Medicine and Health Sciences Commons^™

Implementing A Standardized Protocol For Early Detection Of Undiagnosed Hypertension Patients, Jenscena Hansen, Chris Bell

Doctor of Nursing Practice Projects: College of Nursing

Introduction: Hypertension is a preventable disease that frequently goes unrecognized and undertreated. Early diagnosis can prevent further comorbidities such as heart disease, stroke, and chronic kidney disease. Implementation of this protocol aims to decrease the number of patients with undiagnosed hypertension and increase the identification of patients with elevated blood pressure who did not have a pre-existing diagnosis of hypertension. The goal of implementing a standardized protocol would help eliminate the number of patients who go undiagnosed.

Methods: This quality improvement design had clinical staff flag patients with elevated blood pressure. Identified patients without a diagnosis of hypertension were educated …

Effects Of An Educational Evidence-Based Website To Improve Breast Health Knowledge And Self-Efficacy Of Breast Self-Examination: Interim Analysis, Mackenzie Koch, Jennifer Cera, Brooke Hancock, Elizabeth Graham

Doctor of Nursing Practice Projects: College of Nursing

Purpose and Aims

Breast disease, whether benign or malignant, encompasses a wide array of diagnoses. Breast self- examination (BSE) is a simple screening assessment that improves early recognition and diagnosis. With changes in the 2021 ACOG practice guidelines from mandatory to optional provider-performed clinical breast examinations (CBE), it is imperative for patients to possess basic breast health knowledge and accurate BSE techniques. Current standard patient education is provided via brochures or pamphlets. An educational multimedia website was created using ACOG guidelines to impart knowledge and demonstrate proper BSE techniques. Aims were to evaluate changes in participant’s (1) breast health knowledge …

Zine-Making As An Expressive Arts Therapy Method In An Adult Psychiatric Inpatient Hospital, Lauren Classe

Expressive Therapies Capstone Theses

Zines are handmade versions of magazines with themes embracing art, music, politics, and social issues, offering individuals a platform to reclaim their narratives and connect with others. This paper explores zine-making as an expressive arts therapy method and its potential to foster individual and community expression within the inpatient psychiatric setting. The psychiatric care system is an often chaotic and even oppressive environment for the patients it serves, with a history of stigmatization that drives underfunding, understaffing, and an over-reliance on the biomedical model. By engaging in therapeutic zine-making, individuals in psychiatric care have the opportunity to explore their emotions, …

The Impact Of Aging On Fibroblast Gene Expression In Post-Extraction Wound Healing: A Single-Cell Rna Sequencing Study, Paula Christina Cohen Schlemmer

Theses & Dissertations

Wound healing is slower in aged patients. Immediately after tooth extraction, fibroblasts are activated to rebuild the ECM, which is later remodeled through the expression of MMPs. Gene expression may be altered in fibroblasts of aged patients leading to deficiencies in ECM deposition and the recruitment and proliferation of immune cells, resulting in a slow-healing fibrotic wound.

Using scRNA-seq, soft tissue was profiled from two healthy patients: one young and one aged at the time of tooth extraction. Two weeks post-extraction, a second soft tissue sample was harvested. Differentially expressed genes were used to identify enriched pathways for each …

Serum Antibodies To Periodontal Pathogens And Anti-Malondialdehyde-Acetaldehyde: Potential Role In The Interrelationship Between The Periodontium And Rheumatoid Arthritis, Joyce Lee

Theses & Dissertations

Objectives: Study 1 – To quantify associations between anti-Porphyromonas gingivalis, anti-Prevotella intermedia, and anti-Fusobacterium nucleatum serum antibody concentrations and risk of developing rheumatoid arthritis (RA). Study 2 – To test if periodontal clinical measures, alveolar bone loss (ABL), and the aforementioned serum anti-bacterial antibody concentrations are associated with anti-malondialdehyde-acetaldehyde (MAA) serum antibody concentrations.

Methods: Study 1 – Serum samples pre- and post- RA diagnosis (n=214 cases, 210 matched controls) from the U.S. Department of Defense Serum Repository were utilized to compare timing of elevations of anti-bacterial antibody concentrations relative to RA diagnosis and associations …

Reduction Of Hospital-Acquired Pressure Injuries In The Acute Care Setting, Bailey Rasmussen, Taylor Bacon, Andrew Gross

Doctor of Nursing Practice Projects: College of Nursing

Background: Hospital-acquired pressure injuries (HAPIs) have been a longstanding problem in hospitals nationwide. HAPIs cause significant financial strain to a healthcare system and complications can be devastating to the patient.

Purpose: The purpose of this project was to implement the Standard Pressure Injury Prevention Protocol (SPIPP) 2.0 Checklist for patients in the Intensive Care Unit (ICU). The primary aim of this study was to determine if implementing the checklist would reduce the number of HAPIs.

Methods: This project took place over a four-week period at a Midwest hospital in the ICU. Data were collected via patient chart …

The Role Of Acculturation In The Professional Identity Of Art Therapy And Counseling International Students, Ana Marcela Tobar Chavez

Art Therapy Counseling Final Research Projects

In a country of immigrants, the concept of acculturation needs to be familiar to almost any professional in the mental health field and it is a reality for immigrants and international students. As international and immigrant students continue to join the Art Therapy Counseling profession, it is important to understand how acculturation plays a role in the development of their counseling professional identity. Unlike most master’s students in the art therapy counseling profession, international and immigrant students go through unique experiences such as being born and raised in a different country with difference in cultures, languages, and immigration statuses that …

The Relationship Between Eating Disorders, Attachment Styles And The Uses Of Art Materials, Tsai-Yu Chen

Art Therapy Counseling Final Research Projects

Previous studies showed that both eating disorder (ED) behaviors and attachment styles (ASs) could reflect on individuals’ uses of art materials. This mixed methods study aimed to explore the correlation between ED diagnoses and ASs, investigate clients’ selection of and familiarity with art materials, as well as understand how clients’ self-reports of media interactions match clinical observations. Participants were adults receiving residential care in an ED facility in Midwestern United States. Data were collected through surveys, chart reviews, and discussions with the participants’ therapist. The results of this study found a high prevalence (85%) of insecure attachment in the population. …

Art Therapists’ Familiarity With And Beliefs About Twelve-Step Addiction Recovery Groups, David Brickhouse

Art Therapy Counseling Final Research Projects

This research proposed to study what art therapists know and believe about twelve-step addiction recovery groups such as Alcoholics Anonymous (AA), Narcotics Anonymous (NA), and Cocaine Anonymous (CA). The aim was to better understand the field’s familiarity with 12-step recovery, identify misconceptions about 12-step groups, and assess the comfortability of incorporating 12-step philosophy into clinical practice. Findings include that art therapists integrate 12-step into art making, are likely to refer clients to 12-step groups, and that higher familiarity with 12-step was associated with more positive perceptions and greater integration with clinical practice. The study participants also agreed that accessibility was …

Communication Beyond Words, Anna Brough

Art Therapy Counseling Final Research Projects

This research explores the definition and use of nonverbal communication within the therapeutic setting and the treatment of selective mutism by clinical providers. A phenomenological research method was used to interview three art therapists and two therapists without art therapy training. These interviews were used to explore their understanding and awareness of nonverbal communication within the context of providing treatment to clients with selective mutism. The analysis of participants’ discussions of their experiences of treating those with selective mutism revealed four major themes: Nonverbal Communication, Therapeutic Presence and Alliance, Art Materials and Interventions, and Culture and Society. Findings suggest no …

Understanding Clay And Its Media Properties Through The Expressive Therapies Continuum, Anne Geisz

Art Therapy Counseling Final Research Projects

For centuries, clay has been used by civilizations to hold food, memories, and records of history. To this day, it is used by engineers, hobbyists, artists, art therapists and many more. This art based, heuristic study explores clay through the researcher’s ongoing practice with the material, within the framework of the Expressive Therapies Continuum (ETC) and examines how its unique media properties make it such a versatile material for both ceramic artists and art therapists. Results exhibit these unique media properties and clay’s ability to reach all levels of the ETC through collected data of images, journals, critiques, and notes. …

Melting Premenstrual Dysphoric Disorder/ Premenstrual Exacerbation Symptoms With Metalsmithing: A Group Process, Maureen Bella Russo

Art Therapy Counseling Final Research Projects

People experiencing Premenstrual Dysphoric Disorder/Premenstrual Exacerbation, PMDD/PME, frequently live with debilitating symptoms that can arrest their daily life functions (Barker-Smith, 2020). Finding art to process and transform painful emotions that align with PMDD/PME hormonal depression/anxiety, may assist in supporting people to keep choosing life, especially when these art practices involve group settings and community artmaking (Phillips & Rosal, 1989; Robb, 2022). Metalsmithing requires significant cognitive awareness and promotes mind/body connections in its elemental art form (Carlson, 2015). This proposal outlines a group process involving 8-12 people who will receive a beginner’s metalsmithing, 12-week studio art program at Hyde Park Arts …

Psychological Experiences Of Medical-Surgical Nurses Who Cared For Covid-19 Patients., Cecilia Dapilah

Walden Dissertations and Doctoral Studies

: The outbreak of COVID-19 caused unparalleled pressure that brought healthcare facilities and healthcare staff to their knees across the globe, causing multiple deaths and economic despondency. Several studies have documented the effects of COVID-19 on healthcare workers and facilities, but none have addressed the problem from the psychological perspectives of medical-surgical nurses, especially in developing countries. This study explored the psychological experiences of medical-surgical nurses who cared for COVID-19 patients in developing countries. The theoretical foundation that informed this study was the Schachter-Singer’s theory of emotions. A descriptive qualitative design used purposeful sampling to interview 10 medical-surgical nurses. Their …

Examining Patient Preferences And Perceptions Of Provider Communication Strategies For Variant Reclassification In Hereditary Cancer Genetic Testing, Mitchell Mcelfresh, Katie Hutto, Gwen Reiser, Bronson Riley, Charlie King

Capstones: Genetic Counseling

Genetic testing plays a role in oncology care by providing insight into patient’s cancer risk and guiding medical management. Variants in genes are classified by their potential to cause disease according to the five-tier system recommended by the American College of Medical Genetics (ACMG). Reclassification of variants is fluid and can lead to both changes in medical management and challenging discussions. Previous research has described methods genetic counselors use for recontacting patients about reclassification, but not whether these methods align with patient preferences. This study employed a mixed methods survey for patients in Nebraska (recruited via flyer and mail) and …

Improving Initial Management Of Acute Musculoskeletal Pain In The Emergency Department, Cynthia Y. Norris

Cohort XII

Background/Problem Statement: Acute musculoskeletal pain is one of the major chief complaints amongst Emergency Department (ED) visits each year. In the United States, approximately 41.9 million annual ED visits are musculoskeletal pain related (Fontánez, et al., 2021). Yet, data statistics demonstrate at least 40% of patients reported their pain remained unchanged during their presentation to an ED (Bussey et al., 2020).

Aims/Methods: At University Medical Center, site of the quality improvement project, a total of 91,455 ED annual visits were reported in the latest data reports (El Paso County Hospital District 2022 Annual Report, 2022). This paper chronicles the implementation …

Second Victim Syndrome: Nurses Suffering In Silence, Matthew Riehm

Dissertations

Medication errors are inherent in health care due to human fallibility and inherent systemic complexities. Nurses are often unjustly blamed after committing a medication error despite the multitude of contributing factors. Formal education and healthcare organizations focus on preventing medication errors, but little has been done to support nurses involved in these tragic incidents. Recent cases, including RaDonda Vaught and Kimberly Hiatt, demonstrated the victimization of nurses after committing medication errors that plague the healthcare system potentially causing profound psychological trauma, often known as Second Victim Syndrome, SVS. There is limited research on the phenomenon of SVS in nursing due …

Impact Of Social Determinants Of Health On Skill Of Involvement: Differences In First Year Adn And Bsn Nursing Students In Rural Oklahoma, Cynthia Brown

Dissertations

The impact of Social Determinants of Health (SDOH) on Skill of Involvement (SOI) has not been adequately studied in nursing education. The skill of involvement is defined by Benner (2022) as necessary to expert-level nursing and it brings humanity, meaningfulness, acute situational awareness, and rapid thinking required for strong clinical decision-making in crisis management of the deteriorating patient. It is important for nurse educators to understand how SDOH impacts SOI on nursing students in order to transform the delivery of nursing education. The purpose of this study was to determine the impact of SDOH on SOIs in first-year nursing students …

The Association Between Emotional Intelligence, Empathy, And Social Determinants Of Health Among Accelerated Bachelor Of Science In Nursing Students: A Multi-State Cross-Sectional Descriptive Study, Kwanza Thomas

Dissertations

This study investigated the association between emotional intelligence (managing and understanding), empathy, and social determinants of health (SDOH) among accelerated Bachelor of Science in Nursing (ABSN) students. Despite the exponential increase in ABSN programs in the United States, little is known about the association between these variables among this nursing student population. A cross-sectional, correlational descriptive design was used to survey 104 students completing ABSN programs in Georgia, Mississippi, Philadelphia, and Texas. Participants self-reported their socioeconomic and programmatic characteristics using a researcher-developed questionnaire. Emotional intelligence (managing and understanding) was measured using two instruments, including the Situational Test of Emotional Management …

Effects Of Doctoral Program Education On Cardiovascular And General Health Outcomes Of Physical Therapy Students, Luzarianna Galindo, Laramie Tesillo, Carlos Quintana

DPT Capstones

No abstract provided.

Using Cognitive Dual-Task To Evaluate Individuals With Mild Traumatic Brain Injuries: A Pilot Study, Michelle Galvan, Maryam Buazza, Jacob Mendoza, Jallycia Pearson

DPT Capstones

Background: Traumatic Brain Injury (TBI) presents significant challenges, with cognitive and motor deficits often persisting long after the initial injury. Current assessment methods may fail to detect subtle impairments, highlighting the need for more comprehensive evaluation techniques. This pilot study aims to investigate the efficacy of cognitive dual-task assessments in detecting subtle gait deficits associated with concussion/mild Traumatic Brain Injury (c/mTBI), with a focus on identifying which cognitive dual task would provide the most cognitive cost and afford motion capture sensors the ability to detect subtle gait changes.

Methods: Twenty-two participants without prior concussion or mTBI history underwent dual-task assessments …

Using Motivational Interviewing To Increase Cpap Compliance, Karen Padilla Sanchez

Cohort XII

Background: Obstructive sleep apnea (OSA) affects one billion adults worldwide. Untreated OSA increases the risk of cardiovascular morbidity and mortality (Watach et al.,2021). OSA cost the United States approximately $149 billion dollars per year, with more than half of patients requiring continuous use of a positive airway pressure machine (CPAP) for treatment (Watach et al.,2021). Individuals’ beliefs and perceptions regarding OSA impact CPAP compliance. Motivational Interviewing is an evidenced-based approach to change behaviors and improve patient outcomes (Crosby et al.,2022). A 10-day practice assessment log at Sonno Sleep Center identified (n= 51 of 105) patients lacked adherence of 70% in …

The Relationship Between Social Cognition And Team Cohesion In Collegiate Athletes, Jessica Pegg

Master's Theses

Thesis Abstract

Purpose: This study aimed to investigate the relationship between social cognition and team cohesion in Division III collegiate athletes. Methods: A total of 103 athletes from SUNY Cortland participated. Two questionnaires were used: social cognition was assessed via the Tromsø Social Intelligence Scale (TSIS), and team cohesion was assessed via the Group Environment Questionnaire (GEQ). The two questionnaires, along with demographics, were completed online. Analysis: Pearson’s bivariate correlations were analyzed to assess the relationships among TSIS total score, GEQ total score, and GEQ social cohesion for the total sample and separately by sports season and sports type. Linear …

Addressing Equitable Access In A Safety-Net Hospital System: An Implementation Framework, Hillary Alycon

Dissertations: Doctor of Public Health

Acute care organizations face a significant challenge in effectively implementing health equity programs, particularly in rural areas where guidance is often lacking. Despite abundant literature focusing on health outcomes, there remains a noticeable dearth of published data on implementing health equity initiatives. In response to this gap, I present a comprehensive analysis that utilizes readily available, open-sourced data to address this critical issue.

A thorough assessment of the demographic characteristics of acute care facilities within the catchment regions was conducted based on data from reputable sources such as the US Census Bureau, the American Community Survey, and the County Health …

Restorative Yoga To Increase Mindfulness And Reduce Anxiety And Burnout Of Inpatient Mental Health Workers: A Quality Improvement Project, Rachaele Warden

Doctor of Nursing Practice Papers

Background/Significance: Burnout syndrome negatively impacts healthcare systems via quality reduction of patient care and communication, increased medical errors, hospital-acquired infections, staffing shortages, and costly malpractice suits (De Hert, 2020). The characteristic exhaustion, cynicism, job detachment, feelings of inadequacy and incompetence that emerge from burnout further hinder individual mental health and wellbeing.

Purpose: The purpose of the restorative yoga intervention strives to reduce employee anxiety, burnout and enhance mindfulness-based practice strategies within a local inpatient mental health hospital.

Methods: Quality improvement project with evidence-based interventions.

Interventions: The project intends to hold one instructor-guided and one video-guided 25-minute restorative yoga weekly session …

Comparing The Social Skills Of Male And Female Children With Autism Using Facesay, Elijah Williams, Kimberly Frazier, Cynthia A. Watson

Rehabilitation, Human Resources and Communication Disorders Undergraduate Honors Theses

This study examined the pre- and post-test performance on the Social Skills Improvement Scale (SSiS) Student Forms between groups of male and female children (n=6) with autism spectrum disorder (ASD) aged 6–13 years following 10 sessions of 15-minute engagements with the FaceSay computer program. Between the group of males with ASD and the group of females with ASD, there was no significant difference in the compared difference of scores for the Social Skills Scale between the male group (M=6.3333, SD=28.72862) and the female group (M=4.3333, SD=6.80686); t(4)=-0.117, p=0.912 following independent t-test analysis. Also, between these groups, there was no significant …

Effect Of Music On Executive Functioning In Children, Abigail Grace Dame

Communication Science and Disorders Honors Theses

The present study investigates the impact of music listening and singing on sustained attention in typically developing school-aged children. Participants (N=12) were randomly assigned to one of three conditions: music listening, singing, or paced speech, during which they focused on a predetermined keyword presented in two musical pieces. In the listening condition, participants raised their hands when they heard or said the keyword. In the paced speech and singing conditions, the children omitted only that target word while speaking or singing the other lyrics. We measured baseline inhibition and executive functioning (Stroop Color Word test) and attention (Sustained Attention Response …

Enhancing Speech Production And Emotional Well-Being In People With Non-Fluent Aphasia: Insights From Musical Language Training, Luke Meyer

Communication Science and Disorders Honors Theses

Aphasia, often resulting from stroke, head injury, or other conditions like tumors or diseases, impacts both expression and comprehension of language, written and spoken. This study explores the potential of music in aiding individuals with non-fluent aphasia. The researchers examined if pairing linguistic phrases with a musical structure affects the speech production of individuals with non-fluent aphasia. The researchers gathered a language sample and mood ratings before and after music and speech conditions. The participants’ utterances were longer after undergoing the music condition than the speech condition. The results show that the participants exhibited greater improvement in speech production after …

The Relationship Between Electronic Media And Hearing Loss On Language Development: A Pilot Study, Sarah Marie Mahnesmith

Communication Science and Disorders Honors Theses

Researchers agree that one of the methods by which infants learn spoken language through caregivers’ use of infant directed speech. However, the quantity and quality of language during caregiver-infant interactions may decrease in the presence of electronic media, and media may not only limit language input but create a more complex listening situation for children with sensorineural hearing loss (SNHL). The purpose of this study was to explore the relationship between electronic media exposure in the homes of children with SNHL, as compared to peers with normal hearing (NH), and later language skills. This study will provide novel information on …

Looking Beyond The Fracture: Initiating An Osteoporotic Fracture Liaison Service, Gabriela A. Hildenbrand

Cohort XII

Background/Problem Statement: Osteoporosis, known as the “silent disease,” has been estimated to cause 9 million fragility fractures worldwide, resulting in an osteoporosis fracture every 3 seconds (Pennestrì et al., 2019). Fragility fractures are projected to exceed $25.3 billion US dollars by 2025 (Barton et al., 2021).

Aims/Methods: This paper describes the implementation of an evidence-based practice DNP project using the Plan-Do-Study-Act (PDSA) method at the Texas Tech University Health Sciences Center El Paso Orthopedic Surgery and Rehabilitation Department. The aim of this project is to implement a fracture liaison service (FLS) to help close the post-fracture treatment gap.

Results/Interventions: This …

Tailoring Treatment Approaches With Supplemental Screening: Homeostatic Model Assessment Of Insulin Resistance (Homa-Ir) In An Obese Population, Christine Ruvaclaba

Cohort XII

Background: This quality improvement project, conducted in the Texas-Mexico border region with high obesity rates, aimed to explore the utility of the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) as a screening tool for insulin resistance (IR) among overweight and obese individuals. The study focused on patients with a Body Mass Index (BMI) greater than 25 who exhibited normal blood sugar levels or Hemoglobin A1c (HbA1c) levels less than 5.7%.

Aim/Methods: The aim is to identify early intervention strategies for metabolic disorders, particularly in obese populations. Obesity is often the precursor to comorbid conditions such as diabetes and cardiovascular disease. …