Tan Chingfen Graduate School of Nursing Dissertations
http://hdl.handle.net/20.500.14038/9
2024-03-28T13:25:04ZIn Our World: Uncovering the Meaning of Parent-Nurse Relationships in Childhood Cancer Care
http://hdl.handle.net/20.500.14038/53002
In Our World: Uncovering the Meaning of Parent-Nurse Relationships in Childhood Cancer Care
Costa, Jennifer
Background: The diagnosis of cancer in a child thrusts parents into a complex healthcare system where they find themselves developing new relationships with pediatric oncology nurses. While parents and nurses acknowledge the meaningfulness and complexity of these relationships, many find it difficult to articulate. The purpose of this study was to understand the meaning and experience of the parent-nurse relationship in childhood cancer care.
Methods: This study employed the tenets of Gadamerian hermeneutic philosophy. Data analysis looked to articulate meaningful interpretations of the interviews with parents and nurses of children with cancer through interpretive data analysis and utilized the hermeneutic circle as a way of conceptualizing and understanding the interpretive process.
Results: Sixteen interviews (n = 8 parents, n = 8 nurses) were completed. The findings suggested that both parents and nurses of children with cancer navigate through an evolving inner world unique to the cancer experience. The parent-nurse relationships were mutually identified as dynamic, complex, and emotionally laden, and drew on the shared strength, trust, humanity, and interconnectedness of one another. The parent-nurse relationships played a significant role in traversing the challenges encountered with entry into and navigation through the pediatric cancer world.
Discussion: The findings provide practical knowledge to inform and enhance relationship development at the clinical level, impact how relationship development is taught at the academic level, as well as inform professional development. This study contributes to the understanding of parent-nurse relationships and opens the door for integration of innovative practices in nursing education and clinical care.
2023-12-14T00:00:00ZNurses with Physical Disabilities Experiences During Pre-licensure Education
http://hdl.handle.net/20.500.14038/52571
Nurses with Physical Disabilities Experiences During Pre-licensure Education
Mantlow, Kimberly D.
PURPOSE: To describe the pre-licensure nursing educational experience of integration and inclusion among RNs with a physical disability during their education.
SPECIFIC AIMS: 1) Describe the access RNs with a physical disability had to academic and social opportunities during their prelicensure education program that contributed to academic and social integration (inclusion). 2). Explore perceptions of RNs with a physical disability regarding inclusion and acceptance of their disability as a valued component of student diversity during their prelicensure education program. 3). Describe the contextual factors and key aspects of connection during the pre-licensure educational experiences of RNs who had a physical disability as positive (Disability-Diversity Connect) or negative and disintegrated (Disability-Diversity Disconnect).
FRAMEWORK: This study was guided by The Disability-Diversity Disconnect (DDDM) by Aquino (2016). DESIGN: This study design used was qualitative description. It included semi-structured interviews using an interview guide based on the DDDM.
RESULTS: 16 individuals with 14 different physical disabilities participated in this study. During data analysis four themes emerged: I Saved My Energy for Learning, Determination, Wanting to Find My People and Secrets, Living a Double Life which has a subtheme, Fear of Judgement. CONCLUSION: : Identification of factors related to inclusion within the academic environment provides insight for future work to examine the needs of prelicensure nursing students with physical disabilities and the potential to improve their future educational experiences.
2023-08-15T00:00:00ZReady for Action: A National Study of Pediatric Healthcare Professionals' Attitudes and Beliefs About Weight Stigma
http://hdl.handle.net/20.500.14038/52310
Ready for Action: A National Study of Pediatric Healthcare Professionals' Attitudes and Beliefs About Weight Stigma
Turner, Samantha L
PURPOSE: To quantify pediatric healthcare professionals’ (HCPs’) attitudes and beliefs about weight stigma and levels of implicit and explicit weight bias and describe interventions that are most supported by pediatric HCPs.
SPECIFIC AIMS: 1) Determine the distribution of weight bias among pediatric HCPs and identify associations between characteristics and weight bias. 2) Examine attitudes and beliefs of pediatric HCPs about weight stigma and identify associations between characteristics and attitudes/beliefs. 3) Investigate the relationship between HCPs’ weight bias and attitudes/beliefs. 4) Identify interventions most supported by pediatric HCPs.
Framework: The Health Stigma Discrimination Framework guided this study.
DESIGN: This study utilized a cross-sectional survey of pediatric HCPs. Participants completed the Implicit Association Test (IAT), the Crandall Anti-Fat Attitudes Questionnaire (CAAQ), a researcher-designed questionnaire (BAWSQ), and demographic questions.
RESULTS: The sample exhibited a moderate implicit bias (M=0.59, SD=0.41) and explicit bias (M=38.95, SD=10.9). Participants generally agreed with BAWSQ statements and broadly supported interventions. The most-supported intervention was continuing education units (CEUs) for anti-weight bias activities (n=144, 81.36%). Implicit bias was associated with more years in practice, occupation, and age. Explicit bias was associated with practice setting. As explicit bias increased, so did agreement with BAWSQ question 1 (r=0.208, p=0.005), and disagreement with BAWSQ questions 3 and 4 (r=-0.237, p<0.005; r=-0.394, p<0.001, respectively).
CONCLUSION: Weight bias is prevalent in pediatric healthcare and pediatric HCPs are invested in approaches to reduce weight bias. Future interventions should be brief, concise, and should aim to broaden awareness of pediatric HCPs about the consequences of weight bias.
2023-05-26T00:00:00ZHope for the Future: Key Informants’ Perspectives on HIV Prevention in Dominican Republic Batey Communities
http://hdl.handle.net/20.500.14038/52149
Hope for the Future: Key Informants’ Perspectives on HIV Prevention in Dominican Republic Batey Communities
Filiau, Alaina
Purpose: The purpose of this study, was to understand the interlocking spheres of cultural identity and health behaviors relating to HIV prevention within the batey communities.
Specific Aims: Explore key informants’ perceptions of cultural identity that influence HIV prevention including relationships, expectations, and cultural empowerment among persons, extended family, and neighborhoods. Explore key informants’ perceptions of the cultural factors that enable and nurture protective health behaviors relating to HIV prevention among the DR batey communities. Describe key informants’ perceptions of the positive, existential, and negative dimensions of DR batey culture empowerment with the goal of promoting healthy behaviors for HIV prevention in batey communities.
Framework: The PEN-3 Model by Airhihenbuwa provided the theoretical framework as a culture-centered approach to understanding cultural context relating to health behaviors.
Design: A qualitative descriptive design with maximum variation was utilized, and data was analyzed using qualitative content analysis. Semi-structured qualitative interviews were completed with key informants within the La Romana region of the Dominican Republic.
Results: Semi-structured qualitative interviews were conducted with 12 individuals.
2023-04-18T00:00:00ZDiagnoses Associated with Intellectual and Developmental Disabilities in Adult Decedents: A Secondary Analysis of Healthcare Cost and Utilization Project National Inpatient Sample (HCUP/NIS) Data
http://hdl.handle.net/20.500.14038/51838
Diagnoses Associated with Intellectual and Developmental Disabilities in Adult Decedents: A Secondary Analysis of Healthcare Cost and Utilization Project National Inpatient Sample (HCUP/NIS) Data
Briere, Heather
Purpose: To identify primary and secondary diagnoses preceding death among adults with and without IDD who died during hospitalization.
Specific Aims: 1) to describe the commonly reported base diagnostic related groups preceding death among decedents with and without IDD who died during hospitalization in 2019, 2) to determine which base-DRGs had a higher prevalence rate among adults with IDD than among adults without IDD, controlling for age, gender, race, urbanicity of person’s residence, US census division of hospital, and mean income of person’s zip code, and 3) to use the base-DRGs and ICD-10-CMs to examine the conditions of the Fatal Four/Five as conditions of concern preceding death in decedents with and without IDD.
Framework: The NIMHD Minority Health and Health Disparities Research Framework.
Design: A secondary data analysis using the 2019 Healthcare Cost and Utilization Project National (Nationwide) Inpatient Sample (HCUP-NIS).
Results: Identified fourteen primary diagnoses at the time of death for decedents with IDD that are represented at a higher percentage than for decedents without IDD and have a significant odds ratio for IDD diagnosis.
Conclusion: A new set of conditions is proposed to assist nurses in reducing preventable deaths in decedents with IDD. Dehydration, GI obstruction, respiratory infection, seizures, and sepsis, will be known as the IDD Concerning Conditions. Aspiration, constipation, and GERD, the IDD Contributing Conditions, are conditions that do not cause death in themselves but contribute to the development of at least one of the IDD Concerning Conditions, which do cause death.
2023-02-17T00:00:00ZMental Illness Knowledge and Stigma of Jamaican Diaspora & First-Generation Jamaican Americans
http://hdl.handle.net/20.500.14038/51733
Mental Illness Knowledge and Stigma of Jamaican Diaspora & First-Generation Jamaican Americans
Nyakako, Rose Marie
PURPOSE: To describe U.S. Jamaican diasporan and first-generation Jamaican Americans knowledge of and stigma towards mental illness.
SPECIFIC AIMS:
1. Describe U.S. dwelling Jamaican diaspora and first-generation Jamaican Americans knowledge of mental illness and stigma towards mental illness with identification of drivers and facilitators of stigma.
2. Elicit descriptors used by Jamaican diaspora and first-generation Jamaican Americans to describe mental illness.
3. Determine association of mental illness stigma and mental illness knowledge, to age, gender, education, employment, religiosity, years living in the U.S., socioeconomic status, personal history of mental illness, and family member with mental illness.
FRAMEWORK: The Health Stigma and Discrimination Framework.
DESIGN: Cross-sectional descriptive survey.
RESULTS: Jamaican diaspora years have less knowledge (mean 97.25, SD 10.27) than Jamaican Americans (mean 104.24, SD 7.74; p =.001). Participants > 40 years had less knowledge (mean 97.05, SD 9.54) than those < 40 years (mean 102.08, SD 10.95; p =.003).
Jamaican diaspora years have more stigma (mean -.52, SD .76) than Jamaican Americans (mean -1.10, SD .73; p < .001). Participants > 40 years had more stigma (mean -.48, SD .69) than those < 40 years (mean 1.02, SD .87; p <.001).
CONCLUSION: Older adults have less knowledge of mental illness and more stigma. Jamaican diaspora has less knowledge and more stigma than First-generation Jamaican Americans. Greater mental illness knowledge is associated with less stigma providing support for ongoing efforts to increase public knowledge of mental illness with added emphasis on word choice/terms used when talking about people with mental illness.
PURPOSE: To describe U.S. Jamaican diasporan and first-generation Jamaican Americans knowledge of and stigma towards mental illness.
SPECIFIC AIMS:
1. Describe U.S. dwelling Jamaican diaspora and first-generation Jamaican Americans knowledge of mental illness and stigma towards mental illness with identification of drivers and facilitators of stigma.
2. Elicit descriptors used by Jamaican diaspora and first-generation Jamaican Americans to describe mental illness.
3. Determine association of mental illness stigma and mental illness knowledge, to age, gender, education, employment, religiosity, years living in the U.S., socioeconomic status, personal history of mental illness, and family member with mental illness.
FRAMEWORK: The Health Stigma and Discrimination Framework.
DESIGN: Cross-sectional descriptive survey.
RESULTS: Jamaican diaspora years have less knowledge (mean 97.25, SD 10.27) than Jamaican Americans (mean 104.24, SD 7.74; p =.001). Participants > 40 years had less knowledge (mean 97.05, SD 9.54) than those < 40 years (mean 102.08, SD 10.95; p =.003).
Jamaican diaspora years have more stigma (mean -.52, SD .76) than Jamaican Americans (mean -1.10, SD .73; p < .001). Participants > 40 years had more stigma (mean -.48, SD .69) than those < 40 years (mean 1.02, SD .87; p <.001).
CONCLUSION: Older adults have less knowledge of mental illness and more stigma. Jamaican diaspora has less knowledge and more stigma than First-generation Jamaican Americans. Greater mental illness knowledge is associated with less stigma providing support for ongoing efforts to increase public knowledge of mental illness with added emphasis on word choice/terms used when talking about people with mental illness.
2022-12-15T00:00:00ZA Feasibility Study of Therapeutic Conversations with Family Members to Reduce the Symptoms of Post-Intensive Care Syndrome
http://hdl.handle.net/20.500.14038/34424
A Feasibility Study of Therapeutic Conversations with Family Members to Reduce the Symptoms of Post-Intensive Care Syndrome
Tehan, Tara M.
PURPOSE: The purpose of this feasibility study was to explore the use of a nurse-centered intervention, the Critical Caring Program, with family members of critically ill adults. The intervention was a series of therapeutic conversations with a family member, beginning in the ICU and following patient discharge from the ICU. FRAMEWORK: The Family Adjustment and Adaptation Response Model (Patterson, 1988) provided the conceptual framework; the intervention was adapted from the Calgary Family Assessment and Intervention Model. DESIGN: A randomized, controlled design with two groups (usual care and intervention) was used to assess the feasibility of the intervention. A convenience sample of 19 adult family members were recruited from an 18-bed ICU from October 2021–January 2022. RESULTS: 151 family members were screened for participation; 40 who were eligible and 19 were enrolled. Overall retention was 58% for the intervention group; 62% for the usual care group. Outcomes revealed no statistically significant differences between groups or changes within groups. The nurses viewed the training and conversations as positive but identified incorporating the visits into routine practice as challenging. CONCLUSION: The Calgary Family Intervention Model is a useful model for addressing families’ need for communication and support. Additional research is needed on incorporating therapeutic conversations into critical care nursing practice.
2022-05-25T00:00:00Z“I felt isolated”: Patients’ Hospitalization Experiences During the COVID-19 Pandemic
http://hdl.handle.net/20.500.14038/34423
“I felt isolated”: Patients’ Hospitalization Experiences During the COVID-19 Pandemic
Patrick, Julia
Purpose: The purpose of this Qualitative Descriptive study was to describe the experience of hospitalized adults during the pandemic who did not have COVID-19. Specific Aims: The specific aims of the study were to: Describe the hospital experience, including but not limited to, interactions with hospital staff, visitation, isolation, physical and emotional stressors, and the environment. Identify perceived comfort needs during hospitalization and perceptions of the nurse’s role in providing comforting interventions. Examine the ability to achieve physical, psychospiritual, sociocultural, and environmental comfort during hospitalization despite the required infection control measures. Framework: This study was guided by Kolcaba’s Theory of Comfort (1994). Design: This was a qualitative descriptive study. Semi-structured interviews were conducted. Interview questions focused on the overall hospital experience, the nurse’s role in their experience, comfort needs, and the experience of having comfort needs met during the hospitalization. Results: Twenty participants took part in this study. Conventional content analysis revealed five main themes. The themes are: I don’t expect the hospital to be comfortable, I was always tense, Wanting human connection, Communication is important, and Nurses are busy. Conclusion: The findings identified a need for targeting education, research, and policy development to improve patient comfort (physical, psycho-spiritual, sociocultural, and environmental). This is important as we look toward improving the overall patient experience during hospitalization.
2022-04-25T00:00:00ZIndividuals With Sickle Cell Disease Using SBAR as a Communication Tool: Secondary Data Analysis
http://hdl.handle.net/20.500.14038/34422
Individuals With Sickle Cell Disease Using SBAR as a Communication Tool: Secondary Data Analysis
Jean-Baptiste, Deborah M.
Purpose: The purpose of this study was to determine the usefulness of SBAR-cued web-based communication skills training and address study participants' perceptions of the training. Specific Aims: Evaluate the usefulness and accuracy of participants to answer prompts of SBAR-cued communication responses. Describe individuals' perspectives of the acceptability of using SBAR patient-HCP communication simulation to better prepare for ED visits during a SCC. Framework: This study was guided by The Theory of Self-Care Management for Sickle Cell Disease (SCMSCD). Design: A secondary analysis was conducted using a qualitative descriptive approach. Inter-rater reliability (IRR) of qualitative data was used to evaluate the usefulness and accuracy of participants to answer prompts of SBAR-cued communication responses. Content analysis was also utilized to describe individuals' perspectives of the acceptability of using SBAR patient-HCP communication simulation to better prepare for ED visits during a SCC. Results: IRR between raters ranged from 64%-94% with predominant themes of (1) Patient-Provider Communication and Interaction, (2) Patients want to be Heard and Believed, (3) Accuracy of the ED Experience and Incorporating the Uniqueness of each Patient and (4) Overall Usefulness of the Video Trainer emerging. Conclusions: This secondary analysis supported how SBAR can be effectively used to assist patients in a SCC to communicate with their HCP. Participants' responses indicated the training module facilitated communication between patients and HCPs.
2022-04-20T00:00:00ZExperiences with Exposure to a Distant Reiki Intervention during the COVID-19 Pandemic
http://hdl.handle.net/20.500.14038/34418
Experiences with Exposure to a Distant Reiki Intervention during the COVID-19 Pandemic
DiBenedetto, Jennifer
Purpose: The purpose of the study was to explore the use of virtual distant Reiki as a healing modality to influence the human environmental field patterning. Specific Aims: (1) To determine if it is feasible to recruit and retain participants (through expressions of human choice) to participate in a study comprised of two distant Reiki administrations on a virtual platform. (2) To investigate the preliminary influence of a distant Reiki intervention on pattern of the whole as manifested by participant response in stress and anxiety. (3) To explore the participant’s reflections on their virtual distant Reiki experience within the human environmental field pattern of their home environment as a healing space. Theoretical Framework: The theoretical framework is grounded in Martha Rogers’ Science of Unitary Human Beings. Design: This study incorporates a feasibility, mixed method design. Data was collected through pre and post intervention individualized interviews and two tools (State Trait Anxiety Inventory (STAI) and Impact of Events Scale-Revised (IES-R)). Results: Described changed in pattern manifestation supported the need for home-based interventions during covid 19 pandemic. Quantitative response indicated a statistically significant reduction in perceived stress and anxiety (p< 0.001). Conclusion: The preliminary study findings support the feasibility of a distant Reiki and suggest that nurses, who are Reiki practitioners, may be influential in interacting with the human environmental field to promote change and foster healing.
2022-01-04T00:00:00Z