Medicine and Health Sciences Commons^™

Relationship Between Health Care Costs And Type Of Insurance, Macey Buker

Walden Dissertations and Doctoral Studies

Continued escalation in health care expenditures in the United States has led to an unsustainable model that consumes almost 20% of GDP. Policymakers have recognized the need for industry reform and have taken action through the passage of the Affordable Care Act (ACA). The purpose of this quantitative, longitudinal study was to examine the relationship between the type of health insurance and health care costs. Mechanism theory and game theory provided the theoretical framework. The analysis of secondary data from the Healthcare Cost and Utilization Project included a sample of 1,956,790-inpatient hospital stays from 2007 to 2014. Results of one-way …

Senescence Disorder Literacy Among Prelingual/Culturally Deaf Individuals Age 50 And Older, J. Delores Hart

Walden Dissertations and Doctoral Studies

The preferred method of communication for most prelingual/culturally Deaf individuals is American Sign Language (ASL), and members of this linguistic/cultural minority community are often not recognized as being bilingual. Many prelingually/culturally Deaf individuals have limitations and deficits in English proficiency; which can lead to deficits in general knowledge of health-related terminology. Current projections are that older adults are expected to live longer, and will also experience the development of, increases in and more extended periods of living with senescence/age-related health disorders, also includes prelingual/culturally Deaf individuals. This quantitative research project, utilizing the theoretical framework of health literacy and a modified …

Teacher And Student Variables Affecting Special Education Evaluation And Referral, Lorenzo Adrian Woodson

Walden Dissertations and Doctoral Studies

Past research has revealed that African American/Black boys are referred for special education evaluation at disproportionately higher rates than boys of other racial/ethnic groups. This correlational study used survey methodology to examine whether student and teacher demographic variables predicted how likely a teacher would refer boy students for special education evaluation. The following questions guided this research: 1) To what degree does student race/ethnicity, teacher gender, teacher race/ethnicity, and teacher attitude toward inclusion predict how likely a teacher would refer boys' to special education after controlling for teacher's years of experience in general and special education? 2) What are the …

Impact Of Social Support Networks On Level Of Stress And Self-Esteem Among Canadian Immigrants, Jackie Williamson

Walden Dissertations and Doctoral Studies

Immigration may be an effective survival strategy for individuals from countries involved in war or political unrest.However, the immigration process may exacerbate a number of physical and psychological health symptoms. There are limited data on the health status of new Canadian immigrants, and some social support networks are not formally connected to settlement programs.The purpose of this cross-sectional quantitative study was to assess the level of stress and self-esteem of 400 recent and older immigrants in Canada, and to investigate the impact of social support networks on the mental well-being of recent immigrants.Cultural care and general adaptation theory provided the …

An Evidence-Based Mentorship Program For Experienced Nurses, Roma Allen

Walden Dissertations and Doctoral Studies

Turnover of experienced nurses is a component of the nursing shortage, which has created a lack of expert nurses administering bedside care. The project site is a Chicago suburban hospital with an average first year turnover of experienced nurses at 35%. This rate is above the 27% first year turnover reported by the Metropolitan Chicago Healthcare Council. This project focused on development and evaluation of an evidence-based mentorship program supported by theory that can contribute to an increase in experienced nurse retention. A detailed literature review references causative factors of turnover, such as an increasing workload, a multigenerational and aging …

Clinicians' Perceptions Of Trauma Treatment For People With Intellectual Disabilities, Katherine Elaine Schoech

Walden Dissertations and Doctoral Studies

People with intellectual disabilities (ID) experience trauma and posttraumatic stress disorder (PTSD) in similar ways as individuals in the general population. The purpose of this phenomenological study was to explore and describe clinicians perceptions of trauma treatment for people with ID. Theories of trauma, PTSD, and stigma were part of the conceptual framework from which interview questions were developed. Purposive and snowball sampling were used to recruit 8 participants in the Denver, Colorado area. Four participants had experience working with people with ID, and 4 participants did not have this experience. Participants sat for semi structured open-ended recorded interviews, which …

Initial Findings Of A Medicare Annual Wellness Visit Program, Hesper B. Nowatzki

Walden Dissertations and Doctoral Studies

Despite the emphasis of benefits on preventive health, many older adults are not receiving the recommended age specific, evidence based screenings and vaccinations. The Medicare Annual Wellness Visit (AWV) is designed to address modifiable risk factors with aging adults and close gaps in care not captured in routine office visits. Although a free Medicare benefit to patients, and a reimbursable service to health care providers, participation in the AWV is low nationwide. The purpose of the project is to introduce an AWV program to a rural health clinic in Northwest Illinois that has a population consisting of over 25% of …

The Experiences Of African American Women Participating In Church-Based Weight Loss Programs, Mangle L. Shanks

Walden Dissertations and Doctoral Studies

While obesity is a nationwide phenomenon, African Americans - especially women - continue to be more severely affected than any other ethnic group. According to the Centers for Disease Control and Prevention, over 20% of African American women are obese compared to 15.6% of Caucasian women. The church is an important community center for many African Americans, and is often a site for health promotion programs, though little is known of the effectiveness of these programs. The purpose of this qualitative study was to study the experiences and attitudes of African American women who have gone through a church-based weight-loss …

Servant Leadership And Its Effect On Employee Job Satisfaction And Turnover Intent, Dennis M. Mitterer

Walden Dissertations and Doctoral Studies

Experts expect a shortage of more than 900,000 nurses by 2022, according to the United States Bureau of Labor Statistics Employment Projections. Turnover in nursing contributes significantly to the shortage and often results from poor leadership of nurse managers. The purpose of this quantitative study was to investigate how servant leadership behaviors affected the psychological state and behavioral response of staff nurses as reflected by job satisfaction and turnover intention. Specifically, the research question addressed whether servant leadership positively contributes to the psychological states and the behaviors of staff nurses leading to greater job satisfaction. The study design was correlational, …

Vicarious Trauma Coping And Self-Care Practices Among Trauma Therapists., Annette Zaccari

Walden Dissertations and Doctoral Studies

Therapists who specialize in trauma therapy are indirectly exposed traumatic events presented by clients within the therapeutic relationship. The potential consequences for trauma therapists may be the risk of vicarious trauma. Effective coping and self-care are essential in the practice of trauma work. The research question for this study is: Do coping skills and self-care practices in trauma therapists moderate the disruptive effect of vicarious trauma on the fulfillment of their psychological needs (trust/dependence and control)? The purpose of this research study was to examine quantitatively, the role of trauma therapists' beliefs in the effectiveness of coping skills and time …

Senior Students' Experiences, Perspectives, And Attitudes Of Technological Competencies In Nursing Education, Patricia C. Bennett

Walden Dissertations and Doctoral Studies

Technological standards appear to be needed in undergraduate nursing education, as existing research has yet to establish technological standards for undergraduate nursing students. The purpose of this qualitative study was to examine the lived experiences of senior nursing students with respect to their perceptions regarding exposure to and abilities gained in the areas of information management, information literacy, and computer literacy. The framework of the study was based on Bandura's theory of self-efficacy and the Dreyfus model of skills acquisition. Using a phenomenological approach, in-depth face-to-face interviews were used with a purposive sample to collect data about the technological competencies …

Nonresidential Fathers Parenting Their Children Residing In Shelters: A Phenomenological Study, Karen Denise Hudson

Walden Dissertations and Doctoral Studies

This phenomenological qualitative study explored the parenting role of nonresidential fathers of children living in shelters. Special attention was paid to the perceived contributions of these fathers to the overall health and general well-being of their children residing in shelters. Often separations of nonresidential fathers from their children in shelters decreased their contributions to their children's health and well-being. Increased knowledge of these parental roles and contributions can enhance programs and policies to support these fathers in improving the health and well-being of their children. In-depth semistructured interviews were conducted with 6 demographically diverse nonresidential fathers living in Philadelphia. The …

Influence Of Dual Process Decision-Making Theory In Patients Diagnosed With Cancer, Bonnie D. Quinonez

Walden Dissertations and Doctoral Studies

Each year millions of people face the medical decision-making cycle that comes with a diagnosis of cancer. For patients and their families, this can be a rollercoaster of confusion and fear. Researchers have indicated that the complexity of the decision-making process is underrepresented in the current approach of informed decision-making. The purpose of this study was to add to scientifically-validated research expanding the identification of factors that influence decision-making for individuals diagnosed with cancer. Fuzzy trace theory (FTT) is the dual process memory theory used as the framework for this study. Qualitative data were collected using semistructured interviews with 10 …

Non Medical Prescription Drug Use In Rural Communities And Social Work, Izetta Mounice Briggs-Bolling

Walden Dissertations and Doctoral Studies

This study explored the roles and responsibilities of social workers providing services to nonmedical prescription drug users (NMPDU). Researchers have indicated NMPDU disproportionately affects people living in rural communities. The overarching research question sought to explore the concerns of social workers when providing services to patients coping with NMPDU in the rural community of Ulster County, New York. The intention was to examine systemic challenges facing rural social workers when attempting to decrease morbidity risks and increase the health of Ulster County residents. A total of 7 social workers participated in 3 focus groups to explore their ideas for defining, …

Impact Of Plans, Finance, And Zoning Policies On What Developers Choose To Build, Michele Ann Williams

Walden Dissertations and Doctoral Studies

While there is considerable academic research on the intersection of comprehensive plans, finance policies, zoning policies and how these factors influence real estate developers' choice of what land to develop and what buildings to construct on that land, little is understood about whether these three variables promote or hinder real estate developers' choice of whether to build communities that promote healthy living. Using urban planning theory as the foundation, the purpose of this correlational study was to determine how real estate developers' decisions are made to support healthy New Urbanism development in the United States. Secondary data from the Urban …

Experiences Of Parents Of Self-Harming Adolescent Children, Sheila Nicole Russell

Walden Dissertations and Doctoral Studies

Adolescent self-harm is a growing epidemic in the United States with thousands of adolescent children being treated in hospitals every year. Despite awareness that self-harm impacts the family unit, little attention has been given to the full impact that self-harm has on parents. Due to this lack of knowledge, counselor educators and supervisors are not equipped to train counselors to work with parents of self-harming adolescent children leaving counselors feeling unprepared to work with parents. The purpose of this phenomenological study was to explore the lived experiences of parents who have self-harming adolescent children. Family systems theory was used to …

Working Alliance Between Interpretive And Noninterpretive Therapy Services For Deaf Individuals, Sherri Lee Spain

Walden Dissertations and Doctoral Studies

Deaf individuals typically have access to 2 types of therapeutic services: interpretive (with an interpreter) and noninterpretive (with a sign-fluent therapist). Previous research indicates that the presence of an interpreter may hinder development of working alliance and attachment. There is a lack of empirical evidence assessing the effect of working alliance and attachment based on whether or not therapy incorporates an interpreter. The working alliance theory and the attachment theory were the theoretical foundations for this study. This study examined the difference between the strength of working alliance and attachment to the therapist given the presence or absence of an …

Testing A Psychological Readiness Training Intervention On Ptsd, Depression, Anxiety, & Stress In First Responders, Renee Kosor

Walden Dissertations and Doctoral Studies

Exposure to traumatic events is rare for the general public but common for first responders. However, there is little proactive emotional health care occurring inside the first responder community. No preventive treatment for depression, anxiety, stress, and PTSD exists. The purpose of this study was to determine the efficacy of a psychological readiness training intervention on 361 police officers and firefighters in a medium-size Midwestern city. A combined positive psychological capital and cognitive behavior therapy approach was used to frame the study. This study used a pretest, posttest quasi-experimental design. The participants were a convenience sample of 119 volunteers from …

The Effect Of Two Modes Of Aerobic Assessment On Fifth Grade Students' Self Efficacy, Debra Roth

Walden Dissertations and Doctoral Studies

Declining youth physical activity levels and lack of aerobic fitness have been well documented with a corresponding rise in obesity levels and health issues. Based on Bandura's social cognitive theory, healthy physical activity levels and aerobic fitness are strongly connected to positive physical activity self-efficacy beliefs. This study examined whether student physical activity self-efficacy, motivation, and effort were different for the FitnessGram-® (FG) 1-Mile Run when compared to the 15-minute Aerobic Assessment Based on Improvement (AABI). A concurrent mixed method quasi-experimental approach measured 5th grade students' physical activity self-efficacy beliefs through a pretest and posttest survey while aerobic assessment scores …

Improving Fall Prevention Strategies In An Acute-Care Setting, Sylvia B. Boye-Doe

Walden Dissertations and Doctoral Studies

Falls with or without injuries among the elderly have become a public health concern, with falls among adults age 65 years and older increasing every year. Nurses play a role in ensuring patient safety by following fall prevention guidelines. The purpose of this evidence-based study was to implement the RE-AIM evaluation tool to determine the impact of the Safe Five program on staff compliance with the program; patients' awareness of the need for falls prevention; and falls among older adults, ages 65 years and older, admitted to an acute care nursing unit. The literature supports implementing a falls prevention program …

Socioeconomic Challenges In The Household And The Prevalence Of Comorbidity Among Children With Attention-Deficit Hyperactivity Disorder, Randy Lee Perrin

Walden Dissertations and Doctoral Studies

Attention-deficit hyperactivity disorder (ADHD), the most commonly diagnosed childhood neurobehavioral disorder, is increasing annually at about 5% per year. ADHD has been diagnosed in approximately 6.4 billion children in the U.S., and it is estimated that 66% of those afflicted have 1 or more comorbid conditions. Children with ADHD are often from socioeconomically challenged households. What is unclear from the literature is the relationship between socioeconomic status (SES), defined as education, employment, and income and the reporting of comorbidities with ADHD. The problem is that children with ADHD from low SES households may be reporting a higher prevalence of comorbid …

Investigating Funding Policies For New Clinics In Rural Northwest Region, Cameroon., Chenwi Mbuoko Ngwa

Walden Dissertations and Doctoral Studies

Abstract

Healthcare policies are complex health promotion strategies used by healthcare policy

designers to create awareness, educate, and develop the capacity of sustainable health

promotion practices in rural communities. The purpose of this phenomenological study

was to investigate an occurrence being experience by rural residents in the NWR of

Cameroon where residents lacked nearby healthcare clinics where they can seek medical

treatment and to determine if there were any funding policy requirements for the

construction of new rural community clinics at the NW Regional Delegation of Public

Health. Using Wright's conceptual framework on policy analysis and evaluation and

Coleman's rational …

Beliefs, Costs, And Policies Influencing African American Men's Decisions On Psa Screening, Mary Frances Carter

Walden Dissertations and Doctoral Studies

Despite the growing concerns about routine prostate-specific antigen (PSA) screening in men, little is known about the societal and economic impact of screening among the African American population. The purpose of this qualitative case study was to explore beliefs among African American men about PSA screening, funding for screening, and the role of the United States Preventive Service Task Force in addressing the problem. Guided by rational choice theory, data collection consisted of completion of a health beliefs survey, face-to-face interviews, field notes taken during interview, and interview audio recording. The population for the study included African American men residing …

The Relationship Between Infertility, Infertility Treatment, Psychological Interventions, And Posttraumatic Stress Disorder, Antoinette Corley-Newman

Walden Dissertations and Doctoral Studies

The number of women diagnosed as infertile continues to grow every year. The psychological impact of the infertility experience has been said to create distress equivalent to that associated with life-threatening illnesses and has been linked with posttraumatic stress disorder (PTSD). Using shattered assumption and stress-buffering theory, this quantitative causal comparative study explored the potential functional relationship between infertility and PTSD. The majority of the (all-female) participants were 24- to 34-year-old college graduates. A 2 X 3 factorial between-subjects ANOVA examined and compared the cause and effect of the independent variables, fertility treatment and psychological intervention, on the dependent variable, …

Contributing Factors Of Obesity Among Over-The-Road Truckers, Shari Weiss

Walden Dissertations and Doctoral Studies

Obesity among over-the-road truckers (OTRs) is an epidemic creating significant public health issues among this population. The consequences of obesity (hypertension, diabetes, heart disease) put both truckers' health and their medical clearance at significant risk. The purpose of this study was to examine the impact of gender, physical activity, diet, and sleep on obesity among OTRs. Through a socioecological lens, this study examined whether obesity is significantly impacted by gender, physical activity, nutrition, and sleep. This study also examined the impact of the trucking environment on obesity. The study used a quantitative research design and data were collected through a …

Psychological Resilience In Correctional Officers: The Role Of Demographics, Manuel Chapa Villarreal

Walden Dissertations and Doctoral Studies

Correctional officers occupy an important societal role in maintaining safety and assisting in the rehabilitation of inmates; however, both their performance and mental health are highly susceptible to fatigue because of working in a high stress environment. This study investigated the relationship between correctional officers' demographic factors (level of education, marital status, gender, and race/ethnicity) and their psychological resilience. The Connor-Davidson Resilience Scale 10 (CD-RISC-10) was used to measure correctional officers' resilience when responding and or coping with stress. This study utilized the stress-vulnerability model as a framework to investigate protective factors against and risk factors for psychopathological symptoms. Participants …

The Impact Of Nursing Staff Ratios On Falls Rates In Skilled Nursing Facilities, Akudo Okeorji

Walden Dissertations and Doctoral Studies

Falls and complications from falls are a common problem among adults aged 65 years and older. About 60% of older adults fall every year, causing injuries, hospitalization, nursing home placement, and even death. Most studies on falls among skilled nursing facility (SNF) residents focus on fall preventive measures that fail to include staffing variables such as nursing hours. Although researchers have examined the relationship between nursing staff and patient outcomes in hospital settings, similar studies have not occurred in long-term care facilities. The purpose of this retrospective longitudinal study was to determine whether a correlation exists between nursing staff hours …

The Relationship Between Hispanics/Latino Men Who Have Sex With Men And Women Cultural Beliefs, Risk Behaviors And Self-Disclosure, Donnalee Maria Lawson-Williams

Walden Dissertations and Doctoral Studies

The purpose of this study was to investigate the relationships among cultural/spiritual beliefs, risk behaviors, and disclosure among Hispanic/Latino men who have sex with men and women (MSMW). Minority men who have sex with men are disproportionately affected by HIV, in particular MSM who are Hispanic/Latino or African American. Limited research is available on the link between Hispanic/Latino MSMW, their cultural/spiritual beliefs, risk behavior, and disclosure about risk behaviors to friends and family. The data were obtained from the SJS Project, which used survey methods to gather data on participants from all 50 states and Puerto Rico. Among the participants …

Experiences Of Middle-Aged, African American Women With Excessive Weight, Tina Ann Mcclaire

Walden Dissertations and Doctoral Studies

Obesity and overweight issues are nationally recognized crises for African American women. A noteworthy gap remains in the literature regarding this population's experiences with excessive weight, specifically, the role of culture and social support networks on their experience with being overweight. Without an understanding of the experience and meaning of being overweight for African American women, physicians and clinicians will not be able to fully support African American women in their weight loss journeys. Using the social learning theory as a framework, the purpose of this phenomenological research study was to explore experiences of obese or overweight middle-aged African American …

Workers' Perceptions Of The Effect Of Three-Tier Shift Schedules On Community Functioning, Jillian Leigh Wallace

Walden Dissertations and Doctoral Studies

Shift work is commonplace in many fields that require around-the-clock employee coverage. There is ample evidence that two-tier shift work can detrimentally affect health and functioning. The purpose of this study was to understand the impact of three-tier shift schedules on physical and mental health and community functioning, a concept which refers to activities and behaviors performed by individuals or groups within a system. This study used a qualitative phenomenological design, and community functioning and recovery theory were central to the conceptual framework. In-depth interviews were used to explore the perceptions of three-tier shift workers on their functioning, relationships, mental …