published_or_final_version / Public Health / Master / Master of Public Health

Thesis (Ph.D.)--George Mason University, 2008. / Vita: p. 144. Thesis director: P. J. Maddox. Submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Nursing. Title from PDF t.p. (viewed July 3, 2008). Includes bibliographical references (p. 129-143). Also issued in print.

Thesis (DR. P.H.)--University of Michigan.

Thesis (DR. P.H.)--University of Michigan.

Caregivers often associate fevers with permanent harm and bring children to emergency departments (EDs) unnecessarily. However, families using EDs for nonurgent complaints often have difficulty accessing quality primary care. Mutual misconceptions among caregivers and healthcare providers regarding nonurgent ED use are a barrier to implementing meaningful interventions. The purpose of this project was to identify dominant themes in caregivers’ narratives about bringing children to the ED for nonurgent fevers. Thirty caregivers were recruited in a pediatric ED for participation in qualitative semi-structured interview from August to November 2014. Interview transcripts were coded and analyzed for themes. Caregivers’ decisions to come to the ED revolved around their need for reassurance that children were not in danger. Several major themes emerged: caregivers came to the ED when they felt they had no other options; parents feared that fevers would result in seizures; caregivers frequently drew on family members and the internet for health information; and many families struggled to access their PCPs for sick care due to challenging family logistics. Reducing nonurgent ED utilization requires interventions at the individual and structural level. Individual-level interventions should empower caregivers to manage fevers and other common illnesses at home. However, such interventions may have limited impact on utilization outcomes among families with poor access to primary care. Afterhours primary care should be expanded to accommodate families with rigid work schedules and limited transportation resources.

Unintentional injuries are the leading cause of death for children aged 5-19 Twenty-two million children are injured each year and approximately one quarter of these injuries occur on school premises. Schools must provide nursing services to children who attend school, but ratios of registered nurses to students is higher than the 1:750 recommended ratio. Current school teachers believe pre-service teachers should be trained in emergency care in teacher training programs. Yet, no research has been conducted to evaluate pre-service teachers’ knowledge and attitudes toward emergency care. The purpose of the study was to investigate pre-service teachers’ knowledge of and attitude toward emergency care in the school setting. A cross sectional group-comparison survey design was used. A 40-item questionnaire was administered to pre-service elementary teachers at Ball State University located in Muncie, IN. The questionnaire consisted of questions from “Emergencies in the school setting: Are public school teachers adequately trained to respond?” and Urban public school teachers’ attitudes and perceptions of the effectiveness of CPR and automated external defibrillators. Sub-group comparisons were made using bivariate and multivariate analyses of similar demographic, attitude, and knowledge questions. Findings indicated that pre-service teachers have a positive attitude toward emergency care, low levels of knowledge about emergency care, and a low level of willingness to provide emergency care in schools. In addition, when comparing pre-service teachers who had received emergency care training to those who did not, a statistically significant difference was found in their knowledge about emergency care. Emergency care training has limited influence on pre-service teachers’ attitudes and willingness to provide care. / Department of Physiology and Health Science

The purpose of this current study is to examine the impact of non-pharmacologic pain interventions administered by trained Child Life professionals in an emergency department on pain perception in children. Results showed no significant decrease in children's pain report during the medical procedure compared to before the medical procedure. However, pain after the medical procedure is significantly less than pain during the medical procedure.