Nursing Doctoral Work

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Browsing Nursing Doctoral Work by Subject "cancer"

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    Colorectal Cancer: Increasing Awareness of Screening in a Rural North Dakota Community
    (North Dakota State University, 2022) Gladen, Karissa Rahnelle
    Colorectal cancer (CRC) is the second leading cause of cancer deaths in the United States, yet only 67% of the eligible population have received screening. Preventative CRC screenings help to reduce mortality and allow CRC to be found at the pre-cancerous or early stages, when the disease is highly curable. The purpose of this clinical dissertation project was to determine whether providing an educational booth with informational handouts and informational PowerPoint set on loop for adults ages 18-75 in the rural community of Grafton, ND increased knowledge and intent regarding CRC screening, as well as assisted to better understand barriers to receiving CRC screening. An educational booth with handouts and informational PowerPoint was presented to 28 voluntary participants, ages 18-75. Participants were from a convenience sample of eligible adults already attending a community event in a small-town setting in the rural community of Grafton, North Dakota. Post-survey results after the educational session were evaluated with descriptive statistics. Sixty-four percent of participants (N=28; n=18) indicated increased knowledge on CRC and/or screening modalities. Eighteen participants determined that the educational intervention positively influenced their intent to be screened. Of the ten participants who indicated “no”, the educational intervention did not influence their intent to be screened, eight indicated they had already decided to be screened prior to the intervention. Fifty-three percent of participants (n=15) identified barriers of some form in receiving CRC screening and of these 15 participants, 13 indicated that due to the educational session, they were still likely to begin or continue CRC screening. The co-investigator through the project implementation helped increase awareness of CRC and screening modalities, as well as positively impacted intent to receive CRC screening in Grafton, ND. This project helped illuminate barriers to receive screening, as well as positively influenced participants to choose to be screened despite identified barriers. Future projects should continue to focus on education to provide knowledge and address barriers. Nurse practitioners (NPs) are well suited to meet the needs of CRC education, identifying and alleviating barriers, as well as encouraging patients to receive CRC, all of which can reduce CRC morbidity and mortality.
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    Colorectal Cancer: Utilizing Educational Handouts, Endorsement Letters, and Questionnaires to Increase Screening and Identify Barriers and Facilitators at a Rural Clinic in Elgin, North Dakota
    (North Dakota State University, 2020) Hadsell, Joshua James
    Introduction: Although colorectal cancer (CRC) is the second leading cause of cancer-related deaths among men and women combined in the United States, only 61% of eligible adults are up-to-date with current screening recommendations. Effective screening is hindered by numerous barriers and underutilization of evidence-based interventions. The purpose of this clinical dissertation project was to increase CRC screening in the rural community of Elgin, North Dakota, determine the efficacy of providing targeted educational handouts and endorsement letters, and to identify screening barriers and facilitators. Methods: Educational handouts and screening endorsement letters were developed and distributed to 75 average risk patients (without personal or family history of CRC or certain types of polyps, personal history of inflammatory bowel disease, personal history of receiving radiation to the abdomen or pelvic region, and confirmed or suspected hereditary CRC syndrome). Additional handouts were placed around the community of Elgin. Patients who presented for CRC screening were sent a questionnaire to determine the impact of the interventions. These 75 patients were also contacted via telephone and completed a questionnaire to identify barriers and facilitators and to highlight the effectiveness of the educational handout and the endorsement letter. Results: Five patients contacted the clinic to receive CRC screening. Ninety-seven percent of patients who recalled receiving the endorsement letter and educational handout (n=32) found the material to be informative, 91% of patients appreciated being contacted on behalf of the clinic, and 59% found the handwritten signature on the endorsement letter to be influential. Fifty-one patients identified screening barriers including (in descending order) lack of awareness/knowledge, cost, unpleasant previous experience, embarrassment, lack of motivation, and fear of abnormal findings. Forty-one patients identified screening facilitators including (in descending order) recommending during office visits, providing education on different screening options, sending letter reminders, calling patients, utilizing social media, and sending email reminders. Conclusion: The clinical dissertation project increased CRC screening compliance in Elgin, ND, identified barriers, and highlighted screening facilitators that can be utilized. Future projects should focus efforts on alleviating these barriers via targeted patient education and provider recommendation in order to decrease CRC morbidity and mortality.