Medicine and Health Sciences Commons^™

Take Charge For Therapy Discharge: Outcomes Of A Patient Education Program Applying The Co-Op Approach, Kathryn Westley

Electronic Theses and Dissertations

A thorough needs assessment at HealthSouth Rehabilitation Hospital of Largo revealed slight dissatisfaction scores on the Press Ganey survey for both the occupational therapy department and discharge planning processes. This quality improvement project, Take Charge for Therapy Discharge, implemented a two-session patient education protocol using the Cognitive Orientation to Occupational Performance (CO-OP) approach. Using the Patient-Specific Functional Scale (PSFS), participants identified and prioritized three therapy goals and rated their perceived current performance. Results demonstrated a significant difference between the participants’ PSFS pre and post-intervention scores. Patients’ improved self-perceived goal attainment scores served as evidence that, in addition to using …

A Simulated Learning Experience In Advanced Care Planning Conversations, Brandy Ellis

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Background: The CDC (2012) reports that 1/3 of Americans have no advance care planning (ACP), which is essential for maintaining autonomy when people are no longer able to communicate wishes directly. IOM (2014) reports that providers have limited training in communication techniques and low confidence in holding advanced care planning conversations. Nursing simulation is an effective method of teaching clinical skills in a safe environment. The development of a high fidelity (HF) standardized patient simulation, using the Jeffries Simulation Framework, combined with evidence-based practice classroom curriculum, may increase knowledge and confidence in holding ACP conversations for nurse practitioner students.

Methods: …

Improving Management Of Obstetrical Emergencies: Using Simulation-Based Training, Amira Amatullah

Doctor of Nursing Practice (DNP) Projects

The aim of this Executive Leadership Doctorate in Nursing Practice project was to assess the effectiveness of simulation-based training as a strategy to ensure patient safety and quality care by improving the knowledge and confidence of obstetric nursing staff. Collateral goals included the development of a simulation-based interactive training program to improve staff response to obstetric emergencies and the establishment of an Interprofessional Simulation Training Center.

The use of simulation-based training is widely accepted ans used in healthcare education. Several benefits of simulation-based training include a learner-centered approach, safe acquisition of technical skills training and development of effective communication skills. …

Student Perspectives On Working In Interdisciplinary Teams To Implement Mhealth, Elina Chun

Undergraduate Honors Theses

Interprofessional education of students in healthcare professions can lead to positive outcomes for students that are unique in a university setting. The purpose of this thesis is to describe benefits and challenges students encounter when working with students of other majors. This study used a convenience sample of students working on a university project to implement mHealth. Participants responded to two surveys with quantitative and qualitative questions. Students reported greater appreciation for diversity, the necessity of communication skills, and self-awareness of their own responsibilities in a team.

Acromial Insufficiency Fractures In Reverse Total Shoulder Arthroplasty: A Biomechanical Study, Alicia Kerrigan

Electronic Thesis and Dissertation Repository

Reverse total shoulder arthroplasty (RTSA) is increasingly utilized in the aging population, with a growing list of surgical indications including rotator cuff tear arthropathy, proximal humerus fractures, and revision arthroplasty. Acromial insufficiency fractures following RTSA are poorly understood, difficult to diagnose, and associated with inferior clinical outcomes. There is limited knowledge in the literature regarding the etiology of post-operative acromial fractures. The purpose of this study is to evaluate the role of implant parameters on acromial strain following RTSA.

Using a cadaveric model, a custom designed modular RTSA system was implanted that allowed for evaluation of modifiable parameters including glenoid …

Effects Of Patient Characteristics On Outpatient Rehabilitation Outcomes In Patients With Lumbar Impairments, Jenna Powers

Theses and Dissertations

Lumbar spine impairments affect an individual’s ability to perform activities of daily living, making it pertinent to understand the importance of rehabilitation and variables influencing clinical outcomes. The purpose of this study was to examine variables (demographics, health conditions, and biopsychosocial) that contribute to larger functional status (FS) improvement for patients with lumbar spine impairments seeking outpatient rehabilitation therapy. This study was a secondary data analysis of data collected by FOTO Inc. (Knoxville, TN, USA). A sample of 221,168 participants with lumbar spine impairments were analyzed. Correlations were performed to examine the strength of the linear relationship between variables of …

Critical Illness Survivors’ Perceptions Of Their Recovery: An Interpretive Phenomenological Inquiry, Kelly Calkins

Theses and Dissertations

Surviving critical illness with its physical, cognitive, and psychosocial morbidities is a growing clinical and research challenge and an important public health concern. Currently, there are few interventions for survivors of critical illness after hospital discharge. Potential interventions include rehabilitation services, Intensive Care Unit (ICU) diaries and ICU follow-up clinics, however, most survivors do not have access to these post-hospital interventions.

The purpose of this study is to gain a better understanding of how critical illness survivors experience their recovery, interventions they use, and what they perceive as facilitators and barriers to their recovery. A better understanding of these factors, …

Prognostic Predictive Model To Estimate The Risk Of Multiple Chronic Diseases: Constructing Copulas Using Electronic Medical Record Data, Jason E. Black

Electronic Thesis and Dissertation Repository

Introduction: Multimorbidity, the presence of two or more chronic diseases in an individual, is a pressing medical condition. Novel prevention methods are required to reduce the incidence of multimorbidity. Prognostic predictive models estimate a patient’s risk of developing chronic disease. This thesis developed a single predictive model for three diseases associated with multimorbidity: diabetes, hypertension, and osteoarthritis.

Methods: Univariate logistic regression models were constructed, followed by an analysis of the dependence that existed using copulas. All analyses were based on data from the Canadian Primary Care Sentinel Surveillance Network.

Results: All univariate models were highly predictive, as demonstrated by their …

Examining Eshift Through The Caregiver Policy Lens: A Content Analysis, Ashlee A. Worrall

Electronic Thesis and Dissertation Repository

Purpose: This research study intended to understand how a new model of palliative home care in Ontario, Canada called eShift aligned with the needs of caregivers who cared for a family member at the end-of-life.

Methods: A qualitative secondary analysis using a deductive content analysis of 14 caregiver interviews, three decision-maker interviews, and six home care agency documents collected in a three-year study and were analyzed using The Caregiver Policy Lens framework.

Findings: The eShift model of care met caregivers’ needs through timely access to respite, education, collaborating with the health care team, and physical and psychological support. Caregivers were …

Evaluation Of The Construct Validity Of The Questionnaire To Identify Knee Symptoms Among Individuals Across Canada With Chronic Knee Pain, James Young

Electronic Thesis and Dissertation Repository

The primary purpose of this study was to evaluate the construct validity of the Questionnaire to Identify Knee Symptoms (QuIKS) measurement scale among individuals with chronic knee symptoms consistent with osteoarthritis. Construct validity was assessed using tests of convergent and discriminative validity on 15 pre-specified hypotheses. The secondary objective was to determine the internal consistency reliability of the QuIKS. One hundred and five individuals recruited in select physiotherapy clinics from across Canada were mailed the QuIKS and five other health questionnaires. Fifty-five individuals completed the questionnaire package. While none of the pre-specified construct validity hypotheses were met, nine of the …

Understanding The Process Of Recovery From Critical Illness From The Patient Perspective: A Constructivist Grounded Theory, Tania Larsen

Electronic Thesis and Dissertation Repository

Critical illness creates long-term physical, psychological and cognitive deficits that negatively impact quality of life, persisting well beyond hospital discharge. The purpose of this constructivist grounded theory study is to understand and develop theoretical propositions on factors that patient’s perceive influence the process of recovery from critical illness in order to inform more comprehensive patient care management strategies.

Semi-structured interviews were conducted with 17 participants admitted to an ICU. All interviews were audio-recorded and transcribed verbatim. Data collection and analysis occurred concurrently using the constant comparative method. Data were analysed initially with line-by-line coding, then focused coding. Initial codes were …

Comparing Interprofessional Socialization In Mixed Discipline And Nursing Student Only Cohorts, Kara Groom

Dissertations (1934 -)

A main cause of patient safety incidents are avoidable failures in communication between health professionals. In response, healthcare has entered an era of interprofessionalism in education and patient care. A challenge to substantiating the value of interprofessional education (IPE) has been a limited number of studies that assess the effectiveness of IPE interventions compared to education interventions in which professions were learning separately from one another. This research project helps fill this gap and measures the differences in student interprofessional socialization (IS) between an IPE cohort and a usual care group of one-discipline learners. The purpose was to compare IS …

Wait Times, Resource Use And Patient-Reported Outcomes For Patients Referred For Total Knee Replacement Surgery, Kate Lebedeva

Electronic Thesis and Dissertation Repository

This prospective cohort study evaluated the usual care pathway for patients referred to total knee arthroplasty (TKA). We measured healthcare resource use, costs and health-related quality of life (HRQoL) over the continuum of care. We also determined the proportion of inappropriate referrals and estimated wait times for initial surgical consultation and TKA. We found that two in five patients referred to specialty care were deemed inappropriate surgical candidates. Prior to referral, few conservative treatment options were tried, and many imaging tests ordered by referring providers were unjustified. Overall, the greatest proportion of costs were borne by the patient or private …

The Effect Of A Voice Treatment On Facial Expression In Parkinson’S Disease: Clinical And Demographic Predictors, Amanda D. Bono

Dissertations, Theses, and Capstone Projects

Parkinson’s disease (PD) is a neurodegenerative disease associated with a wide range of motoric, cognitive, and behavioral symptoms. Impairments in facial mobility and emotional expressivity are common and can impair communication, in turn, affecting daily functioning and quality of life. Previous research suggests that the Lee Silverman Voice Treatment © (LSVT LOUD; Ramig et al., 2001, 2011) increases vocal loudness and facial expressivity in individuals with PD compared to PD and healthy controls. This study extends the literature by examining the effects of LSVT and an articulation-based control treatment (i.e., ARTIC) on multiple aspects of facial expressivity (i.e., emotional frequency …

Validity And Reliability Of The Clinician Rated Drop Vertical Jump Scale In Patients Following Anterior Cruciate Ligament Reconstruction, Morgan Jennings

Electronic Thesis and Dissertation Repository

The purpose of this study was to evaluate the validity and reliability of the Clinician Rated Drop Vertical Jump Scale (CR-DVJS) in a population of patients following anterior cruciate ligament reconstruction (ACLR). Patients completed two drop vertical jump tasks at 6 and/or 12-months post-operative. One task was recorded using a motion capture system. Four individuals of varying clinical experience served as raters for the CR-DVJS. Rater scores of valgus collapse did not correlate strongly with motion capture measures of knee abduction moment or angle. However, CR-DVJS scores of trunk and knee flexion did demonstrate an association with 3D measures of …

Electrical Stimulation For Treating Pressure Injuries: Evaluation Of A Knowledge Mobilization Project, Lyndsay Orr

Electronic Thesis and Dissertation Repository

Pressure ulcers (PrU) are a secondary health complication that cause increased morbidity, mortality and decreased quality of life. PrUs have also been shown to have a significant financial burden on the healthcare system. Current best practice guidelines strongly recommend the use of Electrical Stimulation (E-Stim) to increase healing rates of PrUs. Unfortunately, there has been lack of uptake for the use of E-Stim in clinical practice. To address this gap in practice, a knowledge mobilization project called the E-Stim Collaboration Project was developed. The aim of this dissertation was to 1) determine if an education program can change knowledge, attitudes …

Tomographic And Histological Analyses Of Ectopic Calcification Associated With Diffuse Idiopathic Skeletal Hyperostosis (Dish), Dale Edward Fournier

Electronic Thesis and Dissertation Repository

Diffuse idiopathic skeletal hyperostosis (DISH) is a non-inflammatory spondyloarthropathy characterised by the formation of ectopic calcifications of the ligaments/enthuses along the anterolateral aspect of the vertebral column. Despite affecting 15-25% of North Americans over the age of 50, the aetiology of DISH is poorly understood and there are no disease modifying treatments. Our discovery-based approach implemented a transdisciplinary research team to study the basic biology, imaging science, clinical anatomy and significance of DISH in humans. Our novel characterisation defined distinct morphological presentations of ectopic calcifications associated with DISH in cadaveric specimens using micro-computed tomography imaging. Subsequent histopathological analyses demonstrated that …

Health Professional Students' Understanding Of Oral Health In Traumatic Brain Injury, Samira Omar

Electronic Thesis and Dissertation Repository

Oral health is a significant consideration in recovery following severe traumatic brain injury (TBI) as it is associated with overall health. Health-care providers play an essential role in rehabilitation following TBI. Thus, using qualitative descriptive research and focus groups, this thesis examined the experiences and perceptions of eight final-year health-professional students in nursing, occupational therapy, and speech-language pathology with respect to oral health in TBI. Results suggest that health-professional students lack a deep understanding of i) what constitutes oral health, ii) common oral health challenges that may be faced by persons with TBI, and iii) optimal oral care in persons …

"Current Anesthesia Education Practices Regarding Music As An Adjunct For Analgesia And Anxiolysis ", Taylor Hull

College of Science and Health Theses and Dissertations

Background: Music has been proven as an effective complementary and alternative medicine, and can be an important tool for nurse anesthetist.

Objectives: The purpose of this project was to assess if nurse anesthesia programs are including music as a part of the complementary and alternative medicine (CAM) curriculum for anxiety and pain in the perioperative setting.

Method: A descriptive survey was sent to program directors of nurse anesthesia programs in the United States to assess the current level of awareness and education regarding music as an alternative medicine as well as barriers to the addition of music into curriculum. …

A Multi-Level Assessment Of Healthcare Facilities Readiness, Willingness, And Ability To Adopt And Sustain Telehealth Services, Jamie Larson

Theses & Dissertations

Telehealth technologies are becoming more pervasive throughout the healthcare system as a way to provide services to patients that would otherwise have difficulty with access. Currently, little is known about the current state of telehealth use within clinics and hospital in the US. Most studies evaluating telehealth programs are feasibility or small patient outcome studies from one location. Utilizing a hybrid framework combining the levels of complex socio-technical systems with the theory of ready, willing and able. The theory of ready, willing, and able is founded on the basis that these three preconditions need to be met for a change …

Preventing Hospital Acquired Pneumonia: A Quality Improvement Project, Calyn Pascual

Master's Projects and Capstones

Abstract

Problem: From October 2016 to September 2017, the 5^th floor medical surgical telemetry unit has had 9 incidences of hospital-acquired pneumonia (HAP). Among the facility, this is the floor with the highest HAP incidences.

Context: HAP is associated with $40,000 to $65,000 to each patient care cost; an additional 7-9 days of stay in the hospital, increases the chances of discharging a patient to a skilled nursing facility instead of home, and has an attributable mortality rate (Quinn, et al., 2014).

Interventions: Daily oral brushing self-audits are given to patient care technicians (PCT) for both day and evening …

Assessing The Risk Of Falling In Adults One-Year After Total Hip Arthroplasty, William Janes

Electronic Thesis and Dissertation Repository

The purpose of this study was to examine falls prevalence, falls risk factors and knowledge of falls in individuals who have undergone a total hip arthroplasty. There were 135 patients examined at their one-year follow-up appointment for total hip arthroplasty. Our primary outcome, falls prevalence and falls circumstances, found a falls prevalence of 21.5% with identical circumstances to that of average community-dwelling older adults. Female sex, number of prescription medications and multiple joint replacements were found to be significantly associated with the occurrence of falls in the previous year. The Falls Risk for Older People in a Community Setting Questionnaire …

Chronic Bronchitis, Conrad Boyer

Nursing Student Class Projects (Formerly MSN)

Chronic Bronchitis is an aspect of the broad disease known as Chronic Obstructive Pulmonary Disease (COPD). It is a widely prevalent disease in the world today and effects 15 million people and is the third leading cause of death. The signs and symptoms of Chronic Bronchitis is very specific, however diagnoses and treatment is different for each patient and can be quite challenging. The pathophysiology underlying Chronic Bronchitis is quite complex with metaplasia changes within the lung parenchyma, increase in mucous from goblet cell hyperplasia and chronic inflammation leading to permanent scarring. The bodies adaptive processes because of Chronic Bronchitis …

Effect Of Adding Stretching Techniques To Standardized Intervention On Nonspecific Mechanical Neck Pain, Saad S. Alfawaz

Loma Linda University Electronic Theses, Dissertations & Projects

Mechanical neck pain is becoming one of the leading causes of musculoskeletal disorders in the general adult population. Mobilization intervention is considered one of the most effective therapeutic techniques to treat non-specific neck pain. The purpose of this study was to investigate the benefit of adding stretching exercises as part of a rehabilitation program for patients with non-specific mechanical neck pain. Methods: Thirty-eight subjects with non-specific neck pain for at least 2 weeks with mean± SD age 30.9±8.1 years and body mass index (BMI) 26.8±6.7 kg/m2 participated in the study. Participants were randomly assigned to either the combined intervention (passive …

Management Of Chronic Low Back Pain With A Nonpharmacological Pain Management Kit Among Military Personnel, Heidi M. Sterling Bsn, Rn, Dnp Student, Karen A. Macauley Phd, Dnp, Fnp-Bc, Gnp-Bc, Robert Topp Phd, Rn

Doctor of Nursing Practice Final Manuscripts

Background & Purpose:Low back pain is the second leading cause of disability in the United States, affecting 17% of Americans. Chronic low back pain (CLBP) is particularly debilitating among professions such as active duty military personnel (ADMP) who are required to maintain military readiness without the assistance of opioids. This scenario can result in individuals enduring untreated pain or resigning from participation in their unit. The purpose of this project is to determine the effect of providing a nonpharmacological pain management kit (NPMK) on pain and functional ability among ADMP who report CLBP.

Study Design:ADMP who suffer from CLBP were …

Stress Urinary Incontinence In Collegiate Female Athletes: Prevalence And Impact, Marie Bouchard

Master's Projects and Capstones

Abstract

Introduction, definition: Urinary incontinence is the involuntary leaking of urine (a few drops to a few milliliters). It can happen while exercising with no urge to urinate (stress urinary incontinence), with a sudden urge to urinate (overactive bladder or urgency urinary incontinence), or a combination of the two (mixed urinary incontinence). This issue is very common among female athletes. However, because of the reluctance to discuss this problem, it remains underdiagnosed and undertreated.

Methods:An anonymous and confidential survey was distributed to the 90 University of San Francisco female student athletes from seven different varsity sports in December 2017. …

Regular Exercise Throughout Pregnancy And Maternal Recovery Postpartum, Rachel Jenkins

Graduate Theses & Dissertations

Abstract

Introduction: The American College of Obstetricians and Gynecologists recommends that “women with uncomplicated pregnancies should be encouraged to engage in aerobic and strength-conditioning exercises before, during, and after pregnancy.”1 Many pregnant mothers seek guidance regarding exercise regimens’ safety and efficacy. This paper is a systematic review of the current literature on the topic of exercise regimens performed throughout pregnancy and maternal postpartum recovery.

Purpose: To determine if following the American College of Obstetricians and Gynecologists recommendation to engage in regular aerobic and strength-conditioning exercises throughout pregnancy contributes to easier deliveries as measured by the number of caesarean sections, time …

The Influence Of Socioeconomic Factors On Fear Of Falling And Mobility Outcomes After Lower Limb Loss: A Preliminary Study, Tyler Chin, Heather Fox, Juan Gutierrez Jr.

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Current research has revealed that as much as 52.4% of individuals with lower limb loss report falling at least once in the past year. Previous research has also indicated that rehabilitation, including physical therapy (PT), generally improves patient outcomes after definitive amputation. Socioeconomic status has been shown to be an important factor in accessing healthcare but has yet to be investigated in this population. The purpose of this study was to investigate the effects of socioeconomic status and access to PT, and how limb loss affects mobility and fear of falling perception. We hypothesized: [1] individuals with …

Successful Patient Participation In Acute Hospital Physical Therapy, Jesse Kim, Joseph Fertitta, Patrick Williams

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: Research has demonstrated that physical therapy plays a crucial role in patient recovery in the acute hospital setting. Despite known benefits, scheduled sessions do not always occur and are called nontreatment (NT) events. Reported NT ranges from 15% to 26% of scheduled sessions. Previous studies have found an association between NT and patient diagnosis as well as between NT and day of the week on which treatment was scheduled. Identifying additional factors that affect NT is important if therapists and administrators are to make improvements. The purpose of this study is to determine if an association exists between physical …

Physical Therapy Review Of Best Practices Based On Psychology, Bethany Painter

Honors Projects

Physical therapy is a field that is growing and changing constantly. For so long, it was assumed that physical healing should be the sole focus of physical therapy. While this is an important aspect of the rehabilitation process, there is so much more to it than that. The psychological trauma a person may experience following an injury can be just as challenging, if not more challenging to overcome than the physical repercussions of the injury. For this reason, it is important to take psychological healing into consideration, as well as physical healing when creating best practices for physical therapists. The …