Public Health Commons^™

Black American Men's Resiliency And Persistence To Grow Old: A Midwest Qualitative Study, Kimberly Ann Walker

Theses and Dissertations

AbstractAs Black American men continue to experience the highest premature morbidity and mortality, few studies have centered on the intersection of class (low-income) and race (middle-aged and older Black men) with multiple morbidity from a critical race approach in the Midwest region of the U.S. Middle-aged Black men have 31% higher death rate than their White counterparts. A qualitative study was conducted by a community health nurse in the spring of 2021 in a metropolitan city. Thirty-one, low-income Black American men were interviewed focusing on their understanding and perceptions of their complex comorbidities, symptom management for quality of life, short …

Medication Self-Management Behaviors Of Community-Dwelling Adults With Chronic Disease, Michelle Yvonne Williams

Theses and Dissertations

MEDICATION SELF-MANAGEMENT BEHAVIORS OF COMMUNITY- DWELLING

ADULTS WITH CHRONIC DISEASE

by

Michelle Y. Williams, PhD, MSN, RN

The University of Wisconsin-Milwaukee, 2019

Under the Supervision of Professor Rachel Schiffman, PhD, RN, FAAN

Chronic conditions threaten public health, individuals, and families and affect all areas of a person’s life and require significant self-management from the individual with the disease, care from the healthcare provider and team, and support from the individual’s family. The relationship of selected risk and protective factors and communication with healthcare providers to medication self-management behaviors and quality of life was examined in 616 adults with chronic disease …

Patient-Centered Medical Homes And Hospital Value-Based Purchasing: Investigating Provider Responses To Incentives, Lauryn Walker

Theses and Dissertations

Provider incentives are a commonly used policy tool to mold provider behaviors.¹ However, while we frequently measure the change in patient outcomes, failure to consistently produce changes in outcomes does not mean that providers are not changing their behavior. This paper focuses on two programs with null or inconsistent quality outcomes to try to identify why such inconsistency occurs. The two programs, both ratified in the Affordable Care Act, are 1) patient-centered medical homes (PCMHs), and 2) the Medicare Hospital Value-Based Purchasing (HVBP) program.

Chapter 1: Using data from the Medical Expenditure Panel survey (MEPS), I match provider characteristic …

Factors Associated With Hospital Readmissions Among United States Dialysis Facilities, Amber B. Paulus

Theses and Dissertations

Hospital readmissions are a major burden for patients with end stage renal disease (ESRD). On average, one in three hospital discharges among patients with ESRD are followed by a readmission within 30 days. Currently, dialysis facilities are held accountable for readmissions via the ESRD Quality Incentive Program standardized readmission ratio (SRR) clinical measure. However, little is known about facility-level factors associated with readmission. Additionally, unlike other standardized measures of quality in the dialysis setting, incident patients within their first 90-days of dialysis are included in the performance calculation. This study analyzed CMS Dialysis Facility Report data from 2013 to 2016 …

Critical Illness Survivors’ Perceptions Of Their Recovery: An Interpretive Phenomenological Inquiry, Kelly Calkins

Theses and Dissertations

Surviving critical illness with its physical, cognitive, and psychosocial morbidities is a growing clinical and research challenge and an important public health concern. Currently, there are few interventions for survivors of critical illness after hospital discharge. Potential interventions include rehabilitation services, Intensive Care Unit (ICU) diaries and ICU follow-up clinics, however, most survivors do not have access to these post-hospital interventions.

The purpose of this study is to gain a better understanding of how critical illness survivors experience their recovery, interventions they use, and what they perceive as facilitators and barriers to their recovery. A better understanding of these factors, …

The Impact Of Maternal Diabetes On Fetal And Infant Outcomes: A Secondary Analysis Of Peridata.Net® From 2013 To 2017, Christina Lynn Dzioba

Theses and Dissertations

ABSTRACT

THE IMPACT OF MATERNAL DIABETES ON FETAL AND INFANT OUTCOMES:

A SECONDARY ANALYSIS OF PERIDATA.NET® FROM 2013 TO 2017

Christina Dzioba, MS, ARNP, WHNP-BC, C-EFM

Background: Diabetes is a leading cause of morbidity and mortality for most of the developed world and is known to contribute to adverse maternal, fetal, and infant outcomes. The purpose of this study was to examine the relationship of maternal diabetes to fetal and infant outcomes for infants born in a small heterogeneous urban community with significant disparities in infant mortality using data in the PeriData.Net® database.

Methods: Women with diabetes were case matched …

Exploring Factors Influencing Health Promoting Behaviors Among Latino Immigrants, Martin Joseph Mikell

Theses and Dissertations

Latinos immigrants may experience stress during acculturation to the U. S., which can influence their ability to engage in health-promoting behaviors, such as dietary intake and physical activity. Dietary intake and physical activity influence the prevention or development of pre-diabetes/Type 2 Diabetes (T2DM). The immigrant’s ability to perform health-promoting behaviors can also be influenced by their perceptions of self-efficacy to engage in health-promoting behaviors. Limited information is available in the literature on effective strategies for decreasing stress during the acculturation process of Latino immigrants, while also increasing self-efficacy on health-promoting behaviors. The purpose of this study was to explore the …

The Influences Of Family Supportive Supervisor Behaviors On The Relationships Among Work-Family Conflict, Stress, And Turnover Intention In Saudi Arabian Registered Nurses, Sitah S. Alshutwi

Theses and Dissertations

Many countries around the world are struggling to maintain adequate number of nurses. Inadequate nurse staffing could compromise the quality of patient care. Among many factors that contribute to RN turnover, the influence of work–family conflict (WFC) has gained little attention. In Saudi Arabia, the turnover rate among Saudi nurses reached 50 % of the total employed nurses. Work-family conflict was found to be a reason that influence Saudi nurses to leave their workplace. In addition, WFC was found to be significantly association with increased turnover intention (TI) among employees. Furthermore, WFC has been linked to a number of negative …

Rn Perceptions Of Coworker Incivility And Collective Efficacy As Influential To Hospital Structures And Outcomes, Jessica Grace Smith

Theses and Dissertations

Background: An aging population and retiring workforce might affect United States health delivery care and could threaten the quality of care in hospitals. Nurses, as the largest profession in healthcare, can buffer these effects if supported in a safe nurse work environment. The purpose of this dissertation was to understand how peer-to-peer registered nurse workplace incivility as a mediator, and collective efficacy as a moderator, influence relationships among hospital structures (i.e. nurse manager leadership and staffing) and hospital outcomes (i.e. missed nursing care and patient safety cultures).

Methods: Donabedian’s (1980) structure-process-outcomes conceptual framework was the theoretical basis for this study. …

Using Omaha System Documentation To Understand Physical Activity Among Rural Women, Jeanette Melissa Olsen

Theses and Dissertations

Rural women are more inactive and have different barriers to physical activity than those who live in more urban settings, yet few studies have specifically examined physical activity and associated factors in this population. Clinical data documented with standardized terminology by nurses caring for rural women may provide an opportunity to generate evidence that informs and improves nursing care. However, the knowledge to be gained and utility of nurses' clinical documentation in regard to physical activity have not been explored. Accordingly, the purpose of this study was to increase understanding of physical activity and associated factors among rural women by …

The Subjective Well-Being Of Youth Heads Of Households In Rural Southern Malawi, Pamela Fruechting

Theses and Dissertations

Youth-headed households in HIV-endemic sub-Saharan Africa face harsh realities of poverty and loss of parental care. Scientific knowledge of these youth is generally limited to socio-economic and psychological indicators of vulnerability while much less is known about youth-centric meanings of well-being. This is the first known study on the subjective well-being of youth heads of households.

The purpose of this exploratory, youth-centric, qualitative study was to identify experiences of subjective well-being, factors for regulating well-being, and meanings of well-being among youth heads of household in the Thyolo and Chiradzulu districts of rural southern Malawi. The theoretical foundation for this study …

Strategic Flexibility In Not-For-Profit Acute Care Hospitals, Donna Fe Jamieson

Theses and Dissertations

ABSTRACT

STRATEGIC FLEXIBILITY IN NOT-FOR-PROFIT ACUTE CARE HOSPITALS

by

Donna F. M. Jamieson

Despite multiple industry cycles of rapid and complex changes in the last three decades, the body of research in health care services strategy has not addressed the idea of strategic flexibility, that is, when and how should strategy evolve under conditions of environmental turbulence. Strategic flexibility has been defined in the literature as the ability to adapt to rapidly changing conditions by leveraging internal resources and competencies to effectively compete. With increasing scope of responsibility in both nursing and non-nursing functional areas, nurse executives have not only …

Trends In Work-Related Injury Rates And The Associated Incurred Costs In Long-Term Care Centers, Darcie Lange Olson

Theses and Dissertations

Background. Nursing assistants, working in long-term care facilities, have consistently been among the top occupational groups experiencing work-related musculoskeletal injuries. These injuries have been attributed the physical demands of lifting and moving the individuals in their care. Great strides in research have identified successful risk reduction strategies such as the implementation safe patient handling and mobility programs. The benefits of these programs have been advocated over the last two decades, but the rate of injuries among nursing assistants continues to be more than double the national average for all other industries. The purpose of this study was to investigate the …

Personal Characteristics And Learning Preference In End-Of-Life Decision Making Of Chronically Ill Community Dwelling Elders, Leigh Ann Bonney

Theses and Dissertations

Leigh Ann Bonney, RN, MSN; Susan Kossman, RN, PhD; MyoungJin Kim, PhD; Wendy Woith, PhD, Caroline Mallory, PhD

Illinois State University, Mennonite College of Nursing

Personal Characteristics and Learning Preference in End-of-Life Decision Making of

Chronically Ill Community Dwelling Elders

Purpose and Background: Clear decision-making (DM) about end-of-life [EOL] contributes to a good death This requires knowledge of life-sustaining treatment with lack of knowledge contributing to feelings of decisional conflict Decision aids can increase knowledge, but elders' preferred learning methods are unknown. Identifying characteristics associated with preferred learning method and decisional conflict can help nurses tailor information to assist in …