Nursing Commons^™

Chronic Disease Self-Management And Behavior Change Attitudes In Older Adults: A Mixed-Method Feasibility Study, Kimberly A. Sell, Elaine J. Amella, Martina Mueller, Jeannette Andrews Phd, Rn, Faan, Joy Wachs

Faculty Publications

The population of older adults with chronic disease is increasing, yet little is known about their perception of chronic disease and self-management. To develop successful and sustainable chronic disease self-management interventions in the older adult population, health care providers must first understand older adults’ attitudes toward health status and behavior change. This pilot study was conducted to determine the feasibility of the study design. The purpose of this pilot study was to assess the appropriateness of using a mixed-methods research design to investigate Appalachian older adult’s attitude toward the chronic disease experience and health behavior change. A convergent, parallel mixed-method …

Enhanced Deposition Uniformity Via An Auxiliary Electrode In Massive Electrospinning, Dezhi Wu, Zhiming Xiao, Lei Deng, Yu Sun, Qiulin Tan, Linxi Dong, Shaohua Huang, Rui Zhu, Yifang Liu, Wanxi Zheng, Yang Zhao, Lingyun Wang, Daoheng Sun

Publications

Uniform deposition of nanofibers in the massive electrospinning process is critical in the industrial applications of nanofibers. Tip-Induced Electrospinning (TIE) is a cost-effective large-scale nanofiber-manufacturing method, but it has poor deposition uniformity. An auxiliary conductive electrode connected to the emitting electrode was introduced to improve the deposition uniformity of the nanofibers. The effects of the auxiliary electrode shape, the tilted angles and the position of the boat-like electrode on the electric field distribution, the diameter of the nanofibers, the jet control and the deposition uniformity were explored by using finite element analysis of the electric field and experiments. Experiments showed …

Multi-Symptom Management In Hospice Patients During End-Of-Life Transition, Ashley N. B. Sirianni

Theses and Dissertations

The purpose of this quality improvement project is to compare the provider’s perception following an educational model of using single symptom management versus multi-symptom management during the end-of-life transition in adult patients for improved quality of life outcomes. The appraised evidence indicates that it is critical to have anticipatory medications at the patient’s residence to manage multiple symptoms rather than focusing exclusively on a single symptom management such as pain management. In February 2016, the author conducted an educational model among hospice providers for increasing knowledge and awareness of multi-symptom management. Thirty (n = 30) Clinical Nursing Directors, Licensed Practical …

Conceptual Model Of Weight Management In Overweight And Obese African-American Females, Suzanne M. Sutton, Gayenell S. Magwood Phd, Rn, Faha, Faan, Lynne S. Nemeth, Carolyn M. Jenkins

Publications

PROBLEM: Weight management of overweight and obese (OWO) African-American females (AAFs) is a poorly defined concept, leading to ineffective treatment of overweight and obesity, prevention of health sequelae, and risk reduction. METHODS: A conceptual model of the phenomenon of weight management in OWO AAFs was developed through dimensional analysis of the literature. Constructs were identified and sorted into the dimensions of perspective, context, conditions, process, and consequences and integrated into an explanatory matrix. FINDINGS: Through dimensional analysis, weight management in OWO AAFs was characterized as a multidimensional concept, defined from the perspective of weight loss in community-dwelling AAFs. Behaviors associated …

The Fourth Color, April Emily Drafts-Johnson

Senior Theses

This thesis centers around short stories based on the student's favorite author, David Sedaris. Sedaris is a modern humor essayist who uses experiences from his daily life to create vivid, “real-ish” stories to entertain his readers. In nursing and in life, there are interesting tales to be told. The following stories are imaginative events that are based on the author’s personal experiences. Stories about family, coming of age, reflections on life, and fictional recounts of time spent working odd jobs in the hospital are all divided into five themes—the human experience, making the best of it, loss, darkness, and light. …

Multistable Perception In Older Adults: Constructing A Whole From Fragments, Khushi Patel, Maureen Reed

Publications

Visual perception is constructive in nature; that is, a coherent whole is generated from ambiguous fragments that are encountered in dynamic visual scenes. Creating this coherent whole from fragmented sensory inputs requires one to detect, identify, distinguish and organize sensory input. The organization of fragments into a coherent whole is facilitated by the continuous interactions between lower level sensory inputs and higher order processes. However, age-related declines are found in both neural structures and cognitive processes (e.g., attention and inhibition). The impact of these declines on the constructive nature of visual processing was the focus of this study. Here we …

Effects Of Sepsis Protocols On Health Outcomes Of Adult Patients With Sepsis, Monika U. Mróz

Theses and Dissertations

Sepsis is a condition that arises from the host’s own exaggerated response to an infection, directed towards pathogens, but causing multiple organ failure. Sepsis is one of the most common causes of death, and a considerable absorber of healthcare resources. This frequently fatal condition, despite progress in technology and improving knowledge of pathophysiology, is still poorly understood, carries high mortality and morbidity rates, and survivors are often left with permanent disabilities and poor health outcomes.

Initial presentation of sepsis is often nonspecific, making diagnosis difficult, and causing lifesaving treatment delays. Sepsis guidelines are derived from emerging evidence-based research. While there …

Identification Of Mild Freezing Shock Response Pathways In Barley Based On Transcriptome Profiling, Xiaolei Wang, Dezhi Wu, Qian Yang, Jianbin Zeng, Gulei Jin, Zhong-Hua Chen, Guoping Zhang, Fei Dai

Publications

Low temperature is a major abiotic stress affecting crop growth and productivity. A better understanding of low temperature tolerance mechanisms is imperative for developing the crop cultivars with improved tolerance. We herein performed an Illumina RNA-sequencing experiment using two barley genotypes differing in freezing tolerance (Nure, tolerant and Tremois, sensitive), to determine the transcriptome profiling and genotypic difference under mild freezing shock treatment after a very short acclimation for gene induction. A total of 6474 differentially expressed genes, almost evenly distributed on the seven chromosomes, were identified. The key DEGs could be classified into six signaling pathways, i.e., Ca(2+) signaling, …

Allelic Variation Of Bnacc.Tt2.A And Its Association With Seed Coat Color And Fatty Acids In Rapeseed (Brassica Napus L.), Longhua Zhou, Yuanlong Li, Nazim Hussain, Zhilan Li, Dezhi Wu, Lixi Jiang

Publications

Efficient molecular markers for the selection of rapeseed genetic materials with high seed oil content and ideal fatty acid (FA) composition are preferred by rapeseed breeders. Recently, we reported the molecular mechanism of TRANSPARENT TESTA 2 (TT2) in inhibiting seed FA biosynthesis in Arabidopsis. However, evidence showing the association of rapeseed TT2 homologs and seed FA production are still insufficient. In this study, we collected 83 rapeseed (Brassica napus L.) landraces from different geographical backgrounds to conduct association mapping of BnaC.TT2.a in relation to seed coat color and FA biosynthesis. Population background was corrected by 84 pairs of SSR markers …

Mysleep101©: An Educational Mobile Medical Application For Sleep Health In Primary Care, Sonya Cook

Theses and Dissertations

Insufficient sleep has emerged over the past few decades as a public health concern. As little as 1 to 2 hours of sleep loss can produce extreme fatigue and physiological drives similar to thirst and/or hunger which increases the risk of motor vehicle accidents, work related mistakes and injuries. Sleep restriction whether voluntary or involuntary has produced a culture of chronic sleep deprivation that can be seen throughout the population. Chronic lack of quality sleep has been shown to adversely affect cardiovascular health, cognitive function, memory, immune responses and hormonal regulation among other homeostatic functions. Sleep disorders represent the cause …

Nursing Attitudes Towards Suicidal Patients In The Emergency Department: Assessment Interview Training, Belinda Beaver

Theses and Dissertations

This project sought evidence for the effectiveness of pedagogy in professional nursing continuing education and its effect on emergency department nurse attitudes towards patients seeking crisis intervention for suicide. Approximately 12 million emergency department (ED) visits annually were for patients suffering with mental illness and/or suicidal ideation. Emergency department staffs were often not adequately prepared to manage these problems. The purpose of this project was to examine the impact of an educational initiative on nurses’ attitudes about patients expressing suicidal ideation in the emergency departments 2 rural southeastern towns.

The project question was; in two different rural community emergency departments …

Reliability Of The American Community Survey For Unintentional Drowning And Submersion Injury Surveillance: A Comprehensive Assessment Of 10 Socioeconomic Indicators Derived From The 2006-2013 Annual And Multi-Year Data Cycles, Nathaniel Bell, Bo Cai

Faculty Publications

BACKGROUND: Our objective was to evaluate the reliability and predictability of ten socioeconomic indicators obtained from the 2006-2013 annual and multi-year ACS data cycles for unintentional drowning and submersion injury surveillance.

METHODS: Each indicator was evaluated using its margin of error and coefficient of variation. For the multi-year data cycles we calculated the frequency that estimates for the same geographic areas from consecutive surveys were statistically significantly different. Relative risk estimates of drowning-related deaths were constructed using the National Center for Health Statistics compressed mortality file. All analyses were derived using census counties.

RESULTS: Five of the …

Nurses Utilizing The V.O.I.C.E.S. Hiv Prevention Intervention In The Black Church Community, Jason Richard

Theses and Dissertations

The Human Immunodeficiency Virus (HIV) epidemic is a significant problem in the United States, especially in the “Bible Belt” Deep South where the epidemic is hitting this region the hardest. The HIV epidemic in the state of South Carolina is very real, significant, and quite alarming. In fact, the Center for Disease Control and Prevention (CDC) labels South Carolina as an HIV “hot spot.” All racial and ethnic groups are susceptible and impacted by HIV. However, evidence shows that African Americans – especially young adults 18-35, bear the brunt of the burden to the extent that the “new face” of …

Unexpected And Interrupted Transitions Among Newly Licensed Registered Nurses: Perspectives Of Nurse Managers And Preceptors, Sheri S. Webster

Theses and Dissertations

Successful retention of newly licensed registered nurses (NLRNs) into practice is critical to ensure the nursing workforce required to meet current and future health care demands. NLRN turnover rates result in loss of revenue due to high orientation costs and further hinder the development of a stable workforce. For nurse educators and administrators to effectively address early attrition among NLRNs, they must have a clear understanding of the factors that contribute to NLRNs leaving employment. The aim of this qualitative descriptive research was to explore NLRN transition to professional practice from the experiences and perspectives of nurse managers and preceptors …

Client Perceptions Of The Mental Health Engagement Network: A Qualitative Analysis Of An Electronic Personal Health Record, Cheryl Forchuk, Jeffrey P. Reiss, Tony O'Regan, Paige Ethridge, Lorie Donelle Phd, Rn, Fcan, Abraham Rudnick

Publications

BACKGROUND: Information technologies such as websites, mobile phone applications, and virtual reality programs have been shown to deliver innovative and effective treatments for mental illness. Much of the research studying electronic mental health interventions focuses on symptom reduction; however, to facilitate the implementation of electronic interventions in usual mental health care, it is also important to investigate the perceptions of clients who will be using the technologies. To this end, a qualitative analysis of focus group discussions regarding the Mental Health Engagement Network, a web-based personal health record and smartphone intervention, is presented here. METHODS: Individuals living in the community …

Census-Based Socioeconomic Indicators For Monitoring Injury Causes In The Usa: A Review, Nathaniel Bell, Amanda Arrington, Swann Arp Adams

Faculty Publications

BACKGROUND:

Unlike the UK or New Zealand, there is no standard set of census variables in the USA for characterising socioeconomic (SES, socioeconomic status) inequalities in health outcomes, including injury. We systematically reviewed existing US studies to identify conceptual and methodological strengths and limitations of current approaches to determine those most suitable for research and surveillance.

METHODS:

We searched seven electronic databases to identify census variables proposed in the peer-reviewed literature to monitor injury risk. Inclusion criteria were that numerator data were derived from hospital, trauma or vital statistics registries and that exposure variables included census SES constructs.

RESULTS:

From …

Comorbidities And Quality Of Life Among Breast Cancer Survivors: A Prospective Study, Mei R. Fu, Deborah Axelrod, Amber A. Guth, Charles M. Clel, Caitlin E. Ryan, Kristen R. Weaver-Toedtman Phd, Acnp, Anp, Jeanna M. Qiu, Robin Kleinman, Joan Scagliola, Joseph J. Palamar, Gail D’Eramo Melkus

Publications

Many breast cancer survivors have coexistent chronic diseases or comorbidities at the time of their cancer diagnosis. The purpose of the study was to evaluate the association of comorbidities on breast cancer survivors’ quality of life. A prospective design was used to recruit 140 women before cancer surgery , 134 women completed the study . Comorbidities were assessed using self-report and verified by medical record review and the Charlson Comorbidity Index (CCI) before and 12-month after cancer surgery . Quality of life was evaluated using Short-Form Health Survey (SF -36 v2) . Descriptive statistics, chi-square tests, t-tests, Fisher’s exact test, …

Client Perceptions Of The Mental Health Engagement Network: A Secondary Analysis Of An Intervention Using Smartphones And Desktop Devices For Individuals Experiencing Mood Or Psychotic Disorders In Canada, Cheryl Forchuk, Lorie Donelle Phd, Rn, Fcan, Paige Ethridge, Laura Warner

Publications

BACKGROUND: The use of innovative technologies in mental health care has the potential to improve system efficiency, enhance quality of care, and increase patient engagement. The Mental Health Engagement Network (MHEN) project developed, delivered, and evaluated an interactive Web-based personal health record, the Lawson SMART Record (LSR), to assist mental health clients in managing their care and connecting with their care providers. This paper presents a secondary analysis of data collected in the MHEN project regarding clients' perceptions of technology and the use of these technologies in their care.

OBJECTIVE: We aimed to answer six questions: (1) What is the …

Health Behaviors Of Mandated And Voluntary Students In A Motivational Intervention Program, Donna M. Kazemi Phd, Rn, Cne, Fiaan, Maureen J. Levine, Jacek Dmochowski, K Roger Van Horn, Li Qi

Publications

UNLABELLED: College students engage in many unhealthy behaviors, one of these, heavy alcohol use, is a major global public health problem. OBJECTIVE: This longitudinal study examined whether students' mandated/voluntary status in a program to reduce college drinking was associated with overall health, ethnicity, gender, and personality traits. Both mandated and voluntary groups participated in the Motivational Intervention (MI) program to prevent high risk drinking. METHODS: Freshmen (710 voluntary, 190 mandated, n = 900) between the ages of 18 and 21, received the MI at baseline and again at 2 weeks, with boosters at 3, 6 and 12 months. Participants completed …

African Americans' Culturally Specific Approaches To The Management Of Diabetes, Ida J. Spruill, Gayenell S. Magwood Phd, Rn, Faha, Faan, Lynne S. Nemeth, Tiffany H. Williams

Publications

Spirituality is an important multidimensional cultural resource and coping strategy used by many African Americans for managing chronic diseases such as diabetes. Yet, few studies examine meaning and interpretation of colloquial terms frequently used for coping within the context of a community culture. We designed an interpretive qualitative study to gain a deeper understanding of a colloquial phrase, "I ain't claiming it," used among Project SuGar research participants when discussing diabetes. Thematic analysis revealed two major themes, Acknowledgment and Denial, as coping mechanisms through an active or passive relationship with God. Sub-theme of acknowledgment was presented as front seat driver …

An Evidence-Based Approach To Prepare Interdisciplinary Team Members For Implementation Of The Abcde Bundle, Jessica Murner Hamilton

Theses and Dissertations

Quality improvement projects contribute to the development of evidence-based management strategies for successful implementation of evidence-based practices in health care, thus reducing the risk of change implementation failure. This study assessed practice change implementation strategies for the awakening and breathing trial coordination, delirium assessment and management, early exercise and mobility (ABCDE) bundle. The ABCDE bundle is an evidence-based, interdisciplinary framework for managing pain, agitation, and delirium, reducing the duration of mechanical ventilation, and supporting early mobility in critically ill patients. The purpose of this study was to implement a nurse-driven initiative to design and put into place an evidence-based approach …

Best Practice For A Standardized And Safe Registered Nurse Shift Handoff, Nancy Rankin Ewing

Theses and Dissertations

One of the most important times for the delivery of patient care occurs during the change of shift handoff between professional nurses. This complex interchange of information and responsibility carries with it distinct possibilities for error that can adversely affect a patient’s hospitalization, safety, and the quality of patient care outcomes (Blouin, 2011; Hilligoss & Cohen, 2011). Communication errors, including errors during shift handoff, account for more than 70% of sentinel events that occur in the provision of healthcare in the acute care setting (Federwisch, 2007; Streeter, 2010). Poorly conducted and unstructured shift handoffs are known to result in delayed …

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

Theses and Dissertations

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

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

Theses and Dissertations

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

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

Theses and Dissertations

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

The Association Of Individual And Neighborhood Social Cohesion, Stressors, And Crime On Smoking Status Among African-American Women In Southeastern Us Subsidized Housing Neighborhoods, Jeannette O. Andrews, Martina Mueller, Susan D. Newman, Gayenell Magwood Phd, Rn, Faha, Faan, Jasjit S. Ahluwalia, Kellee White, Martha S. Tingen

Publications

The purpose of this study was to examine the associations between individual and neighborhood social contextual factors and smoking prevalence among African-American women in subsidized neighborhoods. We randomly sampled 663 adult women in 17 subsidized neighborhoods in two Southeastern US states. The smoking prevalence among participants was 37.6%, with an estimated neighborhood household prevalence ranging from 30 to 68%. Smokers were more likely to be older, have lower incomes, have lower BMI, and live with other smokers. Women with high social cohesion were less likely to smoke, although living in neighborhoods with higher social cohesion was not associated with smoking …

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

Theses and Dissertations

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

was created for nurse faculty to use that outlined current …

A Spatial Analysis Of Functional Outcomes And Quality Of Life Outcomes After Pediatric Injury, Nathaniel Bell, Sami Kruse, Richard K. Simons, Mariana Brussoni

Faculty Publications

BACKGROUND:

Changes in health-related quality of life (HRQoL) are more regularly being monitored during the first year after injury. Monitoring changes in HRQoL using spatial cluster analysis can potentially identify concentrations of geographic areas with injury survivors with similar outcomes, thereby improving how interventions are delivered or in how outcomes are evaluated.

METHODS:

We used a spatial scan statistic designed for oridinal data to test two different spatial cluster analysis of very low, low, high, and very high HRQoL scores. Our study was based on HRQoL scores returned by children treated for injury at British Columbia Children's Hospital and discharged …

Genetic Architecture Of Limit Dextrinase Inhibitor (Ldi) Activity In Tibetan Wild Barley, Yuqing Huang, Shengguan Cai, Lingzhen Ye, Yong Han, Dezhi Wu, Fei Dai, Chengdao Li, Guoping Zhang

Publications

BACKGROUND: Limit dextrinase inhibitor (LDI) inhibits starch degradation in barley grains during malting because it binds with limit dextrinase (LD). There is a wide genetic variation in LDI synthesis and inactivation during barley grain development and germination. However, the genetic control of LDI activity remains little understood. RESULTS: In this study, association analysis was performed on 162 Tibetan wild accessions by using LDI activity, 835 Diversity Arrays Technology (DArT) markers and single nucleotide polymorphisms (SNPs) of the gene HvLDI encoding LDI. Two DArT markers, bpb-8347, bpb-0068, and 31 SNPs of HvLDI were significantly associated with LDI activity, explaining 10.0%, 6.6% …

Routine Versus Ad Hoc Screening For Acute Stress Following Injury: Who Would Benefit And What Are The Opportunities For Prevention, Nathaniel Bell, Boris Sobolev, Stephen Anderson, Robert Hewko, Richard K. Simons

Faculty Publications

BACKGROUND:

Screening for acute stress is not part of routine trauma care owing in part to high variability of acute stress symptoms in identifying later onset of posttraumatic stress disorder (PTSD). The objective of this pilot study was to assess the sensitivity, specificity, and power to predict onset of PTSD symptoms at 1 and 4 months using a routine screening program in comparison to current ad hoc referral practice.

METHODS:

Prospective cross-sectional observational study of a sample of hospitalized trauma patients over a four-month period from a level-I hospital in Canada. Baseline assessments of acute stress (ASD) and subsyndromal ASD …