Medicine and Health Sciences Commons^™

Elucidating Mechanisms Influencing Maternal Postpartum Health: The Protective Benefits Of Breastfeeding And Associations With Allostatic Load, Experiences Of Stress, And Resiliency, Bi-Sek J. Hsiao

Doctoral Dissertations

Research has established breastfeeding as protective of maternal health, but little is known about the ways breastfeeding interacts with chronic stress pathways and interfaces with stressors such as discrimination and neighborhood deprivation, which are salient in the experiences of many marginalized communities. This research addresses these knowledge gaps through secondary analyses of prospective cohort data generated by the Community Child Health Research Network through Community Based Participatory Research processes. Analytical samples were derived from 2510 postpartum women from five regions in the U.S. who self-identified as Black, Hispanic, or White. Study 1 investigated and found an inverse association between breastfeeding …

Hospital Assessment And Response To Environmental Pollution As A Population Health Need: Identifying Prevalence And Predictors In Community Benefit Practices, Sarah Valentine

Doctoral Dissertations

Hospitals have a growing role in improving population health. Environmental pollution is an important determinant of health with disproportionate effects on Communities of Color. This warrants hospital action. To advance such action, it is important to take stock of current hospital engagement with environmental pollution and to identify factors associated with such engagement. I investigated the following. To what extent do New York State (NYS) non-profit hospitals assess, identify, and respond to environmental pollutants as part of community benefit practices? Do factors previously reported as associated with hospital engagement of social determinants predict engagement with environmental pollution as a community …

Older Women’S Experiences Of Intimate Partner Violence: A Phenomenological Study, Lourdes Irene

Doctoral Dissertations

Intimate partner violence (IPV) is a global public health problem, linked to long-term health, social, and economic consequences. Despite the growing number of women over age 60 in Puerto Rico, knowledge is lacking about culturally specific IPV in women of this age group. This lack of knowledge is problematic because women experiencing abuse often do not report it, health professionals are not educated to identify cases of abuse in older women, and researchers often includes IPV with other types of abuse, such as negligence by families. Therefore, the purpose of this study was to explore and describe the experiences and …

A Grounded Theory Inquiry Into Crying In Women Dealing With The Emotional Stress Of Personal Crisis, Mary Bess Griffith

Doctoral Dissertations

The belief that crying leads to healing is so widely held and of such longstanding that many healthcare professionals—including nurses, physicians, psychiatrists, and psychologists—accept it as fact even though there is little substantiating scientific evidence. Crying is commonly believed to be an essential factor in restoring mind-body equilibrium after physical and/or emotional trauma has been experienced. If, as has been hypothesized by many scientists and healthcare practitioners, emotional crying is a biopsychosocial healing modality, then specifics of its therapeutic praxis, including limitations and ambiguities, should be incorporated into nursing education and practice. In this grounded theory study, the meaning and …

Examining The Relationships Between Gratitude And Readiness For Self-Directed Learning In Undergraduate Nursing Students, Kellee Renee Vess

Doctoral Dissertations

The purpose of this study was to explore the relationships between gratitude and readiness for self-directed learning among nursing students enrolled in a four-year baccalaureate nursing program. For this study a sample of 59 nursing students were selected from a four-year baccalaureate nursing program, situated in a private, faith-based college in the Southeast United States. During data collection, participants were asked to complete the Gratitude 6-item questionnaire [GQ-], the 40-item Self-Directed Learning Readiness Scale for Nursing Education [SDLRS-NE], and two demographic questions (i.e., age and class rank). Using both parametric and nonparametric statistics, this study examined eight research questions, and …

Newly Licensed Registered Nurses' Experiences With Clinical Simulation, Carrie Ann Bailey

Doctoral Dissertations

The purpose of this study was to understand how new graduate nurses perceive the value of simulation in making the transition into professional practice. This study will use a descriptive qualitative approach with a sample of first year nurses. Kolb’s Experiential Learning Model serves as this study’s conceptual framework. For the current study, the sample consisted of 10 newly graduated, female nurses with less than one year of experience working in the hospital setting were interviewed. Data analysis included interviews and transcription by the researcher. Finally, participants were asked about themes to increase rigor. Four themes emerged from this research: …

A Process Improvement Toolkit To Guide The Attainment Of Meaningful Use Stage 2 Requirements, Katie M. Alfredson

Doctoral Dissertations

Healthcare is evolving. Reimbursement is transitioning to a model based on quality and patient outcomes. To remain relevant and survive this transition, providers of care must adapt and implement new models of care delivery that account for these changes. This toolkit was created as a deliverable of a Doctor of Nursing Practice dissertation that explored a successful primary care delivery model of a Patient-Centered Medical Home that utilized an interdisciplinary team approach that included nurses. Through this model high quality care was delivered to achieve desired outcomes, specifically, successful attestation for Stage 2 of the Meaningful Use Incentive Program during …

An Interdisciplinary Team Approach To The Patient-Centered Medical Home As A Means Of Meeting Meaningful Use Stage 2 Requirements, Katie M. Alfredson

Doctoral Dissertations

In an attempt to address the shortcomings of the current U.S. healthcare system, reimbursement structure is changing from fee-for-service to a value-based model. This requires drastic change in how care is delivered. Therefore, care delivery models and reimbursement incentive programs are evolving to promote advancements in care delivery. This project examined an interdisciplinary team model utilized at a rural, privately owned practice that is a Patient Centered Medical Home (PCMH). This practice has incorporated unique structures and processes to attain Stage 2 Meaningful Use requirements in the first year attesting for this stage became available as a means of addressing …

Needs Of Patient’S Families In The Hospital Tele-Intensive Care Unit, Mary L. Jahrsdoerfer

Doctoral Dissertations

Purpose: To explore, identify and describe the perceptions of family members of a patient admitted to a telemedicine intensive care unit (tele-ICU); and to determine if these needs differ from those established by the Critical Care Family Needs Inventory (CCFNI) in the traditional ICU setting. Background: The tele-ICU is a new care modality in which offsite nurses provide consultation to bedside clinical staff at geographically-dispersed ICUs. The last decade demonstrates a growing existence of tele-ICU’s in our healthcare culture. ’Information’, ‘close proximity’, ‘assurance’, ‘support’ and ‘comfort’ have been identified as the top five needs of family members in the traditional …

Exploring Perceptions Of Staff Registered Nurse Preceptors For Undergraduate, Pre-Licensure Nursing Students, Katherine C. Hall

Doctoral Dissertations

Staff nurses are increasingly called upon to accept more responsibilities and roles in addition to provider of patient care, including that of preceptor. Aside from dealing with demands of high acuity patients, working long hours with inadequate staffing, and carrying heavy workloads, nurses may view teaching and supervising students as an additional burden, time-consuming, and not part of their role. The purpose of this dissertation was to explore staff nurse experiences as preceptors to undergraduate, pre-licensure nursing students. Emphasis was placed on exploring RN’s perceptions of the role, specifically the preparation for, support in, and understanding of what the role …

Living With The Choice: A Grounded Theory Of Iraqi Refugee Resettlement To The U.S., Lisa Ann Davenport

Doctoral Dissertations

Though the United States has become a place of increasing resettlement for refugees, particularly Iraqi refugees who have been forced to flee their homeland due to violence, persecution and civil unrest, little is known about Iraqi refugee resettlement in the United States, or the way in which resettlement impacts health and adjustment. A grounded theory study was conducted to develop a substantive theory of Iraqi refugee resettlement. Participants in the qualitative study included 29 Iraqi refugees and 2 community partners who participated in face-to face interviews. Data analysis and interpretation revealed fundamental concepts related to Iraqi refugee resettlement. Results of …

Quality And Safety Education In Newly Hired Rns And Rns In Staff Leadership Roles, Dennis Alan Bertch

Doctoral Dissertations

The intent of this project was to examine the potential knowledge, skills, and attitudes (KSA) gap of practicing bedside registered nurse (RN) care providers regarding the quality and safety education for nurses (QSEN) core competencies. Based on this perceived gap two key questions were explored: (a) do newly hired RNs and RNs in staff leadership roles demonstrate an understanding of the KSAs of the QSEN core competencies?; and (b) was there a difference in the understanding of the KSAs of the QSEN core competencies related to RN educational preparation, years of RN experience, and/or previous quality improvement training within and …

Presence In Nursing Practice: A Critical Hermeneutic Analysis, Alicia Laurel Bright

Doctoral Dissertations

Research Topic

Presence, although it involves action at times, is a humanitarian quality of relating that is ethically generated and has real-world implications for both patient and nurse. It is an interpersonal process characterized by sensitivity, holism, intimacy, vulnerability, and adaptation to unique circumstances that results in enhanced mental wellbeing for nurses and patients, and improved physical wellbeing for patients. Knowing and being with are foundational to being present.

Theory and Protocol

This research is grounded in critical hermeneutics and follows an interpretive approach to field research and data analysis (Herda 1999). This orientation places the researcher and participants in …