<p>To date most research on long-term outcomes of childhood trauma has focused on traumatic brain injuries, but less is known about traumatic injuries not involving the brain. Since traumatic brain injuries can have persistent effects on child behaviour, I investigated whether other types of traumatic injuries could also affect child behaviour in the long term. Currently, limited information is available on possible associations between family function and child behaviour after child trauma; knowledge of the long-term costs of pediatric trauma is also lacking. The main goal of this study was to determine whether family function was associated with behaviour in children who experienced a traumatic injury eight to ten years ago. Additional goals were to determine current expenditures and use of health and social services by child trauma victims and their parents. Pediatric trauma victims were selected from a trauma database at a tertiary care hospital in the Hamilton-Wentworth region. The parents of these children were interviewed to obtain children’s current behaviours and the family’s use of health and social services. The results showed that injury severity was not associated with child behaviour, but associated with family functioning. No relationship was found between health and social service expenditures for children and their injury severity, but there was a relationship between parent health and social service expenditures and child injury severity. The results do not support an association between child behaviour and injury severity following trauma, but they do suggest that expenditures and use of services by injured children and their families are affected long-term. The results suggest that future health and social service uses of injured children and their families may be better understood and planned for by recognizing the continuing effects of trauma. This information could help making appropriate health and social service programs more available to this population.</p> / Master of Science (MSc)

The Effects of Age, Employment, Marriage, and Education on Academic Motivation in Undergraduate Nursing Students Purpose: The amount of research on non-cognitive variables affecting motivation is limited in nursing students. By using Self-Determination Theory, faculty can determine what motivates students to learn which will allow the creation of a learning environment that promotes student achievement. Aim: To determine the effect age, marriage status, employment, and education level have on academic motivation in nursing students in the third semester of a baccalaureate nursing program within the framework of Self-Determination Theory. Method: A descriptive correlational design was used to identify the effect age, marriage status, employment, and education level have on intrinsic motivation and extrinsic motivation in third semester nursing students (n = 39). After IRB approval, a link to an electronic demographic survey and Academic Motivation Scale-College Version 28 (AMS-C28) was distributed to students. Using SPSS-22, four independent t-tests were conducted to determine if differences existed between extrinsic and intrinsic motivation and the variables age, marriage status, employment status, and education level. Results: The findings indicated the following variables had statistically significant relationships with extrinsic motivation: age (t=-2.108, df=30, p=.017, one-tailed) and employment (t=-2.117, df=37, p=.006, one-tailed). Intrinsic motivation was not statistically significant with any variable. Based on these results, unemployed students over 25 are more likely to be extrinsically motivated to learn. Conclusion: Understanding how non-cognitive variables affect motivation will assist nursing faculty in providing a learning environment that will increase student motivation to learn and graduate. Increasing graduation rates can positively affect the nursing workforce and patient care.

External and internal funding is a way that nurse scholars can support research and scholarship activities. Often, programs are supported by a combination of internal and external funding to support projects. External funding through competitive grants is a valuable way to fund initiatives and to expand services. However, these applications commonly require a detailed and complete budget that will provide a framework to fiscally plan for program activities – which can be daunting to novice grant seekers. There is a scarcity of information in the literature on the framework for the development of a program budget or how to begin, which can be a challenge to those new to this process. A well-prepared and developed budget supports the success of an external funding application and serves as the framework to fiscally support and optimize activities. The purpose of this presentation is to provide nurses the basic information on how to develop a budget for external and internal funding applications.

Tobacco use is one of the most preventable sources of death and disease, and yet remains a worldwide problem. With the rising costs of healthcare, the focus of efforts to control them has honed in on lifestyle behaviors that contribute to the escalating costs. Within the scope of this scrutiny, the prevention or cessation of smoking and tobacco usage has become a global priority and a major focal point of worldwide anti-tobacco initiatives. The World Health Organization (WHO) has identified cessation interventions by health care professionals as a crucial factor in successful patient smoking cessation, and studies have shown that personal smoking behaviors by health care professionals are a barrier to effective smoking cessation interventions by those professionals (Lally et al., 2008; Radsma & Bottorff, 2009). This knowledge fueled the creation and distribution of global surveys by the WHO, the Centers for Disease Control and Prevention (CDC), and the Canadian Public Health Association (CPHA) to investigate the prevalence of smoking behaviors in health care professionals and in health care students (“Global Health Professions,” 2014; “WHO/CDC Global,” 2014). This study utilized the Global Health Professions Student Survey. The current study investigated the prevalence of smoking in nursing students of all educational levels at East Tennessee State University, with the expectation that the percentage of students who currently smoke would be substantially lower than that of students who do not smoke. The survey also investigated attitudes towards the role of health professionals in patient smoking cessation and towards personal smoking behaviors.

Skills of inquiry are essential outcomes from a baccalaureate nursing education. Students who demonstrate intellectual curiosity can develop effective skills of inquiry. Nurse educators must place emphasis on teaching and learning strategies which engage student intellectual curiosity. However, the concept of intellectual curiosity is not well-studied across multiple contexts of teaching and learning environments within nursing education. In addition, there is little known about the experienced nurse educator and the meaning of student intellectual curiosity across multiple teaching and learning environments. With the increased emphasis on online teaching and learning in nursing education as a solution for expanding student access and capacity, the concept of intellectual curiosity within the context of online learning needs further exploration. Under the assumptions of philosopher Max van Manen (1990, 1997) and Martin Heidegger (1962), the purpose of this qualitative, hermeneutic phenomenological study was to understand the lived experience of baccalaureate nursing student intellectual curiosity for the experienced nurse educator teaching within the online learning environment. The research question was: What does intellectual curiosity mean to experienced nurse educators teaching in the online environment? A total of eight participants from three different institutions of higher education in the southeastern United States were interviewed through a socratic approach. Diekelmann, Allen, and Tanner’s Steps for Data Analysis (1989) are utilized for data analysis. Three constitutive patterns and seven relational themes emerged through the data analysis process. Ontological considerations of findings, implications for nursing education, and future research investigations are identified.

Advanced practice nurses fill a vital need in the U.S. by increasing access to needed healthcare. Certified Registered Nurse Anesthetists (CRNAs) are one type of advanced practice nurse with a long history of safe and effective peri-anesthetic care. Nurse anesthetists have a rich tradition of providing anesthetic care for rural and underserved communities, and are a primary provider of anesthesia for active and retired military personnel. CRNAs comprise over one-half of the actively practicing U.S. anesthesia workforce currently, and are able to function in any anesthetic care model. Nurse anesthesia educational programs (NAEPs) are the single source for new graduate nurse anesthetists in the U.S. Demographic, geographic and epidemiological factors have combined to produce a predicted increase in the demand for peri-operative anesthesia care among a complex, aging and increasing patient population. The uninterrupted or increased supply of CRNAs to the anesthesia workforce is important. The goal of this study was the production of a comprehensive analysis of potential resource constraints upon the NAEPs in the U.S. This was accomplished through a focused, prospective and correlational research design, grounded conceptually in Resource Dependence Theory. A novel survey tool was developed for the assessment of critical resource constraints, completed by U.S. NAEP administrators and faculty. This research was exploratory in nature and is the basis for continued work in critical resource planning tools for U.S. NAEPs.

The purpose of this work was to examine biological mechanisms and symptom outcomes of illness uncertainty and psychological stress in Parkinson’s disease (PD). Parkinson’s disease is a chronic, progressive neurodegenerative disorder characterized by complex symptoms that fluctuate in onset, severity, level of disability, and responsiveness to treatment. In addition to characteristic motor symptoms of tremor, rigidity, bradykinesia, and postural instability, a considerable number of individuals with PD also experience debilitating pain, fatigue, and medication-induced motor complications of dyskinesia, dystonia, and on-off phenomena. The unpredictable nature of PD symptoms and motor complications coupled with the inability to halt or slow disease progression may result in uncertainty and psychological stress. Evidence is lacking regarding biological mechanisms and symptom outcomes of uncertainty and psychological stress in PD. As such, 80 men and women diagnosed with PD after the age of 49 were recruited to participate in this study. Data specific to characteristics that may contribute to uncertainty and psychobehavioral measures of uncertainty, appraisal, psychological stress, and symptom outcomes of motor symptoms, pain, and fatigue were collected. Biological measures of neuropeptide Y (NPY) and cytokines were obtained. The results revealed that participants perceived a moderate level of illness uncertainty. Uncertainty correlated significantly with motor symptoms, pain severity, and pain interference and predicted more severe pain severity and pain interference. Psychological stress correlated significantly with motor symptoms, pain severity, pain interference, and fatigue and predicted more severe symptoms across all outcomes. NPY was positively correlated with threat appraisals and psychological stress. Cytokines were below the level of detection in this sample, and not used beyond descriptive analyses. In summary, this study found uncertainty and psychological stress contributed to more severe symptom outcomes in PD. This knowledge may be used to guide future studies aimed at further elucidating biobehavioral symptom and health outcomes of uncertainty and psychological stress in PD. It will also facilitate the development of interventions specifically targeted to uncertainty and psychological stress for the ultimate purpose of improving symptom management, health outcomes, and disease progression in PD.

An integrative review was used to examine the effects of being a tutor versus not being a tutor. The matrix method was used to guide the research process, to identify articles that met the inclusion criteria, and to reduce data into common topics of peer tutoring. The results of the integrative review yielded 20 articles and suggested that students in the position to assist others are more confident in communicating in groups and have higher knowledge in the subject they help with than their fellow peers. The literature showed that students in the position to assist others have defined personal and professional standards and leadership skills. However, there is little research on the benefits of being a tutor when compared with the benefits tutees obtain from coming to tutoring sessions. More research is needed to examine the effects of being a tutor. More specifically, there are no studies where the skills of nursing student tutors are compared with nursing student non-tutors. In this study, the researcher created a survey to evaluate nursing student tutors and non-tutors, their communication and leadership skills, as well as their personal and professional growth. Focus groups were created to provide tutors a means of discussing the personal and professional impact that tutoring has had on them. The study results indicated that tutors have decreased nervousness in public speaking, have higher confidence in their communication skills, share their life experiences to help others more often, and readily reach out to instructors and other tutors for assistance.

Fibromyalgia syndrome (FMS) is a debilitating and chronic condition with an array of symptoms, the most distinguishable being widespread pain. FMS patients experience a marked decrease in quality of life related to intensity of symptoms. Current treatment options and pharmaceuticals do not provide adequate relief. This thesis examines integrative and complementary therapy options for symptom management and improvement of quality of life for FMS patients. A literature review was conducted of English current research using multiple databases. Findings indicate mindful movement therapies (MMT) such as yoga and tai chi, mindfulness, sensory-related relaxation techniques with guided imagery, and cognitive behavioral therapy (CBT) provided some relief and increased in perceived quality of life (QoL).

Knowledge of how gender affects learning is scarcely understood in the realm of nursing education. Prior studies have indicated certain learning styles are predictors of passing board examinations. Pinpointing specific learning styles could improve educational outcomes and produce thoroughly equipped nurses. Previous researchers have studied the differences in learning preferences according to gender; however, no studies have solely concentrated on gender specific learning preferences among undergraduate nursing students. Learning Interest, as well as Goal Orientation, were found to be statistically significant between genders.