Nursing Commons^™

Response To And Recovery From Endotracheal Suctioning In Preterm Infants Using Routine Versus Four-Handed Care, Sharon Cone

Theses and Dissertations

Neonatal Intensive Care Units have experienced profound advances in technology and treatment modalities over the last two decades. Infants born at the edge of viability are now surviving despite prolonged hospitalizations. These infants born preterm are prone to a high degree of stress from life sustaining and routine interventions. Much focus has been directed toward addressing noxious environmental factors such as noise, light, and infectious disease; however, little has been done to examine the stress experienced by the professional caregiver who work in these environments. Environmental press theory, which focuses on the interplay between human beings and their surroundings, is …

Caring For A Preterm Infant During The First Six Months Post Nicu Discharge: A Mother’S Perspective, Lois Phillips-Pula

Theses and Dissertations

Overview There are numerous studies in the current literature focusing on the intense emotions experienced by parents, following the birth of a preterm infant, (i.e., born prior to 37 weeks gestational age [GA]). Research findings have helped us understand the fear and anxiety they feel while attempting to navigate the neonatal intensive care unit (NICU) environment. What happens in those early weeks and months at home after discharge, however, is surprisingly absent from the literature. It is well known that preterm infants are readmitted to the hospital during the first few months after discharge at a rate of 10% - …

Living With Hiv: Views Through The Blog, Linda Eastham

Theses and Dissertations

The purpose of this qualitative descriptive study was to develop a greater clarity of how HIV infected individuals live and work within the sphere of HIV infection as represented through unsolicited, personal narratives posted on blogs. Existing, single author, personal blogs were identified via a search engine. Blogs were defined as the blog author's postings and all responses, whether written by the blog author or a reader respondent. Inclusion and exclusion criteria were developed to respect indicators of bloggers' intentions for privacy, e.g., blogs which required a password were excluded. A total of 14 blogs met inclusion criteria. Actions to …

Healthcare Acquired Infection Risk And Toothbrush Contamination In The Icu., Michelle Frazelle

Theses and Dissertations

Healthcare acquired infections (HAIs) are a complex and multi-factorial problem associated with high morbidity, mortality, and cost. Toothbrushes (TBs) may be at risk for contamination with potential pathogenic microorganisms (PPMs) from the patient care environment or autoinnoculation from the patient. We focused on three PPMs: multiply resistant Staphylococcus aureus (MRSA), vancomycin resistant Enterococcus (VRE), and Acinetobacter. Specific aims were to (1) describe environmental factors associated with TB contamination in the ICU; (2) describe the relationship between TB contamination and oral colonization in critically ill adults.

Understanding Mothers Of Late Preterm Infants, Brenda Baker

Theses and Dissertations

The experience of becoming a mother is a personal and social experience influenced by individual characteristics, friends and family, and the infant. The journey to become a mother encompasses concepts of maternal competence and responsiveness. The purpose of this study was to examine maternal competence and responsiveness to the infant in mothers of late preterm infants compared to mothers of full term infants. The conceptual model for this work was based on the work of Reva Rubin describing maternal identity and role development. Maternal competence and responsiveness are components of maternal role and are influenced by social support, maternal self-esteem, …

Managing The Healthcare Needs Of Adolescents With Autism Spectrum Disorder: The Parents' Experience, Julie Strunk

Theses and Dissertations

The purpose of this phenomenological study was to describe the experiences of parents who manage the health needs of an adolescent with Autism Spectrum Disorder (ASD). Qualitative interviews were conducted with parents from 10 families of adolescents with ASD residing in Virginia. Data were analyzed using Clark Moustakas’ method of analysis of data in which the phenomenologist asks the following questions: What are the individual’s experiences, and in what context did they experience them? This study maximized credibility by using three strategies: prolonged engagement, peer debriefing, and member checking. “Parents needing help” emerged as the essence of the parents’ experiences. …

Factors Predicting Exercise Behavior Of Graduate Students, Bibha Gautam

Theses and Dissertations

Graduate school is often experienced as a time of increased demands/expectations resulting in heightened levels of stress due to academic work, family responsibilities, job demands, financial pressure, and other life related issues. Besides stress, graduate school also brings about significant physical inactivity due to the shift of the immediate priority to academic accomplishment. Reports of increasing prevalence of cardiovascular disease (CVD) risk factors among students highlight that this group may have particular risk not well-identified. Yet, relative risk can be reduced by lifestyle modifications, such as eating well, exercising, and stress reduction. The majority of the risk factors, to a …

Oncology Nurses' Impact Scores For Obstacles And Supportive Behaviors At The End Of Life, Joan M. Collett

Theses and Dissertations

Introduction: Oncology nurses provide end-of-life (EOL) care to their patients daily. Oncology nurses' perceptions regarding how to provide quality care to dying patients could be an important addition to the ongoing research on quality EOL care. The purpose of this study was to determine the impact of specific obstacle and supportive behaviors in EOL care as perceived by hospital-based oncology nurses. This study extended the work of Beckstrand, Moore, Callister, and Bond (2009).

Methods: A 69-item questionnaire adapted from previous studies (Beckstrand & Kirchhoff, 2005; Beckstrand, Smith, Heaston, & Bond, 2008) was sent to 1,000 nurses who were members of …

Emergency Nurses' Perception Of Department Design As An Obstacle To End-Of-Life Care, Ryan Jay Rasmussen

Theses and Dissertations

Introduction: Of the 119.2 million visits to the emergency department (ED) in 2006, it was estimated that about 249,000 visits resulted in the patient dying or being pronounced dead on arrival. In two national studies of emergency nurses' perceptions of end-of-life (EOL) care, ED design was identified as a large and frequent obstacle to providing EOL care. The purpose of this study was to determine the impact of ED design on EOL care as perceived by emergency nurses.

Methods: A national, geographically dispersed, random sample of 500 members of the Emergency Nurses Association were sent a 25-item questionnaire regarding ED …

Nurse Practitioner Barriers To Reporting Child Maltreatment, Steven Lee Barlow

Theses and Dissertations

Each year approximately 1,000,000 child become the victims of abuse or neglect. The detrimental effects of child maltreatment (CM) have been well documented and create significant problems for the survivors and for society as well. All fifty states have enacted mandatory reporting laws to combat the CM epidemic. As mandated reporters, nurse practitioners and nurse midwives (APRNs) have the opportunity and responsibilities to identify and refer potential victims of CM, in this study a significant percentage choose not to report their suspicions. Respondents to the study survey identified several potential barriers to APRN reporting such as lack of education and …

The Last Frontier: Rural Emergency Nurses' Perceptions Of End-Of-Life Care, Virginia Claudia Giles

Theses and Dissertations

Introduction: Caring for dying patients is part of working in a rural emergency department. Rural emergency nurses are prepared to provide life-saving treatments but find there are barriers to providing end-of-life (EOL) care. This study was completed to discover what the size, frequency, and magnitude of obstacles were in providing EOL care in rural emergency departments as perceived by rural emergency nurses.

Methods: A 58-item questionnaire was sent to 52 rural hospitals in Idaho, Wyoming, Utah, Nevada, and Alaska. Respondents were asked to rate items on size and frequency of perceived barriers to providing EOL care in rural emergency departments. …

The Experiences Of Families Raising Children With Type 1 Diabetes Mellitus: A Qualitative Investigation, Carol A. Loucks

Theses and Dissertations

Type 1 diabetes mellitus (T1DM), a common, chronic disease, affects the patient as well as the family. It requires daily vigilance in blood sugar monitoring, dietary management and insulin administration. Research has examined the impact of T1DM on family adaptation and relationships. However, few current data describes parents' perceptions of challenges. The purpose of this study was to identify challenges and impact on the family perceived by parents raising children with T1DM. Using a qualitative descriptive design, 21 parents raising children with T1DM participated in audio-recorded focus groups. At the time of the interviews the children ranged in age from …

The Relationship Of Physical Activity, Eating Behaviors, And Hunger Control To Weight Loss And Quality Of Life In Gastric Banding Patients, Nancy Baugh

Theses and Dissertations

Gastric banding as a weight loss surgery has increased in popularity in the United States since its approval by the Food and Drug Administration in 2001. Successful weight loss after weight loss surgery is most frequently defined as greater than 50 percent of excess weight loss (EWL). Systematic reviews show that the band is widely effective in achieving successful weight loss in most patients, however individual studies show more inconsistent outcomes. Although previous research supports gastric bypass surgery as having a positive effect on quality of life after gastric bypass, there is very little data to support this relationship in …

Biobehavioral Relationships And Health Related Quality Of Life In Persons With End Stage Renal Disease On Hemodialysis, Avis Allen

Theses and Dissertations

The study of immune status and biobehavioral measures is limited in professional nursing. The purpose of the pre-pilot study was to describe levels of cytokines prior to, during, and after dialysis, examine changes in cytokine levels from immediate pre-dialysis to immediate post-dialysis, and to compare cytokine patterns prior to and after dialysis. A within subject descriptive study was conducted as part of a larger pilot study to describe levels of cytokines prior to, during, and after dialysis, examine changes in cytokine levels from immediate pre-dialysis to immediate post-dialysis, and to compare cytokine patterns prior to and after dialysis. Serum cytokine …

African American Males Diagnosed With Schizophrenia: A Phenomenological Study, Lorraine Anderson

Theses and Dissertations

Abstract Little is known about how African American men with schizophrenia experience their every day existence. Through applying interpretive phenomenology and using a methodological structure designed by van Manen (1990, 1997), this research aimed to enrich the understanding of living with schizophrenia for these African American males. In this study, five men ranging in age from 21 to 57 described their lives within the context of existing with the diagnosis of schizophrenia. The lived experiences across the interviews revealed four overarching themes: They know that they are mentally ill; they make a special effort to test reality; they assert their …

Mother-Infant Synchrony During Infant Feeding, Barbara Reyna

Theses and Dissertations

MOTHER-INFANT SYNCHRONY DURING INFANT FEEDING By Barbara A. Reyna, PhD A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University. Virginia Commonwealth University, 2010. Major Director: Rita H. Pickler, PhD Endowed Nursing Alumni Professor Department of Family and Community Health Nursing, School of Nursing Synchrony between a mother and her infant is fundamental to their developing relationship. Feeding is an essential activity that provides an opportunity for interaction between a mother and her infant and may lead to synchronous interaction. The purpose this study was to develop and test a …

Facial Expression Discriminates Between Pain And Absence Of Pain In The Non-Communicative, Critically Ill Adult Patient, Mamoona Arif-Rahu

Theses and Dissertations

BACKGROUND: Pain assessment is a significant challenge in critically ill adults, especially those unable to communicate their pain level. At present there is no universally accepted pain scale for use in the non-communicative (cognitively impaired, sedated, paralyzed or mechanically ventilated) patient. Facial expressions are considered among the most reflexive and automatic nonverbal indices of pain. The facial expression component of pain assessment tools include a variety of facial descriptors (wincing, frowning, grimacing, smile/relaxed) with inconsistent pain intensity ratings or checklists of behaviors. The lack of consistent facial expression description and quantification of pain intensity makes standardization of pain evaluation difficult. …

The Relationship Among Maternal Infant Bonding, Spirituality, And Maternal Perception Of Childbirth Experience, Linda Bennington

Theses and Dissertations

The beginning of life is an intense experience for both mother and baby and sets the foundation for future interactions. Researchers have theorized that maternal infant bonding begins prenatally and continues on through the postnatal period. Mṻller (1996) examined that process to determine if prenatal bonding was related to postnatal bonding and discovered that there was only a modest correlation between the two. This led to speculation as to what variables, besides prenatal bonding, could influence postnatal bonding. Klaus & Kennell (1976) noted the detrimental effects of a lack of bonding in terms of abuse and attachment disorders and emphasized …

Mild Traumatic Brain Injury: Are Emergency Department Providers Identifying Which Patients Are At Risk?, Barbara Kay Stuart

Theses and Dissertations

Objective: Identify patients with specific emergency department (ED) discharge diagnoses who later report symptoms associated with a mild traumatic brain injury (MTBI), compare frequency and severity of MTBI symptoms by discharge diagnoses, investigate the frequency of head injury education provided to ED patients with each diagnosis, and finally, to learn what type of changes have occurred in the lives of patients as a result of their injury.

Methods: Fifty-two ED patients, aged 18 to 28 who were at least two weeks post injury, spoke English and were discharged with a diagnosis of concussion/closed head injury (CHI), head laceration, motor vehicle …

The Prevalence Of Postpartum Depression In Hispanic Immigrant Women, Nissa Breann Lucero

Theses and Dissertations

Purpose: The purpose of this study was to determine the prevalence of postpartum depression among Hispanic immigrant women seeking healthcare services at a community health clinic.

Data Sources: Hispanic immigrant women were recruited. Out of 116 study participants, 96 women were in the final sample. Using the Beck PDSS-Spanish version, women were screened for symptoms of postpartum depression.

Conclusions: The prevalence rate of significant symptoms of PPD was 54.2% for the entire sample of 96 women. Nearly 66% of women who screened positive for symptoms of PPD scored above the listed cutoff score for suicidal thoughts. Women were divided into …

Understanding The Perspective Of Adolescent Siblings Of Children With Down Syndrome Who Have Multiple Health Problems, Carol Ann Graff

Theses and Dissertations

The purpose of this qualitative descriptive study was to obtain information from adolescent siblings of children with Down syndrome (CWDS) regarding their perceptions of living with a child who has Down syndrome (DS). Twenty-three adolescents between 12 and 19 years of age who lived with a child who had DS and additional health problems including cardiac, endocrine, gastrointestinal, hematological, neurological, and behavioral conditions were interviewed individually. After examining the tape recorded interviews, major themes revealed both positive and negative aspects of living with a child with DS who has major health problems. However, overall the adolescents reflected more positive experiences …

Understanding Nurses’ Experiences Of Providing End-Of-Life Care In The United States Hospital Setting, Susan Johnson

Theses and Dissertations

Nurses perform a vital role in the care of dying patients and their families. Hence, experiences of nurses are a meaningful source from which to advance holistic end-of-life care. In this study, a hermeneutic phenomenological perspective was used to explore the phenomenon of end-of-life nursing care. Details derived from a scientific exploration into the experiences of 13 registered nurses who provided care for patients and families at end-of-life in the inpatient hospital setting offer understandings regarding this important phenomenon. The hermeneutic phenomenological methods of Max van Manen guided data collection and analysis. Three main themes described the participants’ experience of …

The Lived Experience Of Faith Community Nurses Living The Call To Health Ministry, Deborah Mobley

Theses and Dissertations

Faith community nursing is one of the newest specialized practices of professional nursing. A faith community nurse is an actively registered professional nurse, who serves as a paid or volunteer staff member in a faith community. The faith community nurse promotes health and wholism of the faith community, its groups, families, and individual members. A faith community, as in a church, synagogue or mosque, is an organization of individuals and families who share common beliefs, values, religious doctrine, and faith practices that influence their lives. The faith community functions as a client system for the faith community nurse. The purpose …

Maternal Attitudes Related To Infant Feeding And Breastfeeding Behaviors In Taiwan, Yen-Ju Ho

Theses and Dissertations

Background: The government in Taiwan has promoted breastfeeding in recent years yet, exclusive initiation rates and continuation of breastfeeding remain low. Maternal attitudes have been found to be better predictors of infant feeding method during the postpartum period than socio-demographic factors. Understanding maternal attitudes related to infant feeding in Taiwan will support the development of better targeted, more effective health promotion programs aimed at increasing breastfeeding rates. Objectives: To examine maternal attitudes toward breastfeeding and the relationship of these factors to breastfeeding duration at six weeks postpartum. The Iowa Infant Feeding Attitude Scale (IIFAS) was translated into Chinese for this …

Patient Ventilator Dyssynchrony: Types, Frequency And Patterns In Critically Ill Adults, Karen Mellott

Theses and Dissertations

Patient ventilator dyssynchrony (PVD) occurs frequently, but little is known about the types, frequency and patterns of PVD for longer than 30 minutes. Deeper levels of sedation are associated with PVD. Evaluation of ventilator graphics and the ability to identify PVD should assist clinicians to optimize patient ventilator interactions and promote earlier interventions. The purpose of this study was to identify the different types, frequency and patterns of PVD in critically ill adults and determine the effect of sedation level on PVD. Thirty medical and surgical ICU adult patients were enrolled; 27 were used for analysis. Pressure/time and flow/ time …

Cardiovascular Reactivity To Forgiveness In Females, Carolyn Mccrocklin

Theses and Dissertations

Empirical evidence exists directly relating forgiveness to physiological markers of cardiovascular health based on the manner in which individuals respond to interpersonal offenses. Extant literature has identified the harmful effects of stress in cardiovascular disease and health in general and unforgiveness has been identified as a stressor with potential implications for cardiac health. Understanding cardiac response to the stress of unforgiveness may have favorable implications for heart disease prevention and treatment in women and may prove to be beneficial in reducing allostatic load.

Exploring The Stress Response In New Army Nurses, Laureen Otto

Theses and Dissertations

The study of stress is limited in professional nursing, but it is nearly non-existent in professional military nursing. The purpose of this study was to explore the relationships among psychological, environmental, biological and demographic factors of stress in new Army nurses during the Army Medical Department’s 8-week Officer Basic Leadership Course (OBLC). Using a descriptive prospective, correlational repeated measures design, 33 study participants completed two psychological stress measures (Perceived Stress Scale [PSS] and the Impact of Event Scale – Revised[IES-R]), an environmental measure (Life Experiences Survey [LES]), a biologic measure (salivary cortisol) and a demographic questionnaire at three different time …

Relationship Among Stress Of Labor, Support, And Childbirth Experience In Postpartum Mothers, Sasamon Srisuthisak

Theses and Dissertations

Background: Due to the profound and life-changing aspects of giving birth and to each woman’s individualized birthing experience, it is important to understand the myriad of factors that contribute to a positive childbirth experience. The aims of this study were to: (1) identify factors related to a positive childbirth experience; (2) to examine relationships among women’s perceptions and personal evaluations of their childbirth experience, stress associated with labor pain, support from the nursing staff, initial contact with the baby following birth, support from partners, education, age, and obstetric history; and (3) to identify predictors of a positive childbirth experience. Method: …

Father-Daughter Attachment And Sexual Behavior In African-American Daughters, Karen Hill-Holliday

Theses and Dissertations

Although a relationship has been found in some studies between paternal attachment and female sexual behavior, knowledge of this relationship in African Americans has been limited. The purpose of this research was to determine if there was a relationship between father-daughter attachment, parent teen sexual risk communication and early sexual activity, condom use, history of sexually transmitted infection, global/sexual self-esteem and teen pregnancy in African-American females. An anonymous consent and survey was administered online to N=113 African American college women (age 18-21) attending a southeastern university. Measurements included the Parent Attachment Questionnaire (Father), Rosenberg’s Self-Esteem, Sexual Self-Esteem Inventory (short scale), …

Kangaroo Care In The Nicu: A Practice Guideline, April M. Lee

Theses and Dissertations

Infants weighing less than 2500 grams at birth regardless of gestational age are considered low birthweight (LBW) infants (Conde-Aguedelo, Diaz-Rossello, & Belizan, 2003). These infants have a high mortality rate, and often have developmental problems. Every year, there are over 25 million LBW infants born, and most of them are born in developing countries, where they have an even greater morbidity and mortality risk (Conde-Aguedelo, Diaz-Rossello, & Belizan, 2003). In 1978, two physicians. Dr. Rey and Dr. Martinez, proposed and developed the kangaroo mother care (KMC) method at Instituto Materno Infantil in Bogota, Colombia. This method was developed out of …