School of Nursing Capstones

Permanent URI for this collectionhttps://hdl.handle.net/10877/17201

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The Impact of Verbal Communication on Limited English Proficiency Hispanic Adults: A Systematic Review [poster]
(2023-12) Garcia Rosales, Dailen
The purpose of this project is to perform a systematic review that analyzes how different language concordant verbal communication methods such as language concordant providers and interpreters can affect the health outcomes of LEP Hispanic adults. The Health Belief Model (HBM) is a framework that divides health behavior in three categories: individual perceptions, modifying factors, and likelihood of action. This model emphasizes that preventative health is only possible when an individual understands the risks and benefits of their actions (Mckellar & Sillence, 2020). A fundamental concept of this review is the important role that providers have in educating patients.
The Impact of Verbal Communication on Limited English Proficiency Hispanic Adults: A Systematic Review [paper]
(2023-12) Garcia Rosales, Dailen; Page, Tracey
Introduction: Limited English Proficiency is defined as difficulty reading, writing, understanding, and speaking English. Patients with limited English proficiency experience longer and more frequent hospital stays than patients with language proficiency. A growing body of research is exploring how language concordant providers and interpreter services as methods of verbal communication can affect health outcomes in this population. Methods: This paper utilized Medline Complete, CINAHL, PubMed, and Web of Science to conduct a literature review. Inclusion criteria included primary research studies, published within the last five to six years, peer-reviewed, published in English, performed within the United States, pertaining to limited English proficiency adults, pertaining to verbal communication, pertaining to health outcomes. The initial search produced 4,996 articles, from which nine were selected based on inclusion and exclusion criteria. Results: Clinical outcomes in patients with language-concordant providers had mixed results. Two articles found improvement in clinical outcomes, one article found that language concordant providers are more thorough in history taking, and two articles found no significant differences in language concordant and language discordant care. Patients who received interpreter services received higher quality of care compared to those that did not, although all outcomes did not improve uniformly. Hispanic adults regardless of English proficiency generally have poorer control of chronic conditions. Discussion: Patients with language concordant providers generally have positive health outcomes. Language discordant providers should always utilize professional medical interpreters and should advocate for bilingual staff.
Role of Lifestyle Modifications in the Management of Hidradenitis Suppurativa in Adults [poster]
(2023-12) Maxwell, Joni
Purpose: Review and synthesize the available literature on the relative preventative value of lifestyle modification in HS disease management.
Role of Lifestyle Modifications in the Management of Hidradenitis Suppurativa in Adults: A Systematic Review [paper]
(2023-12) Maxwell, Joni; Page, Tracey
Introduction: Hidradenitis suppurativa is a chronic inflammatory skin disease characterized by recurrent abscesses. The exact cause is unknown, but there is an association with obesity, diabetes, and pro-inflammatory habits like smoking. The purpose of this systematic review is to appraise existing information on lifestyle modifications, their impact on hidradenitis suppurativa, and identify knowledge gaps. Methods: A systematic review of hidradenitis suppurativa, obesity, smoking, and diet was performed using MEDLINE, CINAHL and PubMED databases. The search strategy yielded seven articles that met inclusion criteria. There was a total of 1,710 patients, four cross-sectional studies (n=1,397), two retrospective studies (n=233), and one case control study (n=80). Article results were synthesized into a table. Results: The severity of hidradenitis suppurativa was most closely related to smoking status and obesity. Alternatively, symptomatic improvement was reported in patients who stopped smoking or reduced their weight. Dietary modifications, specifically following a Mediterranean diet, were also associated with lower self- reported disease severity. Discussion: Recurrence and severity of hidradenitis suppurativa may possibly be mitigated with lifestyle modifications. However, randomized controlled trials are needed to determine how much lifestyle modification independently affects hidradenitis suppurativa.
The Impact of Hormone Therapy on Rates of Suicidality in Transgender Youth [poster]
(2023-12) Forbes, Melissa
The current political actions to ban gender-affirming care to transgender youth is attempting to erase and invalidate the transgender population (Abreu et al., 2022). A systematic review is pertinent to demonstrate the need for gender-affirming care access to protect the mental health and wellness of our transgender youth. The purpose of this project is to continue the research into discovering the connection between TGD youth suicidality and the use of GAHT. This review has employed Neuman's framework to provide guidance in comprehending how stressors affect the psychological, physiological, developmental, and sociocultural aspects of TGD youth.
Transgender Youth and the Effects of Gender-Affirming Hormone Therapy on Suicidality: A Systematic Review [paper]
(2023-12) Forbes, Melissa; Page, Tracey
Introduction: This research delves into the impact of gender-affirming hormone therapy on depression, suicidality, and quality of life among transgender youth. With increasing recognition of the importance of affirming medical care for transgender youth, this study aims to examine the specific effects of hormone therapy on mental health and overall well-being among this demographic. Methods: A comprehensive literature review was conducted, encompassing studies published between 2018 and 2023. Databases including PubMed, CINAHL, MEDLINE Complete, Academic Search Complete, and ScienceDirect were utilized to collect relevant articles, focusing on research that explored the effects of gender-affirming hormone therapy on suicidality. Studies employing longitudinal designs, cohort studies, and case studies were included to ensure a comprehensive understanding of the topic. Results: The synthesis of findings from the selected studies consistently demonstrates a significant association between gender-affirming hormone therapy and improvements in depression symptoms, decreased suicidality rates, and enhanced overall quality of life among transgender youth. Various measures, such as standardized mental health assessments and self-reported outcomes, consistently indicate positive outcomes following the initiation of hormone therapy. Discussion: The implications of these findings highlight the critical role of gender-affirming hormone therapy in positively influencing mental health outcomes and well-being among transgender youth. The observed reductions in depression symptoms and suicidality, coupled with improved quality of life, underscore the importance affirming healthcare for this population. Further exploration into the effects and diverse experiences of transgender youth undergoing hormone therapy is recommended to enhance comprehensive care and support for this community.
The Impact of Prostate Cancer Education in African American Men [poster]
(2023-12) Lozoya, Elide
The purpose of this project is to perform a comprehensive literature review and synthesis in order to assess the current state of research pertaining to the effects of prostate cancer screening education specifically in African American men. The Stetler Model was beneficial in evaluating research and effectively translating the results into clinical use.
Prostate Cancer Education Among African American Men and Its Impact on Prostate-Specific Antigen Screening: A Systematic Review [paper]
(2023-12) Lozoya, Elide; Page, Tracey
African American men are at higher risk than any other race for prostate cancer, and they have a higher mortality than any other race. Current guidelines state that men need to make an informed decision before getting screened for prostate cancer. Studies have shown that one of the barriers to prostate cancer screening is a lack of knowledge about the disease and screening. A systematic review was performed to determine if education by an advanced provider will impact African American men prostate cancer screening. This systematic review is based on bibliographic searches in CINAHL Complete, MEDLINE Complete, and PsycInfo using pertinent search terms. Five hundred twenty-eight articles were identified using the search terms and Boolean operators: Prostate cancer screening and African American men or black men and education. Seven articles met the inclusion criteria. The results of this systematic review indicated that provider education about prostate cancer and screening impacts the knowledge and PSA screening of African American men. Providers should take an active role in identifying African American patients who are at risk of prostate cancer within their practice and take the initiative of educating them about prostate cancer and encouraging them to decide about prostate cancer screening.
Martial Arts for Reduction of Childhood Obesity and Health Promotion [poster]
(2023-12) Haertner, Micah
The purpose of this project is to provide a systematic review of literature on martial arts as an intervention for childhood obesity and related health markers.
Martial Arts Training Effects on Health Markers in Adolescents and Children: A Systematic Review [paper]
(2023-12) Haertner, Micah; Littlefield, Amber
Introduction: Childhood obesity has been a growing concern over the past 50 years in the United States. Healthcare providers have extensively studied childhood obesity, yet the rates continue to rise. Obesity contributes to lifelong health complications including cardiovascular disease, hyperlipidemia, hypertension, type 2 diabetes mellitus, and certain cancers. A disproportionate number of Hispanic and non-Hispanic Black children are affected by childhood obesity. Childhood obesity also contributes to the overall economic burden on the healthcare industry. Methods: A review of literature was conducted using PubMed, CINAHL, MEDLINE, and ScienceDirect databases. Articles included in the systematic review must meet the following inclusion criteria: published between 2017 to 2023, report primary research, peer reviewed, written in English, and they must address the effectiveness of martial arts on improving health markers in children. Results: A total of 434 articles were identified and of those articles seven met the inclusion criteria. Common themes across studies were an increase in cardiovascular fitness from martial arts as well as an improvement in body composition due to martial arts training. Discussion: The major findings were improvements in cardiovascular fitness and improvement in body composition. Studies suggest that martial arts could be a feasible method of increasing physical activity and reducing body fat. Some studies suggest that increase in other health markers, such as increases in lean body mass, could be achieved through martial arts. The results were inconclusive on the effects of martial arts on BMI.
Barriers and Outcomes for Low-income Women with Mental Illness During Post-Partum [poster]
(2023-12) Bibles, Sharmelle R.
Introduction: Maternal mortality among low-income mothers in the United States (U.S.) is steadily increasing (Eckert, 2020). The risk for developing mental illness is higher among middle- and low-income households, where 1 in 4 women report depression during pregnancy and 1 in 5 report having postpartum depression (Awini et al., 2023). Several research studies have examined social determinants of health (SDOH) impact on mental healthcare treatment among pregnant and post-partum women. However, gaps in the literature suggest that more research is needed to examine mental health outcomes for mothers and babies with untreated mental illness during the post-partum period. This systematic literature review aims to identify barriers to healthcare, patient outcomes, and helpful interventions for post-partum women with mental illness in low-income communities. Methods: The author extracted data from articles between 2018 and 2023 via CINHAL, Pubmed, and Psychinfo electronic databases. An ancestry search strategy was also used for data collection. Articles selected for this study meet inclusion criteria: (1) primary research articles, (2) published in English, (3) published in a peer-reviewed journal, (4) published within the last five years, and (5) addressed or related to barriers and outcomes for low-income, post-partum women with mental illness. The Rapid Quality Critical Appraisal Tool, adapted by Melnyk and Fineout-Overholt (2019), was used to appraise and evaluate quality of the literature. Results: 1,512 articles were identified, and seven studies met inclusion criteria. Five common themes were identified across studies as barriers for low-income post-partum women in need of mental healthcare: (1) lack of social and community support, (2) lack of transportation and community resources, (3) lack of financial assistance and income, (4) lack of provide education (understanding) and advocacy (5) lack of mental health education. Discussion: Results suggest a critical need for multiple stakeholders to address the complex barriers and social determinants of health that result in poor outcomes for low-income postpartum women with mental illness.
Barriers and Outcomes for Low-income Women with Mental Illness During Post-Partum: A Systematic Review [paper]
(2023-12) Bibles, Sharmelle; Littlefield, Amber
Introduction: Maternal mortality among low-income mothers in the United States (U.S.) is steadily increasing (Eckert, 2020). The risk for developing mental illness is higher among middle- and low-income households, where 1 in 4 women report depression during pregnancy and 1 in 5 report having postpartum depression (Awini et al., 2023). Several research studies have examined social determinants of health (SDOH) impact on mental healthcare treatment among pregnant and post-partum women. However, gaps in the literature suggest that more research is needed to examine mental health outcomes for mothers and babies with untreated mental illness during the post-partum period. This systematic literature review aims to identify barriers to healthcare, patient outcomes, and helpful interventions for post-partum women with mental illness in low-income communities. Methods: The author extracted data from articles between 2018 and 2023 via CINHAL, Pubmed, and Psychinfo electronic databases. An ancestry search strategy was also used for data collection. Articles selected for this study meet inclusion criteria: (1) primary research articles, (2) published in English, (3) published in a peer-reviewed journal, (4) published within the last five years, and (5) addressed or related to barriers and outcomes for low-income, post-partum women with mental illness. The Rapid Quality Critical Appraisal Tool, adapted by Melnyk and Fineout-Overholt (2019), was used to appraise and evaluate quality of the literature. Results: 1,512 articles were identified, and seven studies met inclusion criteria. Five common themes were identified across studies as barriers for low-income post-partum women in need of mental healthcare: (1) lack of social and community support, (2) lack of transportation and community resources, (3) lack of financial assistance and income, (4) lack of provide education (understanding) and advocacy (5) lack of mental health education. Discussion: Results suggest a critical need for multiple stakeholders to address the complex barriers and social determinants of health that result in poor outcomes for low-income postpartum women with mental illness.
Transgender Health and Breast Cancer Risk: Unveiling the Evidence [poster]
(2023-12) Brown, Tiffany N.
The purpose of this systematic review is to examine the breast cancer risk among transgender individuals undergoing GAHT. The review is guided by Dorothea Orem's Self-Care Deficit Nursing Theory, emphasizing the importance of self-care in healthcare and the role of nursing interventions in supporting transgender individuals' self-care related to breast cancer risk. This study aims to provide insights into the medical implications of GAHT in the transgender community, thereby aiding in informed healthcare decisions.
Breast Cancer Risk Among Transgender Individuals Undergoing Gender Affirming Hormone Therapy: A Systematic Review [paper]
(2023-12) Brown, Tiffany Nacole
Introduction: This review addresses the breast cancer risk among transgender individuals undergoing gender-affirming hormone therapy, a crucial but understudied aspect in transgender healthcare. Focusing on gender affirmation, transgender individuals often face healthcare challenges, leading to gaps in broader health concerns like cancer screening. This research, framed by Dorothea Orem's Self-Care Deficit Nursing Theory, aims to fill this gap, comparing the incidence of breast cancer in transgender populations to cisgender counterparts. Methods: A thorough search was conducted in MEDLINE Complete, PubMed, and CINAHL Ultimate from 2013 to 2023. Search terms included transgender, trans, breast cancer, malignancy, tumor, gender affirming therapy, hormone therapy. Studies focusing on transgender individuals undergoing hormone therapy were included, with exclusions for non-English articles and those published before 2013. Results: From 681 articles identified, rigorous screening led to eight studies meeting inclusion criteria. These studies offered a comprehensive view of breast cancer incidence in transgender individuals undergoing gender affirming hormone therapy. Notably, transgender women on estrogen therapy had a higher breast cancer incidence compared to cisgender men, yet lower than cisgender women, while transgender men on testosterone therapy showed similar rates to cisgender men. Discussion: The findings suggest a need for personalized breast cancer screening strategies tailored to transgender individuals. The review emphasizes healthcare providers' role in initiating breast health discussions and the importance of adapting clinical guidelines to transgender individuals' unique needs. Acknowledging the current literature's limitations, the review advocates for more research, policy reform, and advocacy to ensure inclusive and affirming healthcare for the transgender population.
MDMA for Treatment of PTSD [poster]
(2023-12) Hensley, Melissa
The purpose of this paper is to show the current success of using MDMA and psychotherapy to treat this devastating disorder.
Exploring the Therapeutic Potential: A Systematic Review of 3,4-Methylenedioxymethamphetamine (MDMA) in the Management of Post-Traumatic Stress [paper]
(2023-12) Hensley, Melissa; Littlefield, Amber
This systematic review examines the current state of research on the use of 3,4-methylenedioxymethamphetamine (MDMA) as an adjunct to psychotherapy for the treatment of Post-Traumatic Stress Disorder (PTSD). The study explores the historical context of MDMA, its pharmacological mechanisms, and the rationale for its potential therapeutic effects in addressing PTSD symptoms. A thorough examination of clinical trials, randomized controlled trials, and observational studies reveals promising results in terms of safety and efficacy. The review highlights the neurobiological and psychological mechanisms through which MDMA may facilitate the therapeutic process, including enhanced emotional regulation, increased empathy, and improved introspection. Key findings from recent clinical trials, such as the Multidisciplinary Association for Psychedelic Studies (MAPS)-sponsored Phase 3 trials, are presented and discussed. Safety considerations, including potential adverse effects and risk mitigation strategies, are addressed to provide a balanced perspective. The review also discusses the legal and ethical implications surrounding the use of MDMA in therapeutic settings. Additionally, the potential impact of this emerging treatment modality on existing PTSD treatment paradigms and healthcare practices is explored. Overall, this review supports the growing body of evidence suggesting that MDMA-assisted therapy holds promise as a novel and effective approach for individuals suffering from PTSD. While further research is needed to establish long-term safety and efficacy, the findings underscore the potential of MDMA-assisted therapy to contribute to the evolving landscape of mental health treatments for PTSD.
Effectiveness of Prolonged Exposure Therapy vs. Cognitive Processing Therapy in Veterans with Post-Traumatic Stress Disorder [poster]
(2023-12) Crook, Raven
This systematic review investigates the comparative effectiveness of two evidence-based trauma-focused psychotherapies: Prolonged Exposure Therapy (PE) and Cognitive Processing Therapy (CPT). Specifically tailored for veterans battling PTSD, these therapies aim to address the deep and lasting consequences of trauma, with the overarching goal of improving patient outcomes.
Effectiveness of Prolonged Exposure Therapy vs. Cognitive Processing Therapy in Veterans with Post-Traumatic Stress Disorder: A Systematic Review Systematic Review [paper]
(2023-12) Crook, Raven M.; Page, Tracey
Introduction: Traumatic events, especially in combat veterans, can lead to post-traumatic stress disorder (PTSD), impacting mental health and overall functioning. This systematic review compares the effectiveness of two evidence-based trauma-focused psychotherapies, prolonged exposure therapy (PE) and cognitive processing therapy (CPT), in treating PTSD among recent military campaign veterans. Both PE and CPT are endorsed in the current VA/DoD guideline, with PE involving the gradual exploration of trauma memories and CPT addressing negative thoughts. Methods: Utilizing Neuman's Systems Theory, this systematic review examines eight diverse study designs, encompassing quasi-experimental trials, retrospective studies, and randomized controlled trials. A systematic literature review was conducted using specific search terms across seven databases. The selection process resulted in eight relevant articles. Results: PE emerges slightly more effective in six studies, while two studies suggest a slight advantage for CPT. Factors influencing outcomes include treatment timing, session completion, and patient choice. Both therapies exhibit positive impacts on veterans, emphasizing adaptability and individualized approaches. Discussion: This systematic review addresses the urgency of effective treatments for veterans with PTSD, exploring the advantages and limitations of PE and CPT. The findings give evidence of the importance of individualized approaches and highlight the need for further research to inform personalized interventions.
Patient and Provider Attitudes Toward Use of Medication for Opioid Use Disorder [poster]
(2023-12) Trejo, Anyssa
The purpose of this project was to examine the source and effect of negative perceptions of patients with OUD and their providers regarding MOUD to make recommendations to providers to improve treatment and outcomes for this population.
A Systematic Review Examining Patient and Provider Attitudes Toward Use of Medication for Opioid Use Disorder [paper]
(2023-12) Trejo, Anyssa; Page, Tracey
Introduction: Despite drastically rising rates of opioid overdose related deaths, rigid opinions of both patients and providers against the use of medication for opioid use disorder persist in the face of well-established evidence indicating that medication for opioid use disorder is the gold standard of care. The purpose of this systematic review of the literature is to examine the source and effect of negative perceptions and to make recommendations to providers to improve treatment and outcomes for this population. Methods: A systematic review of the literature was conducted to identify the source and extent of perceptions of both patients with opioid use disorder and their providers regarding medication for opioid use disorder. The Neuman Systems Model was used to guide the review to see the patient as a system with many parts that responds to environmental stressors and to bring providers’ focus back to the client’s well-being. Results: Seven articles were included to identify two major themes describing patient and provider attitudes toward medication for opioid use disorder. The first theme identified was that providers and patients carry negative perceptions toward medication for opioid use disorder. The second theme indicated that medication for opioid use disorder is perceived as a replacement drug by providers and patients. Discussion: It is apparent that there is a negative view towards medication for opioid use disorder by both healthcare providers and patients struggling with opioid use disorder. Negative attitudes upheld by healthcare providers and patients continue to prevent access to effective treatment for those struggling with opioid use disorder.

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