Nursing Commons^™

An Exploratory Study Of Physiologic Responses To A Passive Exercise Intervention In Mechanically-Ventilated Critically Ill Adults, Christina M. Amidei

Electronic Theses and Dissertations

Muscle weakness is the most common and persistent problem after a critical illness. Early mobilization of the critically ill patient, beginning with passive exercise and progressing to ambulation, may mitigate muscle effects of the critical illness. However, mobilization may produce adverse effects, especially early in the illness when risk for physiologic deterioration is common. If safe, introducing a mobility intervention early in the illness may facilitate ventilator weaning, shorten intensive care unit and hospitals stays, and improve functional status and quality of life for mechanically ventilated critically ill patients. The aim of this study was assess the cardiopulmonary and inflammatory …

Perceptions Influencing School Nurse Practices To Prevent Childhood Obesity, Susan Quelly

Electronic Theses and Dissertations

Approximately one-third of children in the United States are overweight or obese with increased risks for numerous physical and psychosocial comorbidities. Schools are ideal environments to address this serious health crisis and school nurses are uniquely positioned qualified healthcare providers to actively participate in childhood obesity prevention (COP). A review of the literature provided findings to identify a gap in the knowledge regarding the association between school nurse COP perceptions and practices. A modified theoretical framework based on Bandura’s health promotion by social cognitive theory guided this study. The purpose of this study was to identify the key perceptions (self-efficacy, …

Stressors Experienced By Emergency Department Registered Nurses At The Bedside: A Phenomenological Study, Stephen D. Heglund

Electronic Theses and Dissertations

The Emergency Department (ED) as a workplace for the Registered Nurse (RN) is a stressful environment. Reasons are thought to include interactions with other members of the interdisciplinary team as well as the situations associated with the environment of the ED such as trauma, death, sadness, joy and the general unpredictability of each moment. Studies have documented general health care workplace stress and its influence on staff, but a very limited number of studies have concentrated on the ED. No widely published studies have identified stressors from the perspective of the ED RN. This dissertation is an interpretive phenomenological study …

Front-Line Registered Nurse Job Satisfaction And Predictors: A Meta-Analysis From 1980 - 2009, Deborah Anne Saber

Electronic Theses and Dissertations

Front-line registered nurses (RNs) make up the workforce that directly affect the care of patients in a variety of different healthcare settings. RN job satisfaction is important because it is tied to retention, organizational commitment, workforce safety, patient safety, and cost savings. The strongest predictors have been difficult to determine because workplaces differ, numerous tools to measure satisfaction exist, the workforce is diversified by generations and work positions, and ongoing policy changes directly impact the work of the front-line RN. The strength and stability of the workforce depends on an accurate understanding of the predictors of job satisfaction for the …

Horizontal Violence And The Quality And Safety Of Patient Care: A Conceptual Model, Christina Purpora, Mary A. Blegen

Nursing and Health Professions Faculty Research and Publications

For many years, nurses in international clinical and academic settings have voiced concern about horizontal violence among nurses and its consequences. However, no known framework exists to guide research on the topic to explain these consequences. This paper presents a conceptual model that was developed from four theories to illustrate how the quality and safety of patient care could be affected by horizontal violence. Research is needed to validate the new model and to gather empirical evidence of the consequences of horizontal violence on which to base recommendations for future research, education, and practice.

Distress During The Menopause Transition: A Rich Contextual Analysis Of Midlife Women's Narratives, Marcianna Nosek, Holly Powell Kennedy, Maria Gudmundsdottir

Nursing and Health Professions Faculty Research and Publications

In 2010, nearly 400 million women worldwide were of menopause age (45-54). Although many women transition through menopause with ease, some experience distress and a subsequent decrease in quality of life. The purpose of this qualitative study was to examine the experiences of distress in women during the menopause transition. A narrative analysis methodology was used maintaining participants’ complete narratives when possible. In-person interviews of 15 midlife women were digitally audio recorded and transcribed verbatim. Women shared narratives of distress related to menstrual changes, emotional instability, vaginal dryness, and decreased libido affected by their relationships with self, partners, work, and …

Screening, Brief Intervention, And Referral To Treatment: A Nursing Perspective, Chenit Ong-Flaherty

Nursing and Health Professions Faculty Research and Publications

Screening, brief intervention and referral to treatment (SBIRT) was first initiated by the World Health Organization (WHO) in the mid 1980’s in recognition of alcohol as an important contributor of ill health, mental health issues, injuries from trauma, and social problems .¹ For example, in 2002, 3.2% of deaths worldwide were attributed to alcohol use.¹ SBIRT has been successfully implemented in primary care and emergency departments and globally.^1-11 In emergency medicine, SBIRT has been mandated by the American College of Surgeons Committee on Trauma for all Level I trauma centers in the United States.⁸ There are …

Sleep Quality, Stress, Caregiver Burden, And Quality Of Life In Maternal Caregivers Of Young Children With Bronchopulmonary Dysplasia, Christine A. Feeley

All ETDs from UAB

Mothers are usually the primary caregivers of young children with a chronic illness such as bronchopulmonary dysplasia (BPD), and may have no formal caregiver training. Children with BPD often require complex healthcare at home (complex medication regimens, oxygen via nasal cannula, Gastrostomy feedings, etc.), thus many maternal caregivers experience difficulty balancing the needs of their child with their own needs and other responsibilities. As such, maternal caregivers may report increased levels of stress and caregiver burden, as well as decreased quality of life (QOL). Additionally, a great number of maternal caregivers report poor sleep quality due to nighttime caregiving duties. …

Risk Factors For Stroke In Rural African Americans And Factors That Influence Exercise Behaviors To Reduce Stroke Risk, Dawn M. Aycock

All ETDs from UAB

Stroke has increased among young adults, which is concerning for African Americans (AA) who tend to have stroke at an earlier age and an increased risk for mortality and severe disability. Rural dwellers lack resources which may increase their susceptibility to stroke. Regular exercise can reduce stroke; however, physical activity among AA is low. The purpose of this research was to use an Expanded Health Belief Model to examine perceived and actual stroke risk among rural AA 19 to 54 years of age and factors that influence exercise behaviors to reduce stroke risk. A cross-sectional correlational design was used. Participants …

The Effects Of Psychological Stress, Depressive Symptoms, And Cortisol On Body Mass And Central Adiposity In 10-To12-Year-Old Children, Hong-Thuy Lam

All ETDs from UAB

The percentage of children with elevated body mass and central adiposity has tripled in the U.S. over the past thirty years. While physical factors, such as decreased physical activity and poor nutrition, have been noted to influence elevated body mass and central adiposity in school-aged children, less is known about psychological factors, such as psychological stress and depressive symptoms, especially in 10-to12-year-old children. Further, it has been suggested that cortisol, a biomarker of psychological stress, plays a role in the underlying mechanism that links psychological stress and depressive symptoms to increased body mass and central adiposity, but this has not …

Socioeconomic Patterning Of Obesity Among African American Women In The Jackson Heart Study, Tonya Moore

All ETDs from UAB

Objectives: The purpose of this study was to expand upon what has been observed in literature about obesity and its ties to socioeconomic status (SES) among African American Women (AAW) participants of the Jackson Heart Study (JHS). Methods: This secondary analysis was a sub-study of the JHS and focused on four SES variables: education, income, occupation and wealth; and five outcome variables: body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT). Two analytic samples were created in order to examine data collected during Exam 1 (2000-2004) and Exam 2 (2005-2008). …

Factors Associated With Participant Retention In A Behavioral Weight Loss Study, Cathy C. Roche

All ETDs from UAB

Participant retention in longitudinal research is gaining increasing attention. By identifying factors associated with participant retention, programs can be better designed to promote effective weight loss. This study examines factors associated with participant retention. The Anderson Behavioral Model provided the conceptual framework for the study. The sample consisted of secondary data abstracted from the research records of 316 participants in the University of Alabama at Birmingham cohort of the Look Action for Health in Diabetes (AHEAD) trial. The Look AHEAD trial is a randomized controlled trial designed to investigate the long-term effects of interventions aimed at producing weight loss in …

Vitamin D: Implications Of The Institute Of Medicine Report For Clinical Practice, Dorothy Grasso, Margaret A. Rafferty

Publications and Research

In November 2010, the Institute of Medicine (IOM) released Dietary Reference Intakes for Calcium and Vitamin D, a radical departure from previous advice given regarding these two nutrients that have been reported in respected health journals. The 14-member expert committee found clear and convincing evidence to support the association between adequate levels of vitamin D and bone health. The IOM committee did not find enough evidence to support claims that inadequate levels of vitamin D are linked to increased risks for cancer, cardiovascular disease, or diabetes. In this article, the authors discuss the controversy surrounding vitamin D and provide guidance …

Outcome Comparison Of An Evidence-Based Nurse Residency Program To Other Orientation Models, Debra A. Harrison

UNF Graduate Theses and Dissertations

The purpose of this evidence-based project was to compare one-year outcomes for newly licensed Registered Nurses (NLRNs) in three organizations within the same healthcare system. All three have lower than nationally reported turnover and strategies for NLRN retention. Only one is using a Nurse Residency Program (NRP).

NRPs are recognized as an effective strategy to retain newly licensed registered nurses (NLRNs) in their first year of employment (Institute of Medicine [IOM], 2010; The Advisory Board, 2007; Spector, 2007). The Commission on Collegiate Nursing Education (CCNE) (2008) defines an NRP as a series of learning sessions and work experiences that occur …

Improving Quit Rates For Tobacco-Dependent Hospitalized Patients, Marion G. Mann

UNF Graduate Theses and Dissertations

Abstract

Purpose: The purpose of this project was to evaluate outcomes of an existing inpatient tobacco cessation counseling program with 30-day follow-up among recently admitted tobacco-dependent patients who were tobacco-dependent.

Background/Significance: Tobacco use is considered the number one most preventable cause of disease, disability, and death in the United States. Despite associated dangers, approximately 21% Americans currently smoke. This has led to increased hospital admissions and chronic disease management, costing the United States approximately $96 billion per year. Decades of research and evidence-based clinical practice guidelines substantiate that inpatient tobacco cessation counseling has the potential to improve quit rates post-hospital …

Acute-To-Home Care Nursing Handoffs: Distributed Cognition Across Patterns Of Knowledge, Rosemary Kennedy

Dissertations

Timely, explicit, and effective communication of patient information during care transitions is fundamental to safe care. Studies show that handoffs or transfers of patient care from one provider to another are susceptible to communication failures (Riesenberg et al., 2009a). Most studies on communication failures focus on communication between providers within the same setting of care. Few studies, if any, focus on communication between care settings in different locations. However, research has identified gaps in care during critical transitions and identified poor communication and incomplete transfer of information as the root cause (Naylor et al., 2004). This qualitative dissertation consists of …

Risk Perception, Psychological Well-Being, And Health-Promoting Behaviors In Persons Informed Of A Coronary Artery Calcium Score, Jennie Elizabeth Johnson

Dissertations

Background: Cardiovascular disease (CVD) remains the leading cause of adult deaths because individuals continue to engage in behaviors that exacerbate CVD. New technologies such as coronary artery calcium (CAC) screening detect atherosclerosis before clinical disease is manifested. Awareness of an abnormal finding should enhance motivation for change.

Objective: To examine how awareness of a CAC score affects risk perception and health-promoting behaviors in persons at high risk for CVD.

Methods: This study used a descriptive prospective design with 174 high risk adults (3 or more major risk factors) recruited at a radiology center offering CAC scans in a Chicago suburb. …

The Development Of Trust In The Nurse-Patient Relationship With Hospitalized Mexican American Patients, Sharon M. Jones

Dissertations

The Hispanic population in the United States is growing and this population experiences health care disparities compared to non-Hispanic Whites. Mexican Americans are the largest sub-group of Hispanics and providing nursing care that is patient-centered and culturally competent is important when caring for this population. Trust is an important component of patient-centered care and culturally competent care as well as a major element , (confianza) in the Hispanic culture. Although nursing researchers have identified the need for trust in culturally competent care with Mexican American patients, none have explored how trust develops between the nurse and the Mexican American patient. …

A Systematic Review Of Interventions In Primary Care To Improve Health Literacy For Chronic Disease Behavioral Risk Factors, J Taggart, A Williams, S Dennis, A Newall, T Shortus, N Zwar, E Denny-Wilson, M Harris

Nursing Papers and Journal Articles

Background: To evaluate the effectiveness of interventions used in primary care to improve health literacy for change in smoking, nutrition, alcohol, physical activity and weight (SNAPW).

Methods: A systematic review of intervention studies that included outcomes for health literacy and SNAPW behavioral risk behaviors implemented in primary care settings.

We searched the Cochrane Library, Johanna Briggs Institute, Medline, Embase, CINAHL, Psychinfo, Web of Science, Scopus, APAIS, Australasian Medical Index, Google Scholar, Community of Science and four targeted journals (Patient Education and Counseling, Health Education and Behaviour, American Journal of Preventive Medicine and Preventive Medicine).

Study inclusion criteria: Adults over 18 …

Is There Scope For Community Health Nurses To Address Lifestyle Risk Factors? The Community Nursing Snap Trial, B Chan, R Laws, A Williams, G Davies, M Fanaian, M Harris, Cn Snap Project Team

Nursing Papers and Journal Articles

Background: This paper examines the opportunity and need for lifestyle interventions for patients attending generalist community nursing services in Australia. This will help determine the scope for risk factor management within community health care by generalist community nurses (GCNs).

Methods: This was a quasi-experimental study conducted in four generalist community nursing services in NSW, Australia. Prior to service contacts, clients were offered a computer-assisted telephone interview to collect baseline data on socio-demographics, health conditions, smoking status, physical activity levels, alcohol consumption, height and weight, fruit and vegetable intake and 'readiness-to-change' for lifestyle risk factors.

Results: 804 clients participated (a response …