<p> There is an increasing demand for more baccalaureate- and graduate-prepared registered nurses in the United States, to face the healthcare challenges of the 21st century. As a strategy to meet this need, educational institutions are expanding electronic learning in nursing education; however, technology acceptance in education continues to be a concern for educational institutions. In this context, the goal of the study was to investigate factors that potentially influence registered nurses&rsquo; intentions to adopt e-learning systems. A theoretical model was used to determine whether perceived value, attitude toward e-learning systems, and resistance to change influence registered nurses&rsquo; intentions to use e-learning systems. </p><p> A web-based survey was used to assess the effect of the aforementioned constructs on registered nurses&rsquo; intentions to use e-learning systems. The web-survey instrument was developed as a multi-item questionnaire using Likert-type scales. A 35-item survey instrument was developed using previously validated measurable items. The target population of this study was registered nurses in South Florida. The sample for this study was 323 (over 21% response rate) registered nurses at two hospitals in South Florida. </p><p> Multivariate analysis was conducted using structural equation modeling and robust standard errors with the Satorra-Bentler adjustment. The results revealed that perceived value, attitude toward e-learning systems, and resistance to change influence registered nurses&rsquo; intentions to use e-learning systems. Findings from this investigation may be of interest to educational institutions preparing to make investments in e-learning systems. The information provided in the study will allow administrators in higher educational institutions to make decisions on ways to address the challenges that may be affecting e-learning acceptance by registered nurses.</p>

<p> Many advanced cancer patients receive intensive treatment near the end of life (EOL). Intensive treatment near the EOL is often associated with worse outcomes, such as worse quality of life (QOL), greater distress in patients and caregivers, and higher health care costs. For cancers typically unresponsive to chemotherapy such as lung and gastro-intestinal (GI), the side effects of intensive treatment are endured without increasing survival time. To date, research on EOL care in advanced cancer patients has focused on patient prognostic understanding, physician communication, and patient distress. These factors do not fully explain why many patients receive intensive treatment near the EOL when there is no hope for cure. Hence, there is a need to better understand the factors that influence EOL treatment in order to improve patient and caregiver outcomes. Self-Regulation Theory (SRT) provides a framework that may help explain motivations and care decisions in this population. This study had two aims: 1) to examine the associations between EOL clinical encounters (i.e., EOL conversations with a physician) and treatment intensity in advanced cancer patients near the EOL; and 2) to examine the associations between important SRT constructs (i.e., goal flexibility, hope, and optimism) and treatment intensity in advanced cancer patients near the EOL. A sample of 76 advanced lung and GI cancer patients was recruited from Indiana University Simon Cancer Center. Hope predicted receiving chemotherapy closer to death (&beta; = -.41, t (66) = -2.31, <i>p</i> = .025), indicating more intensive treatment near EOL. Other predictor variables were not significantly associated with intensive treatment. Implications and methodological limitations are discussed. </p>

<p> The suicide rate among post-9/11 veterans has become a national crisis. At a staggering number of 22 suicides per day, our wounded warriors are in dire need of psychological assistance. Currently, the treatment interventions used in the rehabilitation of veterans suffering from mental health disorders are limited. Furthermore, these therapy options available to veterans are not realizing adequate improvements in the management of their symptoms. </p><p> This business proposal advocates the utilization of psychiatric service dogs as an alternative intervention to help veterans manage their PTSD symptoms. Rescues for Warriors (RFW), a nonprofit 501(c)(3) organization, aims to pair task trained service dogs with veterans in need of a rehabilitative canine companion. Using evidence-based selection tools, RFW rescues dogs from local animal shelters and uses comprehensive techniques to train them to patient-specific symptoms. This service will be free of charge for all veteran participants, and therefore, marketing and funding will be very important aspects of this business. While this plan does acknowledge the potential challenges in opening charitable organizations, RFW is rigorously committed to increase the quality of life of our nation&rsquo;s heroes and rescue dogs alike.</p>

<p> This critical analysis of the literature is a comprehensive collection and review of the literature on the strengths-based perspective as it is applied to the treatment of substance use disorders. Literature was collected, analyzed, and critically evaluated to consolidate the existing research on strengths-based treatment approaches, identify ways in which the strengths-based perspective is congruent with culturally competent practice, and to identify strengths, weaknesses, and gaps in the literature. Analyses reveal that there are numerous components of the strengths-based perspective that are congruent with culturally competent practice and that strengths-based treatment approaches may serve as an effective adjunct or alternative to traditional treatment approaches for substance use disorders. While additional research is needed to further our understanding of the effectiveness of this approach, preliminary results indicate that there are numerous therapeutic advantages associated with the strengths-based perspective and its use with substance abusing populations. </p>

<p> Recent changes in the ethnic composition of the population of the United States pose great challenges for healthcare institutions and healthcare providers. In recent years, policy statements on nursing education indicated that nursing educators recognized the need to increase the cultural caring of the nursing workforce (Swanson, 2012). Salimbene (2014) discussed the importance of considering clients&rsquo; culture as an integral part of assessing their healthcare needs and planning culturally appropriate nursing care to meet those needs. Currently, there is a paucity of information regarding patients&rsquo; perceptions of culturally competent care. The purpose of this qualitative study was to identify culturally sensitive caring behaviors of professional nurses from the perspective of Hispanic American maternity patients two to four weeks post-discharge in a WIC program in rural Georgia. Utilization of a phenomenological research design included interviews with 15 Hispanic American women. Data analysis was conducted using phenomenological analysis methods with the aid of the software program Nvivo 11. Themes that were identified were: Better Future, Better Medical Care, Treatment of Patients, Customs and Practices, and Meaning of Care. This information may aid in creating a culturally competent maternity care curriculum.</p>

<p> The purpose of this study was to compare and contrast four age cohorts to determine: (a) if they have any preexisting knowledge about The Blue Zones Power 9 lessons for longevity, (b) if they are currently practicing any of the Power 9 lessons, and (c) to what extent they intend to adopt all or some of the Power 9 lessons in the future. The Transtheoretical Model of Behavior Change (DiClemente &amp; Prochaska, 1982) guided exploration of the respondents&rsquo; adoption of the Power 9 lessons. There were four significant findings in this study. Physical activity and stress relief had similar results in that both the youngest and oldest age cohorts&rsquo; expressed higher frequencies than the two middle age cohorts. Wine consumption and adoption/intention to adopt the Power 9 also had similar results, demonstrating that as age increased, so did the frequency of wine consumption and adoption/intention to adopt the Power 9.</p>

<p> A healthy working environment has been an area of interest for occupation health providers. There is anticipation that a safe working environment improves patient safety, which is associated with reduction in clinical nurse errors. Issues with medication errors and poor working environment pose a greater risk to patient safety. The aim of this qualitative study was to provide a broad understanding on nurses&rsquo; perceptions on the processes that influence a healthy working environment and the impacts of a healthy working environment on patient safety. An interpretive grounded theory methodology was used in this study to evaluate nurses&rsquo; perceptions in acute care settings. The study was carried out in a large city of Southern California and the participants consisted of a community-based purposive population of registered nurses (RNs) in a telemetry. A total of 10 participants with three years working experience in surgical units were recruited and tiered scheduled approach was used for the analysis and refinement of interview questions. The participants were all female registered nurses with three years working experience in acute care settings. The majority of the nurses had a bachelor&rsquo;s degree (44%), masters degree (22%) and 11 % had associate degree. Grounded theory method was used to identify the relevant themes from the interview responses. The transcripts revealed nurses&rsquo; perceptions on the process that facilitate a healthy working environment and HWE impacts on patient safety. The findings of the study showed that communication, teamwork and collaboration within healthcare environment are the most important factors for the development of a healthy working environment. The findings also showed the influence of a health care working environment on medication errors. Nurses reported that lack of communication, nurse shortages and micromanagement increases the chances of medical errors. Nurses reported that effective communication with the nurse leaders, managers and patients provide a stress-free working environment that result in a better care for patients. Enough nursing staff s well as teamwork and collaboration also influences patient safety.</p>

<p>The need for home health care is a growing need in the United States due to the shift of the &ldquo;baby-boomers&rdquo; into the post retirement years. However, there is a growing niche market within this aging population: the lesbian, gay, bisexual and transgendered (LGBT) elders who have lived their adult lives &ldquo;out of the closet&rdquo; and who are facing difficulty receiving care which is compassionate and culturally sensitive at the same time. The mission of Hand-In-Hand Home Health Care is to provide exceptional home health care with a team of professionals that provide patient-centered care which is culturally sensitive and compassionate, achieved with employee training developed by SAGE (Services &amp; Advocacy for GLBT Elders). Hand-In-Hand Home Health Care will achieve economic viability within the first year through optimal cash flow management with Axxess client software and the initial capital assistance with a 7a Small Business Loan. </p>

<p> Employee job satisfaction is an ongoing concern in the field of social work. High caseloads, low compensation, and the lack of job security are sources of job dissatisfaction for novice and seasoned social workers in managed care settings. Specifically, the purpose was to determine if there is a correlation between high caseloads, the lack of job security, and low compensation and job dissatisfaction among novice (<i>n</i> = 24) managed care social workers and seasoned (<i>n</i> = 86) social workers in Texas and the surrounding areas. The emphasis of these factors, if not recognized and addressed through interventions by health care administrators, can lead to novice or seasoned managed care social workers&rsquo; dissatisfaction and within their position and careers with an ending result of desirable professional leaving the field of social work. Herzberg&rsquo;s two-factor theory guided the study. The independent variables were selected for use in a multiple regression analysis at the .05 level of significance. No correlation was found between high caseloads and job dissatisfaction among novice social workers or between low compensation and job dissatisfaction among novice and seasoned social workers. High caseloads were correlated with job dissatisfaction among seasoned social workers. A correlation was found between the lack of job security and job dissatisfaction between novice and seasoned social workers. The research study collected data used in sealing the gap in the health care community by providing valuable information and directions for health care administrators to focus on in an attempt to reduce turnover, increase productivity, and improve the quality of patient care.</p>

PURPOSE: This thesis intends to evaluate the factors which positively and negatively influence patient compliance to performing weekly home-based digital 6-minute-walk-tests (d6MWT) using a smartphone and smart watch. PROBLEM: Long term patient engagement in mobile health apps have proven to be a challenge to maintain. In this thesis, factors that influence patient engagement will be identified when it comes to retaining participants that are using the VascTrac mobile health research application. METHODS: Patient compliance will be calculated based on how many d6MWT are completed out of the expected total. The population is split into four levels of compliance groups from least compliant (0-25% compliance (Group A)) to most compliant (75.1-100% compliance (Group D)). “Open Walk” and survey data are collected and compared amongst these groups to see if there are any direct relationships that could be found. An “End of Study Survey” is also conducted to better understand the reasons behind differing compliance levels. RESULTS: The overall compliance level is 66.1% for all comers with half of the patients scoring above 80%. Patients with higher compliance tend to have a higher weekly “Open Walk” average (correlation coefficient = 0.3). The average of weekly “Open Walk” is 0.53 walks/week. CONCLUSION: Factors that negatively affect whether patients would be compliant to doing the weekly d6MWT are medical issues, technical difficulties, hospitalization, and lack of motivation. Being motivated and having a desire for self-improvement positively influences compliance levels. Decrease use of walking aids correlates to higher compliance and being smartphone naïve at beginning of study correlates to lower compliance. The other factors (age, co-morbidities, smoking habit, etc.) considered did not predict compliance levels.