Scholarship & Research
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Item A registered nurse care manager's role in implementing a veteran obesity program(Montana State University - Bozeman, College of Nursing, 2022) Fleming-Weiler, Denise Dawn; Chairperson, Graduate Committee: Denise RiveraAim: A link exists between obesity, hypertension, cardiovascular disease, diabetes, and numerous other comorbid conditions. Studies have shown that weight reduction has a positive effect on comorbid conditions. The aim is to develop an obesity management program that combats obesity in the veteran population by focusing on self-efficacy and the registered nurse (RN) care manager role. Design: Quality improvement project Methods: The databases searched include Montana State University: CatSearch, Google Scholar, ProQuest, CINAHL, MEDLINE, and EBSCO Web of Science. The study participants include adults who met the Center for Disease Control and Prevention's (CDC) definition of obesity, with a Body Max Index (BMI) greater than 30 kg/m 2. Results: Further research could yield better practices for successfully implementing weight management treatment and intervention plans if programs focus on self-efficacy and collaboration with established programs. Additionally, more research would help identify an obesity registered nurse care manager's impact in combating obesity in the veteran populationItem A quality improvement project to address veteran obesity(Montana State University - Bozeman, College of Nursing, 2022) Anderson, Mary Rebecca; Chairperson, Graduate Committee: Susan LuparellObesity is rising, and veterans have more risk factors than the general public. The health implications and financial burden are enormous. Established guidelines recommend weekly in-person intensive lifestyle counseling focused on diet, exercise, goal-setting, and self-monitoring. Despite referrals to free obesity management classes, few veterans choose to engage. Alternatives to these referrals include provider engagement and nurse follow-up. Research shows promising evidence that self-monitoring with the use of smart phone apps with nurse phone support results in reductions of BMI for some patients. By establishing a clinic workflow, this QI project sought to show that primary care teams can manage obesity alongside other chronic health conditions. The healthcare teams screened, assessed, and began treatment for obesity over an 8-week implementation period. Data from the pilot implementation show greater than 90% staff compliance with process measures. Provider referral rates increased 20% suggesting increased comfort with discussions about weight over time. The project demonstrated that the clinic process is feasible for staff to deliver. Future implementations can focus on patient-level outcomes, such as reduction in BMI and acceptability of the intervention to patients.Item Academic and social engagement in various online-delivery formats for military veteran students(Montana State University - Bozeman, College of Education, Health & Human Development, 2021) Ridenour, Rodney Ross; Chairperson, Graduate Committee: Sweeney WindchiefThis qualitative study explored the social and academic engagement experiences of military veteran students in various online-delivery formats at a small, rural university. There are very few studies describing the experiences of veteran students in online formats in higher education. The researcher interviewed eight military veteran students from different military branches. The participants had a range of prior educational backgrounds. The students had taken several types of online-delivery classes in their coursework and had completed their requirements for bachelor's degrees using online education. Several themes emerged from the engagement in different online formats. The study found student-veterans enjoyed the flexibility to study around their work schedules and being in online classes, which have more nontraditional students. The learning management system provided easy interaction with other students and opportunities to meet with faculty during virtual office hours. Learning and adapting to newer technologies was a negative part of some online formats. Some online formats stressed more written engagement while hybrid formats provided live engagement with other students and instructors. Veteran students liked more interaction from instructors in technical classes, but too much engagement added little value to many classes. The findings of the study indicate veteran students enjoyed engagement with other nontraditional students and instructors who participate in discussions. Negative themes that emerged were online classes with lack of student or instructor involvement and certain online-delivery formats being poor choices for certain subjects and learning styles. Limitations of this study are that it is a small, qualitative study with participants who all successfully fulfilled the requirements for their degrees. This study provides insights on positive and negative engagement experiences of veteran students in different online-delivery formats.Item What interventions are successful in the treatment of sleep disturbances in veterans with PTSD? : an integrative literature review(Montana State University - Bozeman, College of Nursing, 2015) Huston, Erin Marie; Chairperson, Graduate Committee: Jennifer SofiePosttraumatic stress disorder (PTSD) is the most common mental disorder associated with military combat and is a significant health risk for military veterans (Nayback, 2009). The sleep disturbances associated with PTSD are some of the most disabling and difficult to treat aspects of the disorder (Nayback, 2009). The nightmares experienced by veterans are often resistant to typical psychological and pharmacological interventions and require a specifically tailored treatment to improve sleep (Nappi, Drummond, Thorp, & McQuaid, 2009). Interventions for sleep disturbances have not been widely studied in populations with PTSD (Swanson, Favorite, Horin, & Arnedt, 2009).The purpose of this integrative literature review was to gain knowledge of successful interventions for sleep disturbances in veterans with PTSD. Current literature was reviewed and analyzed to increase knowledge of the interventions available for improving sleep in this population. A total of seven articles met inclusion criteria and were utilized in the literature review. Articles were located by searching electronic databases and by hand searching abstracts and reference lists. A constant comparison method was utilized in which data were extracted from the research articles and then compiled into systematic categories (Whittemore & Knafl, 2005). The data were assembled into a large matrix allowing for the comparison of each research study (Whittemore & Knafl, 2005). When performing this literature review, it became evident that there are few interventions available to treat sleep in veterans with PTSD. There did not appear to be a single intervention that was most effective in treating sleep in veterans with PTSD. This review did find literature suggesting that Cognitive Behavioral Therapy (CBT), Imagery Rehearsal Therapy (IRT), and prazosin have all shown varying degrees of effectiveness in the treatment of sleep disturbances in veterans with PTSD. This review of literature suggests it may be beneficial for future research to focus on a combined approach of CBT, IBT, IRT, and prazosin.Item Decreasing suicide among veterans(Montana State University - Bozeman, College of Nursing, 2014) Perry, Livia Csonka Marta; Chairperson, Graduate Committee: Polly PetersenEstimates are showing that approximately 22 veterans commit suicide per day. Those at highest risk for suicide are married, white males between the ages of 50-59 with a high school education or higher, located in specific western, central and eastern states. Research has shown that 45% of those who completed suicide have seen their PCPs in the month preceding their death, and 67% of those who attempt suicide receive medical attention as a result. Although PCPs may be in a strategic position to assess for suicide risk within the veteran population, research has shown that suicide screening is underutilized in the Primary Care Setting. A possible cause for this may be the inadequate training of practitioners in the area of suicide screening. Research has demonstrated that educating PCPs in this area resulted in an increase in suicide screening in their practice settings. To meet this educational gap, a podcast was created for the purpose of educating PCPs on the topic of veteran suicidality and suicide screening. To test the effectiveness of the podcast, Montana State University graduate students from the College of Nursing were invited to participate in listening to the podcast. Each participant completed a corresponding pre and posttest. Test results show an average increase of 21% in correct answers when comparing pre and posttest results, indicating that the podcast effectively served to convey intended information to participants.Item Montana veterans in farming, a study of the institutional on-farm training program(Montana State University - Bozeman, College of Agriculture, 1954) Lee, Don G.This study of the Veterans Institutional On-Farm Training Program, -under the G.I. Bill of Rights, was conducted to determine the progress that enrolled veterans had made in (l) establishment in farming, (2) establishment in home and community, and (3) reactions to present and future agricultural education programs for adults. Schedules were taken by personal interviews. One hundred Type "A", or self-proprietor farmer-veterans were chosen at random from schools that had maintained training classes for two or more years. All veterans in the survey had had at least two years of training prior to being chosen for the survey. Veterans selected were widely scattered throughout the State to give the best possible picture of the veterans progress and agricultural conditions in their respective areas. Schedules were taken largely by Field Supervisors of the Vocational Agricultural Department of the State Department of Public Instruction. The study reveals the progress made by veterans over a span of two years. In general, veterans are becoming better established in farming as shown by an increase in size of farms, a rather stable tenure status, an increase in the land used for crops, increased yields, and a decided increase in labor income and total net worth as sound investments in farming. In addition, livestock management has shown an increase in animal units per farm and increased rate of production of meat and livestock products. There is a gradual trend toward a more diversified type of farming which fits well with climatic and economic conditions for the State as a whole. Veterans are, in the main, rather well satisfied in farming, although they are conservative about their opinions on satisfaction of living conditions. The veteran does not possess strong inclinations to join civic, social, or cooperative organizations, He is more interested and active in community improvement projects and school affairs. The veteran's reaction toward the present training program is quite favorable. Eightly-six percent are interested in similar agricultural education classes for adults in the future. This interest is substantiated by a willingness of 93 percent of all veterans to pay tuition fees for an instructional program. Means of improving adult educational programs are recommended, including methods of class instruction for adults, increased on-farm individual instruction, systematic planning and development of adult classes, and means of presenting a broadened program supplemental to agricultural education.Item A study of demographic characteristics and postsecondary experiences of Montana Veterans Upward Bound participants(Montana State University - Bozeman, College of Education, Health & Human Development, 2001) Petriccione, Luke Louis