Permanent URI for this collection


Recent Submissions

Now showing 1 - 20 of 699
  • Item
    The journey and experiences of female Hispanic nurse leaders
    (December 2023) Dolinta, Jeniffer 1990-; Freysteinson, Wyona; Nava, Angeles; Clutter, Paula
    This study aimed to understand the experiences and perspectives of female Hispanic nurse leaders. Healthcare research suggests a diverse nursing leadership team is critical to delivering high-quality patient care. There is an evident gap in the literature regarding ethnic minority nursing leaders, especially Hispanic women. A phenomenological hermeneutic design was used to describe the lives of Hispanic female nurse leaders through their lens. The study objectives were to 1) Explore the perceptions of being a Hispanic female nurse leader, 2) Describe the trajectory to leadership for Hispanic female nurse leaders, and 3) Gather recommendations from female nurse leaders to guide the journeys of future Hispanic nurses pursuing leadership roles. Paul Ricoeur’s philosophical underpinning guided the semi-structured interviews of fifteen Female Hispanic nurses in formal leadership roles. Ricoeur’s Theory of Interpretation was used to analyze the text through three phases: naïve reading, environmental explanation, and phenomenological interpretation. The environmental analysis uncovered three themes that described the world in which leaders lived: family, culture, and healthcare organization. The phenomenological interpretation identified four phenomenological themes: weaving my life fabric, my inner dialogue, weight on my shoulders, and paving the way. The results of this study highlight the critical need for a diverse and inclusive nursing leadership team. By taking proactive steps to ensure equal opportunities, reducing barriers to career advancement, and developing supportive strategies, organizations and communities can address the challenges in attracting and retaining qualified ethnic minority nurses into leadership positions.
  • Item
    The relationship between anxiety and contraception methods in adult women
    (December 2023) Mogavero-Twist, Michelle 1974-; Cesario, Sandra; Liu, Fuqin; Tilley, Donna Scott
    ABSTRACT Anxiety disorders are significantly prevalent among adults in the United States, with steady increases over recent years. Women are nearly twice as likely to experience an anxiety disorder within their adult lifespan when compared to men. Few studies found have made attempts to explore causes for higher incidences of anxiety disorders in females. Until the etiology of anxiety in women is better understood, women could remain inadequately treated (Aquin et al., 2017; Goddard, 2017). This study was conducted using a non-experimental, descriptive correlational design to examine the relationship between methods of contraception and anxiety in adult women. Adult women who are genetically female, aged 18-52, and currently using any method of birth control or no birth control were recruited via e-mail invitation, exclusively to Texas Woman's University students, and via online social media platform Facebook (FB) with an active weblink that connected to the online consent and online survey software. Data was extracted from the online survey software into an electronic spreadsheet and placed into SPSS version 28 for statistical analysis. Descriptives, correlations, t-tests, ANOVA, and ANCOVA test were performed. A small amount of significance was found in relationships between anxiety levels in adult women and methods of contraception in one of three anxiety scales only, the GAD-7 (p = .02). However, mean anxiety scores were higher for all three anxiety scales for hormonal versus non-hormonal birth control users. These results could foster additional studies regarding hormonal influence on anxiety in women. The results could also encourage collaborative decision making between women and their providers when determining contraceptive methods.
  • Item
    Social determinants of health influential to medication adherence in Hispanic women with cardiovascular disease
    (December 2023) Reid, Amelia P 1955-; Richmond, Misty; Jennifer Woo; Colleen Halverson
    ABSTRACT AMY REID SOCIAL DETERMINANTS OF HEALTH INFLUENTIAL TO MEDICATION ADHERENCE IN HISPANIC WOMEN WITH CARDIOVASCULAR DISEASE The purpose of this study was to investigate the relationship between social determinants of health (socioeconomic-related, patient-related, treatment-related, condition-related, and health system-related factors) and medication adherence in Hispanic women with cardiovascular disease (CVD). The World Health Organization (WHO) Dimensions of Adherence Model postulates that medication adherence is influenced by factors in those five dimensions. A predictive correlational design was used to collect data on the dimensions in this framework. Medication adherence was measured using the Medication Adherence Report Scale (MARS-5). Patient-provider communication was evaluated using the Patient-Centered Communication for Cancer Care (PCC-Ca), and the Short Acculturation Scale for Hispanics (SASH) was used to measure acculturation. The data was analyzed using descriptive statistics, hierarchical linear regression, and one-way ANOVA. The first regression model included patient-provider communication and acculturation as predictors. Step 1 of the regression was significant, F (2,80 = 7.09, p = .001) and explained 15% of variance in medication adherence. Only patient-provider communication contributed significantly to the model (β = .385, p = <.001). After entry of the demographic variables in Step 2, the model was found to be significant, F (11,71) = 4.42, p = <.001) and that the total variance explained by the model was 40%. Patient/provider communication (β = .329, p =.004) and retired employment status (β =.422, p=>001) were found to contribute significantly to the model. There was no significant difference in medication adherence between first, second, and third generation groups (F (2,81) = .418, p = .659). Tukey’s HSD Test for multiple comparisons found that the mean value for medication adherence was not significantly different between first, second, and third generation groups. Assessment of social determinants of health as they relate to medication adherence is essential in the management of CVD. Assessment of the influence of social determinants of health on medication adherence is essential in the management of CVD. Nurses can play a valuable role in promoting adherence by collaborating with other members of the health care team and community partners to assess social determinants of health and develop strategies and programs to promote adherence behaviors. More research is needed to understand the causality of medication non-adherence in this, and other populations of patients diagnosed with chronic disease. Keywords: medication adherence, social determinants of health, cardiovascular disease Hispanic women
  • Item
    Vaccine hesitancy in Hispanic female registered nurses in the San Antonio area
    (December 2023) Martinez, Kathryn Shepperd 1966-; Pickens, Noralyn D; Spencer, Becky; Gullion, Jessica
    The purpose of this study was to reveal experiences of vaccine hesitancy of Hispanic female registered nurses working in healthcare facilities in South Texas during the COVID-19 pandemic. Stake’s case study design was chosen to provide a holistic, contextual view including interviews and artifacts that were meaningful to the participants. Purposeful sampling was used to recruit five participants who met the inclusion criteria. All participants were interviewed twice face to face, audio recorded, and transcribed verbatim. Demographic data was collected to describe the sample. The data were analyzed using Stake methodology and the framework of the SAGE Working Group on Vaccine Hesitancy. Prominent findings across all cases included workplace distrust, lack of employer messaging, changing messaging about personal protective equipment, lack of information, the negative effect of vaccine mandates, a rapidly developed vaccine, and participants who had never previously been vaccine hesitant becoming-hesitant to receive a COVID-19 vaccine. These findings were examined through an ethical lens as well as in the context of structural empowerment and psychological empowerment theories. The participants’ environments were found to be lacking in structural and psychological empowerment, leading to a lack of agency in decision making about protecting themselves from a deadly virus that resulted in distrust in their workplace. When a COVID-19 vaccine was offered, the participants lacked confidence in their workplaces as well as the vaccine itself.
  • Item
    Nurses' perceptions of clinical competency and individualized care in relation to solid organ transplantation
    (December 2023) Ramirez, Alicia 1975-; Ho, Tuong-Vi; Dr. Mikyoung Lee; Moore, Brenda; Cesario, Sandra
    This cross-sectional, descriptive correlational study examined nurses’ perceptions of transplant nursing competency (TNC) and individualized care (IC) levels for solid organ transplant (SOT) recipients, living donors, and their families while also exploring the relationships among nurse characteristics, TNC, and IC. Three hundred ninety-one participants, comprising U.S. nurses caring for SOT recipients, living donors, and their families, completed the survey. A TNC survey was developed based on Standards of Practice for Transplant Nurses and 88 items on a scale of 5-point Likert (1 = strongly disagree to 5 = strongly agree). The ICS-Nurse A & B survey measured the perception of IC, with 34 items on a 5-point Likert (1 = strongly disagree to 5 = strongly agree). The TNC and ICS-Nurse A & B are reliable instruments measuring transplant nurses’ perceptions of clinical competency and individualized care in relation to SOT recipients, living donors, and their families, as demonstrated by their reliability values falling within the range of (.827 - .990). The total TNC mean score was ‘good’ (M = 334.48, SD = 67.74), and the total IC mean score was ‘low’ (M = 64.96, SD 13.07). There was a strong positive correlation between TNC and IC levels (r = .969, p < 0.05). The nurse characteristics (age, gender, highest education level, scope of practice, years as an RN, years as an APRN, years in direct care for transplant patients, type of nursing setting, primary language, race, and ethnicity) predicted a 42.6% variation in the TNC levels (p < .001), and a 42.0% variation in the IC levels (p < .001). The nurse characteristics, age, gender, years as an RN, type of nursing setting, ethnicity, and race significantly influenced IC levels. Also, the TNC level was significantly influenced by the nurses' age, gender, years as an RN, type of nursing setting, and ethnicity. This study provides new evidence to explore transplant nursing practice, education/training, and research.
  • Item
    A phenomenological exploration of the lived experience of concurrent AND-BSN program graduates in the Southwestern U.S.
    (December 2023) Nelson, J. Michelle 1973-; Moore, Brenda; Kubin, Laura; Merritt, Linda
    In 2010, the Institute of Medicine released a policy brief advocating for increased opportunities for nurses to obtain higher levels of education for increasingly complex patient care demands. Nursing programs in the United States responded by adding options for associate degree graduates to obtain baccalaureate degrees, including the innovative partnership pathway, which allows students to complete the associate degree and baccalaureate degree requirements concurrently. This pathway continues to expand in popularity and has proven to be a valuable option that allows students to take advantage of cost-effective and time-efficient associate degree programs while also gaining the additional knowledge offered by the baccalaureate degree. A review of the nursing literature revealed information regarding implementation strategies for concurrent enrollment programs and general descriptions of the challenges and strengths of these programs. However, a gap was identified in the existing literature describing the student perspective. This study aimed to address this gap and explore the lived experience of concurrent enrollment ADN-BSN graduates for the purpose of identifying the rewards, complexities, barriers, and challenges of the pathway for students. A descriptive phenomenological approach was used to gather data from graduates of a large concurrent enrollment ADN-BSN program in the Southwestern United States. Colaizzi’s seven-step data analysis method was used to analyze data. Six themes were identified, including “Choosing the concurrent enrollment program option,” “Managing time,” “Financial considerations,” “BSN curricular attributes,” “Belonging and engagement,” and “Feelings about the program.” Information obtained from the study validated findings in the current literature and added to the overall understanding of the student experience. Analysis of the findings suggests that the concurrent enrollment pathway is a valuable option for students seeking the BSN degree and that there are important implications from the data for nursing educators and the nursing profession in general.
  • Item
    The impact of mandatory substance use disorder education on peer perception of impairment in nurse anesthesia care providers
    (December 2023) O'Con, Katrina Vice 1971-; Richmond, Misty; Cesario, Sandra; Moore, Brenda
    Peer perceptions of substance use disorder and the considerable bias and stigma towards those suffering from or recovering from SUD were the central focus of this study. Stigma may lead to impaired providers trying to overcome SUD alone rather than seek assistance from their colleagues. A gap exists in the literature examining perceptions of impairment between nurse anesthesia care providers (NACPs) with and without SUD education, the impact of demographics, and personal and professional factors that influence those perceptions. Therefore, this study aimed to determine the presence of and the relationships between SUD education, demographics, and personal or professional factors and nurse anesthesia care providers’ attitudes toward impairment among their colleagues. An electronic survey was sent to American Association of Nurse Anesthesiology members. Participants responded to a 55-item questionnaire, which included the Perceptions of Nurse Impairment Inventory. An independent t-test revealed that perceptions were more positive in NACPs who received SUD education (M = 62.44, SD = 7.124) than those who did not (M = 64.17, SD = 6.919). A multiple regression analysis was conducted to predict perceptions of nurse impairment from demographic characteristics. The model explained 4.5% of the variance in perceptions of nurse impairment, F(4, 185) = 3.220, p = .014, adj. R2 = .045. None of the four variables added statistical significance to the prediction, p < .0005, although age made the largest unique contribution to the model (beta = .218). Similarly, a multiple regression analysis was conducted to predict perceptions of nurse impairment from personal and professional factors. The model explained 5.4% of the variance in the perception of nurse impairment. Although none of these five variables added statistical significance to the prediction, F(6, 165) = 1.511, p = .178, adj. R2 = .018, years of nursing experience made the largest unique contribution (beta = .154), followed by a personal history of SUD (beta = .138). Recommendations for future studies include a longitudinal-designed study to correlate peer perceptions of anesthesia care provider impairment with specific educational content requirements and the incidence of SUD and perception among those providers.
  • Item
    The effectiveness of a web-based stress management intervention program for reducing burnout and stress in registered nurses working in high-risk labor and delivery units
    (December 2023) Nelson, Shellie 1971-; Cesario, Sandra; Malecha , Ann; Mbango, Catherine
    According to the literature, the high level of stress experienced by nurses is one of the leading causes of burnout in the profession (Shah et al., 2020). Long-term stress could hurt hospitals by making nurses unhappy, tired, underperforming, or considering leaving. Potentially detrimental results include lengthened hospital stays, increased incidences of medical errors, diminished health outcomes, and diminished levels of patient satisfaction (Schlak et al., 2021). Though there is a lot of research related to the stress nurses feel, there is a gap in the literature about how stress management strategies affect nurses' feelings of stress and burnout. Specific plans are needed to help nurses in high-risk labor and delivery settings deal with stress and avoid burnout. This study observed how a web-based stress management program assists nurses working in high-risk labor and deliver patient care settings feel less stressed and less burned out. This randomized controlled study included three online questionnaires and participation in the web-based BREATHE: Stress Management for Nurses program. One hundred and nine nurses from Texas and California working in high-risk labor and delivery units participated in this study. The Nursing Stress Scale (NSS) measured how stressed-out nurses thought they were. In addition, nurses' levels of burnout were measured using the Maslach Burnout Inventory (MBI). The outcomes of the research showed that there is a significant positive relationship between stress management and burnout with the usage of the BREATHE program. As this study's results indicated, participants who accessed the program showed an improvement in six of the seven subscales of the NSS and two of the three subscales of the MBI.
  • Item
    Social support and loneliness in black women experiencing COVID-19 food insecurity
    (May 2023) Kirkland, Tracie 08/02/1966-; Jennifer Woo; Cesario, Sandra; Mistric, Michael; Tucker, Wesley
    Historically, poverty and racial discrimination have been linked to food insecurity among the Black population, especially among older Black women. Food insecurity also has been linked to social support and loneliness, the latter of which has been exacerbated by conditions experienced during the COVID 19 pandemic. A lack of research about the relationship between social support, loneliness, and food insecurity during the COVID-19 pandemic among Black women who are food insecure prompted this study. The purpose of this study was to fill that gap in the literature. The two research questions developed for this study were focused on the relationships between the independent variables social support (emotional and instrumental), loneliness, and age and the dependent variable food insecurity and the capacity of the independent variables to predict the dependent variable. The data showed that instrumental support was a negative predictor of food insecurity whereas higher degrees of instrumental support were predictive of higher rates of food insecurity. The data also showed a significant negative correlation between age and food insecurity. Specifically, senior women reported less food insecurity than younger, nonsenior women. The introduction of a food insecurity screening protocol is indicated for Black women ages 45–64 living in Houston, Texas who are at various points along the food security/insecurity continuum.
  • Item
    Self-blame attribution in women with cervical cancer
    (August 2023) Minchew, Leigh Anne Jernigan 1969-; Cesario, Sandra; Richmond, Misty; Mbango, Catherine
    The purpose of this study was to determine the impact of self-blame attribution in women with cervical cancer. Although anecdotal information was available to support exploring the phenomenon in a vulnerable population of women with cancer, a gap in the literature existed. Since little is known about the impact of self-blame attribution in women with cervical cancer, a non-experimental, descriptive study was performed between August 2022 and March 2023. Of 415 women eligible to participate, N = 106 (25.5%) women 26-64 years of age completed an online survey. Of the participants, 78.3% reported affiliating with a religious faith, a majority of which were Protestant (42.5%) or Catholic (35.8%). About half of the participants were aware of the human papillomavirus (54.7%) and the HPV vaccine (55.7%). A majority (72.6%) had never received the HPV vaccine and were positive for HPV (89.6). Over half (57.5%) of the participants had experienced an unwanted sexual event in the form of being forced or pressured to have sex (38.7%) or had experienced a sexual assault/rape (18.9%). Descriptive statistics were used to describe the sample. Multiple linear regression was used to determine whether a relationship exists between self-blame attribution, psychological distress, and spiritual well-being and to identify how unwanted sexual experiences predict self-blame attribution. Psychological distress and having experienced a forced or pressured sexual event were noted as significant predictors of self-blame attribution. Bivariate statistics were used to correlate the data with a moderate association noted between behavioral and characterological self-blame in the population. Findings revealed a relationship exists between self-blame attribution, psychological distress, and spiritual well-being in women with cervical cancer although the strength of the relationship remains unknown. Future research is needed to promote health through assessment, intervention, and referral for self-blame attribution in this population.
  • Item
    The lived experiences of the intimate partner of a person who underwent a mastectomy
    (August 2023) Lane, Torina 1975-; Landrum, Peggy; Cesario, Sandra; Malecha , Ann
    The purpose of this study was to answer the research question: What are the lived experiences of the intimate partner who provided support post-operatively to a person (male or female) who underwent a mastectomy during the post-operative phase within the last one to five years? A qualitative research study was used. The study was conducted using a purposive sample to obtain rich descriptions of the lived experiences of intimate partners of a person who underwent a mastectomy. The study involved face-to-face and online platform audio recorded interviews which were analyzed using Colazzi’s (1978) seven step approach to phenomenological data analysis. A descriptive interpretative phenomenological approach was used to gain understanding of the lived experiences of partners of someone who provided support post-operatively to a person who underwent a mastectomy. Findings revealed four main themes: initial responses, aesthetics, communication through it all and resilience. Seven subthemes were also revealed: shock and pride, fearing the unexpected, changes in physical appearance, burdens of surgery, reassurance and supportiveness, and lack of support for intimate partners. The findings from the study may be used to inform nursing practice, nursing education, and future research studies of intimate partners that have provided support to a person that underwent a mastectomy during the post-operative phase.
  • Item
    Out-of-hospital cardiac deaths: Voices of African American family members
    (August 2023) Brandon, Judith Keziah; Littles, Sabrenda; Smith, Gabrielle; Ennis, Joyce
    African Americans experience higher rates of heart disease, which poses the greatest risk of sudden cardiac arrest (SCA). Sudden cardiac death occurs more frequently in residential homes and public locations and in these settings; it is characterized by the term out-of-hospital cardiac arrest (OHCA). Out-of-hospital cardiac arrests often has a high mortality rate and affects African Americans two times more than other races. When a family member dies unexpectedly, the surviving family members must resume their lives, while grieving their loss. There is limited research on the perspective of African Americans that experienced the sudden loss of a family member due to OHCA. This study contributed to the body of research on this phenomenon. Heidegger's hermeneutic phenomenology guided this interpretive phenomenological study to explore the experiences of African American adults whose family members died from OHCA. Ten one-on-one semi-structured interviews were conducted. The data transcribed from these interviews were analyzed using Colaizzi’s method for data analysis. Five themes were identified and represented in the following statements: I could have done something, I was open nerves, I can have a heart attack too, They died that day, and They are being removed. The findings showed that sudden death induced feelings of anger, disbelief, and shock among the participants. The findings suggest the need to educate the public about signs and symptoms of myocardial infarction, cultural training for healthcare professionals, and acknowledging the practice of stoicism as a coping mechanism in African Americans.
  • Item
    The effects of preschool day care, self esteem, and locus of control on the coping behavior of children in the first grade
    (1984-08) McKeighen, Rosemary; Anema, Marion; Bush, Helen; Nieswiadomy, Rose; Gudmundsen, Anne; Jennings, Glen
  • Item
    The experience of women who take virtual childbirth education classes
    (May 2023) Kramer, Kathryn 1977-; Malecha , Ann; Isik, Elif; Woo, Jennifer
    During 2020, the world faced an unprecedented shut-down to help curb the rising epidemic of Covid-19, a novel virus that was causing acute respiratory infections resulting in an abrupt increase in hospitalizations and death across the world. Formalized childbirth education has been a common way for expectant women and their partners to prepare for childbirth and parenting since the mid-20th century in the United States, but by March 2020 in-person events were overwhelmingly cancelled during the Covid-19 crisis. This paved the way for wide-range adoption of virtual education across many sectors including childbirth education. Interactive online approaches to educational content became available from the safety and comfort of one’s own home. Access to virtual childbirth education both from the hospital systems and birth workers in the community greatly increased over the last three years as a response to the pandemic, yet there is a lack of published literature regarding the experience and outcomes related to those that take childbirth education classes through virtual methods. The purpose of this qualitative study is to understand the experience of nulliparous women who took virtual childbirth education classes during the Covid-19 pandemic. This will be explored through the aims of acceptability, meeting expectations, satisfaction, and perceived impact. The study method uses Martin Heidegger’s philosophical approach of interpretative phenomenology. A total of 21 women who were pregnant with their first baby during 2020 to 2022 and took virtual childbirth education classes were interviewed from various locations in Texas and California. Interviews used semi-structured interview questions which were recorded and transcribed through Zoom. The information from this study is important to understand more about the experience of virtual childbirth education and to ensure that a virtual approach is meeting the aims important to participants especially since this is a popular mode of education for the new generation of expectant parents.
  • Item
    Preparedness for end-of-life in patients with advanced metastatic cancer enrolled in a clinical trial (phase I/phase II)
    (December 2022) Goswami, Poonam 1966-; Cesario, Sandra; Malecha , Ann; Freysteinson, PhD, Wyona
    Patients with advanced metastatic cancer enrolled in a phase I clinical trial have a life expectancy of less than nine months. Advance care planning (ACP) is a means of tailoring care to patients’ needs, especially at the end-of-life (EOL). An extensive review of literature identified a positive impact of ACP conversations on patients with cancer including increased decision making for EOL care preferences. Unfortunately, there is little or no information available on their preparedness for EOL, indicating a gap in literature. This study aims to describe the preparedness for EOL, and evaluate the effect of quality of communication (in ACP discussions) on preparedness for EOL in patients with advanced metastatic cancer enrolled in a clinical trial (phase I/phase II) who had ACP discussion with a health care provider. A non-experimental descriptive study design was utilized, participants were recruited from the inpatient unit at a large comprehensive cancer center. The data was collected through REDCap, and was measured with surveys QUAL-EC for preparedness for EOL and QOC for quality of communication. The SPSS version 28.0 analyzed the data, the results indicated 56.8% (n=81) well prepared and 43.2% (n=81) not well prepared for the EOL. Md = 3.5 (IQR: 3.0, 4.1). There was a significant moderate relationship between quality of communication and EOL preparedness, r = .38, n = 81, p < .001, although the effect was only 14.4% (shared variance R2 = 14.4). The results of this study indicate a need for improvement in preparedness for EOL in this patient population. Quality communication skills are essential for addressing patients’ uncertainty, and emotional distress related to EOL discussions and decision-making. Oncology nurses have a vital role in cancer care, trusting relationships with patients and families, and can be trained to develop the communication skills necessary for engaging their patients in difficult conversations that can elicit their fears and worries related to EOL. Coordination between nurses, the healthcare team, and patients’ families can provide the support needed for preparedness for EOL in patients with advanced metastasis that ultimately results in quality of life, quality of care, and quality of death.
  • Item
    Modification to the Miami Emergency Neurological Deficit (MEND) scale to better assess for posterior circulation stroke by nurses
    (May 2023) Fant, Grace Nicole 1985-; Keele, Rebecca; Clutter, Paula; Halverson, Colleen
    Many posterior circulation stroke symptoms (PCS) are missing from current stroke assessment scales used by nurses to assess patients for strokes in emergency rooms and hospitals across the United States. There is not one stroke assessment tool currently available to assess and weigh anterior and posterior strokes proportionately. The purpose of this study was to modify a current stroke assessment instrument, the Miami Emergency Neurological Deficit (MEND) that can be used by nurses to better assess for PCSs. Specifically, this study examined the reliability and validity of the MEND and modified-MEND used by nurses to assess video presentations of patients with anterior circulation stroke (ACS) and posterior circulation stroke symptoms. A prospective, quantitative methodological study was conducted to test the reliability and validity of the modified-MEND, and the accuracy of the nurses’ ability to recognize ACS and PCS symptoms. The researcher developed patient scenarios of anterior and posterior circulation stroke symptoms. The population consisted of registered nurses from stroke accredited acute care hospitals within the CHRISTUS Health system. A total of 89 registered nurses from 9 stroke-accredited facilities participated in this prospective, quantitative study. Interclass correlation coefficients were used to establish consistency of performance of the MEND and modified-MEND. The ICCs showed excellent reliability of both scales. Pearson correlations were conducted to determine the relationship of the NIHSS, MEND, and modified-MEND for the PCS and ACS patients, showing a strong, positive, statistically significant relationship between the MEND and modified-MEND on both the PCS and ACS patient. A one-way repeated measures ANOVA was analyzed for validity of the modified-MEND, showing statistically significant differences and strong effects sizes for PCS and ACS patient. The Cochran’s Q showed statistically significant differences for the modified-MEND in prediction of stroke versus no stroke compared to the MEND and the NIHSS for the PCS patient, further validating the modified-MEND as a stroke assessment tool. There were no statistically significant differences between nursing demographics and accuracy and predication of stroke for the PCS or ACS patient. Results of this study adds new information to the body of evidence regarding stroke assessment scales. Findings from this study support an acceptable level of validity and reliability of the modified-MEND as a stroke assessment tool. Based on what is available in the literature, the modified-MEND may be the first reliable and valid stroke assessment scale that assesses for both PCS and ACS adequately, leaving no reason for missed identification and treatment of PCS patients.
  • Item
    Diversity, equity, and inclusion of black pre-licensure nursing students in Texas institutions of higher education
    (May 2023) Ochieze, Florence N; Fredland, Nina; Mbango, Catherine; Ellis, Kathleen; Dr. Jason Lambert
    Purpose: To describe the experiences and perceptions of Black/African American pre-licensure nursing students related to campus climate diversity, cultural awareness, and sense of belonging, and determine their correlation with the academic performance of Black pre-licensure nursing students. Procedure: A cross-sectional, descriptive correlational quantitative design was used to explore the diversity, equity, and inclusion initiatives on Black pre-licensure students’ academic performance. Subjects were pre-licensure Black nursing students enrolled in a nursing program in Texas. Subjects were recruited using study descriptions and flyers through the students' email addresses and listservs obtained using the Texas Public Information Act. A total of 172 (N = 172) subjects were surveyed using the Campus Diversity Questionnaire-Revised (CDQR), Cultural Awareness Scale (CAS), and Challenged Sense of Belonging Scale (CSBC) instruments via the PsychData survey. The first research question aimed to describe the experiences and perceptions of Black pre-licensure nursing students’ related to campus climate diversity, cultural awareness, and sense of belonging using simple and multiple linear regression analysis. The second research question aimed to determine the relationships between campus climate diversity, cultural awareness, sense of belonging, and iv academic performance for Black pre-licensure nursing students using Ordinal Multinomial Logistic Regression analysis. Sample characteristics were performed using a ten-item demographic form in the Psychdata survey. Results: The data analysis revealed that Black pre-licensure nursing students who experience greater levels of cultural awareness had a greater sense of belonging compared to students with lower levels of cultural awareness as measured by the cultural awareness scale F(1, 171) = 6.199, β = .367, p = .007. Additionally, Black pre-licensure students with higher levels of cultural awareness in the nursing program had higher GPAs p = .009, χ2 (4) = 6.869. The CDQR had a Cronbach alpha coefficient value of α=.930. The CAS had a Cronbach alpha coefficient value of α=.932. The CSBC had a Cronbach alpha coefficient value of α=.933. Summary: Nursing programs should incorporate cultural awareness in the nursing curriculum and higher educational institutions. Nursing programs should provide DEI initiatives such as emotional, financial, and psychological support and resources for the academic success of all students.
  • Item
    The lived experiences of black women who managed college studies while experiencing intimate partner violence
    (May 2023) Powell, Ashley D.; Tilley, Donna Scott; Muoki, Deltra; Cesario, Sandra
    Intimate partner violence (IPV) is a preventable problem that affects individuals of various ages, ethnic groups, and socioeconomic groups. This phenomenological study addressed the following research question: “How did Black women manage their college studies while concurrently experiencing intimate partner violence?” Semi-structured open-ended interview questions were used during individual virtual interviews of 15 cisgender women who were at least 18 years old, who speak, read, write, and understand the English language, and experienced IPV while in enrolled in college. Data was analyzed using Colaizzi’s (1978) method of analysis. This study provides insight on how Black women who concurrently experienced IPV while enrolled in college coped and managed the demands of their college studies, how the abuse impacted their studies, and what professors should know about students who experience IPV.
  • Item
    Development and validation of an instrument to measure surgical conscience in operating room nurses
    (May 2023) Quintana, Danielle Marie 1974-; Keele, Rebecca; Fredland, Nina; Woo, Jennifer
    Surgical conscience is a fundamental principle in the operating room that is well-known to perioperative nurses, yet it was a rarely studied phenomenon prior to this research. Nurses use their surgical conscience to protect patients from poor surgical outcomes. This serves as an additional layer of advocacy for patients who are unable to speak for themselves during the operative procedure. Surgical conscience begins with the knowledge of principles of aseptic technique, infection control and safety, involves ethical and moral decisions, and ultimately requires an obligation to speak or act. When a perioperative nurse fails to use their surgical conscience, the results can be costly and even worse, deadly. Thus, it is critical to be able to measure this phenomenon to develop initiatives for education and training targeted to improve nurses' surgical conscience and ultimately prevent surgical errors. However, no published quantitative measures of surgical conscience were found in the literature prior to this research. The purpose of this methodological study was to psychometrically validate a new instrument entitled the Surgical Conscience Scale with perioperative nurses. The scale was designed after review of literature, creation of a concept analysis, two rounds of content validity and pilot testing. Validity was explored by an exploratory and confirmatory factor analysis with separate groups of participants. Exploratory factor analysis results explained 55% of the variance with 3 factors: Foundational Components, Barriers to Surgical Conscience Action, and Required Attributes. The confirmatory analysis findings did not support goodness-of-fit indices in total; however, a valid and reliable subscale was discovered that measures barriers to using one’s surgical conscience. This 6-item scale, now referred to as the Barriers to Surgical Conscience Action Scale, had all six items of the factor (.734, .754, .806, .689, .573) with strong loadings (> .5). Additionally, the reliability coefficient of the subscale (α = .874) supported the recommendation to use this subscale on its own to measure barriers of surgical conscience. Use of the Barriers to Surgical Conscience Action Scale can promote awareness about the harmful consequences of failed action on behalf of perioperative nurses and help promote proficient surgical conscience usage.