Digital Commons Network^™

Culturally Competent Nutrition Counseling And Health Outcomes Of Patients On Emergency Dialysis, Edlyn Geraldine Bustamante

Walden Dissertations and Doctoral Studies

Undocumented end stage renal disease (ESRD) patients in the United States only have access to emergency dialysis. To compensate for the lack of regular dialysis these patients must follow strict renal dietary restrictions. However, nutrition counseling by a dietitian is not part of the renal management of patients on emergency dialysis. The purpose of this quantitative quasi-experimental treatment-control study was to assess how the application of nutritional counseling that is both culturally and linguistically competent affects dialysis frequency and biochemical lab values such as serum potassium, phosphorus, and vitamin D of patients in emergency dialysis. The study was grounded on …

Development Of An Evidence-Based Protocol For The Management Of Acute Vertebral Fragility Fractures, Shannon De Ann Carey

Walden Dissertations and Doctoral Studies

Vertebral fragility fractures are common, affecting approximately 50% of all postmenopausal women and 33% of men over the age of 50, and are the most common type of fracture seen in osteoporosis. The management of vertebral fragility fractures in the acute care setting is lacking in standardization, in the use of evidence-based practice, and in addressing the underlying cause of osteoporosis. The purpose of this project was to develop an evidence-based protocol to standardize the care of the vertebral fragility fracture in the acute care setting. This protocol included patient education, fall risk assessment, screening for osteoporosis, and follow up …

Impacts Of Observing Live Open Heart Surgery On Young Adults' Health Behaviors, Muhammad Musa Qarizadah

Walden Dissertations and Doctoral Studies

Having a heart healthy lifestyle at a younger age is beneficial in reducing the risk of coronary heart disease (CHD) in adulthood and various health education programs for CHD prevention exist to persuade young adults to adopt a heart healthy lifestyle. Little is known, however, about the influence of watching live open heart surgery on young adults' adoption of a heart healthy lifestyle. To address that gap in knowledge, this study was conducted at a health facility in Virginia where students came to observe live open heart surgery. The purpose of the study was to understand whether watching live open …

Effect Of Multiple Skin-To-Skin Experiences On Exclusive Breastfeeding Rates, Joanna Horst Horst

Walden Dissertations and Doctoral Studies

Breastmilk feeding at birth demonstrates short- and long-term medical and neurodevelopmental advantages. Infants who are exclusively breastfed demonstrate less nausea, vomiting, and diarrhea, and they experience less upper respiratory and ear infections than do infants who are not breastfed. One strategy that supports breastfeeding initiation is providing skin-to-skin contact (STS) with mothers and newborns immediately upon birth. The purpose of this project was to evaluate the impact of a second session of STS on the postpartum unit on exclusive breastfeeding rates at discharge. A retrospective comparison design using Swanson's caring model was used to guide the evaluation study that examined …

Length Of Stay And Reimbursement Rates For Medicare Patients, Wandella Ezell

Walden Dissertations and Doctoral Studies

Medicare reimbursement rates across the United States have varied by as much as 49-130% across healthcare facilities. Geographic adjustments and severity of medical diagnoses attribute to some dissimilarity; however, the source of longer hospitalization and higher re-admission rates among Medicare patients requires financial consistency. The research encompassed (N = 3000) patients with hypertension as the focus for the study because this is a critical group of Medicare patients with a chronic disease that has been identified as a silent killer. The principal goal that drove this research study was to explain the variations in length of stay for Medicare patients …

Early Strategies Of Kindergarten Teachers And Administrators To Lessen The Literacy Gap, Kirstin A. Rossi

Walden Dissertations and Doctoral Studies

Proficiency in literacy is paramount during a child's education. Lacking proficiency can have lasting effects. At both the state and local level, continuing gaps in student achievement in literacy have been documented. The purpose of this qualitative case study was to focus on kindergarten teachers and administrators' early literacy strategies, specifically current practices in early literacy skills and possible resources needed in early literacy to lessen the gap between White students and ethnic minority and students who qualify for free/reduced meals. The constructivist framework was the platform used to investigate teacher and administrator understanding of the 6 early literacy skills, …

Impact Of Staff Education On Geriatric Polypharmacy, Valerie Ikemefuna

Walden Dissertations and Doctoral Studies

Polypharmacy, the simultaneous use of multiple drugs to treat a single ailment or condition, is a

major health problem among the elderly population that contributes to adverse drug side events,

health risks, hospital readmissions, morbidity, and mortality. Therefore, a staff education

program geared toward reduction of such adverse drug events was implemented at a single site.

The purpose of the project was to determine if the staff education program would increase

knowledge of adverse drug events due to geriatric polypharmacy. The Orem theory provided the

theoretical support for the project, and the Iowa model guided the evidence-based practice

change process. …

Barriers And Perceptions Of Black American Men About Prostate Cancer In Georgia, Martins M. Nnoko

Walden Dissertations and Doctoral Studies

In 2016, prostate cancer was the second leading cause of fatality in the United States. However, the population in this study 'Black American men, ages 40 and older, in selected counties in Fulton, DeKalb, Gwinnett, Clayton and Atlanta metropolitan areas' tended to underutilize prostate cancer care. The purpose of this quantitative, nonexperimental descriptive study was to determine whether socio-economic barriers and perceptions of Black American men about prostate cancer reduce their ability to access quality care in this county in Georgia. The Health Belief Model (HBM) was used to inform the predictive validity of perceptions, attitudes, and belief on individual …

Walkability Assessment To Reduce Childhood Obesity In Wilson County Kansas, Nancy Lee Carpenter

Walden Dissertations and Doctoral Studies

Promoting physical exercise is necessary to combat childhood obesity. Walking to school is an encouraged physical activity, but the feasibility of walking to school depends on the walkability of the environment. During the last 40 years, the number of U.S. schoolchildren who walk to school has declined. The purpose of this evidence-based practice project was to perform a walkability assessment of the 2 largest communities in Wilson County Kansas to identify and address walkability issues. Frameworks for this practice initiative were social cognitive theory and the Health Promotion model. Questions for the project addressed whether sidewalks along the main pedestrian …

Using An Apn-Led Transitional Care Program To Reduce 30-Day Hospital Readmissions, Miaozhen Li

Walden Dissertations and Doctoral Studies

Heart failure (HF) is a serious public health problem associated with high mortality rates, hospital readmissions, and health care costs. Transitional care has emerged as a disease management model used to reduce readmissions for hospital-discharged patients with HF. However, the efficacy of an advanced practice nurse (APN)-led transitional care program (TCP) in readmission reduction is under debate. The practice question for this project examined the extent to which an APN-led TCP was effective in reducing 30-day all-cause readmissions for hospital-discharged HF patients. The logic model was the framework guiding this program evaluation. An analysis of quality improvement HF data from …

Examining Poverty, Entrepreneurship, And Multinational Corporation Participation In South Africa, Stephanie Furlough-Morris

Walden Dissertations and Doctoral Studies

Economic development is seen as the best means of accomplishing the goal of eradicating extreme poverty, and at the heart of this development are for-profit companies, especially multinational corporations. The specific problem examined in this study was whether levels of poverty in South Africa had been significantly impacted by the activities of multinational corporations and the level of entrepreneurship in its 9 provinces. To build upon empirical research on the sources of poverty alleviation and the impact of large global enterprises, the purpose of this study was to examine the impact of entrepreneurship and multinational corporation presence on the change …

Impact Of Adverse Childhood Experiences On Maternal Health And Birth Weight In Appalachia, Kristen Baker Dickerson

Walden Dissertations and Doctoral Studies

Adverse birth outcomes and adverse childhood experiences (ACE) are concerns in the United States, with potential to impact health indices now and in the future. The purpose of this study was to quantitatively examine the association between maternal exposure to ACE, low birth weight, and county of residence in the Appalachian population using the Life Course Approach as the theoretical framework. A cross-sectional study design and clustering strategy was used to randomly select potential respondents from a data set that was provided by Ohio Department of Health. Self-administered questionnaires were sent to potential respondents to collect information about ACE in …

Home Care Factors Associated With Hospital Readmission Of Psychiatric Patients, Ashley Renee Payne

Walden Dissertations and Doctoral Studies

There has been inadequate attention to the aftercare of psychiatric patients, resulting in an increase in readmission rates plus longer hospital stays. There is a gap in the aftercare for psychiatric patients; The purpose of this qualitative retrospective study is to explore what may have contributed to readmission for psychiatric patients. The biopsychosocial model was used as the theoretical framework to support the direction of the research. The health belief model and transtheoretical model of change were used to further support for biopsychosocial model. The research questions were created to determine the influences on readmission, psychological well-being, explore the adaptation …

Barriers To Preventive Healthcare For Immigrants In Michigan, Sondos Ghazi Al-Hachim

Walden Dissertations and Doctoral Studies

The Affordable Care Act expanded insurance coverage to the general population; however, expanding insurance coverage to immigrants might not be sufficient to improve utilization of annual physical preventive exams. This study evaluated adult Michigan immigrants' individual demographics, perceptions, and behaviors, as well as the collective cultural and system characteristics that might act as barriers to the utilization of annual physical preventive exams. Ken Wilber's integral operating system model for medicine conceptual framework was used to create a comprehensive map of factors and bring more clarity and understanding to the barriers to annual physical preventive exam. The quantitative survey was the …

Sucrose Use In Children: A Systematic Review, Dorothy Luongo

Walden Dissertations and Doctoral Studies

Sucrose is a method of pain relief that can be used for children during minor painful procedures. Pain left unrelieved has been found to lead to long-term consequences such as distress, anxiety, needle fear, parental non-adherence with vaccination administration, and avoidance of medical care. Therefore, it is important to ensure pain management methods are provided to infant and toddlers. The purpose of this project was to present a systematic review on the use of sucrose in child in primary care. The comfort theory by Kolcaba served as the theoretical framework in exploring the use of sucrose in children in primary …

Urban Dwellers Experiences Regarding Loss Of Natural Environments Due To Rapid Urbanization, Erica Montanye

Walden Dissertations and Doctoral Studies

Little is known about how residents of rapidly growing cities are impacted by the loss of natural environments. Large cities are expanding at an exponential rate, reducing the presence of, and access to, natural environments for urban dwellers. Many benefits to human health regarding the presence of natural environments near where people live and work are known, but impacts of the loss of natural environments for urban dwellers are unknown. The purpose of this qualitative investigation was to understand residents' experiences regarding the loss of natural environments and related impacts. Attention restoration theory and place attachment were the theoretical lenses …

Determinants Of Switching From Peritoneal To Hemodialysis In Preserving Residual Renal Function, Mohamed Katerji

Walden Dissertations and Doctoral Studies

There are more than 2 million end stage renal disease (ESRD) patients in the world. ESRD is becoming more manageable with the advent of competent therapies such as peritoneal dialysis (PD) and hemodialysis (HD). While recent evidence suggests that switching from PD to HD may preserve residual renal function longer than either PD or HD alone as an alternative approach, little is known about the optimal timing and the long-term efficacy of switching dialysis modes. The purpose of this quantitative retrospective study, based on the bio-psychosocial model, was to investigate the optimal timing and determinants of the effectiveness of switching …

Hiv Testing Practices And Provider-Identified Barriers In The Acute Care Setting, Alex Ariri

Walden Dissertations and Doctoral Studies

Despite the Centers for Disease Control and Prevention recommendations to test patients ages 13 to 64 years for HIV at health care settings, routine HIV testing is lacking. As a result, many people are unaware of their HIV seropositive status. The purpose of this quantitative cross-sectional study was to examine relationships between HIV testing and provider type, knowledge, attitudes, and behaviors regarding HIV testing in the acute care setting. The study was informed by social cognitive theory. Using a convenient sampling method, a questionnaire derived from previous surveys (Society of General Internal Medicine and University of Washington) was sent to …

Educational Advocacy And The Foster Child, Jennifer Loetzerich

Walden Dissertations and Doctoral Studies

In Georgia, there are high rates of instability in foster care, and each time a child changes placement, his or her support networks are gone until he or she can rebuild them. The purpose of this case study was to explore if current stakeholders provide effective support and assistance to professionals and others who assist foster students with their educational needs. This case study used a conceptual framework based on Rankism, in which students move up and down the rungs of the ladder of their social system. Data were collected via interviews with a Court Appointed Special Advocate (CASA) worker, …

Assessment Of Postoperative And Postdischarge Wound Infection After Abdominal Hysterectomy, Jinni J. Amin

Walden Dissertations and Doctoral Studies

Surgical site infection (SSI) is the most common healthcare-associated infection. Approximately 2% to 14% of surgical patients are diagnosed with SSI, which may extend length of stay in the hospital or lead to readmission and may necessitate another surgical procedure. Patient readmission due to SSI costs health care industries about $3,000 to $29,000 per case and a total of $10 billion per year. The purpose of this quantitative cross-sectional retrospective study was to examine the association between SSI and teaching status, hospital ownership, and number of beds in the hospital. The epidemiological triad was used as a framework to describe …

Examining The Barriers To The Continuing Education Of Early Childhood Teacher Assistants, Colleen Louise Wright

Walden Dissertations and Doctoral Studies

The Improving Head Start for School Readiness Act of 2007 required teacher assistants (TAs) to obtain their child development associate (CDA) credential by September of 2015. TAs who had not obtained their CDA within the required timeframe were either demoted or terminated from their positions. However, with the increase of working parents, the need for quality early childhood education has risen. In this project study, the barriers TAs confront in regards to their decision to continue their schooling to obtain a CDA credential were examined, as were the factors that deterred or prevented them from enrolling in or completing a …

Barriers Cardiac Nurses Face In Addressing Psychosocial Issues Of Heart Failure Patients, Debra Kay Disbrow

Walden Dissertations and Doctoral Studies

Heart failure is a chronic disease and a common cause of hospitalizations and readmissions within 30-days of discharge. To decrease the cost of care for patients with heart failure, the Centers for Medicare and Medicaid Services initiated the Readmissions Reduction Program that reduces payment to hospitals with preventable readmissions. Among the causes for readmissions of patients with heart failure are concurrent behavioral health issues that can lead to decreased medication compliance and increased risk for disease progression. The prevalence of comorbid depression is as high as 77% among patients with heart failure and may be an important factor in readmissions. …

Understanding The Importance Of Culturally Appropriate Patient-Provider Communication In Diabetes Self-Management, Anita Mwalui

Walden Dissertations and Doctoral Studies

According to the Centers for Disease Control and Prevention, 29.1 million people in the United States have diabetes. Among those 29.1 million people, 21 million have been diagnosed, but 8.1 million have not. Changing demographics in the United States and the prevalence of diabetes are projected to be burdens on the health care system through 2050. Guided by the social cognitive theory, the purpose of this qualitative case study was to understand the importance of culturally appropriate patient-provider communication to the self-management of Type 2 diabetes by patients who are African immigrants. Culturally based health care has unique challenges when …

Contributing Factors Of Obesity Among Over-The-Road Truckers, Shari Weiss

Walden Dissertations and Doctoral Studies

Obesity among over-the-road truckers (OTRs) is an epidemic creating significant public health issues among this population. The consequences of obesity (hypertension, diabetes, heart disease) put both truckers' health and their medical clearance at significant risk. The purpose of this study was to examine the impact of gender, physical activity, diet, and sleep on obesity among OTRs. Through a socioecological lens, this study examined whether obesity is significantly impacted by gender, physical activity, nutrition, and sleep. This study also examined the impact of the trucking environment on obesity. The study used a quantitative research design and data were collected through a …

The Predictive Relationship Between Naturopathic Basic Science Curriculum And Nplex I Performance, Tammy Marie Aragon

Walden Dissertations and Doctoral Studies

Naturopathic medical schools are concerned with low first-time pass rates on the Naturopathic Physicians Licensing Exam Part I (NPLEX I) that may impact schools' accreditation with the Council on Naturopathic Medical Education (CNME). At a North American school of naturopathic medicine first-time pass rates have been a concern for 3 of the last 5 years. The purpose of this quantitative study was to determine whether students' naturopathic basic science content area scores predict NPLEX I scores at this this school. Grounded in general systems theory, a predictive correlational research design utilizing multiple logistic regression analyses was used. Archival data were …

Development And Evaluation Of An Evidence-Based Educational Process To Reduce Post-Transplant Infections, Erica Vanessa Henderson

Walden Dissertations and Doctoral Studies

The targeted transplant center's abdominal organ transplant unit had difficulty providing

adequate education to patients prior to discharge, which had resulted in a 24% readmission rate within 30 days due to infections. Patients and caregivers were unavailable to receive education despite multiple attempts, which made it challenging for health care providers to complete this aspect of their job, resulting in a negative impact on patients' long-term outcomes. A more structured educational environment was needed to provide appropriate and effective patient and caregiver education to increase adherence and positive outcomes. The health promotion model served as a foundation for the development …

Science Content Knowledge: A Component Of Teacher Effectiveness In A Primary School In Jamaica, Euphemia Sophia Robinson

Walden Dissertations and Doctoral Studies

Empirical evidence from the National Education Inspectorate suggested that teachers at the primary school in this study in an island country in the Caribbean have inadequate science content knowledge. Students' average performance on the science Grade Six Achievement Test (GSAT) has been below 40% for the last 5 years. The purpose of this bounded case study, guided by Shulman's conceptual framework, was to understand teachers' science subject matter knowledge (SMK). The guiding questions focused on teachers' abilities to demonstrate components of Shulman's SMK during science teaching and lesson planning and to gather their views on their abilities to meet the …

Knowledge Of Malaria Infection And Treatment-Seeking Behavior Among Tanzanian Pregnant Women, Emebet T. Derjew

Walden Dissertations and Doctoral Studies

Despite the availability of effective drugs to prevent malaria during pregnancy using intermittent preventive treatment with Sulfadoxine-Pyrimethamine or Fansidar and insecticide bed net, use of these methods are still little used in Sub-Saharan Africa, including Tanzania. As a result, many pregnant women are at risk of malaria consequences such as maternal anemia and low birth weight babies, which increase the rate of infant mortality. Data from the Demographic Health Survey for Tanzania HIV/AIDs and the Malaria Indicator Survey 2011-2012 were used in a cross-sectional design guided by the health belief model. Logistic regression examined the association between (a) preventive treatment-seeking …

A Developmental Project Focusing On Young Adult Hispanic-Americans, Tarsicio Gacheru

Walden Dissertations and Doctoral Studies

Reducing diabetes risk among Hispanic-American adults in the United States is a critical public health need and programs targeting young Hispanic-American adults with prediabetes can reduce the risk for developing diabetes. The purpose of this project was twofold: (a) to examine the literature related to diabetes prevention best practices among young adult Hispanic-Americans with prediabetes and (b) create an intervention program to promote these best practices to delay or reverse the trajectory toward diabetes. The inclusion criteria for the literature review were studies with at least a 12-month follow-up and reported outcomes related to changes in diet, increased exercise, and …

Emotional-Social Intelligence: Development During Online And On-Campus Holistic Healthcare Programs, Bradley J. Boute

Walden Dissertations and Doctoral Studies

As with traditional healthcare providers, emotional-social intelligence (ESI) plays a role in the holistic practitioner-client relationship. It is important to determine if students in holistic healthcare programs increase their ESI, and subsequently better serve their clients. The purpose of this quantitative, quasi-experimental study was to determine if online education can develop students' ESI at levels similar to that of traditional programs. This study is based on the theory of ESI and transformative learning theory. The sample consisted of 95 students in an online program and 61 in a traditional program. Multiple linear regression, ANCOVA, and Pearson Correlation's were used to …