Medicine and Health Sciences Commons^™

Handling Effects In Moderate To Late Preterm Infants In Neonatal Intensive Care, Nancy Brashear

Loma Linda University Electronic Theses, Dissertations & Projects

Providing a thriving environment to preterm infants receiving care in the neonatal intensive care unit is an ongoing area of interest to stakeholders interested in infant health. With advances in monitoring technology, there are new methods to assess the effects of care on preterm infants. Effects of neonatal handling have been analyzed in terms of physiological, behavioral, and pain responses. Further assessment of the effects of handling is needed to determine the impact, if any, on renal and cerebral regional oxygenation in moderate to late preterm infants (34-36 ^6/7 gestation). A conceptual model was developed based on pertinent theoretical frameworks …

Burnout, Self-Efficacy, And Resilience In Haitian Nurses: A Cross-Sectional Study, Marie Therese Georges

Loma Linda University Electronic Theses, Dissertations & Projects

Though nursing burnout is a global problem, research on nurse burnout in Haiti is scarce. Haitian nurses operate in a resource-poor work environment in the context of multiple personal and social challenges. This study assessed burnout (emotional exhaustion, depersonalization, and personal accomplishment) and identified its influencing factors among a sample of Haitian nurses. A cross-sectional survey in French and Haitian Creole was conducted in five Haitian hospitals using forward and back translated scales measuring burnout (i.e., emotional exhaustion, depersonalization, personal accomplishment), self-efficacy, nursing work environment, resilience, and demographic factors. Haitian nurses (N = 179) self-reported moderate emotional exhaustion (M = …

Inflammation, Depression And Non-Adherence Correlates In Persons On Hemodialysis, Kathleen Fulmer

Loma Linda University Electronic Theses, Dissertations & Projects

The hemodialysis patient is at risk for a high inflammatory state as evidenced by the elevation of the pro-inflammatory cytokine, interleukin-6 which has been linked to lower serotonin levels and development of depression. The biological and psychological stress of living with End Stage Renal Disease on hemodialysis increases the risk for depression which is the leading psychological disorder affecting these patients which is also underdiagnosed and under-treated. The phenomenon of depression can manifest itself in the maladaptive behavior of non-adherence which has been associated with increased mortality, morbidity and decreased quality of life for the hemodialysis patient. The purpose of …

Association Of Nurses’ Sanctification Of Work With Work-Related Outcomes And Patient Satisfaction, Hazel M. Ada

Loma Linda University Electronic Theses, Dissertations & Projects

Nurses working in hospitals face many intrinsic stressors, including widespread job dissatisfaction, burnout, and frustration. These challenges, in turn, may affect patient care. Nursing often attracts individuals who wish to serve others, and some may find the expression of spirituality on the job helpful in finding meaning, satisfaction, and value in their work (Kociszewski, 2004). Sanctification of work (SoW) is a promising facet of spirituality defined by researchers as an individual’s experience of their work as a manifestation of God or sacred qualities that affects their effectiveness and engagement on the job (Walker, Jones, Wuensch, Aziz, and Cope, 2008). In …

Social Empathy And Associated Factors Among Nurses: A Mixed Method Study, Gudrun Klim

Loma Linda University Electronic Theses, Dissertations & Projects

The aim of this study was to measure and describe social empathy among nurses and to explore how selected demographic, personal, and work-related factors were associated with social empathy. A cross-sectional, observational research design employing mixed methods (i.e., embedded triangulation with quantitative and qualitative components) was used. Registered Nurses employed at a large northwestern US healthcare system comprised the sample (N = 614 [17% response rate]). The sample was recruited via an email invitation that included a link to the study instruments. These instruments included demographic questions developed by the investigator and the following validated tools: Interpersonal and Social Empathy …

Saudi Nurse Knowledge, Cultural Perspective, And Intent Regarding Cervical Cancer Prevention, Alaa Mujallad

Loma Linda University Electronic Theses, Dissertations & Projects

Cervical cancer can be controlled by providing screening and vaccination. Although rates for this female cancer are decreasing in developed countries, these low rates are not observed in the other countries. In Saudi Arabia, cervical cancer cases are increasing dramatically (from only 152 cases in 2014, to 241 cases in 2017). Lack of knowledge about cervical cancer prevention presumably contributes to the morbidity and mortality rate among Saudi women, as do religio-cultural beliefs about modesty, sexuality, and premarital virginity. Therefore, this study sought to describe how Saudi nurses’ knowledge and religio-cultural beliefs effected their intentions to promote cervical cancer prevention. …

Accreditation Perceptions And Involvement In Saudi Arabian Schools Of Nursing, Amal Abdul Aziz Alaskar

Loma Linda University Electronic Theses, Dissertations & Projects

“Accreditation is a voluntary program in which trained external peer reviewers evaluate an academic institution and compares it with pre-established performance standards” (Alkhenizan & Shaw, 2012, p. 407). Those standards need to be applied by the faculty and administrators working at institutions of higher education. To understand, evaluate, and improve the quality of higher education, it is crucial to explore and examine how those implementing accreditation perceive the process of accreditation and whether it has any association with their motivation and involvement.

This quantitative descriptive correlational study used a survey method to examine whether there is a relationship between perceptions …

The Lived Experience Of Retention And Progression Of Black/African American Nursing Students, India Mylon Medley

Loma Linda University Electronic Theses, Dissertations & Projects

Despite recent strides to increase workforce diversity, nurses continue to inadequately reflect the ethnic composition of the population they serve. To effectively answer the national calls for increased diversity in the nursing workforce, there must be a greater representation of minority students studying nursing. However, minority nursing students, especially those of Black/African American descent, have less access to nursing education, poorer retention and progression rates in nursing programs, and are more likely to withdraw from programs. The existence of an increasingly diverse nursing workforce depends upon the recruitment, retention, progression, and graduation of minority students. Whereas Historically Black Colleges and …

Clinicians’ Perspectives On Adopting A Lung Cancer Palliative Care Intervention, Shaunna Siler

Loma Linda University Electronic Theses, Dissertations & Projects

Despite the significant progress in implementing palliative care interventions for cancer patients, few intervention studies seek healthcare clinicians’ input prior to implementation. The purpose of this research was then to explore palliative care and oncology clinicians’ (e.g., physicians, nurses, social workers, and chaplains) perspectives on current challenges and useful practices in meeting the quality of life needs of lung cancer patients and family caregivers, and to increase the likelihood of the adoption of a palliative care intervention based on understanding current trends in palliative care delivery at three outpatient oncology sites. The conceptual framework used for this study was the …

An Examination Of The Moderating Effect Of Proactive Coping In Nicu Nurses, Britan M. Moore

Loma Linda University Electronic Theses, Dissertations & Projects

The NICU environment is unique in that the patient population consists of critically ill neonates. Research has revealed that there are increased levels of depression, secondary traumatic stress, and burnout in nurses. Problem solving and support seeking coping strategies have been shown to be associated with lower levels of burnout and increased patient and job satisfaction in general staff nurses. Multiple linear regression and a hierarchical stepwise technique was used to conduct moderator analyses assessing whether the use of problem solving or support seeking strategies moderated the relationship between secondary traumatic stress levels and burnout as well as between depressive …

Organizational, Nurse, And Patient Empowerment At A Magnet And Non-Magnet Hospital, Mai Yaseen

Loma Linda University Electronic Theses, Dissertations & Projects

Purpose/Aims: To explore the relationships between organizational, nurse, and patient empowerment at a Magnet designated hospital versus a non-Magnet designated hospital. There are three aims to the study. Aim 1 examines the relationship between level of organizational empowerment and individual nurse self-empowerment (Self-efficacy). Aim 2 examines the relationship between individual nurse self-empowerment and patient empowerment. Aim 3 investigates if there are any differences in empowerment levels between a Magnet and non-Magnet designated hospital. Background: Patients must feel empowered to make decisions and participate in their care however; it is the healthcare provider’s role to prepare patients to make these decisions. …

Predictors Of Postpartum Depression Among Women In Karachi, Pakistan, Vimla Gill John

Loma Linda University Electronic Theses, Dissertations & Projects

Pakistan has the highest prevalence of postpartum depression (PPD) among Asian countries. The purpose of this quantitative, cross-sectional study was to determine the predictors of PPD among women in Karachi, Pakistan. The Transactional Model of Stress and Coping was used as a framework. A purposive convenience sample of 234 postpartum women was taken from out-patient departments of a tertiary care hospital in Karachi, Pakistan. A survey in English and Urdu containing the Edinburgh Postnatal Depression Scale (EPDS), DUREL Religion Index Subscale three, Cohen’s 10-item Perceived Stress Scale (PSS), Multidimensional Scale of Perceived Social Support (MSPSS), Abuse Assessment Screen, Traditional postpartum …

Use Of Outcome-Present State Test Model Of Clinical Reasoning With Filipino Nursing Students, Susy Agustino Jael

Loma Linda University Electronic Theses, Dissertations & Projects

Clinical reasoning is a nursing competency necessary to make the best decision to deliver safe and effective care. A review of the literature shows a link between hazardous errors in patient care and poor clinical reasoning among nurses, and suggests that more study be given to best way to teach clinical reasoning. It is crucial that nurses today and of the future possess the clinical reasoning skills to provide increasingly complex patient care. This study tested the effect of the Outcome-Present State Test (OPT) Model of Clinical Reasoning on Filipino junior nursing students’ clinical reasoning scores on the Health Sciences …

Factors Influencing Blood Pressure Among Rural Adults With Hypertension In China, Lili Yang

Loma Linda University Electronic Theses, Dissertations & Projects

The low rate of hypertension control in China has caught the attention of health providers. To achieve better outcomes, providers need to know what factors are significantly predictive of hypertension control. Researchers have rarely studied illness perception in China although it is one of the predictors for illness outcomes often studied in other countries. The purpose of this study was to examine the relationship among demographic and health-related characteristics, illness perception, adherence to medication and to self-management, and blood pressure in a sample of rural adults with hypertension in the Zhejiang Province of China. Leventhal’s Self-Regulation Model guided this cross-sectional, …

Experiences Of Nurses And Midwives During The Ebola Outbreak In Liberia, West Africa, Erhuvwukorotu S. Kollie

Loma Linda University Electronic Theses, Dissertations & Projects

The 2014 – 2015 Ebola outbreak in the West African region resulted in many deaths and has been responsible for devastating health and socioeconomic upheaval. The decision of nurses and midwives whether or not to render care during outbreaks is vital for the containment of the disease. The purpose of this study was to explore the experiences of nurses and midwives during the Ebola outbreak in Liberia. A grounded theory method based on Corbin and Strauss (2015) and Charmaz (2014) was used, resulting in a conceptual model describing the process involved in the work decisions made by the study participants. …

The Lived Experience Of Aging: Listening To The Oldest-Old, Julia A. Pusztai

Loma Linda University Electronic Theses, Dissertations & Projects

Although embraced as desirable by most, living into very old age is largely unexplored as a distinct season of life, with increased, varied, and cumulative changes during a unique time of vulnerability and frailty. The purpose of this study was to listen to the oldest-old, and to explore their lived experience of growing old. This hermeneutic phenomenology study examines the experience of finding meaning and living with losses and gains in advanced old age. This study design included three separate interviews one month apart with participants over 85 years of age. Purposive sampling resulted in 13 participants, 5 being male …

Effect Of A Simulation Course On Medication Administration Safety Of Malaysian Nursing Student, Noraidah L. Guntalib

Loma Linda University Electronic Theses, Dissertations & Projects

Improving safety during medication administration has been a goal of today’s healthcare environment. The complexity of both medication use and the medication management process, especially in the in-patient setting, creates a significant risk for hospitalized clients. Medication administration errors have harmed millions of people and cost millions of dollars worldwide, including Malaysia. Patient safety is dependent on nurses (including student nurses), who must consistently demonstrate behaviour fundamental to the safe administration of medication. Therefore, nursing education must provide teaching and foster learning in students to prepare them to be a safe nurse. Literature has shown that deficiencies of knowledge and …

Hospice Care In Malaysia: Knowledge, Attitude And Time Of Discussion, Shanthi Ellen Solomon

Loma Linda University Electronic Theses, Dissertations & Projects

Despite available and adequate hospice care resources, fewer terminally ill patients in Malaysia use hospice care services than one might reasonably expect. It is reported that only around 10% of patients who die of terminal illness in Malaysia, die in hospice care (Devaraj, 2003). The projected number of individuals that should receive palliative care in Malaysia is 17 to 27% (Connor & Sepulveda Bermedo, 2014). In order to study why hospice care is not accessed as expected, nurses and doctors in Penang and Sabah completed a survey measuring knowledge of current hospice practices, attitude toward caring for the dying, personal …

Effects Of Nurse Caring Behaviors On Mothers' Anxiety And Attachment In Pregnancy Following Perinatal Loss, Joyce G. Oliverio Volsch

Loma Linda University Electronic Theses, Dissertations & Projects

Childbirth is usually a joyful experience for most families. However, women who have experienced the death of a baby during pregnancy often view subsequent pregnancies with fear and apprehension. It is estimated that 59% – 86% of women with previous perinatal loss will become pregnant again (O’Leary, 2004). There is limited research on what bereaved parents perceive as caring behaviors by nurses following the human experience of perinatal loss. The purpose of this research study was to determine if nurse caring behaviors (NCB) during the perinatal loss event affect pregnancy-specific anxiety (PSA) and maternal-fetal attachment (MFA) in women who are …

Predictors Of Health In Adult Child Caregivers Of Parent Stroke Survivors In China, Yuqin Pan

Loma Linda University Electronic Theses, Dissertations & Projects

Strokes are the leading cause of adult disability and death in China. The prevalence is 6 - 9% among adults over 65 in urban areas. It is estimated that currently there are more than 7.5 million stroke survivors with an annual increase of 2.5 million new cases. These stroke survivors are in great need of care during their rehabilitation. The tradition of filial piety involves adult children in caregiving to their parent stroke survivors; however, the caregiving responsibility becomes more challenging due to shrinking family size and modernization; thus caregiver health is often compromised. Data were collected by face-to-face interviews …

Creating A Healing Environment: Strategies Christian Nurses Use, Jane Bacon Pfeiffer

Loma Linda University Electronic Theses, Dissertations & Projects

Nursing metaparadigm concepts of nurse, person, environment, and health are the conceptual building blocks which provide direction to nursing research and knowledge development (Fawcett & Desnato-Madeya, 2013). Interaction of person, nurse and environment facilitate optimal outcomes yet, there remains a need for research on the paradigm concept of environment and creation of a healing environment in particular. (Meleis, 2010).

The purpose of this study was to explore the strategies Christian nurses used to create a healing environment and enhance well-being for non-end-of-life, hospitalized patients from admission forward. Specific aims included identifying nurses’ perspectives on (1) the strategies Christian nurses used …

The Association Of Health Literacy With Self-Care Agency In Older Adults In Jamaica, Heather F. Fletcher

Loma Linda University Electronic Theses, Dissertations & Projects

Older adults are the fastest growing segment of the population in Jamaica. With an increase from 10% (252,225) of the total Jamaican population in 1995 to 11% (279,051) in 2005, the rate is expected to rise to 25% by 2025. Thus, it will be critically important to understand factors that may contribute to health maintenance, disease prevention, and wellness promotion. Two such factors – not studied extensively in this country - are health literacy and self-care. The purposes of this study were to (a) generate health literacy profile data with the newly-developed Health Literacy Questionnaire for community-dwelling older adults in …

Exploring Healthcare Simulation As A Platform For Interprofessional Education, Janice Christine Palaganas

Loma Linda University Electronic Theses, Dissertations & Projects

Interprofessional education (IPE) is gradually recognized as essential to patient safety and implemented as a standard for healthcare education through professional organization recommendations and accrediting bodies. Given the increasing adoption of experiential and team-based learning, healthcare simulation (HCS) has become a preferred vehicle for IPE. As healthcare professional educators explore simulation as a platform for IPE, a need to better understand the state of the science has become apparent. This descriptive comparative study examines how the most commonly used simulation modalities and IPE teaching methods (low-technology versus high-technology; multiprofessional versus collaborative team-based activities; observational versus active methods; standardized patients versus …

The Efficacy Of An Audio Program And Discussion Guide In Promoting Exclusive Breastfeeding In Cameroon, Africa, Kathryn R. Reinsma

Loma Linda University Electronic Theses, Dissertations & Projects

Background: In the Northwest Region of Cameroon, approximately 90% of women initiate breastfeeding; however, only 34% continue exclusive breastfeeding for the recommended six months (Kakute, et al., 2005; WHO, 2008). Entertainment-education is a mass-media communication strategy of placing educational information into media such as television programs, movies, and radio programs (Siegel & Lotenberg, 2007). This form of behavioral change communication has proven effective in addressing health-related issues in developing countries.

Purpose: The aim was to design an audio program and discussion guide to test the hypothesis that an audio program and discussion guide improves exclusive breastfeeding knowledge, beliefs, benefits, self-efficacy, …

Foundation For Evaluating Injured Firefighters Returning To Work, Deanna Stover

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to establish a foundation for developing an evidence-based assessment guideline to be used by nursing and medical personnel when evaluating a firefighter's ability to return to work after a lower extremity injury. Two on-line survey instruments were used to record the opinions and beliefs of healthcare providers and firefighters. The final samples included 63 California healthcare providers (with and without professional work experience with firefighters) and 312 California firefighters. Most of the healthcare providers with professional work experience with firefighters use the National Fire Protection Association (NFPA) 1582 Standard on Comprehensive Occupational Medical Program …

Nurses' Spiritual Care Practices: Assessment, Type, Frequency, And Correlates, Iris Mamier

Loma Linda University Electronic Theses, Dissertations & Projects

This descriptive, correlational study described the type, frequency, and correlates of nurses' spiritual care practices (quantitative) and their experiences with the sacred at work (qualitative). A convenience sample of 554 (24%) of the Registered Nurses employed at a western United States faith-based tertiary care health system participated in this online survey. Nurses' spiritual care practices were assessed using the 17-item Nurses' Spiritual Care Practice Questionnaire (NSCQ). Factorial validity and reliability of the pilot NSCQ were established. Spiritual care practices most frequently endorsed were assessing patients' spiritual beliefs pertaining to health and listening to patients' stories of illness and their spiritual …

An Evaluation Of Interventions Designed To Impact Nurses : A Pilot Project, Pamela G. Bing Perry

Loma Linda University Electronic Theses, Dissertations & Projects

This pilot project was designed from a systems approach as defined within the field of marriage and family (MFT). Systems theory has been used successfully in examining and working with organizational relationships as exemplified in the work of Edwin H. Friedman. His contribution includes several books specifically developed for use in organizations; one that was tailored for religious groups; and another for managers (Friedman, 2007). While other MFT modalities have also been used effectively with organizations, the complexity of the influences operating within an organization most closely matches the systems approach. For this reason, this is the conceptual framework applied …

Breathlessness Descriptors In Patients With Chronic Obstructive Pulmonary Disease Versus Congestive Heart Failure, Adelaide De Souza Caroci

Loma Linda University Electronic Theses, Dissertations & Projects

This cross-sectional descriptive study investigated breathlessness (dyspnea) in stable patients with Chronic Obstructive Pulmonary Disease (COPD) and Congestive Heart Failure (CHF). The purpose of this study was (a) to characterize the most common terms COPD and CHF patients use to describe their breathing, (b) to identify the frequency of dyspnea in patients with COPD and CHF, and (c) to determine the intensity of dyspnea in these populations.

A purposive sample of 60 patients, 30 with moderate to severe COPD and 30 patients with moderate to severe CHF, met the inclusion criteria and were enrolled in this study. The participants provided …

Pediatric Intensive Care Nurses : Post-Traumatic Stress Disorder-Like Symptoms, Juanita J. Allen

Loma Linda University Electronic Theses, Dissertations & Projects

Medical personnel are not only exposed to routine pressures of demanding roles, but research reveals that they can suffer from severe stress related to exposure to critical incidents. These events can overwhelm an individual's ability for emotional adjustment leading to negative symptoms such as emotional numbing, mood changes, estrangement from friends or family, decreased ability to perform or function on the job, development of posttraumatic stress disorder (PTSD) symptoms, loss of work through attrition, and depression. Contact with seriously injured children or children who have died has been shown to constitute just such a critical incident for pre-hospital care personnel …

Identified Barriers To Well Child Care For Homeless Children Under Age Thirteen, Judith G. Riemer

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to identify barriers perceived by homeless families to well child care for their children under age thirteen and to determine if there is a relationship between perceived barriers and duration of homelessness. Using an investigator-modified version of Melnyk's Barriers Scale and a demographic measure, a convenience sample of homeless families (N = 53) from three transitional shelters in two southern California counties were surveyed via questionnaire. Barriers to well child care for homeless children were identified. No relationship was determined to exist between duration of homelessness and perceived barriers using a measurement of correlation.