Digital Commons Network^™

The Role Of Inflammatory Biological Markers In Novel Pharmacotherapies For Populations With Depression, Stacey Boyer

Walden Dissertations and Doctoral Studies

Current interventional pharmaceutical therapies targeted for depression are not adequate to achieve sufficient remission following treatment. Researchers explored inflammatory biomarkers as a way of understanding why treatment for depression is effective for some and not others. The purpose of this secondary data analysis study was to determine if there was a relationship between inflammatory biomarkers and treatment efficacy in persons diagnosed with depression who have demonstrated a previous lack of remission. Using the immune-cytokine paradigm of depression (POD) allowed depression to be viewed as multifaceted and a potential signal of chronic immune system activation. This secondary data analysis included findings …

Chronically Homeless Transgender Women Obtaining Social Services From Outreach Workers, Larry Jack Cameron

Walden Dissertations and Doctoral Studies

In the United States, homelessness is often connected to traumatic events such as domestic violence, job loss, or post incarceration experiences, frequently resulting in substance use disorders, medical issues, and related mental illnesses. Although researchers have considered how homelessness and social service interventions affect sexual and gender minority youth, they have not adequately studied the causes and effects of homelessness among transgender women. The purpose of this interpretive phenomenological study was to bridge this gap in knowledge by exploring the experiences of chronically homeless transgender women. The research question focused on the lived experiences of chronically homeless transgender women who …

Effective Cyber Security Strategies For Small Businesses, Kimberly Diane Cook

Walden Dissertations and Doctoral Studies

Disruptive technologies developed in the digital age expose individuals, businesses, and government entities to potential cyber security vulnerabilities. Through the conceptual framework of general systems theory, this multiple case study was used to explore the strategies among owners of 4 retail small- and medium-size enterprises (SMEs) in Melbourne, Florida, who successfully protected their businesses against cyber attacks. The data were collected from a review of archival company documents and semistructured interviews. Yin's 5-phased cycles for analyzing case studies provided the guidelines for the data analysis process. Three themes emerged from thematic analysis across the data sets: cyber security strategy, reliance …

Improving Workflow At The Point Of Care Using The Electronic Health Record, Rox Ann Sparks

Walden Dissertations and Doctoral Studies

The electronic health record (EHR) is an important part of the effort to improve health care and reduce costs in the United States. Primary care providers, among the largest group of caregivers in the nation, often experience difficulty with implementation and utilization of EHRs. Efforts to enhance the provider's effectiveness in the use of the EHR should result in improved patient outcomes as well as decreasing the overall cost of health care. Guided by the diffusion of innovation theory, this project was initiated to develop a plan for improved usage of the EHR in a primary care setting. A survey …

Exploring Personal And Societal Expectations Of Blind Veterans, Malinda L. Wimbs

Walden Dissertations and Doctoral Studies

More U.S. men and women are returning from military service obligations with physical and mental disabilities which complicate their transition to civilian life. Few researchers, however, have examined the post service experiences of blind veterans and whether they are affected by societal expectations of people living with disabilities. The purpose of this qualitative study was to gain knowledge about the experiences of U.S. veterans who suffered vision loss, and the influence of societal expectations on their lives. Hermeneutic phenomenological methodology was used to explore the personal meanings 8 veterans, who lost their vision during active service, attached to their experiences …

Examining The Retention Of African American Young Adults In Their Childhood Church, Stacia Lynn Alexander

Walden Dissertations and Doctoral Studies

The purpose of this study was to examine the reasons for the decline of young adult church attendance after an affiliation with church during childhood. Religion plays an important role in the lives of African Americans as a coping mechanism for loss, adversity, racism, and trauma. In addition, spiritual exploration is a component of psychological development during maturation. Using the social identity theory, the study explored the impact of childhood church affiliation and coping styles of young adults. African American Youth between 18 and 30 years old were randomly selected to complete a combination of questions from the Lasting Faith …

Teachers' Stage Of Concern And Self-Efficacy Regarding Teaching Students In An Inclusive Classroom, Sonya Yvette Avery

Walden Dissertations and Doctoral Studies

Federal legislation mandates inclusion of students with special needs in general classrooms. Teachers in the Shelco school system implemented this mandate to teach in an inclusive classroom given limited professional development, and a desire for more. To determine their preparedness to teach with inclusion, 44 general education teachers participated in this correlational study. Two surveys were administered: Teachers' Self-Efficacy Survey and Stages of Concern Questionnaire. Scores were combined to identify and recommend groups of teachers for differentiated professional development. Social constructivism, which focuses on how learning is affected by social concepts such as self-efficacy and concerns, was the theoretical framework. …

Special Education Teachers' Experiences And Perceptions Of Instructing Students With Learning Disabilities, Kala Harris Johnstone

Walden Dissertations and Doctoral Studies

An urban middle school in the northeastern United States was having a problem with low performance on state annual reading tests on the part of students with learning disabilities. Consequently, the middle school was not meeting the reading academic targets that were set by the Department of Education in the northeastern United States. The purpose of this exploratory qualitative case study was to explore special education teachers' experiences and perceptions about how teaching reading to students with learning disabilities was affecting special education teachers' pedagogy. Glasser's choice theory, which theorizes that an individual's behavior is chosen, formed the conceptual framework.- …

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 …

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 …

Five Factor Personality Traits In Schizophrenics With A History Of Violent Behavior, Ashley Lust

Walden Dissertations and Doctoral Studies

The diagnosis of schizophrenia has been associated with increased risk of violence and aggression. However, the extent of this association in relation to displayed personality traits among individuals diagnosed with schizophrenia have not been fully investigated. The lack of research has resulted in an inability to determine why only some individuals with schizophrenia display violent tendencies when others do not. Guided by Costa and McCrae's five-factor model of personality and Eysenck's theory of personality and crime, the purpose of this study was to investigate the relationship between the five personality traits and the display of violence among individuals with schizophrenia, …

The Perceptions Of Video Surveillance And Its Influence On Cargiver Stress In The Home Care Setting, Asuncion Neri-Candelaria

Walden Dissertations and Doctoral Studies

Given the stress involved in caring for elders, the propensity for abuse among the older adult population continues to be a problem, as the number of caregivers providing care in the home is increasing to meet the demand of an increasing population of older adults. One solution is to implement video surveillance in the home. The purpose of this phenomenological, retrospective and prospective study was to describe the perceptions and experiences of caregivers that affect stress in the home care setting and to describe participants' perceptions about the impact of video surveillance in the home environment on caregiver stress and …

Teachers' Perceptions Of Teach For America Training And Classroom Management In Urban Middle Schools, Tenechia Platt

Walden Dissertations and Doctoral Studies

Teach for America (TFA) is an alternative certification program that recruits and trains college graduates and places them in urban public school settings to combat teacher shortage and to decrease achievement disparities between urban and suburban school districts. Teachers prepared by the TFA program have struggled to establish and maintain effective classroom management. The purpose of this case study was to explore TFA teachers' perceptions of the emphasis placed on classroom management during their TFA training and to identify strategies that were taught to assist TFA teachers working in urban middle schools. The conceptual framework for the study was comprised …

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 …

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 …

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 …

Strategies For Improving Labor Productivity In Construction Companies, Lakew G. Buli

Walden Dissertations and Doctoral Studies

Even with advanced technology and new project management methodologies, construction company leaders continue to face challenges to improve labor productivity. This multiple case study was an exploration of the strategies that construction company leaders use to improve labor productivity in Doha, Qatar. The case population consisted of 6 construction company leaders operating in Doha, Qatar, who successfully identified and implemented strategies to improve labor productivity. The conceptual framework for this study was the expectancy theory. The data collection process included semistructured interviews and company documentation. Data were compiled and organized, disassembled into fragments, reassembled into a sequence of groups, and …

Influences Of Provider-Patient Communication On Health Literacy And Public Policy Relevant Outcomes, Rachel Carla Cartwright-Vanzant

Walden Dissertations and Doctoral Studies

Several artifacts of federal policy address the connection between health literacy of patients and health outcomes. These laws include The Plain Writing Act, Health Information Technology for Economic and Clinical Health, and the Health Insurance Portability and Accountability Act. Even with this policy structure, little is known about how nurses' knowledge of health literacy may influence patient understanding of medical information and health outcomes. Using Knowles' principles of effective communication, the purpose of this mixed-methods study was to concurrently examine the relationship between nurse knowledge of health literacy and communication techniques used by nurses to identify any causal relationships in …

The Use Of Humor With Families During Pediatric Trauma Intake Assessments, Letitia Batton

Walden Dissertations and Doctoral Studies

Traditionally from a positive psychological view, humor is regarded as an adaptive force, a vital aspect of healing, and possibly a beneficial coping tool when faced with traumatic circumstances. Despite these beliefs, little is known about how humor relieves stress with parents in the initial intake assessment when their child has been traumatically injured. The purpose of this phenomenological study was to explore social workers' use of humor during pediatric trauma assessments. A sample of 6 parents were from pediatric parent trauma support groups to participate in this study, which employed a subject-intensive theoretical framework. Face-to-face interviews and participant observation …

Emergency Medical Service Career Longevity: Impact Of Alignment Between Preemployment Expectations And Postemployment Perceptions, Michael Joseph Belotto

Walden Dissertations and Doctoral Studies

The purpose of this qualitative study was to investigate whether there were differences between the preconceived notions of emergency medical technicians and paramedics prior to entering the profession and their notions of the vocation after facing the realities of the job. The contribution of alignment or misalignment to job satisfaction and the intention to leave the profession was also further investigated. This research is important as there currently is a gap in the literature pertaining to the factors affecting career longevity of emergency medical service (EMS) professionals. The degree of fit between individual and occupational characteristics guided this phenomenological study …

Violent Aggression Exposure, Psychoemotional Distress, Aggressive Behavior, And Academic Performance Among Adolescents, Joyce Renee Evans

Walden Dissertations and Doctoral Studies

Sixty percent of youth indicate exposure to violence. Such exposure is a noted risk factor for youths' well-being, including cognitive, emotional, and behavioral development. However, there is a gap in the literature regarding whether exposure to violence predicts impaired academic performance. The purpose of this quantitative study was to test a model with cognitive, behavioral, and emotional sequelae of exposure as mediators of the relationship between exposure to violence and academic performance among adolescents who are at risk for exposure and attend inner-city high schools. Ninety-nine students, primarily female and African-American, in Grades 10 to 12 at two public schools …

Effect Of Therapeutic Alliance Of Clients On Methadone Maintenance Treatment Outcomes, Teresa Lyn Fresquez

Walden Dissertations and Doctoral Studies

Opioid abuse costs affect the majority of the adult population in our society directly or indirectly. The current prevailing medical treatment for opioid addiction is methadone maintenance treatment (MMT). MMT reduces infectious disease spread, illicit drug use, criminal activity, and overdose potential. MMT is only as effective as the length of time a client remains active and compliant with the program. In previous studies, therapeutic alliance (TA) has been shown to positively influence the effectiveness of substance abuse treatment. However, a gap exists in research in regards to the impact of TA on the effectiveness of MMT outcomes. The theoretical …

Managerial Strategies For Improving Employee Engagement: A Single Case Study, Ann-Marie Alcala

Walden Dissertations and Doctoral Studies

In 2013, 1% of Medicare reimbursements were withheld from U.S. hospitals, with a

proposed cap of 2% in 2017 for redistribution to those hospitals that improve overall care and patient satisfaction. The purpose of this single case study was to explore the engagement strategies that some hospital middle managers used to improve employee performance to increase patient satisfaction. The sample included 4 health care middle managers in 1 hospital in northeast Connecticut. The conceptual framework that grounded this study was Kahn's personal engagement theory. Data were collected via semistructured interviews, participant observations, and review of hospital and public government documents. …

Improving Breastfeeding Knowledge Of Staff Nurses, Patience Sirri Mbonifor

Walden Dissertations and Doctoral Studies

The World Health Organization advocates that newborn babies require exclusive breastfeeding until 6 months of age to attain a desired level of growth. Despite this recommendation, exclusive breastfeeding rates continue to be at low levels globally. The purpose of this DNP project was to examine best practices for increasing the breastfeeding knowledge of health care workers, and to understand how breastfeeding is promoted in different healthcare systems. The Critical Appraisal Checklist and the Cochrane Handbook for Systematic Reviews framed this systematic literature review. Additionally, Melnyk's levels of evidence was used to evaluate each article. Articles for inclusion were limited to …

Impact Of The Childcare Setting And Caregiver Education On Toddler Language Environment, Snejana Nihtianova

Walden Dissertations and Doctoral Studies

Young children's early language development is strongly related to their school performance, and slow language growth may predict later academic problems. The link between the language quality and amount of speech that children hear and their language development is well documented; however, the factors that impact variability in linguistic input are not well understood. The purpose of this quantitative study was to assess the association between childcare settings and childcare provider education level and toddlers' language environment. The study sample consisted of 29 Bulgarian children. The study used a new technology called Language Environment Analysis, which is the preferred method …

Role Of The Nurse During Disaster Preparedness: A Systematic Literature Review And Application To Public Health Nurses, Elizabeth Rivera-Rodriguez

Walden Dissertations and Doctoral Studies

After the 2001 attacks on the World Trade Center, public health garnered more attention. This event forced public health nurses to acquire new roles needed to respond to disasters. The purpose of this project was to synthesize the current evidence related to the role of nurses during disaster preparedness and apply that evidence to public health nurses. The practice question focused on the role of nurses during disasters which were not a part of their normal daily activity. The Fineout-Overholt, Melnyk, Stillwell, and Williamson hierarchy for grading evidence was the theoretical framework used. A systematic literature review was conducted to …

Predictors Of Job Satisfaction Among County Jail Correctional Officers, Richara Simmons

Walden Dissertations and Doctoral Studies

Job satisfaction among jail correctional officers is important because it ensures the continuity of officers who can promote and maintain a safe environment inside the jail for all staff and inmates. Most job satisfaction studies on correctional officers, however, are focused on prison officers and not county jail officers. The purpose of this correlational study was to test and extend Herzberg's Motivation-Hygiene theory by exploring job satisfaction and motivation among jail correctional officers in Miami-Dade Florida. Survey data were collected from 149 correctional officers using Specter's (1994) Job Satisfaction Survey. Data were analyzed through correlational and multiple regression analyses. Findings …

Strategies Clinic Managers Use To Reduce Missed Medical Appointments, Sophea Ey Skym

Walden Dissertations and Doctoral Studies

Patients who miss their medical appointments increase health care costs for themselves and for clinics. The purpose of this qualitative, single exploratory case study was to explore strategies health care clinic managers use to reduce medical no-shows for patient-scheduled appointments. Change management theory guided the scope and analysis. The data collection included a single clinical operations manager who have strategies to mitigate no-shows for patient-scheduled appointments participated in a semistructured interview in southeastern Virginia, the direct observation of 2 office workers in their natural setting of scheduling appointments, and for methodological triangulation, a review of organizational archival documents about missed …

Working Alliance Between Interpretive And Noninterpretive Therapy Services For Deaf Individuals, Sherri Lee Spain

Walden Dissertations and Doctoral Studies

Deaf individuals typically have access to 2 types of therapeutic services: interpretive (with an interpreter) and noninterpretive (with a sign-fluent therapist). Previous research indicates that the presence of an interpreter may hinder development of working alliance and attachment. There is a lack of empirical evidence assessing the effect of working alliance and attachment based on whether or not therapy incorporates an interpreter. The working alliance theory and the attachment theory were the theoretical foundations for this study. This study examined the difference between the strength of working alliance and attachment to the therapist given the presence or absence of an …