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The Effects Of Vesico-Vaginal Fistula In The Lives Of Women In Southeastern Nigeria, Chioma Esther Amutaigwe Jan 2023

The Effects Of Vesico-Vaginal Fistula In The Lives Of Women In Southeastern Nigeria, Chioma Esther Amutaigwe

Walden Dissertations and Doctoral Studies

Vesico-vaginal fistula (VVF) is a maternal health problem faced by women in developing countries. VVF is one of the most devastating consequences of prolonged obstructed labor and is still prevalent in resource-poor countries like Nigeria where fertility is high, the status of women is low, and obstetric services are often inadequate. The objective of this study was to enrich our understanding of the effects of VVF as it relates to women’s experiences in southeastern Nigeria. I adopted the Transactional Model of Stress and Coping in this study; this theory posits that people, when contending with any kind of stressors, are …


Tuberculosis-Associated Knowledge, Stigma, And Health Seeking Behavior Among Traders In Onitsha Main Market, Anambra State, Nigeria, Benedeth N. Ezeosim Jan 2023

Tuberculosis-Associated Knowledge, Stigma, And Health Seeking Behavior Among Traders In Onitsha Main Market, Anambra State, Nigeria, Benedeth N. Ezeosim

Walden Dissertations and Doctoral Studies

The utilization of tuberculosis (TB) health care services in a Nigerian state has not been optimal. Many residents do not utilize available health care resources when they experience symptoms of TB. Although much is known about the determinants of health seeking behavior (HSB), there is a gap on how TB knowledge and TB related stigma among traders in one main market contribute to HSB. This study examined the effect of TB knowledge and TB related stigma on HSB among traders. The health stigma and discrimination and health belif models served as the theoretical foundation. A quantitative cross-sectional analytical survey design …


Perinatal Nursing Education Related To Opioid Use Disorder, Britney Taniguchi Jan 2023

Perinatal Nursing Education Related To Opioid Use Disorder, Britney Taniguchi

Walden Dissertations and Doctoral Studies

Opioid use disorder (OUD) contributes to severe perinatal and neonatal morbidity and mortality in the United States, leading to alarming complications for pregnant women, mothers, and newborns. Complications the mother experiences with OUD include increased mortality, overdose, infections, endocarditis, narcotic bowel syndrome, and accident-related injury. Complications the newborn can suffer include neonatal abstinence syndrome, respiratory depression, microcephaly, and sudden infant death syndrome. Framed within the analysis, design, development, implementation, and evaluation model of instructional design, this project aimed to plan, implement, and evaluate a staff education program on opioid use disorder. The staff education program was presented to 13 perinatal …


The Disaster Health System: Built For Collaboration And Coordination In A Complex Environment, Leslie E. Taylor Jan 2023

The Disaster Health System: Built For Collaboration And Coordination In A Complex Environment, Leslie E. Taylor

Walden Dissertations and Doctoral Studies

This qualitative case study examined patient distribution and coordination during complex, rapidly changing, uncertain emergencies or disasters. The study explored how Washington State’s Northwest Healthcare Response Network (NHRN) uses the state’s patient tracking system, WaTrac, as a collaboration tool for Emergency Support Function 8 (ESF 8) and public health emergency operations. This study used complexity theory to address a gap in the literature, acknowledging the importance of relationships among members of the NHRN and how the patient tracking system could enhance positive patient outcomes. This study included nine healthcare response participants; all were members of the NHRN healthcare coalition serving …


Predictors Of Retention Among Individuals With Hiv Initiating Antiretroviral Therapy In Ghana, Ivy Ama Okae Jan 2023

Predictors Of Retention Among Individuals With Hiv Initiating Antiretroviral Therapy In Ghana, Ivy Ama Okae

Walden Dissertations and Doctoral Studies

Abstract Managing HIV requires lifelong therapy. Retaining clients on lifelong therapeutic antiretroviral therapy (ART) ensures the suppression of viral replication and better health outcomes. The time of the start of ART management is also a factor in determining better health outcomes for persons living with HIV. This study examined the association between initiation criteria (treat all, Option B+, and CDC T-cell count < 500) and retention on ART at 12 months for 17,974 randomly selected clients in the Ghana Health Service's HIV patient electronic database. Analyses controlled for age, gender, educational status, alcohol use, treatment/adherence monitoring, and tuberculosis disease treatment. Bronfenbrenner's ecological systems theory guided the interpretation of the findings. Results shows that retention was positively associated with all treatment initiation criteria. Clients initiated with CD4 count ≤ 500 criteria seemed to be retained at 12 months on ART at a higher rate than initiation criteria based on Option B+ and treat all. The study results may contribute to positive social change by supporting CD4 testing for clients before initiation of ART to improve retention and ensure the availability and use of adherence counseling, no tuberculosis disease and its prevention, and low use of alcohol among people living with HIV. The results of this study may also provide opportunities for public health policy intervention efforts requiring a personalized, group-based approach to service delivery at the intrapersonal level, interconnected with interpersonal, meso, and meta factors at the community level.


Narrative Inquiry Into Postsecondary Transition Outcomes For Young Adults With Intellectual & Developmental Disabilities, Eric R. Sarrett Aug 2022

Narrative Inquiry Into Postsecondary Transition Outcomes For Young Adults With Intellectual & Developmental Disabilities, Eric R. Sarrett

Walden Dissertations and Doctoral Studies

Young adults with intellectual and developmental disabilities (IDD) continue to struggle with community engagement despite decades of research and policy initiatives addressing postsecondary transition. Evidence shows that persons with IDD are engaging in employment, postsecondary education, independent living, socialization, and other roles at significantly diminished rates, yet little data exists describing this participation in the voices of those affected. The purpose of this narrative inquiry was to describe community integration of persons with IDD in the decade following postsecondary transition in their own words. Critical disability theory was used as a lens to explore the successes and failures of public …


Relationships Between Stress Self-Management, Social Support, And Health In Hispanic Informal Caregiver Burnout Prevention, Nicole Alexandra Mas Román Jan 2022

Relationships Between Stress Self-Management, Social Support, And Health In Hispanic Informal Caregiver Burnout Prevention, Nicole Alexandra Mas Román

Walden Dissertations and Doctoral Studies

Burnout syndrome is a psychological disorder characterized by physical, emotional, and mental distress and exhaustion resulting in feelings of depression, anxiety, irritability, and negative attitudes. If left unattended, burnout syndrome can lead to new or worsening health outcomes. The purpose of this nonexperimental quantitative study was to examine the relationship between stress self-management, perceived social support, health status, and burden among Puerto Rican informal caregivers. The theoretical foundations for this research were the informal caregiving integrative model and the individual and family self-management theory. Survey data were collected from 415 participants. Multiple regression analyses were performed to determine the relationship …


Use Of The Hester Davis Falls Risk Assessment Scale In Medical-Surgical Patients, Gideon M. Nyakundi Jan 2022

Use Of The Hester Davis Falls Risk Assessment Scale In Medical-Surgical Patients, Gideon M. Nyakundi

Walden Dissertations and Doctoral Studies

AbstractIdentifying and containing patient falls before they happen, reporting fall occurrence, and analyzing fall causes could increase patient safety to achieve the triple aim of improved quality, reduced cost, and accessibility in healthcare. Patient falls within the medical-surgical population continue to present challenges to patients, families, hospitals, and society, despite the use of fall-related predictive analysis tools. The purpose of this quantitative study was to determine the extent to which the overall score on the Hester Davis Falls Risk Assessment Scale (HDS), comprised of patient-related factors such as medications, volume/electrolyte status, age, last known fall date, mobility, toileting needs, communication/sensory …


Comprehensive Sex Education, Religious Affiliated Organizations, And Std Knowledge Among Young Adults, Leslie Marie Shaffer Jan 2022

Comprehensive Sex Education, Religious Affiliated Organizations, And Std Knowledge Among Young Adults, Leslie Marie Shaffer

Walden Dissertations and Doctoral Studies

AbstractEvery year there are approximately 20 million new cases of sexually transmitted diseases (STDs) in the United States, and half of these are among young adults. Stark County, Ohio recently experienced an increase in chlamydia, gonorrhea, and syphilis cases among 18- to 24-year-old individuals. Public health practitioners have since called for research regarding factors that affect STD knowledge and perceptions in this population. This cross-sectional study was guided by the social-ecological model and assessed the association between attendance at a religious-affiliated institution, access to comprehensive sex education, and STD knowledge. One hundred thirty-eight (n=138) participants, aged 18 to 24 years, …


Readiness Of Adolescent And Young Sickle Cell Patients To Transition From Pediatric To Adult Care, Tanisha D. Belton Jan 2022

Readiness Of Adolescent And Young Sickle Cell Patients To Transition From Pediatric To Adult Care, Tanisha D. Belton

Walden Dissertations and Doctoral Studies

Patients with sickle cell disease (SCD) face many challenges as they enter adulthood; therefore, preparing for the transition to adult care is crucial. Assessing the knowledge and skills adolescents and young adults (AYAs) possess before transitioning to adult care can aid in the success of their transition. However, a gap exists regarding factors attributed to guiding patients’ sense of readiness. The purpose of this quantitative study, driven by the theory of self-care management of SCD, was to examine the self-perceived readiness of SCD patients as they prepare to transition to adult care. Cross-sectional survey data were collected from 68 sickle …


Perceived Diabetes Susceptibility Among African American Female College Students, Khaliah India Wilson Jan 2022

Perceived Diabetes Susceptibility Among African American Female College Students, Khaliah India Wilson

Walden Dissertations and Doctoral Studies

Type 2 diabetes is a leading cause of death among African American women ages 20-44 years, and African American female college students are at high risk. Research shows that college students tend to underestimate their susceptibility to Type 2 diabetes, despite their existing risk factors. There is a gap in knowledge concerning African American female college students and their perception of diabetes susceptibility, despite their increased risk. The purpose of this quantitative nonexperimental, correlational study was to identify the factors associated with perceived personal susceptibility to Type 2 diabetes and Type 2 diabetes-related health behavior among African American female college …


Perceived Barriers To Health Care Access And Delivery Among Arkansas Medicaid Beneficiaries, Kimbra D. Butler Jan 2022

Perceived Barriers To Health Care Access And Delivery Among Arkansas Medicaid Beneficiaries, Kimbra D. Butler

Walden Dissertations and Doctoral Studies

Arkansas has historically been one of the lowest ranking states in the United States in education, economy, opportunity, crime and corrections, and health care. Though more than 3 million Arkansans live in the state, nearly 1 million receive Medicaid-funded health insurance. This phenomenological study employed a constructivist paradigm and focused on the perceptions of underserved Arkansans regarding their health and their access to health care; additionally, within this study, the Health Belief Model shifted the study’s focus to individuals’ perspectives, perceptions, experiences, and opinions through interview responses. The research was intended to identify factors that may relate to the higher …


Health Department Prevention/Education Plans And Perceived Risks Of Zika Infection, Lacey Jacques Jan 2022

Health Department Prevention/Education Plans And Perceived Risks Of Zika Infection, Lacey Jacques

Walden Dissertations and Doctoral Studies

AbstractZika virus is an infectious disease caused by the bite of an infected mosquito that has been linked to increased rates of microcephaly and other devastating birth defects. The existing body of knowledge has focused on the individual-level factors that influence a person’s decisions about prevention activities and risk perceptions related to Zika virus. The purpose of this study was to determine the relationship between state-level plans for prevention and education and individual-level risk perceptions. Rosenstock’s health belief model lays a foundation for why individuals make the health decisions they do and helps explain how these can be influenced for …


Secondary Data Analysis Of The Association Of Screen Time With Selected Health Behaviors, Kellany Cadogan Noland Jan 2022

Secondary Data Analysis Of The Association Of Screen Time With Selected Health Behaviors, Kellany Cadogan Noland

Walden Dissertations and Doctoral Studies

The noticeable disparity in youth access of preventive healthcare and youth’s tendency towards excessive screen time have been linked to poor health outcomes. This issue prompted the current study, which had three core purposes: to identify associations between screen time and selected health behaviors, to identify target sociocultural and personal determinants of youth health, and to provide evidence to prompt innovation in promoting youth health via screen-based strategies. The social cognitive theory provided a context for triadic reciprocity between youth personal factors, environmental factors, and behaviors. A quantitative secondary analysis was completed using SPSS-27 to identify whether there was an …


Health-Related Quality Of Life For Veterans Transitioned Into Civilian Life, Vicki Ann Guerra Jan 2022

Health-Related Quality Of Life For Veterans Transitioned Into Civilian Life, Vicki Ann Guerra

Walden Dissertations and Doctoral Studies

Texas veterans transitioning to civilian life have experienced health issues after discharge. There are processes to follow before seeking treatment or diagnosis for any health issue prior to military discharge. Given the gaps in the literature on veteran health, quality of life and transition to civilian life, scholars lack understanding of the transitional events that take place. Veteran health issues are impacted by medical appointment wait-times, day to day life events, and this can lead to decreased quality of life. The purpose of this mixed-methods study (N=36) was to evaluate veterans’ health related quality of life who had transitioned from …


Marijuana Legalization And Depression Effects On Marijuana Use In African American Late Adolescents, Anthony Olusegun Iroko Jan 2022

Marijuana Legalization And Depression Effects On Marijuana Use In African American Late Adolescents, Anthony Olusegun Iroko

Walden Dissertations and Doctoral Studies

State medical marijuana legalization (MML) may contribute to increased cannabis use among older adolescents, especially African American youth and adolescents with depression. This quantitative cross-sectional correlational study, which utilized Smart’s availability-proneness theory of drug use as a guiding framework, had a two-fold purpose: to determine if state MML status and self-reported depression were significantly related to past-month marijuana use and to assess if state MML status significantly moderated between depression and past-month marijuana use. The study utilized data from 1,391 African American late adolescents (aged 16-20) who participated in the 2018 National Survey on Drug Use and Health. Binary logistic …


Typhoid Fever Among Low-Income Women Living In Gujranwala, Pakistan., Tehmina S. Khan Jan 2022

Typhoid Fever Among Low-Income Women Living In Gujranwala, Pakistan., Tehmina S. Khan

Walden Dissertations and Doctoral Studies

Approximately 21 million individuals suffer from typhoid fever (TF) globally, and most outbreaks occur in Southeast Asia. The incidence of TF is high in Pakistan, particularly in low socioeconomic areas, and a new drug-resistant strain makes it difficult to control the spread of TF. There is a pressing need for up-to-date and accurate data regarding the attitudes, beliefs, and habits leading to the spread of TF infection among individuals living in low socioeconomic areas of Pakistan. This qualitative, phenomenological study was grounded in the health belief model and explored factors that influence the spread of TF among women of childbearing …


Perceptions Of Implicit Bias In New York City Healthcare System During Covid-19, Kiesha Jackson Jan 2022

Perceptions Of Implicit Bias In New York City Healthcare System During Covid-19, Kiesha Jackson

Walden Dissertations and Doctoral Studies

Implicit bias has been identified as a significant problem that hinders effective healthcare delivery. The purpose of this qualitative exploratory phenomenological study was to examine whether implicit bias influenced healthcare services for African Americans with comorbidities aged 30 and over living in New York City during the COVID-19 pandemic. Current studies show healthcare disparities, revealing barriers with healthcare delivery; however, they do not disclose a patient’s lived experience qualitatively, which constituted a gap in the literature. The frameworks of the behavioral model of health services use, and social construction and policy design guided this study. Research questions addressed (a) whether …


The Double Burden Of Intra-Household Malnutrition Among Mother–Child Dyads In South Africa, Puveshni Crozier Jan 2022

The Double Burden Of Intra-Household Malnutrition Among Mother–Child Dyads In South Africa, Puveshni Crozier

Walden Dissertations and Doctoral Studies

Household-level double burden of malnutrition (HL-DBM) challenges traditional South African vertical malnutrition programs. Research has associated a household with an overweight/obese mother of reproductive age and her under 5-year-old child with signs of undernutrition (wasting, stunting, or thinness) with socioeconomic levels, maternal characteristics, features of the household, and child’s demographics. Grounded in the social determinants of health conceptual framework, this study aimed to investigate the determinants of HL-DBM in South Africa across the reproductive-child health continuum. Using the representative 2017 Wave 5 South African National Income Dynamics Study survey secondary data, a total sample of 314 homes met this non-experimental …


Integrated Care Impact On Postpartum Visit Compliance And Readmissions, Matthew Herrick Jan 2022

Integrated Care Impact On Postpartum Visit Compliance And Readmissions, Matthew Herrick

Walden Dissertations and Doctoral Studies

The specific research problem that was addressed through this study is the low rate of postpartum visits among Medicaid-enrolled women, leading to increased postpartum complications and readmissions. The purpose of this quantitative study was to evaluate if hospital readmissions can be reduced by integrated care home visiting services relating to postpartum visit compliance. The research questions evaluated the relationships between postpartum visit compliance, hospital readmissions among Medicaid-enrolled women in Indiana, and an integrated care home visiting program. The Donabedian model for quality-of-care grounds this study and is based on structure, process, and outcome. Through this model, healthcare leaders can evaluate …


Bullying, Participation In Violence, Suicidal Ideation, And Behavior Among African American Youth, Kierystan Lorquoyea Johnson Jan 2022

Bullying, Participation In Violence, Suicidal Ideation, And Behavior Among African American Youth, Kierystan Lorquoyea Johnson

Walden Dissertations and Doctoral Studies

Suicide is the second leading cause of death among adolescent, teens, and young adults. Suicidal ideation is a predictor of suicide attempts. Guided by the integrated motivational-volitional model and social cognitive theory, Youth Risk Behavior Surveillance Survey data were used to investigate whether traditional bullying, cyberbullying, and participation in physically violent behavior (independent variables) were associated with suicidal ideation and behavior (dependent variables) among African American high school aged youth controlling for age, gender, physical, and sexual abuse. It was found that experiencing traditional bullying increased suicidal ideation significantly, as there is an 82% increase in likelihood. There was also …


Association Between Opioid-Related Emergency Department Visits And Financial Liability Of Hospitals, Mary-Zitta Muabe Jan 2022

Association Between Opioid-Related Emergency Department Visits And Financial Liability Of Hospitals, Mary-Zitta Muabe

Walden Dissertations and Doctoral Studies

Emergency departments (EDs) are experiencing an influx of patients with opioid-related which result in increased opioid misuse, abuse, and overdoses. The purpose of this study was to examine the relationship between opioid-related ED visits and financial liability of hospitals by evaluating if an increase in opioid-related ED visits leads to an increase in average ED visit costs. The framework used for this study was Reason’s theory of failures, which involves improving healthcare maturity in terms of risk management, achieved through enhanced efficiency. The analyzed research questions included analysis between the number of opioid-related ED visits and financial liability of hospitals …


The Risk Factors For Hiv In African American Transgender Women In Connecticut, Oliver Kunda Jan 2022

The Risk Factors For Hiv In African American Transgender Women In Connecticut, Oliver Kunda

Walden Dissertations and Doctoral Studies

AbstractThe human immunodeficiency virus (HIV) incidence rate is 70 times higher for African American transgender women than in the general population. Despite decades of outreach and intervention effort to reduce HIV incidence in the transgender community by the lesbian, gay, bi-sexual, transexual, queer, plus (LGBTQ+) community and public health organizations, the HIV prevalence rate for transgender women remains high at 38%. The purpose of this qualitative exploratory case study was to gain insights into how attitude, subjective social norms, and perceived behavioral control influence HIV risk behaviors of African American transgender women in Connecticut. Ajzen’s theory of planned behavior provided …


Oral Health Behaviors, Attitudes, And Dental Diseases In Native American/Alaskan Native School-Age Children, Tawanda Martin Jan 2022

Oral Health Behaviors, Attitudes, And Dental Diseases In Native American/Alaskan Native School-Age Children, Tawanda Martin

Walden Dissertations and Doctoral Studies

Dental disease is a highly preventable pediatric disease, and 70% of Native American/Alaskan Native (NA/AN) preschool children have a history of dental caries, which is 3.5 times higher than in the general population. This study aimed to conduct a meta-analysis examining the impact of oral health behaviors and attitudes of NA/AN parents and guardians on dental disease in NA/AN school-age children. The impact of frequency of flossing and brushing, consumption of sugary foods, dental visits, dental attendance reason, sealants, fluoride treatment, and oral health education by NA/AN parents and guardians on children’s caries and periodontal diseases status was explored. Additionally, …


Health Educators’ Perspectives On Black And Latin@ College Students’ Health Literacy, Desiree Williams Brown Jan 2022

Health Educators’ Perspectives On Black And Latin@ College Students’ Health Literacy, Desiree Williams Brown

Walden Dissertations and Doctoral Studies

AbstractEmerging adulthood is a critical life stage when participation in higher education can facilitate the transition of young individuals into adulthood and independence. The barriers associated with low health literacy levels are higher among racial or ethnic groups facing health inequalities, including those enrolled in higher education institutions. The purpose of this basic qualitative study was to explore how health educators promoted the health literacy of Black and Latino emerging adult college students. The theoretical framework was based on Bandura’s social cognitive theory. Eight health professionals who served to promote health literacy across diverse college campuses and different states in …


Effects Of Socioeconomic Status, Demographic Characteristics, And Education On Sarcopenic Obesity, Moruf Oladele Olaleye Jan 2022

Effects Of Socioeconomic Status, Demographic Characteristics, And Education On Sarcopenic Obesity, Moruf Oladele Olaleye

Walden Dissertations and Doctoral Studies

The general problem is that although the body of research about obesity is robust, there is a lack of research addressing the problem of sarcopenic obesity. Specifically, there is a lack of research examining the statistical significance of the relationship between the independent variables of socioeconomic status, demographic characteristics, and education and the dependent variable of sarcopenic obesity. This research may advance practice and policy by lending support for developing interventions to address factors that have a statistically significant relationship with sarcopenic obesity. The purpose of this quantitative causal-comparative study was to identify independent variables among socioeconomic, demographic, and education …


Type Of Union And Reproductive Health Influence On Domestic Violence In Sierra Leone, Yvonne Rowe Jan 2022

Type Of Union And Reproductive Health Influence On Domestic Violence In Sierra Leone, Yvonne Rowe

Walden Dissertations and Doctoral Studies

Domestic violence (DV) is one of the most hidden but prevalent public health concerns affecting women of childbearing age in Africa, despite ongoing prevention initiatives. Lack of power and control in the household is a significant precursor of DV in women, especially in sub-Saharan Africa. While poverty, gender inequality, and societal norms have been identified as directly related to DV, the factors of type of union and reproductive health choice remain unexplored. This quantitative study with a cross-sectional design assessed the relationship between the type of union, female contraceptive use, and type of DV amongst women in Sierra Leone. Anchored …


Experiences Of Critical Care Nurse Managers In Addressing Nurses' Work-Related Stress, Mariana Tsucuneli Jan 2022

Experiences Of Critical Care Nurse Managers In Addressing Nurses' Work-Related Stress, Mariana Tsucuneli

Walden Dissertations and Doctoral Studies

AbstractNurses who work in the critical care unit are more likely to experience work-related stress, fatigue, understaffing, undesirable performance outcomes, and compromised workplace safety than general care nurses. Nurse managers in these units possess insights into nurses' stress-inducing challenges, in addition to managerial and administrative perspectives. Yet there is a lack of available knowledge about the experiences of critical care nurse managers in addressing nurses' work-related stress. The purpose of this study was to explore critical care nurse managers’ experiences of potential strategies to effectively address work-related stress among nurses. The job-demand resource model was the theoretical framework for the …


The Association Between Self-Efficacy, Patient Health Education, And Self-Management In Patients With Rheumatoid Arthritis, Julie Vultaggio Jan 2022

The Association Between Self-Efficacy, Patient Health Education, And Self-Management In Patients With Rheumatoid Arthritis, Julie Vultaggio

Walden Dissertations and Doctoral Studies

Although previous researchers have studied education for patients with chronic conditions, they have not adequately considered the relationship between self-efficacy (SE), patient health education, and perception of self-management (SM) in patients with rheumatoid arthritis (RA). Educating a patient can empower them to better SM. The purpose this study was to examine these associations in this patient population. This quantitative research study featured a descriptive, nonexperimental cross-sectional survey design using nonprobability convenience sampling. The theoretical framework was the social cognitive theory. The independent variables were SE and patient health education. SM was the dependent variable. Patients with RA from a rheumatology …


Chronic Obstructive Pulmonary Disease 30-Day Readmission Rates In California, Illinois, And New York, Theresa Teverbaugh Jan 2022

Chronic Obstructive Pulmonary Disease 30-Day Readmission Rates In California, Illinois, And New York, Theresa Teverbaugh

Walden Dissertations and Doctoral Studies

AbstractThe Centers for Medicare and Medicaid Services (CMS) have implemented financial penalties to reduce hospital readmissions for various conditions, including chronic obstructive pulmonary disease (COPD). As a result, hospital administrators explore ways to prevent financial penalties for excessive COPD 30-day hospital readmissions. The purpose of this quantitative study was to determine if there was a correlation between hospital Medicare reimbursement, quality-of-care measures related to patient satisfaction, and 30-day readmissions rates for COPD patients in California, Illinois, and New York. The quality-of-care measures included communication with nurses, communication with doctors, the hospital staff's responsiveness, and medicine communication. The secondary data were …