Digital Commons Network^™

Informal Caregivers' Lived Experiences Caring For A Black Man Receiving Hemodialysis, Tanikka Joy Greene

Walden Dissertations and Doctoral Studies

Numerous quantitative studies have assessed caregiver burden in multiple chronic diseases, but an identified gap and underrepresentation exists in the literature regarding studies using an inductive approach that allow informal caregivers to describe the lived experiences of caring for Black men receiving hemodialysis. The transactional model of stress and coping and the stress process model guided this study. The key research questions centered on the experiences, psychological, physical, and financial limitations associated with caregiving. This phenomenological study used a purposive sample of 15 unpaid primary caregivers over the age of 18 caring for a Black male on hemodialysis from Mecklenburg …

Strategies For Achieving Patient-Centered Healthcare And Cost Containment, Quincy Von Handy

Walden Dissertations and Doctoral Studies

Implementing successful value-centered care strategies that support patient-centeredness while reducing cost is a significant challenge for healthcare leaders. In 2001, the Committee on Quality of Healthcare in America and the Institute of Medicine identified patient-centeredness as 1 of 6 improvement goals to improve quality of care for the 21st century. The purpose of this multiple case study was to explore patient-centered strategies that healthcare managers used to reduce the cost of healthcare for elderly patients without reducing the quality of patient care. The conceptual framework that grounded this study was patient-centered care, and the opposing theory was the primary care …

Educational Intervention On Metabolic Syndrome For Psychiatric Providers, Chika Emelda Okafor

Walden Dissertations and Doctoral Studies

Statistics show a high prevalence of metabolic syndrome (MetS) in patients with mental illness receiving second-generation antipsychotic medications. MetS is associated with elevation of obesity, truncal obesity, blood pressure, cholesterol, and fasting glucose. The purpose of this project was to educate psychiatric providers about the importance of MetS screening, early detection, management, and referral for better treatment and management. The project was guided by Lewin's theory of change model. The project inquired if educational intervention on MetS improved providers' knowledge and intent to adopt MetS guidelines. A literature review and established guidelines of the American Psychiatric Association and American Diabetic …

Parents' And Teachers' Perceptions Of Parental Involvement, Sebrina Rochell Patton

Walden Dissertations and Doctoral Studies

Lack of parental involvement is an issue in the educational system because parents and teachers do not understand each other's views. Research has shown that when parents and teachers provide students with support, student achievement increases. The problem of teachers' and parents' lack of common understanding of parental involvement was addressed in this study. Epstein's model of parental involvement and the theory of planned behavior served as the theoretical framework of this qualitative, exploratory, phenomenological study to explore the perceptions of 5 teachers and 10 parents who were purposefully sampled. The research questions were focused on parents' and teachers' perceptions …

Correctional Social Work Practice With Female Offenders In A Midwestern State, Veronica Labrell Smith

Walden Dissertations and Doctoral Studies

A women's prison in the midwestern region of the United States experienced an increase of female inmates. Incarcerated women have reported higher rates of substance abuse problems, prior victimization, and mental illness than their male counterparts. Clinical social workers are often the primary service providers in criminal justice settings. The purpose of this action research project was to explore the challenges faced by social workers in a midwestern state when providing clinical treatment services to female offenders. Postmodern feminist theory and pathways theory provided a framework for understanding the factors related to female offending. The practice-focused research question explored the …

Social Work Crisis Interventions With Traumatic Death Survivors In Medical Settings, Sabrina R. Spencer

Walden Dissertations and Doctoral Studies

Traumatic death survivors are an at-risk population that could benefit from social work interventions. This action research study explored social work perspectives on crisis practice with traumatic death survivors in acute medical settings. The research questions focused on whether early crisis interventions by social workers would benefit traumatic death survivors, which interventions were recommended in crisis practice with this population, the potential effects of repeated trauma exposure on the social workers providing the crisis interventions, and recommendations to manage this professional exposure to trauma. The purpose of the study was to explore social work perspectives on potential benefits of crisis …

Mobile Technology Deployment Strategies For Improving The Quality Of Healthcare, Won K. Song

Walden Dissertations and Doctoral Studies

Ineffective deployment of mobile technology jeopardizes healthcare quality, cost control, and access, resulting in healthcare organizations losing customers and revenue. A multiple case study was conducted to explore the strategies that chief information officers (CIOs) used for the effective deployment of mobile technology in healthcare organizations. The study population consisted of 3 healthcare CIOs and 2 healthcare information technology consultants who have experience in deploying mobile technology in a healthcare organization in the United States. The conceptual framework that grounded the study was Wallace and Iyer's health information technology value hierarchy. Data were collected using semistructured interviews and document reviews, …

Strategies Investment Banking Leaders Use To Retain Frontline Employees, Kenya Monica Walton

Walden Dissertations and Doctoral Studies

Banking leaders face the loss of profitability because of low employee retention in their organizations. Retention issues negatively affect business operations and market performance. The purpose of this multiple case study was to explore strategies that investment-banking leaders use to retain frontline employees. Herzberg's 2-factor theory was the conceptual framework for this study. Data were collected through semistructured interviews with 5 banking leaders in New York and through a review of company documents on retention strategies. The data were analyzed using Yin's 5-step process of compiling, disassembling, reassembling, interpreting, and concluding data. The 3 themes that emerged from data analysis …

A Clinical Practice Guideline To Improve Education In The Heart Failure Population, Mailey L. Wilks

Walden Dissertations and Doctoral Studies

Managing heart failure patients in the outpatient setting can pose a challenge for nurses and health care staff due to the need to educate patients on self-care skills and management of disease. Several factors, including health literacy and numeracy, need to be considered when developing an education program for heart failure patients to promote self-care management. The purpose of this project was to provide nursing staff with a clinical practice guideline (CPG) that incorporated health and numeracy literacy assessment into an individualized education program. The Johns Hopkins nursing evidence-based practice (EBP) model, the situation-specific theory of heart failure (HF) self-care, …

Trends In Prevalence And Predictors Of Undernutrition Among Children In South Central, Monica Kabahimba Zikusooka

Walden Dissertations and Doctoral Studies

Undernutrition is a global public health challenge. In Somalia, undernutrition is chronic with the situation often graded for emergency response. The purpose of this study was to provide contextual evidence regarding trends of prevalence and predictors of undernutrition in South Central Somalia. Following the UNICEF conceptual framework of determinants of undernutrition, the study examined which individual, household, and society factors were associated with undernutrition. Using secondary data from cross-sectional nutritional surveys implemented by the Somalia Food Security and Nutrition Analysis Unit from 2007 to 2012, a sample of 75,756 and 60,856 children aged 6-59 months was used in analyzing trends …

Nursing Education To Prevent Resident Falls In Long-Term Care, Henrietta Aguwa

Walden Dissertations and Doctoral Studies

Residents in nursing facilities are more prone to falls than those living in the community. Injuries resulting from falls impact residents, their families, and healthcare costs. The gap in nursing practice was the lack of a comprehensive fall-prevention program in a long-term care facility that had experienced high fall rates among residents. This project addressed whether an educational program using the American Medical Directors Association's clinical practice guideline and the Centers for Disease Control and Prevention's STEADI (Stopping Elderly Accidents, Deaths, & Injuries) toolkit for fall- prevention improved the self-efficacy of direct-care staff in preventing falls among residents in a …

Predicting Maritime Pilot Selection With Personality Traits, Tara Brook Barca

Walden Dissertations and Doctoral Studies

Maritime pilots provide a vital service in facilitating the safe and efficient passage of vessels into and out of ports and waterways worldwide. Lack of effective selection of maritime pilots can jeopardize the welfare of people, property, and marine ecosystems. Based on Edwards' conceptualization of person-job fit theory, this quantitative, ex post facto study was an examination of whether personality traits, as measured by the Personality Research Form E (PRF-E), could predict maritime pilot selection. The research questions were: (a) Is there a significant relationship between respondents' PRF-E scale ratings and selection for a maritime pilot job and (b) How …

An Exploration Of The Experiences Of Equine Therapy Specialists, Jaime Lyn Battestella-Williams

Walden Dissertations and Doctoral Studies

Horses have been an integral part of human history and progress for centuries. Horses and humans have united in diverse ways, including farming, war, construction, racing, and other areas of sports. Researchers have indicated that the use of horses for mental health and wellness is a growing trend that continues to lack strong, empirical evidence. Currently, there is limited research available on the experiences of certified equine specialists incorporating horses into mental health and wellness. It is essential to gain further insight into the incorporation of horses into psychology and counseling for therapists, as well as potential clients, interested in …

Educating Staff Nurses For Successful Patient Discharge, Julie First-Williams

Walden Dissertations and Doctoral Studies

The definition of a successful discharge is a discharge that results in patients successfully managing a chronic disease for at least 30 days without requiring an acute inpatient hospitalization. Many chronic disease readmissions are preventable. Successful discharge planning takes a multidisciplinary team that includes nurses who assess the discharge plan and provide additional education where needed. The purpose of this project was to determine staff nurses' understanding of their role in discharge education. Dorothea Orem's self-care deficit theory guided the project and root cause analysis was used in the development of the problem statements. Staff nurses (n=12) from evening and …

A Delphi Study Analysis Of Best Practices For Data Quality And Management In Healthcare Information Systems, Olivia L. Pollard

Walden Dissertations and Doctoral Studies

Healthcare in the US continues to suffer from the poor data quality practices processes that would ensure accuracy of patient health care records and information. A lack of current scholarly research on best practices in data quality and records management has failed to identify potential flaws within the relatively new electronic health records environment that affect not only patient safety but also cost, reimbursements, services, and most importantly, patient safety. The focus of this study was to current best practices using a panel of 25 health care industry data quality experts. The conceptual lens was developed from the International Monetary …

Social Anxiety, Quality Of Life, And Healthy Lifestyle Behaviors Of Women With Infertility Problems, Esra Savaş

Walden Dissertations and Doctoral Studies

Not having a child has significant psychosocial effects on women experiencing infertility problems. There is a gap in research on social anxiety, quality of life, and healthy lifestyle behaviors of women during infertility, fertility treatment, and subsequent pregnancy. The purpose of this quantitative comparative study was to investigate the social anxiety, quality of life, and healthy lifestyle behaviors of Turkish women with infertility issues and Turkish women who conceived after infertility treatment, as measured by the Liebowitz Social Anxiety Scale, the Fertility Quality of Life Questionnaire, and the Healthy Lifestyle Behavior Scale II. The social support and stress buffering theory …

Regulating Medicolegal Death Investigations, Antoinette Vicks

Walden Dissertations and Doctoral Studies

Medicolegal death investigators (MDIs) are a crucial part of the death investigation process but the profession remains unregulated and lacks a required accreditation or licensing process that many other professions use. Research shows the current medicolegal death investigations system, though a crucial government function, has existing deficits in its functionality that affect service delivery. The current study was based on an educational theory and utilized open ended survey questions. Data from 16 investigators was collected through surveys where relevant information was asked in the context of their situation and questions were specific to the phenomenon being studied. The data was …

Post-Hurricane Sandy Coping Strategies And Resilience Factors Among People With Disabilities, Miriam Mukasa

Walden Dissertations and Doctoral Studies

People with disabilities are likely to experience difficulties overcoming the impact of natural disasters. Few scholars have focused on this population's ability to recover and handle stress following a natural disaster. The purpose of this phenomenological study was to explore and describe coping strategies and resilience factors that people with physical or mental disabilities used in the aftermath of Hurricane Sandy. Resilience theory was used as the theoretical framework. Through face-to-face interviews, 10 persons with disabilities shared their experiences of coping and resilience. A lens of interpretative phenomenological analysis was used to identify emergent themes related to persons with disabilities' …

Social And Structural Barriers To Safer Sex Among Heterosexual Female Sex Workers, Erika Nikole Harding-Davis

Walden Dissertations and Doctoral Studies

Individuals infected with HIV through heterosexual contact made up 24% (9,578) of all new infections in the United States. Female sex workers are at increased risk of getting HIV and other sexually transmitted infections (STI) because they may be more likely to participate in risky sexual behaviors including sex with multiple partners and condom-less anal/vaginal sex. Guided by the syndemic theory, the purpose of this study was to explore the relationships between social and structural factors (homelessness, substance use, immigration status, and use of healthcare) and risky sexual behaviors (condom-less vaginal sex and multiple sex partners) among female sex workers …

Service Providers' Perspectives On Coping Strategies Of Discharged Adolescent Psychiatric Patients, Laneeka S. Henry

Walden Dissertations and Doctoral Studies

Using systems theory, the purpose of this qualitative study was to explore the perspectives of service providers about the psychiatric experiences of hospitalized adolescents, their coping strategies and the aftercare services they used following discharge. The goal was to learn about their experiences as they transitioned into mainstream culture. This study was conducted for psychiatric policy makers to assist with implementing therapeutic programs that teach adolescents coping strategies that help them make a smooth transition. The technique used to recruit 21 participants (psychiatrists, psychologists, social workers, psychiatric nurses, and direct care workers) was snowballing. The participants involved in face-to-face or …

Job Transitioning Experiences Of Blue-Collar Employees After Federal Downsizing, Eduardo Hurtado

Walden Dissertations and Doctoral Studies

Downsizing, realignment, and closure of military bases have forced many low-skilled, blue-collar federal employees into involuntary job loss and job transition. The impact of involuntary job loss on blue-collar workers has been linked to stress and other adverse psychological effects. There is gap in the literature regarding the lived experiences of federal blue-collar employees following downsizing of military bases. The purpose of this qualitative, interpretive phenomenological study was to examine lived experiences of job loss and job transition for federal blue-collar employees following downsizing of military bases. Schlossberg's transition theory provided a conceptual framework for the study. Ten ex-federal blue-collar …

Prescreening Recommendations For Patients On Medical Cannabis, Wen Chieh Hu

Walden Dissertations and Doctoral Studies

Marijuana is the most frequently used illegal substance in the United States and is most widely used among young people aged 12 to 21 years. Accurate screening and monitored issuance of medical cannabis recommendations have been shown to decrease abuse rates of the substance, create fewer deaths from opiates, reduce crime rates, reduce marijuana use in youths, decrease car crash deaths, and lessen prevalence of suicide in young men. The purpose of this project was to explore whether multiple screening methods for depression and anxiety in patients who seek medical cannabis referrals for anxiety and depression would improve screening and …

Emergency Preparedness Experiences By Emergency Managers In Rural Hospitals Of The Pacific Northwest, Gabriella Korosi

Walden Dissertations and Doctoral Studies

This qualitative research focused on the emergency preparedness (EP) rule implementation in rural hospitals in the Pacific Northwest. A new law has been implemented that requires hospitals to comply with Medicaid and Medicare law. Learning about the implementation and preparedness process could help rural regions in the Pacific Northwest better prepare for emergencies and comply with the law. The purpose of the study was to gain increased understanding of how the new EP rule of 2016 impacts rural hospitals' preparedness in the Pacific Northwest. The theoretical framework was complexity theory. This study focused on the lived experience of emergency managers …

Effective Planning Of Urban Communities' Vulnerabilities For Mitigation Of Homelessness After A Natural Disaster, Tamara Michelle Lapsley

Walden Dissertations and Doctoral Studies

Urban communities often lack the ability to recover after disaster plans have been implemented because of a lack of coordinated resources among federal, state, and local agencies. As a result, economically marginalized citizens find themselves in risky conditions, particularly concerning finding and securing post-disaster housing. Using social conflict theory as a guide, the purpose of this exploratory case study of an urban area in a southern state was to better understand the specific vulnerabilities of urban communities and develop solutions for challenges related to emergency or temporary shelters to victims. Data were primarily collected through interviews with 10 residents who …

Experiences Of Ex-Offenders Assigned To A Work Release Program, Julia Marie Cottrell Lefevre

Walden Dissertations and Doctoral Studies

Ex-offenders face many challenges and barriers in obtaining sustainable employment when reentering society. Researchers have demonstrated that participation in a work release program prior to release from prison may be beneficial. However, not all work release reentry programs are alike. Because offenders are the benefactors of these programs, it is essential their experiences are captured. The purpose of this phenomenological study was to understand and describe unique experiences of male ex-offenders previously assigned to a work release program in an urban setting in an Atlantic East Coast state. Bronfenbrenner's ecological systems theory framed the study. This study gives voice to …

Simulation As A Remediation Tool For Clinically At-Risk Associate Degree Nursing Students, Janna G. Lock

Walden Dissertations and Doctoral Studies

Evidence-based remediation options are limited for nursing students who fail their clinical competency evaluations. Scholarly literature provides a paucity of studies related to the use of simulation-based technology to remediate nursing students. The research question focused on the difference in the initial competency demonstration evaluation scores of associate degree nursing students compared to the reevaluation scores after remediation with simulation-based technology. Benner's novice to expert and Kolb's experiential learning theories were used to explain how nurses acquire and develop skills. The researcher used a quantitative one-group pretest posttest design to examine archival data from 149 nursing students from a South-Central …

Military Sexual Trauma Survivors' Experiences And Perceptions Of Cognitive Processing Therapy, Sally A. Mead

Walden Dissertations and Doctoral Studies

Military sexual trauma (MST) has been associated with poor emotional and psychological well-being, less overall life satisfaction, and poorer health in general as well as higher rates of posttraumatic stress disorder (PTSD). The Department of Veterans Affairs provides treatment for veterans who experienced MST and recommends cognitive processing therapy (CPT) as a preferred treatment modality. Quantitative studies have shown that CPT can decrease symptoms of PTSD; however, a neglected area of study concerns the experiences of veterans who receive CPT for MST-related PTSD. In this generic qualitative study, the perceptions and experiences of female veterans who were survivors of MST …

The Long-Term Health-Related Outcomes Of Breast Ironing In Cameroon, Norbert Nicholas Njume Nkwelle

Walden Dissertations and Doctoral Studies

Breast ironing (BI) practice is a common practice in Cameroon. Most villages and towns continue with BI because they believe it constitutes a positive cultural lifestyle. However, public health officials and other advocates have branded BI as a harmful traditional practice because of the traumatic impact it has on the women who experience it. The purpose of this quasi-experimental study was to examine the perceived long-term health-related outcomes of BI and the quality of life changes on these women. Underpinning this study was the betrayal theory of trauma. A survey was used to collect data from 230 women. Descriptive analysis …

Telehealth Implementation Strategies For Healthcare Providers, Ismaila Gbenga Olatinwo

Walden Dissertations and Doctoral Studies

The shift in the landscape of healthcare services from inpatient care to outpatient care prompts healthcare leaders to re-evaluate their strategies to boost declining revenue. Telehealth offers potential for increasing efficiency and access to care, and the acceptance of its modal quality is essential for its diffusion and adoption. The purpose of this single case study was to explore strategies that healthcare providers used to implement telehealth to increase profitability. The conceptual framework was the technology acceptance model. Data were collected through semistructured interviews and review of organizational documents. The research population comprised 4 healthcare leaders in 1 organization in …

Impact Of Food Insecurity On The Management Of Illness In Wayne County, Ohio, Bernadette Coleen Paul

Walden Dissertations and Doctoral Studies

The incidence of food insecurity coupled with poor management of illnesses poses a

public health challenge. Poor adherence to medication regimens is a contributor to poor

health outcomes, especially among the socioeconomically disadvantaged. Food insecurity

is a global health and nutrition problem that affects approximately 50 million people in

the United States. The number of food-insecure households in the United States has

increased by 12% since 1995, and so has the burden of management of illnesses. The cost

of healthcare has risen from 5% of the Gross Domestic Product (GDP) in 1960 to 20% of

the GDP currently. This quantitative …