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Treatment Adherence Among Women Infected With Human Immunodeficiency Virus With A History Of Gender-Based Violence, Olivia Mcgregor

Walden Dissertations and Doctoral Studies

Women infected with Human Immunodeficiency Virus (HIV) are at high risk of myriad conditions, especially gender-based violence (GBV). GBV can be a hindrance to treatment adherence, which is pertinent to improving the health of people living with HIV. The purpose of this longitudinal research study was to assess the effects of GBV on treatment adherence among HIV infected women, with specific focus on when the violence occurred (recent or lifetime) and the stratifying type of GBV (sexual, physical, and psychological). The health belief model (HBM) served as a theoretical groundwork. Participants were selected from secondary data, collected by the Women’s …

Physical Activity Improves Depressive Symptoms In Older Adults, Karen Lee Fahey

Walden Dissertations and Doctoral Studies

Engaging in physical activity can help older adults to take part in community activities, maintain relationships, and initiate new friendships, thus preventing loneliness and depression. The purpose of this quality improvement (QI) project was to evaluate whether participation in physical activity improved depressive symptoms in 15 older adults at a local senior center. Pender’s health promotion model was used to determine nursing and behavioral science views on components that affect health behavior. The Exercise Benefit/Barrier Scale (EBBS) survey was evaluated before implementation of the walking program to measure the benefits of and barriers to exercise. The EBBS results showed that …

Health Literacy Among Elderly Hispanics And Medication Usage, Wilda Parker

Walden Dissertations and Doctoral Studies

Health literacy among the elderly Hispanics is a problem for 44% who read at the lowest level due to issues with recognition, cognition, or vision. The purpose of this study was to determine the extent that elderly Hispanics have problems with medication adherence due to health literacy. The social cognitive theory was the framework for this study. Inclusion criteria consisted of being 65-75 years of age, and speaking and/or reading English and/or Spanish. Questionnaires from 156 individuals were completed in Cobb County/Atlanta GA and analyzed using multiple regression to determine the relationship between health literacy and medication usage. Medication adherence …

Health Care Clinicians' Compliance With Conducting Spiritual Assessments And Providing Spiritual Care To Infertile Women, Lesa Miller

Walden Dissertations and Doctoral Studies

Infertility is a disease that can cause psychological impairments in women, and the inability to achieve motherhood brings about cultural and social stigma. Spirituality is a protective element that may provide consolation to women experiencing infertility, yet the literature has shown that few clinicians conduct spirituality assessments or provide spiritual care to patients. The objectives of this scholarly project were to conduct an assessment to determine the needs of health care clinicians in regard to spirituality and spiritual patient care and to develop an educational module based on identified knowledge deficits. Guided by the knowledge-to-action cycle, a needs assessment was …

Analyzing Interrelationships Between Food Safety Practices And Inspections Among Food Staff In Manitoba, Kirandeep Kaur Brar

Walden Dissertations and Doctoral Studies

The incidence and prevalence of food safety practices among food staff working in food establishments in Manitoba is underrepresented and has not been adequately reviewed and researched. Uncertified food staff are at higher risk of not following food safety practices that can cause contamination of food and result in foodborne illness. The purpose of this quantitative study was to determine the prevalence of food safety practices among food staff in Manitoba and to determine the relationship between food safety certification and routine health inspections. Pender's health promotion model and Bandura's social cognitive theory were used to explain the relationships and …

Effects Of An Integrated Electronic Health Record On An Academic Medical Center, Kenneth E. Koppenhaver Ii

Walden Dissertations and Doctoral Studies

The debate about healthcare reform revolves around a triple aim of improving the health of populations, improving the patient experience, and reducing the cost of care. A major tool discussed in this debate has been the adoption of electronic health record (EHR) systems to record and guide care delivery. Due to low adoption rates and limited examples of success, the problem was a lack of understanding by healthcare organizations of how the EHR fundamentally changes an organization through the interactions of people, processes, and technology over time. The purpose of this case study was to explore the people, processes, and …

Teen Dating Violence: Co-Occurrence With Bullying Among African American Teens In South Florida, Rosemarie Hemmings

Walden Dissertations and Doctoral Studies

Teen dating violence and bullying are major public health concerns but are preventable. Both dating violence and bullying occur within similar social context and the prevalence of teen dating violence was highest for African American teens as reported on the 2011 Youth Risk Behavior Survey (YRBS). Social learning theory provides a foundation for understanding and changing behavior related to dating violence victimization and bully victimization. The research questions focused on relationships between bully and teen dating violence victimization when controlling for race/ethnicity, gender, substance abuse, age, and age of first sexual intercourse. Additionally, the potential mediating variable of spending time …

Managing Acute Pain In Postoperative Surgical Patients, Sabrina Gregory

Walden Dissertations and Doctoral Studies

Every year, millions of Americans suffer from either chronic or acute pain that results in tremendous healthcare cost, rehabilitation, and loss of work productivity. Pain is an unpleasant sensation associated with sensory and emotional experiences that can cause potential or actual tissue damage. One plausible solution to managing pain is the use of nonpharmacological modalities such as guided imagery. The purpose of this project was to determine if there was a difference in pain scores following pharmacological interventions and the use of guided imagery among postoperative same day surgical patients. Guided imagery is a nonpharmacological modality that uses pictures, music, …

Crafting A System Of Profound Knowledge Management In Long-Term Care, Charlotte Johnston

Walden Dissertations and Doctoral Studies

The paradigm shift to a knowledge economy, predicted by Drucker, is currently reflected in a knowing-to-doing gap in healthcare, potentially threatening the lives of long-term care (LTC) residents and sustainability of LTC organizations. The purpose of this grounded theory study was to seek a substantive conceptual theory to explain how LTC uses knowledge management (KM) to improve performance by probing the a priori views and lived experiences of 11 LTC knowledge creators, managers, and users. Data were collected via semi structured interviews that were transcribed and coded. The research questions guided by the conceptual concentrated on how KM is used …

Association Between Haart And Metabolic Syndrome Components Among Hiv-Positive Adults In Southeastern Nigeria, Bridget Okiemute Amechi

Walden Dissertations and Doctoral Studies

Highly active antiretroviral therapy (HAART) contributes to metabolic disorders and the growing prevalence of metabolic syndrome (MetS) in human immunodeficiency virus (HIV)-infected patients. Hypertension, obesity, and hyperglycemia (components of MetS) are risk factors for cardiovascular disease. Studies have shown that HIV patients on HAART have a 2-fold risk of dying from MetS. There are no such studies in Umuahia; hence the need for this study to fill this gap. Using a sample size of 192 medical records of HIV-infected patients in Federal Medical Centre, Umuahia, and applying metabolic syndrome theory, this study examined the relationships among types of HAART regimen, …

Differences In Preferences For Using Microbicides Among Gay Men Seeking Internet, Nnenna Jean Wilson

Walden Dissertations and Doctoral Studies

Efforts to reduce the spread of human immunodeficiency virus (HIV) and find innovative alternatives to condom use are important public health challenges. While the incidence of HIV is leveling off among some populations, it is escalating in other populations such as young African American men who have sex with men (MSM). Guided by the health belief model (HBM) and the AIDS risk reduction model (ARRM), this quantitative, cross-sectional study sought to use multiple linear regression, binary logistic regression, and Fisher's exact test to determine how perceived susceptibility, as measured by the AIDS Health Belief Scale (AHBS), and labeling of unprotected …

Health Care Provider Perceptions Of High Blood Pressure Screening For Asymptomatic African American Teens, Juanita Braxton

Walden Dissertations and Doctoral Studies

Health care provider perceptions of typical practices play a significant role in evaluating the efficacy of screening and diagnosis of teen high blood pressure in African Americans. African American adults are more likely to develop high blood pressure than are any other ethnic group; however, there is a gap in the literature concerning high blood pressure in teens. Approximately 1 to 5 of every 100 children has high blood pressure. This purpose of this phenomenological study was to explore the perspectives of health care providers on high blood pressure screening and diagnosis of African American asymptomatic teens. The health belief …

Cultural Influences On The Weight, Diet, And Physical Activity Of Pregnant Immigrant Latinas, Martha Eugenia Dominguez

Walden Dissertations and Doctoral Studies

The problem addressed in this phenomenological study is how culture and acculturation can potentially influence gestational weight during pregnancy, leading to overweight and obesity among immigrant Latinas. To understand the possible influence of culture and acculturation on the diet, exercise, and weight of pregnant immigrant Latinas, the experiences of immigrant Latinas who had undergone a pregnancy in Mexico and were pregnant in California were examined. The ecological model theory was applied as a framework for exploring the participants' experiences regarding nutrition, physical activity, and weight gain. Semistructured interviews with 10 qualified participants were conducted. Data analysis entailed an inductive approach …

Risk Of Alzheimer's Disease Among Older Hispanic/Latinos With Diabetes, Kathy Bianco

Walden Dissertations and Doctoral Studies

Alzheimer's disease (AD) is the 6th leading cause of death in older Americans. Currently there is no cure for AD, and even though the specific cause is unknown, diabetes mellitus type 2 (DM2) is regarded as a risk factor. Hispanics have a higher incidence of DM2 and possibly AD. I chose a life course theoretical model for this quantitative cross-sectional study to illuminate the variables most pertinent to a pathway from good health to poor health. The variables chosen were hypertension (HTN), obesity, smoking, stroke, dyslipidemia, and lower educational attainment. The research questions were used to examine biologic, metabolic, sociologic, …

Lived Experiences Of Women From The Odi Community In Nigeria Of Female Genital Mutilation, Doris Atibinye Dotimi

Walden Dissertations and Doctoral Studies

Female genital mutilation (FGM) is a public health challenge because it jeopardizes the health of women and girls. FGM is condemned worldwide but, it is still practiced in the Odi community of Nigeria. The literature on women's lived experiences of FGM in other parts of the world was reviewed, but knowledge is lacking on the lived experiences of women from Odi community in Nigeria. The purpose of this phenomenological study was to explore their lived experiences, their perspectives on the current legislation for the prevention of FGM, and their perspectives on the cultural myths surrounding the practice. The phenomenological lens …

Nigerian Women's Empowerment Status And Its Influence On Access To Reproductive Health Services, Temi Aregbesola

Walden Dissertations and Doctoral Studies

Nigeria is a patriarchal society, which puts women in subordinate positions that may prompt gender-based discrimination. While evidence of this phenomenon has been investigated in Nigeria and other African countries, no such investigation has been conducted with immigrant and first-generation Nigerian women in the United States. The purpose of this study was to examine the role of a Nigerian woman's perceived empowerment and status on her willingness to access reproductive health services. The research questions examined views of Nigerian traditional beliefs' influence on status and how attitudes around traditional beliefs relate to access to reproductive health services and/or knowledge. Data …

Beliefs Among Mothers Of Adolescent Females On Cervical Cancer Vaccination, Aja Rochelle Gardner

Walden Dissertations and Doctoral Studies

Hispanic and African American women are infected with sexually transmitted diseases more often than are Caucasian women. This racial disparity is also seen in the incidence of human papillomavirus (HPV) and cervical cancer. The medical connection between HPV and cervical cancer is often unknown or misunderstood among women. This study addressed the beliefs and subsequent health decisions of minority parents regarding whether to get their daughters vaccinated against HPV. The theoretical framework for this study was Rosenstock's health belief model (HBM). The specific study design used was Husserl and Heidegher's theory on Phenomenology. This qualitative study utilized focus groups containing …

The Aftermath Of Violence: The Lived Experience Phenomena Of Assault In Nursing, Kathleen Clark

Walden Dissertations and Doctoral Studies

Despite the high incidence of violence directed at registered nurses while on duty, there is limited qualitative data that explores the lived experience of returning to the workplace after an assaultive incident. This phenomenological study sought to explore and analyze the phenomena of registered nurses who are employed in high-risk settings. The research questions considered the detailed descriptions of the experiences of nurses returning to the workplace. The conceptual framework was resiliency, as these participants continued to survive and thrive after the adverse assaultive events. Data were collected using in-depth interviews from purposeful sampling. Registered nurses working in the high …

Risk Factors For Tuberculosis And Multidrug-Resistant Tuberculosis Complications Among Foreign-Born Persons In Houston, Texas, James N. Isaboke

Walden Dissertations and Doctoral Studies

Tuberculosis (TB) is a leading public health problem across the world. For various reasons, TB and multidrug-resistant tuberculosis (MDR-TB) have increased. Clarification on TB/HIV co-infection and homelessness as risk factors for TB and MDR-TB is required to inform policy interventions to reduce TB-related morbidity, mortality, and healthcare costs. In this quantitative study, data from the Houston Health Department (N = 341) were analyzed to explore the relationship between TB and MDR-TB outcomes and TB/HIV co-infection and type of housing/homelessness. Foreign-born persons are disproportionately affected in the United States. The socio-ecological model provided a theoretical framework for the investigation. Multiple and …

Emotional Intelligence, Job Satisfaction, And Burnout For Dietitians, Cara Perdue

Walden Dissertations and Doctoral Studies

There are low retention rates of dietitians and this impacts quality of care. Emotional intelligence (EI) may be the missing component to improve retention, due to EI increasing job satisfaction and decreasing burnout for other health providers. The purpose of this study was to examine the relationship between EI, job satisfaction, and burnout for dietitians. The theoretical framework utilized was the 4-branch model of EI. Method of inquiry was convenience, quantitative non-experimental design. Registered dietitians (N = 84,173) living in the United States were contacted via e-mail. Approximately 9.5% of dietitians (n = 8,038) completed the Wong and Law EI …

Job Satisfaction, Organizational Culture, And British Nurses' Intention To Leave Employment, Brendan Edward Williams

Walden Dissertations and Doctoral Studies

In spite of decades of research, concerning nurse's intention to leave their employer (ITL), in 2011, 31.2% of the British nurses surveyed indicated they had formed an ITL. Grounded in reasoned action theory as developed by Ajzen and Fishbein, the purpose of the correlational study was to provide hospital managers with information regarding the relationship among nurse's job satisfaction (JS), organizational culture (OC), and ITL. The archival data from the 2011 NHS Staff Survey included responses from nurses (n = 21,257) across the British National Health Service. The Spearman's rho correlates rs (21,257) indicated relationships among nurse's job satisfaction, organizational …

Direct-To-Consumer Advertisements And Medical Services Utilization Among Adult Dermatology Patients In The United States, Heribert Zouetchou

Walden Dissertations and Doctoral Studies

Pharmaceutical product claim and help-seeking advertisements have prompted the types and purposes of medical dermatology service(s) that patients have used in the United States. Indeed, researchers have demonstrated that 94% of working nurse practitioners affirmed receiving from their patients a request for a cancer drug advertised. However, adult dermatology patients members of Saint Nicholas Catholic Church or/and patients at MedStar Clinic in Houston, Texas, have not been of interest for any study so far. The purpose of this quantitative study was to assess the relationship between product claim, help-seeking, types, and purposes of medical dermatology services used amongst males and …

Evidence-Based Alternative Therapy To Reduce Anxiety In Ambulatory Mental Health Patients, Renee Ann Denobrega

Walden Dissertations and Doctoral Studies

Evidence-Based Alternative Therapy to Reduce Anxiety in Ambulatory Mental Health Patients

by

Renee Denobrega

MS, Widener University, 2013

BS, Alvernia University, 2007

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

January 2016

Meaningfulness Of Work As Perceived By Women From Diverse Social Classes: A Grounded Theory Exploration, Jennifer L. Hutmire

Walden Dissertations and Doctoral Studies

Despite research connecting the meaningfulness of work with positive organizational outcomes, such as increased employee well-being, job satisfaction, engagement, and retention, there remains a lack of adequate, inclusive research explaining differences in women's perceptions of the meaningfulness of work. The purpose of this qualitative grounded theory study was to address this gap in the literature by developing a theory about the formation of perceptions of the meaningfulness of work and about the impact of those perceptions. Research questions explored perceptions that women from diverse social classes have of the meaningfulness of work, what influenced those perceptions, the impact of those …

Total Quality System Breakdowns In Outsourced Clinical Trials, Hemali Barrios

Walden Dissertations and Doctoral Studies

Numerous deaths, tragedies, and underreported drug side effects occur in outsourced clinical trials. Total quality system breakdowns occur even though quality agreement contracts and quality management systems are used by pharmaceutical organizations. The purpose of this single case study was to explore strategies clinical quality assurance managers use to avoid breakdowns in quality with outsourced clinical trials in Asia-Pacific countries. The study included a purposeful sample of 15 clinical quality assurance managers from 1 pharmaceutical organization located in the Northeast region of the United States. The conceptual framework was von Bertalanffy's general systems theory. Face-to-face semistructured interviews or e-mail questionnaires …

Employee Engagement In A Cardiac Catherization Lab, Rhonda J. Smith

Walden Dissertations and Doctoral Studies

Employee Engagement in a Cardiac Catheterization Lab

by

Rhonda J. Smith

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

February 2016

This study adds to the existing body of knowledge on employee engagement and workplace climate in the catheter laboratory setting. The study goals were to discover the current state of workplace satisfaction and then to share the results with the staff to determine what to improve and how to guide them through the Lean process. This study was guided by Kanter's structural empowerment theory, which holds that structural factors …

The Relationship Of General Science Grades To Program Completion In An Associate Degree Nursing Program, Catherine Edlebeck

Walden Dissertations and Doctoral Studies

High attrition of nursing students in the United States may contribute to a shortage of registered nurses and inefficient use of scarce resources. The purpose of this study was to explore the relationship between nursing student grades in 3 science prerequisites and length of time to program completion on each of the study college's 4 campuses. Ausubel's theory of subsumption, wherein a learner's ability to meaningfully learn new data depends on the existing cognitive structure within which the new material is assimilated, was used as a theoretical framework. Prerequisite science course grades for 575 nursing students attending a Midwestern technical …

Medical Community Distrust And The Influenza Vaccination Rates Of Black Americans, Kenyatte Irby Winston

Walden Dissertations and Doctoral Studies

Black Americans experience influenza vaccination rates that are lower than the rates of other ethnic groups. Low influenza vaccination rates among the Black community are associated with higher influenza infection rates, influenza-related hospitalizations, and higher influenza mortality rates. There is a belief within the Black American community that the medical establishment does not have the Black American patient in its best interest, leading to feelings of distrust. The purpose of this study was to determine if the distrust of the medical community is a relevant factor in the low influenza vaccination rates of Black Americans aged 18 and older in …

The Pharmaceutical Industry's Effect On Rheumatologists' Patterns Of Care, Frank Bailey

Walden Dissertations and Doctoral Studies

Drug makers have developed numerous techniques to influence treatment choices. Almost no information exists regarding the pharmaceutical industry's influence on rheumatologists and how these pressures could affect patient care. This phenomenological research, conducted within the framework of social exchange theory, explored the lived experiences of rheumatologists regarding their interactions with agents of the pharmaceutical industry. A researcher-designed interview protocol was used to gather feedback from 10 rheumatologists regarding how interactions with agents of the pharmaceutical industry made them feel. Using horizonalization, meaningful statements made by rheumatologists were condensed into specific themes and patterns, which provided a composite summary of their …

Relational Intelligence: A Framework To Enhance Interprofessional Collaborative Care, Elizabeth Ekole

Walden Dissertations and Doctoral Studies

Many studies have reported that the training for practitioners does not stimulate reflexes that contribute to the tenets of teamwork and collaboration. No studies were found to investigate relational intelligence (RQ) in pharmacist-physician relationships as a catalyst for collaborative and hence cost effective quality care. This study addressed the role and potential opportunity to promote RQ as a critical leadership skill in the collaboration between pharmacists and physicians. Using RQ as the conceptual framework, this phenomenological study explored how pharmacists and physicians in a hospital setting perceive RQ as a leadership skill when working collaboratively. A total of 10 participants …