Doctor of Nursing Practice (DNP) Final Projects
The Doctor of Nursing Practice Final Projects collection contains the completed works of students from the DNP Program at Arizona State University's College of Nursing and Health Innovation. These projects are the culminating product of the curricula and demonstrate clinical scholarship.
Collaborating Institutions:
College of Nursing and Health Innovation
Displaying 1 - 7 of 7
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- All Subjects: Cognitive Behavioral Therapy
- All Subjects: Needs Assessment
Description
Sleep deprivation is linked to poor mental and physical health outcomes for professional firefighters. The importance of sleep hygiene practices and health promotional activities may increase the amount of quality sleep firefighters get on their days off. As the adverse outcomes of circadian misalignment due to sleep deprivation becomes more apparent in firefighter wellbeing, the need for a sleep health program becomes more evident. The purpose of this paper is to examine and assess the effects of a sleep health program for firefighter wellness. Research emphasizing the relevance of poor health outcomes related to sleep disturbances is prevalent in the literature. The findings have prompted the development of an evidence-based sleep coaching program for firefighters in a local fire department guided by The Cognitive Behavioral Therapy Model (Brewin, C.R., 1996). and a knowledge-to-Action process framework for evidence-based-practice (Graham et al., 2006).
ContributorsAnon, Melanie (Author) / McIntosh, Wayne (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-28
Description
Depression and anxiety are common and debilitating illnesses that negatively impact personal well-being and functioning. The effects of depression and anxiety not only affect the individual, but also peers, family, the community, economy, and even the health care system. Pharmacological therapy is a first line treatment for depression and anxiety, but the risk for relapse remains. Cognitive behavioral therapy (CBT) and mindfulness-based cognitive therapy (MBCT) are treatments that have demonstrated effectiveness in treating depression. The evidence suggests that both therapies are successful in terms of reducing depressive symptoms, but most effective when combined. Further, evidence shows that the combination of MBCT and traditional pharmacological therapy provides relief from depressive symptoms and lengthens the amount of time between recurrent episodes and improves the quality of life. A project was implemented at an integrated health clinic to evaluate the effectiveness of a mindfulness-based intervention to reduce the symptoms of depression and anxiety. The results revealed that practicing mindfulness was statistically and clinically significant in reducing depression and anxiety. In addition, mindfulness scores increased over 30 day application of the intervention. The results demonstrated the value of utilizing mindfulness as a cost-effective therapy in addition to pharmacological treatment to decrease symptoms of depression and anxiety, as well as improve mindfulness. The ease of use demonstrated the value of mindfulness and self-directed skills aimed at improving wellness, reducing depression and anxiety which will result in the improvement of individual, economic, healthcare system, and community health.
ContributorsFong, Luis (Author) / Guthrey, Ann (Thesis advisor)
Created2018-04-28
Description
Background/Purpose: The prevalence of overweight and obesity in the pediatric population is a global epidemic. Rapid weight gain in early childhood exacerbates risk factors for obesity, chronic disease in adulthood, and disqualifies 31% of American youth from serving in the Armed Forces. Although the pediatric dependents weight crisis reflects the national dilemma, there are inconsistencies in provider knowledge, limited access to evidence-based, weight management intervention, and treatment options. This paper will assess provider needs, identify opportunity to improve practice, and process used in weight management in the clinic.
Method: Eight military and four civilian pediatric and family practice providers completed a 16-item needs assessment survey. The survey was distributed via email using an online survey tool, and a printed version was provided to those who had not completed it online. Data was collected over 8 weeks and a descriptive analysis of content was done using the Intellectus software.
Results: Although the response rate was 88.9%, it was lower than anticipated due to COVID-19 related military deployments. Descriptive data were obtained on a variety of provider needs and practices. Results provided valuable information on current attitudes of providers. Providers demonstrated a significant need for a multidisciplinary support team including a dietician and more time dedicated to weight management at office visits. At least 50% of providers have had motivational interviewing training and report that they apply these techniques as part of an intervention in patient’s weight management care.
Implication: Data supports overweight and obesity care practice changes in the clinic. Areas identified by providers included the need for further training and clinic management support including the availability of a pediatric dietician added to the healthcare team.
ContributorsGolding, Sonya S. (Author) / Jacobson, Diana (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-27
Description
Background: Around 40-50% of people with Parkinson’s disease will develop anxiety or depression, the number one factors affecting their quality of life. Cognitive behavioral therapy is the most well-established intervention for anxiety and depression in people with Parkinson’s disease. Purpose: The project addresses a southwestern Parkinson-specific community center’s need for mental health by incorporating a cognitive behavioral therapy-based mental health program, guided by the Cognitive Behavioral Model. Methods: Recruitment at the center took place during a virtual weekly meeting with inclusion criteria of a Parkinson’s disease diagnosis, 50 years or older, and English speaking. A four-week, virtual, nurse-led cognitive behavioral therapy-based mental health program was created to examine the effects on anxiety, depression, and quality of life in ten people with Parkinson’s disease. Pre-and post-intervention Geriatric Anxiety Inventory (Cronbach’s alpha, 0.91), Hamilton Depression Rating Scale (Cronbach’s alpha, 0.87), and Parkinson’s Disease Questionnaires (Cronbach’s alpha, 0.84) were used to assess anxiety, depression, and quality of life. Results: Using a Two-tailed paired samples t-Test, mean values and p-value were calculated with alpha value of 0.05, t(39) = -0.10, p = .922 for anxiety, Alpha value of 0.05, t(16)=3.69, p=0.002 for depression, Alpha value of 0.05, t(38)=5.07, p<0.001 for quality of life, and Alpha value of 0.05, t(5)=4.54, p=0.006 for emotional wellbeing. Conclusion: A cognitive behavioral therapy-based mental health program at a Parkinson-specific center has the potential to improve quality of life and decrease depression in people with Parkinson’s disease. Implications: Research with larger sample sizes, longer duration of therapy, and in-person format would be beneficial.
ContributorsKielbania, Meghan (Author) / De' Santiago, Stephanie (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-28
Description
Childhood cancer affects nearly eleven-thousand children under the age of fifteen years each year, which launches families into a treatment trajectory of unforeseen complexities in several domains. As pediatric oncology healthcare providers tailor family-centered care for these highly fragile children, it is vital to understand the family’s lifestyle and available community resources. Children residing in remote areas may experience more burdensome needs as they progress in the cancer treatment trajectory, which healthcare providers may not be aware of unless the information is specifically solicited or incidentally discovered. Use of an evidence-based needs assessment for families who reside in remote zip codes will aid in identification of unique needs and assist the multi-disciplinary care team to specifically tailor interventions to the family. Forty semi-structured interviews were conducted with parents of childhood cancer survivors using an expert-validated needs assessment tool. The purpose of this Doctor of Nursing Practice (DNP) project is to develop a needs assessment for children with cancer in order to identify which needs are amplified in a remote community in order to match and create resources to meet those needs.
ContributorsHarrell, Lauren (Author) / Jacobson, Diana (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-30
Description
Sickle cell disease is a genetic hemoglobinopathy resulting in chronic and daily pain, risk of serious sequelae, and altered activities of daily living. Resources dedicated to helping individuals with sickle cell disease are lacking, especially compared to other chronic diseases. Children with sickle cell disease experience school absence, fractured peer relationships, frequent healthcare visits, stigma, and feelings of isolation. Additionally, chronic pain decreases developmentally important play and physical activity in these children. The purpose of this Doctor of Nursing Practice (DNP) project is to conduct a needs assessment to inform sickle cell disease family camp programming in southern Arizona. Once a camp experience can be safely implemented, the effects of a camp experience on knowledge, empowerment, and disease management in children with sickle cell disease will be investigated. Research specific to camps for children suffering from sickle cell disease is lacking, however ample evidence suggests the benefit of disease specific camps. Medical specialty camps provide an opportunity for children and families to normalize their condition, participate in activities, and form peer relationships in an environment that safely accommodates their unique needs. This has led to the initiation of an evidence-based project to develop a needs assessment for families affected by sickle cell disease and community partners to inform camp activity development guided by Bandura’s theory of self-efficacy and the Centers for Disease Control and Prevention (CDC) Framework for Program Evaluation.
ContributorsCessna-Vargas, Carolyn (Author) / Jacobson, Diana (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-23
Description
Background: Suicidal ideation and attempts are increasing in the adolescent population and suicide is now the second leading cause of death for youth 10-24 years of age (Center for Disease Control and Prevention [CDC], 2016). Children that continue to struggle with suicidality and depression after treatment as usual have an increased length of stay, from an average of five days to nine days per admission. Recidivism rates are also increasing, with some patients
requiring readmission the same day as discharge.
Method: The purpose of project was to check the feasibility of the use of cognitive behavioral therapy-based group called Creating Opportunities for Personal Empowerment (COPE) in the treatment of children with depression and suicidality. The study patients participated in up to 7 groups of a 60-minute lesson of COPE each day, combined with interactive activities that helped
them practice problem solving and coping skills. The feasibility of the COPE groups were measured by the consistent decrease of Columbia Suicide Severity Rating Scale at the beginning and conclusion of lessons as well as consistency of engaged participation in the COPE groups on the unit based of staff observation obtained from Staff Survey.
Results: The results analyzed using the two-tailed Wilcoxon signed rank test were significant based on an alpha value of 0.05, V = 0.00, z = -3.64, p < .001. This indicated that the differences between Pre-CSSR and Post-CSSR were not likely due to random post variation. The median of Pre-CSSR (Mdn = 1.00) was significantly lower than the median of Post-CSSR (Mdn = 2.00).
Discussion: The results proved feasibility of a cognitive behavioral therapy-based group in the treatment of depression and suicidality of children in an inpatient unit.
requiring readmission the same day as discharge.
Method: The purpose of project was to check the feasibility of the use of cognitive behavioral therapy-based group called Creating Opportunities for Personal Empowerment (COPE) in the treatment of children with depression and suicidality. The study patients participated in up to 7 groups of a 60-minute lesson of COPE each day, combined with interactive activities that helped
them practice problem solving and coping skills. The feasibility of the COPE groups were measured by the consistent decrease of Columbia Suicide Severity Rating Scale at the beginning and conclusion of lessons as well as consistency of engaged participation in the COPE groups on the unit based of staff observation obtained from Staff Survey.
Results: The results analyzed using the two-tailed Wilcoxon signed rank test were significant based on an alpha value of 0.05, V = 0.00, z = -3.64, p < .001. This indicated that the differences between Pre-CSSR and Post-CSSR were not likely due to random post variation. The median of Pre-CSSR (Mdn = 1.00) was significantly lower than the median of Post-CSSR (Mdn = 2.00).
Discussion: The results proved feasibility of a cognitive behavioral therapy-based group in the treatment of depression and suicidality of children in an inpatient unit.
ContributorsFreeman, Latasha (Author) / Guthery, Ann (Thesis advisor)
Created2020-05-02