Nursing Commons^™

Dyspnea: Effect Of Auricular Acupressure In End Stage Lung Cancer Patients, A Pilot Feasibility Study, Roger Alan Strong Phd

Dissertations

Introduction: Dyspnea is a debilitating symptom, common in advanced lung cancer patients, and poorly controlled. The National Institutes of Health has promoted the need for research regarding end of life care symptom control. Purpose: Conduct a feasibility study evaluating auricular acupressure effects on dyspnea in hospice lung cancer patients. Theoretical framework: The UCSF School of Nursing Symptom Management Faculty Group's Model for Symptom Management was used for the conceptual framework. The model includes three dimensions: symptom experience, symptom management strategies, and symptom outcomes. The Human Energy Field Theory provided context for using auricular acupressure. Aim: Conduct a pilot study evaluating …

A Quantitative And Qualitative Inquiry Into Moral Distress, Compassion Fatigue, Medication Error, And Critical Care Nursing, Jeanne Maiden Phd, Ms, Rn, Cns

Dissertations

A correlational embedded mixed method design was used for this study. A purposive sample of 205 critical care nurses (CCNs) provided quantitative data for the study. A focus group interview of five CCNs provided the qualitative data. The Moral Distress Scale (MDS), Professional Quality of Life Scale (ProQOL), and Medication Administration Error (MAE) Scale and demographics form were used to measure quantitative data. Quantitative findings included the majority of participants were female (91.7%); mean age 47 (SD = 7.91) years; mean years worked as a nurse was 23 (SD = 8.48); mean years worked on respective unit was 13.6 (SD …

Predictors Of Re-Hospitalization For Home Healthcare Patients, Brenda Fischer Phd, Msn, Mba, Rn, Cphq

Dissertations

The overall purpose of this study was to examine the predictive capability of OASIS admission data for acute care re-hospitalization of home healthcare patients. Secondary data analysis using logistic regression was conducted on retrospective data from OASIS collected during the time period of July 1, 2006 to June 30, 2007. This study was conducted in a Medicare certified Home Health organization that is part of the largest public health system in California. The sample of 1802 patients with complete episodes of care was derived from a data set of 5,523 patients. All patients were included in the analysis and logistic …

Obesity Risk Knowledge, Self-Efficacy, And Physical Activity In Families Of Adolescents, Elaine M. Rutkowski Phd, Msn, Rn, Cns

Dissertations

There were no significant relationships found between parental obesity risk knowledge and physical activity in their children. nor between parent's self efficacy and their children's physical activity. In addition there was no significant relationship between the adolescents' obesity risk knowledge and their physical activity. There was, however, a statistically significant relationship between adolescent's self efficacy and physical activity. The result of the correlation between parent's self-efficacy and their level of physical activity was not significant but approached significance (p = .07) and may be identified as a trend. There was a statistically significant negative correlation between parents who describe their …

A Comparison Of Perinatal Care Providers' Use Of The National Institute Of Child Health And Human Development Standardized Terminology In Documentation Of Intrapartal Fetal Heart Rate Patterns, Faye M. Sigman

Dissertations

The purpose of this study was to determine if perinatal team members; nurses (RN) and primary care providers (PCP), were using the NICHD standardized terminology to document Fetal Heart Rate patterns during labor. Agreement in documentation of FHR and agreement in concept between the RN and PCP was also studied. A descriptive, comparative research design was used. Cohen?s Kappa statistics measured agreement in documentation of FHR patterns and Chi square measured agreement in concept, p< 0.05 for each. A retrospective medical records chart review was performed on 400 charts, meeting inclusion criteria, from three community hospitals. There were three data collection points and four criteria reviewed. This study found the use of NICHD terminology to document FHR alarmingly low (RN=51%; PCP=13%). It was used most often for decelerations (81%) RN, (22%) PCP, and least often for variability (19%) RN, (3%) PCP. Incomplete documentation was extremely high for the PCP (69%) and 81 charts (20%) had no FHR documentation. Agreement in documentation varied between the RN and PCP. They agreed most often on accelerations (81.4%) and least often on baseline rate (41.5%). When looking at all there points in time the RN and PCP agreed in documentation 59% but agreed in concept 78%. There were four areas where the RN and PCP agreed in their use of NICHD terminology: Accelerations on admission n=151, Kappa=0.091, p=0.007; variability during labor n=68, Kappa=0.27, p=0.015; variability prior to delivery n=33 Kappa=0.33, p=0.010, and decelerations during labor n=103, Kappa=0.16, p=0.018. Data from this study supports expanding this research, to identifying barriers to documentation. It also appears that education in use of NICHD terminology is needed.

A Comparison Of An Individually Tailored And A Standardized Asthma Self-Management Education Program, Judy Ann Shackelford

Dissertations

Asthma is one of the most prevalent chronic diseases in the United States (Centers for Disease Control [CDC], 2003). According to the CDC (2003), prevalence of asthma continues to rise in epidemic proportions and is very costly. While asthma cannot be prevented or cured, it can be controlled to improve quality of life. Self-management is key to controlling asthma (CDC, 2003; National Heart, Lung, and Blood Institute [NHLBI], 2002). State of the science for asthma self-management establishes that health care costs decrease for self-management intervention groups (Lindberg et al, 2002; Thoonen et al, 2003). Education is essential to support asthma …

Missouri Ozark Women's Experiences Of Living With Postpartum Depression Symptoms, Nathalie B. Williams

Dissertations

Depression is a serious complication of the postpartum period that affects not only women but their children and families as well. Rural women are of particular concern because of the significant barriers to health care that they experience as a result of isolation, poverty, traditional beliefs, and a lack of accessible and adequate health related services. A review of the literature to identify evidence based nursing interventions that focused on primary and secondary prevention of postpartum depression revealed few interventions and there were no studies identified that targeted or even included women living in rural areas of the United States. …

Perceptions Of Dyspnea, Physical Activity, And Functional Status In Obese Women, Donna Althea Jewell

Dissertations

PURPOSE: King's Theory of Goal Attainment guided this study exploring the physical sensation of dyspnea that obese women feel and how it affects their functioning. BACKGROUND AND SIGNIFICANCE: Obesity prevalence has doubled since 1980. Current research is investigating how to reduce prevalence and examining obesity's impact on the respiratory system. Little research was found that investigated the impact obesity has on routine activities because of dyspena and function and whether physical activity has a mitigating effect. METHODS: A comparative descriptive research design was used. A survey of dyspnea felt during routine activities was created; IRB approval to survey community-dwelling women …

Perceived Organizational Support And Ethical Work Climates As Predictors Of Turnover Intention Of Licensed Nurses In Skilled Nursing Facilities, Anna A. Filipova

Dissertations

The purpose of this study was twofold: (1) to replicate Victor and Cullen's (1987; 1988) studies to confirm whether ethical climates (ECs) arise in skilled nursing facilities (SNFs), and whether organizations and groups within organizations have identifiable ECs; and (2) to test a model that examines the effects of ECs and perceived organizational support (POS) on licensed nurses' turnover intention (TOI) through job satisfaction (JS) and organizational commitment (OC).

A cross-sectional survey design was implemented. Three hundred and fifty nine freestanding SNFs were selected in a midwestern state. While a total of 110 facilities (31%) agreed to participate, responses were …

Parental Decision Making In The Administration Of Stimulant Medication For Their Latency Age Children With Attention Deficit Hyperactivity Disorder (Adhd), Randye Kay Phd, Msn, Rn

Dissertations

The purpose of this study was to examine parental decision making in the administration of stimulant medication to their latency age children with Attention Deficit Hyperactivity Disorder (ADHD). Research has shown that psychostimulants, used to treat ADHD are effective for 75-90% of children (US Department of Health and Human Services, 2001), however children do not take their medication from 20-65% of the time. A qualitative study using a type of grounded theory, dimensional analysis (Schatzman, 1991), was conducted to study the experiences of fourteen parents whose children began medication treatment between the ages of 5 and 12. Semi stuctured, audiotaped …

Families Moving Forward: Homeless Women With Children Transitioning To Independent Living, Kristin Elizabeth Hoyt Phd

Dissertations

Family homelessness is one of the most profound and disturbing social problems of the 21st century and is projected to remain an ongoing issue for the United States in upcoming years. The fastest growing segment in the homeless population continues to be families, specifically single women with children. One intervention to the problem of homeless women with children is by providing them with transitional housing, a step beyond the familiar short-term emergency shelter. Transitional housing typically shelters families for up to 2 years. During this extended stay, women participate in programs designed to assist them with addiction, mental health, domestic …

Transition To Nursing Home Of Korean-American Elders, Myungja Kim Hahm Phd

Dissertations

The purpose of this study was to explore factors affecting Korean-American (KA) elders during the transition to nursing homes in the first month following admission. The three aims of this proposed study were (1) to explore culture specific factors that affect KA elders' perspectives during the transitional period to a nursing home, (2) to identify thoughts and feelings of KA elders about their admission into a nursing home, (3) to describe the adjustment process associated with admission to a nursing home. A grounded theory design was utilized to explore KA elders' perceptions/experiences associated with adjustment to a nursing home. Open-ended, …

The Lived Experience Of Wives And Husbands With Coronary Heart Disease, Patricia A. Bradley Phd

Dissertations

The purpose of this feminist hermeneutic study was to discover the meaning of living in the community with a husband who has coronary heart disease (CHD). Ten women, aged 47-74 who were married from 4 to 55 years, participated in unstructured face to face interviews. The women were interviewed 6 to 18 months after their husbands were diagnosed with medically or surgically treated CHD. Audio recorded transcribed interview data were analyzed to identify the essential themes and sub-themes. Texts were interpreted guided by hermeneutic phenomenology (Gadamer 1960/1989; 1976) and van Manen's (1990) research activities. A feminist lens was applied to …

Psychometric Testing Of The Walker's Feelings And Thoughts About Weight Scale In Taiwan, Shu-Wen Chang Phd

Dissertations

Background: The majority of women do not return to their pre-pregnant weight after six weeks postpartum in Taiwan. Excessive postpartum weight retention or gain can lead to long-term obesity and increase a woman's risk of major health problems. Trends among Taiwanese women reveal an increasing prevalence of obesity. Limiting postpartum weight retention is important for preventing long-term obesity development. Objectives: The purpose of this study was to examine predictors of postpartum weight gain among Taiwanese women using the modified Thriving Model (Walker & Kim, 2002) as the guiding conceptual framework and to examine the psychometric properties of a Chinese Version …

Navy Nurses' Experiences During Operation Unified Assistance Aboard The Usns Mercy: A Grounded Theory Study, Angelica L.C. Almonte Phd

Dissertations

On December 26, 2004, the most powerful earthquake in 40 years erupted under the Indian Ocean triggering a deadly tsunami that devastated 11 Asian and African countries and killed more than 280,000. The US Navy responded through Operation Unified Assistance (OUA). In a historic first on the hospital ship USNS MERCY, the U.S. Navy deployed one team with members from the Navy, the U.S Public Health Service, a non-government organization (NGO), and a civilian mariner crew to provide humanitarian aid. Despite these efforts, there is a dearth of scholarly research work published on nurses' experiences during the disaster. The purpose …

Symptom Burden At End Of Life In Patients With Terminal And Life-Threatening Illness In Intensive Care Units, Peggy G. Kalowes Phd, Msn, Rn, Cns

Dissertations

The purpose of this study was to examine the symptom burden and severity of symptom distress reported by ICU patients at high-risk for death and to compare patient-rated symptoms and distress for concordance with symptoms reported by a family member. A prospective, correlational design with two data-points was used to study a convenience sample of 80 patients and 53 family members. The Condensed Memorial Symptom Assessment Scale (CMSAS) was used to gain patient/proxy report of symptoms on the first and third day after admission to the ICU. The majority of patients were symptomatic (98%), reporting an average of 10.23 symptoms. …

A Composite Cognition Instrument For Nursing Care Of Combat Casualties, Patricia Frohock Hanes Phd, Msn, Maed, Rn

Dissertations

In the course of caring for military and civilian combat casualties, military nurses must make rapid, accurate decisions. When developing methods to teach nurses essential content for combat casualty care, it is important to understand the cognitive and learning processes involved in acquiring that knowledge. Measures to examine how military nurses think and learn have significance, especially when applied to the high-stress, high-stakes practice arena of combat causality care. Use of these measures in evaluating educational strategies will help answer the need for better deployment readiness for military nurses. The purpose of this study is to develop an instrument to …

The Relationship Between Nurse Manager Leadership Attributes And Nurse Clinical Autonomy: Magnet Versus Non-Magnet Hospitals, Catherine A. Verkaaik Phd

Dissertations

Purpose: This research evaluated relationships among hospital types (Magnet versus non-Magnet), nurse manger leadership attributes, and staff registered nurse autonomy. Hypothesis: Magnet hospital status would be related to positive nurse manager leadership attributes which would be related to greater clinical nurse autonomy and nurse manager leadership would mediate relationships between hospital status and clinical nurse autonomy. Conceptual Basis and Background: Structural Contingency Theory modified in the Nursing Systems Outcomes Research model was the research model for conceptualizing the structure-environment-effectiveness relationship. Critical Social Theory (CST) provided the conceptual/motivational basis for this study, a lens through which to frame the question. Clinical …

African American Father-Child Reproductive Health Communication, Nnenna Ohalete Phd

Dissertations

African-American children have their sexual debut (first voluntary penile-vaginal penetration) earlier thus are at disproportionately greater risk for more sexual partners and sexually transmitted infections. Father-child reproductive health communication was found to influence the timing of sex in other children however, a dearth of studies in African-American fathers existed. In this qualitative study reproductive health communication was explored in tape-recorded interviews of 19 African-American fathers from the perspective of critical theory, with the use of critical ethnography as methodology. How the content and pattern of reproductive health communication influenced sexual debut, and how fathers' moral/ethical stances influenced reproductive health communication …

Patient Handling Safety For Nursing Staff, Don Nielsen

Dissertations

The effectiveness of video scoring and feedback about the scoring of the components of safe patient transfers was observed among eight nursing staff members in a skilled nursing department within an acute care hospital.

An ABCA (and sometimes ABCDA), multiple baseline across individuals design was utilized in the study. The dependent variable under investigation was the percentage of safe lifting components. Following baseline measures, nursing staff participated in an information phase during which they reviewed and discussed components of safe patient transfers. A video scoring phase was introduced, during which, participants viewed and scored a model video of a patienttransfer. …

Beholding The Beauty Of Self: The Psychological Integration Of The Afrocentric-Self Among African-American Females Socialized In A Eurocentric Aesthetic, Donna Lynn Cook Phd

Dissertations

Self-esteem and body image disturbances prominently figure into many physical and psychological health disorders such as depression, eating disorders, anxiety disorders, and chemical dependency. In Euro-American culture, media images of femininity and physical attractiveness reinforce generally held perceptions of the idealized female beauty as tall, white, slender, and often blond and blue eyed. The physical morphology of African-American women does not genetically "fit" this westernized standard of beauty with implications for their mental health. The socialization of African-American women in a culture that embraces a different ethnic standard of beauty influences their perceptions of how physically attractive they see themselves. …

What Are They Saying: Voices From The Inner City? Lived Experience Of Inner City African American Adolescents With Asthma, Othello Childress Phd

Dissertations

The purpose of this study was to investigate the lived experience of African-American adolescents with asthma who reside in an inner city community. The research in this area of interest is sparse, yet the morbidity and mortality rates related to asthma within the African-American population are greater than the general population. This study offers the experience of living with asthma from the perspective of the young African-American adolescent. Using phenomenological methodology, the nurse researcher selected 13 African-American adolescents; aged 12 to 15, who reside and attend middle school in the inner city. All of the participants had a confirmed medical …

Defining Health And Health-Related Behaviors Following A Near-Death Experience, Suzanne C. Robertson Phd

Dissertations

While broad categories of health and influences on definitions of health have been identified, the process through which adults define and re-define health has not been researched. The purpose of this study was to investigate the process of defining health and appropriate health-related behaviors following a near-death experience (NDE) as an adult and to articulate a grounded theory of decision-making. Five men and 15 women from the United States and United Kingdom were interviewed and the data were analyzed using the constant comparative method. The basic social process was I Still Had to Go Through the Process of Understanding. Understanding …

The Relationship Between Coping, Anxiety, And Quality Of Life For Taiwanese Post-Coronary Artery Bypass Graft Surgery Patients, Heng-Hsin Tung Phd

Dissertations

Coronary artery bypass grafting surgery (CABG) is a stressful event and requires coping strategies to achieve adaptation. In Taiwan, despite the fact that the incidence of CABG is increasing in both men and women, research on post-CABG adaptation is very limited and no research focuses on outcomes for women. This can lead to problems for health care providers who lack effective interventions to help these patients. The purpose of the study was to examine the relationship between coping, anxiety, and quality of life in Taiwanese post-CABG patients. A cross-sectional correlational design was used; the sample consisted of 50 female and …

Healthy Lifestyles Of Adults In A Work Setting, Kim Schafer Astroth

Dissertations

Nurses have a key role in promoting healthy lifestyles to reduce incidence of disease in adults. Since the 1980¿s, researchers have recognized readiness as a key component of adopting healthy lifestyle change. Prochaska¿s transtheoretical model, which contains readiness, or stage of change, served as the theoretical framework for the current study. The purpose of this study was to test an exercise behavior model, and in so doing: (a) compare the concurrence rates of exercise stage of change classifications obtained from the four selected exercise stage of change self-report measures; and (b) determine the relative strength of the predictive factors of …

Nurse Practitioner Adoption Of Clinical Innovations, Rhoberta Jones Haley Phd

Dissertations

Adoption of clinical innovations by Nurse Practitioners (NP) is a complex phenomenon, rooted in personal values and influenced by challenges within health care environments. When clinical innovations are adopted or rejected by NPs, this decision has meaning for patients, NPs, health care agencies, and society. The decision controls the opportunity for patients to access a clinical innovation that could reduce morbidity and mortality, save money, and provide satisfaction related to the health care encounter. The purpose of the study was to increase knowledge about NP adoption of clinical innovations, particularly emotionally-laden clinical innovations. The lines of inquiry focused on what …

A Retrospective Evaluation Of The Planetree Patient Centered Model Of Care Program's Impact On Inpatient Quality Outcomes, Susan Stone Phd

Dissertations

This retrospective quasi experimental study evaluated the effectiveness of Planetree's patient-centered model of care. Donabedian's model linking structure and process to outcome was used to frame this study. The structure variable is the inpatient acute care hospital unit and the process variable consists of the Planetree patient-centered model of care. Outcomes are (1) patient satisfaction, (2) length of stay, (3) readmission, (4) cost per case, and (5) productive nursing hours per patient day. All data for patient satisfaction, length of stay, readmission, cost per case and productive nurse hours per patient day were retrospective, no participant recruitment was needed. Data …

Healthcare Encounters Of Formerly Incarcerated Women: A Grounded Theory Study, Karen Sue Hoyt Phd

Dissertations

The adult correctional population in the United States soared to nearly 7 million people (Bureau of Justice Statistics [BJS], 2005). Over 2 million individuals were housed in prisons or jails in the United States. Nearly 7 percent (6.9%) were women (BJS, 2005). Recent trends in the adult correctional population suggest that there has been a stark increase in the number of formerly incarcerated women in the United States. The purpose of this research was to explore how formerly incarcerated women perceived their healthcare encounters. The aims of this study were to answer the following questions. How did formerly incarcerated women …

Older Single Women In Transition: Moving To A Supportive Retirement Community, Linda L. Hansen-Kyle Phd

Dissertations

This study explored role changes, resilience, social, and health challenges encountered by older women who transitioned to a retirement community that provided social, health, and safety support structures. The aim of this study was to analyze and describe the transition from the viewpoint of the participants. Although previous research has shown transitions lead to psychosocial, emotional, physical, and health changes, the importance of this study stems from the lack of research on older women moving to supportive communities and their unique challenges. A convenience sample of 39 women, aged 70-94, who had been living alone before moving to a church …

Resilience And Quality Of Life In Taiwanese Survivors Of Childhood Cancer, Li-Na Chou Phd, Msn, Rn

Dissertations

Survivors of childhood cancer are at risk to develop physiologic-psychosocial complications that affect their quality of life. This study explored how the independent variables of illness-related risk (ILLRK), individual risks (IRK), protective factors (PF) and resilience (RS) affected the dependent variable---quality of life (QOL)--in Taiwanese survivors of childhood cancer. Triangulated research methodology was employed to (1) identify the statistical relationships between the variables and (2) explore qualitatively what these variables meant to the subjects and how their perceptions further explained the statistical results. Haase's (2004) Adolescent Resilience Model was used as the theoretical framework. Ninety-eight Taiwanese adolescent cancer survivors, diagnosed …