Medicine and Health Sciences Commons^™

Shared Presence: Caring For A Dying Spouse, Lana Sue Mclouth Kanacki Phd, Ms, Rn

Dissertations

There is limited research on female spouses and their end-of-life experience with their dying husbands. The purpose of this study was to explore wives' perceptions of hospital and hospice care at their husbands' end-of-life. The grounded theory method was used for this study. Data were collected over thirteen months and then transcribed and coded for meaning. Participants were 25 elderly widows (62-103 years of age) with 19 husbands' deaths in a hospice setting and 6 in the hospital. They were widowed from 6 months to 10 years after the death of their spouses. They were good informants with excellent recollections …

Quality Of Life, Hope, Social Support, And Self-Care In Heart Failure Patients, Karen A. Mcgurk Phd, Mn, Rn

Dissertations

Heart failure is a significant, chronic health problem. Much is known about physiological factors related to this condition. Less is known about the psychosocial aspects that influence disease risk, progression, and treatment. The purpose of this study was to describe the relationships between quality of life, hope, social support, and self-care. A descriptive, correlational study was conducted. The participants were 65 heart failure patients who attended 2 military-based heart failure clinics. Quality of Life was measured using the Left Ventricular Dysfunction Questionnaire (LVD-36), Hope was measured using the Herth Hope Index (HUI), Social Support was measured using the Medical Outcomes …

Quality Of Life, Religious/Spiritual Coping, Demoralization And Depression In Heart Failure Patients, Terry Larsen Phd, Rn, Cns

Dissertations

Background: Research suggests that the heart failure (HF) population is particularly vulnerable to depression. Other factors may also affect quality of life such as religious/spiritual coping, and demoralization. Purpose: The purpose of this descriptive correlational study was to examine factors that predict health-related quality of life (HRQoL) in adults with heart failure. Specific Aims: (1) to examine level of religious/spiritual coping, spiritual distress, demoralization, depression and HRQoL among adults with heart failure; (2) to examine the relationships of religious/spiritual coping, spiritual distress demoralization, depression and selected demographic variables (age, gender, race/ethnicity and length of living with HF) with HRQoL. Methods: …

Tuberculosis Awareness And Public Opinion On Expanding Health Insurance Coverage, Belal A. Saadeh Phd, Msn, Rn

Dissertations

This quantitative descriptive cross-sectional study examined the effect of TB awareness and demographic variables on the level of support for expanding health insurance coverage for all residents, including undocumented immigrants. A modified 13-item tool developed by Morisky et al. (1990) was used to measure TB awareness; a single item created by the researcher assessed personal opinion regarding expansion of health insurance coverage; and a demographic questionnaire was used to collect data from 281 registered voters in San Diego County. The majority of San Diego County voters participating in the study supported at least some expansion of health insurance coverage. ANOVA …

Notch-1 Activates Nf-Кb Activity In Cervical Cancer And Estrogen Receptor Negative Breast Cancer, Yin Peng

Dissertations

Breast and cervical cancer are two common cancers that severely endanger women's health. The fatality rates of breast and cervical cancer are ranked first and fifth, respectively, in cancer related deaths in women worldwide. Continuous dedication to cancer research is urgently required to elucidate the cancer cell survival mechanism that is responsible for disease aggressiveness and poor prognosis.

Emerging data indicate that Notch-1 is aberrantly regulated in human cervical and ER- breast cancer and inhibiting Notch-1 sensitizes cancer cells to apoptosis. However, the mechanism by which Notch-1 promotes cell survival is not known. NF-КB is also deregulated in these two …

Digging Below The Demographic Level: Examining The Effects Of Internalized Racial And Social Attitudes On White Physicians-In-Training Self-Reported Cross Cultural Competency, Sha'kema Maigre't Blackmon

Dissertations

The racial and social attitudes of White physicians-in-training were explored in relation to aspects of self-perceived cross cultural competence. Specifically, internal motivation to respond without prejudice, ethnocultural empathy, color-blind racial attitudes, and general just world beliefs were examined as possible predictors of patient centered attitudes toward patients of color and skillfulness in providing cross cultural care. Multivariate multiple regression analyses found that internal motivation to respond without prejudice was significantly associated with patient centeredness toward patients of color. Global ethnocultural empathy was significantly associated with patient centeredness and skillfulness in providing cross cultural care. General just world beliefs attitudes had …

Quality Of Life And Health Outcomes In Overweight And Non-Overweight Children With Asthma., Amy Becker Manion

Dissertations

Over the last two decades the number of children and adolescents who are overweight has more than doubled. Currently, an estimated 18 percent of children and adolescents ages 6-19 years are overweight. Following this trend in childhood overweight, there has been an alarming increase in the number of children with asthma who are overweight. The increasing trend in both asthma and overweight has led to the suggestion of a causal relationship between the two. Childhood overweight has been found to have a profound negative impact on quality of life (QOL), yet there is a dearth of research regarding the impact …

Depressive Symptoms In Women Being Screened For Cardiovascular Disease Risk, Suzanne Marie Savoy

Dissertations

Background: Depressive symptomology is an independent risk factor for cardiovascular disease. Over 15% of persons with cardiovascular disease have depressive symptoms, and women are twice as likely to experience these symptoms as men. Depressive symptoms in women “ at risk ” for cardiovascular disease has not been well studied.

Purpose: This study investigated the relationship between depressive symptoms, health-promoting lifestyle behaviors, heart disease risk awareness, cardiac risk, and quality of life in women at risk for cardiovascular disease. Whether the effect of depressive symptoms on quality of life was mediated by cardiac risk and/or health-promoting lifestyle behaviors was also examined. …

Moral Distress And Avoidance Behavior In Nurses Working In Critical Care And Non-Critical Care Units, Mary Jo De Villers

Dissertations

Significance: Nurses facing impediments to what they perceive as moral practice may experience inner turmoil, frustration, and moral distress. These scenarios may culminate in resignation from employment at the individual level, increased attrition at the systems level, and poor patient outcomes, including increased morbidity and mortality.

Purpose: To explore the relationships between moral distress and avoidance thoughts and behavior between nurses currently practicing in critical care and non-critical care settings.

Methods: A descriptive cross-sectional comparative design was used. The sample was comprised of a randomized subset of 370 critical care nurses, a convenience sample of 87 nurses from a nursing …

Using Matching Methods From Both Fisher's Experimental Design And Rubin's Causal Model To Compare Between Two Medical Facilities With Extremely Skewed Number Of Subjects, Gideon D. Bahn

Dissertations

The present study deals with the problem of comparison between a two medical facilities' with extremely skewed sample sizes from non-experimental study. The data came from a study of rehabilitation interventions with patients diagnosed with cardiac and pulmonary issues who received treatment either in inpatient rehabilitation facilities (IRFs) or in skilled nursing facilities (SNFs). Due to inclusion and exclusion criteria, however, the study had failed to recruit sufficient number of participants between two comparison groups: 319 from IRFs and 27 from SNFs. As a result, the main hypothesis of the study was not tested due to the disparity of the …

Pushing On: A Grounded Theory Study Of Maternal Perinatal Bereavement., Patricia Wright

Dissertations

Over 1 million American women experience the unexpected loss of a pregnancy each year (Ventura, Abma, Mosher, & Henshaw, 2009). The care and support they receive from family members, friends, and health care providers is often inadequate. Despite nearly 3 decades of research, very little is known about women's experiences of loss and the trajectory of perinatal bereavement. This classic grounded theory study was undertaken to discover a substantive theory of maternal perinatal bereavement, which was empirically derived from the words of the participants.

Data were collected from interviews with 19 women who had experienced the loss of a pregnancy, …

Identifying Factors That Enhance Or Hinder The Utilization Of Strengths By Healthcare Managers, Gene C. Milton

Dissertations

The purpose of this study was to examine perceptions of strengths-use at Hackettstown Regional Medical Center (HRMC), and common factors and conditions that enhanced and hindered strengths-utilization among middle managers at HRMC, a 111-bed acute care facility in Hackettstown, New Jersey. The study identified factors and conditions that can be expanded and improved upon to promote strengths-use at HRMC in the future. The population for this explorative study was selected from approximately 200 full-time executives, managers, and staff at HRMC who took the StrengthsFinder Profile from January 2007 through June 2009. The vehicle used for data collection was 5 focus …

Pressure Ulcer Risk Factors For Patients With Hospital Versus Community Acquired Pressure Ulcers, Margaret Talley Phd, Mn, Rn, Cns, Cwcn-Ap

Dissertations

Purpose: Pressure ulcers are a major health problem in the United States. Patients who develop pressure ulcers have longer hospital stays, significant increase in morbidity and mortality, added pain and suffering. The purpose of this study was to examine community versus hospital specific pressure ulcer risk factors to identify whether the most severe pressure ulcer stages can be predicted from the knowledge of an individual's risk factors as has been reported in the literature. Methodology: The sample of patients with stageable III-IV and unstageable pressure ulcer patients included in the analysis was extracted from a Microsoft Access database developed by …

The Nursing Clinical Instructor's Rationale, Preparation, And Meaning For The Post-Clinical Conference, Joseph Michael Mucha

Dissertations

Purpose

Nursing education is a complex combination of classroom and clinical instruction. The clinical portion is usually divided into the pre-clinical conference, direct care, and the post-clinical conference. Many goals are listed in the literature as learning outcomes for the post-clinical conference. The purpose of this study was to describe the most important goals, meaning, rationale, and preparation for the post-clinical conference by clinical nursing instructors in associate degree and baccalaureate degree programs.

Method

This study used a survey design with an instrument developed to identify clinical nursing instructors’ meaning, rationale, and preparation for the post-clinical conference. Two open-ended questions …

Grades In Prerequisite Courses As Predictors Of Success In A Nursing Program, Elaine Zeilke Foster

Dissertations

Problem: The U.S. Bureau of Labor Statistics forecast that by 2016 more than one million new and replacement nurses will be needed to fill jobs in the health care field . In order to meet the medical needs of a changing society, schools of nursing must continue to educate and graduate significant numbers of nurses. This may be done by increasing the success rates of those who are admitted in nursing programs. Success rate is thought to be related to admission criteria used to admit students which, in turn, may reduce attrition rate, which is between 20 to 40% in …