Medicine and Health Sciences Commons^™

Examining The Lived Experience Of Caregivers Learning A Home Program From A Pediatric Occupational Therapist, Michelle Finet

Theses and Dissertations

The purpose of this study was to examine the lived experiences of family caregivers as they learned a home program from an occupational therapist for their child. Gaining information from the caregiver on experiences with patient education may enable therapists to develop an understanding of the needs of caregivers during the educational process that occurs when a therapist is giving the caregiver a home program. Meeting the learning needs of the caregivers may possibly reduce the amount of overall therapy needed by the child. This phenomenological approach sought to answer the following research questions: (a) what are the lived experiences …

Regulatory Mechanisms In Borrelia Burgdorferi-Induced Arthritis, Emily Siebers Hansen

Theses and Dissertations

Lyme arthritis is a common symptom of Lyme borreliosis that involves inflammation of the synovial joints. Elucidating the immune events involved in Lyme arthritis is complicated by the fact that not all individuals infected with B. burgdorferi develop arthritis. Additionally, Lyme arthritis manifests in different severities between affected individuals. It is known that an inflammatory response is initiated by B. burgdorferi infection and that inflammatory T cells contribute to the development of arthritis. However, the anti-inflammatory mechanisms that regulate the pathogenic T cells’ response are not entirely understood. Here, the hypothesis that a dysregulated immune response results in an excessive …

The Influences Of Family Supportive Supervisor Behaviors On The Relationships Among Work-Family Conflict, Stress, And Turnover Intention In Saudi Arabian Registered Nurses, Sitah S. Alshutwi

Theses and Dissertations

Many countries around the world are struggling to maintain adequate number of nurses. Inadequate nurse staffing could compromise the quality of patient care. Among many factors that contribute to RN turnover, the influence of work–family conflict (WFC) has gained little attention. In Saudi Arabia, the turnover rate among Saudi nurses reached 50 % of the total employed nurses. Work-family conflict was found to be a reason that influence Saudi nurses to leave their workplace. In addition, WFC was found to be significantly association with increased turnover intention (TI) among employees. Furthermore, WFC has been linked to a number of negative …

The Utility Of Mobile Phones For Health Among Women Living With Hiv In Urban Malawi, Linda Marie Dietrich

Theses and Dissertations

The use of mobile phones are becoming ubiquitous with growing interest by healthcare providers to utilize mobile phone technology for various health-related applications, called mHealth. This is especially true in low-income countries such as those in sub-Saharan Africa. When implementing mHealth applications, it is important to understand the dynamic social, cultural and environmental factors where mHealth will be implemented to ensure that interventions developed are effective. A qualitative study to explore the sociotechnical factors experienced by women participating in an HIV support group in urban Malawi was conducted to enhance our understanding of women’s experience with mobile phone use and …

The Potential Effect Of Breastfeeding On Maternal Senstivity During The First Year Of Life, Sawsan Hammad Hammad

Theses and Dissertations

Background: Poor maternal sensitivity leads to insecure infant attachment, which has been associated with negative consequences in cognitive and mental health in school-aged children that continue into adulthood. Maternal sensitivity is defined as the mother’s ability to recognize and respond to her infant’s cues consistently and appropriately; it is indicative of the interactions between mothers and their infants, which is characterized by mutual and concurrent interchanges, often referred to as the “mother-infant dance” If the mother is able to accurately recognize her infant’s cues, then she can provide an appropriate and secure foundation to encourage the infant’s exploration, watching over …

Patient-Delivered Partner Therapy: Elicitation Research Using A Mixed-Method Study Design To Support The Development Of A Behavioral Intervention For Sexually Transmitted Infection Clinic Patients, Steven Alan John

Theses and Dissertations

The transmission of sexually transmitted infections (i.e., STIs) remains a preventable public health problem within the United States. Repeatedly acquired STIs are highly prevalent despite efficacious treatment options, and mechanisms to increase partner notification are paramount to decreasing reinfections. One mechanism to accelerate the time to partner treatment, increase partner treatment, reduce repeat infections, and reduce community prevalence of STIs is the use of patient-delivered partner therapy (PDPT). PDPT is the practice of providing patients diagnosed with a bacterial STI medication to give directly to their partner for treatment without requiring the partner to participate in diagnostic testing, screening, or …

The Association Of Nurses’ Assessment And Certainty To Pain Management And Outcomes For Nursing Home Residents In Jordan, Mohammad Jamil Rababa

Theses and Dissertations

Despite advances in dementia care Pain in people with dementia is still under recognized, underestimated, and undertreated because of poor assessment, poor treatment, and factors relating to nurses’ critical thinking and decision-making skills. Unrelieved pain leads to many serious negative health outcomes in people with dementia. The purpose of the study was to examine temporally based relationships between change in behavior, the nurses’ level of certainty regarding pain, assessment scope and outcomes of pain and agitation. Relationship between severity of dementia, comorbid burden, ability to verbally self-report symptoms and patient outcomes of pain and agitation was also investigated.

A Convenient …

Video Modeling To Increase Interaction For Children With Autism Spectrum Disorder In A Museum Setting Using An Application On A Tablet, Bethany Miota Miota

Theses and Dissertations

The purpose of this thesis was to perform an exploratory study to determine if the ScanDo! app intervention is an assistive technology that increases interaction for children with Autism Spectrum Disorder (ASD) in a museum setting. The ScanDo! app intervention presented a video demonstration that modeled the interaction for each learning station by scanning the QR code attached to the station. Using a naturally occurring baseline single-subject design with ABA and reversed ABA phases, two children with ASD and their parents visited the grocery store exhibit at a children’s museum. Observers of the trials and questionnaires completed by parents before …

Type 1 Diabetes: Factors That Affect Youth/Parent Dyads’ Health Related Quality Of Life And Youth Metabolic Control, Joan Pennington Totka

Theses and Dissertations

ABSTRACT

TYPE 1 DIABETES: FACTORS THAT AFFECT YOUTH/PARENT DYADS’ QUALITY OF LIFE AND YOUTH METABOLIC CONTROL

by

Joan Pennington Totka

The University of Wisconsin-Milwaukee, 2016

Under the Supervision of Professor Julia Snethen

Type 1 Diabetes (T1D) is one of the most psychologically and behaviorally demanding of all chronic illnesses for youth (preadolescents and adolescents) with T1D and their primary caregivers. T1D affects one out of every 400 to 600 youth, making it one of the most common chronic conditions in school-aged youth in the United States. Advances in technology and treatment continue; however, more than 80% of youth do not …

A Feasibility Study Of Using Headspace For Mindfulness Among Individuals Undergoing Surgical Repair Of The Rotator Cuff, Hanna Rae Paul

Theses and Dissertations

Mindfulness-based interventions (MBIs) have been found to help reduce psychological distress and pain in chronic musculoskeletal conditions. However, very limited evidence exists determining the impact of mindfulness on psychological distress and pain in acute musculoskeletal conditions including rotator cuff tears. Among individuals undergoing surgical repair of a rotator cuff tear, it is not clear how mindfulness may be combined with usual care, given the requirement of intense training as part of frequently used MBI protocols. The purpose of the present study was to determine if it was feasible to combine Headspace, a mobile application for mindfulness training that can be …

Sensitivity Analysis Of Geometry Changes In The Simulation Of Basilar Aneurysms, Paul Eserkaln

Theses and Dissertations

Computer simulation is a useful tool in the research and treatment of basilar aneurysms. Current technology allows researchers to create 3D models from cerebral vasculature in-vivo, allowing for the investigation of surgical options with minimal risk to the patient. The method used to construct these models overlooks smaller lateral arterial branches which are difficult to discern due to resolution limits of the imaging process. These lateral branches have minimal impact on the overall blood flow through the basilar artery, but they play a significant role in the health of the patient, so it is important to ensure sufficient blood will …

The Transcriptional Effects Of Photobiomodulation In An In Vitro Model Of Diabetic Retinopathy, Hannah Jane Therese Fisher

Theses and Dissertations

Diabetic retinopathy (DR) is the most common complication of diabetes mellitus and a leading cause of blindness. The pathophysiology of DR is complicated, involving inflammation, oxidative stress, retinal vascular proliferation, and vascular degeneration. Symptomatically, the growth and subsequent rupture of vessels within the frame of view leads to the development of vision loss and eventual blindness. Prior to the development of symptoms, oxidative stress involved in DR leads to the activation of the transcription factor, nuclear factor-kB (NF-kB), resulting in the excess production of vascular endothelial growth factor (VEGF) and intracellular adhesion molecule-1 (ICAM-1), proteins involved in vascular development and …

Longitudinal Patient Records: A Re-Examination Of The Possibility, Zeanab Hassan Bassi

Theses and Dissertations

It has long been recognized that the Longitudinal Patient Record (LPR) has been defined as “A life-long incremental process where each clinical encounter is merely an updating of the file” (Gabrieli, 1997) Understanding the health condition of patient longitudinally is very important to the care of the patient. However, it is not clear to what extent a longitudinal patient record is in fact possible, since a true longitudinal patient record would need to include all information for a patient, from cradle to grave, across all healthcare providers and systems, across all corporate or geographic or national boundaries. Compiling or maintaining …

Ipad Application For Pain Assessment In Youths With Developmental Disabilities And Complex Communication Needs, Alyssa Rose Guard

Theses and Dissertations

Aims: Development of a new pain assessment for youths with communication challenges. The Guard-Putzer Pain Assessment Domains (gPAD) for the iPad was designed and tested as a more universally accessible way for youths, ages 7-to-12 years, with a developmental disability (DD) to express their private pain experiences through self-report. Methods: A two-phase process developed the design for an app, created an interactive prototype, and tested its face validity and user interface. This work included a review of current assessments and pain apps as well as completed a survey to obtain descriptive data on clinical practicality of the gPAD. Fifteen occupational …

Essays On Health And Labor Market Practices In The U.S., Mona Khadem Sameni

Theses and Dissertations

This dissertation investigates the link between different aspects of labor market and individuals’ health. The first chapter analyzes the relationship between the use of four different substances and nonstandard work schedules. Using the NLSY97 and applying standard panel techniques as well as survival analyses, I find that contrary to most previous evidence, nonstandard work schedule is not necessarily associated with an increase in substance use, and in the case of drinking and binge drinking such correlation is actually negative. Evidence also suggests that drug prone individuals tend to work more at nonstandard schedules. Results are robust to the specification at …

The Influence Of Transcultural Humility Simulation Development Activities On The Cultural Competence Of Baccalaureate Nursing Students, Teresa Hamilton

Theses and Dissertations

One way to mitigate health disparities in the provision of nursing care and impact social justice with vulnerable populations is the development of cultural competence. Although addressed in nursing curricula, gaps in how to best address cultural competence remain. A study was undertaken to determine whether participation in a researcher-designed intervention, entitled Transcultural Humility Simulation development, based on components of Campinha-Bacote’s model with an emphasis on “becoming” culturally competent, improved cultural competence in graduating baccalaureate nursing students. A longitudinal, descriptive, quasi-experimental, pretest-posttest comparison group design using embedded mixed methods was used. A total of 57 student participants from one baccalaureate …

Point Of Use Biosand Filters Of The Rural Dominican Republic, Kurtis Quamme

Theses and Dissertations

The point of use biosand filter (BSF) is used globally as a drinking water treatment solution. In this research, point of use BSFs were inoculated with active biosand from the Linnwood Drinking Water Treatment plant slow sand filter beds (Milwaukee, Wisconsin) and with sands collected from point of use filters operating in the Dominican Republic. These filters were maintained with varying source waters (surface water, groundwater, or tap water to simulate chlorination encountered in the field). The microbial community of filters with varied influents and biosand inoculum were analyzed quantitatively by sequencing and qPCR. Filter efficacy and microbial community were …

Exploring Proximal And Distal Psychosocial Stressors Influencing The Health Outcomes Of Urban American Indians In The Midwest, Alina Aloma

Theses and Dissertations

Researchers have theorized that colonization and forced assimilation of American Indians/Alaska Natives (AI/AN) in the U.S. are associated with the current health outcomes of AI/AN groups. The literature has begun to link a number of negative health outcomes such as chronic illnesses, substance abuse, grief, depression, and anxiety with distal stressors associated with historical loss, as well as with proximal stressors that are continued reminders of historical trauma such as present day discrimination. The present study utilized a quantitative methodology along with a community informed framework through collaboration with multiple urban AI/AN-serving agencies in a metropolitan area of the Midwest …

Barriers To Nurses’ Promoting Mobility In Hospitalized Older Adults, Gordana Dermody

Theses and Dissertations

Objectives: To examine the association between nurses’ knowledge, attitude and external barriers and the nurse’s mobility-promoting behavior. Nurse perception of the priority organizations place on mobility, and the relationship of nurses’ level of experience to nurse prioritization for promoting mobility was also investigated.

Design: Cross-sectional, descriptive, correlation study with convenience sampling.

Setting: Two community-based hospitals in the Pacific Northwest of the U.S.

Participants: Eighty-five nurses caring for 98 inpatients 65 and older.

Measurement: Nurses’ knowledge, attitude and external barriers were examined with a validated 5-point Likert Scale. Patient-related and other clinical barriers and the nurses mobility-promoting behavior was obtained with …

Survey Of Assessing Pain In Clinical Practice And Applicability Of A New Assessment, Michelle Rose Konz

Theses and Dissertations

ABSTRACT

SURVEY OF ASSESSING PAIN IN CLINICAL PRACTICE AND APPLICABILITY OF A

NEW ASSESSMENT

by

Michelle Konz

The University of Wisconsin-Milwaukee, 2016

Under the Supervision of Professor Joyce Engel, PhD

Aims The purpose of this study is to identify pain assessments that are being used to measure an individual’s pain experience and to discover how occupational therapists are currently assessing pain in youths who have complex communication needs with a developmental disability (DD). Methods Phase 1: A literature review was conducted through the use of electronic databases to research 17 different methods of pain assessment to create descriptive charts to …

Translating Modified Ashworth Scale Into Functional Measures And Quantitative Kinematic Values: A Pilot Study, Patrick Frigge

Theses and Dissertations

TRANSLATING MODIFIED ASHWORTH SCALE INTO FUNCTIONAL MEASURES AND QUANTITATIVE KINEMATIC VALUES: A PILOT STUDY

by

Patrick D. Frigge

The University of Wisconsin-Milwaukee, 2016

Under the Supervision of Professor Ying-Chih Wang, PhD

Introduction: Spasticity is a motor disorder characterized by a velocity-dependent increase in tonic stretch reflexes. The gold standard for assessing spasticity in stroke patients is the Modified Ashworth Scale (MAS), but the scale is highly subjective to the clinician’s opinion and previous experience and lacks psychometric fidelity. Numerous studies have criticized the scale’s subjectivity and lack of rater reliability. Development of a quantitative spasticity device in routine clinical care …

Using A Database Of Typical Speakers To Describe The Expository Language Skills Of Children With Language Impairment, Joanna Carol Zwerlein

Theses and Dissertations

Purpose. This study examined the expository language skills of older students with language impairment (LI) in relation to a large database of typically developing (TD) students. The purpose of the study was to investigate whether comparing language samples to the database allowed users to distinguish between adolescents with LI and those with typical language, and develop individual profiles of relative strengths and weaknesses in children with LI.

Methods. School speech-language pathologists elicited expository language samples from high school students with LI (N = 9; mean age = 16;8 [years;months]) by asking them to explain how to play their favorite game …

Perspectives Of Stuttering Treatment: Parents, Children, And Adolescents, Heather Darlene Salvo

Theses and Dissertations

ABSTRACT

Perspectives of Stuttering Treatment:

Parents, Children, and Adolescents

By Heather D. Salvo

The University of Wisconsin-Milwaukee August 2016

Under the Supervision of Carol H. Seery

Department of Communication Sciences and Disorders

Purpose. The main purpose of this study was to investigate whether age affects the perspectives of children (ages 8-12), adolescents (ages 13-17), and parents related to stuttering treatment experiences and outcomes. A secondary purpose of this study was to investigate whether the perspectives of children and adolescents regarding stuttering treatment experiences and outcome preferences differed from the perspective of their parents.

Participants. Participants required internet access and minors …

Is The Therapeutic Alliance Associated With And Predictive Of Treatment Retention And Outcome Among Latinos?: A Secondary Analysis Of An Rct Of Behavioral Activation For Latinos With Depression Versus Treatment-As-Usual, Maria Magdalena Santos

Theses and Dissertations

A robust association between the therapeutic alliance and various forms of psychotherapy outcome has been demonstrated. The therapist-client alliance has been shown to be associated with and predictive of dropout and depression symptom change with primarily U.S. White samples. The current study examines whether the alliance is associated with retention, as measured by dropout and session attendance, and depression change in a sample of low-income Spanish-speaking Latinos in the U.S. who received Behavioral Activation for Latinos (BAL) with depression or treatment-as-usual (TAU). Given the proposition that BA treatment fosters the alliance systematically throughout treatment, and that usual treatment was not …

Essays On Two Implications Of The Affordable Care Act (Aca), Esmaeil Salem

Theses and Dissertations

ESSAYS ON TWO IMPLICATIONS

OF THE AFFORDABLE CARE ACT (ACA)

by

Esmaeil Salem

The University of Wisconsin-Milwaukee, 2016

Under the Supervision of Professor Scott J. Adams

The main objective of my dissertation is to investigate some of the causal effects of the Affordable Care Act (ACA) on U.S. healthcare system. After an overview about some of the new provisions enacted by the ACA and their components and timelines, effects of the ACA on immunization coverage for children under age of three and its impact on retention of the insureds receiving newly established rebates would be assessed.

Chapter 2 evaluates changes …

A Brief Rational Disputation Exercise Enhances Cardiovascular, Anxiety, And Affective Recovery Following Worry-Recall, Michelle Rosalie Di Paolo

Theses and Dissertations

Rational Emotive Behavior Therapy (REBT) (Ellis, 1958), educates a client on the relationship between one’s irrational beliefs (IBs) and the dysfunctional emotional/behavioral consequences of maintaining those beliefs such as symptoms of anxiety, depression, and sleep dysfunction (Ellis, Gordan, Neenan, & Palmer, 1997), symptoms also commonly correlated with high trait perseverative cognition (PC; Verkuil, Brosschot, de Beurs, & Thayer, 2009). In addition to symptoms of anxiety and depression, high levels of PC, a construct comprised of measures of trait worry and rumination, have been linked to acute cardiovascular (CV) health concerns that overtime when left unmitigated may lead to chronic conditions …

The Influence Of Perceived Same-Status Nurse-To-Nurse Coworker Exchange Relationships, Quality Of Care Provided, Overall Nurse Job Satisfaction, And Organizational Commitment On Intent To Stay And Job Search Behavior Of Nurses In The Acute Care Nurse Work Environment, Madonna M. Kubichka

Theses and Dissertations

ABSTRACT

THE INFLUENCE OF PERCEIVED SAME-STATUS NURSE-TO-NURSE COWORKER EXCHANGE RELATIONSHIPS, QUALITY OF CARE PROVIDED, OVERALL NURSE JOB SATISFACTION, AND ORGANIZATIONAL COMMITMENT ON INTENT TO STAY AND JOB SEARCH BEHAVIOR OF NURSES IN THE ACUTE CARE NURSE WORK ENVIRONMENT

by

Madonna M. Kubichka

The University of Wisconsin-Milwaukee, 2016

Under the Supervision of Dr. Karen Morin

The nurse turnover rate continues to rise; currently 17.2%. The challenges of the acute care environment are multifaceted and contribute to nurse turnover. Stressful working conditions may contribute to negative relationships among colleagues; subsequently quality of care can suffer, as well as, job satisfaction and nurse …

Rn Perceptions Of Coworker Incivility And Collective Efficacy As Influential To Hospital Structures And Outcomes, Jessica Grace Smith

Theses and Dissertations

Background: An aging population and retiring workforce might affect United States health delivery care and could threaten the quality of care in hospitals. Nurses, as the largest profession in healthcare, can buffer these effects if supported in a safe nurse work environment. The purpose of this dissertation was to understand how peer-to-peer registered nurse workplace incivility as a mediator, and collective efficacy as a moderator, influence relationships among hospital structures (i.e. nurse manager leadership and staffing) and hospital outcomes (i.e. missed nursing care and patient safety cultures).

Methods: Donabedian’s (1980) structure-process-outcomes conceptual framework was the theoretical basis for this study. …

A Phenomenographical Study On The Perceived Factors Affecting Certified Registered Nurse Anesthetist Role Transition, Andy John Tracy

Theses and Dissertations

The role transition from student registered nurse anesthetist (SRNA) to certified registered nurse anesthetist (CRNA) can be challenging and stressful. A qualitative phenomenographical research approach was utilized to identify the factors affecting CRNA role transition. Online recruitment and interviewing techniques were utilized to sample recently graduated CRNAs in order to identify these factors. Five factors were found promoting CRNA role transition: mastery of self-efficacy and confidence, expert coaching and guidance, supportive work environment, peer support, and previous experience. Four factors were also found impeding CRNA role transition: practice limitations, lack of orientation and preceptor, hostile work environment, and decreased work …

Barriers And Facilitators To Completion Of An Undergraduate Nursing Program: Exploration Of Mindfulness, Mindlessness, And Retention Among Ethnic Minorities, Amber Faye Young-Brice

Theses and Dissertations

As the United States population continues to grow and diversify, so too must the nursing workforce in order to meet the challenging healthcare needs of a diversifying population. Currently the nursing profession is overwhelmingly White, with only 25% of registered nurses identifying as ethnic minority (Robert Wood Johnson Foundation (RWJF), 2016). Research suggests that a diverse nursing workforce benefits many segments of the population, where better care is provided because the nurse reflects the ethnic or racial background of their patient (Glazer, Clark, & Bankston, 2015; RWJF, 2016). In order to continue to diversify the nursing profession, a pipeline of …