Thesis (M.S.)--University of Florida, 2004. / Typescript. Title from title page of source document. Document formatted into pages; contains 33 pages. Includes Vita. Includes bibliographical references.

Patient safety culture (PSC) is a critical factor in creating high reliability healthcare organizations. However, few studies to date have correlated PSC measures with actual safety outcomes. In particular, nursing home studies have only recently appeared in the literature. Nursing homes differ from hospitals in that the vast majority of direct care is provided by certified nursing assistants (CNAs), not licensed nurses. Thus nursing home PSC could differ in important ways from PSC in acute care institutions. This dissertation was a secondary data analysis that examined whether CNAs’ perceptions of patient safety culture were correlated with clinical outcomes in a random sample of 74 nursing homes in five randomly selected states. This study matched CNA PSC survey data using the Hospital Survey of Patient Safety Culture (HSOPSC) with Minimum Data Set (MDS), Area Resource File (ARF) and Online Survey Certification and Reporting (OSCAR) data from those same homes during the first two quarters of 2005. In the original study, 1579 nurse aides out of 2872 completed the survey, for a 55% response rate. In addition to clinical outcomes, this study examined the relationship between CNA PSC scores and staff turnover. The relationship between certain demographic variables, such as level of education, tenure as a CNA, and PSC scores was evaluated. The relationship between certain facility characteristics, such as profit status and bed occupancy was also assessed. An exploratory factor analysis of the original HSOPSC instrument was re-run for this nursing home CNA sample. Data were analyzed using Poisson regression and multilevel techniques; descriptive statistics were compiled for demographic data. Major findings from the regression analyses and combined GEE models suggest that certain factors, such as CNA turnover and LPN staffing may predict CNA PSC scores. CNA PSC scores were associated with rates of falls and restraint use, but were not associated with differences in pressure ulcer rates in this sample. Few associations for CNA PSC with individual subscales were identified. The exploratory factor analysis revealed some potential differences in how items and subscales factored in this nursing home CNA population. This dissertation represents an important step in the evaluation of CNA PSC in nursing homes and the relationship of PSC to safety outcomes. Future work on nursing home PSC and clinical and workforce outcomes is described.

The aim of this study was to measure the effects of audiologic intervention on self-perceived quality of life in the elderly hearing-impaired population. The tested hypothesis was that hearing aid use would result in improved quality of life as measured by utilities. In this study, utilities were obtained using the U-Titer II, an interactive software program designed to measure an individual's health state preference or utility. This study also examined the issue of numeracy, which is described as an understanding of basic probability, and its effect with an individual's ability to accurately complete utilities. Data from 54 individuals fit with hearing aids in this randomized, controlled, pre-test/post-test experimental design study were analyzed. The participants completed the U-Titer II, a test of numeracy and the International Outcome Inventory for hearing Aids (IOI-HA). Three utility approaches were used in this study: Time Trade-Off (TTO), Standard Gamble (SG) and Rating Scale (RS). With each of the utility approaches, disease-specific (e.g., deafness vs. perfect hearing) and generic (death vs. perfect health) anchors were incorporated. Several research questions were posed to examine the sensitivity of utilities to hearing aid intervention. Question 1: Can the effects of hearing aid intervention be determined with a utility approach? Statistically significant differences between pre- and post-intervention utility scores were measured with disease-specific and generic anchors for only the TTO and RS approaches. These findings suggest that hearing aid intervention outcomes can be measured using either the TTO or RS utility approaches. Question 2: Is numeracy ability a factor in the usefulness of a utility approach for assessing the effects of hearing aid intervention? Statistical analysis showed that mean utility scores changed very little as a function of numeracy ability. These findings suggest that numeracy ability does not appear to affect utility scores. Question 3: What, if any, are the relationships between hearing aid benefit as measured by a utility approach and hearing aid benefit as measured by the IOI-HA? Spearman Rho correlations were conducted on the benefit data obtained from the two self-report measures (IOI-HA and utilities). The major findings from these analyses determined that the IOI-HA total scores were significantly correlated with utility outcomes as measured by TTO generic, TTO disease-specific, and RS disease-specific anchors. In general, correlations between the measures were higher with the disease-specific anchors than the generic anchors. Also, none of the correlations between any IOI-HA outcome domains and utility change scores with generic anchors obtained with the RS scale were significant. For utilities measured with disease-specific anchors, significant correlations were found with two IOI-HA outcome domains (benefit and satisfaction) and utility change scores as measured by the TTO technique. When the RS technique was utilized, significant correlations were found for four of the seven outcome domains (benefit, satisfaction, participation and impact of others). Thus, if the IOI-HA is used as a measure against which to validate the utility approach as a measure of hearing aid outcomes, the measure with the most face validity is a RS method with disease-specific anchors. However, if one wished to compare hearing aid intervention to intervention in other areas of health care, these data support the use of a TTO approach.

In 2014 Bodenheimer and Sinsky published the Quadruple Aim model, which argued that healthcare provider wellbeing was the missing link to improving patient and population health outcomes, as well as cost containment. Rather than treating burnout, however, experts in fields outside healthcare are finding validity in promoting thriving at work as a means to prevent burnout and improve employee satisfaction, engagement, and productivity. The purposes of this study were to investigate the relationship between thriving and emotional exhaustion (which is widely considered a core element of burnout) in healthcare providers, and the impact thriving had on primary care population health outcomes as measured by quantifiable value-based quality performance metrics. Using Georges' (2013) Emancipatory Theory of Compassion and Bodenheimer and Sinsky's Quadruple Aim as conceptual frameworks, this descriptive, non-experimental study used advanced applied biostatistical techniques to analyze archival data from the December 2018 UCHealth Physician and Advanced Practice Provider Voice Survey as well as provider performance scores from the same time period. Results of the study were mixed, showing that while there is an inverse relationship between thriving and emotional exhaustion in healthcare providers, thriving did not predict population health outcomes. By evaluating thriving in healthcare providers in relation to emotional exhaustion and in context of value-based health care delivery systems, this study was the first of its kind. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2020. / FAU Electronic Theses and Dissertations Collection

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OBJETIVO: Avaliar a responsividade da escala de avaliação funcional para pacientes com distrofia muscular de Duchenne (FES-DMD-D4), sentar e levantar do solo, no período de um ano. MÉTODO: Estudo observacional, longitudinal e retrospectivo. Foi estudada, utilizando o software FES-DMDDATA, uma amostra com 25 pacientes na atividade sentar no solo e 28 pacientes para a atividade levantar do solo. As avaliações ocorreram a cada três meses no período de um ano. Para análise estatística da capacidade de resposta foram utilizados índices de tamanho de efeito, como, effect size (ES) e Standardized Response Mean (SRM). RESULTADOS: A responsividade da atividade de sentar no solo foi considerada baixa a moderada em intervalos de três meses (ES de 0.28 a 0.54 e SRM de 0.38 a 0.71), moderada a alta em intervalos de seis meses (ES de 0.69 a 1.07 e SRM de 0.86 a 1.19), alta em intervalos de nove meses (ES de 1.3 a 1.17 e SRM de 1.26 a 1.55) e doze meses (ES de 1.9 e SRM de 1.72). Na atividade levantar do solo, a responsividade variou em baixa, moderada e alta em intervalos de três meses (ES de 0.21 a 0.33 e SRM de 0.45 a 0.83), baixa a alta em intervalos de seis meses (ES de 0.46 a 0.59 e SRM de 0.73 a 0.97), moderada a alta em intervalos de nove meses (ES de 0.76 a 0.88 e SRM de 1.03 a 1.22) e alta em doze meses (ES de 1.14 e SRM de 1.25). CONCLUSÃO: Para detectar alterações clinicamente significativas e consistentes nas atividades funcionais sentar e levantar do solo recomendamos a utilização da FES-DMD-D4 em intervalos a partir de seis meses, pois foi neste período de tempo que a capacidade de resposta variou de moderada a alta / OBJECTIVE: To evaluate responsiveness of functional scale for Duchenne muscular dystrophy - sitting and standing from the ground (FES-DMD - D4) in three months evaluation intervals in a one year follow up. METHODS: Observational, longitudinal and retrospective study. It was studied, using FESDMD- DATA software, films of sample of 25 patients performing sitting on the activity of soil and 28 patients performing the activity of from the ground. The evaluations were performed every three months within one year. The analysis for statistical responsiveness of the instrument we use effect size (ES) and Standardized Response Mean (SRM) tests. RESULTS: The responsiveness of the activity of sitting on the ground was considered low to moderate every three months (ES 0.28 to 0.54 and 0.38 to 0.71 SRM), moderate to high in intervals of six months (ES 0.69 the 1.07 and the 1.19 0.86 SRM), High at intervals of nine months (1,3 ES of the 1.17 and the 1.55 1.26 SRM), and twelve months (ES SRM 1.9 and 1.72). In raising from the ground activity, the responsiveness varied at low, moderate and high in intervals of three months (ES 0.21 to 0.33 and 0.45 to 0.83 SRM), low to high in intervals of six months (ES 0.46 to 0.59 and 0.73 to 0.97 SRM), moderate to high at intervals of nine months (ES 0.76 to 0.88 and 1.03 to 1.22 SRM ) and high in twelve months (ES 1.14 and SRM 1.25). CONCLUSION: To detect clinically significant changes and consistent in functional activities of sitting and standing from the ground we recommend using the FES-DMD-D4 at intervals from six months because it was at this time that the responsiveness was moderate to high

Professional research project (Au.D.)--University of South Florida, 2002. / Title from PDF of title page. / Document formatted into pages; contains 45 pages. / Includes bibliographical references. / Text (Electronic thesis) in PDF format. / ABSTRACT: The aim of this study was to measure the effects of audiologic intervention on self-perceived quality of life in the elderly hearing-impaired population. The tested hypothesis was that hearing aid use would result in improved quality of life as measured by utilities. In this study, utilities were obtained using the U-Titer II, an interactive software program designed to measure an individual's health state preference or utility. This study also examined the issue of numeracy, which is described as an understanding of basic probability, and its effect with an individual's ability to accurately complete utilities. / Data from 54 individuals fit with hearing aids in this randomized, controlled, pre-test/post-test experimental design study were analyzed. The participants completed the U-Titer II, a test of numeracy and the International Outcome Inventory for hearing Aids (IOI-HA). Three utility approaches were used in this study: Time Trade-Off (TTO), Standard Gamble (SG) and Rating Scale (RS). With each of the utility approaches, disease-specific (e.g., deafness vs. perfect hearing) and generic (death vs. perfect health) anchors were incorporated. / Several research questions were posed to examine the sensitivity of utilities to hearing aid intervention. Question 1: Can the effects of hearing aid intervention be determined with a utility approach? Statistically significant differences between pre- and post-intervention utility scores were measured with disease-specific and generic anchors for only the TTO and RS approaches. These findings suggest that hearing aid intervention outcomes can be measured using either the TTO or RS utility approaches. / Question 2: Is numeracy ability a factor in the usefulness of a utility approach for assessing the effects of hearing aid intervention? Statistical analysis showed that mean utility scores changed very little as a function of numeracy ability. These findings suggest that numeracy ability does not appear to affect utility scores. Question 3: What, if any, are the relationships between hearing aid benefit as measured by a utility approach and hearing aid benefit as measured by the IOI-HA? / Spearman Rho correlations were conducted on the benefit data obtained from the two self-report measures (IOI-HA and utilities). The major findings from these analyses determined that the IOI-HA total scores were significantly correlated with utility outcomes as measured by TTO generic, TTO disease-specific, and RS disease-specific anchors. In general, correlations between the measures were higher with the disease-specific anchors than the generic anchors. Also, none of the correlations between any IOI-HA outcome domains and utility change scores with generic anchors obtained with the RS scale were significant. / For utilities measured with disease-specific anchors, significant correlations were found with two IOI-HA outcome domains (benefit and satisfaction) and utility change scores as measured by the TTO technique. When the RS technique was utilized, significant correlations were found for four of the seven outcome domains (benefit, satisfaction, participation and impact of others). Thus, if the IOI-HA is used as a measure against which to validate the utility approach as a measure of hearing aid outcomes, the measure with the most face validity is a RS method with disease-specific anchors. However, if one wished to compare hearing aid intervention to intervention in other areas of health care, these data support the use of a TTO approach. / System requirements: World Wide Web browser and PDF reader. / Mode of access: World Wide Web.

Thesis (M.S.)--University of South Florida, 2007. / Title from PDF of title page. Document formatted into pages; contains 20 pages. Includes bibliographical references.

Thesis (M.S.)--University of Alabama at Birmingham, 2007. / Title from first page of PDF file (viewed Oct. 31, 2007). Includes bibliographical references (p. 42-45).

Diss. (sammanfattning) Linköping : Univ., 2002. / Härtill 5 uppsatser.