalition coaches (n=7), one previous and six current.
Intervention: A component of the broader SDSU Extension 1416 Centers for Disease Control (CDC) and Supplemental Nutrition Assistance Program Education (SNAP-Ed) intervention.
Analysis: STATA was utilized for the quantitative scorecard data by running paired ttests. NVivo was utilized in the …

Barriers To Ghanaian Midwives’ Ability To Provide Quality Care: A Glaserian Grounded Theory Study, Yakubu Ismaila

Theses: Doctorates and Masters

The midwifery model of care that promotes the employment of trained and regulated midwives for the provision of maternal and neonatal care has been found to be beneficial, especially in Low and Middle-Income Countries that have high maternal and neonatal mortalities. Midwives in those setting are however, facing a myriad of barriers which negatively affect their ability to provide optimal care. Although Ghana is implementing the midwifery model of care, maternal and neonatal mortality remains high in the country. Little is known from the point of view of midwives, who are the primary providers of maternal and neonatal care, about …