http://hdl.handle.net/2271/235 University of Kansas School of Nursing Search the Channel s http://www.kumc.edu/archie/simple-search http://hdl.handle.net/2271/413 title: Understanding Nursing Home Culture Change: The High and Low authors: Seibert, Ashley Michelle; Bott, Marjorie J. <br>abstract: Culture Change is the transformation of a nursing home (NH) from an institutional establishment with a top down approach to decision making to a resident‐centered program that creates an environment that focuses on what is most important to residents and staff. Twenty‐five care practices from the Colorado Foundation for Medical Care served as the theoretical framework for seven dimensions of Culture Change—home‐like environment, resident‐directed care, staff/resident relationships, NH staff empowerment, NH leadership, quality improvement, and shared values. Using a secondary data analysis, the overall aim of the study was to examine differences in staff and leadership reports of Culture Change among Kansas nursing homes with high (n = 7) and low turnover rates (n = 5). Facility turnover rates were obtained from the 2006 Kansas Medicaid Cost Report. Leadership (n=75) and staff (n=437) participants from Kansas nursing homes (6 rural and 6 urban) completed data collection with response rates ranging from 26 to 85%. We hypothesized that staff in nursing homes with low turnover rates would report higher levels of Culture Change than staff in high turnover homes. Data analysis was conducted using two sample t‐tests. Although both leaders and staff in low turnover nursing homes reported higher levels of Culture Change across all dimensions than those in high turnover homes, we only found significance (p <.05) differences in the staff/resident relationships dimension by leaders and staff, and in the leadership dimension by leaders. The results of this study revealed that turnover rates have potential to serve as a proxy measure for some aspects of Culture Change. However, further testing in a larger sample is needed. <br>description: Submitted to the School of Nursing in partial fulfillment of the requirements for the Nursing Honors Program. <br> http://hdl.handle.net/2271/412 title: The Perceived Behavioral Control of Breastfeeding Among Pregnant Adolescents and Its Relation to Postpartum Breastfeeding Difficulties authors: Gross, Jennifer; Wambach, Karen; Aaronson, Lauren <br>abstract: Despite a large body of evidence supporting breastfeeding as best for infants and mothers, rates still fall short of the Healthy People 2010 Goals. The initiation and duration rates of adolescents are even lower, despite the fact that benefits for this population may be greater. Breastfeeding can be explained using the theory of planned behavior and its concepts of attitude, subjective norm, perceived behavioral control, and intentions. The purpose of this secondary analysis (N = 289) was 1) to determine the relationship between prenatal breastfeeding control (PBC), prenatal feeding intentions and breastfeeding at birth; and 2) among those who initiate breastfeeding, the relationship between PBC and breastfeeding concerns and difficulties at three and six weeks postpartum. Data from a randomized control trial was obtained from a questionnaire measuring theory concepts upon enrollment and at 32 – 36 weeks gestation. Upon delivery, 69% of the teens (n = 201) initiated exclusive or partial breastfeeding. All breastfeeding participants were contacted by phone at 3 and 6 weeks postpartum, and completed the Breastfeeding Experiences Scale. Data analyses included descriptive statistics, Pearson or Spearman correlations, Chi‐Square analysis, and narrative content and frequency analysis. PBC perceptions were significantly related to prenatal intentions to breastfeed (r = .54, p = .01), but not significantly related to three and six week breastfeeding problem severity perceptions. Among those who breastfed at birth, mean prenatal PBC levels were higher among those who continued breastfeeding at three weeks (t = ‐2.3 (163), p = .026). Weaning decisions in the early postpartum period were based on physical issues, but included psychosocial issues as time progressed. In conclusion, the TPB is a useful model for predicting intentions to breastfeed in this vulnerable population. <br>description: Submitted to the School of Nursing in partial fulfillment of the requirements for the Nursing Honors Program. <br> http://hdl.handle.net/2271/411 title: Perinatal Risk Factors and Postpartum Depression: A Comparison of Publicly and Privately Insured Women authors: Fuhs, Emily; Breedlove, Ginger <br>abstract: Postpartum depression affects approximately 13% of women and is considered a major complication of childbirth. When it is undetected or untreated there is an increased risk for morbidity. Increased awareness of perinatal risk factors can improve care provided to pregnant and postpartum women. Also, increasing provider understanding of perinatal depression can help with earlier identification of prenatal risks, leading to more effective treatment prior to the traditional diagnosis of postpartum depression. This study examined how perinatal maternal risk factors, perceived stress, and depression related to postpartum depression among privately insured women and those on Medicaid. Using the Cohen Perceived Stress Scale (PSS), pregnant women were assessed twice, both during pregnancy and the postpartum period. Participants were also assessed for psychosocial challenges during pregnancy and related medical diagnoses before delivery using items from the CDC Pregnancy Risk Assessment Monitoring tool (PRAMS). The prevalence of depression was determined by completion of the Edinburgh Postnatal Depression Scale (EPDS) and the Center for Epidemiological Studies Depression Scale (CES‐D). From a larger data sample, frequency of perinatal stress and depression, psychosocial conflict, and medical conditions were described in relationship to postpartum depression among the two sample groups. Participants were women seeking prenatal care prior to 21 weeks. They were aged 21‐30 years old with no more than one previous birth, no previous preterm birth and no complications in the current pregnancy. Other inclusion criterion included residence in the Kansas City Area, fluency in reading and speaking the English language, and private or public insurance coverage at the time of enrollment. Preliminary data analysis suggested that prenatal stress has a slightly higher incidence among the public pay population. The mean PSS scores throughout the perinatal period for Medicaid mothers was 15.7 with a range from 2‐28; mean PSS scores of mothers with private pay were 15.2 with a range from 2‐26. Scores on the CES‐D through pregnancy and the EPDS during the postpartum period trended towards higher scores in the private pay group. Women with Medicaid tended to report increased social stressors and decreased social support with 50% (n=4) of these women showing the likelihood for a depressive illness in the postpartum period. Further analysis with a larger sample and study completion is needed to determine the full effects of stress and depression in relation to physical problems, social conflict, and intent of pregnancy among participants. Increased awareness of perinatal risk factors, stress and depression can improve care and lead to more effective treatments prior to the traditional diagnosis of postpartum depression. Ultimately, these actions will help to improve the health and function of the mother, newborn, and family. <br>description: Submitted to the School of Nursing in partial fulfillment of the requirements for the Nursing Honors Program. <br> http://hdl.handle.net/2271/410 title: Prenatal Health Education Needs of Medically Indigent and Under‐Insured Pregnant Women authors: Dresser, Kaitlyn Marie; Brewer, M. Kathleen <br>abstract: Education is an important and integral part of prenatal health and plays an important part in reducing prenatal health disparities among vulnerable populations. In an effort to improve health outcomes for mothers and their infants, nurses need to design relevant prenatal health education programs when caring for medically‐indigent and under‐insured pregnant women. The purpose of this pilot study was to determine the prenatal educational needs of medially‐indigent and under‐insured pregnant women to design appropriate health promotion programs. Women were asked to respond to questions related to their diet, exercise, use of medications, number of pregnancies, their reproductive health, and use of tobacco and alcohol. The information gained from this pilot study provides the framework necessary to develop relevant educational programs and to increase awareness of healthy lifestyle behaviors and thereby change unhealthy prenatal behaviors for this population of vulnerable women. The design of the study was a descriptive, cross‐sectional survey. All pregnant women receiving prenatal care at the JayDoc Free Health Clinic were invited to complete a Prenatal Health Survey designed by the March of Dimes. The women were given the option of completing the survey in English or Spanish. Descriptive statistics were used to summarize the study results. A total of 15 pregnant women ranging in age from 17 years to 34 years (mean age 26 years) completed the survey. The majority of the women (n=12) completed the questionnaire in Spanish. The most significant results of the study were: (1) 87%of the women (n =13) reported they did not receive routine dental care and (2) 40% of the women (n = 6) reported they did not regularly exercise. The results of this study have implications for nurses caring for medically‐indigent and under‐insured pregnant women. When caring for this population of vulnerable women, it is important to assess their need of dental care. If it is determined the women are in need of such care, nurses need to be able to provide appropriate education about the importance of dental health and dental care resources. <br>description: Submitted to the School of Nursing in partial fulfillment of the requirements for the Nursing Honors Program. <br> http://hdl.handle.net/2271/409 title: Editorial authors: Neuberger, Geri B. <br>abstract: Welcome to this inaugural issue of The Journal of BSN Honors Research. This journal is a compilation of original articles written by a select group of senior nursing students who participated in the Bachelor of Science in Nursing Honors Program under the direction of their faculty mentor. The Nursing Honors Program offers enhanced educational opportunities for the most ac ademically talented, promising, and motivated baccalaureate students. <br>description: Introductory editorial by Geri B. Neuberger, RN, EdD, Professor and Coordinator BSN Honors Program <br> http://hdl.handle.net/2271/408 title: The Journal of BSN Honors Research, Volume 1, Issue 1, 2008 authors: Neuberger, Geri B.; Dresser, Kaitlyn Marie; Fuhs, Emily; Gross, Jennifer; Seibert, Ashley Michelle <br>abstract: Welcome to this inaugural issue of The Journal of BSN Honors Research. This journal is a compilation of original articles written by a select group of senior nursing students who participated in the Bachelor of Science in Nursing Honors Program under the direction of their faculty mentor. The Nursing Honors Program offers enhanced educational opportunities for the most ac ademically talented, promising, and motivated baccalaureate students. <br> http://hdl.handle.net/2271/361 title: The Journal of Undergraduate Nursing Writing: Volume 2, Number 1, October 2008 http://hdl.handle.net/2271/360 title: Nurses and MRSA: Stopping the Spread authors: Whetter, Chrissy <br> http://hdl.handle.net/2271/359 title: Responsible Sexual Behavior in Adolescents Through Comprehensive Sex Education authors: Tafreshi, Azita <br> http://hdl.handle.net/2271/358 title: Ending a Life in the Beginning: An Informative Analysis of Pediatric End-of-Life Palliative Care authors: Sanchez, Czarina Mae <br>