Theses and Dissertations at Montana State University (MSU)
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Item Improving health outcomes by reducing vitamin D deficiency in a rural clinical setting: a quality improvement project(Montana State University - Bozeman, College of Nursing, 2024) Pollard, Saije Madisen; Chairperson, Graduate Committee: Julie Ruff; This is a manuscript style paper that includes co-authored chapters.Vitamin D deficiency strongly correlates with high morbidity and health risks such as fatigue, mood irregularities, and muscle weakness. As of 2023, there are over one billion people of various ages suffering from vitamin D deficiency (Almuqbil et al 2023). A rural Wyoming clinic lacked a standardized process to screen for vitamin D deficiency, yet the condition is highly prevalent within their patient population. This quality improvement project aimed to implement a standardized vitamin D screening process within the rural Wyoming clinic. Patients were screened and offered a blood draw to obtain their vitamin D levels at each office visit. If applicable, patients were offered vitamin D supplementation. In concurrence with the lab draw, patients were asked to fill out a PHQ-9, GAD-7 and Fatigue Severity Scale (FSS) to track their mood and energy levels. The lab draws and screening questionnaires were repeated after eight weeks of supplementation. Screening for vitamin D deficiency improved from less than 20 percent prior to implementing the standardized process to over 90 percent after eight weeks of implementation. There was no significant correlation between PHQ-9, GAD-7, FSS and vitamin D levels. Eight individuals received the eight-week lab draw and 62 percent of these individuals had optimal vitamin D levels, 70-100mg/dL. The standardized vitamin D screening process was successful in increasing quality and frequency of screening; however, a significant correlation between mood, fatigue, and vitamin D levels was not found.Item A descriptive study of rural women's health literacy about vitamin D(Montana State University - Bozeman, College of Nursing, 2011) Larson, Jennifer Lynn Doores; Chairperson, Graduate Committee: M. Jean Shreffler-GrantThe purpose of this study was to determine women's health literacy about vitamin D. Few studies address rural women's health literacy. As major health decision makers for their families, rural women have influence over the health of rural populations. Vitamin D deficiency is suggested to be associated with chronic diseases such as rickets, cancer, diabetes, cardiovascular disease, and multiple sclerosis. Therefore, this study was designed to highlight the unique rural women's circumstance surrounding health literacy about vitamin D. Nola Pender's revised Health Promotion Model (HPM) framed this descriptive survey. The survey included a quiz about vitamin D facts, as well as information about vitamin D practices and selected factors outlined by the HPM. In this study, relationships were explored between vitamin D health literacy and rural women's perceived access to health care services, as well as, the HPM selected factors. A sample of 400 women was randomly selected for the mailed survey, yielding a response rate of 41.2% (n = 126). The results showed that the majority of the participants had (a) marginal health literacy about vitamin D, (b) took widely varying amounts of vitamin D, (c) and got their information about vitamin D from their primary care provider, their most trusted source, and (d) reported access to health care services as easy. No significant relationship between access to services and vitamin D health literacy was found. The relationship between vitamin D health literacy and self-efficacy for health promotion was the only factor that showed significance. The study has implications for additional research about the relationship between self-efficacy for health promotion and health literacy of rural women. Additionally, research into rural women's relationships with their primary health care providers, may, in turn, improve rural women's health literacy. Implications for nurses include the importance of (a) obtaining histories about vitamin supplement dosages, (b) providing education about vitamin D; (c) addressing vitamin D and cardiovascular health, (d) and addressing rural women's health literacy needs verbally and through appropriately written material.