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ABSTRACT Nursing physical fatigue is a critical issue that may lead to degradation of care delivery and ultimately result in medical errors. This issue is equally relevant due to the looming shortage of nurses, which has been linked to the physical demands and potential occupational hazards intrinsic to the profession;

ABSTRACT Nursing physical fatigue is a critical issue that may lead to degradation of care delivery and ultimately result in medical errors. This issue is equally relevant due to the looming shortage of nurses, which has been linked to the physical demands and potential occupational hazards intrinsic to the profession; as well as to the graying of the nursing workforce who experiences gradual loss of strength and agility that accompanies aging as time in the career advances. In a hospital Emergency Department, the level of nursing physical fatigue can potentially reach its threshold in light of challenging workloads, scope of job assignments and demanding schedules. While in other safety-sensitive industries such as aviation and nuclear plants, similar concerns have been the object of systematic research and addressed with consequent regulations, just recently, the healthcare sector has been engaged in further investigations. This study proposed to explore the linkage between Emergency Department design-layout and nursing physical fatigue. It was expected that further understanding on this relationship would support evidence-based design propositions linking nursing wellness, job satisfaction, and performance to a higher quality of care and improved patient safety levels. To this end, data collection was performed during four weeks in a community-based hospital. A convenience sample of twenty-four eligible nurses was invited to participate in this two-part study. The first section consisted of the completion of a self-administered questionnaire, which assessed nurses' perception of the impact of working conditions on nursing physical fatigue. The second section included the monitoring, through the use of accelerometers, of nurses' actual activity intensity levels during three consecutive shifts. Among other findings, data demonstrated that nurses perceive several attributes or components of the built environment as potential contributors to physical fatigue. In addition, various operational practices and organizational protocols were linked to physical fatigue. Contrary to nurses' perception of physical fatigue, their actual physical activity levels fell mostly between sedentary or light intensity ranges. This paradox offers the opportunity for design interventions that, in alignment with operational practices and organizational protocols will enhance nurses' performance and improve nurses' retention.
ContributorsShakman, Karen (Author) / Bender, Diane (Thesis advisor) / Stein, Morris (Committee member) / Lamb, Gerri (Committee member) / Arizona State University (Publisher)
Created2011
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Purpose: The purpose of this study is to examine perceptions of medical-surgical nurses of alcohol-abusing patients admitted to an acute care facility Background: Studies report that many nurses have negative feelings about substance-abusing patients (Neville & Roan, 2014). It has been found nurses report a lack of knowledge about substance

Purpose: The purpose of this study is to examine perceptions of medical-surgical nurses of alcohol-abusing patients admitted to an acute care facility Background: Studies report that many nurses have negative feelings about substance-abusing patients (Neville & Roan, 2014). It has been found nurses report a lack of knowledge about substance abuse disorders, as well as a view that substance abusing patients are more emotionally challenging and dangerous, often leading to decreased motivation and lower levels of job satisfaction (van Boekel, Brouwers, van Weeghel & Garrestsen, 2013). However, studies have found that additional education can positively impact nurses' perceptions (Arthur, 2001). Methods/Approach: This study is a descriptive design using a 17-question 2-part survey. The first part of the survey includes seven demographic questions pertaining to the participants' characteristics and experiences. The second part of the survey is adapted from the Short Alcohol and Alcohol Problems Perception Questionnaire (SAAPPQ), a valid and reliable instrument used to assess healthcare providers' attitudes toward working with alcohol-abusing patients. Results: Eighty four medical-surgical nurses participated in the study. Over half reported having four hours or less of continuing education on alcohol abuse disorder. Regression analyses identified positive relationships between factors, particularly continuing education, on perceptions of alcohol-abusing patients. Conclusions/Implications: Results of this study can be used to determine what factors contribute to nurses' perceptions of alcohol-abusing patients in the medical-surgical unit, therefore aiding in identifying and developing effective policies, protocols, and interventions aimed at improving quality of patient care in this specific patient population.
ContributorsScalise, Bailey Nicole (Author) / Hosley, Brenda (Thesis director) / Baumhover, Nancy (Committee member) / Todd, Michael (Committee member) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
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Advances in health care have resulted in an increase in life expectancy causing a rapid growth in the number of older adults at a global level. At the same time, socioeconomic development is transitioning family structures and social relationships. With reduced family engagement, many older adults are more at risk

Advances in health care have resulted in an increase in life expectancy causing a rapid growth in the number of older adults at a global level. At the same time, socioeconomic development is transitioning family structures and social relationships. With reduced family engagement, many older adults are more at risk for physical and psychological health issues including loneliness, which is considered a public health issue affecting their quality of life and well-being. This descriptive, exploratory study aims to describe the significance of loneliness in three northern regions of the Sultanate of Oman. The purpose of this study is to examine the prevalence and correlates of loneliness and the relationship of loneliness to health statuses among older Omani adults aged 60 years and above. A demographic data questionnaire, the UCLA loneliness scale, and SF-12-v-1 health status instruments were used for data collection. The sample includes 113 Omani older adults, male (n = 36) and female (n = 77), who experienced a mixture from low to high and severe levels of loneliness. Among these older adults, 34.5% perceived low level, 34.5% moderate level, 22.1% high, and 8.8% were severely lonely. The main demographic factors that were associated with the older adults level of loneliness were female gender, older age 80 years and above, living with others who were not a family member, and being unemployed. When controlling for demographic and environmental factors loneliness was a significant predictor (p < .001) for lower mental health status but not for physical health status (p > .05).
ContributorsAl Yazeedi, Salma Abdullah (Author) / marek, karen D (Thesis advisor) / Shin, Cha-Nam (Committee member) / Komnenich, Pauline (Committee member) / Hawkins, Paul (Committee member) / Arizona State University (Publisher)
Created2019
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2019 coronavirus disease (COVID-19) remains a pressing health concern, especially with lagging youth vaccination rates despite its evident benefits. Given the significant role of vaccination in safeguarding individual and community health, this dissertation sought to explore how the use of serious games may offer hope for addressing the COVID-19 vaccine

2019 coronavirus disease (COVID-19) remains a pressing health concern, especially with lagging youth vaccination rates despite its evident benefits. Given the significant role of vaccination in safeguarding individual and community health, this dissertation sought to explore how the use of serious games may offer hope for addressing the COVID-19 vaccine coverage gap among youths. This dissertation collected, appraised, and synthesized existing evidence on serious game-based vaccination interventions, finding increased youths’ vaccine knowledge but limited effectiveness in boosting their vaccination intentions and uptake. Using serious game in youth health education considered key attributes including gamification, game mechanics, educational, health-related content, and objective, tailored for youth and adaptability, real life relevance, engagement, interactivity, safe environment, feedback, and assessment. Stemming from technological advances and interdisciplinary collaborations, these games provided experiences that resonated with diverse populations. Outcomes from such educational games have shown improved health knowledge, attitudes, and behaviors, improved self-efficacy and reduced health disparities. The dissertation also presented a pilot study randomization control trial (RCT) on a COVID- 19 game-based intervention (vs. usual care) targeting unvaccinated youth, showing its feasibility, acceptability and positive influence on vaccine knowledge, vaccination intention and uptake. Partnering with key stakeholders and adapting game designs for ongoing relevance could contribute to intervention effectiveness in promoting youth vaccination, catering to diverse needs and preferences.
ContributorsOu, Lihong (Author) / Reifsnider, Elizabeth (Thesis advisor) / Chen, Angela Chia-Chen (Committee member) / Todd, Michael (Committee member) / Amresh, Ashish (Committee member) / Mun, Chung Jung (Committee member) / Arizona State University (Publisher)
Created2023
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Masters Entry into Professional Nursing (MEPN) students are entry level students in an accelerated nursing curriculum with a minimum requirement of a Bachelor’s degree in a non-nursing discipline. This qualitative descriptive study sought to explore the experiences of MEPN students during the program using the conceptual framework of Schon’s reflection-in-action

Masters Entry into Professional Nursing (MEPN) students are entry level students in an accelerated nursing curriculum with a minimum requirement of a Bachelor’s degree in a non-nursing discipline. This qualitative descriptive study sought to explore the experiences of MEPN students during the program using the conceptual framework of Schon’s reflection-in-action and an associated lens of interprofessional education and practice. Nine participants were recruited using maximum variation sampling. Participants were all female, over the age of 21, all recent graduates of a MEPN program, with previous baccalaureate degrees in the sciences and humanities. Data were analyzed using directed content analysis. Participants identified five steps in the MEPN journey: (1) Choosing to Pursue Nursing, (2) Coming into MEPN, (3) Bridging Disciplines to Become a Nurse, (4) Reflecting on the Journey, and (5) Being a Nurse. They identified facilitators and barriers they encountered navigating the program and described the knowledge they brought from their prior discipline and provided examples of how they applied it in nursing practice during the MEPN program. The findings have significant implications for nursing practice and nursing education. The essential elements of Schon’s framework for effective problem solving were evident and necessary for building knowledge in practice. Participants recognized the need to think differently when solving professional practice problems consistent with the process of reflection-in-action. They acknowledged benefits and challenges of working with peers in interprofessional education and practice. Faculty can more purposefully use what students bring from other disciplines to support interprofessional relationships and reflection-in-action in clinical practice.
ContributorsMueller, Judith Marie (Author) / Lamb, Gerri (Thesis advisor) / Evans, Bronwynne (Committee member) / Krahe Billings, Eve (Committee member) / Arizona State University (Publisher)
Created2023
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Postpartum depression affects approximately 15% of the childbearing population in the United States and has been linked to a number of negative maternal and infant outcomes. Mothers who rate low in areas of confidence and self-efficacy tend to have lower satisfaction and view their infants as having more negative temperaments.

Postpartum depression affects approximately 15% of the childbearing population in the United States and has been linked to a number of negative maternal and infant outcomes. Mothers who rate low in areas of confidence and self-efficacy tend to have lower satisfaction and view their infants as having more negative temperaments. Infants of depressed mothers have been found to have delays in social and emotional growth which can impair their health and future developmental outcomes. The purpose of this study was to determine if there is any evidence to support the hypothesis that maternal depression is associated with infant social and emotional development and maternal role satisfaction among low-income women in rural Arizona. This study employed a repeated measures correlational descriptive prospective longitudinal design using chart reviews analyzing existing clinical data. Purposive sampling was used to select charts of women who participated in the Verde Valley Medical Center branch of the Arizona Healthy Families program. Chart reviews were used to identify charts that met the inclusion criteria of mothers and their infants who completed at least 18 months of the Arizona Healthy Families Program. Findings of this study indicated evidence of a relationship between depression, infant social and emotional development, and maternal role satisfaction. Mothers who had infants that scored higher, with higher being indicative of concern, on the Ages & Stages Questionnaire: Social-Emotional Edition 2 (ASQ:SE 2) had lower role satisfaction scores on the Healthy Families Parenting Inventory (HFPI) and mothers who indicated dissatisfaction at 6 months postpartum were more likely to continue to indicate lower maternal satisfaction at 12 and 18 months postpartum when infant ASQ:SE 2 scores were higher. Investigating the role of the visiting service providers, such as Healthy Families, and their impact on young families for risk identification and resource support will provide information to policy and lawmakers to aid in decisions for funding and help support young families with the goal of growing strong, healthy families in healthcare deserts like rural Arizona. Keywords: Postpartum depression, maternal depression, infant social and emotional development, maternal role, maternal role satisfaction
ContributorsArgent, Autumn Leif (Author) / Reifsnider, Elizabeth (Thesis advisor) / Hinde, Katie (Committee member) / Todd, Michael (Committee member) / Whisner, Corrie (Committee member) / Arizona State University (Publisher)
Created2024
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Job burnout, a prolonged reaction to job stress, includes mental and physical aspects of exhaustion related to professional work life. Linked to individual health-related problems, decreased job satisfaction, poor organizational commitment, and higher turnover, burnout poses a problem for both employees and organizations. The nursing profession identifies the prevalence of

Job burnout, a prolonged reaction to job stress, includes mental and physical aspects of exhaustion related to professional work life. Linked to individual health-related problems, decreased job satisfaction, poor organizational commitment, and higher turnover, burnout poses a problem for both employees and organizations. The nursing profession identifies the prevalence of burnout and the resulting harmful effects in many settings, yet until now, rural critical access hospital settings have not been considered. To build and maintain a competent, healthy rural nursing workforce that responds innovatively to growing healthcare needs, it is important to examine burnout levels in rural nurses and to identify factors that might be associated with mitigating burnout.

This study focuses on how psychological capital, socio-demographic and organizational work-related factors are associated with burnout in this population. This cross-sectional, descriptive correlational study employed the Maslach Burnout Inventory for Health Professionals, the Psychological Capital Questionnaire, and a sociodemographic questionnaire assessing individual and organizational work-related factors as self-report tools. Descriptive statistics, correlations, and regression analyses were performed to assess aspects of the nurses’ work environment, while describing the relationships among the variables.Means and standard deviations were examined across key variables and compared to reports from other studies. Hypotheses predicted psychological capital would be associated with burnout (negatively associated with emotional exhaustion and depersonalization, positively associated with personal accomplishment), and that individual sociodemographic and organizational work-related factors would also be associated with BO. It was further hypothesized that PsyCap would moderate the relationship between work-related factors and BO.

Maslach Burnout Inventory results reveal similar findings to those in the global sample. However, levels of emotional exhaustion and professional accomplishment were greater in our rural nurse sample compared to published values. Higher levels of psychological capital were found to be related to decreases in depersonalization and correlated to greater professional accomplishment. Psychological capital was not found to moderate associations within this study. Intent to stay more than one year had a strong, negative correlation with emotional exhaustion. The findings suggest burnout in this sample resembles that of the global problem and sets a baseline from which psychological capital trainings may be built.
ContributorsMcCay, Rebecca (Author) / Larkey, Linda K (Thesis advisor) / Kelly, Lesly (Committee member) / Todd, Michael (Committee member) / Arizona State University (Publisher)
Created2019
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Harm to patients remains high in US hospitals despite significant progress to improve the quality of care in our health systems. Leadership, a culture of patient safety, and a climate conducive to innovation in patient care are necessary to advance positive patient safety outcomes. Yet, little is known about how

Harm to patients remains high in US hospitals despite significant progress to improve the quality of care in our health systems. Leadership, a culture of patient safety, and a climate conducive to innovation in patient care are necessary to advance positive patient safety outcomes. Yet, little is known about how leadership can impact patient safety within a climate of innovation. This study examines the effects of transformational and transactional leadership (singularly and with transactional augmenting transformational leadership) as related to nurses’ perception of patient safety, how communication elements of a culture of patient safety may strengthen that relationship, and how the mediating role of team innovation climate may help explain the relationship between transformational and transactional leadership and nurses’ perception of patient safety. The variables were measured using three validated and reliable survey instruments: The Multifactor Leadership Questionnaire (MLQ Form 5X), the Team Climate Inventory-short (TCI), the Agency for Healthcare Research and Quality (AHRQ) Hospital Survey on Patient Safety Culture. A convenience sample of all staff registered nurses (N=952) from the single academic medical center with direct patient care responsibility was surveyed via e-mail for this research. A total of 210 surveys were returned, 157 met inclusion criteria for a response rate of 16%. Transformational leadership had a statistically significant relationship with patient safety perception, while the relationship of transactional leadership with patient safety perceptions was not significant. The results of the regression analysis that tested the effect of communication elements of a culture of patient safety on the relationship between transactional and transformational leadership and patient safety perception were not significant. Transformational leadership was significantly related with team innovation climate after controlling the effect of transactional leadership supporting the augmentation effect. Mediation analysis showed that team innovation climate had a significant mediating effect on the relationship between transformational leadership and patient safety perception. Team innovation climate had a significant mediating effect on the relationship between managers’ transformational leadership and patient safety perception after controlling for transactional leadership supporting the augmentation effect. This is the first study known to test the augmentation of transformational leadership related to patient safety and the role of team innovation climate.
ContributorsYounger, Samuel (Author) / Larkey, Linda (Thesis advisor) / Porter O'Grady, Timothy (Committee member) / Lamb, Gerri (Committee member) / Arizona State University (Publisher)
Created2019
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This descriptive research used social network analysis to explore the influence of relationships and communication among hospital nursing (RN, LPN, CNA) and discharge planning staff on adherence to evidence-based practices (EBP) for reducing preventable hospital readmissions. Although previous studies have shown that nurses are a valued source of research information

This descriptive research used social network analysis to explore the influence of relationships and communication among hospital nursing (RN, LPN, CNA) and discharge planning staff on adherence to evidence-based practices (EBP) for reducing preventable hospital readmissions. Although previous studies have shown that nurses are a valued source of research information for each other, there have been few studies concerning the role that staff relationships and communication play in adherence to evidence-based practice. The investigator developed the Relational Model of Communication and Adherence to EBP from diffusion of innovation theory, social network theories, relational coordination theory, and quality improvement literature.

The study sample consisted of 10 adult-medical surgical units, five home care agencies and six long-term care facilities. A total of 273 hospital nursing and discharge planning staff and 69 post-acute staff participated. Hospital staff completed a survey about communication patterns for patient care and patient discharge and about communication quality on the unit. Hospital and post-acute care staff completed surveys about relationship quality and demographic characteristics. Evidence-based practice adherence rates for risk assessment, medication reconciliation, and discharge summary were measured as documented in the electronic medical record.

Social network analysis was used to analyze the communication patterns for patient care communication at the unit. These findings were correlated with (1) aggregate responses for communication quality, (2) aggregate responses for relationship quality, and (3) EBP adherence. Statistically significant relationships were found between communication patterns, and communication quality and relationship quality. There were

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two significant relationships between communication quality, and EBP adherence. Limitations in response rates and missing data prevented the analysis of all of the hypothesized relationships.

The findings from this study provide empirical support for the role of social networks and relationships among staff in adoption of, and adherence to, EBP. Social network theory and social network analysis, especially the concept of knowledge sharing, provide ways to understand and leverage the influence of peer relationships. Future studies are needed to better understand the contribution that relationships among staff (social networks) have in the adoption of and adherence to EBP among nursing staff. Further model development and multilevel studies are
ContributorsSolomons, Nan M (Author) / Lamb, Gerri (Thesis advisor) / Verran, Joyce (Committee member) / Marek, Karen (Committee member) / Arizona State University (Publisher)
Created2016
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ABSTRACT

The purpose of this study was to investigate physical activity (PA) program characteristics preferred by low-income childbearing age Latinas and the relationship with the participants’ personal characteristics, cultural values, and acculturation. This was an exploratory study guided by the Preferences and Health Behavior Model (PaHBM), developed by this investigator. Recruitment

ABSTRACT

The purpose of this study was to investigate physical activity (PA) program characteristics preferred by low-income childbearing age Latinas and the relationship with the participants’ personal characteristics, cultural values, and acculturation. This was an exploratory study guided by the Preferences and Health Behavior Model (PaHBM), developed by this investigator. Recruitment occurred at three sites; two sites were located in Phoenix, AZ and one site was located in Houston, TX. Non pregnant Latinas between 18 to 35 years old were included (N=275). Latinas were excluded if they were pregnant, incarcerated, physically or mentally disabled, or had chronic diseases (e.g. cardiovascular disease). Quantitative data were collected using the Predictors and Preferences of Physical Activity Research Intervention Participation in an Underserved Latina Community Questionnaire, developed by this author, along with the Brief Acculturation Rating Scale for Mexican Americans, and the Mexican American Cultural Values Scale. The hypotheses were tested utilizing Chi-square, Pearson correlation and logistic regression. Annual family income, parity, country of origin, BMI and acculturation were the personal characteristics significantly associated with preferred PA program by this group of Latinas. Latino women were heterogeneous in their preferences. In general, sixty percent endorsed dancing as the type of activity preferred, 20% preferred PA education and 20% preferred walking. Major differences were found between the types of activity the Latino women were currently participating in compared to their preferred type of activity. Of the 124 who reported to be walking/jogging, almost half (49) preferred dancing, 22 preferred PA education and only 12 preferred walking. The study findings add to the existing knowledge by looking at factors that should be considered when developing PA interventions as well as when prescribing or recommending PA to this population. These results demonstrate the need to identify the preferred PA program characteristics of Latinas prior to developing interventions. Failure to know the patient’s preferred PA program characteristics may result in prescribing or recommending an undesired activity and decrease participation in PA interventions.



RESUMEN

El propósito de este estudio fue identificar las características preferidas en un programa de actividad física por una comunidad de mujeres Latinas de bajos recursos económicos y en edad fértil, así como la relación de esas características con sus propias características personales, sus valores culturales y su adaptación a la comunidad Anglosajona. Este fue un estudio exploratorio guiado por el “Modelo Preferencias y Comportamiento Saludables” (PaHBM), por sus siglas en Ingles, desarrollado por esta investigadora. El reclutamiento de las Latinas ocurrió en tres sedes: Una en Houston, TX y dos en Phoenix, AZ. Las mujeres Latinas fueron incluidas si tenían entre 18 y 35 años de edad. Se excluyeron mujeres que estaban embarazadas, estuvieran encarceladas, físicamente o mentalmente incapacitadas o que sufrieran alguna enfermedad crónica. Los datos cuantitativos fueron recolectados a través de una encuesta llamada “Predictores y preferencias de participación en un programa investigativo de actividad física”, desarrollada por la autora de este estudio, además utilizando la escala breve de aculturación para Mejicanos Americanos y la escala de valores culturales en Mejicanos Americanos. Las hipótesis fueron probadas utilizando el Chi-cuadrado, la correlación de Pearson, y la regresión lógica. Las características personales más asociadas con las características del programa preferido fueron el salario anual de la familia, el número de hijos, el país de origen, y el índice de masa corporal. En general, 60% prefirieron bailar, 20% clases de actividad física y 20% caminar. Mayores diferencias se encontraron en el tipo de actividad en las que las mujeres Latinas estaban participando, comparado con lo que ellas preferían. De 124 participantes que estaban caminando o trotando, 49 Latinas (39%) preferían bailar, 22 Latinas (17%) preferían clases de actividad física y solo 12 Latinas (10%) prefirieron caminar. Estos resultados demuestran la necesidad de identificar las características del programa de actividad física antes de crear dicho programa. Estos resultados son una adición a los conocimientos existentes, en los que se identificaron factores que deben ser considerados cuando se planea un programa así como cuando se prescribe o se recomienda actividad física a esta población. Sera un fracaso no conocer las preferencias de una paciente para mantenerse físicamente activa porque puede resultar en la prescripción o recomendación de actividades que la paciente no desea y esto se traducirá en reducción de la participación en programas de actividad física.
ContributorsJiménez, Blanca Flor (Author) / Reifsnider, Elizabeth G. (Thesis advisor) / Belyea, Michael (Committee member) / Shin, Cha-Nam (Committee member) / Arizona State University (Publisher)
Created2016