Family Practice Nursing Commons^™

Enhancing Elderly Advance Care Planning Experience At A Primary Care Clinic, Oi Shan Wong

Doctoral Projects

The purpose of the project was to examine if the identification of readiness for an advance care planning (ACP) discussion of elderly participants would enhance the outcomes of participants' satisfaction, improve the likelihood of having an ACP discussion and increase the completion rates of an advance directive (AD) document after an office visit.

Forty-four elderly participants, who met the selection criteria, were recruited from a primary clinic in Northern California from October 1, 2017 to December 31, 2017 (Female, n =28). All participants were randomly assigned to either an intervention group (n= 22) or a control group ( …

Sexually Transmitted Infection Prevention In 18 To 24-Year-Old Heterosexual Men: Pilot Study, Susan P. Mckeefrey

Doctoral Projects

The CDC reported that there were over 20 million cases in the United States and half affected young adults, 15 to 25-year olds. Strategies STD prevention have been developed by the CDC but does not include avoiding alcohol or other similar agents in the context of a sexual encounter. The purpose of this study was to assess the effectiveness of STD prevention education intervention by improving Condom Use Self-Efficacy in heterosexually 18 to 24-year old men. It was hypothesized self-efficacy would improve with a face-to-face brief educational intervention. A quasi-experimental, pre-/post-test design with simple randomization of subjects into control and …

Attitudes And Perceptions Of Advanced Practice Nurses Towards Health Information Technology And Its Effects On Caring, Debbie Ramos Shih

Doctoral Projects

Technology is rapidly, constantly evolving, and affecting healthcare. While it has the ability to improve healthcare outcomes, it is important to realize the impact this technology has on the relationships between patients and nurses (Korhonen, et al., 2015). Interactions with patients are increasing through computer technology and decreasing by physical presence and touch, potentially compromising the development of a trusting relationship and thus affecting patient quality outcomes (Sandelowski, 2002).

This cross sectional study explored the attitudes and perceptions of APRNs towards HIT and its effects on caring. 150 Advanced Practice Clinicians in a Northern California healthcare was surveyed, using the …

Preconception Care Of Women On Prescribed Opioids, Rebecca-Maria Norwick

Doctoral Projects

The landmark 2015 report from the Center for Disease Control (CDC) posited that too many women of reproductive age received prescribed opioids. This is significant because fetal exposure to a known teratogen can have catastrophic outcomes. Furthermore, women are often ambivalent about birth control and many pregnancies are unplanned. Fortunately, women identify interactions with health care providers as acceptable cues for preconception decision making. Data has shown that Medicaid populations are disproportionately prescribed opioids compared to insured populations. However, the CDC defines reproductive status by age only. Therefore, the purpose of this research project was to identify women’s actual risk …

African American Men And Ostrich Behavior, Debbie Slack-Gay

Doctoral Projects

This project explores why African American men choose Ostrich Behavior when it comes to health care prevention and maintenance as related to hypertension. The population was African American men, ages18–80, in Northern California. Men were recruited while getting a haircut or waiting for one or after church services. Blood pressure readings were taken and a health questionnaire was administered. The results show that even if hypertension is known, men ages 18–45 go to fewer office visits than African American men in other age groups, and older men tend to seek medical care and take medication if prescribed.

Effectiveness And Feasibility Of In-Office Versus Smartphone Text-Delivered Nutrition Education In The College Setting: A Mixed-Methods Pilot Study, Jordan Rose, Deepika Goyal, Mary Ellen Wilkosz, Anita Catlin

Doctoral Projects

Often, being away from home for the first time, coupled with limited knowledge regarding healthy eating behaviors, leads to poor food choices and an increased risk of obesity among college-aged young adults. These college students are prone to high-calorie diets and limited physical activity, putting them at risk for obesity, a physiologically, psychologically, and financially costly epidemic in the United States. College students use their cellular phones over eight and a half hours a day and cell phones are their primary means of information consumption outside of the classroom, suggesting that the phones would be a useful tool to provide …

Development And Evaluation Of A Chronic Care Management Toolkit, Heidi Hongxin He

Doctoral Projects

Currently, little research is available on the topic of Chronic Care Management (CCM) service and its impact on patient health outcomes, largely because the service was recently introduced by Medicare in January 2015. The purpose of this Doctor in Nursing Practice (DNP) project is to create a Chronic Care Management (CCM) Toolkit specific to an established pulmonology practice based in a Central California community. This quality improvement pilot project also included an evaluation of the newly developed CCM Toolkit designed for this project. The evaluation was accomplished by surveying CCM care team members in this pulmonary practice (an internal group), …

Undiagnosed Depression In The Elderly And Healthcare Education, Nancy J. Wynn-Grundy

Doctoral Projects

This descriptive study examined undiagnosed depression in the elderly and how it affects the elderly from retaining healthcare education. It is estimated by 2029, 20% of the United States population will be age 65 and older (Colby & Ortman, 2014). Depression in the elderly who have chronic diseases, is estimated to be undiagnosed up to 40% (Chaoyang et al., 2009). A hallmark symptom of depression is the inability to concentrate. It is unknown if undiagnosed depression will affect the older adult from retaining pertinent healthcare education. The 30 point Geriatric Depression Scale (GDS) was administered to a class of elderly …

How To Start A Nurse Practitioner Faculty Managed Clinic: Missing Components?, Johnna Edmunds

Doctoral Projects

A serious need exists for improved access to primary care for vulnerable populations. Nurse Practitioner Faculty Managed Clinics (NPFMC) can help to alleviate this problem. The purpose of this qualitative, descriptive study was to identify and examine the beginning components necessary for implementing this inter-professional collaboration. A comprehensive literature review identified the absence of these components, which were then revealed through the interviews with founders of NPFMCs. Prior to the interviews two manuals were reviewed about the process of starting a free clinic. Questions were explored relating to the participants’ experiences in starting a NPFMC. Review of the manuals was …

Exploring The Needs And Preferences For A Diabetes Self-Management Program In Hispanics Living In The Central Valley Of California, Emily Lane Kimble

Doctoral Projects

Diabetes mellitus type 2 is an ever increasing threat to the health of people living in the United States, especially those of Hispanic ethnicity. This ethnic group is disproportionately afflicted with the chronic condition and is also more likely than non-Hispanic whites to suffer from serious complications of diabetes. This project examines this growing problem among Hispanics living in the Central Valley of California by exploring how best to structure diabetes self-management education in a network of community health centers.

The Social Cognitive Theory provides a theoretical basis for investigation into motivation for diabetes self-management. This needs assessment specifically explored …

A Phenomenological Assessment Of Factors That Affect Medication Adherence Among Hypertensive Nigerian Immigrants, Beulah Iroegbu

Doctoral Projects

This qualitative study explored the perceptions that affect medication adherence among hypertensive Nigerian immigrants in Sacramento, California. The research questions focused on factors that influenced the adherence to hypertension medication; specifically, how the sample population explained the cause of hypertension and whether culture and religion impacted the cause and management of hypertension. A phenomenological approach was used to understand perceptions about medication adherence. A predefined group of 9 acted as a purposive sample and was given semi-structured individual interviews. Qualitative data analysis of the interviews was performed using Colaizzi's 7-step method. Results from the study found the cause of hypertension …

Chinese Community Physicians' Perception Toward Collaboration With Advanced Practice Nurses, Ivy Tan

Doctoral Projects

Effective interprofessional collaboration has been shown to be beneficial for both patients and providers. Yet collaboration between physicians and advanced practiced nurses (APNs) has been problematic. Little was known about such collaboration in an ethnic group like the Chinese community. This quantitative descriptive capstone project was to assess the perception among physicians, who are the members of the Chinese Community Healthcare Association in the San Francisco area, toward collaboration with APNs. The study also attempted to gain insight of collaborative attitudes of physicians in the Chinese community in order to fill the gap in the literature in this area. Data …

Attention Deficit Hyperactivity Disorder And Mindfulness Practice In Children And Adolescents: A Comprehensive Review Of Evidence-Based Research, Donna Nikander

Doctoral Projects

Attention Deficit Hyperactivity Disorder (ADHD) is the most common mental illness in the United States among male and female children and adolescents between the ages of 3 and 17. The emerging fields of neurobiology and neuroimaging have proposed a relationship between mindfulness meditation therapies—initially referred to as mindfulness-based stress reduction (MBSR) and now simply known as mindfulness—and improvements in attention and self-regulation, two major problem areas for ADHD sufferers. Furthermore, recent studies suggest that mindfulness therapies may be effective in reducing symptoms of ADHD in children and adolescents. The purpose of this paper is to review, analyze and synthesize the …

Long-Acting Reversible Contraceptive Methods, Same-Day Initiation And Early Removal, Sandra Mary Loehner

Doctoral Projects

Objective: The study was conducted to identify the early removal rate of Long-Acting Reversible Contraceptive (LARC) methods and factors associated with early removal.

Study Design: A non-experimental descriptive design based upon retrospective chart review of electronic medical records (EMR) was used. There was a total of 96 subjects, ages 15-47 years who had a LARC method inserted within a 12-month time period and subsequent removal within 6-months of insertion date. Subjects were grouped according to same-day insertion versus non-same-day insertion.

Results: Seventy percent of study subjects with early removal had their LARC method inserted under a same-day protocol. Most subjects …

Pilot Study: Avoiding Readmissions Of Heart Failure Patients Across Transitions Of Care, Analiza Baldonado

Doctoral Projects

Background: A major problem facing the U.S. healthcare system is avoidable hospital readmissions. Patients with Heart Failure (HF) face variety of barriers to health care and are at higher risk for readmissions. To address this problem, evidence-based interventions focused on safe transition from hospital to home are needed.

Methods: A quality improvement pilot project was implemented to evaluate the feasibility of evidence based interventions in preventing avoidable readmissions. The project setting was in a 900 bed health care system. The descriptive statistical methods were means and frequencies. The Transition Coordinator (TC) enrolled a convenience sample of 30 participants. The evidence …

The Use Of Complementary And Alternative Medicine For Menopausal Symptoms Among Chinese-American Women, Rebecca Kwai-Ying Chung

Master's Projects

The objectives of this research were to study the use of complementary and alternative medicine (CAM) for menopausal symptoms among Chinese-American women, and to examine the correlation between CAM use, acculturation, and CAM insurance coverage. The study revealed that Chinese-American women experience menopausal symptoms even when they still have regular menstrual cycles. Early education on women's health, especially about menopause, is recommended. A significant correlation was found between the women being asked by their health care providers regarding CAM use, and open discussion regarding the women's CAM use with their health care providers (p<0.05). The researchers suggest that health care providers ask their patients about their CAM use in order to encourage open discussion of CAM use with their patients.

Perceived Barriers By Hispanic Mothers In Obtaining Primary Health Care For Their Childern, Michael Allen Hart

Master's Projects

Purpose: Hispanic mothers tend to over use hospital emergency services and under use primary care providers when seeking health care for their children. In order to change this health care utilization behavior, researchers must understand the barriers to health care perceived by Hispanic mothers. Design: In this non-experimental survey study, a non-probability, purposive sampling of 45 Hispanic mothers at a rural county pediatric clinic were surveyed. Methods: Using the Health Belief Model (HBM) as its framework an 18-item survey examined, barriers to health care, cues to action, subjects' knowledge, family satisfaction, access, and likelihood of action. Findings: The data suggest …

Childern Witnessing Domestic Violence, Meghan Denzel

Master's Projects

Statement of Problem: Although witnessing violence in the family may account for many symptoms brought to the attention of the primary care providers, such violence is seldom identified as an issue. The purpose of this study was to assess the incidence of children witnessing violence in the home, as self reported by victims of domestic violence in a clinical setting. Method: The study was a retrospective chart review. Data was gathered from a survey administered to individuals identified in the emergency department as victims of domestic violence. The survey addressed demographics, child witnesses to violence, and co-factors of violence including …

A Comparison Of Domestic Violence Screening, Attitudes, And Knowledge Base, Terry Gardner

Master's Projects

Objective: To compare advanced practice nurses' (APNs) and physicians' (MDs) domestic violence screening behaviors, perceived obstacles, and knowledge base so as to determine the efficacy of the collaborative practice model of care. Design: The survey questionnaires were the "Nurse Practitioners' Experience with Partner Abuse in Alaska" and the "Physicians' Experience with Partner Abuse in Alaska". Significant differences were evaluated by using one-way analysis of variance (ANOVA). Setting: Two 200-300 bed urban HMO medical centers. Participants: Thirty-five providers (23 MDs and 12 APNs) with the mean age of 40, and with 8 years clinical practice in California. Results: Of total providers, …

Nurse Practitioners' Practices Related To Testicular Cancer And Testicular Self-Examination, April E. Schwegel

Master's Projects

Testicular cancer remains the number one cancer for men age 15 through 35. Early detection is essential to decrease morbidity and mortality. The purpose of this study was to identify and describe the extent to which California nurse practitioners screen for testicular cancer and the frequency of teaching testicular self-examination to patients. The study surveyed 425 adult or family nurse practitioners, currently practicing in the state of California, with a patient population that includes males age 15-35. The study supported the previous findings of Sladden and Dickinson (1995). Nurse practitioners do believe that testicular self-examination is an effective screening method …

Does The Congestive Heart Failure Program Improve Patient's Functional Health Status?, Lily Lu

Master's Projects

Congestive heart failure (CHF) is a significant health problem in the U.S. There are over 2 million Americans diagnosed with CHF, with 200,000 CHF related deaths every year. A CHF Comprehensive Care Program in a Northern California medical center began in August, 1997 to case manage and educate CHF patients and their family members. The program educated CHF patients to self-manage the chronic condition by daily weight, low sodium diet, medication adherence, activity and rest balance, and daily exercise. This study used a one group. Pre and post test study design to evaluate the effectiveness of the CHF program. The …

An Hiv/Aids Educational Workshop For Adolescents, Sharron Anne Daggett

Master's Projects

Adolescents are threatened with infection by the Human Immunodeficiency Virus (IIlV) and Acquired Immunodeficiency Syndrome (AIDS). Data reveal that the number of adolescents infected with HIV is increasing. Adolescent risk taking behaviors and lack of preventive education are major factors associated with this rise. Family nurse practitioners (FNPs) who care for adolescents have a duty to offer their patients preventive health care. Adolescents can participate by attending HN and AIDS prevention workshops that will present them with facts. Adolescents who attend these workshops will gain the knowledge to protect themselves against mv and AIDS. The workshop in this study was …

Screening For Domestic Violence: Performance And Barriers, Linda S. Hoffman

Master's Projects

Domestic violence is a major medical and sociological problem for women. The purpose of this study was to describe the incidence of and barriers to domestic violence screening by health care providers in one urban county in northern California. A convenience sample of 71 physicians and nurse practitioners with specialties in family practice, OB/GYN, and internal medicine provided the data. Descriptive statistics were used to analyze the results of responses to a questionnaire. The majority of the providers agreed that screening for domestic violence was appropriate and reported being comfortable with the subject. However, the majority did not address the …

Evaluation Of Nurse Practitioner Management Of Obese Patients, Sevasti Simotas

Master's Projects

The purpose of this research project was to study current practice behaviors of adult and family nurse practitioners when evaluating and managing obese patients. Forty-three nurse practitioners were surveyed by questionnaire. Study results indicated that nurses• assessment of obesity was limited in the areas of body mass index measurement and co-morbid condition assessment. In addition, the nurse practitioners studied did not discuss adjusting caloric intake to support patients' caloric needs. The discussion of caloric intake versus caloric needs in conjunction with portion control is important to ensure weight loss success. The knowledge gained from this research may increase nurse practitioners' …