Medicine and Health Sciences Commons^™

Cultural Aspects Of End Of Life Advance Care Planning For African Americans: An Ethnonursing Study, John Collins

Electronic Theses and Dissertations

Introduction: Advance directive completion rates among the general population are low. Studies report even lower completion rates among African Americans are impacted by demographic variables, cultural distinctives related to patient autonomy, mistrust of the healthcare system, low health literacy, strong spiritual beliefs, desire for aggressive interventions, importance of family-communal decision making, and presence of comorbidities. End of Life (EOL) advance care planning (ACP) promotes patient and family centered care. The purpose of this study was to identify culturally based meanings, expressions, and traditions of EOL ACP and decision making among African Americans, to better understand and provide culturally congruent nursing …

Understanding Substance Use And Recovery In Maine: A Culture-Centered Approach, Carter Hathaway

Electronic Theses and Dissertations

There is ever-increasing attention to Maine’s substance use problem, particularly in the case of opioid-related deaths. With yearly death tolls increasing, citizens of Maine wonder what the best methods are in approaching the issue and preventing further harm. While statistics about the issue are repeated in news coverage and by political figures, there is a need to understand what substance use and recovery actually mean to individuals who experience them on a daily basis. The following thesis uses Mohan J. Dutta’s (2008) culture-centered approach to health communication to explore the meanings of substance use and recovery as well as the …

The Impact Of Evidence-Based Practice On A Culture Of Safety, Donald C. Hunt

Nursing Theses and Dissertations

Background: 210,000 to 440,000 deaths have been caused by errors in healthcare. Providers who are committed to core values that emphasize safety contribute to a “culture of safety.’ This culture is required for healthcare institutions to achieve high-reliability status demonstrating high potential for error but few adverse outcomes. There is little known about contributors to the culture of safety and the commitment of providers to its core values.

Purpose: To determine relationships among the predictors- EBP culture, individual evidence-based decision making, organizational implementation of evidence-based practice - and a culture of safety.

Design: Correlational Predictive Design.

Sample: Two-hundred seventeen nurses …

The Experience Of Female Veterans’ Transitioning To Post—Active— Duty Health Care, Sarah A. Bradwisch

Theses & Dissertations

Problem Statement: Female veterans are growing in record numbers and are the fastest growing segment of the veteran population in the United States(U.S.). After discharge from the military, female veterans face a difficult challenge in finding quality, efficient, and gender-specific health care following active duty. The growing number of female veterans in the Department of Veterans Affairs (VA) health care facilities has highlighted gaps in access to care and quality of care for female veterans. Methodology: Interpretive phenomenology was used to better understand the meaning of 11 U.S. female veterans’ experiences. Semi-structured telephone interviews and the analytic approach of Martin …

Cultural Competence Of Public Health Nurses Who Care For Diverse Populations, Althea Michelle Otuata

Walden Dissertations and Doctoral Studies

Despite advances in health, science, and technology, U.S. healthcare lags in providing access to care and quality care to racial and ethnic minorities. Cultural competence has been noted as a strategy to improve access and quality. The purpose of this project was to assess public health nurses' cultural competence before and after participating in cultural competence informational modules. Two conceptual models were used in this project for theoretical guidance: Leininger's cultural care diversity and universality theory and Campinha-Bacote's process of cultural competence. To assess the nurses' cultural competence, the Cultural Competence Self-Assessment Checklist questionnaire was e-mailed to 57 public health …

Contributors To The Development Of Intercultural Competence In Nursing Students, Esther Zazzi

Walden Dissertations and Doctoral Studies

Nurses deal more effectively with cultural diversity when they have an ethnorelative orientation toward cultural difference and commonality on the Intercultural Development Continuum, which was the theoretical framework of this study. Scholarly literature shows limited knowledge on what fosters nurses' intercultural development. Thus, this quantitative, retrospective study was the first investigation in health care in Switzerland conducted on nursing students' orientation on the Intercultural Development Inventory (IDI) and the relationship to student demographic variables. The sample for this secondary data analysis consisted of the IDI results from nursing students enrolled between 2010 and 2016 at the largest nursing college in …

Preventing Obesity And Type 2 Diabetes In Immigrant Populations, Maxwell K. Chikuta

Walden Dissertations and Doctoral Studies

Obesity-related diseases have been increasing in African immigrants throughout the United States. Although research has been done to identify risk factors associated with many ethnic groups in the United States, only a few studies exist that explore obesity and type 2 diabetes diseases among Central African immigrants. The conceptual framework for this qualitative case study was social constructivism and the health belief model. The primary research question addressed the potential underlying causes for an increase in obesity and type 2 diabetes among Central African Immigrants. The secondary research questions explored how culture, illiteracy, and religion contribute to the problem of …

Lived Experience Of Tongans With Obesity And Diabetes, Gladys Adjei-Poku

Walden Dissertations and Doctoral Studies

People of Pacific Island descent are afflicted by obesity and diabetes more than other populations. Although interventions have succeeded in reducing these conditions among other groups, they have been unsuccessful among Tongans and other Pacific Islanders. Furthermore, little is known about the cultural perspectives of this population with a high rate of obesity and diabetes. Accordingly, this descriptive phenomenological study was conducted to investigate the lived experiences of Tongans with obesity and diabetes in a western metropolitan area of the United States to understand their predisposition toward these conditions and suggest appropriate interventions. Purposive sampling was used to recruit 11 …

Factors Affecting Health Care Access And Utilization Among U.S. Migrant Farmworkers, Melinda R. Kelly

Walden Dissertations and Doctoral Studies

There are over 3 million seasonal and migrant farmworkers in the U.S. agricultural industry with a significant percentage of farmworkers documented or native to the United States. Migrant farmworkers live below the federal poverty levels at high rates and experience low health care access and utilization. Guided by the fundamental cause theory, the purpose of this phenomenological study was to examine the lived experiences of migrant farmworkers and identify the factors impacting their health care access and utilization. Face-to-face interviews were conducted with 12 migrant farmworkers who had worked in Southwest Texas agricultural stream. Data were analyzed and coded to …