Nursing (M.S.)

The goal of this research was to compare and contrast the elderly and adolescent populations’ knowledge about cholesterol and their lifestyle choices. Data for this study were gathered via a researcher-written survey that was given to elderly and adolescent sample populations in a rural area of western Pennsylvania. Each group consisted of 36 participants. The survey concerned demographics, lifestyle, and knowledge about cholesterol. Quantitative data were analyzed using descriptive statistics for demographics, level of knowledge, and lifestyle comparison.

A knowledge deficit was found in both sample populations. The elderly were able to answer only an average of 9% of the questions about cholesterol and the adolescents answered an average of 34% of these correctly.

The data also showed that the sample populations had several risk factors for developing high blood cholesterol. For example, 58% of the adolescent’s and 31% of the elderly used tobacco products. Thirty-five percent of the elderly population is overweight. The adolescent population was 8% overweight. The median time the elderly exercised four times per week was only 20 minutes whereas the adolescents exercised a median of 45 minutes six times per week. Of those that smoke and are sedentary only 6% were in the elderly population but 14% of the adolescent population fall into this category. More than 41% of the adolescents and only 14% of the elderly did not want additional education about cholesterol.

Teaching about cholesterol is recommended using an adaptation of the American Heart Association’s “Cardiovascular Risk Factor Education Program”. Smoking cessation also needs to be addressed.

This study compared a resident pet program and or visitation pet program and their effect on the loneliness experienced by nursing home residents. The sample was comprised of 52 subjects from two nursing homes in Northwestern Pennsylvania. The evaluation tool was the UCLA Loneliness Scale (version 3) by Russell. Subjects completed a 20-question questionnaire. The statistical tests were the t-test and the pearson correlation coefficient. Review of the data analysis suggested there was no significant difference in the loneliness scores and the type of pet program. An inversely related correlation was found between the loneliness scores and the number of years in the nursing home.

Hysterectomy, the removal of the uterus, is one of the most common surgical procedures performed; after cesarean delivery, it is the second most frequently performed major surgical procedure in the U.S. Approximately 75% of all hysterectomies are performed in women between the ages of 20 and 49 years. The highest overall rate is in the southern states with the lowest rates consistently in the northeastern portion of the U.S. Hysterectomy is more often performed in African-Americans than in Caucasians and is more frequently performed by male gynecologists' than female gynecologists. One in five women in the United Kingdom will have a hysterectomy by the time they reach the age of sixty-five (Chapple, 1995). Hysterectomy is often the last resort for women suffering from problems affecting the uterus. The most common problems include: uterine fibroids, cancer, abnormal uterine bleeding, pain and endometriosis. A lot of effort is made by the patient and her health care provider to avoid unnecessary surgery. Once the decision for hysterectomy is made it is important for the woman to understand the surgery and its risks as well as what is to be expected after surgery (Berek, Adashi, & Hillard, 1996).

The purpose of this study was to design a pamphlet to educate women undergoing hysterectomy about their post-operative course; in order to improve recovery and facilitate satisfaction of stay.

A retrospective study of 100 patient medical records was done to determine whether preoperative standardized screening tests could be reduced in healthy ambulatory surgical patients age 40 or older without compromising patient surgical outcome. A two way chi-square test of association was utilized to determine if there was any association between the outcome of patients’ elective ambulatory surgical procedures and the preoperative assessments which included the health history and physical examination, electrocardiogram, chest x-ray, and laboratory tests. This study found no statistically significant association between the preoperative assessments and patient surgical outcome. The results of this study indicate that preoperative tests are of little significance in predicting surgical outcome in healthy ambulatory patients. The study further indicated that the health history and physical examination should be done first and used as a tool in determining what preoperative standardized screening tests need to be performed.

The purpose of this study was to determine if women with a family history of breast cancer are adhering to the recommended guidelines for mammography use more often than women without a family history of breast cancer. Literature indicates these women are at high risk for contracting breast cancer and compliance with mammography screening is low (Center for Disease Control, 1997). An existing survey authored by Dr. Anna Miller (Miller & Champion, 1996) that examined demographics, compliance, attitudes, beliefs, influencing factors and knowledge of mammography usage was utilized. The sample consisted of 90 women from 2 sites in northwestern Pennsylvania. The results from this study indicate that women with a family history do not adhere to guidelines more than women without a family history. The compliance rate of having at least one mammogram was 80% in the group with a family history and 78% in the group without a family history of breast cancer. This is higher than what is reported in the literature. Having a health care provider recommend a mammogram was the greatest measure of adherence. The results were consistent with Dr. Miller’s study, and indicate that primary care providers are in a valuable position to influence compliance.

Sexually transmitted diseases (STDs) and their sequelae are very important problems in the adolescent population. There are 3 million adolescents that contract STDs each year (Donovan, 1997).

The purpose of this study was to determine if primary care providers are counseling adolescents about STDs. The study is a quantitative descriptive study in rural northwestern Pennsylvania. It consisted of six demographic questions and 37 yes and no questions to determine the percentage of PCPs (a) providing adequate STD counseling, (b) performing adequate risk assessments, (c) using adequate interaction skills, and (d) who indicated they cover the topics risk of contracting a STD and sexual abstinence for prevention.

Forty eight questionnaires were mailed to primary care providers, 23 were returned, and 17 were entered into the study. Fifty nine percent of the subjects counseled. Nearly the same percentage of males and females counseled. PCPs aged 41-50, in practice 11-15 years, and were nurse practitioners did the most counseling. PCPs aged 31 to 40, in practice six to 10 years, and were a pediatrician did the least amount of counseling. All primary care providers who counseled (a) performed adequate risk assessments, (b) adequately discussed the risk reduction topics, and (c) covered the risk reduction topics entitled risk of contracting an STD and sexual abstinence for prevention. All primary care providers used adequate interaction skills.

This study investigated high school students’ preferences for school-based health services. This non-experimental, quantitative design used a researcher-modified questionnaire. The survey addressed accessibility of services, availability of comprehensive medical services and health education/counseling at school, and identified students’ preferences in those services offered at school. The survey was completed by 117 students at a high school in northwestern, Pennsylvania. Thirty-eight percent stated they should have received health care and did not. Reasons included inconvenient office hours, lack of resources to pay fees, not wanting to see the family doctor, or miss school. These agreed with what is reported in the literature. Students were most interested (60% to 88%) in treatment for minor injuries, illnesses, and having routine physical examinations for sports and working papers. Interest was also high in education on health and nutrition, smoking, drug and alcohol abuse, and weight reduction. Overall, the results of this study agreed with findings in the literature. With the information generated from this study, an initial proposal for a school-based clinic was developed. It included a brief statement of the problem, the results of the needs assessment, statistics showing an increased pattern of usage of health room services, program plan and goals, expected costs, and possible funding sources.

This study investigated the research questions: How many people have an advance directive? and Do people want their primary care provider to discuss advanced directives during a routine office visit? This nonexperimental, quantitative study used a researcher designed questionnaire. The questionnaire was given to 100 members of a local wellness center who varied in sex, age, marital status and religion. Seventy-nine questionnaires were returned. Twenty-three percent of the research subjects indicated that they had advance directives, which was higher than the 15%-18% reported in the literature for random populations. But, only 43% wanted their primary care provider to discuss advance directives during a routine office visit, well below the 65%-68% reported in the literature for random populations. The results of this study, in contrast to other studies in the literature, showed that these subjects did not want their primary care provider to initiate a discussion of advance directives.

Asthma is the most common chronic childhood illness (Adams & Marano, 1995; Centers for Disease Control and Prevention, 1995). As children with asthma enter school, their teachers may become involved in helping them manage their asthma. Research literature review reveals few studies on teachers’ knowledge of asthma, or on the effectiveness of asthma education programs. The American Respiratory Alliance of Western Pennsylvania conducted an asthma education inservice program for elementary school teachers as part of their School Asthma Initiative. This study was conducted to assess the effectiveness of this inservice program. Malcolm Knowles’ Adult Learning Theory was the conceptual framework for this study. Thirty-six elementary school teachers participated in the study. Teachers’ asthma knowledge was tested using an identical Asthma IQ pretest and posttest. The teachers had a significant increase in their scores on the tests taken after the inservice program (p<0.01).

Responses to a researcher written survey revealed that although at least 60% of teachers reported having students with asthma, and almost one-half of teachers had previously had to assist a student with asthma symptoms, only two teachers had ever attended an asthma education program. Nearly all of the teachers perceived that they should have some role in assisting students to manage their asthma.

Children with asthma need proper support at school (National Institute of Health, 1997). Recognizing teachers, at least in part, as caregivers of children with asthma, and asthma, and networking in community based organizations to participate in asthma education programs, offers the nurse practitioner another opportunity for education.

The purpose of this study was to explore the relationship between nursing staff members who have positive or negative attitudes towards the change process and their support or nonsupport for the organizational strategic direction. Differences in attitudes towards the change process and degree of organizational support among nursing staff members with different licensure status were evaluated. This study also identified patterns and trends in relation to nursing staff members’ perceptions concerning factors that helped or hindered the successful change process within their organization. With this information, nursing leaders can better understand employees’ reactions to strategic change and implement steps prior to the change process to gain a more successful outcome. A literature review found little concerning nursing staff attitudes toward the process of change. However, the literature documented the rapid change taking place in healthcare institutions across the nation. The research participants in this study were forty-two nursing staff members in two rural hospitals in northwestern Pennsylvania. The research questionnaire utilized in this study consisted of a demographic section, a seven-point Likert scale that measured attitude and organizational support, one yes or no question with a comment section, and two descriptive questions with comment sections. The attitudinal and organizational support tools used were developed by Dr. Karen Gaertner of Georgetown University. The researcher designed descriptive questions were added to gain further insight into nursing staff attitudes and perceptions about successful or unsuccessful change efforts within their organization. This study concluded that there was no significant correlation between attitude and organizational support. The study did not reach a level of significance when looking at differences between or within the groups. Further research is recommended to verify these results in a larger sample, in more diverse healthcare organizations, and in other geographic locations.