Matching Items (27)
Description
ABSTRACT Approximately 3.5% of adolescents in the United States have chronic daily headache (CDH). Chronic daily headaches in adolescents are often refractory to the adult pharmacological interventions. And as a result, adolescents typically experience increased levels of stress, which exacerbates their headaches. Chronic daily headaches negatively impact both the adolescent and their family. Adolescents with CDHs frequently exemplify comorbid psychiatric symptoms such as anxiety, depression, and increased risk for suicide. Risk factors for CDH in adolescents have been well studied; however, few studies have focused on psychologically based interventions to enhance effective coping, positive mental health, and pain relief in this group of teens. Given the paucity of psychologically focused interventions in this group, further research is necessary to test and develop the effectiveness of cognitive behavioral skills building (CBSB) interventions. This pilot study focused on the use of a CBSB intervention that emphasized problem solving, cue recognition, effective communication, behavior modeling, cognitive reappraisal, stress management, effective coping, and positive thinking. A randomized controlled trial pilot study was conducted. The intervention group received a seven-week intervention focused on CBSB techniques and headache education, while the comparison headache education group received a seven-week program focused on basic headache hygiene measures (e.g., adequate sleep, adequate hydration, dietary triggers, environmental triggers). The total sample included 32 adolescents inclusive of the ages 13 and 17 years. Paired t-tests resulted in significant preliminary positive effects for COPE-HEP on anxiety, depression, beliefs, headache disability, headache frequency, and headache duration. Comparison group education resulted in significant preliminary positive effects on anxiety, depression, headache disability, headache frequency, headache pain level, headache duration, and medication frequency. There were no significant changes over time in means of parent perception of pain interference for both groups. Independent t-tests revealed that COPE-HEP teens had significantly less anxiety and headache duration at post-intervention. The acceptability of the COPE-HEP intervention with adolescents with CDHs in a specialty care setting is supported by this study, while the feasibility of conducting this study in a specialty care setting is partially supported. These findings support a need to refine the intervention and test both its short and long-term effects in a full-scale randomized controlled trial with adolescents who have CDHs.
ContributorsHickman, Carolyn (Author) / Melnyk, Bernadette M (Thesis advisor) / Jacobson, Diana (Thesis advisor) / Gance-Cleveland, Bonnie (Committee member) / Szalacha, Laura (Committee member) / Arizona State University (Publisher)
Created2012
Description
Abstract
Objective: The purpose of this literature review is to examine the most psychometrically sound (e.g., valid and reliable) instruments measuring physical activity (PA) so that reflection of preschool children’s activity and documentation of intervention effects on preschool child PA is accurate.
Methods: Rigorous validation and calibration studies and those studies designed to test the psychometric properties of PA measurement instruments were specifically sought out to include in this review. Articles were excluded if they did not include specific information about the validity and reliability of the PA measures used with preschool children.
Discussion: Of the six articles reviewed, the systematic review used the most rigorous protocols to conduct its review, yielding the highest level of evidence appraising several validation studies. Because Pfeiffer et al. (2006) utilized the most valid and reliable criterion measure (Cosmed® portable metabolic system), the validation study this research team conducted is deemed to have identified the most valid and reliable cut points to utilize when reducing accelerometry data.
Conclusion: Current cut-points vary widely and greatly affect the reported results of a study. Therefore, it is critical that authors reference validation studies used to support the cut-points that were employed in the data-reduction phase. Currently, validation methods have been identified using high quality criterion measures in rigorous validation studies and thus it is strongly recommended that those cut points be used in data reduction processes.
Objective: The purpose of this literature review is to examine the most psychometrically sound (e.g., valid and reliable) instruments measuring physical activity (PA) so that reflection of preschool children’s activity and documentation of intervention effects on preschool child PA is accurate.
Methods: Rigorous validation and calibration studies and those studies designed to test the psychometric properties of PA measurement instruments were specifically sought out to include in this review. Articles were excluded if they did not include specific information about the validity and reliability of the PA measures used with preschool children.
Discussion: Of the six articles reviewed, the systematic review used the most rigorous protocols to conduct its review, yielding the highest level of evidence appraising several validation studies. Because Pfeiffer et al. (2006) utilized the most valid and reliable criterion measure (Cosmed® portable metabolic system), the validation study this research team conducted is deemed to have identified the most valid and reliable cut points to utilize when reducing accelerometry data.
Conclusion: Current cut-points vary widely and greatly affect the reported results of a study. Therefore, it is critical that authors reference validation studies used to support the cut-points that were employed in the data-reduction phase. Currently, validation methods have been identified using high quality criterion measures in rigorous validation studies and thus it is strongly recommended that those cut points be used in data reduction processes.
ContributorsAcuna, Kelsey Manique (Author) / Jacobson, Diana (Thesis director) / Small, Leigh (Committee member) / Barrett, The Honors College (Contributor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor) / W. P. Carey School of Business (Contributor)
Created2014-05
Description
The purpose of this study is to learn about registered nurses' thoughts and experiences about the use of music and music therapy in the nursing field and whether or not nurses believe that there is supporting evidence practicing music therapy. Through an online survey administered to a local chapter of Sigma Theta Tau International Nursing Honors Society via SurveyMonkey, the study will 1) Assess the awareness and knowledge that registered nurses have regarding the use of music in the medical field. 2) Understand bedside nurses' willingness to use music as a complementary medicine in their own practices. 3) Ascertain where and how bedside nurses get knowledge about the use of music in the medical field. 4) Determine what constraints or barriers may influence bedside nurses' utilization of music in their practice. 5) The study will also examine the extent to which bedside nurses have had experience with observing music therapy or have utilized music therapists in their own practice.
ContributorsVintilescu, Maria Oana (Author) / Kenny, Katherine (Thesis director) / Jacobson, Diana (Committee member) / Barrett, The Honors College (Contributor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2013-12
Description
There is a shortage of online resources for children who have epilepsy. Most of the current online resources are designed for populations with a higher health literacy. This creative project addresses this shortage by offering education for children with epilepsy that they are able to access and utilize online to understand their disease in greater depth. Comprehending discharge information after hospitalization can be difficult for children and families, which is why providing an accessible resource that also can be utilized at home increases understanding about the disorder and ability to manage the disorder. Basic information on epilepsy, safety tips for daily living, medication explanation, first aid information, and interactive resources are included on the website and are all geared toward children. A website developer, Sylvestri Customization™, assisted with creating the website utilizing template, search engine optimization and strategies for website sustainability. The website was created after completing a thorough review of current research literature and reviewing multiple, similar hospital educational websites while also consulting with healthcare professionals to ensure the information was evidence-based. While the website provides supplemental education via an online platform for children with epilepsy to explore, there is a need for future research to test the acceptability and efficacy of the website.
ContributorsMilow, Alexandra (Co-author) / Denniston, Michaela (Co-author) / Crawford, Daniel (Thesis director) / Jacobson, Diana (Committee member) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor) / Barrett, The Honors College (Contributor)
Created2016-12
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 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.
ContributorsBahena, Sara (Author) / Jacobson, Diana (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-26
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 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.
ContributorsFriedl, Anne (Author) / Jacobson, Diana (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-29
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 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.
ContributorsChaisson, Charlotte (Author) / Jacobson, Diana (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-29
Description
Objective: To understand and prevent adverse discharge events, the project assesses the needs and gaps of discharge care coordination for child(ren) with medical complexities (CMC). The National Survey of Children’s Health show 87.4% of CMC does not receive care in a well-functioning system, and 47.4% did not receive adequate care coordination 1. Therefore, does initiating measurement tools and communication before and after discharge identify and prevent discharge related adverse events?
Methods: After IRB approval, a mixed-methods approach project occurred at southwestern pediatric free-standing hospital. Through eight weeks of convenience sampling, CMC caregivers were recruited in the inpatient setting (n=5). Qualitative and quantitative data were obtained through: [Pediatric] Care Transitions Measurement Tool – 15 (CTM- 15), with a Cronbach’s alpha of .932; a demographics survey; a post-discharge survey; and electronic health records.
Results: The CTM-15 post-discharge score was 83.3 (N = 4, SD = 9.83, SE¬M = 4.92). CTM-15 qualitative data included: communication issues; rushed discharge; poor discharge anticipatory guidance; hospital policy concerns; follow-up appointment issues; and prescription errors. LOS average for all participants was 137.8 days (SD = 102.75, SEM = 45.95) with 40 unintended hospital days (SD = 41.55, SEM = 18.51). Issues encountered 30 days post-discharge included: prescription errors, follow-up issues, and home health issues.
Conclusion: Hospitalized CMC have an increased risk to encounter a discharge adverse event because of a complex intertwining of disciplines, services, medications, and needs. Communication, tools, and surveys did not capture all the problems encountered by families with CMC; however, it did identify areas of notable concern.
ContributorsChalla, Hannah (Author) / Bucci, Aimee (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-05-02
Description
Objectives: Asthma education is essential for every pediatric asthma management plan. This Doctor of Nursing Practice (DNP) Quality Improvement (QI) project, guided by the Social Cognitive Theory, aims to explore effective and innovative interventions for asthma management and determine if telehealth is an effective way to deliver asthma education to parents.
Methods: Parents (n = 5) of children with asthma at an urban pediatric primary care clinic were recruited to attend four weekly, 60-minute asthma education sessions over Zoom®. Participants were recruited with flyers and clinic referrals. Participants answered pre- and post-intervention online questionnaires following informed consent, including the Parental Asthma Management Self-Efficacy Scale (PAMSES), the Asthma Control Test (ACT), and a parent program evaluation. Paired sample t-tests were conducted to analyze data and measure mean differences in pre-and post-parent self-efficacy and asthma control in their child.
Results: The results include a statistically significant change in pre-intervention and post-intervention mean PAMSES scores. There was no significant difference between pre-intervention and post-intervention ACT scores; however, there was an increase in mean ACT scores from baseline.
Conclusions: Telehealth is a practical and cost-effective way to address gaps in asthma education and improve patient outcomes. The use of telehealth may be an effective way to address gaps in parent/patient education regarding the prevention of and management of asthma symptoms. Ongoing assessment is needed to evaluate if asthma telehealth education can be effective in other settings, languages, and age groups.
ContributorsFlores, M. Cynthia (Author) / Jacobson, Diana (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-29
Description
Introduction: Drowning is the leading cause of death in children between 1 and 4 years of age; in Arizona drownings are double the national average for this age group. The goal of this Doctor of Nursing project was to educate and empower pediatric providers to give quality drowning prevention (DP) anticipatory guidance (AG) to caregivers of children between 1 and 4 years of age at every well exam.
Method: This quality improvement (QI) project included 32 providers from six pediatric clinics in Arizona. A one-hour education session focused on drowning prevention followed one month later by a a thirty-minute follow-up feedback session were conducted. Pre- and post- education surveys were administered at the first session to measure perceived previous and future intended DP AG practice. An additional follow-up survey was administered at the second session to evaluate perceived change. In addition, caregivers were contacted and surveyed one to three months post initial education to assess provider delivery of AG. Likert-scales and descriptive statistics were used to evaluate data sets.
Results: Post-educational intervention, providers reported increased intention (p = 0.027) to provide water safety AG, and increased intention (p < 0.001) to connect water AG to developmental milestones. Post-intervention follow-up indicated an increased provision of developmentally specific water safety AG to caregivers (p < 0.001) and increased connection of developmental milestones in AG (p = 0.016). Barriers that prevent water safety AG were reported as time constraints and other perceived AG of higher priority.
Implications: This QI project adds to the literature and demonstrates the benefit of education to invigorate and empower increased provision of quality DP AG from providers.
ContributorsDiMiceli, Carolyn (Author) / Jacobson, Diana (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-22