Medicine and Health Sciences Commons^™

Situation Awareness And Cognitive Load In Nursing Students Managing A Computer-Based Virtual Reality Simulated Deteriorating Patient, Tracy Chesney

Electronic Theses and Dissertations

Background: When a patient’s baseline clinical state shifts to a worse clinical state requiring a transfer to a higher level of care within the healthcare system, it is the hallmark of a deteriorating patient situation. Up to 37% of newly licensed nurses fail to identify and manage a deteriorating patient partly due to inexperience and a lack of expertise, contributing to lower situation awareness (SA), specifically in cue perception. Long-term memory schema development leads to expertise that allows individuals to develop higher SA necessary to identify and effectively manage patient deterioration. Expert nurses access long-term memory schema in managing deteriorating …

Benefits And Risks Of Sun Exposure To Maintain Adequate Vitamin D Levels., Jonathan Raymond-Lezman, Suzanne Riskin M.D.

HPD Articles

Vitamin D is a hormone that can be generated in the skin upon ultraviolet light exposure or ingested through supplementation. Vitamin D deficiency may have numerous deleterious effects on health. Sun avoidance strategies should be avoided due to the unwanted health risks associated with hypovitaminosis D. We present an objective investigation of the benefits and risks of using sun exposure to increase vitamin D levels and how it impacts human health. A review of the literature was conducted using Embase and PubMed to examine the relationship between UV exposure, vitamin D levels, health benefits, and risks. UV exposure is the …

School-Based Development And Implementation Of An Educational Toolkit, Chantel M. Kilford Ms

Doctor of Nursing Practice (DNP) Projects

The purpose of this evidence-based change in practice is to increase knowledge and confidence among healthcare providers and teachers within a high school setting by providing an educational tool kit about behavioral disorders in children. The disorders that will be focused upon are conduct disorder, oppositional defiant disorder, and common co-morbidities of these disorders. There will be education about an appropriate childhood, evidence based mental health assessment tool that assesses childhood mental health, including how to score the tool and interpret the results. Evidence suggests that healthcare providers and teachers are not confident or knowledgeable about identification, assessment, and behavioral …

Covid, Creativity, And Connecting Through Change: Reviewing The Literature On How Art Therapy Can Help Children And Adolescents Cope With Pandemic-Related Grief, Lydia Speicher

Expressive Therapies Capstone Theses

The COVID-19 pandemic has been one of the most significant global events in the past century, both resulting in massive casualties and significant mental health outcomes across the world. Some of the most impacted populations are children and adolescents whose lives have been interrupted during their formative years. The purpose of this literature review is to explore how art therapy has been used during the COVID-19 pandemic to address the grief experienced by children and adolescents through their losses of stability and peer support surrounded by uncertainty. This literature review seeks to understand exactly how the pandemic has affected the …

The Breath As A Holistic Regulator: An Expressive Arts Therapy Community Project, Jacobita Munoz

Expressive Therapies Capstone Theses

This capstone offers the idea that evolution has challenged appropriate breathing and led humans to breathe incorrectly, thus negatively affecting their physical and mental health. As breath can damage the body, it can also serve as a regulator of the mind and body. This thesis points out the multiple effects when uniting controlled respiration, drumming and nature sounds. Breathing, music and nature have many things in common. These include repetition, pattern, awareness of the present moment and relaxation. They all contain a rhythm, and they offer self-regulatory skills. Music-based expressive arts therapies intervention is postulated to provide breathing techniques, united …

Prescribing Music To Forensic Settings: A Literature Review, Sydney A. Bouchard

Expressive Therapies Capstone Theses

Though prison is inherently musical, evidence-based forensic music therapy is rather understudied. This thesis critically reviews musical experiences in forensic environments and synthesizes its intersection with inmates' psychological distress. Additionally, the literature explores how forensic music therapy can act as a health and social resource for the incarcerated and their communities. Engaging in this work is vital because healthier correctional systems mean healthier communities (Hopwood, 2021). This review synthesizes relevant literature to inform better practices in music therapy, counseling, and healthcare and seeks to popularize discussion around an otherwise unpopular population, incarcerated folx. Emerging themes include (1) incarceration breeds negative …

How Art Therapy Can Be Used To Teach Queer Inclusive Sex Education To Queer Youth: A Literature Review, Olivia Souza

Expressive Therapies Capstone Theses

This literature review examines the potential of art-making as a tool to educate and inform queer youth about queer sexual experiences. Many queer individuals lack information about safe and healthy sex due to the exclusion of queer experiences in sex education programs. Current sex programs solely focus on abstinence and heterosexual experiences, leaving queer youth in the dark about what to expect from future sexual experiences they may have and how to practice safe queer sex. Through a search of the literature, it was discovered that there is a gap in research using art therapy in this specific context. Through …

Can Psycho-Social Benefits Be Observed In Those With Intellectual Disabilities During Dmt?, Hannah Johnson

Expressive Therapies Capstone Theses

Often training and learning opportunities ignore the unique needs of individuals with intellectual disabilities. Helping this population cope with problems that will occur in their lives could increase their feelings of well-being and might decrease feelings of isolation. This workshop used the techniques from Mary Starks Whitehouse’s practice of Authentic Movement (Whitehouse et al., 1999) to support paticipants’ emotional self regulation during training for a new job at an apple orchard. The use of Dance Movement Therapy (DMT) as an intervention for individuals with intellectual disabilities could increase coping skills, which could create greater opportunities for them to increase their …

Playing With Policy: What Insights Arise From Transgender Adults After Participating In A Legislative Theatre Exercise, Skylar A. Stratemeyer

Expressive Therapies Capstone Theses

The transgender community is underrepresented in the current body of academic research, underserved in the current clinical model of healthcare services, and legislatively oppressed on a state and federal level in the United States. As of March 2023, more than 400 anti-LGBTQI laws have been introduced on a state level in 2023 alone (ACLU, 2023). In response to the hostile Western sociopolitical climate, this thesis will focus on what insights arise from transgender adults and cisgender allies (N = 12) after participating in a dramatherapeutic group therapy session that explored current anti-trans legislation and highlighted the legal needs of …

Connecting With Our Roles Through Post Traumatic Growth After Experiencing Medical Trauma, Marie Angier

Expressive Therapies Capstone Theses

This paper explores the combination of drama therapist, Robert Landy’s (1993), Role Theory and the psychological concept of Post Traumatic Growth (Tedeschi, 2018). The author created a protocol that involved psychoeducation surrounding the five domains of Post Traumatic Growth and a role card sort involving the drama therapeutic process of role theory. A young adult client experiencing significant medical trauma participated in these processes during a three session intervention. Results indicated that the client viewed negative experiences as potentials for growth toward furthered resilience and future hope and optimism. The sample size was limited to one person and further search …

Enacting Stories: Discovering Parallels Of Narrative And Expressive Therapies, A Literature Review, Zoe Reddig

Expressive Therapies Capstone Theses

This literature review will analyze the use of narrative therapy (NT) techniques, dance/movement therapy (DMT) techniques, and expressive therapy (ET) techniques in an effort to distinguish where theoretical parallels exist between these methods of counsel. Narrative therapy is a postmodern framework of counseling that assists clients in resisting damaging stories that have been embedded through bioecological systems of exposure throughout development. Narrative therapy structures its philosophy through processes of externalization and deconstruction, and encourages the process of reframing or re-authoring one’s personal self-narrative. At their core, DMT and ET already utilize components of foundational NT practices, through processes of enactment, …

Art Therapy As A Tool For Korean American Families: A Literature Review, Minju Park

Expressive Therapies Capstone Theses

This literature review aims to offer a comprehensive overview of attributes of Korean culture that make significant impacts on the family dynamic in the Korean immigrant households and to learn different types of art therapy that can help them. This literature review identifies specifically the struggles both first-generation Korean immigrant parents and second-generation Korean-American adolescents experience in order to understand where their conflicts come from. Later, different approaches of art therapy for the conflicts Korean immigrant households face are discussed. Data are collected from existing literature and videos by terms including art therapy for immigrants, family art therapy, Korean immigrant …

Post-Partum Deprssion: An Educational Intervention For Nursing Staff In A Rural Hospital Obstetrics, Tonya Jewell

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

Postpartum depression (PPD) is a type of depression that has occurred in women during pregnancy or after the delivery of a child. In the United States, approximately 13.2% of postpartum women were diagnosed with postpartum depression. Research indicated that early identification of PPD led to the best outcomes for postpartum mothers. Routine postpartum depression education and screening for postpartum depression did not exist in the perinatal unit at a Southeast Georgia rural hospital. Lack of nursing knowledge and skill were two barriers identified to screening patients for PPD and providing discharge education. The study provided an educational intervention to provide …

The Integration Of Catholic Mission And Ethics In Contributing To A Good Death, Noah Dimas

Electronic Theses and Dissertations

Catholic healthcare ethics exists within a morality that is under regular heavy scrutiny. This is furthered by the healthcare space itself becoming more secular as the greater society itself moves beyond the religious origins of healthcare. However, this does not have to be relegated to a negative. Rather, this can become a strong call to action for Catholic healthcare to rally together and advocate for itself in the wider healthcare space. This is especially true as these challenges to the Catholic moral-ethical framework begin to question the presence of both Catholic and religious healthcare as whole. These challenges, if left …

Exploring The Effects Of Psychosocial Factors And Relationships To Postpartum Depression Symptoms Among Iranian Immigrant Women Living In Canada: A Cross-Sectional Study, Monica Gola

Electronic Theses and Dissertations

Introduction: Immigrant women’s health garners attention as migration creates changes in social networks and parenting needs. The effect of psychosocial factors, such as maternal self-efficacy, measured by ability to manage parenting responsibilities, social support and cultural postpartum practices on postpartum depression symptoms are not well known in Canadian immigrant women. Methodology: A cross-sectional descriptive survey design guided by Bandura’s Reciprocal Determinism was used to explore the relationships between psychosocial factors including: maternal self-efficacy, social support, cultural postpartum practices; and symptoms of postpartum depression (PPD) among recent Iranian immigrant women living in Canada. Results: A total of 114 participants completed the …

The Ethics Of Governance Of Data Analytics In Healthcare, Andrew Harrington

Electronic Theses and Dissertations

Recent literature and studies on data governance usually focus on data ethics and governance from a specific country or industry, which has been mostly business, without considering the larger global impact that is affected. Data is a worldwide asset; thus, its implications and considerations should be viewed as such. Hence, this dissertation attempts to incorporate this view by weaving together topics in healthcare, such as the blending of finance and delivery, data governance at the micro and macro levels, data analytics in healthcare, ethics of AI and information management, and technology’s impact on end-of-life practices. Through highlighting these areas of …

Introducing A Trauma-Informed Care Model To Address Racial Disparities In Perinatal Outcomes Among African American Women, Mariah K. White

Honors College Theses

Racial disparities in maternal and infant health have remained an issue within the United States despite efforts to advance and improve our health system. Most maternal deaths are preventable, especially with early and adequate maternal care. Infant mortality occurs for several reasons, but inadequate care usage increases the risk for adverse outcomes. Prenatal care usage within the United States has been inadequate for numerous years, most commonly among African American women, despite its known benefit. Low prenatal care usage among African American women can be attributed to community barriers, social injustices, trauma, discrimination, and health care mistrust. Trauma is common …

Shared Decision Making In Self-Care Management And Health Outcomes Of Adolescents And Young Adults With Sickle Cell Disease, Judith M. Odityo

Dissertations and Theses (Open Access)

Background: Shared decision making (SDM) is a model of care with a potential to guide disease self-care management and promote optimal health outcomes in adolescents and young adults (AYA) with sickle cell disease (SCD).

Aims: To identify the perceived involvement of AYA with SCD in the SDM process and examine its association with self-care management and health outcomes.

Methods: Data were collected from a major sickle cell center. Using a cross-sectional design, participants completed surveys and data were analyzed with descriptive statistics, analysis of variance, multiple linear regression, and correlational statistics.

Results: Participants (N=25) were on average age 22.72 (SD …

Endothelial To Mesenchymal Transition In Human And Murine Congenital Diaphragmatic Hernia Pulmonary Hypertension, Jamie L. Gilley

Dissertations and Theses (Open Access)

Background: Congenital diaphragmatic hernia (CDH) is one of the most complex congenital disorders, characterized by pulmonary hypertension and hypoplasia. CDH-associated pulmonary hypertension (CDH-PH) features devastating morbidity and mortality (25-30%) among neonates. An unmet need is determining the mechanisms triggering CDH-PH to save infants and improve their quality of life. Prior data suggest abnormal remodeling of the pulmonary vascular extracellular matrix, presumed to be driven by endothelial-to-mesenchymal transition (EndoMT), hinders postnatal vasodilation and limits efficacy of anti-PH therapy in CDH. Although abnormal vascular development and remodeling are known CDH traits, there is limited data on the role of EndoMT in CDH-PH. …

Noninvasive Screening Of Nonalcoholic Fatty Liver Disease Among People Living With Hiv, Essi M. Havor

Dissertations and Theses (Open Access)

Background: Nonalcoholic fatty liver disease (NAFLD) disproportionately affects up to 75% of people living with HIV (PLWH). Given the high HIV prevalence in Houston and Harris County, knowledge of the prevalence of NAFLD in PLWH is needed to inform prevention efforts. In addition, such knowledge is required to raise awareness among at-risk individuals and healthcare professionals.

Specific Aims: This cross-sectional study aimed (1) to examine the demographic, behavioral, clinical, and psychosocial characteristics of PLWH in Houston/Harris County, Texas, and to estimate the prevalence of NAFLD, (2) to determine factors associated with the severity of NAFLD, and (3) to identify specific …

Examining Asian Americans' Perceived Barriers To Healthcare Access, Kathleen Nguyen, Jennifer Ramos

Honors Thesis

This research aimed to examine Asian Americans and their perceived barriers to healthcare access. Asian Americans, due to not being a homogenous ethnic group, experience health disparities that are different to those that other ethnic groups experience. Compared to whites in America, Asian Americans are less likely to have job-based insurance coverage and because of this are then less likely to be insured (Brown et al., 2000). Additionally, the most common perceived barriers to accessing healthcare for Asian Americans are cultural attitudes, financial and socioeconomic status, as well as language barriers. These barriers found in the literature served as the …

Black Male Educator Shortage In The Mississippi Public School System: Impact, Challenges, And Intervention Strategies, Jilkiah Bryant

Honors Theses

The shortage of Black male educators in Mississippi's public school systems is a critical issue with far-reaching implications for the state's education system. Despite the state's sizable Black population, the percentage of Black male teachers remains disproportionately low, and there is little evidence of progress being made to address this issue. This paper examines the impact of the Black male educator shortage on Mississippi's education system, the challenges faced by Black male educators, and related intervention strategies to increase the number of Black male teachers in Mississippi's public school systems. Through a comprehensive literature review and interviews with Black male …

Improving Patient Safety With A Pressure Injury Prevention Bundle In A Urban Intensive Care Unit, Radha Denmark, Cassie Belzer, Christopher Bartlett

Quality Improvement/Patient Safety Symposium

Gap Identification/Background

About 2.5 million Americans in acute care facilities develop a hospital-acquired pressure injury (HAPI) each year, with an incidence up to 45% in intensive care settings (ICUs)¹ costing $75,000-$150,000 per patient². They are painful, reduce quality of life, and increase morbidity and mortality, resulting in 60,000 deaths annually in the United States.²

Guideline recommendations are that HAPI prevention begins with a comprehensive risk assessment that is not dependent on a single risk tool since no single tool is comprehensive. However, a chart audit conducted in a 24-bed trauma-surgical intensive care unit (TSICU) of a …

The Ethical Contribution Of Cultural Diversity As A Social Determinant Of Health, Pooja Patel

Electronic Theses and Dissertations

The dissertation examines how cultural diversity as a social determinant of health, aligned with human life, human dignity, human rights, and human equity provides an ethical contribution. My explanation of the ethical contribution of cultural diversity as a SDOH refers to a quadrant of topics that expands the approach of the UNESCO Declaration of Bioethics and Human Rights. The UNESCO approach addresses cultural diversity in relation to human dignity and human rights. I adopt a quadrant of topics that aligns human dignity with human life and human rights with equity. Aligning these topics in the quadrant (dignity/life and rights/equity) explains …

Primary Care Providers’ Practices And Attitudes Towards Brca Genetic Testing For Unaffected 19- To 24-Year-Old Patients., Madison C. Groene, Terri Blase Ms, Cgc, Jessica Maxwell Md, Frcsc

Capstones: Genetic Counseling

Prior literature has described unique psychosocial considerations for emerging adults (18- to 25-year-olds) considering predictive BRCA genetic testing. Due to these unique concerns, the Society of Gynecologic Oncology (SGO) recommends waiting until individuals are older than 21 before offering testing. While primary care providers (PCPs) are important stakeholders in increasing access to hereditary cancer genetic testing, their approach for emerging adults has not been previously described. We surveyed PCPs in Nebraska regarding their pre- and post-test clinical practices as well as attitudes towards BRCA genetic testing for unaffected 19- to 24-year-olds. Pre-test clinical practice questions and attitudes questions were asked …

Weight Loss Communication And Treatment In Primary Care, Courtney Russell, Sarah Puckett, Jessica Mcrill

Doctor of Nursing Practice Projects

Obesity is undertreated in the primary care setting as a single medical condition. Obese patients are higher risk for comorbid conditions including heart disease, hypertension, diabetes mellitus and stroke. There is no universal screening tool implemented in the primary care setting for obesity management. An extensive literature review was completed to identify barriers in the primary care settings for providers to treat obesity as a disease state, assess current practices for weight management in these settings, and to identify health behaviors of adult patients with obesity. This project implemented the Five A’s Communication Tool to identify patients willing to discuss …

Use Of Anticipatory Guidelines In Late Infants And Toddlers 12 To 24 Months In Primary Care, Claire E. Eller

Doctor of Nursing Practice Projects

Anticipatory guidance is a well-known and utilized method that has been implemented in a majority of pediatric primary care offices. As the need for efficiency grows and increasing patient volumes climb, there is a growing need for strategies to provide this information effectively and efficiently. Prior evidence can be utilized to identify the most critical knowledge caregivers and parents will require. Our findings indicate safety, communication, nutrition, social development, and behavior as cornerstone topics for anticipatory guidance. To increase the volume of education provided to parents and caregivers, alternate methods beyond verbal discussion could be used. After gathering scientific literature …

Implementing The Timed Up And Go Test To Prevent Falls, Shamika Allen

Doctor of Nursing Practice Projects

Falls are the most reported injury within the geriatric population. Behavioral health patients have the most injurious falls, with falls impacting multiple things such as staffing, cost, injury, and quality of life for the patient (Ocker et al., 2020). Currently, the standardized fall assessment for new patients upon admission is the Morse Fall Scale (MFS). This fall assessment was intended to assess the level of fall risk for patients who are on an acute medical floor during their hospital stay. The Timed Up and Go test (TUG) is a fall assessment that has been used in geriatric patients to assess …

Implementing An Emr System In A Small Psychiatric Practice, Brandy Mccrudden

Doctor of Nursing Practice Projects

Electronic medical records (EMRs) can aid in improving surveillance, monitoring, adherence to practice guidelines, improving communication, and reducing medical errors. The adoption of EMRs in psychiatry and mental health settings has been slow despite the offered benefits. This project aimed to develop an implementation and training plan to successfully transition from paper charts to EMRs in a psychiatry practice. An extensive literature review was conducted on the adoption of EMRs in mental health settings, and a guideline for implementation was created to overcome identified barriers. Implementation guidelines included a planning phase, staff training plan, and rollout using a phase-in approach. …

A Multifaceted Approach To Promoting Speaking Up Behavior In A Community Hospital, Carrie Carls

Doctor of Nursing Practice Projects

Introduction

This project describes results of a multifaceted approach to promoting Speaking Up Behavior (SUB) among nurses in a community hospital. Patient safety outcomes, perception of healthy work environment, and nurse retention are connected to caregiver communication.

Methods

Interventions included development of a structured SUB communication and debriefing tool, SUB administrative policy, leadership rounding and verbal support for SUB, formal recognition of SUB, and SUB education including role-playing activities. Cross-sectional surveys evaluating nurse comfort and confidence with SUB using validated tools were implemented before and after the multifaceted interventions.

Results

The bedside nurse voluntary turnover rate reduced from 14.5% to …