Alumni Dissertations

 

Alumni Dissertations

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  • An Investigation of the Relationship between Nursing Faculty Attitudes toward Culturally Diverse Patients and Transcultural Self-Efficacy

    Author:
    Emma Kontzamanis
    Year of Dissertation:
    2013
    Program:
    Nursing Studies
    Advisor:
    Keville Frederickson
    Abstract:

    This descriptive study was designed to examine the relationship between nursing faculty attitudes toward culturally diverse patients and transcultural self-efficacy (perceived confidence in performing transcultural nursing skills). Nursing faculty are the educators of the largest group of health care providers. As such, they can have the greatest impact on student development of cultural competence and the provision of culturally competent care which promotes positive patient outcomes. The Cultural Attitude Scale, the Transcultural Self-Efficay Tool, the Social Desirability Scale and a demographic information sheet were completed by a sample of nursing faculty (N = 65) from a large northeastern public college system. Psychometric evaluation of the instruments indicated reliability. Significant findings were that the older, longer licensed faculty had a more positive attitude toward the White and Asian patient and faculty who received their basic nursing education in the U.S. had a more negative attitude toward the Black patient. A decline in mean scores of attitude over the last 20 years indicated a more negative attitude toward culturally diverse patients. There was no difference in transcultural self-efficacy scores for faculty with formal and/or informal education in transcultural nursing and those with no formal or informal education in transcultural nursing. Recommendations for future research include investigating the variables separately, conducting qualitative and mixed method studies with faculty and instrument refinement and development.

  • Role Stress, Eating Behaviors, and Obesity in Clergy

    Author:
    Nancy Manister
    Year of Dissertation:
    2012
    Program:
    Nursing Studies
    Advisor:
    Eileen Gigliotti
    Abstract:

    Purpose: This study, based on The Neuman Systems Model (Neuman, 2011) and Kahn and colleagues (1964) Organizational Role Theory, examined the relations between role stress, eating behaviors, and obesity in Lutheran Church Missouri Synod clergy. Method: This was a randomized, cross sectional, web based study (N = 430), response rate 38%. Variables were measured by the Role Conflict and Ambiguity Scales (Rizzo, House, & Lirtzman, 1970); Emotional and Restrained Eating Behavior Scales of the Dutch Eating Behavior Questionnaire (Van Strien, Frijters, Bergers, & DeFares, 1986), and self-report of height and weight for BMI calculation. Findings: Obesity was high (overweight/obese 81.4%, obese 36.7%). Emotional eating behavior partially mediates the relation between role stress and obesity (∼ 77 - 78%), and restrained eating was not a mediator. In ancillary analysis, restrained eating was found to moderate the relation between emotional eating and obesity. Low social support was the most significant contributor to role stress (r = -.41, p < .0001), which was moderate. Conclusions: Emotional eating partially mediates the relation between role stress and obesity. Restrained eating appears to moderate the relation between emotional eating and obesity. Future studies should examine the relation between role stress and the ability, rather than the intent, to restrain eating. Regarding Neuman's model, revisions to tests of relations between the normal line of defense and core response were proposed.

  • The Lived Experiences of Dominican Women with Stage IV Breast Cancer

    Author:
    Alsacia Pacsi
    Year of Dissertation:
    2010
    Program:
    Nursing Studies
    Advisor:
    Keville Frederickson
    Abstract:

    ABSTRACT The Lived Experiences of Dominican Women with Stage IV Breast Cancer by Alsacia Lorena Pacsi MS, RN, FNP, CEN, CCRN Background: The diagnosis of breast cancer, for most, elicits anxiety and fear due to the disease and treatment process which usually has a devastating effect on the person, both physically and emotionally. Would ethnicity change or modify this stereotypical response? This study was done to illuminate the perceptions of Dominican women living with Stage IV breast cancer. Methods: This phenomenological study explored the lived experiences of Dominican women diagnosed with Stage IV breast cancer (advanced breast cancer) using a purposive sample of convenience to illuminate the perceptions of Dominican women living with advanced breast cancer. Six second-generation United States (US) born women of Dominican immigrants, residing in the New York City (NYC) area, underwent face-to-face in-depth interviews. Each participant was interviewed once and data analyzed using the descriptive phenomenological method of Amadeo Giorgi. Results: The four essences that unfolded in this study were uncertainty, coping, loving, and believing. The overall meaning of the experience of Dominican women with Stage IV breast cancer is described as one of uncertainty and unknowing, accepting the diagnosis so that thinking results in positive changes and healthy choices, enjoying life through the meaningful participation in the lives of others and accepting support and trusting in God through prayer, faith and hope to create ever lasting memories for their children. The synthesis of the overall structure for these women is to `leave a legacy of love.' Interpretation of the overall meaning of the experience and structure aligned with Roy's Adaptation Model (RAM) philosophic principles of humanism and veritivity (Roy & Andrews, 2009). The overall meaning of the experience, as expressed by the participants, was translated to and aligned with these principles. Conclusions: Analyzing the results of this research, one can infer that adaptation for the Dominican woman does not mean an acceptance of their illness, on the contrary. Adaptation in this case is an impetus to build a new environment and a new legacy for their children. Future studies should be done using qualitative and quantitative methodology in order to further explore the phenomenon of parenting in this population. .

  • Becoming Someone Different: A Grounded Theory Study of How Nurses Integrate Pregnancy and Full Time Employment

    Author:
    Paul Quinn
    Year of Dissertation:
    2013
    Program:
    Nursing Studies
    Advisor:
    Barbara DiCicco-Bloom
    Abstract:

    In the United States, 40% of the contemporary nursing workforce is comprised of women of childbearing age, 65% of whom are employed full-time. Hence, the likelihood of pregnancy occurring for this population at some point in their employment is high. A holistic exploration of how nurses integrate pregnancy and full-time employment has been lacking. The purpose of this research was to explore how primiparous nurses managed pregnancy and full-time employment. Using a grounded theory approach, nurses who were pregnant and delivered their first baby, while employed full-time on 12-hour work shifts, provided a firsthand account of how they incorporated pregnancy with employment. Nurses, as social actors, experience many interactions in their workplace environment. The basic social process, becoming someone different, emerged to explain those interactions and allowed a substantive grounded theory to be developed. From that exploration, the researcher will present the basic social process, becoming someone different, and the four core categories that arose from the analysis: 1) looking different, feeling different - to explain how the physical and emotional changes of pregnancy result in nurses looking and feeling differently about themselves as nurses; 2) expectations while expecting - where the nurse, with previous experiences and ideas about what is expected of her and what she expects from others, changes how she sees herself, based upon her interactions in the workplace with her peers and coworkers; 3) connecting differently - explains how the nurse, while pregnant, develops new relationships and interactions with the people in her environment, specifically her peers, coworkers and patients, and 4) transitioning labor - where, despite challenges from interactions within the workplace from coworkers or tasks, the participant nurses began to focus on their eventual maternity leave and working as long as possible up to the time of delivery in order to prolong that maternity leave

  • AN INVESTIGATION OF THE RELATIONSHIP AMONG SOCIAL SUPPORT, MOTIVATION, PERCEIVED COMPETENCE, AND PURSUIT OF A BACCALAUREATE DEGREE AMONG ASSOCIATE DEGREE NURSE GRADUATES

    Author:
    Margaret Reilly
    Year of Dissertation:
    2012
    Program:
    Nursing Studies
    Advisor:
    Keville Frederickson
    Abstract:

    The Institute of Medicine Reports of the last ten years highlight the increased complexity of health care and the need for new ways for health providers to respond. While other professional programs have adapted to the growing complexity of the healthcare system and implemented increased educational requirements for entry to practice, notably pharmacy and physical therapy, nursing has not, and remains the least educated among health professionals The growing trend towards a two year Associate Degree as the initial nursing education degree is increasing at the same time that patient needs are becoming more complicated and health care is becoming more complex. The changing environment of the healthcare system requires an adaptive response from nursing. There is a need to explore those factors that influence educational mobility towards pursuit of a baccalaureate degree among associate degree nurse graduates, the largest segment of the nursing workforce. This quantitative, non-experimental, cross-sectional descriptive study explored the relationship among social support, motivation, competence and the pursuit of a baccalaureate degree among associate degree nurse graduates. The Roy Adaptation Model was used to guide the research design and Self-Determination Theory was used in the interpretation. A sample of 267 associate degree nurses who graduated from the City University of New York between 1997 and 2007 participated in a computer assisted telephone survey. Questionnaires included the Medical Outcomes Social Support Survey, adapted versions of the Self-Regulation for Learning and Perceived Competence Questionnaires as well as some selected demographic questions. Significant predictors for pursuit of a baccalaureate in nursing degree among this population included younger age, non-Hispanic Black race, income range of $104K to $145K and autonomous regulation of learning. Significant differences were found in autonomous regulation and perceived competence between those who did and those who did not pursue a BS. Social support was not a predictor, although it correctly classified 87% of those who pursued a baccalaureate degree.

  • The Relationship of Work Stressors and Perceived Organizational Support on Front Line Nurse Manager Work Engagement

    Author:
    Anne Marie Simmons
    Year of Dissertation:
    2013
    Program:
    Nursing Studies
    Advisor:
    Donna Nickitas
    Abstract:

    Abstract The purpose of this study was to examine the relationship of work stressors and perceived organizational support on front line nurse manager work engagement. A non-experimental descriptive, cross sectional design examined the relationship in a convenience sample of 97 front line nurse managers from the New York tri-state area and members of the American Organization of Nurse Executives. Instruments used to measure work engagement, work stressors and perceived organizational support, were: (1) the Utrecht Work Engagement Scale (UWES); (2) Challenge-Hindrance Stressor Scale and (3) Survey of Perceived Organizational Support (SPOS). Pearson's correlation and linear regression analyses indicated support for the relationship between all variables. There was a negative direct relationship between work engagement and work stressors and a positive significant relationship between perceived organizational support and work engagement. The conceptual framework of Kahn's work engagement and the Job Demands-Resources Model revealed that organizational support is needed to promote front line nurse manager work engagement. Work engagement, perceived organizational support and work stressors are professional environmental factors that impact the leadership and well-being of FLNM. These factors, properly promoted and implemented, lead to FLNM's success, retention and job performance.

  • The Lived Experience of Caring Presence for Nursing Students and Nursing Faculty

    Author:
    Valerie Taylor-Haslip
    Year of Dissertation:
    2013
    Program:
    Nursing Studies
    Advisor:
    Donna Nickitas
    Abstract:

    Abstract THE LIVED EXPERIENCE OF CARING PRESENCE FOR NURSING FACULTY AND NURSING STUDENTS by Valerie Taylor-Haslip, MS, RN, FNP Adviser: Professor Donna M. Nickitas The lived experience of caring-presence phenomenon may have meaning for nursing faculty and nursing students, but is not sufficiently researched in the discipline of nursing. This hermeneutic phenomenological qualitative study is designed to understand the lived experience of caring presence within the context of the nursing faculty and nursing student relationship. Nine full time tenure track nursing faculty and six full time clinical nursing students participated, by means of in-depth interviews describing the meaning of caring presence within a nursing faculty-nursing student relationship. The van Manen phenomenological approach was used as the applied methodology for interpretation and reflection of the findings for this study. The findings of the study reveal caring-presence is a distinct phenomenon with five interconnected essential themes that illuminate the experience. Paterson and Zderad's Humanistic Nursing Theory and Jean Watson's Transpersonal Caring Relationship were used as a framework to reflect upon the findings. The research findings have implications for continued research in the development of caring-presence as a concept and as a phenomenon. The implications for nursing education include development of pedagogical approaches, teaching and learning strategies, and caring science curriculum development based upon the caring-presence relationship of nursing faculty and nursing students. The caring-presence relationship between nursing faculty and nursing students transforms both the faculty and the student.

  • The Effect of an Educational Model, Developing Nurses' Thinking (DNT), on Nursing Students' Accurate Diagnoses of Patients' Responses to Health Problems

    Author:
    Mary Tesoro
    Year of Dissertation:
    2011
    Program:
    Nursing Studies
    Advisor:
    Margaret Lunney
    Abstract:

    Abstract The Effect of an Educational Model, Developing Nurses' Thinking (DNT), on Nursing Students' Accurate Diagnoses of Patients' Responses to Health Problems By Mary G. McCaffery Tesoro This was a quasi-experimental study, pretest and posttest design, to determine whether use of the Developing Nurses' Thinking (DNT) model during two weeks of clinical post conferences improved nursing students' diagnostic accuracy. The DNT model integrates four constructs, patient safety, domain knowledge, critical thinking processes, and repeated practice, to guide students' thinking when interpreting patient data and developing effective plans of care. Two accompanying worksheets helped students to operationalize the model and provided guidance for thinking processes. Students (N = 83) from two baccalaureate degree programs in the first clinical nursing courses volunteered to participate in the study. Two sets of two parallel case studies were developed for the pretest and posttest and validated by three experienced faculty. Diagnostic accuracy was measured on a seven point scale using the Lunney Scoring Method. Statistical analyses included independent t - test, paired t - test, and general linear regression modeling. The results were that both groups of students varied widely in accuracy of nursing diagnosis. The hypothesis was supported in that the intervention group had statistically significant improvement in accuracy posttest scores compared to those in the control group. The results were consistent with previous studies that accuracy varied and use of a teaching aid such as the DNT model helped nursing students to improve accuracy. The implications are that use of a model that integrates the constructs of patient safety, domain knowledge, critical thinking process, and repeated practice, the DNT model, may help nursing students to develop effective thinking habits in the context of patient safety and improve diagnostic accuracy.

  • The Lived Experience of Puerto Rican Single Mothers Raising Children in a Violent Community

    Author:
    Mirian Zavala
    Year of Dissertation:
    2012
    Program:
    Nursing Studies
    Advisor:
    Keville Frederickson
    Abstract:

    The Live Experience of Puerto Rican Single Mothers Raising Children in a Violent Community by Mirian Zavala, M.S.N., R.N. Advisor: Professor Keville Frederickson The prevalence of single mothers in the United States continues to increase. Adding to the pressures of single mothering is raising their children in a violent community. In the Bronx, where this study was conducted, Hispanics now represent more than 51% of the population up from 48.4% in 2000. In 2004, nation-wide, 26.6% of the Hispanics of Puerto Rican descent lived in single parent households. The lived experience of Puerto Rican single mothers was examined using qualitative research based on van Manen's method. Each of the five participants were interviewed and told their story about living as a Puerto Rican single mother raising their children in a violent community. The six themes that emerged were: protection, family and friends, portending doom, belief in God, carrying extra loads, and turning points. The transformed essence that emerged was that Puerto Rican single mothers raised their children in a violent community by: protecting and monitoring their children's whereabouts through portending doom. They cope with bad situations by relying on family and friends, believing in God, carrying extra loads, and creating turning points. The nursing model, the RAM, was integrated into the essence statement, which stated that these women were able to adapt to a life of needing to protect their children, and the use of family and/or trusted neighbors in order to raise their children in a violent community by making positive choices at turning points. By portending doom rather than denying the events of the environment, they were able to protect themselves and their children. The belief in God, as a philosophical approach to their reality, provided a link between the Puerto Rican single mothers who were raising their children in a violent community and the concept of adaptation.