Thesis (Ph.D. (Industrial Psychology))--North-West University, Vaal Triangle Campus, 2005.

Thesis (M.A. (Industrial Psychology))--North-West University, Vaal Triangle Campus, 2007.

<p> Heart failure patients who visit the Emergency Department often because of chronic nature of their illness require a specific plan of care. Successful engagement requires that nurses identify and act on factors to facilitate transition across the care continuum. This study was undertaken to examine the relationship of three major quality care indicators: social support, perception of nurse caring, and patient satisfaction among patients with heart failure admitted to the emergency department. The study further explored the association of these indicators with demographic and illness variables of the study participants.</p><p> The Quality Caring nursing framework was used as the theoretical framework for the study. A total of 115 adult participants, 71 males and 44 females who were admitted in the emergency department of two public hospitals in the mid-Atlantic region of the United States were recruited. Data were collected using a survey package consisting of four instruments: the Medical Outcomes Study (MOS) Social Support Survey measuring perceived social support, the Caring Assessment Tool (CAT) measuring nurse caring, and the Consumer Emergency Care Satisfaction Scale (CESS) measuring satisfaction with care in the emergency department.</p><p> Although the major study hypotheses that high levels of social support would be associated with caring and with patient satisfaction were not supported, there were significant associations found between aspects of social support, caring measure and the demographic and illness measures such as marital status and the number the number of household members. Also, those who were employed perceived more social support than those who were unemployed and those who were retired had a significantly higher perception of caring.</p><p> These findings challenge nurse clinicians, educators, and administrators to further investigate the roles of social support, caring and patient satisfaction in multiple aspects of chronic illness.</p>

Background: Good health at community and individual levels are key policy priorities. These priorities can be shown through supporting parents about various different healthy lifestyle choices. In order to know where interventions are needed, it is of interest to study how parents generally feel and how they perceive their parenting. Aim: To study how parents rate their own health and parenting skills, and examine whether there is any correlation between perceived general health and perceived parental competence.  Further, this study will show whether there is a correlation between rate of perceived general health and rate of perceived parental competence when it comes to gender. Method: 64 questionnaires were collected at strategic open kindergartens in the municipality of Uppsala. The questionnaires were distributed to the parents present and who chose to participate in this study. Main result: The result of this study shows that parents have a high rate of general health. A weak correlation between rate of perceived general health and rate of perceived parental competence were found. However a clear correlation between rate of perceived general health and rate of perceived parental competence could be seen of fathers, while the mothers are unrelated. Conclusion:  Parents in Uppsala seems to feel generally well and believe they are capable parents. It also appears that these two factors are interrelated so that parents who are doing well also generally feel better in their parenting. More and major studies are needed to obtain a general and trustworthy result.

<p> The hospitalization of one's infant is a stressful situation that can lead to decreased bonding and poor health outcomes. This longitudinal comparative design study examined the effects of neonatal palliative care (PC) consultation on stress levels and satisfaction scores of parents of neonatal intensive care unit (NICU) infants. Clinical data was abstracted from the medical record. Demographic data, stress scores, and satisfaction reports were obtained via self-report.</p><p> Mean stress scores indicated most parents experienced moderate stress due to NICU hospitalization. Some parents met diagnostic criteria for acute stress disorder. While all parents expressed satisfaction with care received; PC parents were extremely satisfied with care. No statistically significant differences in stress or satisfaction scores were noted between parents who received PC consultation and those who did not. Study conclusions validate previous research regarding NICU parent stress and show that additional quantitative and qualitative research regarding NICU palliative care is warranted. </p>

<p> The purpose of this study was to investigate factors that influence consumer choice in menu items at fast food chain restaurants. The study utilized social media, specifically Facebook, to collect data from various areas of the United States.</p><p> Previous literature on the effectiveness of nutrition menu labeling on decreasing calories ordered reported mixed results. Some studies point to groups that may be least affected by menu labeling: men, individuals of certain races, obese individuals, individuals of lower socioeconomic status, unemployed individuals, and individuals who dine outside of the home frequently.</p><p> The results of this study indicated that men and individuals who dine outside of the home more than three times per week are less influenced by nutrition information than their counterparts. Additionally, about half the participants in this study reported that they do not notice or look for nutrition information. Further research and outreach programs are needed in this area.</p>

<p> Obesity is a serious global issue and it is increasing in prevalence in the United States. The purpose of this interpretive hermeneutic phenomenological study was to gain insight into the nature of the impact of work on obesity through reflecting on the lived experiences of employed adults. The research study used a van Kaam method as modified by Moustakas with in-depth, semi-structured interviews to explore factors surrounding the impact of work on obesity. Fifteen participants from two industries (Home Health Care and Education) were interviewed for the study. It was theorized that obesity was influenced by an inability to balance the demands and influence of the work environment with healthy weight management practices. The study revealed that the workplace does affect obesity because of food choices available within the organization, lack of health discussions, work hour demands, and lack of streamlined work processes that enables break periods. The most influential factors on the participants&rsquo; state of obesity were external to the workplace. The study also found that unhealthy habits and external relationships influence people&rsquo;s state of obesity. Social policy change leaders should consider the person as the epicenter of the obesity issue because unhealthy habits are passed from generation to generation and a lack of both self-control and motivation exacerbates the obesity issue.</p>

<p> Falls are the fifth leading cause of death for persons over the age of 55 (CDC, 2010). However, not all falls result in death. In 2006, 10.5% or 2.1 million visits to the emergency room were the result of older adults falling. Non-fatal falls have long-term effects that impact a person's well-being physically, financially, and emotionally. It is estimated that health care costs of non-fatal falls is expected to reach $54.9 billion by 2020 (Englander, Hodson &amp; Terregrossa, 1996). Intrinsic and extrinsic fall risk factors have been identified for persons over the age of 65. Intrinsic fall risk factors include age, gender, ethnicity, medical conditions, number and type of medications, impaired mobility/gait, impaired vision, impaired cognition, psychological status, poor nutritional status, sedentary behavior, living alone, and a history of falls. Extrinsic fall risk factors include poor lighting, slippery floors, uneven surfaces, inappropriate walking aids, and lack of assistive devices (Feder, 2000; Lord, Sherrington, &amp; Menz, 2000). A less understood fall risk factor is the <i> fear of falling</i>. Therefore, an emotional rather than physical component <i> fear of falling</i> is known to increase the risk of falls (Friedman, et al., 2002). This is highly relevant given that approximately half of community-dwelling older adults experience a <i>fear of falling</i> (Howland et al., 1993). Recent falls is a known cause for developing a <i>fear of falling </i>. However, <i>fear of falling</i> is also reported to be prevalent among non-fallers (Vellas, et al., 1997). Up to 70% of recent fallers and up to 40% of those not reporting recent falls acknowledge experiencing a <i>fear of falling</i> (Arfken, 1994; Tinetti, 1994; Tinetti, Speechley, &amp; Ginter, 1988). Of greater relevance is that up to 50% of people who report <i>fear of falling</i> restrict or eliminate social and physical activities because of that fear (Tinetti et al., 1988). Researchers hypothesize that <i>fear of falling</i> begins a cycle of decreased activity that leads to loss of independence followed by further debility that increases the risk of further falls (Arfken, Lach, Birge <i> et al.</i>, 1994). The purpose of this correlational study is to evaluate the impact of <i>fear of falling</i> on functional independence for older adults living in a border community under the care of home health services. The Health Belief Model is used to understand how <i>fear of falling</i> impacts functional independence (one's perceived susceptibility to <i>fear of falling</i>, one's perceived level of severity to <i> fear of falling and self-efficacy</i>, which is the person's perception of his/her capabilities within specific situations and activities).</p><p> Ninety nine participants greater than or equal to 65 years of age were recruited from a convenience sample of home health patients receiving services from two local home health agencies. <i>Fear of falling</i> was measured using the Falls Efficacy Scale (FES) (Tinetti, Richman &amp; Powell, 1990) and activities of daily living (ADL) were measured using the KATZ ADL-staircase (Sonn &amp; Hulter-&Aring;sberg, 1991). The research questions used to guide this study were: <i>Fear of falling</i> will improve prediction of functional independence when considered with other known fall risk factors (KATZ ADL-staircase) (gender, number of medications, age, FES, subjective question <i>fear of falling</i>, socio-economic status and number of diagnoses). For participants in this study, there was a significant correlation between <i>fear of falling</i> and independence with ADL. Furthermore, results of a regression analysis indicated that reported <i>fear of falling </i> and FES scores both contributed to strengthen a model to predict participant's level of functional independence. However, fear of falling did not contribute to predicting these participants' history of falls. Reported number of falls was best predicted with a model that included number of diagnoses, number of medications, and age. Future research should incorporate and evaluate the efficacy of using an interdisciplinary team approach for an intervention to prevent falls and reduce the impact of <i>fear of falling</i> on functional independence of older adults living in the community.</p>

<p>Healthcare as an industry included over 14 million workers in the United States and accounted for more than 15 percent of total Gross Domestic Product in 2008. Healthcare, particularly hospitals, played a significant role in shaping the culture, economy and quality of life throughout the United States beginning in the late nineteenth century and continuing to the present. For this reason, it was important to understand the nature of hospitals as healthcare organizations and the nature of leadership within these organizations. Metaphors were identified as a viable way to capture the structure and functioning of hospitals through their evolution as organizations over the past century and were used to evaluate the effectiveness of hospital leadership in responding to environmental, financial and societal changes. Based on this assessment, the role of metaphors as a leadership tool was examined and as well as the potential role of metaphors in promoting organizations development. </p><p> A survey of Certified Professionals in Healthcare Quality (CPHQ) in the Northeastern United States was used to assess the prevalence of the two most common metaphors cited in the literature for healthcare organizations, mechanistic and complex adaptive system. A unique aspect of this survey was the use of paired statements reflecting characteristics of the two most common metaphors to evaluate their use in healthcare organizations. Surprisingly, the metaphors frequently cited in the literature were identified infrequently and no metaphors were identified consistently across hospitals in the region. </p>

<p> This research investigated a queuing theory known as Erlang-C and its applicability in its use in central sterile supply. Erlang-C was used to calculate human resource needs in real time to encourage effectiveness in preparing trays for surgery. No consistent way of organizing tray preparation for surgery in a hospital currently exists. Efficiency in preparing trays is the goal of this study. Once surgical instruments are used, they need to be organized in sterilizable trays by a sterile processing technician before being sterilized. This study examines the actual versus the predicted output. The current situation can be described in three parts. First, there is no existing system to mathematically define the process of quality when preparing a surgical tray. There is no currently existing system to describe what theoretical productivity (benchmark) in tray preparation consists of. There is no currently existing system to describe how many technicians are needed to complete the surgical trays necessary for one day of surgery. There are several different types of sterilizable trays and the number and complexity of instruments in each of these types of containers (small, medium or large) varies. The current process is facilitated by a program called ABACUS with VIA Embedded software&trade; which provides information to the technician about which instrument to inspect and in what order. The proposed process could easily be integrated into the ABACUS system. This dissertation should improve both quality and productivity to address the three following points: 1) To improve quality, for which new parameters are added called instrument inspection specifications or instrument characteristics (lumen, traction surface, box lock, recess and handling time) introduced to describe what should be inspected during tray preparation (these instrument inspection specifications were assigned an ancillary number of seconds of inspection time for each specific feature of the instrument), 2) A new definition for trays is proposed based on the number of instruments and characteristics per tray (small trays are defined as having between 0 and 18 box locks, medium trays 18 to 75 box locks per tray and large trays 75 to 161 box locks) 3) To optimize manpower, Erlang-C queuing system was used as a simulation tool to describe the needs measured in number of technicians per type of tray per half hour. Further improvement to the Erlang program would be required to generate data for a full day of surgery. </p>