Medicine and Health Sciences Commons^™

Assessing Nursing Student Engagement In Clinical And Simulation Experiences, Karrie Osborne

Dissertations

clinical education, nursing education, student engagement

Effectiveness Of A Virtual Learning Environment On Pediatric Students’ Knowledge, Self-Confidence And Satisfaction With Learning Growth And Development Concepts, Laura Marie Robbins-Frank

Dissertations

growth and development, knowledge, pediatric nursing students, satisfaction, self-confidence, virtual learning environments

Burnout, Collective Efficacy, And The Social Network Of A Unit, Amy Kiefer

Dissertations

Burnout, Collective Efficacy, Social Network, Social Network Analysis

Maternal-Fetal Attachment And Its Relationship To Quality Of Life In Pregnant Women With Diabetes, Cheryl Ann Angel

Dissertations

Background: Maternal-fetal attachment (MFA) is the bond between a mother and her unborn child during pregnancy. Pregnant women with diabetes are considered high-risk and their numbers are expected to increase as levels of obesity rise and women wait longer to have children. This researcher has observed health care providers instructing pregnant women with diabetes about diabetes self-management (DSM) activities such as “dietary management” and encouraging the women to make those changes for their baby. However, some women remained unable to successfully engage in DSM behaviors despite having exhibited signs of MFA, e.g., expressing “thoughts of the fetus” to health care …

Impact Of Parent Presence On Stress In Infants In The Neonatal Intensive Care Unit, Susan M. Horner

Dissertations

The purpose of this study was to examine potential relationships between cumulative stress exposure in infants in neonatal intensive care units (NICU), as measured using a resting salivary cortisol level at NICU discharge, and the amount (hours per week) or frequency (days per week) of parent presence and skin-to-skin care (SSC). This descriptive study was conducted via a secondary analysis of a dataset representing 78 NICU families from a tertiary level NICU in the Midwest. Median length of stay was 33 days, and a resting salivary cortisol level collected at one month of age was used for infants not discharged …

Relationships Among Nursing Presence, Openness, And Fatigue In Acute Care Nurses, Barbara Therese Pudelek

Dissertations

Nursing presence was first identified when Florence Nightingale established a physical nursing presence or "being" and providing compassionate care or "doing" in the military hospitals during the Crimean War (Watson, 1998; Boeck, 2014; Dossey, 2000). Nursing presence has been a central focus in nursing throughout the past several decades (Turpin, 2014) and has been positively linked to the development of nurse-patient relationships. Nursing presence has been hypothesized to transpire when a joint relationship develops between the patient and the nurse. The patient allows the nurse into a relationship in which the nurse recognizes the patient as a unique being and …

Health Promotion And Cancer Screening Of Arab Americans, Lamyaa Alyaba

Dissertations

Introduction: Although Arab Americans represent one of the fastest-growing populations in the U.S., there is very little health data about their preventive health habits and health-promoting lifestyle, including cancer screening. Purpose: the purpose of this study is to examine the relationship between personal factors, health-promoting behaviors, and cancer-screening behaviors of Arab Americans while controlling for acculturation. Design: Pender's Health Promotion Model was the conceptual framework for the study. a cross-sectional correlational design explored the relationship between the study variables utilizing an online-based survey to collect data from Arab Americans. Multimodal recruitment was used to recruit a convenience sample of 287 …

Pediatric Providers' Perceptions Of Their Role In Early Detection Of Postpartum Depression, Laura Aime De La Pena

Dissertations

The birth of a child is usually a happy occasion in a woman's life. It is also often a time of overwhelming anxiety, stress and hormonal changes. Postpartum depression (PPD) could occur during the first year of childbirth in approximately 10-20% of mothers (Waldrop, Ledford, Perry, & Beeber, 2017). PPD is the most common maternal health problem within the first year after childbirth (the American College of Obstetricians and Gynecologists, 2018). Recognition of mothers who are at risk for PPD allows health professionals to initiate care that can prevent further problems for the mother, infant, and the rest of their …

The Situational Context Of Safety Culture From The Perspective Of Medical-Surgical Staff Nurses And Nurse Leaders In A Hospital, Lisa Harton

Dissertations

People enter into healthcare facilities to maintain or restore health; however, often times those seeking health are harmed during the process by avoidable medical errors. Since the Institute of Medicine report on patient harm, safety culture continues to be the largest barrier in realizing safer patient care. Staff nurses' comprise the largest component of the health care workforce in hospitals and consistently have the lowest perceptions of a safety culture. Leaders who play a key role in creating and sustaining a safety culture consistently have the most favorable perception of safety culture. The development of a safety culture and safer …

Factors Associated With Diabetic Peripheral Neuropathy And Quality Of Life Among Type 2 Diabetes Patients In Saudi Arabia, Awatef Ibraheem

Dissertations

Evidence has suggested that diabetic peripheral neuropathy (DPN) is associated with decreased quality of life (QoL) and impaired physical and emotional health. About 82% of the diabetic population in Saudi Arabia show signs of DPN. However, it is under-recognized and undertreated. Further, DPN is linked to several clinical and metabolic risk factors. However, there is minimal evidence from Saudi Arabia on the impact of DPN on the individual's QoL. The aims of this current study were to (1) examine the impact of DPN symptoms on functioning, health perception, and QoL and (2) explore the biologic and individual factors associated with …

Behavioral Symptoms, Inflammation And Cortisol: Relationship To Cardiac Health And Quality Of Life In Cardiac Rehabilitation Patients, Deborah Anne Sindewald

Dissertations

Background: The experience of a cardiac event is associated with psychological stress, which is often accompanied by depressive mood, fatigue and sleep disturbance (i.e., psycho-behavioral symptoms). To assist in recovery, cardiac patients can participate in a structured rehabilitation program, which provides monitored exercise and health education. There is limited knowledge, however, as to the extent to which cardiac rehabilitation reduces psycho-behavioral symptoms; nor is there knowledge of the association of these symptoms with stress-related biological mediators. Cortisol and inflammatory mediators (e.g., interleukin 6; IL-6) contribute to cardiovascular disease, and are also associated with greater stress perception, depressive mood, fatigue, and …

Vigilance Of Certified Registered Nurse Anesthetists, Timothy Finn

Dissertations

Vigilance of certified registered nurse anesthetists (CRNAs) is an integral component of the care they provide patients under general anesthetic. the practice of CRNas is important as the official seal of the American Association of Nurse Anesthetists (AANA). on the seal, Morpheus, the god of dreams, is shown holding the Lamp of Learning, by the light of which he keeps vigil (Hirter & Van Nest, 1995). as the patients remain unconscious under general anesthesia, CRNas remain the patients' eyes and ears remains responsive to their needs. the CRNa must remain attentive to the patient's needs by continuously monitoring the patient …

Identifying Transfer Of Care Gaps: Electronic Health Record Capture Of Perioperative Handoff Communications, Sharon Giarrizzo-Wilson

Dissertations

Transitions in patient care are held together by interdisciplinary handoff communications intended to coordinate the patient's ongoing care requirements. Patients with complexity in care encumber the transfer of care process requiring a higher level of care coordination between the interdisciplinary team (Coleman, 2003; Naylor et al., 2004). While the literature is abundant on the characteristics and quality of handoff communications, it is limited on the requirements of what data is necessary for ongoing care following transfer communications (Galatzan & Carrington, 2018). This dissertation explores the verbal information transferred during Operating Room (OR) to Post Anesthesia Care Unit (PACU) nursing handoff …

Women's Decision-Making For Subsequent Pregnancy After A Cesarean Delivery, Melinda Dixon

Dissertations

The purpose of this study is to generate a theory of the decision making process for women as they choose a birth option after a previous Cesarean delivery. The research method of choice when little is known about the phenomena is qualitative research. A qualitative approach was used to generate a substantive theory of decision making for women deciding subsequent pregnancy birth mode after a previous Cesarean delivery. The classical grounded theory methodology including sampling plan, recruitment, data collection and analysis outlined in Glaser and Strauss (1967) guided this study. Twelve study participants with a history of one previous Cesarean …

The Effectiveness Of An Ambulatory Care Health System Redesign On Patient Engagement, Healthcare Utilization, And Clinical Indicators, Nancy Johansen Madsen

Dissertations

Diabetes is a lifelong debilitating and deadly chronic disease affecting nearly one out of every eleven Americans. This public health problem costs $245 billion annually in the United States. Long term research trials have shown that diabetes complications can be prevented with good glycemic control, but it is difficult for patients to maintain control without much support from their healthcare team. U.S. healthcare remains fragmented. With the passage of the Affordable Care Act, there are opportunities to redesign health care delivery to minimize fragmentation and improve patient outcomes. The aim of this study is to determine if a redesigned care …

Behavioral Symptom Clusters, Inflammation, And Quality Of Life In Chronic Low Back Pain Patients, Anitha Saravanan

Dissertations

Chronic low back pain (CLBP) is a prevalent condition, often involving an inflammatory process. Those with CLBP frequently experience behavioral symptoms, including depressed mood, fatigue, and sleep disturbance, which may exacerbate pain and reduce quality of life (QOL). The purpose of this study was to identify behavioral symptom clusters (depressive mood, fatigue, poor sleep) in individuals with CLBP, and to determine whether there are differences in pain, QOL and inflammation (plasma IL-6) based on cluster membership. CLBP patients (N=69; age = 56±13 years) completed measures of pain, depressive mood, fatigue, sleep, and QOL. Blood was obtained for IL-6 measurement. LCA …

Predicting Decision-Making In Relation To Health-Risk Behavior In College Freshmen, Anne Bijumon Luckose

Dissertations

Method/Measurements: A cross-sectional correlational design explored the relationships between decision-making, health-risk behaviors and social support systems in college freshmen. The aims of the study were: 1) to explore the relationship between decision-making and health-risk behaviors among college freshmen; 2) to determine whether or not family support and social support jointly predict decision-making among college freshmen; and 3) to ascertain whether or not the effect of family support on decision-making is different for male and female college freshmen. Measurement was collected at one time-point and participants in this study completed on-line questionnaires through a web-based online survey software application with measures …

Getting On The Same Page: A Grounded Theory Study Of Nurse And Physician Collaborative Practice Development, Julie Cerese

Dissertations

The movement toward an integrated approach to healthcare professionals' education, interprofessional education (IPE), has been advancing over the past 60 years in the United Kingdom, Canada, and more recently in the United States. Support for IPE as a mechanism to positively impact collaborative practice and patient outcomes comes from international and national healthcare and educational leadership agencies as well as professional medicine and nursing thought leaders. Theories have evolved to explain the linkages among IPE, collaborative practice, and positive patient outcomes. Researchers have found support for the short term positive impact of IPE on attitudes, perceptions, clarity about roles and …

The Impact Of Mood On Health Behaviors And Quality Of Life For Women With Cardiovascular Disease, Jacqueline Ann Tulley

Dissertations

Methods/Measurements: A cross-sectional correlational design explored the relationships between symptoms, functional status, health perceptions and QoL in women with CVD. The aims of the study were: 1) to determine the relationship of symptoms (depression/anxiety) to functional status (health-promoting behaviors), health perceptions (illness perception), and QoL; and 2) to determine whether age is a factor contributing to negative mood symptoms, functional status, health perceptions, and QoL after controlling for social support. Measurements were collected at one time-point to address these aims that included the following: biological function (Framingham Recurrent Risk Model and Functional Comorbidity Index), symptoms (Patient Health Questionnaire-8 and Generalized …

Perceptions Of Pediatric Hospital Safety Culture In The U.S.: A Secondary Data Analysis Of The 2016 Hospital Survey On Patient Safety Culture, Pamela J. Gampetro

Dissertations

This study explored differences in conceptualizing safety cultures in pediatric hospitals and specialty units from an interprofessional perspective on a national level. Errors in the pediatric population can quickly cause harm and frequently lead to adverse events (AEs). Research has explored the problems of patient harm and identified strategies to prevent those harms; but sustainable improvements, particularly in pediatric settings, have not been achieved. This cross-sectional descriptive study used national data from the Hospital Survey on Patient Safety Culture's 2016 dataset developed by the Agency for Healthcare Research and Quality measuring 12 dimensions of safety culture. The extracted sample included …

Exploring The Legacy Of Imogene King In The Making Of A Nurse Educator, Leader, And Nurse Theorist, Margaret Mary Kotowski

Dissertations

Imogene King was a pioneer in the profession of nursing. Known primarily for her work as a nurse theorist, King’s career encompassed a great deal more. King was a nurse educator who impacted the lives and careers of hundreds of students through her direct teaching, her mentorship, and generous spirit when it came to share knowledge. King was also a leader in the profession of nursing taking an active role in the various state American Nurse Associations (ANA) where she lived. The ANA awarded her with the prestigious Jessie M. Scott Award for her outstanding work in education. Also, an …

Simulation Using A Standardized Patient To Measure Perception And Congruency Of Spiritual Care For A Veteran From Three Perspectives To Inform Nursing Education And Practice, Mary E. Desmond

Dissertations

Spiritual care refers to a purposeful process of helping another find meaning and purpose

in life through a mutual connection. Providing spiritual care is a professional nursing mandate, yet nurses report barriers in education and practice. Veterans want spiritual care to promote quality of life, and to cope with military experiences and chronic conditions. Patients report receiving less than desired spiritual care and nurses report infrequent provision of spiritual care. It is also unclear how congruent patients and nurses are in their perceptions of spiritual care. A spiritual care simulation and performance checklist was developed using a review of the …

Correlation Of The Boost Risk Stratification Tool As A Predictor Of Unplanned 30-Day Readmission In Elderly Patients, Carol K. Sieck

Dissertations

Carol K. Sieck

Loyola University Chicago

CORRELATION OF THE BOOST RISK STRATIFICATION TOOL AS A PREDICTOR OF UNPLANNED 30-DAY REAMDISSION IN ELDERLY PATIENTS

Risk stratification tools can identify patients at risk for 30-day readmission but available tools lack predictive strength. While physical, functional and social determinants of health have demonstrated an association with readmission, available risk stratification tools have been inconsistent in their use of variables to predict readmission. The Better Outcomes by Optimizing Safe Transitions (BOOST) 8 P's tool is a risk stratification tool developed by the Society of Hospital Medicine but has no published validation studies. The theoretical …

It Is Always The Monkey On My Back: The Diagnosis Of Cirrhosis, Mary Tiberg

Dissertations

Mary Tiberg

Loyola University Chicago

IT IS ALWAYS THE MONKEY ON MY BACK: THE DIAGNOSIS OF CIRRHOSIS

A significant current challenge in health care today is meeting the needs of a population that has chronic disease, especially for those that have a health condition with a life threatening long -term outcome (Falkenstern, et al., 2005). In these health illness transitions, when there are no secure expectations, there are the additional burdens of enduring emotional unease, facing the closing stages of physical stamina, and confronting an indeterminate future. The objective of this study was to explore and describe the experience of …

What Is The Relationship Between Vitamin D Status, Pregnancy Symptoms And Quality Of Life?, Jennifer Woo

Dissertations

Purpose and Background/Significance: The main purpose of the study is to determine: (1) to determine if there is a relationship between vitamin D status, pregnancy symptoms, health promoting behaviors, and quality of life and (2) to determine if differences exist in pregnancy symptoms, health promoting behaviors and quality of life between African American and Hispanic women. There is evidence to show that vitamin D deficiency has been associated with numerous symptoms such as musculoskeletal pain, poor sleep, and depression. However, whether low levels of vitamin D is associated with these and other symptoms during pregnancy is unknown. What is known …

Unavoidable Pressure Ulcers: An Ethnonursing Study, Catherine M. Clarey-Sanford

Dissertations

Catherine M. Clarey-Sanford

Loyola University Chicago

UNAVOIDABLE PRESSURE ULCER: AN ETHNONURSING STUDY

In an effort to improve patient safety and the quality of care in the acute care setting, there has been an increased focus on the prevention of adverse events believed to be avoidable. Hospital-acquired pressure ulcers (HAPU) have been listed as one of those adverse events, and hospitals are no longer reimbursed for related costs. However, there are patient conditions and clinical situations in which a pressure ulcer can be deemed unavoidable. In acute care, unavoidable means that the patient developed a pressure ulcer even though the provider …

Simulation Learning And Transfer To The Clinical Environment In Undergraduate Nursing Students, David A. Miles

Dissertations

Simulation learning is an integral component of many undergraduate nursing programs throughout the country. Experiential learning through simulation allows students to improve their cognitive, affective, and psychomotor skills. Some clinical experiences lack significant practice of clinical skills for students; including the inability to assume the role of the nurse. A recent literature review revealed a need to advance the understanding of simulation learning and transfer; with many questions still remaining unanswered. The aim of this study was to conceptualize the process by which simulation learning transfers to the clinical environment in undergraduate nursing students. Twenty-five, fourth-year traditional nursing students, who …

The Relationship Between Light Exposure And Fatigue And Mood In The Patient Undergoing Bone Marrow Transplant, Kimberly S. Anderson-Drevs

Dissertations

Exposure to light is known to produce changes within the human body. It has demonstrated ability to produce changes in the circadian rhythm and the sleep wake cycle and to change the production and secretion of melatonin and corticosteroids. The bulk of research is related to the use of bright light therapy (BLT) for certain depressive disorders. The literature does not provide a standard of care for BLT administration dose or schedule. This study intended to define any relationship between natural and ambient light with a hospitalized patient’s mood and/or fatigue level. Further it aimed to relate cumulative light levels …

Restoring Trust: A Grounded Theory Study Of Cyberbullying Among Young Women, Nancy H. Camp

Dissertations

Cyberbullying is a global and national public health issue with the potential to affect the healthy social and emotional development of adolescents and young adults. There has been an 80% increase in social media use in 18-29 year olds between 2004 and 2014 (Gahagen, Vaterlaus, & Frost, 2016). In a study of 14-24 year olds (MTV/AP, 2011), 76% identified cyberbullying as a serious problem, with more than 56% reporting they have experienced cyberbullying. Cyberbullying research has been conducted predominantly with adolescents (ages 11-18 years), however scant research has been conducted with older adolescents and young adults (ages 18-30 years). This …

What Is The Process Of Relational Work Of The Nurse?, Daniela Terrizzi Defrino

Dissertations

The process of how nurses work in relationships to accomplish their work is presented in this dissertation. This study has made the relational work process of nurses explicit. While research demonstrates that increased nurse staffing is associated with better patient outcomes and with nurses experiencing less burnout and job dissatisfaction, the process is not explored in the empirical literature.

The research question was: “What is the process of relational work of the nurse?” Data collection and analysis conformed to the process of classical grounded theory. Interviews were face to face with 23 registered nurses working as direct care staff nurses …