Digital Commons Network^™

The Association Between Osteoporosis And Early Menopause Following Hysterectomy, Mia Meeyaong-Won Botkin

Walden Dissertations and Doctoral Studies

Osteoporosis is considered to be the most adverse public health disease associated with substantial mortality among postmenopausal women. Hysterectomy, surgically induced menopause, contributes to the early onset of menopause. However, there was no evidence of an association between early menopause following hysterectomy and osteoporosis among postmenopausal women. The purpose of this quantitative study was to examine the association between demographic and behavioral factors and the prevalence of osteoporosis among hysterectomized postmenopausal women. The integrated theory of health behavior change theoretical framework guided study. Cross-sectional secondary data from the 2009-2010 National Health and Nutrition Examination Survey were used. Multiple logistic regression …

Gender Pay Disparity Among Women, Garnise Ann Dennis

Walden Dissertations and Doctoral Studies

Irrespective of professional experience and educational background, gender pay disparity is a problem in the federal government. Women have to overcome salary barriers, such as agency segregation, position segregation, and invisible barriers known as the glass ceiling and the glass wall. Recent studies have indicated that human capital variables, people skills, discrimination, and policies all contribute to gender pay disparity in America's workforce. However, there are limited studies that focus on the indirect factors that also contribute to gender pay inequality. The purpose of this quantitative research was to investigate the relationship between wages and job responsibility (as defined by …

Lived Experiences Of Women From The Odi Community In Nigeria Of Female Genital Mutilation, Doris Atibinye Dotimi

Walden Dissertations and Doctoral Studies

Female genital mutilation (FGM) is a public health challenge because it jeopardizes the health of women and girls. FGM is condemned worldwide but, it is still practiced in the Odi community of Nigeria. The literature on women's lived experiences of FGM in other parts of the world was reviewed, but knowledge is lacking on the lived experiences of women from Odi community in Nigeria. The purpose of this phenomenological study was to explore their lived experiences, their perspectives on the current legislation for the prevention of FGM, and their perspectives on the cultural myths surrounding the practice. The phenomenological lens …

The Role Of Illness Intrusiveness And Personal Control In Mediating The Relationship Between The Intravenous Immunoglobulin Treatment Experience And Quality Of Life In Neurological Autoimmune Patients, Pamela Jane Gennari

Walden Dissertations and Doctoral Studies

Intravenous immunoglobulin (IVIG) is a common treatment for the neurological autoimmune diseases multiple sclerosis, multifocal motor neuropathy, myasthenia gravis, and chronic inflammatory demyelinating polyneuropathy. However, there is scant literature regarding the psychological effects of this treatment on quality of life (QOL). Using illness intrusiveness theory and personal control theory, this correlational, cross-sectional study examined the relationship between the IVIG treatment experience and QOL in neurological autoimmune patients. Surveys were employed to collect data from 79 patients at a neurological infusion center in Phoenix, AZ. Quantitative analyses included correlation, multiple regression, and mediation analyses to determine whether (a) IVIG treatment experience …

Strategies To Improve Patient Satisfaction And Organizational Performance In Health Care, Leanne Fay Heppell

Walden Dissertations and Doctoral Studies

Walden University

College of Management and Technology

This is to certify that the doctoral study by

Leanne Heppell

has been found to be complete and satisfactory in all respects,

and that any and all revisions required by

the review committee have been made.

Review Committee

Dr. Carol-Anne Faint, Committee Chairperson, Doctor of Business Administration Faculty

Dr. Rocky Dwyer, Committee Member, Doctor of Business Administration Faculty

Dr. Kenneth Gossett, University Reviewer, Doctor of Business Administration Faculty

Chief Academic Officer

Eric Riedel, Ph.D.

Walden University

2016

Perceptions And Behaviors Of Caribbean And South American Women Of Color Living In The United States Towards Breast Cancer, Bernadette Serena Loncke

Walden Dissertations and Doctoral Studies

Breast cancer is a global public health issue, and even though the incidence and mortality rates for this disease have declined, a substantial gap in mortality rates between U.S. women of color and European American women remains. Strategies have been initiated to decrease this gap, but they have not addressed the special needs of women of color residing in the United States, who tend to be diagnosed only after they have developed late-stage breast cancer. The purpose of this phenomenological study was to understand the perceptions and behaviors of 20 first-generation Caribbean and South American-born women of color living in …

Caregivers' Perceptions Of An Early Diagnosis Of Alzheimer's Disease In African Americans, Stanita Jackson

Walden Dissertations and Doctoral Studies

Alzheimer's disease (AD) is significantly more prevalent among African Americans than within the general population, but rates of early detection are lower in the African American community. Researchers have demonstrated that both pessimistic Alzheimer's-directed health beliefs, and negative perceptions of the effectiveness and the accessibility of medical care act as barriers to care seeking by African American family members of individuals with the disease. Recent research into causal judgments made by potential caregivers about individuals with undiagnosed AD suggests that gender bias and errors in attribution may constitute covert barriers to both lay and professional interpretations regarding the need for …

Development Of A Teach-Back Educational Module For Heart Failure Discharge Teaching, Marissa Blair Jamarik

Walden Dissertations and Doctoral Studies

Heart failure (HF) readmissions create a financial burden for healthcare nationwide and speak to the lack of effective discharge preparation for patients to be successful with self-care at home. The 183-bed hospital where this DNP quality initiative will take place currently reports an observed-over-expected (O/E) readmission rate for HF patients (Centers for Medicare and Medicaid [CMS]). Core measures on HF developed by the Joint Commission and the Centers for Medicare and Medicaid Services do not appear to be enough to ensure successful transitions of care from hospital to home. Guided by the LOGIC model, the purpose of this quality improvement …

Executive Compensation, Firm Performance, And Net Community Benefits Within Nonprofit Urban Hospitals, Terry Deshawn Long

Walden Dissertations and Doctoral Studies

Nonprofit hospitals are under increased pressure to maintain financial stability and compliance with Internal Revenue Service (IRS) net community benefit requirements. Boards of directors are not always confident that the compensation packages awarded to executives stimulate them to act in the organization's best interest. The principal-agent theory formed the basis of this correlational study. Archival data from National Center for Charitable Statistics, Guidestar, and the Center for Medicare & Medicaid Services were collected from 117 nonprofit urban hospitals for the fiscal year 2013. Regression analysis was used to determine the significance of relationships between return on assets (ROA), change in …

The Relationship Between Suicide Ideation And Adult Support Among African American Adolescent Lesbians, Latonya Jill Watters

Walden Dissertations and Doctoral Studies

The suicide rate among African-American youths has significantly increased in recent years. Studies have indicated that racism, sexism, and homophobia put African-American adolescent lesbians (AAALs) at high risk for suicide. Earlier studies recognized the importance of adult support for adults, but the relationship between the AAAL suicide rate and the level of adult support has never been formally studied. Based on social support theory, this survey study examined the relationship between adult social support and attitudes toward homosexuality (as the independent variables) and suicidality and hopelessness (as the dependent variables) in a convenience sample of 200 self-identified 13-to-19-year-old AAALs. Data …

Nigerian Women's Empowerment Status And Its Influence On Access To Reproductive Health Services, Temi Aregbesola

Walden Dissertations and Doctoral Studies

Nigeria is a patriarchal society, which puts women in subordinate positions that may prompt gender-based discrimination. While evidence of this phenomenon has been investigated in Nigeria and other African countries, no such investigation has been conducted with immigrant and first-generation Nigerian women in the United States. The purpose of this study was to examine the role of a Nigerian woman's perceived empowerment and status on her willingness to access reproductive health services. The research questions examined views of Nigerian traditional beliefs' influence on status and how attitudes around traditional beliefs relate to access to reproductive health services and/or knowledge. Data …

Effect Of Class Size On Student Achievement In Secondary School, Christopher Eric Uhrain

Walden Dissertations and Doctoral Studies

The school board of a school district in South Carolina has proposed to increase class size in all schools due to mandatory budgetary reductions. However, at the secondary school level, the literature on the effect of larger class size on student achievement is conflicting. The theoretical framework by Lazear suggested that the minimization of negative externalities (i.e., problematic behavioral and academic characteristics of students) achieved through the mechanism of smaller class size impacts student learning. Reducing the number of students in a classroom alters the entire classroom environment, creating a more positive learning environment in which students are able to …

The Effect Of Personal Beliefs And Perceptions On Influenza Vaccination Uptake Among Older Adults, Rani Sujatha Athota

Walden Dissertations and Doctoral Studies

Despite a 90% fatality rate and high risk of complications from influenza infection, vaccination coverage remains lower among African American (AA) and Hispanic American (HA) older adults. Health care professionals, families, and older adults are concerned with improving vaccination uptake. The purpose of this study was to examine differences among older adult AA and HA compared to European Americans (EA) on how their personal beliefs and perceptions affect vaccination uptake. The health belief model guided this study. The study research design was a quantitative cross-sectional analysis of the 2009 National H1N1 Flu Survey. Weighed prevalence of vaccine uptake indicated all …

Nurses' Knowledge Of Pain Assessments And Reassessments Impacts Hospitalized Patients' Reporting Of Pain, M. Michele Potter Williams Williams

Walden Dissertations and Doctoral Studies

Ineffective pain management can prolong a patient's length of stay and increase cost of care. Inadequate pain control decreases the patient's quality of life and contributes to poor health outcomes. A recent record audit showed that documentation of pain reassessments occurred only 20% of the time within an hour after administering pain medication. Furthermore, nurses may have insufficient knowledge regarding pain assessments and reassessments or hold irrational fears about addiction leading to inadequate treatment of pain. The purpose of this quality improvement project was to evaluate the effectiveness of an educational program for acute care nurses for the assessment and …

Predictors Of Influenza Vaccination Compliance Among Union And Nonunion Workers In A Pennsylvania Health Care System, Ericka Lynne Kalp

Walden Dissertations and Doctoral Studies

To improve U.S. residents' health, advocates are focusing their efforts on workplace health. Researchers have found that unionization is a positive influence on workers' participation in health promotion programs relating to smoking and obesity prevention. However, the effect of union membership on other health promotion initiatives, such as influenza vaccination compliance among health care workers, has not been examined. The purpose of this quantitative study was to address this knowledge gap between a union and a nonunion health care facility in the U.S. state of Pennsylvania. The health belief model was used to determine if different domains of influenza vaccination …

Parents Perception Of Safety In Pennsylvania And Children's Activity And Weight, Linda C. Carr

Walden Dissertations and Doctoral Studies

Physical activity is associated with many health benefits to include weight management, lower risk for chronic diseases, and improved mental health and self esteem. The built environment has been linked to lower physical activity levels and overweight and obesity in children living in low income communities but the exact causes need further investigation. The purpose of this quantitative, cross sectional study was to examine the association between parents' perception of safety and body mass index (BMI) percentile and children's physical activity/ inactivity levels and children's BMI as measured by the National Survey of Children's Health (2011/12 NSCH). The sample consisted …

Predictors Of Stress Among Caribbean Community College Students, Jean Merle Da Silva

Walden Dissertations and Doctoral Studies

Research on North American and European students have reported moderate to severe levels of stress in more than 90% of students, which has been linked to negative health outcomes. However, there is a paucity of data on the stress of Caribbean students. Higher education in the Caribbean has undergone a transformation with wider access and higher enrollment; thus, it is important that the effects and characteristics of this transformation are researched and documented. Accordingly, the purpose of this quantitative study was to examine the experience of students in 2 year community colleges in the Caribbean. Using the theoretical foundation of …

Moving Evidence Into Practice: Early Sepsis Identification And Timely Intervention In The Emergency Department (Project Code Sepsis), Jonjon Macalintal

Walden Dissertations and Doctoral Studies

Sepsis is the leading cause of death among hospitalized patients in the United States, is responsible for more than 200,000 deaths annually, and has as high as a 50% mortality rate. Sepsis requires prompt identification so that early goal-directed therapy can be instituted to lead to better outcomes. The purpose of this quality improvement project was to determine if implementing an evidence-based identification and intervention program, Project Code Sepsis, in the emergency department can increase the number of patients who receive antibiotics within the first hour of triage and decrease the length of hospital stay. Specifically, the primary project goals …

A Phenomenological Study Of The Experience Of Humanist, Spiritual, And Transpersonal Films On Positive Organizational Behaviors In The Workplace, Frederick Henry Keeve

Walden Dissertations and Doctoral Studies

A solution is needed to counteract violent news, Internet, and other negative media images and management behaviors in the workplace, in order to boost engagement and prosocial behaviors at work. The purpose of this phenomenological study was to explore the attitudes of working professionals toward prosocial behaviors and employee engagement in the workplace as affected by transpersonal Hollywood films. An organization's ability to survive is directly related to empowerment and innovation. Classic films provide a gateway for transpersonal experiences that could change behavior and thoughts. Peterson and Seligman's transformational typology involving 6 character virtues and 24 strengths was the basis …

Implementation Of International Financial Reporting Standards By Listed Companies In Nigeria, Emmanuel Inalegwu Ogbenjuwa

Walden Dissertations and Doctoral Studies

This study is on implementation of International Financial Reporting Standards (IFRS) by reporting entities in Nigeria. Since Nigeria adopted IFRS in 2010, managers of reporting entities have been confronted with organizational changes both in the structures and processes of financial reporting. Previous studies have not assessed the claims that adopting IFRS improves the quality of financial reports and managerial efficiency. This study evaluated the assertion that IFRS adoption impacts the quality of financial reports, operational costs, and operational efficiencies of management. The theoretical frameworks which undergirded the study were theories of organizational behaviors and attitudinal change. Data were collected via …

Experience With Social Support Systems Among Women Exposed To Intimate Partner Violence In Cameroon, Ahone Esther-Alice Ngujede

Walden Dissertations and Doctoral Studies

The southwest and northwest regions of Cameroon have experienced high rates of intimate partner violence (IPV). Limited information is available about IPV victims' experiences with social support systems. This phenomenological study was aimed at investigating IPV victims' lived experiences with social support systems in Cameroon. Some of these systems are the judicial system, police officers, hospitals and clinics, and domestic violence agencies. The Health Belief Model (HBM) and the Transtheoretical Model of Change (TTM) were used to understand how 8 self-identified victims of IPV were able to discuss their lived experiences with social support systems. The research questions addressed women's …

The Utility Of Health Care Performance Indicators In Evaluating Low Back Surgery, Pradeep K. Narotam

Walden Dissertations and Doctoral Studies

Low back syndrome affects 20% of people, and it is estimated that 30% of patients are unable to return to work after surgery. The monitoring of health care outcomes could improve the delivery of health services. The health performance conceptual framework, derived from the Donabedian model, was used to evaluate the functional outcome, clinical recovery, response to surgery, and physician performance of the surgical management of lumbar spine degeneration. A quantitative study (n=685) was undertaken using an administrative database in a repeated-measures design. The clinical and functional outcome improvements were analyzed using t tests. Surgical complexity on health outcome was …

Diabetes Self-Management Education For Adults With Type 2 Diabetes Mellitus, Rondalyn Dennis-Bradshaw

Walden Dissertations and Doctoral Studies

Diabetes, a major public health challenge in St. Kitts, has been a focus of international public health community research. Although researchers have demonstrated that diabetes self-management education is a cost-effective strategy for the prevention of diabetes-related complications, they have yet to establish whether there is adequate education occurring in treatment settings with diabetic patients. The purpose of the study was to implement and evaluate the short-term effectiveness of a diabetes self-management education intervention on diabetes-related knowledge and accepted behavioral changes to decrease risk for complications. Based on a self-care approach, this education intervention was designed to improve diabetes-related knowledge and …

We Left Lassie Behind: Defense Personnel Relocation, Animal Abandonment, And Shelter Impacts, Gabriele Griffiths

Walden Dissertations and Doctoral Studies

When Department of Defense (DoD) personnel receive orders to relocate to a new duty installation, nearly one third abandon their companion animals, which negatively affects the local shelters' costs, personnel, and capabilities to provide quality care for shelter animals. There is a lack of research on relevant policies among local government policy makers, installation commanders, directors of animal shelters, and animal rights advocates about the abandonment of companion animals by DoD personnel. The purpose of this qualitative descriptive case study was to investigate the relationship between the influx of abandoned DoD companion animals and the management and logistical (including financial) …

The Behavioral Impact Of Knowledge On Breast Cancer Risk Reduction, Mia Hung

Walden Dissertations and Doctoral Studies

The purpose of this study was to investigate the behavioral impact of knowledge regarding the relationship between breast cancer, vitamin D supplementation, and sunlight exposure considering levels of self-efficacy and response-efficacy. The study was based on protection motivation theory, which attributes behavior change to cognitive processes related to perceived threats and has demonstrated efficacy in promoting breast cancer risk-reducing behaviors. The study employed a quasi-experimental research design based on a survey using SurveyMonkey. Participants were New York City-residing women ranging in age from 25 to 74 who were recruited via an invitation from SurveyMonkey. Correlation analysis and linear regression analysis …

Teachers' Perspectives On Implementing Social-Emotional Learning Standards, Sheila Youngblood

Walden Dissertations and Doctoral Studies

The problem this study addresses is the extent to which social-emotional learning programming is effectively implemented. Since social-emotional learning programming has emerged as a significant aspect of U.S. education, man states have included social-emotional standards and programming as an essential part of the curriculum. Researchers have found that effective reform includes not only emphasis on academic and standardized test scores, but also on social-emotional influences. As a school reform initiative, a Social Emotional Learning (SEL) program is being implemented at a Midwestern high school. The purpose of this qualitative descriptive interview study was to explore the perceived effectiveness of the …

Leaders' Risk Propensity And Delegation Of Critical Decision-Making Authority, Reginald Carlton Doctor

Walden Dissertations and Doctoral Studies

A leader's unwillingness to delegate critical decision-making authority to subordinate managers and employees negatively impacts the performance of a firm. There is a lack of research that measures a leader's willingness to delegate critical decision-making authority to subordinate managers and employees based on their individual risk propensities. The purpose of this study was to provide empirical evidence of the influence risk propensity has on a leader's willingness to delegate critical decision-making authority. Specifically, this study examined the extent that risk propensity of leaders affect delegating critical decision making authority to subordinate managers and employees. The research design was a quantitative …

Organizational Change: Evaluating The Effect Of Motivational Interviewing On Readiness To Change, Conrado Joaquin Grimolizzi-Jensen

Walden Dissertations and Doctoral Studies

Failure accompanies most organizational change efforts. Change agents' efforts focus on employee resistance or readiness to change without considering employee ambivalence. Motivational interviewing (MI) may reduce ambivalence and improve the success rate of organizational change initiatives. The purpose of this experimental research was to evaluate the effectiveness of MI to increase readiness to organizational change, to assess the influence of MI on change-related beliefs, and to investigate the relationship between beliefs and readiness to change. The theoretical framework was the transtheoretical model of change, the theory of planned behavior, and social cognitive theory. Through random assignment, 56 employees of a …

The Perceptions Of Managers Relating To Subordinate Productivity In Virtual Work Arrangements, Frank Melvin

Walden Dissertations and Doctoral Studies

Some managers tend to resist virtual work and find it challenging to manage the productivity of subordinates working virtually. This phenomenological study examined managers' perceptions of subordinate productivity in virtual work arrangements. Adaptive structuration theory and McGregor's X and Y theory guided this study. The primary research questions focused on the managers' perceptions of worker productivity in virtual work arrangements and the related challenges. Data collection included semistructured interviews with 40 business managers responsible for overseeing the productivity of virtual workers. The study was conducted in the Atlanta, Georgia metropolitan area. Utilizing the Stevick'Colaizzi'Keen method of data analysis, 3 primary …

The Association Between Rheumatoid Arthritis And Type 2 Diabetes Mellitus, Magaly Perez Nieves

Walden Dissertations and Doctoral Studies

A research report from the Centers for Disease Control and Prevention (CDC) indicated that more than 50% of people with diabetes mellitus (DM) in the United States (U.S.) also have arthritis. The diabetes population is disproportionately affected by arthritis, but there has been limited and inconsistent research to confirm the association between type 2 diabetes mellitus (T2DM) and rheumatoid arthritis (RA). The current study aimed to identify an association between T2DM and RA for noninstitutionalized U.S. adults between 1999 and 2012 using a nationally representative sample from the National Health and Nutrition Examination Survey (NHANES) database (n =31,488 ). A …