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Articles 1 - 30 of 31
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Family Caregivers' Perspectives On Establishing Hospice Care In Belize, Rachael Florita Battle
Family Caregivers' Perspectives On Establishing Hospice Care In Belize, Rachael Florita Battle
Walden Dissertations and Doctoral Studies
End-of-life (EOL) care decisions present a challenge for family caregivers. Despite the increasing number of terminally ill patients in need of pain management and comfort care, there is limited qualitative data about how populations in the developing world can access culturally appropriate resources and EOL support. In this phenomenological study, 17 Garifuna family caregivers in southern Belize were interviewed about their experience caring for terminally family members. The conceptual frameworks were Kübler-Ross’s hospice approach and Watson’s theory of human caring. The two theories were selected based on their significance to this process: Kübler Ross’s hospice approach and its impact on …
Tobacco Treatment Education Module For Nurses Working In The Inpatient Psychiatric Setting, Marchell Rene Spielmann
Tobacco Treatment Education Module For Nurses Working In The Inpatient Psychiatric Setting, Marchell Rene Spielmann
Walden Dissertations and Doctoral Studies
Tobacco use among people with mental illness remain a significant problem in the western United States. At the project site, there is widespread tobacco use among patients with mental illness and lack of training for nurses to address the issue. The purpose of this project was to educate nurses working in the acute psychiatric setting about evidence-based tobacco treatment interventions. The practice-focused question addressed whether a tobacco education program would increase nurses' knowledge, confidence, and skills to provide tobacco treatment interventions to patients with a mental illness. Self-determination theory and the transtheoretical model of change provided the theoretical framework for …
Public Health Nurses’ Perceptions Of High School Dropout Rates As A Public Health Issue, Maria Wallace
Public Health Nurses’ Perceptions Of High School Dropout Rates As A Public Health Issue, Maria Wallace
Walden Dissertations and Doctoral Studies
Education is one of the strongest predictors of health, and well-being. Early termination of education can lead to poorer health, shorter lifespans, and increased stress on the healthcare system. Improving overall high school graduation rates has been debated and discussed by the Toronto District School Board (TDSB) and the Ministry of Education, however, there is a paucity of research on increased graduation rates as they relate to public health in the Canadian context. The purpose of this phenomenological qualitative study was to explore the perceptions of liaison public health nurses (PHNs) who worked directly with the TDSB regarding their roles …
Effects Of Medical Professionals' Communication With Men Sleeping With Men And Hiv/Aids, Dawne D. Dickerson
Effects Of Medical Professionals' Communication With Men Sleeping With Men And Hiv/Aids, Dawne D. Dickerson
Walden Dissertations and Doctoral Studies
The human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) initially emerged in the 1980s and ever since, a battle has been underway with regard to understanding some of the root issues attributed to behavior and HIV/AIDS. AIDS is prevalent in the men sleeping with men (MSM) community. There is lack of studies evaluating the quality and quantity of communication between MSM and medical professionals, which can be a catalyst to help reduce HIV/AIDS within this community. The aim of this quantitative study was to evaluate the relationship between quantity and quality of medical professionals' communication and regular HIV …
Successful Strategies For Increased Dental Practice Competitiveness, William Eyster
Successful Strategies For Increased Dental Practice Competitiveness, William Eyster
Walden Dissertations and Doctoral Studies
The rapid expansion of dental service organizations (DSOs) continues to disrupt the traditional dental practice model and there was a 12.2% increase in DSOs between 2015 and 2016. Some solo and small group dental practice owners lack strategies to adapt their businesses to be successful in newly competitive markets including DSOs. Grounded in systems theory, the purpose of this qualitative multicase study was to explore strategies dental practice owners use to adapt their businesses to be successful in newly competitive markets. The participants included 3 solo and 2 small group dental practice owners in central Kentucky who demonstrated success in …
Implementing Esi Education Project For Nurses In The Triage Process, Narissara L. Tran
Implementing Esi Education Project For Nurses In The Triage Process, Narissara L. Tran
Walden Dissertations and Doctoral Studies
Triage nursing assessment supports nursing professionals in delivering safe and effective patient care in emergency departments. This staff education project was driven by an observation of inconsistencies in triage among emergency department (ED) nursing staff. The purpose of the project was to improve the triage assessment knowledge of ED nurses. Specifically, the aim was to determine if educating ED nursing staff about using the Emergency Severity Index (ESI), a 5-level triage algorithm and a previously developed tool, would improve nurse knowledge in the triage process. Following discussion with the ED nursing manager at a hospital, a presentation on the ESI …
Closing The Gaps In Rural Healthcare In Texas: A Formative Bounded Case Study, Marianne Bogel
Closing The Gaps In Rural Healthcare In Texas: A Formative Bounded Case Study, Marianne Bogel
Walden Dissertations and Doctoral Studies
Maldistribution of healthcare professionals persists in remote and rural communities throughout the world. Adoption of a Community Paramedic (CP) program could improve access to quality healthcare for rural communities. The conceptual framework defined rural communities by their distinct characteristics — community efficacy, weaknesses, attitudes, assets, deficits, local culture, and the driving and restraining forces — and not defined by their small populations or distances to cities. The theoretical foundation was a synthesis of theories of Bandura, Rogers, and Lewin. This study assessed community characteristics that may influence the likelihood of success, sustainability, or program failure of the Australian CP model …
Quality Improvement Initiative To Improve Patient Attendance In Diabetes Self-Management Education Classes, Charon Denise Randel
Quality Improvement Initiative To Improve Patient Attendance In Diabetes Self-Management Education Classes, Charon Denise Randel
Walden Dissertations and Doctoral Studies
Diabetes self-management education (DSME) is a key resource in the battle against diabetes and its secondary effects. This quality improvement project was conducted to address the decreased attendance rates of DSME classes in a community health center in the southern United States. The practice question for this project explored process-related strategies to increase patient attendance in DSME classes. Based on review of patient reports of reasons for nonattendance and an evaluation of peer reviewed literature on improving attendance in DSME, the following strategies were implemented: (a) alternative solutions such as providing patients with the dates for a year of initial …
Nurse Managers’ Self And Authentic Leadership In Relation To Their Job Satisfaction, L'Ouverture Ellis
Nurse Managers’ Self And Authentic Leadership In Relation To Their Job Satisfaction, L'Ouverture Ellis
Walden Dissertations and Doctoral Studies
There is a high cost to nurse manager turnover and added to this challenge is the difficult tasks that hospitals have of recruiting and retaining nurse managers. These difficulties make it challenging for healthcare providing institutions to achieve consistent positive patient and staff outcomes. The current study examined the relationship between self-leadership, authentic leadership, and job satisfaction with nurse managers. Three elements making up the theoretical framework of this research were self-leadership, authentic leadership, and job satisfaction. The 2 predictor variables were self-leadership and authentic leadership. An evaluation of whether a relationship existed between the predictors and the criterion, job …
Adolescent Obesity Intervention In An Outpatient Primary Care Setting, Chinyere Susanna Awamba-Agu
Adolescent Obesity Intervention In An Outpatient Primary Care Setting, Chinyere Susanna Awamba-Agu
Walden Dissertations and Doctoral Studies
Lack of education in the outpatient setting related to causes, complications, and prevention of obesity is associated with high rates of obesity in adolescents 12 to 19 years of age. The gap in the adolescents' and family members' knowledge of obesity contributes to the adolescents' high calorie consumption and the development of obesity. The purpose of this project was to develop a staff education guideline for use by clinicians to educate adolescents and their families on how to develop nutritious food plans and decrease obesity. The project practice question asked whether educating the primary care providers in the primary care …
Cultural Competence Of Public Health Nurses Who Care For Diverse Populations, Althea Michelle Otuata
Cultural Competence Of Public Health Nurses Who Care For Diverse Populations, Althea Michelle Otuata
Walden Dissertations and Doctoral Studies
Despite advances in health, science, and technology, U.S. healthcare lags in providing access to care and quality care to racial and ethnic minorities. Cultural competence has been noted as a strategy to improve access and quality. The purpose of this project was to assess public health nurses' cultural competence before and after participating in cultural competence informational modules. Two conceptual models were used in this project for theoretical guidance: Leininger's cultural care diversity and universality theory and Campinha-Bacote's process of cultural competence. To assess the nurses' cultural competence, the Cultural Competence Self-Assessment Checklist questionnaire was e-mailed to 57 public health …
An Analysis Of Employee Motivation After Metamorphose, Conglomerated Public Health Care Systems, Aleta Marie Lymon
An Analysis Of Employee Motivation After Metamorphose, Conglomerated Public Health Care Systems, Aleta Marie Lymon
Walden Dissertations and Doctoral Studies
A global epidemic of metamorphosed, conglomerated health care systems changed the face of public health care organizations. The problem is, public health care organizations merge into new systems, but the culture for each merged organization has not been formed under the new system. Public administrators, health care workers and the Department of Health and Human Services are affected when there are issues in health care behavioral practices and performance outcomes. Research found that employee motivation is hard to achieve when there are issues within the internal structure of a new system. Using Herzberg's motivation-hygiene and Tajfel and Turner's social identity …
Patient Awareness And Knowledge Of Medically Induced Radiation Exposure, Travis L. Mann
Patient Awareness And Knowledge Of Medically Induced Radiation Exposure, Travis L. Mann
Walden Dissertations and Doctoral Studies
The level of knowledge and awareness among patients about the concepts and implications of medical radiation is unknown. The purpose of this qualitative, case study was to explore patients' awareness and knowledge of information regarding this topic from their perspectives. The health belief model provided the framework for the study. A total of 20 individuals were recruited using purposive sampling. All participants were above the age of 18 in central North Carolina and had undergone or are currently undergoing medical radiation exams. Data were collected using semistructured interviews and analyzed using Yin's 5-phased cycle, which involved compiling, disassembling, reassembling, interpreting, …
Cardiovascular Exercise Participation And Obstructive Sleep Apnea Among Adults Over Normal Weight In The United States, Marytherese Agwara
Cardiovascular Exercise Participation And Obstructive Sleep Apnea Among Adults Over Normal Weight In The United States, Marytherese Agwara
Walden Dissertations and Doctoral Studies
Obstructive sleep apnea (OSA) is a type of sleep apnea that is common, complicated, and a major contributor to cardiovascular diseases, neurocognitive impairment, and mortality. This disease has additional negative impacts on patients' lives by contributing to daytime sleepiness and low productivity at work as well as absenteeism and work-related injuries. Several studies have been conducted to assess the relationship between cardiovascular exercises and OSA; however, a definite conclusion is lacking. The purpose of this quantitative cross-sectional study was to assess the relationship between cardiovascular exercise participation and OSA by examining the relationship between total cardiovascular exercise participation per week …
Development Of A Standardized Oral Care Staff Education Program, Katrina Detoye
Development Of A Standardized Oral Care Staff Education Program, Katrina Detoye
Walden Dissertations and Doctoral Studies
Hospital-acquired infections such as nonventilated hospital-acquired pneumonia (NV-HAP) are significant patient safety concerns. The lack of oral care in the nonventilated acute care patient population is a major contributor to NV-HAP. Nursing staff are on the frontline in the provision of oral care to hospitalized patients, but a lack of knowledge regarding the relationship between oral care and NV-HAP was identified as a gap in practice at the project site. The purpose of the project was to develop a staff education program on oral care of the nonventilated patient population. The practice-focused question addressed whether an evidence-based education for nurses …
Addressing Human Papillomavirus Vaccination In Primary Care Pediatrics, Natasha Marie Subramaniam
Addressing Human Papillomavirus Vaccination In Primary Care Pediatrics, Natasha Marie Subramaniam
Walden Dissertations and Doctoral Studies
Human papillomavirus (HPV) is the most common sexually transmitted disease in the United States. Despite most common transmission, HPV immunization in adolescents remains below target rates of 80% as outlined by Healthy People 2020 Objectives. Nearly all individuals will contract HPV during their lifetime. The purpose of this project was to educate providers on successfully promoting HPV immunization in adolescents utilizing evidence-based methods. The health belief model (HBM) was the theoretical underpinning utilized to teach providers on discussions about 9vHPV immunization with parents of adolescents. The practice focused question explored whether an education program using concepts from the HBM would …
Emotional Intelligence And Sociodemographic Status In Associate Degree Nursing Students, Melanie Renee Benington
Emotional Intelligence And Sociodemographic Status In Associate Degree Nursing Students, Melanie Renee Benington
Walden Dissertations and Doctoral Studies
Emotional intelligence (EI) is essential for providing quality and competent care in the nursing profession. Because nurses need to be competent in EI, it is important to determine if inherent factors and academic performance contribute to the development of EI. The purpose of this study, guided by the 4-branch ability model of EI by Mayer and Salovey, was to examine the relationship of EI levels and academic performance, gender, and ethnic background in associate degree nursing (ADN) students who attended a community college. Using convenience sampling, 110 ADN students completed the Schutte Self-Report Emotional Intelligence Test and sociodemographic data. Data …
Maintaining Confidentiality Among Hiv Infected Couples: Physicians' Patterns Of Decision In Nigeria, Francess Uju Ayaebene
Maintaining Confidentiality Among Hiv Infected Couples: Physicians' Patterns Of Decision In Nigeria, Francess Uju Ayaebene
Walden Dissertations and Doctoral Studies
Policies mandating HIV status disclosure to decrease incidence create ethical challenges for physicians on whether to breach or maintain infected patients' confidentiality. In Sub-Saharan Africa where HIV incidence is high, there is a need for clear guidelines/policies on making confidentiality decisions. The purpose of this quantitative quasi experiment was to determine whether the gender, gender orientation, and sexual relationship of an infected patient and physicians' demographics predicted physicians' decisions to breach confidentiality. In Plateau State, Nigeria, 222 physicians were given vignette questionnaires containing 6 different descriptions of gender, gender orientation, and sexual relationships of a hypothetical patient. Each physician decided …
Social And Structural Barriers To Safer Sex Among Heterosexual Female Sex Workers, Erika Nikole Harding-Davis
Social And Structural Barriers To Safer Sex Among Heterosexual Female Sex Workers, Erika Nikole Harding-Davis
Walden Dissertations and Doctoral Studies
Individuals infected with HIV through heterosexual contact made up 24% (9,578) of all new infections in the United States. Female sex workers are at increased risk of getting HIV and other sexually transmitted infections (STI) because they may be more likely to participate in risky sexual behaviors including sex with multiple partners and condom-less anal/vaginal sex. Guided by the syndemic theory, the purpose of this study was to explore the relationships between social and structural factors (homelessness, substance use, immigration status, and use of healthcare) and risky sexual behaviors (condom-less vaginal sex and multiple sex partners) among female sex workers …
The Role Of The Physicians' Assistant In Trinidad And Tobago's Healthcare System, Martha Ann Pamponette
The Role Of The Physicians' Assistant In Trinidad And Tobago's Healthcare System, Martha Ann Pamponette
Walden Dissertations and Doctoral Studies
The profession of physicians' assistant was introduced in the 1960s to assist with physician shortages in the United States of America. Since then, some countries have introduced this profession to fill the gaps that exist in the physician shortages problem in their health care system. Yet, in many countries like Trinidad and Tobago, this role remains absent from the health care system. The objective of this study was to assess how professionalization supports the introduction of the physicians' assistant role in Trinidad and Tobago. Using the theory of profession as a theoretical framework, and through an evaluation of institutional, regulatory, …
Factors Affecting Health Care Access And Utilization Among U.S. Migrant Farmworkers, Melinda R. Kelly
Factors Affecting Health Care Access And Utilization Among U.S. Migrant Farmworkers, Melinda R. Kelly
Walden Dissertations and Doctoral Studies
There are over 3 million seasonal and migrant farmworkers in the U.S. agricultural industry with a significant percentage of farmworkers documented or native to the United States. Migrant farmworkers live below the federal poverty levels at high rates and experience low health care access and utilization. Guided by the fundamental cause theory, the purpose of this phenomenological study was to examine the lived experiences of migrant farmworkers and identify the factors impacting their health care access and utilization. Face-to-face interviews were conducted with 12 migrant farmworkers who had worked in Southwest Texas agricultural stream. Data were analyzed and coded to …
Cultivating Cultural Competence To Address Childhood Obesity In Ethnic Minority Youth, Tia Knight-Forbes
Cultivating Cultural Competence To Address Childhood Obesity In Ethnic Minority Youth, Tia Knight-Forbes
Walden Dissertations and Doctoral Studies
Obesity is an increasingly prevalent health issue, especially among children who live in high poverty, low income, and low education areas that lack needed resources and health care to promote quality of life. African American youth have a higher rate of obesity than other populations. The purpose of this project was to address an identified gap in practice by improving health care professionals' ability to provide culturally competent care to African American youth. An educational intervention framed by the Purnell model for cultural competence was developed to address the question, Will cultural competency staff education improve knowledge to prevent and …
Perceptions Of Barriers To Oral Care Among African American Families In Durham, North Carolina, Samuel Motto
Perceptions Of Barriers To Oral Care Among African American Families In Durham, North Carolina, Samuel Motto
Walden Dissertations and Doctoral Studies
Dental caries is one of the biggest issues of concern for healthcare providers in Durham, North Carolina due to the high prevalence of dental caries in African Americans. Many researchers have identified socio-economic, low income, poor education, psychological behavior, awareness, allied diseases, environment, unhealthy diet, obesity, type II diabetes, and inadequate health facilities as the possible reasons for its high prevalence, yet literature lacks information regarding how African Americans perceive the problem of oral health. Knowledge of the perceived factors may help to identify the actual cause of dental caries through the eyes of African Americans. The purpose of this …
Noncompliance With Follow-Up Visits In Primary Care, Amanda Michelle Northern
Noncompliance With Follow-Up Visits In Primary Care, Amanda Michelle Northern
Walden Dissertations and Doctoral Studies
No-show appointments, also referred to as missed appointments, occur 23% to 34% annually in general practice care settings. Missed appointments can lead to reduction in appointment availability, decrease in provider/staff productivity, patient/provider discordance, disruption in continuity of care, and reduced quality of care. There is a gap in the nursing literature regarding effective interventions to reduce missed appointments. The purpose of this quality improvement, secondary analysis project was to determine whether implementation of an evidence-based no-show, nurse-led intervention would reduce missed appointment rates in a family medicine practice. The health belief model and the plan, do, study, act model guided …
Socioeconomic Status, Water, Sanitation, Hygiene, And Economic Cost Of Childhood Diarrheal Diseases In Uganda, Sarah Birungi Nahalamba
Socioeconomic Status, Water, Sanitation, Hygiene, And Economic Cost Of Childhood Diarrheal Diseases In Uganda, Sarah Birungi Nahalamba
Walden Dissertations and Doctoral Studies
Worldwide, diarrhea is the second leading cause of death in children aged under 5, yet it is both preventable and treatable. Several studies have established the effects of exposure to inadequate water, sanitation, and hygiene (WASH) on diarrhea prevalence, but little was known on how the interactions of socioeconomic status and WASH influence the economic cost of treatment of diarrhea. This retrospective cross-sectional survey study was focused on assessing the correlation between socioeconomic status, WASH, and household cost of treatment of diarrhea among children aged under 5 in Uganda using the multiple exposure-multiple effect model. Secondary data from the 2015/16 …
Patient Awareness And Knowledge Of Medically Induced Radiation Exposure, Travis L. Mann
Patient Awareness And Knowledge Of Medically Induced Radiation Exposure, Travis L. Mann
Walden Dissertations and Doctoral Studies
The level of knowledge and awareness among patients about the concepts and implications of medical radiation is unknown. The purpose of this qualitative, case study was to explore patients' awareness and knowledge of information regarding this topic from their perspectives. The health belief model provided the framework for the study. A total of 20 individuals were recruited using purposive sampling. All participants were above the age of 18 in central North Carolina and had undergone or are currently undergoing medical radiation exams. Data were collected using semistructured interviews and analyzed using Yin's 5-phased cycle, which involved compiling, disassembling, reassembling, interpreting, …
Strategies For Nursing Staff Working In A Correctional Facility., Ima James
Strategies For Nursing Staff Working In A Correctional Facility., Ima James
Walden Dissertations and Doctoral Studies
As primary care providers in correctional facilities, correctional nurses are expected to balance inmates' healthcare needs with the security demands of the facility. This project explored whether an evidence-based education program could provide strategies for promoting health, a healthy work environment, and a sense of well-being to improve the knowledge, coping skills, and well-being of nurses working in a correctional occupational setting. Twenty nurses participated in an educational intervention project that was guided by the transactional theory of stress. Using a pretest/posttest design, data were collected over a 2-week period and calculated using means and percentages. The descriptive statistics using …
Integrating Health Care Systems To Maintain Quality Care And To Manage Cost, Marilynn Noble
Integrating Health Care Systems To Maintain Quality Care And To Manage Cost, Marilynn Noble
Walden Dissertations and Doctoral Studies
The rising cost of health care in the Philippines is a concern for the Department of Defense and TRICARE beneficiaries. The purpose of this quantitative cross-sectional research study was to determine the efficacy and acceptability of a different method to deliver health care to increase access to health care and decrease out-of-pocket costs while maintaining quality of care for TOP Standard beneficiaries who receive health care under the Philippine Demonstration. Secondary data was used to determine the acceptability of an alternative reimbursement methodology to decrease cost but maintain access to quality care. The Andersen's behavioral health care model and the …
Oral Health Literacy And Oral Hygiene Habits In A Kentucky Appalachian Community, Katie D. Schill
Oral Health Literacy And Oral Hygiene Habits In A Kentucky Appalachian Community, Katie D. Schill
Walden Dissertations and Doctoral Studies
This study sought to identify the level of oral health literacy held by people who live in transitional and distressed Kentucky Appalachian areas and if this effects how often they are using oral hygiene techniques. Data were also collected to describe the attitudes Kentucky Appalachian adults hold toward oral hygiene and oral health status. Current documentation shows that poor oral health remains a public health threat in this population despite efforts such as school-based sealant programs and increased dental insurance coverage. This study followed a quantitative design and 99 participants were polled using a survey specifically developed for this study's …
Development Of An Online Resource Manual And Online Protocol To Facilitate Care Coordination, Leonore Bingham
Development Of An Online Resource Manual And Online Protocol To Facilitate Care Coordination, Leonore Bingham
Walden Dissertations and Doctoral Studies
Persons with disabilities tend to be in poorer health compared to those without disabilities, and timely coordination of care is essential for maintaining optimal health and wellness. The problem addressed in the Care Coordination Referral Project was the lack of timely access to health care and preventive care services for clients with disabilities in the organization for which this project was developed. Using the appraisal of guidelines research and evaluation II model, the purpose of this DNP project was to analyze and synthesize the evidence-based literature to support the project and develop an online health care resource manual and protocol. …