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Browsing by Author "Sloan, Rebecca S."
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Item Adapted dance- connecting mind, body and soul(2014-01-29) Swinford, Rachel R.; Ellett, Marsha L.; Sloan, Rebecca S.; Crabtree, Jeffrey L.; Horton-Deutsch, Sara L.; Stanton-Nichols, Kathleen A.Using Heideggerian interpretive phenomenology, this study illuminates the lived experience of an adapted dance program for individuals with Down syndrome and their family members. The overall pattern from both dancers and family members was adapted dance: connecting mind, body and soul. The primary theme from dancer interpretations was expressing a mosaic of positive experiences, and the primary theme from family member interpretations was experiencing pride in their loved ones. The dance program provided dancers an opportunity to express their authentic self while experiencing moments of full embodiment in the connection of their mind, body and soul. While dancers experienced the connection of mind-body-soul, family members recognized the importance of this connection in their loved one. This research is instrumental in advocating for opportunities for individuals with Down syndrome to experience dance as a social, physical and intellectual activity that results in learning and increasing social interactions. The research findings from this study can support future initiatives for dance programs that may influence a population that has limited access to physical activity and dance. The study’s teaching strategies, dance activities, class procedures and sequences, and feedback techniques can be used by other professionals who teach individuals with intellectual disabilities.Item Domestic Violence Advocacy(2014) Wood, Leila Grace; Hostetter, Carol; Sullenberger, Sabrina Williamson; Barton, William H., 1949-; Adamek, Margaret E.; Sloan, Rebecca S.Advocacy, in the form of direct service, is a critical type of intervention to help intimate partner or domestic violence survivors. Little is known the best practices for social workers and other helping professionals to assist survivors of domestic violence who present for services at shelters, non-residential outreach, and legal settings. This dissertation reviews relevant research related to domestic violence direct services, which is also called advocacy. The study also outlines a brief overview of the history, theory, and paradigms of thought related to the movement to end intimate partner violence. The research project used the grounded theory method to conduct and analyze semi-structured, in-depth interviews with advocates at domestic violence agency to answer the research question: What constructs and practices inform the delivery of direct services to survivors of domestic violence from shelter and non-residential service advocates? A total of 22 women working primarily with domestic violence survivors in shelters and non-residential agencies participated in the dissertation study. Participants came from one Midwestern and one Southwestern state. The interviewees had a range 1-20 years of experience in the field of domestic violence advocacy. Eighteen of 22 participants had experienced some sort of intimate violence in their lifetime. Several important findings emerged. Advocates typically enter the field because of personal motivations. The empowerment and strengths-based perspective are important to the delivery of advocacy services, as is belief in hope. Advocates typically endorse a survivor centered approach to their work. Data analysis revealed a concurrent process of advocacy that occurs within advocates and between advocates and survivors. This parallel process is marked in the earlier state of assessing and grounding; in the middle stage of establishing and affirming; and the ending stages of hoping and reflecting. These findings suggest the importance of personal experiences, hope, and reflection in the delivery of advocacy services. Community collaboration and support are essential to maintaining services that are aimed at the individual needs of survivors. More research is needed about the perceptions of services among survivors of domestic violence.Item Dual Degree Programs in Social Work and Divinity: Graduates' Experiences of Journey Companions(2010-07-21T19:40:41Z) Muehlhausen, Beth L.; Adamek, Margaret E.; Byers, Katharine V.; Caucci, Frank; Sloan, Rebecca S.There is a growing trend for graduate schools of social work to offer students the option of receiving dual degrees, which gives students the ability to obtain a Master of Social Work (MSW) along with a second graduate degree in less time than it would take to complete each degree individually. As of 2005, there were approximately 30 different types of degrees that could be combined with graduate studies in social work--one of which is a Master of Divinity (M.Div.). Very little is known about the effectiveness of such programs and the experiences of graduates completing them. The aim of this study was to describe the lived experiences of persons receiving an MSW and an M.Div. from dual degree programs. The National Association of Social Workers (NASW) includes religious and spiritual beliefs in its definition of culturally competent practice within the code of ethics. Dual degree graduates are trained to engage in culturally competent practice by virtue of being extensively trained in the cultural context of the church through their M.Div. degree and extensively trained in the context of social work service delivery though their MSW degree. Dual degree programs in social work and divinity are quite timely given that 96% of Americans say they believe in God or a universal spirit. Phenomenology seeks to understand a particular phenomenon from the point of view of those who have experienced it. With this in mind, this study reports the findings resulting from interviews conducted with 16 graduates regarding their experiences while in a dual degree program. One of the key phenomenological patterns that emerged in all the interviews conducted was that dual degree graduates want “journey companions,” i.e. persons who share their worldview.Item Illness Representation and Medication Adherence of Patients with Chronic Kidney Disease(2012-03-16) McManus, M. Sue; Welch, Janet L.; Rawl, Susan M.; Sloan, Rebecca S.; Halstead, Judith A.Chronic kidney disease (CKD) places a high personal and economic burden globally on individuals, families, and society. Although kidney protective medications slow the progression of CKD to end stage kidney disease, adherence to these medications is inadequate. The primary purposes of this study are to: 1) describe the illness and treatment beliefs of CKD patients in stage 3 guided by the Common Sense M model (CSM); and 2) examine the relationship of those beliefs with adherence to renal protective medications, ACE-I. Secondary purposes of this study include determining adherence levels of ACE-I among patients with CKD stage 3; examining relationships between individual and clinical characteristics with patient beliefs and medication adherence with ACE-I; and examining the relationship between the Medication Adherence Report Scale (MARS) and the Medication Possession Ratio (MPR). Using a descriptive cross-sectional design, a convenience sample of 92 individuals with Stage 3 CKD was obtained from a Midwestern VA medical center. Data were collected through self-administered mailed surveys and medical record reviews. Data analyses were performed using descriptive statistics, correlation, t-tests and ANOVA. Seventeen symptoms experienced were perceived as related to CKD by at least one respondent with most reporting legs/feet swelling (n=31). Top perceived cause of CKD was aging (60%). Revised Illness Perception Questionnaire (IPQ-R) items were scored from 1 to 5 with higher scores indicating perceptions of higher personal and treatment control of chronic, cyclical illness with serious consequences and negative emotional reactions. In this study, the CKD timeline was perceived as a long-term chronic rather than short-term acute condition (M = 3.8), with minimal cyclical exacerbations (M = 2.7), and moderate severity of consequences (M = 3.1). Respondents perceived having both, but more personal control than treatment control of CKD (M = 3.5 v 3.2). Participants did not perceive CKD as related to a great negative emotional response (M = 2.8). Illness Representations were not found to be significantly correlated with self-reported medication adherence. Medication adherence levels by self-report (M = 4.8 [5 = perfect adherence]) and pharmacy refill records (73% had perfect refill ratio of 1:1) reveal highly adherent levels among this sample.Item The lived experience of obtaining required childhood vaccinations from Latino immigrants’ perspective(2014-07-07) deRose, Barbara Sue; Sims, Sharon L.; Sloan, Rebecca S.; Mays, Rose M.; Ward, Richard E.Vaccinations are an important step in preventing childhood illnesses and disease outbreaks in the community. Complete immunizations before school assure eligibility for enrollment and protect children against severe illness. The fact that foreign-born children of Latino immigrants face health disparities in receiving vaccinations is well documented. However, there is little information in the literature about the actual experience of immigrants facing the complexities of the health system, and through their eyes, which factors ultimately affect vaccination rates of immigrant Latino children. The purpose of this study is to give voice to Latino immigrant families who have recently immigrated to the United States, in terms of the issues they encountered when engaging the health care system for vaccinations.Item The lived experiences of Indian nurses working in the United States : perceptions and attitudes towards nurse-physician collaboration(2013) Hale, Robyn Kathleen; Fisher, Dr. Mary L.; Sloan, Rebecca S.; Riner, Mary Beth; Ward, Richard E.Nurse-physician collaboration has received much attention over the past decade in the USA. The release of three reports from the Institute of Medicine implicated poor communication and collaboration among nurses and physicians as a major contributing factor to the incidence of sentinel events and medical errors. Despite the growing awareness of the imperative related to collaboration between nurses and physicians to ensure patient safety, the problem of poor nurse-physician collaboration remains endemic throughout the country. Indian nurses, along with many other internationally educated nurses, comprise 12-15.2% of the nursing workforce in the USA. Little is known about how Indian nurses culture potentially influences their ability to effectively collaborate with physicians to ensure patient safety. The purpose of this study is to understand Indian nurses’ attitudes and perceptions about nurse-physician collaboration. Hermeneutic interpretive phenomenology as influenced by the work of Martin Heidegger guided this study through the use of interviews via Skype. The overall experience of the Indian nurses was of one experiencing a dramatic positive change in nurse-physician collaboration in the USA as compared to India. Four themes emerged describing this phenomenon: Respect/feeling heard, Being Trusted, Assurance of Accountability, and Finding Freedom. Indian nurses practicing in the USA find a freedom that empowers them to collaborate with physicians for patient safety. They, as all nurses may, benefit from continuing educational opportunities that demonstrate ways to collaborate more fully.Item OSTOMY COMPLICATIONS AND ASSOCIATED RISK FACTORS: DEVELOPMENT AND TESTING OF TWO INSTRUMENTS(2011-08-23) Pittman, Joyce A.; Rawl, Susan M.; Bakas, Tamilyn; Ellett, Marsha; Sloan, Rebecca S.Complications following intestinal ostomy surgery can diminish quality of life for individuals living with an ostomy, resulting in physical and psychosocial limitations. Risk factors contributing to ostomy complications are not well established in the literature. The purposes of this study were to: 1) identify risk factors contributing to the development of fecal ostomy complications; 2) describe the incidence and severity of early fecal ostomy complications; and 3) estimate the reliability and validity of two newly developed instruments, Ostomy Risk Factor Index (ORFI) and Ostomy Complication Severity Index (OCSI). Using a prospective longitudinal design, 71 adult patients who had undergone ostomy surgery were recruited from three acute care settings. Data were collected through self-administered surveys, medical record review, and direct observation prior to discharge and at 30 to 60 days post-operatively. Data were analyzed using descriptive statistics, analysis of variance, chi-square tests, correlation, and multiple regression. Psychometric properties of the Ostomy Risk Factor Index and the Ostomy Complication Severity Index were examined using content validity indices, Cohen coefficient kappa, Pearson correlation coefficient, and intra-class correlation. Two risk factors were found to be predictive of ostomy complications scores, stoma/abdomen characteristics (p= .007) and BMI (p= .002). Ostomy complications and ostomy adjustment were significantly inversely correlated (r= - 0.27, p=.04) and stoma care self-efficacy and ostomy adjustment were significantly correlated (r= .599, p= .01). The ORFI and OCSI demonstrated acceptable content validity (CVI= 0.9). ORFI demonstrated acceptable inter-rater reliability for 10 of the 14 items (k= 1.0) and excellent intraclass correlation of total scores between raters (r= .998, p= .001). The OCSI demonstrated acceptable inter-rater reliability for all of the items (k= .71- 1.0) and excellent intra-class vii correlation of total scores between raters (r= .991, p= .000). The OCSI demonstrated acceptable internal consistency (Cronbach's alpha .68). In conclusion, this study provides new knowledge regarding risk factors, incidence and severity of ostomy complications, and provided support for the validity and reliability of two new instruments for the researcher and practitioner to reliably identify and describe important contributors (risk factors) and outcomes (complications) that affect care of the patient with an ostomy.Item Out of the Chrysalis of Silence, Into a World of Possibilities: Family Experiences of Having a Child Who Uses a Speech Generating Device(2010-01-13T14:54:41Z) Crisp, Cheryl Lee; Ellet, Marsha L.; Sloan, Rebecca S.; Sturm, Lynne Anne, 1954-; Swenson, MelindaThere are children in this world who are silenced by disability. The struggles of these children as they attempt to find a voice are difficult and often considered insurmountable. With advances in computer technology, devices are available to assist the child to have a voice. This voice is not found easily or acquired without difficulty. Even after finding and acquiring the necessary device, the child requires education and support to learn to use the device effectively. Challenges may be specific to the child’s disability, the support systems involved with the child, or even the technology itself. It is the adults in the child’s life, and the child’s family in particular, who provide needed support and assistance in helping him/her find an effective way of expressing his/her ideas. Families are an essential component in assisting their children to learn to use the device. My pilot study examined parents’ likes and dislikes of their child’s communication device. The preliminary data from that study illuminated several factors that increased the struggles of these children and their families as they work together to learn the device. These factors include financial, emotional, and developmental costs; as well as the lack of appropriately trained professionals; and excessive time lapses from evaluation to receipt of the device. The purpose of this study was to give a voice to the experiences of families around a child’s use of one type of augmentative and alternative (AAC), a speech generating device (SGD), by analyzing family’s experiences of the child’s use of a SGD as seen through the lens of the child’s primary caregiver. Interpretive phenomenologic methods for data collection and interpretation were used to elucidate the experience of families who have a child who is currently using or who has previously used a SGD as a method of communication. One cannot learn about the lived experience of the family without first listening to their story and allowing the family to share how their child’s use of a SGD affected the life of their family.Item Surviving the Perfect Storm of Diabetes in the World of the Schitsu'umsh(2010-10-21) Tiedt, Jane A.; Sloan, Rebecca S.; Frey, Rodney, 1950-; Mays, Rose M.; Pesut, Daniel J.Diabetes is a significant health problem in the United States which disproportionately affects Native Americans. Despite many new prevention and intervention programs, there has been a prolific increase in the incidence of diabetes among Native Americans. The purpose of this qualitative study was to explore the experience of Coeur d’Alene tribal members living with type 2 diabetes using a Heideggerian hermeneutic framework. Participants were recruited through the local diabetes educator at the tribal clinic using purposive and snowball sampling. Individual interviews were conducted with ten Coeur d’Alene tribal members whom had type 2 diabetes and were willing to share their stories of about living with diabetes. Participants ranged in age from 26-86. Interviews lasted from 25-90 minutes and focused on gathering stories about their daily life with their diabetes, and barriers and supports to their diabetes self-management. These became the data for hermeneutic interpretations. Individual transcripts were read and reread for initial themes. Next, comparisons between and across transcripts were done through interpretive emersion into the texts. Emerging themes and patterns were brought before a group of qualitative nurse researchers and doctoral students as a means of cross-checking and validating interpretations. Perseverance was the overarching pattern in the stories of living with diabetes in the world of Schitsu’umsh. The four themes that emerged under the umbrella of perseverance were valuing tribal traditions, being inattentively caring, struggling with disease burdens, and experiencing tensions in patient-provider relations. Living with diabetes in the world of the Schitsu’umsh was always a tenuous balancing act. There was an ever present dialectic tension between strengths and barriers underlying their daily struggles for balance. By increasing our understanding of Native American experiences of living with diabetes, collaborative partnerships can be developed with the tribes to address these barriers to diabetes self-management and to develop culturally relevant diabetes education programs. There is also a need to address cultural competence by the health care community and to work at eliminating biases and prejudice in our healthcare system. This work brings new cultural understandings of what it means to live with diabetes in one Native American group.Item To report or not report : a qualitative study of nurses' decisions in error reporting(2014) Koehn, Amy R.; Ebright, Patricia; Burke-Draucker, Claire; Ironside, Pamela M.; Sloan, Rebecca S.This qualitative study was successful in utilization of grounded theory methodology to ascertain nurses’ decision-making processes following their awareness of having made a medical error, as well as how and/or if they corrected and reported the error. Significant literature documents the existence of medical errors; however, this unique study interviewed thirty nurses from adult intensive care units seeking to discover through a detailed interview process their individual stories and experiences, which were then analyzed for common themes. Common themes led to the development of a theoretical model of thought processes regarding error reporting when nurses made an error. Within this theoretical model are multiple processes that outline a shared, time-orientated sequence of events nurses encounter before, during, and after an error. One common theme was the error occurred during a busy day when they had been doing something unfamiliar. Each nurse expressed personal anguish at the realization she had made an error, she sought to understand why the error happened and what corrective action was needed. Whether the error was reported on or told about depended on each unit’s expectation and what needed to be done to protect the patient. If there was no perceived patient harm, errors were not reported. Even for reported errors, no one followed-up with the nurses in this study. Nurses were left on their own to reflect on what had happened and to consider what could be done to prevent error recurrence. The overall impact of the process of and the recovery from the error led to learning from the error that persisted throughout her nursing career. Findings from this study illuminate the unique viewpoint of licensed nurses’ experiences with errors and have the potential to influence how the prevention of, notification about and resolution of errors are dealt with in the clinical setting. Further research is needed to answer multiple questions that will contribute to nursing knowledge about error reporting activities and the means to continue to improve error-reporting rates