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.

  • 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.

  • 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"

  • Appreciative Inquiry to Transform Nursing Practice for Mentoring Children of Promise

    Author:
    Kathleen Falk
    Year of Dissertation:
    2013
    Program:
    Nursing Studies
    Advisor:
    Margaret Lunney
    Abstract:

    Abstract APPRECIATIVE INQUIRY TO TRANSFORM NURSING PRACTICE FOR MENTORING CHILDREN OF PROMISE By Kathleen Falk Advisor, Professor Margaret Lunney A Nurse-Mentoring Program based on Peplau's Interpersonal Relationship Theory (1952) and Erickson, Tomlin and Swain Modeling and Role Modeling Theory (1983) was implemented to promote optimum health and educational outcomes among children at high risk for intergenerational incarceration. The aim of this study was to reflect on the existing strength and effectiveness in the nurse-mentoring program for children with incarcerated parents, to lead the nurse-mentors in discovering what is important, and build a collective vision of the preferred future for mentoring this population. Through the appreciative inquiry (AI) process, a type of action research, nurses transformed their practice in assisting children toward healthy behaviors. Participants were RNs who enrolled in a Baccalaureate program and worked for at least 60 hours in the role of nurse-mentor. Data were collected through individual interviews and focus groups that resulted in consensus for an action plan. A dialectic-hermeneutic approach was employed to interpret the texts of participants who experienced working with Children of Promise and construct personal meaning from them. An action plan was implemented and evaluated after three months. Based on the evaluation, conclusions were drawn and a collective view emerged regarding best nurse-mentoring practices for this program and implications for other programs for children with incarcerated parents. The nursing theories were effective in helping participants to establish relationships with children in the context of mentoring.

  • Oncology Nurses and the Lived Experience of Participation in an Evidence-Based Practice Project

    Author:
    Mary Fridman
    Year of Dissertation:
    2011
    Program:
    Nursing Studies
    Advisor:
    Keville Frederickson
    Abstract:

    Abstract ONCOLOGY NURSES AND THE LIVED EXPERIENCE OF PARTICIPATING IN AN EVIDENCE-BASED PRACTICE PROJECT by Mary Fridman Nursing practice based on evidence is linked to improved patient outcomes. Barriers to evidence-based practice (EBP) in nursing have been identified at the individual nurse level, but recently increased attention has been paid to barriers at the organizational system and contextual level, and recommendations for organizational-level changes have been made and in some cases implemented. A gap in the EBP implementation literature is the qualitative study of the experiences of nurses who have engaged in EBP and is herein proposed as a prerequisite to the design of intervention studies. This paper presents a qualitative study using the phenomenological approach of M. Van Manen (1990) with the underlying philosophy developed by E. Husserl (1931). This study uncovered the lived experience of nurses' participation in an EBP project and drew from the experiences of nurses who had participated in an EBP project within an oncology academic hospital-based nursing setting that contains an organizational infrastructure of EBP. The Power as Knowing Participation in Change theory was found to be applicable to the findings. Keywords: Implementation science, Evidence-Based Practice, Qualitative, Phenomenology, Barrett's theory of power

  • Afro-Caribbean Mothers' Cultural Perceptions of their Child's Weight and Food Practices in London and New York

    Author:
    Heather Gibson
    Year of Dissertation:
    2013
    Program:
    Nursing Studies
    Advisor:
    Keville Frederickson
    Abstract:

    The World Health Organization has argued that greater efforts are needed to prevent and manage childhood obesity. In urban cities, the Black sub-group of Afro-Caribbeans has a high rate of childhood obesity and overweight. The purpose of this study was to analyze Afro-Caribbean mothers' cultural perceptions in London and New York regarding childhood weight and food practices in children age 6 to 12 years. This qualitative content analysis, guided by the Developmental Niche, used a purposive sample of 30 Afro-Caribbean mothers to illuminate cultural perceptions of food and weight in their children. Semi-structured in- depth interviews were conducted with 15 mothers in both London and New York City. Each participant completed a demographic questionnaire that also included two quantitative questions. The first measured mother's perception of weight using a visual image and the other assessed the written description of the child's weight. The eight themes that emerged were: perceptions of childhood obesity within the general population; parents' role in child obesity; physical activity (PA); weight of child; cooking techniques; types of food consumed; food is a social bond that connects child with others; and food preparation varies according to families. Additionally, there were 29 subthemes such as: extracurricular PA is expensive, lack of knowledge about what constitutes a healthy weight, health care provider's involvement, cultural techniques modified and eating as a way to maintain cultural rituals. More than one-quarter of the mother's (27%) in both London and New York had overweight or obese children. In general, mothers tended to select a visual image that showed their children at a lower weight than their actual size. Furthermore, most mothers of overweight and obese children did not perceive their children as such in their responses to the visual images. The implications for nursing practice and future research include increasing cultural competence for nurses, health care providers and students; increasing parent education regarding healthy food substitutes and weight recognition; developing policies to increase physical education for children; and providing weight and nutrition interventions to the extended family.

  • Hypertension Knowledge, Expectation of Care, Social Support, and Adherence to Prescribed Medications of African Americans with Hypertension Framed by The Roy Adaptation Model

    Author:
    Andrea Grant
    Year of Dissertation:
    2013
    Program:
    Nursing Studies
    Advisor:
    Keville Frederickson
    Abstract:

    Hypertension (HTN) prevalence in African Americans contribute to higher rates of disabilities and deaths from stroke, myocardial infarction, and end stage renal disease than all other racial groups in the United States. The major reason documented for these poor health outcomes is related to lower HTN control rates among African Americans compared to other racial/ethnic groups. Though overall HTN awareness, pharmacological treatments and control have significantly improved for all populations, studies found that rates of HTN control and adherence with anti-hypertensive medications are lower for African Americans compared to other subgroups. Study Aims The primary aim was to determine whether hypertension knowledge, expectation of care, and social support are predictors of adherence to prescribed medications while controlling for socioeconomic factors in the context of hypertension among African Americans. Methods A cross sectional quantitative approach was used. A secondary data analysis was conducted with 387 hypertensive African Americans. The Morisky Medication Adherence scale was used to measure adherence, internal consistency was established, (r=.61). The Roy Adaptation Model (RAM) was used to link HTN knowledge, expectations of care, social support, and socioeconomic factors with adherence to medications to provide an understanding of the process of adaptation. Logistic regressions were used to determine the relationships among the variables. Results The sample (N=387) was primarily female (76%) and men (24%). On average, participants scored high in knowledge about hypertension; mean knowledge score was .91 (SD = .09). Controlling for patient covariates, hypertension knowledge was not found to be a predictor of adherence to prescribed medications (p=.469). Expectation of care was found to be a predictor of adherence to prescribed medications (p=.008); social support was found to be a predictor of adherence to medications (p=.006). Conclusion and Implications This study supports findings regarding expectations of care, social support, and adherence to medication in African American patients with hypertension. The findings are useful for planning patient management initiatives specific to chronic disease such as hypertension.