Digital Commons Network^™

Diabetes Self-Management Education For Adults With Type 2 Diabetes Mellitus, Rondalyn Dennis-Bradshaw

Walden Dissertations and Doctoral Studies

Diabetes, a major public health challenge in St. Kitts, has been a focus of international public health community research. Although researchers have demonstrated that diabetes self-management education is a cost-effective strategy for the prevention of diabetes-related complications, they have yet to establish whether there is adequate education occurring in treatment settings with diabetic patients. The purpose of the study was to implement and evaluate the short-term effectiveness of a diabetes self-management education intervention on diabetes-related knowledge and accepted behavioral changes to decrease risk for complications. Based on a self-care approach, this education intervention was designed to improve diabetes-related knowledge and …

Crash Risk Associated With Cellular Phone Use While Driving, Tiffani Ann Fordyce

Walden Dissertations and Doctoral Studies

There are inconsistencies in the published literature on the effect of cellular phone use while driving. The objective of this study was to estimate an adjusted nationwide crash rate associated with cell phone use while driving and to compare statewide crash rates prior to and following the implementation of legislation banning cell phone use while driving. Crash rates in nationally representative databases were calculated based on imputed values for cell phone use using the propensity score method. The imputed nationwide crash rate for fatal crashes (1.61 per 100 fatal crashes) and all crashes (1.409 per 100 crashes) represented a 2 …

Internal Attributes That Mitigate Perceived Job Insecurity: Improving Employee Satisfaction, Shelly Leigh Rogers-Sharer

Walden Dissertations and Doctoral Studies

Employee satisfaction has been found to have a strong relationship with perceived job security. This study explored job insecurity in an unstable global economy. Specifically, it examined internal attributes of employees, hypothesizing that such attributes would enable employees to better cope with work-related stressors such as job insecurity. Specific attributes of personality and employability were assessed as potential moderators of job satisfaction and security, utilizing the theory of work adjustment and person-environment correspondence as theoretical frameworks. The specific attributes included facets of conscientiousness and neuroticism as well as dispositions of employability including openness to change at work, work and career …

Fukushima Nuclear Disaster Response Impact On Graduate Students, Sean Eric Kil Patrick Gay

Walden Dissertations and Doctoral Studies

The roles that universities played in the response to the Fukushima nuclear disaster were significant and varied; however, there was limited study on participating graduate students. The purpose of this study was to understand the impact of disaster response on graduate students' personal and academic development. This study examined research questions about the perceived impact on academic and personal identity development. Empowerment, cognitive content engagement, general systems theory, and utilitarianism formed the theoretical foundation. This study used a transcendental phenomenological approach to examine the subjects' experiences in the context of involvement in disaster response. The primary source of data was …

Understanding Health Literacy Skills Of Patients With Cardiovascular Disease And Diabetes, Patrick J. Dunn

Walden Dissertations and Doctoral Studies

Health literacy is the ability to understand and act on health information and is linked to health outcomes. It is unclear how health literacy skills are developed in patients with complex conditions, such as cardiovascular disease and diabetes. The purpose of this grounded theory study was to gain perspectives of both patients and healthcare professionals on how health literacy skills were developed in patients with cardiovascular disease or diabetes. The research questions addressed how knowledge and skills were acquired, the role of digital tools, instructional strategies used by healthcare professionals, and how the instructional strategies of the healthcare professionals matched …

Evaluation Of Empowerment Levels Of The Cleveland Clinic Nurse, Cynthia J. Willis

Walden Dissertations and Doctoral Studies

Nurses' perceptions of their work environment and empowerment in relationship to patient satisfaction are well explored in the literature. Empowerment has been linked to improved job satisfaction and improving the elements of empowerment cam improve overall patient satisfaction. This project examined 2 nursing units, 1 with lower patient satisfaction scores (Unit A) and 1 with higher patient satisfaction scores (Unit B), in order to compare their structural empowerment scores as measured by the Conditions of Work Effectiveness Questionnaire II (CWEQ-II). A total of 29 nurses who worked full-time, part-time, or per diem on 1 of the 2 units were recruited …

Evaluation Of Post-Deployment Ptsd Screening Of Marines Returning From A Combat Deployment, Erika L. Hall

Walden Dissertations and Doctoral Studies

The purpose of this quantitative study was to examine whether the post-deployment screening instrument currently utilized to assess active-duty Marines for symptoms of PTSD upon their return from a combat deployment can be solely relied upon to accurately assess for PTSD. Additionally, this study sought to compare the number of Marines who have sought trauma-related mental health treatment based on their answers on the Post-Deployment Health Assessment (PDHA) to the number who have sought trauma-related mental health treatment based on their answers on their PTSD Checklist - Military Version (PCL-M). The participants in this study were comprised of a sample …

Evaluation Of The System Attributes Of Timeliness And Completeness Of The West Virginia Electronic Disease Surveillance System' Nationaledss Based System, Rebecca Lee Fahey

Walden Dissertations and Doctoral Studies

Despite technological advances in public health informatics, the evaluation of infectious

disease surveillance systems data remains incomplete. In this study, a thorough

evaluation was performed of the West Virginia Electronic Disease Surveillance System

(WVEDSS, 2007-2010) and the West Virginia Electronic Disease Surveillance System NationalEDSS -Based System (WVEDSS-NBS; March 2012 - March 2014) for Category II infectious diseases in West Virginia. The purpose was to identify key areas in the surveillance system process from disease diagnosis to disease prevention that need improvement. Grounded in the diffusion of innovation theory, a quasi-experimental, interrupted, time-series design was used to evaluate the 2 data …

Assessing The Impact Of Major Health Policies On Provider Practice, Nadine Josephs

Walden Dissertations and Doctoral Studies

Many health care stakeholders have expressed concerns with the distribution and availability of primary care physicians (PCP) across the United States. Despite programs such as Healthy People 2010 and 2020 Initiatives, statewide and local health care expansion efforts and policies; access to PCP remains a challenge for health care consumers. The purpose of this mixed method research study was to evaluate the impact of several health care access policies on the practices of primary care providers and assess their perspectives regarding disparities in access. Patton and Sawicki's policy analysis and evaluation process was the framework used in this study as …

Spheres Of Influence: Understanding African American Males' Perceptions And Attitudes Toward Infant Feeding Practices, Makeva M. Rhoden

Walden Dissertations and Doctoral Studies

Although U.S. breastfeeding rates have steadily increased since 2000, there continues to be a disparity in breastfeeding rates for African American (AA) women compared to their non-Hispanic White counterparts. A male partner's perception, specifically his positive attitude toward breastfeeding, may influence breastfeeding initiation and duration rates. This study was an exploration of AA male perceptions and attitudes toward breastfeeding and what effect masculinity ideology (gender norms) has on such attitudes. The socio-ecological model (SEM) was used as the theoretical framework to examine the various environmental levels that intersect with one another to influence these attitudes. A mixed methods study design, …

Screening For Peripheral Artery Disease, Cheryl Gordon

Walden Dissertations and Doctoral Studies

Peripheral artery disease (PAD) affects 8 to 10 million Americans, and the incidence of PAD is expected to increase as the population ages. A high percentage of the PAD is undiagnosed prior to the onset of a serious cardiovascular event; therefore, the inability to screen and diagnose for PAD in the early stages could hinder efforts to decrease adverse consequences of cardiovascular disease. Individuals with PAD have a 3 to 5 times increased risk of cardiovascular disease (CVD) mortality when compared to people without PAD. Guided by the Stetler model, the purpose of this project was to evaluate the relationship …

The Use Of Mock Code Training In Improving Resuscitation Response, Maureen Anne O'Brien

Walden Dissertations and Doctoral Studies

The American Heart Association's Get With the Guidelines (GWTG) has established measures for how quickly a resuscitation team is to respond in a cardiac arrest with performance of cardiopulmonary resuscitation (CPR) and defibrillation. Two of the core measures for GWTG require initiation of CPR within 1 minute of cardiac arrest and defibrillation within 2 minutes in at least 85% of cases. The problem of interest in this Doctor of Nursing Practice (DNP) project was that the facility had not been able to reach 85% on these 2 measures. The purpose of this project was to achieve nursing response times for …

Physicians' Perceptions And Practice Regarding The Prevention Of Catheter-Associated Urinary Tract Infections In The Icu, Marilyn Keng-Nasang Mbi Feh

Walden Dissertations and Doctoral Studies

Catheter associated urinary tract infection (CAUTI) incidence continue to rise despite all prevention efforts. The state of Georgia incidence of CAUTI between 2012 and 2013 showed an increase by 350 cases. The challenge is translating CAUTI prevention knowledge into practice by all physicians. The purpose of this correlational study was to improve the epidemiological understanding of CAUTI. Looking at physicians’ perception and practice of CAUTI preventions was necessary. A total of 336 physicians from the state of Georgia completed a 26-item survey. Additionally, a pilot study was conducted on a small sample of participants. The result of the Cronbach alpha …

Can Nurse-Facilitated Support Groups Foster Self-Awareness?, Althea Lenore Phillips

Walden Dissertations and Doctoral Studies

Students with learning disabilities (LDs) represent 9% of students attending college, and college administrators must comply with a large number of federal requirements outlining the provision of educational services for students with LDs, including offering support groups. Nurse-facilitated support groups, held within the university setting, could provide effective social support, increasing likelihood of college success among students with LDs. The purpose of this project was to develop a plan for implementing nurse-facilitated support groups for students with LDs within the student health services (SHS) department at a university designed to improve their coping skills on personal, social, and academic levels. …

Predictors Of Condom Use Among Middle-Income, African American Women, Yvonne Maire Reed

Walden Dissertations and Doctoral Studies

Abstract

The human immunodeficiency virus (HIV) and acquired immune deficiency syndrome

(AIDS) continue to be a major public health threat, not only within the United States but

also on a global scale. Within the U.S. heterosexual population, African Americans

(AAs) continue to bear the greatest burden of new HIV infections. Additionally,

HIV/AIDS interventions have focused on low-income AA women, virtually ignoring

their middle-class counterparts who may be subject to the same sexual risks. The purpose of this quantitative, cross-sectional study was to determine whether if there was an association between the 5 constructs of the Health Belief Model (HBM) and …

Obesity And Workplace Injury In Hazardous Occupations Among The Hispanic/Latino Population, Barbara Klyde

Walden Dissertations and Doctoral Studies

Over the past 20 years, adult obesity has increased in the United States, especially among the Hispanic/Latino population. In 2010, the Occupational Safety and Health Administration Environmental and Safety News, reported that younger workers, ages 18 to19 years of age, worked in the most high-risk occupations such as agriculture, construction, fishing, and manufacturing. The reported fatality rates for these occupations were 5.6 times greater for Hispanic workers compared to other race/ethnicity groups reported by the Bureau of Labor Statistics in 2013. This study determined whether obesity contributed to workplace injury or mortality in hazardous occupations, using federal, state, and independent …

Genome-Wide Association Study On The Sleep Symptom Of Post Traumatic Stress Disorder, Tammy Pooler

Walden Dissertations and Doctoral Studies

Posttraumatic stress disorder (PTSD) is a psychiatric condition that presents with 3 main symptoms're-experiencing, avoidance/numbing, and hyper arousal'after an individual experiences a traumatic event. Recent evidence suggests a potential genetic basis for PTSD and a sub symptom of hyper arousal, sleep, as a potential pathway for PTSD development, but no study has identified candidate genes associated with specific symptoms such as sleep difficulty. Based on a conceptual framework in which specific genes are associated with the onset of PTSD, this study used a genome-wide association

study (GWAS) method with a case control study design to compare the genomes of individuals …

Factors Relating To Underrepresentation Of Black American Women In Health Care Administration, Alquietta Lavayle Brown

Walden Dissertations and Doctoral Studies

There is a low representation of Black American women (BAW) in health care senior leadership. With the high level of health problems found among the Black community, diversifying the executive leadership with BAW may be instrumental in increasing provider trust and reducing discriminatory action. Using critical race theory as the conceptual framework, this study examined the experiences, perceptions, and influential or deterrent factors inhibiting advancement of BAW in the health care field. Inquiry centered on factors related to lack of advancement, experiences at different stages of career progression, and strategies impacting career advancement. A qualitative research design using a transcendental …

Interpersonal Safety Of Active Duty Women In The Deployed Environment Of Bagram Afghanistan, Cynthia Tara Ferguson

Walden Dissertations and Doctoral Studies

In the United States Armed Forces, 30% of women in the military suffer physical assault each year; in 2009, there were 22 reported cases of sexual assault in the U.S. Central Command. Aggravated assault, gang violence, sexual assault, homicide, and suicide can damage the morale of military personnel at a deployed site and collectively cost millions of dollars over time. Interpersonal violence in the United States military is destructive to the military system and directly diminishes mission readiness. This study was designed to illuminate the environmental, cultural, and political influences that affect interpersonal safety among military women in the deployed …

Glioblastoma Multiforme: Geographic Variations In Tumor Size, Treatment Options, And Survival Rate, Susan Rebecca Nohelty

Walden Dissertations and Doctoral Studies

Glioblastoma multiforme (GBM) is a destructive brain cancer that results in death 12 to 15 months after diagnosis. The purpose of this retrospective study was to determine if variations in tumor size at diagnosis, treatment options, and survival rate occur in GBM patients living in urban and rural areas of the United States. Using the behavior model of health services as the theoretical framework, this study used secondary data sets of GBM cases reported from 1988 to 2011 from the Surveillance, Epidemiology, and End Results program. Tumor size was measured in millimeters; treatment was evaluated by ascertaining the number of …

Temporality Of Risk Factors And The Gender Differential Related To Autism Spectrum Disorder Diagnosis, Donna L. Sullivan

Walden Dissertations and Doctoral Studies

Autism spectrum disorders (ASD) constitute life-long neurodevelopmental conditions. Globally, ASD risk for males remains 2 to 4 times greater than for females. Critical exposure mechanisms, their timing on ASD risk, and associations with the ASD gender differential remain elusive. The purpose of this study was to describe the relationship between preconception, pregnancy, recalled lactation practice, and infant traits, on ASD risk and the gender differential of ASD. A recently published temporal framework was adapted to study effects of maternal smoking and vitamin use, and recalled lactation practice on offspring ASD diagnosis with adjustment for preconception health and infant breathing traits. …

Perceived Factors Contributing To Coronary Heart Disease In African American Women, Funmilola O. Sholanke

Walden Dissertations and Doctoral Studies

African American women (AAW) suffer from disproportionately high death rates due to coronary heart disease (CHD) compared to Caucasian women. Although there have been a number of studies targeting African American adults with CHD in clinical interventions, very few studies have addressed the social determinants of health and the influence of AAW's perceptions of health factors on health outcomes. The purpose of this phenomenological study was to fill the gap in the existing knowledge base by examining the lived experiences of 10 AAW diagnosed with CHD with a focus on the perceptions of environmental, socioeconomic, and cultural factors related to …

How Spiritual Values Correlate With Hospice Use For African Americans, Latrina Dion Frazier

Walden Dissertations and Doctoral Studies

End of life hospice services have consistently been underused by African Americans. This disproportionate use of hospice has contributed to poor quality of life and a lack of cost-effective care for patients with terminal illness. Driven by the theory of reasoned action, the purpose of this quantitative study was to test associations between African Americans' perceptions of hospice, decisions to use hospice, and religiosity. A convenience sample of 154 African American adults was surveyed online. The survey instrument combined the AARP End of Life survey, Perception of Hospice survey, and the Religiousness Measure survey. The results of a multiple linear …

The Effect Of Evaluating A Quality Improvement Initiative On Reducing Hospital Transfers Of Nursing Home Residents, Denise Eileen Jarboe

Walden Dissertations and Doctoral Studies

The Effect of a Quality Improvement Initiative on Reducing Hospital Transfers of Nursing Home Residents

by

Denise Eileen Jarboe

MSN, Walden University, 2010

BS, University of Maryland, 1981

Project Study Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

February 2015

Nursing homes (NH) in the 21st century provide skilled healthcare services for resident populations who are older, frailer, and often suffering from multiple incurable chronic medical conditions. Nurses practicing in this setting must be keen observers and effective communicators with the ability to recognize and report subtle changes in health status …

Bedside Nurses' Influence On Patients' Continuum Of Care Through Effective Discharge Teaching, Mary Ann Whicker

Walden Dissertations and Doctoral Studies

The evolution of person-centered healthcare reinforces the need for nursing to provide effective patient education. Literature suggests nurses desire to provide strong discharge education to patients, but are challenged by knowledge gaps and other barriers. This DNP project developed a plan for integrating teach-back on a 30-bed cardiac unit, focusing on heart failure patients. Following a logic model, the process improvement plan to implement teach-back includes education on teach-back, empowerment of unit champions to support the project and evaluation of effectiveness of the education plan and impact on heart failure patients. The sample size of 15 cardiac nurses provides a …

The Association Of Lead With Cataracts And Vision-Related Problems In Perimenopausal Women, Imogene Drakes

Walden Dissertations and Doctoral Studies

Around the world, women are subject to an earlier incidence of cataracts, have a higher risk for cataracts, and also have a higher risk for other vision-related problems than men. Previous research has indicated an association between endogenous lead stored in long bones and cataracts in men over 60 years of age; however, a similar study in women did not reveal an association. This case control study was conducted to investigate whether perimenopausal mobilization of endogenous lead serves as a possible causative factor for women's generalized vision issues and cataract incidence in particular. Secondary data were gathered from 1,416 women …

How Nursing Educators Address The Differing Learning Styles Of Students, Kimmie Sue Gore

Walden Dissertations and Doctoral Studies

Educational research has shown that student learning styles, and educators' consideration of learning styles, significantly influence the academic success of adult learners. This project study was designed to identify the perceptions and attitudes of nursing faculty concerning student learning styles and consideration of student learning styles in their praxis. The study was guided by Malcolm Knowles' theory of andragogy, and investigated nursing educators' knowledge about learning styles and course delivery with regards to students with different learning styles. It used a descriptive multiple case study approach and collected data among nursing educators using the Principles of Adult Learning Survey (PALS) …

Exploring The Risk Factors That Influence The Parental Dental Deferment Decision, Megan White

Walden Dissertations and Doctoral Studies

When caregivers defer their personal routine dental care (RDC) in order to provide RDC for their children, they risk detrimental consequences in their personal health and the health of their children. The purpose of this qualitative case study was to identify the risk factors that led to the parental dental deferment decision. The oral health and personal care services conceptual models guided the development of the research questions, facilitated the selection of risk factors on the decision-making process, and provided the basis for the data analysis thematic categories. Ten caregivers who made the decision to defer their personal RDC for …

Practice Guidelines For Self-Management Of Osteoarthritis Pain In The Home-Based Settings, Oyesola Omowunmi Akintan

Walden Dissertations and Doctoral Studies

Osteoarthritis (OA) is a debilitating chronic illness that can prevent older adults from accomplishing their activities of daily living or ambulate without pain. The project's purpose was to develop and disseminate multidisciplinary educational practice guidelines to nurses for use in older homebound male Veteran's Administration OA patients to improve home-based pain management and self-care preventative strategies. Orem's theory of self-care management constituted the theoretical framework. The design was a quality improvement project and involved formation of 6 panels of interdisciplinary teams who reviewed the American Society of Anesthesiologist (ASA) and Osteoarthritis Research Society International (OARSI) guidelines. The ASA and OARSI …

Nitrate In Private Wells:Knowledge, Oppinions,And Perceptions Of Stakeholders, Augustus D. Jaja

Walden Dissertations and Doctoral Studies

The purpose of this quantitative study was to examine data describing nitrate concentration and cases of congenital cardiac defects. Residents with private wells and other stakeholders need data to make informed environmental decisions about the adverse health implications of nitrate contamination of private well water. Researchers have examined the exposure of nitrate in contaminated groundwater, but they have not examined nitrate levels in unregulated water systems. This gap in the literature highlighted the need to provide nitrate data for future research and private well users. Guided by the social ecological model, a quantitative, cross-sectional, nonexperimental design was used to survey …