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Chronic Care Management Services At A Clinical Medical Group, Sharon Guccione
Chronic Care Management Services At A Clinical Medical Group, Sharon Guccione
Walden Dissertations and Doctoral Studies
The purpose of this project was to design a chronic care plan using the chronic care management (CCM) framework to improve health services at lower healthcare costs. The practice-focused question explored whether the operationalization of the CCM model would impact progress toward the management of chronic illness for the target population of Medicare beneficiaries with 2 or more chronic illnesses in an urban acute care agency located in the western United States. The middle-range theory, logic rational plan model, Lewin’s change theory, and the CCM’s coordination care and collaborative care concepts were used to guide the project. Data were collected …
Implementation Of A Diabetic Resource Toolkit In A Veterans Administration Emergency Department, Caroline Hairston
Implementation Of A Diabetic Resource Toolkit In A Veterans Administration Emergency Department, Caroline Hairston
Walden Dissertations and Doctoral Studies
Diabetes is the 7th leading cause of death in the United States. Uncontrolled diabetes and lack of self-care knowledge leads to increased emergency department (ED) visits, utilizing limited health care resources. The practice-focused question asked whether a patient-focused diabetic self-care toolkit could decrease the number of diabetes-related ED visits. The purpose of this project was to reduce the number of diabetes-related ED visits and was supported by the social cognitive theory. The sources of evidence included the facility's ED Information System (EDIS) data and a patient survey developed by the project lead. There were 149 participants (135 males and 14 …
Quality Of Life Among Entrepreneurs With Chronic Fatigue Syndrome, Brittany Kesler
Quality Of Life Among Entrepreneurs With Chronic Fatigue Syndrome, Brittany Kesler
Walden Dissertations and Doctoral Studies
The impacts of chronic fatigue syndrome (CFS) are far reaching, resulting in many burdens in the individual lives of CFS patients. One notable challenge lies in the inability to participate in the workforce due to associated physical, mental, and emotional symptoms. Previous research indicates that alternative employment options may help to overcome work related barriers presented with various types of chronic illness. Entrepreneurship is one path to working that offers many benefits, including autonomy, flexibility of work schedule, choice of work environment, and control. Questions though remain as to whether entrepreneurship enhances QOL or exacerbates symptoms among individuals with CFS. …
Alzheimer's Disease Dementia: Stress, Female Caregiver Burden, And Older Caregiver Health Outcomes, Nadia Muhammad
Alzheimer's Disease Dementia: Stress, Female Caregiver Burden, And Older Caregiver Health Outcomes, Nadia Muhammad
Walden Dissertations and Doctoral Studies
Alzheimer's disease dementia caregivers are heavily engaged in providing daily assistance to individuals encumbered with Alzheimer's disease, but these caregiving duties can have a devastating effect on caregivers' self-reported health and mental outcomes. The purpose of this study was to evaluate older female caregivers' background and contextual stressors and care stressors on caregivers' self-reported harm to health resulting from the stress of caregiving, health status and emotional stress. The stress process model for Alzheimer's caregivers served as the theoretical foundation for this study. Correlation and logistic and linear regression analysis were used to evaluate if a relationship exists between the …
Improving Glycemic Control In Adult With Type 2 Diabetes, Basirat Romoke Triplett
Improving Glycemic Control In Adult With Type 2 Diabetes, Basirat Romoke Triplett
Walden Dissertations and Doctoral Studies
Ninety percent of people with diabetes have Type 2 diabetes mellitus (T2DM). T2DM is a complex disease that affects every organ in the body, which makes effective management of the disease imperative. The American Association of Clinical Endocrinologist (AACE) and American College of Endocrinology (ACE) strongly recommended early treatment initiation among the target population to delay disease progression and complications. The purpose of this evidence-based project was to examine the impact of using the T2DM management algorithm for effective management of adults with T2DM over a 3-month period. The shared experience decision-making model and the chronic care model were used …
Exploring The Role Of Religious Leaders In Preventing Sickle Cell Disease In Nigeria, Grace Awe
Exploring The Role Of Religious Leaders In Preventing Sickle Cell Disease In Nigeria, Grace Awe
Walden Dissertations and Doctoral Studies
Nigeria has high rates of sickle cell disease (SCD), which is attributed to the lack of awareness of the disease among the reproductive age in the country. The purpose of this cross-sectional study was to explore the role of religious leaders in contributing to awareness and prevention of SCD in Nigeria. Religious leaders' knowledge, attitude, and prevention and awareness practices of SCD, and how they translated to the prevention of SCD through improved counseling of premarital couples, were explored. A stratified random sampling was employed in selecting a sample of 150 religious leaders from different religious affiliations. Data were collected …
Achieving Glycemic Control In Rural Clinics, Gayla Diane Mclaughlin
Achieving Glycemic Control In Rural Clinics, Gayla Diane Mclaughlin
Walden Dissertations and Doctoral Studies
Diabetes is the 7th leading cause of death in the United States and is the main cause of chronic kidney failure, nontraumatic limb amputations, blindness, myocardial infarction, and stroke. Many patients with diabetes do not meet goals for at least 1 control measure of blood sugar, blood pressure, or cholesterol. The purpose of the project was to implement a template for documentation--a toolkit for patient care management-to improve blood glucose and blood pressure levels in a rural health clinic in central Texas for 33 patients with diabetes during a 6- to 8-week timeframe. The practice-focused question asked whether management of …
Predictive Relationship Between Treatment Adherence, Glycated Hemoglobin And Diabetic Complications Among Jamaicans, Christian Anaba Nwaukwa
Predictive Relationship Between Treatment Adherence, Glycated Hemoglobin And Diabetic Complications Among Jamaicans, Christian Anaba Nwaukwa
Walden Dissertations and Doctoral Studies
Patient nonadherence to physicians' prescribed therapeutic regimen is the greatest challenge in the effective treatment of patients with diabetes worldwide. Scientific evidence has revealed that nonadherence to prescribed medication could result in diabetic complications such as cardiovascular disease, retinopathy, nephropathy, and neuropathic diabetic foot ulcers. The purpose of this study was to explore predictive relationships between levels of adherence to antidiabetic medications, patient HbA1c levels, and diabetic complications among Jamaicans, an understudied population. The research question that guided this study was: Do the patient level of adherence and HbA1c levels have any predictive relationship with the severity of diabetic complications …
Congregational Health Promotion By African American Female Pastors In The Christian Faith, Arlene Obazee
Congregational Health Promotion By African American Female Pastors In The Christian Faith, Arlene Obazee
Walden Dissertations and Doctoral Studies
Health disparities have mostly affected African Americans who are poor, uninsured, under insured and unemployed. This population of African Americans seek spiritual solace and social counseling from their pastors, and church-based health promotion (CBHP) offers the opportunity to reach millions of the U. S. Black population. The lack of studies on female African American pastors implementing congregational health promotion activities influenced this study. This qualitative study helped in understanding the experiences, perspectives, and influences of 13 female African American Christian pastors on health-related issues within their congregation. Feminist theory and CBHP model guided this qualitative case study. Open-ended interview questions, …
Predictors Of Readmission To Youth Counseling Services Among Adolescents In Saskatoon Canada, Felicia Lawal
Predictors Of Readmission To Youth Counseling Services Among Adolescents In Saskatoon Canada, Felicia Lawal
Walden Dissertations and Doctoral Studies
Anxiety, depression, and substance use disorders are some of the frequently occurring mental illnesses among Canadian children and adolescents that can result in debilitating short and long terms outcomes. The rise in readmission rates for recipients of mental illness in Saskatchewan, coupled with the high incidences of suicide-related deaths, necessitates a patient outcome evaluation for predictors of readmission to youth counseling services among adolescents. The purpose of this secondary data analysis study was to explore the associations between anxiety, depression, substance use disorder, individual counseling, family counseling, group counseling, and the outcome of readmission within 1 year following discharge from …
Examining Health Disparities And Childhood Obesity In Florida And Georgia, Jennifer Wesley
Examining Health Disparities And Childhood Obesity In Florida And Georgia, Jennifer Wesley
Walden Dissertations and Doctoral Studies
Childhood obesity is a major issue in the United States. The rates of obesity vary among racial and ethnic groups in the U.S. South. The purpose of this quantitative cross-sectional study was to investigate significant state health disparities differences in childhood obesity in the South region between Florida and Georgia. To steer this study, the social cognitive theory was used. The associations between neighborhood safety and support, physical activity, family health and activities on body mass index were examined in this study. Data was obtained from the National Survey of Children's Health 2011-2012 on 1,688 children aged 10-17 years residing …
Association Between Body Mass Index And Depression On Hbaic Control Among Veterans, Opokua Osei-Yeboah
Association Between Body Mass Index And Depression On Hbaic Control Among Veterans, Opokua Osei-Yeboah
Walden Dissertations and Doctoral Studies
The study investigated the association between body mass index (BMI) and depression based upon glycated hemoglobin levels (HBA1C) among United States veterans. Based on Bandura's social cognitive theory, a cross-sectional analysis examined the association between BMI and depression on HBA1C regulation, and if the interaction between BMI and depression affects HBAIC regulation among veterans. Multiple regression analysis was used to test the multivariate associations between depression and BMI on the outcome variable of HBA1C. Linearity, normality, and homoscedasticity were assessed using normal probability plots and residual analysis. Durbin-Watson statistics were used to test for autocorrelations, and variance inflation factor was …
Health Care Facilities As A Predictor Of Breast Cancer Survival Rates, Elizabeth Natalie Webster
Health Care Facilities As A Predictor Of Breast Cancer Survival Rates, Elizabeth Natalie Webster
Walden Dissertations and Doctoral Studies
The disparity between survival rates for Black and White women with breast cancer is well documented and has been examined in terms socioeconomics, environment, tumor type, and genetics. However, there is little examination of the role of health care facilities in cancer disparities. Health care facilities are representative of societal norms and beliefs that include location, quality of care, finance, policies, and staffing; therefore, they are a proxy for social justice and social change. The purpose of this study was to examine correlations between health care facility type; social determinants of cancer such as poverty, culture, and social justice; and …
Influence Of Maternal Psychosocial Health On Infant Feeding Practices, Tessy Linda Aguzie
Influence Of Maternal Psychosocial Health On Infant Feeding Practices, Tessy Linda Aguzie
Walden Dissertations and Doctoral Studies
Choice of nutrition has a great effect on the early development of human growth. Despite increased knowledge on the benefit of breastfeeding to both mother and child, some mothers still choose to formula feed. The purpose of this study is to explain how maternal health contributes to choices. The theory of maternal role attainment and the social cognitive theory are used to evaluate these feeding choices. This study tests for the association between maternal weight status and choice of infant feeding practices, the association between postpartum depression and choice of feeding and finally, if depression mediates the relationship between maternal …
Factors Influencing Alzheimer's Disease Healthcare Utilization Patterns In Puerto Rico, Carlamarie Noboa
Factors Influencing Alzheimer's Disease Healthcare Utilization Patterns In Puerto Rico, Carlamarie Noboa
Walden Dissertations and Doctoral Studies
Alzheimer's disease (AD) is associated with substantial healthcare utilization costs, resulting in a public health priority. In this study, the relationship between the demographic characteristics of age, gender, and type of health insurance; the presence of comorbidities of older Puerto Rican residents diagnosed with AD; and their healthcare utilization patterns (i.e., medical office and emergency room visits and hospital admissions) was examined using Andersen's behavioral model. Data from the 2013 Puerto Rico Health Study was used in this retrospective cohort design study. All AD cases aged -?¥ 60 years were extracted using systematic random sampling. One-way ANOVA-WELCH, Mann-Whitney U test, …
Decreasing Acute Diabetes Complications Through Self-Management Education, Eugene O. Okafor
Decreasing Acute Diabetes Complications Through Self-Management Education, Eugene O. Okafor
Walden Dissertations and Doctoral Studies
Diabetes mellitus is a chronic disease that affects millions of people in the United States. The purpose of this project was to develop a guideline to help clinical staff provide clear and concise diabetes self-management instructions to patients in a community setting. Orem's self-care deficit theory (SCD) and health belief model (HBM) provided a platform to assess how patients' self-care deficit contributes to illness and the effect of patients' perception of illness. SCD theory and the HBM provided the framework for the development of the guideline to decrease diabetes acute complications through self-management education. The practice-focused question was whether the …
Emergency Medical Services First Responder Certification Level's Impact On Ambulance Scene Times, Devin Todd Price
Emergency Medical Services First Responder Certification Level's Impact On Ambulance Scene Times, Devin Todd Price
Walden Dissertations and Doctoral Studies
The foundation of modern-day emergency medical service (EMS) systems began in 1966, based on hospital medical care. Demand for evidence to support prehospital practices that have been in existence for the past half-century has continued to grow; yet, researchers have not adequately explored the relationship between the medical certification level of emergency first responders and the amount of time an ambulance spends on the scene. The purpose of this quantitative study was to examine and compare ambulance scene times for emergency responses when basic life support (BLS) certified first responders or advanced life support (ALS) first responders are first on …
Analysis Of Latent Tuberculosis Infection Treatment Adherence In An Inner-City Clinic, Yvonne Washington-Turay
Analysis Of Latent Tuberculosis Infection Treatment Adherence In An Inner-City Clinic, Yvonne Washington-Turay
Walden Dissertations and Doctoral Studies
More than 10 million people in the United States are known to have latent tuberculosis infection (LTBI), and more than 300,000 begin treatment for LTBI annually. However, many fail to adhere to therapy for numerous reasons. The purpose of this project was to evaluate the impact of a new guideline, Targeted Tuberculin Testing and the Treatment of Latent Tuberculosis, at inner-city tuberculosis (TB) control clinic in the United States. The practice-focused question for the project asked if the implementation of the clinical guideline using a shorter regimen improved LTBI treatment adherence. The health beliefs model was the framework used to …
Use Of Hpv Vaccination For Cervical Cancer Prevention In African American Women, Diamond Diane Hanson
Use Of Hpv Vaccination For Cervical Cancer Prevention In African American Women, Diamond Diane Hanson
Walden Dissertations and Doctoral Studies
Despite the availability of the human papillomavirus (HPV) vaccine, African American women are still at risk for contracting HPV. This is significant because HPV is one of the main risk factors for cervical cancer. The purpose of this quantitative study was to explore the relationship between the use of HPV vaccination for cervical cancer prevention and personal history of HPV, reduced access to healthcare, and risky sexual behaviors in African American women. The theoretical framework used for this study was the health belief model (HBM). Two hundred twenty-nine (n=229) African American women living in the United States, ages 18-49, who …
Hiv Testing Service Utilization Among Men And Women In Dominica, Carol Rosetta Jno.Baptiste-Smith
Hiv Testing Service Utilization Among Men And Women In Dominica, Carol Rosetta Jno.Baptiste-Smith
Walden Dissertations and Doctoral Studies
Voluntary HIV/AIDS testing and counselling (VHTC) is one of the preventive measures used in many countries to decrease the spread of HIV/AIDS. Archived data from National HIV/AIDS Response Program's (NHARP) raw 2016 dataset were used to identify relationships and to assess significant differences between sociodemographic factors and selected sexual risk behaviours versus VHTC practices among adults 18 years and older who resided in Dominica. The health belief model was used as the framework for this cross-sectional study. The sample comprised 982 participants (40% [394] men and 60% [588] women). Logistic regression analysis was used to assess associations between sociodemographic and …
Quality Of Nutrition Services For Children And Pregnant Women In Ntungamo District, Uganda, Church Tophill
Quality Of Nutrition Services For Children And Pregnant Women In Ntungamo District, Uganda, Church Tophill
Walden Dissertations and Doctoral Studies
Inadequate nutrition during infancy and early childhood seriously interferes with brain development, leading to neurological and behavioral disorders. Such effects are detrimental to children under 2 years of age. The purpose of this cross-sectional study was to better understand the quality of nutrition services offered to children and pregnant women in Ntungamo District in southwestern Uganda. The cross-sectional design facilitated comparison of different variables, using a research-question-driven approach, assessing existing secondary data from SPRING Uganda database. Stepwise, backward multiple logistic regression was used to identify the independent variables that influenced the provision of quality nutrition assessment, counseling, and support (NACS) …
Understanding Feeding Style And Young Children's Consumption Of Food, Mary W. Bean
Understanding Feeding Style And Young Children's Consumption Of Food, Mary W. Bean
Walden Dissertations and Doctoral Studies
Due to increased rates of childhood obesity since 2010, researchers have examined family environmental factors and family influences on children's consumption of healthy foods. While previous research has examined how factors such as food presentation and the food intake of other family members can predict a child's body mass index, there has been little research examining whether parent factors predict the amount of healthy foods children eat. This quantitative survey study examined whether certain parent factors, specifically parents' attitudes about food, parents' feeding styles, and parents' attachment styles, predicted the amount of fruits and vegetables children ate. Understanding the extent …
A Limited Rational Choice Theory In Local Public Health Decision Making, Lona Bryan
A Limited Rational Choice Theory In Local Public Health Decision Making, Lona Bryan
Walden Dissertations and Doctoral Studies
The threat and occurrence of terrorist attacks have increased in the United States since September 2011, heightening concerns for weaponized anthrax, other biological pathogens, and epidemics and pandemics. Early decisions and funding levels in local public health agencies can be the first line of defense or first point of failure; yet little is understood about how decisions are made when there are budget cuts before a biological event happens. Using Lindblom's conceptualization of limited rational choice theory, the purpose of this single case study was to understand how a local public health official made decisions after budget cuts in a …
Minimizing Home Health Care-Acquired Pressure Injuries Through Effective Nursing Teamwork, Juliana Baah
Minimizing Home Health Care-Acquired Pressure Injuries Through Effective Nursing Teamwork, Juliana Baah
Walden Dissertations and Doctoral Studies
Pressure injuries (PIs) affect an estimated 2.5 million people in America and cost the nation approximately $11.6 billion each year. The goal of this DNP project was to minimize the rate of PIs at a home health care agency through effective teamwork. Prevention of PIs is very important because PIs damage patients' skin integrity, cause significant amount of pain, are costly to treat, and cause life-threatening infections. The purpose of this DNP project was to evaluate nursing compliance with PI prevention measures and the level of nursing teamwork at the project agency. The Braden-Bergstrom conceptual framework was used to explain …
Factors Associated With Adherence To Diabetes Medication Among Individuals With Type 2 Diabetes In Cambridge, Ontario, Canada., Benedict Osamuimen Atekha
Factors Associated With Adherence To Diabetes Medication Among Individuals With Type 2 Diabetes In Cambridge, Ontario, Canada., Benedict Osamuimen Atekha
Walden Dissertations and Doctoral Studies
Although it is known that the prevalence of type 2 diabetes is on the rise in Canada, more information is needed on how well type 2 diabetes patients living in Cambridge, Ontario self-manage their diabetes and what factors influence their adherence to diabetes medication regimens. The objective of this cross-sectional study based on the theory of planned behavior was to determine if there are predictors of adherence to diabetes medications among patients living with type 2 diabetes in Cambridge. The World Health Organization STEPwise Approach to Surveillance was used to collect demographic data. Adherence and diabetes knowledge were assessed with …
Head Start Parent Perspectives On Child Exposure To Secondhand Smoke At Home, Christiana Abani Bekie
Head Start Parent Perspectives On Child Exposure To Secondhand Smoke At Home, Christiana Abani Bekie
Walden Dissertations and Doctoral Studies
Children exposed to secondhand smoke (SHS) are at risk of developing ear infections, asthma, wheezing, bronchitis, as well as retarded lung growth. Indoor smoking is the main source of children's exposure to SHS. Despite a downward trend in smoking, children from low income families, especially African American and Hispanic children, continue to be exposed to SHS at a higher rate than their wealthier counterparts. This multiple case study explored the perceptions of 15 parents of 3- to 5-year-old children currently enrolled in Head Start regarding children's exposure to SHS. This study relied on the social ecological model, the theory of …
Sport-Related Concussion And Lower Extremity Musculoskeletal Injuries In High School Athletes, Lisa Koperna
Sport-Related Concussion And Lower Extremity Musculoskeletal Injuries In High School Athletes, Lisa Koperna
Walden Dissertations and Doctoral Studies
Sport-related injuries (SRI) can be foreseen and averted when mechanisms and risk factors are completely understood. An appreciation of the relationship between sport-related concussion (SRC) and lower extremity musculoskeletal injuries (LEMI) is emerging amid professional and collegiate athletes. However, findings of such a relationship in adults may not be generalizable to younger populations, and the literature has not addressed this relationship in adolescents. The purpose of this cross-sectional quantitative study was to examine the relationship between SRC and LEMI in high school athletes. The dynamic model of etiology in sport injury provided the study's conceptual framework. A de-identified secondary dataset …
Association Between Adaptive Sports Programs And Quality Of Life Among Amputee Veterans, Sean V. Seay
Association Between Adaptive Sports Programs And Quality Of Life Among Amputee Veterans, Sean V. Seay
Walden Dissertations and Doctoral Studies
Adaptive sports programs (ASPs) are important for enhancing the physical, psychological, and social aspects of life for amputee combat veterans while reducing the risk of depression and anger. Although the role of ASPs in improving quality of life (QoL) has been researched in relation to amputee combat veterans of World War II, the Korean War, and the Vietnam War, there has been limited examination of the role of ASPs in improving QoL among veterans of Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation Noble Eagle (OND). Therefore, the purpose of this study was to assess the effects of …
Catheter-Associated Urinary Tract Infection In New York And North Carolina, Kehinde O. Abiodun
Catheter-Associated Urinary Tract Infection In New York And North Carolina, Kehinde O. Abiodun
Walden Dissertations and Doctoral Studies
In the United States, many hospitalized patients with indwelling urinary catheters acquire catheter-associated urinary tract infections (CAUTI) during their hospital stay. CAUTI negatively affects peoples' health and quality of life and causes a financial burden to individuals and the nation. The purpose of this quantitative cross-sectional study was to explore the relationship between gender, age, and hospital types and CAUTI incidence in New York and North Carolina over a 3-year period. The theoretical framework of choice was the Donabedian model. Simple logistic regression and hierarchical multivariable logistic regression analysis were performed on archival data that was requested from Healthcare Cost …
Education Models For Teaching Adults About Modifying Dietary Carbohydrate And Controlling Weight, Vincient Cleamons
Education Models For Teaching Adults About Modifying Dietary Carbohydrate And Controlling Weight, Vincient Cleamons
Walden Dissertations and Doctoral Studies
The prevalence of diabetes and other pathophysiological conditions has been correlated with the incidence of obesity. A large portion of an adult community in the northwestern United States suffers from excessive weight that has been linked to premature mortality rates and certain forms of diabetes. Excess calories from carbohydrate have been shown to increase weight. Therefore, diets that are modified in carbohydrate and calories may help mitigate weight and obesity comorbidities. This qualitative, single case study's purpose was to explore the methods health care professionals use for teaching adults about controlling weight. Altheide and Johnson's analytic realism theory, in which …