Medicine and Health Sciences Commons^™

The Green House Nursing Home Model: The Gh Elements And Their Impact On Quality Of Care In Nursing Homes., Deborah Kaminka Niyongabo

Electronic Theses and Dissertations

Nursing homes (NHs) have been described as hospital-like facilities where residents are more likely to experience isolation or abuse. The Green House (GH) model is a type of culture change which focuses on deinstitutionalizing traditional NHs to provide better quality of care and quality of life to NH residents. The two main objectives of this study are: to describe the GH model and its elements and to identify which GH elements impact the quality of care. This study also seeks to identify organizational theories used in the GH analysis. The next objective is to analyze the impact of the GH …

Managing Stress In A Constantly-Changing Workforce, Lorri Burch-Hubbard

Electronic Theses and Dissertations

When staffing reductions occur in the workplace, staff left behind may face increased stress, may not be given the support they need to manage the feelings caused by the reduction. This study was conducted to evaluate the impact of stress caused by staffing reductions has on medical technologists (MT), medical technicians (MLT) and respiratory therapists (RT), and to identify any common methods of stress management used by those staff who remain in the organization.

Literature research showed the negative impact stress can have on individuals when it is not addressed, such as decreased work performance, health issues, and even the …

The Impact Of State-Level Laws On Syringe Service Program Access And Risk Environment Of People Who Inject Drugs (Pwid), Samuel Pettyjohn

Electronic Theses and Dissertations

Background: Understanding concentrated areas with high rates of opioid use disorder (OUD) allows for improved placement of Narcan access points through syringe services programs (SSPs). People Who Inject Drugs (PWID) have lower risk of contracting infectious diseases the closer they are to SSPs. Tennessee law prohibits SSPs within 2000ft of a school or park, impacting the placement of SSPs in non-urban areas. Testing factors related to SSP siting placement within a system dynamic model can better determine the relationship between PWID risk environment and SSP access and utility.

Methods: We identified areas of greatest need for harm reduction interventions within …

Oral Health-Related Quality Of Life In Us Adults With Type 2 Diabetes., Giang Truong Vu

Electronic Theses and Dissertations

This dissertation focused on the relationship between type 2 diabetes (T2DM) and oral health-related quality of life (OHRQoL) and the factors associated with this relationship in the US. The objectives of the dissertation research were a three-part process: (1) to understand the relationships of T2DM with poor OHRQoL, clarify risk and preventive factors that affect this association, and identify research gaps in the literature, (2) to analyze risk factors associated with poor OHRQoL in US adults with T2DM using a nationally representative random probability cluster sample, and (3) to apply structural equation modeling (SEM) to a simplified Andersen’s Behavioral Model …

Preventable Hospitalization Among Type 2 Diabetes Patients In Kentucky Before And After Medicaid Expansion 2010-2017., Turky Jamil Arbaein

Electronic Theses and Dissertations

Objectives: 1) Analyze county level variation in T2DM-PH rates in Kentucky before ACA (2010-2013) and after the ACA (2014-2017). 2) Analyze the relationship between county level socioeconomic factors (income per capita, percentage of uninsured people, percent of urban population, primary care and general preventive offices, population aged 65 and above, median age, household income, percentage in poverty, and unemployment rate ) and county level T2DM-PH rates before (2010-2013) and after (2014-2017) ACA implementation in Kentucky. Method: This research was conducted in two phases: Phase one of this study estimated the county-level PH variation among T2DM patients across eight years (2010-2017), …

Resources To Access Health Care For Low Socioeconomic Status Youth Athletes, Stephanie Walsh

Electronic Theses and Dissertations

Background: Approximately 60 million youth participate in organized sports, with 13.5 million receiving care for sports related injuries each year. Most youth sports organizations do not have readily accessible health care resources; relying on parents and guardians to manage injuries. However, a majority of parents and guardians are untrained in appropriate management of injuries, therefore there is a need for understanding the availability of health care resources within the community. Resources necessary to access health care include health services, health insurance, transportation, and communication. Barriers to these resources may affect lower socioeconomic status family’s accessibility to care. Purpose: Investigate the …

Assessing The Percieved Barriers To Early Detection, Treatment, And Management Of Cervical Cancer Among Ghanaian Women, Angela D. Blackwell

Electronic Theses and Dissertations

Introduction: The purpose of this study was to assess the perceived barriers and strategies for improvement of timely detection, treatment, and management of cervical cancer among Ghanaian women in a tertiary hospital setting. Methods: Sixty semi-structured interviews, comprised of thirty-five cervical cancer patients and twenty-five healthcare professionals who provide cervical cancer care, were conducted. Two focus groups were conducted, including four healthcare professionals and another with two healthcare professionals—the data were analyzed using NVivo 12. A theoretical thematic analysis was utilized to identify common themes and sub-themes that arose from the participant interviews. The social-ecological model framework was employed to …

The Effect Of Patient And Hospital-Level Factors On 30-Day Readmission After Initial Hospitalization Due To Stroke, Emmanuel Akowuah

Electronic Theses and Dissertations

Background: Hospital readmissions account for a large part of healthcare costs, especially among stroke patients. Readmission is common among disabled stroke survivors because they often suffer some neurological deficits, functional impairment, and other preexisting cardiovascular conditions. Although previous studies have explored the relationship between hospital readmissions after initial hospitalization due to stroke and a set of predictors using various analytical models, it often remains uncertain which predictors are most influential or essential. This study aimed to assess the effect of patient and hospital-levels factors on 30-day readmission after initial hospitalization due to stroke using the Anderson model of healthcare …

Eye Screening In U.S. Adults With Diabetes: Examination Of Trends, Racial And Ethnic Differences, And Contribution Of Medicaid Expansion, Meps 2010-2017, Karon Lewis

Electronic Theses and Dissertations

Diabetic retinopathy (DR) is a prevalent cause of vision impairment and blindness among adults in the United States. Early diagnosis of DR through dilated eye examinations can reduce the risk of vision impairment or loss. Differences in eye examination rates by race and ethnicity have been suggested by prior studies emphasizing importance of increasing insurance coverage and access to care among minority populations. The Affordable Care Act aimed to expand health insurance coverage and improve access to care. This study examined trends overall and by race and ethnicity in eye examination rates and the contribution of Medicaid expansion on changes …