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.
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- All Subjects: Social Support
Purpose: To collect and analyze participant demographic information and explore use of instruments to measure perceived social support and quality of life at a local cancer support program. Specific objectives included:
1. Gather and analyze participant demographic information and program utilization by participants for a non-profit cancer support agency.
2. Assess the extent to which those using the support programs experience perceived social support (PSS) and quality of life (QOL).
3. Assess the utility of the survey process and selected instruments to guide program planning.
Background: Obtaining the diagnosis of cancer is traumatic, but support groups assist in emotional healing among group members. There is strong evidence correlating support group participation with PSS and QOL. The Wilson and Cleary model of QOL clearly links social support and QOL and provided the conceptual framework for this project.
Methods: A survey for self-reported participant demographics, support activities, QOL scores, and PSS scores was implemented. Both online and pencil and paper surveys were available. Instruments included the Flanagan Quality of Life Scale (Cronbach’s α = .82 to .92) and the Multidimensional Scale of Perceived Social Support Scale (Cronbach’s α = 0.91) and a demographic survey created for this project.
Outcomes: All but one survey was completed online (n=48). Respondents were primarily white, female, cancer free at the time of the survey, and over the age of 55. QOL and PSS scores within this sample emulated previous research of correlations between instruments and people with chronic illnesses.
Conclusion: Correlations of sample demographics and instrument scores reflected current literature; this project validates an effective and affordable means to evaluate program effectiveness. Future use of the survey is to better tailor services to meet the objectives of the agency to improve QOL for all individuals affected by cancer.
Keywords: Cancer, support group, quality of life, perceived social support
The birth of a new baby is known to be a joyful time for families. However, such a treasured experience can quickly reroute in a matter of moments which leaves the family feeling helpless, frightened, and guilty. The innate process of bonding and attachment is interrupted by the resuscitative course following a traumatic birth. Separation, grief, anger, and fear promote what’s being deemed more and more frequently as parental posttraumatic stress disorder (PTSD). Rates of parental PTSD associated with separation at birth are equivalating those of post-partum depression and post-partum psychosis. Emotionally unstable parents are unable to adequately care for their newborn for both short and long term needs.
Facilitation and support of the parental role in an altered environment, such as a neonatal intensive care unit (NICU), is thought to create opportunities for relationship security. Establishment of an emotionally invested caregiver has been proven to minimize sequelae of the NICU patient, reduce length of stay, cut readmission rates, and lower the incidence of failure to thrive post-discharge. A parental psychosocial program was instituted in a 32-bed NICU within a southwest children’s hospital. The program efficacy was analyzed several months after implementation. Results are concurrent with the thought that individual counseling for NICU families reduces stress scores and improves patient satisfaction at discharge.
Background and Significance: NIRS data can be used in conjunction with standard vital sign monitoring to help clinicians understand blood flow and metabolic demands of organ systems, particularly cerebral, renal, and mesenteric blood flow patterns. A NICU unit in the northwestern US adopted NIRS use on their patients in 2008, however, NIRS monitoring usage decreased over the past 5 years, citing a lack of continued education and comfort interpreting and managing NIRS monitored patients. One patient was monitored with NIRS in the year prior to the QI project.
Methods: A 5 point Likert-Type survey was designed to examine provider comfort and confidence using and interpreting NIRS on NICU patients. No Croanbach’s alpha value exists for the survey as it was purposefully designed for the QI project. An educational presentation on the use and interpretation of NIRS on NICU patients was created and delivered during a formal provider staff meeting. Pre and Post education surveys were distributed electronically to participants and were presented 1 week prior to educational session and 1 month after educational session. IBM SPSS version 23 was used for descriptive statistics, paired t tests, and Wilcoxon test. Significance set to p<0.05.
Results: In total, 18 providers (N=18) were surveyed, and 13 paired survey results (n=13) were received (8 MD and 5 NNP). Paired-samples t tests were calculated to compare the mean total score (TS) for pre/post comfort and pre/post confidence. This was a significant improvement for both comfort (t(11) = -3.13, p=0.010) and confidence (t(11) = -3.37, p=0.006). Wilcoxon test showed a significant increase in the times a provider managed a patient with NIRS (z=-2.762, p=0.006). The number NIRS monitored patients increased from one in the previous year to 15 patients in the 5 months of data tracking, a clinically significant increase.
Conclusions: Providing educational session on previously utilized clinical applications can improve providers comfort and confidence and influence their usage in clinical practice. Future continuing education sessions could be designed for different clinical applications in order to keep clinicians abreast of the current evidenced based applications of advanced clinical monitors.
leading to chronic stress, a sense of powerlessness, and decreased autonomy. Social support may improve health empowerment and lead to increased perception of well-being.
Purpose: The purpose of this project was to evaluate the effectiveness of social support provided by a cancer support agency on health empowerment and perceived well-being in adults impacted by cancer.
Conceptual Framework: The Health Empowerment Theory maintains that perceived wellbeing is the desired outcome; mediated by health empowerment through social support, personal growth, and purposeful participation in active goal attainment.
Methods: Twelve adults impacted by cancer agreed to complete online questionnaires at
baseline and at 12 weeks after beginning participation in social support programs provided by a cancer support agency.
Instruments included: Patient Empowerment Scale, The Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS), and The Office of National Statistics (ONS) Subjective Well-Being Questions.
Results: Four participants completed pre and post surveys. An increase was seen in
empowerment scores (pre M = 1.78, SD = 0.35 and post M = 3.05, SD = 0.42). There was no
increase in perceived well-being: SWEMWBS pre (M= 3.71, SD= 0.76), post (M= 3.57, SD=
0.65); ONS pre (M= 7.69, SD= 1.36), post (M= 6.59, SD= 1.52).
Implications: The data showed an increase in health empowerment scores after utilizing social support programs, lending support to the agency’s support strategies. It is recommended that the measures be included in surveys routinely conducted by the agency to continue to assess the impact of programming on health empowerment, and perceived well-being.
The health benefits of breastfeeding are well documented and exclusive breastfeeding for at least the first six months of life is the target of national and global health care organizations. Although initial breastfeeding is on the rise, the percentage of infants still breastfeeding at six months drops significantly. In the population of newly delivered mothers of an obstetric practice, there is no readily accessible breastfeeding support offered following hospital discharge. A review of relevant literature revealed that lack of support is often cited as a key factor in the discontinuation of breastfeeding, whereas the evidence shows that participation in peer support has a positive effect on breastfeeding self-efficacy, which can have a positive effect on breastfeeding duration.
To address this problem, the initiation of a breastfeeding closed social network Facebook group for this practice setting population was developed and implemented to provide readily accessible peer support and have a positive effect on the outcome of breastfeeding self-efficacy. Three months after initiation of the Facebook group, an anonymous voluntary survey was offered to group members, and 25 members participated in the survey. Responses demonstrated that peer support is helpful with breastfeeding confidence and that, following participation in the group, the respondents wanted to continue breastfeeding.