Theses and Dissertations at Montana State University (MSU)
Permanent URI for this collectionhttps://scholarworks.montana.edu/handle/1/733
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Item 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. LucasThis 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.Item Pain and quality of life in older osteoarthritic women living in different environments(Montana State University - Bozeman, College of Nursing, 1991) Christiaens, Phyllis CharleneItem Health-related quality of life outcomes of participants in a Montana-specific, online support community for people in Montana with inflammatory bowel disease(Montana State University - Bozeman, College of Education, Health & Human Development, 2014) Nehasil, Mary Jo; Chairperson, Graduate Committee: Marilyn LockhartResearch shows that access to social support can help mitigate the negative psychological effects of chronic illness, and positively influence health outcomes, ultimately improving the health-related quality of life (HRQOL) of those affected. However, many with inflammatory bowel disease (IBD) in Montana may lack access to social support and illness-related knowledge needed to manage their disease successfully. If a viable, accessible, and beneficial opportunity were available, it would be crucial to have the endorsement of local physicians. The problem addressed in this study was that those serving individuals in Montana with IBD need to know how individuals participating in a Montana-specific, online support community for those in Montana with IBD assess and describe their experiences within the community, and how they report that their experiences have affected their HRQOL in the areas of social support and illness knowledge. Three research questions were posed: How do participants assess and describe their experiences within the online community; how have their experiences impacted their HRQOL as exhibited through impacts on social support; and, how have their experiences impacted their HRQOL as exhibited through impacts on illness knowledge? Ten participants were recruited from the membership of the online community, MontanasGotGuts.org. A 20-item, self-report survey instrument was initially used to obtain demographic data, website usage data, and data on participants' experiences. Next, qualitative research methods, using semi-structured interviews, were conducted to collect more insightful, descriptive data. Study findings consisted of four major themes with 14 subthemes that illustrated how the participants experienced the online community. The major themes included: participants expressed a need to meet others with IBD; participants reported low active participation levels; participants valued the community as a source of IBD-related information; and, participants valued the community as a source of social support. Recommendations were made to the researcher, the national IBD community, those with IBD and their physicians, and other online health community administrators.Item The lived experience of patients with psoriasis(Montana State University - Bozeman, College of Nursing, 2005) Gittings, Megan McGonigle; Chairperson, Graduate Committee: Madine ParkerPsoriasis 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.