Medicine and Health Sciences Commons^™

Being Alone: The Experience Of Elderly Homebound Females, Sharon Davis Burt Dnsc, Msn, Rn

Dissertations

Elderly women comprise one of the fastest growing segments of the population in the United States. This growth is due in large part to increasing longevity, and a woman's life expectancy has now reached 79 years. However, along with those added years comes an increase in morbidity and a greater likelihood of living alone. This study describes the life experience of a specific group of elderly women, those who are homebound and living alone. When elderly women are included in research, the same combination of descriptors used for the participants in this study has not been incorporated. Consequently, while much …

Testing A Theoretical Model Of Critical Thinking And Cognitive Development, Jane Rapps Dnsc, Ms, Msed, Rn

Dissertations

The goal of nursing education is to educate individuals in such a way that they become self-determining, independent thinkers who are prepared to keep pace with the rapidly changing demands of today's health care system. Nurses must utilize critical thought and reasoned action in clinical practice in order to render state of the art health care for individuals, families, groups, and communities. The purpose of this study was to test a proposed theoretical model of critical thinking and cognitive development. Perry's theory of adult cognitive development and Kataoka-Yahiro and Saylor's Critical Thinking Model for Nursing Judgment guided this research. Data …

The Experience Of Decision-Making Among Telephone Advice/Triage Nurses, Ann Mayo Dnsc, Msn, Rn

Dissertations

The role of the telephone advice/triage nurse is both complex and demanding. All decisions are made while assessing patients without seeing or touching patients. In addition, the role is often developed to decrease health care costs which can be perceived by nurses as being in conflict with their nursing beliefs. The ambiguous nature of the role makes these nurses' daily experiences with decision-making a challenge. Using a phenomenological method, the lived experience of decision-making among telephone advice/triage nurses was explored by conducting multiple interviews with ten nurses. The internal structure of the lived experience was identified through the philosophical perspective …

Major Trauma Outcomes: At What Cost? And For Whom? A Cost-Effectiveness Analysis, A. Elaine Bond Dnsc, Msn, Aprn, Ccrn

Dissertations

The purpose of this triangulated descriptive study was threefold: (a) to identify the financial costs for acute trauma care, including costs for those who die early in treatment, and who pays those costs; (b) to identify the relationship between costs and severity of injury; and (c) to identify survivor functional and psychosocial costs, or quality of life, not only by current health care outcome criteria, but also from patients' and families' perspectives. Retrospective review determined the financial differences (total charges of $9,945,973 and institutional costs of $7,089,962) for 370 patients' severity of injury and functional outcomes at discharge, using the …

The Journey Through Perspective Transformation: Learning Nursing Theory, Judith R. Heggie Dnsc, Ms, Rn

Dissertations

Through the use of grounded theory, educational methods most useful for nurses to achieve a perspective transformation, as exemplified by learning nursing theory were examined. Perspective transformation is a theory originally developed by Mezirow (1978) in a study of older women returning to college for additional education. Mezirow defined perspective transformation as the alteration or change of meaning perspectives. Perspective transformation in an individual can be compared to a paradigm change within a scientific community. Within the nursing literature on perspective transformation, most articles related to the perspective transformation needed for nurses to learn to use nursing theory as the …

Direct Service Staff's Perceptions Of Psychotropic Medication In Noninstitutional Settings For Individuals With Developmental Disabilities, Leeann Christian

Dissertations

Approximately 35-55% of individuals with mental retardation who live in the community are prescribed psychotropic and/or antiepileptic medication (Aman, Saphare, & Burrows, 1995; Singh, Guernsey, & Ellis, 1992). As more individuals with severe behavior challenges are transitioned from institutions into the community, these rates are likely to increase. Given these prevalence rates, it is important to determine whether staff who serve people with mental retardation are adequately educated about psychotropic medications. Previous studies (Aman, Singh, & White, 1987; Gadow, 1983; Singh, Epstein, Stout, Luebke, & Ellis, 1994; Singh et al., 1996) surveyed a variety of service providers in school and …

The Relationship Between Leadership/Followership In Staff Nurses And Employment Setting, Elaine S. Vandoren

Dissertations

This study tested the hypothesis that staff nurses in hospitals used different leadership and followership behaviors than staff nurses in home care settings. Leadership behaviors were measured using the Multifactor Leadership Questionnaire (Bass, 1995); followership was measured using Kelley’s Followership Style Questionnaire (1992). Three hospital and home care agencies belonging to a private nonprofit corporation in the Midwest provided data. A total of 136 surveys were used in data analysis; 57% of distributed surveys were returned.

Differences between the hospital and home care staff nurses were not found. Self-perception, difficulty in applying clinical behaviors to the MLQ, unknown aspects of …

History Of The United States Air Force Nurse Corps, 1949-1954, Sharon A. Vairo Dnsc

Dissertations

The Air Force Nurse Corps (AFNC) was established effective July 1, 1949, however, no history of the AFNC has been written. The purpose of this investigation was to examine the first five years of the AFNC when its initial framework, policies, and practices were established. Included in this period was the story of the AFNC response to its first great challenge of the Korean War beginning just before the corps first anniversary. The study framework consists of the four themes of (1) dedication to serve, protect, and care for soldier patients; (2) slow advance in status; (3) need for adequate …

Ethnographic Inquiry Of Social Support Throughout Women's Labor And Childbirth Experiences, Nancy Jane Pinder Saks Dnsc, Msn, Rn

Dissertations

The purpose of this study was to explore the phenomenon of social support throughout labor and childbirth in order to develop descriptive theory based on the behaviors of the labor and childbirth convoy. Utilizing ethnographic methodology, five women and their support convoys were observed throughout the women's labor and childbirth experience. Word processing and the ETHNOGRAPH software were used for data management, and constant comparative coding methodology was employed for data analysis. Affirmative, affective and aid-giving behaviors were enacted by all convoy members. Consistently, social support was found to be communicated to the laboring woman by her lay supporters by …

Health Ministry In The Life Of A Congregation With A Parish Nurse: Caring And Connecting Through Christ, Mary Ann Chase-Ziolek

Dissertations

No abstract provided.

Rupture In The Ordinary, Geraldine Abbatiello

Dissertations

No abstract provided.

Intentional Classroom Humor In Nursing : A Multiple Case Study, Joan Kay Ulloth

Dissertations

Problem. The purpose of this study was to examine the perceived connections between the intentional use of humor in the nursing classroom and student learning in the cognitive and affective domains while seeking to understand student and teacher perceptions and responses to humor.

Method. This study used a case study approach and the end result is a multiple case study of three associate degree nursing instructors in the Midwest. The data collection methods included observations, interviews, and surveys. Data from the different sources were examined within and across cases for commonality or difference of experience. Connections were made between …

Eating-Disorder Patterns In The Minnesota Multiphasic Personaity Inventory, Karen Baer-Barkley

Dissertations

Problem. Early intervention is crucial for effective treatment of eating disorders. While there have recently been many assessment tools developed specifically for eating disorders, a screening tool is still needed. This study sought to identify, in an eating-disordered sample, the existence of a v-shaped pattern on scales 4-5-6 of the MMPI, a commonly used general measure of psychopathology.

Method. The sample consisted of 356 females who were being treated for eating disorders through the HOPE program between 1989 and 1996. Past research on the MMPI has produced equivocal results on identifying significant patterns on the clinical scales. Since prior research …

Characteristics And Perceptions Of Trauma Recidivists And Non-Recidivists, Vicki A. Keough

Dissertations

No abstract provided.

The Caregiver's Experience Of Deliberative Mutual Patterning With Pain-Ridden Substance Users, Gaile Hausaman Nellett

Dissertations

No abstract provided.

Belief-Desire Reasoning In Zimbabwean Children: A Search For Evidence Of The Universality Of A Child's Theory Of Mind, Chipo Dyanda

Dissertations

No abstract provided.

Critical Thinking Attributes Of Undergraduate Nursing Faculty, Julie A. Coon

Dissertations

The purpose of this study was to examine the critical thinking skills of undergraduate nursing faculty to determine how these skills compared with the established critical thinking skill norms for undergraduate nursing students and if the critical thinking skills of nursing faculty were related to the type of program they teach in, their years of experience in nursing education, their level of formal education, their preferred methods of instruction, and their level of formal training in critical thinking. Nursing faculty from 17 Associate Degree Nursing (ADN) programs and 11 Bachelor of Science in Nursing (BSN) programs in the State of …

An Evaluation Of The Efficacy Of Selected Nonpharmacologic Pain Interventions In Infants, Cindy Smith Greenberg Dnsc, Ms, Rn, Cpnp

Dissertations

Infants subjected to painful stimuli respond with deleterious physiologic and metabolic effects, behavioral changes, and potentially long term effects on painful stimuli processing and response. There are few studies that address effective pain interventions for infants, particularly those interventions that staff nurses can implement independently. Interventions must be identified and their effectiveness must be validated for this vulnerable population. Pharmacologic management of pain may cause deleterious side effects and needs to be ordered by physicians or nurse practitioners. Nonpharmacologic methods to manage pain can usually be implemented by staff nurses independently. This study evaluated the efficacy of two nonpharmacologic pain …

The Lived Experience Of Women Prior To Hospitalization For Acute Myocardial Infarction, Llamae R. Hughes Dnsc

Dissertations

Recent research indicates that the majority of women underestimate their risk of developing coronary artery disease (CAD). CAD claims the lives of more women than all forms of cancer; however, women have not received the symptom recognition or treatment that has been accorded to men with CAD. Review of literature indicated a lack of research regarding the experiences of women with acute myocardial infarction (AMI). This phenomenological study explored the lived experience of women with AMI immediately prior to hospitalization. The lines of inquiry focused on descriptive language regarding pre-event feelings, the symptoms experienced at AMI onset, their response to …

A Phenomenological Inquiry Of Nurse Transition To Family-Centered Perinatal Nursing, Paula Kaye Lilja Dnsc, Msn, Rn

Dissertations

The purpose of this phenomenological study was to obtain a better understanding of how nurses caring for perinatal patients and their families view their clinical practice role after experiencing the transition from traditional maternity care to family-centered perinatal nursing. The volunteer participants in the study were 13 female registered nurses employed on a family-centered perinatal unit in one of four hospital settings. The researcher conducted unstructured interviews with the participants and analyzed the qualitative data. The history of the transition and the context in which the family-centered perinatal nursing model was being practiced are presented. Two major features of the …

The Clastogenic Effects Of Cyclophosphamide And A Sixty Hertz Electromagnetic Field On Bone Marrow Cells Of Cd-1 Mice, Kevin K. Block

Dissertations

Extremely low frequency (ELF) electromagnetic fields (EMF) have been correlated with the induction of cancer in a number of epidemiological studies (Feychting and Ahlbom, 1993; T,m and Lee, 1994; London e t al. 1991; Lovely et al., 1994; Tomenius, 1986; Wertheimer and Leeper, 1979, 1982). Two hypothesis were tested in the present study. The first hypothesis tested was that exposure to a 7.3 G magnetic field for 24 hours would increase the frequency of clastogenic and/or mutagenic events in bone m arrow cells of mice. The second hypothesis tested was that exposure to a 7.3 G magnetic field for 24 …

Estimating Ibnr Reserves With Robust Statistics, Daniel Cheung

Dissertations

There is often a considerable time lag between an incurred of an accident, such as medical malpractice or product liability, and the time it is reported to the insurance company. These Incurred But Not Reported (IBNR) losses need to be predicted in order to determine the necessary loss reserves. Many actuarial methods have been developed for IBNR reserves estimation. However, none of the methods being used for loss reserving is robust to outliers, nor do they provide adequate statistical inferences to support the actuarial decisions. The rank-based method proposed in this thesis is robust to outliers, and provides statistical inference …

Role Expectation Of Chief Nurse Executive Officers In Integrated Healthcare Systems Located In Highly Managed Care Markets, Daniel L. Gross Dnsc

Dissertations

The healthcare industry is undergoing radical transformation. Healthcare's transformation is characterized by new patterns of organization, alliance, management, administration, and governance. Traditional fee-for-service reimbursement strategies are rapidly dissolving and managed health care is proliferating. Managed care and managed competition are forcing hospitals and healthcare providers to reduce expenses and identify improved methods for healthcare delivery. Integrated healthcare delivery systems (IDSs) and networks are at the center of healthcare reform. Chief Nurse Executive Officers (CNEOs) are increasingly finding themselves in roles within complex IDSs located within highly managed care markets (HMCMs). This new work environment is altering old and mandating new …

Igniting The Mind: Engaging Nursing Students In The Process Of Learning, Jo-Ann L. Rossitto Dnsc, Ma, Rn

Dissertations

The purpose of this grounded theory study was to explore the perceptions of associate degree nursing faculty regarding their classroom teaching experiences. A purposive, convenience sample of twenty-one educators volunteered to participate in the study. Data were primarily obtained through semi-structured interviews over a period of six months. Data collection and analysis occurred simultaneously utilizing the constant comparative method. Igniting the Mind emerged as the core category of the study. This category represented the methods nurse educators use to involve students in the process of learning. Igniting the Mind entails making a connection, letting go, getting buy-in, trying something new, …

The Perspectives Of The Woman/Nurse/Executive Working In The Managed Care Environment Of Southern California, Cheryl Lynn Brandi Dnsc, Ms, Msn, Rn

Dissertations

The purpose of this study was to explore the perspectives of the woman/nurse/executive working in the managed care environment of Southern California. This research was extremely timely because (a) Southern California leads the nation in managed care market penetration, (b) changes in health care financing have resulted in a prolific expansion of nurse executive responsibilities, and (c) nurse executive experiences regarding increased responsibilities have not been researched. Role expansion impacts both male and female nurse executives, but female nurse executives must confront the dilemma of functioning in administrative domains which have been largely dominated by men. Knowledge about their experiences …

Correlates Of Staff Nurse Work Satisfaction In Hospitals With Shared Governance, Mary Kay Flynn Dnsc, Rn, Ccrn

Dissertations

Lack of staff nurse participation in hospital decision-making has been cited as a major reason for the dissatisfaction in nursing. Shared governance has been proposed as an organizational model that provides staff nurses with both the structure and the mechanism for having increased decision-making authority. The purpose of this study was to investigate the relationship of organizational culture, perceived importance of involvement and actual involvement in decision-making, the discrepancy between importance and involvement, staff nurse years of involvement in shared governance, control over nursing practice, and work satisfaction among staff nurses working in hospitals with shared governance. A descriptive, correlational …

The Process Of Ending Domestic Violence Among Latinas: Aguantando No Mas, Nancy A. Coffin-Romig Dnsc, Msn, Rn

Dissertations

The purpose of this study was to explore the sociocultural factors which play a role in the process of ending an abusive relationship among Latinas. Dimensional analysis was the method employed for the development of a grounded theory. Aguantando or enduring emerged from this study as pivotal in gaining an understanding of the process of ending an abusive relationship for Latinas. Participants indicated that personal and religious beliefs, the importance of family, and the needs of their children were reasons for aguantando or enduring the abuse. The decision to no longer aguantar, or endure, occurred through a series of encounters …

The Work Of Living With Hiv: A Study Of Binational Groups, Christina Joy Dnsc

Dissertations

The purpose of this investigation was to study the experience of individuals who live with and manage HIV infection and AIDS. The context of living with HIV/AIDS, the prevailing conditions, the actions/strategies used, and the consequences of the actions were considered using grounded theory methodology and dimensional analysis. A purposeful sample of 21 individuals HIV positive or diagnosed with AIDS from San Diego, California and Tijuana, Mexico were interviewed using semi-structured questions. Data were analyzed using open and axial coding, the constant comparative method, and dimensional analysis. The work of living with HIV emerged as the central dimension within the …

Determinants Of Health-Promoting Lifestyle Among Nurses In Taiwan, Chou Chuan-Chiang Yao Dnsc, Ms, Rn

Dissertations

This two-phase study was undertaken to: (1) determine the relationships of self-efficacy, perceived health status, perceived social support, age, marital status, education, work shift, work setting, and years employed as a registered nurse (RN) to the practice of a health-promoting lifestyle; (2) determine the combination of predictor variables explaining the variance in the practice of a health-promoting lifestyle; and (3) investigate other personal and environmental cues and characteristics related to health-promoting lifestyles among nurses (N = 218) in Taiwan. Findings of the quantitative approach in Phase One indicated that a health-promoting lifestyle was significantly related to self-efficacy, perceived health status, …

The Experiences Of Taiwanese Women Caregiving For Parents-In-Law, Shu-Yuan Chao Dnsc

Dissertations

Using grounded theory, a semi-structured in-depth interview was conducted to explore the experiences of Taiwanese women who were caregivers for their parents-in-law. Thirty-one Taiwanese women aged 23 to 58 participated in this study. Just Doing was identified as the core category to indicate the caregivers' striving process once they committed to their in-laws' care. Recognizing Duty, Experiencing Trials, and Responding to Caregiving were subcategories and reflected how a caregiver perceived her role, how she was affected by caregiving tasks, and what responses she had to the caregiving situation. The findings also suggested that caregiving behaviors were influenced by cultural expectations …