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Articles 61 - 90 of 465
Full-Text Articles in Medicine and Health Sciences
The Relationship Between Advanced Payment Model Providers And Patient Behavior, Harry Petaway
The Relationship Between Advanced Payment Model Providers And Patient Behavior, Harry Petaway
Walden Dissertations and Doctoral Studies
Public health initiatives include vaccination and screening efforts to reduce the burden of disease. This study addressed colorectal cancer (CRC) screening behaviors of accountable care organization (ACO) patients with different social determinants of health and providers’ ability to comply with the Medicare Shared Savings Plan (MSSP) quality measure ACO #19. This study followed the socioecological model and a cross-sectional quantitative design to assess data from the MSSP public use file 2019 across three manuscripts to expand on current literature. The purpose was to determine whether patient behavior was the primary driver to improve healthcare quality. Study results showed that performance …
How Cyber Activity Influences Depression And Anxiety In Teenagers, Mary Fridah Gatwiri Muiruri
How Cyber Activity Influences Depression And Anxiety In Teenagers, Mary Fridah Gatwiri Muiruri
Walden Dissertations and Doctoral Studies
Both depression and anxiety have been a focus of scholars since their rates have recently skyrocketed from 5.4 % in 2003 to 20 % currently among teenagers in the United States. Although numerous studies have assessed the association between playing video games and depression, few studies have examined how cyberbullying and screen time contribute to depressive symptoms in teenagers. The purpose of this study was to analyze cyberbullying and screen time on depression in teens. . The exploration of associations between the dependent variable, depression, and the independent variables, screen time, video gaming, and cyberbullying, were guided by Bandura’s social …
Nursing Staff Education Fall Prevention Program At A Skilled Nursing Facility, Solomon Lomo
Nursing Staff Education Fall Prevention Program At A Skilled Nursing Facility, Solomon Lomo
Walden Dissertations and Doctoral Studies
Falls have negative effects on the confidence, function, and quality of life in older adults and are major cause of injury and death among this population. The quality assurance report in a long-term care facility identified an average of 10 falls per week in the last quarter of 2017. The facility has a person-centered policy, which creates fall prevention challenges when usual fall protective practices are prohibited. The purpose of this education program was to educate staff nurses working with patients in a long-term care facility on additional evidenced based practices to prevent falls and injuries without compromising the person-centered …
Professional Nurse Attitudes Of Poverty Before And After Participation In A Poverty Simulation, Beth Mueller
Professional Nurse Attitudes Of Poverty Before And After Participation In A Poverty Simulation, Beth Mueller
Walden Dissertations and Doctoral Studies
Implicit bias in healthcare toward those living in poverty may contribute to inequalities in care and increase the likelihood of patient noncompliance. The purpose of this study was to determine if participation in a poverty simulation had an impact on the attitudes of professional nurses toward those in poverty. Mezirow’s transformational theory was used to guide the study by allowing the learner to examine meaning and revise perspective after participation in an online module. This module included an online poverty simulation created by The United Way of Connecticut titled Making Tough Choices as well as a pre- and post-simulation survey …
Nutrition Practices And Obesity Standards Among Obese, African American Women, Martina Peterson
Nutrition Practices And Obesity Standards Among Obese, African American Women, Martina Peterson
Walden Dissertations and Doctoral Studies
Obesity in the United States has been labeled a national pandemic. Obesity occurs across all populations, regardless of age, sex, race, ethnicity, socioeconomic status, education level, or geographical region; however, it has disproportionately affected African American women. The purpose of this phenomenological study was to gain an understanding of African American women’s behaviors that are preventing them from conforming to nutrition and obesity standards of the body mass index (BMI) guidelines. The targeted population for this study was 10 obese or morbidly obese African American women, ages 30 to 45. The data were collected using telephone interviews due to the …
Use Of Critical Thinking Strategies By Nurse Educators, Josephine Tundun Akintonde
Use Of Critical Thinking Strategies By Nurse Educators, Josephine Tundun Akintonde
Walden Dissertations and Doctoral Studies
AbstractNew graduate nurses often lack the clinical decision-making skills that are essential for developing clinical competency. Critical thinking abilities are essential for nursing excellence and professional competency. However, little is known about nurse educators' techniques and teaching practices for developing students’ critical thinking. The purpose of this phenomenological study, guided by constructivist learning theory, was to understand the lived experiences of nurse educators who used critical thinking teaching strategies in a baccalaureate nursing program to develop critical thinking skills in nursing students. Thirteen nurse educators from baccalaureate nursing programs were interviewed using open-ended questions. Interviews were transcribed and manually coded. …
Understanding Resilience Among Individuals With Adverse Childhood Experiences (Aces), Meghan Larson
Understanding Resilience Among Individuals With Adverse Childhood Experiences (Aces), Meghan Larson
Walden Dissertations and Doctoral Studies
Adverse childhood experiences (ACEs), such as abuse, neglect, and dysfunction in a child’s home are considered a public health crisis due to their correlation to health disparities and psychosocial problems in adulthood such as substance use, relationships, education, and maintaining employment. However, some individuals are resilient and demonstrate the ability to adapt and function well despite experiencing adverse events. To better understand resilience when ACEs are present, I conducted a basic qualitative research study to explore the lived experiences of individuals in Tennessee with elevated ACE and resilience scores. A purposeful sample of 12 participants who scored high on ratings …
Type 2 Diabetes And Pesticide Exposure Among U.S. Hispanic Migrant Farmworkers, Judith Faustin-Gabriel
Type 2 Diabetes And Pesticide Exposure Among U.S. Hispanic Migrant Farmworkers, Judith Faustin-Gabriel
Walden Dissertations and Doctoral Studies
AbstractHispanic migrant farmworkers provide indispensable services to the United States, yet they are low-paid, uninsured employees working in extremely hazardous conditions. Public health and other healthcare professionals have worked to address the impact of pesticide exposure in the Hispanic migrant population. Although pesticides have been associated with various chronic diseases, limited evidence and studies have established an association between pesticide exposure and Diabetes Type 2 (DT2) among Hispanic migrant farmworkers. Guided by fundamental causes theory, this study addressed whether there is a relationship between agricultural pesticide exposure and DT2 among Hispanic migrant farmworkers in the United States who participated in …
Racial Disparities In Hypertension Self-Awareness And Hospitalizations For Hypertension-Related Illnesses Among Adult Arkansans, Chimfumnanya Nwanze-Smith
Racial Disparities In Hypertension Self-Awareness And Hospitalizations For Hypertension-Related Illnesses Among Adult Arkansans, Chimfumnanya Nwanze-Smith
Walden Dissertations and Doctoral Studies
Black individuals in the United States are twice as likely as White individuals to die of cardiovascular diseases. Between 2010 and 2016 in Arkansas (AR), hypertension (HTN) and HTN-related diseases had an age-adjusted death rate of 230.4 deaths per 100,000 population compared to 173.6 deaths per 100,000 population for Whites. The purpose of this quantitative, cross-sectional study was to explore the potential association between HTN self-awareness and emergency department (ED) visits and hospitalization rates for HTN and HTN-related illnesses between Black and White individuals in AR. The socioecological framework was used to explore sociodemographic (SDF) and socioeconomic (SES) factors as …
Increasing Staff Knowledge Regarding The Use Of Nonpharmacological Interventions With Long-Term Care Residents Diagnosed With Dementia, Larissa Latrice Anderson
Increasing Staff Knowledge Regarding The Use Of Nonpharmacological Interventions With Long-Term Care Residents Diagnosed With Dementia, Larissa Latrice Anderson
Walden Dissertations and Doctoral Studies
Dementia is an umbrella term that describes a clinical syndrome of progressive cognitive decline. The prevalence of a dementia diagnosis increases with age, making it a common occurrence within the older population. In long-term care facilities, where 5% of the older population reside, antipsychotic medications are the first line of defense and the choice of treatment among patients diagnosed with dementia. Recently, the Center for Medicare and Medicaid Services (CMS) announced a new goal of decreasing antipsychotic medication usage by 15% by the end of 2019. Guided by Watson’s Theory of Caring, this project was conducted to determine if an …
Perceptions Of Midwestern Msn Nps Of The Dnp Degree, Margaret Gallagher
Perceptions Of Midwestern Msn Nps Of The Dnp Degree, Margaret Gallagher
Walden Dissertations and Doctoral Studies
Strong professional forces have emerged within healthcare with expectations for a Doctor of Nursing Practice (DNP) degree for nurse practitioner (NP) practice. While NP contribution to societal healthcare is evident, most of these frontline workers are still only masters’ prepared nurses (MSN). A problem exists in that their views of the DNP have been minimally studied. Hence, the purpose of this study was to investigate perceptions of Midwestern MSN NPs of the DNP. The study was supported by the self-determination theory (SDT) proposing that motivation for goal achievement was driven by perceptions of intrinsic and extrinsic rewards, which set priorities …
An Integrated Approach To Hand Hygiene, Tarsha Renee Stewart
An Integrated Approach To Hand Hygiene, Tarsha Renee Stewart
Walden Dissertations and Doctoral Studies
AbstractHealthcare-associated infections (HCAIs) threaten the quality and safety of the services provided. HCAIs are infections that occur while a patient is receiving treatment for another condition in any type of healthcare. The Centers for Disease Control estimates that approximately one in every 20 inpatients will become infected with an HCAI during their hospital stay. Proper hand hygiene is the most significant intervention in preventing HCAIs. Despite hand hygiene's effectiveness, evidence suggests that only 50% of healthcare workers are compliant with proper hand hygiene techniques. The purpose of this project is to increase nurse’s knowledge the via education. Kotter's eight-step change …
Socioeconomic Factors And Comorbid Conditions In Children With Autism Spectrum Disorder, William Paris
Socioeconomic Factors And Comorbid Conditions In Children With Autism Spectrum Disorder, William Paris
Walden Dissertations and Doctoral Studies
Autism spectrum disorder (ASD) is a neurodevelopmental disorder that impacts children and adults. Comorbid conditions such as anxiety, depression, behavioral issues, and low socioeconomic status negatively impact health care quality in children with ASD. Missing from the academic literature is the quantification of the relationship between parental education and employment and health insurance coverage on the prevalence of comorbid conditions in children with ASD. The purpose of this cross-sectional quantitative analysis was to examine and quantify the relationship between parental education and employment, health insurance coverage, and the reporting of comorbid conditions (anxiety, depression, behavioral issues) in a nationally representative …
Determinants Of Fruit And Vegetable Consumption For Adults In The Panhandle Of Nebraska, Erin Marie Norman
Determinants Of Fruit And Vegetable Consumption For Adults In The Panhandle Of Nebraska, Erin Marie Norman
Walden Dissertations and Doctoral Studies
Low fruit and vegetable (F/V) consumption has been documented and is associated with increased risk of chronic disease. Previous studies have revealed that consuming the recommended servings of F/V per day can be influenced by many determinants including healthy eating self-efficacy, cooking confidence, perceived family support, perceived access, perceived quality, and perceived cost of fruits and vegetables. The purpose of this study was to examine these determinants of F/V consumption at the individual level of the socioecological model for adults ages 18 years and older residing in the panhandle of Nebraska. The socioecological model (SEM) provided the theoretical framework for …
The Impact Of Assertiveness And Religiosity On The Expression Of Dissent Among U.S. Immigrant Nigerian Workers, Peter Osiabia Azorji
The Impact Of Assertiveness And Religiosity On The Expression Of Dissent Among U.S. Immigrant Nigerian Workers, Peter Osiabia Azorji
Walden Dissertations and Doctoral Studies
AbstractScholars have studied dissent in general, but few have focused on the impact of cultural contexts and characteristics on dissent. Literature on the influence of cultural factors on expression of disagreement in organizations, by immigrant Nigerian workers in the US has not received adequate attention. There is therefore a compelling need to bridge this gap. This quantitative nonexperimental correlation study examined the impact of assertiveness and religiosity (variables that may be influenced by culture), on expression of minority dissent among Nigerian immigrant workers in the United States. The inquiry was based on two theoretical models: Bourhis et al.âs interactive acculturation …
Safety Planning: Self-Management Approaches For Intimate Partner Violence In Ohio, Yvette Clemons
Safety Planning: Self-Management Approaches For Intimate Partner Violence In Ohio, Yvette Clemons
Walden Dissertations and Doctoral Studies
AbstractIntimate partner violence (IPV) is a global health education and promotion burden that has affected one in four women in the United States between the ages of 18-24, who are at increased risk of subsequent negative health outcomes of sexually transmitted inflections, mental health and substance abuse disorders, exacerbated suicidal ideations, and death. Exploring the health education needs and learning preferences of women affected by IPV who have utilized self-management strategies during safety planning interventions was the purpose for this phenomenological qualitative study and aligned the four research questions. SurveyMonkey was used to conduct interviews of 30 women align with …
Factors Influencing Family Planning Uptake Among Adolescents And Postpartum Women In Kenya, Shiphrah Kuria-Ndiritu
Factors Influencing Family Planning Uptake Among Adolescents And Postpartum Women In Kenya, Shiphrah Kuria-Ndiritu
Walden Dissertations and Doctoral Studies
Family planning (FP) is a cost-effective public health strategy, but the uptake is low with marked disparity among adolescents and postpartum women. However, data on these marginalized groups are limited. This quantitative, cross-sectional study sought to provide information on the factors that contribute to the uptake of FP among adolescents and postpartum women in Kenya. The 2014 Kenya Demographic Health Survey FP data were analyzed regarding the factors associated with FP uptake among adolescents and postpartum women as well as the differences by region. The factors were organized according to the socioecological model (SEM) and included intrapersonal, interpersonal, community, and …
Impact Of Social Barrier Removal On Primary Care Use By Managed Care Enrollees, Pamme Lyons-Taylor
Impact Of Social Barrier Removal On Primary Care Use By Managed Care Enrollees, Pamme Lyons-Taylor
Walden Dissertations and Doctoral Studies
Personal health represents a complex relationship among social, physical, and emotional factors that can be influenced by health-seeking behaviors. Prior research indicates that greater use of preventive services leads to longer life and lower healthcare costs. For some populations, evidence suggests that social barriers hinder access to preventive services. To better understand the relationship between social factors and the other personal-health factors, de-identified healthcare claims and social service encounter data for 4,480 low-income individuals enrolled in Medicare Advantage or Managed Medicaid at one national health insurance were examined using a retrospective, quasi-experimental design for services rendered between October 1, 2014 …
Pharmacological Management Of The Diabetic Patient: A Staff Education Project, Wilantha Silva
Pharmacological Management Of The Diabetic Patient: A Staff Education Project, Wilantha Silva
Walden Dissertations and Doctoral Studies
Poorly controlled diabetes can lead to health complications that impact quality of life, increase healthcare costs, and create a negative impact on communities. Pharmacological management of diabetes was identified by stakeholders as a gap in practice at a clinic in the southeastern United States. The purpose of this project was to develop staff education based on American Diabetes Association (ADA) and American Association of Clinical Endocrinologists (AACE) standards of care, deliver education to primary care nurse practitioners (NPs), and evaluate their learning and confidence levels. The primary framework for this project was the chronic care model. An expert panel, including …
Hospital-Acquired Condition Ranking Score Among Types Of Safety-Net Hospitals, Jude C. Iruka
Hospital-Acquired Condition Ranking Score Among Types Of Safety-Net Hospitals, Jude C. Iruka
Walden Dissertations and Doctoral Studies
Abstract The Center for Medicare and Medicaid Services has been shifting from paying hospitals for the volume of services they delivered to paying them for the quality of those services, known as pay-for-performance, to incentivize hospitals to offer improved care at a lower cost. When a patient goes to the hospital to receive care for one condition and develops another condition during that hospital stay, the second condition is referred to as a hospital-acquired condition. It is anticipated that 1.7 million infections are acquired at some point in-hospital stay in the United States annually, resulting in nearly 100,000 deaths in …
The Relationship Between Cultural Competency And Hospital Quality Measure Outcomes, Linda Nguyen Quach
The Relationship Between Cultural Competency And Hospital Quality Measure Outcomes, Linda Nguyen Quach
Walden Dissertations and Doctoral Studies
Healthcare organizations have little evidence concerning how cultural competency impacts hospital quality outcomes of care transition and patients’ overall experience with care. Identifying if cultural competency translates into quality measures is important for healthcare administrators and could contribute to optimizing patient care. The purpose of this quantitative study was to explore the relationship between hospital cultural competency and hospital quality measures and compare California and other states’ acute care hospital cultural competency scores. Donabedian’s lasting framework for health care quality and Campinha-Bacote’s model of cultural competence in health care were used to frame this research. Hospital Consumer Assessment of Healthcare …
Lived Experiences Of African American Women Coping With Breast Cancer In Rural Northeastern North Carolina, Denise Germaine Belle
Lived Experiences Of African American Women Coping With Breast Cancer In Rural Northeastern North Carolina, Denise Germaine Belle
Walden Dissertations and Doctoral Studies
This qualitative study examined the phenomenology of breast cancer among seven African American female participants who reside in rural, medically underserved communities in Northeastern North Carolina. The aim of this descriptive study was to explore the answers to the overarching question of how African American women with breast cancer self-manage the emotional, physical, financial, and social issues associated with the diagnosis and treatment. The transactional model of stress and coping provided the theoretical framework for examining the role of social reinforcements, beliefs, attitudes, and intentions on the health behavior of African American women with breast cancer in some rural, resource-stricken …
The Impact Of Socioeconomic Status And Ethnicity On Chronic Obstructive Pulmonary Disease Patients, Donald Garret Abshier
The Impact Of Socioeconomic Status And Ethnicity On Chronic Obstructive Pulmonary Disease Patients, Donald Garret Abshier
Walden Dissertations and Doctoral Studies
Chronic obstructive pulmonary disease (COPD) is a progressive and debilitating respiratory condition that leads to significant medial and financial burdens. For many patients with COPD, multiple socioeconomic factors contribute to health disparities, including income, education, employment status, and race/ethnicity. The purpose of this study was to examine the impact of SES and race/ethnicity on COPD patients. For this cross-sectional study, using secondary data analysis, the Social-Ecological Model (SEM), which discusses five levels of influence, was utilized. Data from over 3,222 participants aged 18 and over, living in Nevada were obtained from the 2018 Behavioral Risk Factor Surveillance System (BRFSS) study. …
Drug-Resistant Neisseria Gonorrhoeae; Identification Of At-Risk Groups In Florida By Regional Variation, Scott August Herber
Drug-Resistant Neisseria Gonorrhoeae; Identification Of At-Risk Groups In Florida By Regional Variation, Scott August Herber
Walden Dissertations and Doctoral Studies
Neisseria gonorrhoeae has been on the rise in the State of Florida since 2013. Florida currently follows the Centers for Disease Control and Prevention guidelines for identifying those at-risk for gonorrhea and drug resistant gonorrhea infections. These groups are narrowly defined and do not consider the different population dynamics throughout the State. This study examined the question of who is at-risk for contracting drug resistant strains of gonorrhea in the eight different regions of Florida based on the prescribed use of last-line-of-antibiotic-defense. Florida’s Surveillance Tools and Reporting System provided 12 years of secondary data from 2007 to 2018. The data …
Territoriality As A Factor In Nursing Incivility, Carolyn Wright
Territoriality As A Factor In Nursing Incivility, Carolyn Wright
Walden Dissertations and Doctoral Studies
AbstractIncivility and hazing in health care results in unsafe environments, not only for the nurse but also for the client, facility, and other health professionals. The project site, a privately owned medical clinic, has a high employee turnover rate with exit interviews indicating bullying and incivility from long-term nursing staff toward new employees as critical reasons for employee resignation. The literature offers minimal information regarding territoriality, a concept associated with aggressive (i.e., alpha) behaviors in animals and humans and incivility in nursing. The purpose of the project was to identify whether territoriality was a behavioral factor that may have contributed …
Physical Distress And Psychological Outcomes: An Examination Of Hurricane Katrina Rebuilders, Danita M. Muse
Physical Distress And Psychological Outcomes: An Examination Of Hurricane Katrina Rebuilders, Danita M. Muse
Walden Dissertations and Doctoral Studies
AbstractHurricane Katrina made land fall in New Orleans on August 29, 2005. When Hurricane Katrina came ashore at the mouth of the Mississippi River it struck with such vengeance that the protective levees surrounding the New Orleans area were breached. The purpose of this quantitative research is to broaden the understanding the relationship between two phenomena: physical distress and posttraumatic growth among Hurricane Katrina rebuilders who rebuilt their lives 15 years following a natural disaster along the Gulf Coast. The Conservation of Resources and Self-Efficacy Theory were the theoretical framework for this study. The research questions examined if statistically significant …
Staff Education On Medication Screening Tool For Nursing Home Residents, Jinkee Sarah Beltran
Staff Education On Medication Screening Tool For Nursing Home Residents, Jinkee Sarah Beltran
Walden Dissertations and Doctoral Studies
The prevalence of potentially inappropriate medications (PIMs) among nursing home residents continues to be high. Researchers have demonstrated that the use of a medication screening tool identifying PIMs can improve medication safety among older adults. Screening tools, such as the Beers criteria and the Screening Tool for Older Persons’ Prescriptions (STOPP), are evidence-based guidelines that use several validated criteria to identify PIMs in older adults’ medication regimens. While the use of these tools is standard in the acute care setting, limited studies have been conducted regarding their use in the nursing home setting. The purpose of this project was to …
Motivational Interviewing: A Strategy To Improve Health Professional's Communication, Lanita James
Motivational Interviewing: A Strategy To Improve Health Professional's Communication, Lanita James
Walden Dissertations and Doctoral Studies
Miscommunication between patients and healthcare professionals is common in U.S. hospitals and is considered one of the chief factors in reduced patient satisfaction with care. Collaboration with the nurse researcher who reviewed the Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS) data for a local hospital noted that negative ratings were directly related to the miscommunication between the patient and care providers. Further identified that the nursing staff was not knowledgeable about evidenced-based strategies needed to communicate effectively with the patients. The purpose of this DNP project was to develop an education program to increase nurses' knowledge about …
Age-Of-Consent Policies And Hiv Among Adolescents In Sub-Sahara Africa, Suzanne Marie King
Age-Of-Consent Policies And Hiv Among Adolescents In Sub-Sahara Africa, Suzanne Marie King
Walden Dissertations and Doctoral Studies
Age of consent policies have recently been identified as a barrier to HIV testing among adolescents in HIV endemic Sub-Sahara Africa. Grounded in the modified social ecological model, the purpose of this study was to determine if these policies were related to HIV testing rates and prevalence. In this quantitative research secondary data sets from the Demographic Health Survey were used. This study included all sexually active respondents aged 18 years or below (N=37,015) and then was further limited by respondents that had HIV test results (N=25,107). Binary logistic regression showed that respondents with lower age of consent had higher …
Association Between Food Insecurity And Influenza Outcome In The United States., Sabrina Fiona Pink
Association Between Food Insecurity And Influenza Outcome In The United States., Sabrina Fiona Pink
Walden Dissertations and Doctoral Studies
AbstractThe influenza virus is one of the most commonly occurring respiratory viral infections in the world. The outer capsule of the virus contains 18H proteins and 11N proteins, which allows the virus to reform in over 100 different strands and outperform the vaccine. Despite efforts to improve access to care and reduce vaccine inequities; the Center for Disease Control and Prevention estimates 9-45 million documented influenza-related illnesses, 140,000 to 810,000 hospitalization, and 64,000 deaths yearly. The purpose of this study is to investigate whether food insecurity, access to care and other social determinants of health such as age, race, and …