• The Nurses' Role Supporting Quality of Life in School-Aged Children (ages 7-17) with Brain Tumors; Role in Clinic and Support Group

      Leger, Robin; Dunnebier, Nichole (2014-05-17)
      Background: The United States is home to approximately 13,000 Pediatric Nurse Practitioners (PNP), professionals whom are deemed capable of providing care to the growing number of children with chronic illnesses (Dunham, Freed, Lamard, Loveland-Cherry, Martyn, 2010). Some 2,000 children are affected by brain tumors each year and are often cared for by a PNP. They can suffer from affected Health Related Quality of Life (HRQOL) factors or sequela that the PNP is responsible for addressing. Objective: To gain insight into the PNP’s role in caring for the pediatric patient with a brain tumor and observe how she addressed HRQOL factors and long-term sequela the child is faced with. Methods: An observational descriptive study was conducted. A convenience sample of six children undergoing treatment in clinic and nine children in remission at a support group were observed, specifically appraising the PNP’s role in caring for them. Results: Children seen in both the clinic and the support group experience HRQOL factors, and the PNP addressed them in several different ways. She assessed the children’s signs and symptoms, made plans of care, identified referrals needed, and made them feel as though they had were a part of a group with hope for the future. Conclusion: The PNP plays a pivotal role in caring for children with brain tumors through continuity of care; they are one of the first people to meet the patient and family members, and are responsible to ensure their comfort. PNPs also play the vital role of assessing the patient and identifying the child and family needs, any abnormalities, as well as addressing sequela. Finally, in support group, the PNP is a facilitator for the children’s peer support, reflection on their experiences and promotes hope for their future.
    • The Association of Symptoms of Anxiety in Children Ages 6-12 and the Exposure to Violence in the Media

      Hills, Donna; Crowley, Jacklyn (2014-05-17)
      Through a review of the literature, my research project explored whether or not violence in the media causes symptoms of anxiety in children ages 6-12. It is suspected by multiple child psychologists that violence in the media can affect children and cause them to develop symptoms of anxiety. By reviewing case studies as well as scholarly articles and journals I found that there was some evidence to support this premise as well as evidence that did not. The focus of my literature review was children ages 6-12 because they tend to be impressionable and vulnerable to their experiences. Limitations to this study would include articles that reported studies on age groups other than the childhood age group such as young adults and the adolescent, as well as the manifestation of anxiety and definition of violence defined differently by various authors.
    • Sexually Transmitted Infections in the Elderly: Nursing Implications for Prevention and Education

      Leger, Robin; Winslow, Catherine (2014-05-17)
      This study will examine why the elderly population in the United States is at high risk for contracting and spreading sexually transmitted diseases. Through a review of literature, many different risk factors will be identified and discussed. The study will also include methods of prevention to protect this population. Education strategies will also be discussed, not only for the members of the elderly population, but for the health care professionals who treat them. By identifying risk factors, providing education, and learning about prevention, the rate sexually transmitted diseases are being spread will decrease among the elderly population.
    • The Mirena Migraine - A Review of the Pharmacodynamics of Levonorgestrel and Its Implications in Women's Health

      Magazzu, Tammi; Earl, Lexus (2014-05-17)
      The new progestin, levonorgestrel, delivered via an intrauterine system or subdermal implant is showing promising signs of preventing pregnancy, decreasing excessive bleeding with menstruation, and returning fertility when removed (Backman, 2004). As promising as the levonorgestrel parental systems are, side effects are a common cause for concern and are a large reason for premature removal (Coukell & Balfour, 1998). Other than prolonged bleeding from insertion, and heavier periods for some women, other side effects have been observed such as weight gain, mood changes, dizziness and persistent, headache (Backman, 2004). With headache being one of the primary reasons for premature removal, previous literature has shown strong antiestrogenic activity among the pharmacodynamics of levonorgestrel (Schindler, 2003), which in turn may be the causative agent for the headache experienced among users. Given that headaches are mediated by vasodilation and vasoconstriction, the antiestrogenic activity of levonorgestrel is hypothesized to affect estrogen mediated vasodilation (Schindler, 2003). As one of the strongest antagonist of estrogen, levonorgestrel has also been discussed to affect the oxidation of low-density lipoprotein (LDL) cholesterol impacting the endothelium of the cardiac vasculature (Zhu, Bonet, & Knopp, 2000). This review aims to identify how levonorgestrel could be the causative agent for the physiologic phenomenon of a headache experienced among users so that medical professionals and drug manufacturers can be guided towards developing and prescribing a more effective and tolerable birth control option.
    • Communication Techniques Used by Medical and Surgical Nurses to Communicate with Patients with Alzheimer's Disease

      Frost, Marion; Mathieu, Chelsea (2014-05-17)
      Through the process of a literature review and an online survey of medical and surgical nurses currently working in the hospital environment, this study investigates “Techniques Used by Medical and Surgical Nurses to Communicate with Patients with Alzheimer’s Disease.” The literature review covers current research explaining how Alzheimer’s disease affects a person’s ability to verbally communicate and ability to understand verbal communication. The research also covers the most effective communication techniques to utilize when communicating with a person with Alzheimer’s disease. Nurses in the medical and surgical fields have been given an online survey which includes demographic information, scenarios, and various communication techniques that could be implemented when talking to someone with Alzheimer’s disease. The information from the online survey has been analyzed for trends to show if nurses are using the proper techniques when communicating or if they are following the misconceptions. This study contributes to an area of research that is lacking information, as well as explores if medical and surgical nurses are communicating effectively with an ever growing population of patients with Alzheimer’s disease.
    • Literature Review of Kennedy Terminal Ulcers: Identification, Diagnosis, Nursing Goals, and Interventions

      Hills, Donna; Vera, Rachel (2014-05-17)
      Although not greatly researched, the paucity of available literature theorizes that Kennedy Terminal Ulcers (KTUs) are clinical indications of skin failure. Through a review of the literature, the topics of: (1) methods of KTU identification, (2) how to make a proper nursing diagnosis, and (3) suggested nursing interventions will be discussed. Included in this literature review are anecdotal articles written by experienced healthcare professionals working in the hospice and palliative care fields. Case studies which focus on the development and treatment of KTUs incurred by end-of-life patients receiving hospice or palliative care services are also presented. The available literature corroborates that there are five characteristic wound criteria that serve to identify and diagnose KTUs. Though clinical professionals have different approaches on how to treat KTUs, the current literature concurs that nursing interventions should include: adequate pain control, hemorrhage prophylaxis, effective wound dressings, exudate management, infection prophylaxis, effective debridement methods, and odor control. Limitations encountered by the clinicians studying the development and treatment of KTUs include ethical dilemmas (i.e. inducing patient fatigue, inflicting emotional distress, or occupying the patient's valuable time as they approach end of life) and limited awareness of the existence of KTUs. Further research is needed to raise awareness of the existence of KTUs and how they are indicative of skin failure, for they must be identified, diagnosed, and treated accordingly so nurses are able to better advocate for the patient and ensure quality comfort care is provided as the patient approaches end of life.
    • A Literature Review of the Onset of Social Media and its Effect on HIPPA Violations

      Magazzu, Tammi; Bogosian, Jamie (2014-05-17)
      Social media has become increasingly popular in the United States and is accessed daily. It consists of different websites such as Facebook and Twitter. Access to these websites is easy and fast, allowing users to frequently network. In many situations, social media can be utilized in a positive manner. However, in fields such as nursing, social media can be detrimental. The Health Insurance Portability and Accountability Act, HIPAA, provides specific and strict regulations regarding the use of social media in the medical field. Breaching patient confidentiality can jeopardize a nurse’s job and future career. With the onset of social media, HIPAA violations have increased. This thesis will provide a literature review of social media and its onset, and how it affected HIPAA. I will show how these websites have caused more violations of HIPAA, and provide interventions and suggestions to decrease the violations. Specific methods will be included to show how the problem can be fixed. In addition, a brief history of social media will be provided to illustrate how it is extremely prevalent.
    • A Literature Review of the Negative Impact of Dementia on the Nutritional Status of Hospitalized Elderly Patients

      Frost, Marion; Geary, Jennifer (2014-05-17)
      Dementia is a progressive psychological disorder in the elderly population that leads to cognitive impairment and can have an impact on many areas of their life, especially nutrition. It is very common to see hospitalized dementia patients not receiving proper nutrition because they are unable to feed themselves, and often are not provided with the help they need. Nutrition is often a topic that is overlooked in the hospital setting because of the narrow focus on the patient’s diagnosis that caused their admission. Dementia is also a disease that may not be diagnosed until it has progressed to later stages, with the person suffering for many years before interventions take place. This is a very important issue in nursing because malnutrition can lead to further illness and a delay of healing in the elderly, leading to prolonged hospital stays, readmissions, and reoccurring health problems in these patients. This thesis will be a review of medical and nursing journals that look at the impact of dementia on proper nutrition in the hospitalized patients and the different nursing interventions that are used to improve nutrition in these patients. I will also make suggestions for changes in these nursing interventions to improve their effectiveness. A review of the epidemiology of dementia and nutrition requirements of the elderly person will also be included in this thesis.
    • Parents' Perception of Health-Related Quality of Life (HRQOL) and Hope for Their Child Living with Plagiocephaly: A Case Series

      Leger, Robin; Durgin, Gabrielle (2014-05-17)
      Purpose: To examine Positional Plagiocephaly and its relationship to the parents’ perception of the quality of life (QOL) and hope for the future of their child. Study Design and Methods: For the purpose of this honors thesis, a descriptive case series with parent interviews of their experience with infants and toddlers with Positional Plagiocephaly was conducted. In addition, themes from parental postings from a web-based social network for parents of children treated for Positional Plagiocephaly were constructed. Results: A convenience sample of three cases with six parents and themes from the social network were obtained. Two of the case studies were family members and the third case study was a friend of a colleague. Posts made by parents from three pages on a social network were obtained. Consent was obtained prior to the start of the interviews. This project was accepted by the Institutional Review Board (IRB) at Salem State University. The student researcher also completed the Collaborative Institutional Training Initiative (human subject training). This research demonstrated that larger case series are needed to look at the long term effects of this diagnosis. Both qualitative and quantitative studies on the nurse’s role, health- related quality of life (HRQOL), and hope measures need to be conducted. This research may also help nurses and other medical personnel address issues that parents who have a child with Positional Plagiocephaly are concerned about.
    • Knowledge of HIV screening in Women of Childbearing Age: 18-50

      Leger, Robin; Najjar, Alexandra (2015-05-01)
      Background and Significance: Today across the globe, children are still being born with Human Immunodeficiency Virus (HIV) contracted from their mothers. Although the Center for Disease Control and Prevention (CDC) recommends that all women be screened for HIV during each pregnancy, women are still failing to meet this goal. Research shows that women who understand the benefits of HIV screening for their developing child in utero are more likely to receive an HIV screen during pregnancy. Furthermore, research has shown that women who perceive themselves as “low-risk” are less likely to receive and HIV screen prenatally. Methodology: The nursing student and faculty advisor composed a survey with questions on demographics, HIV transmission knowledge and a self-evaluation tool to assess women’s perception on their own knowledge of HIV transmission, screening, and benefits of screening. Results: Nearly 70% of women indicated of how much they themselves believed to known about HIV transmission with a range of scores from 27 to 100. Women’s responses to the VAS for knowledge of benefits of prenatal treatment for the developing fetus were much more discouraging than the previous VAS scale results. For this scale, there was a mean of only 34.1 with a range of 0-93. The standard deviation among responses was 27.1, meaning there was high variability among samples. Finally, the last VAS scale asked women to rate their knowledge of the fact that HIV transmission from mother to child can be prevented over 98% with the proper treatment. Women’s mean for this scale was only 44.7 with a range of 0-96 and the standard deviation among responses was 30.8, meaning there was also high variability among responses. Education level had absolutely no correlation to women’s knowledge of HIV transmission, screening, or treatment benefits during pregnancy. Of equal importance, results show that the majority of HIV transmission questions that were answered incorrectly were related to oral transmission. Implications: Education about HIV transmission and screening during pregnancy needs to be spread to women of all educational levels. Further research can focus on how best to educate women and how to promote prenatal HIV screening for all women during every pregnancy.
    • Systematic Literature Review: A Family Approach to Postnatal Depression

      Campbell, Charlene; Swain, Charlene (2015-05-01)
      Through a systematic review of literature, this research project explores a family approach to postnatal depression (PND). Within the first year of giving birth, seven to 15 percent of woman experience postnatal depression. Postnatal depression does not solely affect new mothers, but also fathers and babies. In conducting a systematic review of Cumulative Index of Nursing and Allied Health Literature (CINAHL), Boston Public Library Electronic Resources, and Education Resources Information Centre Database (ERIC), along with Google and Google Scholar, nine peer-reviewed studies were ultimately selected for inclusion in this review. The systematic literature review revealed the benefits of a family approach to postnatal depression. Three main themes emerged from the research: 1) social and relationship support; 2) paternal PND; and 3) PND stigma. According to the results found in this review, teaching about PND should be focused on the all-new families in addition to the new mother. These results demonstrate teaching interventions should occur during the prenatal and postnatal time to reduce PND instances in both women and men.
    • Advancements of Nursing Roles in Pediatric Burn Care

      Leger, Robin; Scherrer, Stephanie (2015-05-01)
      Burns are a common injury for children, especially in toddlers and adolescents. Nurses are in the front line of care and possess many roles within the care of pediatric burn patients. Nursing roles in pediatric burn care can be organized into three major areas of care, including acute, rehabilitative and psychological. it is the roles that nurses carry out that make a difference in the long term quality of life in the pediatric burn patient. Goals and objectives: To address nursing roles in all three major areas of nursing care in pediatric burn care, acute care, rehabilitation care, psychosocial care, long term care and follow-up care.
    • How Stigma and Negative Attitudes Towards the Mentally Ill Affect Patients' Quality of Care: Moving Towards a Better Understanding for Change

      Fraley, Hannah; Shanahan, Molly (2015-05-01)
      Background: 1 out of every 4 American adults currently have a form of mental illness, while 50% of others will develop a mental disorder at some point in time. Mental illness not only emotionally deteriorates a person; it impairs one’s ability to function daily. Mental illness is highly correlated with other chronic diseases, such as diabetes, cardiac conditions and obesity, as well as homelessness and drug and alcohol dependency. The mentally ill are less likely to access healthcare for treatment due to experienced stigmatization, negative attitudes and stereotypes due to their diagnosis. The aim of this study is to detect and understand the negative attitudes towards the mentally ill, and to recognize how to work towards facilitating change in health care. Methods: CINAHL databases were searched to identify studies performed relating to the stigmatization of mental illnesses and how negative stereotypes affected patients’ quality of care. Results included data from qualitative and quantitative studies. Out of 171 reviewed papers, 11 met the criteria to perform this literature analysis. Results: Stigma towards the mentally ill is a prominent theme identified within the literature. Evidence based changes to eliminate stigma and negative attitudes towards mental disorders must be taken to improve quality of care. Understanding experienced stigma among the mentally ill is a first step to promote much-needed changes to health care delivery.
    • Information Available to Patients Diagnosed with Dementia: Interviews With Caregivers and Their Experiences

      Fraley, Hannah; Williams, Leigh (2015-05-01)
      Purpose: Dementia is a prevalent problem for older adults and their families. Early intervention and a multidisciplinary approach for treatment have been linked to better quality of life. The primary objective of this study was to discover what information is available to patients with dementia upon diagnosis and how beneficial the information given is perceived by the primary caregivers. Secondary objectives included types of resources most utilized by the caregiver and how caregivers found out about such resources. Methods: A qualitative study design was employed using snowball sampling methods and semi-structured interviews among primary caregivers (n= 5) of patients with Alzheimer’s Disease (n= 3), Lewy Body Dementia (n= 1), and Dementia Unspecified (n= 1) respectively. Thematic coding methods were used to identify potential barriers to accessing timely information regarding disease prognosis and optimal resources. Results: Several themes emerged from caregiver interviews. Central themes found among the caregivers include: 1.) chronic grief 2.) chronic frustrations 3.) chronic guilt 4.) total responsibility of care. Several subthemes emerged that compound upon these caregiver experiences including provider related parries such as lack of quality information, and access barriers including difficulty finding community resources. Conclusion: Caregivers interviewed in this study perceive support from their health care team in general, yet have limited perceived support in navigating how to access community resources. Patients and their families need guidance and support from the health care team upon diagnosis, yet also need ongoing support and education while caring for a loved one with Dementia.
    • Depression and Mental Health Awareness Regarding Adololescents Within the Primary Health Care Setting: Study Protocol

      Fraley, Hannah; Visconti, Andrew (2015-05-01)
      Background: Depression is a serious illness, warranting adequate access to care and treatment among adolescents. The aim of this study was to further understand college students’ perception of mental illness and perceived parental views regarding mental health disorders. Methods: Ethnicity and fields of study were analyzed to note any significance amongst the groups. Convenience sampling was used, targeting participants’ ages 18-25 years at Salem State University. Using mixed methods methodology, participants was asked to conduct a survey questionnaire. Survey questions were geared towards participant perception of depression, and perceptions of parental views on mental illness. Results: A total of 266 anonymous surveys were collected and analyzed to find that the majority of participants’ parental views on education and depression were correct. On the other hand, 25% of surveyors believed that their parents would believe that depression is caused by bad or weak character. As for ethnicity, Asian or Pacific Islander (50%), Hispanic or Latinos (35%), and Black or African American (36%) were more likely to think that their parents would believe that depression is caused by bad or weak character. As for fields of study, non-science majors were more likely to have stigmatizing beliefs in regards to depression. Conclusion: Further education on depression knowledge should be acknowledged in the school system, media, and more importantly; our health care system. Increased and more in-depth screenings for adolescent depression should be seen by the primary health care provider in order to decrease the number of untreated depression cases. For future studies, a more in-depth survey should be distributed with a larger sample size to increase the numbers in diversity.
    • Todos Estamos Satisfechos? Are We All Satisfied? A Review of the Literature

      Fraley, Hannah; Crampton, Taylor (2015-05-01)
      United States healthcare is experiencing a growing need for medical interpretation among diverse populations. Of note, the Hispanic population is steadily growing reaching upwards of 17% of the US population. The Hispanic patient experience and perception of care is poorly understood in the context of patient to provider communication in the US, despite 62% of Hispanics primarily speaking Spanish and limited English. A review of the literature was conducted, the Cumulative Index of Nursing and Allied Health Literature (CINAHL) database was exhaustively searched for English language research published between 2000 and October 2014 that identified disparities between Spanish-speakers and English-speakers regarding their healthcare experiences. Keyword searches included the following: Spanish speaking patients, patient satisfaction, and health disparity. Of twenty-five articles initially yielded by the search strategy, seventeen articles were selected that met inclusion criteria for further analysis and review. Within these articles, it appeared that patients generally did experience a lower rate of satisfaction as compared to English-speaking patients regarding their healthcare providers and the language utilized. Contrastingly, an article described a population of Spanish-speaking patients whose language barrier was not reported as an issue when being assessed for domestic violence. Limited research exists which targets the Hispanic patient population and language barriers faced when communicating with their health care providers. This presents an important gap in the literature to consider for this patient population specifically their experiences and perceptions of how care is delivered in the US. Culturally relevant research is needed in order to appropriately change the way in which health care is delivered to this population, which will ultimately improve patient to provider communication and health literacy.
    • Preparedness and Risk Factors of Compassion Fatigue in Undergraduate Nursing Students

      Leger, Robin; Homan, Sara Marie (2016-04-01)
      The incidence of compassion fatigue is increasing among healthcare workers especially those who do not know what compassion fatigue is and have not developed healthy ways to cope with compassion fatigue. Unfamiliarity with compassion fatigue stems back to nursing school. Research has been done on what compassion fatigue is, its causes and coping mechanisms but there is limited research as to how compassion fatigue effects students or whether or not nursing school prepares students on how to combat compassion fatigue in high stress or difficult situations. The intended purpose of this study is to evaluate the risk factors of compassion fatigue in undergraduate nursing students and their preparedness to deal with compassion fatigue as novice nurses. Methods: The study was set up as a quantitative study of freshman, sophomore, junior and senior undergraduate nursing students in the Salem State University Nursing Program. The ten-question survey contained questions related to demographics, risk factors for compassion fatigue and preparedness. Results: Data was analyzed using SPSS. Of the 607 possible BSN students, 105 (18%) BSN students completed the survey. 0% of students reported having no stress while 67.7% of students reported having an above average to extreme stress. 43.2% of BSN students reported frequently or constantly being preoccupied with the stressors of others. 73.3% of students reported that they had never heard of the term compassion fatigue. 96.2% of students reported that they do not frequently take time to wind down and reflect after a stressful situation. Conclusion: In conclusion, the research clearly demonstrates that students are in need of further education regarding the risk of compassion fatigue and how to better prepare themselves. The undergraduate nursing student's reported having several risk factors already in place including high stress and ineffective coping. They also reported being unprepared to deal with challenging situations involving patients.
    • Education Needs of Adults Living with Sickle Cell Disease in the U.S. and Jamaica

      Leger, Robin; Jordan, Kyle (2016-05-01)
      Purpose: To identify psychosocial and physiological components of sickle cell disease (SCD) health promotion to be included in patient and family education materials provided to an adult living with SCD for the promotion of wellness and reduction in complications of the disease. Background and significance: SCD occurs in approximately one in five hundred Jamaican born people and about 0.49 out of 1000 in America and results in intense pain episodes, and multi­organ failure (Knight-Madden, 2011). The role of the nurse and other healthcare providers as well as community based organizations in patient education is critical for promotion of quality of life. Tannahill (2009) argues that "fostering of empowering attributes such as resilience, self­esteem, confidence and lifeskills" also falls under the realm of education. Methods: A combination of telephone and written questionnaires were completed by nurse experts caring for patients with SCD in the U.S. and Jamaica, as well as executive board members of community based organizations for the support of community members living with SCD and their families. Discussion: There is a consensus that individuals with SCD are not adequately educated about the condition and its implications. Respondents recommended that those living with SCD be taught about basic physiology of the disease, family planning, early signs of complications, and exacerbating factors. Furthermore, each respondent explored barriers to effective educational interventions as well as methods of enhancing the quality and effectiveness of these interactions. This information can be used to develop effective educational materials for improving health outcomes.
    • Nursing Students’ versus Non-nursing Students’ Understanding of Oral Contraceptives

      Fraley, Hannah; Quirk, Victoria Josephine (2016-05-01)
      BACKGROUND/PURPOSE: Many people are aware that oral contraceptives (OCs) are used to correct unwanted side effects from a woman's menstrual cycle or used to prevent an unwanted pregnancy from occurring, or used in combination. However, many students are unaware of side effects and risks that OCs can have upon each individual consumer. The purpose of this study was to examine undergraduate nursing students' understanding of OCs and compare it to undergraduate non-nursing students' understanding ofOCs to see if the side effects of OCs are truly understood. DESIGN AND METHODS: A quantitative study was conducted among undergraduate students attending Salem State University, located in Salem, Massachusetts. The survey was accessible from early November 2015 until December 2015. An online survey database was utilized to collect responses electronically and was sent to both nursing and non-nursing students who attended Salem State University during that time frame. RESULTS: Regardless of the major or class standing, most participants had a general understanding of the risks and side effects that OCs can have. IMPLICATIONS: Healthcare providers should focus teaching on OCs towards helping consumers accurately understand the side effects and risks that are associated with this medication, along with deciphering the truth from various misconceptions.
    • Student Nurses' Knowledge of End-of-Life Treatment Options in Dementia Patients

      Fraley, Hannah; Coulter, Shelby Anne (2016-05-01)
      Dementia is a serious disease that affects 46.8 million elders globally with 9.9 million new cases each year. It is not often understood that dementia is considered a terminal illness, and it is thought that misconceptions about dementia may be a factor of poor quality of care for this vulnerable population at the end of their lives. Nurses are on the front lines of caring for dementia patients, however nurses may lack knowledge of how to best care for dementia patients and their families. A qualitative survey study will be conducted using a convenience sample of Salem State nursing students (N= 100). Specific study aims include: do nursing students know about dementia, advanced directives, and end of life care and treatment options specifically related to the dementia patient? Thematic coding methods will be used to analyze the data. Results from this study will help identify knowledge needs of nursing students related to end-of-life treatment for dementia patients. Understanding knowledge needs of nurses can further inform future educational programs for nursing students in order to increase the quality of care for this population.