Digital Commons Network^™

Challenges Of Aging With The Hiv Virus And Comorbidities, Rommie Navylia Abele

Walden Dissertations and Doctoral Studies

Since the introduction of antiretroviral therapy, the survival rate of infected HIV patients has been on the rise with a predicted increase by 2030. The longer a person lives with the virus, the more prone to HIV-associated chronic diseases he or she becomes, but it is not clear whether these diseases are solely from aging with the virus or from long-term use of antiretroviral therapy. Scientists demonstrated that the introduction of antiretroviral therapy led to an increased life expectancy yet early onset of comorbidities; however, they failed to address the challenges that people 50 years old or older face, as …

Domestic Violence And Demographic Variables As Predictors Of Resiliency Among Young Adults, Sylvanus O. Abraham

Walden Dissertations and Doctoral Studies

An increased understanding of resilience may determine how human psychological development can result in positive outcomes despite adversarial situations. However, current studies have not provided a relevant predictive model that can adequately predict resilience, particularly among young adults exposed to domestic violence. Based on Bronfenbrenner's ecological systems theory, the purpose of this quantitative noncomparative study was to examine whether domestic violence, age, gender, ethnicity, individual emotional and physical abilities, types of domestic violence exposure, and frequency of domestic violence exposure could adequately predict resilience among young adults. Quantitative data were collected from 118 young adults in the Midsouth region of …

A Chronic Obstructive Pulmonary Disease Self-Management Packet To Reduce 30-Day Readmissions, Josette Askratni

Walden Dissertations and Doctoral Studies

Chronic obstructive pulmonary disease (COPD) signifies a significant public health challenge that is both avoidable and treatable. There was no standardized education offered to the COPD population at the practice location. The scope of the project encompassed standardizing education by developing a self-management packet for the COPD patients. The goal of this project was to examine how the development of a standardized COPD self-management packet enhances the quality of care and strategizes reducing 30-day readmissions compared to nonstandardized delivery of education. Orem's self-care theory and Bandura's self-efficacy concept were used to explain the principle of self-management, while Rosswurm and Larrabee's …

The Need For Public Policy Initiatives To Retain Medical Doctors In Ethiopia, Berhanu Bankashe Balaker

Walden Dissertations and Doctoral Studies

Ethiopia suffers from a medical shortage or brain drainthat has severely affected its already fragile health care system. The country has a very low physician-to-population ratio,whilemany in the medical community continue to leave in great numbers. Aphenomenological approach was used in this study to explore the lived experiences of medical doctors who have left Ethiopia, with contemporary migration theory serving as the conceptual framework. The central research question focused onwhy Ethiopian medical doctors leave their country and what can be done to retain them. Participants were 10 medical doctors of Ethiopian origin who live and practice medicine in the Washington, …

Head Start Parent Perspectives On Child Exposure To Secondhand Smoke At Home, Christiana Abani Bekie

Walden Dissertations and Doctoral Studies

Children exposed to secondhand smoke (SHS) are at risk of developing ear infections, asthma, wheezing, bronchitis, as well as retarded lung growth. Indoor smoking is the main source of children's exposure to SHS. Despite a downward trend in smoking, children from low income families, especially African American and Hispanic children, continue to be exposed to SHS at a higher rate than their wealthier counterparts. This multiple case study explored the perceptions of 15 parents of 3- to 5-year-old children currently enrolled in Head Start regarding children's exposure to SHS. This study relied on the social ecological model, the theory of …

A Nurse-Led Evidence-Based Quality Improvement Program On Childhood Obesity Prevention, Ana Flor Rasonabe Ciocson

Walden Dissertations and Doctoral Studies

The increased prevalence rate of childhood obesity in Saudi Arabia is a nationwide health issue. The doctoral project was instituted in the pediatric out-patient clinic (POPC) of a tertiary university hospital in Riyadh, Saudi Arabia. Child obesity clinic and clinical practice guideline (CPG) for primary prevention were not available in the pediatric outpatient clinic with a high incidence of newly diagnose obese children. The focus of this doctoral project was to improve the clinical nursing practice of POPC nurses through the adoption of CPG on primary prevention of childhood obesity. The knowledge translation into action framework provided a summary of …

Veterans With Chronic Back Pain Managed In Primary Care: Patient Aligned Care Team, Bonnie Grimes

Walden Dissertations and Doctoral Studies

Chronic pain affects approximately 100 million adults in the United States annually, and costs exceeding $635 billion. Pain is the most common complaint in primary care, and chronic pain accounts for up to 16% of emergency room visits. Additionally, chronic pain accounts for 25% of missed workdays annually. Veterans are particularly vulnerable to chronic pain and have an increased incidence of chronic non-cancer pain. Chronic pain for veterans cost the Veterans Administration (VA) about $385 billion each year. This project evaluated the Patient Aligned Care Team (PACT) model to manage chronic lower back pain (CLBP) at a VA primary care …

The Impact Of Caseworkers' Educational Background And Placement Outcomes For Foster Children, Katrina Haynes

Walden Dissertations and Doctoral Studies

Decades of data document that permanent placements of children in the welfare system has been a concern in Mississippi. As foster care rates increase, more children are awaiting placement. Researchers have linked child welfare workers' educational background to placement outcomes for foster care children; however, researchers have not addressed the relationship between child welfare workers' educational backgrounds and foster care placement outcomes in Mississippi. This quantitative study examined the educational backgrounds of social work and nonsocial work child welfare caseworkers and other factors such as children's gender and race as predictors in placement outcomes for children in welfare custody. Attachment …

Health Literacy As A Measure To Reduce Cost, Improve Health And Access, Vivian Dee

Walden Dissertations and Doctoral Studies

The United States dedicates greater than 17% of its gross national product to healthcare. This percentage is expected to go up to 20% by 2018. Despite the high cost of care, the health care system remains inefficient and ineffective. Barriers include reduced access to care related to low health literacy. Complicating low health literacy is the high readability score of patient education materials. The high readability score is in part due to tools that are not standardized and measure different aspects of education materials creating varying readability scores. The purpose of this quality improvement project was to adopt a tool, …

Assessment And Treatment Of Postpartum Depression Among Mothers In Imo-State, Nigeria, Allison Chinyere Nnaka

Walden Dissertations and Doctoral Studies

Postpartum depression affects many postpartum mothers. When postpartum depression is not timely assessed, identified, and treated, it can lead to problems with mother child bonding and cause family problems, negligence, and infant death. The purpose of this phenomenological study was to understand Imo State women's lived experiences and perception on sufficiency of the assessment and treatment received for their postpartum depression. The conceptual theory for this study was the empowerment theory. In-depth, face-to-face interviews were conducted to examine 10 Imo State postpartum mothers' lived experiences of assessment processes and to understand if their psychological desires were addressed. The interviews were …

Using Appreciative Inquiry To Discover School Administrators' Learning Management Best Practices Development, Michelle Estes Tittle

Walden Dissertations and Doctoral Studies

The U.S. Department of Education has mandated that each U.S. state develop successful initiatives to help students navigate their educational experience. Yet in Alabama students neither advance academically nor in improved life skills development. It is unclear if school administrators in Alabama Schools have contextual best practices for strategic planning and implementation to support and improve the experiences of vulnerable K-12 students. The purpose of this descriptive case study was to explore how administrators of Alabama schools develop contextual best practices for strategic planning and implementation to support students. The conceptual framework was designed using collaboration theory, organizational learning theory, …

An Exploratory Case Study: Persistence And Retention Of Students In An Alternative High School, Lametrica Andrews

Walden Dissertations and Doctoral Studies

Students with emotional behavioral disorders (EBD) are at greater risk for dropping out of high school than other students, and are likely to experience fewer employment options and more societal marginalization. Alternative schools have been viewed as a last chance and best option for educating many students with EBD who have not actually been diagnosed. The purpose of this qualitative case study was to explore persistence and retention in the alternative school setting for students who may or may not have been diagnosed with EBD. Students in this study will be referred to as EBD. Although they have not been …

Social Support, Gender, And Burden In Caregivers Of Patients With Alzheimer's Disease, Jennifer Lynne Wisneski

Walden Dissertations and Doctoral Studies

There are 15.9 million adults in the United States providing care to a family member diagnosed with Alzheimer's disease. Family member caregivers experience detrimental physical and mental health stress because of their caregiving role. The purpose of this study was to determine if the independent variables of marital status, perceived social support, and gender of family member caregivers of patients with Alzheimer's disease were related to the dependent variable of caregiver burden. The variables were examined through the lens of John Bowlby's attachment theory using archival data (n = 586) from the REACH II program. The results of the analysis …

Academic Entitlement And The Decision-Making Of Tenured Professors, A. Roland Chambers

Walden Dissertations and Doctoral Studies

Academic entitlement is a concern in higher education because of the potential societal and market driven influences on credible scholarship. Most of the research has focused on negative attitudes and behaviors attributed to students. The considerations of tenured professors who interact with academically entitled students and strategies for effective classroom management has not been fully explored. Constructivism provided the theoretical framework for the qualitative case study. Data were collected from open-ended, semistructured interviews with a purposeful sample of 10 tenured professors from a state college in the Southeastern United States to explore (a) the meanings participants attributed to academic entitlement, …

Elementary Teachers' Experiences Integrating Technology With Literacy Instruction, Valerie Coward-Vaughn

Walden Dissertations and Doctoral Studies

Elementary educators at the urban elementary school in this study struggled with technology-enhanced literacy pedagogy to increase student success. The purpose of this case study was to examine the extent to which educators built relationships between technology and teaching to improve student success. The study was guided by Venkatesh's unified theory of acceptance which was used to examine how educators accept and use technology in literacy instruction. The research questions examined teachers' perceptions of how they can build better relationships with technology and teaching to enhance student literacy success and their perceptions of administrative and district support services to enhance …

The Mediating Effect Of Leader Member Exchange On Personality Congruence And Affective Commitment, Ebru Evrensel Inanc

Walden Dissertations and Doctoral Studies

The personality congruence of supervisors and subordinates and its influence on work outcomes is a relatively new topic in social and behavioral sciences. Most well-known personality theory is Big Five that includes openness, conscientiousness, neuroticism, extraversion and agreeableness traits. LMX theory focuses on the mutual relationship between a supervisor and a subordinate. There is a gap in the literature regarding the mediating role of LMX perceptions of subordinates on the relationship between personality congruence of supervisors and subordinates and affective commitment (AC). The purpose of this cross-sectional design was first to explore the direct relationship between supervisors and subordinates personality …

Determining Criteria For Distinguishing States Of Consciousness, Barry Matthew Klein

Walden Dissertations and Doctoral Studies

Even though there are many views on consciousness theory in the pertinent literature, there remains a need for a unifying framework for specifying the features of specific states of consciousness. In order to know what kinds of experiences conscious states have in common, researchers need to elicit testimony that is more direct and finer-grained than has been previously available. This dissertation endeavors to fill a gap in current research by addressing concepts and methods for making requisite distinctions. This research illuminates the question of whether specific states of consciousness can be reliably and validly distinguished from each other. In order …

Perceptions Of Private Medical Practitioners Towards The Nigerian National Tuberculosis Treatment Guidelines, Chijioke Pius Osakwe

Walden Dissertations and Doctoral Studies

Tuberculosis (TB) is a major public health problem in many parts of the world. Nigeria is one of the 30 countries in the world that has the highest burden of TB. Private medical practitioners in Nigeria play an important role in health care delivery. Motivating them to adhere to TB treatment guidelines in managing persons suspected of having TB or diagnosed with the disease is one of the strategies employed by the National Tuberculosis Program to Reduce the Burden of TB. Few studies were identified which used qualitative study approaches to study the perceptions of these practitioners towards the TB …

Effects Of Teaching Methods On Achievement Of English Language Learners, Kathy Short

Walden Dissertations and Doctoral Studies

An American school overseas is concerned with offering equal academic opportunities for the non-native English language learners (ELLs) on campus. It has not been determined if the in-class teaching method or the out-of-class teaching method is more effective. The purpose of this study is to determine if there is a difference in end-of-year achievement between these 2 different methods. Guided by Vygotsky`s theory of cognitive social development and Krashen`s theory of exposure to language, the research question addressed the difference in 3rd through 5th grade students' achievement test scores between the in-class teaching method and the out-of-class teaching method. The …

The Relationships Between Older, Physically Impaired Men And Their Pets., Jennifer Hughes Williams

Walden Dissertations and Doctoral Studies

The present study examined older male adults' lived experiences with pet ownership. There is robust literature on older adults and the human-animal bond, but presently there are no qualitative phenomenological studies that focus solely on older physically impaired males who live alone and the relationships they have with their pets. With the guiding framework of biopsychosocial theory and using intensive interviews, 10 older males (65+) who suffered from some physical impairment discussed the relationships they have with their pets, and how their companion animals affect their physical, emotional, and social health. All interviews were transcribed, coded, and analyzed for themes. …

The Relationship Between Attachment, Self-Regulation, And Resilience In Undergraduate Students' College Adjustment, Scott Tanner

Walden Dissertations and Doctoral Studies

Difficulty adjusting to college life is noted in nearly 20% of freshmen who fail to return to college. The purpose of this quantitative survey design study, grounded in attachment theory, was to investigate the best predictor (e.g., secure parental attachment, self-regulation, or resilience) of college adaptation, the combined contribution of the variables in predicting college adaptation, and whether a bivariate relationship existed between the variables and subcomponents of college adaptation. The Connor Davidson Resilience Scale Revised, Parental Attachment Questionnaire, Short Self-Regulation Questionnaire, and Student Adaptation to College Questionnaire were securely administered online to a sample of 68 full-time students from …

Managerial Strategies For Maximizing Benefits From Electronic Health Record Systems, Jarrod Borek

Walden Dissertations and Doctoral Studies

In 2009, the U.S. government allocated $27 billion to health care agencies for electronic health records (EHRs) implementation. The increased use of EHR systems is expected to drive down health care costs and increase profits. To meet this anticipated return on investment (ROI), hospital managers need to be able to successfully design, deploy, and manage EHR systems. The purpose of this single case study was to explore organizational management strategies that hospital managers can use to ensure their investments in EHRs meet targeted ROIs and work efficiency goals. The conceptual framework for this study was based on the technology acceptance …

Teacher Perceptions Of Parental Involvement At An Inner-City K-8 Center In The United States, Latonya Eaford

Walden Dissertations and Doctoral Studies

Educators and researchers have long considered parental involvement to be an integral factor in the success of students. However, parental involvement is low in many U.S. schools. Guided by Epstein's parental model, the purpose of this case study was to examine teachers' perceptions and experiences of parental involvement at an inner-city K-8 center in the United States which has had low parental involvement over the last 5 years. The overarching research question concerned teacher perceptions and experiences regarding communicating with parents, encouraging learning at home, and parents volunteering. Data sources consisted of interviews, questionnaires, and unobtrusive data. Purposeful sampling was …

Management Of Inappropriate Behaviors By Healthcare Risk Managers, Sahar Ebrahim Zadeh

Walden Dissertations and Doctoral Studies

Medical errors are the 3rd leading cause of death in the U.S.. The problem is timely recognition and management of inappropriate healthcare worker behaviors that lead to intimidation and loss of staff focus, eventually leading to errors. The purpose of this qualitative modified Delphi study was to seek consensus among a panel of experts in hospital risk management practices on the practical methods for early detection of inappropriate behaviors among hospital staff, which may be used by hospital managers to considerably mitigate the risk of medical mishaps. High reliability theory guided the research process, utilizing the conceptual framework of fair …

Educational Module On Health Literacy For Hypertension In The Inmate Population, Pamela Mokoko

Walden Dissertations and Doctoral Studies

Hypertension is a major public health issue in the United States that affects approximately 70 million adults; the high blood pressure of nearly half is considered to be uncontrolled. Uncontrolled hypertension is especially true in the incarcerated population. Due to low health literacy on hypertension in the inmate population, there are recurrent hospital visits, an increase in the admission rate and an increased length of stay in hospitals, all of which may lead to an increase in the cost of healthcare. The purpose of this scholarly project was to develop an expertly reviewed, evidence-based, self-paced, computerized, educational module to promote …

Low Health Literacy And Hpv Vaccine Uptake Of African American And Hispanic American Women, Peter Ntiamoah

Walden Dissertations and Doctoral Studies

Cervical cancer incidence in the United States has declined for the past 40 years, yet the odds of developing cervical cancer is much higher among marginalized women, particularly African American and Hispanic American women. Although preventable through vaccination against the human papillomavirus (HPV) prior to infection, uptake and completion rates of the vaccine among African American and Hispanic American women are low. The purpose of the study was to determine if a significant relationship existed between the health literacy levels of African American and Hispanic American women, ages 18-26, and the low HPV vaccination uptake. The integrated behavioral model, which …

Oral Care And The Connection To Adverse Events In Dentistry, Melissa A. Rhoney

Walden Dissertations and Doctoral Studies

As the healthcare industry continues to change, dental providers are concerned about the different types of adverse events that can occur if systemic diseases are not well understood when treating patients. The purpose of this study was to explore the level of understanding among dental care providers of the relationship between oral care and systemic diseases and how these are linked to adverse events. The theoretical foundation that was used for this study was the Swiss cheese model. The research questions were designed to address the level of understanding among dental care providers of the link between oral care and …

Health Disparities Among Hispanic Americans With Type 2 Diabetes, Nelson Sitton

Walden Dissertations and Doctoral Studies

The ongoing increase in Type 2 diabetes among Hispanic Americans challenges the American public health system, particularly with health issues arising from not following appropriate health directives for the disease. This quantitative, cross-sectional, correlational study used primary data to assess the relationship between diabetes knowledge (as measured by the Diabetes Knowledge Questionnaire), health literacy level (as measured by the Short Assessment of Health Literacy-Spanish and English), education level, self-efficacy (as measured by the Diabetes Self-efficacy questionnaire), and self-reported diabetes self-care behaviors (as measured by the Summary of Diabetes Self-care Activities) among a sample of Hispanic Americans with Type 2 diabetes. …

Patient Self-Assessment For Older Adult Fall Prevention, Deborah Brennan

Walden Dissertations and Doctoral Studies

Falls and falls with injury are a leading contributor to decreased quality of life for adults aged 65 and older. Complications associated with fall occurrences include death, long term disability, decreased mobility, decreased quality of life, and psychological effects.

The practice focused question addressed in the project asked if the use of a standardized publicly available assessment for falls risk will assist registered nurses in learning more about the patient's fall risk. To address the question, the Stay Independent Check Your Risk for Falling Questionnaire (SICRFQ), obtained from the CDC website, was used as the basis for an education program …

Health Literacy Best Practices In Policy Development, Stacie Lee Trueheart

Walden Dissertations and Doctoral Studies

Low health literacy is a problem the U.S. faces and, like health care itself, is a complex issue stemming from patient demographics and the healthcare providers being very diverse. Tools have been developed to mitigate the risks of low health literacy, however, without formal policy. The purpose of this qualitative case study was to explore and compare commonalities in health literacy best practices of organizations that are recognized as leaders in health literacy and are addressing low health literacy in their communities. By comparing the organizations' abilities to implement standards of plain language and health literacy tools/guidelines, best practice and …