Theses and Dissertations at Montana State University (MSU)
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Item Sleep attitudes in adolescents: demographic differences and associations with sleep health(Montana State University - Bozeman, College of Letters & Science, 2023) Alvarado, Giovanni; Chairperson, Graduate Committee: Cara A. PalmerAbout 70-90% of adolescents in the United States receive less than the recommended 8 hours of sleep on a nightly basis despite its importance in everyday functioning (Keyes et al., 2015). Health-related attitudes are modifiable and predict actual health behaviors and previous research suggests that there are differences in how people value sleep (Ruggiero et al., 2019). Although previous work has examined sleep attitudes in teenagers, this has yet to be examined quantitatively in relation to actual sleep behavior. The purpose of this study is to examine how adolescents prioritize sleep and how this relates to other sleep outcomes. Participants included 649 adolescents from the United States (ages 13-18, M = 16.2, SD = 1.08; female = 79.7%; white = 45.2%) and were recruited through advertisements distributed throughout Instagram. Participants completed a brief 15-minute online survey to assess sleep outcomes and sleep attitudes. Adolescents completed the Charlotte Attitudes Towards Sleep Scale, the Pittsburgh Sleep Quality Index, the Sleep Timing Questionnaire, the Adolescent Sleep Hygiene Scale, the MacArthur Scale of Subjective Social Status - Youth Version, and sociodemographics. A series of regression models were conducted examining sleep outcomes predicted by adolescent sleep attitudes while adjusting for sociodemographics. An additional regression model was conducted examining adolescent sleep attitudes predicted by perceived socioeconomic status while adjusting for sociodemographics. Results suggested that teens who reported more positive attitudes towards sleep also reported longer sleep duration, better sleep quality, shorter sleep latency, earlier weekday and weekend bedtimes, and better sleep hygiene. There were also no significant differences in sleep atttitudes across sociodemographics. Follow-up exploratory analyses examined the two sleep attitudes subscales as independent predictors and outcomes and the pattern of findings remained unchanged. This study helps address the lack of research surrounding sleep attitudes in an adolescent sample. Results showed that sleep attitudes significantly predict sleep outcomes, but no significant differences were found across sociodemographic groups once accounting for covariates. Overall, findings from this study advance research on sleep attitudes by examining attitudes in a youth sample and suggest that sleep attitudes are a possible modifiable target to minimize sleep health difficulties.Item Atypical antipsychotics and metabolic side effect monitoring: a quality improvement project(Montana State University - Bozeman, College of Nursing, 2022) Maricich, Allison Nicole; Chairperson, Graduate Committee: Lindsay BenesSecond-generation antipsychotics (SGAs) have increasingly been utilized by psychiatric providers for patients experiencing a wide array of psychiatric disorders. Originally, SGAs were approved for patients 18 years of age and older; they now have been more consistently utilized in patients under the age of 18. SGAs have significant benefits for many patients, although metabolic side effects from the medication can be detrimental to patients' overall sense of wellbeing. The doctor of nursing practice (DNP) quality improvement (QI) project aimed to improve the metabolic screening rates of adolescent patients admitted to an inpatient residential unit at a pediatric psychiatric hospital. This was done by implementing a paper screening tool that outlined which screening laboratory values had been completed, which needed completing, and when each of these laboratory values were ordered for completion, highlighting a fasting lipid panel, hemoglobin A1c, weight, and blood pressure. A four-week implementation period took place from February 4, 2022 to March 4, 2022. Participants in the project included four psychiatric providers: two psychiatric mental health nurse practitioners (PMHNP) and two psychiatrists. Procedures that took place included (1) providers were educated on the purpose of the QI project and the importance of metabolic screening, (2) the paper screening tool was completed for patients prescribed SGAs, (3) laboratory studies were ordered based on the provider's discretion after completing the paper document, and (4) the paper document was stored and scanned into the patient's chart upon discharge. The results indicated that 75% of patients prescribed SGAs had paper screening tools completed, 85% of patients prescribed SGAs had metabolic screening laboratory studies ordered, and 55% of patients prescribed SGAs had metabolic screening laboratory studies completed. These findings mirrored current literature regarding metabolic screening in patients taking SGAs, suggesting that with the implementation of consistent education, completion of a physical paper screening tool, and systematic ordering of metabolic screening laboratory values, metabolic screening rates improve. The QI project showed success in the preliminary stages and throughout the four-week implementation timeframe, indicating that continuing the project will likely have benefits for adolescent patients prescribed SGAs in residential psychiatric units.Item Educating psychiatric nurses in cognitive behavioral therapy for adolescent patients: a quality improvement project(Montana State University - Bozeman, College of Nursing, 2021) Thralls, Claire Eileen; Chairperson, Graduate Committee: Tracy HellemIt is estimated that 20% of adolescents have a diagnosable mental health disorder. However, there is a deficit of providers that are available to treat this population. This gap in care can potentially be mitigated by increasing mental health caregivers' education on therapeutic interventions. Cognitive behavioral therapy (CBT) is considered to be the gold standard of care for the population of adolescent mental health patients. This project set out to educate nurses working on an inpatient adolescent unit on topics of evidence-based CBT and adolescent group therapy. Nurses interacted in a 3-hour educational intervention that reviewed topics of CBT, group therapy with adolescents, and the Creating Opportunity for Empowerment (COPE) program. Additionally, the nurses participated in a role-playing group therapy session to practice implementing CBT interventions to adolescent patient populations. This intervention was utilized to determine the feasibility and effectiveness in educating psychiatric nursing staff on CBT concepts with regard to group therapy for adolescent populations. After participation in the intervention, nursing staff reported benefits and satisfaction with the CBT and group therapy intervention, increased understanding of CBT concepts and interventions, and enhanced preparation for working with adolescent psychiatric patients. It is hoped that this project will guide adolescent-mental-health caregivers in seeking additional education in CBT practices to enhance their education in evidence-based interventions.Item Family environmental risk factors for adolescent substance use: an integrative review of the literature(Montana State University - Bozeman, College of Nursing, 2019) Walker, John Caleb; Chairperson, Graduate Committee: Tracy HellemSubstance use continues to be an ongoing problem throughout the United States and worldwide. In terms of substance use initiation, adolescence is characterized as an especially vulnerable developmental time period. There are many potential influences that can affect an adolescent's risk for initiating substance using behaviors. One particularly influential factor is the family environment the adolescent is exposed to on a daily basis. The purpose of this project was to summarize the evidence on the topic of adolescent substance use risk factors within the immediate family environment. Following an integrative review guideline, three library databases were searched utilizing a set of key search terms in order to obtain all relevant studies related to this topic. Each relevant research article found in the literature search that met the inclusion and exclusion criteria was included in the review process. Research findings were extracted from these research studies, organized into common categories, and integrative summaries were presented. The results of the review were categorized and presented based on commonly identified influential factors that were examined in the primary studies. As a result of this review, it was concluded that many significantly influential immediate family environment risk and protective factors have been identified in the literature. The significance of these findings and the potential implications for practice, prevention, and research, are discussed.Item The effect of drug-free school zone laws on teen drug use(Montana State University - Bozeman, College of Agriculture, 2019) Wert, Eric Daniel; Chairperson, Graduate Committee: Mark AndersonOne often stated goal of drug policy in the United States is keeping drugs and drug related violence away from children. Drug-free school zone laws, which impose harsher penalties on those caught on drug related offenses near schools, are perhaps the most ubiquitous policies with this specific aim in mind. While some form of drug-free zone is currently enforced in all 50 states, several have made reforms to their laws in the last 10 years. Using data from the Youth Risk Behavior Survey, I estimate the relationship between weakening drug-free school zone laws and teen drug use. I find little evidence to suggest these reforms have led to increases in teen drug use.Item Group Diabetes Self-Management Education (DSME) for adolescents with type 1 diabetes to improve knowledge and understanding of self-management skills(Montana State University - Bozeman, College of Nursing, 2018) Stewart, Maria Lynn; Chairperson, Graduate Committee: Jennifer SofieThose with type 1 diabetes mellitus (T1DM) are required to perform many self-care activities, such as monitoring blood glucose and taking insulin, every day to prevent long term complications associated with the disease, such as retinopathy, neuropathy, nephropathy and heart disease (American Diabetes Association, ADA). Knowledge of the self-management skills required to care for diabetes is known as Diabetes Self-Management Education (DSME). Adolescents with T1DM struggle with management of their disease for many reasons, and most often it is the family who receives the education at diagnosis. This leaves the adolescent vulnerable to a gap in understanding their disease process and proper management skills. Implementation of group DSME that is led by a diabetes specialist is showing promise in the adult setting and has implications for youth with T1DM as well (Raymond, et al, 2015). Surveys assessing knowledge and confidence in management of T1DM were given before and after a group DSME class were given to nine participants. Results of the post surveys show that there was an increase in both knowledge and confidence after the class among all participants. These results suggest that there is a benefit to group, adolescent specific DSME classes.Item Increasing health literacy in adolescents(Montana State University - Bozeman, College of Nursing, 2018) Buckingham, Claire; Chairperson, Graduate Committee: Jean M. Shreffler-GrantNearly half of American adults have difficulty understanding and using health information. Despite numerous efforts to address health literacy, measurable improvements have been limited. Measures and improvements in the health literacy of adolescents are even more inadequate. Adolescents are developing important life skills and health behaviors which makes this an opportune stage in life to intervene and improve health literacy. The purpose of this project was to measure and increase health literacy among adolescents. To achieve this purpose, a sample of 23 adolescents, age 15-16, participated in a pre-test survey to measure health literacy using the Newest Vital Sign and eHEALS, attended an educational intervention, and completed a post-test survey to re-measure health literacy. The educational intervention contained information on where to find health information online and how to evaluate those sources. The pre-test survey scores on the Newest Vital Sign indicate that most of the 23 participants (65%) had adequate health literacy prior to the educational intervention. Following the educational intervention, there was no significant change in the participants' Newest Vital Sign scores while there was a significant improvement in the eHEALS scores. The results indicate that the educational intervention improved participants' perceived skills at using electronic health information. Further research and programs are needed to continue to identify successful methods of improving health literacy in adolescents. Measuring the health literacy of patients allows providers to tailor communication and education to each patient and improve the patients' experience.Item Motivating adolescent females into Science, Technology, Engineering and Mathematics (STEM)(Montana State University - Bozeman, College of Letters & Science, 2017) Essman, Sandra Lea; Chairperson, Graduate Committee: Greg FrancisDuring the treatment time period, the junior high life science class of seventh and eighth grade students were introduced to science, technology, engineering, and mathematics (STEM) with the goal to motivate the female students into related areas of study. During the treatment, students participated in presentations, labs, activities, and cooperative group assignments that dealt with STEM courses and careers. These included presenters with STEM careers coming into the classroom or meeting online to talk to the students about their STEM careers, engineering labs which the students participated in to heighten their awareness of everyday objects we use that are related to STEM, and the students working together in the classroom on STEM activities to reinforce the many aspects of STEM in our lives. All of this was done with the intense purpose to increase the female students' knowledge of STEM in order to motivate them to want to take more STEM related courses in school and to further their education into STEM related careers.Item The effectiveness of adolescent group counseling in Montana district youth guidance and aftercare homes(Montana State University - Bozeman, 1976) Crnkovich, Carlene Ann GemmellItem Adolescent decision making and risk behavior(Montana State University - Bozeman, College of Nursing, 1996) Trombetta, Dolores Jean