Medicine and Health Sciences Commons^™

Evaluating Self-Management Of Adults With Multiple Chronic Conditions Residing In Rural Communities: A Descriptive Cross-Sectional Study, Jessica J. Miller

Theses & Dissertations

Background

Chronic diseases are the leading cause of death and disability in the United States and are on the rise. Multiple chronic conditions are increasing in frequency with 1 in 4 adults affected. Behaviors of adults from rural communities are at an increased risk of developing MCC because of limited access to health care resources and behaviors. Supporting the development of self-management skills can help adults be more active in their own health and promote healthy lifestyle behaviors. The Individual and Family Self-management was the guiding framework for this cross-sectional study.

Purpose

The purpose of this study was to determine …

Glycemic Variability In Patients With Stage Ii-Iii Colon Cancer, Natalie Mandolfo

Theses & Dissertations

Patients with cancer experience metabolic changes such as hypoglycemia, hyperglycemia, and glycemic variability; collectively termed malglycemia. Glycemic variability, defined as fluctuations in glucose, is a marker of metabolic instability. Higher glycemic variability is associated with adverse health outcomes in the general population and in those with diabetes. Little is known about glycemic variability in patients with cancer, especially those with solid tumor malignancies. Glycemic variability is associated with increased infection, shorter periods of remission, and higher mortality in patients with hematological cancer. This body of work describes the concept and measurement of glycemic variability to assess glycemic control in patients …

The Role Of Extracellular Vesicles In Cancer-Related Fatigue And Its Co-Occurring Symptoms, Dilorom M. Sass

Theses & Dissertations

Cancer survivors report many debilitating symptoms associated with cancer and its treatments. About 30% will report long-term cancer-related fatigue (CRF) which often co-occurs with depressive symptoms, sleep disturbances, cognitive fatigue, and poor overall health-related quality of life. The underlying causes of these co-occurring symptoms have been related to systemic processes such as inflammation. Extracellular vesicles (EVs) contain systemic markers such as genetic and protein materials that inform about cell-to-cell interactions that influence immune signaling and inflammatory processing. No study to date has explored the associations of EVs with cancer-related symptoms. So, the purpose of this dissertation was to investigate the …

Examining Depressive Symptoms Over Time In Women With Coronary Heart Disease, Sydney A. Buckland

Theses & Dissertations

Coronary heart disease (CHD) is the number one killer of women in the US. Women also experience roughly twice as much depression as men, and depression in CHD is associated with increased morbidity and mortality. Despite these facts, women continue to be under-represented in CHD research, and results by gender are not routinely reported.

Screening for depression in this population is problematic due to inconsistent inclusion of somatic symptoms on screening instruments and disagreement about appropriate cutoff scores.

This body of work clarifies the concept of depression in women with CHD, presents a systematic review of the longitudinal literature on …

Recent Veterans’ Self-Management Of Health During Military To Civilian Life Transition: A Grounded Theory Study, Narda A. Ligotti

Theses & Dissertations

United States Veterans of combat within Iraq and/or Afghanistan return home to face an array of somatic and psychological health concerns. Little was known about how they manage their health after military discharge. The research question for this study was “how do OIF/OEF/OND combat Veterans and their primary support persons manage Veterans’ health at home?” There is little information about these Veterans’ perspective of self-management of health in the home. This study was designed to provide a theoretical understanding of self-management and family support in this population. The Family Management Style Framework (Knafl, Deatrick & Havill, 2012) was used as …

Early Oral Feeding After Bowel Resection, Jennifer Strang

Theses & Dissertations

Research Focus: The primary purpose of this project was to determine if there was an association of factors with time to first solid meal in gastrointestinal (GI) surgery patients and the impact solid diet has on length of stay (LOS) in the hospital, GI symptoms, and incidence of post-operative ileus (POI). A secondary purpose was to observe and describe when an oral diet was started and the progression of diet after GI surgery.

Research Methods: This study was a cross-sectional, retrospective chart review of a convenience sample in a multi-centered hospital system conducted in 84 GI resection patients …

Self-Efficacy For Symptom Management In Adult Hematopoietic Stem Cell Transplant Patients, Lynn White

Theses & Dissertations

Hematopoietic stem cell transplant (HSCT) is a treatment for hematologic cancers and other hematologic conditions that causes severe treatment-related symptoms. The first 30 days after HSCT, or the acute phase, is when symptoms are most intense. During this time, the ability of patients to manage their symptoms, in collaboration with their health care providers, is crucial to reduce the distress caused by the symptoms. Self-efficacy is the person’s confidence in their ability to perform a behavior, such as symptom management. This body of work describes the concept of self-efficacy for symptom management (SESM), presents an integrated literature review on self-efficacy …

Peer Intervention To Increase Physical Activity Among Working Women, Sheri A. Rowland

Theses & Dissertations

Most Americans do not engage in enough healthy physical activity (PA), with working women particularly at-risk for inactivity. Workplace PA interventions have been effective, however studies using peers as the central theoretical strategy, have not been found. Social cognitive theory and social comparison theory were used to develop a peer-modeling workplace PA intervention. The aims of this experimental, two-group, preliminary study were: 1) assess intervention feasibility, 2) determine the intervention effect on cardiorespiratory fitness (primary outcome), and PA behavior, cardiovascular risk, self-efficacy, motivation, and social comparison, and 3) describe participant perceptions of the intervention using qualitative focus-group data. Female employees …

The Effects Of A Preceptor Coaching Intervention On Use Of Clinical Judgment By New Graduate Nurses, Sue A. Schuelke

Theses & Dissertations

This work attempts to evaluate a preceptor intervention on the development of critical thinking/clinical judgment from the new graduate’s point of view as well as from the preceptor’s point of view. Manuscript 1 is a systematic review of the literature related to preceptor’s interventions and its effect on clinical judgment. Manuscript 2 describes the results of focus group interviews of preceptors and the viewpoint on clinical judgment and related concepts. Results of a pilot study: The effects of a preceptors coaching on new graduates clinical judgement, is reported in Manuscript 3. Each section includes an overview of each manuscript, a …

Nurses’ Perceptions Of Importance And Achievability Of The Ten Attributes Of Health Literate Healthcare Organizations In Their Institutions: A Descriptive Study, Anna Ten Napel

Theses & Dissertations

Health literacy defined is the degree to which individuals have the capacity to obtain process and understand basic health information to make appropriate health decisions (IOM, 2004). To be a health literate consumer, a person must be able to read, listen, understand, and make decisions related to their health. Hospitals seeking to be Health Literate Organizations must have a strong commitment to improving and reengineering to make it easier for patients to navigate, understand and use information and services to take care of their health (IOM, 2013). High quality, safe health care depends on clear communication between patients, families, providers, …

Effects Of Undergraduate Nursing Student-Preceptor Relationship On The Student's Self-Reported Clinical Competence, Self-Esteem, And Readiness To Work As A Registered Nurse (Rn), Gloria N. Otoo

Theses & Dissertations

No abstract provided.

Faith-Based Leaders Caring For Older Adults In A Natural Disaster: A Study Of Hurricane Sandy, Mercy Joseph

Theses & Dissertations

The purpose of this study was to explore how faith-based leaders cared for community-dwelling older adults in a natural disaster. This research focused on Hurricane Sandy, which affected Long Island, New York, in October 2012. The research question was: How do faith-based leaders care for community-dwelling older adults affected by a natural disaster, such as Hurricane Sandy? Natural disasters are often unexpected and can cause disruption, trauma, loss, and devastation of communities. A review of the literature identified that local faith-based leaders have a major role in the recovery process before, during, and after a natural disaster. Community-dwelling older adults …

The Relationship Between New Nurses Who Volunteer And The Caring Behavior New Nurses Exhibit In The Practice Setting, One Year Post Graduation, Nicolette Fiore-Lopez

Theses & Dissertations

Volunteering is engaged in by millions world-wide and nurses comprise a significant portion of those who provide their professional talents, unpaid, to the underserved in local, national and international efforts. Nurses who have engaged in volunteer activities anecdotally describe personally transforming experiences gained through their efforts and for many nurses volunteering becomes part of their professional mandate. Although many social disciplines have studied volunteering, to date there has been a paucity of research on nurses who volunteer. The purpose of this study was to describe the characteristics of novice nurses who volunteer and determine the influence of volunteering and associated …

The Impact Of Technology-Enhanced Learning Activities On Nursing Student Engagement In The Classroom, Alicia A. Stone

Theses & Dissertations

Educating student nurses in the present environment requires professors to stay current with new methodologies as well as innovations in technology. The question is how to address both the impact of technology and the skills of clinical reasoning, and keep the students involved in the material. If there can be integration of each aspect through the use of technology-enhanced learning activities on the internet and preparation to approach the issue, then perhaps this can increase success. This is a quasi-experimental intervention study that explored the impact of a case study blogging assignment on the engagement of students enrolled in a …

The Lived Experience Of Observant Jewish Nursing Students: A Phenomenological Study, Toby Bressler

Theses & Dissertations

Background: With expanding cultural diversity in the United States (U.S. Department of Health and Human Services, 2009), it is essential to increase the diversity of the nursing profession to match the patients who are being cared for in our healthcare system (IOM, 2003; Sullivan Commission, 2004). Despite improvements to the demographic composition of the nursing workforce in recent decades, the nursing workforce has remained predominantly homogeneous and to meet the current and future health needs of the public while providing culturally relevant care, the nursing workforce needs to increase its diversity (IOM, 2010). This demographic shift creates a social imperative …

Determinants Of Patient Activation In Hospitalized Multimorbid Patients, Myra S. Schmaderer

Theses & Dissertations

Post-hospitalization care transition is a vulnerable time for multimorbid patients. Self-management challenges happen due to acute symptoms and complex new treatment plans. Literature suggests higher activated patients have better outcomes; however, there is little research that identifies determinants that predict patient activation in the multimorbid hospitalized patient. Understanding predictive factors will facilitate planning interventions that promote self-management of multimorbid conditions. The purpose of this dissertation was to identify determinants that predict patient activation in patients with multimorbidity at discharge from the hospital.

A descriptive, predictive research study was conducted with 200 hospitalized multimorbid patients discharged to home. Their mean age …

A Grounded Theory Study Of How Parents Made The Decision About Residential Group Home Placement For Their Adult Child With Intellectual/Developmental Disabilities, Laura A. Sardinia-Prager

Theses & Dissertations

Background: The parent caregivers of a child with an Intellectual Disability/Developmental Disability (ID/DD) face lifelong challenges that may at some point involve the decision about residential group home placement of the adult child. In the course of the child’s lifetime, the parents who have provided care may need to consider a safe alternative. The decision about residential group home placement of the adult child can be the result of numerous factors. Objective: The purpose of this qualitative inquiry was to investigate the phenomenon of how the parent caregivers made the decision for residential group home placement for their adult child …

A Descriptive Mixed-Methods Study Examining Resilience And Transitioning To Adulthood Among Emerging Adults With Disabilities, Jennifer E. Mannino

Theses & Dissertations

Transitioning to adulthood is not without challenges. The move away from family influence towards independence and self-determination is filled with uncertainty. As emerging adults (18-29) transition to adulthood they will encounter various challenges related to their new adult roles (Arnett & Tanner, 2005; Jensen & Arnett, 2012). Increased challenges and vulnerabilities in transitioning are evident among emerging adults with disabilities because they face additional challenges related to their disability over and above what all others of this developmental stage experience (Betz & Redcay, 2002; Blomquist, 2007; Faux & Nehring, 2010; King, Baldwin, Currie & Evans, 2005; Murray, 2003; National Research …

A Narrative Analysis Of The Stories Of Mothers Who Have Parented A Child Diagnosed With Hodgkin's Disease And Is Currently In Early Survivorship, Jennifer M. Darcy

Theses & Dissertations

With the growing number of survivors of childhood cancer in the United States, it has been essential for research to look more closely at the challenges these “children” and their families face later in life as they live to adulthood. While much has been written about childhood cancer survivors and their parents independently, there are unique struggles that a mother and a childhood cancer survivor face as a dyad. A diagnosis of cancer falling on one’s child is undoubtedly a life altering event. Examining the dyadic relationship over time offers a unique perspective to understanding the parenting experience with a …