Nursing-Dissertations

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    A narrative analysis of the partner of a patient who has undergone a prostatectomy
    (2024-05) Ford, Meredith A; Damon Cottrell; Liu, Fuqin; Misty Richmond; Darpan Patel
    The purpose of this study was to explore the storied narratives of the partners of those who have undergone a prostatectomy due to prostate cancer. Cancer affects the quality of life of the family by causing complex feelings and lifestyle changes that can be overwhelming; however, with prostate cancer being a couple’s disease, it may have a substantial effect on the partner. This study aims to shed light on the experiences and needs of the partner of those who have undergone a radical prostatectomy (RP). Using the narrative analysis methodology of qualitative research, interviews with eleven participants were conducted with a semi-structured interview guide. Six overarching themes explained the relationship changes and the barriers of the participants. They did not feel well educated on the impact an RP would have on their relationship and intimacy. Participants shared the impact an RP had on their relationship and intimacy. Fear from the loss of control was clear, and participants expressed a desire for support and a need for information. They vocalized elevating their partner’s needs and protected the affected partner. The biggest barrier they expressed was the lack of support and information on how this treatment would impact them. Medical professionals, especially nurses at the forefront of care, are invaluable in educating partners about the impact that the RP would have on their relationship. Resources and support should be offered to the partner.
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    Caring for a family member with Alzheimer's disease: the lived experiences of African American caregivers
    (2024-05) Reed, LaGaryion S.; Dr. Judith McFarlane; Dr. Sabrina Pickens; Dr. Teresa Sparks
    Alzheimer’s disease is the most common type of dementia and is a significant health problem for the person with Alzheimer’s and for their caregiver. African Americans have at least double the prevalence of Alzheimer’s disease compared to European Americans. Additionally, African American caregivers provide up to 40 more hours of care per week than White caregivers. Despite these disparities, there is limited research on the experiences of African Americans providing care for family members with Alzheimer’s. The purpose of this qualitative study was to describe how African American family caregivers of persons with Alzheimer’s disease manage caregiving. Descriptive phenomenology was the method used to understand the lived experiences of African American family caregivers. Data collection consisted of demographic information to describe the sample and semi-structured interviews to address the research question. Based on participant preference, 15 individual semi-structured and in-depth interviews were conducted by the researcher via telephone or videoconference. Guided by Swanson’s theory of caring, the data transcribed from the audio-recorded interviews were analyzed by the researcher using Colaizzi’s methodology. Eight themes emerged from the data: (a) Parenting All Over Again, (b) Self-Sacrifice, (c) Caring for the Caregiver, (d) Connecting to God, (e) Responsibility to Care, (f) Trapped, (g) Beyond Exhaustion, and (h) Loss of Self. Based on these findings, there is a considerable need for greater support, health promotion, and development of appropriate interventions to alleviate the challenges experienced by African American caregivers of family members with Alzheimer’s disease.
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    The effect of a mobile clinical decision support application on clinical decision-making skills and satisfaction in undergraduate nursing students
    (2024-05) Miles, Janice Marie; Lee, Mikyoung; Halverson, Colleen; Wilson, Cecilia
    Clinical decision-making is an essential nursing skill that undergraduate nursing students struggle to develop. This dissertation comprises two manuscripts focusing on mobile clinical decision support (mCDS) resources in undergraduate student nurses: a systematic literature review and an empirical intervention study. The literature review manuscript identified which mCDS resources student nurses utilized and assessed how they affected students’ knowledge, skills, and perceptions. Information related to medication administration and medical calculators was most commonly sought. There were mixed results on the effects of mCDS apps on students’ knowledge and skills. None of the studies evaluated the impact of an mCDS app on students’ clinical reasoning or decision-making. The second manuscript presents a randomized controlled trial with pre-test and post-test design. The Technology Acceptance Model guided the study. The experimental group (EG) (n = 26) used an mCDS app (Medscape) while completing sepsis and cardiac tamponade scenarios, while the control group (CG) (n = 28) used traditional tools. Outcomes included the students’ perceptions of the usefulness, ease of use, attitude toward use, satisfaction with, and behavioral intent to use the app, as well as self-efficacy in clinical reasoning and decision-making skills. Students in the EG positively perceived the usefulness, ease of use, attitude toward use, satisfaction with, and intent to use the mCDS app. Perceived usefulness and attitude toward use were significant predictors of intent to use the app. After completing the scenarios, the change in clinical reasoning scores over time differed for the two groups; scores increased in the EG but declined in the CG. Also, the EG had significantly higher clinical reasoning scores than the CG. In exploring the cardiac scenario, the EG had higher clinical decision-making scores than the CG. However, the groups did not differ significantly regarding sepsis or combined total scenario scores. This study showed that mCDS apps promote clinical reasoning and decision-making. However, future research should utilize diverse clinical scenarios with varying complexity and include a more diverse population from multiple universities and other settings, such as simulation exercises, to ensure the generalizability of the findings and support students’ use of mCDS apps during clinical practice.
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    The development and validation of an instrument measuring psychological need satisfaction of lactation
    (2024-05) Barta, Kelsie Renea 1991-; Richmond, Misty; Cesario, Sandra; Spencer, Becky
    Basic psychological need satisfaction is a widely studied phenomenon within the field of psychology that was not examined in the context of lactation prior to this research. Derived from Self-Determination Theory, the basic psychological needs of autonomy, competence, and relatedness are theorized to result in well-being and functioning when the needs are met. In the United States, breastfeeding rates are below Healthy People 2030 targets. Therefore, a goal of this research was to test the premise that satisfying the needs of autonomy, competence, and relatedness could improve postpartum well-being and breastfeeding outcomes. To accomplish this, it is necessary to be able to objectively measure the phenomenon of psychological need satisfaction in the context of lactation. Given that no such measure exists in the literature, the purpose of this study was to develop and validate the Lactation Psychological Needs Scale. The instrument was designed based on a review of literature, content validity testing, and pilot testing in the intended population. The validity of the instrument was established through exploratory and confirmatory factor analyses in separate samples. Both factor analyses yielded a three-factor solution aligned with the three basic psychological needs enumerated in Self-Determination Theory: autonomy, competence, and relatedness. After modification, the confirmatory analysis supported goodness-of-fit of the final 12-item instrument. The instrument and each subscale demonstrated appropriate internal consistency reliability and were related to concurrently measured variables in the expected directions, supporting the construct validity of the instrument. The Lactation Psychological Needs Scale appears preliminarily valid and reliable and supports the theoretical premises tested. Self-Determination Theory offers a new explanation for understanding lactation outcomes and postpartum well-being, which can be further explored through subsequent uses of this novel instrument.
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    Examining medication dosage calculation exam scores in undergraduate nursing students: Simulation compared to classroom instruction
    (2024-05) Aguirri, Amanda 1979-; Ann Malecha; Brenda Moore; Deltra Muoki
    Medication administration is a primary responsibility of nurses, and clinical education is critical to preventing medication errors and maintaining patient safety. Nurse educators struggle to determine the most effective teaching strategy related to this skill. This dissertation study aimed to examine the effect of participating in a simulation activity versus a lecture-style review on medication calculation exam scores. A quasi-experimental posttest-only design recruited prelicensure baccalaureate nursing students (n = 93) to participate in a simulation lab activity before taking the medication exam. The new simulation activity was created and facilitated using the Healthcare Simulation Standards of Best Practice as a guide (INACSL, Decker, et al., 2021; INACSL, McDermott, et al., 2021; INACSL, Persico, et al., 2021; INACSL, Watts, et al., 2021). The intervention group’s results were compared to a historical control group (n = 105) who received a lecture-style review session in a classroom environment prior to the exam. An independent samples t-test revealed that students in the intervention group had higher exam scores (M=89.14, SD=14.19) compared to the control group (M=82.29, SD=17.28; t (195) = 3.06, p= .003). Participants in the intervention group were more likely to pass the exam in fewer attempts compared to the control group (X2 = 7.34, p = .007). Independent samples t-tests were also used to analyze exam scores on one-step (“review”) medication calculations versus multi-step (“new”) medication calculations between the intervention and control groups. There was no significant difference in scores on the review items between the intervention and control groups. However, participants in the intervention group scored higher on the new items (M = 70.22, SD = 12.334) as compared to the control group (M = 64.48, SD = 14.410, t (196) = 3.019, p = .003, two-tailed). The findings of this study indicate that undergraduate students who participate in a medication simulation prior to taking their medication exam may perform better than students who only attended a lecture-style review in the classroom.
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    A critical discourse analysis of the language of hospice enrollment: A multiple case study of patient, family, nurse, and physician discourse in the United States
    (2024-05) Parker, Robert 1962-; Liu, Fuqin; Fredland, Nina; Ennis, Joyce; Hamilton, Patti
    The Medicare Hospice Benefit, established in 1982, is integral to end-of-life care. Despite the demonstrated benefits, hospice enrollment among Medicare beneficiaries continues to decline. In 2021, only 47.3% of eligible Medicare decedents utilized hospice services. Although all racial and ethnic groups’ enrollment numbers are low compared to the opportunity for enrollment, the underrepresentation is most significant of non-White populations. The overall underutilization of hospice services calls for a reevaluation of the hospice dialogue. Our investigation adopted the principles of critical discourse analysis, as conceptualized by Fairclough in 1993 to answer the question: How do discourses of patients, caregivers, nurses, and medical directors reveal the social structures and power relationships that shape hospice enrollment? Using critical discourse analysis, we examined the role of language used to reveal hospice enrollment discourses. Using a multiple case study design, we recruited and segmented participants into four distinct case groups: patients, their primary family caregivers, the hospice registered nurses, and medical directors responsible for the initiation of hospice enrollment. We then incorporated critical discourse analysis as a secondary design by using Fairclough’s three-dimensional framework to analyze the structural, relational, and symbolic dimensions of discourse in the interview texts based on the case groups positional reference to the study’s question. Our aim was to reveal the power relationships and social structures to emphasize or minimize hospice enrollment decisions. This study’s findings revealed three dominant discourses: Decision Dynamics, Help, and Beliefs and Believe. The inferences drawn from this study emphasize the need for a patient-centric modality in hospice enrollment decisions that fully recognizes and engages with the interrelated connections of familial dynamics, societal norms, and personal sovereignty.
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    Perceptions and experiences of health for mothers of children with autism spectrum disorder
    (2024-05) Gautam, Kunta 1978-; Freysteinson, Wyona; Fletcher, Tina; Schultz, Rebecca
    The purpose of this study was to interview mothers who had children with an autism spectrum disorder to understand their perceptions and experiences regarding their health. The interview aimed to describe the study question: What are the perceptions and experiences of health for mothers with children with autism? Eleven mothers participated in the study. Two were interviewed in person, nine were interviewed via Zoom, and the conversations were recorded. The transcribed data were analyzed using environmental analysis and phenomenological interpretation. Using an Excel spreadsheet, data were categorized into themes. A second interview was conducted with four mothers via Zoom to validate the findings. The study's findings created two themes under environmental analysis and three under phenomenological interpretation. These themes were nonsupport to support, stillness to rumble, flood of emotions, self-talk, and me-time. Mothers provided recommendations to other mothers who have children with autism spectrum disorder. Implications for nursing research, education, and practice were identified based on the study findings. This study provides a foundation for developing interventions targeting the health and well-being of the mothers. The descriptive data from this study can help construct future observational and experimental research.
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    A phenomenological study to explore mirror viewing in African American women with obesity
    (2024-05) Omondi, Harriet; Freysteinson, Wyona; Mbango, Catherine; Schultz, Rebecca
    Obesity is among the most preventable healthcare epidemics linked to multiple health problems, such as diabetes, hypertension, arthritis, cardiovascular disease, and certain cancers. Unfortunately, African American women are disproportionately affected by obesity (US Department of Health and Human Services, 2020). Mirror exposure has been used to manage various eating disorders, such as anorexia nervosa, bulimia nervosa, and binge eating (Butler & Heimberg, 2020). A phenomenological study investigated the mirror viewing experience in African American women with obesity. The study was conducted in an urban multi-specialty clinic. African American women who self-identified as obese were interviewed. Data collected included their demographics, and semi-structured questions focused on the participants' mirror viewing experience. The data was analyzed using Ricoeur's (1981/2016) interpretive approach. Two environmental themes identified were (1) family and culture, and (2) stereotype/stigma and bias. The five phenomenological themes identified were: (1) I don’t like what I see, (2) the struggle is real, (3) camouflage, (4) call for action, (5) loving the skin you are in. The results generate new knowledge to understand the mirror viewing experience in African American women with obesity and nursing theory development.
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    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.
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    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.
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    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
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    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.
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    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.
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    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.
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    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.
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    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.
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    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.
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    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.
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    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.