ItemPoverty Simulation Impact on Prelicensure Healthcare Students at a Four-Year University(2022-08) Cockerham, Mona; Camel, Simone; Williams, Mary ItemLeft Without Being Seen: Rapid Reduction 18-Month Journey(2022-10-15) Elliott, Tana; Cockerham, Mona ItemNurse Adaptability and Post-traumatic Stress Disorder Symptoms During the COVID- 19 Pandemic: The Effects of Family and Perceived Organizational Support(Frontiers in Psychology, 2022-03-04) Cockerham, Mona; Beier, Margaret E.; Branson, Sandy; Boss, LisaObjective: To examine the effect of family and perceived organizational support on the relationship between nurse adaptability and their experience with COVID-related PTSD (post-traumatic stress disorder) symptoms in frontline nurses working on COVID- 19 units. Background: Proximity to and survival of life-threatening events contribute to a diagnosis of PTSD, which is characterized by avoidance of reminders of trauma, intrusive thoughts, flashbacks of events, sleep disturbances, and hypervigilance. Using the job-demands and resource model, we examined the effect of adaptability, family support, and perceived organizational support on PTSD symptoms for nurses during the COVID-19 pandemic. Specifically, we tested whether perceptions of environmental supports—i.e., family and organizational support—moderated the relationship between nurse adaptability and COVID-related PTSD symptoms. Methods: A sample of frontline nurses working on COVID-19 units during the COVID-19 pandemic in Texas (N = 277) participated in this cross-sectional, observational study. Frontline Nurses reported demographic information and completed surveys designed to measure adaptability, perceived organizational support, family support, and COVID related PTSD symptoms. Results: Adaptability was significantly positively correlated (medium effects) to perceived organizational and family support (r = 0.51 and 0.56, respectively, p < 0.01). Adaptability and perceived organizational support were also negatively correlated with COVID-related PTSD symptoms (medium effects). Adaptability was negatively correlated with COVID-related PTSD symptoms, supporting Hypothesis 1 (r = -0.43, p < 0.01). Perceived organizational support was also significantly negatively correlated with COVID-19-related PTSD symptoms (r = -0.30, p < 0.01). Family support was not significantly correlated with COVID-related PTSD but was positively related to experiencing COVID-related PTSD after other variables were accounted for. Conclusion: Findings suggest that individual adaptability and organizational support may reduce PTSD severity in frontline nurses working during a crisis; however, family support may increase PTSD symptoms. We provide suggestions for strengthening individual adaptability and healthcare leadership including remaining highly engaged to show support by providing rapid communication, remaining calm during difficult circumstances, and maintaining a consistent, physical presence during difficult times. Moreover, our results suggest additional support for nurses with families to adapt to crisis. ItemEffectiveness of an Adaptive Quizzing System as a Self-Regulated Study Tool to Improve Nursing Students' Learning(Graphy Publications (International Journal of Nursing & Clinical Practices), 2018) Simon-Campbell, E'Loria; Phelan, JuliaExploring ways to help students achieve success in nursing programs is critical to improving student learning, success in nursing programs, and ultimately the number of graduates. Strategies for increasing NCLEX-RN pass rates range from modifying admission criteria, altering the number of times students can retake courses, and implementing remediation and progression policies. There does not appear, however, to be one single strategy which, when employed, can assure NCLEX-RN success. There is clear evidence, however, that studying using repeated self-testing has greater learning benefits that repeated reading, although it is unclear to what extent students understand and apply this principle on their own. In this paper we describe the implementation and use of an adaptive quizzing and learning system to provide students an environment for studying by self-testing to better master curricular material and prepare for exams. The study implemented a retrospective descriptive and correlational design to explore the relationship between usage and mastery measured in the system, course outcome data, standardized testing (ATI) scores, and NCLEX outcomes. Use of the system was voluntary and no course credit was assigned. All students (N = 36) used the practice quizzing feature of the system, answered an average of 574 questions with an overall average quizzing mastery level of 3.48 (on a scale of 1-8). There was a strong, positive correlation between the number of questions answered and overall mastery level; with increased usage students were better able to correctly answer more difficult questions and mastery of the content improved. All students in the group passed the NCLEX-RN (on the first or second attempt). Findings support the use of adaptive quizzing as a self-regulated learning strategy for nursing students and indicate that as students actively study and learn in the system, their mastery of course content increases. Additional implications will be discussed. ItemPTSD and Health Perspective: Victim of Motor Vehicle Accidents in Jordan(European Scientific Institute (European Scientific Journal), 2015) Al-Kofahy, LilibethMotor vehicle accident survivors who develop post-traumatic stress disorder have become an important health issue. Trauma resulting from Motor Vehicle Accidents has been attracting of increasing concern, with death from injuries is projected to reach 8.4 million in 2020 as compared to 5.1 million in 1990, particularly in developing countries including Jordan. A descriptive phenomenological approach was used for this study to identify and explore the lived experience of post-traumatic stress disorder of individuals who have been involved in a motor vehicle accident in Jordan. Seven themes were explicated from the participants’ transcripts of interview: feeling frustrated at a diminishing health status; struggling to maintain a state of independence; harboring feelings of not being able to recover; feeling discriminated against and marginalized by society; feeling ignored and neglected by health care professionals; feeling abandoned by family; moving toward acceptance through having faith in God. The current social services policies of the Jordanian Health Care System have given little credence to the health care needs of people with PTSD. As a result of this inattention, there is a noticeable lack of processes and protocols concerning care of the mentally ill and people with PTSD. The lack of policy direction has also led to a lack of health resources in this area including specialized clinics. Access to the limited services continues to place patients in vulnerable situations. Lack of policy direction has also impacted on access to health benefits. Presently, support of people with PTSD primarily falls to the family within Jordanian culture. Social support includes providing physical, emotional and financial assistance. Although change is taking place, it is slow and spasmodic. ItemApplying mindfulness to influence the patient and care team experience.(Sciedu (Journal of Nursing Education and Practice), 2018) Singh, Keerat S.; Davis, Patricia; Cockerham, MonaObjective:In today’s work environment, specifically in health care, mindfulness is a personal and professional strategy to improve performance and productivity. To influence the patient and care team hospital experience through the concepts of mindfulness and perception.Methods:This was a prospective observational project completed by medical/surgical nurses using an online survey pre- and post an educational program and an aggregate score of the 5 nurse-sensitive questions on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, a survey based in the United States that is mailed to patients post discharge to home to measure patient satisfaction with their hospitalization. The HCAHPS survey is a patient satisfaction survey required by the Centers for Medicare and Medicaid Services (CMS) for all hospitals in the United States. The purpose of the HCAHPS survey is to provide a standardized survey instrument and data collection methodology for measuring patients’ perspectives on their hospital care and hospital experience.Results:The aggregate nurse-sensitive HCAHPS scores increased from 85.5 to 89.8 over one month. For mindfulness, after the educational program, among the ten nurse survey questions the percentage went up as much as 0.57%. Conclusions: An educational program related to the benefits of mindfulness can positively effect nurses’ engagement in the workplace and positively increase HCAHPS scores. Continuing education on mindfulness should carry over month to month.In this research project, participants provided feedback to the researcher of feeling empowered to bring in new ideas, present different ways to grow, and tackle challenges ItemStress and cortisol as predictors of fatigue in medical/surgical nurses and nurse leaders: A biobehavioral approach(Sciedu (Journal of Nursing Education), 2018) Cockerham, Mona; Kang, Duck-Hee; Howe, Robin; Weimer, Susan; Boss, Lisa; Kamat, Sharvari R.Objective:High acuity and long work hours are significant contributors to nurses’ stress. Studies evaluating consecutive workdays with the use of biobehavioral methods are limited in the US. The aim of this study was to assess changes in and the relationship between stress, fatigue, and cortisol.Methods:In an observational within-subject design, we studied stress, fatigue and cortisol before and after 2 consecutive 12-hourday shifts in an acute care setting. Specifically, the study was designed to: (1) assess the effect of stress on fatigue; (2) examine the effect of stress on cortisol; (3) compare the levels of stress, fatigue, and cortisol; and (4) compare the responses of stress,fatigue, and cortisol between acute care, day shift staff nurses and nurse leaders.Results:Stress, fatigue, and cortisol increased significantly from baseline to Day 2 (p= .001, .004, and .010, respectively; paired t-test). In a comparison of nurses and nurse leaders, stress and fatigue at baseline were significantly higher in acute care nurses than in nurse leaders (p≥.00 and .05, respectively; independent t-test). At the end of 2 consecutive shifts, cortisol was significantly higher in staff nurses than in nurse leaders (p= .001). Conclusions: Competing initiatives pressure nurse leaders to work long hours to support organizational goals, sometimes at the expense of a healthy work environment. Nurses from direct care staff to executives should be educated in and demonstrate best practices in relation to endorsements from the American Nurses Association on fatigue and interventions to lessen the risks to patient safety. ItemSubjective sleep measures in children: Self-report(Frontiers Media (Frontiers in Pediatrics), 2017) Erwin, Andrea M.; Bashore, LisaThe American Academy of Sleep Medicine (AASM) recently published a consensus statement on the recommended number of hours of sleep in infants and children. The AASM expert panel identified seven health categories in children influenced by sleep duration, a component of sleep quality. For optimal health and general function, children require a certain number of hours of sleep each night. Limited data exist to subjectively assess sleep in this population. Practitioners must evaluate overall sleep quality not simply sleep duration. The purpose of this article is to provide a mini-review of the self-report sleep measures used in children. The authors individually completed a review of the literature for this article via an independent review followed by collaborative discussion. The subjective measures included in this mini-review have been used in children, but not all measures have reported psychometrics. Several tools included in this mini-review measure subjective sleep in children but with limited reliabilities or only preliminary psychometrics. Accurate measurement of self-reported sleep in children is critical to identify sleep problems in this population and further detect associated health problems. Ongoing studies are warranted to establish reliable and valid measures of self-reported sleep in children to accurately detect health problems associated with poor sleep quality. This mini-review of the literature is an important first step to identify the most reliable subjective sleep measures in children.