Medicine and Health Sciences Commons^™

Art Therapy Assessment And Sense Of Safety, Sophie C. Restall

Art Therapy | Master's Theses

This study aimed to understand how artmaking experiences during assessment may influence the formation of the therapeutic alliance at the start of therapy. Rather than measuring therapeutic alliance directly, this study identified psychological safety as a vital component of the therapeutic relationship and an important topic of study via literature on attachment theory. Using a mixed-methods, repeated-measures design, this study compared artmaking experiences and feelings of psychological safety in response to two interventions––a Human Figure Drawing (HFD) assessment and an Expressive Therapies Continuum (ETC) assessment. Overall, qualitative data from semi-structured interviews and quantitative data from the Art-Based Intervention (ABI) questionnaire …

Relationships Of Secondary Traumatic Stress, Compassion Fatigue, And Compassion Satisfaction Among Maternity Nurses Caring For Patients Who Succumbed To Maternal Mortality, Debra Joy Mendelson

Theses & Dissertations

Background:

Maternity nurses work where positive outcomes are the norm, leaving them more vulnerable to the adverse effects of dealing with death. Limited data indicate that caring for a maternity patient who dies may result in nurses developing secondary traumatic stress and associated compassion fatigue, which may affect their job performance. Research is warranted to promote a better understanding of nurses’ experiences, especially since the increase in maternal mortality has resulted in more nurses being exposed to maternal death.

Purpose:

The purpose of this study was to explore relationships between secondary traumatic stress, compassion fatigue, and compassion satisfaction of maternity …

Impact Of Tiered Implementation Of Clinical Decision Support System For Acute Kidney Injury And Nephrotoxin Exposure In Cardiac Surgery Patients, Christopher M. Justice Ii

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Nephrotoxin exposure may worsen kidney injury and impair kidney recovery if continued in patients with acute kidney injury (AKI).

Objective: To determine if tiered implementation of a clinical decision support system (CDSS) would reduce nephrotoxin use in cardiac surgery patients with AKI.

Methods: We assessed patients admitted to the cardiac surgery intensive care unit at a tertiary care center from January 2020 to December 2021, and August 2022 to September 2023. A passive electronic AKI alert was activated in Jul 2020, followed by an electronic nephrotoxin alert in March 2023. In this alert, active nephrotoxic medication orders resulted in …

Increasing First-Attempt Endotracheal Intubation Success Rates In The Aeromedical Environment, Jared Copeland

Graduate Theses, Dissertations, and Problem Reports (ETD)

Problem Statement: In 2022, the first-attempt endotracheal intubation success rate of an aeromedical agency had steadily declined and was currently below the international average of 88.48%. This decreased success rate potentially placed patients at risk for adverse events that increase morbidity and mortality. Background: Patients who experience a failed first-attempt intubation are at greater risk of intubation related complications. These complications include hypoxemia episodes, severe arrhythmias, pulmonary aspiration, hypotension episodes, cardiac arrest, and death. Literature Review: Preoxygenation, patient positioning, maintenance of oxygenation, drug selection, and device utilization have been found to increase first-attempt endotracheal success rates. Project Aims: The project …

Improving Patient Self-Advocacy And Communication With Providers Through Diabetes Self-Management Education: Analyses From A Randomized Controlled Trial, Brenna Owens Kirk

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: West Virginia (WV), a rural state in Appalachia, has the highest type 2 diabetes mellitus (T2DM) prevalence in the United States. Open communication in the patient-provider relationship is an integral part of comprehensive chronic disease management. This is especially true for patients living with T2DM, a disease that requires many complex, daily self-management activities and is associated with increased emotional distress. However, patients living with T2DM are often reluctant to openly share their concerns regarding self-care with their provider. This study aimed to test the effectiveness of the Diabetes and Hypertension Self-Management Program (DHSMP), a 12-week group lifestyle …

Implementing A Nurse-Driven Clostridium Difficile Screening Protocol, Sandrela Magnuson

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Background: Clostridium difficile infection (CDI) is a prevalent infection often contracted in hospitals. CDI is also increasingly originating from community settings. In addition to the health risks associated with CDI, diagnosis of a hospital-acquired CDI can have a significant financial impact on hospital systems. When hospital acquired, hospital systems are no longer reimbursed by payers. Secondary to the increasing prevalence of community-acquired CDI, mechanisms for early detection and isolation are warranted.

Local Problem: J.W. Ruby Memorial Hospital has an integrated Clostridium difficile (C. difficile) electronic health record (EHR) screening questionnaire that requires updating to align with current guidelines.

Purpose: …

Developing And Adapting An Art Therapy Mask Creation (Atmc) Intervention For Individuals With Traumatic Brain Injury (Tbi) Across Select Clinical And Non-Clinical Settings, Stephen John Heck

Graduate Theses, Dissertations, and Problem Reports (ETD)

The study aimed to explore the feasibility and adaptation of the Art Therapy Mask Creation (ATMC) technique in select clinical and non-clinical settings for individuals with traumatic brain injuries (TBIs). Utilizing the Consolidated Framework for Implementation Research (CFIR), qualitative interviews were conducted to assess barriers, facilitators, and feasibility of implementing the ATMC. Major findings included the ATMC’s adaptability across diverse settings, the flexibility and accessibility of art therapy as an intervention, and the significance of addressing emotional and psychological needs in individuals with TBIs. These insights contributed to understanding evolving healthcare practices, the role of technology, the importance of human …

Impact Of The Use Of Nutrition Information On Glycemic Control In Adults With Diabetes, Katelyn Richardson

All Master's Theses

The purpose of this study is to examine the association between glycemic control in adults with diabetes and the use of nutrition information (NI). A cross-sectional design evaluated adults with diabetes from the 2009-2010 and 2017-2020 NHANES databases. Use of NI was quantified based on the subject’s use of the Nutrition Facts Label, use of calorie information at restaurants, and use of either the USDA Food Guide Pyramid or My Plate. Glycemic control was established if the subject’s hemoglobin A1C concentration was 7.0% or lower. SAS Software (v. 9.4) was used for all statistical analysis. Differences between prevalences were established …

Impact Of Diet Culture On Disordered Eating Habits In College Students, Laura Vanderlinde Padgett

All Master's Theses

Eating Disorders (ED) impact people worldwide at increasing rates and are a contemporary public health issue in the United States. The purpose of this research was to understand if exposure to Diet Culture impacts disordered eating behaviors in college students. A cross-sectional study was conducted of adults aged 18 and older who were currently enrolled in at least one college-level course during the period of August 2023 to December 2023. Utilizing the platform Qualtrics, an anonymous survey was created and distributed via online and in-person sources. Researchers created 5 survey questions aimed at collecting data on the familiarity and exposure …

An Examination Of Working Memory In Dancers And Non-Dancers, Mason Low

All Master's Theses

The present study examined the behavioral working memory differences between dancers and non-dancers. Previous research has indicated that dance can provide an enhancing effect on working memory, particularly in non-dancers. A Dance History Questionnaire along with the letters backward, digits backward, digits forward, letters forward, and abstract visual subtests of the Test of Learning and Memory II was used to collect data. The current study found that dancers had greater visuospatial memory than non-dancers and that dance experience may have an effect on certain working memory tests such as the letters forward subtest.

Factors Associated With The Prevalence Of Iron Deficiency And Anemia In Women Of Reproductive Age In The U.S.: Nhanes 2015-2020, Catherine Wise

All Master's Theses

Iron deficiency (ID) is well recognized as the most prevalent nutrient insufficiency and a leading cause of anemia. Women of reproductive age (WRA), females 15 to 49, are at an increased risk of ID and anemia. This is due to the heightened iron demands of this life stage, including puberty, menstruation, and pregnancy, which require iron intakes ranging from 15 to 27 mg/day. Poor health and nutrition increase the risk of ID and progression to anemia. Consequences of ID and anemia range from exhaustion and decreased cognitive function to an increased risk of mortality. This study aimed to assess the …

Prenatal Androgen Exposure Reduces Ovarian Function, Marlee Weets

All Master's Theses

Polycystic ovary syndrome (PCOS) is the most common reproductive and endocrine disorder, being the leading cause of infertility for females of reproductive age. The etiology of PCOS is not fully known, although it is hypothesized that there is a genetic, epigenetic, and environmental component to the disease. One of the environmental influences that can cause an abnormal reproductive phenotype similar to PCOS is prenatal exposure to excess androgens (male sex hormones). Previous studies have shown that prenatal exposure to androgens in mice can cause a PCOS-like ovarian phenotype similar to people with PCOS. To examine how prenatal androgen exposure causes …

Bone Stress Injuries, Risk Of Low Energy Availability, Disordered Eating, Menstrual Dysfunction, Training Volume, And Exercise Dependence In Female Trail Runners, Saleen Zarate, Kelly Pritchett, Robert Pritchett, Namrita Kumar Brooke

All Master's Theses

ABSTRACT

BONE STRESS INJURIES, RISK OF LOW ENERGY AVAILABILITY, DISORDERED EATING, MENSTRUAL DYSFUNCTION, TRAINING VOLUME, AND EXERCISE DEPENDENCE IN FEMALE TRAIL RUNNERS

by

Saleen Zarate

June 2024

Problematic LEA can lead to REDs, which results in negative health outcomes such as impaired bone health. Trail runners may engage in a higher volume of training and may be at risk for LEA, MD, DE, and EXD, which may further increase the risk for bone stress injuries. This study aimed to explore and compare the prevalence of self-reported SFs between competitive and recreational female trail runners. Specifically, we aimed to examine risk …

Student Academic Success System, Brandi Castle

Doctor of Nursing Practice Projects

This project aimed to enhance academic success and retention rates in a practical nursing program through the implementation of a Student Academic Success System (SASS), utilizing evidence-based teaching strategies. A quality improvement design using both the Iowa Model of Evidence-Based Practice and the Plan, Do, Study, Act (PDSA) framework was guided by Kolb’s Model. Nurse faculty saw a need for increased student retention among practical nursing students; the student then proposed a plan, translated evidence, created a pre- and post-survey, and carried out SASS with the use of trained nurse faculty coaches. The goal of the project was to reduce …

Impact Of An Education Program On Screening For Non-Alcoholic Fatty Liver Disease In Patients With Type 2 Diabetes, Lauren Rucker

Doctor of Nursing Practice Projects

Type 2 Diabetes Mellitus (T2DM) has the potential for multiple complications which include non-alcoholic fatty liver disease (NAFLD). The American Diabetes Association (ADA) updated its guidelines recommending screening of patients with T2DM for NAFLD (ADA, 2023). Screening is prompted by the increased incidence of NAFLD in patients with T2DM. Approximately 70% of people with T2DM suffer from NAFLD which can progress to hepatic steatosis or non-alcoholic steatohepatitis (NASH) (ADA, 2023). NALFD is a common diagnosis leading to the need for liver transplantation (Alkhouri et al., 2020). This project aims to determine if an education program for primary care providers and …

Lncreasing Clinical Judgment And Critical Thinking Skills Using The Ncsbn Clinical Judgment Measurement Model In Licensed Nursing, Kathryn Roberts

Doctor of Nursing Practice Projects

Licensed nurses are having problems with critical thinking and using clinical judgment when caring for patients (Rogers & Franklin, 2023). There has been increased emphasis on critical thinking and clinical judgment in nursing school curriculum but not in hospital/orientation curriculum (Dickison et al., 2019). This quality improvement project aims to address the gaps in critical thinking and clinical judgment skills among licensed nurses by focusing on integrating the NCSBN-CJM, and cues into the prebriefing of the Respiratory Distress/Oversedation Scenario within the project hospital orientation program. The project utilized a quasi-experimental study design to investigate the cause-and-effect relationship by integrating the …

Comparison Of Platelet-Rich Plasma Injections And Hyaluronic Acid Injections In The Treatment Of Knee Osteoarthritis, Isaac Knutson

Physician Assistant Scholarly Project Papers

Osteoarthritis is one of the most common diseases that people can suffer from in today’s society. This degenerative disease can affect any of the body’s joints, but is most common in the knees, hands and spine. Osteoarthritis occurs when the protective cartilage that covers the ends of bones in joints wears down. This lack of protective cartilage leads to the bones grinding on each other causing loss of range of motion, pain, and limited function. This review studied the effects of two specific treatments for knee osteoarthritis: platelet-rich plasma injections and hyaluronic acid injections. Both of these treatments can be …

Probiotic Therapy For The Treatment And Prevention Of Bacterial Vaginosis, Chelsea Scheil

Physician Assistant Scholarly Project Papers

Bacterial vaginosis (BV) is a common presenting complaint in healthcare, and patients often experience recurrences at a frustrating rate. The mainstay of current treatment is antibiotic therapy, either via oral or vaginal route. When recurrences occur, stronger antibiotics are often employed. This current method of treatment does not address an underlying component that impacts infection recurrence and rate of recurrence- the patient’s baseline vaginal microbiome and the healthy bacteria that support it. To determine the efficacy and safety of probiotic therapy for the treatment of bacterial vaginosis, a literature review was completed using databases PubMed and Embase. The results of …

Advanced Practice Providers In Emergency Medicine, Matthew Kalonick

Physician Assistant Scholarly Project Papers

The emergency department is at the core of healthcare in western medicine. It is commonly the first site of patient contact prior to admission or surgical intervention. Management of admission and discharge from the ED is integral to efficient flow of hospital operation. The critical operation of the ED has long acted as a barrier for the application of advanced practice providers (nurse practitioners and physician assistants) from being heavily utilized in this setting. As healthcare costs, physician shortages, and the acceptance of APPs has increased over time, EDs have increased their utilization of APPs. However, there remains concerns regarding …

Treatment Of Irritable Bowel Syndrome: Tricyclic Antidepressants Versus Diet Modification And Visceral Manipulation, Alexis Int Veldt

Physician Assistant Scholarly Project Papers

Irritable bowel syndrome (IBS) is a disorder of the gut-brain interaction that is a chronic and often debilitating disorder characterized by symptoms of recurrent abdominal pain and disordered defecation, affecting up to 10-12% of adults in North America. The purpose of this study analysis is to compare tricyclic antidepressant (TCA) use to diet modification and visceral manipulation in the treatment of IBS. A literature review was performed using various health science databases such as, PubMed, Google Scholar and ClinicalKey, within a time frame of 20 years. Studies chosen for review were peer reviewed and focused on randomized control trials. Several …

Efficacy Of Platelet Rich Plasma Injections To Combat Chronic Tendinopathies, Rachel Kisse

Physician Assistant Scholarly Project Papers

Tendinopathy is a clinical syndrome marked by persistent localized pain and tendon thickening, stemming from repetitive overuse-induced trauma. This musculoskeletal condition poses diagnostic and management challenges due to its chronic nature. Management entails a multifaceted approach, encompassing activity modification, pain control, and rehabilitative exercise. The pathophysiological shift from inflammation to degeneration highlights the need for changes in comprehensive management strategies in which platelet rich plasma (PRP) injections have gained growing interest with limited literature support for its use in clinical practice. This literature review was performed to inform clinicians about the properties, safety, and efficacy of PRP injections as an …

Premenstrual Dysphoric Disorder/Premenstrual Syndrome Luteal Phase Treatment, Shelby Gawarecki

Physician Assistant Scholarly Project Papers

Many women suffer from PMS/PMDD symptoms that affect their emotional and physical wellbeing. This research aimed to compare luteal phase treatment options for PMS/PMDD, such as SSRIs, progesterone, and sepranolone. The research was conducted using electronic search databases PubMed, Embase, CINHAL, Access Medicine, Cochrane Library, and NaProTECHNOLOGY Creighton Model FertilityCare System. Studies used in this research were found using keyword and MESH search terms. Each reviewed study was peer-reviewed, including randomized control trials or a meta-analysis. Among the treatments analyzed, SSRIs emerged as a consistent primary treatment for symptom alleviation, particularly in addressing cognitive symptoms associated with PMS/PMDD. SSRIs, at …

Chimeric Antigen Receptor T Cell (Car-T) Vs Standard Of Care Therapy For Treatment Of Relapsed Or Refractory Diffuse Large B Cell Lymphoma, Jessica Frenkel

Physician Assistant Scholarly Project Papers

Diffuse large B cell lymphoma is the most common and aggressive subset of non-Hodgkin lymphoma. Approximately 20-50% of patients will either relapse or become refractory to primary chemoimmunotherapy treatment methods and require second line treatment, which consists of aggressive high dose chemotherapy and autologous stem cell transplantation (ASCT). Chimeric antigen T cell receptor (CAR-T) therapy is a novel treatment strategy consisting of autologously derived genetically engineered T cells that has been tested as an alternative method for treatment of aggressive forms of DLBCL. The purpose of this review is to compare the efficacy, safety, and cost effectiveness of standard of …

Multi-Cancer Early Detection Tests Versus Low-Dose Ct In Lung Cancer Screening, Maren Dockter

Physician Assistant Scholarly Project Papers

Lung cancer is responsible for the most cancer-related deaths worldwide (de Koning et a., 2020). While the implementation of low dose CT (LDCT) screening for high-risk individuals has been shown to improve outcomes and reduce mortality by 20%, there is still room for improvement in screening (Reduced Lung-Cancer Mortality with Low-Dose Computed Tomographic Screening,” 2011). Multi-cancer early detection (MCED) tests aim to detect earlystage cancer with the goal of improving treatment outcomes. This technology works by combining plasma analysis for cell-free DNA and methylation patterns with artificial intelligence to detect malignancies and predict tumor origin sites. The purpose of this …

Let’S Move! Benefits Of Exercise Compared To Ssris (Escitalopram) For The Management Of Depression: Research From 2020 And Beyond, Brianna Droessler-Aschliman

Physician Assistant Scholarly Project Papers

The purpose of this literature review is to determine the effectiveness of exercise as either monotherapy or in combination with SSRIs (selective serotonin reuptake inhibitors) for the management of major depressive disorder. Studies gathered for this review came from the following databases: PubMed, SpringerLink, Academic Search Ultimate, Academic Search Complete, and CINAHL. Current research completed between the years 2020-2023 that consisted of either clinical trials, RCTs, or meta-analysis were included. A total of eleven studies were reviewed that addressed either the benefits of exercise, SSRIs, or a combination for the management of depression. Upon completion of the literature review, it …

Treating Rheumatoid Arthritis: Immunosuppression Versus Stem Cell Therapy, Bailee Blickensderfer

Physician Assistant Scholarly Project Papers

methotrexate monotherapy, rheumatoid, arthritis, mesenchymal stem cell transplantation, anti-TNF, CXCL8, CXCL12, CXCL13, umbilical cord mesenchymal stem cell, and adipose tissue mesenchymal stem cell

Sebaceous Carcinoma: A Commitment To A Standard Of Care, Stephany Janice Sophia Dimoulas

Physician Assistant Scholarly Project Papers

Sebaceous carcinomas (SC) have their origin in the sebaceous glands of the dermis and may develop as a result of de novo mutations, from benign sebaceous neoplasms, or as a result of microsatellite instability and loss of mismatch repair gene expression secondary to Muir-Torre Syndrome (MTS). SCs may also arise from the Meibomian glands, the glands of Zeis, or the sebaceous glands of the caruncle if occurring periocularly. Although SCs may occur at any sebaceous gland-containing location, the most common areas of involvement include the periocular, head, and neck regions. Given its capacity for nodal and distal metastasis as well …

Efficacy Of Vitamin D Versus Biological Agents In The Management Of Rheumatoid Arthritis, Kayli Day

Physician Assistant Scholarly Project Papers

Rheumatoid arthritis (RA) is a chronic inflammatory disease leading to joint destruction. There are several treatment options available to patients, including conventional disease modifying antirheumatic drugs (DMARDS) and biological agents, but their efficacies vary per patient and have significant adverse effects and costs associated. There is, however, encouraging evidence to suggest the incorporation of vitamin D in treatment regimens may be a promising option for patients. A comprehensive literature review was conducted using PubMed and CINHAL databases, employing keywords and MeSH terms related to RA treatment options, with the goal to compare efficacy of biological agents and vitamin D in …

Viral Bronchiolitis: High Flow Nasal Cannula Versus Non-Invasive Ventilation Management’S Effect On Length Of Stay, Prevention Of Mechanical Ventilation, And Mortality, Justis Caldwell

Physician Assistant Scholarly Project Papers

Viral bronchitis is a disease process most common in children under two years old. Bronchiolitis is caused by inflammation of the epithelial cell lining of the small airways in the lungs. This causes increased mucus production and inflammation that can cause necrosis of these cells. The inflammation and increased secretions cause an obstruction in the lower airways that results in wheezing. The most common causative pathogen is respiratory syncytial virus, but other common viruses, including adenovirus, human metapneumovirus, influenza, and parainfluenza, can also cause it. A literature review was performed using the electronic search database PubMed. Keyword and mesh terms …

Minimally Invasive Therapies In The Treatment Of Arthropathy, Steven Bateman

Physician Assistant Scholarly Project Papers

It is estimated that 27% of adults over 45 years of age suffer from osteoarthritis of the hip secondary to articular cartilage damage over the lifespan. Joint pain diminishes life quality, limits range of motion and overall activity, and frequently impairs basic ambulation. These functional deficits worsen the progression of comorbidities that are often referred to as lifestylerelated chronic disease as physical activity subsequently declines. This literature review explores the efficacy of minimally invasive therapies that precede and delay surgical intervention in adult patients experiencing functional limitations and pain in major joints. The study examines the effectiveness of various interventions, …