Honors Projects for Nursing & Dental Hygiene

Permanent URI for this collectionhttps://hdl.handle.net/10125/27041

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Quantitative Analysis of the Current State of the General Public’s Perceptions of and Intentions to Perform Pro-Environmental Behaviors
(University of Hawaii at Manoa, 2021) Dorosy, Meghan; Tse, Alice; Nursing
Qualitative Analysis of the Current State of the General Public’s Perceptions of and Intentions to Perform Pro-Environmental Behaviors
(University of Hawaii at Manoa, 2021) Kawakami, Noelani; Tse, Alice; Nursing
Perceptions of Nutrition in Adolescents
(University of Hawai'i at Manoa, 2019) Higa, Mason; Tse, Alice; Endrizal, Cyndy; Nursing
Dietary choices may affect the risk of developing obesity and related health complications. There is insufficient evidence on how perceptions of nutrition in adolescents compare with the United States Department of Agriculture’s (USDA’s) MyPlate recommendations. This cross- sectional study compared the intake of fruits, vegetables, grains, protein, and dairy that 14- to 16- year-old children thought they should be consuming in a 24-hour period with the USDA’s MyPlate recommendations. A convenience sample completed a plate drawing activity at a health care site in Honolulu, Hawaiʻi, during which each participant was asked semi-structured, open- ended clarifying questions. The responses were sorted into the five MyPlate food groups and compared with the MyPlate recommendations by the principal investigator and a registered dietitian nutritionist. Of 13 adolescents who were approached, 11 (84.62%) met the inclusion criteria and enrolled in the study. Ten (90.91%) were male and 6 (54.55%) were 16 years old. Intake of fruits (Mdn = 80.00%, 95% CI [29.40%, 260.60%]), vegetables (Mdn = 40.57%, 95% CI [18.01%, 131.21%]), grains (Mdn = 70.00%, 95% CI [6.33%, 197.67%]), and protein (Mdn = 171.43%, 95% CI [93.19%, 301.31%]) varied when compared to the MyPlate recommendations. However, dairy intake (Mdn = 41.67%, 95% CI [14.17%, 80.25%]) fell below the recommendations. Adolescents tend to vary in their responses on intake. Further work on differentiating what adolescents think they should be eating from what they actually ate and want to eat needs to be done by nurses, dietitians, and health professionals.
Congruence between Injection Drug User Clients’ and Providers’ Perspective of Wound Care
(University of Hawai'i at Manoa, 2019) Azouz, Lilly; Tse, Alice; Qureshi, Kristine; Nursing
Nursing is a discipline that is committed to assisting patients develop self-help skills. One of the groups that need more involvement with their own care is injection drug users (IDU). The purpose of this study is to learn the similarities and differences of what IDU clients indicate they can do to take care of their wounds, and what are the nurse providers’ estimations of how well the IDU clients can take care of their wounds. Ten IDU clients and 1 wound care nurse practitioner participated over a 4 week period from July to August of 2018. A mixed method design was utilized. Semi-structured client interviews were performed. The wound care nurse practitioner completed a quantitative survey on each patient’s ability to take care of their wounds. Descriptive statistics and thematic analysis were used. Two client themes were evolved: basic management of wounds and physiological needs. 100% of the clients were willing to learn, they believed with more teaching they can do more to take care of their wounds. The provider believes only 20% of the clients in this sample can actually be educated to care for their wounds. While wound care providers and IDU clients may not have the same understanding of client independence abilities, further involving the patient with their care may assist the patient contribute to taking care of their wounds and further development to their own self-help skills. Key words: Nursing perspective, Injection drug user (IDU), Wound care, Homeless, Nurse, therapeutic relationship
Incidence of Burnout in Nursing Students
(University of Hawaii at Manoa, 2014) Coloma, Mazie; Codier, Estelle; Nursing
Nursing students are vulnerable to burnout as they struggle to master new skills while adapting to a new role. Their levels of burnout have been compared to the high levels of burnout experienced by nurses in clinical practice due to various stressors. Studies have shown students who experience burnout during nursing school are likely to underperform in future nursing practice. Burnout can affect student health as well. While there is ample research on nursing burnout and how detrimental it is to the nurses’ well being and the safety of their patients, little research has been published exploring burnout as experienced by nursing students. The purpose of this quantitative, descriptive study is to examine burnout in nursing students and answer the following research questions: 1) Do nursing students experience burnout? 2) Is there a correlation between student demographics and level of burnout? 3) What are the possible sources of burnout in nursing students? Three cohorts of nursing students completing their final semesters at the University of Hawaii School of Nursing were surveyed using the Maslach Burnout Inventory. Students were also surveyed for demographical information and self-report of burnout indicators. Findings showed high levels of exhaustion and cynicism, and moderate levels of professional efficacy in nursing students across all semesters. No significant correlations were found but academic workload and finances were identified as common sources of nursing student stress. This study supports future exploration of burnout experienced by nursing students and the need for measures to counteract burnout during nursing school.
Exploring salutogenesis as a concept of health and wellbeing in nurses who thrive professionally
(University of Hawaii at Manoa, 2017-05) Stock, Eleanor; Codier, Estelle; Nursing
Aim: To determine whether salutogenesis, a concept of health and wellbeing, can be identified in nurses who self-describe themselves as thriving professionally. Background: Nurse burnout can potentially impact clinical performance, patient safety, and increase the turnover of nurses, which all contribute to additional health care costs (Rushton, Batcheller, Schroeder & Donohue, 2015). The ability to not only avoid burnout, but to thrive in stressful environments is an important factor worth exploring. The salutogenic theory is related to this. Methods: This was a mixed method, exploratory, descriptive study which was undertaken to describe elements of the salutogenic theory, in survey data, from twelve nurses who describe themselves as “thriving” professionally. Qualitative data was analyzed for themes. Quantitative data was compared to the salutogenic model. Results: Qualitative data analysis revealed the importance of the following main themes: other people, passion, coping mechanisms, personal characteristics, and time. Quantitative data revealed the average Sense of Coherence (SOC) score, which measures a person’s perceived health, was 73.58 out of a possible 91 points. Ranking of scores revealed the four highest scoring means all correlated to the meaningfulness category of the SOC questionnaire.
Factors Associated with Leadership Behaviors in Nursing Students
(University of Hawaii at Manoa, 2016-05) Harada, Alissa; Codier, Estelle; Nursing
Over the next twenty years it is anticipated that novice nurses will begin to fill vacant nurse leadership positions as “the Baby Boomer” generation nurses retire. The Hawai’i Academic Progression in Nursing Leadership and Mentorship (L&M) program developed and implemented a pilot program using modules from the New Careers in Nursing Leadership Development Toolkit (4th edition) and the New Careers in Nursing Mentoring Program Toolkit and Handbook published by the Robert Wood Johnson Foundation. The purpose of the study was to identify and describe factors associated with nursing student leadership behaviors. Three cohorts of students participated in completing a survey developed for the purposes of this study. The first cohort was used to pilot the L&M program. The other two cohorts had components of the L&M program integrated into their nursing undergraduate curriculum. The results revealed a number of observable differences amongst the three cohorts. For example, the findings showed students self-report of preparedness to take on a leadership position upon completion of the program differed by cohort. In the Executive RN to BSN cohort (100%) responded they felt prepared to take on a leadership position, while 57.1% of the KCC nursing cohort and 38.6% of the UHM nursing cohort felt prepared to take on a leadership position. The finding of this study will contribute to our understanding of nursing L&M education. However, future studies are required to continue improving our knowledge of leadership development in undergraduate education to ensure sustainability of leadership as Baby Boomers leave the nursing workforce.
Examining Student Perspectives of Learning Effectiveness in High Fidelity Simulation
(University of Hawaii at Manoa, 2015-05) Yester, Chloe; Codier, Estelle; Nursing
Background: High Fidelity Simulation is defined as a representation of an actual event, which can be presented through different methods such as computer software, case studies, written scenarios, acting, role playing, games or manikins (Bearnson and Wiker, 2005, Beaubien and Baker, 2004, Goldenberg, D., Andrusyszyb, M.A., & Iwasiw, C. (2005). Simulation learning allows students to interact and participate in simulated scenarios, gaining experience and the opportunity to practice in a mock clinical setting. In 2012, an $8 million simulation center opened at the University of Hawaii School of Nursing. Minimal research has been conducted in this area, and the simulation center aims to support research endeavors that examine simulation teaching and learning. With these vast resources now available in the field of nursing simulation, it's an opportune time to examine the effectiveness of simulation as a learning tool. Purpose-This study was undertaken to explore the perspectives of students on simulation learning-effectiveness. Method-Participants in the study included nursing students with experience in simulation learning environments. Focus groups were conducted to explore students' perceptions of simulation learning. The study investigator led the focus groups, which were recorded, transcribed, and later analyzed. Qualitative responses were analyzed according to the Theory of Experiential Learning, (Kolb 1984). This data was organized into themes. It is hoped that this qualitative data will contribute evidence for understanding factors that influence the success of student learning in simulation environments. Outcome- Twenty-five nursing students were included in the focus group discussions. Data from the focus group sessions was analyzed and sorted into the 4 categories described in Kolb's Theory. These phases include "Concrete-Experience," "Reflective-Observation, "Abstract-Conceptualization," and "Active-Experimentation." An overwhelming amount of data was categorized in the "Reflective-Observation," phase. This could have been influenced by the debriefing process that is performed immediately following simulation learning experiences. While all categories were represented in the data, data clearly indicated that the phase of learning that simulation addressed most often was the Reflective-Observation phase. Conclusion- Overall, 88% of participants reported performing differently in clinical situations as a result of simulation learning. Participants reported that simulation activities directly applied to their actions in real life clinical experiences. This suggests that students perceive simulation to be an effective tool for learning.
Documenting the Nursing Process: A Community Based Participative Research Study
(University of Hawaii at Manoa, 2015-05) Goya, Zoeann; Codier, Estelle; Nursing
This community based participative research (CBPR) study evaluated the Joint Commission (TJC) required nursing process documentation in the electronic medical records for patients at Wahiawa General Hospitals (WGH). The study’s research question asked the following: Did 1 on 1 education improve documentation of the nursing process in electronic health records? Quantitative data was collected over the course of one year that included preeducation baseline data and post-education data. Pre-education data was taken from medical records during the months of November 2013 to January 2014 for patients who had targeted diagnoses using WGH'S care-plan audit tool. Post-education data collection took place from mid March 2014 to the second week of July 2014. A total of 30 charts each month (5 charts from the ICU, 10 charts from the telemetry unit, and 15 charts from the Medical surgical unit) were used for pre-intervention baseline data collection. Diagnoses targeted for chart review included the following: Congestive heart failure (CHF), pneumonia, sepsis, diabetic ketoacidosis (DKA), chronic obstructive pulmonary disease (COPD), acute myocardial infarction (AMI) or cellulitis. These 7 diagnoses were chosen due to the high frequency and high risk of these diagnoses for the population served by WGH. Descriptive and inferential statistics were utilized to analyze study data. It was hoped that findings from this research result in an improvement in nurses compliance with the nursing process in documentation, thus improving care as well as compliance with federally mandated documentation procedures.
An Observation of Range-of-Motion Movements Illustrated by Elders while Gardening
(University of Hawaii at Manoa, 2015-05) Fletcher, Yun-Wen Betty; Codier, Estelle; Nursing
According to the Administration on Aging (AoA) persons 65 years or older comprised 12.9% of the U.S. population in 2009. They estimate that by 2030, this number will increase to 19% (U.S. Department of Health and Human Services, n.d.). As this population continues to grow, it is important for healthcare providers to learn to manage and promote the health of the elderly. One important consideration is physical activity. Physical activity is integral to the health and well being of older adults. It can lead to the prevention of chronic disease, can help to maintain physiologic function and mobility, prevent falls, and positively impact psychological health and cognition. A subset of physical activity is exercise, of which there are various kinds. These include: aerobic, strength, balance, and flexibility (Francois, Brach, & Studenski, 2014). Gardening is one form of aerobic exercise that incorporates range of motion movements (Francois, Brach, & Studenski, 2014). Gardening does not just offer physical benefits. In a study conducted by Wang and Glicksman (2013), the reasons why seniors participated in community gardening encompassed nine main themes. These were: mental health benefits, the end produce, continuation of a past life, having something to do/responsibility, connection to growth and beauty, connections with others, physical health, being able to learn something new, and helping one another (Wang & Glicksman, 2013). This research was an observational study of elders working in a community garden in Manoa. It examined the range of motion movements illustrated by this population during gardening. A study instrument composed of various range of motion movements was used to identify range of motion movements observed.
A Qualitative Exploration of Dancing Hula for Health
(University of Hawaii at Manoa, 2015-05) Duong, Brenda; Tse, Alice; Nursing
This study sought to illicit views about hula, the traditional dance of Native Hawaiians, as connections to health and well-being. Self-regulation and social cognitive theory were the guiding frameworks. Dancing hula was selected as the intervention of focus since prior research demonstrated the energy expenditure of dancing hula is equivalent with moderate and vigorous intensity exercise. Two focus group interviews were held: one with cardiac rehabilitation participants of a hālau hula (hula school) (n=6), and the other with participants of a structured women’s life management and drug abuse treatment program (n=4). Analysis resulted in 4 major themes: • Hula promotes physical health. • Hula promotes mental health. • Hula promotes social support. • Hula promotes spirituality. Dancing hula for health was perceived as teaching effective self-regulation. For the hālau participants, hula provided strong, significant, and enduring connections and also a social and cultural avenue for achieving physical and mental cardiac rehabilitation activities. For the life management participants, dancing hula was perceived as providing opportunities to learn attention to task, instilling a disciplined approach and developing the group’s confidence that additional effort will lead to positive outcomes. It is important to explore meaningful and culturally acceptable ways for clients to achieve health outcomes. Empowering client groups to build their own capacity to achieve health outcomes through holistic approaches is needed. In conclusion, based on the participant’s response, hula has the potential to impact the physical, mental, social, and spiritual components of health. The incorporation of hula into healthcare warrants future exploration.
A Study of Emotional Difference As Expressed in Drawings Between Abused and nonabused Children
(University of Hawaii at Manoa, 2015-11-20) Carman, Donna Rae
The present study seeks to answer the question: "Is there a significant emotional difference, as expressed in drawings, between abused and nonabused children?" Each nurse at one time or another is faced with the challenge of caring for an abused child. Thus, the answer to this question is important to the understanding of the special needs of abused children. Indeed, it may ultimately lead nurses to a comprehension of what is specifically needed by the abused child to facilitate his developmental process.
An Exploratory Study of Type of Anesthesia Administered and Postoperative Complications of the Alcoholic Patient
(University of Hawaii at Manoa, 2015-11-20) Boeder, Gregory Scott
The purpose of this research project was to explore if general anesthesia is used more often than regional anesthesia in the chronic alcoholic patient versus the acute alcoholic patient and to determine if' there is a higher incidence of postoperative complications among the chronic alcoholic as compared to the acute alcoholic patient. The reason the investigator decided on such a topic was because of his interest in the field of anesthesia and the higher incidence of alcoholism that is becoming a major social problem faced by society and the health profession today.
The Relationship Between Antepartal Maternal Perceptions of Her Pregnancy/Fetus and Her Subsequent Attachment Bahaviors in the First Two Days Postpartum A Pilot Study
(University of Hawaii at Manoa, 2015-11-20) Bloom, Kathleen H.
The foundation for the maternal-infant relationship is set early in the postpartal period, from the first few hours after birth through the first two weeks. Lack of early, effective bonding can lead to problems in integrating the baby into the family unit, with possible severe psychopathology and/or child abuse as outcomes.
Process Outcome Measures of Patients with Head and Neck, Thoracic, and Gynecologic Malignancies Seen in the Multidisciplinary Cancer Care Clinic
(University of Hawaii at Manoa, 2014-09-26) Tsuruoka, Perry; Codier, Estelle; Nursing
Cancer was second leading cause of death in the United States in 2010, second only to cardiovascular disease. Currently, more than 13 million people are living with some form of cancer in the United States. Over 1.6 million new cases of cancer were estimated in 2013 alone and approximately 580,000 cancer patients died from their disease in the same year. Cancer is unfortunately a very prominent disease in the U.S., but many treatment options are available for cancer patients. One method of treatment involves the use of multidisciplinary clinics (MDCs). The MDC approach has the patient at the center of a team consisting of members such as physicians, nurses, and other ancillary staff who convene multiple times across all phases of cancer treatment and is widely utilized in cancer care. However, limited empirical evidence exists on the efficacy of the MDC approach in cancer care. While other studies have shown positive correlations between quality of care and patient outcomes from the utilization of MDCs in chronic disease, little information was found reporting positive patient outcomes and quality of care in relation to cancer MDCs. Therefore, this study was undertaken to explore the relationship of quality of care and patient outcomes with the care delivered in a cancer care MDC and analyzed findings using descriptive and inferential statistics.
Emotional Intelligence and Nursing Student Leadership
(University of Hawaii at Manoa, 2014-09-26) Szeles, Heather; Codier, Estelle; Nursing
The purpose of this mixed method, exploratory study is to measure the impact of a peer coaching program on the measured Emotional Intelligence (EI) of a group of nursing student leaders. The Student Ambassador Program at the University of Hawaii at Manoa’s School of Nursing is an opportunity for nursing students to build leadership skills and foster professional relationships in order to become nursing leaders. Nursing students will be entering the profession during a period of unprecedented change. It is anticipated that senior nurse leaders may soon retire leaving a gap. Participation in the study was offered to nurses in the Student Ambassador program. Students who agreed to participate received instruction on EI and its importance in leadership. Participants then took a pre intervention EI test (The Mayer-Salovey-Caruso Emotional Intelligence Test, v2) in order to obtain a baseline EI ability score. Students then participated in a series of peer coaching sessions across a four-month period. Participants then took a post intervention MSCEIT test, and were also given a qualitative survey. The analysis of the paired sample t-test showed that total group EI scores did not statistically differ from pre to posttest, t(8) = .036 > .05. Eighty percent of participants, however, reported perceived changes in EI ability as a result of the intervention. Additionally, ninety percent reported that peer coaching was beneficial to their leadership development. This study and its findings contribute to the body of EI literature and research on nursing education and leadership development.
Obstacles to Health Care for Transgender People in Hawaii
(University of Hawaii at Manoa, 2014-09-26) Scott, Jennifer; Codier, Estelle; Nursing
Societal stigma impacts the treatment of transgender and gender non-conforming people in many ways. Heterosexuals constitute a social majority and a heterosexually oriented gender roles are well established, which may cause minority sexual orientation, gay, lesbian, and transgender, to be the opposite of “normal”. What is transgender or gender non-conforming? “Transgender/gender non-conforming” describes people whose gender identity or expression is different, at least part of the time, from their anatomical gender at birth (Grant et al., 2010). This means that someone that is anatomically born a male identify as female or vice versa. There are many different terms that transgender/gender non-conforming people identify with. The following are a list of terms transgender people may identify with: 1. Transgender 2. Transsexual 3. FTM (female to male) 4. MTF (male to female) 5. Intersex (genital ambiguity) 6. Gender non-conforming (gender variant) 7. Gender-queer 8. Androgynous (sexual ambiguity) 9. Feminine male 10. Masculine female or butch 11. A.G. or Aggressive 12. Third gender (neither man nor woman) 13. Cross dresser 14. Drag performer (King/Queen) No research has been conducted on the transgender populace and their access to healthcare in Hawai‘i. There is also very little data on transgender healthcare issues incorporated in the undergraduate nursing school curriculum. Only one study was found on promoting awareness in Baccalaureate nursing programs on LGBT issues in aging (Lim & Bernstein, 2012).
Distress levels in newly diagnosed, ethnically diverse breast cancer patients
(University of Hawaii at Manoa, 2014-09-26) Noyama, Kameron; Codier, Estelle; Nursing
The American College of Surgeons’ Commission on Cancer (CoC) requires psychosocial screening for oncology patients, so the Queen’s Medical Center Cancer Center implemented the National Comprehensive Cancer Network (NCCN) distress thermometer (DT). The DT assesses: 1) patient’s rating of distress on a 0-10 scale (higher scores represent higher distress, and 2) variables (e.g. practical, emotional, family, spiritual, and physical) that may contribute to distress. This study was undertaken to explore the relationship between DT scores and demographic, disease, and hospital process variables associated with high distress levels among newly diagnosed breast cancer patients treated at the QMC outpatient cancer center. Through retrospective chart review, the following data was collected: DT variables, demographic data, and disease specific data (e.g. cancer staging), and hospital process data (e.g. referral delays) variables were collected. Inferential statistics were performed to explore associations among the study variables. A total of 33 patients with newly diagnosed breast cancer were identified. Overall mean distress level was 2.97 ± 2.8; and 33.3% reported a distress level ≥ 4. Depression correlated significantly with higher DT scores. Higher mean distress scores were associated with depression, worry, sadness, and nervousness (p ≤ .05). Distress level did not correlated with age, ethnicity, stage of disease, grade, type of cancer treatment, or number of co-morbidities. Recommendations for future research include replication of the study in a larger population and inclusion of other types of cancers in a study that includes male patients.
Getting Fit With Your Smartphone: An Application-Based Program for Nursing Students
(University of Hawaii at Manoa, 2014-09-26) Imai, Lauren; Nigg, Claudio; Nursing
Regular physical activity (PA) has been shown to reduce morbidity and lengthen life span (Blair, Sallis, & Archer, 2012). PA participation reduces fatigue, improves concentration, reduces stress, and enhances overall mental health (ADAA, 2012). Regular PA has also has been shown to reduce stress levels of nursing students (Chipas, Cordrey, Floyd, Grubbs, Miller, et al., 2012). Smartphones are revolutionizing healthcare, playing a part in both disease management and prevention. Smartphone fitness applications use GPS capabilities to record and log workout data including distance, duration, pace, and calories burned. This project was an exploratory study undertaken to evaluate the feasibility and usability of a cell phone motivational program in increasing PA participation and reducing stress of nursing students. Participants from the undergraduate nursing program at the University of Hawaii at Mānoa (N=73) utilized smartphone fitness applications for a one-month time period. Changes in PA (!!=148.33, !"!=155.03; !!=145.56, !"!=156.93), TV watching (!!=3.52, !"!=2.15; !!=3.96, !"!=2.56), perceived stress (!!=3.00, !"!=0.72; !!=2.87, !"!=0.59), PA stage of change (!!=3.26, !"!=1.05; !!=2.80, !"!=1.14), PA self-efficacy (!!=3.81, !"!=1.21; !!=3.57, !"!=1.16), PA intention (!!=3.65, !"!=1.07; !!=3.19, !"!=1.20), PA attitude (!!=4.24, !"!=0.85; !!=4.19, !" =0.91), and PA subjective norms (!!=3.78, !"!=1.23; !!=3.94, !"!=0.94), were explored. No difference was shown between pre and post-intervention variables (p>0.05). Correlational findings are consistent with that of the Theory of Planned Behavior (Azjen, 1991). Compared to previous literature, nursing students enrolled in the study were already participating in regular PA, and did not have high levels of perceived stress. Future research on the use of such devices for more high-risk populations is recommended.
Graduate Nursing Education Outcomes in Multi-User Virtual Environment (MUVE) Learning
(University of Hawaii at Manoa, 2014-09-26) Hughes, LeeArron; Codier, Estelle; Nursing
Multi-user virtual environments (MUVE) are Internet based virtual worlds in which multiple users simultaneously interact for many different purposes, including learning (Anderson, 2009). Research evidence demonstrates that MUVE learning links formal and informal cognitive processes, improving learning outcomes (Cook, 2012). Many universities have incorporated MUVE learning into their curriculum and students report positive learning experiences in MUVE. When given a choice many students prefer MUVE learning activities versus traditional activities (Skiba, 2009). However, little research exists about MUVE learning in nursing education. This mixed method exploratory study is undertaken to measure learning outcomes in graduate nursing MUVE learning activities based in second life, a free public MUVE. The study sample consisted of graduate Clinical Nurse Specialist (CNS) students currently enrolled in a class based largely in Second Life. Prospective participants were introduced to the study in an e-mail from the study Primary Investigator, with an accompanying electronic informed consent form. After receiving consent, participant’s dialogues from MUVE learning activities were de-identified to maintain anonymity and were analyzed using a scale to evaluate learning outcomes. A follow-up survey was administered at the semester’s conclusion to collect data on participant’s comparisons of MUVE and traditional learning activities. Descriptive and inferential statistics as well as analysis of themes were used to analyze study data.

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