Public Health and Community Nursing Commons^™

Preventive Interventions Targeting Social Determinants Of Health: Implications For Healthcare Utilization And Cost, Audrey Wrinkle

NEXUS: The Liberty Journal of Interdisciplinary Studies

Preventive interventions targeting social determinants of health could reduce avoidable healthcare utilization and positively impact long-term cost outcomes within healthcare systems. Evidence indicates that financial and social barriers to preventive care lead to delayed treatment and increased use of high-cost healthcare services in the long term. Preventive interventions focusing on upstream social factors, like home-based care and digital health programs, could improve patient outcomes and reduce avoidable service utilization. Also, incorporating social needs data into policy creation could promote better allocation of healthcare resources. This research highlights the role of prevention-focused strategies in promoting cost-effective, sustainable healthcare delivery.

To Heal A Mind: A Comparison Of Functional And Conventional Treatments In Major Depressive Disorder, Gillian Chambers

Senior Honors Theses

Incidence of major depressive disorder is increasing year over year, with little able to be done to halt the spread of the condition. However, there are many treatment possibilities considered unconventional by the healthcare system. This thesis examines the respective benefits and risks, in comparison to one another, between conventional pharmacological treatment and functional, holistic treatment of depression. This was done via integrative review of available clinical literature, synthesizing evidence on both conventional and functional treatments for depression, as dictated by Whittemore and Knafl (2005). Exploratory search methods revealed 758 records fulfilling inclusion criteria, which were screened and narrowed down …

Nursing Care Regarding Social Determinants Of Health For Breastfeeding In Mothers And Infants, Natalie Jefson

Senior Honors Theses

Breastfeeding is incredibly important to the health and well-being of the mother-infant dyad. Because of this, there are both world-wide and national recommendations and guidelines for breastfeeding in the United States. Although many women choose to initiate breastfeeding, the percentage of women who continue breastfeeding for the recommended duration does not meet the Healthy People goal for the United States. Many factors influence this early breastfeeding cessation, including physical and socioeconomic barriers. Certain populations face increased barriers to reaching these goals related to social determinants of health which can and should be addressed by nurses through preventive measures and education.

Child Abuse From A Nursing Perspective: Assessment And Implications, Ashtyn Spring

Senior Honors Theses

Nurses experience the relationship dynamics between pediatric patients and their families firsthand. Being informed by the goals of holistic care, nurses should be assessing for unhealthy dynamics among pediatric patients and their caregivers so they can respond appropriately when a potential for abuse is present. Healthcare workers have the duty to provide safety and healing to their patients. Through the unique contact nurses have with patients, their training for accurate assessment skills, and their responsibility as healthcare workers, nurses are placed with the opportunity to help children out of abusive situations. Prompt identification of the potential for abuse can prevent …

Nursing Care Of Family Caregivers: Interventions And Considerations Regarding Current Issues Facing Family Caregivers Of Persons With Dementia Relevant To Nursing Practice, Alayna Kent

Senior Honors Theses

There are an estimated 6.5 million Americans age 65 and older who are currently living with Alzheimer’s dementia. A large majority of these individuals receive care from a nonprofessional family caregiver, typically in the home setting. It is well documented that family caregivers of dementia patients experience many unique challenges. These challenges provide valuable opportunities for nurses to provide helpful interventions to aid this vulnerable population. An integrated review of the recent literature was conducted, and articles were chosen by a method modeled after the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flowsheet. The research was then analyzed …

Communicating Comfort In Crisis: A Literature Review On Overcoming The Emergency Room Environment To Foster The Nurse-Patient Relationship, Faith G. Davenport

Senior Honors Theses

The average emergency room patient is not receiving the compassionate nurse-patient communication that patients experience on other hospital floors. Fewer positive nurse-patient interactions prompt patients to state that they feel uncomforted and dissatisfied on hospital exit surveys, inciting hospital management to investigate how to reverse this trend to retain their federal funding. Emergency room nurses cite multiple barriers inherent in their work environment that prevent them from building rapport with their patients, including a layout not conducive to private conversations, strict time constraints, and a fluctuating workload. Working for a prolonged period under these conditions is driving many nurses to …

The Measles-Mumps-Rubella Vaccine And Parental Hesitancy: The World’S Unspoken Pandemic, Kayla James

Senior Honors Theses

The Measles-Mumps-Rubella vaccine (MMR) is a proven necessity for the prevention of measles, mumps, and rubella, which possess severe and possibly life-threatening complications. However, the means in which these vaccines are produced, mandated, or scheduled raise certain concerns within the medical and pharmaceutical consumer community. In fact, there are various communities around the globe that willfully choose to refuse the MMR vaccine, along with many other pediatric vaccinations, resulting in diminished vaccination rates and risk of possible outbreak of any of these three diseases. With this impending threat on the rise, it is necessary to engage in research to best …

Loneliness, Social Isolation, And Their Connection To Overall Health Across The Lifespan, Paige Miller

Senior Honors Theses

Due to recent circumstances, the incidence of loneliness and social isolation has skyrocketed. Fortunately, there have already been countless studies examining the longer-term implications of these two factors on health. Loneliness and social isolation have been found to impact cardiovascular health, stress response, immune function, resilience, mental health, attachment, spiritual health, and many other determinants of health. A variety of research was examined outlining the psychological implications of loneliness and social isolation. These factors also influence physiological processes and can exacerbate a variety of diseases. After presentation of this evidence, a collection of possible interventions will be discussed, and their …

Polycystic Ovarian Syndrome And Insulin Resistance: An Evaluation Of Treatment Modalities And Complication Prevention, Sarah Mann

Senior Honors Theses

Polycystic ovarian syndrome (PCOS) is a reproductive and endocrine disorder in women of childbearing age. This disorder includes multiple clinical manifestations, namely insulin resistance (IR) and infertility related to hormonal imbalances and anovulation. Despite being a common condition, its etiology and treatment modalities remain poorly defined. Without proper understanding and management of the condition, women may suffer numerous complications besides infertility such as diabetes mellitus type II (DMII), endometrial cancer, and cardiovascular disease. Therefore, further research is critical. This integrative review will create a comprehensive understanding of PCOS' pathophysiology, potential complications, treatment methods, and nursing considerations to promote the health …

A Patient-Centered Medical Home Model For Improvement Of Healthcare For The Homeless Population: An Integrative Review, Dale Ellen Strickland

Doctoral Dissertations and Projects

The homeless population is surrounded by many obstacles while trying to obtain the essentials of life including food, water, shelter, clothes, medical care, and safety. In many areas of the United States and other countries homelessness is becoming an increasing problem. Compared to standard healthcare, the Patient-Centered Medical Home Model is offering a better experience for homeless patients. This integrated review provides a selection of published studies and information on the homeless population and the beginning of the Patient-Centered Medical Home Model to improve access and healthcare to many homeless patients. As the model is accepted by more medical professionals, …

A Hepatitis C Screening Tool For An Uninsured Population, Kimberly Belle Babcock-Nobles

Doctoral Dissertations and Projects

Hepatitis C virus (HCV) is a public health epidemic effecting 3.5 million people in the United States alone. The uninsured, underserved residents of a rural county in North Carolina have limited access to screening and early detection for HCV. Through collective efforts, a free medical clinic partnered with a grant funded, nonprofit organization to provide free hepatitis C testing by use of a mobile medical unit. The aim of this study was to determine if use of an HCV screening tool would increase the number of patients screened for testing as compared retrospectively to the number of patients screened without …

Raising Awareness Of Compassion Fatigue Among Healthcare Providers In The Coronary Care Unit, Keri Tifft

Doctoral Dissertations and Projects

Compassion fatigue is a pressing issue in critical care units across the healthcare field. There is a sincere desire by nurses to give the best care possible to each of their patients; however, many obligations split the nurse’s attention so they do not feel as if they are providing the best care to their patients. When nurses stop viewing their patients as humans and start viewing them as tasks, the compassion that the nursing profession prides itself on, is no longer there to the degree that is needed for quality care. Increasing awareness of compassion fatigue and teaching nurses and …

A Practical Understanding Of Preeclampsia For A Nurse In A Third World Setting, Anna Lovin

Senior Honors Theses

Preeclampsia is a disease of pregnancy that affects approximately 3-5% of women with child. It is one of the primary causes of mortality in mothers and babies across the globe. The exact cause, pathogenesis, or disease progression is unknown. Therefore, there is no definition of which patients are at risk for developing preeclampsia and what can work as a preventative measure. In high socioeconomic settings where there is good healthcare, standard treatment is established to manage the symptoms and decrease the progression of preeclampsia to eclampsia. However, in more rural, third-world settings of developing countries, caring for patients with preeclampsia …

Pain Management: A Flowsheet For Providers, Lisa Swezey

Doctoral Dissertations and Projects

Many different factors led to the trend of providers prescribing opioids for chronic pain. However, the misuse of and many deaths related to opioid prescriptions have caused the trend to reverse its direction. National organizations call for providers to stay clear of opioid medication and increase the use of nonpharmacological pain management, but also to treat pain adequately. There are still many barriers to decreasing the use of opioids and increasing the use of nonpharmacological methods. This scholarly project hoped to use an educational flowsheet to assist providers in meeting the demands from national organizations to decrease the use of …

Pediatric Primary Care Concussion Evaluation And Management, Kaitlyn Layman

Doctoral Dissertations and Scholarly Projects

Concussions are an important and timely subject, especially within the pediatric population, as they are the most involved in extracurricular contact sports and are susceptible to concussions and their sequelae. The researcher performed a quasi-experimental pilot study in a pediatric primary care office where the researcher educated 15 providers on the HEADS UP concussion screening tool and management approach. The researcher gave providers pre- and post-intervention surveys to determine if providers’ comfort and knowledge regarding assessing and managing concussions within the pediatric primary care setting changed. Four providers participated in the study. The researcher conducted a chart review two months …

Maternal Obesity And Fetal Macrosomia: An Integrative Review Of The Literature Regarding Interventions, Charity Stalcup

Senior Honors Theses

Research suggests pre-pregnancy obesity is associated with an increased risk of macrosomia in the newborn. Since women are expected to gain weight during pregnancy, the standard recommendation of weight loss for obesity is not ideal for this population. In this systematic review of the literature regarding interventions for maternal obesity to reduce fetal macrosomia, 149 articles were screened using three different databases to identify recent randomized controlled trials related to this topic. A total of 11 full text articles were analyzed and included in the review. The articles addressed nutritional, lifestyle, and pharmacological interventions. The results indicated there is currently …

An Educational Intervention To Raise The Awareness Of Limited Health Literacy And The Need To Utilize Recommended Strategies And Interventions Among Healthcare Clinicians In A Program Of All-Inclusive Care For The Elderly Setting, Esther Carpenter

Doctoral Dissertations and Scholarly Projects

Health literacy is a complex, common, and challenging issue facing the United States and the world today. Occurring in the context of care delivery and significantly impacting the quality of care provided, health literacy is not simply a patient problem; but places a substantial burden on healthcare clinicians to ensure they are providing clear communication. Research suggests a lack of awareness and training among healthcare clinicians related to health literacy, resulting in clinicians being unaware of and unprepared to address this issue in practice. The purpose of this evidence-based practice project was to raise the awareness of limited health literacy …

Perceived Knowledge And Perceptions Of Palliative Care Among Advanced Practice Cardiac Providers, Jordan Vance

Doctoral Dissertations and Projects

Providers of healthcare have continued to focus on addressing patients’ chronic health outcomes. When understanding how to manage chronic disease, there remains many opportunities in facilitation of better management. With such a wide range of individuals who suffer with a chronic condition, better management to address this population is essential. Palliative care aids in accomplishing this task. It was seen that there was a lack of education in relation to palliative care, with perceptions that continued to be a barrier to the utilization of the service. Due to the lack in education, the strongest barrier to palliative care service utilization …

Deaf Access To Healthcare, Jennifer L. Yates

Senior Honors Theses

Modern medical professionals strive to provide culturally competent care; however, Deaf[1] culture remains overlooked. Common language and experience draw deaf individuals together as a cultural group. Ignorance about Deaf culture perpetuates barriers to holistic care in the medical setting. Deaf patients receive misdiagnoses, delayed treatment, and privacy breaches. Deaf culture understandably avoids healthcare and is characterized by numerous health disparities as a result. Obstacles hindering Deaf access to healthcare are directly opposed to the intended therapeutic relationship and holistic care. Increased awareness of Deaf culture is required to improve the Deaf’s access to healthcare.

[1] The word deaf should …

The Benefits Of Breastfeeding, Annagrace E. Anderson

Senior Honors Theses

Breast milk is the gold standard for infant nutrition. In the past, infant formula was promoted as equal or superior to breast milk. However, research has shown that breastfeeding is the superior form of infant nutrition except in rare circumstances. Breast milk provides for all of a newborn’s caloric needs and has the correct balance of nutrients to promote proper development. In addition, breast milk provides protection against illnesses, supports an infant’s immune system, and promotes life-long health for the newborn. Mothers also experience personal benefits by breastfeeding such as decreased cancer risks, bonding with their babies, and faster postpartum …

Goals Of Exclusive Breastfeeding And The Effectiveness Of Programs And Initiatives In Attaining Them, Natalie Scott

Senior Honors Theses

Over recent years, breastfeeding has gained renewed significance in research and practice. Both in the United States and around the world, especially in poor countries that do not have easy access to quality healthcare, breastfeeding has been shown to dramatically and positively affect the health and lifespan of infants. However, there is still a low prevalence of effective breastfeeding practices universally. Even with the presence of global programs and goals that are geared toward exclusive breastfeeding habits, global rates are lower than what is desired. There are various determinants of breastfeeding that factor into a woman’s decision and practice of …

Health Literacy Assessment And Chronic Disease: An Integrative Review, Dana S. Woody

Doctoral Dissertations and Scholarly Projects

Health literacy is a matter of grave concern in health care today. Defined as more than the ability to read and write, it involves obtaining, processing, and understanding health information. Yet it is a concept often misunderstood and overlooked in the environment of professional care. Specifically, low health literacy in the setting of chronic disease has proven to be a challenging and costly phenomena. Given the high prevalence of chronic disease, there is a pressing need for health care providers to acknowledge this subject matter in care delivery. This integrative review provides a synthesis of published evidence identifying and clarifying …

The Effects Of Iron Deficiency Anemia And Iron Supplementation In Pregnancy, Anna J. Cox

Senior Honors Theses

Iron deficiency anemia (IDA) is a condition that occurs in both underdeveloped and developed countries worldwide. This disorder is diagnosed in an individual who presents the common signs and symptoms of anemia along with consistently low clinical markers of stored iron. Iron deficiency (ID) usually precedes a diagnosis of IDA as the insufficient amount of iron often goes undetected until one’s quality of life is diminished. Certain populations, such as women who are pregnant or of reproductive age, are particularly at risk for ID and the development of IDA. During pregnancy, the recommended dietary allowance (RDA) for iron is greater …

Training Traditional Birth Attendants In Sub-Saharan Africa, Lindsey J. Smith

Senior Honors Theses

Even after many adjustments, recommended practice regarding traditional birth attendants (TBAs) and their contribution to lowering the maternal mortality rate (MMR) continues to be disputed among various stakeholders. Sub-Saharan Africa continues to see high maternal mortality rates, despite various attempts by the World Health Organization (WHO) and others at utilizing the formal health care system (Prata, et al., 2011). Considering all factors and variables behind the reason for this problem in Sub-Saharan African, it is reasonable to conclude that training traditional birth attendants (TBAs) in evidence-based practice, in conjunction with developing longer-term strategies, is an appropriate approach for the short …

Faith Community Nursing: Bridging The Gap Between Effective Healthcare And Biblical Ministry, Moriah Kenna

Senior Honors Theses

The United States’ traditional health care system is unprepared to combat the growing rates of chronic illness in its population. With over 90% of those aged 66 years and older living with a chronic illness, an emphasis on preventative care must be enacted. Faith community nursing is a viable and effective option for long-term preventative management of chronic illnesses in the community. Faith community nursing fits both the mission of the Christian church and the needs of the healthcare community and greater awareness of this must be achieved in both the faith and healthcare sectors to bring about maximum results.

Is Dietary Intervention A Viable Method For Improving Outcomes In Adult Patients With Asthma?, Jennifer Grolimund

Senior Honors Theses

Asthma is a disease process characterized by episodic inflammation of the lower airway in response to various triggers. Those with asthma have trouble breathing effectively during an acute episode, making asthma a potentially life threatening condition. Standard medical treatment of asthma, including medications and environmental changes, can be effective at reducing or eliminating negative outcomes in patients with asthma. However, a holistic approach to patient care, including an examination of dietary influence, may also be useful for patients trying to manage the course of their illness. Variations in intake of individual nutrients or in total dietary patterns may play a …

Osteoporosis In Men, Seunggee Hong

Senior Honors Theses

Osteoporosis is a progressive bone disease that is characterized by a decrease in bone mass and density. Osteoporosis can occur in both genders. Women are more likely to be diagnosed with osteoporosis. Since men have larger bones than women, it is difficult to diagnose osteoporosis. However, presently, the occurrence rate of osteoporosis in men is increasing. It is very important to be aware of an increase of the true frequency of osteoporosis in men which is essential for prevention and long-term health. The purpose of this thesis is to examine pathogenesis of osteoporosis, hormone-related factors, lifestyle, diet, and exercise habits …

Use Of Immunotherapy In The Treatment Of Peanut Allergies In The Pediatric Population, Bethany Rauscher

Senior Honors Theses

Peanut allergies are a serious issue that must be monitored and treated effectively to avoid severe adverse effects and death. In the last decade, their incidence has increased significantly, due to indeterminate factors. Because people typically do not outgrow peanut allergies and the effects of exposure can be life-threatening, it is important that a cure or management method is developed and refined. Recent research regarding treatment for peanut allergies has focused on the use of immunotherapy, a process aimed at desensitizing children's immune systems so that they do not reject foods that contain peanuts. Some studies utilizing immunotherapy have provided …

Human Immunodeficiency Virus/Autoimmune Deficiency Syndrome: A Pathophysiology And Cultural Perspective Of Treatment In Sub-Saharan Africa, Kari N. Stanley

Senior Honors Theses

The human immunodeficiency virus (HIV) is a retrovirus that attacks the body’s immune system increasing risk for development of opportunistic infections and ultimately acquired immunodeficiency syndrome (AIDS). Without treatment HIV can run its course within 10 years; however, several categories of antiretroviral therapy now exist that have various mechanisms of action designed to stop a patient’s viral load from increasing so rapidly. The prevalence and risk for transmission is highest in Sub-Saharan Africa where resources and access to treatment is limited and underutilized. In order for health care providers to begin changing the statistics, cultural competence must be the foundation …

The Benefits Of Breastfeeding, Helen L. Byers

Senior Honors Theses

It is important to educate women of childbearing age, their families, and society of the benefits that breastfeeding has over bottle-feeding and formula-feeding. The benefits of breastfeeding are in three main categories. First, the developmental, physical, emotional, and spiritual benefits of the baby will be discussed. Then the physical, emotional, and spiritual benefits for the mother will be talked about along with possible contraindications or difficulties. Finally, the financial benefits of breastfeeding over feeding an infant from the bottle will be discussed as it relates to the family and government. The goal is to persuade that breastfeeding is a superior …