Theses and Dissertations at Montana State University (MSU)

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    Multiple domain social determinants of health screening in adults
    (Montana State University - Bozeman, College of Nursing, 2021) Gillaspie, Danielle Rae; Chairperson, Graduate Committee: Amanda H. Lucas
    This DNP project sought to identify and address two social determinants of health (SDOH) negatively affecting adult patients ages 18 and older at the chosen primary care site in southwestern Montana. It was guided by the Centers for Disease Control's definition of five classifications of SDOH found to influence individuals' long-term health outcomes. The two SMART goals identified in this DNP project were firstly the successful screening rate of 50% of all adults ages 18 and older seen by participating providers at the primary care site. Secondly, two SDOH would be identified reflecting the highest rate of disparities in unmet social needs. These aims were accomplished through the utilization of the PRAPARE screening tool into providers' existing workflows and the creation of a patient resource guide addressing the two identified social determinants of health. The PRAPARE questionnaire was used as a self-administered screening tool to assess unmet social needs of participating individuals. Specific questions from the PRAPARE questionnaire were paired with the overarching SDOH and were scored. When patients reported one unmet need, it was recorded as one point under the corresponding SDOH. Data was then aggregated to determine the two social determinants demonstrating the highest rate of disparities within adult participants at the project site. The patient resource guide (Appendix E) aimed to address the two social determinants of greatest need at the site and provide community services available for the two SDOH.
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    Pain and quality of life in older osteoarthritic women living in different environments
    (Montana State University - Bozeman, College of Nursing, 1991) Christiaens, Phyllis Charlene
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    The lived experience of patients with psoriasis
    (Montana State University - Bozeman, College of Nursing, 2005) Gittings, Megan McGonigle; Chairperson, Graduate Committee: Madine Parker
    Psoriasis is a chronic skin disease affecting an estimated 4.5 million adults. Symptoms can be mild to severe, and consist of silvery exfoliative plaques of skin. Although there are various forms of treatment, there is no cure. Existing data regarding psoriasis confirms a link between decreased quality of life and psoriasis. Subjective data regarding the disease has been documented since 1976, however, there exists a lack of qualitative nursing research regarding psoriasis. Additionally, only one study was found in which the lived experience of psoriasis patients was documented. This phenomenologic study explores three patientαs lived experience with psoriasis in Montana. One on one interviews were conducted with the participants to document the experiences of living with psoriasis. Using the Roy Adaptation Model as a framework, particular emphasis is given to adaptative versus maladaptive responses. Entitled βlived experience statementsγ, quotes were taken from the interview transcripts and organized by common themes as well as individual statements. This was done, in part, due to Royαs belief that living systems are complex, and that adaptation can be an individual and dynamic response to the environment. An individualαs experience, while not common among all participants, is still reflective of their adaptation to disease. Participant responses illustrate concerns of patients with psoriasis and day to day events that may occur in their lives. By becoming familiar with lived experience statements, nurses, nurse practitioners and other health care providers can develop a deeper appreciation for the impact a diagnosis of psoriasis carries. This understanding may foster holistic care for the psoriasis patient, as well as encourage the nurse to be more aware of adaptation and the nurseαs role in the adaptive process.
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