Medicine and Health Sciences Commons^™

Primary Care Nurse Attitudes, Beliefs And Confidence Levels Regarding Alcohol Abuse And Its Treatment: Impact Of Educational Intervention., Raja Sekhar Vadlamudi

Electronic Theses and Dissertations

Alcohol abuse has been a major burden on the society. In the fight against it a key issue the education of the primary care nurses has been ignored. This study evaluates the effect of education program on the attitudes, beliefs, and confidence levels of primary care nurses regarding alcohol abuse and its treatment. Data from the Project Mainstream educational intervention were used with permission from the investigators. Two hundred one students and faculty of nursing at Vanderbilt University participated in the intervention, which was designed to train primary care providers in the Brief Negotiated Intervention technique for early detection and …

Trapped In A State Of Mitigating Danger: Forgotten Process, Forgotten Women, Alva Hunt Reid

Doctoral Dissertations

Women who are in intimate partner abusive relationships undergo a change process, which is a spectrum of emotional and behavioral responses to violence that is identifiable in stages. The end result is that women terminate their relationships or renegotiate their circumstances to halt the violence: Treatment protocol for abused women is shifting to individualized intervention based on these stages. Leaving and returning to an abusive relationship is a predominant theme in the change process that has not been investigated.

The present study examined this forgotten leave-return process in a sample of forgotten women. Grounded theory methodology was utilized to describe …

Chlorpyrifos In Human Breast Milk?, Karyn Ann Casey

Doctoral Dissertations

The widespread use of pesticides by farmers, pest control operators and even the general public can pose significant risks to children's health. One particular pesticide, chlorpyrifos, was the most widely used pesticide in the United States with total use estimated at approximately 30 million pounds per year. Young children and the developing fetus are far more susceptible to the effects of pesticide exposure as a result of unusual exposure patterns and developmental immaturities. Transplacental transfer and lactational exposure are the pathways exclusive to the developing fetus and infant. Chlorpyrifos exposure is of special concern in this population because of its …

The Only Way Out Is To Die: Perceptions And Experiences Of Rural, Homebound, Older Diabetics, Sharon Robbins George

Doctoral Dissertations

The purpose of this phenomenological study was to investigate the meaning of diabetes, as perceived and experienced by rural, homebound, 65-year and older, diabetics requiring insulin. The sixty-five year and older persons are disproportionately affected by diabetes. They are more likely than younger diabetics to have co-morbidities, disabilities and difficulty preventing diabetic complications. Guidelines for diabetes management and treatment developed by the American Diabetes Association are not specifically targeted for the 65-year and older population. Phenomenological research was used to examine and describe the understanding of diabetes from perspectives of older diabetics.

A purposive sample of participants was recruited from …

Perceptions Of High Risk Behaviors Among Culturally Diverse Adolescents And The Role Of Parental Influence And Parent Communication, Sharlene E. Junio

Master's Projects

Eighty seven ethnically diverse 9th and 1oth graders from an urban high school in Northern California were studied. Students were mostly female, between 14 and 16 years of age, and reported to be mostly Asian and Filipino. Students completed an 18-item Likert scale questionnaire requesting information about their overall relationship with their parents and their communication with their parents about drugs, sex, alcohol, birth control, and personal problems. Results of this study showed that participants rated their overall relationship with their parents as "good" or "very good." Despite this, communication was lacking among parents and adolescents in all topics of …

Evaluation Of An Oral Health Training Program For School Nurses, Linda Drengler

Master's Projects

Pediatric dental disease is a silent epidemic (Committee on Health, Education, Labor, and Pensions, 2002). Dental decay is commonly unrecognized and under-treated, and can affect children's growth and development as well as their ability to perform in school. Effective interventions to prevent dental decay include water fluoridation, dental sealants, pediatric dental screenings, and dental health education programs. This pre-experimental design study evaluated the effectiveness of an oral health training program for school nurses. This training program was designed based on the First 5 California <;>ral Health Training Program (2003). A non-randomized sample of fourteen (N=l4) school nurses participated in the …

Evaluation Of The Effectiveness Of A Diabetes Managment Training Program For Unlicensed Assistive Personnel In Schools, Elaine M. Gomer

Master's Projects

This study evaluated the diabetes management-training program for unlicensed assistive personnel (UAP). The purpose of the program was to prepare UAP to recognize and respond to the health care needs of students diagnosed with diabetes mellitus. Twenty UAP participated. Teaching strategies were based on Albert Bandura' s social learning theory~ Two instruments were administered before and after the program. One was a 1 0-question survey addressing self-efficacy; the other was a 10 question multiple-choice test measuring knowledge of diabetes. Results of paired t tests indicate consistent and significant improvement in both perceptions of self-efficacy and knowledge (p < .05). This program provides a framework for school nurses training UAP that assist in the health care of students with diabetes. It is important that school nurses capitalize on the contribution that informed confident UAP might contribute to the provision of safe quality care to students with diabetes.

Evaluation Of An Oral Health Training Program For School Nurses, Kelley Haines-Kolostian

Master's Projects

Pediatric dental disease is a silent epidemic (Committee on Health, Education, Labor, and Pensions, 2002). Dental decay is commonly unrecognized and under-treated. Dental disease can affect children's growth and development as well as their ability to perform in school. Effective interventions to prevent dental decay include water fluoridation, dental sealants, pediatric dental screenings, and dental health education programs. This pre-experimental design study evaluated the effectiveness of an oral health training program for school nurses. This training program was designed based on the First 5 California Oral Health Training Program, First Smiles (First Smiles Program of California, 2003). The presentation was …

Job Satisfaction Among Staff Nurses In Mental Health Units In A Va Facility, Edith R. Lombard

Master's Projects

Studies have indicated that work environment in mental health is stressful, however, few studies have focused on staff working in acute mental health settings (Jenkins & Elliott, 2004). The purpose of this study was to describe job satisfaction among a sample of mental health staff nurses who were caring for patients with acute psychiatric disorders in a federal hospital. The second purpose was to determine if there were relationships between global job satisfaction and ethnicity, years in the organization, current unit, field of nursing, working with patients with mental disorders and age of staff nurses. An anonymous survey was distributed …

Nurse's Perceptions Of Causes Of Medication Errors And Barriers To Reporting, Virginia M. Ulanimo

Master's Projects

Objective: To describe medical-surgical nurses' perceptions of frequent causes of medication errors, of what constitutes a medication error, and of what are the barriers and empowerments to reporting. The study also explored the nurses' perceptions of the effect of physician order entry (POE) and barcode medication administration (BCMA) on medication errors. Background: Causes of medication errors have been investigated by numerous researchers in an attempt to determine safe medication administration process. Information technology (IT) systems enhance patient safety. No published studies were found on nurses' perceptions of medication errors in a setting with IT systems in place. Method: A descriptive …

Being Whole: Aligning Personhoods To Achieve Successful Childbirth With A History Of Childhood Sexual Abuse During Perinatal Services, Karla Kendall Richmond Phd, Msn, Rnc, Cns

Dissertations

Being a pregnant female is a temporary condition. A woman with a history of childhood sexual abuse aligns the personhoods of child victim, adult survivor and pregnant female to achieve a successful pregnancy, labor, delivery and postpartum experience. Female survivors desire to be recognized and function as whole being during the perinatal experience. It is estimated that 15 to 32 percent of females prior to the age of eighteen have unwanted sexual contact. Female survivors carry this history of childhood sexual abuse (CSA) with them throughout their lives which may involve childbirth. There are many long-term psychological consequences that can …

Nurses' Perception Of Family Presence During Resuscitation, Josephine Njoku

Master's Projects

Background Family witnessed resuscitation (FWR) is the concept of allowing family members at bedside during cardiopulmonary resuscitation. Studies have shown that the lack of standard policies by hospitals regarding FWR forces nurses to make different decisions regarding family presence at bedside during resuscitation. The framework for this study is Sandman's teleological model. Objectives To examine nurses' perceptions of having family members present during adult cardiac resuscitation. Methods A descriptive study of 57 registered nurses (n = 57) from northern California was conducted. Participants completed a mailed survey consisting of a 22-item Likert scale questionnaire titled "Family Presence Risk-Benefit Scale." Results …

Chronically Ill Adolescents' Involvement In Health Treatment Decision Making, Edna B. Domingo Phd

Dissertations

The purposes of this study were to explore preferences for involvement of chronically ill adolescents in health treatment decision-making; describe, explain and predict relationships and differences in self-confidence in decision-making between older and younger chronically ill adolescents; and explore relationships between severity of symptoms and self-confidence in health treatment decision-making among chronically ill adolescents. Ten to twenty million American children have some type of chronic illnesses with 90% survival to adulthood. There is lack of current literature on adolescent preferences for involvement in health care decisions. Courts and legislators assume that minors lack the requisite capacity for information, and lack …

Psychosocial Responses By Adolescent Male Victims To Peer Bullying, Karin Eve Reuter-Rice Phd

Dissertations

Bullying remains a pervasive problem in most schools throughout the nation. Peer-bullied victims report higher levels of depression, suicidal ideation, anxiety, and concerns regarding their safety in school. Reactions of victims to peer bullying have been extreme, as in the cases of the rampage school shooters. Primarily, current research has not focused on the high school adolescent, although most school shooters arise from that age group. The overall purpose of this study was to examine the psychosocial responses by adolescent male victims to peer bullying. Research questions addressed the frequency and severity of peer-victimization, distress, anxiety, and their perception of …

Nursing Students' Knowledge And Attitudes Regarding Pain And Pain Management, Ruth L. Schaffler Phd

Dissertations

Pain is a universal human experience and is a primary reason people seek health care; however, undertreatment of pain has been reported in the literature as a significant clinical problem for more than three decades. Researchers have concluded that nurses have inadequate knowledge of pain assessment, are misinformed about opioids, and have inappropriate attitudes about pain and pain management that lead to the undertreatment of pain. One question is whether those misconceptions are acquired in nursing school or whether they are present when students enroll in nursing programs. The purpose of this quasi-experimental study was to examine the attitudes regarding …

A Pilot Study: The Effects Of Group Exercise On Fatigue And Quality Of Life During Cancer Treatment, Joanna M. Losito

Master's Projects

Fatigue affects 60-100% of all cancer patients, is difficult to manage, and can have a profound impact on everyday functioning and quality of life. Though seemingly counterintuitive, exercise has emerged as a promising intervention for the management of cancer related fatigue (CRF). Current research predominantly involves individual, home-based exercise programs with few studies exploring other modes of exercise delivery. The purpose of this pilot study was to determine if participation in a structured group exercise program (SGEP) was a feasible intervention for adult oncology patients receiving cancer treatment and to test the impact of a SGEP on reducing CRF and …

Evidence-Based Practice Considerations In Facilitating The Risk Surveillance Of Occupational Exposure To Antineoplastic Agents, Theresa A. Rafique

MSN Research Projects

According to Martin and Larson (2003), healthcare professionals involved with handling antineoplastic drugs may be exposed inadvertently to these agents, placing them at potential risk for acute and long-term adverse effects. For example, cyclophosphamide one of the most frequently used antineoplastic agents in clinical treatment facilities, is a known human carcinogen (Larson, Khazaeli, & Dillon, 2003). While the health risks associated with cytotoxic use have been well established, there is little information available about how people perceive these risks, particularly among those most affected by it-chemotherapy nurses. Therefore, the purpose of this Evidence Based Practice (EBP) project was to develop …

Screening Of Postpartum Depression Among Chinese Immigrants, Beahwa Yeoh

Master's Projects

Postpartum depression among the Chinese population in the United States has been understudied even though the Chinese community continues to rapidly increase in numbers. The purpose of this study is to investigate the prevalence of postpartum depression among Chinese immigrants using the "Edinburgh Postnatal Depression Scale," a self-report questionnaire. This study also reports demographics obtained from participants and explores the practice of "zuo ye zi" among Chinese immigrants. In the spring of 2005, twenty-eight postpartum Chinese women, all first generation immigrants, were asked to participate in this study during home visits conducted by public health nurses in Alameda County, CA. …

An Exploratory Study Of Functional Status In Post Cardiac Arrest Survivors Discharged To Home, John J. Whitcomb Phd

Dissertations

Cardiopulmonary arrest is a major health problem, claiming 350,000 to 450,000 lives per year in the United States, but survival has increased to 49% from the use of Automated External Defibrillators (AED) by lay personnel. Leidy's work on functional status is a comprehensive framework to describe functional status and has not been used in this population. The specific aims of the project were to describe perceived functional capacity, physical functional performance, mental health, symptom distress, and demographic factors in survivors of cardiopulmonary arrest after discharge to home and to examine the relationship among perceived functional capacity, mental health and physical …

Incidence And Clinical Predictors Of Risk Factors For Inappropriate Shock In Patients With Implantable Cardioverter-Defibrillators, Shu-Ling Lo Phd

Dissertations

Sudden cardiac death (SCD) is a major unresolved medical problem worldwide. Although Implantable Cardioverter-Defibrillators (ICD) are highly effective in diagnosing and treating life threatening arrhythmias, inappropriate shock therapy (IST) occurs in approximately 5-20% of ICD recipients. IST results in pain, anxiety, induction of ventricular arrhythmias, decreased battery longevity, and even death. Researchers studying clinical predictors of IST have drawn findings based on single case studies with small samples or with outdated data. This study filled this gap by describing the incidence and co-existing clinical predictors of IST. Methodology This descriptive, retrospective study analyzed the incidence and clinical predictors of IST …

Managing Susceptibility To Hereditary Breast And Ovarian Cancer, Cynthia E. Perry Phd, Msn, Rn

Dissertations

The recent identification of Breast Cancer 1 (BRCA1) and BRCA2 genes offers an opportunity for high-risk individuals to learn whether they may be genetically predisposed to develop breast and/or ovarian cancer. The purpose of this study was to examine how unaffected women, identified as BRCA positive and variant of uncertain significance (VUS) mutation carriers, managed their susceptibility to hereditary breast and ovarian cancer (HBOC). Thirty North American women ranging in age from 22 to 60 years responded to open-ended interviews. These interviews were analyzed using constant comparative method to generate a grounded theory. Managing Susceptibility was identified as the basic …

Workplace Empowerment And Job Satisfaction In Primary Care Nurse Practitioners In Southeast Kansas, Karen Zafuta Johnson

Electronic Theses & Dissertations

The purpose guiding this study was to identify perceptions of workplace empowerment and levels of job satisfaction in a group of primary care nurse practitioners in the southeast Kansas area. A quantitative study was conducted and examined as to what background variables are significant for empowerment to be fully realized. This will add knowledge to other studies that have been done on nurse practitioner's job satisfaction so that more will be known about this vital and growing profession.

The population for this study included 30 nurse practitioners that currently work in a primary care setting in the southeast Kansas area …

Beyond The Patient: Nursing Presence With Families During The Perioperative Period, Joyce P. Miller

Theses and Graduate Projects

Nurses have used the intervention of caring for many years, but little attention has been given to describing the phenomenon of nursing presence in the perioperative setting. The purpose of this research was to learn more about the experience of the connection of the family to the nurse who kept them informed during the perioperative period. A hermeneutic phenomenological approach was utilized to identify patterns of caring, connecting, and transpersonal nursing presence described by the family of surgical patients. Five women were interviewed for this study. Transcribed interviews became the phenomenological texts for my hermeneutic analysis. Essential themes were uncovered …

Culture Brokering: A Case Study Resolving Conflict In A Health Care Setting, Katherine A. Baumgartner

Theses and Graduate Projects

This paper describes the application of a culture brokering model developed by Mary Ann Jezewski to a cultural conflict within a pediatric clinic. The purpose of the case study was to explore the usefulness of the culture brokering model as a tool in resolving conflict as well as a process to expand cross-cultural understanding and promote connectedness of the patient in the health care system. A practice model for the advanced practice nurse is discussed which combines the cultural brokering model and places it within the framework of Leininger's Theory of Culture Care Diversity and Universality. The cultural conflict in …

Unintended Pregnancy Prevention And Active Duty Women, Min S. Chung-Park Phd, Msn, Whnp

Dissertations

Studies have shown that a structured education program for women decreases risky sexual behavior identified as vulnerable for AIDS. However, the outcomes from a structured, repeated, educational intervention in reducing the rates of unintended pregnancies have not been studied in military females who are considered as a high risk. The purpose of this quasi-experimental longitudinal study was to implement and evaluate the effects of a reproductive health educational program regarding knowledge, attitudes, decisional balance, self-efficacy, stages of change, and contraceptive use, and to identify independent variables most likely to predict behavior change in the use of contraceptives among single, active …

Nurses Perceptions Of Barriers And Facilitators To Research Utilization In Their Nursing Practice, David Ray Renfro

Master's Projects

Today in nursing we are driven in the direction of evidence based practices. The nursing profession must continue to encourage nurses to ask "Why" when providing interventions. We must ensure that the interventions provided are both warranted, and the most efficacious intervention achievable. As a profession, we can no longer stand on our methods of practice simply because it is the way we have always practiced. It is a challenge for nursing leaders to implement a culture of evidence based practice, and to promote research utilization. The purpose of this study was to identify nurse's perceptions of barriers and facilitators …

Self-Efficacy And Sexual Transmitted Disease Prevention Among College Women, Dominique M. Ly

Master's Projects

According to the Center of Disease Control (2002), sexual transmitted diseases (STDs) are on the rise, especially among women. By far, women bear the greatest burden of STDs because they suffer more frequently and develop more serious complications than men. This study explored the relationship between self-efficacy and safe sex behaviors among college women. The data was collected by using questionnaires from the General Perceived Self-Efficacy Scale (GPSE) and the Condom Use Self-Efficacy Scale(CUSES). The sample was composed of 38 unmarried female college students between the ages of 18 and 25 years-of-age who had been sexually active within the last …

A Survey Of California Nurse Practitioners' Health Practices And Counseling Habits, Jessica Malone

Master's Projects

Morbidity and mortality due to obesity continues to rise in the United States despite well known Healthy People 2010 and American College of Sports Medicine guidelines on physical activity. In the U.S. today, more than 60 percent of Americans aged 20 years and older are overweight (Hedley et al., 2004). This study investigated the exercise practices of California nurse practitioners (NPs }, how their practices compare to recommended guidelines, and to what extent California NPs prescribe aerobic exercise and strength training to their clients. The California Nurse Practitioners Physical Activity Questionnaire was self-administered at the annual2005 California Association for Nurse …

Discovering Strengths Of Homeless Abused Women, Jean Croce Hemphill

Doctoral Dissertations

The purpose of this qualitative study was to investigate the experience of discovering strengths of homeless abused women. An emancipatory feminist and existential phenomenological research design was used. Seventeen homeless abused women participated in facilitative dialogues that explored experiences of strength, and assisted in consciousness raising and then discovery of each woman’s own strengths. There were four levels of analysis used to identify a thematic structure. The thematic structure was derived from the various themes of strength that were facilitated in the dialogue and expressed in the words of the women. These various themes were clustered and organized within a …

Breast Milk Or Formula: An Existential Phenomenological Study Of Infant Feeding Decisions Made By Wic Recipients In East Tennessee, Jenny Blair Short

Doctoral Dissertations

Research indicates that breast milk is superior to formula as a source of infant nutrition. Research also indicates that infants born to impoverished women and women who are nutritionally at risk are at increased risk of a host of neonatal complications. Despite this evidence, women enrolled in the USDA's Special Supplemental Food Program for Women, Infants and Children (WIC) are less likely to initiate and continue to breastfeed their infants than women in the general population.

This existential phenomenological research study was performed to explore the experience of making infant nutrition decisions for infants 6 months of age and younger …