Medicine and Health Sciences Commons^™

Conceptual Metaphor In The Health Care Culture, Cheryl D. Glennon Dnsc, Ms, Rn

Dissertations

The conceptual metaphor has meaning only when understood within the cultural framework which gives rise to the conceptualization. The purpose of this study was to investigate the interaction of cognition (conceptual metaphor) and culture as manifest during intercultural communication in teaching-learning sessions between health care providers and patients. An ethnography of communication (Hymes, 1974; Saville-Troike, 1989) was the method employed to investigate the use of metaphor by patients, nurses and other health care professionals. Patients were viewed as a sojourner group in the health care culture; nurses and their health care partners were seen as a host group. Data were …

Yale Nurse: Yale School Of Nursing Newsletter, September 1998, Yale University School Of Nursing

Yale School of Nursing Alumni Newsletters and Magazines

This issue features the celebration of the School's 75th anniversary and the start of the Dean appointment for Catherine L. Gillis DNSc, RN, FAAN

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Mid-Atlantic Ethics Committee Newsletter, Summer 1998

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.

The Relationship Of Self-Esteem, Learned Resourcefulness And Social Support To Health-Related Quality Of Life In Long-Term Cancer Survivors, Leli W. Pedro Dnsc, Ms, Rnc, Ocn

Dissertations

Increased survival and advances in oncology research demand that health professionals attend to the gap in knowledge regarding health-related quality of life (HRQL) variables associated with the unique sequelae of cancer in the long-term (LT) cancer survivor. Research in this area may direct the development of effective interventions to increase the HRQL of LT cancer survivors. The study's purpose was to describe the relationships between self-esteem, learned resourcefulness, and social support to HRQL as well as their predictive value to HRQL for LT cancer survivors. A quantitative, descriptive, correlational, and noninterventional design was used to describe the relationship of self-esteem, …

Relationships Between Posttraumatic Stress, Acculturation, And Maternal Sensitivity In Vietnamese And Hmong Mothers, Gwendolyn F. Foss Dnsc

Dissertations

The purposes of this study were to determine if posttraumatic stress (PTS), depression, and anxiety occurred in a community sample of Vietnamese and Hmong mothers and to describe relationships between PTS, depression, anxiety, acculturation and maternal sensitivity. Transition theory (Bridges, 1980), and a conceptual model of parenting in immigrant populations building on Belsky's (1984) work, provided the theoretical framework (Foss, 1996). The sample was divided evenly between Vietnamese and Hmong participants. Ages ranged from 17–43 years, time lived in the United States ranged from 3–21 years, and education ranged from no formal education to completion of college. Maternal sensitivity was …

Being Alone: The Experience Of Elderly Homebound Females, Sharon Davis Burt Dnsc, Msn, Rn

Dissertations

Elderly women comprise one of the fastest growing segments of the population in the United States. This growth is due in large part to increasing longevity, and a woman's life expectancy has now reached 79 years. However, along with those added years comes an increase in morbidity and a greater likelihood of living alone. This study describes the life experience of a specific group of elderly women, those who are homebound and living alone. When elderly women are included in research, the same combination of descriptors used for the participants in this study has not been incorporated. Consequently, while much …

Testing A Theoretical Model Of Critical Thinking And Cognitive Development, Jane Rapps Dnsc, Ms, Msed, Rn

Dissertations

The goal of nursing education is to educate individuals in such a way that they become self-determining, independent thinkers who are prepared to keep pace with the rapidly changing demands of today's health care system. Nurses must utilize critical thought and reasoned action in clinical practice in order to render state of the art health care for individuals, families, groups, and communities. The purpose of this study was to test a proposed theoretical model of critical thinking and cognitive development. Perry's theory of adult cognitive development and Kataoka-Yahiro and Saylor's Critical Thinking Model for Nursing Judgment guided this research. Data …

The Experience Of Decision-Making Among Telephone Advice/Triage Nurses, Ann Mayo Dnsc, Msn, Rn

Dissertations

The role of the telephone advice/triage nurse is both complex and demanding. All decisions are made while assessing patients without seeing or touching patients. In addition, the role is often developed to decrease health care costs which can be perceived by nurses as being in conflict with their nursing beliefs. The ambiguous nature of the role makes these nurses' daily experiences with decision-making a challenge. Using a phenomenological method, the lived experience of decision-making among telephone advice/triage nurses was explored by conducting multiple interviews with ten nurses. The internal structure of the lived experience was identified through the philosophical perspective …

Major Trauma Outcomes: At What Cost? And For Whom? A Cost-Effectiveness Analysis, A. Elaine Bond Dnsc, Msn, Aprn, Ccrn

Dissertations

The purpose of this triangulated descriptive study was threefold: (a) to identify the financial costs for acute trauma care, including costs for those who die early in treatment, and who pays those costs; (b) to identify the relationship between costs and severity of injury; and (c) to identify survivor functional and psychosocial costs, or quality of life, not only by current health care outcome criteria, but also from patients' and families' perspectives. Retrospective review determined the financial differences (total charges of $9,945,973 and institutional costs of $7,089,962) for 370 patients' severity of injury and functional outcomes at discharge, using the …

The Journey Through Perspective Transformation: Learning Nursing Theory, Judith R. Heggie Dnsc, Ms, Rn

Dissertations

Through the use of grounded theory, educational methods most useful for nurses to achieve a perspective transformation, as exemplified by learning nursing theory were examined. Perspective transformation is a theory originally developed by Mezirow (1978) in a study of older women returning to college for additional education. Mezirow defined perspective transformation as the alteration or change of meaning perspectives. Perspective transformation in an individual can be compared to a paradigm change within a scientific community. Within the nursing literature on perspective transformation, most articles related to the perspective transformation needed for nurses to learn to use nursing theory as the …

Mid-Atlantic Ethics Committee Newsletter, Spring 1998

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.

Yale Nurse: Yale School Of Nursing Newsletter, April 1998, Yale University School Of Nursing

Yale School of Nursing Alumni Newsletters and Magazines

This issue includes part two of a two-part series, Graduate Entry Program in Nursing (GEPN): A Twenty-Year History.

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Oncolog, Volume 43, Number 03, March 1998, Sunita Patterson, Don Norwood, Alison Ruffin, Linda White Hilton Rn, Bsn, Faan

OncoLog MD Anderson's Report to Physicians (All issues) Archives

• Promising radio frequency treatment: new option for patients with unresectable liver tumors
• Nurse practitioners go beyond traditional nursing boundaries
• International patient center offers help, haven to patients far from home
• House Call: Old Friends, New Context: When Someone Close Has Cancer
• Protocols: Trials Open to Patients with Biliary Tract Hepatocellular Carcinoma
• DiaLog: Searching for Opportunity? First Look for Disaster by Linda White Hilton, RN, MSN, FAAN, Director, Clinical Cancer Prevention Programs

History Of The United States Air Force Nurse Corps, 1949-1954, Sharon A. Vairo Dnsc

Dissertations

The Air Force Nurse Corps (AFNC) was established effective July 1, 1949, however, no history of the AFNC has been written. The purpose of this investigation was to examine the first five years of the AFNC when its initial framework, policies, and practices were established. Included in this period was the story of the AFNC response to its first great challenge of the Korean War beginning just before the corps first anniversary. The study framework consists of the four themes of (1) dedication to serve, protect, and care for soldier patients; (2) slow advance in status; (3) need for adequate …

Ethnographic Inquiry Of Social Support Throughout Women's Labor And Childbirth Experiences, Nancy Jane Pinder Saks Dnsc, Msn, Rn

Dissertations

The purpose of this study was to explore the phenomenon of social support throughout labor and childbirth in order to develop descriptive theory based on the behaviors of the labor and childbirth convoy. Utilizing ethnographic methodology, five women and their support convoys were observed throughout the women's labor and childbirth experience. Word processing and the ETHNOGRAPH software were used for data management, and constant comparative coding methodology was employed for data analysis. Affirmative, affective and aid-giving behaviors were enacted by all convoy members. Consistently, social support was found to be communicated to the laboring woman by her lay supporters by …

Union Wages, Rents, And Skills In Health Care Labor Markets, Barry T. Hirsch, Edward J. Schumacher

Health Care Administration Faculty Research

We examine the effect of unions on the earnings of health care workers, with emphasis on the measurement and sources of union wage premiums. Using data constructed from the 1973 though 1994 Current Population Surveys, standard union premium estimates are found to be substantially lower among workers in health care than in other sectors of the economy, and to be smaller among higher skill than among lower skill occupational groups. Longitudinal analysis of workers switching union status, which controls for worker-specific skills, indicates a small impact of unions on earnings within both high and low skilled health care occupations. Evidence …

Rural Palliative Care Nursing: A Modified Grounded Theory Study, Ruth Mcconigley

Theses: Doctorates and Masters

This paper presents the findings of a study of rural palliative care nurses in Western Australia. The numbers of rural centres in Western Australia offering palliative care services are increasing; however at present there is little empirical data available about the roles of the nurses involved. This study was undertaken to begin to correct this deficit. The study examines basic social processes associated with the role of rural palliative care nurses and identities issues that affect the nurses’ professional practice. A modified grounded theory approach was used to form a conceptual framework that describes rural palliative care nursing. Theoretical sampling …

Predicting The Severity Of Radiation Skin Reactions In Women With Breast Cancer, Davina Porock

Theses: Doctorates and Masters

Skin reactions are unavoidable side effects of radiotherapy for breast cancer that may limit the amount of treatment a patient is able to receive. As well, the discomfort associated with the treatment may negatively affect the patient's quality of life and their willingness to complete a course of treatment that typically extends over seven weeks. Prior literature suggests that variations in patients' tissue reactions to radiation may be related to Individual patient characteristics. Before health care providers can intervene to prevent or minimise skin reactions, a clinical model that helps predict which patients will experience more skin reactions is needed. …

Mid-Atlantic Ethics Committee Newsletter, Fall-Winter 1997

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.

Nurses Alumni Association Bulletin, Fall 1997, Betty Piersol, Elizabeth K. Prisnock, Marian E. Smith, Margaret Summers, Sue Henrie-Strup, Maureen Mcvail

Nursing Alumni Bulletins

1997-1998 Meeting Dates Calendar

1998 Annual Luncheon-Meeting Notice

Officers and Committee Chairs

Bulletin Publication Committee

1997-1998 Meeting Dates Calendar

The President's Message

Treasurer's Report

Trivia and News About Our Graduates

Highlights of 1997

Keeping Kids Healthy After Hours

Scholarship Funds At Work

Tribute to Tanya

Medical Mission Outreach 1996

History Of The Jefferson Pin

Facts Not Fiction

Rib Ticklers

Mama Will Protect Me

Happy Birthday

Fiftieth Anniversary

Resume of Minutes of Alumni Association Meetings

Alumni Office News

Committee Reports

• Bulletin
• By-Laws
• Development
• Diploma School of Nursing Alumni Association-Mabel C. Prevost Scholarship Fund
• Nominating
• Relief Fund
• Satellite
• Social
• Scholarship

Luncheon Photos …

An Evaluation Of The Efficacy Of Selected Nonpharmacologic Pain Interventions In Infants, Cindy Smith Greenberg Dnsc, Ms, Rn, Cpnp

Dissertations

Infants subjected to painful stimuli respond with deleterious physiologic and metabolic effects, behavioral changes, and potentially long term effects on painful stimuli processing and response. There are few studies that address effective pain interventions for infants, particularly those interventions that staff nurses can implement independently. Interventions must be identified and their effectiveness must be validated for this vulnerable population. Pharmacologic management of pain may cause deleterious side effects and needs to be ordered by physicians or nurse practitioners. Nonpharmacologic methods to manage pain can usually be implemented by staff nurses independently. This study evaluated the efficacy of two nonpharmacologic pain …

The Lived Experience Of Women Prior To Hospitalization For Acute Myocardial Infarction, Llamae R. Hughes Dnsc

Dissertations

Recent research indicates that the majority of women underestimate their risk of developing coronary artery disease (CAD). CAD claims the lives of more women than all forms of cancer; however, women have not received the symptom recognition or treatment that has been accorded to men with CAD. Review of literature indicated a lack of research regarding the experiences of women with acute myocardial infarction (AMI). This phenomenological study explored the lived experience of women with AMI immediately prior to hospitalization. The lines of inquiry focused on descriptive language regarding pre-event feelings, the symptoms experienced at AMI onset, their response to …

A Phenomenological Inquiry Of Nurse Transition To Family-Centered Perinatal Nursing, Paula Kaye Lilja Dnsc, Msn, Rn

Dissertations

The purpose of this phenomenological study was to obtain a better understanding of how nurses caring for perinatal patients and their families view their clinical practice role after experiencing the transition from traditional maternity care to family-centered perinatal nursing. The volunteer participants in the study were 13 female registered nurses employed on a family-centered perinatal unit in one of four hospital settings. The researcher conducted unstructured interviews with the participants and analyzed the qualitative data. The history of the transition and the context in which the family-centered perinatal nursing model was being practiced are presented. Two major features of the …

Compensating Differentials And Unmeasured Ability In The Labor Market For Nurses: Why Do Hospitals Pay More?, Edward J. Schumacher, Barry T. Hirsch

Health Care Administration Faculty Research

Registered nurses (RNs) employed in hospitals realize a large wage advantage relative to RNs employed elsewhere. Cross-sectional estimates indicate a hospital RN wage advantage of roughly 20%. This paper examines possible sources of the hospital premium, a topic of some interest given the current shifting of medical care out of hospitals. Longitudinal analysis of Current Population Survey data for 1979-94 suggests that a third to a half of the advantage is due to unmeasured worker ability, and the authors conclude that the remainder of the advantage probably reflects compensating differentials for hospital disamenities. Supporting these conclusions is evidence that hospital …

Role Expectation Of Chief Nurse Executive Officers In Integrated Healthcare Systems Located In Highly Managed Care Markets, Daniel L. Gross Dnsc

Dissertations

The healthcare industry is undergoing radical transformation. Healthcare's transformation is characterized by new patterns of organization, alliance, management, administration, and governance. Traditional fee-for-service reimbursement strategies are rapidly dissolving and managed health care is proliferating. Managed care and managed competition are forcing hospitals and healthcare providers to reduce expenses and identify improved methods for healthcare delivery. Integrated healthcare delivery systems (IDSs) and networks are at the center of healthcare reform. Chief Nurse Executive Officers (CNEOs) are increasingly finding themselves in roles within complex IDSs located within highly managed care markets (HMCMs). This new work environment is altering old and mandating new …

Igniting The Mind: Engaging Nursing Students In The Process Of Learning, Jo-Ann L. Rossitto Dnsc, Ma, Rn

Dissertations

The purpose of this grounded theory study was to explore the perceptions of associate degree nursing faculty regarding their classroom teaching experiences. A purposive, convenience sample of twenty-one educators volunteered to participate in the study. Data were primarily obtained through semi-structured interviews over a period of six months. Data collection and analysis occurred simultaneously utilizing the constant comparative method. Igniting the Mind emerged as the core category of the study. This category represented the methods nurse educators use to involve students in the process of learning. Igniting the Mind entails making a connection, letting go, getting buy-in, trying something new, …

The Perspectives Of The Woman/Nurse/Executive Working In The Managed Care Environment Of Southern California, Cheryl Lynn Brandi Dnsc, Ms, Msn, Rn

Dissertations

The purpose of this study was to explore the perspectives of the woman/nurse/executive working in the managed care environment of Southern California. This research was extremely timely because (a) Southern California leads the nation in managed care market penetration, (b) changes in health care financing have resulted in a prolific expansion of nurse executive responsibilities, and (c) nurse executive experiences regarding increased responsibilities have not been researched. Role expansion impacts both male and female nurse executives, but female nurse executives must confront the dilemma of functioning in administrative domains which have been largely dominated by men. Knowledge about their experiences …

Correlates Of Staff Nurse Work Satisfaction In Hospitals With Shared Governance, Mary Kay Flynn Dnsc, Rn, Ccrn

Dissertations

Lack of staff nurse participation in hospital decision-making has been cited as a major reason for the dissatisfaction in nursing. Shared governance has been proposed as an organizational model that provides staff nurses with both the structure and the mechanism for having increased decision-making authority. The purpose of this study was to investigate the relationship of organizational culture, perceived importance of involvement and actual involvement in decision-making, the discrepancy between importance and involvement, staff nurse years of involvement in shared governance, control over nursing practice, and work satisfaction among staff nurses working in hospitals with shared governance. A descriptive, correlational …

The Process Of Ending Domestic Violence Among Latinas: Aguantando No Mas, Nancy A. Coffin-Romig Dnsc, Msn, Rn

Dissertations

The purpose of this study was to explore the sociocultural factors which play a role in the process of ending an abusive relationship among Latinas. Dimensional analysis was the method employed for the development of a grounded theory. Aguantando or enduring emerged from this study as pivotal in gaining an understanding of the process of ending an abusive relationship for Latinas. Participants indicated that personal and religious beliefs, the importance of family, and the needs of their children were reasons for aguantando or enduring the abuse. The decision to no longer aguantar, or endure, occurred through a series of encounters …

The Work Of Living With Hiv: A Study Of Binational Groups, Christina Joy Dnsc

Dissertations

The purpose of this investigation was to study the experience of individuals who live with and manage HIV infection and AIDS. The context of living with HIV/AIDS, the prevailing conditions, the actions/strategies used, and the consequences of the actions were considered using grounded theory methodology and dimensional analysis. A purposeful sample of 21 individuals HIV positive or diagnosed with AIDS from San Diego, California and Tijuana, Mexico were interviewed using semi-structured questions. Data were analyzed using open and axial coding, the constant comparative method, and dimensional analysis. The work of living with HIV emerged as the central dimension within the …