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Addiction Behind the American Dream: A Case for Harm Reduction among Upper and Middle Class
Sean Marc Sanga
The purpose of this study is to help bring awareness to the significant lack of information revolving around the idea of harm reduction interventions. This study will mainly focus on the upper and middle class, therefore, the end goal is to gain insight on what exactly deters or dissuades this specific population from gaining care. In addition, I hope it will provide some solutions to the growing drug problem among Middle America.
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Babies Behind Bars: Separation and Segregation of Incarcerated Mothers from their Children
Cielita Castro Capistrano
Over the past years, the imprisonment rate for women in the United States has been substantially increasing, resulting in continuous higher incarceration rates of women in prison. The United States “has the highest incarceration rate of women in the world, with over 205,000 women currently behind bars in either state and federal prisons or jails and another million on probation or parole” (Clarke et. al., 2013). Furthermore, the prisons and jails here in America are primarily focusing on the incarcerated male population leading to these institutions not prioritizing the proper health and safety protocols for these incarcerated women, who are mostly mothers. Incarcerated mothers are a vulnerable group of people in this society that often comes with a long history and experience of mental health problems, unemployment, poverty, sexual, emotional, physical, and mental abuse. This paper is conducted using a systematic search of different electronic databases and search engines that provided enough information to answer the research question for this literature review.
The purpose of this thesis is to explore and inform people regarding how important resources are for the future of the entire community as a whole. The gathered information in this thesis will be utilized to compose a proposal on how the entire society as a whole can work together with focusing on helping these people in achieving a second chance to have a better life. Focusing on these vulnerable populations will lessen the gaps that the society have been trying to fill that they cannot successfully fulfill since they need to start focusing on the cause of the problem, rather than interventions after a problem has already been created. The study design that this study will conduct will be a qualitative survey study that will be conducted using an existing thematic analysis to see if there will be a major impact on giving incarcerated mothers prolonged time with their newborn baby during their sentence.
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Benefits of Rooming-in on Infants with Neonatal Opioid Withdrawal Syndrome
Emma Ricioli
Neonatal opioid withdrawal syndrome (NOWS) is a significant public health concern, affecting infants born to mothers who use opioids during pregnancy. Those exposed in-utero exhibit numerous signs of withdrawal after delivery including tremors, gastrointestinal distress, inconsolability, and poor feeding. Typical treatment for infants suffering from NOWS included direct admission to the neonatal intensive care unit (NICU) for close observation and pharmacological interventions. However, NICU stays can interfere with bonding and breastfeeding. They can also lead to increased lengths of stay, higher costs, and more invasive pharmacological treatments. These infants typically do not have any other concerning health issues besides NOWS and therefore should not be immediately transferred to the NICU. Rather, they should be able to room-in with their parents. Rooming-in is associated with improved neonatal outcomes, shorter length of stay, and a decrease in cost. The literature review identified limited data regarding the effectiveness of non-separation techniques when implemented in small hospitals with fewer resources. A research proposal will be discussed as well that focuses on implementing rooming-in techniques in rural hospitals located in Northern California. Infants with NOWS born at these hospitals between August 2023-December 2024 will be admitted directly to the NICU. Infants born between January 2025-May 2026 will room-in with their parents. The will be a quantitative study that utilizes a retrospective cohort design. Descriptive statistics will be used to determine if implementing non-separation techniques improves outcomes for infants suffering from neonatal opioid withdrawal syndrome.
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Caffeine Usage and Effects on Quality of Life, Clinical Performance, and Safety Among Nurses
Alexander Carl Yanga
Background: The purpose of this investigation is to examine the effects of caffeine consumption on the nurse’s quality of life. It also will explore the relationship between caffeine consumption, nurses' clinical performance, and patient safety. Nurses often endure long hours with demanding tasks to ensure client health and safety. Long work shifts and low margins for error can be taxing, which could result in fatigue, poorer sleep, and increased risk for mistakes. Caffeine is an accepted and effective option for combating fatigue and boosting alertness short term. Questions arise about whether caffeine is beneficial or if consumption causes a decrease in the nurse’s clinical performance and safety over time.
Literature Review: A literature review was conducted to explore relationships between caffeine consumption, sleep, alertness, and education about caffeine usage. Primary articles, related to caffeine, nursing, sleep, fatigue, and alertness, were found using university databases. Overall patterns were found, including: a need for further education on high-energy drink usage; higher perceived stress and sleep disturbances with caffeine usage; and lower alertness levels with changes in sleep quality.
Proposed Study: The proposed study is a quantitative, comparative approach that will use an online self-reported survey to collect data. The targeted population includes working registered nurses. The sample involves 100 critical care nurses within Northern California’s Bay Area hospitals. There will be questions, using a numeric scale, about their background, demographics, caffeine consumption habits, sleep habits, perception of clinical performance, perception of work fatigue and stress, and perception of clinical safety. Descriptive and comparative statistics will be used to examine connections between caffeine consumption and perceptions of sleep, stress, fatigue, clinical performance, and patient safety.
Clinical Significance: Results of this investigation may have potential for increasing knowledge about relationships between nurses' quality of life, caffeine use, clinical performance and patient safety.
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Early Diagnosis of Celiac Disease in Pediatric Patients
Nicole Gertsberg
Celiac disease affects about 1% of the population; however, the indistinct symptoms make it difficult to diagnose. Children are vulnerable populations who are able to experience this disease, but go severely undiagnosed. As a result, when this population matures, additional health issues arise such as other autoimmune diseases. Different studies were done regarding diet modifications, gaps in research, and treatment options for Celiac disease. This is the reason to investigate whether early diagnosis in childhood will achieve better health outcomes through diet modifications. A cohort study will be performed on Celiac disease patients, ages 5 to 15 years old at outpatient clinics at UCSF. This study will compare two groups: diet modifications starting at 5 years old to diagnose Celiac disease and diet modifications at 15 years old to diagnose Celiac disease. The groups will be examined for health outcomes related to Celiac disease 10 years from the start of the study to see if earlier diagnosis made a significant difference. The data will be collected through patient reports of symptoms and medical office visits. The results, 10 years from now, should show no extra health issues. In conclusion, the clinical implications of this study should show that early diagnosis in pediatric patients correlates with the decreased number of medical problems as they grow up. Due to this research, more extensive medical doctor visits can determine Celiac disease much earlier as a prevention method to Irritable bowel syndrome symptoms.
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Education in the Emergency Department for Cardiac Conditions
Shelby Thomason
In the United States 610,000 people die every year from coronary artery disease which equates to 1 in 4 deaths. Inequity in access to healthcare is a persistent issue that impact patient outcomes. Tracking adherence and patient outcomes can be challenging, especially for patients who may not have access to necessary resources or support. Nurses are often overworked and have limited time to provide in-depth education. Patients and their families often struggle to afford caregivers or other resources that can help manage these chronic cardiac conditions.
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Effectiveness of Music Therapy in Postoperative Children with Developmental Disabilities
Isabel Arellano
Administration of opioids is the preferred practice to treat postoperative pain in a hospital setting. However, there are disadvantages to this method (Benyamin et al., 2008). Postoperative children with developmental disabilities are difficult to assess and manage pain. A patient analgesic pump (PCA) pump administers low dose opioid to the patient during pain episodes. However, many children with developmental disabilities are unable to adequately verbalize their pain and/or understand the purpose of a PCA. To help with this problem they are given a parent/nurse controlled analgesia (PNCA) pump (Czarnecki et al., 2018). However, due to the unknown safety range and efficacy of the PNCA it may cause potential adverse effects. The purpose of this research proposal is to explore if music therapy can be used as an additive pain management treatment for postoperative pain in children with developmental disabilities. This proposal will consist of a quasi-experimental design with two convenient sample groups (experimental and control). Both groups will be given a pre and post test to measure their Faces, Legs, Activity, Cry, and Consolability (FLACC) scores. The experimental group will receive the therapy intervention. Descriptive statistics will be used to compare the means of the two samples from the pre- and post-tests. Inferential statistics will be used to determine the p-value and if the results are statistically significant. If p-value is less than 0.05 then I can reject the null hypothesis, proving music therapy decreases postoperative pain levels in children with disabilities.
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Effects of Nurse-Patient Relationship on Medication Adherence of Mental Health Patients
April Monica Magbual
Medication adherence among mentally ill patients (MIP) is a significant issue in healthcare which require extra support & guidance to encourage better recovery. Administering medication is a critical role of nurses that must be performed effectively and appropriately. Employing a nurse-patient relationship (NPR) and nursing presence has been shown to create a positive outcome and an essential characteristic to improve medication adherence. However, there is insufficient research exploring NPR and medication adherence specifically for MIPs. Participants’ cultural variations, age range, specific interventions & economic factors influencing medication compliance are missing.
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Family-Based Interventions Impact on Pediatric Obesity
Renee Camins
Background: Obesity rates among children in the United States have been on the rise, with 19.7% of children aged 2-19 classified as obese (CDC, 2022). Low socioeconomic status is a risk factor for pediatric obesity,Children from low-income households are more likely to be overweight or obese than their peers from higher economic backgrounds. Obesity can lead to serious and chronic health problems such as diabetes, high blood pressure, and breathing difficulties, and is also a risk factor for leading causes of death in adults including stroke, cardiovascular disease, and cancer (CDC, 2022). Educational interventions and access to exercise resources may offer promising solutions for addressing pediatric obesity and improving health outcomes. Objective: The object of the proposal is to conduct research on obesity trends and educational interventions to combat obesity. The research proposal will then investigate the effectiveness of a specific evidence-based educational intervention and resources provided to families in reducing obesity rates. The proposal intends to determine whether these interventions and resources can contribute to a decline in obesity rates. Method: The proposal will consist of a quasi experimental design. The convenience sample will consist of low-income families with children 4-11 years of age that have a BMI greater than 30. Sample size will include 150 children recruited through pediatric doctors offices in Marin County. The participants will be given a pre test questionnaire, and a post test after the intervention.
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Fatherhood and the Influence of Spouses Postpartum Depression on Relationship Satisfaction
Emma Salinas
Postpartum depression and the effects it has on women have long been well studied and documented, however, little research has been done on how this illness affects these women’s partners. Considering the significant amount of research conducted on postpartum depression (PPD) from the perspective of women and the increasing trend towards family-oriented approaches, it is vital to further undertake studies concentrating on the male perspective of coping with a partner who has PPD. This in turn opens a new and important area of research for the clinical psychology community. This research proposal aims to focus on fathers’ coping styles when living with a partner suffering from postpartum depression as well as how it may influence/alter relationship satisfaction. This research proposal would include a mixed-method research design using both semi-structured, face-to-face interviews conducted individually and surveys. The sample size would include 20 couples, 10 fathers, and 10 mothers currently experiencing postpartum depression. Couples would be voluntarily recruited through a flier at their pediatricians’ offices. Inclusion criteria would include all participants being over the age of 18, having a partner with clinically diagnosed postpartum depression, living together with said partner, and being at least 2 months postpartum. The results from this study have not yet been collected but are presumed to reveal multiple themes describing the fathers’ journey through their partners’ postpartum depression. These findings would not only highlight a need for pre-emptive education on maternal PPD and more accessible resources but also assessing fathers’ emotional responses to parenthood and their partners’ depression.
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How Implicit Bias Leads to Racial Disparities in Maternal Care and Experiences
Mia Yee
Background: Maternal mortality rates have decreased all over the world. However, in the United States, the maternal mortality rate has been steadily increasing. Women of color reportedly are forced to accept the burden of an unequal association between race and morbidity & mortality due to implicit discriminatory attitudes of healthcare professionals. Objective: To better understand the relationship between implicit bias and maternal care in the San Francisco Bay Area between non-Hispanic White & Black women and to explore racial disparities in their maternal narratives. A literature review was performed and a study is proposed. Future Directions: To Identify the differences in maternal care among women of color so that possible interventions can be researched and implemented to improve patient-centered maternal care to all women and to reduce discriminatory practice in the San Francisco Bay Area.
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Improving the Psychosocial Effects of a Burn Injury
Leila Young
Burn injuries are an existing risk factor of social impairment. The main priority of care for a burn patient includes the focus on pain management and wound care. However, scarce research has been studied on how to improve the psychological adjustment of burn victims. There is limited availability of evidenced based practice that is related to promoting a healthy social life after a burn. Without interventions to help re-engage burn victims with society, they will turn to negative coping mechanisms such as avoidance, isolation and distancing. The goal of this study is to enhance the social interaction of burn survivors during their recovery. This mixed method study aims to improve social impairment of burn victims in the Bay Area with the use of journaling. A pre and post test will be given, using the tool PROMIS-29, to acknowledge the psychological state of the burn victims before and after the journaling intervention. The sample size will include 100 participants that have been recruited through burn centers, burn units, in-patient hospitals and support groups. Participants will write journal entries each day for six weeks. The journal entries will be examined for similar themes and the results of this study will demonstrate the psychological wellbeing of the participants. In evaluation, the post test and journal entries will show the impact of the intervention of psychosocial ramifications. The literature suggests that there is no reason to focus on the psychological dynamic of burn victims. This study will identify interventions that progress the development of psychological dynamics and ability to interact in society of burn victims in the Bay Area. This study will provide evidenced based practice that can be used to further the research of burn survivors.
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Kangaroo Care Education for Low Socioeconomic Status Families in The Neonatal Care Unit
Joara Peterson
The early contact between mother and baby is known as skin-to-skin, also referred to as “kangaroo care” (KC). It involves placing the baby on the mother’s chest as soon as it is appropriate (Thompson, 1979). This interaction was primarily for bonding but many researchers have discovered additional benefits. There is significant correlation between kangaroo care and weight gain (especially for low birth weight infants), as well as body temperature and heart rate regulation, which reduces the risk of medical complications. It also decreases levels of stress in mothers and babies by lowering the release of cortisol hormone (Mohammadi et al. 2021). The purpose of this study is to investigate the disparities in access and utilization of KC for newborns. The study will also assess the impact of these disparities on maternal and infant outcomes such as weight gain, temperature regulation, neurocognitive enhancement, particularly among families of low-socioeconomic status. A literature review investigated research on topics such as benefits of kangaroo care, challenges and disparities for implementation of kangaroo care for families with low socioeconomic status, and prenatal teaching as an intervention. Pregnant women will be randomly assigned to either the control or experimental group receiving the intervention. We will use descriptive statistics to compare the means of the two groups of women. The inferential statistics will be used to determine the p-value and predict statistical significance . If the p-value is lower than 0.05 there will be a higher probability that the results are statistically significant and not by random chance that prenatal education will increase kangaroo care as an intervention, therefore we can reject the null hypothesis.
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Maternal Postnatal Depressive Symptoms and Its Effects on Infant Bonding
Tammy Nguyen
The objective of this thesis is to gain insight on precipitating factors that increase postpartum mother’s depressive symptoms, including stress and anxiety, and how attachment is influenced. Maternal-infant bonding is defined as the emotional relationship and interaction between mother and infant. Postnatal depressive symptoms typically are under-diagnosed due to a lack of education and the stigma of believing that the effects are “normal” consequences of motherhood. Those affected may not seek professional help. Unrealistic expectations about bonding with their infants can have a negative mental health impact on mothers and influence infants’ behaviors. High expectations of needing to be a perfect mother or not meeting certain goals for their child’s care can make mothers feel unaccomplished, increase stress and frustration, lead to parental burnout, and in severe cases, resentment towards their infant. Many factors impact maternal experiences in the postpartum phase, including economic stressors and marital differences, but most importantly infant behaviors. Mothers who struggle to meet their infant’s needs, such as feeding, diaper changes, or sleeping arrangements may encounter negative infant reactivity emotions, which only deepens their depression.
To investigate, primary research articles about mother-infant attachment and bonding and causes of ineffective attachment were examined. A plan for future study will include the Maternal Role Attainment Theory by Ramona Mercer. The study will use a prospective longitudinal mixed methods design. Two hundred pregnant women will be followed until one-year postpartum. Quantitative data collection will include surveys asking about mother’s anxiety on a rating scale. Qualitative data will be gathered on infants’ emotional reactivity when stressed and interventions used by mothers to console them. This research may offer insights that aids nurses in providing effective care for mothers with postpartum depression and their newborns.
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Polypharmacy: Increasing Medication Adherence
James Cyril Kelly
Polypharmacy is a common problem among older adults where they take multiple medications concurrently, leading to negative health outcomes such as adverse drug reactions, drug-drug interactions, and non-adherence to medications. To address this issue, a randomized controlled trial (RCT) is proposed that will involve elderly patients (aged 65 years or older) who are taking five or more medications. Participants will be randomly assigned to either the intervention or control group, with the intervention group receiving nurse-led medication therapy management (MTM) and patient education to improve medication adherence. The Health Belief Model can be used to educate and empower older adults on the risks associated with polypharmacy and help them make informed decisions about their medication regimen. The proposed RCT has the potential to improve medication adherence and reduce negative health outcomes associated with polypharmacy, ultimately improving the overall health and well-being of the older adult population.
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Prevalence of Hypoglycemia Induced by Overtreatment in Elderly Type Two Diabetics Using Continuous Blood Glucose Monitors
Alyssa Mae T. Tubera
Background: The most common way of reading blood glucose (BG) levels in type II diabetics is by manually pricking one’s finger with a needle and measuring the glucose through a monitoring device. There has been an increased use in continuous glucose monitoring (CGM) that permits clients to wear a sensor on their arm that simultaneously records glucose levels throughout the day and reports the results to a smartphone or monitoring device. Depending on the result and whether the patient is using insulin, it will determine how much medication will be administered. There is little research on the impacts of using CGM devices in conjunction with antihyperglycemic drugs in type II diabetics who live independently and are over age 65.
Objective: To examine devices that monitor BG continuously compared to devices that monitor BG with periodic finger sticks. The question arises: Are elderly patients with type II Diabetes who live independently and use these devices, disproportionately affected by hypoglycemic episodes induced by over-treatment with anti-diabetic drugs?
Literature Review: Research highlighted benefits of using CGM devices versus self-monitoring BG such as recording glucose levels at night, increased self-care behavior, and decreased hemoglobin A1C. Other factors may contribute to hypoglycemia such as physical exercise, prolonged fasting, and use of ACE inhibitors. There remains a knowledge gap in the impact that CGM devices have on independent type II diabetics who live independently.
Proposal:
Purpose: To gather data on prevalence of hypoglycemia in independent, type II diabetics ≥65 years old while using CGM devices and antidiabetic medications
Population: type II diabetics ≥65 years who live independently, use CGM devices, and antihyperglycemic medications
Study Design: Prospective Longitudinal observational study
Study Method: Survey
Clinical Significance:
Study intends to bring awareness of possible complications of using CGM devices in type II diabetics ≥65 who live independently.
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Sexual Education In Adolescence: Contraception Education For Adolescents Leads To Improved Sexual Practices
Marie Poellinger and Erica Jade Fong
Adolescents of low socioeconomic status from 13-18 years of age face many challenges when it comes to maintaining safe sexual health practices, leading to unwanted pregnancies and exposure to sexually transmitted diseases (STI’s). Challenges include:
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economic barriers → limited access to health care or lack of health insurance
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lack of proper sex education and therefore limited knowledge around contraceptive
Addressing these challenges is crucial for better sexual health outcomes. The nurse’s role is essential in providing education about contraceptive options, access to local resources, and guidance pertaining to safe sexual health practices (Dixon, 2014)
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Supportive Interventions for Adults with Needle Phobia
Camille Alyssa Bustos
The focus on addressing needle phobia has primarily been limited to psychology clinics, leaving a gap in support for those receiving injections from health care professionals in the hospital or clinic setting. It is important for health care providers and mental health professionals to work together to address this gap and ensure that individuals with needle phobia have access to the care and treatment they need (Centers for Disease Control and Prevention [CDC], 2022).
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The Effect of Delivery Method on Breastfeeding Initiation and Duration
Mariana Carina Benitez
There is a plethora of research focusing on the physical effects of each delivery method on a mother’s ability to initiate and sustain breastfeeding, however, there may be more psychosocial factors that influence a mothers decision to start and continue breastfeeding once they deliver. It is very common to be educated about breastfeeding after the baby has already been delivered, but it is often missed that education before may improve breastfeeding rates and increase mothers' breastfeeding self-efficacy rates. The primary purpose of this project is to evaluate the effectiveness of breastfeeding support groups that provide information, guidance, and social support from other breastfeeding mothers prenatally and postpartum. The goal of this is study is to examine how support groups address psychosocial factors that influence a mothers decision to initiate and continue breastfeeding, such as self-efficacy. A single group, pretest/posttest design will be utilized for the study. Participants will include nulliparous pregnant women over the age of 18 from an outpatient obstetrics clinic in San Rafael. They will attend a support group led by other breastfeeding mothers twice, at 35 weeks and 37 weeks. The participants will complete a demographic survey before going into the support group as well as the Prenatal Breast-feeding Self-efficacy Scale. Two weeks after delivery, the mother will complete the Breastfeeding Self-Efficacy Scale Short-Form to evaluate their feelings toward breastfeeding postpartum. Statistical analysis will be completed on the tools utilized in the study. The results of this study will demonstrate that attending the support groups will have a positive effect on the self-efficacy of mothers while breastfeeding. Therefore, pregnant women will benefit from support groups led by other breastfeeding mothers as it will increase their individual self-efficacy.
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The Effects of Breastfeeding Education on Working Moms of Low Socioeconomic Status
Grace Ngo and Suzanne Manseau
Breastfeeding plays an important role in promoting immunity due to the high concentration of antibodies (Tangsuksan et al., 2020). Immunity is important for the infant the first year of their lives. Women of low socioeconomic status (LSES) are less likely to breastfeed due to a lack of resources (Kebede & Seifu, 2021). In addition LSES women living in Marin often lack the proper resources and education for breastfeeding (Heck et al., 2006). The purpose of this thesis proposal is to investigate if educating pregnant women of low socioeconomic status will increase breastfeeding rates.
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The Effects of Exercise on the Body’s Tolerance to Breast Cancer Treatments
Lindsay C. Lim
Background: Breast cancer is known as one of the most common types of cancer. Treatments for this cancer include chemotherapy, radiation therapy, and surgery. These treatments, however, can cause negative side effects such as extra pain and fatigue. Exercise is a common intervention that is used in order to keep the body strong while these treatments are occurring.
Objective: The objective of this thesis is to find a correlation between exercise and how it can decrease negative side effects in patients with breast cancer. This thesis includes a literature review which talks about what types of exercise are best, if a structured program is better, and if there is a positive correlation with a decrease in fatigue.
Methods: This study will be a longitudinal mixed method design utilizing surveys and observations. 90 participants who are either going through chemotherapy, radiation therapy, or surgery will be taken from an oncology infusion center and an operating room. Participants will be randomly placed into two groups, group A who will be going through treatment normally and group B who will be participating in a 6 month weekly exercise program. The participants will then be asked to answer the brief pain inventory to assess their pain and the revised piper fatigue scale to assess their fatigue. Participants will complete the survey again in 6 months to evaluate the continued outcome of the exercise.
Results: Results have not yet been collected but exercise is expected to help decrease symptoms of pain and fatigue in breast cancer patients. Group B will state that they are experiencing less symptoms and more relief.
Conclusion: The literature and previous studies have shown that exercise does help to decrease negative symptoms. This project is hoping to prove that exercise will help to relieve symptoms of fatigue and pain in breast cancer patients.
A collection of research posters authored by students from the Department of Nursing at Dominican University of California.
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