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Prevalence Of Premenstrual Syndrome, Premenstrual Dysphoric Disorder, And Dysmenorrhea In Nursing Students: A Systematic Review, Meta-Analysis, And Evidence-Based Recommendations, Sabyasachi Maity, Bharathi Gadad, Hansapani Rodrigo, Seham Noorani, Ayesha Usman, Chloe Lark, Mona Attarpour, Ivy Mageto, Lucas Schwartz, Nikhilesh Anand

School of Medicine Publications

Introduction: Menstrual disorders—including premenstrual syndrome (PMS), premenstrual dysphoric disorder (PMDD), and dysmenorrhea—are highly prevalent among women of reproductive age and are associated with impaired academic performance, psychological distress, and reduced social functioning. Nursing students are particularly vulnerable due to the combined demands of intensive academic schedules and clinical training, yet prevalence estimates and institutional responses remain inconsistent.

Methods: A systematic review and meta-analysis were conducted in accordance with PRISMA 2020 guidelines and registered in PROSPERO (CRD420251109363). PubMed, Scopus, Web of Science, CINAHL Ultimate, and APA PsycINFO were searched for studies published between 2016 and 2025. Eligible studies reported prevalence or …

Immediate Skin-To-Skin Contact At Very Preterm Birth And Effect On Infant Socio-Emotional Stress Response And Mother–Infant Cortisol Co-Regulation: Secondary Outcomes From The Randomised Clinical Immediate Parent-Infant Skin-To-Skin Study (Ipistoss), Karoline Lode-Kolz, Siri Lillieskold, Hanne Brit Hetland, Eleonora Mascheroni, Stina Klemming, Hanne Pike, Agnes Linner, Nils J. Bergman, Bjorn Westrup, Ulrika Ådén, Evalotte Morelius, Rosario Montirosso, Wibke Jonas, Siren Rettedal

Research outputs 2022 to 2026

Objective To explore the effects of immediate parent–infant skin-to-skin contact (iSSC) at very preterm birth on maternal–infant behavioural responses and hypothalamic–pituitary–adrenal (HPA) axis reactivity to age-appropriate socio-emotional stress at 4months corrected age. Design Two secondary outcomes from a multicentre randomised controlled trial with two non-blinded parallel groups. Setting Three Scandinavian neonatal intensive care units, level 2 and level 3. Participants 91 infants born at gestational age 28+0to 32+6 from April 2018 to June 2021. Singletons and twins with a second caregiver present were included, regardless of mode of birth. Higher-order births, infants with congenital infections and major malformations were excluded. …

Staff Education On Motivational Interviewing And Culturally Responsive Education To Reduce No-Shows And Appointment Cancellations, Aisha Adigun

Walden Dissertations and Doctoral Studies

No-show and late appointment cancellations remain significant challenges in outpatient psychiatry clinics, negatively impacting continuity of care, clinic efficiency, and patient outcomes. Motivational interviewing (MI) and culturally responsive communication are evidence-based approaches that support patient engagement and understanding, yet they are not consistently incorporated into staff education related to appointment adherence. This project evaluates whether staff education on MI and culturally responsive communication increases staff knowledge and skills in educating patients about no-show and appointment cancellation policies and whether this education contributes to improved appointment attendance. A pre–post intervention design will be used in an outpatient psychiatry clinic. Clinical and …

A Quality Improvement Staff Education To Reduce Mental Health Stigma Among Healthcare Professionals, Chinwe Anthonia Chukwumerije

Walden Dissertations and Doctoral Studies

Mental health stigma among healthcare professionals remains a barrier to help-seeking behaviors, workforce well-being, and psychological safety. This Doctor of Nursing Practice project addressed a practice gap by providing standardized, evidence-based staff education to reduce mental health stigma. The practice-focused question examined whether implementing an evidence-based staff education guideline improved healthcare professionals’ knowledge, attitudes, and confidence regarding mental health stigma. An evidence-based educational intervention was developed using the ADDIE instructional design model and informed by an integrative literature review. The intervention was delivered through structured staff education sessions and evaluated using pre- and post-intervention design. Results demonstrated improved knowledge of …

Staff Education To Improve Consistent Utilization Of The Phq-9 Depression Screening Tool, Ekaette Akpabio

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project addressed the inconsistent use of standardized depression screening tools in an outpatient behavioral health setting. The purpose of the project was to implement a structured staff education intervention to improve clinician knowledge, confidence, and consistency in PHQ-9 documentation. Guided by the Johns Hopkins Evidence-Based Practice Model, the project involved delivering targeted education to behavioral health clinicians and evaluating practice implications. Findings support that staff education promotes improved documentation practices, supports accurate symptom assessment, and enhances patient safety. Incorporating standardized screening education into onboarding and ongoing professional development may contribute to sustainable, evidence-based mental …

Staff Education To Improve Timely Intake Response And Follow-Up Communication, Evelyn Noel

Walden Dissertations and Doctoral Studies

A lack of staff knowledge regarding timely intake response and follow-up communication processes resulted in inconsistent management of client follow-up at the private mental health clinic in Florida. This gap in practice guided the practice-focused question: Does educating mental health clinical staff on timely intake response and follow-up communication improve staff knowledge in managing client follow-up processes in a private mental health clinic, as evidenced by pre- and post-surveys? This educational initiative employed the analysis, design, development, implementation, and evaluation (ADDIE) model, the Johns Hopkins evidence-based practice (JHEBP) model, the Walden University DNP Project Checklist, and the DNP Project Process …

Staff Education Project Staff Education To Increase Knowledge Of The Patient Health Questionnaire-9 Screening Tool, Linda Ejem

Walden Dissertations and Doctoral Studies

This staff education doctoral project focused on educating nursing staff about the Patient Health Questionnaire-9 (PHQ-9) for depression screening in inpatient psychiatric care. Addressing this issue is crucial, as poor adherence leads to missed diagnoses and treatment, increased hospital visits, and poor patient outcomes. Low adherence to the PHQ-9 depression screening protocol has emerged as a significant practice gap. The purpose of this doctoral project was to increase nursing staff knowledge of the PHQ-9 depression screening tool in psychiatric care through staff education. The practice-focused question was: Does education on PHQ-9 depression symptoms improve nursing staff knowledge as compared pre- …

Resilience Education To Increase Staff Knowledge Regarding Stress Management, Patricia Ngozi Egwu

Walden Dissertations and Doctoral Studies

This doctoral project implemented a staff education program to promote nursing knowledge of resilience training and stress management at an outpatient mental health clinic. Workplace stress contributes to medication errors and to poor Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Nurse Communication scores, both of which undermine patient safety. The practice-based question was: Does resilience education enhance stress management strategy knowledge from pre- to post-education? The purpose was to evaluate whether structured resilience education improved nursing knowledge of stress management, guided by the analysis, design, development, implementation, and evaluation (ADDIE) model. Using the Johns Hopkins evidence-based practice (JHEBP) …

Staff Education On Implementation Of De-Escalation Techniques In An Adult Psychiatry Facility: A Quality Improvement Program To Enhance Knowledge And Reduce Aggressive Behavior, Lilian Agbonzebeta Azenabor

Walden Dissertations and Doctoral Studies

Managing aggression and violence is a persistent issue in adult psychiatric facilities. Frequent aggression and violence can cause serious harm to staff, increase absenteeism and burnout, and lower job satisfaction. Stakeholders’ reports from the project site indicated inconsistent staff use of de-escalation techniques, highlighting gaps and the need to improve staff knowledge. The practice-focused question was: Will a staff education program specifically designed to implement a comprehensive staff training on de-escalation strategies increase staff’s knowledge? The purpose of this staff education project was to evaluate the effectiveness of an evidence-based training program designed to enhance staff knowledge on de-escalation techniques. …

Staff Education In Standardizing A Nurse-Led Fall Prevention Bundle To Reduce Inpatient Falls In Teleneurology Units, Tiffany Scott

Walden Dissertations and Doctoral Studies

Due to complex neurological deficits that raise the risk of falls, falls among persons admitted to inpatient tele-neurology units represent a substantial and continuous problem in nursing practice. A preliminary evaluation conducted at the project site revealed inconsistent fall prevention procedures, inconsistent use of risk assessments, and a lack of a standardized, evidence based strategy to lower fall risk in this especially susceptible group. A practice focused investigation into whether the adoption of a standardized, nurse led fall prevention bundle would improve staff adherence to fall prevention protocols and lower the incidence of inpatient falls over a six month period …

Staff Education To Use Mindfulness Strategies To Prevent Burnout In Psychiatric Health Settings, Rebecca Ikeoluwa Gabriel

Walden Dissertations and Doctoral Studies

There was a significant gap in practice at an outpatient psychiatric mental health clinic regarding organized, evidence-based training on mindfulness techniques to reduce stress and emotional exhaustion among psychiatric mental health staff. This project’s practice-focused question was “Does educating psychiatric mental health staff on mindfulness strategies for burnout improve their knowledge, as evidenced by pre- and post-surveys?” This educational intervention was developed, implemented, and evaluated using the Johns Hopkins Evidence-Based Practice paradigm and the ADDIE instructional design model. A literature search was conducted using CINAHL Complete, MEDLINE/PubMed, ProQuest, and the Cochrane Library, with assistance from the librarians at Walden University. …

Staff Education On Mindfulness-Based Intervention To Reduce Burnout Among Mental Health Clinicians, Abosede Oyeronke Oyedele

Walden Dissertations and Doctoral Studies

Clinician burnout is increasingly prevalent in outpatient mental health settings due to high emotional demands, heavy caseloads, and limited organizational resources, contributing to reduced job satisfaction, increased turnover, and diminished quality of care. The gap in practice at the project center revealed a deficiency in knowledge among mental health clinic staff regarding effective stress management and burnout prevention, which led to the practice question: Does educating providers and staff on mindfulness-based interventions improve knowledge, as evidenced by pre- and postsurveys? To close this gap, this Doctor of Nursing Practice (DNP) project educated staff members on mindfulness-based interventions (MBIs). The Walden …

Lgbtq+ Cultural Competency Training For Mental Health Care Workers, Shyla Noelle Herndon-Dye

Walden Dissertations and Doctoral Studies

The purpose of the staff education project was to address a noticeable gap in training regarding lesbian, gay, bisexual, transgender, and queer (LGBTQ+) cultural competencies for the multidisciplinary mental health care workers of an inpatient child and adolescent psychiatry unit. LGBTQ+ individuals commonly encounter discriminatory barriers to care, resulting in mental health disparities and medical distrust; thus, mental health care workers must engage in professional allyship and improve their capability to sufficiently care for this population. The practice question that guided this project was the following: Will a staff education program designed to educate multidisciplinary mental health care workers on …

Staff Education Program To Improve Pediatric Medication Adherence Knowledge In Primary Care, Coby Anderson

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice project was focused on a staff education program aimed at addressing the knowledge gaps of primary healthcare providers regarding pediatric medication adherence. Nonadherence among pediatric patients is a significant issue leading to adverse health outcomes and increased healthcare costs. The project underscores the necessity of enhancing provider knowledge and communication skills, alongside implementing systematic strategies to promote adherence. My objective with the project was to elevate primary healthcare providers’ understanding and practical application of pediatric adherence techniques through targeted, evidence-based education. I developed the practice-focused question to examine whether this tailored staff education could bolster …

Staff Education To Reduce The Incidence Of Bias In Managing Patients With Opioid Use Disorder In A Rehabilitation Center, Almarie Alison Mclaren

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project addressed stigma and implicit bias toward individuals with opioid use disorder (OUD) within a rehabilitation subacute care setting. OUD remains a significant public health concern and at the project site, inconsistent staff education was identified as a practice gap requiring intervention. The purpose of this practice-focused DNP project was to evaluate the impact of a structured staff education intervention on healthcare staff knowledge, attitudes, and confidence in caring for patients with OUD. The project was guided by a thorough evidence search. The project was implemented using brief, unit-based educational sessions delivered to interdisciplinary …

Staff Education On Implementing Exercise For The Management Of Depression In Adults In A Comprehensive Mental Health Facility, Afolasade Jarrett

Walden Dissertations and Doctoral Studies

In a comprehensive mental health facility, patients diagnosed with major depression continue to experience depressive symptoms despite treatment. Despite using standard treatment with antidepressants and psychotherapy, facility data showed that 40% of these patients are still experiencing depression symptoms that negatively impact their overall functioning and quality of life. There is evidence supporting exercise as an effective strategy for depression treatment. Therefore, a staff education project was proposed to educate staff about exercise for depression management in adults. A thorough literature search in four databases yielded 12 articles with high quality evidence supporting educating staff to use exercise for depression …

Skin Injury (Moisture-Associated Skin Damage, Skin Tears, And Pressure Injury) Prevention Education: An Evidence-Based Practice Project, Elizabeth Lopez

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction and Aims: Skin injuries, particularly pressure injuries, pose significant challenges in hospitals, especially for critically ill patients, leading to discomfort and increased healthcare costs. Such injuries profoundly impact patient outcomes, resulting in increased morbidity and mortality rates. Furthermore, these injuries can severely affect patients' quality of life, impeding their recovery. This project at LLUMC aims to address knowledge gaps among ED nursing staff regarding skin injury prevention through targeted education, thereby enhancing nurses' knowledge and confidence in managing these injuries.

Methodology: To evaluate the effectiveness of the skin injury prevention education initiative, eight tools were utilized, including the …

Effectiveness Of Dialectical-Behavioral Intervention On Emotional Regulation Difficulties, Distress Tolerance, And Social Functioning Among Patients With Bipolar Disorder: Randomized Controlled Trial, Nashwa Ibrahim

Nursing

Aim

To determine the effect of implementing dialectical behavior therapy (DBT) skills training groups on emotional regulation difficulties, distress tolerance, and social functioning among patients with bipolar disorder (BD).

Methods

A randomized controlled trial was conducted with 120 patients diagnosed with BD who were attending follow-up at the outpatient clinic. Participants were randomly assigned to either the experimental group, which received 16 group psychoeducation sessions held twice weekly, or the control group, which received standard outpatient care. Analysis of variance (ANOVA) with repeated measures was applied to compare normally distributed quantitative variables across more than two time points or stages, …

Leader Rounding For Outcomes To Improve Employee Retention, Laura R. Escobar

Electronic Theses and Dissertations

Intention to leave a nursing staff position, if not addressed, may lead to an increased rate of nursing turnover. High turnover rates can negatively affect staffing patterns, increase organizational costs, and disrupt the continuity of patient care. A quantitative quasi-experimental pre-/posttest design was used to evaluate the impact of the High Reliability Organization Leader Rounding for Outcomes tool to reduce the intent-to-leave scores, as measured by the Turnover Intention Scale (TIS-6), compared to current practice over 12 weeks. Implementation of the tool provided a structured leader rounding process designed to strengthen communication, recognize staff contributions, and proactively identify workplace concerns. …

Caring For Post Icu Patients: Knowledge And Attitude Among Nurses Working In General Wards, At Tertiary Hospitals, Dar Es Salaam, Tanzania, Nazahed Mkiramweni, Kahabi Isangula, Masunga Iseselo, Dickson Mkoka, Emmanuel Mlay

School of Nursing & Midwifery, East Africa

Introduction: Caring for patients from the Intensive Care Unit (post-ICU) in general wards iscritical in determining patient outcomes. As primary caregivers, nurses provide hour-to-hour care and are essential in monitoring and addressing any signs of deterioration during this crucial transition period. Adequate knowledge and a positive attitudeare vital for ensuring the timely identification and management of complications. This study aimed to assess the knowledge and attitudes of nurses caring for post-ICU patients in general wards.

Methods: A hospital-based descriptive cross-sectional study wasconducted from May to August 2021 at Muhimbili National Hospital (MHN), Muhimbili Orthopedic Institute (MOI), and Jakaya …

Patient Wait Time And Throughput Interventions In The Cardiology Outpatient Setting, Chioma Ohiri Tawose

Electronic Theses and Dissertations

Healthcare collaboration and patient care require effective communication. Poor communication impacts wait time. Inadequate communication in the outpatient cardiology clinic can lead to disruptive patient throughput, or workflow, and extend patient length of visit. The purpose of this project was to implement a means of communication for clinicians and healthcare assistants to improve patient flow and cut down idleness, ultimately reducing patient wait time. The project established the incorporation of a built-in electronic health record communication notification system, the Event Button, for asynchronous communication between staff. A quantitative quality improvement design was used to conduct this project. Inferential and descriptive …

Humanity Is Evolving Its Consciousness: The Role Of Archetypal Energies As Guides During An Unfolding Weeding Out And Alignment Process, Carroy U. Ferguson

Psychology Faculty Publication Series

Humanity is evolving its consciousness at individual and collective levels.  Given these seemingly tumultuous times, as of this writing (January 2026), to make such a statement may sound like a strange thing to say.  However, I suggest that if you are alive today and if you are reading these words, these are the very times for which you were born—to assist Humanity as it evolves its consciousness with your unique gifts, whatever they may be.  That is, this period of our individual and collective human being-ness may be characterized as an unfolding period of weeding out and alignment with the …

Clinical Practice Guidelines For Suicide Risk Assessment, Jelitta Cleatus

Walden Dissertations and Doctoral Studies

In this doctoral project, I developed a clinical practice guideline (CPG) to address the lack of a standardized suicide risk assessment protocol at a Texas mental health clinic. At project initiation, suicide risk assessment at the facility was inconsistent due to the absence of a CPG. The guideline incorporated the Columbia-Suicide Severity Rating Scale (C-SSRS), a validated instrument that improved early detection of suicidal ideation and behaviors, which were often under recognized in older adults. This inconsistency led to the following clinical question, Does the evidence support the development of a CPG for assessing suicide risk among high-risk patients using …

Staff Education On Medication Adherence, Jerome Obiagba

Walden Dissertations and Doctoral Studies

Summary The Doctor of Nursing Practice (DNP) project focuses on improving medication adherence in mental health settings, where many patients do not take medications as prescribed, leading to worsening symptoms, relapse, frequent hospitalizations, higher healthcare costs, and reduced quality of life. This problem mainly affects individuals with anxiety, bipolar disorder, major depressive disorder, and schizophrenia, and is often related to poor understanding of treatment, cultural beliefs, or limited access to care. Because nurses play a key role in medication monitoring, education, and patient support, the project examined whether staff education improves nurses’ knowledge, confidence, and effectiveness compared to standard practice …

Staff Education To Streamline Congestive Heart Failure Education, Shannon Hunter

Walden Dissertations and Doctoral Studies

Congestive heart failure (CHF) is a progressive disease that affects a diverse population. Patient-centered education is key to lowering rehospitalizations and mortality rates. Although nurses are essential providers of patient-centered education, those in acute care settings often have unclear directions for implementing and documenting CHF education. Multiple educational materials within electronic health record (EHR) systems further complicate the process and highlight the practice gap. The aim of this Doctor of Nursing Practice (DNP) project was to streamline CHF education by clarifying the role of nurses in education delivery and documentation, potentially enhancing nurse confidence and improving patient health outcomes, with …

Mental Health First Aid Training In K-12 Schools, Jenna L. Workman, Brianna L. Schierberg, Grace H. Sullivan, Erin Robinson

Posters-at-the-Capitol

The increasing prevalence of mental health challenges among school-aged children has become a rising public health concern. Recent data indicates that nearly 70% of schools report heightened mental health problems among students, with anxiety and depression being most common (National Center for Education Statistics, 2024). The purpose of this capstone project is to raise awareness of mental health issues in K–12 public schools and to increase faculty and staff confidence in recognizing and assisting students experiencing mental health difficulties through nurse-led Mental Health First Aid (MHFA) training. Using Peplau’s Interpersonal Relations Theory as a guiding framework, this project emphasizes the …

Staff Education For The Management Of Chronic Pain In Patients With Mental Health Disorders, Jude Osagie Ukpebor

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice project was a practice-focused quality improvement staff education initiative designed to address a gap in nurses’ knowledge related to chronic pain management in patients with mental health disorders. Chronic pain frequently coexists with psychiatric conditions, yet nurses often lack formal education on biopsychosocial, trauma-informed, and non-pharmacologic pain management approaches, contributing to fragmented and inequitable care. Addressing this gap is essential to improving patient outcomes and advancing evidence-based nursing practice. The practice-focused question asked whether implementing a targeted nurse education program would improve nurses’ knowledge related to chronic pain management in patients with mental health disorders. …

Assessment Of Parental Knowledge And Anxiety Surrounding The Informed Consent Discussion For Neonatal Cardiac Interventions, Kristal Mancuso Hock

ETDs from 2020-2029

The purpose of this dissertation was to explore the complexities of the informed consent (IC) process in the context of neonatal cardiac interventions, with a focus on parental knowledge and anxiety during decision-making. Across three manuscripts, this work examined conceptual dimensions, feasibility, and acceptability of a new prenatal treatment (palliative care (PC) support sessions), and the effect sizes of this new treatment on parental knowledge and anxiety levels surrounding the IC discussion for neonatal cardiac palliations. The first manuscript employed dimensional analysis to conduct a concept analysis of IC in surgical care. The review of 27 publications revealed three distinct …

Self-Stigma Of Seeking Help, Psychological Safety, And Employee Assistance Program Use In Nurses, Latisha Lenee Marshall

Walden Dissertations and Doctoral Studies

Employee assistance programs (EAPs) remain underutilized across various U.S. work sectors, including nursing. There are several barriers that impede nurses from using EAP services, including self-stigma of seeking help (SSOSH) and psychological safety (PS). The purposes of this study, which used the health promotion model as its theoretical framework, were to determine (a) if there was a difference in the level of SSOSH in nurses who have used EAPs and those who have not used EAPs, (b) if there was a difference in the level of PS in nurses who have used EAPs and nurses who have not used EAPs, …

Exploring The Relationship Among Nurse-Specific Factors And Triage Accuracy In The Emergency Setting, Krisada Suamchaiyaphum

ETDs from 2020-2029

Triage is a critical function of emergency nursing practice, directly influencing patient safety, flow, and outcomes in the emergency department (ED). Despite widespread use of standardized triage training and resources, triage accuracy among ED nurses remains suboptimal. The purpose of this three-manuscript dissertation was to examine factors associated with triage accuracy in the ED setting. Manuscript One was an integrative literature review of 14 studies published between 2011 and 2021, with reported triage accuracy rates ranging from 59.3% to 82%. Primary factors associated with triage accuracy were: nurse-specific, patient, and work environment factors. Manuscript Two reported a retrospective study of …