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Scholars Symposium 2024: Nursing

Nursing

A Mother's Touch: The Fight Against Neonatal Abstinence Syndrome

by Kaitlynn Gibson (Undergraduate), Blythe Anderson (Undergraduate), Marie Weinhold (Undergraduate)

Neonatal Abstinence Syndrome (NAS) is a disorder resulting from persistent opioid exposure while a fetus is developing in-utero and then the sudden halting of that exposure at birth. This process affects the digestive system, nervous system, and muscles. Historically, it results in the separation of mother and baby at birth as the infant often must be transferred to a neonatal intensive care unit (NICU) for treatment. This has been shown to cause a direct increase in the length of stay and severity of symptoms due to the interruption of mother-infant bonding. This study sought to identify the role maternal presence plays in NAS cases and how the support of nurses in the dyad remaining together impacts the neonates’ symptoms of NAS. We conducted an integrative review for NAS treatment using full-text articles from PubMed. Our inclusion criteria included relevance to NAS and rooming-in practices; conduction within the past ten years; and conclusive results that emphasized non-pharmacological interventions. Exclusion criteria maintained that articles could not be published outside of ten years or include multiple variables outside our research question. We found that NAS should be treated using rooming in, breastfeeding, and other non-pharmacological methods. Evidence supports decreasing barriers to breastfeeding for mothers with opioid use disorder (OUD) and neonates with NAS. Further, nursing care should be centered on providing support for rooming-in and maximizing the use of non-pharmacological interventions. The conduction of randomized controlled trials (RCT) is needed for the further development of data. Follow-up studies examining the long-term success rates of infants with NAS and rooming-in six to twelve months after are also warranted.

 

Effects of Aerobic Exercise on the Mental Health of the Peripartum Mother: A Literature Review

by Emma Bailey (Undergraduate), Aaron Swedeen (Undergraduate), Azarian Bennett (Undergraduate), Ellie Reese (Undergraduate), Johanna Zillia (Undergraduate)

One of the biggest challenges facing our generation today is depression and mental health. This is an issue that can become amplified in women who are pregnant or postpartum. In this project, we will be analyzing articles about the effects aerobic exercise has on maternal mental health in the peripartum and postpartum periods of pregnancy. We have analyzed and appraised 10 articles, in which we focused on articles that answered our question if exercise during pregnancy and postpartum helps with postpartum depression. Most of the studies we found neither confirmed nor denied exercise as a definite treatment to postpartum depression, but it became clear that exercise has been successful as a means of prevention. Our research showed us that while we have a good starting point, many more studies need to be conducted to confirm exercise as a sole strategy for preventing postpartum depression. Most of the articles we analyzed had limitations, this led us to be cautious about the reliability of the articles. Overall, the articles we have analyzed led us to the following conclusion: aerobic exercise seems to positively affect maternal mental health. While there should still be many more studies and experiments conducted; women should be able to find relief from postpartum depression if they can implement some form of exercise, aerobic or otherwise, into their routine.

 

Non-Pharmacological Interventions for Drug Exposed Neonates

by Hallie Northrop (Undergraduate), Charlotte Blair (Undergraduate), Aubrey Johnson (Undergraduate), Hannah Sloan (Undergraduate)

Neonatal Abstinence Syndrome is the withdrawal of neonates from intrauterine drug exposure shortly after birth. The treatment of Neonatal Abstinence Syndrome (NAS) usually consists of both pharmacological and nonpharmacological therapies. However, nonpharmacological therapies usually tend to be underrepresented in the plan of care for treatment. The aim of our research is to determine the effects of nonpharmacological therapies as the baseline treatment of NAS and how that affects the overall outcome of neonate’s recovery and hospital duration. We specifically examined the comparison between nonpharmacological contact methods and nonpharmacological artificial contact methods on the recovery and hospital stay of the neonate. The contact methods in this study are breastfeeding, babywearing, and skin-to-skin contact. The artificial contact methods in this study are swaddling, pacifiers, swings, vibrating mattresses, and acupuncture. The recovery of the neonates was determined using the Finnegan score; the FLACC scale; the reports of nurses, parents, and physicians; NOWS; and the duration of hospital stay. Through the review of literature, we have concluded that non-pharmacological contact and artificial contact methods should be incorporated into the standard treatment of NAS. Which is evidenced by the reduction of severity of withdrawal symptoms in the neonate and a reduction in the hospital stay. More research needs to be conducted as to how it will be incorporated with pharmacological interventions. Results determined the need for the appraisal of the implementation of the interventions into hospitals for the treatment of NAS in neonates.

 

Comparison of the Ketogenic Diet and the Mediterranean Diet in Symptom Management in Women with Polycystic Ovary Syndrome (PCOS)

by Elisabeth Sayler (Undergraduate), Caroline Holdeman (Undergraduate), Faith Ayers (Undergraduate), Sydney Huffman (Undergraduate)

Rationale: In women of reproductive age, Polycystic Ovary Syndrome (PCOS) is the most common endocrine and metabolic disorder causing excess androgen production, irregular ovulation with abnormal menstrual cycles, and ovarian cysts. Obesity, insulin resistance, and other hormone imbalances are associated with PCOS. Non-pharmacological treatments, including therapeutic diets, evaluate the effectiveness of symptom reduction and sustaining long-term management. Question: Therapeutic diets are an effective non-pharmacological method to manage some of the common PCOS symptoms. Among these, the Ketogenic diet and the Mediterranean diet show promising results. In women with PCOS, how does the Mediterranean diet compare to the Ketogenic diet in managing symptoms? Literature Search: By searching PubMed and using specific inclusion and exclusion criteria, 10 articles were selected to explore the relationship between the Ketogenic diet versus the Mediterranean diet in symptom management in women with PCOS. Appraisal Method: The John Hopkins Method was used to appraise the research articles used in this study to determine the strength and quality in answering our research question. Best-Evidence Synthesis: In women with PCOS, diet adherence improves symptom management and corrects hormonal imbalances. The Ketogenic and Mediterranean diets differ in short and long-term symptom management, as the short-term studies revealed the Ketogenic diet successfully manages PCOS symptoms and imbalanced hormones. In comparison, the Mediterranean diet provides similar results to the Ketogenic diet, although it may not be as effective as quickly. Overall, the articles suggest that the Mediterranean diet is more sustainable and a better diet to maintain throughout a lifetime. Recommendations: From the research conducted in this study, further longitudinal studies will increase the confidence in the sustainability of the Ketogenic diet versus the more commonly used anti-inflammatory Mediterranean diet.

 

Managing Gestational Diabetes Mellitus (GDM) through Resistance Training in Pregnant Women

Megan Lail (Undergraduate), Annika Wagner (Undergraduate), Katherine Redding (Undergraduate)

Intro: In recent years, gestational diabetes mellitus (GDM) has become significantly more prevalent, presenting concerns for both mother and fetus. Resistance training (RT) has the potential to more effectively manage gestational diabetes mellitus than current standard methods. The implementation of RT in comparison to regular treatments, including insulin, would increase adherence, improve cost-effectiveness, and reduce insulin use. This article seeks to answer the following question: In persons with gestational diabetes mellitus, what is the effect of RT compared to usual care in lowering blood glucose levels during pregnancy? Methods: The Cinahl, Cochrane, Medline, and PubMed research databases yielded various articles using search terms such as “gestational diabetes or GDM,” “resistance training,” “glycemic control,” and “insulin resistance.” The John Hopkins Evidence-Based Practice Model was used to appraise and evaluate ten of these articles to determine the answer to the research question. Results: Pharmacologic and non-pharmacologic treatments among those with GDM have variable adherence. It also showed that RT assists in glucose control; however, there is conflicting data on the amount of time and intensity needed for maximum benefit. Additionally, obese women with GDM yielded significant success in lowering blood glucose with RT. Finally, the research indicated that combined interventions (e.g. diet, exercise, education) will yield more significant results than one intervention alone. Conclusion: Due to the lack of large studies, results are unclear as to the effects of RT in managing glucose control. However, it is suggested that combined interventions are more effective than RT alone. RT is also considered safe and should be encouraged at the discretion of individual providers. Future larger studies should be conducted to provide conclusive results to improve evidence-based practice for women with gestational diabetes mellitus.

 

Young Adult Caregivers Need for Increased Social Support and Awareness

Audrey Abalos (Undergraduate), Bryn Marshall (Undergraduate), Natalia Flores (Undergraduate), Elizabeth Strunk (Undergraduate),Jayla Martin (Undergraduate), 

There are millions of young adult caregivers (YACs) worldwide. A literature review of 10 articles on YACs, their social lives, their relationships with professionals, and the support they received revealed that a lack of social support puts pressure on young adults involved in caregiving that their peers do not experience. YACs experience additional responsibilities, role reversal issues, increased mental health struggles, and a lack of autonomy as well as isolation from their peers. We wanted to discover the impacts of social support as a resource for YACs compared to usual care. We believe that social support would be beneficial for the YAC population. Databases such as Pubmed, CINAHL, Cochrane Library, and sites such as Google Scholar provided the resources for our research. Research showed an overall lack of social support and awareness for YACs. Interviews with YACs revealed they received little recognition from healthcare professionals, which led to a lack of education on the disease they were caring for. There was also no information provided on social services available to them. There is an improved quality of life in YACs when social support is provided, both in person and through social media. Social support would be meaningful for YACs and we recommend healthcare providers become more involved in YACs lives and make social support more attainable for YACs.

 

The Effect of Resistance Training on Bone Mineral Density in Postmenopausal Women

Jacob Painter (Undergraduate), Lydia Payne (Undergraduate), Emily Walsh (Undergraduate), Savannah Stein (Undergraduate)

Objective: Given the risk of osteoporosis and pathological fractures in postmenopausal women, this study systematically reviews the existing literature to evaluate the effectiveness of resistance training on bone mineral density (BMD) in postmenopausal women, aiming to identify a possible intervention for those suffering from low bone mineral density (BMD) post-menopause. Methods: Extensive research across multiple databases was conducted to find articles exploring the relationship between resistance training and bone mineral density in postmenopausal women. Search parameters included peer-reviewed articles in English published within the last five years, without constraints on the level of intensity, load magnitude, and frequency or duration of training. Each article was rigorously appraised based on the level of evidence and quality. The search yielded ten articles encompassing randomized control trials, quasi-experimental studies, and literature reviews. Results: The research primarily agreed that resistance training positively impacts the bone mineral density of postmenopausal women. The impact, though beneficial, was considered minimal by a majority of the studies. Conclusion: The collective findings support that although high-intensity resistance training has a beneficial impact on bone mineral density (BMD) in post-menopausal women, further research is necessary to determine the best possible outcomes for bone mineral density (BMD) in this population. To standardize the results of this research, specific information regarding intensity, exercise regimen, and frequency are topics of interest for future research.

 

Effect of Spiritual Care at End of Life: A Literature Review

Isabel Rahn (Undergraduate), Logan Smith (Undergraduate), Milaina Reaoch (Undergraduate)

End of life care is something that is crucial to nursing, and there is much variation on how to do this well. Spiritual care is a key part of holistic care, but this is often neglected in the care of patients with terminal illness. In a literature review on this subject, articles were found from countries all over the world, demonstrating the universality of this topic. These articles came together to make a few points. The first of these points is that spiritual care is shown to improve quality of life when it aligns with the patient’s religious and cultural background. Next, these articles demonstrated that there is a negative correlation between depression/anxiety and spiritual well-being. Finally, these articles concluded that patients with a spiritual background are more receptive to spiritual care and have improved quality of life in their terminal illnesses. There is great variety in the types of spiritual care provided, resulting in inconclusive evidence for what spiritual care looks like in nursing. Based on the literature that has been analyzed, it is clear that there is very little research done on what spiritual care looks like from a Christian worldview. Another recommendation for research is addressing the effects of long term spiritual care, as most of the research focuses on short-term effects while hospitalized. This research adds to EBP practice by recommending that spiritual assessments should be done on patients to determine how we can best provide spiritual care to them. Assessing a patient's readiness for accepting spiritual care is also important, and offering spiritual care to all patients.

 

Rescuing an Infant's Respiratory System

Madison Lozier (Undergraduate), Madelyn Keenan (Undergraduate), Kylie Atchison (Undergraduate), Isabel Junker (Undergraduate), Mackenzie Niemeyer (Undergraduate)

This paper explores significant research that was conducted to determine the success of interventions completed for infants in respiratory distress syndrome. Particularly, the research focuses on the effectiveness of surfactant therapy compared to prone positioning in infants. Respiratory Distress Syndrome is a common complication, as most newborn codes are due to a respiratory factor and not cardiac related. While prone position has proven success in clinical trials and improved oxygenation levels, the overall research concludes that surfactant therapy has the best overall outcomes in infants with Respiratory Distress Syndrome. Leading to positive lung response and prevention of further lung complications, ultimately improving their overall lung function and quality of life. No adverse effects from surfactant therapy or prone positioning were drawn from the research that was selected for this study. Further investigation would be required to conclude if these interventions cause any negative effects on the infant. In conclusion, surfactant therapy and prone positioning has proven to benefit infants in respiratory distress syndrome, improving their overall oxygenation.

 

Rural Maternal Mental Health, Stigma, Childcare, and Care-Seeking: A Mixed Method Study

Marcia Williams (Faculty)

Background: Perinatal depression and anxiety (PDA) impacts 20% of pregnant and postpartum individuals and families. One in five Americans live in rural areas with poorly understood health disparities, including 28 million childbearing persons. Missing in the literature is the contextual element of rural influence of PDA, endorsed and anticipated stigma perceptions, and choice of preferred treatment. Purpose To evaluate contributing factors to care-seeking behaviors and stigma among rural, childbearing women with PDA symptoms. Methods: (Design, Participants, Setting, Data Collection, Analytical Approach) A mixed-method convergent design with complementarity intent was approved by the University of Utah Institutional Review Board. A convenience sample of 180 pregnant to 1-year postpartum individuals from 11 rural Ohio counties completed electronic surveys that captured measures of clinical symptoms, stigma, and care-seeking preferences. Purposive sampling among those with mild and moderate PDA explored known rural barriers and facilitators for mental health care-seeking. The analysis of quantitative and qualitative data occurred separately and merged. Descriptive statistics, bivariate analysis, and multivariable linear regression described the care-seeking intentions of survey participants. The focused ethnography used key informants for recruitment, feedback, and member checking aligning codes with quantitative data. A mixed method bivariate analysis transformed qualitative codes into numeric data to enhance and clarify barriers and facilitators from both data sets. Results: A higher positivity rate for PDA exists than expected. Demographic variables of education and social support, the severity of PDA clinical symptoms, and culturally congruent leveraging of barriers and facilitators including childcare are highly related to the intention of care-seeking behaviors among rural Ohio childbearing women. Stigma and preferences in care-seeking vary between those with mild and moderate PDA symptoms. Conclusions & Implications: There is a dynamic interaction between stigma, PDA symptoms, rurality, and care-seeking behavior in this under-researched population. A contextual understanding from the participants themselves highlights preferred interventions. In resource-poor areas, task-sharing approaches to care include self, clergy, primary care, and lay persons that correspond to the severity of clinical symptoms.

 

Doula Support and Its Effect on Maternal Health Outcomes

by Abigail Adkinson (Undergraduate), Jessi Smarrella (Undergraduate), Kaitlynn Mercer (Undergraduate), Kylie Mortensen (Undergraduate)

The support of a doula reduces poor maternal health outcomes for intrapartum and postpartum women. Evaluating the effects of doulas The effect that doulas have on maternal health outcomes improves the birthing experience. We evaluated 10 articles using the Johns Hopkins appraisal tools. The goal of this literature review was to evaluate and synthesize the current literature on the positive effects of using a doula during and after pregnancy. Doula care reduced the need for medical interventions and incidences of complications, such as cesarean sections, length of labor, and premature deliveries. The use of a doula improved breastfeeding outcomes and decreased maternal stress and anxiety. When doula care was started earlier in pregnancy, maternal health outcomes improved more than when it was only used later in pregnancy. Among women from lower socioeconomic classes or racial minorities, using a doula was significant in improving their health outcomes compared to others from the same socioeconomic classes or racial minorities. Doulas provide support that can be utilized by intrapartum and postpartum women to improve their maternal health outcomes and we recommend education of healthcare professionals on incorporating doula care throughout the peripartum period.

 

The Doula Effect: An Evidence Review

Caleigh Sullivan (Undergraduate), Katie Sills (Undergraduate), Elleigh Perkins (Undergraduate), Karis White (Undergraduate), Madisyn Rubright (Undergraduate)

Doulas offer prenatal, labor, and postnatal support for the mother and are beneficial additions to the nursing practice. In doula care, studies have shown that there is a positive correlation between maternal and infant outcomes and the involvement of a doula in their care. The purpose of this study is to show the positive benefits of the addition of a doula based on statistical data and first-hand research interviews. Doula care significantly impacts maternal and infant outcomes physically, emotionally, and holistically. By initiating the use of doulas during pregnancy, statistically the results of satisfaction for families is increased. There is consistency between the likelihood of breastfeeding, decreased rate of cesarean sections, decreased prematurity in infants, and maternal well-being with those cared for by doulas. Our best evidence recommendation is to continue to educate doulas on specific maternal and infant outcomes and continually prepare them. There is a need for consistent education and discussion of the greater influence of doulas in healthcare settings.

 

The Effectiveness of Light Therapy in Comparison to Usual Care in the Treatment of Seasonal Affective Disorder: An Integrative Review

McKayla Naill (Undergraduate), Noah Harvey (Undergraduate), Madeline Heigley (Undergraduate), John Lawler (Undergraduate), Emma Logothetis (Undergraduate)

Introduction: Bright light therapy (BLT) has commonly been used to treat seasonal affective disorder (SAD). However, little is known about how bright light therapy compares to usual care in adults with SAD. The purpose of this review was to evaluate the efficacy of bright light therapy compared to usual care on depression symptoms in the treatment of seasonal affective disorder. Methods: We conducted a systematic search of PubMed, Cochrane, PsycINFO, and ScienceDirect databases to identify articles meeting predefined selection criteria for the treatment of SAD using therapeutic approaches such as light therapy and other mainstream interventions. We analyzed the articles using Johns Hopkins EBP Tools and synthesized data according to the efficacy of BLT compared to usual care on the relief of depression symptoms. Results: A total of 10 studies met our predestined inclusion criteria. Analysis of the use and effectiveness of BLT in the treatment of SAD compared to placebo and other treatment modalities showed bright light therapy significantly more effective than placebo and usual care interventions in alleviating depressive symptoms of SAD. However, bright light therapy in conjunction with other interventions, such as cognitive behavior therapy (CBT) and pharmacotherapy, demonstrated the highest reduction and prevention in SAD symptoms. Conclusion: Our literature review indicates that bright light therapy is an effective first-line treatment for alleviating symptoms of seasonal affective disorder. Findings consistently demonstrated the effectiveness of BLT compared to placebo and usual care, yet contradict that SAD is best treated when BLT is combined with CBT and/or pharmacotherapy. While BLT is an effective intervention for seasonal affective disorder that should be incorporated into short-term practice, further research is needed to determine the long-term efficacy and implementation of BLT as a stand-alone or combined treatment for SAD.

 

 

Current Best Practice Treatment for NAS

Serine Warner (Undergraduate)

Destiny is having the worst week of her life. She’s either too hot or too cold. She can't shake a fever. Her muscles are twitching and her skin is crawling. Not to mention all the GI issues; to top it off she can’t sleep. To make matters worse Destiny knows someone who can relieve her pain, instead they push her to the side leaving her to scream in anguish. Destiny is addicted to opioids. Destiny is 2 days old. She was born in the hospital to a mother who was addicted, and therefore, she was born addicted. She is undergoing current best-practice treatment for neonatal abstinence syndrome, or NAS. The CDC defines NAS as a “withdrawal syndrome that can occur in newborns exposed to certain substances, including opioids, during pregnancy”. As we see in Destiny’s case, current policies for infants suffering from NAS do not offer medical intervention, but rather, it forces the child to suffer through the painful symptoms of withdrawal. This paper will review the problems, causes, and solutions to current NAS care treatment policies.

 

Nursing Education and Service Learning: A Novel Approach to the Community Health Fair

by Michele Dodds (Undergraduate)

The purpose of this poster is to share a pilot project with a novel approach to using the community health fair with a population underrepresented in school health screenings, homeschoolers. Through service-learning senior-level BSN students were able to complete health screenings, health education, and integrate STEM activities for a population of home schoolers ranging from preschool to high school. The novel approach of STEM learning integration encouraged both participation and reinforced learning. The development process is discussed with benefits for nursing education and areas for future improvements and evaluation.

 

In-Patients with Alzheimer's Disease: How Does Music Therapy Affect Cognitive Function and Physiological Well-being?

by Malea Williams (Undergraduate), McKenna Supplee (Undergraduate), Kaylee Phillips (Undergraduate), Ally Singer (Undergraduate)

According to the Alzheimer’s Association’s yearly report, Alzheimer’s Disease is a progressive neurologic disease that impacts 6.7 million Americans each year. About 1 in 9 people, or 10.75% age 65 and older are living with Alzheimer’s. Research on the management of Alzheimer’s is vital because the patients and their families deserve ways of easing the weight of this pathologic diagnosis without a current cure. This literature review showed an improvement in anxiety, depression, and irritability but was inconclusive about the cognitive effects of music therapy. We recommend additional studies be conducted since Alzheimer’s impacts so many patients and families and because anything that can be done to lessen the severity of this fatal disease is crucial as we continue to look for a cure.

 

Influences on Vaping Usage

by Kylee Root (Undergraduate), Olivia Conover (Undergraduate), Brookelyn Tuinstra (Undergraduate)

Vaping has grown more and more prevalent worldwide and has become a public health problem. Over 2 million adolescents are estimated to be current e-cigarette users in 2021 (Park-Lee 2021). This addictive behavior has numerous negative side effects on physical and mental health. A big question is what is influencing so many adolescents to vape and what can discourage them to stop? We looked at ten articles through the John Hopkins Literature Review system. We concluded that social support and marketing play an important role in influencing e-cigarette usage in adolescents. Both of these components have the power and potential to encourage teens to vape, or not to vape.

 

The Efficacy of Light Therapy Versus Cognitive Behavioral Therapy as Treatment Modalities for Seasonal Affective Disorder.

Danelle Osterhout (Undergraduate), Hannah Benjamin (Undergraduate), Jacob Raasch (Undergraduate), Rebecca Slone (Undergraduate)

Seasonal affective disorder, also known as SAD, is a type of depression that occurs during certain seasons of the year, most often the fall or winter seasons affecting 5% of people in the world. It is theorized that SAD is caused by the lack of daylight from the seasonal changes of fall and winter in which the days become shorter with less light than in the summer months. SAD is best treated with light therapy (LT), pharmaceuticals, and cognitive behavioral therapy (CBT). The purpose of this study is to explore the effectiveness of light therapy versus cognitive behavioral therapy to see positive patient outcomes based on statistical data and randomized control trials. We appraised 10 articles utilizing the Johns Hopkins Evidence-Based Practice model to answer our question. Through the articles appraised, it was discovered that in treating SAD with light therapy alone, there was a 47% chance of remission for the patients. There is a positive correlation between LT and CBT that the 47% remission rate increased to 73% when LT and CBT was used in conjunction in the treatment plan of SAD. Our recommendation for the effective treatment of SAD is to use light therapy and cognitive behavioral therapy simultaneously as it has shown increased remission rates in treating SAD compared to utilizing a singular method of treatment.