BSN Class of 2013 Honors Graduates

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Sam E. Benton

Perceptions of Nurse Practitioners in Relation to Care of Department of
Correctional Patients

Advisor: Catherine Ingram Fogel, PhD, WHCNP, FAAN

Statement

I went into nursing because I like taking care of people and interacting with them. Nursing also provides many different options for patient care and work in a variety of different settings.

Abstract

The prison population in the United States is the largest in the world. Compared to the general population, inmates are at higher risk for chronic illnesses and death. Little data is available regarding the ethical dilemmas Nurse Practitioners (NPs) face when taking care of Department of Correctional (DOC) patients. To assess the concerns, knowledge, and comfort level of NPs in providing care to DOC patients, we conducted an anonymous electronic survey asking NPs in North Carolina to rate their concerns and indicate if these concerns affected the quality of care DOC patients received. We also asked the participants if they think that training in this area is beneficial. Out of 371 NPs who consented to participate, 171 of them provided care to DOC patients. On average, the participants rated their safety, emotional, and ethical concerns to be average, and they felt that their personal perceptions or concerns had little to average influence on the quality of care DOC patients received. Although these results suggest average or normal concerns with regards to nursing care of DOC patients, the responses for each question were varied and it ranged from the participants having none to having very high concerns. This is the first study to assess the impact of nurses’ perceptions on the care of DOC patients through an electronic survey. Additional studies with large number of nurses who have diverse academic and nursing experiences are required to validate these findings.

Devin Christel Fohn

Hippotherapy as a Rehabilitation Method for Regaining Ambulatory Function in Spinal Cord Injury Patients

Advisor: Beth F. Lamanna, WHNP, MPH, RN

Statement

I chose to go into nursing because I have a passion for caring for others as well as a passion for understanding the amazing human body. Nursing is a perfect way for me to pursue both of those passions. I was also drawn to the field because nursing allows me to be on the front line—to be a patient advocate and to care for the patient holistically. It is the nurse who is constantly there for the patient for not just physical needs, but also emotional and spiritual needs. I want to be the nurse who helps make a difference for that patient during a difficult time in their life.

Abstract

A spinal cord injury (SCI) is a devastating neurological injury that can result in immediate and significant motor and sensory deficits and thus requires long-term rehabilitation.  There exists a need for improvement in SCI rehabilitation in the proportion of SCI patients who regain ambulatory function as well as in the quality of ambulatory function that is recovered.  Hippotherapy is a treatment strategy that utilizes the movement of the horse to produce positive neuromuscular effects in the rider.  A literature review was conducted to investigate the use of hippotherapy as a potential rehabilitation method for SCI patients regaining ambulatory function.  “Articles” was used to search databases such as PubMed, CINAHL, and Web of Science, for peer-reviewed articles and ebook content using the key terms spinal cord injury, ambulation, locomotion, and hippotherapy.  There is evidence to support that hippotherapy may help with the physiological mechanisms required for regaining ambulatory function in SCI patients- central pattern generator training, cortical reorganization, proprioceptive and vestibular input modulation, attentional capacity, muscle strength, balance, coordination, muscle spasticity, and psychological well-being.  A lack of peer-reviewed literature on the efficacy of hippotherapy for SCI is the main obstacle to it being a standard treatment option.  Nurses involved in SCI rehabilitation play a key role in advocating for research that enables the best evidence-based patient care.  This literature review supports the need for and importance of studies of hippotherapy efficacy for SCI patients.

Sheena Brooke Hilton

Sudden Cardiac Death in Young Athletes: What is the First Step in Prevention?

Advisor: Michael G. Goley, MSN, CPNP, RN

Statement

I have an incredible passion to help others. Since I was a young girl, I knew I wanted to be a nurse. Many times this passion has be reignited throughout my life. When my dad
had a heart attack several years ago, I saw the nurses as heroes and my desire to be just like them has not stopped burning.

Abstract

Sudden cardiac death is defined as a rapid and unexpected failure of proper heart function.  Many times this is caused by an underlying heart condition that has been previously undetected.  This study surveys 200 participants that included coaches, parents, and non-parents and focuses on finding the first steps in preventing young athletes from dying because of undetected heart conditions.  The results show an incredible need to provide the public with more information and to create awareness regarding sudden cardiac death. Almost 90% of survey respondents felt a lack of adequate information available to the public regarding sudden cardiac death.  With such an apparent discrepancy of knowledge of sudden cardiac death an educational brochure was created, in order to get useful information in the hands of parents and athletes.

David Nathaniel Johnson

Increasing Nurses’ Capacity to Effectively Address Patient Psychosocial Needs at the End of Life

Advisor: Theresa Raphael-Grimm, PhD, CNS

Statement

I chose nursing because I like science and I like people. I am interested in exploring the world and helping out where I can, and I believe that, as a nurse, I will have valuable knowledge and skills that will allow me to offer significant help to others.

Abstract

This paper and the accompanying film address the need for nurses to become more comfortable discussing end of life care with patients and to see the value in doing so.  End of life care in America is financially unsustainable and ineffective in addressing important patient psychosocial needs at the end of life.  Nurses are in a unique position to help.  By conversing with patients to relieve emotional suffering, establish goals of care, review treatment options, and advocate for palliative care utilization, nurses can improve the care patients receive near the end of life.  Unfortunately, nurses often do not feel comfortable talking about these critical issues.  The film aims to give nursing students, nursing faculty, and practicing nurses an opportunity to acknowledge the usual barriers to end of life discussions and witness an example of effective communication.  The idea is that those who watch it would feel more comfortable and confident talking about end of life care.  This would hopefully result in more and more nurses initiating and facilitating end of life care discussions with their patients.

Rebecca Kabatchnick

Remembering the “Forgotten Bereaved”: Understanding and Caring for Siblings of Completed Suicide Victims in Adolescence and Early Adulthood

Advisor: Beth Perry Black, PhD, RN

Highest Honors

Statement

Through dedicating my life to caring for others, I hope to honor my grandmother, who was a nurse for over 40 years, and my brother, who passed away only months before my
nursing school graduation. I came to love nursing upon hearing the stories of my  grandmother and helping her take care of my grandfather, a stroke victim who was bedridden for 14 years. My experiences with my grandparents inspired me to begin volunteering at a nursing home during high school. Over the course of my teenage years, I realized that I wanted to pursue a career in nursing full of learning, growing, and making a difference in the lives of patients. My journey at the UNC School of Nursing helped me develop a passion for nursing that I am certain will last for many years to come.

Abstract

Despite experiencing the psychiatric, physical, and social consequences of sibling suicide, surviving siblings remain the “forgotten bereaved” throughout bereavement literature.  This review of literature explores the psychiatric sequelae and interventions for surviving siblings of completed suicide victims in adolescence and early adulthood in the United States.  Research questions included the following: 1) what are the implications of disenfranchised grief and psychiatric sequelae in siblings of completed suicide victims?; and 2) how can healthcare providers effectively care for siblings of completed suicide victims in early adulthood?.  Methods included utilizing CINAHL, PubMed, and PsycInfo as sources of bereavement literature.  This review of literature illustrates how healthcare providers and community members must reach out with early, evidence-based interventions to ensure that the grief of this at-risk group does not remain disenfranchised and hidden.  With proper care and interventions, siblings and parents of completed suicide victims can receive the help and support they desperately need. 

Sarah Abigail Kaminer

Exploring Knowledge Beliefs and Practices Regarding HIV/AIDS Among North Carolina Health Care Providers Working In Faith-based Clinics

Advisor: Christina Harlan, BSN, MA

Statement

I love people—caring for them, interacting with them, learning from them. However, in a high school Anatomy and Physiology class, I developed a deep fascination for the
science of the body. In nursing, I found a career that fulfills my love for people and my thirst for scientific knowledge.

Abstract

Evidence in the literature of the 1990s reveals stigmas regarding HIV among Evangelical Christian leaders and a low knowledge base in people with a religious or conservative belief system (Peruga, 1993; Green, Radman, 1997). A survey was developed to explore knowledge, beliefs and practices regarding HIV/AIDS among North Carolina health care providers working in faith-based clinics. Evidence from this study divides participants into those with high comfort providing care to people living with HIV (PLWH) and those with a high discomfort level.  Very few respondents chose neutral options. Results of this study reveal low HIV knowledge among health care providers who self identify as Christian — a deficit that is associated with restrictive attitudes toward PLWH.  Respondents identifying with the Baptist denomination were more likely to disapprove of condom distribution in the lobby of faith-based clinics.  Thirty years after the identification of HIV, there is a need to re-examine correlates of the populations previously associated with high degrees of stigma and low knowledge. Knowledge, attitude and stigma scales are widely available, but they have not been used in populations with conservative moral values in the US. Further studies are needed to explore variation in denomination, religiosity and political ideology among health care providers regarding the effects of knowledge, beliefs and attitudes on HIV stigma and clinical practice.

Kelsey Knight

Caring Across the Language Barrier

Advisor: Christina Harlan, BSN, MA

Statement

For a long time, I imagined I would pursue a career in academia. I enjoyed research and writing, and the idea of teaching was attractive to me. Then I read Tracy Kidder’s
book, called Mountains Beyond Mountains, about Dr. Paul Farmer. I became interested in development, the idea of healing, and social justice issues related to health care. Rather than only writing about these issues, which is important in itself, I felt that I needed to “do.” Nursing gives me the opportunity not only to do—to provide direct care to others—but to also research, grow as an individual, and learn about the human experience.

Abstract

It is generally acknowledged that language barriers negatively affect quality of communication, and therefore the quality of care nurses can provide to patients. Much of the literature explores nurses’ perceptions of and experiences with language barriers in a health care setting, but little is written about how exactly language barriers influence care. The aim of this paper is to explore in what ways comprehensive nursing care is obstructed by a language barrier. Swanson’s theory of caring and five caring processes serve as a framework with which to approach the issue. A language barrier can hinder nurses’ abilities to “maintain belief” in a patient, “know” a patient, “be with” a patient, “do for” a patient, and “enable” a patient—or care for a patient comprehensively, as defined by Swanson’s theory of caring. The growth of the Hispanic population in particular in the United States emphasizes the need to address language barriers in a health care setting.  Nurses have a legal and ethical responsibility to utilize interpretive services when working with patients with limited proficiency in English. The reality is that interpretive services are not always utilized when necessary. More research is needed to determine how nurses and interpretive services can interface more effectively, and, more generally, how language barriers can realistically be bridged.

Lindsay Elizabeth Larison

Sex Trafficking and the Nursing Role: An Online Educational Module for Nurses

Advisor: Rhonda K. Lanning, MSN, CNM, IBCLC, RN

Highest Honors

Statement

I have always felt drawn to a career path that promotes health and wellness. Nursing seemed to be the perfect fit due to the profession’s holistic, personal approach to patient care.

Abstract

Sex trafficking is a health and social justice issue affecting the United States.  The U.S. Department of Justice (2005) estimates between 100,000 and 150,000 people are currently sex slaves in the Unites States. The purpose of the Sex Trafficking and the Nursing Role:  An Online Educational Module for Nurses is to provide nursing students, nurses in practice and other healthcare personnel with a means of educating themselves on the topic of sex trafficking, and preparing them to intervene on behalf of victims.  The main goal in module development was to create a teaching tool that would stimulate and engage learners.  David A. Kolb (1984) suggested the experiential learning module, presenting different learning techniques to meet the needs of students with various learning styles.  With this theory in mind, the Sex Trafficking and the Nursing Role: An Online Educational Module for Nurses encourages a multi-tiered learning program, including a lecture, quizzes, videos, and case studies, which are also adaptable to active simulations.  The intended use for the Sex Trafficking and the Nursing Role: An Online Educational Module for Nurses is incorporation into the registered nurse curriculum, particularly as an addition to the public health nursing course. 

Mary Susan Miller

Effective Communication: What Should It Look Like in Healthcare?

Advisor: Julianne B. Page, MSN, RN

Statement

I come from a line of nurses who have shown me the rewards of caring for others. I am passionate about patient education and holistic health care, and I hope to empower my patients with knowledge to improve their long-term health.

Abstract

Effective communication is vital to healthcare and greatly contributes to patient safety, patient satisfaction, and personnel satisfaction.  As healthcare becomes increasingly interdisciplinary and patient stays become shorter, it cannot be assumed that members of the healthcare team already understand how to implement effective communication; they must be taught specific, evidenced-based strategies to overcome communication barriers and deal with conflict.  Using Dewey’s theory of experiential learning, Reusch’s theory of communication, and evidence-based standardized communication tools, I developed a workshop to teach effective communication.  The results of the workshop, as well as a review of the literature reveal that specific communication strategies are effective and should be implemented throughout training programs for doctors, nurses, and other healthcare professionals.

Tally Miller

The Effectiveness of the COPE Parenting Program: Statistical Analysis

Advisor: Catherine Ingram Fogel, PhD, WHCNP, FAAN

Statement

I chose to go into nursing because of the limitless opportunities there are for professional development and growth. I felt that this type of ever-evolving career would suit my inquisitive personality and give me an outlet to create caring, compassionate relationships with individuals on a daily basis.

Abstract

 The question being addressed in this project is two fold: (1) How did the Communities and Opportunities for Parenting, Protection, and Empowerment (COPE) intervention model effect parenting attitudes of female inmates at the North Carolina Correctional Institute for Women (NCCIW)? (2) Is the COPE program an effective intervention that increases parenting self-esteem? The COPE intervention was analyzed using comparative results from the Adult-Adolescent Parenting Inventory (AAPI), the Caregiving (Parental) Helplessness Questionnaire (CHQ) and the Parenting Stress Index (PSI).   When comparing T1 and T2 data from all three instruments, CHQ, PSI and AAPI, the reliability of constructs in the instruments ranged from good to questionable according to the Cronbach’s alpha reliability standardized test. Mean results of T1 and T2 constructs from these instruments showed an increased trend in change among the women prisoners. Although the mean data supports an increase in parental self-esteem and attitudes, the low alpha reliabilities and small differences in means indicate a need to further analyze the data. The effectiveness of the Cope Parenting Program cannot be fully supported by the statistical analysis completed in this review.

Courtney O’Connor

Examination of Domestic Violence Resource Utilization in Medically
Underserved North Carolina Counties

Advisor: Theresa Raphael-Grimm, PhD, CNS

Statement

Growing up, I was always interested in health care, but it wasn’t until some family members were patients that I realized the impact nurses can have on the patient experience. Mother Teresa said, “Do small things with great love,” and I have found that nursing provides endless opportunities to put these words into action on a daily basis. I am excited to begin a career that will allow me to care for patients holistically and
to provide the same kind of compassionate nursing care that has been so important to my family.

Abstract

Domestic violence is a significant health issue, affecting over 12 million people annually in the United States.  It crosses all socioeconomic, racial, cultural, gender, and religious boundaries and costs the United States economy over $8.3 billion annually (Centers for Disease Control and Prevention [CDC], 2012).  Survivors have multiple needs following their experiences with domestic violence, ranging from immediate medical care to long term assistance with counseling.  In North Carolina, there are 96 domestic violence agencies (North Carolina Domestic Violence Service Providers) that provided 476,979 services in 2010-2011 (Council for Women, 2011). As a Domestic Violence and Sexual Assault Patient Advocate and Hospital Responder at the Durham Crisis Response Center, I have witnessed the effects of domestic violence, the extent of survivor needs, and the work resource agencies do to assist survivors.  Urban areas of the state have accessible resources, including local crisis response centers and large hospitals, giving survivors of domestic violence somewhere to turn when they are in need of assistance.  But what about survivors who live in more remote areas of the state?  What resources are available to them and how are such services identified and utilized? This exploratory paper reviews the literature on intimate partner/domestic violence and provides qualitative data from telephone interviews with representatives from five domestic violence resource agencies in medically underserved counties throughout North Carolina.  The qualitative data was obtained in an effort to examine the phenomena affecting domestic violence resource utilization, and to better understand the identification and referral patterns affecting survivors.

Winona E. Poulton

Using the Social Ecological Model as a Framework for Evaluating Predictors of Rapid Repeat Pregnancy During Adolescence

Advisor: Kathy Alden, EdD, MSN, IBCLC, RN

Highest Honors

Statement

As a public health analyst prior to nursing school, I found working with women and children to be very rewarding, but that my lack of practical skills hindered me from being
as effective at meeting their needs as I could have been. Nursing school provided an avenue to achieving some clinical competence, and I hope to use my new nursing
skills to improve my ability to achieve positive outcomes for at-risk women and children.

Abstract

Rapid repeat pregnancy (RRP) during adolescence has been shown to have profound negative consequences for parenting teens and their offspring. Prevention of RRP has become an important goal of national agencies, and as such, many interventions have been developed to help decrease RRP in this population. Outcomes from studies evaluating these interventions have been mixed, however, showing limited success at prevention of RRP, which highlights the difficulty addressing the complex needs of parenting teens. The current review looks at the causes of RRP through the lens of the Social Ecological Model in order to inform potential future nursing interventions and research. To this end, a systematic and comprehensive review of the literature was performed, which examines the predictors of RRP in intervention studies published in the last 10 years. To further inform the review, health care professionals with expertise in teen pregnancy were surveyed about RRP. Responses from these key informants enrich the data abstracted from the literature in order to provide a more comprehensive view of this complex problem. Results of this process show that many interrelated factors are predictive of RRP, and future programming must reflect these lessons in order to be successful. Discussion of emerging themes as well as suggestions for future research and nursing practice are included.

David Reed

Criminal Record-Related Collateral Consequences, Employment, Stress,
and Health Among Women in the NC Work First Program

Advisor: Shawn M. Kniepp, PhD, ANP-BC, APHN-BC

Statement

I chose nursing because I saw it as the best opportunity to serve others in need.

Abstract

Most research of health disparities between those with a criminal record and the general population remains focused on differences that develop during the time period an individual is incarcerated.  There is a lack of research exploring health disparities between those who have acquired a criminal record (with or without being incarcerated) and the general population.  This pilot study explores the extent to which a criminal record can act as a social determinant of health through stress and unemployment.  The study team is currently recruiting 10 unemployed women enrolled in the North Carolina Work First Program.  Relationships between having a criminal record, employment patterns, stress, and health are explored through a series of surveys over 8 months.  The surveys measure demographic information, severity of health problems and health history, perceived stress and criminal record-related discrimination, job search experiences, and employment-related dimensions.  Participants will complete a baseline survey and then be followed for 8 months, filling out an additional survey every month to track changes in the previously mentioned variables throughout the study period.

Charlotte Refvem

A Critique on the Ethics of International Immersion Experiences for Nursing Students

Advisor: Beth Perry Black, PhD, RN

Statement

I have been intrigued by health care since childhood. My father is a doctor and I always enjoyed listening to his stories and occasionally watching him work. As I have gotten older, my desire to work with people in the health care setting has increased. I began to be interested in nursing when I realized that I wanted to spend significant time with people who are hospitalized. I believe that meaningful relationships between the patient and nurse can contribute to better outcomes. I am passionate about patient advocacy and believe that nurses have a unique opportunity to provide for clients. Ultimately,
nursing encompasses all things I enjoy; people, health care, and compassion. I am excited to see where this path leads.

Abstract

With the growing diversity of America, nurses are providing care for clients from many different cultural backgrounds on a daily basis.  Nurses need to be adequately prepared to deliver high-quality health care to every patient.  This increasing demand should compel nursing educators to prepare students to become culturally competent professionals.  Cultural immersion experiences originated as a way for nursing students to gain cultural competence for their future practice.  The social justice of these programs and their effect on the persons in the destination countries is not adequately researched.  Levi (2009) described the ethics of international clinical placements and of students providing care for which they are under-qualified.  The purpose of this study is to critique current cultural immersion programs based on the ethical principles outlined by Levi.  Results show that while these experiences are perceived to be beneficial to the participants, there is inadequate evidence that shows they can ethically continue.  Immersion programs should consider the ethical implications of their presence in another country if they are to be included in nursing education.

Olivia Reid

Nursing Students’ Knowledge and Attitudes About Human Trafficking: A
Look at Human Trafficking Education in One Accelerated Baccalaureate Nursing Program

Advisor: Kathy Alden, EdD, MSN, IBCLC, RN

Highest Honors

Statement

I chose to pursue nursing because it incorporates all of the things I am passionate about, including education, science, providing support, and building relationships. I love knowing
that I have had a positive impact on a person or taught them something vital to their lives when I finish a shift.

Abstract

Human trafficking is a horrifying reality for millions of people worldwide and is an issue that has only recently been brought to the attention of the public.  Evidence shows that health care professionals are in the fortuitous position to identify human trafficking victims while they are captive.  However, there is a general lack of knowledge and awareness about human trafficking among healthcare professionals.  Current literature shows that there is a need for human trafficking education to be included in pre-licensure education programs for health care professionals, as well as in the workplace as continuing education.  Only a handful of studies have been conducted to analyze the knowledge and attitudes of health care professionals and students about human trafficking.  More specifically, no studies were found that involve nursing students’ knowledge and attitudes about human trafficking.  This study aimed to address that gap with the purpose of answering the following question: is there a difference in nursing students’ knowledge and attitudes about human trafficking during the first semester of a baccalaureate nursing program as compared to the last semester?  A survey of knowledge and attitude-based questions was given to a group of accelerated baccalaureate nursing students (ABSN) in their first semester (n=37) and a group in their last semester (n=33) at one large, public university.  Survey results were analyzed using chi-square analysis and Fisher’s exact test.  No statistically significant difference was found between the two groups suggesting that the topic of human trafficking is not being adequately addressed in this nursing program.   

Emily Ryan

Social Support and Perinatal Loss: A Secondary Data Analysis of Interviews With Participants Receiving Lethal Fetal Diagnoses

Advisor: Beth Perry Black, PhD, RN

Statement

I decided to pursue nursing after completing my masters degree in bioethics. During my graduate program, we spent a lot of time talking to patients about their experiences with
the medical system. I was always impressed by how highly they spoke of their nurses. I knew that I didn’t want to stay in academia and that I wanted to find a career that involved direct patient care. Nursing offered me the most mobility with my career while still giving me the opportunity to work directly with patients.

Abstract

Social support is essential for the healthy management of emotions and subsequent resolution of grief after a perinatal loss (PNL).  A secondary analysis was performed on verbatim transcripts, 39 in total, originally collected as part of a study designed to examine elements of the experience of pregnant women and their partners when the fetus was significantly impaired.  Comprehensive definitions of social support developed by Hinson Langford et al. (1997) were used to classify incidences of social support described by participants.  Final analysis consisted of identifying and categorizing all statements in the interview transcripts that pertained to social support provided by friends, family, and practitioners during the period of loss and mourning.  Patients overwhelmingly received emotional support from family and friends, while clinicians predominantly provided informational support.  Appraisal support was sought from friends, family, and clergy and principally focused on the patient’s decision to terminate or continue the pregnancy.  Instrumental support varied by need, but noticeably came in the form of assistance planning and funding funerals for those participants who chose palliative pregnancies or financial support for those who chose termination.  Clinicians at or around the period of diagnosis universally provided some form of informational support to patients when they discussed options for continuing or terminating the pregnancy.  Negative informational and emotional support was observed in some of these interactions.  Clinicians should consider the distinction between lack of support and perceived negative support in their future practice with patients receiving a severe fetal diagnosis.

Joanna Marie Solkoff

How Nursing Affects Nurses: A Literature Review on Nursing-Centered Self Awareness

Advisor: JoAn Williams, MSN, ARNP-BC, RN

Statement

Even as a little girl I knew I wanted to help people. After a holiday party in my first grade class, I saw a homeless man on the street. I went over to him and gave him the cookies from the party. I think that I have spent my whole life looking for a way to make a difference in people’s lives and when I found nursing, I felt like I finally found the career for me.

Abstract

Self-awareness is arguably at the center of every patient-centered nursing action.  While it is referenced throughout the nursing literature and in many multidisciplinary sources, it seems to have gone undefined within the nursing literature.  In order for nursing literature and practice to proceed towards attaining better, more individualized patient care, it seems like an operational definition should be developed.  This literature review was undertaken with the intention of developing an operational definition of nursing-centered self-awareness.  Nursing-centered in this context and according to early nurse theorists like Henderson (1960) means “nursing approaches which emphasize human needs” and “require nurses to move to a more client centered, and hence empathic approach” (as cited by Rawlinson, 1990, p. 114).  By integrating these patient-centered practice ideas into the definition of self-awareness and by defining self-awareness within the context of nursing and individualized patient care, the nursing literature will finally have a concrete definition from which to progress the ideas behind self-awareness, emotional intelligence, reflective practice, and cultural awareness.  Through line-by-line coding, organizing, and identifying thematic connections within the nursing literature and other multidisciplinary sources on nursing-centered self-awareness, six areas were identified.  These six areas were identified as areas, or concepts, critical to the definition of nursing-centered self-awareness.  These six areas are comprised of the cognitive self, the affective self, the behavioral self, the guidepost self, the diversity-related self, and the constantly changing self. 

Rachel Stowe

Caregiver Burden and Resource Availability in Hematopoietic Stem Cell
Transplantation

Advisor: Deborah K. Mayer, PhD, AOCN, FAAN, RN

Statement

I have always had an interest in health care, but I did not realize how important the role of the nurse was until a family member became seriously ill a few years ago. During this
time, I learned that a compassionate and intelligent nurse can have a significant impact on patients and their families during life’s most vulnerable moments. It was at this point
that I realized that my interests in science and interacting with others would equip me to truly make a difference in the lives of those who are sick.

Abstract

Informal caregivers of patients undergoing hematopoietic stem cell transplantation (HSCT) face many challenges and experience a variety of needs throughout the transplant trajectory. This study aims to use a systematic literature review to examine the experience and unique needs of HSCT caregivers, describe interventions that have been implemented to ease HSCT caregiver burden, and investigate the resources and services available to caregivers at two local HSCT centers through face-to-face interviews. Previous research has indicated that HSCT caregivers commonly experience physical, psychological, spiritual, educational, social, and financial needs while providing care. Interventions described in the literature recommend that institutions offer services that promote self-care, autonomy, expressive talking, and problem-solving education to holistically meet caregivers’ needs. Primary sources who were interviewed at the designated HSCT centers indicated that their multidisciplinary care teams routinely assess and attend to the educational, social, and financial needs of caregivers; however, psychological, spiritual, and physical needs are generally not addressed until the caregiver brings them to the attention of the team. Recommendations for both institutions include the development and implementation of a quality of life assessment specific to the unique experience of caregivers throughout the transplant trajectory. Additionally, members of each institution’s multidisciplinary HSCT team should consider designing assessments and interventions that would proactively address caregivers’ psychological, spiritual, and physical needs. Overall, HSCT teams must recognize that caregivers have unique needs that must be met in order for them to provide safe, quality care to HSCT patients.