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The Suffering Journey: Lived Experiences of Persons Who Have Endured Life-Impacting Suffering Events, Braband, Barbara J.

	Suffering is a frequently unacknowledged and complex phenomenon in health care settings despite its centrality to every patient’s health care experience. Patients’ journeys of suffering due to illness are often compounded by ancillary suffering issues that further intensify their complexity. Health care professionals tend to ignore or minimize how suffering experiences influence illness and their impact on patients and families. Many professionals talk “around” suffering when interacting with suffering patients and families while failing to address its significance in their illness experience. Those professionals who do recognize its existence often struggle with how to offer supportive care while balancing suffering’s toll on their personal and professional lives. Suffering is a key phenomenon impacting clients’ decision-making processes, but it is often not the basis for healthcare professionals’ care and interventions. There is a critical need for health care professionals to discover the significance of their clients’ stories of suffering, and to unravel suffering’s meaning and its impact on their patients’ healing, health care experiences and decisions.

		Dissertation (1469 kb)


Generational Differences of Baccalaureate Nursing Students' Preferred Teaching Methods and Faculty Use of Teaching Methods, Delahoyde, Theresa

	Nursing education is experiencing a generational phenomenon with student enrollment spanning three generations. Classrooms of the 21st century include the occasional Baby Boomer and a large number of Generation X and Generation Y students. Each of these generations has its own unique set of characteristics that have been shaped by values, trends, behaviors, and events in society. These generational characteristics create vast opportunities to learn, as well as challenges. One such challenge is the use of teaching methods that are congruent with nursing student preferences. Although there is a wide range of studies conducted on student learning styles within the nursing education field, there is little research on the preferred teaching methods of nursing students. The purpose of this quantitative, descriptive study was to compare the preferred teaching methods of multi-generational baccalaureate nursing students with faculty use of teaching methods. The research study included 367 participants; 38 nursing faculty and 329 nursing students from five different colleges within the Midwest region. The results of the two-tailed t-test found four statistically significant findings between Generation X and Y students and their preferred teaching methods including; lecture, listening to the professor lecture versus working in groups; actively participating in group discussion; and the importance of participating in group assignments. The results of the Analysis of Variance (ANOVA) found seventeen statistically significant findings between levels of students (freshmen/sophomores, juniors, & seniors) and their preferred teaching methods. Lecture was found to be the most frequently used teaching method by faculty as well as the most preferred teaching method by students. Overall, the support for a variety of teaching methods was also found in the analysis of data.

		Dissertation (628 kb)


The Emotional Impact on Native and Non-native Employees Who Stay After an Internal Appointment of a Leader in a Higher Education Institution, Ehrlich, Jeff A.

	The purpose of this study was to examine the felt emotions of those who stay after the appointment of an internal candidate in a small, Midwest higher educational institution. This study began with an assumption that those who stay after the leadership change will have specific felt emotions related to the leadership change based on their time of employment with the institution. This concept was explored and discussed with others and it was determined that two groups of employees, as defined by the author, would be examined. The two groups of employees are native and non-native. The natives are those who either are a graduate from the institution or employed for over five years. The non-natives did not graduate from the institution or were employed for less than five years. The information from this qualitative, phenomenological study was gathered though a card sort of emotions, respondent drawings, and semi-structured interviews. The employees of both groups and the different felt emotions that were experienced with the leadership change were reported. This research showed that the two group’s experiences were different, based on their relation to the leadership change and actual number of years of employment of each native or non-native at this institution.

		Dissertation (4652 kb)


Nurses’ Attitudes towards Sex Offenders, Fitzke, Molly M.

	Nurses, who provide care for their patients act out of loyalty and obligation but also, adhere to a nursing code of ethics or core values and ideals. Nurses are educated to be compassionate and nonjudgmental. One’s own ethical belief may be compromised when assigned patients that are known sex offenders. However, little is known about nurses’ attitudes when caring for a sex offender. This descriptive study will describe how registered nurses respond to caring for sex offenders. The sample for this study was composed of a random selection of 1,000 registered nurses from the Midwest state board of nursing registry that were mailed postcards inviting participation in an anonymous online survey. Sixty-eight respondents completed all questionnaire items. The research questions guiding the study were 1. What are the attitudes of nurses towards sex offenders, 2. Are there differences among social isolation, capacity to change, blame attribution, and deviancy in nurses’ scores, 3. Do nurses who have cared for a sex offender score differently than nurses who have not knowingly cared for a sex offender, and 4? Do nurses with specific sex offender education score differently than those without specific sex offender education? Survey Monkey© was the online survey tool to collect data from the participants. The data were analyzed using SPSS software to perform descriptive and t-test analysis. Overall results from the data revealed that a majority of 13 nurses practice nonjudgmental care to all of their patients, regardless if the patient is a known sex offender. Further studies should be initiated to investigate nursing who actually work predominately with sex offenders and in forensic nursing.

		Dissertation (682 kb)


Intimate Partner Violence:The Lived Experience of an Individual’s Perception of the Holistic Severing of One’s Self from an Intimate Partner Violence Relationship, Gabriel, Sue L.

	Intimate partner violence (IPV) is intertwined in the lives of untold numbers of men, women, and children around the world. This human abuse dates back as far as the Roman times, when women were considered property of their husbands. In many ways, this viewpoint continues to hold true for many families today. Between one and two million women are victims of IPV yearly. This occurs at the hands of their spouses, boyfriends, ex-spouses, and ex-boyfriends. There are numerous assessment tools used to identify victims and potential victims of IPV. Education in this area is insufficient for healthcare professionals, which makes it difficult to make the transition from assessment to intervention. Many victims feel there are not adequate resources available in their communities or enough professionals who are willing to get involved. Information is abundant about risk factors, types of abuse, why victims continue to remain in these relationships, and who the abusers often are. However, there is very little literature that identifies what decisive factor occurs in the lives of victims that gives them the courage and strength to sever their ties with their abuser and become survivors. This case study of one will document in rich text, the passage of one victim, who unsuspectingly journeyed into the dark world of intimate partner violence. She will identify her reason for severing ties with her abuser, and she will reflect on her journey through several phases in her life, to emerge on the other side, into hope and healing. This study will amplify and augment previously documented information on IPV, and help to educate students and healthcare professionals. By sharing her story, it is the hope of the participant in this case study that she is able give hope to others who are contemplating their journey and wish to emerge as survivors.

		Dissertation (948 kb)


Entry Level Competence of Nurses by the Type of Program, Hawkins, Peggy

	The purpose of the study was to determine whether type of program had an effect on entry level nursing competence. Pass rate scores on the national licensure exam were used to measure nursing competence for nurses.

		Dissertation (304 kb)


Academic and Nonacademic Predictors of Future Success on the NCLEX-RN® Licensure Examination for Nurses, Humphrey, Jo Ann

	The purpose of this retrospective, descriptive study was to explore possible differences between academic and nonacademic predictors and subsequent success rates on NCLEX-RN® examination in a sample of nursing students. This is a high-stakes examination because graduate nurses must successfully complete this requirement to practice as registered nurses. Data were examined from academic records of 338 nursing graduates who completed associate degree requirements at a college in the Midwest between April 2006 and August 2007. Descriptive and inferential statistics were explored to discern possible differences between the dependent variable, NCLEX-RN® passage rates and various independent variables. Statistical analysis revealed the academic predictors to be good indicators of future success on NCLEX-RN®. For college GPA the t-test for equality of means revealed t = 9.080, df = 204.100, p = .000 and mean difference = .35534. Conversely, high school GPA demonstrated t = 1.286, df = 157.528, p = .200 and mean difference = .08081. An explanation of this significant finding with college GPA and lack of significance in high school GPA may be the rigor of nursing education compared to high school course work. Composite ACT as well as math and science ACT were highly predictive of future success on NCLEX-RN®. The mean ACT score for those who passed NCLEX-RN® was 21.6387 and the mean ACT score for those who failed the licensure examination was 19.5968. Nonacademic predictors were not as strong indicators of future success on the licensure examination as academic predictors, however. Only student age at the time of sitting for the NCLEX examination proved to be predictive of future success. Both the HESI Exit Exam (E2) and ATI Comprehensive RN Predictor were predictive of future success on NCLEX-RN®.

		Dissertation (761 kb)


In Search of a Message to Promote Personal Health Information Management, Jacobs, Ellen B.

	Research has shown that individuals who take an active role in their health and health care have better outcomes, lower costs, and higher functional status than those who take a more passive role. To be an active participant, individuals need information about themselves. However, most individuals are uninterested in taking on the responsibility of personal health information management (PHIM). Adopting PHIM requires individuals to adopt new behaviors. This study begins to answer the question; What may influence students at an academic medical center to adopt PHIM? People are more likely to accept new ideas or take action when they perceive they will benefit from that idea or action. The most effective way of learning what is personally relevant to the specific target audience is to ask them. A qualitative research design using focus groups to collect the data was completed at an academic medical center in a medium sized Midwestern city. This site was selected because the university offered students free Web based PHR. The results of the study can be used to inform a to inform a social marketing strategy for promoting PHIM. Through the application of the Motivation, Opportunity, and Ability Model to the research findings, by comparing characteristics of the research participants to those of prior research, and by integrating the findings into the conceptual framework composed of a matrix of the marketing mix to the MOA Model, potentially personally relevant goals were identified. The students felt personally relevant goals were the need to maintain immunization records in an organized, convenient manner. They perceived that were healthy and had small amount of discretionary time, and favored systems that involved technology. The message that may influence students to adopt PHIM would include increasing awareness, describing ―how to,‖ and scary story of those who suffered because they did not do PHIM. These messages would best deliver the messages by an authority, a celebrity, or an organization with nothing to gain.

		Dissertation (1403 kb)


The Effect of a School Nurse Led Education Intervention on Blood Pressure and Physical Activity Levels in Adolescents, Leibold, Nancyruth

	Regular physical activity (PA) is a necessary health promotion behavior for adolescents. Benefits of regular physical activity are optimal body weight, lowering blood pressure (BP), and decreasing risk factors for chronic illnesses. Yet declining physical activity levels and increasing sedentary behaviors along with the rising prevalence of overweight and obesity, type 2 diabetes, and hypertension exists in teenagers. The purpose of this quantitative research was to study the effects of a School Nurse led teaching intervention to promote physical activity as a healthy behavior on blood pressures and physical activity levels in adolescents. Youth empowerment was the theoretical framework for the study and a peer leader was incorporated. A true experimental design used repeated measures with the same intervention for a total of 4 measures (two before intervention and two after intervention) was implemented. The intervention group received a School Nurse led education session on the healthy benefits of PA. The measures were blood pressure, pulse, body mass index, and physical activity levels. A significant drop in systolic blood pressure was found in the intervention group after education. A negative relationship was found between both systolic blood pressure (SBP) and physical activity levels and diastolic blood pressure (DBP) and physical activity levels. Mean physical activity levels increased in the intervention group post education. Possible implications for School Nurse practice include further study, continued use of School Nurse led education programs with teens and dissemination of the findings to other School Nurses.

		Dissertation (499 kb)


Nursing Students' Perception of How Prepared They Are To Assess Patients' Spiritual Needs, Mahon Graham, Patricia E.

	According to the literature, currently there is no assessment for spiritual development of nurses, physicians, ministers or patients. They could be at any stage in their faith development. Spiritual development has seldom been a criterion for nursing entry, graduation, or practice. Nor is religious affiliation usually a criterion for education or practices. Spiritual competence is the basis for fostering hope, purpose and meaning. Therefore, the nursing profession needs to develop nurses who are capable of responding to patients’ spiritual needs in a competent and sensitive way. Providing education to nursing students may increase students’ awareness of importance of patients’ spiritual needs. Gaining comfort with one’s own spirituality is the initial step in developing awareness and sensitivity to patients’ spiritual needs. A mixed method study examined nursing students’ perception of how prepared they are in assessing their patients’ spiritual needs after participating in a four hour spirituality seminar. Quantitative data were collected on senior nursing students (N=24) completing the Spirituality Assessment Scale (SAS) surveys before and after participating in a fourhour spirituality seminar. The qualitative study took a phenomenological approach examining senior nursing students’ (N=12) open-ended questionnaire in an interview format.

		Dissertation (371 kb)


Barriers to the Publication of Scientific Literature by Academic Certified, Moos, Daniel D.

	Nurse anesthesia is the oldest advanced practice nursing specialty. Nurse anesthetists were authors of scholarly articles from the very beginning of the profession. In the past two scholarly journals failed, in part, due to a lack of submissions. A qualitative study, utilizing a descriptive design with content analysis, was undertaken to identify barriers to the publication of scientific literature by academic Certified Registered Nurse Anesthetists (CRNAs). Additional information included identification of strategies to reduce barriers, rewards associated with publication, and effects of barriers on professional development. Fifteen academic CRNAs were interviewed. Interviews were recorded and verbatim transcripts were generated. Transcripts were analyzed using descriptive qualitative analysis techniques. Barriers to the publication of scientific literature included time, institutional, preparation, motivation, limited outlets for dissemination, and mentorship. Strategies to diminish barriers included adequate education, time, mentorship, professional support, institutional, and motivation. Effects on professional development were dependent upon institutional expectations. If writing for publication is an expectation, barriers can effect promotion and opportunities, dissemination of knowledge, and professional prestige. If not an expectation, it may limit future opportunities in academia, professional prestige, and self esteem. Rewards of publishing in the scientific literature included dissemination of knowledge, sense of accomplishment, prestige, professional rewards, and self improvement.

		Dissertation (806 kb)


Experiences of African Americans in Nursing Education, Orduna, Aubray

	Representation of minorities in the nursing profession does not mirror the diversity of the US population, although there have been significant increases in enrollment and graduation rates. The purpose of this narrative phenomenological study was to explore lived experiences of African Americans in nursing education. This study attempted to describe lived experiences of African Americans in nursing education through the analysis of data derived from individual interviews detailing lived and shared experiences among this ethnic group. A purposive sampling technique was utilized. Eleven American-born African American registered nurses who had attended both private colleges and public universities volunteered. A survey tool developed by the researcher was used to conduct semi-structured interviews. Interviews were audiotaped and transcribed. Transcripts of the interviews were analyzed and coded utilizing a computerized software program. Six themes emerged: feelings of isolation, student interaction, support systems, faculty attitudes, perceptions of prejudice and inner strength and personal drive. Participants described both negative and positive factors affecting their nursing education experience. Through personal inner strength, determination to become a nurse and utilization of support systems, participants were able to persist and were successful at attaining their goal of becoming a nurse. More descriptive studies exploring the experiences of minorities to allow voices of African Americans to be heard regarding their perceptions of nursing educational experiences are suggested. Further research into the relationship between cultural identity and minority student success is also suggested.

		Dissertation (802 kb)


A Reframing of Protective Factors in the Contexts of Risk, Adversity and Competence in Adolescents, Pierorazio, Daria A.

	The focus of this research was the study of adolescent resilience.

		Dissertation (902 kb)


Characteristics of Retained Nursing Faculty, Piskac, Ellen M.

	Facing a shortage of nurses and nursing faculty, colleges and universities need to consider those individual and employment characteristics are related to retention of nursing faculty. The purpose of this descriptive study was to describe those individual and employment characteristics associated with retention in the nurse faculty role. Faculty (N=211) in NLNAC accredited schools of nursing in seven states was surveyed. Results of the study supported the following hypotheses: there was a relationship between age, number of children under age eighteen living in homes of nurse educators, highest level of formal education of nurse educators, yearly income earned at nursing education position, number of years employed as a nurse, number of years employed as a nurse educator, number of years in present nursing education position, plans to leave nursing education in years, reasons for leaving nursing education, and years employed in nursing education. Determining perceptions of nurses about the nurse faculty role, comparing longevity in nursing education of master‟s prepared nurse faculty and master‟s prepared nurse faculty with emphasis in nursing education and determining factors other than individual or employment responsible for retention of nurse educators are suggested for further study.

		Dissertation (350 kb)


The Perceived Role of Physician Office Health Coaches In Delivering Chronic Care to Patients In A Primary Care Clinic Group In The Midwest: A Phenomelogical Qualitative Study, Roberts-Anderson, Janet Patricia

	Newly hired Physician Office Health Coaches (POHCs) were part of a system delivery redesign to improve patient centered care that utilized disease registries to expose care opportunities, adoption of standardized clinical standards, and use of health care teams to create new relationships with activated, empowered patients. The purpose of this study was to explore the perceived experiences of POHCs as they delivered quality chronic care to patients. Field research was conducted at seven primary care family medicine or internal medicine clinics within a clinic organization and consisted of seven interviews with POHCs. The research question was how do POHCs describe the experience of their role in primary care clinics’ implementation of the Chronic Care Model? To interpret interview transcripts, NVivo software assisted analysis and themes emerged. By using the Transtheorectical Model of behavior change with motivational interviewing, POHCs assisted patients to explore their ambivalence, move toward positive goal setting, and learn skills necessary for self-management. Physician Office Health Coaches identified chronic care delivery opportunities by creating and maintaining a disease registry which in turn nurtured a relationship with patients. They utilized the techniques of motivational interviewing to assist patients in goal setting and tracked patient progress through chart reviews. Acting as an extension of the doctor, being an advocate for patients, and a resource for information were all roles for coaches. The POHCs also challenged old ways of delivery to try new processes using PDSA cycles.

		Dissertation (6063 kb)


Nursing Students' Self Efficacy Following Participation in a Service Learning Teaching Activity, Smid, Mary Kay

	The role of nurse as teacher plays a significant part in maintaining wellness of clients. Students must build professional confidence in their ability to teach health care content. Students learn content, skills and attitude so they can teach content, skills and impact clients’ health. Nursing literature supports service learning as an effective means of preparing students for active, professional community roles. This mixed method quasiexperimental study examined whether or not nursing students experienced increased self efficacy related to client teaching following participation in a service learning teaching activity. Quantitative research questions explored potential relationship of increased content knowledge and increased awareness of service learning as a means of learning after participants completed a service learning teaching activity. Participants scored significantly higher on post-content assessment then on pre-content assessment (t = -4.268, df = 41, = 0.000). Participants scored higher on the post- service learning survey than on the pre-service learning survey (t = -2.148, df = 41, = 0.041). Qualitative research explored possible increase in student effectiveness in client teaching after participating in a service learning teaching activity. Attitude, content, knowledge and skills were identified as qualitative themes. When principles of nursing education are combined with service learning nursing students are better prepared to teach as nurses in a community setting. Longitudinal research studies are needed to explore the effectiveness of service learning when introduced at the beginning of a nursing curriculum when students have multiple opportunities to experience self efficacy related to skills needed in a community setting.

		Dissertation (134 kb)


Psychiatric Nurses' Perceptions of Competence In Developing Therapeutic Relationships, Taylor-Trujillo, Ann

	Psychiatric Nursing as a specialty is over 100 years old. The specialty has roots to the Mental Health Reform Movement of the 19th century, which reorganized mental health asylums into hospital settings. Throughout the progression of this specialty, one skill that has created the foundation of psychiatric nursing practice is the one-to-one therapeutic relationship. As with the entire nursing profession, psychiatric-mental health nursing is undergoing significant difficulty in recruiting and retaining nurses in the profession due to many obstacles created by current conditions in acute care units in psychiatric hospitals. A qualitative study with phenomenological approach was used since the objective of the study was to explore the perceptions of nurses actually working in the field of psychiatric nursing. Four themes and subthemes emerged from the data analysis; the role of the nurse, with subthemes of patient safety, unit management, patient support, and nursing tasks; trust development based on three subthemes, person-centered, communication/listening, and boundaries; skill acquisition through life experiences, ongoing education, and observation of others’ skills; and the final theme was student experiences regarding recruitment to the specialty of psychiatric nursing.

		Dissertation (289 kb)


Measuring Changes in Attitude, Skill and Knowledge of Undergraduate Nursing Students after Receiving an Educational Intervention in Intimate Partner Violence, Wallace, Connie M.

	The purpose of this quasi- experimental study was to determine whether an educational intervention had an effect on nursing students' perceived attitudes, skills, and knowledge regarding Intimate Partner Violence (IPV). The research question was as follows: Is there a difference in nursing students' perceived attitudes, skills, and knowledge after an educational intervention than before the educational intervention? The nursing profession is uniquely positioned to make a difference in the lives of adults and children who experience the harsh reality of IPV. Literature findings indicated nurses often believe themselves to be ill-equipped to offer appropriate and beneficial interventions. This study employed an educational intervention in the form of a two credit hour elective nursing course and assessed its effectiveness as measured through perceived change in student attitudes, skills, and knowledge. A variety of active learning strategies were used in the elective nursing course designed for this study. The experimental sample had a total of 20 participants, and the control sample had a total of six participants. Repeated measures ANOVA were used to analyze the data. Qualitative responses were obtained through the use of short answer questions. The experimental group mean scores indicated an improvement in attitude, skills, and knowledge. There was a statistically significant difference in 11 the mean scores for attitude (P < .01). The mean scores for skills and knowledge increased, but were not statistically significant. Findings from this study suggested that students who received education and structured learning experiences related to IPV intervention have a positive change in attitude, skills and knowledge. Further research is recommended to assess whether these changes diminish over time, after completion of the course. It may also be of interest to examine the effects of personal experiences with IPV in students and nurses who provide care to clients who experience IPV.

		Dissertation (887 kb)


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