Nursing Commons^™

Choices Related To Maximizing Quality Of Life At End Of Life, Theresa Lynn

Dissertations

Humans, including those residing in the United States, can live in denial of their own mortality. Because of this, futile care is sometimes provided, often at great monetary expense and for little or no return in terms of quality or length of life. At least two opportunities exist for making choices regarding care at the end of life in the U.S.: completing advance directives and choosing hospice care. This dissertation consists of three studies related to this topic. The first is a quantitative study about advance directives and attitude toward death. The advance directive completion rate among adults in the …

Patients' Perception Of Feeling Known By Their Nurses And The Nurse Practice Environment, Deene' L. Mollon

Dissertations

Healthcare leaders have a responsibility to understand the connection between healthy practice environments and patients’ perceptions of care. The purpose of this research was to explore the relationship between the nurses’ perception of the practice environment and the patients’ perception of feeling known by their nurses.

This descriptive, correlational study used quantitative and qualitative methodology. A convenience sample of 123 patients, on six patient care units, completed the Patients’ Perception of Feeling Known by their Nurses Scale and a supplemental survey designed to determine the content validity of the Patients’ Perception of Feeling Known by their Nurses Scale. To …

Leadership Practices Among Undergraduate Nursing Instructors, Melissa Martin Bryant

Dissertations

The purpose of this study is to identify leadership practices of nursing instructors in the southern U.S.; and to determine if instructor leadership practices differ from the ‘norm’ leadership practices reported by the LPI instrument (Posner 2008), or from the practices observed by their matched students (observer version). Further, the purpose is to determine the relationship between instructors self-reported leadership practices (self-version) and student observed practices based on institution type, and instructor education level. The consisted of a group of instructors and students that were primarily Caucasian and female. The demographics for the instructors and students were similar to the …

Use Of Dietary And Herbal Supplements In Older Adults With Osteoarthritis, Sharon Denise Mcdonald

Dissertations

Over the past several decades, older adults with Osteoarthritis (OA) have increasingly used more natural products in an effort to manage chronic pain. The theoretical framework for this study was the Lazarus and Folkman transactional theory of stress and coping. This framework was chosen based on the belief that older adults with OA are taking natural products as an active problem solving coping strategy to manage the pain, disability, and alterations they experience in their health related quality life including functional status, physical symptoms, emotional health, and social functioning. Older adults also take prescription medications for Osteoarthritis and a variety …

Efficacy Of Behavioral Interventions In African-Americans With Type Ii Diabetes: A Comparative Effectiveness Analysis, Tangela Nicole Hales

Dissertations

Context: The efficiency and effectiveness of the healthcare system are prime foci for nursing research.

Objective:The purpose of this study was to review and critically appraise the current state of the evidence in the treatment of African American adults with type II diabetes. To address this objective, a systematic review was undertaken that investigated the comparative effectiveness of behavioral interventions in improving glycemic control.

Methods: Robust methodological approaches to comparative effectiveness research (CER) serve to improve the transparency, consistency, and scientific rigor of the research. The methods for this systematic review of literature followed those recommended in the Agency …

A Measure Of Soft Skill Gains Acquisition With Engagement In Baccalaureate Nursing Programs, Wendy J. Williams-Buenzli

Dissertations

This dissertation examined soft skill acquisition from engagement in baccalaureate nursing programs. Baccalaureate nursing programs prepare nurses to be the future leaders of nursing practice. Soft skills include critical thinking, interpersonal communications, and ethical decision-making. To explore the acquisition of soft skills, this research study analyzed data from the National Survey of Student Engagement to explore for gains in critical thinking, ethical decision-making, and critical thinking. After gains scores were identified, then correlations were run to identify key engagement indicators. The findings of the study found gains in soft skill behaviors from freshman year to senior year of baccalaureate education. …

Knowledge Of Stroke Symptom And Risk Factors And Acculturation Among Cambodian Immigrants Living In Southern California, Samantha N. Sangsanoi-Terkchareon

Dissertations

The purpose of this quantitative study was to describe and examine the relationships between age, gender, educational level, health insurance status, and income to level of acculturation and knowledge of stroke symptom and risk factors recognition among Cambodian immigrants (n=200) living in Southern California. The data were analyzed using Pearson correlation, Kendal Tau, Chi-Square, and multiple regression to the determine relationship between depend and independent variables. The results of this study were that Cambodian participants’ mean age was 46.07 (SD= 17.51), average years of education were 8.95 (SD=5.26) and the mean number of people in each household was …

Retrospective Electronic Health Record Review Of Preoperative Screening Of Candidates For Total Joint Replacement, Jill Ann Rude

Dissertations

Advanced practice nurses (APNs) play an important role in preoperative screening. The purpose of this project was to determine the effectiveness of pre-operative screening criterion established February 2012 for patients greater than 40 years old who underwent total knee or hip replacement surgery. Of the 1850 electronic health records reviewed, 1065 (57.6%) total knee and total hip replacement surgeries took place before and 785 (42.4%) took place after screening criteria were implemented. Before implementation of screening criteria 53 (4.98%) patients experienced critical changes (code blue or critical assessment team call); after the implementation of screening 30 (3.82%) patients experienced critical …

Academic And Non-Academic Variables As Predictors Of Nclex-Rn Success Among Traditional Associate Degree Students At Southern Adventist University, Christine Moniyung

Dissertations

Problem

The School of Nursing at Southern Adventist University offers both Associate of Science and Bachelor of Science in nursing degrees. A majority of the students who sit for the NCLEX-RN are associate of science in nursing graduates. The pass rate dropped from 94.9% in 2010 to 88.8% in 2011. The pass rate went up to 93.3% in 2012, but dropped again by almost 5% in the following year, and to an all-time low of 76.5% in 2014.

Unlike most AS nursing program student populations in the nation, the majority of SAU students are young and considered traditional-age college students. …

Influence Of Maternal Prior Life Adversity On The Psycho-Neuroendocrine-Immune Profile During Pregnancy, Karen J. Kotz

Dissertations

Pregnancy is accompanied by a multitude of physical and psychological changes. Adaptation to these changes through reduced anxiety and attenuated stress responsiveness is necessary across gestation and into the postpartum period for optimal maternal-infant health. In contrast, exposure to higher amounts of stressors during pregnancy can disrupt neuroendocrine-immune processes required for successful pregnancy outcomes. Evolving evidence demonstrates that exposure to adversity early in life has long-lasting effects on stress response systems that alter stress reactivity during adulthood. Given this evidence, it is posited that women who experience greater pre-pregnancy adversity during their childhood are at greater risk for negative maternal-infant …

Attitude, Subjective Norm, And Perceived Behavioral Control As Indicators For Nurse Educators’ Intention To Use Critical Thinking Teaching Strategies: A Structural Equation Model Analysis, Angerlita Yolanda Smith

Dissertations

Problem

Deficiencies in new nursing graduates’ ability to use critical thinking skills have been documented. Researchers have found that the continued use of traditional teaching methods and less student-centered approaches for critical thinking development has contributed to this problem. This particular issue has evoked much concern for institutions and organizations involved with the safe delivery of patient care. The purpose of this study was to examine (a) the relationship between the factors educator characteristics, attitude, subjective norm and perceived behavioral control in a hypothesized model that may influence nurse educators’ intention to use instructional methods that promote critical thinking in …

Easing My Burden: A Grounded Theory Study Of Kidney Transplant Recipients' Experience With Their Transplant Coordinators, Gwen E. Mcnatt

Dissertations

Organ transplantation holds the promise of new life or better life for thousands of Americans every year. Transplantation involves a process that stretches over time beginning at referral, moving to transplantation and long term care. The transplant coordinator is considered an integral part of this care. Transplant coordinators are considered so important to the care of these patients that transplant centers are required to have at least one transplant coordinator by federal regulations.

The role of the transplant coordinator, however, is not well defined. Although many of the role dimensions attributed to transplant coordinators are consistent with nursing practice, the …

Implementation Of Sleep Problem Screening In A Pediatric Primary Care Office, Jennifer Erin O'Donnell

Dissertations

Sleep problems, a major problem for children and their parents, are the most common complaint brought to pediatric clinicians (advanced practice nurses and other healthcare providers) attention but are often ignored and underdiagnosed in the pediatric population (Faruqui, Khubchandani, Price, Bolyard, & Reddy, 2011). “Sufficient amounts of good quality sleep are necessary for healthy development in childhood” (Bordeleau, Bernier, & Carrier, 2012, p. 254). Inadequate sleep in children has been linked to numerous adverse outcomes psychologically as well as physically (Owens, Jones, & Nash, 2011). The American Academy of Pediatrics (AAP), issued recommendations in 2002 stating screening for snoring, one …

Onsite Integrative Clinics: Acupuncture, Positive Patient Outcomes, And Frequency Of Provider Office Visits, Sherry Shoemaker Phd

Dissertations

Purpose and Aims. There is limited information about outcomes of care, resource utilization, and associated costs for patients who receive acupuncture in integrative health settings. The purpose of this study was to address this gap through the following aims: To examine: (1) changes in patient pain levels pre/post acupuncture treatments; (2) relationships between receiving acupuncture treatments (number of treatments, length of time, select demographic factors, (age, gender), pain level pre and post acupuncture treatments; (3) relationships between number of treatments, length of time, age, gender, pain level (pre/post acupuncture treatments) and provider visits (pre/post acupuncture treatments); and (4) relationship between …

Exploring A Diabetic Registry For Cardiovascular Risk Factors, Mary C. Anziano Phd

Dissertations

Background: Cardiovascular disease is the leading cause of death in the United States. There were over 18 million people diagnosed with diabetes in 2002. These disease processes together combine for significant health burden on society (American Diabetes Association, 2008). The purpose of the study was to describe the relationship between select demographics, and clinical characteristics to determine risk factors for cardiovascular disease in a diabetic population. Methods: A retrospective descriptive study was conducted using a diabetic registry database containing patients diagnosed with diabetes from January 1, 2011 to December 31, 2012. Study variables included age, gender, socio-economic status, glycosylated hemoglobin …

The Case Of Reintegration Of Women Post Incarceration, Deana Raley Noble Phd

Dissertations

Women released from prison or jail face particular obstacles and challenges on reentry to the community, many of which are related to their childhood and to gender roles as women and mothers. This study relates the lived experience of one woman's successful transition to economic and mainstream societal reintegration and family reconnection after release from prison and the insights gained by the researcher. Case study methodology congruent with Miller's Relational-Cultural Theory philosophical framework was utilized in this in-depth, single case design and represents a unique case. The overall purpose of this descriptive and explanatory research was to explore precursors to …

Relationship Between Age And Pre-End Stage Renal Disease Care In Elderly Hemodialysis Patients, Rubette Harford Phd, Msn, Rn

Dissertations

Purpose: The primary purpose of this dissertation was to examine the relationship between age and receipt of three components of pre-end stage renal disease care prior to first initiation of hemodialysis, and to explore the implications of differences in interpretation of funding policies for dialysis services in Puerto Rico and the U.S. mainland. Background: The growing burden of chronic kidney disease (CKD) is a national public health concern, particularly within the aged population. It is estimated that more than 25 million Americans are living with some level of kidney disease, with an increasing prevalence noted with increasing age (Coresh et …

Assessing The Monitoring And Management Of Overweight And Obesity In Children Hospitalized For Asthma, Anne E. Borgmeyer

Dissertations

Asthma and overweight are two of the most common chronic health problems in children. Data support a relationship between the two health issues. Although asthma is one of the top reasons for hospital admission for children, little is known about the prevalence of overweight and obesity or clinical practice related to weight in children hospitalized for asthma. The purpose of this project was to assess weight characteristics of children admitted with asthma, as well as the current practices of monitoring and management of overweight and obesity in children hospitalized with asthma. A retrospective review of medical records was conducted. The …

Depressive Symptomatology And Perceived Social Support In Adolescents With Type 2 Diabetes, Kristiana Gay Huffman Cullum Phd, Cpnp

Dissertations

Type 2 diabetes has increased dramatically in the pediatric population in the last decade. One of the comorbidities of diabetes is depression. In the presence of depression, diabetes may be mismanaged by patients and lead to a decline in health. Diabetes with comorbid depression may have better disease management outcomes in the presence of higher levels of social support. Defining childhood depression, which encompasses adolescence, and the subtleties of this disorder compared to the adult counterpart, was needed to better delineate important variables for this research study. There are several instruments that evaluate adolescents' perceived social support, but a fairly …

Symptom Burden And Healthcare Utilization In Pulmonary Arterial Hypertension, Catherina Anne Madani Phd

Dissertations

Background: Pulmonary arterial hypertension (PAH) is a rapidly progressive disease. There is currently no cure; thus treatment is aimed at prolonging survival, improving functional status (FS), and symptom mitigation. Symptom burden (SB) can impact quality of life (QOL), and lead to increased healthcare utilization. Palliative care (PC) has been associated with higher QOL, decreased depression, aggressive care, and mortality. The Institute of Medicine's (IOM) recent report supports earlier integration of PC for people living with serious illness. Detection of patients at high risk for heavy SB may help to identify patients who could benefit from earlier integration of PC into …

Patients With Advanced Lung Cancer: Quality Of Life And Perception Of Dyspnea, Barbara A. Roces Phd, Msn, Np, Rn

Dissertations

Background: Dyspnea perception can be defined as a multidimensional experience of breathing discomfort, influenced by physiological, psychological, social, and environmental factors, that includes secondary psychological and behavioral responses and cannot be defined only by physical objective abnormalities (Mularski et al., 2010). Dyspnea is the most common and distressing symptom in patients with advanced lung cancer and decreases one's quality of life (QOL) (Smith et al., 2001). Furthermore, dyspnea has been found to interfere with physical activities such as walking, work, and psychological activities such as disposition, taking pleasure in life, relationship with others, and sleep (Tanaka, Akechi, Okuyama, Nishiwaki, & …

Patient Care Technology And The Nurse-Patient Relationship, Belinda M. Toole Phd, Msn, Rn

Dissertations

Background: Technological devices are increasingly used in healthcare and their proliferation has providers questioning the impact on the patient-provider relationship. Technological device integration has been studied in the primary care setting, less extensively in the acute care setting. The impact of device use on the nurse-patient relationship in acute care setting required further study, particularly with nursing's history of holistic practice incorporating caring and presence. Objectives: The study purpose was to explore the patient's perceptions of nurse caring and presence when technological devices were used in care delivery in the acute care setting. Specific aims were: 1) to describe the …

Skin Cancer Risk Perception And Sunscreen Use In Adolescent Female Soccer Athletes, Cheryl L. Butera Phd, Msn, Aprn, Fnp-Bc, Np-C, Phn

Dissertations

Over 3.5 million cases of skin cancer are diagnosed annually in the United States. In adolescent females ages 15-19, melanoma is the second most common form of cancer. The greatest risk factor for skin cancer is ultraviolet rays from the sun. Research has shown that sunscreen use is protective of all skin cancers, especially melanoma. The purpose of this study was to obtain perceptions about risk of skin cancer and sunscreen use among 13- to 18-year-old adolescent female club soccer athletes as a basis for effective interventions to improve sunscreen use in this population. The Health Belief Model was employed …

Increasing Patients’ Knowledge In Transmission Of Bacterial Vaginosis And Its Treatment Regimens, Debra Garner

Dissertations

Research has shown bacterial vaginosis to be one of the most common vaginal disorders in women of child bearing age (Chen, Tian, & Beigi, 2009; Centers for Disease Control, 2012; Menard, 2011). Each year many women are seen by their gynecologist, sexually transmitted infection (STI) clinics, and emergency rooms (ER) for complaints of having malodorous discharge (Bradshaw, et al., 2005). Several STI’s and adverse pregnancy outcomes have been attributed to women having bacterial vaginosis (Bradshaw, et al, 2005; Chen, et al.2009; Elkins, & Mayeaux, 2010). Women are predisposed to bacterial vaginosis by the use of wearing non cotton underwear, douching, …

Provider Perception Of Patient Satisfaction If Antibiotics Are Not Given For Upper Respiratory Infection, Robyn Doniel Drake

Dissertations

The purpose of this project was to assess if advanced practice nurse practitioners perceived patient satisfaction of patients seen in Metropolitan Retail Clinics was improved after educational materials were given to explain when antibiotics work. I hypothesized that provider perception of patient satisfaction would decrease unnecessary prescribing of antibiotics after providing patient education? This project used questionnaires to collect data from control and intervention groups to demonstrate a gain in provider perception if patient satisfaction after education was given in the intervention group. The results of this project did not reveal to the primary investigator what was originally assumed, that …

Nutrition, Appetite And Weight Loss In Elders Living In Long-Term Care Facilities, Karene Marie Goodman

Dissertations

Abstract Elders living in long-term care facilities often experience weight loss. Weight loss in elders has been shown to increase their risk of death. Existing research has identified numerous factors associated with appetite and weight loss in elders. Dementia, depression, acute and chronic illness, and medications have all been identified as potential causes of decreased appetite and weight loss in elders. Only a few nutritional and appetite assessment tools exist, and these tools are not widely used in long-term care facilities. The purpose of this descriptive study was to validate the Simplified Nutritional Appetite Questionnaire (SNAQ), an appetite assessment tool …

Instituting A Behavioral Wellness Program And Updating A Clinical Pathway For Economically Disadvantaged Overweight And Obese Adults In A Community Health Center: A Clinical Scholarship Project, Kimberly D. Buck

Dissertations

This project is intentionally instituted in an underserved community in an attempt to bridge the gap of health disparities in a population that would otherwise not have access to such programs. The purpose of this clinical scholarship project is to work with the Midwestern health center to encourage weight loss as well as to promote healthy lifestyles and reduce risk factors among economically disadvantaged persons by: (a) starting a wellness program that incorporates both behavioral and physical health using principles of motivational interviewing and health coaching, and (b) updating a clinical pathway for persons with a body mass index twenty-five …

Nurse Practice Environment And Peripheral Intravenous Infiltrations In A Pediatric Hospital On The Magnet Journey, Jannise Topacio Baclig Phd

Dissertations

Background: Characteristics such as quality patient care, excellence in nursing, and innovations in professional nursing practice shape a health care organization into a "magnet" organization. Magnet designation is a key aspect of nursing, which places pressure on healthcare organizations to commit to nursing excellence and patient care should they take the challenge of attaining this prestige. With growing focus on quality and safety, nursing needs to remain diligent in ensuring a healthy work environment that not only supports the profession, but also sustains exceptional patient outcomes. The purpose of this research study was to describe the relationship of the nurse …

Safety Hazards Education For Mothers Who Are Homeless: Target Teaching To Improve Knowledge Of Safety Hazards For Children Under Five Years Of Age, Susan Halpern Fliesher

Dissertations

The leading cause of morbidity and mortality in children in the U. S. is unintentional injury (Center for Disease Control Child Injury Report, 2000 to 2006), but there is little information about homeless mothers with children and child unintentional injury. Frencher et al. (2010) compared lower socioeconomic families with children with housing to homeless families with children, and found that unintentional injury was 13% higher among homeless children. Mothers who are homeless often need to navigate a variety of temporary housing and may lack understanding of child safety hazards in strange environments, limiting their ability to ensure their children’s safety …

Quantitative Measurement Of Reciprocal Social Behavior Among Toddlers Aged 18 To 24, Rebecca Sarah Light-Pearlman

Dissertations

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that starts in early childhood. It is characterized by impairments in reciprocal social behavior, impaired language, and stereotypic behavior/restricted interests (Pine, Luby, Abbacchi, & Constantino, 2006). One in 68 children is affected by ASD (Centers for Disease Control and Prevention, 2014). The prevalence of ASD is rapidly increasing. New estimates show a 23% increase in the number of cases since 2009 and a 78% increase in case numbers since 2007 (CDC, 2013). The purposes of this project were to: (a) establish normative parameters of reciprocal social behaviors, among toddlers aged 18 to …