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Articles 1 - 30 of 39
Full-Text Articles in Nursing
Implementation Of Sleep Problem Screening In A Pediatric Primary Care Office, Jennifer Erin O'Donnell
Implementation Of Sleep Problem Screening In A Pediatric Primary Care Office, Jennifer Erin O'Donnell
Dissertations
Sleep problems, a major problem for children and their parents, are the most common complaint brought to pediatric clinicians (advanced practice nurses and other healthcare providers) attention but are often ignored and underdiagnosed in the pediatric population (Faruqui, Khubchandani, Price, Bolyard, & Reddy, 2011). “Sufficient amounts of good quality sleep are necessary for healthy development in childhood” (Bordeleau, Bernier, & Carrier, 2012, p. 254). Inadequate sleep in children has been linked to numerous adverse outcomes psychologically as well as physically (Owens, Jones, & Nash, 2011). The American Academy of Pediatrics (AAP), issued recommendations in 2002 stating screening for snoring, one …
Onsite Integrative Clinics: Acupuncture, Positive Patient Outcomes, And Frequency Of Provider Office Visits, Sherry Shoemaker Phd
Onsite Integrative Clinics: Acupuncture, Positive Patient Outcomes, And Frequency Of Provider Office Visits, Sherry Shoemaker Phd
Dissertations
Purpose and Aims. There is limited information about outcomes of care, resource utilization, and associated costs for patients who receive acupuncture in integrative health settings. The purpose of this study was to address this gap through the following aims: To examine: (1) changes in patient pain levels pre/post acupuncture treatments; (2) relationships between receiving acupuncture treatments (number of treatments, length of time, select demographic factors, (age, gender), pain level pre and post acupuncture treatments; (3) relationships between number of treatments, length of time, age, gender, pain level (pre/post acupuncture treatments) and provider visits (pre/post acupuncture treatments); and (4) relationship between …
Exploring A Diabetic Registry For Cardiovascular Risk Factors, Mary C. Anziano Phd
Exploring A Diabetic Registry For Cardiovascular Risk Factors, Mary C. Anziano Phd
Dissertations
Background: Cardiovascular disease is the leading cause of death in the United States. There were over 18 million people diagnosed with diabetes in 2002. These disease processes together combine for significant health burden on society (American Diabetes Association, 2008). The purpose of the study was to describe the relationship between select demographics, and clinical characteristics to determine risk factors for cardiovascular disease in a diabetic population. Methods: A retrospective descriptive study was conducted using a diabetic registry database containing patients diagnosed with diabetes from January 1, 2011 to December 31, 2012. Study variables included age, gender, socio-economic status, glycosylated hemoglobin …
The Case Of Reintegration Of Women Post Incarceration, Deana Raley Noble Phd
The Case Of Reintegration Of Women Post Incarceration, Deana Raley Noble Phd
Dissertations
Women released from prison or jail face particular obstacles and challenges on reentry to the community, many of which are related to their childhood and to gender roles as women and mothers. This study relates the lived experience of one woman's successful transition to economic and mainstream societal reintegration and family reconnection after release from prison and the insights gained by the researcher. Case study methodology congruent with Miller's Relational-Cultural Theory philosophical framework was utilized in this in-depth, single case design and represents a unique case. The overall purpose of this descriptive and explanatory research was to explore precursors to …
Relationship Between Age And Pre-End Stage Renal Disease Care In Elderly Hemodialysis Patients, Rubette Harford Phd, Msn, Rn
Relationship Between Age And Pre-End Stage Renal Disease Care In Elderly Hemodialysis Patients, Rubette Harford Phd, Msn, Rn
Dissertations
Purpose: The primary purpose of this dissertation was to examine the relationship between age and receipt of three components of pre-end stage renal disease care prior to first initiation of hemodialysis, and to explore the implications of differences in interpretation of funding policies for dialysis services in Puerto Rico and the U.S. mainland. Background: The growing burden of chronic kidney disease (CKD) is a national public health concern, particularly within the aged population. It is estimated that more than 25 million Americans are living with some level of kidney disease, with an increasing prevalence noted with increasing age (Coresh et …
Assessing The Monitoring And Management Of Overweight And Obesity In Children Hospitalized For Asthma, Anne E. Borgmeyer
Assessing The Monitoring And Management Of Overweight And Obesity In Children Hospitalized For Asthma, Anne E. Borgmeyer
Dissertations
Asthma and overweight are two of the most common chronic health problems in children. Data support a relationship between the two health issues. Although asthma is one of the top reasons for hospital admission for children, little is known about the prevalence of overweight and obesity or clinical practice related to weight in children hospitalized for asthma. The purpose of this project was to assess weight characteristics of children admitted with asthma, as well as the current practices of monitoring and management of overweight and obesity in children hospitalized with asthma. A retrospective review of medical records was conducted. The …
Patients With Advanced Lung Cancer: Quality Of Life And Perception Of Dyspnea, Barbara A. Roces Phd, Msn, Np, Rn
Patients With Advanced Lung Cancer: Quality Of Life And Perception Of Dyspnea, Barbara A. Roces Phd, Msn, Np, Rn
Dissertations
Background: Dyspnea perception can be defined as a multidimensional experience of breathing discomfort, influenced by physiological, psychological, social, and environmental factors, that includes secondary psychological and behavioral responses and cannot be defined only by physical objective abnormalities (Mularski et al., 2010). Dyspnea is the most common and distressing symptom in patients with advanced lung cancer and decreases one's quality of life (QOL) (Smith et al., 2001). Furthermore, dyspnea has been found to interfere with physical activities such as walking, work, and psychological activities such as disposition, taking pleasure in life, relationship with others, and sleep (Tanaka, Akechi, Okuyama, Nishiwaki, & …
Depressive Symptomatology And Perceived Social Support In Adolescents With Type 2 Diabetes, Kristiana Gay Huffman Cullum Phd, Cpnp
Depressive Symptomatology And Perceived Social Support In Adolescents With Type 2 Diabetes, Kristiana Gay Huffman Cullum Phd, Cpnp
Dissertations
Type 2 diabetes has increased dramatically in the pediatric population in the last decade. One of the comorbidities of diabetes is depression. In the presence of depression, diabetes may be mismanaged by patients and lead to a decline in health. Diabetes with comorbid depression may have better disease management outcomes in the presence of higher levels of social support. Defining childhood depression, which encompasses adolescence, and the subtleties of this disorder compared to the adult counterpart, was needed to better delineate important variables for this research study. There are several instruments that evaluate adolescents' perceived social support, but a fairly …
Symptom Burden And Healthcare Utilization In Pulmonary Arterial Hypertension, Catherina Anne Madani Phd
Symptom Burden And Healthcare Utilization In Pulmonary Arterial Hypertension, Catherina Anne Madani Phd
Dissertations
Background: Pulmonary arterial hypertension (PAH) is a rapidly progressive disease. There is currently no cure; thus treatment is aimed at prolonging survival, improving functional status (FS), and symptom mitigation. Symptom burden (SB) can impact quality of life (QOL), and lead to increased healthcare utilization. Palliative care (PC) has been associated with higher QOL, decreased depression, aggressive care, and mortality. The Institute of Medicine's (IOM) recent report supports earlier integration of PC for people living with serious illness. Detection of patients at high risk for heavy SB may help to identify patients who could benefit from earlier integration of PC into …
Patient Care Technology And The Nurse-Patient Relationship, Belinda M. Toole Phd, Msn, Rn
Patient Care Technology And The Nurse-Patient Relationship, Belinda M. Toole Phd, Msn, Rn
Dissertations
Background: Technological devices are increasingly used in healthcare and their proliferation has providers questioning the impact on the patient-provider relationship. Technological device integration has been studied in the primary care setting, less extensively in the acute care setting. The impact of device use on the nurse-patient relationship in acute care setting required further study, particularly with nursing's history of holistic practice incorporating caring and presence. Objectives: The study purpose was to explore the patient's perceptions of nurse caring and presence when technological devices were used in care delivery in the acute care setting. Specific aims were: 1) to describe the …
Skin Cancer Risk Perception And Sunscreen Use In Adolescent Female Soccer Athletes, Cheryl L. Butera Phd, Msn, Aprn, Fnp-Bc, Np-C, Phn
Skin Cancer Risk Perception And Sunscreen Use In Adolescent Female Soccer Athletes, Cheryl L. Butera Phd, Msn, Aprn, Fnp-Bc, Np-C, Phn
Dissertations
Over 3.5 million cases of skin cancer are diagnosed annually in the United States. In adolescent females ages 15-19, melanoma is the second most common form of cancer. The greatest risk factor for skin cancer is ultraviolet rays from the sun. Research has shown that sunscreen use is protective of all skin cancers, especially melanoma. The purpose of this study was to obtain perceptions about risk of skin cancer and sunscreen use among 13- to 18-year-old adolescent female club soccer athletes as a basis for effective interventions to improve sunscreen use in this population. The Health Belief Model was employed …
Provider Perception Of Patient Satisfaction If Antibiotics Are Not Given For Upper Respiratory Infection, Robyn Doniel Drake
Provider Perception Of Patient Satisfaction If Antibiotics Are Not Given For Upper Respiratory Infection, Robyn Doniel Drake
Dissertations
The purpose of this project was to assess if advanced practice nurse practitioners perceived patient satisfaction of patients seen in Metropolitan Retail Clinics was improved after educational materials were given to explain when antibiotics work. I hypothesized that provider perception of patient satisfaction would decrease unnecessary prescribing of antibiotics after providing patient education? This project used questionnaires to collect data from control and intervention groups to demonstrate a gain in provider perception if patient satisfaction after education was given in the intervention group. The results of this project did not reveal to the primary investigator what was originally assumed, that …
Increasing Patients’ Knowledge In Transmission Of Bacterial Vaginosis And Its Treatment Regimens, Debra Garner
Increasing Patients’ Knowledge In Transmission Of Bacterial Vaginosis And Its Treatment Regimens, Debra Garner
Dissertations
Research has shown bacterial vaginosis to be one of the most common vaginal disorders in women of child bearing age (Chen, Tian, & Beigi, 2009; Centers for Disease Control, 2012; Menard, 2011). Each year many women are seen by their gynecologist, sexually transmitted infection (STI) clinics, and emergency rooms (ER) for complaints of having malodorous discharge (Bradshaw, et al., 2005). Several STI’s and adverse pregnancy outcomes have been attributed to women having bacterial vaginosis (Bradshaw, et al, 2005; Chen, et al.2009; Elkins, & Mayeaux, 2010). Women are predisposed to bacterial vaginosis by the use of wearing non cotton underwear, douching, …
Nutrition, Appetite And Weight Loss In Elders Living In Long-Term Care Facilities, Karene Marie Goodman
Nutrition, Appetite And Weight Loss In Elders Living In Long-Term Care Facilities, Karene Marie Goodman
Dissertations
Abstract Elders living in long-term care facilities often experience weight loss. Weight loss in elders has been shown to increase their risk of death. Existing research has identified numerous factors associated with appetite and weight loss in elders. Dementia, depression, acute and chronic illness, and medications have all been identified as potential causes of decreased appetite and weight loss in elders. Only a few nutritional and appetite assessment tools exist, and these tools are not widely used in long-term care facilities. The purpose of this descriptive study was to validate the Simplified Nutritional Appetite Questionnaire (SNAQ), an appetite assessment tool …
Instituting A Behavioral Wellness Program And Updating A Clinical Pathway For Economically Disadvantaged Overweight And Obese Adults In A Community Health Center: A Clinical Scholarship Project, Kimberly D. Buck
Dissertations
This project is intentionally instituted in an underserved community in an attempt to bridge the gap of health disparities in a population that would otherwise not have access to such programs. The purpose of this clinical scholarship project is to work with the Midwestern health center to encourage weight loss as well as to promote healthy lifestyles and reduce risk factors among economically disadvantaged persons by: (a) starting a wellness program that incorporates both behavioral and physical health using principles of motivational interviewing and health coaching, and (b) updating a clinical pathway for persons with a body mass index twenty-five …
Nurse Practice Environment And Peripheral Intravenous Infiltrations In A Pediatric Hospital On The Magnet Journey, Jannise Topacio Baclig Phd
Nurse Practice Environment And Peripheral Intravenous Infiltrations In A Pediatric Hospital On The Magnet Journey, Jannise Topacio Baclig Phd
Dissertations
Background: Characteristics such as quality patient care, excellence in nursing, and innovations in professional nursing practice shape a health care organization into a "magnet" organization. Magnet designation is a key aspect of nursing, which places pressure on healthcare organizations to commit to nursing excellence and patient care should they take the challenge of attaining this prestige. With growing focus on quality and safety, nursing needs to remain diligent in ensuring a healthy work environment that not only supports the profession, but also sustains exceptional patient outcomes. The purpose of this research study was to describe the relationship of the nurse …
Safety Hazards Education For Mothers Who Are Homeless: Target Teaching To Improve Knowledge Of Safety Hazards For Children Under Five Years Of Age, Susan Halpern Fliesher
Safety Hazards Education For Mothers Who Are Homeless: Target Teaching To Improve Knowledge Of Safety Hazards For Children Under Five Years Of Age, Susan Halpern Fliesher
Dissertations
The leading cause of morbidity and mortality in children in the U. S. is unintentional injury (Center for Disease Control Child Injury Report, 2000 to 2006), but there is little information about homeless mothers with children and child unintentional injury. Frencher et al. (2010) compared lower socioeconomic families with children with housing to homeless families with children, and found that unintentional injury was 13% higher among homeless children. Mothers who are homeless often need to navigate a variety of temporary housing and may lack understanding of child safety hazards in strange environments, limiting their ability to ensure their children’s safety …
Quantitative Measurement Of Reciprocal Social Behavior Among Toddlers Aged 18 To 24, Rebecca Sarah Light-Pearlman
Quantitative Measurement Of Reciprocal Social Behavior Among Toddlers Aged 18 To 24, Rebecca Sarah Light-Pearlman
Dissertations
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that starts in early childhood. It is characterized by impairments in reciprocal social behavior, impaired language, and stereotypic behavior/restricted interests (Pine, Luby, Abbacchi, & Constantino, 2006). One in 68 children is affected by ASD (Centers for Disease Control and Prevention, 2014). The prevalence of ASD is rapidly increasing. New estimates show a 23% increase in the number of cases since 2009 and a 78% increase in case numbers since 2007 (CDC, 2013). The purposes of this project were to: (a) establish normative parameters of reciprocal social behaviors, among toddlers aged 18 to …
Validation Of The Transportation Burden Questionnaire Among Family Caregivers Of Older Adults, Bryant James Price
Validation Of The Transportation Burden Questionnaire Among Family Caregivers Of Older Adults, Bryant James Price
Dissertations
Because family caregivers provide a substantial amount of informal care to dependent loved ones, the potential burden such care may place on family members is an important area for clinical research and intervention. While the provision of transportation is recognized in the literature as a caregiving task and a component of global burden, few studies, to date, have addressed this as a distinct concern for measurement and intervention. The purpose of this study was to determine if an item set focused specifically on transportation burden would be additive to accepted global measures of burden in a volunteer sample of caregivers. …
Efficacy Of Mantram Repetition Program On Sleep In Veterans With Posttraumatic Stress Disorder, Lindsay Cosco Holt Phd
Efficacy Of Mantram Repetition Program On Sleep In Veterans With Posttraumatic Stress Disorder, Lindsay Cosco Holt Phd
Dissertations
Posttraumatic Stress Disorder (PTSD) affects over seven million (3.5%) of the US adult population. In 2011, 476,515 veterans were currently seeking treatment for PTSD. Statistics show that 87% of veterans with PTSD report sleep disturbances and 52% experience frequent nightmares, making sleep the second most common reason why veterans seek mental health care upon return from deployment (Germain et al., 2006). Studies have sought to find a link between PTSD and sleep, and the importance of sleep in the recovery process, but there is a gap in the research on sleep disturbances and interventions for improvement in veterans with PTSD. …
Hospital Fall Prevention Using Interactive Patient Care Technology, Verna A. Sitzer Phd, Mn, Rn, Cns
Hospital Fall Prevention Using Interactive Patient Care Technology, Verna A. Sitzer Phd, Mn, Rn, Cns
Dissertations
The impact of patient engagement in hospital fall prevention using interactive patient care technology is not known. The purpose of this investigation was to examine the engagement of hospitalized patients in a computer-based, interactive patient care fall prevention pathway, comprised of a self-assessment of fall risk questionnaire and a fall prevention video, and hospital fall outcomes. The aims were to 1) formulate an interactive patient care technology conceptual framework to guide the study, 2) provide reliability and validity evidence for a patient self-assessment of fall risk questionnaire, and 3) explore the relationship between the fall prevention pathway engagement characteristics and …
Is Combat Exposure Predictive Of Higher Preoperative Stress In Military Members?, Eric J. Bopp Phd
Is Combat Exposure Predictive Of Higher Preoperative Stress In Military Members?, Eric J. Bopp Phd
Dissertations
Since September 11, 2001, the United States has been engaged in large-scale combat operations exposing numerous military service members to stressful, traumatic, and threatening environments. As a result, many of these individuals have experienced significant psychological problems, such as anxiety, depression, and posttraumatic stress disorder (PTSD), as well as physiological alterations, such as cardiovascular changes and neuroendocrine disturbances. The preoperative experience may be perceived as stressful, often increasing in magnitude as the patient progresses through the preoperative period. Military anesthesia providers frequently provide anesthetic care to military members with a history of combat exposure. Anecdotally, it is not uncommon for …
Fetal Heart Monitoring, Nursing Surveillance, And Cesarean Birth, María Del Carmen Colombo Phd
Fetal Heart Monitoring, Nursing Surveillance, And Cesarean Birth, María Del Carmen Colombo Phd
Dissertations
Purpose: Birth by cesarean delivery is a major public health issue with nearly one in three births delivered by cesarean section. Cesarean birth may be necessary to save mother or baby, but the rapid rise since 1996 without concomitant reduction in maternal and neonatal morbidity and mortality may indicate this mode of delivery may be over utilized. Cesarean births pose significant maternal and newborn health risks. Identification of factors that may contribute to reduction in the first cesarean birth in low-risk women who are nulliparous, term gestation, with single fetus in head down position (NTSV) is a health priority. The …
Professional Quality Of Life And Emergency Department Nurses' Communication Patterns, Elvira Dominguez-Gomez Phd
Professional Quality Of Life And Emergency Department Nurses' Communication Patterns, Elvira Dominguez-Gomez Phd
Dissertations
The purpose of this mixed methods embedded design study was to examine relationships between compassion satisfaction, burnout, compassion fatigue/secondary trauma, and perceived levels of communication difficulty in emergency room nurses employed at a health care system. Quantitative data was collected from a purposive sample of 43 emergency room nurses using the Professional Quality of Life Scale (ProQOL), the Silencing Response Scale, and a demographic form. The study's embedded qualitative component was participants' experiences with traumatic cases in the emergency room. Qualitative data was collected via telephone interview with 10 emergency room nurses obtained from a subset of the original sample …
Gestational Weight Gain Patterns, Hope R. Farquharson Phd
Gestational Weight Gain Patterns, Hope R. Farquharson Phd
Dissertations
Background: Managing gestational weight gain (GWG) remains a global health priority as obesity among women of childbearing age and their children have been linked to excessive GWG. Excessive GWG has been linked to increased rates of cesarean sections, preterm births, hypertensive disorders, gestational diabetes, large for gestational age newborns, postpartum weight retention, long-term obesity for the woman and her children. Conversely, adverse outcomes resulting from weight gain below recommendation could potentially include preterm births, increased rates of neonatal intensive care admission, and newborn morbidity and mortality. Previous studies indicate the need for healthcare providers to help women gain within the …
Delirium Rate And Risk Factors In Palliative Care Outpatients And Caregiver Coping Strategies, Sarah Deur Livermore Phd, Fnp
Delirium Rate And Risk Factors In Palliative Care Outpatients And Caregiver Coping Strategies, Sarah Deur Livermore Phd, Fnp
Dissertations
Background: Delirium causes suffering and in terminal illness undermines important goals to die at home. Improved knowledge about delirium among palliative outpatients can lead to improved patient outcomes through early identification and treatment in the home. Conversely, a missed diagnosis leads to costly hospital admissions, and is the most common reason to seek long-term care placement (Breitbart & Alici, 2008). Medicare stresses the importance by listing it as a common cause of falls among non-reimbursed hospital events. Prior evaluation of outpatient delirium rate was 14% among demented community dwelling elders (Steis, Evans, et al., 2012a). It is hypothesized that frail, …
A Phenomenological Study Of Acceptability Of Preexposure Prophylaxis Therapy Within The Lived Experiences Of Hiv Negative Male-To-Female Transgender Young Adults, Gloria N. Nwagwu Phd
A Phenomenological Study Of Acceptability Of Preexposure Prophylaxis Therapy Within The Lived Experiences Of Hiv Negative Male-To-Female Transgender Young Adults, Gloria N. Nwagwu Phd
Dissertations
The male-to-female transgender (MtF-TG) are individuals assigned a male gender at birth but self identify as female. MtF-TG young adults experience discrimination, stigmatization, isolation, and homelessness as a result of gender identity and gender expression. The transgender populations are linked to high rate of new HIV infection. The use of Preexposure prophylaxis (PrEP) therapy demonstrated a decrease in HIV infection risk ranging from 42% to 73% among sexual minority individuals. The goal of this three-part study was achieved through concept analysis, data collection, and analysis. The following aims were addressed; analyze the concept of transgender, explore currently used HIV prevention …
Identification Of Posttraumatic Stress Disorder Symptoms In Post-Icu Patients, Heather Warlan Phd, Rn, Ccrn
Identification Of Posttraumatic Stress Disorder Symptoms In Post-Icu Patients, Heather Warlan Phd, Rn, Ccrn
Dissertations
Background: Patients receiving critical care are experiencing post-traumatic stress syndrome (PTSS) as a result of life-saving interventions received in the intensive care unit (ICU). PTSS is associated with poor patient outcomes and decreased quality of life compared to post-ICU patients without PTSS. Personal and clinical characteristics that place patients at higher risk for PTSS are still being examined. It is also unknown to what extent patients are being screened for ICU-induced PTSS. Objectives: This body of work aims to examine the risk factors associated with ICU-related PTSS and describe the screening experiences of patients who recently received care in an …
Transitioning Adolescents With Type I Diabetes To Adult Care, Kathyann Kenny Marsh Phd
Transitioning Adolescents With Type I Diabetes To Adult Care, Kathyann Kenny Marsh Phd
Dissertations
Background: Care transitions, defined as hospital discharge or movement from one healthcare setting to another, are currently a major concern for healthcare providers and policy makers alike. These care transitions are occurring in the context of increasingly fragmented care and have been known to result in hospital readmissions, adverse events, and medication errors. The adolescents' transition between pediatric and the adult care system is not only fragmented but occurs at a time when they are most vulnerable and ill equipped for change. Objectives: The purpose of this research was to conduct a feasibility study to examine if the use of …
A Sleep Apnea Program For Commercial Drivers, Gayla Ann Dace
A Sleep Apnea Program For Commercial Drivers, Gayla Ann Dace
Dissertations
Sleepy driving is a major contributing factor to the motor vehicle crash risk associated with commercial drivers (Pack et al., 2006). In commercial vehicles, approximately 31% to 41% of major crashes can be linked to sleepy driving (Gurubhagavatula et al., 2004). An average non-fatality crash involving a commercial motor vehicle costs about $75,637 while a fatality crash averages about $3.54 million (Gurubhagavatula et al., 2004). A contributing factor to sleepy driving is obstructive sleep apnea (Pack et al., 2006). The purposes of this study were to: (1) determine how many commercial motor vehicle drivers referred to a sleep center as …