DSpace Repository :: Browsing by Author "Oliver, JoAnn S."

Browsing by Author "Oliver, JoAnn S."

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Cancer Survivors in Saint Lucia Deeply Value Social Support: Considerations for Cancer Control in Under-Resourced Communities
(MDPI, 2022) Auguste, Aviane; Cox, Shania; Oliver, JoAnn S.; Phillip, Dorothy; Gabriel, Owen; St Catherine, James; Radix, Carlene; Luce, Daniele; Barul, Christine; Institut National de la Sante et de la Recherche Medicale (Inserm); Ecole des Hautes Etudes en Sante Publique (EHESP); Universite des Antilles; University of Alabama Tuscaloosa
Understanding the views of cancer survivors on their experience is important for informing community-based interventions. We studied, for the first time, the views of cancer survivors residing in Saint Lucia on their overall care experience. We used interview data from a cohort of adult cancer survivors from Saint Lucia between 2019 and 2020. We performed a thematic analysis to derive themes from codes. Forty-four survivors provided responses to at least one of the three questions. The majority of survivors were black, female and diagnosed with breast cancer. Survivors were interviewed on average five years after diagnosis. Four common themes emerged; "Availability of support groups", "Importance of support from family and friends", "Access to finances" and "Health education and patient navigation". Travel overseas for health services was common among survivors. Survivors expressed emotional distress during travel due to isolation from family and local providers. This is typical among island populations and is distinct from existing patient frameworks. Survivors also suggested that networking amongst providers and interventions assisted families of cancer survivors. Although tertiary care services are limited, we showed that survivors deeply value and depend on their inter-personal relationships during care. Interventions aimed at strengthening the inter-personal environment of survivors are warranted.
Cognitive apprenticeship in hospital orientation for newly graduated nurses
(University of Alabama Libraries, 2017) Key, Betty Ann; Wright, Vivian H.; University of Alabama Tuscaloosa
The transition from student nurse to practicing, newly graduated nurse has been described as a time of challenge. Lack of confidence has been described as a source of uncertainty during the role transition from student nurse to practicing nurse. Cognitive apprenticeship (CA) is an instructional strategy that can facilitate ease of transition for newly graduated nurses (NGNs) during the clinical or preceptorship portion of hospital orientation. The purpose of this mixed methods pretest-posttest design was to explore if there would be a difference in confidence and ease of transition to practice, after completing a cognitive apprenticeship based hospital orientation. Newly graduated, newly hired registered nurses as well as experienced nurse preceptors were solicited for participation in this study. The Casey-Fink Graduate Nurse Experience Survey was administered as both the pretest and posttest. Qualitative data were also collected from focus group interviews of both newly graduated nurses and preceptors. The findings indicated that there was a statistically significant difference in confidence after a CA-based orientation. Furthermore, the findings revealed the importance of preceptor training for effective preceptorships. This study adds to the literature regarding transition to practice strategies as well as pedagogical strategies for preceptorships.
Community Perspectives and Environmental Justice Issues in an Unincorporated Black Township
(MDPI, 2022) Moore, Teriana; Payne-Foster, Pamela; Oliver, JoAnn S.; Spears, Ellen Griffith; Spencer, Christopher H.; Maye, Jacqueline; Allen, Rebecca S.; University of Alabama Tuscaloosa
Through each era, the southeastern United States was and continues to be an epicenter for industrial companies to establish factories and plants. Though this development attracts economic gain for the companies and surrounding areas, low-income and predominantly Black communities bear the brunt of the environmental consequences while frequently remaining stagnant economically. This qualitative, community-based participatory research study grew out of a larger study designed to recruit lay community advisors from communities labeled as hard to reach in research. We focus on Holt, Alabama, an unincorporated community in the southeastern United States region. The primary goal of this research inquiry is to thematically analyze community interviews stemming from a topic of research, practice, and policy interest to community members: the effects of industrial pollution on Holt citizens' daily lives. Content analysis of focus-group transcripts revealed four emergent themes, including: (1) how the pollution affects their water, soil, and air quality; (2) illness related to pollution; (3) community engagement and empowerment; and (4) suggestions regarding what government officials could do to address this area of need. Building upon the prior research regarding environmental justice, human flourishing, and the definition of nurturing environments, suggestions are made regarding the creation, implementation, and maintenance of project advisory councils focused on issues of environmental justice. Community advocacy and empowerment as well as community and scientific partnerships are imperative to alleviate problems associated with environmental justice.
A cultural framework for pain management: understanding traditional cultural values in Hispanic patients with chronic pain and limited English proficiency
(University of Alabama Libraries, 2015) Torres, Calia; Thorn, Beverly E.; University of Alabama Tuscaloosa
Objective: In the United States, Hispanics face additional barriers to accurate pain management due to language and cultural differences. One way to address pain disparities among Hispanic patients is to further investigate the role of cultural values that influence chronic pain management. The aim of this study was to to obtain patients’ perspectives and deepen our understanding of the cultural beliefs influencing the pain management decisions of Hispanics with low acculturation and limited English proficiency who turn to Federally Health Qualified Centers (FQHCs) for healthcare services. Methods: The sample included 24 (17 females and 7 males) Spanish-speaking patients with chronic pain. Participants participated in a focus group or key-informant interview and shared about their pain management needs and factors influencing how they experience, report, and treat their chronic pain. Descriptive data on pain and mood variables were also collected to inform how this unique population compares to the original norms reported in the pain literature. Results: Across all interviews, patients’ reported preference for self-care practices, non-invasive medical treatments and reported negative attitudes towards pain medications. Beliefs about pain relief and finding the cure for chronic pain significantly affected their expectations about medical visits. Satisfaction with healthcare providers was highly influenced by patients’ expectations and preference for personal, warm, and friendly interactions. This study also highlights the emphasis of family needs over individual needs and how this prioritization prevented participants from expressing pain behaviors and seeking care. Conclusion: The implications of our findings suggest that patients’ unfamiliarity with mainstream treatment options for chronic pain may shape their expectations and satisfaction with medical visits.
The lived experience of transition to practice for the new graduate licensed practical nurse working in long term care
(University of Alabama Libraries, 2016) Jones, Julie Savage; Kuntz, Aaron M.; University of Alabama Tuscaloosa
For the past decade, the role of licensed practical nurse (LPN) has been a topic of discussion among the National League for Nursing (NLN) and the National Council for State Boards of Nursing (NCSBN). The NLN recently called for nurse educators to examine the LPN role in the current healthcare system. Transition to practice issues experienced by the new graduate licensed practical nurse (NGLPN) are important issues that reflect nursing education. This study explores the lived experience of transition to practice for the NGLPN working in the long-term care (LTC) setting. The study will open the conversation about NGLPN transition to practice among practical nursing educators and nursing administrators of LTC facilities. Van Manen’s and Benner’s use of interpretive phenomenology informed the study design. The researcher interviewed three new graduate LPNs, graduating from one school in a state community college practical nursing program. The graduates were interviewed three times for no more than 60 minutes each in an effort to learn about experiences of transition to practice in long-term care. Themes that emerged from the negative experiences include intimidating, disrupting behaviors, death and dying. Subthemes that emerged from the intimidating and disruptive behaviors include integrity, human dignity, and self-determination. The subtheme unprepared emerged from the death and dying theme. Themes that emerged from the positive experiences are relationships and feeling supported. Caring emerged as a subtheme of relationships. Personal growth and human flourishing (HF) emerged as a theme of the positive and negative experience.
Medical-surgical nurses’ experiences caring for patients with suspected opioid use disorder
(University of Alabama Libraries, 2018) Bridges, Angela Weekley; Erevelles, Nirmala; University of Alabama Tuscaloosa
Opioid use disorders (OUDs) are epidemic in the United States. Individuals with undisclosed OUDs are commonly encountered in general hospital settings. Many studies confirm negative attitudes of healthcare professionals towards patients with substance use disorders (SUDs), especially nurses. Current evidence suggests negative attitudes of healthcare professionals are associated with negative outcomes for this patient population. This qualitative study examined medical-surgical nurses’ experiences caring for patients with suspected OUDs. Study findings included that nurses could remember little or no content on SUDs from nursing curricula. It was through experiences caring for actual OUD patients that enabled nurses to identify patients who may have an OUD. Identification of those suspected of OUD was based on frequent and/or bogus admissions, identifying Dilaudid as the drug of choice, setting phone alarms for the next opiate dose, rating all pain as severe, patient behaviors suggesting little or no pain, and a range of negative behaviors. Attitudes towards suspected OUD patients were largely negative and based on acting out behaviors and disruption of unit routines. Nurses had mixed feelings over the patient’s report of pain versus behaviors and assessment findings suggesting little or no pain. Consequently, a common pain management strategy was limiting opiates. Additionally, nurse-patient relationships were limited and nonproductive at best. Nurses were discouraged from caring because they felt they were not making a difference in the underlying problem; furthermore, giving pain medications made them feel they were drug dealers rather than healers. Paradoxically, most nurses did not engage in actions that might have validated the underlying OUD and the development of a treatment plan. Facilitation of treatment or referral may have enhanced nurses’ self-esteem and improved the outcome for this patient population. Study recommendations included the addition or enhancement of content related to SUDs, especially OUDs, in nursing curricula and staff training in acute care settings. Care may be improved in hospital settings through collaboration with physicians and administration to reduce opiate prescribing and the establishment of brief screening, intervention and referral processes.
Memory and Cancer: A Review of the Literature
(WB Saunders, 2014) McDougall, Graham J., Jr.; Oliver, JoAnn S.; Scogin, Forrest; University of Alabama Tuscaloosa
The mental health of cancer survivors has not always been the primary emphasis of treatment protocols since physical health outcomes have taken precedence. Older cancer survivors experience a double jeopardy since they are at risk for memory impairments and mild cognitive impairment and because they are greater than 55 years of age. Of the 9.6 million cancer survivors in the US who have completed active treatment, many report cognitive difficulties, with labels such as "chemo brain," "not as sharp," "woolly-headedness," or the "mind does not work as quickly". To date, most of our knowledge of cognitive impairment in cancer survivors comes from female breast cancer survivors. Studies indicate that these survivors have diminished executive function, verbal memory, and motor function. Cancer survivors want to live independently in the community for as long as possible however, these cognitive deficits may prevent this desired lifestyle. To broaden our understanding this paper reviews the literature on the cognitive impairment and memory deficits experienced by three groups of cancer survivors breast, colorectal, and prostate cancer, that make up 60% of all survivors nationally. Even though mental health declined after a cancer diagnosis, the long-term outcomes of cancer survivors did not differ from persons without cancer in depression or cognitive function. (C) 2014 Elsevier Inc. All rights reserved.
A mixed-methods exploration of death exposure in certified nursing assistants: moderating factors and implications
(University of Alabama Libraries, 2017) Eichorst, Morgan Kay; Allen, Rebecca S.; University of Alabama Tuscaloosa
Certified Nursing Assistants (CNAs) are responsible for 80-90% of direct-to-resident care in skilled nursing home facilities (SNFs), and often develop close, family-like relationships with their residents. With SNFs becoming an increasingly common place of death for older adults, CNAs now find themselves engaging in end-of-life caregiving without proper training, or institutional support for the emotional outcomes. Moreover, little is known about the impact of frequent death exposure on CNAs. The present project examined these issues in a set of three interrelated studies, employing mixed-methods analyses. The first study found support for a new measure of attitudes toward advance care planning (ACP) in two samples, while finding that personal exposure to death is significantly related to more developed ACP attitudes. The second, qualitative study revealed CNAs’ varying attitudes toward death, the importance of their relationships with residents, and the ways in which exposure to the dying process has influenced their ACP attitudes. Finally, while study 3 failed to find support for behavioral inhibition and experiential avoidance as moderators of the impact of death exposure on negative death attitudes, results supported the relationship between these variables and their impact on compassion fatigue. Moreover, positive death attitudes, and death exposure, were found to be more influential to ACP attitudes than negative death attitudes. Implications highlight researcher’s imperative to develop interventions focusing on education and support of CNAs in their role as end-of-life caregivers to decrease high job turnover, and increase quality-of-care outcomes for residents.
Preparation and Planning for Future Care in the Deep South: Adapting a Validated Tool for Cultural Sensitivity
(Oxford University Press, 2019) Allen, Rebecca S.; Oliver, JoAnn S.; Eichorst, Morgan K.; Mieskowski, Lisa; Payne-Foster, Pamela; Sorensen, Silvia; University of Alabama Tuscaloosa; US Department of Veterans Affairs; Veterans Health Administration (VHA); Salem Veterans Affairs Medical Center; University of Rochester
Background and Objectives: This study describes the adaptation and validation of Sorensen et al. (2017)'s preparation for future care (PFC) scale with diverse samples including rural dwelling African Americans and certified nursing assistants (CNAs), and subsequent psychometric development. Research Design and Methods: Responses to the five-subscale PFC survey from 33 rural African American men across 12 months and cognitive interviews with a subset of 12 of these men are described. Psychometric refinement included descriptive qualitative analyses of consultations with experienced lay research advisors (N = 4 and N = 7) regarding potential changes to the PFC and a confirmatory factor analysis of the resultant scale (N = 138). Results: Cognitive interviews with rural African American men revealed difficulty understanding Eurocentric questions. Emergent themes included emotional avoidance of planning, considerations of nursing homes and possible care providers, and coping strategies. In two consultation meetings, trained lay research advisors recommended language modifications to the original questions and response options. Factor analyzing the resultant scale revealed support for the original subscale constructs (acceptable fit: chi(2) = 205.03, df = 124, p < .001; root mean square error of approximation = .069 [.052-.085]; comparative fit index = .93; Tucker-Lewis index = .91). Discussion and Implications: PFC and engagement in advance care planning is uncommon among African Americans, possibly due to distrust of and lack of cultural competency among health care professionals. The resulting tool and response options may be used as an interview guide/survey with African Americans to gain understanding about their preparation for future health care needs.
Race, immigration status and job satisfaction among certified nursing assistants
(University of Alabama Libraries, 2013) Zakoscielna, Karolina Magdalena; Parmelee, Patricia A.; University of Alabama Tuscaloosa
Certified Nursing Assistants (CNAs) provide up to 90% of direct care to long-term care residents. Unfortunately, CNAs have an extraordinarily high turnover rate that is accompanied by low levels of work satisfaction. A largely qualitative body of literature has indicated that perceived lack of respect and perceived discrimination drive job satisfaction differently in CNAs of different race/ethnicity. This quantitative study examined CNA job satisfaction with an emphasis on race, immigration status, dementia training, respect, and perceived discrimination. Secondary data analysis of the National Nursing Assistant Survey used information from 3,017 nursing assistants in 1,500 nursing facilities, including data on training, supervision, client relationships, and workplace environment. This study looked at a sample of 2,352 participants; 61.3% were Non-Hispanic Whites (NHWs) and 31.4% were African Americans (AAs); 89% were US born citizens, 4.2% immigrants, and 6.8% citizens through naturalization. Path analyses indicated that race predicts job satisfaction, and that both respect and discrimination partially mediate that association. This pattern of findings was consistent across both racial groups. These effects varied with age. Immigration status and dementia training were hypothesized to moderate these effects by improving understanding of problem behavior, yet neither hypothesis was supported. These results highlight the complex nature of CNA job satisfaction in long-term care.
Theory-based post -simulation debriefing: perceived effectiveness of debriefing and transfer of learning
(University of Alabama Libraries, 2019) Colvin, Natasha Renee; March, Alice L.; University of Alabama Tuscaloosa
Background Nurse educators have an obligation to ensure that students learn, develop, and apply higher-order cognitive skills. New graduates are expected to practice at a higher performance level in order to care for more complex patients, yet barriers to clinical education, such as securing clinical sites, have made it difficult for nurse educators to provide a variety of learning experiences. Many nursing faculty are either supplementing or replacing clinical experiences with simulation-based training with the goal of students transferring the knowledge and skills learned in the laboratory setting to the “real” patient care environment. Significance Debriefing has been recognized as the most significant component of a simulated learning experience (Shinnick, Woo, Horwich, & Steadman, 2011; Forneris, 2015). Little is known regarding the effectiveness of debriefing strategies, and so the evaluation of debriefing is critical to ensure learning outcomes and students’ transfer of learning. Specifically, the evaluation of the debriefer’s effectiveness in engaging students during a structured, theory-based debriefing is critical, as the practice of debriefing methods broadens throughout nursing curriculum (Shinnick et al., 2011; Forneris, 2015). Methods A quasi-experimental, post-test-only control-group design was utilized to examine how non-theory-based debriefing compared to theory-based debriefing on students perceptions of the debriefing effectiveness and their transfer of learning following a high-fidelity simulation. Results Frequencies and percentages, independent t-tests, and Pearson product-moment correlation were applied to the data set. The study results did not show a statistically significance difference between the theory-based versus non-theory based learning groups. Additional data analysis demonstrated a statistically significant negative correlation in age and transfer of learning. Further, there was a statistically significant positive correlation between DASH-SV and LTT total score. Conclusions Further research is needed on a larger representation of nursing students. Ideally, transfer of learning and students perceptions of debriefing effectiveness should be evaluated with a more diverse, nationally representative sample of nursing students. Additionally, future research should also examine additional predictors and factors that could influence transfer of learning, For example, sex, type of nursing program, and semester level of the nursing student. j
Vicarious learning and perceived self-efficacy among pre-licensure nursing students during pediatric end-of-life situations
(University of Alabama Libraries, 2018) Mohr, Stephanie Barger; March, Alice L.; University of Alabama Tuscaloosa
Despite decades of acknowledgement among nursing academics and organizations, end-of-life (EOL) nursing education is significantly lacking. Insufficient EOL care education leaves nursing students feeling ill-prepared to adequately care for clients and their loved ones at EOL. Though the literature reveals a recent increase in didactic and simulation-related EOL education sporadically being integrated into nursing curricula, minimal research addresses important topics of pediatric EOL care and provision of therapeutic communication, considered critical to EOL care. End-of-life clinical experiences, particularly in pediatrics, are limited for pre-licensure nursing students. Though effective, simulations can be costly and timely to execute, are restricted by limited availability of space, and require facilitators who are adequately trained in provision of EOL care. Such barriers prompt the question as to whether there is a more cost and time-effective alternative to active simulation, by which students can gain improved self-efficacy in provision of therapeutic communication during pediatric EOL situations. The literature has shown vicarious learning to provide students with opportunities to gain experience and knowledge through observation of their peers in simulated settings. This study specifically evaluated the effectiveness of vicarious versus active learning on pre-licensure nursing students’ perceived self-efficacy in providing therapeutic communication during pediatric EOL situations. Data collected over time with baseline Self-Efficacy in Communication During Difficult Situations Scale scores (SECS1), post-EOL simulation self-efficacy scale scores (SECS2), and post-simulation debriefing self-efficacy scale scores (SECS3) revealed no statistically significant differences in perceived self-efficacy within or between the vicarious and active learner groups. Therefore, vicarious learning seems to be a viable pedagogical approach for providing pre-licensure nursing students important learning opportunities related to pediatric EOL care, as well as improved self-efficacy in providing therapeutic communication during difficult situations.

Browsing by Author "Oliver, JoAnn S."

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