Nursing Commons^™

Achieving Cultural Competence Through The Use Of Community Health Workers: Open Cities Health Center's Approach, Dorii Gbolo

Theses and Graduate Projects

The purpose of this project is to identify objectives necessary for incorporating a Community Health Worker (CHW) program within an urban Federally Qualified Community Clinic setting, for the purpose of enhancing the culturally specific care provided by the clinic. CHWs offer our current fragmented and complex health care system an opportunity to improve the health of underserved populations in our country. The use of CHWs dates back to the 1960's as an attempt to expand health care to the underserved residing in poor communities.

If one is poor, an immigrant, or just different from the norms of our society receiving …

Designing An International Friendship Model For Children, Charlotte Martins

Theses and Graduate Projects

In 2006 this writer traveled to Windhoek, Namibia to take the course Walking the Truth; Culture, Gender and HIV/AID,S in Sub-Saharan Africa. As part of that class each student was assigned to work with an organization or individual whose mission was working with HIV/AIDS patients or there families. It was from this experience that the project was born. The purpose of this project is to design a friendship model that links children of middle school age from different cultures and different nations together through letter writing.

Supporting Lactation: Beyond Nutrition, Desiree' M. Bertilrud

Theses and Graduate Projects

Breastfeeding provides nutritional, health, immunological, psychological, economical and environmental benefits. Despite the abundance of scientific evidence and public health campaigns, the United States fails to meet national goals for breast feeding rates. Numerous barriers to lactation are identified and explored. However, by far, returning to work has the greatest impact on the duration of breastfeeding. Employers and organizations who support breastfeeding are the recipients of a multitude of benefits. The purpose of this project is to identify the strategic steps to establish a lactation room in an outpatient clinic setting for employees to support maternal-child relationships, foster employee satisfaction, and …

Firearms And Children: A Public Health Issue, Janet M. Benz

Theses and Graduate Projects

This is the time for nurses as individuals and collectively as a profession to realize their obligation to society in regards to the injury and death caused by firearms. Not one population or single community is immune from gun violence in America; it is an epidemic that does not discriminate. There are monumental implications for both nurses in practice and leadership to make a difference when it comes to changing policy from a public health perspective to reduce gun violence and save lives. In this project, Margaret Newman's (1994) theory of Health as Expanding consciousness is applied to the role …

Supporting Charge Nurses In Their Leadership Development: A Framework For Education, Sonja Rivers

Theses and Graduate Projects

This project examines the complex and multifaceted role of the charge nurse in the acute care setting and compares the charge nurse's role to that of a front line leader. Charge nurse competencies are identified and leadership skills and behaviors necessary for the charge nurse to function effectively in the role are explored including those related to emotional intelligence. A conceptual framework for education is developed using Botatzis' Theory of Self-Directed Learning, and Swanson's middle range theory of caring, Nursing as Informed Caring for the Well-Being of others.

How One's Cultural View Of Obesity Affects Care Giving, Marietta Kramper Farris

Theses and Graduate Projects

As the United States faces the challenge of obesity it is important to understand the cultural aspects of caring for these patients. Leininger's Transcultural Nursing Theory is used as a framework for the development of an educational program for health care professionals. The obese patients receiving care should be able to count on their care givers to appreciate the biases, stigmatization and discrimination of the culture in which they live. A review of the history of cultural views of obesity and thinness is used as a starting point. An in-depth review of related research is presented to detail bias, stigmatization, …

Development Of A Standardized Nursing Curriculum For The Alabama Community College System: A Critical Case Study, Alice G. Raymond

Doctoral Dissertations

The purpose of this case study was to describe how the Alabama Community College System (ACCS) standardized their nursing curriculum. A single research question was the focus of the study: “How did the ACCS develop its standardized nursing curriculum?” The sub questions were, “who were the key players in the process?”, “Who had the positions of power and dominance, and who did not?”, “Who were included and who were excluded in the process?”, “What were the reasons for inclusion and exclusion?”, and “What were the contextual elements that influenced the development of the curriculum?”

Data from multiple sources were gathered. …

Application At The Bedside: Moving From Knowing How To Knowing Why In Nursing, Joyel J. Brule

Walden Dissertations and Doctoral Studies

The nursing field is beginning to emerge as a profession with curricula that emphasis nursing as a discipline distinguished from a medically dominated paradigm. This changing focus places emphasis on professional competence upon graduation and entry into practice to foster fitness for purpose within an environment of continuously changing expectations of the nurse by society. Despite a growing body of research on transition into practice, a gap exists as to when this transition occurs and how this finding may influence educational preparation of nurses. This qualitative, exploratory study examined nurses’ perceptions of their transformation from novice to professional practitioner by …

Sense Of Humor, Stress And Coping, And Outcomes In Children's Lives, Lambertha Okhuizen-Stier Phd, Mph, Rn

Dissertations

Children are confronted with many stressors in their environment which may bring about symptoms such as anxiety, sadness, worry, aggressiveness, hyperactivity, restlessness, or low self esteem (Sharrer & Ryan-Wenger, 2002). To prevent the short and long term effects of stress, children may use coping strategies to manage or alter stressful life events (Lazarus & Folkman, 1984). This study explores the relationships between stress and sense of humor among school-age children. A sample of 106 students (and parents/guardians) in the San Diego Unified School District (SDUSD) returned self-report instruments packets containing the Multidimensional Sense of Humor Scale for Children, and the …

The Relationships Among Adaptive Behaviors Of Children With Autism Spectrum Disorder, Their Family Support Networks, Parental Stress, And Parental Coping, Heather Roberts Hall

Theses and Dissertations (ETD)

Purpose: The purpose of this study was to examine the adaptive behaviors of children with Autism Spectrum Disorder (ASD), their family support networks, parental stress, and parental coping and the relationships among these variables.

Background: Autism is the fastest growing diagnosed developmental disorder. When parents receive a diagnosis of autism for their child, mothers and fathers are affected differently. The costs to families of children with autism are personal, social, and affect family finances and day to day living. Parents of a child with autism are at high risk for increased stress levels. The child’s socially unacceptable behaviors and communication …

Knowledge Of Pain Management In Older Adults As A Content Area For Continuing Professional Education For Licensed Nurses, Wanda Cleveland Dubuisson

Dissertations

The research of the last 30 years has revealed the inadequacy of pain management in the older adult. Although evidenced-based clinical practice guidelines exist to direct the management of pain in the older adult, health care providers are either unaware or lack the proper understanding of the guidelines. This study investigated the differences in knowledge of pain management in older adults when examining licensed acute care nurses and extended care nurses. It sampled 118 acute care nurses working in two hospitals in Mississippi and 78 extended care nurses working in six extended care facilities (ECF) in Mississippi.

Based upon the …

An Educational Initiative To Promote Evidence-Based Practice, Laurel Ann Ecoff Phd, Ms, Rn, Nea-Bc

Dissertations

Evidence-based practice (EBP), recognized as essential in providing quality patient care and achieving optimal outcomes, is the integration of the best research evidence, patient preference, and clinician expertise. Healthcare providers must attain expertise in integrating EBP into the clinical setting. Fellowships are one strategy reported in the literature to assist nurses in acquiring needed knowledge and skills for evidence-based care. The purpose of the study was to evaluate the effectiveness of an educational intervention, the Evidence-Based Practice Institute (EPBI), to teach nurses the process of EBP for project implementation to improve nursing and patient outcomes. This descriptive study used a …

The Sweat Lodge Ceremony As Experienced By Nurses A Hermeneutic Phenomenological Study, Patricia L. Engstrom

Theses and Graduate Projects

Nursing must reconnect with its roots found in the teachings of Florence Nightingale and be open to ancient indigenous wisdom, focusing on caring, healing and being present. To practice as culturally competent healers, nurses must grow in self awareness and an ability to understand cultural and spiritual practices, as well as communicate with and show respect to people from all walks of life. A Hermeneutic Phenomenological study was done by interviewing three participants to explore what it was like for Master in Arts nursing students participating in an Augsburg College Department of Nursing Immersion to experience a Sweat Lodge Ceremony; …

The Use Of Healing Touch In Adults With Hepatitis C Virus Receiving Interferon And Ribavirin: A Pilot Study, Margaret Ann Taylor Phd, Msn, Cns, Htcp/I

Dissertations

In the United States, an estimated 3.2 million individuals are infected with hepatitis C virus (HCV) the nation's most common chronic blood-borne viral infection. The number of deaths from HCV was predicted to triple within the next two decades. The most effective treatment for HCV is a combination of interferon and ribavirin; however, as many as 92% of patients experienced fatigue as a side effect. The severity of this symptom caused some patients to skip dosages or even stop the required medication regimen before it was completed. The primary purpose of this pilot study was to test the feasibility of …

Exploring A Model Of Transcultural Nursing Practice That Promotes Cultural Care Preservation/Maintenance, Margaret Sormana

Theses and Graduate Projects

Migration is increasing due to instability in most parts of the world. Immigrants are faced with the choice to either maintain their unique cultural heritage or adopt the culture of the host country. Most immigrants desire to maintain their cultural heritage which requires balancing the values of their cultural heritage with those of the host country. Balancing includes silence which can reinforce self-blame when the values are in conflict. This project sought to break these patterns by engaging a group of Somali women in creative artistic activities. Based on Leininger's model of Cultural Care Diversity and Universality (1985), Watson's Human …

The Contemporary Perspective Of Wellness Through The Voices Of The Kūpuna, Anne P. Odell Phd

Dissertations

Few studies successfully explain the decline of Hawaiian health, nor provide enough insight to the cultural determinants that affect Hawaiian wellness. For over two hundred years, Hawaiians have been influenced by a changing landscape mostly imposed upon Hawaiians and Hawaiian lands as a consequence of being conquered by powerful Western cultures. This grounded theory study utilized video elicitation and focus group methodologies to examine the perspective of wellness in a group of Hawaiian elders known as kūpuna. Following the viewing of a documentary film designed to elicit culturally based memories, a series of interview questions were asked to foster group …

A Model Of Holistic Nursing As A Pathway To Nurse Self-Care, Kristin Mchale

Theses and Graduate Projects

The purpose of this project is to develop a model of holistic nursing practice as a pathway to nurse self-care. Specifically, this project integrates nursing theory, relevant literature, and reflection on holistic nursing practice. The significance of the project is identified as the current low priority of nurse self-care and the need for nurse self-healing- Additionally, holistic nursing, as a pathway to nurse self-care, is examined through the theoretical lens of Jean Watson. Furthermore, literature and research are examined in the areas of (t) the meaning of the holistic nursing experience, (2) self-care and complementary, alternative medicine use by nurses, …

An Exploration Of The Relationship Between Stress Physiological Signals And Stress Behaviors In Preterm Infants During Periods Of Environmental Stress In The Intensive Care Unit., Niang-Huei Peng

Dissertations

The purpose of this descriptive study was to examine relationships between stress physiological signals and stress behaviors in preterm infants during periods of environmental stress. The study used a repeated-measures design to examine the relationships between environmental stressors, sleep-wake states, and both stress physiological signals and stress behavioral responses in one group of preterm infants. Measurements of these variables for each preterm infant were recorded every two minutes during four 60-minute observation periods (two in the morning and two in the afternoon) conducted over two days (one morning and one afternoon observation each day). The sample was 37 preterm infants …

Intergenerational Communication: Its Effect On Early Screening Activities In African-American Adult Daughters Of Mothers With Breast Cancer, Rita R. Callahan Phd, Ma, Bsn, Rn

Dissertations

Health communication at numerous levels is vital to sustainability of healthy individuals. The notion of African-American mothers and adult daughters sharing breast health and breast cancer knowledge openly and honestly could be the initial step in addressing the high morbidity and mortality that continues to affect this population. Communication is a variable that has yet to be studied between African-American mothers diagnosed with breast cancer and their adult daughters. This study first examined whether this relationship existed, and secondly if it was strong enough in supporting and encouraging one another towards consistent breast health and breast cancer screening activities. The …

The Efficacy Of Oral Dexmedetomidine As An Anesthetic Pre-Operative Medication And As A Deterrent To Emergence Delirium, Brian W. Mountain

Masters Theses

Introduction: Emergence delirium (ED) has been described as “…a mental disturbance during the recovery from general anesthesia consisting of hallucinations, delusions and confusion manifested by moaning, restlessness, involuntary physical activity, and thrashing about in bed”(Sikich & Lerman, 2004). This phenomenon has been considered a common post-anesthetic problem in children and adults since its description in the literature in 1960. According to Cole, Muray, McAllister & Hirshberg (2002), ED occurs most frequently in the initial ten minutes of recovery, but many children who arrive in a post-anesthesia recovery area asleep experience agitation later during recovery. There are multiple definitions of ED …

Promoting Healthy Development: Educating Somali Mothers And Children On The Importance Of Outdoor Physical Activity, Rebecca S. Wawra

Theses and Graduate Projects

This paper describes an educational program that was designed to provide education and awareness for Somali mothers and children about the importance of outdoor physical activity on healthy child development. The program is based on Margaret Newman's nursing theory of Health as Expanding Consciousness and Hartrick-Doane & Varcoe's concept of walking with. A comprehensive literature review was completed to exemplify the need for outdoor physical activity education in the immigrant population.

Spirituality And Symptom Self Management Of Osteoarthritis, Lois M. Kannan Phd

Dissertations

Healthcare providers need to identify holistic self-care techniques that are endorsed by patients as effective strategies for symptom management of osteoarthritis, which is the single most common cause of disability in older adults. Research in this area may direct the development of interventions to ensure that older adults are afforded every opportunity to remain active and productive, with an improved health related quality of life, despite age related musculoskeletal conditions. The purpose of this study was to describe the relationships among symptom experience, symptom management, and symptom outcome based on spiritual well-being. A quantitative, descriptive, correlational, and noninterventional study design, …

Transformations With Tai Chi: The Experience Of Community-Dwelling Tai Chi Practitioners, Sunny Yim Alperson Phd

Dissertations

While Tai Chi practice has dramatically increased across the U.S., its mechanism is unknown, and overall understanding of the phenomenon is lacking. The purpose of this study was to explore the experience of community-dwelling Tai Chi practitioners through a qualitative study, detailing its social and personal appeal, the reasons for their continued involvement, its symbolic meanings, and its impact on their lives. Utilizing the grounded theory method and dimensional analysis, in-depth interview data from 23 practitioners, aged 49-82 were audio-recorded, transcribed, coded and analyzed to derive a grounded theory. A theoretical model, transformation with moving meditation was developed, reflecting the …

Identifying Determinants Of Physical Activity In Maritime Union Members Using The Theory Of Planned Behavior, Susan Atkinson Tweed

Health Services Research Dissertations

This study examined the usefulness of the Theory of Planned Behavior to predict how attitude, subjective norm, perceived behavioral control, and intention are associated with physical activity in longshoremen from the Hampton Roads Shipping Association-International Longshoreman's Association (HRSA-ILA). The study was conducted in two phases. In the first phase, five focus groups were conducted to elicit information about the health behaviors of longshoremen. From the results of these focus groups, a 90-question, theory based, self-reported questionnaire was developed to identify beliefs, attitudes, subjective norms, perceived behavioral control, and intentions that contribute to longshoremen engaging in physical activity. In the second …

Effect Of Outside Employment On Academic Success Among Full-Time Associate Degree Nursing Students, Julian A. Moore

Educational Foundations & Leadership Theses & Dissertations

Large portions of the United States are experiencing a shortage of nurses in the workplace. In 2001 the American Hospital Association reported that there were 126,000 vacancies for RNs nationwide. Sixty percent of all U.S. educated RNs who entered the field in 2000 received their education at the associate degree level and 79% of these associate degree recipients graduated from a community college. Improving completion rates in nursing programs is one major strategy in the effort to relieve this shortage of nurses.

The intent of this research was to study the effect of various factors on the academic achievement of …

Bringing Down The Barriers Of Maggot Debridement Therapy, Kristine L. Gillard

Theses and Graduate Projects

The purpose of this paper is to describe the rationale for Maggot Debridement Therapy (MDT) and the development of a practice model. Chronic wounds are a growing problem in health care. Debridement of a wound is an essential component of wound healing as the presence of devitalized tissue can impede the healing process. Even with today's high-tech medicine there are still times we need to resort back to the basic and simple principles from nature that may help combat medical problems. The use of maggot larvae for wound debridement has made resurgence into wound management in the last 15 years. …

Becoming A Mother Across Cultures: Challenges Nurses Experience Teaching Prenatal Care To Recent Immigrant Sudanese Women, Cathy E. Miller

Theses and Graduate Projects

The purpose of this project is to provide an overview of Maternal Role Attainment (MRA) theory as discussed in nursing literature and explore how separation from culture may affect the transition to becoming a mother. Nursing issues related to teaching and supporting recent immigrant Sudanese women will also be identified. MRA is a complex developmental and transitional experience for women. In the United States, many women take on this role with the support of their culture, family, friends and community. However, over the past few years, the local public health agency has served a small number of immigrant pregnant Sudanese …

Bed Assignment: A Nurse's Call, Sandra L. Prince

Theses and Graduate Projects

The purpose of this Integrated Thesis Project is to develop a nursing unit based bed assignment procedural guideline. Currently general care patients admitted to the hospital are assigned to a bed through a centralized bed assignment process that does not involve nursing input. The nursing unit based bed assignment process is developed using the assumption that nurses will select the right bed for the right patient the first time with consideration given to patient's individual needs and staffing on the unit. A nursing unit based bed assignment process is anticipated to increase satisfaction for patient, family and nurse. Jean Watson's …

Beyond Florence Nightingale: Celebrating Nursing At Augsburg Central Nursing Center, Lori J. Keith

Theses and Graduate Projects

The face of healthcare and our society are changing. People have difficulty accessing or paying for health services. One approach to meeting the needs of the under served is the utilization of nursing centers. The Augsburg College Department, in collaboration with Central Lutheran Church, maintains a no fee nurse managed center. Many nursing centers face continual difficulties in remaining viable or have closed because of funding issues. This project was developed to garner support for the Augsburg Central Nursing Center from Evangelical Lutheran Churches in America (ELCA) churches in the area. Fostering this relationship can provide necessary items and monies …

Closing The Research Gap: Enhancing Cambodian Participation In Clinical Research, Elsa C. Carlson

Theses and Graduate Projects

Obtaining proper sampling of a heterogeneous population remains a concern in research studies. Many studies have examined the low numbers of African-Americans recruited to clinical trials. Other studies have also focused on Latino-Hispanic disparity in research. However, there remains paucity in research involving Asian participation. This project aims to develop a nursing model of cultural immersion in the Cambodian community's culture that will foster deeper understanding, acceptance, and trust. In so doing, a research-friendly milieu of collaboration by the Cambodian community and the research community will be established. Madeleine Leininger's Theory of Culture Care Diversity and Universality is the theoretical …