Medicine and Health Sciences Commons^™

Living With Hypertension: Experiences Of Black Men Related To Their Perceptions Of The Clinical Encounter At Diagnosis, Glenda Mccartney Feild

Doctoral Dissertations

Introduction: In the U.S., hypertension (HTN) is the most common primary diagnosis and HTN related illnesses are the number one cause of death. Being a member of the Black population increases the risk for developing HTN. Black males are reported to develop HTN earlier in life and have a high incidence of undiagnosed, untreated, and uncontrolled HTN. Sociocultural and gender barriers influence this population’s perceptions of medical experiences, which affects their participation in health-promoting behaviors such as eating a healthy diet, engaging in regular physical activity, avoiding tobacco, limiting alcohol consumption, and decreasing stress.

Purpose: The purpose of this study …

"I Saved The Iguana": A Mixed Methods Study Examining Responder Mental Health After Major Disasters And Humanitarian Relief Events, Suzanne Marie Boswell

Doctoral Dissertations

The purpose of this mixed methods study was twofold. The first was to use Hobfoll’s (1989) Conservation of Resources theory to predict psychological stress based on responders’ perceptions of resource adequacy. The second was to use qualitative interviewing to gain a more comprehensive understanding of the disaster/humanitarian responder experience.

The study is significant given the expanding role of nurses within disaster/humanitarian response organizations. Furthermore, psychological stress results in increased turnover of human resources in these organizations. This turnover is detrimental to humanitarian systems that already lack adequate coverage and sufficiency because funding and human/material resources grow at a slower pace …

Protecting The Skin Of Older Adults Through Surveillance And Pressure Ulcer Prevention Beginning In Emergency Services, Jennifer L. Zoeteman

Doctoral Dissertations

ED (emergency department) personnel are admitting to inpatient services increasing numbers of elderly clients who are at risk for skin breakdown. The ED environment is designed for short term care in response to emergent situations. Pressure related injuries originating in the ED lead to both physical suffering and financial burdens. Pressure relief strategies have been actively employed on an inpatient basis without translation to the ED environment. Evidence for best practice in PUP (pressure ulcer prevention) in the ED is not widely embraced. Prevention of PUs is primarily within the scope of nursing practice and amenable to improvements in the …

Perceptions Of Residential Elders Following Facilitated Advance Care Planning, Teresa M. Boersma

Doctoral Dissertations

The purpose of this project was to explore the perceptions of residential elders following a facilitated advance care planning (ACP) conversation. While literature is available regarding ACP and advance directives (ADs), there is minimal knowledge of first hand experiences from those who complete ACP and live in a residential or retirement community. Five residents of a retirement community who participated in facilitated ACP conversations also participated in a focus group interview to explore their perceptions of facilitators of and barriers to ACP and completing an AD. The interview was audio recorded and transcribed verbatim. Then the transcript was reviewed for …

An Evidence-Based Evaluation Of Medication Barcode Scanning Acceptance In A Community Hospital, Marie M. Vanderkooi

Doctoral Dissertations

Barcode scanning during medication administration is a powerful tool to prevent errors and support patient safety. In spite of the significant patient safety benefits, there is a lack of adoption and acceptance of barcode scanning. The purpose of this project was to implement an evidence-based assessment, utilizing a survey instrument based on the technology acceptance model, to understand adoption and acceptance of barcode scanning at a community hospital. Forty-four people, 38 nurses and 8 respiratory therapists, participated in the survey. Data analyses were performed using descriptive statistics, Kruskal-Wallis, Mann-Whitney U, and Spearman's rho tests. The subscales for the intention to …

The Effectiveness Of A Psychoeducational Intervention On Health Promoting Behaviors And Physical Health Of Adult Patients (18 And Over) On Antipsychotic Medications, Alice O. Mwanda

Doctoral Dissertations

Individuals on antipsychotic medications have been found to be disproportionately affected by overweight and obesity which increases their cardiometabolic risk. Psychoeducation has been found to be an effective strategy for risk reduction of cardiometabolic risks. This intervention examined the effectiveness of a psychoeducational intervention in adults (aged 18 and above) with severe mental illness. The four session, 8 week intervention encouraged an increase in fruit and vegetable intake and engagement in physical activity. The conceptual frameworks included the Health Promotion Model and Chronic Care Model. Outcome measures included nutrition, physical activity and health promoting behaviors. Biological outcomes included weight, BMI, …

The Influence Of Supportive Nursing Leadership In Staff Nurse Retention, Theresa L. Dawson

Doctoral Dissertations

Based on the increasing need to retain healthcare’s greatest assets, work environments must provide positive relationships and RN empowerment in an effort to improve staff nurse retention. A variety of factors can influence a registered nurse’s intent to stay, however supportive nursing leadership is thought to have the greatest impact on improving work environments resulting in greater job satisfaction. The purpose of this organizational assessment was to determine the current culture of supportive nursing leadership, RN perceptions of supervisory support, and themes that appeared to require nursing leadership development intervention. Based on these findings a series of leadership development workshops …

Primary Care Assessment And Interventions To Improve Physical Activity Among Insufficiently Active Adults Ages 18 Through 64 Years Old, Thomas A. Sanchez

Doctoral Dissertations

A number of chronic and debilitating conditions such as cardiovascular disease, stroke, hypertension, anxiety, depression, pain, osteoporosis, and falls are known to be delayed, improved, or prevented by increasing physical activity (PA) levels. The numbers of those affected form a substantial portion of the US population. As of 2011, for example, 26 million adults in the U.S. were diagnosed with diabetes mellitus (DM) alone. Another 79 million people had elevated blood glucose measurements putting them at risk for DM. Despite knowledge of the connection with chronic disease, PA levels are not consistently and quantitatively assessed during primary care office visits. …

Enhancing Communication, Satisfaction, And Self Efficacy In High-Risk Prenatal Women Using ‘Ask Me 3’, Cynthia A. Betterly

Doctoral Dissertations

Despite the recent advances in health care related to the patient-centered medical home, meaningful use, and the Affordable Care Act, the health care system has failed the vast number of patients who do not understand basic health information providers or educational materials designed to communicate to them. For the purpose of this project, low health literacy is framed as a barrier to patient and provider communication. Unfortunately, low health literacy often leads to adverse outcomes. These poor outcomes make improving health literacy a priority by acknowledging and evaluating health literacy interventions. The purpose of this project is to evaluate the …

Use Of The Cope Intervention For Depressed Adolescents, Lindsey R. Jelsma

Doctoral Dissertations

Depression disorders often present during adolescence. Depression can lead to difficulties with relationships, problems in school, and associated high risk behaviors. The goal is to identify and treat depression as soon as possible. The purpose of this project is to implement a cognitive– behavioral based intervention called Creating Opportunities for Personal Empowerment (COPE) to depressed adolescents. Previously, the COPE program has been implemented in outpatient and school settings. This intervention was implemented to adolescents in an inpatient psychiatric hospital. Effectiveness, acceptability, and feasibility were evaluated.

Twenty-five adolescents, majority female, ages 12-18 participated in this project. The participants completed all seven …

School-Based Nurse Managed Health Centers, Sylvia J. Simons

Doctoral Dissertations

School-based health centers (SBHCs) are a directed approach for providing health services to students who may otherwise lack them. Over the past 40 years, the number of SBHCs has olved from targeting public health concerns to the development of a specific collaborative model of care that is responsive to the unique needs of children. The purpose of this project was to develop a sustainable model for the creation and implementation of a school-based nurse-managed health center (SB-NMHC) with the capacity to improve health access and quality, and to reduce cost, while also mitigating present and future health disparities within a …

Relational Coordination: The Perception And Experiences Of Student Nurses And Nursing Faculty In A Hospital Setting, Clare Lamontagne

Doctoral Dissertations

The purpose of this study was to describe and measure student nurses’ and nursing faculty experiences and perceptions of relational coordination during their most recent clinical experience in a hospital setting. The complexity of healthcare settings in the United States necessitates a coordinated approach to patient care in order to meet the divergent needs of its citizens. Healthcare students and professionals need to be prepared to work collaboratively and communicate proficiently and effectively. The theory of relational coordination states that, in a well-functioning organization, members of the healthcare team engage in frequent, timely, accurate, and problem-solving communication and have high …

A Preliminary Model Of Dignity Management In Hospice, Qiaohong Guo

Doctoral Dissertations

This study aims to develop a preliminary model of dignity management (MDM) in hospice describing the social process used by the interdisciplinary team to support the dignity of the patient-family unit in hospice. A qualitative, grounded theory methodology was used to achieve this goal. Research samples, including dying patients, their families and hospice staff, were recruited from a residential hospice in North Amherst, Massachusetts. Data collection methods included interview, observation, and document review. Symbolic interactionism and pragmatism provided the philosophical basis for this study. Thematic analysis was used to explore the definitions of dignity; and grounded theory analytic techniques for …

Needs Of Patient’S Families In The Hospital Tele-Intensive Care Unit, Mary L. Jahrsdoerfer

Doctoral Dissertations

Purpose: To explore, identify and describe the perceptions of family members of a patient admitted to a telemedicine intensive care unit (tele-ICU); and to determine if these needs differ from those established by the Critical Care Family Needs Inventory (CCFNI) in the traditional ICU setting. Background: The tele-ICU is a new care modality in which offsite nurses provide consultation to bedside clinical staff at geographically-dispersed ICUs. The last decade demonstrates a growing existence of tele-ICU’s in our healthcare culture. ’Information’, ‘close proximity’, ‘assurance’, ‘support’ and ‘comfort’ have been identified as the top five needs of family members in the traditional …

Exploring Perceptions Of Staff Registered Nurse Preceptors For Undergraduate, Pre-Licensure Nursing Students, Katherine C. Hall

Doctoral Dissertations

Staff nurses are increasingly called upon to accept more responsibilities and roles in addition to provider of patient care, including that of preceptor. Aside from dealing with demands of high acuity patients, working long hours with inadequate staffing, and carrying heavy workloads, nurses may view teaching and supervising students as an additional burden, time-consuming, and not part of their role. The purpose of this dissertation was to explore staff nurse experiences as preceptors to undergraduate, pre-licensure nursing students. Emphasis was placed on exploring RN’s perceptions of the role, specifically the preparation for, support in, and understanding of what the role …

Using A Mental Health Board Game Intervention To Reduce Mental Illness Stigma Among Nursing Students, Anna Kristina Wassink

Doctoral Dissertations

Mental illness stigma can be displayed by anyone including those working in the health care field. Bachelor of Science in Nursing (BSN) students are one group within the health care field. The purpose of this project is to explore attitude change among BSN students related to mental illness stigma. The question guiding this project is whether a creative game implemented in conjunction with the existing educational and clinical experiences is helpful in reducing mental illness stigma in BSN students. Thirty-eight participants, 5 males and 33 females, a majority of whom were 20-21 years old, participated in this project. The intervention …

Discovery Of The Meanings, Expressions, And Practices Related To Malaria Care Among The Maasai, Cecily Weller Strang

Doctoral Dissertations

Each year, malaria invades and infects 300 million persons, kills up to 1 million, and 90% of deaths are among children in Sub-Saharan Africa. Malaria illness and deaths cost Africa $12 billion in lost productivity. Eighty percent of all malaria cases occur in 17 African countries; one is Kenya, where one group suffers incessantly from malaria, the Maasai. Their pastoral, indigenous lifestyle places the Maasai men, women, and children daily at malaria risk. Although malaria is preventable and treatable, high mortality and morbidity occurrence continues. Global interest in malaria care includes prevention, treatment, and eradication. The current use of generic …

An Evidence-Based Approach For The Implementation Of An Osteoporosis Educational And Exercise Intervention Among Perimenopausal Women, Joanne Maura Cecile Finazzi

Doctoral Dissertations

According to the osteoporosis criteria developed by the World Health Organization, 10 million individuals residing in the United States are estimated to have osteoporosis, and 8 million of these individuals are women (National Osteoporosis Foundation [NOF], 2009). Educational and exercise interventions (Bohaty, Rocole, Wehling, & Waltman, 2008) have been developed in an effort to prevent osteoporosis. However, medical record reviews reveal that only 18% of patients receive counseling regarding osteoporosis educational interventions and exercise preventive measures during health care visits (Lee, Zuckerman, & Weiss, 2002).

The purpose of the pilot study was to examine the effectiveness of a 4-week, 4- …