PhD, University of Cincinnati, 2001, Nursing : Doctoral Program in Nursing

With increasing sophistication and portability of medical equipment and health care advances, infants and children who require technology to survive are cared for at home. Yet little is known about the population of technology dependent infants and their families. Therefore, the purpose of this study was to examine the experience of receiving and caring for a technology dependent in the home. van Manen's phenomenological method was selected for inquiry. Data were collected from interviews with eight mothers, as well as researcher personal experience, etymological sources, idiomatic phrases, and descriptions in literature. The seven common essential themes extracted from the data were receiving and caring for a technology dependent infant in the home is: (1) moving from learning care to making judgments regarding infant's health; (2) getting to know the infant's likes, dislikes, and health related behaviors; (3) recognizing changes in family dynamics and meeting family needs through adjustments in roles, responsibilities, and lifestyles; (4) learning to manage the increased work and time infant care requires; (5) navigating an ever changing array of emotions and concerns; (6) ascribing improvements in infant and family situation to being home; and (7) recognizing differences but seeing similarities when comparing infant to others. When the concepts of the Kenner Transition Model were linked with the essential themes, three overall themes that describe the essence of the phenomenon were extracted: (1) Moving from learning about infant to making judgments regarding infant's health; (2) Recognizing the need for adjustment in roles, responsibilities, and priorities; and (3) Navigating constantly changing emotions to achieve near normalcy. Practice implications include better preparation of the families for home life before discharge. An increase in responsibility for infant care and equipment negotiations before discharge can ease a family into these roles. Encouraging f (open full item for complete abstract)

Committee: Dr. Margaret Miller (Advisor) Subjects: Health Sciences, Nursing

MS, University of Cincinnati, 2019, Medicine: Clinical and Translational Research

Background: Effective nurse communication at discharge is critical for safe transition to home for hospitalized children, including those with limited English proficiency (LEP), who are at high risk of reutilization. Little is known about nurse-family communication at hospital discharge. Objectives: To describe and compare the safety and family-centeredness of nurse communication and the level of family-engagement in the discharge process for English Proficient (EP) versus LEP families. Methods: This single-center cross-sectional study used direct observation of discharges for hospitalized EP and LEP patients 0-18 years of age and their parents or caregivers. Trained observers collected quantitative and qualitative details of nurse-family discharge communication focusing on 3 domains: 1) safe discharge; 2) family-centeredness; and 3) family-engagement. Descriptive statistics assessed patient characteristics and percentages of encounters where all components were discussed within each domain. Communication domains were compared between EP and LEP encounters using chi-square test and Fisher's exact test. Field notes were reviewed to clarify and supplement quantitative findings. Results: We observed 104 discharge encounters, of which 40 (38%) were with LEP families. In the safe discharge domain, nurses discussed all 7 components in 37% of encounters; no LEP encounters had all components discussed (p<0.001). Discussion of diagnoses, reasons to call primary care providers, and emergency department return precautions, as well as availability of discharge instructions in primary language were less frequent for LEP compared to EP encounters. All components were used in 10% of encounters for the family-centered domain and 87% of encounters for the family-engagement domain; there were no differences between LEP and EP families for these domains (p=0.74 and p=41, respectively). Conclusions: We identified several opportunities to improve nurse-family discharge co (open full item for complete abstract)

Committee: Aimin Chen Ph.D. (Committee Chair); Amanda Schondelmeyer M.D. (Committee Member); Heidi Sucharew Ph.D. (Committee Member) Subjects: Surgery

Master of Gerontological Studies, Miami University, 2011, Gerontology

The purpose of this research is to use existing literature and ongoing evaluation of one state's initiatives to articulate a program theory of nursing home transition. The resulting model is a testable nursing home transition program model for Ohio, and can guide the development and evaluation of future programs in other locations.

Committee: Suzanne Kunkel PhD (Committee Chair); Kathryn McGrew PhD (Committee Member); Robert Applebaum PhD (Committee Member) Subjects: Gerontology

Master of Arts, Miami University, 2013, Population and Social Gerontology

Nursing home transition programs (NHTPs) use home and community based services (HCBS) to relocate nursing home residents to the community. Because these programs are relatively young, little is known about the factors affecting nursing home readmission in NTHPs. Using Andersen's Behavioral Model (1995) as a guiding framework, this study uses binary logistic regression analysis to examine factors of nursing home readmission in the Providing Alternatives to Transitioning Home program (PATH). PATH is a NHTP that connects nursing home residents with Medicaid HCBS waiver programs in four northeast Ohio counties. Secondary data from PATH program records were analyzed and 302 program participants were included in the sample. Two factors, county nursing home density and the number of hospitalizations, were significant predictors of readmission for PATH participants (p<0.05). These findings illuminate a few of the challenges that policymakers face in trying to rebalance Ohio's long term care system.

Committee: Robert Applebaum Ph.D. (Advisor); Chalermpol Chamchan Ph.D. (Advisor); Orapin Pitakmahaket Ph.D. (Advisor); Amara Soonthorndhada Ph.D. (Committee Chair); Suvinee Wivatvanit Ph.D. (Committee Member) Subjects: Aging; Gerontology; Health Care