Medicine and Health Sciences Commons^™

The Effect Of Evaluating A Quality Improvement Initiative On Reducing Hospital Transfers Of Nursing Home Residents, Denise Eileen Jarboe

Walden Dissertations and Doctoral Studies

The Effect of a Quality Improvement Initiative on Reducing Hospital Transfers of Nursing Home Residents

by

Denise Eileen Jarboe

MSN, Walden University, 2010

BS, University of Maryland, 1981

Project Study Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

February 2015

Nursing homes (NH) in the 21st century provide skilled healthcare services for resident populations who are older, frailer, and often suffering from multiple incurable chronic medical conditions. Nurses practicing in this setting must be keen observers and effective communicators with the ability to recognize and report subtle changes in health status …

Current Capacity Building Needs Of Occupational Therapists Related To Older Driver Screening, Assessment, And Intervention, Ranyouri Hines Senia

Walden Dissertations and Doctoral Studies

Older adult safe driving is a growing public health issue; however, the skill set of occupational therapists that provide services to these older clients is unclear. The extent to which occupational therapists possess the skills to evaluate an elderly person's ability to operate safely an automobile is unclear. Therefore, the purpose of this quantitative, cross-sectional survey was to determine the current capacity building needs of occupational therapists (OT) related to older driver screening, assessment, and intervention. The ecology of human performance framework was the theoretical base of the study. The independent variables were the OTs' training related to older drivers, …

The Impact Of Caring For Seniors On The Caregiver's Stress Level, Georgina Ugochi Njoku

Walden Dissertations and Doctoral Studies

The number of Canadian seniors with 2 or more chronic health conditions living into their late 90s or older has never been greater. As such, concerns have been raised that the Canadian healthcare system will be unable to meet the growing healthcare needs of the aging population. In this project, an Advanced Practice Nursing needs assessment was used to identify the impact that caring for a senior has on caregivers' stress levels, and what resources caregivers need to in order to cope with their role. Guided by Neuman's system model theory and Rogers' diffusion of innovation model, a convenience sampling …

Predictors Of Physician Use Of The New Nia Alzheimer's Assessment Protocols, Richard Norman Schultz

Walden Dissertations and Doctoral Studies

Consensus is lacking on early diagnostic criteria and the exact symptoms of Alzheimer's disease (AD). A new, in-office test may help physicians detect the early symptoms of AD, based upon new National Institute of Aging (NIA) criteria. However, a gap exists in knowledge regarding physicians' current use or intent to use the new protocols. Choreographing the descriptive AD terminology in the Diagnostic and Statistical Manual of Mental Disorders IV-TR and the International Classification of Diseases (ICD-10) is recommended. Thus, the purpose of this study was to understand possible contributing factors to physician's use or intent to use of the new …

Predictors Of Recidivism For Offenders With Mental Illness And Substance Use Disorders, Linda Buckmon

Walden Dissertations and Doctoral Studies

Mental illness and substance use disorders have been determined to be leading predictors for recidivism among criminal offenders in the United States who are released to community supervision. Women make up an increasing in percentage of this criminal justice population; however, few studies have explored the role that gender plays in determining men and women's recidivism. Offender's education, employment, and peer association have also been reported to be predictors increasing the likelihood of recidivism among criminal offenders. This study was designed to determine if gender, mental illness, substance use disorder, employment, education, and peer association predicted recidivism. Differential association theory …

Predictors Of Community Supervision Failures Among Female Offenders, Fayola Wolfe

Walden Dissertations and Doctoral Studies

This study explored the predictors of community supervision failures amongst female offenders in the United States criminal justice system. Female offenders have, in comparison with male offenders, particular challenges for community reintegration. This study used the relational theory and Maslow's hierarchy of needs theory to investigate the effects of childhood trauma on adult female offenders' behaviors, including substance use disorder and mental health issues. Secondary archival data were obtained from the Court Services and Offender Supervision Agency's AUTO Screener and Supervision and Management Automated Record Tracking System; this data pool included information on 1,085 female offenders who had served at …

Social Determinants Of Health Inequality And Life Expectancy Among Women Of Edo State, Nigeria, Daniel Aromeh Odekina

Walden Dissertations and Doctoral Studies

Health inequality conflates a huge number of economic, social, and political issues. These issues, together described as social determinants, determine a population's health through influencing health status and life expectancy. The research purpose of this study was to examine how social determinants affected the life expectancy of the women of Edo State, based on secondary data from Nigeria's 2008 demographic and health survey (NDHS). The theories that guided the study were self-efficacy beliefs of the social cognitive theory and physical self-concept of the health belief model. This quantitative cross-sectional study examined the associations between socioeconomic status, nutritional status, literacy/educational attainment, …

The Psychological Resilience Of Spousal Caregivers Of Multiple Sclerosis Family, Marisa Diane Diaz

Walden Dissertations and Doctoral Studies

The purpose of this quantitative study was to examine an under-researched topic: the relationship between psychological resilience and personal growth with spousal caregivers of patients diagnosed with Multiple Sclerosis (MS). Chronic illnesses contribute to potentially stressful changes (i.e., lifestyle, quality of life, financial wellbeing, and interpersonal relationships) for the caregiver. The theoretical foundation for this study was Walsh's family resilience theory, which contends that resilience is vital for coping with stressful life experiences and leading a more successful life. Three separate analyses were conducted to examine the relationship between the total scores of the RS and the PGIS, the SWLS, …

Relationship Between Stress Burden And Perceived Support Among Elderly Male Spousal Caregivers, Stephanie Fitzsimmons Sexton

Walden Dissertations and Doctoral Studies

As older couples age, often one partner becomes more competent and able to care for the other, in which case they are able to remain in their homes. In one township in the northeastern United States, the caregiving role had a significant effect on the lives of elderly men who care for their wives. The purpose of this quantitative project study was to determine the relationship between perceived stress burden and perceived level of social support services and between perceived stress burden and use of support services by elderly male spousal caregivers residing in active adult communities. Watson's theory of …

The Impact Of Supply Chain Logistics Performance Index On The Control Of Neglected Tropical Diseases In Low- And Middle-Income Countries, Farouk Adams Umaru

Walden Dissertations and Doctoral Studies

Neglected tropical diseases (NTD) in low- and middle-income countries are still not on target per the World Health Organization's (WHO) elimination goal of 2020. Mass drug administration (MDA) is one of the effective strategies supported by the WHO for the control and subsequent elimination of NTD. This quantitative study explored how supply chain logistic capacity may be hampering MDA coverage in countries in which the diseases are endemic. The study examined secondary data from WHO data bank for MDA coverage, to quantify the relationship between supply chain logistics capacity, as measured by the World Bank's logistics performance index (LPIs), and …

Autonomy In The California Disability Services System, Lisa Ann S. Carbone

Walden Dissertations and Doctoral Studies

Legislation concerning California residents with intellectual and developmental disabilities (ID/DD) requires recipients of services to be treated as independent individuals while emphasizing self-determination. At the same time, under regulatory procedures, recipients are considered dependent on the delivered services and not self-determinant. Neither the California Department of Developmental Services nor the trade associations representing community service providers have established a unified, systematic practice to support self-determination. This phenomenological study explored the experience of adults with ID/DD working toward self-determination.

Specifically, it explored how medical and social models contribute to shaping and actualizing the independence of this population. Interviews with eight adults …

The Effects Of Stress And Burden On Caregivers Of Individuals With A Chronic Illness, Betty Wilborn-Lee

Walden Dissertations and Doctoral Studies

Informal caregivers have played a significant social and economic role in the care and treatment of individuals diagnosed with chronic illness. However, caregiving can have harmful effects on a caregiver's physical, psychological, and emotional well-being. Using caregiver stress theory as the theoretical framework, the purpose of this archival research was to determine the predictive relationship of stress in relation to caregiver quality of life for 309 selected cases. Correlational and hierarchical multiple linear regression analyses were used to examine the relationship between the independent variables and the dependent variable. The independent variables examined were environment and context, stressors related to …

Nursing Care Of Terminal Patients In Intensive Care Units, Pervell Velethia Dunbar

Walden Dissertations and Doctoral Studies

Nursing Care for Terminal Patients in Intensive Care Units

by

Pervell Dunbar

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

August 2015

Although the goal of the ICU has always been to save lives, ICU now additionally provides end-of life (EOL) care. The objective of this project was to provide ICU nurses with a comprehensive awareness of physical, emotional, and spiritual EOL care issues of patients and their families in order to be better equipped to handle EOL care. The framework used was Jean Watson's Caring model (10 Caritas). A …

Improving The Experiences Of Informal And Formal Alzheimer's Disease And Dementias Caregivers, Roxroy Anthony Reid

Walden Dissertations and Doctoral Studies

Informal and formal caregivers of persons with Alzheimer's disease and related dementias (ADRD) encounter a more difficult and unique set of challenges than do caregivers of individuals with general disabilities. If adequate caregiver supports are not provided, caregivers may experience increased strain as the disease progresses, increasing the likelihood of unnecessary institutionalization of their care recipients and increasing the cost to the public. Using rational choice theory and political systems theory, the purpose of this study was to differentiate between the phenomenological experiences of formal and informal caregivers of ADRD patients. The overall research was a qualitative design that used …

Racism Vs. Social Capital: A Case Study Of Two Majority Black Communities, Bruce W. Strouble

Walden Dissertations and Doctoral Studies

Several researchers have identified social capital as a means to improve the social sustainability of communities. While there have been many studies investigating the benefits of social capital in homogeneous White communities, few have examined it in Black homogeneous communities. Also, there has been limited research on the influence of racism on social capital in African American communities. In this dissertation a comparative case study was used within a critical race theory framework. The purpose was to explore the role of racial oppression in shaping social capital in majority African American communities. Data were collected from 2 majority Black communities …

The Influence Of Religion On Attitudes Toward Alcohol Use In Jewish Adolescents, Toby R. Levin

Walden Dissertations and Doctoral Studies

Historically, the Jewish faith has used alcohol in rituals and religious holidays in which adolescents are permitted to fully participate and this exposure to alcohol may influence attitudes and beliefs about underage drinking among Jewish adolescents. The purpose of this study was to determine if there was a relationship between the Jewish religion and attitudes toward alcohol among Jewish adolescents. The theoretical frameworks, on which this study was based, were the social bond theory and the social development theory. Each of these theories indicates that community is important to the individual. Using a cross sectional study design, 160 adolescents participated …

Religious-Base Social Relationship And The Psychological Well-Being Of The Elderly: Gender And Race Variations, Eugene C. Uche

Walden Dissertations and Doctoral Studies

More people in the United States are approaching retirement age, a trend which has resulted in increased study on life satisfaction and psychological well-being of the elderly. Previous researchers have focused on the relationship between religious social support and life satisfaction; however, there remains a gap in the literature regarding how race and gender may influence this association. Knowledge of interactions between religiosity, gender, and race will enable counselors working with different groups of religiously inclined clients to develop and implement religious-based interventions specific to their clients. Guided by the social ecological model, the purpose of this study was to …

Analysis Of Variance In Recidivism Between Special Needs Offenders And Regular Offender Populations In Texas, Park Esewiata Atatah

Walden Dissertations and Doctoral Studies

A Specialized or Super Intensive-1 (SI-1) supervision level refers to a contact requirement imposed on special needs offenders (SNOs) under Texas parole supervision. SI-1 supervision requires greater contact with parole officers and treatment providers than supervision levels used on regular offenders (ROs), yet little is known about whether SI-1 supervision offenders violate terms of their parole or commit new crimes at a different rate compared to the regular offender population in the State of Texas. Reconstruction theory and the social construction of reality were used as theoretical underpinnings of this study, which examined whether differences in offenders' supervision levels created …

An Examination Of Awareness Of Over-The-Counter Nonsteroidal Anti-Inflammatory Drugs And Adverse Events, Michelle Popa

Walden Dissertations and Doctoral Studies

The elderly population is among the fastest growing populations in the United States. Finding and consuming medications safely and effectively are challenging endeavors for this population. Nonsteroidal anti-inflammatory drugs (NSAIDs) are a widely consumed class of medications among the elderly population, with 70% of individuals consuming over-the-counter (OTC) NSAIDs once a week and 34% using them daily. The purpose of this quantitative study was to determine whether (a) patients are aware of the risks associated with the consumption of NSAIDs, and (b) there are differences in awareness based upon specific demographic characteristics and levels of patient-physician communication. The health belief …

Factors Contributing To The Increase In Hiv/Aids And Late Diagnoses Of The Virus Among Older Adults, Lorraine C. Barnett

Walden Dissertations and Doctoral Studies

The Centers for Disease Control and Prevention predicted that the incidence of HIV/AIDS among the American population aged 50 years and over would account for 50% of all HIV/AIDS cases in the United States by 2015. Yet there is little research available about the reason for the high prevalence or the availability of interventions available for this population. The purpose of this study was to explore factors related to HIV/AIDS awareness in a group of older recipients of health care and their health care providers. This study was intended to help fill the information gaps in this area by using …

Influence Of Coping Styles On Social Support Seeking Among Cancer Patient Family Caregivers, Sandra Renee Rankin

Walden Dissertations and Doctoral Studies

Family caregivers of cancer patients may enter a predeath grief cycle when their loved one is diagnosed with cancer. The emotional upheaval and accompanying stress that define predeath grief may lead to health problems for the caregiver, and also interfere with their ability to provide care for their loved one. The purpose of the present research was to examine the relationship between coping styles of family caregivers and the tendency of those caregivers to seek social support during active caregiving. This study employed a quantitative approach based on the revised coping theory and the process of bereavement, which is grounded …

The Experience Of Menopause As Reported By Sedentary Women, April Elizabeth Ann Rietdyk

Walden Dissertations and Doctoral Studies

Limited research exists on the experiences of sedentary women as they transition through menopause. This gap creates difficulty for public health practitioners as they strive to develop resources, implement programs, or influence policy change at the community level for this group of marginalized women. Keeping women healthy throughout the aging process, including menopause, improves their quality of life and decreases the impact aging has on the health care system. This phenomenological study, through in-depth interviews, provided the opportunity for sedentary women to share their thoughts and experiences of menopause. Thirteen sedentary women between the ages of 40 and 60, experiencing …

The Relationship Between Depression And Cognitive Deterioration In Older Adults, Rakesh Chand

Walden Dissertations and Doctoral Studies

The population structure of the United States is changing; the older age group is increasing in size relative to the younger generation. The trend is expected to continue, especially starting in 2020, when the baby boomer population---estimated at 80 million---will be reaching their 65 th birthday, a time associated with increasing health complications, including depression and dementia. The study employed a holistic paradigm as the conceptual framework to examine the association between depression and dementia in older adults, and generated a grounded theory to illuminate the relationship between depression and dementia. This theory was then used to assess the efficacy …

Emotional Support In Managing Cardiovascular Diseases Among Hispanic And Non- Hispanic Menopausal Women, Claudette Andrea

Walden Dissertations and Doctoral Studies

Effective recognition and proper treatment of cardiovascular diseases (CVDs) in Hispanic woman is a public health problem that needs further investigation. Guided by the stress and coping social support theory, the purpose of this cross-sectional survey study was to examine the relationship between attitudes, emotional support, and the perception of success in managing cardiovascular diseases (CVDs) in 335 Hispanic women living in Atlanta, Georgia. Correlations, independent-sample t tests, simple linear regression, and multiple linear regressions showed ethnicity as a moderating variable between the perception of success in handling CVD and emotional support, while emotional support was shown to be a …

Who Shares? Managerial Knowledge Transfer Practices In British Columbia's Ministry Of Health Services, Gwendolyn Elizabeth Lock

Walden Dissertations and Doctoral Studies

The British Columbia government's Ministry of Health Services will experience significant loss of operational knowledge from an aging managerial workforce, increased staff turnover, and difficulties in recruitment. The purpose of this study is to provide the ministry's Strategic Human Resources Planning branch staff with a map and description of knowledge transfer practices used by approximately 40 managers within the ministry's Health Sector Information Management/Information Technology division and its Vital Statistics Agency. The study is a mixed-methods case study of knowledge retention and transfer practices founded on a knowledge management and social network theoretical foundation. To understand the ministry's complex nature …

A Phenomenological Inquiry Of Chronic Homeless Individuals' Challenges To Independence, Dewana Hall

Walden Dissertations and Doctoral Studies

Homelessness is a comprehensive social problem affecting approximately 744,000 people in the U.S. Despite consistent efforts from politicians, state and local leaders, and service providers, the number of homeless people continues to rise. Although there are some explanations in the literature to account for the increase of homelessness, the literature tends to not include the voices of the homeless themselves. The purpose of this phenomenological study, which used Maslow's hierarchy of needs as its conceptual framework, was to understand the life experiences of members of the homeless population, as perceived by four male residents of a mission in an eastern …

Locus Of Control And Adjustment To Vision Loss Among People With Age Related Macular Degeneration, Delinda Stinnette

Walden Dissertations and Doctoral Studies

People aged 65 and older account for 12.8% of the population and for 30% of all visually impaired individuals. Age-related Macular Degeneration (ARMD) has been identified as a significant public health issue, with a potential 8 million Americans at risk. While the literature supports a connection between LOC and adaptation to ARMD, there is a gap in the current literature supporting this relationship even when other factors are controlled (i.e. age, sex, education, type of ARMD, when diagnosed, the use of medical treatments, the use of visual assistance devices, participant engagement in rehabilitation, and depression). The present survey study used …

Faces In The Mirror: Exploring Conflict Styles Of Adults In School Communities Using The Face -Negotiation Theory, Christine D. Gross

Walden Dissertations and Doctoral Studies

This correlation study focused on the lack of understanding of the relationship between social self-image "face" and conflict styles among adult employees on school campuses. An individual's social self-image may involve concerns for the social representation of oneself, another individual, or a relationship. Limited research pertaining to the degree face concerns affect conflict styles within school communities is a problem for school administrators because conflict styles can influence conflict outcomes and impact workplace quality on school campuses. This study relied on Ting-Toomey's face-negotiation theory, which proposes that individuals prefer conflict styles based upon face concerns. Research questions explored correlations between …

Factors Related To Caring For The Elderly Among Three Generations Of Nurses, Joanna Fairley

Walden Dissertations and Doctoral Studies

Three generations of registered nurses make up the current nursing workforce: Baby boomers, Gen X, and Gen Y. Each generation brings its own values, behaviors, and beliefs to the workplace. The generational diversity among nurses needs to be assessed along with other factors, such as social values of the elderly, anxiety toward aging, and practice settings, to examine how each factor impacts registered nurses' attitudes toward caring for the elderly. An exploration of these factors is significant to nurse leaders, since nurses have been known to display negative attitudes toward the elderly. The theoretical foundation for this study was based …