Nursing Commons^™

Lived Experience: East African Somali Speaking Women Accessing The U.S. Healthcare System, Shukri Adam Phd

Dissertations

Access to prenatal healthcare for East African Somali Speaking Women (EASSW) who are immigrants to the U.S. has been dependent on the availability of a systematic healthcare treatment model. The purpose of this study was to explore EASSW's lived experiences in accessing prenatal healthcare services in the U.S. A descriptive, qualitative phenomenological approach informed by the work of Husserl was used to explore EASSW's experiences, views, and problems encountered while attempting to access prenatal healthcare services in the U.S. Fifteen EASSW of childbearing age (ages 18–45) were recruited for this study. All participants interviewed privately, beginning with a semi-structured, open-ended …

A Retrospective Analysis Of Maternal And Child Outcomes Following An Obesity Intervention Program, Melinda S. Bender Phd

Dissertations

Background: One of the highest risk groups for childhood obesity and associated co-morbidities in the United States are low-income Hispanic preschool children. To reduce obesity, effective interventions are being sought to improve health behaviors among high risks groups. Objectives: To evaluate a subset of data from a larger 9-month promotora facilitated obesity intervention study. The aims were to determine: 1) pre- to post-program differences in health behaviors including: (a) children's consumption of high carbohydrate beverages (HCB); and (b) maternal walking, beliefs, knowledge, self-efficacy, and relationship building regarding nutrition and physical activity; and 2) which covariates were significant for change in …

Cord Blood Collection In Pregnant Women For Stem Cell Research, Irene Carr Phd

Dissertations

Umbilical cord blood (UCB) stem cells form commonly banked types of human tissue. Confusion remains about sources of stem cells and their use. Birth is a once in a lifetime opportunity with 74 million births per year in the world and four million occur in the United States. Cord blood contains hematopoietic stem cells and pluripotent mesenchymal cells (Moise, 2005). There is a surge of interest in the clinical use and research investigation of umbilical cord blood for transplantation and regenerative medicine. Clinicians need increased awareness and education of options for private versus public donation and banking of cord blood …

Examining Nursing Presence In The Acute Care Setting As An Indicator Of Patient Satisfaction With Nursing Care, Wendy Hansbrough Phd, Msn, Rn

Dissertations

Nursing presence is conceptualized as occurring within the nurse-patient relationship when the nurse acknowledges the uniqueness of the patient, within his or her context of being and chooses to intervene on the patient's behalf with a patient who allows the nurse into a reciprocal relationship. Nursing presence is described as occurring in varying levels and nurse expertise is suggested as one antecedent. Quantification of nursing presence would be useful in examination of nursing care outcomes, quality management and research. The Presence of Nursing Scale, PONS (Kostovich, 2002) was used in this study to test its reliability and determine its validity …

Emergence Delirium In U.S. Military Combat Veterans, Jason M. Mcguire Phd, Crna

Dissertations

This dissertation study examined the phenomenon of emergence delirium in U.S. military combat veterans. Emergence delirium is a post-anesthetic phenomenon that occurs immediately following emergence from general anesthesia and is characterized by agitation, confusion, and violent physical and/or verbal behavior. Clinical evidence suggests that emergence delirium is occurring with greater frequency among military personnel returning from conflict in the Middle East. This body of work is a culmination of three distinctive phases and is presented in three individual manuscripts. The first manuscript, "Risk Factors for Emergence Delirium in U.S. Military Members," was published in the Journal of PeriAnesthesia Nursing with …

California School Nurse Survey, Rachel Van Niekerk Phd

Dissertations

The purpose of this study was to obtain evidence to support the assumption that school nurses have a positive effect on school attendance and medication administration practices and to hear the voice of the California school nurse. Data from this exploratory, descriptive study came from an online researcher developed survey consisting of both forced choice and open-ended questions completed by California school nurses representing the three major regions of California (Northern, Central, and Southern). The following three research questions guided the study: 1) What is the relationship between school and nurse factors on student outcomes? 2) How valued do California …

Mother-Son Connectedness, Substance Use, And Young Men's Criminal Justice System Involvement, Kim L. Moreno Phd

Dissertations

The relationship between a mother and her son and its influence on health and risk behaviors as a boy becomes a man has had little exploration. The purpose of this study was to examine the relationships between mother-son connectedness, substance use, serious delinquency, violent delinquency, and criminal justice system involvement in young men. This study uses data from The National Longitudinal Study of Adolescent Health (ADD Health), a school-based study of students in grades 7–12 in the United States. Multiple regression, ANOVA, and logistic regression were used to analyze independent and dependent variables. Results show a perception of connectedness, which …

The Post Deployment Lived Experience Of U.S. Military Troops After Combat-Related Blast Exposure, Shirely A. Jett Phd

Dissertations

Blast-induced neurotrauma (BINT) is a newly emerging re-occurrence of an old combat-related injury in U.S. military troops returning from deployment in Afghanistan and Iraq. BINT is leading to a silent epidemic of symptomatic troops who face barriers to accessing healthcare and suffer debilitating symptoms in silence. The purpose of this hermeneutic phenomenological study was to discover the meaning of the lived experience of U.S. troops returning from Afghanistan and Iraq after combat-related blast exposure. Eleven service members and veterans ranging in age from 21 to over 30 years old participated in semi-structured face to face interviews. These service members and …

A Quantitative Inquiry Into Moral Distress And Psychological Empowerment In Critical Care Nurses Caring For Adults During End Of Life, Annette Marie Browning Phd, Rn, Cns

Dissertations

Background Critical care nurses care for many adults at end of life and it is known that these nurses can experience moral distress. Moral distress occurs when nurses are unable to perform what they believe is ethically correct. There has been speculation that psychological empowerment may ameliorate moral distress among critical care nurses. However, research has yet to examine the relationship between moral distress and psychological empowerment in the population of critical care nurses.

Objectives To describe the relationships between moral distress, psychological empowerment and select demographics in critical care nurses caring for patients at EOL.

Method Using a quantitative …

Nutritional Status And Clinical Outcomes Of Residents Admitted To A Nursing Home, Sheryl Nespor Phd

Dissertations

Purpose The purpose of this research study was to describe the nutritional status (well nourished, at risk for malnutrition, or malnourished) of residents admitted to nursing homes and adverse clinical outcomes in those residents after four weeks. Methodology A descriptive, correlational design utilizing medical record data was used to examine the relationship between nutritional status and adverse clinical outcomes of weight loss and pressure ulcers. Results The sample (n=69) was predominately Caucasian (90%) with 38% having one or more pressure ulcers on admission. Most of the residents were admitted from an acute care facility (97%) and were either malnourished or …

Fibromyalgia Self-Care Management: Use Of Essential Oils, Regina Ann Sacco Izu Phd

Dissertations

Fibromyalgia is a female dominant chronic syndrome of diffuse muscle pain on palpation of at least 11 of 18 syndrome-associated tender points present for 3 months or longer. There is no cure. Self-care management involving multimodal integrative medicine approaches may increase treatment involvement resulting in a sense of control and pain relief. This embedded, single case study explored 'how' and 'why' an informant with fibromyalgia chose to initiate and continue self-care management using essential oils over several years to treat symptoms within context reality. Orem's Self-Care Deficit Model and the Principles of Integrative Medicine from the University of Arizona formed …

Compassionate Care, The Patient Perspective, Lori Burnell Phd

Dissertations

Professional mandates call for nurses to respond with compassion (e.g., American Nurses Association [ANA] Code of Ethics, International Council of Nurses [ICN]) and countless hospital mission and vision statements prominently display compassion as their fundamental purpose. As a component of healthcare and nursing models, however, defining characteristics and standards are inconsistent. Compassion as a means of establishing a connection on a spiritual level abounds in the literature (Buck, 2006; Grant, 2004; O'Brien, 2008; Schultz et al., 2007) and is documented as a nursing requirement (e.g., ANA, ICN); however, it remains virtually uncharted from the lens of the patient. Through interpretive …

Improving Diabetic Outcomes With Caring Communication: Identifying Communication Patterning For The Human Diabetic, James R. Kennett Phd

Dissertations

Introduction. The purpose of this study was to identify the influence of caring communication for people living with diabetes (PLD) and the relationship to diabetic outcomes. Caring communication has not been studied for improving diabetic outcomes. Randomized control trials (RCTs) direct care, however people do not do what they told, they need to be included in their care. PLD need a voice to establish what is important to them. Incorporating medical, communication, and nursing science as multidisciplinary approach within a theoretical framework can be predictive diabetic outcomes. Methods. A correlational cross sectional survey design study was done. A sample of …

Relationship Between Self-Stigma And Personal Empowerment Among People Who Have Severe Mental Illness, Diane Fischer Hickman Phd

Dissertations

The purpose of this study was to examine the relationship between self-stigma of mental illness and personal empowerment among people who have a severe mental illness. It had been hypothesized that self-stigma of mental illness and personal empowerment are at opposite end of a continuum. As such, individuals who perceive themselves in a stigmatized manner tend to reciprocally perceive themselves as being relatively powerless, rather than having a strong sense of personal empowerment. Likewise, individuals who perceive themselves as having a relatively strong sense of personal empowerment tend to experience a low degree of self-stigma. To test this hypothesis, a …

Spiritual Well-Being And Quality Of Life Among Persons With Paraplegia, Darlene Nelson Finocchiaro Phd, Msn, Rn, Crrn

Dissertations

With the advent of better emergency response and medical advances, the life expectancy of persons with spinal cord injury (SCI) is about 85% to 90% compared to that of non-disabled persons. Since SCI survivors are living well into their 70s, quality of life (QOL) is a major concern. The purpose of this study, informed by Ferrell and Grant's Quality of Life Model, was to examine relationships between spiritual well-being (SWB), existential well-being (EWB), religious spiritual well-being (RWB), depression, length of injury, age, gender, ethnicity, and QOL while living with paraplegia one year and longer. A descriptive, correlational, cross-sectional design, with …

A Retrospective Study Of Substance Use And Mental Health Disorders In A Sample Of Urban American Indian And Alaska Natives, Kathryn Aimee Fuller Phd

Dissertations

This retrospective study examined the prevalence of mental health disorders, co-occurring disorders (COD), and alcohol, tobacco, and other drug use (ATOD) among a sample of urban-dwelling adult American Indian and Alaska Natives (AI/ANs) seeking behavioral health services from one metropolitan Indian clinic in Southwestern United States. A descriptive quantitative design employed retrospective data from AI/AN subjects (N = 123) verified as tribally enrolled and receiving outpatient behavioral health services. Chart abstraction included patient demographics, substance use and mental health diagnoses, and ATOD scores from the Patient Health Questionnaire-9 (PHQ-9) and the Addiction Severity Index-NAV (ASI-NAV). The t-test compared gender differences …

A Salutogenic Framework To Understand Disparity In Breast Cancer Screening Behavior In African American Women, Regina Conway-Phillips

Dissertations

African American women (AAW) have the highest breast cancer mortality rate than any other racial or ethnic group. Limited access to care reduces mammography screening for AAW. Despite barriers, some AAW engage in breast cancer screening (BCS) behaviors like mammography. The salutogenic theory of health focuses on positive health behaviors and offers a framework to understand personal factors which allow some AAW to overcome adversity and engage in BCS. Sense of coherence (SOC) is central to salutogenic theory. Individuals with greater SOC utilize available resources to attain optimal health. This study: 1) Evaluated the contribution of SOC, social support and …

Working Together Toward A Common Goal: A Grounded Theory Of Nurse-Physician Collaboration, Lori Lynn Fewster-Thuente

Dissertations

Purpose: Effective collaboration has been identified as essential to quality patient care processes and outcomes. Yet, the conceptual and theoretical basis for understanding and practicing collaboration remains underdeveloped and imprecise. These factors may hamper the study of collaboration and therefore the optimization of care processes and outcomes. The purpose of this study was to understand the social processes associated with collaboration between nurses and physicians, with the intention of theory development.

Background: Collaboration, or a lack thereof, has been shown to impact both provider and patient satisfaction and outcomes. JCAHO now requires proof of collaboration for accreditation. Many organizations state …

Acts-Hf: Attention, Cognition And Self-Care In Heart Failure, Catherine M. Murks

Dissertations

Background: Patients with heart failure (HF) are required to participate in self-care activities. This activities include taking prescribed medications, monitoring for symptoms, intervening appropriately and evaluating the response to the treatment. Cognitive impairment occurs relatively frequently in this population. Few studies have attempted to describe the nature of the relationship between self-care and cognitive impairment in this population.

Purpose:/ This study investigated the relationship between cognitive function and self-care ability in patients with HF. It also investigated the relationship between both self-care and cognitive function and subsequent hospital admission.

Methods:/ Participants were recruited from outpatient areas at two cardiology groups …

Gestational Diabetes, Depression, And The Impact On Maternal Child Health Outcomes, Mary Alice Byrn

Dissertations

Antenatal depression occurs in about 20% of all pregnancies and gestational diabetes occurs in up to 14% of all pregnancies. Although there is sufficient information on (1) depression during pregnancy and (2) depression and diabetes, there is little information about depression and gestational diabetes. This comparative, longitudinal research study was done to better understand the relationship between gestational diabetes and depression. The study aims were the following: (1) to determine whether women with gestational diabetes had more depression than women without gestational diabetes, (2) to determine whether factors predictive of depression in pregnant women with gestational diabetes were different from …

A Study To Determine The Influence Of Workload On Nursing Personnel, Supreeta G. Amin

Dissertations

The alarming number of adverse medical events and associated costs have placed immense importance toward the safety and health of both patients and medical personnel. A shrinking nurse workforce, an aging patient and nursing population coupled with a mismatch between hospital demands and the available nursing staff have created a situation detrimental to both patient and nursing personnel. Long working hours, working more than one job, low staffing ratios, high patient acuity, minimal social support, low experience level, complicated equipment, complex procedures and varying workload are some factors that may have a negative impact on the quality of care provided …

Being And Becoming A U.S. Iraq War Veteran: An Exploration Of The Social Construction Of An Emerging Identity, Anna Stachyra

Dissertations

Background: Traditional perspectives of veteran mental health are grounded in physiological and psychological principles of trauma response and recovery. An alternative perspective is needed for the provision of culturally relevant healthcare to our nation's newest veterans. Research Question: Based on the premise that each veteran cohort has a characteristically identifiable cultural form and process of cultural identification and negotiated development, the research question guiding this study was, "What is the culture of the Iraq War veteran?" Study Aim: The purpose of this study was to describe, from social constructivist perspective, Operation Iraqi Freedom [OIF] veteran cultural identity development. Study Design …

Community Assessment Of Cardiovascular Health And Risk Among People Of Mexican Descent In Berwyn, Illinois, Karen Ann Larimer

Dissertations

Background: Cardiovascular disease (CVD) is the number one cause of death in the United States and affects persons of all races and ethnicities. The number of persons of Mexican ethnicity has increased significantly in the United States, notably in the community of Berwyn, a suburb of Chicago, IL where according to the U.S. 2010 census 60% of the community is now of Mexican descent. The factors that contribute to CVD risk in persons of Mexican decent within this community must be understood before culturally appropriate risk reduction strategies are designed and implemented.

Purpose: The purpose of this community-based study is …

Study Of Stress, Housing Program Use, And Nursing Usage Among Homeless In Chicago, Henry Christian Cheung

Dissertations

Homelessness places people at risk of stressors that translate into stress and subsequently affect their health. Using Neuman Systems Model as a framework to identify modalities for nursing intervention among stressors and health problems of homeless people, this study compared stress levels among homeless people from three different homeless housing program types, investigated variables that predict the presence of stress among homeless, identified the degree of self-reported contact homeless people had with nurses, and measured to what extent nurses are preferred as health care providers by homeless people. This was accomplished through a cross-sectional, secondary data analysis of data from …

Spiritual Care In Advanced Practice Nursing, Barbara Baele Vincensi

Dissertations

Spiritual care has the potential to improve clients' health and quality of life. Since clients desire spiritual care from their health care providers as they age or as their health worsens, geriatric nurse practitioners (GNPs) were chosen to participate in this study. This cross-sectional, descriptive, survey design investigates the relationships and differences between practicing GNPs spiritual perspectives and their ability to assess clients' spiritual care needs (SCN) and provide specific spiritual care interventions (SCI). Differences and relationships were also investigated based on demographic variables of the GNPs. In addition, participants were asked to define spirituality in an open ended question. …

Feasibility Study Among Military Personnel With Traumatic Amputation During Military Combat Or Training, Michele (Shelly) R. Burdette-Taylor Phd, Msn, Rn-Bc, Cwcn, Cfcn

Dissertations

Military operations have resulted in a significant number of mangled extremities leading to traumatic amputations. Extremity injuries predominate, representing 50% to 70% of all injuries treated (Melcer, 2010). The majority of injuries sustained in Operation Endearing Freedom/Operation Iraqi Freedom (OEF/OIF) are combined penetrating, burn and blast injuries, traumatic amputation, and infections from the multi-drug resistant organism, Acinetobacter (Melcer, 2010). The purpose of this study was to measure the quality of well-being and impact of events in a group of adults who served in the U.S. armed forces and sustained the loss of one or more limbs during any combat or …

Shrouded In Stigma: A Heuristic Study Of Living With Hiv, Neal Stacy Rosenburg

Dissertations

HIV-related stigma is a serious hindrance to addressing the recruitment, maintenance, and follow-up nursing care of HIV-infected persons. This study was anchored within the heuristic research model, which engaged both the researcher and participants in a dialogical and aesthetic manner to unveil the stigma of HIV. The close proximity of the researcher and study participants revealed the most visceral, emotional, and self-reflective nature of gathering data, while maintaining the integrity and rigor of a qualitative study. The purpose of this heuristic study was to examine the lived experiences of HIV-infected individuals relating to internalized stigma within an existential context. This …

The Cultivation And Practice Of Spiritual Care Expertise In An Inpatient Palliative Care Setting, Gail Elaine Pittroff

Dissertations

Caregivers involved in palliative care seek to understand problems and challenges at end of life through research to determine the best care for patients and their families. Spiritual care is a key component of quality end of life care, yet there is a paucity of research on spiritual care in inpatient settings at end of life in nursing literature. The purpose of this study was to examine the personhood and spiritual care practices of inpatient palliative nurse consultants. This study describes expert nurse’s experience of delivering spiritual care for patients and families at end of life in inpatient palliative care …

The Mother's Perspective: Understanding More About The Health Care Needs Of The Preschool Child With Autism, Margaret W. Bultas

Dissertations

Background Information: The prevalence of autism spectrum disorders (ASD) has dramatically risen over the last decades. It is known that children with ASD visit health care providers (HCP) more frequently than typically developing peers. Given behavioral and medical complexities of these children, mothers may experience barriers in this process. Purpose: The purpose of this study was to gain a better understanding of mothers’ experiences of taking their children to the HCP. Aims of this study were to reveal mothers’ concerns related to these experiences, examine resources and barriers affecting the quality of the visit, and discover more about the effect …

Spermatogenesis: Laser Microdissection Optimization, Deborah Ann Hansen

Dissertations

Studies link paternal environmental exposures to pesticides, herbicides, and radiation to adverse reproductive outcomes such as developmental delays, malignancies, and structural birth defects. To date, 900 children of Vietnam veterans with presumed Agent Orange exposure receive VA presumptive service connected benefits because these children have Spina Bifida. To date, there are limited data to explain the underlying causal mechanisms whereby paternal environmental exposures result in adverse reproductive events. Laser microdissection (LMD) is the only technology that allows the isolation of cell subpopulations from complex tissues such as the testes without disturbing the cell’s bimolecular signature. LMD is essential in the …