Nursing electronic theses and dissertations (MU)
Permanent URI for this collection
The items in this collection are the theses and dissertations written by students of the Sinclair School of Nursing. Some items may be viewed only by members of the University of Missouri System and/or University of Missouri-Columbia. Click on one of the browse buttons above for a complete listing of the works.
Browse
Recent Submissions
Item Animal-assisted interventions for dementia in the outpatient clinic setting : a feasiblity study(University of Missouri--Columbia, 2025) Babka, Jennifer Rose; Lane, Kari R.[EMBARGOED UNTIL 12/01/2026] Behavioral and psychological symptoms of dementia are highly prevalent; however, there are currently no established interventions specifically designed to manage these symptoms within outpatient clinic settings. Animal-assisted interventions have demonstrated acceptability and effectiveness as non-pharmacological approaches for symptom management in various clinical populations. Despite this, there is a notable lack of research exploring the application of animal-assisted interventions for persons with dementia in outpatient memory clinics. This mixed-methods feasibility study aimed to evaluate both the feasibility and acceptability of an animal-assisted intervention for persons with dementia (PWDs) in an outpatient clinic environment. Data were collected from three groups of participants: (1) PWDs, (2) caregivers, and (3) health care providers. Ten PWDs participated in the intervention, each engaging with a certified therapy dog for a minimum of 10 minutes prior to their scheduled appointments in a memory clinic. Following the intervention, PWDs and their caregivers completed investigator-developed Likert scale surveys and participated in semi-structured telephone interviews. Health care providers also completed post-intervention Likert scale surveys. Qualitative data from interviews were transcribed and analyzed using thematic analysis. Findings indicated that all PWDs (100%) reported feeling comfortable, and the majority (88.9%) reported feeling happy during their interaction with the therapy dog. Similarly, all caregivers (100%) expressed comfort with the therapy dog interaction and reported that the experience made the person with dementia feel happy (90%). Across all participant groups, including health care providers, no one reported the interaction as burdensome (100%). Thematic analysis of qualitative interviews revealed four overarching themes: (1) baseline behaviors and feelings, (2) feelings towards the opportunity, (3) positive interactions with dogs, and (4) positive overall experiences at doctor appointments. Recruitment strategies for the study proved feasible, and the intervention was considered safe across all participant groups. Overall, this study provides preliminary evidence supporting the feasibility and acceptability of animal-assisted interventions for PWDs in outpatient clinical settings. Future research is warranted to investigate the potential impact of animal-assisted interventions on specific behavioral and psychological symptoms of dementia within this context.Item Exploring pain assessment and management experiences in recently hospitalized minoritized older adults : a qualitative study(University of Missouri--Columbia, 2025) Woods, Ashley; Vogelsmeier, AmyIntroduction: Pain is often undertreated in older adults, and most pain assessment tools were validated in predominantly White, English-speaking populations. This study explored pain assessment and management experiences of hospitalized Hispanic/Latinx, Native American, and White older adults. Methods: A descriptive qualitative design with semi-structured interviews was conducted with 22 older adults who had been hospitalized on a medical-surgical unit. Thematic analysis was used to examine results within each group, across racial and ethnic groups, and in the intersectionality with biological sex. Results: Participants included seven Hispanic/Latinx participants, seven Native American participants, and eight White participants. Six shared themes were identified: (1) Tough it out; (2) Relationships with the healthcare team; (3) Lifespan-shaped meanings of pain; (4) Enacted self-management and advocacy; (5) Cultural framing; and (6) Pain scores as a communication barrier or bridge. Subthemes varied by group, revealing nuanced differences. Additional variations were noted with biological sex, including spirituality, silence vs disclosure, staff checks, pain as burden, alternative medicine use, inadequacy of pain scales, and co-morbidity/polypharmacy. Conclusion: Pain assessment and management while hospitalized is both universal and deeply individual. Tailoring approaches to cultural nuances and lived experiences is essential for equitable, person-centered care.Item Exploring differences in novice nurses' perceptions when communicating with physicians based on communication apprehension and race(University of Missouri--Columbia, 2025) Lawson, Tywana McQuillan; Vogelsmeier, AmyObjective: Effective nurse–physician communication is essential for safe patient care, yet novice nurses may experience varying confidence levels in these interactions. This study explored perceptions of novice nurses when communicating with physicians, and differences based on the influence of communication apprehension and race. Method: Using an interpretative phenomenology qualitative approach, data were obtained through photo elicitation and semi-structured interviews to capture nuanced perceptions. Descriptive data were collected through a demographic profile and the Personal Report of Communication Apprehension (PRCA-24) to measure communication anxiety levels. Weick's Sensemaking theory guided the analysis, and each photograph was assigned to a sensemaking property. Findings: Ten novice nurses participated in the study. Most were female (n=9; 90%) with a mean of 8.5 months of experience, 50% identified as Black (n=5), and 50% (n=5) as White, and had a mean PRCA-24 score of 76.4. Analysis identified how feelings of more and less apprehension are reflected within nearly all the sensemaking properties. Sensemaking also helped explain strategies novice nurses use to decrease their apprehension. More apprehension was reflected under four of the seven sensemaking properties, including retrospective, enactment, social, and ongoing, while less apprehension was reflected in all sensemaking properties except plausibility. Only one participant was coded under the identity construction sensemaking property, and no participants were coded under the plausibility property. Participants with average PRCA-24 scores were coded under the keyword buffer needed. All other sensemaking properties and keywords were similar across groups. Only white participants were coded in the social sensemaking property; all other properties were similar across groups. Conclusions: These results highlight the need for targeted communication training strategies in nursing education and transition to practice programs.Item An exploration of somatic symptoms in health profession students(University of Missouri--Columbia, 2025) Sperling, Edith L; Thompson, Sarah; Hulett, Jennifer[EMBARGOED UNTIL 05/01/2026] Background Health profession student stress, anxiety, and depression is well-known to be elevated, but much less research has been done on the relationship of mental and physical symptoms in this population in the U.S. In this dissertation, I present a scoping review on the previous research done in this area, and then a repeated- measures observational study which assesses the prevalence, severity, and relationship between perceived stress, anxiety, depression, and physical symptoms among first- and second-year medical, dental, veterinary, and physical therapy students at a large health sciences university. Methods PRIMSA-ScR guidelines were followed for the scoping review. For the repeated-measures study, surveys were distributed by university email in August and November of the 2024-25 academic year which included the Perceived Stress Scale with helplessness and self-efficacy subscales, the Generalized Anxiety Disorder scale, the Patient Health Questionnaire scales for depression and somatization, the NIH Toolbox Emotional Social Support scale, and the Simple Lifestyle Indicator Questionnaire. Results The scoping review included 29 articles related to the prevalence, severity, and measurement of somatic symptoms of stress in medical students. In the repeated-measures study, perceived stress, helplessness, self-efficacy, anxiety, depression, physical symptoms, and general self-rated health all significantly worsened over the course of the semester, with physical therapy students most affected. Mental and physical health measures were moderately to strongly correlated at both timepoints. Conclusions Results of both the scoping review and repeatedmeasures study provide evidence for a relationship between mental and physical symptoms in health profession students. More research into measures of mental and physical health in a larger sample size, with other potential moderators and mediators, and with mixed-methods designs, will be useful. Eventually, longitudinal research inclusive of objective measures to track students' mental and physical markers from prior to school, through school, and into professional practice may be indicated to further illuminate the links between mental health, physical health, and career attrition.Item Sperm banking in adolescent and young adult males diagnosed with cancer(University of Missouri--Columbia, 2025) Sandheinrich, Taryn; Armer, Jane[EMBARGOED UNTIL 05/01/2026] Background: Some 87,050 adolescent and young adults (AYA) were diagnosed with cancer in the United States in 2022. While treatment advances have increased 5-year survival rates to more than 86%, many AYA cancer survivors have long-term deficits secondary to cancer-directed therapy. Interrupted childbearing and infertility can affect AYA self-esteem, quality of life, and relationships. Despite this knowledge, AYA fertility preservation rates have been reported as low as 18%. Purpose: The study purpose was to evaluate factors in the decision to bank sperm in newly-diagnosed AYA males. Methods: A qualitative descriptive design with semi-structured interviews was used to better understand factors in the decision to bank sperm. Grounded theory sampling and analysis techniques were used to collect and analyze data. Results: Eleven AYA male cancer survivors (𝑥̄ = 18 yrs [14-22]) participated in audio-recorded interviews which were conducted in person or by telephone. Nine participants identified as white, two as black, and none as Hispanic. All participants had banked sperm within the previous 36 months. Five themes emerged from data analysis: 1) sperm banking as an "insurance policy;" 2) perceived barriers to banking; 3) perspectives on family-building; 4) information to support autonomy; and 5) guidance in the decision to bank sperm. Conclusion: Participants expressed that they desired information on fertility and fertility preservation. While they appreciated guidance, the decision was ultimately theirs to make. Framing banking sperm as an "insurance policy" helped participants engage in shared decision-making with parents and/or the fertility specialist. Findings provide health professionals caring for AYA male cancer survivors fuller understanding of how to engage and frame fertility conversations to elicit shared decision-making