Alumni Dissertations

 

Alumni Dissertations

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  • Clinical Nurse Faculty and the Lived Experience of Clinical Grading

    Author:
    Bernadette Amicucci
    Year of Dissertation:
    2011
    Program:
    Nursing Studies
    Advisor:
    Keville Frederickson
    Abstract:

    Clinical grading is one approach to assure that future nurses have the knowledge and skills to provide safe patient care. The phenomenon being explored for this study was the experience of clinical grading for clinical nurse faculty. Through the use of a qualitative phenomenological method, the lived experience of grading nursing student clinical performance for experienced clinical nurse faculty in pre-licensure programs is described. Eleven full-time nursing faculty were recruited using a purposive technique to obtain a convenience sample. Each participant first underwent an initial in-depth personal interview followed by a brief follow-up interview a few weeks later. The van Manen method of hermeneutic phenomenology was applied to describe and interpret the data while developing an understanding of the experience for the participants. Findings from this study revealed five essential themes. These essential themes were collated to form a textual interpretive statement which illuminated the meaning of the experience of clinical grading for the participants. Barrett's theory of Power as Knowing Participation in Change emerged as one way to reflect on the findings in a way that was meaningful to nursing. Recommendations for future research and implications for nursing are identified.

  • Examining the association of medication complexity with health-related quality of life in older adults receiving community-based long term services and supports

    Author:
    Claudia Beck
    Year of Dissertation:
    2014
    Program:
    Nursing Studies
    Advisor:
    Kathleen Nokes
    Abstract:

    Abstract EXAMINING THE ASSOCIATION OF MEDICATION COMPLEXITY WITH HEALTH-RELATED QUALITY OF LIFE IN OLDER ADULTS RECEIVING COMMUNITY-BASED LONG TERM SERVICES AND SUPPORTS by Claudia A. Beck Adviser: Dr. Kathleen Nokes While the complexity of a medication regimen is a concern for all individuals, it is of significant concern for community-dwelling older adults who often require multiple medications to treat chronic health problems. Health related quality of life (HRQoL) has been identified as a key quality outcome measure when assessing care of older adults, particularly those with long-term care needs. Although the use of multiple medications has been widely explored in the literature, there is a paucity of data regarding the combination of several medication-related factors (number of active medications, therapeutic drug class, and medication regimen complexity) and HRQoL in older adults. Wilson and Cleary's health-related quality of life conceptual model was the theoretical framework used to guide this study. This secondary analysis examined the relationship among the number of active medications, the number of therapeutic drug classes, and medication regimen complexity and HRQoL in community-dwelling older adults (68% Hispanic, 75% female) who were recent recipients of home and community-based services (H&CBS). The subjects in this study (N =123) were enrolled in a large, multi-site study (N=470) (R01-AG025524, PI, M. Naylor). Medication-related data were obtained from medical charts, counted to include the active number of medications as all prescription and over the counter drugs (mean =9.3), and a therapeutic drug class tool (mean =4.9) measured the number of distinct therapeutic drug classes included in a medication regimen. Medication regimen complexity (mean = 20.6) was measured using the Medication Regimen Complexity Index (MRCI). The Medical Outcomes Study Short Form (MOS SF-12 v2) physical (PCS) and mental component scores (MCS) measured HRQoL. After controlling for age, gender, education, race, ethnicity, marital status and cognitive status, it was determined that the number of active medications (beta coefficient -.497, p=.012) was a key predictor of physical health-related quality of life, while therapeutic drug class and medication regimen complexity were not associated with either physical or mental health-related quality of life. The number of medications impacts on physical health-related quality of life but the directionality of that relationship is not clear; there were no significant effects on mental health-related-related quality of life and medication-related variables. Keywords: Older adults, active medications, therapeutic drug class, medication regimen complexity, community-based long term services and supports.

  • The Relationship of Nursing Career Perception Congruence and Perceived Social Support on Hispanic Middle School Female Nursing Career Choice

    Author:
    Karen Bourgeois
    Year of Dissertation:
    2014
    Program:
    Nursing Studies
    Advisor:
    Keville Frederickson
    Abstract:

    The purpose of this study was to examine the relationship of nursing career perception congruence and perceived social support on Hispanic middle school females' nursing career choice. A non-experimental descriptive, cross sectional design examined the relationship in a convenience sample of 200 Hispanic middle school females from the New York tri-state area. Instruments used to measure nursing career choice, nursing career perception congruence, and perceived social support, were: (1) the Nursing Career Choice Questionnaire (NCC); (2) Attitudes, Values, and Beliefs Scale (AVBS); and (3) the Child and Adolescent Social Support Scale (CASSS) .Multinomial logistic regression analyses indicated support for the relationship between all variables. There was a positive significant relationship between nursing career choice and nursing career perception congruence and a positive significant relationship between perceived social support and nursing career choice. The conceptual framework of Lent, Brown and Hackett's Social Cognitive Career Theory revealed that nursing career perception congruence and social support is needed to promote nursing career choice. Nursing career choice, nursing career perception congruence and perceived social support are environmental factors that influence the nursing career choice of Hispanic middle school females.

  • Hypertonic Lower Extremities in Infants: Correlation to Motor Function Scores at Thirteen Months of Age

    Author:
    Susan Brillhart
    Year of Dissertation:
    2013
    Program:
    Nursing Studies
    Advisor:
    Martha Whetsell
    Abstract:

    Exploring a large data set, hypertonicity of the lower extremities has been incidentally identified as occurring in one out of every five infants, whether term or preterm. This retrospective, longitudinal, descriptive, quantitative study examined data from 463 functionally and structurally normal infants and identified infants that were considered to be hypertonic at either hospital discharge and at one month of corrected gestational age to determine what their motor capabilities were at 13 months of age. Understanding the correlation will assist in determining whether early intervention is indicated for these infants. Multiple statistical analyses revealed no correlation between hypertonicity as a young infant and the Bayley-II motor function score at 13 months of age. The Roy Adaptation model was used as the conceptual framework of the study and ordinal regression was utilized to analyze the data.

  • "If She Can Do It, So Can I" An Ethnography of a Supportive Living Environment for Women in the Criminal Justice System and their Children

    Author:
    Regina Cardaci
    Year of Dissertation:
    2014
    Program:
    Nursing Studies
    Advisor:
    Barbara DiCicco-Bloom
    Abstract:

    There are now more women in prisons and jails than at any time in United States history. A large number of these women will be returning to the community. Women returning to the community after release from prison or jail face numerous challenges to successful reentry, e.g., securing housing and employment. In addition, following separation and care of their children by others, women with children struggle to resume their roles as mother. This dissertation is an exploration of a program that assists women transitioning from incarceration to the community. This program helps women by helping to develop job skills and offering assistance in finding permanent housing. Another goal of the program is to facilitate mothering and thereby improve family relationships. In addition, these women are offered counseling, substance addiction services, and assistance in navigating the complicated parole system. This study aims to discover how the participants experience and conceptualize this program. Although the program's success is of interest, this thesis does not constitute a formal evaluation. v An ethnographic approach was used to collect the data; specifically, the methods used included participant observation; and in-depth interviews with the women and the staff, as well as with the executives who are the administrators of this organization. After a year of data collection through participant observation and interviews, three common themes emerged: parenting the parent; the impact of competing demands, and power: If she can do it, so can I. These themes recurred throughout the women's stories.

  • The Lived Experiences of Transition to Adult Healthcare in Young Adults with Cerebral Palsy

    Author:
    Ellen Carroll
    Year of Dissertation:
    2013
    Program:
    Nursing Studies
    Advisor:
    Carol Roye
    Abstract:

    Background: Health Care Transition (HCT) describes the purposeful, planned movement of adolescents from child to adult-orientated care. The purpose of this phenomenological study is to uncover the meaning of transition to adult centered care as experienced by Young Adults with Cerebral Palsy (YA-CP) through the research question: What are the lived experiences of young adults with cerebral palsy transitioning from pediatric to adult healthcare? Method: 6 females and 3 males, aged 19 -25 years of age, who identified as carrying the diagnosis of cerebral palsy without cognitive impairment were interviewed. Giorgi's (1985) method for analysis of phenomenology was the framework for the study and guided the phenomenological reduction. Results: The lived experiences of YA-CPs transition to adult health care, expressed from the data is expert novices with evidence and experience based expectations, negotiating new systems (effective/ineffective) interdependently (parents and provider support) accepting less than was expected. Conclusions: More information and support is needed for the YA-CP during transition to ensure a well-organized move to appropriate adult-oriented health care that is considerate of the lifelong impact of the disorder. Nursing's role as advocate, mentor and guide can optimize the individual's response to the transition process.

  • Torah True: The Lived Experience of Orthodox Jewish Registered Nurses

    Author:
    Barbara Cohen
    Year of Dissertation:
    2013
    Program:
    Nursing Studies
    Advisor:
    Keville Frederickson
    Abstract:

    Abstract TORAH TRUE: THE LIVED EXPERIENCE OF ORTHODOX JEWISH REGISTERED NURSES By Barbara Cohen Advisor: Professor Keville Frederickson The purpose of this qualitative study was to explore the experience of female Orthodox Jewish registered nurses. Data analysis was accomplished utilizing van Manen's interpretive phenomenological approach. Understanding this phenomenon is of value to nurses, other healthcare professionals, and employers as it illuminates the experience of female Orthodox Jewish registered nurses, a religious minority, in their workplace. The research participants were Orthodox Jewish Registered Nurses in the New York tri -&ndash state area. The majority of participants had acute care nursing experience. A smaller subset of participants, unable to obtain hospital based positions, were employed in home health, fee for service, long term care and summer camp settings. In-&ndashd epth in person interviews were had with each registered nurse as well as briefer follow-up interviews. The six essential themes synthesized from the data were: I) Torah is my anchor and compass,/ II) Jewish girls do become nurses but it isn't easy,/ III) Navigating a hostile work place,,/ IV) Always striving, /V) Cultural competence for all, even for me/ and, VI) Give me an opportunity. >The concept of resilience was applied to account for the dichotomy presented by the participants' ongoing lived experiences: on the one hand being ostracized, bullied, and excluded and, on the other hand, rising above these experiences to show their commitment to the profession and competence as nurses, their persistence in the face of adverse conditions and their continued faith in G-&ndash d, Torah laws and rules, commitment to healing the world (tikkun olam);/, and to the Jewish people. The integrated essential essence of the lived experience of Orthodox Jewish Registered Nurses was defined as: Faith based (Torah) law, practice, and family customs provide the unshakeable primary anchor and compass of Orthodox Jewish Nurses who ask for the opportunity to join the profession, navigating professional nursing practice in sometimes challenging or hostile work environments while striving to provide and obtain cultural competence for all, including themselves. / Key Words:// Orthodox Jewish, Registered Nurses, religion, nursing, cultural competence, phenomenology, van Manen, faith-based nursing practice

  • Understanding Workplace Reciprocity of Emergency Nurses: A Qualitative Study

    Author:
    Christine Corcoran
    Year of Dissertation:
    2014
    Program:
    Nursing Studies
    Advisor:
    Keville Frederickson
    Abstract:

    Emergency nurses work with other health care providers under uncertain conditions to provide care to patients with all kinds of illnesses and afflictions from all walks of life. Despite implications that they must work together to accomplish their tasks, there are few studies that explore the relationships among emergency department personnel. Furthermore, there are even fewer that focus on the way emergency nurses work together to provide care to their patients. The purpose of the study was to understand the lived experience of workplace reciprocity of emergency nurses through the use of a qualitative phenomenological method. Nurses with three or more years of current emergency nursing experience were recruited using a purposive technique to obtain a convenient sample. Each participant was interviewed. The data was analyzed and interpreted using Giorgi's Phenomenological Method. Findings from this study identified six essences: emergency department culture, balancing, technology, caring, bridging, and connection. These essences of the participants' experiences were synthesized. Workplace reciprocity between and among emergency department nurses is influenced by the emergency department culture, balancing, and technology on caring for patients and each other as seen in the bridging and connection for the purpose of creating and maintaining workplace relationships. This statement synthesized the meaning of workplace reciprocity among this sample of emergency nurses for this study. Paterson and Zderad's Humanistic Nursing Theory emerged as a way to reflect on the findings in a way that was meaningful to nursing. Implications for nursing practice and recommendations for future research are identified.

  • The Experience of the Listener and the Storyteller When a Traumatic Event is Shared Within the Dyad

    Author:
    Jeanne Cummings
    Year of Dissertation:
    2011
    Program:
    Nursing Studies
    Advisor:
    Keville Frederickson
    Abstract:

    Abstract THE EXPERIENCE OF THE LISTENER AND THE STORYTELLER WHEN A TRAUMATIC EVENT IS SHARED WITHIN THE DYAD by Jeanne Cummings, RN, MS, CS, NP, BC Advisor, Professor Keville Frederickson This qualitative study was done to illuminate the experience of the listener and the storyteller when a traumatic event is shared within the dyad. Nurses often care for their patients within the nurse-patient relationship that constitutes a dyad. Individuals who have experienced traumatic events may share their experience with nurses in story form. Repeatedly listening to these stories may have consequences for these nurses. Understanding the experience of both members of the listener-storyteller dyad can be valuable for nurses who are very often the listener for their patient storytellers. The research participants consisted of dyads; each with a storyteller and a listener. The storytellers were from a group of people involved in the crash-landing of a commercial jetliner that came to be known as the "Miracle on the Hudson." Each storyteller chose a listener who had previously listened to them share the story of this traumatic event. The author conducted an in-depth interview with each individual storyteller and listener. Interviewing both members of the dyad was a way to shed light on their experiences in a way that could not be done by interviewing only 1 individual. The phenomenon was explored using an interpretive phenomenological approach outlined by van Manen. The Roy Adaptation Model of Nursing (RAM) was found to be applicable to the findings of this study. Keywords: Trauma, storytelling, listening, dyad, nursing, "Miracle on the Hudson"

  • The Lived Experiences of Nurses Caring for Dying Pediatric Patients

    Author:
    Danna Curcio
    Year of Dissertation:
    2014
    Program:
    Nursing Studies
    Advisor:
    Martha Whetsell
    Abstract:

    The purpose of this research study was to explore the lived experiences of nurses caring for dying pediatric patients. Nurses and health care professionals may at times have difficulty adjusting and processing when life ends and this may have the potential to interfere with patient care. Reflection on past events and actions enable critical discovery of strategies to benefit both nurses and patients. The method for conducting this research study was from a qualitative phenomenological perspective exploring the lived experiences of nurses caring for dying pediatric patients. The philosophical underpinning of Merleau-Ponty (2008), in combination with the research method of van Manen (1990), was used for this research study. Nine female nurse participants, with between 1 and 4 years experience were interviewed. The meaning of the context of the lived experiences of nurses caring for dying pediatric patents uncovered seven essential themes of empathy, feelings of ambivalence, inevitability, inspiration, relationship, self-preservation, and sorrow bringing to a close that through the lived experiences of nurses caring for dying pediatric patients an overall theme of censoring becomes apparent. The Roy Adaptation Model (RAM) (Roy & Andrews, 1991; Roy, 2009) was found to be a nursing model that helped to understand that the nurse is an adaptive system functioning for a purposeful cause.