Nursing Commons^™

Validation Of The Transportation Burden Questionnaire Among Family Caregivers Of Older Adults, Bryant James Price

Dissertations

Because family caregivers provide a substantial amount of informal care to dependent loved ones, the potential burden such care may place on family members is an important area for clinical research and intervention. While the provision of transportation is recognized in the literature as a caregiving task and a component of global burden, few studies, to date, have addressed this as a distinct concern for measurement and intervention. The purpose of this study was to determine if an item set focused specifically on transportation burden would be additive to accepted global measures of burden in a volunteer sample of caregivers. …

Efficacy Of Mantram Repetition Program On Sleep In Veterans With Posttraumatic Stress Disorder, Lindsay Cosco Holt Phd

Dissertations

Posttraumatic Stress Disorder (PTSD) affects over seven million (3.5%) of the US adult population. In 2011, 476,515 veterans were currently seeking treatment for PTSD. Statistics show that 87% of veterans with PTSD report sleep disturbances and 52% experience frequent nightmares, making sleep the second most common reason why veterans seek mental health care upon return from deployment (Germain et al., 2006). Studies have sought to find a link between PTSD and sleep, and the importance of sleep in the recovery process, but there is a gap in the research on sleep disturbances and interventions for improvement in veterans with PTSD. …

Gestational Weight Gain Patterns, Hope R. Farquharson Phd

Dissertations

Background: Managing gestational weight gain (GWG) remains a global health priority as obesity among women of childbearing age and their children have been linked to excessive GWG. Excessive GWG has been linked to increased rates of cesarean sections, preterm births, hypertensive disorders, gestational diabetes, large for gestational age newborns, postpartum weight retention, long-term obesity for the woman and her children. Conversely, adverse outcomes resulting from weight gain below recommendation could potentially include preterm births, increased rates of neonatal intensive care admission, and newborn morbidity and mortality. Previous studies indicate the need for healthcare providers to help women gain within the …

Is Combat Exposure Predictive Of Higher Preoperative Stress In Military Members?, Eric J. Bopp Phd

Dissertations

Since September 11, 2001, the United States has been engaged in large-scale combat operations exposing numerous military service members to stressful, traumatic, and threatening environments. As a result, many of these individuals have experienced significant psychological problems, such as anxiety, depression, and posttraumatic stress disorder (PTSD), as well as physiological alterations, such as cardiovascular changes and neuroendocrine disturbances. The preoperative experience may be perceived as stressful, often increasing in magnitude as the patient progresses through the preoperative period. Military anesthesia providers frequently provide anesthetic care to military members with a history of combat exposure. Anecdotally, it is not uncommon for …

Identification Of Posttraumatic Stress Disorder Symptoms In Post-Icu Patients, Heather Warlan Phd, Rn, Ccrn

Dissertations

Background: Patients receiving critical care are experiencing post-traumatic stress syndrome (PTSS) as a result of life-saving interventions received in the intensive care unit (ICU). PTSS is associated with poor patient outcomes and decreased quality of life compared to post-ICU patients without PTSS. Personal and clinical characteristics that place patients at higher risk for PTSS are still being examined. It is also unknown to what extent patients are being screened for ICU-induced PTSS. Objectives: This body of work aims to examine the risk factors associated with ICU-related PTSS and describe the screening experiences of patients who recently received care in an …

Delirium Rate And Risk Factors In Palliative Care Outpatients And Caregiver Coping Strategies, Sarah Deur Livermore Phd, Fnp

Dissertations

Background: Delirium causes suffering and in terminal illness undermines important goals to die at home. Improved knowledge about delirium among palliative outpatients can lead to improved patient outcomes through early identification and treatment in the home. Conversely, a missed diagnosis leads to costly hospital admissions, and is the most common reason to seek long-term care placement (Breitbart & Alici, 2008). Medicare stresses the importance by listing it as a common cause of falls among non-reimbursed hospital events. Prior evaluation of outpatient delirium rate was 14% among demented community dwelling elders (Steis, Evans, et al., 2012a). It is hypothesized that frail, …

Professional Quality Of Life And Emergency Department Nurses' Communication Patterns, Elvira Dominguez-Gomez Phd

Dissertations

The purpose of this mixed methods embedded design study was to examine relationships between compassion satisfaction, burnout, compassion fatigue/secondary trauma, and perceived levels of communication difficulty in emergency room nurses employed at a health care system. Quantitative data was collected from a purposive sample of 43 emergency room nurses using the Professional Quality of Life Scale (ProQOL), the Silencing Response Scale, and a demographic form. The study's embedded qualitative component was participants' experiences with traumatic cases in the emergency room. Qualitative data was collected via telephone interview with 10 emergency room nurses obtained from a subset of the original sample …

Fetal Heart Monitoring, Nursing Surveillance, And Cesarean Birth, María Del Carmen Colombo Phd

Dissertations

Purpose: Birth by cesarean delivery is a major public health issue with nearly one in three births delivered by cesarean section. Cesarean birth may be necessary to save mother or baby, but the rapid rise since 1996 without concomitant reduction in maternal and neonatal morbidity and mortality may indicate this mode of delivery may be over utilized. Cesarean births pose significant maternal and newborn health risks. Identification of factors that may contribute to reduction in the first cesarean birth in low-risk women who are nulliparous, term gestation, with single fetus in head down position (NTSV) is a health priority. The …

Transitioning Adolescents With Type I Diabetes To Adult Care, Kathyann Kenny Marsh Phd

Dissertations

Background: Care transitions, defined as hospital discharge or movement from one healthcare setting to another, are currently a major concern for healthcare providers and policy makers alike. These care transitions are occurring in the context of increasingly fragmented care and have been known to result in hospital readmissions, adverse events, and medication errors. The adolescents' transition between pediatric and the adult care system is not only fragmented but occurs at a time when they are most vulnerable and ill equipped for change. Objectives: The purpose of this research was to conduct a feasibility study to examine if the use of …

A Phenomenological Study Of Acceptability Of Preexposure Prophylaxis Therapy Within The Lived Experiences Of Hiv Negative Male-To-Female Transgender Young Adults, Gloria N. Nwagwu Phd

Dissertations

The male-to-female transgender (MtF-TG) are individuals assigned a male gender at birth but self identify as female. MtF-TG young adults experience discrimination, stigmatization, isolation, and homelessness as a result of gender identity and gender expression. The transgender populations are linked to high rate of new HIV infection. The use of Preexposure prophylaxis (PrEP) therapy demonstrated a decrease in HIV infection risk ranging from 42% to 73% among sexual minority individuals. The goal of this three-part study was achieved through concept analysis, data collection, and analysis. The following aims were addressed; analyze the concept of transgender, explore currently used HIV prevention …

Hospital Fall Prevention Using Interactive Patient Care Technology, Verna A. Sitzer Phd, Mn, Rn, Cns

Dissertations

The impact of patient engagement in hospital fall prevention using interactive patient care technology is not known. The purpose of this investigation was to examine the engagement of hospitalized patients in a computer-based, interactive patient care fall prevention pathway, comprised of a self-assessment of fall risk questionnaire and a fall prevention video, and hospital fall outcomes. The aims were to 1) formulate an interactive patient care technology conceptual framework to guide the study, 2) provide reliability and validity evidence for a patient self-assessment of fall risk questionnaire, and 3) explore the relationship between the fall prevention pathway engagement characteristics and …

A Sleep Apnea Program For Commercial Drivers, Gayla Ann Dace

Dissertations

Sleepy driving is a major contributing factor to the motor vehicle crash risk associated with commercial drivers (Pack et al., 2006). In commercial vehicles, approximately 31% to 41% of major crashes can be linked to sleepy driving (Gurubhagavatula et al., 2004). An average non-fatality crash involving a commercial motor vehicle costs about $75,637 while a fatality crash averages about $3.54 million (Gurubhagavatula et al., 2004). A contributing factor to sleepy driving is obstructive sleep apnea (Pack et al., 2006). The purposes of this study were to: (1) determine how many commercial motor vehicle drivers referred to a sleep center as …

Relationship Between Horizontal Violence Among Registered Nurses And Falls, Elizabeth Densford Rocha Phd

Dissertations

Background: Horizontal violence is a manifestation of oppressed group behavior leading to low self-esteem and feelings of worthlessness among nurses. Horizontal violence leads to the creation of a hostile, unsafe work environment preventing nurses from performing at their highest potentials. A hostile work environment leads to a culture of unsafe patient care which may result in increased harm to patients. An understanding of why horizontal violence occurs and the implications of this phenomenon are the first steps in addressing this destructive behavior as well as protecting patients from harm. Health care environments must support nurses to perform at their best …

Does Participation In A Multi-Modal Activity-Based Program Impacts On Functional Recovery, And Quality Of Life In Adults With Spinal Cord Injury?, Carolyn S. Gerber Phd, Msn, Rn

Dissertations

The purpose of this study was to explore the relationships between relevant personal factors, participation in a multi-modal activity-based training program, and the program's impact on an individual's level of functional recovery, and overall quality of life in adults with Spinal Cord Injury (SCI). A descriptive, correlational design was performed on a secondary analysis dataset to conduct this study. Inferential statistics were performed with mixed ANOVA's on measures of ASIA UEM and LEM scores, EuroQol, and SWLS to compare their means. The study proposed that participation in a multi-modal activity-based training program would be associated with greater functional recovery, less …

Relationship Between Participation In Nurse Externship Program And Rn Retention And Quality Care, Lourdes C. Salandanan Phd

Dissertations

Study Background. Nurse externship programs were initially developed by healthcare institutions as a recruitment tool for new nurses. Literature has demonstrated the positive outcomes of the program on the participants and healthcare institutions but during times of economic difficulties, health care institutions discontinue the program. The studies that demonstrate the value of the program are limited to the recruitment phase and the 2-year retention of the newly graduated nurses. There is a need to demonstrate the value of the program in terms quality of care and long term RN retention. Research Questions. The three research questions this study addressed include: …

Factors Affecting Health Promotion Lifestyle Behaviors Among Arab American Women, Kholoud Khalil Phd

Dissertations

Guided by Pender and colleagues' (2006) revised health promotion model (HPM), this descriptive correlational study was designed to explore the relationships between personal factors (comprised of sociodemographic factors, degree of acculturation, and perceived stress), perceived health self-efficacy, perceived social support, and health promotion lifestyle behaviors (HPLBs) among a group of Arab American women (AAW) living in Southern California. A second purpose was to explore the psychometric properties of the translated version of the perceived health competence scale (PHCS). A convenience sample of 267 AAW were administered a paper copy of a self-reported survey. Four of the study's five standardized measures …

Determinants Of Physical Activity In Arab American Children, Wearn Alkhatib Phd

Dissertations

Physical activity is an integral part of preventing and managing childhood and adolescent obesity. Lack of regular physical activity has negative impact on physical and psychosocial health. Arab Americans (AAs), one of the most rapidly growing minorities in United States, tend to have a high prevalence of obesity and low participation in physical activity. The purpose of this study was to describe determinants of physical activity, including self-efficacy, social support, physical environment, and selected demographics among AA children in Southern California. A descriptive correlational study using a cross sectional design was conducted. Self-administered questionnaires were completed by children (N=206) recruited …

Factors That Relate To Registered Nurses' Readiness For Interprofessional Learning In The Context Of Continuing Professional Development, Collette Williams

Dissertations

Today’s health-care professionals practice in a highly technological, multidisciplinary environment. In order to provide safe, effective, and high-quality patient care, collaboration is required among all professionals. Traditionally each profession has operated independently in regard to continued professional development. The purpose of this study was to assess practicing registered nurses’ readiness toward interprofessional learning in order to align learning with current practice.

Method. An ex post facto study design was used to gather data to examine if there is a relationship between variables of demographics and readiness for interprofessional learning. The Readiness for Interprofessional Learning Scale (RIPLS) assesses the readiness for …

The Impact Of Insulin Management On Quality Of Life In Type 2 Diabetes, Sandra Ellen Mccormick

Dissertations

Complications of type 2 diabetes (T2DM) are severe but can be minimized through excellent glycemic control, optimally achieved by using intensive, or basal-bolus, insulin management. The quality of life (QOL) effects of basal-bolus insulin management are not fully known. This cross-sectional, observational study was based on the Revised Wilson and Cleary Model for Health Related Quality of Life, which measures five QOL domains (biological function, symptoms, functional status, general health perceptions, and overall QOL). The study aims were to describe, compare, and predict QOL in persons with T2DM based on type of insulin management (oral meds only, basal insulin only, …

Psychometric Evaluation Of The Neonatal Pain, Agitation, And Sedation Scale (N-Pass) Tool In Infants And Children Age One To Thirty-Six Months In The Post-Anesthesia Care Unit, Patricia A. Hummel

Dissertations

The purpose of this study was to investigate the Neonatal Pain, Agitation, and Sedation Scale (N-PASS) tool for evidence of validity and reliability in infants and children aged one to thirty-six months in the Post-Anesthesia Care Unit (PACU). This study design was a prospective, non-experimental psychometric evaluation of the N-PASS tool.

The research was conducted at a Midwestern Medical Center. The sample analyzed comprised forty subjects aged one to thirty-six months.

Data collection involved the evaluation of participants every five minutes, utilizing the N-PASS sedation subscale along with the University of Michigan Sedation Scale (UMSS) and the N-PASS pain/agitation subscale …

Fitting Things Together: A Grounded Theory Study Of Clinical Judgment In Nursing, Mary Elizabeth Wilber

Dissertations

Safe and appropriate patient care hinges on the nurse's skill in assessment and interpretation of data to support accurate clinical judgments; however, a review of nursing literature reveals the lack of an empirically derived theory of clinical judgment or methods to teach the skill. Progress has been limited because of the difficulties inherent in measuring cognitive work in complex practice environments, as well as the tendency of nursing authors and researchers to substitute a wide variety of terms for clinical judgment. Knowledge development in any discipline is hampered when terms are not clearly defined and the distinction between related concepts …

Factors Mediating Disruptive Behaviors In A Veterans Affairs Medical Center, Marylois Lacey

Dissertations

. Disruptive behaviors are often related to care giving situations in which the patient wants something that is not possible, refuses to participate in what is required, demands instant gratification, or demands immediate emotional support. In response to the patients’ demands and actions, health care providers use limit setting, activity demand, and denial of request. This study sought to answer the following questions: (a) Are code greens associated with symptoms of a medical and/or psychiatric diagnosis, denial of request, limit setting, and activity demand? (b) Are activity demand, denial of request, and limit setting more likely to be associated with …

Quality Of Life Among Southwest American Indians And Alaska Natives Living With The Hepatitis C Virus, Rydell Todicheeney-Mannes Phd, Rn, Acns-Bc

Dissertations

Background: Hepatitis C Virus is considered to be a global public health threat because seventy-five percent of infected persons have no symptoms and are unaware of their infection. It is significant to note that AI/ANs commonly contend with issues that prevent them from receiving or seeking medical care. Objectives: The purpose of this study was to: (a) Characterize the level of depression, alcohol consumption, stigma, and quality of life; (b) Examine the relationship among the variables of age, gender, residing on an AI/AN reservation, current partner status, depression, alcohol consumption, and stigma with quality of life in a sample of …

Acupuncture For Sleep Disturbances In Veterans With Post Traumatic Stress Disorder, Heather C. King Phd

Dissertations

Post Traumatic Stress Disorder (PTSD) has emerged as a significant problem among Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans. Disturbed sleep is one of the most frequently reported symptoms among OEF/OIF veterans with PTSD. PTSD itself is impairing, but the burden of this disorder is likely heightened when accompanied by sleep disturbances. Sleep disturbances have been associated with a 75-90% increased risk of co-morbid conditions, increased levels of depression and anxiety, daytime sleepiness and fatigue, reduced psychomotor performance, diminished work productivity, and decreased quality of life. These consequences of disturbed sleep emphasize the critical need for additional evidence based therapies …

The Journey To Becoming-Authentic From The Voices Of Nursing Students Living With Attention Deficit Hyperactivity Disorder, Sheryl Lynn Allen

Dissertations

Research and literature on nursing students living with attention deficit hyperactivity disorder (ADHD) in higher education is deficient in supporting the needs of a growing population. The aim of this study sought to uncover the essence of nursing students’ experiences through a hermeneutic phenomenological approach and promote deeper understanding of the meaning of lifeworld experiences through the lens of critical social theory (CST). CST sustains freedom from ideological restraints to allow exploration into individual experiences. The voices of student participants provide the medium for articulating meaning. An integrative approach using van Manen’s (1990) and Munhall’s (2012) methods guided this study. …

Group Empowerment Capacity And Capability In Schools Of Nursing, Mary Louanne Friend

Dissertations

Nursing education is experiencing rapid changes as nurses are expected to transform and lead health care delivery within the United States. The ability to produce graduates who can promote a culture of safety, and provide patient centered care in collaboration with others will require nursing administrators and faculty who are empowered and able to achieve goals. The Sieloff Theory of Group Empowerment within Organizations (Sieloff & Bularzik, 2011) provided the theoretical basis for this exploratory correlational study examining group empowerment capacity and empowerment in administrators and faculty within the United States. Empowerment was conceptualized as the ability of the group …

A Descriptive Exploratory Study Of The Experience Of Gay Partners Of Hiv-Positive Men, Jon Christensen Phd, Msn, Rn

Dissertations

HIV disease/AIDS has been the focus of much research since its introduction in 1981 and continues to have profound implications for those living with the disease and for those who are in close social relationships with them. One group that has received minimal attention in the HIV/AIDS literature is gay partners of HIV infected men. The aim of this study was to explore and describe the experiences of gay men living with a life partner who has HIV disease/AIDS who were not primary caregivers. A qualitative study using an interpretive descriptive approach was employed to study the experiences of ten …

Effects Of Acculturation On Mammography Utilization Among Korean American Women, Jungeun K. Kim Phd

Dissertations

The purpose of this study was to examine the relationship between acculturation and mammography utilization among Korean American (KA) women. The specific aims of this study were to determine the differences in demographic characteristics, perceived health beliefs, self-efficacy, and knowledge of breast cancer, and mammogram history among the four cultural groups (American identity, Bicultural, Korean identity, and Marginality) of KA women, and to examine the effects of the level of acculturation on the likelihood of getting a mammogram. Breast cancer remains the most commonly diagnosed cancer among KA women. However, KA women consistently have lower screening rates for breast cancer. …

Compassion Fatigue: Prevalence Among Nurses At A Midwest Pediatric Hospital, Branch Carole

Dissertations

Compassion fatigue is a term used to describe the unique stressors affecting people in care-giving professions (Joinson in 1992). For nurses, the impact of compassion fatigue may result in stress-related symptoms, job dissatisfaction, decreased productivity, patient satisfaction, safety issues, and job turnover. The purposes of this non-experimental descriptive survey using electronic distribution to collect data were to identify the prevalence of compassion fatigue composed of burnout and secondary traumatic stress and compassion satisfaction among nurses and nursing staff who deliver direct patient care at the hospital and the relationship between demographic variables (age, work category, level of education, work experience) …

A Pilot Project To Develop A Tool To Assess Gain In Knowledge In Third Graders Participating In A Science Based Drug Prevention Education Curriculum, Miriam Dawn Butler

Dissertations

Drug use and abuse presents a significant problem to individuals, families, and law enforcement in communities across the United States. Methamphetamine is a particular concern in one rural eastern Missouri county. Much work is being done in this county by multiple agencies to decrease methamphetamine production and use. Little attention, however, has been focused on prevention in the elementary schools. Substance use and experimentation may begin as early as 12 years old or even earlier. By initiating a proven drug prevention education curriculum before children begin to experiment with tobacco, alcohol and illicit drugs, drug use may be delayed or …