Medicine and Health Sciences Commons^™

Comparison Of Affordable Care Act And Ryan White Coverage On Treatment Compliance, Engagement, Affordability, And Health Status For People Living With Hiv/Aids, Todd Blum

Walden Dissertations and Doctoral Studies

The Ryan White HIV/AIDS Program (RWHAP) provides HIV care to uninsured people living with HIV/AIDS (PLWHA). Although the RWHAP has helped PLWHA achieve a viral suppression rate of 84%, this does not meet the 90% target goals under the U.N. 90-90-90 plan to end the AIDS epidemic. The Affordable Care Act (ACA) was enacted to enhance access and health status, but outcomes have not been measured for PLWHA. The purpose of this quantitative correlational cross-sectional study was to determine whether PLWHA enrolled in an ACA qualified health plan (ACAQHP) achieved improved health status compared to PLWHA enrolled in the RWHAP. …

Relationship Between Health Risk Behaviors And Obesity Among American High School Students, Jacques Jean-Paul Cherry

Walden Dissertations and Doctoral Studies

Adolescent obesity is a serious health condition that affects more than 55% of students aged 12 to 19 years in the United States. Recent statistical data have noted that the rate of adolescent obesity has more than quadrupled during the past few decades. Genetics and factors such as tobacco use, alcohol use, and marijuana use have contributed to this critical public health issue. Although uniqueness of prevalence has often been linked to gender and race, associations related to these health risk behaviors and increased body mass index remain relatively unexplored among today’s U.S. youth. Adolescence has been described as a …

Improving Nursing Knowledge Of Heart Failure Discharge Self-Care Instructions, Maria Patricia Picar Deza

Walden Dissertations and Doctoral Studies

Patients with heart failure (HF) have recurrent symptoms that lead to frequent hospital readmissions. Moreover, HF is one of the leading causes of 30-day hospital readmissions. Evidence shows that patients with a high level of HF self-care have decreased readmissions. HF self-care education is commonly delivered by the nurse at hospital discharge, and the patient’s transition to self-care is a critical point in the continuum of care. However, nurses must be knowledgeable of patient self-care in HF to effectively convey this information to the patient upon discharge. Therefore, this staff education project question asked whether nursing knowledge of HF patient …

Maternal And Infant Birth Characteristics As Predictors Of Sudden Unexpected Infant Death, Betty Jean Ezell

Walden Dissertations and Doctoral Studies

Sudden Unexpected Infant Death (SUID) is a public health issue recognized by the United States Centers for Disease Control and Prevention (CDC) as the sudden and unexpected death of a baby less than 1 year old, often during sleep, with no obvious cause. Despite known SUID risk factors for infants and mothers, there is limited research on combinations of infant birth characteristics and mother demographics that could be indicative of a higher risk of infant death. The purpose of this cross-sectional quantitative study was to examine the extent to which infant birth characteristics, delivery characteristics, month prenatal care began, and …

Association Between Mental Health Problems, Substance Use, And Social Support In Youth, Venida Gray

Walden Dissertations and Doctoral Studies

Mental health problems are a major public health concern and may be associated with substance use among youth. Youth who receive inadequate social support are at risk of experiencing mental health problems and engaging in substance use. The purpose of this study, guided by the relational regulation theory of social support and the self-medication theory, was to determine whether there was an association between mental health problems, social support, and substance abuse among middle school (MS) and high school (HS) students and whether this association varies with age, using secondary data from the Maine Integrated Youth Health Survey This study …

Work-Life Balance Best Practices, Amy Marie Higgins

Walden Dissertations and Doctoral Studies

Poor balance between workplace and family life has been shown to increase stress and impact emotional well-being. Nurses continue to report burnout and high stress levels from time spent in the workplace which contributes to an inability to balance work with life. The gap in nursing practice leadership is the lack of knowledge and tools for supporting the emotional well-being of managers and direct care nursing staff. The purpose of this systematic review was to compile a summary of rigorous evidence-based literature on programs and strategies that nursing leaders can use to provide support in achieving work-life balance for nursing …

Impact Of Food Assistance Programs On Food Insecurity, Diet Quality And Obesity, Jessica Eileen Hill

Walden Dissertations and Doctoral Studies

Obesity remains a public health issue in the United States because it contributes to chronic diseases. The Supplemental Nutrition Assistance Program (SNAP) was designed to increase food security, alleviate hunger, and increase access to a healthful diet; however, it may have the opposite effect and contribute to obesity. The purpose of this study was to examine to what extent participation in SNAP impacts food insecurity, diet quality, and obesity in U.S. adults. The social-ecological model guided the study which was conducted using a quantitative a cross-sectional research design and secondary analyses of the 2013-2014 National Health and Nutrition Examination Survey …

Nurse Educator Perceptions Of Using Simulation For Evaluation Of Nursing Competencies, Angela Elizabeth Horton

Walden Dissertations and Doctoral Studies

Over the past 10 years, simulation technology has been increasingly used in clinical settings to evaluate nursing competencies and ensure safe patient care. However, not all simulation laboratories are used consistently by hospital nursing education departments to support learning. The purpose of this qualitative case study, framed by constructivist theory, was to identify nurse educators’ perceptions of the value of using simulation to evaluate nurse competence. Research questions addressed how nurse educators decided what teaching methods to use when evaluating nursing competencies. The participant sample included 8 nurse educators responsible for the education of new and practicing nurses in the …

Improving Care Of Patients With Asthma Through Staff Education, Nicholas Moscatelli

Walden Dissertations and Doctoral Studies

Chronic asthma is a health epidemic and an increasing problem in the pediatric population. The purpose of this project was to raise nursing staff awareness of symptom recognition, treatment protocols, preventive measures, and detrimental effects of asthma for children. Adult learning theory provided the framework to support the staff education program on asthma. The project site stakeholders and the DNP student identified educational opportunities to assist staff in meeting caregiver needs, improving symptom recognition, and improving asthma outcomes. Prior to presentation of the educational program to the clinic nursing staff, it was reviewed by an expert panel including the clinic …

Patient Risks And Clinical Care Disruptions In Rural Hospital Mergers, Gabriel Muzanenhamo

Walden Dissertations and Doctoral Studies

Over 440,000 U.S. citizens are dying annually from avoidable, hospital-associated adverse events, with rural inhabitants experiencing more significant health threats than any other group in the United States. The trend of large health systems acquiring and consolidating rural hospitals (RHs) to improve the coordination of clinical care is backfiring, and accumulating patient safety risks. Although arguments for supporting hospital mergers in the past have focused on efficiency and presented a chance for struggling RHs with a financial survival mode, limited research has explicitly examined the impact of rural hospital mergers (RHMs). This study was constructed to explore the relationship between …

Fall-Related Patient Education: An Essential Feature Of A Fall Prevention Program, Immaculata Okonkwo

Walden Dissertations and Doctoral Studies

This project documented the evaluation of a voluntary patient falls prevention education

program (VPFPEP) of a rehabilitative facility in a Mid-Atlantic US state and ascertained

its sustainability. The project was designed using the customized Moore et al. evaluation

model and Lippitt’s planned theory of change to encourage patient engagement in

physical activity (PA) through fall prevention education to allay patients’ fear of falling.

The sample included patients who opted into the facility’s VPFPEP. Evaluation was

performed using run charts to visually and quantitatively monitor trends and patterns of

fall incidents over time. Run charts also facilitated comparison of injuries sustained …

Adult Attachment For African American Women Who Have Mothers With Borderline Personality Disorder, Elizabeth Uchechi Onyeali

Walden Dissertations and Doctoral Studies

The effects that borderline personality disorder (BPD) can have on the loved ones of those who suffer from the mental illness is significant and can be deleterious and enduring. Maternal BPD can adversely impact mother-daughter relationships by fostering abnormal connections and insecure attachment bonds. This is particularly the case for African American mothers, of whom research suggests that the early attachment bond between them and their daughters significantly shapes how their daughters behave, perceive themselves, and relate to others. The purpose of this qualitative transcendental phenomenological study was to explore how the experiences of being raised by a mother diagnosed …

Program Evaluation Of A Black Barbershop Health Outreach Campaign, Berkina Denise Porter

Walden Dissertations and Doctoral Studies

Black-owned barbershops in the Black community lack barber administered interventions to provide education and health screenings to Black men. Increasing knowledge of health assessments in a black barbershop setting increases the number of health screenings and preventative care among Black men. Grounded in general systems theory, the purpose of this qualitative summative program evaluation was to explore the extent to which a nonprofit Black barbershop health program aligns with the Health Research (HR) program objectives. The evaluation was performed for a nonprofit organization located in Maryland, 6 years after the organization implemented the HR Program Network of barbers and salon …

Evidence-Based Pediatric Diabetic Ketoacidosis Education, Sonya Sandhu

Walden Dissertations and Doctoral Studies

Pediatric patients with diabetic ketoacidosis (DKA) are a unique subset of patients who arrive to the emergency department (ED) for care, and differ from adults regarding symptomology, treatment, and adverse effects. Nurses who will encounter this patient population must have adequate knowledge and confidence to care for them, yet research continues to show a gap in practice. The purpose of this doctoral project was to determine if a staff education project would increase ED nurse knowledge and confidence in caring for pediatric emergency patients with DKA. Utilizing Kirkpatrick’s evaluation model, an evidence-based staff education program was formulated, reviewed by an …

Socioeconomic And Sociocultural Factors Associated With Parenting Choice And Fertility Experience Among Lesbian And Nonlesbian Women, Annette Silvia

Walden Dissertations and Doctoral Studies

Minorities including lesbians may face disparities that contribute to minority stress, which leads to adverse health outcomes. The purpose of this social epidemiology study was to examine the association between insured status, perceived stress, and parental status among lesbians and nonlesbians. The theoretical foundation was minority stress, and the design was quantitative with a convenience sample of women aged 18 years and older. Data on demographics, perceived stress, fertility quality of life, and lesbian identity disclosure were collected via online survey. Among the 314 respondents, 102 self-selected as lesbian (49% parents), and 212 self-selected as nonlesbian (73.1% parents). More than …

Primary Payer Status And 30-Day Readmission Rates Among U.S. Diabetes Patients, Christina Marie Swilling

Walden Dissertations and Doctoral Studies

Diabetes is a leading cause of hospitalization and readmission in the United States. The 30-day readmission rate for diabetic patients represents substantial costs to the nation’s health care system. The purpose of this quantitative study was to examine the relationship between primary payer status and hospital readmission rates among individuals whose primary or secondary reason for admission was Type 2 diabetes mellitus (T2DM). Secondary data from the Healthcare Cost Utilization Program Nationwide Database of the 2015 National Readmission Database was analyzed. Participants in the data set included 41,068 diabetes patients, 53.8% of whom were female. The average age was 67.26, …

Improving The Ethical Use Of E-Health And Emr, Josephine Tafie

Walden Dissertations and Doctoral Studies

Improving the Ethical Use of E-health and EMR

by

Josephine Tafie

MS, Walden University

BS, Washington Adventist University

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

August 2020

Abstract

The healthcare industry is experiencing ethical problems with the integration of new technological applications, such as e-health and electronic medical records (EMRs) in service delivery. Thus, the purpose of this capstone project was to conduct a systematic literature review to determine the best practices that are well suited to a large urban hospital, to ensure patients’ privacy with the continued use …

Examining The Relationship Between Rural African-American Adolescents’ Self-Perception And Their Academic Performance, Vincent Dewayne Tompkins

Walden Dissertations and Doctoral Studies

Poverty, crime, and the need for public assistance are associated with dropping out of high school in the United States. African American adolescents have a higher dropout rate than their White peers, especially in the rural south. Moreover, racial discrimination toward African American adolescents is more prevalent in the rural south compared with the urban areas of United States. Academic self-perception and experienced racial discrimination are probable factors that influence African American adolescents to leave school before they graduate. This study was conducted to determine a relationship between the combination of rural African American adolescent’s academic self-perception as measured by …

The Impact Of Faculty Bullying On Associate Degree Nursing Students, Angela M. Vitale

Walden Dissertations and Doctoral Studies

Bullying is prevalent in the profession of nursing, impacting the quality of health care and health care costs. The foundation of bullying, in the profession of nursing, may be attributed to bullying behaviors in nursing academia among nursing faculty and nursing students. Using Bandura’s social learning theory, the purpose of this study was to determine the relationship between bullying behaviors of nursing faculty and bullying behaviors of nursing students in associate degree nursing programs. Seventy-one randomly selected registered nurses who graduated from associate degree nursing programs in the past 5 years completed an online Incivility in Nursing Education-Revised survey. Spearman’s …

Exploring Health Literacy In The Acute Care Setting In A Rural Border Region, Shiloh Williams

Walden Dissertations and Doctoral Studies

Health literacy is important to ensuring patients have the necessary knowledge and skills needed to actively participate as a member of their own healthcare team. Patients with low health literacy are at increased risk for poor outcomes and limited participation in decisions affecting their health or treatment plan. Using the Social Ecological Model (SEM) as a framework, the purpose of this study was to determine the relationship between medical-surgical registered nurses, medical-surgical patients and the registered nurse’s (RN) assessment of their patient’s health literacy of those who live in a rural-border region. The study’s sample consisted of 84 pairs of …

Association Between Metabolic Syndrome And Second Primary Cancer Among Colorectal Cancer Patients, Olukayode Ayodeji Agbeyomi

Walden Dissertations and Doctoral Studies

Colorectal cancer (CRC) is the third most common diagnosed cancer in both women and men in the United States. The gradual increase of incidence of second primary cancer (SPC) among CRC individuals has been a concern in recent times. Many CRC survivals have been forced back to be hospitalized for life-threatening cancers that are nonmetastatic cancers of CRC. Literature has suggested that there may be a relationship between metabolic syndrome (MetS) and CRC cases. The importance of early surveillance, detection, and treatment of SPC in CRC patients is significant to achieve better survival rates. The aim of this retrospective quantitative …

Assessing Pain-Related Factors As Predictors Of Distress During Transitional Musculoskeletal Pain Experience, Gary Robert Ahlstrom

Walden Dissertations and Doctoral Studies

During people’s pain experience, certain difficulties may emerge within individuals’ psychological and social domains that can confound and exacerbate the frequency of their pain-related distress episodes. Previous research has consistently found psychosocial factors evident during the first months of unresolved pain are reliable predictors of pain chronicity and disability at 12 months. This exploratory descriptive quantitative multivariate study included 2 nationwide online surveys that examined the frequency of moderate-to-severe symptoms of distress within the anxiety-depression spectrum, and the extent that 8 pain-related factors influenced and predicted episodes of anxiety and depressed mood, which included 2 demographic risk factors (age range …

An Educational Program For Providers On Asthma Management For Pediatric Clients, Ngozi Anyatonwu

Walden Dissertations and Doctoral Studies

Asthma, a chronic inflammatory respiratory disease, is the third-ranking cause of hospitalization among children under the age of 15. Of the 25 million Americans living with asthma, 6.2 million are children under the age of 18. In 2018, more than 11.4 million people with asthma, including more than 3 million children reported having one or more asthma exacerbations. The burden of pediatric asthma accounts for more than 13.8 million missed school days among children ages 5 to 17 years, $3 billion in losses due to missed work, $29 billion due to asthma-related mortality and $50.3 billion in medical costs. Asthma …

Family Members’ Lived Experiences Of Chronic Migraine, Elizabeth Biddle

Walden Dissertations and Doctoral Studies

Chronic migraine (CM) is a growing phenomenon in the United States and has been recognized as a disabling headache disorder. CM negatively affects the quality of life not only of CM sufferers but also their family members. The lived experiences of the family member of CM sufferers has not been sufficiently investigated. The purpose of this study was to gain in-depth insight into the lived experiences of family members who lived with CM sufferers. The phenomenological approach, guided by the social support theory, was used to investigate the lived experiences of family members who live with CM sufferers through open-ended …

Hispanic Nursing Students’ Perspectives On Student-Clinical Instructor Relationships And Learning, Inela Brito

Walden Dissertations and Doctoral Studies

Non-Hispanic students are more likely to be successful in their nursing school studies than Hispanic students. Facilitators and barriers to classroom success for Hispanic students has been studied; however, few studies have addressed the academic clinical experience and the clinical instructor’s role in Hispanic students’ success. The purpose of this descriptive phenomenological study was to explore the perspectives of undergraduate senior Hispanic nursing students regarding how student-instructor interactions in the clinical setting influenced students’ ability to learn and succeed in completing their studies. The research questions were guided by an adapted institutional support model and were used to explore how …

Strengthening Mental Health Awareness Of University Students Using An Online Training Module, Lavern Rosemarie Bourne

Walden Dissertations and Doctoral Studies

Canadian youth pursuing postsecondary education are facing a major mental health crisis. There are substantial gaps between the diagnosis and treatment of mental illnesses. The purpose of this study was to evaluate whether a web-based mental health educational intervention was an effective tool with which to increase mental health awareness and help-seeking behaviors of university students. The theory of planned behavior, the help-seeking model, and the technology acceptance model were the theories that guided this study. Using a quantitative quasi-experimental research design, data were collected from 329 undergraduate students in the Faculty of Health Sciences at a university in Eastern …

Association Of Social Support And Depressive Symptoms Among African Americans, Jacketta Renee Cobbs

Walden Dissertations and Doctoral Studies

Depression affects over 120 million individuals worldwide; in the United States, depression is a leading cause of disability for individuals’ ages 15-44 years. Social support can affect both physical and depressive symptoms; therefore, most patients with heart failure (HF) need support from family and/or friends to effectively manage their health condition. This indicates family and/or friends are expected to be the core support system for long term care of those with HF. The purpose of this study was to determine whether social support contributes to depressive symptoms among African Americans with HF. The research questions examined the experience of different …

Nurses’ Aesthetic Responses And Emotional Judgements To Senior Leaders’ Symbolism, Lucinda A. Easler

Walden Dissertations and Doctoral Studies

Stress can be heightened during a merger; understanding how acute care nurses who work in a hospital undergoing a merger, experience senior leaders’ use of symbolism may help to promote hospital and leader sustainability. Executive symbolism unfolds into aesthetic experience, normally considered a response to art, with few studies of its existence and benefit to organizational life. The purpose of this phenomenological-hermeneutic study guided by Parker’s aesthetic theory was to examine acute care nurses’ emotional responses and experiences with senior leaders’ use of executive symbolism in the midst of the organizational change. Interviews with 11 acute care registered nurses were …

Accelerated Baccalaureate Nursing Student And Faculty Perceptions Of Blended Learning, Emily Elliott

Walden Dissertations and Doctoral Studies

In response to the demand for baccalaureate-educated nurses, nursing schools offer an accelerated baccalaureate of science in nursing (BSN). The problem is nursing programs have used blended learning approaches, but it is unclear whether and in what ways accelerated BSN students benefit from this learning design. The purpose of this qualitative case study was to explore how faculty and students perceived the benefits and challenges of an accelerated BSN program utilizing a blended learning format. Knowles’s adult learning theory served as the conceptual framework through which interview data were analyzed. Participants included 6 faculty and 7 students from 1 school …

Group Education Program To Increase Obesity Knowledge In Cardiac Care Nurses, Ethel Emenogu

Walden Dissertations and Doctoral Studies

Obesity increases the severity of cardiac disease, leading to increased mortality and morbidity. The need to address obesity is critical in reducing obesity-associated complications such as heart failure, strokes, heart attacks, and even death. Obesity is also a risk factor for many chronic diseases such as heart disease, cancer, diabetes, hypertension, and depression. Evidence has shown that obese individuals with cardiac disease are at increased risk of developing complications. The practice-focused question for this doctoral project asked whether a group educational program could increase obesity knowledge among cardiac care clinic nurses. The purpose of this DNP project was to provide …