Theses and Dissertations at Montana State University (MSU)
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Item A description of a project on the use of mindfulness for stroke survivor caregivers(Montana State University - Bozeman, College of Nursing, 2021) Kirby-Johnson, Valerie Katherine; Chairperson, Graduate Committee: Tracy HellemSome stroke survivor caregivers experience caregiver burden and depression after their family member experiences a life-altering cerebrovascular accident. Stroke survivor caregivers may face negative mental and physical health impacts when providing stroke survivors' care within their home, which can lead to the stroke survivor encountering negative health outcomes. Educating stroke survivor caregivers on mindfulness cognitive behavioral therapy provides them with a tool that can allow them to better cope with caregiver burden and depression that can be experienced when providing care. Therefore, the purpose of this project was to provide stroke survivor caregivers with education about the use of mindfulness to improve mental health. Data collection consisted of the Caregiver Burden Scale and Patient Health Questionnaire at baseline, at time of stroke survivors' discharge and two weeks after discharge to home. Largely related to the onset of the COVID-19 pandemic, this project had limited recruitment (n=2) and retention (n=0). Given the mounting evidence on the benefits of mindfulness practices, this project could be implemented in the future when social interactions, such as in-person support groups, resume post COVID-19 era.Item Implementation of a nurse-driven algorithm for safety companion usage: a pilot study(Montana State University - Bozeman, College of Nursing, 2019) Phillips, Kahrin Lillian; Chairperson, Graduate Committee: Jennifer Sofie and Susan Luparell (co-chair)Safety companions, also known as sitters, are commonly placed in a 1:1 setting with patients in hospital settings to maintain their safety. These patients include (a) those that are suicidal, confused, delirious, or violent; (b) those with psychiatric issues; (c) those with behaviors that interfere with their medical treatment; and (d) those experiencing behavioral problems associated with substance abuse. However, several problems exist with the use of safety companions, such as cost, inconsistent evidence supporting their effectiveness, and lack of evidence-based guidelines for their use. The primary aim of this pilot study was to assist staff RNs on a 39-bed inpatient hospital unit in using more discernment in the use and management of safety companions. Based on the needs of key stakeholders at the pilot site and a thorough review of the literature, a nurse-driven, evidence-based algorithm for safety companion usage was developed and implemented over four months to meet this aim. In addition, the project investigated the issues surrounding safety companion use and compared these issues to those experienced at the pilot site. Five online surveys targeting different groups of stakeholders were used pre- and post-implementation of the algorithm to assess their perceptions of the algorithm and its effect on the management of safety companion usage. The success of the algorithm was determined by the level of nursing satisfaction with the algorithm and whether it was helpful to assess their patients for a safety companion. The primary aim of the project was successfully met, with all participating team leaders finding the algorithm to be 'somewhat' to 'very effective' in helping staff RNs in being more discerning with the use and management of safety companions. Most of the unit's participating team leaders (87.5%) were satisfied with the algorithm, and all of the participating staff nurses found the algorithm to be 'somewhat helpful' or 'very helpful.' Implications for improvement included room for additional education and training for safety companions, improved staffing and support when using the algorithm, and issues surrounding patient safety.Item Father-specific education in the inpatient setting(Montana State University - Bozeman, College of Nursing, 2019) Smith, Pamela Alejandra; Chairperson, Graduate Committee: Sandra Benavides-VaelloThe early postpartum period is an important period of time to prepare mothers and fathers for parenthood. Father's involvement in children's lives has shown to be beneficial for the child's health and the entire family dynamics too. Evidence shows that parental education increases knowledge and confidence levels in parents. Currently, the majority of educational efforts and programs target mothers, leaving men with none or minimal tools to succeed as fathers of a newborn. A major goal of Healthy People 2020 in relation to children's health is a ten percent reduction in infant and neonatal deaths. One key approach for reaching this goal includes increasing the amount of educational and community based programs for infant and child health to increase knowledge in parents (both mothers and fathers) of safe practices with infants and children. This pre/post-quasi-experimental project was designed to evaluate gender specific education and changes in parental confidence level when exposed to educational literature. The project was implemented in the maternity unit at St. Vincent's Healthcare in Billings, Montana. With a total of 32 fathers as participants. Results of the project indicated an overall maintenance or improvement of parent confidence level evidenced by a maintenance or increase in Karitane Parenting Confidence Scale scores. Results of the project are expected to facilitate fathers' responsiveness to baby and better bonding of baby to father in the immediate future. Outcomes are expected to lead to positive consequences in children's health and development. Results also indicate the educational intervention with fathers was overall successful in fulfilling the purpose of this scholarly project.Item Social support and health of partners of people with multiple sclerosis(Montana State University - Bozeman, College of Nursing, 1995) Burns, Laura JeanItem Rural caregivers risk perceptions of environmental hazards(Montana State University - Bozeman, College of Nursing, 2014) Rassi, Rebecca Lynn; Chairperson, Graduate Committee: Wade G. HillThe mounting scientific evidence linking environmental exposures to human health hazards has increased the need for effective environmental risk communication efforts to the public. One key component of providing effective environmental risk communication is risk perception: understanding how individuals and communities perceive environmental health risks. Risk perception research has shown that environmental risk perceptions are affected by social, cultural, and economic factors as well as other concepts such as power, trust, and mass media. Nested in the larger Environmental Risk Reduction through Nursing Intervention Evaluation project (ERRNIE), the purpose of this study was to describe how rural caregivers perceive the severity of environmental health exposures and to determine which environmental exposures were most concerning to rural caregivers. The study was guided by two aspects of the health belief model, perceived susceptibility and perceived severity. Findings indicated that uncontrollable exposures such as exotic infectious disease, water quality concerns, and radon were perceived as most concerning while common controllable exposures were least concerning. These findings were discussed as it applies to current risk perception theory and to risk communication efforts of nurses and nurse practitioners.Item Caregiver fatigue in the intensive care unit : an integrative review(Montana State University - Bozeman, College of Nursing, 2013) Silvers, Holly Allison; Chairperson, Graduate Committee: Susan LuparellCaregiver fatigue is a real problem facing critical care nurses. The causes need to be identified and addressed in a timely manner so prevention strategies can be developed. Reduction of caregiver fatigue may subsequently prevent burnout and keep nurses from leaving the profession or experiencing distress in their personal and professional lives. The purpose of this integrative review was to explore the causes of caregiver fatigue among critical care nurses working in intensive care units. Inclusion and exclusion criteria were established prior to the integrative review and five empirical studies were identified that met the criteria. Potential causes of caregiver fatigue identified in the evidence were staffing concerns, shortage of nurses, overtime, increased work load, scheduling conflicts, communication barriers, younger age of patient, severity of injury, polytrauma, family grief and anger, inadequate pain control, medication errors, emotional distress, constancy of presence, burden of responsibility, negotiating hierarchical power, engaging in bodily caring, being mothers, daughters, aunts, sisters, and increased personal stressors. Better understanding of the causes of caregiver fatigue will hopefully lead to the development and implementation of interventions to preserve the mental health of nurses and prevent further decline and burnout.Item Supporting caregivers through education on dementia(Montana State University - Bozeman, College of Nursing, 2011) Smith, Kammiell Marie; Chairperson, Graduate Committee: Elizabeth S. KinionDementia, a degenerative condition, is a progressive and debilitating disease evidenced by a decline in cognitive function affecting memory, communication, motor activity, and judgment. It is difficult for caregivers to cope with substantial changes in behavior, personality, and communication associated with this illness. Consequently, as the population ages the incidence of dementia will increase. It draws particular importance to the family caregiver role in maintaining the activities of daily care and managing unpredictable, progressive changes of the disease. Caregivers of persons with dementia take on a role that has considerable responsibility. Family caregivers also experience an added sense of duty that often leads to caregiver stress and burden. The purpose of this project was to develop an educational program. The program included a comprehensive literature review, input gathered from two assistive living homes and one senior center, and a one-hour educational presentation. The one hour educational presentation was presented at two assisted living homes and one senior center. Careful consideration was given to the aspects of stress and burden on family care givers of individuals with dementia. Psychosocial interventions, caregiver self-care, community resources, and interventions to assist with activities of daily living were also discussed. Content for the educational presentation addressed the following topics: signs and symptoms of dementia; interventions to assist with communication, behavioral and environmental management; and community resources to help with caregiver burden. Of the eight key lessons learned, two lessons are important to note. First, it is imperative to assess the emotional needs of the caregiver prior to the program development. Second, caregivers require an individualized approach to dealing with individuals with dementia. Important roles for Family Psychiatric Mental Health Nurse Practitioners (FPMHNP) are to provide anticipatory guidance to family caregivers about managing the changes in behavior, personality, and communication associated with dementia. They should also develop individualized, appropriately tailored, psychosocial interventions for the management of dementia. The FPMHNP is instrumental in assisting family caregivers with self-care management and providing information on community resources.