Medicine and Health Sciences Commons^™

Perceived Levels Of Nurse Educators' Attainment Of Nln Core Competencies, Julie Kinney Higbie

Dissertations

Nurse educators need to be well-prepared with essential competencies, to prepare nurses for their future in health care. Nurses who are recruited to teach, must meet at least minimal competencies and be provided appropriate resources to assume their roles in academia. The recently published National League for Nursing (NLN) Core Competencies for Nurse Educators (2005) identify the skills, knowledge and attitudes necessary for both novice and experienced faculty.

This research study explored faculty's perceived attainment of these competencies utilizing Benner's Novice to Expert theory as a framework. It examined several areas of interest related to nurse educator competency, years of …

A Critical Reflection On Advanced Practice Nursing, Patricia Quinn Phd

Dissertations

Legitimation of the Nurse Practitioner (NP) and advanced practice nursing is explored using the framework of critical theory and the case study methodology of Yin. Three different cases are analyzed using classic themes of critical theory - oppression, alienation and ideology and false consciousness. Three publishable articles comprise this portfolio. First is "Looking for love (legitimation) in all the wrong places - A critique of Nurse Practitioner effectiveness literature". This article reviews the literature of NP effectiveness and offers an analysis of the failures and problems of these positivistic studies. Article two is "At least some of us are still …

Thai Patients' Experiences Of End-Stage Renal Disease: A Path Through An Unknown World, Chuleeporn Piyasut Phd

Dissertations

The purpose of the study was to explore how Thai end-stage renal disease (ESRD) patients manage the challenges of living with hemodialysis. The participants were Thai ESRD patients, who were receiving hemodialysis in one of the central provinces in Thailand. A grounded theory approach was employed in this study as it focuses on social processes grounded in individual experiences of participants in the study. The participants included 30 ESRD patients, aged 26-75, who had been undergoing hemodialysis from 6 months to 12 years. Individual in-depth interviews were audio-recorded and transcribed. Data were analyzed by using Atlas.ti. Data analysis revealed "a …

Breastfeeding And Mothers With Chronic Health Conditions, Blanche Landis Phd

Dissertations

Breastfeeding and Mothers with Chronic Health Conditions Breastfeeding may be most beneficial for women with specific chronic illness and may decrease the risk or prevent those illnesses from developing in their children. This study examined the initiation and duration rates of mothers identified as having asthma, hypertension, and diabetes; differences between the three groups in their efforts to breastfeed, and associations between determinants/outcomes of breastfeeding and behavioral beliefs, normative beliefs, and perceived control of mothers using Ajzen's Theory of Planned Behavior (TPB). A retrospective quantitative methodology was used to compare rates of initiation and duration, the differences between the three …

Pharmaceutical Marketing: A Comparison Of Different Markets, Paul Sherlock

Dissertations

No abstract provided.

The Abortion Attitudes Of Counselor, Social Worker, And Nursing Trainees, Mary J. Ball

Dissertations

This study examined the similarities and dissimilarities in abortion attitudes among counselors (CTs, n = 51), social workers (SWTs, n = 42), and nurses in training (NTs, n = 78), based on profession, age, race, gender, and religion. Data were analyzed using analysis of variance and standard multiple regression. It was predicted that profession, religion, age, gender, and race would predict the abortion attitudes of CTs, SWTs, and NTs in training. It was also predicted that the attitudes of CTs and SWTs would be most similar, and that both of these groups would hold more positive abortion attitudes than NTs. …

Grade Point Average As A Predictor Of Timely Graduation From Associate Degree Registered Nursing Programs, Delores J. Jackson

Dissertations

The purpose of this study was to determine if admission selection strategies that utilize cumulative and/or pre-requisite GPA are predictive of timely graduation for associate degree nursing (RN-AD) students. Data were obtained from de-identified records of 437 associate degree nursing students enrolled in three Midwest community colleges from 2003-2006. Of the total sample, only 44% of the students graduated on time (i.e., in four semesters or two years). Although a statistically significant difference was found for timely graduation rates between colleges (ranging from 29% in College B to 54% in College A), no relationship was found for cumulative GPA, pre-requisite …

Violence, Depression, Parental Stress, And Child Neglect Among High Risk Postpartum Women, Kristen D. Lambert Phd, Msn, Rn

Dissertations

The purpose of this study was to characterize a vulnerable population of postpartum women at risk for family violence and maladaptive outcomes and to determine the degree the identified attributes increase the risk of child neglect and psychological aggression. Lazarus' Appraisal Theory and Scaer's Traumatic Spectrum framework provided a conceptual basis to examine the interrelationships between intimate partner violence (IPV), depression, previous traumatic history, and child neglect. A descriptive correlation design using secondary analysis of longitudinal data collected for the Healthy Families San Diego Clinical Trial was used. Standardized measures including the CTS, CTS2, CTSPC, CES-D and PSI were administered …

Predictors Of Job Satisfaction And Burnout In Travel Nurses, Marcia Faller Phd, Msn, Rn

Dissertations

This study examined various individual and work environment characteristics and their influence as predictors of travel nurse job satisfaction and burnout. In addition it described travel nurses; a population of nurses that has not been previously studied. An explanatory sequential mixed methods design was used in order to take advantage of the exploratory nature of the qualitative portion in describing the attitudes and motivations of travel nurses in detail; and to further explain the findings from the quantitative portion of the study. The quantitative portion of the study used a descriptive correlational methodology with secondary data analysis of a cross-sectional …

The Impact Of A Clinical Mentor Program On Patient Outcomes, Cynthia M. Steckel Phd

Dissertations

The increasing complexity of patient care requires an expert nurse to navigate the hospital stay, yet today's workforce brings a declining supply of seasoned nurses, creating a patient need/nurse expertise gap. The clinical mentor role was developed to bridge this gap and create a safety net, using expert nurses, relieved of a patient assignment, to provide oversight for quality patient care. Results reported elsewhere showed improvements in failure to rescue and pressure ulcers six months before and after implementation. The purpose of this study was to examine the long-term impact of this new care model over the subsequent three years …

The Effect Of Shapedown On Habits And Self-Esteem For Overweight And Obese Children, Susan Bonnell Phd

Dissertations

Obesity in children is increased in the United States and globally which creates both physical and psychological health risks and co-morbidities affecting the development of positive self-esteem (Sinton & Birch, 2005; Whetstone, Morrissey, & Cummings, 2007). The development of poor self-esteem in children increases the risk of problem behaviors such as aggression, crime, teenage pregnancy, drug and alcohol use, tobacco use, and eating disorders (Brook et al., 2007). Treatment of childhood obesity is multifaceted, requiring behavioral and lifestyle changes for both child and family to achieve a healthy weight (De-Santis-Moniaci & Altshuler, 2007; Plourde, 2006; Ritchie, Crawford, Hoelscher, & Sothern, …

Battery And Abuse In The Elderly: A Forensic Analysis, Amy Y. Carney Phd, Mfs, Np

Dissertations

Elder abuse is a recognized social problem in the United States. First labeled as "granny battering" and originally studied under the umbrella of family violence, maltreatment of the elderly has received more funding and research in recent years. Multiple aspects of elder abuse have been examined in the literature including measures for detection, assessment, and documentation. Although studies have examined the circumstances surrounding abuse as well as theories of causation and characteristics of the abuser and the abused, studies of the relationship between the abuser and the abused are less well documented. The purpose of this research was to examine …

Application Of Systems Engineering Science To The Healthcare Environment, Jonathan Mack Phd, Msn, Anp, Rn

Dissertations

This Doctoral dissertation consists of a research portfolio examining the application of systems engineering techniques to the healthcare environment. The portfolio consists of three final publishable articles submitted to meet the program requirements for the, Doctor of Philosophy in Nursing degree from the University of San Diego, Hahn school of Nursing and Health Sciences. Article one is titled; "Use of a bed projection tool to predict ICU bed needs." This article describes the dissertation research study in which a bed projection tool was piloted on an ICU unit to determine the tool's ability to predict inpatient bed requirements. Article 2 …

Evaluation Of Medication Effects On Academic Performance, Sleep, And Core Adhd Symptoms In Children, Tina K. Head

Dissertations

Idiosyncratic effects of Vyvanse™ (lisdexamfetamine dimesylate) and placebo were evaluated in a double-blind alternating treatments experimental design in this 4-week study. Direct, objective measures were combined with traditional behavior ratings to provide data sets to assess whether or not the prescribed stimulant medication showed detectable therapeutic effects for a child whose positive response to medication was not obvious via traditional subjective methods. Effects of medication on core ADHD symptoms, academic performance, and sleep in four children ages 10-12 with attention deficit/ hyperactivity disorder. Potential side effects were also measured. Daily measures included parent rating scales, side effects checklist, sleep journal …

Knowledge Transfer In Public School Food Service: Post-Implementation Of The Process Approach To Haccp Food Safety System, Lydia Rebecca Frass

Dissertations

Based on Havelock's (Havelock & University of Michigan. Center for Research on Utilization of Scientific Knowledge, 1969) Knowledge Transfer Model and using Kirkpatrick's Training Evaluation Model (1996a, 1996b) levels of Reaction, Behavior, and Learning, this study analyzed knowledge transfer between public school district managers, cafeteria managers, and line workers. These employees were trained through cascade training methods during the federally mandated implementation of the Process Approach to HACCP food safety system beginning in the 2005-2006 school year.

Measuring Behavior, an Observation Checklist (based on HACCP's 7 steps and 10 FDA food borne illness risk factors and interventions) was used to …

Experimental Analysis Of Gambling Using A Concurrent-Schedules Procedure, Andrew Ellis Brandt

Dissertations

Gambling has been experimentally investigated using various types of gambling simulations designed to mimic the contingencies found in real-world games of chance. Findings from past risky choice research suggest that certain procedures used in existing gambling simulations may systematically increase levels of gambling. Two of these characteristics, the use of a participant stake and the type of options available during gambling, were tested in four experiments in which participants had the opportunity to gamble using tokens exchangeable for entries into a $50 lottery. Experiments 1 and 2 tested persistence on a gamble option when either a single-option or a concurrent …

Neurodevelopmental Outcomes Of High Risk Infants, Lisa E. Miklush Phd, Msn, Rnc, Cns

Dissertations

Background: Infant developmental research has revealed amazing physical, cognitive, and social capacities of the human infant. Along with this knowledge is a growing appreciation of numerous factors that have the potential to impact the individual infant's developmental trajectory, either enhancing or compromising the eventual outcome. Enhanced understanding of those factors that shape infant developmental trajectories will provide an evidence base for the establishment of a supportive environment for the youngest members of society. Purpose: To determine the relationship between neurodevelopmental outcome and gestational age, birth weight, Apgar scores, NICU admission, infant gender, maternal depression, home environment, and parent-child interaction. Methodology: …

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 …

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 …

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: …

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 …

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 …

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. …

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 …

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 …

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 …

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 …

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 …