Medicine and Health Sciences Commons^™

A Comparison Of An Individually Tailored And A Standardized Asthma Self-Management Education Program, Judy Ann Shackelford

Dissertations

Asthma is one of the most prevalent chronic diseases in the United States (Centers for Disease Control [CDC], 2003). According to the CDC (2003), prevalence of asthma continues to rise in epidemic proportions and is very costly. While asthma cannot be prevented or cured, it can be controlled to improve quality of life. Self-management is key to controlling asthma (CDC, 2003; National Heart, Lung, and Blood Institute [NHLBI], 2002). State of the science for asthma self-management establishes that health care costs decrease for self-management intervention groups (Lindberg et al, 2002; Thoonen et al, 2003). Education is essential to support asthma …

Missouri Ozark Women's Experiences Of Living With Postpartum Depression Symptoms, Nathalie B. Williams

Dissertations

Depression is a serious complication of the postpartum period that affects not only women but their children and families as well. Rural women are of particular concern because of the significant barriers to health care that they experience as a result of isolation, poverty, traditional beliefs, and a lack of accessible and adequate health related services. A review of the literature to identify evidence based nursing interventions that focused on primary and secondary prevention of postpartum depression revealed few interventions and there were no studies identified that targeted or even included women living in rural areas of the United States. …

Perceptions Of Dyspnea, Physical Activity, And Functional Status In Obese Women, Donna Althea Jewell

Dissertations

PURPOSE: King's Theory of Goal Attainment guided this study exploring the physical sensation of dyspnea that obese women feel and how it affects their functioning. BACKGROUND AND SIGNIFICANCE: Obesity prevalence has doubled since 1980. Current research is investigating how to reduce prevalence and examining obesity's impact on the respiratory system. Little research was found that investigated the impact obesity has on routine activities because of dyspena and function and whether physical activity has a mitigating effect. METHODS: A comparative descriptive research design was used. A survey of dyspnea felt during routine activities was created; IRB approval to survey community-dwelling women …

A Study Of Disaster Preparedness Of Rural Hospitals In The United States, Barbara Cliff

Dissertations

This dissertation examines disaster preparedness in the U.S. and explores the relationships between risk perception, funding from the Health Resources and Services Administration (HRSA), and preparedness. Secondary data analysis was conducted using the National Study of Rural Hospitals from Johns Hopkins University. The study, based on a random sample of rural hospitals, consisted of a mail questionnaire and a follow-up phone interview with the hospital's Chief Executive Officer (n = 134).

A model of disaster preparedness was utilized to examine seven elements of preparedness. Risk perception was examined by seven risk threats, and HRSA funding was examined as a …

Treatment Of Co-Morbid Methamphetamine Substance Abuse And Borderline Personality Disorder Features Using Modified Dialectical Behavior Therapy, Jessica R. Schultz Fischer

Dissertations

The study investigated the effectiveness of a time-limited, skills-based treatment in a population of female substance abusers. This project implemented a pilot clinical trial to evaluate the effectiveness of a 12-session modified Dialectical Behavior Therapy (DBT) protocol among a small sample of women, with co-morbid borderline personality disorder features, receiving concurrent outpatient treatment for methamphetamine abuse. A non-concurrent multiple baseline design was used. In addition to on-going assessment conducted during baseline and weekly over the course of treatment, a comprehensive assessment battery was administered pre-, and post-treatment as well as at 1 and 3 months following treatment. Findings suggest that …

An Investigation Of Relationship Characteristics, Exercise And Physical Activity, Couple And Life Satisfaction, Mark W. St. Martin

Dissertations

Exercise has been shown to be positively related to many different variables including sexual satisfaction, mental health, and physical health. These variables, in turn, have been linked to increased life satisfaction and couple satisfaction. The primary purpose of this study was to examine the relationships between exercise and couple satisfaction as well as exercise and life satisfaction. A secondary purpose was to replicate previous findings on the relationships between communication, love, sexual satisfaction, self-esteem, and physical health and couple satisfaction.

A total of 229 undergraduate and graduate students from a large Midwestern university in the United States participated in this …

Perceived Organizational Support And Ethical Work Climates As Predictors Of Turnover Intention Of Licensed Nurses In Skilled Nursing Facilities, Anna A. Filipova

Dissertations

The purpose of this study was twofold: (1) to replicate Victor and Cullen's (1987; 1988) studies to confirm whether ethical climates (ECs) arise in skilled nursing facilities (SNFs), and whether organizations and groups within organizations have identifiable ECs; and (2) to test a model that examines the effects of ECs and perceived organizational support (POS) on licensed nurses' turnover intention (TOI) through job satisfaction (JS) and organizational commitment (OC).

A cross-sectional survey design was implemented. Three hundred and fifty nine freestanding SNFs were selected in a midwestern state. While a total of 110 facilities (31%) agreed to participate, responses were …

A Mixed Methods Analysis Of The Concept Of Female Sexual Health, Laura C. Ford

Dissertations

The theoretical concept of health includes the ability to function physiologically, perceive a state of wellness, participate in social relationships, and be disease-free. Currently, the medical field approaches sexuality from a disease prevention and treatment perspective. Female sexual health must be understood holistically (i.e., emotionally, sociologically, and physiologically) for healthcare providers to help their patients optimize their sexual health; however, little research has been conducted from a holistic perspective. This study's purpose was to begin an exploration of the meaning of female sexual health.

This study utilized focus groups and a survey to explore the concept female sexual health as …

Perceptions And Intervention Practices Of Speech-Language Pathologists Serving Students With Emotional/Behavioral Disorders, Laura A. Getty

Dissertations

A relationship between emotional/behavioral disorders (E/BD) and language deficits has been validated by researchers in special education (Cantwell & Baker, 1991; Beichman, Cantwell, Forness, Kavale, & Kaufmann, 1998; Cohen, Barwick, Horodezky, Vallance, & Im, 1998) as well as researchers in speech-language pathology (Hyter, 2003; Hyter, Rogers-Adkinson, Self, Simmons, Jantz, 2001; Ruhl, Hughes, & Camarata, 1992; Gallagher, 1999; Fujiki, Brinton, Morgan, & Hart, 1999). The exact prevalence rate between E/BD and language deficits was not definitive as it varies between 35% and 97% depending on the study reviewed (Benner, Nelson, & Epstein, 2002). While it has been documented that a relationship …

Creating A Culture Of Safety: The Influence Of Medical Simulation On The Attitudes Of Surgical Team Members, Diane J. Jones

Dissertations

The objective of this study was to determine change in individual and aggregate attitudes of the members of two subspecialty surgery teams (cardiac and vascular) in six domains (teamwork climate, safety climate, job satisfaction, stress recognition, perception of management, and working conditions) following medical team simulation and debriefing exercises. The study was a pre-post partially randomized controlled, quasi-experimental study that took place in a 545-bed hospital with a high-volume cardiovascular surgery program. Participants included interdisciplinary team members caring for cardiac and vascular surgery patients.

Main outcome measures included change in responses to safety attitudes questionnaires (SAQs) administered before, 1 week …

Parental Decision Making In The Administration Of Stimulant Medication For Their Latency Age Children With Attention Deficit Hyperactivity Disorder (Adhd), Randye Kay Phd, Msn, Rn

Dissertations

The purpose of this study was to examine parental decision making in the administration of stimulant medication to their latency age children with Attention Deficit Hyperactivity Disorder (ADHD). Research has shown that psychostimulants, used to treat ADHD are effective for 75-90% of children (US Department of Health and Human Services, 2001), however children do not take their medication from 20-65% of the time. A qualitative study using a type of grounded theory, dimensional analysis (Schatzman, 1991), was conducted to study the experiences of fourteen parents whose children began medication treatment between the ages of 5 and 12. Semi stuctured, audiotaped …

Work Stress, Non-Work Stress And Mental Health Among School-Based Speech-Language Pathologists: Effects Of Social Support, Lena Gloria Caesar

Dissertations

This study utilized secondary data from the Work and Well-being of SLPs survey (Caesar, 2004) to examine possible sources (predictors) of work stress, job satisfaction, and psychological distress among 409 speech-language pathologists (SLPs) employed in public school settings in Michigan. This study also investigated the relationship of work-related and non-work-related stress to the mental health status of SLPs and sought to determine the mediating and/or moderating effects of varied types of social support on the mental health of respondents. Data analysis was done in three stages. First, each of the dependent and independent variables were described statistically. Secondly, correlation analyses …

Families Moving Forward: Homeless Women With Children Transitioning To Independent Living, Kristin Elizabeth Hoyt Phd

Dissertations

Family homelessness is one of the most profound and disturbing social problems of the 21st century and is projected to remain an ongoing issue for the United States in upcoming years. The fastest growing segment in the homeless population continues to be families, specifically single women with children. One intervention to the problem of homeless women with children is by providing them with transitional housing, a step beyond the familiar short-term emergency shelter. Transitional housing typically shelters families for up to 2 years. During this extended stay, women participate in programs designed to assist them with addiction, mental health, domestic …

Effects Of Two Parkinson’S Disease Patient Education Models On Disease Self-Management And Quality Of Life, Lorraine Pearl-Kraus

Dissertations

Purpose. To compare the effects of Parkinson's Disease Collaborative Care (PDCC) and Parkinson's Disease Information Training (PDIT) patient education disease-management models on patients' (a) perceived self-efficacy in PD self-management, and (b) self-reported perceived PD-Health Related Quality of Life.

Methods. 41 middle-stage (Hoehn & Yahr Stages 2 & 3) patients (24 males & 17 females; age range 48-78; mean 67.59 years) were randomized to the PDCC (n = 21) or PDIT (n = 20) group. Prior to inception, 3 withdrew; after the first session, 3 more withdrew. Participants in both groups attended three consecutive weekly, 2-hour patient education sessions with presenters …

The Lived Experience Of Wives And Husbands With Coronary Heart Disease, Patricia A. Bradley Phd

Dissertations

The purpose of this feminist hermeneutic study was to discover the meaning of living in the community with a husband who has coronary heart disease (CHD). Ten women, aged 47-74 who were married from 4 to 55 years, participated in unstructured face to face interviews. The women were interviewed 6 to 18 months after their husbands were diagnosed with medically or surgically treated CHD. Audio recorded transcribed interview data were analyzed to identify the essential themes and sub-themes. Texts were interpreted guided by hermeneutic phenomenology (Gadamer 1960/1989; 1976) and van Manen's (1990) research activities. A feminist lens was applied to …

Transition To Nursing Home Of Korean-American Elders, Myungja Kim Hahm Phd

Dissertations

The purpose of this study was to explore factors affecting Korean-American (KA) elders during the transition to nursing homes in the first month following admission. The three aims of this proposed study were (1) to explore culture specific factors that affect KA elders' perspectives during the transitional period to a nursing home, (2) to identify thoughts and feelings of KA elders about their admission into a nursing home, (3) to describe the adjustment process associated with admission to a nursing home. A grounded theory design was utilized to explore KA elders' perceptions/experiences associated with adjustment to a nursing home. Open-ended, …

Symptom Burden At End Of Life In Patients With Terminal And Life-Threatening Illness In Intensive Care Units, Peggy G. Kalowes Phd, Msn, Rn, Cns

Dissertations

The purpose of this study was to examine the symptom burden and severity of symptom distress reported by ICU patients at high-risk for death and to compare patient-rated symptoms and distress for concordance with symptoms reported by a family member. A prospective, correlational design with two data-points was used to study a convenience sample of 80 patients and 53 family members. The Condensed Memorial Symptom Assessment Scale (CMSAS) was used to gain patient/proxy report of symptoms on the first and third day after admission to the ICU. The majority of patients were symptomatic (98%), reporting an average of 10.23 symptoms. …

Navy Nurses' Experiences During Operation Unified Assistance Aboard The Usns Mercy: A Grounded Theory Study, Angelica L.C. Almonte Phd

Dissertations

On December 26, 2004, the most powerful earthquake in 40 years erupted under the Indian Ocean triggering a deadly tsunami that devastated 11 Asian and African countries and killed more than 280,000. The US Navy responded through Operation Unified Assistance (OUA). In a historic first on the hospital ship USNS MERCY, the U.S. Navy deployed one team with members from the Navy, the U.S Public Health Service, a non-government organization (NGO), and a civilian mariner crew to provide humanitarian aid. Despite these efforts, there is a dearth of scholarly research work published on nurses' experiences during the disaster. The purpose …

Psychometric Testing Of The Walker's Feelings And Thoughts About Weight Scale In Taiwan, Shu-Wen Chang Phd

Dissertations

Background: The majority of women do not return to their pre-pregnant weight after six weeks postpartum in Taiwan. Excessive postpartum weight retention or gain can lead to long-term obesity and increase a woman's risk of major health problems. Trends among Taiwanese women reveal an increasing prevalence of obesity. Limiting postpartum weight retention is important for preventing long-term obesity development. Objectives: The purpose of this study was to examine predictors of postpartum weight gain among Taiwanese women using the modified Thriving Model (Walker & Kim, 2002) as the guiding conceptual framework and to examine the psychometric properties of a Chinese Version …

A Comparative Study Of Learning Styles And Job Satisfaction To Medical Specialty Chosen Among Physician Assistant Graduates, Eric H. Vangsnes

Dissertations

Since the mid-1980s, a trend has developed whereby Physician Assistants (PAs) are making a transition into medical and surgical specialties (Hooker, 1992). In 1984, 18% of PAs worked in medical and surgical specialties; by 1991, this proportion had risen to 22%; and by 2006, 43% of all PAs worked in medical and surgical specialties ( American Academy of Physician Assistants (AAPA) Census Data 2006 , 2007; Hooker, 1992). One development that may have increased the number of PAs entering specialties was the creation of post-graduate residency programs.

This research examined possible associations between learning style and medical specialty, medical specialty …

A Composite Cognition Instrument For Nursing Care Of Combat Casualties, Patricia Frohock Hanes Phd, Msn, Maed, Rn

Dissertations

In the course of caring for military and civilian combat casualties, military nurses must make rapid, accurate decisions. When developing methods to teach nurses essential content for combat casualty care, it is important to understand the cognitive and learning processes involved in acquiring that knowledge. Measures to examine how military nurses think and learn have significance, especially when applied to the high-stress, high-stakes practice arena of combat causality care. Use of these measures in evaluating educational strategies will help answer the need for better deployment readiness for military nurses. The purpose of this study is to develop an instrument to …

The Relationship Between Nurse Manager Leadership Attributes And Nurse Clinical Autonomy: Magnet Versus Non-Magnet Hospitals, Catherine A. Verkaaik Phd

Dissertations

Purpose: This research evaluated relationships among hospital types (Magnet versus non-Magnet), nurse manger leadership attributes, and staff registered nurse autonomy. Hypothesis: Magnet hospital status would be related to positive nurse manager leadership attributes which would be related to greater clinical nurse autonomy and nurse manager leadership would mediate relationships between hospital status and clinical nurse autonomy. Conceptual Basis and Background: Structural Contingency Theory modified in the Nursing Systems Outcomes Research model was the research model for conceptualizing the structure-environment-effectiveness relationship. Critical Social Theory (CST) provided the conceptual/motivational basis for this study, a lens through which to frame the question. Clinical …

Understanding The Relationship Between The Emotional Competence Inventory - University Edition And The Myers-Briggs Type Indicator In The Admission Of College Students To An Orthopaedics-Based Honors Program, Carrie A. Yocum

Dissertations

Problem

The Orthopaedic Scholar Institute (OSI) Team realized its need for a more objective selection and admission process that, as much as possible, quantified the characteristics desired in OSI students rather than relying solely on referral perception, intuition, and an interview, but it did not have a clear method or approach to do so. Administering standardized inventories that highlighted these desired characteristics and aided in the selection and admission process seemed to be an objective approach to obtain more quantifiable data. The problem for my study was, therefore, whether the Myers- Briggs Type Indicator (MBTI) alone could measure a student’s …

The Health Of Patient Privacy: The Patient's Perspective On The Hipaa Protected Health Information, Deborah Lange-Kuitse

Dissertations

Problem

As healthcare entities continue to focus on HIPAA compliance, they must enforce policies that require patients to sign and express understanding of the organization’s privacy policies. It appears the patient’s perspective on healthcare privacy has not been considered within the HIPAA privacy ruling. Patients are healthcare consumers, yet little research has been done on assessing the individual consumer’s perspective on what Protected Health Information (PHI) is actually important to protect and from whom it is important to protect it.

Method

A quantitative survey was developed and distributed to the participants of the Carnegie group, an independent insurance firm in …