Josie Jacqueline Caves
Cervical Cancer Prevention in the Developing World: A Nicaragua Study
Advisor: Chris Harlan, BSN, MA, Clinical Assistant Professor
Statement
I understand now that I chose to go into nursing because I have always been interested in global health, and I chose this field because it offers a unique skill set and philosophy for understanding and confronting global health problems. This project has helped me clarify my career goals as well as learn a great deal about reproductive health in Latin America, which is a topic of interest to me.
Abstract
In the summer of 2010, a student group from the University of North Carolina (UNC) conducted a pilot study consisting of a reproductive health status survey of women in the semi-rural municipality of El Sauce, Nicaragua. Preliminary results from the survey enabled the students to identify cervical cancer resulting from human papillomavirus (HPV) infection to be an area of concern for this population. The study population had a low knowledge base of sexually transmitted infection prevention and a very low frequency of condom use. Although a substantial number of women were screened for cervical cancer via Pap testing, many women never received the results of their exam. This paper supplies an introduction to HPV and cervical cancer and the disproportionally high burden of these diseases felt in developing countries and in Nicaragua specifically. Current primary and secondary prevention strategies are discussed, as are the findings of the UNC 2010 pilot study.
Rebekah J. Cramer
G-R-O-W H-E-A-L-T-H-Y: A Service-Learning Project Educating Pregnant and Parenting Teens about Nutrition
Advisor: Kathryn R. Alden, EdD, MSN, RN, IBCLC, Clinical Associate Professor
Statement
I grew up in Indonesia. Throughout the 14 years that I lived there, I got to know many doctors and nurses that spent their lives helping people. I was especially impacted by the sacrifices I saw made to meet the needs of the tsunami victims
in 2004. That was my junior year in high school; the same year that I decided I wanted to be a nurse. The years that I spent watching these doctors and nurses serve the Indonesian people taught me that there was nothing more rewarding than to sacrifice myself for others. The years that I have spent in nursing school, however, have taught me that it is no sacrifice to serve others. It is pure joy! I found that the honors program provided me with a unique opportunity to deeply engage with an interesting topic while also offering me a chance to impact my community by designing simple and practical education materials.
Abstract
Despite a decrease in adolescent pregnancy rates over the past two decades (CDC, 2010), teen pregnancy remains a pervasive health issue in the United States today. There is still a significant discrepancy in the pregnancy rates of white compared to nonwhite teens, with minorities having significantly higher rates (NCDHHS, 2010). Furthermore, there continues to be an appalling lack of educational resources. A comprehensive literature review of nutrition research available for pregnant and parenting adolescents revealed that most information is either older than 10 years or was published outside of United States. Consequently, while fewer teens are getting pregnant, those who do become pregnant still face devastating complications for themselves and their infants. These complications include increased rates of preterm births and low birth weight infants, as well as a greater likelihood of postpartum hemorrhage and osteoporosis for the young mother. These complications can be addressed by improving the nutrition of teen mothers and their babies. Simple and practical nutritional resources are required to improve health outcomes for adolescent mothers and their infants. This service-learning project was developed to meet this need. The goal is to provide teen mothers with easy-to-understand and easy-to-use nutritional information for themselves and their babies. A literature review was performed in order to inform the development of two pamphlets and a website. These educational resources addressed the nutritional needs of the teen mother and her infant by discussing a healthy pregnancy diet and the benefits of breastfeeding. All three resources are available in English and Spanish.
Sarah Cameron McAbee
The Use of Physical Restraints among the Hospitalized Geriatric Population: A Review of the Literature and Recommendations for Future Practice
Advisor: Julianne B. Page, RN, MSN, Clinical Assistant Professor
Statement
I chose to go into the field of nursing because I believe nursing is both a science and an art. By choosing a career in nursing I will be able to use scientific knowledge to provide effective care to my patients, but unlike in other health care professions, I will be able to use the art of caring to positively impact patients and their families during a time of need. By pursuing honors I have been able to improve my research techniques and writing skills. The honors program has given me an opportunity to gain a greater knowledge base about a subject that I am passionate about, the care of geriatric patients. I plan to use the knowledge I have gained through completing this project to act as an advocate for geriatric patients by creating a physical restraint review committee at the hospital where I work. It will focus on reducing the use of restraints.
Abstract
As the nation’s population continues to age and the number of older people utilizing acute care continues to increase, the use of physical restraints is affecting the quality of care provided. The use of physical restraints, any device used to restrict movement and access to the body, among geriatric patients continues to occur in hospitals although their use has been associated with negative patient outcomes. This literature review based on scholarly nursing articles examines the prevalence of restraint use, factors influencing the use of restraints, and educational programs used to decrease the use of restraints. Physical restraints are used at a disproportionately higher rate among the geriatric population; however there is a scarcity of available literature exploring the subject. Nursing attitudes concerning restraints and cognitive impairment of patients are the factors that have the greatest influence on restraint use. Unit based and continuing education programs have been successful in decreasing the use of restraints among geriatric patients in the hospital. This paper argues for the development of further research concerning the prevalence of physical restraint use among elderly patients and the implementation of evidenced based educational programs at all levels of the nursing profession in order to decrease the use of physical restraints and improve the quality of care provided to geriatric patients in the acute care setting.
Jennifer Gail Parker Myers
Beyond I’ll Call the Chaplain: Furthering Spiritual Care in Nursing
Advisor: Kathryn R. Alden, EdD, MSN, RN, IBCLC, Clinical Associate Professor
Statement
My call to nursing began when I became interested in patient advocacy after I felt the tangible difference great nurses make in the lives of patients and families. I wanted a hands-on and challenging profession that had a direct impact on the lives of those around me. Pursuing this project has given me the opportunity to develop my research, writing, and time management skills. I have been fortunate to do extensive research on a topic that is interesting to me but is not widely
examined in nursing curricula.
Abstract
Nursing’s holistic framework encompasses spiritual care. In its broadest sense, spirituality encompasses religion, provides meaning and purpose to one’s life, and offers a sense of connectedness with the self, others, nature, and a higher power. Religion is a system of beliefs and worship involving rituals, scriptures, and teachings that connect people through shared beliefs. The nursing profession is deeply rooted in spiritual and religious traditions. Nursing philosophers and theorists recognize spirituality as an integral part of nursing care, even while failing to make a clear distinction between spirituality and religion. Nurses are expected to care for patients in a way that respects the patients’ spiritual and religious beliefs. Spiritual care is linked to desirable patient outcomes and increased patient satisfaction. Although attending to patients’ spirituality and religious beliefs is a significant element of culturally sensitive and appropriate nursing care, most nursing education curricula does not adequately prepare nurses to provide spiritual care in practice. Additionally, there are inherent barriers to spiritual care within the healthcare environment. Nevertheless, nurses can implement meaningful practices to promote the spiritual well-being of their patients. Spiritual care in nursing practice is the focus of this paper.
Brian H. Sealy
Nonpharmacological Interventions to Reduce Aggressive Behavior in Persons with Dementia Living in Long-Term Care Facilities
Advisor: Anna Song Beeber, PhD, RN, Assistant Professor
Highest Honors
Statement
I worked in computing for a number of years, and I found that I was tired of sitting in front of a screen all day, and I wanted to do something that made a difference in people’s lives. I found that I naturally gravitated towards reading the health section of the New York Times and other periodicals, so I thought I would put my interest in health care together with my desire for a people-focused vocation, and what I came up with was nursing! I feel really fortunate that UNC-CH has given me the opportunity to pursue this vocation. The principal benefit of writing an honors paper has been to immerse myself in a topic and to see what kinds of studies nursing researchers are doing.
Abstract
With aging of the population in the U.S. and in other developed countries, the number of people with dementia, a disease mostly of old age, is growing rapidly. Dementia has a number of disturbing symptoms, among the most challenging is aggressive behavior (AB), including both physical and verbal aggression. Many persons with dementia (PWD) live in long-term care facilities, and those that exhibit AB usually direct it to the caregiving staff in the facility, leading to injury and a difficult working and living environment. Psychotropic medications are often prescribed to reduce AB, but these drugs have dangerous side effects, and the therapeutic effect, usually sedation, further impairs the functioning of PWD. It is important, then, to look at nonpharmacological interventions as alternatives to drugs. This study reviewed the literature on such interventions published from 2005-2010, and it looked at review articles published 2005-2008 to examine pre-2005 research on nonpharmacological interventions. The databases CINAHL, PUBMED, PsycInfo, and AgeLine were searched for studies related to nonpharmacological interventions for AB in PWD living in long-term care facilities. The research is generally small in scale and often lacking in randomization, blinding and controls. Playing preferred music, structured walking programs, and multisensory stimulation emerged as interventions that have support in the literature, though much more research needs to be done both on these and other interventions that do not involve medication.
Rachael B. Smith
Prenatal Care Coverage in Rural Nicaragua: Implications Related to Healthcare Access at Two Politically and Geographically Distinct Sites
Advisor: Chris Harlan, BSN, MA, Clinical Assistant Professor
Statement
I went back to school to become a nurse because it is a career that gives you the privilege of being a part of a vulnerable person’s life and the opportunity to learn something different everyday. My summer experience was invaluable, and I truly believe traveling opens your eyes and makes you a better critical thinker. I wanted to share some of my experiences and research from Nicaragua with faculty and students at the School of Nursing.
Abstract
Nicaragua is the second poorest country in the western hemisphere, and as a country, it continues to develop a comprehensive and far-reaching health system. The purpose of this paper was to 1) Analyze how the political system in Nicaragua affects and accounts for health outcomes related to health access and 2) compare surveillance research regarding access to prenatal care from two distinct regions of Nicaragua. Since 2008, the Collaborative Summer Health Initiative of UNC has sent researchers to Nicaragua to conduct health surveillance surveys to women of reproductive age (15-49). In 2008 and 2009 the team from UNC went to the North Atlantic Autonomous Region (RAAN) of Nicaragua, which is both geographically and politically isolated. In 2010, I participated in a team that conducted similar research in a more politically empowered region, the department of Leon. Data from 2009 and 2010 survey years regarding prenatal care and health care access was compared and contrasted to determine if differences existed between the two sites. In RAAN, of the surveyed women, 65.9% answered “yes” to the question “Did you receive prenatal care during your last pregnancy?” while in Leon 97.2% answered “yes” to the same question. While the research is ongoing and any conclusions drawn from the 2009 and 2010 research are speculative in nature; the RAAN and Leon data exhibit significant differences in prenatal care coverage between the two sites. Health surveillance can aid policy-making groups in Nicaragua in determining how to allocate resources to meet the health needs.