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Identification, Diagnosis, Counseling, And Referral Of Overweight Military Dependent Children To Reverse Early Childhood Obesity, Gerald William Hall

Walden Dissertations and Doctoral Studies

Since 1980, the obesity rate in children 5 to 11 years of age has increased from 7% to 18%. The lack of structured physical activity and poor dietary habits childhood are primary risk factors for obesity related comorbidities in adulthood. Guided by primary care providers, families can reverse childhood obesity by implementing healthy dietary habits and engaging in structured physical activity. The purpose of this quality improvement project was to develop an evidenced-based policy with procedures to standardize the timely and consistent identification of overweight children at a primary care clinic serving military families. With an emphasis on obesity prevention …

Strategies For Health Care Administration Leaders To Reduce Hospital Employee Turnover, Malee Kirk

Walden Dissertations and Doctoral Studies

Staff turnover is high in the hospital industry, influencing health care administration leaders to implement successful strategies to decrease staff turnover. The purpose of this case study was to explore successful strategies to reduce hospital employee turnover. Five health care leaders from Raleigh, North Carolina hospitals were in the sample drawn from the population of medical professionals with successful employee retention in their hospital settings. The conceptual framework for this study was the Herzberg dual-factor theory with the supporting theory, Maslow's hierarchy of needs theory, and the opposing theory, Vroom's expectancy theory. Semistructured interviews occurred with 5 leaders. The review …

The Effect Of Hospital Nurse Basic Psychological Needs Satisfaction On Turnover Intention And Compassion Fatigue, David Stephen Klein

Walden Dissertations and Doctoral Studies

Nursing is a stressful occupation, which can often lead to compassion fatigue (CF) and turnover intention (TI). When their basic psychological needs (BPN) of competence, relatedness, and autonomy are not met, registered nurses (RNs) may develop a higher propensity to experience CF and TI. Amid projected nursing shortages, the loss of these health care providers may threaten the quality of patient care. Although there is research on BPN and their relationship with well-being and functioning, research is lacking on the relationship between BPN satisfaction, CF and TI among RNs. Researchers have also not examined whether RNs' BPN satisfaction moderates the …

Paralleled Support Models For Young Adults With Intellectual And Developmental Disabilities, Lucy Ellen Klym

Walden Dissertations and Doctoral Studies

In the State of Indiana, for students over the age of 14 who have been diagnosed with intellectual or developmental disabilities, the transition from special education to Medicaid waiver oversight should occur seamlessly, but gaps in integrated and aligned goal development strategies remain. As a consequence, students who need adult-based support may not be receiving the full scope of services to which they are entitled. Using common-pool resource theory as a foundation, the purpose of this explanatory case study of transitional services to Indiana Medicaid was to understand, from the perspective of disability support service staff, the barriers to effective …

Applying Clinical Guidelines To Curtail Opioid Overprescribing In Primary Care, Glenda Leflore

Walden Dissertations and Doctoral Studies

The purpose of this scholarly project was to evaluate an evidence-based quality improvement program implemented in 2016 in a clinical practice setting to curtail overprescribing of opioids for noncancer pain management. In 2001, the National Pharmaceutical Council and The Joint Commission on Accreditation and Hospital Accreditation initiated a standard of practice for opioid use in noncancer pain management that resulted in opioid overprescribing and a 200% increase in opioid-related deaths and incalculable societal costs. Primary care providers including nurse practitioners issue the greatest number of opioid prescriptions; therefore, to address the problem of opioid overprescribing, the 2016 Centers for Disease …

Exploring Customer Service Through Hospital Management Strategies, Delores Leonard Leonard

Walden Dissertations and Doctoral Studies

Patient demand for a better quality of healthcare and services has increased as insurance companies have decreased payments to hospitals. The purpose of this qualitative single exploratory case study was to explore hospital managers' strategies to improve customer service. Data were gathered from semistructured interviews with 5 hospital managers who implemented customer service strategies in their hospital systems, hospital policy and procedure documents, and qualitative data from the Consumer Assessment of Healthcare Providers and Systems Hospital Compare website. Expectation-confirmation theory served as the conceptual framework that grounded the study. Data were analyzed using methodological triangulation, and 3 themes emerged: the …

Registered Nurse Job Satisfaction And Nursing Leadership, Maria Candida Libano

Walden Dissertations and Doctoral Studies

Job dissatisfaction among nurses may contribute to disengagement and withdrawal from the profession. The degree of leadership support in the workplace influences job satisfaction, and when nurses are satisfied with their job, they provide better patient care. Guided by the social cognitive theory, which asserts a relationship between behavior change and one's surroundings, this quantitative, exploratory project sought to determine the type of nursing leadership practiced in the facility where the project took place, whether nurses were satisfied with their job, and if patients were satisfied with their care. Participants in the project included 55 registered nurses and 5 nurse …

The Critical Role Of The Psychiatric Emergency Response Team In The Adoption Of A Violence Risk Assessment Tool., Angela Mackay

Walden Dissertations and Doctoral Studies

Workplace violence is a persistent problem in health care, and incidence rates have increased over the years. Traditional reporting systems, relying mostly on paper formats, are inadequate for developing effective predictive models for intervention and reducing acts of violence by patients to staff. The purpose of the development and deployment of the psychiatric emergency response team (PERT) was to provide effective intervention within the MIAHTAPS (Altered Mental status, Irritability, Agitation, History of Violence, Threatening, Attacking Objects, Pacing, and Staring) behavior prediction tool to reduce the severity and rates of violence in a hospital setting. Lewin's change theory was used to …

Managerial Intervention Strategies To Reduce Patient No-Show Rates, Charl Mattheus

Walden Dissertations and Doctoral Studies

High patient no-show rates increase health care costs, decrease healthcare access, and reduce the clinical efficiency and productivity of health care facilities. The purpose of this exploratory qualitative single case study was to explore and analyze the managerial intervention strategies healthcare administrators use to reduce patient no-show rates. The targeted research population was active American College of Healthcare Executives (ACHE), Hawaii-Pacific Chapter healthcare administrative members with operational and supervisory experience addressing administrative patient no-show interventions. The conceptual framework was the theory of planned behavior. Semistructured interviews were conducted with 4 healthcare administrators, and appointment cancellation policy documents were reviewed. Interpretations …

Hourly Rounding: A Fall Prevention Strategy In Long-Term Care, Robyn Mitchell

Walden Dissertations and Doctoral Studies

Falls and injuries related to falls are some of the most common and costly incidents that occur in the long-term care environment. Purposeful hourly rounding is a proactive way for nursing staff to identify patient needs and demonstrate positive fall prevention outcomes. This project examined a process improvement endeavor of a long-term care unit that experienced an increase in the number of falls over 3 months. The purpose was to evaluate whether staff education and implementation of an evidence-based hourly rounding program would affect the number of patient falls. The Johns Hopkins nursing evidence-based conceptual model, Kurt Lewin's change model, …

Suicidal Behavior In Inmates Through The Pathway Of Psychopathy And Depression, Zsofia Muller-Balazsfi

Walden Dissertations and Doctoral Studies

Prison inmates are more prone to commit suicide than are individuals in the general population. Current scientific research has identified risk factors of suicide in the general population, such as mood disorders, but only a few research studies have examined risk factors that are particularly relevant to the incarcerated population. This study used a quantitative archival research design to examine the effect of primary and secondary psychopathic personality traits on the development of suicidal behavior in the mentally ill male prison inmate population at a U.S. federal prison located in the Southeast. Data on psychopathic traits as measured by the …

Understanding The Importance Of Culturally Appropriate Patient-Provider Communication In Diabetes Self-Management, Anita Mwalui

Walden Dissertations and Doctoral Studies

According to the Centers for Disease Control and Prevention, 29.1 million people in the United States have diabetes. Among those 29.1 million people, 21 million have been diagnosed, but 8.1 million have not. Changing demographics in the United States and the prevalence of diabetes are projected to be burdens on the health care system through 2050. Guided by the social cognitive theory, the purpose of this qualitative case study was to understand the importance of culturally appropriate patient-provider communication to the self-management of Type 2 diabetes by patients who are African immigrants. Culturally based health care has unique challenges when …

Investigating The Efficacy Of The Coping Strategies Adolescents Use To Handle Cyberbullying, Stacey Neaville

Walden Dissertations and Doctoral Studies

Cyberbullying can negatively influence adolescents' overall wellbeing. Previous studies on cyberbullying provided knowledge about ways youths cope with cyberbullying; yet the literature lacks information about the efficacy of the coping strategies of cyberbullying victims. The purpose of this straight qualitative study was to investigate what coping strategies cyberbullying victims found effective for handling cyberbullying. The transactional model of coping, approach-avoidance coping, and self-efficacy theory formed the conceptual model to explore, analyze, and understand coping with cyberbullying. Using flyers and snowball sampling, 6 adolescents in Grades 10 to 12 were recruited to participate in the study. Data from semistructured phone interviews …

Environmental Relocation Policy As Experienced By One Eastern Missouri Dioxin-Contaminated Community, Susan Annette Olsen

Walden Dissertations and Doctoral Studies

Research on environmental relocation is scant and narrow, focusing on a few aspects of permanent relocation and social impacts of natural disasters. As a result, little is known about the long term social impacts of the Environmental Protection Agency's (EPA) environmental relocation policy. A combined conceptual and theoretical framework of Walter's placeways; Ullberg's disaster memoryscapes; Richardson's remembrance and memorialization; Dynes' social capital; and, Norris, Stevens, Pfefferbaum, Wyche, and Pfefferbaum's work on community resilience guided this phenomenological study with the purpose of better understanding competing and complementary roles of each of these constructs in the context of environmental relocation of one …

The Experiences Of Parenting Coordinators Working With Couples Engaged In Intimate Partner Violence, Ann M. Ordway

Walden Dissertations and Doctoral Studies

In families where parents present with intimate partner violence dynamics, courts routinely impose restraints restricting communications between those parents. However, the same courts also routinely fashion arrangements whereby those same parents share custody of their children. Children in families with this dynamic are often used as communication facilitators and triangulated by parental conflict. This grounded theory study generated a theory about parenting coordination work with high conflict couples with intimate partner violence dynamics. This theory may have utility for parenting coordinators working more effectively with the described population. Semi-structured interviews were conducted with 10 professional parenting coordinators who have worked …

Using Health Literacy To Improve Emergency Department Discharge, Alicia Ortiz

Walden Dissertations and Doctoral Studies

Patients with limited health literacy often fail to understand verbal and written discharge instructions, and they frequently return to the emergency department (ED) for care. Patients returning to the ED and 30-day readmission rate are core quality performance measures. The purpose of this project was to decrease repeat visits and readmissions to the ED by implementing components of health literacy programs within the ED on patient education and written discharge instructions. Change implementation consisted of (a) use of teach back method (b) modifying medical terminology to language that patient could understand (c) limiting use of words with more than three …

Anxiety And Healthcare Utilization Among Mothers Of Children With Mental Health Disorders, Maria Lynn Perrotta

Walden Dissertations and Doctoral Studies

Anxiety can influence an individual's decision-making process; however, researchers have yet to establish whether anxiety has an impact on the healthcare utilization practices of mothers of children with a mental health diagnosis. The purpose of this study was to assess whether trait anxiety, coping styles, and self-efficacy in mothers of children with a mental health diagnosis affected their healthcare utilization decisions. The transactional model of stress and coping was used to analyze the impact of children with mental health disorders on their caretakers. For this study, a quantitative, cross-sectional research design was employed. The 4 survey tools, administered through SurveyMonkey.com …

Elementary School Social Workers' Perspectives On The Development Of Resilience In Early Childhood, Dan Podraza

Walden Dissertations and Doctoral Studies

Researchers have stressed the importance of addressing the social/emotional needs of early childhood (EC) children, including the development of resilience; however, some U.S. school personnel focus more on academics than on these needs. When young children possess these skills, they can handle social/emotional challenges later in life. The purpose of this qualitative bounded case study was to explore school social workers' (SWs) perspectives about resilience in EC settings. Research questions focused on knowledge of existing programs, participants' perceptions of the successes and challenges of working with EC students, and their recommendations to improve EC students' education. Bronfenbrenner's ecological systems theory …

Differentiation Of Self As A Predictor Of Vicarious Trauma In Mental Health Professionals, Denise Purvis

Walden Dissertations and Doctoral Studies

Mental health professionals in all settings work with clients who are affected by trauma. Traumatic events expose mental health professionals to the negative psychological and emotional impact of witnessing and listening to client stories. Vicarious trauma is the emotional consequence of this empathic engagement with clients. The purpose of this correlational study was to identify predictors of vicarious trauma in mental health professionals that had not been studied before. The theoretical framework guiding the study was the Bowen family systems theory and the construct of differentiation of self. A regression analysis was conducted with a purposive sample of 83 licensed …

Perceptions Of Administrators, Teachers, And Coaches On Instructional Coaching: Implications For Instructional Practices, Tosha Latrece Quattlebaum

Walden Dissertations and Doctoral Studies

Instructional coaching is designed to positively impact instructional practices, yet not enough is known about whether administrators, teachers, and instructional coaches have similar perceptions about this approach. The purpose of the case study was to examine the perceptions of administrators, teachers, and instructional coaches concerning instructional coaching, the impact instructional coaches have on instructional practices, and barriers encountered by instructional coaches. Guided by Knowles' theory of andragogy, the research questions were designed to explore the relationship between collective and individual actions of adult learners when acquiring information and learning new concepts. The case study involved a purposeful sample consisting of …

The Link Between Therapists' Social Class Attributions And Treating Clients Of Low Socioeconomic Status, Dan Sharir

Walden Dissertations and Doctoral Studies

Social class may impact the ways people are perceived and treated by others. The social class attributions of therapists may influence the manner in which they conceptualize their clients' problems and their relationship with their clients. There is a gap in the literature concerning the link between therapists' social class attributions and their responses toward low socioeconomic status (SES) clients in actual clinical settings, which could impact the therapists' interaction with their clients and the treatment process. The purpose of this qualitative descriptive case study was to examine the links between therapists' social class attributions and their experiences with low …

Introduction Of Evidence-Based Practice To Acute Stroke Center Nursing In Jakarta, Indonesia, Tonya Sue Stagner

Walden Dissertations and Doctoral Studies

Evidence-based practice (EBP) is a relatively new concept for nurses in Indonesia; it has not

been integrated into nursing care. This project sought to introduce EBP to nurses at an acute stroke center (ASC). The knowledge transfer team approach guided the project. The goal was to identify and analyze current data and to develop an EBP guideline for clinical nursing practice in the ASC. Sources of evidence that was used to address the practice-focused question included project team members, organizational documents, and a database search to identify EBP guidelines for the nursing care of acute stroke patients. A database search …

Influence Of Psychological Needs And Gaming Motivation On Well-Being Of Adult Gamers, Rene Sterling

Walden Dissertations and Doctoral Studies

Adult online gaming is a fast-growing global entertainment industry, and many gamers spend more time playing games and less time engaging in work or other activities, which negatively affects their lives and relationships. This quantitative study addressed how psychological needs and gaming motivation predicted gaming behavior, life satisfaction, and relationship satisfaction using a mediational model. The theoretical foundation was self-determination theory, which addresses how personal choices are influenced by internal factors, especially psychological needs and motivation. An online survey was used to collect self-reported data from a convenience sample of 935 adult gaming participants using the Basic Needs Satisfaction in …

Motivations Of Antitrafficking Volunteers, Jonathan Edward Sullivan

Walden Dissertations and Doctoral Studies

Abstract

Human trafficking is a worldwide crisis, and agencies rely on volunteers to help serve its victims. Past researchers have suggested that motivation to volunteer is multifaceted and that volunteer turnover hinders accomplishing mission objectives. The research question was to examine if there were any differentiating motivations of antitrafficking volunteers from the current literature. This study was a qualitative case study of an antitrafficking religion-sponsored agency in the United States. Self-determination theory guided the research consisting of 7 agency volunteers. Candidates met the established criteria of minimum age and duration of service. The interpretive phenomenological analysis process helped to assess …

Roles Of Community Pharmacists In Improving Oral Health Awareness In Plateau State, Northern Nigeria, Olaniyi O. Taiwo

Walden Dissertations and Doctoral Studies

There is poor oral health awareness in Nigeria. This is mainly attributed to limited access to correct information on oral health as well as a lack of oral health care providers. The impact of the poor oral health awareness is worse in Northern Nigeria due to the uneven distribution of oral health care workers and training facilities. The purpose of this cross-sectional study was to describe the roles of community pharmacists (CPs) in Plateau State, Nigeria as sources of oral health information. Theoretical framework for this study was the theory of planned behavior (TPB). Background knowledge and practices of oral …

A Comparative Study Of Elementary Mathematics Specialists And Mathematics Coaches On Fourth Grade Students' Mathematics Achievement, Tiffany D. Tynes Curry

Walden Dissertations and Doctoral Studies

Federal dollars are utilized to develop instructional programs for students not demonstrating mathematical proficiency on state standardized mathematics assessments, but there is a lack of empirical data on the effectiveness of two different approaches that were used in the local context. The purpose of this quantitative, nonexperimental, casual-comparative study was to determine if state achievement test scores of students in fourth grade who received instruction from a Mathematics Specialist (MS) during the 2007-2009 academic years demonstrated a statistically significant difference from the mathematics state achievement test scores of fourth grade students who received instruction from Grades 1-8 credentialed teachers supported …

Gender Inequality In Women's Knowledge And Awareness Of Hiv/Aids In Port Harcourt, Maureen A. Wagbara

Walden Dissertations and Doctoral Studies

In Nigeria, gender inequality significantly impacts women's knowledge and awareness of the transmission of the human immunodeficiency virus (HIV) and the proliferation of acquired immunodeficiency syndrome (AIDS). Early marriage, traditional beliefs, religion, and polygamy all contribute to gender inequality. This study explored the role of these and other sociocultural practices in the gender inequalities that increase vulnerability of contracting HIV/AIDS among women in Port Harcourt, Rivers State, Nigeria. The study employed a phenomenological design, collected data through a semistructured interview approach, which was managed using NVivo software. The purposive sample comprised 20 female students from a college in Port Harcourt. …

Successful Ethical Decision-Making Practices From The Professional Accountants' Perspective, Tammy Tanner Webster

Walden Dissertations and Doctoral Studies

Unethical behavior includes all decisions and actions counterproductive to an organization's mission and can cause irrevocable damage to the organization's professional reputation. The Securities and Exchange Commission reported 807 ethical violations in 2015. This study was underpinned by the ethical leadership theory, which emphasizes leadership decision making based on fair and just practices, for all involved parties. The purpose of this qualitative multiple-case study was to explore the ethical decision-making best practices that not-for-profit accounting managers in the Washington, DC, metropolitan area needed to strengthen the ethical decision-making process in their organizations. Data were collected through semistructured interviews from 5 …

Strategies In Outsourcing R&D Processes To Maintain Market Competitiveness, Berina Yerkic-Husejnovic

Walden Dissertations and Doctoral Studies

In the 21st century, managing outsourced research and development (R&D) processes is critical to an organization's success. Guided by the logistic outsourcing theory developed by de Boer, Gaytan, and Arroyo, the purpose of this single case study was to explore strategies and processes organizational leaders used to manage outsourced R&D to maintain market competitiveness. Semistructured interviews were conducted with 5 purposefully selected business leaders who were responsible for outsourcing R&D in a single Fortune 500 corporation in the Mid-Atlantic region of the United States. Company records were also gathered as data. Yin's 5-step process for a case study and key …

Leadership Among Directors Of Social Services At Rehabilitative Healthcare Chains, John Paul Tuanqui Abenojarj

Walden Dissertations and Doctoral Studies

Rehabilitation and healthcare centers (RHCs) provide ongoing care to the elderly and chronically ill. To maximize the quality of this care, RHC staff must be properly trained to respond to patient care crises and communicate across departments. Although researchers have studied the leadership styles, strategies, and interactions of facility administrators and nursing directors, there is a substantial gap in the literature on the leadership styles and strategies employed by directors of social services (DSSs). The aim of this phenomenological study was to address this gap in the research by exploring how DSSs influenced leadership policies, prepared subordinates for crisis intervention …