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 …

Adult Attachment And Relationship Satisfaction Among Men Who Experienced Childhood Abuse, Selisha Nelson

Walden Dissertations and Doctoral Studies

Experiences of childhood physical and sexual abuse among men have not been sufficiently studied because many men are not forthcoming about experiences of abuse. This abuse is linked to aggressive behaviors, difficulty developing and maintaining close relationships, and various psychological disorders. Current research has not fully examined relationships between childhood abuse, adult attachment, and levels of relationship satisfaction among men. The purpose of this nonexperimental quantitative study was to evaluate the relationship between adult attachment as measured by the Relationship Scales Questionnaire and relationship satisfaction as measured by the Couples Satisfaction Index among men abused during childhood. Bowlby's theory of …

Completion Of Preventive Health Care Actions By Older Women With Hiv/Aids, Patricia Kay Correll

Walden Dissertations and Doctoral Studies

The widespread use of highly active antiretroviral therapy (HAART) has resulted in longer lifespans for HIV seropositive women in the United States, during which preventive health care is recommended. Failing to complete recommended cancer screening tests can result in cancer being diagnosed at a later stage with a poorer prognosis. The purpose of the study, based on the ecosocial theory, was to describe the sociodemographic and clinical variables of HIV seropositive women who failed to complete recommended screening tests for breast, cervical, and colorectal cancers, and determine if the presence of hypertension, obesity, diabetes, depression, or tobacco use impacted the …

The Effect Of A Drama On Young Adults' Attitudes About Domestic Violence, Regina Watson

Walden Dissertations and Doctoral Studies

Intimate partner abuse has been and remains a pervasive problem that has been documented in every race, religion, class, and level of education. This study presented the rationale for achieving positive social change by examining the problem through prevention rather than reaction and intervention. Although many theories of causation have been presented at various times, none has been proven or offers a complete explanation. Social ecological theory examines the interaction of individual, community, relational, and societal influences on the development of attitudes and behavior acceptance. This pre and post-survey group, quasi-experimental study examined the effects of an intervention on attitudes …

A Community Health Program To Reduce Cardiovascular Risk In Women, Xander Bacchus

Walden Dissertations and Doctoral Studies

Cardiovascular disease (CVD) is the leading cause of death among United States women. Regular aerobic exercise can significantly reduce CVD risk. This dissertation reflects one of the first studies of the efficacy of Community Health Programs (CHP) in promoting exercise among American women aged 25 to 65. Primary data used from a study involved a sample of 42 women aged 25 to 65 who attended a CVD and exercise-related CHP, while a 42-member control group merely received the CHP information in a printed form. A pretest was administered at the outset of the study, and a posttest was administered at …

Health Care Administration Faculty Perceptions On Competency Education, Graduate Preparedness, And Employer Competency Expectations, Wittney A. Jones

Walden Dissertations and Doctoral Studies

Health care administration programs have transitioned to using the competency approach to better prepare graduates for workplace success. The responsibility of preparing graduates lies with the program faculty, yet little is known about faculty perceptions of the competency approach. The purpose of this cross-sectional study was to assess the perceptions of graduate-level health care administration faculty about the competency approach, the approach's effect on graduate preparedness, and employer expectations. Adult learning theory and the theory of self-efficacy were used as the theoretical foundations for the study. Faculty demographics related to personal information, workplace/teaching experience, and program information served as the …

The Healthy, Hunger-Free Kids Act And High School Obesity, Derek Grills

Walden Dissertations and Doctoral Studies

United States high school student obesity rates have doubled in the past 30 years to 13%, threatening the health of millions of adolescents. To mitigate the epidemic, Congress passed the Healthy, Hunger-Free Kids Act (HHFKA) in 2010, which mandated significant changes to school nutrition and physical education. From a public policy perspective, the HHFKA changed school nutrition and exercise policy to affect obesity rates by changing intake and energy expenditure at school, though no study using national-level data examined this relationship. As such, the purpose of the study was to examine whether HHFKA policy compliance had a statistically significant effect …

Recent Graduates' Perspective On The Efficacy Of Nursing Simulation Laboratory Experiences, Holli Sowerby

Walden Dissertations and Doctoral Studies

It has become progressively difficult to find suitable clinical placement for nursing students. To help meet this need, local schools of nursing are turning to high-fidelity simulation manikins to substitute for clinical experience. There is a lack of research that explores recently graduated nurses' perceptions about the efficacy of simulation experiences. Guided by the constructivist theory, this qualitative case study identified how recent RN graduates viewed simulation experiences and whether associate's-degree RN program graduates and bachelor's-program RN graduates viewed simulation differently. Nine recent graduates participated in individual face-to-face interviews. The data were coded and grouped into 5 major themes in …

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 …

A Qualitative Analysis Of Migrant Women Farmworkers' A Qualit Ative Analysis Of Migrant Women Farmworkers’ Perceptions Of Maternal Care Management, Stacey A. Pilling

Walden Dissertations and Doctoral Studies

The purpose of this phenomenological study was to examine migrant women farmworkers' views of perinatal care management while working in the fields. Like men, women migrant farmworkers are exposed to many physical, chemical, and biological hazards that pose human health risks. However, women of childbearing age are at an increased risk of having reproductive health difficulties and adverse pregnancy outcomes, and the infant mortality rate among migrant farmworkers is estimated to be twice the national average. Perinatal care is a critical factor in reducing adverse outcomes for perinatal and newborn mortality. Face-to-face interviews were conducted with 15 migrant women farmworkers …

Spiritual Transcendence And Burnout Rate Among Psychologists And Social Workers Working With Severely Mentally Ill Patients, Cynthia Fuhrer Cameron

Walden Dissertations and Doctoral Studies

Burnout is a psychological syndrome caused by occupational stress, which often manifests in mental health professionals who experience demanding and emotionally charged relationships with clients. Guided by the equity theory, this study examined the relationship between spiritual transcendence and burnout in psychologists and social workers who work with severely mentally ill patients after accounting for specific personality traits. Constructs were measured via the Spiritual Transcendence scale (STS), Maslach Burnout inventory (MBI), and the NEO-Five Factor Inventory (NEO-FFI). Sixty eight psychologists and social workers were selected from psychiatric hospitals, community centers, and private practice in Nevada to participate in the study. …

Self Esteem, Locus Of Control, And The Relationship With Registered Nurses' Experience With Workplace Incivility, Elizabeth Anne Berry

Walden Dissertations and Doctoral Studies

The study's purpose is evaluating the relationship between locus of control and selfesteem

in relation to the registered nurse's experience and perception with lateral and

vertical incivility. There is a lack of research concerning nurse-to-nurse incivility within

the nursing profession. The hypothesis examined whether dynamics of locus of control

and self-esteem could provide insight into the personality dynamics influencing incivility

in the workplace. This non-experimental quantitative study used 2 self-evaluation tools

and 1 demographic survey tool to collect data via Survey Monkey, a commercial data

collection company. Participants were 65 randomly selected faculty (n = 36) and

graduate students (n …

Preventative Strategies To Improve Birth Outcomes Among African American Women In Rhode Island, Yvonne Michele Heredia

Walden Dissertations and Doctoral Studies

Despite increased access to prenatal care, birth outcomes continue to be a major source of disparity among women in the United States. The focus on lifestyle choices and negative behaviors prior to a pregnancy to reduce adverse birth outcomes has become a well-documented strategy. The purpose of this study was to determine if preparing for a pregnancy in advance improves birth outcomes for African American women of childbearing age between the ages of 12 and 45 years in the State of Rhode Island (RI). The theoretical foundation for this study was based on Prochaska's model of change, which is also …

Communication Skills Of Novice Psychiatric Nurses With Aggressive Psychiatric Patients, Rose Moss

Walden Dissertations and Doctoral Studies

Communication Skills of Novice Psychiatric Nurses with Aggressive Psychiatric Patients

by

Rose L. Moss

MS, University of Hartford, 1996

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

March 2015

The transition from novice nurse to a competent psychiatric staff nurse is often associated with major communication challenges, primarily when caring for aggressive patients. Guided by Peplau's theory, this quantitative study assessed the communication skills of novice psychiatric nurses (N = 25) who worked 24 months or less in the state psychiatric hospital with aggressive psychiatric patients. Additionally, certain demographic data …

The Role Of Sociodemographic Characteristics And Antiretroviral Prophylaxis On Risky Sexual Behavior Among Men Who Have Sex With Men, Leonard Obodo

Walden Dissertations and Doctoral Studies

Recent multicenter, randomized, double blind clinical trials have shown no association between HIV preexposure prophylaxis (PrEP) and increased sexual risk behavior among high-risk men who have sex with men (MSM). However, little research has been conducted under natural conditions devoid of clinical trial controlled environment to confirm the lack of association between PrEP and increased sexual risk behavior. Also, research has shown conflicting associations between sociodemographic characteristics and sexual risk behavior among MSM. In this cross-sectional, web-based, primary data analysis, MSM who reside in United States of America (USA) and who make use of PrEP for HIV prevention were examined …

Obesity Surveillance In Childhood, Jessica Garcia

Walden Dissertations and Doctoral Studies

Current practice behaviors for obesity management have remained refractory. Research has shown that lack of time and poor training/skills by primary care providers has led to poor or absent obesity counseling in practice. The purpose of this intervention was to facilitate obesity counseling in a pediatric office by using an evidence-based model called the 5As model of behavioral change. Lewin's change theory was the framework for this project to help clinicians transition their practice to include the 5As model in practice. The project consisted of a 30-minute power point presentation that included 2 case samples demonstrating how the 5As would …

Nurses Knowledge, Skills, And Attitude Toward Electronic Health Records (Ehr), Sharon L. Adams

Walden Dissertations and Doctoral Studies

Information technology (IT) has been rapidly integrated into the healthcare industry, including nursing, and has the ability to reduce errors, cut cost, and enhance patient care. However, approximately 45% of the current nurse workforce lacks adequate training in computer skills, which may hinder the adoption of health-related IT in the workplace. Characteristics of Rogers's diffusion of innovation (relative advantage, compatibility, complexity, trialability, and observability) guided this project. This project was conducted to address the problem of IT adoption on a local level and was designed to assess whether simulation training on a generic electronic health record (EHR) system would improve …

Critical Care Nurses' Perceptions Of Their Knowledge And Self-Efficacy About Providing End-Of-Life Care, Mary Kathryn Gaffney

Walden Dissertations and Doctoral Studies

Most nurses receive limited formal education regarding end-of-life (EOL) care, which affects their ability to meet dying patients' needs. Guided by Bandura's social learning theory, this explanatory correlational study examined the relationships between critical care nurses' personal and professional characteristics and their perceived knowledge and self-efficacy when providing EOL care at an academic medical center. Convenience sampling was used to recruit participants from the eligible adult, pediatric, and neonatal critical care nurses for this study. The 67 participants completed the End-of-Life Professional Caregiver Survey (EPCS) to assess EOL care knowledge and self-confidence. Total EPCS scores revealed only moderate levels of …

Physician Assistants' Preventive Medicine Practices And Related Habits, Attitudes, And Beliefs, Judia Yael Malachi

Walden Dissertations and Doctoral Studies

Physician assistants play a pivotal role in expanding access to care, yet research on their preventive medicine practices is limited. Guided by Lewis's conceptual model for predicting counseling practices, this cross-sectional study examined the relationship between physician assistants' preventive medicine practices, personal health habits, prevention and counseling attitudes, and perceived barriers to the delivery of clinical preventive services. A 104-item self-administered survey was used to collect data from 314 physician assistants attending the American Academy of Physician Assistants' 42nd Annual Conference. Data were analyzed using descriptive statistics, Pearson's correlation, and stepwise multiple regression. Results indicated that physician assistants engaged in …

The Creation Of A Pacemaker Clinic At A Federally-Funded Patient-Centered Medical Home: A Quality Improvement Project, Tony Anno

Walden Dissertations and Doctoral Studies

It is common for clinicians to implant medical devices, such as permanent pacemakers and implantable defibrillators, for cardiac diseases. These medical devices require follow-up care at regular intervals to ensure proper device function and optimal outcomes. Currently, many individuals without insurance or financial resources lack access to recommended follow-up care after implantation of a cardiac device. The purpose of this project was to determine the number of individuals who have had a medical device implanted without insurance coverage over a 3-year period, and then to establish a clinic that provides this service. The standard of care and operating procedure for …

School Administrator And Staff Member Perceptions Of A Teenage Pregnancy Prevention Program, Sharon Lacretia Mcconnell-Smith

Walden Dissertations and Doctoral Studies

Mississippi is among the states with the highest teenage pregnancy rates, and the study site is among the high schools with the highest teenage pregnancy rates in the state. The purpose of this qualitative case study was to identify successful practices and areas for improvement in the implementation of a teenage pregnancy prevention program (TPPP) at the study site based on the perspectives of school administrators and staff members. Bandura's social cognitive theory provided a conceptual framework for considering behaviors and the social contexts in which they occur. Twelve participants were interviewed, including 3 administrators and 9 staff members. Data …

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 …

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 …

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 …

Media Literacy Education Exposure Related To Self-Esteem, Body Esteem, And Sociocultural Ideals In College Students And Graduates, Tammy Stargardt

Walden Dissertations and Doctoral Studies

The prevalence of eating disorders (ED) in the United States has increased while the media consistently presents thinner representations of the body. Scholars have found media to negatively influence factors associated with the development of EDs. The purpose of this quantitative nonexperimental cross-sectional survey design study was to explore relationships between exposure levels to MLE and self-esteem, body esteem, and the internalization societal appearance ideals. Participants included undergraduate students or recent graduates majoring in either communications or an alternative major with comparatively less MLE curriculum. The Body Esteem Scale, Sociocultural Attitudes towards Appearance Questionnaire-3, and Rosenberg Self-Esteem Scale Surveys were …

The Correlation Among Personality Characteristics, Stress, And Coping Of Caregivers Of Individuals With Intellectual And Developmental Disabilities, Natasha O'Connor

Walden Dissertations and Doctoral Studies

There is little research on the coping strategies of direct support professional caregivers working with the intellectually disabled (ID) and developmentally disabled (DD). The study was guided by Lazarus and Folkman's (1984) theory of the transactional model of stress and coping. The purpose of this study was to assess whether there is a correlation among the independent variables of coping and personality characteristics with stress as the dependent variable. A convenience sample of 69 professional caregivers was used. Data were collected using the Ways of Coping Questionnaire, Perceived Stress Scale, NEO-FFI-3, and a demographic questionnaire. A correlational analysis was conducted …

Analysis Of Telephonic Pharmacist Counseling, Katherine N. Swift

Walden Dissertations and Doctoral Studies

Medication complexity and nonadherence are significant risk factors for avoidable hospitalizations and health care spending for older adults in the United States. However, limited empirical research has investigated pharmacist-run telephonic medication management programs as a potential solution to the problem of reducing medication complexity while improving medication adherence. This quantitative study employed the behavioral change model to analyze archival data from a sample of 1,148 participants, examining the relationship of a pharmacist-run telephonic consulting program on medication adherence and medication complexity for one pharmacy benefit management firm's Medicare Part D recipients. The primary research questions investigated the relationship of medication …

The Effect Of The Implementation Of Relationship-Based Care On Patient Satisfaction, Laura Ellen Field

Walden Dissertations and Doctoral Studies

The purpose of this project was to evaluate the effects of relationship-based care (RBC) on patient satisfaction. RBC is a caring model that promotes a caring and healing environment by establishing and maintaining therapeutic relationships between patient, self, and coworker. The Centers for Medicare & Medicaid Services links Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores with reimbursement to hospitals. It is essential to not only achieve high patient satisfaction scores in order to ensure full financial reimbursement, but also to ensure high quality, patient-centered care. The current project assessed samples from 2 medical surgical groups, one system-wide …

The Effects Of Nursing Education On Decreasing Catheter Associated Urinary Tract Infection Rates, Pamela R. Gordon

Walden Dissertations and Doctoral Studies

Catheter-associated urinary tract infections (CAUTIs) account for 40% of all nosocomial infections in the United States, affecting nearly 900,000 patients per year. The indwelling urinary catheter (IUC) is a widely utilized device in modern hospital environments, yet they are not always used appropriately in hospital settings and can result in prolonged use and improper management, increasing risk of infections and length of stay. Nurses are the primary champions to promote preventative measures, provide patient education, and evaluate evidence-based practice (EBP) strategies to decrease CAUTIs. The purpose of this study was to determine if nursing education on EBP guidelines could decrease …

Interrupting The Sepsis Process With An Evidence-Based Education Intervention, Martha Olson

Walden Dissertations and Doctoral Studies

Interrupting the Sepsis Process with an Evidence-Based Education Intervention

by

Martha Olson

MSN, Walden University, 2013

MS, Southwest Minnesota State University, 2003

BSN, The University of Iowa, 1998

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

May 2015

Abstract

Sepsis is a concern, especially for the vulnerable populations. The early signs of sepsis are vague and often difficult to detect, but when detected early, are treatable with antibiotics and fluid resuscitation. When a nurse is unaware of the early signs, treatment is delayed and multiorgan failure may progress quickly. To …