Date of Award
11-15-2023
Document Type
Dissertation
Degree Name
Doctor of Nursing Practice (DNP)
Department
Nursing
First Advisor
Kristina Thomas Dreifuerst
Abstract
ABSTRACT APPLICATION OF THE SOCIAL DETERMINANTS OF HEALTH TO GERIATRIC PATIENTS BY NURSE PRACTITIONER STUDENTS Patient outcomes are influenced by the social determinants of health (SDOH), which influence differing exposures to opportunities or health risks. Holistic care of geriatric patients includes considering SDOH in patient assessment, diagnosis, and care delivery. Understanding how NP students care for geriatric patients using a SDOH lens provides insight into their practice behaviors and helps educators understand how to strengthen NP programs to achieve better patient outcomes and advance health equity for the geriatric population. The purpose of this study was to describe how NP students conceptualize SDOH for geriatric patients, explore NP student comfort in asking about patient SDOH as part of their assessment, and to describe how NP students apply their knowledge of SDOH to their assessment and plan of care for geriatric patients. This study utilized a multi-method descriptive approach with both qualitative and quantitative methods within three separate study arms. Participants included family nurse practitioners (FNP) and adult gerontology primary care nurse practitioners (AGPCNP) in their last clinical practicum who took care of geriatric patients in an outpatient setting. Qualitative and quantitative data was collected from study participants in the form of survey responses, debriefing sessions, and care management plans. The findings of this study revealed that NP students could identify SDOH associated with geriatric patients. They were most comfortable asking about, and most frequently identified, considered, and incorporated SDOH of social support, transportation, and access to care into the plan of care of geriatric patients. NP students were least comfortable asking about, and least frequently identified, considered, and incorporated SDOH of discrimination, civic participation, and crime and violence into the plan of care of geriatric patients. Identification and interventions by NP students were limited to the most common SDOH. This study contributes to the understanding of the transfer of knowledge about SDOH to the clinical practice of NP students when caring for geriatric patients. This study informs nurse educators on how to strengthen NP programs to teach SDOH and practical SDOH mitigation interventions in the plan of care for geriatric patients.