Medicine and Health Sciences Commons^™

Quality Improvement Project: A Comparison Of Daily Routine Chest Radiography Versus Clinically-Indicated Chest Radiography In Preventing Ventilator-Associated Pneumonia In Adult Icu Patients On Ventilators: An Evidenced Based Practice Project, Kimberly Mckenney

Theses and Dissertations

Ventilator-associated pneumonia is one of the critical complications identified by a chest x-ray (CXR). However, there is a controversy about the use of CXRs. Overuse of the CXR has also identified concern among the ICU patient population. The purpose of this evidenced-based practice project was to determine if there were differences in patient outcomes when receiving daily routine CXRs as compared to clinically-indicated CXRs. Patient outcomes measured were: ICU length of stay, complications while on the ventilator and ICU mortality, number of ventilator days, diagnostic efficacy, therapeutic efficacy, costs, and radiation exposure The author identified 30 articles in the search …

The Effects Of Multiple Gratitude Interventions Among Informal Caregivers Of Persons With Dementia And Alzheimer's Disease, Cristy Degregory

Theses and Dissertations

The purpose of this group randomized intervention trial was to examine the impact of participation in three telephone-based gratitude interventions on the physical, psychological and social functioning of participants in caregiver support groups who are unpaid family caregivers of persons with dementia and Alzheimer’s disease. Fredrickson’s (2001) Broaden-and-Build Theory informed the investigation of the effect of three gratitude interventions on participants’ levels of gratitude, positive aspects of caregiving, subjective well-being, physical health and mental health. This was a randomized, wait-list controlled study involving informal caregivers involved in support groups. The research questions were: 1.) How does gratitude contribute to subjective …

Early Screening And Identification Of Preschool Children Affected By Serious Emotional Disorders, Cathy Renee Robey-Williams

Theses and Dissertations

Mental illness has surpassed physical health problems as the leading cause for morbidity and mortality in American children. National prevalence of serious emotional disorders in the 0-5 age group has ranged from 9.5% to 14.2%. Of the 15 million children affected by mental illness, less than 20- 25% receive any treatment. Nationwide, early screening, identification, and treatment of preschoolers with emotional or behavioral disorders have become a critical priority in order to reduce the increasing burden of healthcare costs for mental illness and psychiatric care. The purpose of this study was to test the feasibility of a screening process for …

Use Of Secure Messaging By United States Veterans And Significant Others, Claudia S. Derman

Theses and Dissertations

ABSTRACT

USE OF SECURE MESSAGING BY UNITED STATES VETERANS AND SIGNIFICANT OTHERS

By

Claudia S. Derman

The University of Wisconsin-Milwaukee, 2014

Under the Supervision of Professor Karen H. Morin, PhD, RN, ANEF, FAAN

The purpose of this study was to describe the topics discussed using secure messaging (SM), the pattern of use of SM, and whether the themes discussed and/or the pattern of use varied based on gender and age of the SM user. Secure messaging is an example of a technology that focuses on patient-centered communication. Secure messaging allows patients to communicate with their clinicians using the Internet and …

Exploring The Phenomenon Of Presence In An Online Educational Environment Through The Lived Experiences Of Graduate Nursing Faculty, John G. Rosselli

Theses and Dissertations

In this dissertation, the phenomenon of presence in an online educational environment is explored through the lived experiences of graduate nursing faculty who teach online.

Greater understanding of the phenomenon of presence in online educational environments may lead to better learner-instructor relationships, higher levels of inquiry and critical thinking on the part of faculty and students, and ultimately better student outcomes. Utilizing principles of Hermeneutic Phenomenology and deductive inquiry, and based on the learner-centric Being There for the Online Learner Model, the author conducted in-depth interviews with a purposive sample of 13 graduate nursing faculty members who teach online at …

Best Practices In High Fidelity Patient Simulation To Enhance Higher Order Thinking Skills, Kathryn S. Mock

Theses and Dissertations

Undergraduate nursing education has begun to use very expensive and time intensive high fidelity simulation activities without making full use of the ability to build higher order thinking skills in students. Current research in high fidelity patient simulation has tended to be subjective and focus on critical thinking. However, reflective thinking habits of mind must be in place before full use can be made of critical thinking skills. A comprehensive search of all reflective thinking literature used in conjunction with simulated patient experiences by healthcare students was undertaken. A guideline

was created for nurse faculty to use that outlined current …

Use Of Photobiomodulation In Osteoclast Formation: Possible Intervention For The Treatment Of Osteoporosis, Lisa Lauren Anderson-Antle

Theses and Dissertations

After critically examining the literature to gain a robust understanding for the pathogenesis of bone loss, specifically osteoporosis, the development of a possible new intervention to prevent or treat osteoporosis was explored. The purpose of this dissertation was to pilot test a new protocol designed to answer the broad research question: Does Near-Infrared Light Emitting Diode (NIR-LED) treatment affect Receptor Activator of Nuclear Factor Kappa-B Ligand (RANKL) induced osteoclastogenesis in a cell culture model?

Osteoporosis is defined as a disease characterized by low bone mass and structural deterioration of bone tissue, leading to bone fragility and an increased susceptibility to …

Factors Associated With Parent Depressive Symptoms And Family Quality Of Life In Families With And Without Adolescents And Young Adults With Spina Bifida, Monique M. Ridosh

Theses and Dissertations

The purpose of this study was to explore which context and process factors contribute to parent depressive symptoms (PDS) and family quality of life (FQOL) in families with adolescents/young adults (AYA) with and without spina bifida (SB). Secondary analysis was conducted on data (N = 209) from a multi-site cross-sectional study of adaptation in AYA with SB. Measures included: Behavior Rating Inventory of Executive Function (Behavioral Regulation Index and Metacognition Index), FACES III (Cohesion subscale), Family APGAR, Family Inventory of Resources for Management (Family Mastery and Health subscale), a single-item measure of stress, Beck Depression Inventory (BDI-II) and The FQOL …

Oncology Nurses' Suggestions For Improving Obstacles In End-Of-Life Care, Rosanne Johnson Oliver

Theses and Dissertations

The purpose of this paper was to determine the most important changes needed to improve the quality of end-of-life (EOL) care to terminal cancer patients as perceived by experienced oncology nurses. The study was designed as a cross-sectional survey, sampling 1,000 Oncology Nursing Society members from the United States with experience caring for inpatient cancer patients, who could read English, and had experience in EOL care. Eligible nurses responded to an open-ended item sent to them as part of a mailed questionnaire. Nurses were asked to respond to the following question: “If you had the ability to change just one …

Vaccination Status And Attitudes Of Urban School Employees In Utah, Kim Estella Thompson

Theses and Dissertations

Individuals who work with children are at risk for exposure to vaccine-preventable diseases. School settings can quickly become outbreak centers for communicable infection since school employees are in direct contact with children in confined areas for many hours each day. Therefore, it is important for school employees to be fully vaccinated. There are many reasons school employees may be inadequately vaccinated. One common myth is that adults believe vaccines are only for children. Another reason for inadequate vaccination rates among school employees is that many adults believe vaccinations received during childhood are still effective. Healthcare providers (HCPs) constitute the first …

Distress In Women With Ovarian Cancer, Judith Dellaripa

Theses and Dissertations

Clinicians and researchers know that women experience distress related to the diagnosis of and treatment for ovarian cancer. A review of the literature revealed that while there is interest in the topic, distress is inconsistently defined and measured. Women have been reported to have a variety of distress experiences including the challenges of late diagnosis and the treatment regimen, communication difficulties with healthcare providers, and concern about the effect of their diagnosis on their loved ones. Without information directly from women, assumptions predominate about what the experience is like and what they would find helpful from support persons. Women’s perceptions …

The Affective Domain In Nursing Education: Educators' Perspectives, Linda Darlene Taylor

Theses and Dissertations

Affective learning in nursing education continues to be important in the development of professional values. Affective learning is defined as a type of learning that reaches the emotional and belief system of those who facilitate and participate in it and establishes attitudes and professional values. There is limited exploration of affective learning in nursing education. How educators are facilitating learning in this domain is important to future nursing education practice as it transforms to meet new societal and health care demands. The purpose of this study was to explore the meaning, experience and the act of teaching in the affective …

Treatment Decision Making In African American Women Diagnosed With Advanced Breast Cancer, Dauphne Annette Sims

Theses and Dissertations

ABSTRACT

TREATMENT DECISION MAKING IN AFRICAN AMERICAN WOMEN DIAGNOSED WITH ADVANCED BREAST CANCER

by

Dauphne Annette Sims

When diagnosed with breast cancer African American women have more advanced stage breast disease and encounter disparities throughout the cancer care continuum. The process of making treatment decisions can widen or narrow disparities in health outcomes. The decision making process in African American women may be influenced by several dynamics that influence how treatment decisions are made and have been previously unexplained. Guided by the conceptual framework of Cultural Capital, this grounded theory study explored the treatment decision making process of 12 African …

What Inez Knows: A Qualitative, Longitudinal Case Study Of One Woman's Journey Through The Maze Of Living With Hiv And A Serious Mental Illness, Linda Austin

Theses and Dissertations

WHAT INEZ KNOWS: A QUALITATIVE, LONGITUDINAL CASE STUDY OF ONE WOMAN'S JOURNEY THROUGH THE MAZE OF LIVING WITH HIV AND A SERIOUS MENTAL ILLNESS

by

Linda Austin

The University of Wisconsin-Milwaukee, 2014

Under the Supervision of Professor Patricia E. Stevens

Although more than thirty years have passed since AIDS was first diagnosed in the U. S., the HIV/AIDS epidemic continues and the prevalence and incidence statistics remain alarming. Twenty-five percent of the people living with HIV in the United States are women, but only half of these women are in care and even fewer women (42%) have viral suppression. Women …

The Subjective Well-Being Of Youth Heads Of Households In Rural Southern Malawi, Pamela Fruechting

Theses and Dissertations

Youth-headed households in HIV-endemic sub-Saharan Africa face harsh realities of poverty and loss of parental care. Scientific knowledge of these youth is generally limited to socio-economic and psychological indicators of vulnerability while much less is known about youth-centric meanings of well-being. This is the first known study on the subjective well-being of youth heads of households.

The purpose of this exploratory, youth-centric, qualitative study was to identify experiences of subjective well-being, factors for regulating well-being, and meanings of well-being among youth heads of household in the Thyolo and Chiradzulu districts of rural southern Malawi. The theoretical foundation for this study …

The Influence Of Maternal Contexts On Infant Outcomes, Secondary Analysis Of Wpcr Data 2000-2010, Mary Roseanne Butler

Theses and Dissertations

Congenital heart defects (CHD) are the most prevalent birth defect in the world and occur in approximately 6-8 of every 1,000 live births (Hoffman & Kaplan, 2002). CHD continues to be one of the leading causes of infant morbidity and mortality today. Five to ten percent of all cases of CHD can be attributed to a chromosomal abnormality, 3%-5% are linked to single gene defects, and approximately 2% are a result of known environmental factors (Clark, 2001). With only 10%-15% of the causes of CHD are understood, the remaining 85%-90% of all CHD cases, the etiologies remain unknown. The purpose …

Strategic Flexibility In Not-For-Profit Acute Care Hospitals, Donna Fe Jamieson

Theses and Dissertations

ABSTRACT

STRATEGIC FLEXIBILITY IN NOT-FOR-PROFIT ACUTE CARE HOSPITALS

by

Donna F. M. Jamieson

Despite multiple industry cycles of rapid and complex changes in the last three decades, the body of research in health care services strategy has not addressed the idea of strategic flexibility, that is, when and how should strategy evolve under conditions of environmental turbulence. Strategic flexibility has been defined in the literature as the ability to adapt to rapidly changing conditions by leveraging internal resources and competencies to effectively compete. With increasing scope of responsibility in both nursing and non-nursing functional areas, nurse executives have not only …

Testing Components Of A Self-Management Theory In Adolescents With Type 1 Diabetes Mellitus, Gwen Marie Verchota

Theses and Dissertations

Advances in treatment technology and the importance of obtaining normoglycemia in order to prevent or delay complications associated with Type 1 Diabetes Mellitus (T1DM) has shifted much of the emphasis of diabetes self-management (SM) onto the adolescent and his or her family. The primary responsibility for managing T1DM in childhood is with the parent whereas during adolescence, increasing levels of responsibility for SM are transferred to the adolescent. This study examined the relationships of key context and process variables on proximal (self-management behaviors [SMB]) and distal outcomes (metabolic control and diabetes-specific health-related quality of life [DQOL]) from the Individual and …

Women's Experiences Living With Depression, Susan Marie Jarchow

Theses and Dissertations

In the United States, depression affects many Americans at different levels. Depression among women is a major public health problem. According to the National Alliance on Mental Illness), about 1 in 5 women develop depression at some point in their lives, and are nearly twice as likely as men to have depression. Much of the research about depression in women are quantitative studies aimed mostly at collecting epidemiological or survey data that focus on rates of mental illness, while not taking into account the qualitative subjective and contextual illness perspectives of women living with depression.

The purpose of this study …

Continuous Positive Airway Pressure Use And Mild Obstructive Sleep Apnea Syndrome (Osas), Michelle L. Nelson

Theses and Dissertations

ABSTRACT

CONTINUOUS POSITIVE AIRWAY PRESSURE USE AND MILD OBSTRUCTIVE SLEEP APNEA SYNDROME (OSAS)

by

Michelle L. Nelson

The University of Wisconsin-Milwaukee, 2014

Under the Supervision of Jennifer Doering, PhD, RN

Obstructive sleep apnea syndrome (OSAS) is an increasingly recognized sleep disorder that affects an estimated ten percent of middle-aged women and 25 percent of middle-aged men. Continuous positive airway pressure (CPAP) is the standard treatment for individuals with moderate to severe OSAS. However, it is estimated that 80 percent of individuals with OSAS have a milder form of the disease. The use of CPAP therapy in persons with mild OSAS …

Collegiality, The Nursing Practice Environment, And Missed Nursing Care, Katherine Irene Menard

Theses and Dissertations

The practice environment of nurses has received attention in recent time related to a heightened awareness of the need for improved patient safety and an anticipated return of a nursing shortage. Existing literature has identified the presence and negative outcomes of unhealthy peer relationships among nurses, however; positive peer relationships (collegial) have received little attention in nursing research. This descriptive correlational study used data obtained through online survey methodology to describe the current state of collegiality among staff nurses working in the hospital setting and the relationship collegiality has to the nursing practice environment and missed nursing care.

Collegiality levels …

Relationship Of Mitochondrial Enzymes To Fatigue Intensity And Health-Related Quality Of Life In Men With Prostate Cancer Receiving External Beam Radiation Therapy, Kristin Filler

Theses and Dissertations

Introduction: Cancer-related fatigue is often described by patients as a lack of energy, mental or physical tiredness, diminished endurance, and prolonged recovery after activity. Etiologic mechanisms underlying CRF are not well understood. Methods: A literature review was conducted to examine studies that had investigated the association of mitochondrial dysfunction with fatigue. The major conclusion from this review was that alterations in energy metabolism may contribute to fatigue. Therefore, the dissertation study focused on laboratory techniques for measuring mitochondrial oxidative phosphorylation enzymes (complexes I-V) and a mitochondrial-specific oxidative stress marker (superoxide dismutase 2 [SOD2]). The primary aim of the dissertation research …

Factors Contributing To Infant Feeding Practices With Latina Mothers, Diana Cartagena

Theses and Dissertations

Background: An estimated 9.7% of U.S. infants and toddlers are considered overweight. Hispanic infants persistently show higher prevalence rates for being overweight compared to black and white infants. Little is known about factors promoting excessive infant weight gain in Latinos. Purpose: Primary aim of this study was to describe multidimensional factors and maternal feeding practices that may correlate with infant overfeeding in Latina mothers. A secondary aim was to determine whether there was an association between these factors and infant weight gain. Subjects: Sixty-two low-income immigrant Latina mothers and their infants ages 4-12 months receiving assistance through the Special Supplemental …

The Impact Of The Ohana Mana Challenge On Native Hawaiian And Pacific Islander Children, Kristin Kay Van Tassell

Theses and Dissertations

In this four-week, family-focused pilot intervention study, researchers studied the impact of culturally relevant nutrition and activity sessions on eleven children from eight Native Hawaiian and Pacific Islander (NHPI) families. Mixed methods were used in analysis. In their favorite meal drawings, children included more fruits and vegetables at week four than week one, which was consistent with their self-reported intake of healthy foods that were new to them. From week one to four, mean total scores increased on the nutrition and exercise knowledge exercise questionnaire and the physical activity self-efficacy tool; however, the mean total score decreased on healthy diet …

A School-Based Intervention’S Impact On Children’S Knowledge And Self-Efficacy Related To Physical Activity And Nutrition: A Pilot Study, Katherine Turley Jenkins

Theses and Dissertations

Childhood obesity has become epidemic in the United States. One of the best places to combat this problem is within the school system. The purpose of this study was to examine changes in exercise self-efficacy, science interest, and science knowledge of children who participated in a school-based anatomy and healthy lifestyle intervention called Anatomy Academy. In this pilot study, 212 study participants were recruited from 5th and 6th grade children enrolled in one of three charter schools who participated in our 7-week intervention, Anatomy Academy. Children completed four questionnaires pre and post intervention: (1) a science knowledge questionnaire, (2) a …

Patient Discomfort In The Icu: Ett Movement Effects, Virginia Hamilton

Theses and Dissertations

Critically ill patients who require MV are at risk for a number of complications, including the development of ventilator-associated events (VAE) and agitation that may require the use of sedation. Patients experience anxiety and discomfort during mechanical ventilation from a variety of sources including unfamiliar breathing assistance and an inability to communicate anxiety and pain verbally, but a primary cause of discomfort identified by these patients is the simply the presence of the endotracheal tube (ETT). Discomfort often leads to agitation and may be exacerbated by ETT movement. Management of agitation typically involves the use of sedative therapy and has …

Symptoms, Cytokines, And Quality Of Life Of Patients With Chronic Graft-Versus-Host Disease Following Allogeneic Hematopoietic Stem Cell Transplantation, Debra Kelly

Theses and Dissertations

Introduction: Chronic graft-versus-host disease (cGVHD) is a serious complication following allo-HSCT characterized by immune dysregulation, organ dysfunction, risk for infection, and distressing symptoms. Complications may include scleroderma, hepatic dysfunction and bronchiolitis obliterans. Advances in allo-HSCT for many hematologic dyscrasias (e.g. acute and chronic leukemias, aplastic anemia, and myelodysplastic syndrome) have improved survival which has generated a renewed focus on survivorship issues. Distressing symptoms are noted as negatively impacting quality of life (QoL). The relationship between inflammation and behavioral responses may impact symptoms. Examining patterns and levels of inflammation with symptoms is relevant. Objective: The aims of this study were to …

An Analysis Of Interpreter-Mediated Healthcare Interactions, Robin Dawson Estrada

Theses and Dissertations

The content and quality of communication between nurse practitioners and patients in primary care encounters contributes to diagnostic decision making, the provision of culturally appropriate interventions, and ultimately may impact health outcomes. In caring for patients with limited English proficiency, the addition of language discordance increases the complexity of the interaction and communication processes and the potential for disparate health outcomes. Most prior research on interpreter-mediated healthcare interactions has focused on accuracy, cost, satisfaction, and role enactment, but there is a lack of systematic research examining the actual interaction processes within the context of primary care clinic visits.

The aim …

An Analysis Of The Cause, Effect & Control Of Hyperlipidemia From A Nursing Perspective, Melissa Rodgers

Theses and Dissertations

No abstract provided.

Best Practice For Antipsychotic Medication Management In Community Dwelling Older Adults With Schizophrenia, Estelle Marie Brown

Theses and Dissertations

Schizophrenia, aging, and medication factors combine to present a very complex clinical presentation in caring for the elderly population with schizophrenia. The aging body displays a slowing of physiological processes, which alters the pharmacokinetics and pharmacodynamics of medications prescribed. Multiple comorbid health factors and the medications recommended for treatment may become detrimental to the overall body health, causing more problems for the older individual. This evidence based practice project reviewed literature and evidence to focus on the question, "In community dwelling older adults with schizophrenia, what is best practice for antipsychotic medication management?" The literature search resulted in classifying 16 …