Matching Items (300)
Filtering by

Clear all filters

189062-Thumbnail Image.png
Description

While the COVID-19 pandemic continues to evolve, America’s nursing work force continue to work in the most challenging of circumstances. While expected to hold the fort and continue on, deep inside, they bury an unprecedented level of acute stress, anxiety and depression. Peer support groups have been posed as a

While the COVID-19 pandemic continues to evolve, America’s nursing work force continue to work in the most challenging of circumstances. While expected to hold the fort and continue on, deep inside, they bury an unprecedented level of acute stress, anxiety and depression. Peer support groups have been posed as a possible coping behavior. This cross-sectional designed project was developed to assess the worth and feasibility of a virtual peer support group with a focus on healthcare provider wellness during a period of surge of the COVID-19 pandemic. Overwhelmed staff, technology/documentation changes and challenges, competing clinical demands, short-staffing and Zoom fatigue were identified as the limiting factors for this project’s completion within its given timeframe. These findings informed of current barriers, providing a basis for future program development to mitigate the impact of psychological distress among healthcare providers. Evolving literature on this topic supports recommendations for further study and action by individual health care providers, organizations and at the state and national levels.

Created2021-12-01
189892-Thumbnail Image.png
Description

The escalation of the opioid epidemic in the United States has sparked sweeping legislation meant to regulate physicians' opioid prescribing practices. The demands of such policies force physicians to initiate discussions that could jeopardize the collaborative doctor- patient relationships necessary for curbing inappropriate opioid prescriptions. Drawing on sociopragmatics, this discourse

The escalation of the opioid epidemic in the United States has sparked sweeping legislation meant to regulate physicians' opioid prescribing practices. The demands of such policies force physicians to initiate discussions that could jeopardize the collaborative doctor- patient relationships necessary for curbing inappropriate opioid prescriptions. Drawing on sociopragmatics, this discourse analysis study of primary care interactions examines the face- saving linguistic features employed by physicians in negotiating the line between policy demands and maintaining collaborative relationships. The findings reveal several face-saving acts‚"pseudo requests, downtowners, broadening, redirection, tag questions, impersonalization, listing, and (negative) imagery‚"used by physicians when enacting the three most prominent policies: (1) monitoring opioid use, (2) prescribing anti-overdose medication, and (3) transitioning patients from opioids to alternative treatment. Informed by Goffman's concept of "face-work," this study provides evidence of the communicative burden placed on physicians implementing disagreeable opioid policies, as well as opening up discussions on how policymakers and medical institutions can support physicians in implementing opioid policies. Keywords: opioids, face-work, face threats, medical discourse, doctor-patient interaction, discourse analysis, sociopragmatics

ContributorsTorres, Peter Joseph (Author)
Created2023-01-18
189893-Thumbnail Image.png
Description

In recent years, the opioid crisis in the United States has sparked significant discussion on doctor- patient interactions concerning chronic pain treatments, but little to no attention has been given to investigating the vocal aspects of patient talk. This exploratory sociolinguistic study intends to fill this knowledge gap by employing

In recent years, the opioid crisis in the United States has sparked significant discussion on doctor- patient interactions concerning chronic pain treatments, but little to no attention has been given to investigating the vocal aspects of patient talk. This exploratory sociolinguistic study intends to fill this knowledge gap by employing prosodic discourse analysis to examine context-specific linguistic features used by the interlocutors of two distinct medical interactions. We found that patients employed both low pitch and creak as linguistic resources when describing chronic pain, narrating symptoms, and requesting opioids. The situational use of both features informs us about the linguistic ways in which patients frame fraught issues like chronic pain in light of the current opioid crisis. This study expands the breadth of phonetic analysis within the domain of discourse analysis, serving to illuminate discussions surrounding the illocutionary role of the lower vocal tract in expressing emotions.

ContributorsTorres, Peter Joseph (Author) / Henry,Stephen Gresham (Author) / Ramanathan, Vaidehi (Author)
Created2019-12-19
189894-Thumbnail Image.png
Description

This is a dissertation of a current faculty member

ContributorsTorres, Peter Joseph (Author)
Created2022-07-01
189895-Thumbnail Image.png
Description

The present study uses corpus-assisted discourse analysis to examine the role of modality in policy verb phrases, using California opioid policies as a case study. By tracking the behavior of permissive and restrictive modals across time, this study highlights two potential discourse functions of modals in policy drafting: (i) to

The present study uses corpus-assisted discourse analysis to examine the role of modality in policy verb phrases, using California opioid policies as a case study. By tracking the behavior of permissive and restrictive modals across time, this study highlights two potential discourse functions of modals in policy drafting: (i) to reflect the gravity of the issues on the ground, and (ii) to express permission and restriction by highlighting and deemphasizing a policy's suggestive intent, respectively. This study shows that the increased use of restrictive modality has significant positive correlations with California's worsening opioid crisis and its rising fatalities. A closer examination of state policy amendments reveals that altering policy modals has the potential to either broaden or limit the terms of existing policies. Informed by Van Dijk's “context models,” this study provides a cogent applied corpus linguistics framework for analyzing policy text and offers both political and linguistic perspectives into our understanding of modals and how communities address epidemics, respectively.

ContributorsTorres, Peter Joseph (Author) / Elsevier Science Ltd. (Publisher)
Created2021-12-15
189896-Thumbnail Image.png
Description

Patient-clinician interactions are central to technical and interpersonal processes of medical care. Video recordings of these interactions provide a rich source of data and a stable record that allows for repeated viewing and analysis. Collecting video recordings requires navigating ethical and feasibility constraints; further, realizing the potential of video requires

Patient-clinician interactions are central to technical and interpersonal processes of medical care. Video recordings of these interactions provide a rich source of data and a stable record that allows for repeated viewing and analysis. Collecting video recordings requires navigating ethical and feasibility constraints; further, realizing the potential of video requires specialized research skills. Interdisciplinary collaborations involving practitioners, medical educators, and social scientists are needed to provide the clinical perspectives, methodological expertise, and capacity needed to make collecting video worthwhile. Such collaboration ensures that research questions will be based on scholarship from the social sciences, resonate with practice, and produce results that fit educational needs. However, the literature lacks suggested practices for building and sustaining interdisciplinary research collaborations involving video data. In this paper, we provide concrete advice based on our experience collecting and analyzing a single set of video-recorded clinical encounters and non-video data, which have so far yielded nine distinct studies. We present the research process, timeline, and advice based on our experience with interdisciplinary collaboration. We found that integrating disciplines and traditions required patience, compromise, and mutual respect; learning from each other enhanced our enjoyment of the process, our productivity, and the clinical relevance of our research.

Created2021-10-01
186401-Thumbnail Image.png
Description
The purpose of this Doctor of Nursing Practice (DNP) project is to develop and implement a culturally tailored educational program into a community clinic in a northern border community in Mexico to prevent and combat childhood obesity. In Mexico, 33.2% of children are overweight or obese and numbers are

The purpose of this Doctor of Nursing Practice (DNP) project is to develop and implement a culturally tailored educational program into a community clinic in a northern border community in Mexico to prevent and combat childhood obesity. In Mexico, 33.2% of children are overweight or obese and numbers are continuing to rise, which has a significant impact on physical and psychological health and can lead to diabetes, fatty liver disease, thyroid disease, cardiovascular disease, cancer, depression, and other chronic diseases. Guided by Bandura’s theory of self-efficacy, weekly education sessions were delivered to members of the community clinic for two weeks. Content included both a nutrition component and an exercise component. An emphasis was made on increasing physical activity, increasing water consumption, decreasing sugar sweetened beverages, and increasing fruit and vegetable consumption. Videos were developed for each education session. Worksheets and handouts were developed to enhance learning and give participants a tangible reference for individual learning. Content was taken from the CDC and adapted to fit the needs of the community. All content was culturally tailored for low literacy levels and translated to Spanish. Knowledge, behavior change, and self-efficacy were measured by pre and post surveys. Self-efficacy showed statistically significant change from pre and post intervention. These findings suggest that healthy eating and exercise education can potentially increase knowledge, promote behavior change, and enhance self-efficacy, which can, in turn, prevent and combat childhood obesity and related disease states.
Created2022-04-26
186402-Thumbnail Image.png
Description
Background: Existing practice standards for discharge education are insufficient to support parents of children with new enteral feeding devices in the outpatient setting which has led to increased clinic and emergency department visits, hospital stays, and preventable complications. The purpose of this Doctor of Nursing Practice (DNP) project was to

Background: Existing practice standards for discharge education are insufficient to support parents of children with new enteral feeding devices in the outpatient setting which has led to increased clinic and emergency department visits, hospital stays, and preventable complications. The purpose of this Doctor of Nursing Practice (DNP) project was to design and deliver a comprehensive evidence-based enteral feeding tube hospital-based discharge education intervention for parents after their child’s gastrostomy tube placement surgery. Guided by Transition’s theory, the project aims to bridge the gap in education by providing the parent with ongoing support and education about their child’s gastrostomy tube. Methods: This project measured the impact of inpatient discharge education with ongoing support and outpatient education on parent knowledge and confidence. All English-speaking parents of pediatric patients ages 0-17 years with new gastrostomy tubes at a large, urban, freestanding pediatric hospital in the southwest United States were eligible for participation. Institutional Review Board approval was obtained. Informed consent was obtained from all participants. The education intervention was delivered at hospital discharge then reinforced at the first follow-up visit in the surgery clinic. Data analysis included demographic items, a Paired Samples T-Test, and a Two-tailed Wilcoxon Signed Rank Test analyses. Results: Results indicated a statistically significant difference in parent knowledge after the educational intervention. Results also indicated a clinically significant increase in parent confidence. Conclusion: Providing ongoing support and education positively impacts parent knowledge and confidence related to the care of their child’s new gastrostomy tube. Future impacts of this educational intervention may demonstrate a decrease in clinic and emergency department (ED) visits, hospital expenditure, and preventable complications.
Created2022-04-29
186403-Thumbnail Image.png
Description
Purpose/Background: Children exposed to adverse childhood experiences (ACEs) and toxic stress have an increased risk of developing chronic illness and early death in the absence of protective factors. Many providers feel inadequately prepared to screen for and treat ACEs. This quality improvement project, based on the Health

Purpose/Background: Children exposed to adverse childhood experiences (ACEs) and toxic stress have an increased risk of developing chronic illness and early death in the absence of protective factors. Many providers feel inadequately prepared to screen for and treat ACEs. This quality improvement project, based on the Health Belief Model, investigated if providing ACEs education before a screening program is effective in improving attitudes, knowledge, and the number of completed screenings. Method: The project was conducted at a pediatric primary care practice in the southwestern United States. All providers voluntarily consented to attend four education sessions: 1) Trauma overview, 2) Trauma physiology, 3) Trauma-informed care, 4) Screening tool/referral process. An anonymous pre/post-education Likert-Scale survey was completed to assess knowledge and attitudes about ACEs and screening. The number of completed ACEs screening tools and referrals made were collected four- and eight-weeks post-implementation. Results: Data were analyzed using Intellectus Statistics SoftwareTM. There was a significant increase in ACEs knowledge from the pre-test (p= .011, ?=.05). There was not a significant change in attitudes from the pre-test (p=.066, ?=.05). However, the mean pre- to post-survey scores increased for both categories, indicating improved attitudes. Over the first four weeks, 75% of eligible children were screened and 6% were referred to an ACEs resource program. In the second four weeks, 56% of children were screened and 8.6% were referred. Discussion: A comprehensive education program for providers can improve knowledge about ACEs screening, leading to improved screening practices, early identification, and the introduction of protective resources.
Created2022-04-29
186404-Thumbnail Image.png
Description
Background: People with diabetes are at greater risk for comorbid cardiovascular disease, end stage organ damage, disability, and early death. There is substantial evidence that individualizing self-care education, such as eating a healthy diet, greatly improves diabetes management. Objective: The purpose of this paper is to review the

Background: People with diabetes are at greater risk for comorbid cardiovascular disease, end stage organ damage, disability, and early death. There is substantial evidence that individualizing self-care education, such as eating a healthy diet, greatly improves diabetes management. Objective: The purpose of this paper is to review the outcomes of a diabetes education program offered to underserved women in the Southwestern United States. Methods: Four weekly nutrition classes were individualized and taught at a nonprofit organization in the southwest United States. Behavior change was measured using the Summary of Diabetes Self-Care Activities (SDSCA) tool. Classes were advertised via the center’s monthly class calendar and fliers. A total of nine participants (N=9) came to every class and took the SDSCA survey before and after class instruction. Results: Descriptive statistics and two 2-tailed t-tests with the critical value set at p<0.05 were used for data analysis. The participants were Hispanic women, most between the ages of 40-49, and had an income between $0-14,000. The mean difference between the variables of both general diet and specific diet pre and post-tests were significantly different from zero. The assumptions of normality and homogeneity were met. The results of both two-tailed paired sample t-tests were significant suggesting the means of general and specific diet pre-tests were significantly lower than the means of the general and specific diet post-tests. Discussion: The assumptions of normality and homogeneity were met and the results were significant. The pre-intervention scores for both categories were statistically significantly lower than the post-intervention scores for both categories. Thus, the desired outcome of helping clients within the organization modify, adapt, or change self-care behaviors related to diet was met.
Created2022-04-26