Digital Commons Network^™

The Effect Of Early Childhood Abuse On Educational Attainment, Onzie Luke

Walden Dissertations and Doctoral Studies

The purpose of this study was to fill a gap in the literature regarding survivors of child abuse and their capacity to continue their educational pursuits beyond high school. Thus, this study explored the lived experience of self-identified abuse survivors who were enrolled in higher education. The theoretical bases for this study included Bandura'€™s social cognitive theory, Rotter'€™s theory of locus of control and Heider'€™s and Weiner'€™s theory of attribution. Open-ended interviews were conducted with 15 survivors of child abuse enrolled in an undergraduate or graduate degree program at an online or brick and mortar university. The interviews were then …

Addresing Challenges In Caring For Morbidly Obese By Learning About Bariatric Care, John Abayomi Makanjuola

Walden Dissertations and Doctoral Studies

Obesity is a public health issue linked to high morbidity and mortality among critically ill patients. There are approximately 15.5 million morbidly obese adults in the United States. The purpose of the project was to develop and implement an educational program using evidence-based protocols for bariatric care to educate nurses and caregivers regarding best practices when attending to obese patients. The practice-focused question examined whether learning about evidence-based bariatric care would improve the knowledge of nurses and caregivers caring for morbidly obese patients in an acute care setting. The theoretical foundation was Bandura'€™s self-efficacy theory. A questionnaire using a Likert …

Noncompliance With Follow-Up Visits In Primary Care, Amanda Michelle Northern

Walden Dissertations and Doctoral Studies

No-show appointments, also referred to as missed appointments, occur 23% to 34% annually in general practice care settings. Missed appointments can lead to reduction in appointment availability, decrease in provider/staff productivity, patient/provider discordance, disruption in continuity of care, and reduced quality of care. There is a gap in the nursing literature regarding effective interventions to reduce missed appointments. The purpose of this quality improvement, secondary analysis project was to determine whether implementation of an evidence-based no-show, nurse-led intervention would reduce missed appointment rates in a family medicine practice. The health belief model and the plan, do, study, act model guided …

Knowledge, Attitudes, And Beliefs About Food Additives And Obesity, Lorna Theresa Ingram

Walden Dissertations and Doctoral Studies

Knowledge, Attitudes, and Beliefs about Food Additives and Obesity

by

Lorna Theresa Ingram

MS, Long Island University, 2007

BA, Florida International University, 1999

Dissertation Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Philosophy

Walden University

November 2019

Obesity is a chronic health problem that affects the health and well being of its population. The purpose of this cross-sectional, descriptive study was to examine whether there is a relationship between individuals’ knowledge, attitudes, and beliefs regarding food additives and obesity. The research questions concerned knowledge, attitudes, and beliefs participants had regarding food additives and obesity. The …

African American Sibling Relationships When Caring For An Alzheimer’S Parent, Cynthia M. Smith

Walden Dissertations and Doctoral Studies

Alzheimer’s disease (AD) is the most commonly occurring form of dementia that affects African Americans at 2 to 3 times higher rate than other ethnic or racial groups in the United States. As the number of older African Americans with AD grows rapidly so will the need for daily supports; therefore, informal caregivers, such as an adult offspring, often assume the role of filial caregiver. Focusing on the unique patterns of caregiving among African Americans, this generic qualitative study may help explain the adult offspring’s perspective on sibling relationships as they function in the role of primary filial caregiver. Equity …

Relationship Between Senior Leadership Style And Patient Satisfaction In The Inpatient Rehabilitation Facility, Amy Elder

Walden Dissertations and Doctoral Studies

Patient satisfaction has a significant role in the healthcare industry, as high patient satisfaction can improve quality outcomes. Hospital leadership is responsible for the culture, outcomes, and patient experience, which can involve different leadership styles. The purpose of this quantitative study was to examine the relationship between leadership style of senior leaders and patient satisfaction in inpatient rehabilitation facilities (IRFs). Through the theoretical framework of transformational and transactional leadership theories, the research questions were designed to determine whether a statistically significant relationship existed between leadership style (transformational, transactional, and laissez-faire leadership) and patient satisfaction. The Multifactor Leadership Questionnaire was administered …

Physical Activity, Healthcare Use, And Medication Use In Diabetes Patients, Julie Kwon Evans

Walden Dissertations and Doctoral Studies

Physical Activity, Healthcare Use, and Medication Use in Diabetes Patients

by

Julie Kwon Evans

MS, The Chicago School of Professional Psychology, 2013

Dissertation Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Philosophy

Psychology

Walden University

November 2019

An Instructional Module For Nurses To Teach Patients With Gestational Diabetes Mellitus, Josephine Onyekachi Ollawa

Walden Dissertations and Doctoral Studies

Gestational diabetes mellitus (GDM) is a carbohydrate metabolism issue during pregnancy that is dangerous for mother and the baby. GDM occurs in 1 out of 3 diabetic women in 16.2% of live births. GDM knowledge and treatment practices among nurses were found inadequate when nurses’ effectiveness in treating a disease they have a shallow knowledge about (GDM) was investigated in the local medical facility. A GDM instructional module was applied and its effectiveness in promoting nurse’s use of GDM education as a treatment strategy tested. The total concept for knowledge and care, empowerment and the social cognitive theories grounded this …

Wellness Paradigms In Predicting Stress And Burnout Among Beginning Expatriate Teachers, Kimala Proctor

Walden Dissertations and Doctoral Studies

Research indicates that the current teacher shortage is in part due to stress and burnout. A topic that has not been examined is beginning expatriate English medium teachers (EMTs) with 5 years or less of teaching experience in the United Arab Emirates and the relationship between using individualized, self-initiated wellness paradigms and stress, job burnout, and intent to leave the teaching profession. The transactional model of stress and coping, Maslach's multidimensional theory of burnout, and the health promotion model were used to evaluate the moderating effects of the EMTs' burnout and stress levels on their wellness and intent to leave. …

Compassion Fatigue In Registered Dietitians Who Treat Patients With Eating Disorders, Caryn Alyce Honig

Walden Dissertations and Doctoral Studies

Registered dietitians who treat patients with eating disorders may be at risk for developing compassion fatigue due to exposure to patients' chronic complications. Dietetic courses and programs do not comprise coping and resilience training, therefore, dietitians who work with these patients may need additional education. The purpose of this basic qualitative research study was to investigate the perceptions of practicing registered dietitians and dietetic educators on the risk of compassion fatigue, investigate ways to manage and prevent the development of compassion fatigue, and explore the possible need for professional education. Knowles's theory of andragogy provided the conceptual framework as perceptions …

Meanings Of Preconception Health To Overweight Women In An Economically Depressed County, Valeria Ninette Balogh

Walden Dissertations and Doctoral Studies

The intention-behavior gap between receiving professional health information and transitioning to improved health behaviors prior to conception is not well understood. In order to improve preconception health across the board, a more integrative understanding of the problem must present itself. This study combined elements from the theory of planned behavior, self-determination theory, and the bioecological model of human development as it's foundation. Qualitative phenomenology and semistructured face-to-face interviews were used to gain a deeper understanding of the ways in which nine overweight and obese women described preconception intentions and beliefs and the bioecological experiences leading to those beliefs. Interpretation of …

The Experience Of Older Homeless Females With Type 2 Diabetes, Joan Jacqueline Downes

Walden Dissertations and Doctoral Studies

The purpose of this phenomenological study was to explore the experience of older homeless females who have type 2 diabetes mellitus. Women who have stable housing often find it difficult to manage their diabetes; for those who are homeless, managing the disease is even more difficult. This chronic disease has impacted people all over the world and decreased their quality of life. However, people who are homeless may be at a higher risk of this stressful illness. Managing glycemic levels is a crucial factor in decreasing the adverse results in type 2 diabetes. In this study, face-to-face interviews were conducted …

Substance Use Treatment Needs For Survivors Of Commercial Sexual Exploitation Of Children, Emma Elisa Riley-Horvath

Walden Dissertations and Doctoral Studies

Commercial Sexual Exploitation of Children (CSEC) is the sexual exploitation of minors

for commercial profit. The intersection between sex trafficking victimization and substance use has not yet been explored in clinical research and is not reflected in current clinical treatment of survivors when they exit their exploitation. The research question explored in this study focused on the substance use treatment considerations and challenges clinical social workers face when treating survivors of CSEC living in Massachusetts. Subquestions included understanding how cumulative trauma from CSEC impacts substance use treatment and how the coercive use of substances aimed at maintaining victim submission impacts …

Depression Screening For Bariatric Surgical Patients, Cova Teresa Stidham

Walden Dissertations and Doctoral Studies

Obesity in the United States has increased to epidemic numbers over the last decade. Practitioners need to reverse the trend. To address the problem of depression in obesity, a practice guideline from a bariatric clinic for under-served populations was proposed to an expert panel. The Spell Out on First Use (PHQ-9) screening is a valid and reliable self-screening tool to assist the practitioner in determining the level of depression if any. The PHQ-9 has nine questions. No formal screening existed at the bariatric clinic, and the practice guideline (with algorithm and revised workflow) was proposed for use at the clinic. …

Late-Stage Breast Cancer Diagnosis Among Haitian Women In The United States, Marie-Hortence Prosper

Walden Dissertations and Doctoral Studies

Breast cancer is the 2nd leading cause of death among women. While a significant amount of research has been done to understand the different disparities related to this disease, there is still more to learn about the relationship between a person's nationality and the staging of breast cancer. Using the Surveillance, Epidemiology, and End Results Program as the data source, this retrospective cohort study was aimed at assessing late-stage breast cancer among Caribbean immigrants, specifically comparing Haitian women with Americans and other immigrant populations in the United States. The research questions addressed the link between nationality and the likelihood of …

Factors Associated With Maternal Mortality In Greater Accra Ghana 2016: Case-Control Study, Edmund Sekyi Eghan

Walden Dissertations and Doctoral Studies

Maternal mortality is a critical area of concern globally, despite the availability of accessible preventive measures. The role of sociodemographic and service delivery factors in maternal mortality in the Accra Metropolitan Area of Ghana are important to examine. As part of the United Nations (UN) Millennium Campaign, the UN implemented 8 Millennium Development Goals (MDGs); maternal mortality reduction by 75% between 1990 and 2015 was among the fundamental MDGs to be achieved by 2015. The purpose of this case-control study was to use secondary data to assess the relationships between sociodemographic variables, service delivery factors, and maternal mortality among 8,171 …

Predictors Of Poor Pregnancy Outcomes Among Pregnant Women In Island Maternity, Nigeria, Letam Nwi-Ue

Walden Dissertations and Doctoral Studies

Pregnancy outcomes have improved tremendously in developed countries. Notwithstanding, it is still a huge challenge in developing countries, especially Sub-Saharan Africa. In 2015 in Nigeria, about 145 women died daily from pregnancy-related causes. Similarly, nearly 2,300 children under 5 years were lost in the same year. Nigeria consistently underperformed in some of the critical pregnancy indicators such as maternal and neonatal mortality, second worst only to India in the world. Studies on poor pregnancy outcomes are scarce in Nigeria. The purpose of this quantitative, retrospective cross-sectional study was to use local evidence to ascertain the risk factors that predict poor …

Acculturation And Diabetes Among New York's Bangladeshi Immigrants, Renee Mehrra

Walden Dissertations and Doctoral Studies

There are more than 3.4 million South Asians in the United States. Among this subgroup, Bangladeshis in New York have a high prevalence of Type 2 diabetes ranging from 15 to 24% compared to the general population. This study examined the effect of acculturation through length of stay in the United States and understanding of the English language, and the role of gender on self-efficacy (SE) and diabetes self-management among 336 New York Bangladeshi immigrants between the ages of 21 and 75 who had been diagnosed with type 2 diabetes with A1C -‰¥ 6.5%, as verified by their medical record …

Child Malnutrition In A Developing Country: A Persistent Challenge In Haiti, Jeanne M. Constant-Edma

Walden Dissertations and Doctoral Studies

Malnutrition is characterized by the insufficient intake of certain nutrients and the inability of the body to absorb or use these nutrients. This health problem continues to be a persistent challenge among children under 5 years of age in developing countries, including Haiti, despite food aid provided. The purpose of this study was to determine the association between dietary habits in children under 5 years of age in Haiti and their malnutrition status. Community organization theory was used to determine the association between determinants of health such as dietary habits, parents' knowledge and experience, cultural eating habits, socioeconomic status, and …

Preconception Health And Preterm Birth Differences Among U.S.-Born And Foreign-Born Black Women, Sheree Holmes Keitt

Walden Dissertations and Doctoral Studies

Foreign-born Black women giving birth in the United States have superior preterm birth outcomes compared to their U.S-born Black peers. Many studies have focused on tobacco use and medical risk factors, but few have focused solely on preconception health. The purpose of this study was to examine preconception health and preterm birth differences among U.S.-born and foreign-born Black women. Three theoretical frameworks guided this study: the life course theory, healthy migrant theory/immigrant paradox, and weathering theory. Primary research questions assessed (a) if there were an association between chronic preconception risk factors, prepregnancy obesity, diabetes, and hypertension, in U.S.-born and foreign-born …

Can Online Media-Literacy Education Mitigate The Effects Of A Toxic Media?, Patricia Tefo

Walden Dissertations and Doctoral Studies

Media-literacy education provides a way for people to assess and critically evaluate media images. Traditional media literacy programs have mitigated the negative effects of idealized media imagery such as reduced self-esteem, eating-disordered attitudes, and low body-satisfaction among women. Although education is moving increasingly to online platforms, the potential of media literacy education delivered online has not been evaluated. Based on social comparison and objectification theories, the purpose of this study was to quantitatively assess the comparative efficacy of online and face-to-face media literacy education programs. A quasi-experimental design using pre- and post-media literacy education program questionnaires was used. A mixed-method …

Body Weight Self-Perceptions And Experiences Of Nigerian Women Immigrants, Fatimah Binta Ali

Walden Dissertations and Doctoral Studies

Low-income immigrants in the United States experience declining health with increasing length of stay in the country. Their declining health over time has been associated with increased smoking, obesity prevalence, and higher risk for developing diabetes and heart disease. How immigrants perceive their body weight and size, influenced by social interaction, culture, gender, and acculturation is also significant to healthy weight maintenance. Not knowing one's healthy weight could result in body weight misperception and resistance to attaining a healthy weight. The aim of this qualitative study, based on the social constructivist framework, was to understand Nigerian women immigrants' (NWI's) body …

Effect Of Model Of Care And Comorbidities On Multiple-Drug-Resistant Tuberculosis Treatment In Nigeria, Oluremilekun Comfort Kusimo

Walden Dissertations and Doctoral Studies

Multidrug-resistant tuberculosis (MDR-TB) is a public health problem in several countries such as Angola, India, China, Kenya, and Nigeria. Due to the increasing high burden of MDR-TB, most of these countries do not have adequate capacities to manage MDR-TB patients effectively. This study investigated the effect of model of care; human immunodeficiency virus comorbidity; and demographic factors such as age, gender, and marital status on the treatment outcomes of MDR-TB patients in Nigeria. The study was based on the analysis of secondary data of 402 MDR-TB patients accessed from the data systems of the National Tuberculosis, Buruli Ulcer, and Leprosy …

Community Risk Factors And Health Inspection Violations In Mississippi Delta Census Tracts, Chrystal S. Early

Walden Dissertations and Doctoral Studies

A concerning public health issue in America is about food deserts urban and rural communities that lack grocery retailers that offer affordable, nutritious, and diverse foods. Empirical evidence has shown significant associations between neighborhood disadvantage/disorder risk factors of high poverty and high percentages of ethnic minority residents with presence/ absence of healthy food retailers in food deserts. The purpose of this quantitative correlational study, framed by the disparities in food safety conceptual model, was to examine if county-level poverty, number of African American residents, number of elderly (i.e., age 65 or older) residents, vehicle ownership, and crime rates were significantly …

Depression Screening In Poststroke, Shannah Lowe

Walden Dissertations and Doctoral Studies

Depression, a sequela of stroke, is underrecognized and underreported. The American Heart/Stroke Association estimated 1/3 of patients develop depression after a stroke. Depression after a stroke has negative influence on stroke recovery through decreased participation in rehabilitation, and increased morbidity and mortality. The American Heart/Stroke Association recommended that depression screening be conducted on stroke patient; however, there is a lack of guidance regarding the optimal time and tools for depression screening. The practice problem identified was the absence of depression screening in poststroke patients at the project site. The project question focused on identifying evidence-based approaches for depression screening in …

The Effects Of Breastfeeding Support On Women Enrolled For Wic Benefits, Judith Marie Khanuja

Walden Dissertations and Doctoral Studies

Breastfeeding has been shown to protect both the mother and infant, and health care professionals consider it to be the best choice for feeding an infant. The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides food, referrals to other social service programs, and nutrition and breastfeeding education for enrolled families. However, community support for the breastfeeding woman once she leaves the hospital is limited, especially in Philadelphia, PA. The purpose of this mixed-methods study was to explore the impact of prenatal breastfeeding education and understand the role that members of the community play in the infant feeding …

Built Environments And Childhood Obesity Epidemic In The Immigrant Population, Monique M. Nurse

Walden Dissertations and Doctoral Studies

A lack of adequately built environments can negatively affect obesity rates among adolescents. The purpose of this quantitative cross-sectional study was to determine if there is a relationship between the presence of built environments and childhood obesity among the immigrant population living in Cobb County Georgia. The social ecological model was used to explain how environmental factors may influence behavior. The research questions addressed whether walkability and elements of built environments such as to healthy foods and access to parks and recreational areas of census tracts affect childhood obesity when adjusting for race/ethnicity and immigrant population in Cobb County. Data …

Standardized Clinical Guideline For Assessment, Documentation, And Treatment Of Statins, Esther Onyirimba

Walden Dissertations and Doctoral Studies

The purpose of this project was to develop a practice guideline for screening patients at risk for cardiovascular disease, educate the staff at the site about the guideline, and implement the guideline at a primary care clinic. The intention was to identify and treat patients at risk for cardiovascular disease to prevent occurrence of heart disease. Cardiovascular disease includes hypertension, coronary heart disease, heart failure, and stroke. Coronary heart disease is one of the leading causes of death in the Western world. The local practice problem and focus of this project was underprescribed statin therapy for patients at risk for …

Instrumental Role Modeling And The Sensitive Topic Of Obesity: A Grounded Theory, Tulie Blot Gay

Walden Dissertations and Doctoral Studies

The nurse practitioner (NP) role is more prominent now than ever before in primary healthcare, positioning them as providers who defend initiatives and ongoing health agendas. Obesity is among those agendas. The concept of instrumental role modeling was explained as a combination of understanding and physical presence that gives meaning and quality to inspire change. It implied that health professionals are not merely insightful clinicians but suggested their expertise is complimented by demonstrations of wellness in knowledge and practice. This topic of weight was perceived as sensitive but must be addressed. In this grounded theory study, the perspectives of NPs …

The Influence Of Food Insecurity, Low-Income, And Race On Diabetes Self-Management Practices Among Women With Diabetes, Jill La Capria

Walden Dissertations and Doctoral Studies

Diabetes is a chronic condition affecting more than 30 million adults living in the United States. Diabetes self-management (DSM) can prevent or delay the complications of diabetes and improve clinical outcomes; however, data show that low-income, food insecurity, female gender, and race contribute to challenges performing effective DSM. The health belief model was the theoretical framework for this cross-sectional study, which examined how food insecurity, low-income, and race affect DSM activities in women with diabetes. The sample population from the 2017 Behavioral Risk Factor Surveillance System survey consisted of 1,842 women with diabetes who were 18 years of age or …