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Walden University

Walden Dissertations and Doctoral Studies

2022

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Full-Text Articles in Medicine and Health Sciences

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 …

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Improving Nurses' Knowledge On The Assessment And Documentation Practices In The Pediatric Settings Of A Jamaican Hospital, Binol Rajesh Balachandar Jan 2022

Improving Nurses' Knowledge On The Assessment And Documentation Practices In The Pediatric Settings Of A Jamaican Hospital, Binol Rajesh Balachandar

Walden Dissertations and Doctoral Studies

AbstractThere have been anecdotal reports from the on-site Quality Assurance team, administrators, and educators that a theory-practice gap exists in pediatric nursing practice settings relating to the specific assessment and documentation. A deidentified chart review confirmed the reported practice gaps in 80% of the patient records. Therefore, in collaboration with the in-service unit, this staff education project and the educational interventions were implemented, and the knowledge improvement was appraised using a pre and posteducation survey. Mozirow’s reflective learning theory formed the basis for staff education, utilizing adult learning principles. Twenty-five consenting nurses completed the preeducation survey (N = 25); however, …

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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 …

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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 …

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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, …

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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 …

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Exploring Moral Distress, Ethical Climate, And Psychological Empowerment Among New Registered Nurses, Luz Bruel Mauro Jan 2022

Exploring Moral Distress, Ethical Climate, And Psychological Empowerment Among New Registered Nurses, Luz Bruel Mauro

Walden Dissertations and Doctoral Studies

Moral distress in nursing has been an issue for decades and has consequences on nurses’ physical, emotional, and psychological well-being. Nurses in different settings experience a high intensity and frequency of moral distress particularly in intensive care units (ICU), but few studies have examined the moral distress of non-ICU nurses. The purpose of this 3-manuscript dissertation was to assess the frequency and level of moral distress, ethical climate, and psychological empowerment among new registered nurses (NRNs) who work in non-ICU settings. The conceptual framework of Jameson's moral distress guided this study. Twenty-three NRNs with fewer than 3 years of experience …

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Perceptions Of Associate Degree Nursing Faculty Of A Primary End-Of-Life Care Course Within Prelicensure Nursing Curricula, Katherine Zaharchuk Jan 2022

Perceptions Of Associate Degree Nursing Faculty Of A Primary End-Of-Life Care Course Within Prelicensure Nursing Curricula, Katherine Zaharchuk

Walden Dissertations and Doctoral Studies

AbstractThe responsibility for educating U.S. nursing students on end-of-life (EOL) care concepts lies with prelicensure nursing programs; however, the majority of all prelicensure nursing programs offer only a few lectures, and only a small percentage offer EOL and palliative care courses. The lack of education on EOL care results in greater stress for nurses, poor symptom management for patients, and reduced support for family caregivers. There is limited knowledge on why primary EOL education has not yet been adopted by many Associate Degree in Nursing (ADN) programs. The purpose of this qualitative study was to explore the perceptions of ADN …

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Creating A Clinical Practice Guideline For Patients With Uncontrolled Hypertension, Nar'cissa Mcdonald Jan 2022

Creating A Clinical Practice Guideline For Patients With Uncontrolled Hypertension, Nar'cissa Mcdonald

Walden Dissertations and Doctoral Studies

Cardiovascular disease is the leading cause of death globally, with hypertension (HTN)the primary causal factor. The nursing professions' role as a critical agent in facilitating the management of patients should be based on best practices. No specific standard exists in the United States for nurses despite the publication of Clinical Practice Guidelines (CPGs) on HTN for adults. A gap in practice was identified in an outpatient primary care clinic located on the Gulf Coast of Mississippi, as there is no comprehensive CPG for nurses to provide patients with complete HTN diagnosis and management care. A literature review revealed that clinical …

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Organizational Barriers To Effective University Student Mental Health Services, Felicia Evans-Edwards Jan 2022

Organizational Barriers To Effective University Student Mental Health Services, Felicia Evans-Edwards

Walden Dissertations and Doctoral Studies

This study was focused on organizational barriers to effective university student mental health services access in the department of student resources (DSR) at a for-profit university in the northeastern United States. Once such barriers are addressed, faculty may be more successful in reaching out to students needing mental health services who are not self-identifying as needing these services. The Baldrige excellence framework guided this descriptive case study to examine the organizational barriers that prevent university leadership from creating clear policies and procedures for faculty to refer students to mental health services. Data sources included interviews with the behavioral health leader …

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The Lived Experience Of Individuals Thinking About Food And Coping With Stress, Tobi Martin Jan 2022

The Lived Experience Of Individuals Thinking About Food And Coping With Stress, Tobi Martin

Walden Dissertations and Doctoral Studies

Stress results in many people altering their eating patterns, often consuming food high in sugar and fat. Such behavior is a factor in the growing obesity epidemic and can potentially cause the development of chronic diseases, resulting in employment problems and billions of extra dollars spent on national health care programs. Researchers have focused on the concept of “emotional eating” while overlooking the overarching research question of this study, which was about exploring the experience of individuals using eating behavior as a coping mechanism to deal with stress. All responses were viewed through the lens of social cognitive theory. Interviews …

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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 …

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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 …

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Perceived Discrimination As A Moderator Of The Relationship Between Allostatic Load And Asthma Control, Vera Kern Jan 2022

Perceived Discrimination As A Moderator Of The Relationship Between Allostatic Load And Asthma Control, Vera Kern

Walden Dissertations and Doctoral Studies

While asthma prevalence in the United States is generally declining, African Americans tend to experience poorer outcomes regarding asthma severity and control. The purpose of the present study was to test whether discrimination (everyday and lifetime) moderated the relationship between allostatic load and asthma severity/asthma control (dyspnea and peak flow). In previous literature, researchers established the relationship between allostatic load and asthma severity/asthma control among African Americans. The biopsychosocial model and allostatic load theory served as the theoretical frameworks for this study. In this cross-sectional, nonexperimental, quantitative design, 201 African Americans between the ages of 34 and 82 years were …

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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 …

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The Correlation Between Laura’S Law And The Incarceration Of The Mentally Ill In A Southwestern State, Aaron Alarcon-Bowen Jan 2022

The Correlation Between Laura’S Law And The Incarceration Of The Mentally Ill In A Southwestern State, Aaron Alarcon-Bowen

Walden Dissertations and Doctoral Studies

Assisted outpatient treatment and involuntary outpatient treatment laws refer to the power of the court system to order community-based treatment without hospitalization to individuals with a mental illness diagnosis. Studies have linked these laws to a decrease in the use of incarceration among this population. The effectiveness of the assisted outpatient treatment law in a Southwestern state, known as Laura’s Law, has not been studied. With a theoretical foundation based on the social contract and multiple streams analysis theories, a quantitative, casual, comparative study using an independent t test was centered on determining whether the mean numbers of incarcerated individuals …

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Job Satisfaction Among Nurse Practitioners Who Work At Retail Health Care Centers, Karen Morrissey Jan 2022

Job Satisfaction Among Nurse Practitioners Who Work At Retail Health Care Centers, Karen Morrissey

Walden Dissertations and Doctoral Studies

Retail health care clinics (RHCCs) were designed to ease the shortage of access to primary care by having nurse practitioners (NPs) provide quality care to patients on a walk-in approach. RHCCs can be stressful work environments and when NPs become dissatisfied, they may leave RHCCs which creates a shortage of primary care access. The purpose of this descriptive study, guided by Herzberg’s dual-factor theory, was to determine if there was a relationship between: (a) challenge/autonomy, and professional growth and job satisfaction among NPs who work at RHCCs and (b) intrapractice partnership/collegiality, professional, social and community interaction, time and benefits and …

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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 …

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Preconception Protective Factors Associated With Preterm Birth In Black/African American And Non-Hispanic White Women In Nyc, Joyce Yvonne Hall Jan 2022

Preconception Protective Factors Associated With Preterm Birth In Black/African American And Non-Hispanic White Women In Nyc, Joyce Yvonne Hall

Walden Dissertations and Doctoral Studies

Racial disparities in preterm birth have persisted during the past two decades. Though studies have delineated the medical, behavioral, and social risk factors explaining racial disparities in preterm birth, less is known about protective factors. This quantitative, correlational study was conducted to examine the prevalence, association, and risk of preconception health protective factors and sociodemographic covariates between Black/African American and non-Hispanic White women with preterm birth in New York City (NYC). The maternal and child health (MCH) life course approach was the theoretical foundation. The NYC Pregnancy Risk Assessment Monitoring System 2016–2018 Phase 8 survey data, which included 2,161 women …

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Medicine Adherence As A Determinant Of Complication Development In Diabetes And Hypertension Patients On A Medical Aid Scheme In Zimbabwe, Tsitsi Moyo Jan 2022

Medicine Adherence As A Determinant Of Complication Development In Diabetes And Hypertension Patients On A Medical Aid Scheme In Zimbabwe, Tsitsi Moyo

Walden Dissertations and Doctoral Studies

Pharmacotherapy is a significant component of chronic disease management; its efficacy depends on long term, correct, and consistent use; however, medicine adherence rates remain low. The cost of medicines is considered a significant barrier to adherence, especially in low-income settings. This quantitative cross-sectional study was conducted using data from Cimas Medical Aid Society collected between 2015 and 2019. The purpose of the study was to determine the extent of the association between medicine adherence, complication development, and cost of care among diabetic and hypertensive patients while controlling for age and gender on a population that does not experience cost barriers …

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The Efficacy Of Barcoded Medication Administration In The Emergency Department, Aleksandr Vasserman Jan 2022

The Efficacy Of Barcoded Medication Administration In The Emergency Department, Aleksandr Vasserman

Walden Dissertations and Doctoral Studies

The practice problem addressed in this Doctor of Nursing Practice project was safe medication administration in the emergency department (ED). Paper-based delivery of medication administration is prone to errors and multiple points of failure affecting patients’ safety. The gap in nursing practice was the lack of analysis regarding the efficacy of the barcoded medication administration (BCMA) process in the ED. The practice-focused question for this project addressed whether the implementation of BCMA in the ED effectively reduced medication administration errors as compared to the previously used paper-based, non-BCMA process. The aim of this doctoral project was to review the efficacy …

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Staff Education In Caring For Children With Type 1 Diabetes, Freda Ansah-Larbi Jan 2022

Staff Education In Caring For Children With Type 1 Diabetes, Freda Ansah-Larbi

Walden Dissertations and Doctoral Studies

AbstractType1 diabetes affects over 1.6 million people living in the United States of which about 200,000 are children under the age of 20, with an increase of 1.9% per year between 2002–2015. The large number of children with type 1 diabetes was observed in the project’s practice setting. In addition to the physical health impact on children, this disease also has major personal, economic, and social impacts on children and their families. Therefore, effective management is essential in reducing the risk of complications and achieving an overall improvement in the quality of life of patients. The purpose of the project …

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Development Of Staff Education On Improved Compliance Adherence In Sleep Apnea, Mayla F. Garcia Jan 2022

Development Of Staff Education On Improved Compliance Adherence In Sleep Apnea, Mayla F. Garcia

Walden Dissertations and Doctoral Studies

The increasing prevalence of sleep disorders such as obstructive sleep apnea (OSA) affects approximately 25% of adults in the United States and an estimated 34% of men and 17% of women in the primary care population. In the clinical project site, the practice problem involved the increasing clinicians’ knowledge about OSA and being able to implement screening tools for further treatment and evaluation. The purpose of this project was to develop an educational training and intervention for staff to increase their knowledge of OSA conditions and have it validated by a panel of experts before dispersing it to the intended …

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Crisis Intervention Team Training On Autism Among Female Cit-Trained Police Officers, Julie Hall Jan 2022

Crisis Intervention Team Training On Autism Among Female Cit-Trained Police Officers, Julie Hall

Walden Dissertations and Doctoral Studies

The problem addressed in this qualitative case study was the lack of documentation that supports the perceptions and experiences of crisis intervention team (CIT) trained female police officers related to their encounters with persons with mental illness (PwMI) with autism. Using Giles’s communicative accommodation theory (CAT), the purpose of this study examined the perceptions of CIT-trained female police officers of PwMI with autism during encounters. Giles’s CAT was aligned closest with the teachings of CIT training. Seven participants provided data which comprised of completed questionnaires and transcribed interviews. The method of analysis used was a combination of inductive coding and …

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Lived Experiences Of Nurse Leaders, Catherine Jeannette Mohammed Jan 2022

Lived Experiences Of Nurse Leaders, Catherine Jeannette Mohammed

Walden Dissertations and Doctoral Studies

AbstractThe National Academy of Medicine (NAM) has called for more leadership, more accountability, and increased education and training of health care leaders. The NAM has demanded that nurses participate in health care policy making, increase their knowledge of research and data collection, advise leaders across the business world, train and educate seamlessly, and practice to the full extent of their licensure. The purpose of this qualitative phenomenological study was to explore the lived experiences of 12 influential nurse leaders from the state of Arizona. Transformational leadership theory provided the framework for the study. Semi-structured interview data were transcribed, coded, and …

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Weight Change And Hyponatremia As Predictors Of Polydipsia Among Persons With Schizophrenia, Kingsley Okechukwu Nwachukwu Jan 2022

Weight Change And Hyponatremia As Predictors Of Polydipsia Among Persons With Schizophrenia, Kingsley Okechukwu Nwachukwu

Walden Dissertations and Doctoral Studies

AbstractPolydipsia is found in 20% of inpatients with chronic severe mental disorders. Of this, 80% are diagnosed with chronic schizophrenia, hence polydipsia is strongly associated with chronic schizophrenia. Despite the prevalence and serious health complications of coexisting polydipsia in this population, its current method of detection is flawed. The purpose of this quantitative study was to accurately identify comorbid polydipsia in schizophrenia using periodic weight change and hyponatremia. The Wilson’s complexity theory and primary data were used to attempt to explain the relationship between weight change and hyponatremia and polydipsia, in a cross-sectional study design. The dependent variable was polydipsia, …

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Leadership Relationships And Advancement Opportunities Among African American Female Nurses, Kendra Pitts Jan 2022

Leadership Relationships And Advancement Opportunities Among African American Female Nurses, Kendra Pitts

Walden Dissertations and Doctoral Studies

A healthy work environment for nurses is critical to staff recruitment, retention, patient safety, and the financial sustainability and viability of a healthcare organization. The specific research problem under study was whether a lack of advancement opportunity or a lack of good leadership has an impact on African American female nurses leaving the nursing profession. Researchers have investigated the impact of leadership and advancement opportunity on the general population, but there is a dearth of research specific to African American female nurses and their reason for leaving the profession. Secondary quantitative data analysis was performed using survey data from the …

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Association Between Parental Socioeconomic Status And Childhood Obesity In The Southwest Geopolitical Zone Of Nigeria, Omatsola Aboyowa Sifo Jan 2022

Association Between Parental Socioeconomic Status And Childhood Obesity In The Southwest Geopolitical Zone Of Nigeria, Omatsola Aboyowa Sifo

Walden Dissertations and Doctoral Studies

AbstractGlobally, childhood obesity is a major social and public health concern characterized by complications such as high cholesterol and high blood pressure. The purpose of this quantitative cross-sectional study was to examine the association between childhood obesity in children age 6–12 years and the socioeconomic status of their parents in the Southwest geopolitical zone of Nigeria. Social cognitive theory served as the theoretical framework for the study. Questionnaire data were collected from 384 parents/guardians of children age 6–12 years across three states in the Southwest geopolitical zone of Nigeria. Data were analyzed using descriptive statistics and multiple logistic regression at …

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Perceptions Of Human Interactions In Adult Patients After Using Digital Therapeutic Mobile Applications, Traci Brakefield Jan 2022

Perceptions Of Human Interactions In Adult Patients After Using Digital Therapeutic Mobile Applications, Traci Brakefield

Walden Dissertations and Doctoral Studies

AbstractWhile the use of technology in healthcare has been present for many years, the recent rise of digital therapeutics in healthcare has been understudied, specifically regarding the perceptions and experiences of patients using mobile applications. Traditional healthcare involves face-to-face human interactions, requiring scheduled check-ins and provides structured interventions. Conversely, Digital therapeutics is primarily comprised of human to machine interactions. Digital therapeutics allows the user to access intervention in their time of individual need. The decrease of human-to-human interaction and the rise of human-to-machine interaction was explored in this qualitative descriptive phenomenological study from the patient perspective. Watson’s theory of human …

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Spirituality, Hiv And Black/African American Women, Shawanna D. Brun Jan 2022

Spirituality, Hiv And Black/African American Women, Shawanna D. Brun

Walden Dissertations and Doctoral Studies

Despite the surmounting prevalence of human immunodeficiency virus (HIV) among Black women, few studies have been conducted to examine culturally appropriate prevention methods to reduce the occurrence of the disease. The purpose of this cross-sectional study was to explore how religion/spirituality affects the attitudes, beliefs, and self-perceptions of HIV/AIDS among 151 Black/African women, ages 25-44, in Florida, and to investigate the impact of HIV-related stigma on the attitudes, beliefs, and self-perceptions of HIV/AIDS within this population. Social cognitive theory was the framework of the study. Multiple linear regression and hierarchical regression were used to analyze the survey data. Results revealed …

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