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Full-Text Articles in Public Health and Community Nursing

Making A Global Impact One Vaccine At A Time, Janice E. Hawkins, Deborah C. Gray Jan 2018

Making A Global Impact One Vaccine At A Time, Janice E. Hawkins, Deborah C. Gray

Ellmer School of Nursing Faculty Publications

(First paragraph) Did you know that, worldwide, almost one third of deaths among children under age 5 can be prevented by vaccines? It's stunning to think that one child dies every 20 seconds from an immunization-preventable disease. That equates to 12 lives that could be saved in the time it takes to read this brief article!


Assessment Of Alcohol Withdrawal Syndrome Incidence And Identification Of Other Correlating Risk Factors In Patients Admitted Through The Emergency Department, Hannah Young Jan 2018

Assessment Of Alcohol Withdrawal Syndrome Incidence And Identification Of Other Correlating Risk Factors In Patients Admitted Through The Emergency Department, Hannah Young

DNP Projects

PURPOSE: The purpose of this project was to measure adherence rates to the current alcohol use screening process, and identification of correlations of alcohol use and outcomes in patients admitted to Norton Hospital, via the emergency department.

METHODS: The study design is a retrospective descriptive evaluation, of adherence to the current alcohol use screening process, and associations among age, gender, ethnicity, length of stay, number of ICU days, restraint use days, level of care at admission (ICU, TCU, LLM/tele, MS), incidence of AWS/DTs, and activation of the CIWA protocol among the adult inpatient population of Norton Hospital’s downtown campus, admitted …


Impact Of Education On Provider Knowledge And Screening Practices Related To Childhood Obesity, Natalie B. Fulk Jan 2018

Impact Of Education On Provider Knowledge And Screening Practices Related To Childhood Obesity, Natalie B. Fulk

DNP Projects

PURPOSE: The purpose of this study was to evaluate the effect of a provider education program on BMI screening practices and provider knowledge related to childhood obesity by implementing an educational intervention to advanced practice providers in a primary care clinic setting.

METHODS: A pretest/posttest design was used to examine changes in provider knowledge about BMI screening practices in children and adolescents, and lifestyle recommendations after a brief educational intervention was provided. A retrospective chart review was used to assess the screening and management practices for an elevated BMI percentile and provider documentation of lifestyle recommendations.

RESULTS: A total of …


A Retrospective Comparative Analysis On The Effectiveness Of Pharmacologic Weight Loss, Emily Dunn Jan 2018

A Retrospective Comparative Analysis On The Effectiveness Of Pharmacologic Weight Loss, Emily Dunn

DNP Projects

PURPOSE:Obesity costs the U.S. roughly $147 billion in health care spending annually. There has been a call for healthcare providers to initiate all possible weight loss interventions. One treatment strategy not used to its fullest potential is that of prescribing antiobesity medications. The purpose of this project was to examine and evaluate the effectiveness of three common weight loss medications used in the treatment of obesity, including discussion and recommendations.

METHODS: This project was a single-center retrospective study comparing three different groups of patients seen at a rural weight loss clinic. The sample consisted of 84 patients seen between September …


The Effect Of A School-Based Health Center On Access To Care In A Rural Community, Macey Cornwell Jan 2018

The Effect Of A School-Based Health Center On Access To Care In A Rural Community, Macey Cornwell

DNP Projects

BACKGROUND: Lack of access to healthcare is a nationwide issue that affects underserved, minority, and rural populations. School-Based Health Centers (SBHCs) is one way to help increase access to care for students, staff, and family members.

PURPOSE: The purpose of this project was to provide preliminary data on the impact of a SBHC in a rural Kentucky community on access to care and school attendance.

METHODS: A univariate descriptive analysis was conducted to evaluate the perceived impact of the SBHC on access to care and demographic factors. Data was analyzed using Pearson’s Product Moment Correlation, two-sample t-tests, and The Wilcoxon …


Evaluation Of The Crafft Substance Use Screening Tool In Primary Care, Leanne Coleman Jan 2018

Evaluation Of The Crafft Substance Use Screening Tool In Primary Care, Leanne Coleman

DNP Projects

PURPOSE: The purpose of this research study was to evaluate the use of the CRAFFT tool within a pediatric primary care setting. The specific objective was to assess the frequency of documentation of substance use screening, counseling, and/or intervention before and after the implementation of the CRAFFT tool.

METHOD: The practice site chose to implement an evidence based adolescent substance use screening tool (CRAFFT Tool) to improve practice. This practice improvement project utilized a descriptive design with a review of electronic medical records before and after a substance use screening tool was implemented. Two hundred medical records were reviewed, 100 …


Structural Stress And Otherness: How Do They Influence Psychological Stress?, Christine Dewilde Jan 2018

Structural Stress And Otherness: How Do They Influence Psychological Stress?, Christine Dewilde

Theses and Dissertations

Background: The Theory of Cultural Distress offers a framework for understanding the potential outcomes in patients who do not receive care that incorporates their cultural beliefs (DeWilde & Burton, 2017).This study represents initial steps in researching the theory byexploring the layering of stressors that place the patient at risk for Cultural Distress. Methods: Utilized aCross-sectional descriptive correlational analysis of intersecting identities (Structural Stressors), ethnicity-related stressors (Otherness) and ethnic-identity (Otherness) to develop understanding of the potential effects of these variables on psychological stress. Independent variables included intersecting identities, perceived ethnic discrimination, concern for stereotype confirmation, own group conformity pressure, and …


How To Prepare Interprofessional Teams In Two Weeks: An Innovative Education Program Nested In Telehealth, Tina S. Haney, Karen Kott, Carolyn M. Rutledge, Bruce Britton, Christianne N. Fowler, Rebecca D. Poston Jan 2018

How To Prepare Interprofessional Teams In Two Weeks: An Innovative Education Program Nested In Telehealth, Tina S. Haney, Karen Kott, Carolyn M. Rutledge, Bruce Britton, Christianne N. Fowler, Rebecca D. Poston

Ellmer School of Nursing Faculty Publications

PROBLEM:

Preparing health professional students for interprofessional collaborative practice, especially at a distance where provider shortages prevail remains difficult.

APPROACH:

A two-week interprofessional education (IPE) immersion experience preparing students from 11 disciplines and four universities was implemented. Week-one, using online technology, students develop/present an interprofessional careplan for a complex patient. Students then meet face-to-face to conduct group interviews with two standardized patient dyads. Week-two, students develop a website for use of the patient dyads. Websites are presented to faculty and fellow students via an online virtual meeting space.

OUTCOMES:

To date, 594 students have participated demonstrating capacity to: 1.effectively engage …


Health Promotion Behavior Among Hypertensive And Normotensive Armenian Americans, Zoya Minasyan, Leslie C. Hussey, Kathleen Brewer Jan 2018

Health Promotion Behavior Among Hypertensive And Normotensive Armenian Americans, Zoya Minasyan, Leslie C. Hussey, Kathleen Brewer

Journal of Social, Behavioral, and Health Sciences

Hypertension presents a significant health risk to both developed and developing countries, affecting approximately 78 million Americans of various ethnic backgrounds. Though a great deal of research about hypertension and minority groups has been published, no studies were located about hypertension in the Armenian American population, despite evidence of health disparities in this population. The purpose of the present study was to examine the differences in health promotion behavior between hypertensive and normotensive Armenian Americans. A quantitative approach was used to examine the relationship between hypertensive status and health promotion behavior. With a sample size of n = 204, this …


The Role Of The Public Health Nurse In Rural Areas Of Kerry And Cork, Hannah Healy Jan 2018

The Role Of The Public Health Nurse In Rural Areas Of Kerry And Cork, Hannah Healy

Theses

Aim of Research: To understand and gain insight into the role of the Public Health nurse in rural communities in Kerry and Cork.

Background: Public health nursing is the single largest group in community care, current figure employed by the HSE stands at 1,438. Demographic, changes such as the increase in population coupled with the shift in care from the acute sector to primary care has provided many challenges to the PHN service .

Objective: Whilst there have been substantial reviews on the role and workload of the PHN in Ireland, there is limited qualitative research available on what the …


Improving Adherence To Mental Health Treatment In A Low-Income Clinic, Janice G. Gandy Dec 2017

Improving Adherence To Mental Health Treatment In A Low-Income Clinic, Janice G. Gandy

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

The increasing prevalence of mental illness in the United States presents significant challenges for primary care providers in low-income settings. Integrated Behavioral Health (IBH) programs have resulted in improved general health for low-income participants; however, managing appointment adherence, in which the patient attends appointment as scheduled, is particularly challenging. The purpose of this pilot project was to implement bundled interventions at a low-income primary care clinic to improve patient adherence to behavioral health treatment. The bundle of interventions included: 1) educational interventions emphasizing the benefits of IBH care 2) warm patient handoffs between the primary care provider to a behavioral …


Lost In Translation, Daniel Pena Dec 2017

Lost In Translation, Daniel Pena

Master's Projects and Capstones

At the conclusion of a patient’s hospitalization the Registered Nurse (RN) will review all discharge instructions in the patients room in their preferred language. Plan time for the discharge and facilitate a calm quiet environment, such as the patient’s room with the door closed, if possible. Get the discharge instructions printed out in their preferred language and a set for yourself in English would be best so you are able to review the instructions line by line with them. When the patients medical team, such as but not limited to, medical doctors, pharmacists, physical therapists, and social work have completed …


Improving Early Sepsis Identification On Inpatient Units, Yee Yang Dec 2017

Improving Early Sepsis Identification On Inpatient Units, Yee Yang

Master's Projects and Capstones

Sepsis is a serious complication caused by an overwhelming immune response to infection that affect millions of people worldwide each year. Sepsis is a time sensitive illness that requires early identification and quick interventions to improve patient outcomes. This quality improvement project includes a team of clinical nurse leader (CNL) students and gathering information on the nursing compliance of the sepsis protocol at a large metropolitan hospital. The observations on different inpatient units and chart review conducted at the large metropolitan hospital led to increased awareness of gaps that prolong the identification of sepsis among patients; also to the creation …


Exploring Perceptions And Experiences With Resources Among Rural Alzheimer's Dementia Family Caregivers In The Midwest, Rita M. Million Dec 2017

Exploring Perceptions And Experiences With Resources Among Rural Alzheimer's Dementia Family Caregivers In The Midwest, Rita M. Million

Theses & Dissertations

Exploring PERCEPTIONS AND EXPERIENCES WITH RESOURCES AMONG RURAL Alzheimer’s Dementia Family Caregivers in the Midwest

Rita M. Million

University of Nebraska, 2017

Supervisor: Karen Schumacher, Ph.D., RN

Background. Despite vast amounts of research on informal caregiving in the Alzheimer’s dementia (AD) population, research on the experience and perceptions of rural caregivers is limited. A better understanding of rural caregivers’ knowledge, use, and nonuse of resources is essential to offset the impact of caregiving. Purpose. This study explored Alzheimer’s dementia family caregivers’ experiences and perceptions with resources in rural Midwest communities. Design. A descriptive qualitative approach with one-time semi-structured interviews was …


Data Aggregation Reporting Tool For Implementation In Home Health Fall Reduction Program, Jose Alberto Cruz Dec 2017

Data Aggregation Reporting Tool For Implementation In Home Health Fall Reduction Program, Jose Alberto Cruz

Master's Projects and Capstones

Abstract

Falls are a major preventable problem in healthcare that affects people of all ages but disproportionately affects the frail and elderly. Fall reduction programs play a significant role in reducing falls and fall related injuries and are a critical component in Home Health settings. This project takes place in a home health and hospice services agency. The purpose of the project consisted of aggregating fall data for benchmarking metrics to bring the agency’s Fall Reduction Program closer to compliance with state and national fall prevention guidelines. Two hundred and three fall event reports were analyzed and a problem arose …


Inpatient Hospice Home: A Needs Assessment And Business Plan, Stacey Middleton Dec 2017

Inpatient Hospice Home: A Needs Assessment And Business Plan, Stacey Middleton

Doctor of Nursing Practice Scholarly Project

An Abstract of the Scholarly Project by

Stacey Middleton

There are two constants that every person can count on in life, being born and dying. No amount of research is required, and there is no need to challenge the inevitable. When a child is born, people celebrate and congratulate the new parents and their family. When a person dies, people are saddened by the loss of a friend and loved one. Death comes to all and is either, fast and unexpected or a slow drawn out process. Every dying patient deserves to die with dignity, be free from pain, and …


Vietnamese American Women’S Beliefs And Perceptions On Cervical Cancer, Cervical Cancer Screening, And Cancer Prevention Vaccines: A Community-Based Participatory Study, Connie Kim Yen Nguyen-Truong, Kim Quy Vo Nguyen, Thai Hien Nguyen, Tuong Vy Le, Anthony My Truong, Keara Rodela, Rachael Allan Dec 2017

Vietnamese American Women’S Beliefs And Perceptions On Cervical Cancer, Cervical Cancer Screening, And Cancer Prevention Vaccines: A Community-Based Participatory Study, Connie Kim Yen Nguyen-Truong, Kim Quy Vo Nguyen, Thai Hien Nguyen, Tuong Vy Le, Anthony My Truong, Keara Rodela, Rachael Allan

Asian/Pacific Island Nursing Journal

Cervical cancer remains commonly diagnosed in Vietnamese American women. Despite efforts to increase cervical cancer screening among Vietnamese American women, participation rates are persistently lower than the national goal. The objective of this study is to explore beliefs of Vietnamese American women about cervical cancer, cervical cancer screening, and cancer prevention vaccines. A qualitative descriptive investigation captured group perceptions about meaning and beliefs of cervical cancer, screening, and cancer prevention vaccines, and participants’ stories using a community-based participatory research approach.

Forty Vietnamese American women were recruited from the Portland, Oregon metropolitan area into four focus groups. Using a process of …


A Quality Improvement Initiative To Increase Statin Therapy Adherence Among Patients With Diabetes Aged 65 Years And Older, Kelly Nunemaker Dec 2017

A Quality Improvement Initiative To Increase Statin Therapy Adherence Among Patients With Diabetes Aged 65 Years And Older, Kelly Nunemaker

Doctor of Nursing Practice

The purpose of this project was to improve statin therapy adherence among diabetic patients aged 65 and older treated at a small family practice clinic in western San Antonio. Additionally, the project aimed to decrease LDL cholesterol (LDL-C) levels in this patient population as recommended to 70 mg/dl or less. Diabetic patients are more likely to die from a cardiac event than patients without diabetes. Statin therapy is an important factor in lowering cholesterol, which reduces the patient’s risk for atherosclerosis. Educating patients aged 65 and older about the role of statin therapy in preventing cardiovascular events, stroke, and vascular …


Improving Hpv Vaccination Series Initiation Rates And Compliance Among Indigent Women In South Texas, Ages 19-26, Through Provider Recommendation And Additional Clinic Funding: A Quality Improvement Project, Lacey Cudd Dec 2017

Improving Hpv Vaccination Series Initiation Rates And Compliance Among Indigent Women In South Texas, Ages 19-26, Through Provider Recommendation And Additional Clinic Funding: A Quality Improvement Project, Lacey Cudd

Doctor of Nursing Practice

The purpose of this quality improvement project was to increase human papillomavirus vaccination series initiation rates among indigent women, ages 19-26, at a clinic in South Texas. The human papillomavirus is a sexually transmitted infection that has been associated with multiple types of cancers. Each year, approximately 6.2 million cases of the human papillomavirus infection are diagnosed; as many as 75% of all new infections occur among females 18-26 years of age. The human papillomavirus vaccination has a high efficacy in regards to cancer prevention, preventing as many as 76% of cancers with only one dose. The project included educating …


Effect Of Socioeconomic Disadvantage, Remoteness And Indigenous Status On Hospital Usage For Western Australian Preterm Infants Under 12 Months Of Age: A Population-Based Data Linkage Study, Natalie A. Strobel, Sue Peter, Kimberley E. Mcauley, Daniel R. Mcaullay, Rhonda Marriott, Karen M. Edmond Dec 2017

Effect Of Socioeconomic Disadvantage, Remoteness And Indigenous Status On Hospital Usage For Western Australian Preterm Infants Under 12 Months Of Age: A Population-Based Data Linkage Study, Natalie A. Strobel, Sue Peter, Kimberley E. Mcauley, Daniel R. Mcaullay, Rhonda Marriott, Karen M. Edmond

Research outputs 2014 to 2021

Objectives:

Our primary objective was to determine the incidence of hospital admission and emergency department presentation in Indigenous and non-Indigenous preterm infants aged postdischarge from birth admission to 11 months in Western Australia. Secondary objectives were to assess incidence in the poorest infants from remote areas and to determine the primary causes of hospital usage in preterm infants.

Design:

Prospective population-based linked data set.

Setting and participants:

All preterm babies born in Western Australia during 2010 and 2011.

Main outcome measures:

All-cause hospitalisations and emergency department presentations.

Results:

There were 6.9% (4211/61 254) preterm infants, 13.1% (433/3311) Indigenous …


Openpediatrics: Integrating Technology Into Pediatric Healthcare Education, Marisa Albert Dec 2017

Openpediatrics: Integrating Technology Into Pediatric Healthcare Education, Marisa Albert

Senior Honors Projects

In contemporary times, the dissemination of knowledge across specialties has become convenient through the use of computer technology and the internet. Technology has been integrated into educational systems worldwide and has become invaluable in the advancement of healthcare. Nursing practice and education has utilized modern technology as a resource for continuing education such as through the use of online RN-BSN programs and sharing improvements in healthcare practice. A great part of a nursing student’s education is understanding the importance of a nurse’s professional commitment to lifelong learning by utilizing critical thinking skills to support evidence-based practice to improve standards of …


Self-Management As A Mediator Of The Relationship Between Social Support And Health Outcomes Of African American Adults With Type 2 Diabetes., Tariq N. Al-Dwaikat Dec 2017

Self-Management As A Mediator Of The Relationship Between Social Support And Health Outcomes Of African American Adults With Type 2 Diabetes., Tariq N. Al-Dwaikat

Electronic Theses and Dissertations

Type 2 diabetes (T2D) is often associated with serious complications. African American adults have higher rates of diabetes-related complications than other ethnicities. Diabetes self-management reduces the risk of developing biological and psychological symptoms. Social support promotes positive behavior change and self-management that leads to improved biobehavioral and psychosocial outcomes. Few studies explored the relationship between social support dimensions and self-management behaviors, diabetes biomarkers, and psychosocial outcomes of African American adults with T2D. The purpose of this dissertation was to examine the relationships of various dimensions of social support with self-management behaviors and diabetes biomarkers and psychosocial outcomes of African American …


The Relationship Of Religion, Religiosity, And Parental Communication In The Sexual Behaviors Of Filipinos Aged 18-25 Years In The United States And The Philippines, Ivy C. Tuason, Racidon Bernarte, Fanglong Dong Nov 2017

The Relationship Of Religion, Religiosity, And Parental Communication In The Sexual Behaviors Of Filipinos Aged 18-25 Years In The United States And The Philippines, Ivy C. Tuason, Racidon Bernarte, Fanglong Dong

Asian/Pacific Island Nursing Journal

This cross-sectional survey research aims to explore and compare the relationship of religion, religiosity, and parental communication to the sexual behaviors of Filipinos aged 18-25 years in the United States and the Philippines. The Duke University Religion Index and Parent-Teen Sexual Risk Communication Scale-III was used to measure religiosity and parental communication. There were 130 participants living in the United States and 247 living in the Philippines included in this study. Among respondents from the Philippines, low levels of parental communication were associated with an increased report for the lack of condom use during the last intercourse. Catholics had a …


Impact Of Hpv Education On Knowledge, Perception, And Cultural Influence Among African American Parents, Christina Lattner, Christina Lattner Nov 2017

Impact Of Hpv Education On Knowledge, Perception, And Cultural Influence Among African American Parents, Christina Lattner, Christina Lattner

Grace Peterson Nursing Research Colloquium

Abstract

Background: Infection with human papillomavirus (HPV), the sexually transmitted virus that causes cervical and penial cancer can be prevented. An effective vaccine has been approved for both boys and girls since 2006. Despite recommendation from the Center of Disease Control, vaccination initiation and completion rates among African American adolescents in the United States are lower than average in the nation.

Objectives: The purpose of this descriptive survey study was to identify African-American parents’ knowledge and perceptions of sexually transmitted HPV infection and the HPV vaccination. The secondary objective was to use a single-group pre-test post-test research design to …


College Students, Experiences On Smart Phone Technology Usage: A Qualitative Content Analysis Study, Fatemeh Jafarzadeh-Kenarsari, Parand Pourghane Nov 2017

College Students, Experiences On Smart Phone Technology Usage: A Qualitative Content Analysis Study, Fatemeh Jafarzadeh-Kenarsari, Parand Pourghane

The Qualitative Report

Besides many benefits of the cell phone technology, numerous arguments are raised on the different and important negative effects of such a technology. This qualitative content analysis study explored the common usages of smart phone technology, its challenges, and benefits among Iranian college students. Participants were 32 bachelor degree students who were recruited using purposive sampling method with maximum variation. Data were collected through 11 individual semi-structured interviews and 3 focus group discussions (5-8 students in each group). Data analysis was done based on a conventional content analysis approach. Data analysis resulted in 3 main themes and 12 sub-themes. The …


Mālama Nā Makua I Nā Keiki Me Ka Hānō: Native Hawaiian Parents Caring For Their Children With Asthma, May K. Kealoha, Merle Kataoka-Yahiro Oct 2017

Mālama Nā Makua I Nā Keiki Me Ka Hānō: Native Hawaiian Parents Caring For Their Children With Asthma, May K. Kealoha, Merle Kataoka-Yahiro

Asian/Pacific Island Nursing Journal

Native Hawaiian children have the highest prevalence rate of asthma among all ethnicities in the State of Hawai‘i. Literature is limited regarding native Hawaiian parents’ perception and experience caring for their children with asthma. The purpose of this study is to explore contemporary native Hawaiian parents’ perspective and experience of caring for their children with asthma in the context of uncertainty. We applied a descriptive qualitative approach by means of directed content analysis using focus groups. Directed content analysis applied Mishel’s Uncertainty in Illness Theory to guide data collection, organization, and analysis. We found that parents’ personal stories about their …


A Retrospective Analysis Of Nursing Students' Clinical Experience In An All-Male Maximum Security Prison., Mary T. Bouchaud, Madeline Brooks, Beth Ann Swan Oct 2017

A Retrospective Analysis Of Nursing Students' Clinical Experience In An All-Male Maximum Security Prison., Mary T. Bouchaud, Madeline Brooks, Beth Ann Swan

College of Nursing Faculty Papers & Presentations

Prisons provide an ideal learning experience to prepare prelicensure students with the knowledge and skill set needed for practice in the 21st century. Beginning descriptive evidence demonstrates that correctional health is an innovative community resource to educate nursing students in today's changing model of health care delivery and practice. This article shares results from a retrospective analysis of the perceptions and experiences of nursing students during their community clinical rotation in an all-male maximum security prison.


Unrecognized Epidemic Kills Farmers, M. Susan Jones, Deborah B. Reed, Matthew L. Hunt Oct 2017

Unrecognized Epidemic Kills Farmers, M. Susan Jones, Deborah B. Reed, Matthew L. Hunt

Nursing Faculty Publications

No abstract provided.


Perceived Knowledge And Perceptions Of Palliative Care Among Advanced Practice Cardiac Providers, Jordan Vance Sep 2017

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 …


Exploration And Description Of Faith Community Nurses’ Documentation Practices And Perceived Documentation Barriers., Susan M. Dyess, Donna M. Callaghan, Andra S. Opalinski Dr. Aug 2017

Exploration And Description Of Faith Community Nurses’ Documentation Practices And Perceived Documentation Barriers., Susan M. Dyess, Donna M. Callaghan, Andra S. Opalinski Dr.

International Journal of Faith Community Nursing

Purpose: Documentation within Faith Community Nursing is an expected aspect of the professional specialty but is under-studied. Findings in previously published studies suggest there is a lack of consistent documentation practices among FCNs. Therefore, the aim of this research study was to explore and describe documentation practices of FCNs, and identify the perceived barriers to documentation.

Methodology: This mixed methods research had both qualitative and quantitative components. The qualitative inquiry involved three live focus groups and three telephonic key informant interviews (n = 28). Conventional content analysis was used to examine all qualitative data. The quantitative inquiry involved a survey …