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Association Between Covid-19 Health Knowledge, Self-Efficacy And Preventive Behaviors Among Nursing Students, Josephine Miane Britanico

Walden Dissertations and Doctoral Studies

Abstract Nursing students possess valuable public health knowledge to prevent the spread of COVID-19 infection. They can provide health education to the public with reliable information and adequate resources. To better understand the role nursing students can take in prevention efforts, the purpose of this quantitative correlational study was to examine the association between COVID-19 health knowledge, self-efficacy, and preventive behavior among undergraduate nursing students. The health belief model was the theoretical framework that guided this study. The primary research questions assessed (a) if there was a statistically significant association between COVID-19 health knowledge and preventive behavior among nursing students, …

Gender Dynamics In The Management Care Of Internally Displaced Persons: The Boko Haram Insurgency, Evelyn Kikelomo Ikuenobe Otaigbe

Walden Dissertations and Doctoral Studies

The Boko Haram asymmetric insurgency and warfare have decimated the Northeastern region of Nigeria and its neighboring environs of Chad, Niger, and Benin. The purpose of this study was to explore the peculiar socioethnic and cultural challenges encountered by female victims of Boko Haram terrorism at internally displaced persons camps in Abuja, Nigeria, including challenges in functioning, relocating, and acclimating back into society. A phenomenological approach was applied to understand participants’ lived experiences. Data collection occurred through interviews and observation. Data analysis involved the synthesis of narratives, and generation of themes. Among the emergent themes were poor feeding; lack of …

Comparison Of The Effects Of Telehealth Versus N95 On Nurse-Patient Communication, Tony Christopher Bloomfield

Walden Dissertations and Doctoral Studies

Telehealth and face masks are some of the infection control measures nurses use while attending to patients. Nurses provide the most patient care in hospital settings and thus spend the most time with patients in their recovery journey. Because communication is paramount to the role nurses play as health care professionals, there is a substantial need to investigate how infection control measures affect the quality of nurse-patient communication. The purpose of this quantitative cross-sectional study was to describe the relationship of methods aimed at maintaining social distancing between nurses and patients to nurse-patient communication and to compare differences in the …

Education On Protective Measures For Primary Care Staff During Covid Outbreaks, Lenina Ochioza Ukeju Chi-Ukpai

Walden Dissertations and Doctoral Studies

Since the emergence of COVID-19, healthcare workers have been in continuous risk of infection because of the way the disease is transmitted. Hence, the proper use of personal protective equipment (PPE) is important during the pandemic. The aim of this project was to increase healthcare workers’ and patients’ disease protection and prevention. This staff education project assessed the knowledge of proper PPE practice among healthcare workers who were in close contact with COVID-19 patients and provided lectures and practice in proper donning and doffing of PPE. Guided by the Lewin theory of change, the knowledge of the 9 health care …

Lived Experiences Of Job-Hopping Millennials During The Covid-19 Pandemic, Dottie Dancy

Walden Dissertations and Doctoral Studies

Millennials, also known as “the job-hopping generation,” are on the brink of becoming the largest generation in the workforce by 2025. In March 2020, a global pandemic was declared due to the spread of the virus known as COVID-19, which led to more than 5.3 million deaths globally. Prior research has been conducted concerning the job-hopping tendencies of Millennials, but previous studies have not incorporated the life-changing event of the global pandemic and how it may have changed the beliefs and attitudes of the Millennial generation. The purpose of this qualitative study was to explore the voluntary job-hopping beliefs and …

Gender-Based Hiv Epidemic, Care Retention, And Medication Adherence In South-South Nigeria, Iniobong U. Akai

Walden Dissertations and Doctoral Studies

AbstractWomen 15-24 years of age globally have a 60% higher rate of human immunodeficiency virus (HIV) infection than men and account for over half of the population of people living with HIV worldwide. In Akwa Ibom State (AKS), Nigeria, more women than men are infected and living with HIV despite being the minority. The socioecological model and HIV treatment cascade framework formed the theoretical foundation for the study. The purpose of the study was to explore the impact of gender on the drivers of the HIV epidemic in AKS using data from the AKS AIDS Indicator Survey. I examined the …

Informal Caregivers’ Experiences Of Caring For Older Adults Diagnosed With Urinary Tract Infections, Novelett M. Stennett-James

Walden Dissertations and Doctoral Studies

Informal caregivers’ experiences of caring for older adults diagnosed with a urinary tract infection (UTI) is a prevalent issue that affects adults as they age. The purpose of this generic qualitative study was to understand informal caregivers’ experiences observing and reporting to doctors observable changes of behavior in older adults that were later linked to unconventional symptoms of potential UTIs. Attribution theory was used as the theoretical framework for this study. This qualitative study addressed the research question of informal caregivers’ experiences observing and reporting to doctors observed changes in older adults associated with unconventional UTI symptoms. Data were collected …

Strategies To Mitigate Inappropriate Test Utilization By Physicians To Improve Efficiency In A Healthcare Setting, Christine C. Wood

Walden Dissertations and Doctoral Studies

Inappropriate test utilization by physicians for clinical decision-making in patient care is a significant problem facing some healthcare leaders. Healthcare leaders are concerned about inappropriate test utilization because it can increase healthcare costs and degrade patient outcomes. Grounded in the complex adaptive system and Lean Six Sigma conceptual frameworks, the purpose of this qualitative single-case study was to identify strategies seven hospital leaders in Maryland and Washington, DC. who implemented successful test utilization strategies for physicians. Data were collected from semistructured virtual interviews and organizational reports and analyzed using Yin’s 5 step process. Five themes emerged: (a) continuing physician education, …

Examination Of The Association Between Poverty, Income, And Education Levels On Tuberculosis Prevalence In Nigeria: Rural Niger Delta Case Study, Nwinmene George Zarakpege

Walden Dissertations and Doctoral Studies

Despite the global decline in tuberculosis (TB) cases, the prevalence of TB in rural populations in Nigeria is rising. To date, poverty and low educational levels continue to affect treatment and other prevention strategies to eradicate the disease. The purpose of this cross-sectional study was to assess the association between poverty, educational levels, household structure and vaccination status on TB prevalence in rural Niger Delta, Nigeria. The theoretical framework for this study was the socio-ecological model. Data were obtained from residents of rural Niger Delta in Nigeria attending a teaching hospital in southern Nigeria. The relationship between the stated demographic …

Associations Between Depression, Social Support, And Sexual Risk-Taking Behaviors Among Hiv-Infected Adult Black Women In The Southeastern United States, Joy Ireri Kagendo

Walden Dissertations and Doctoral Studies

African Americans continue to carry the burden of new HIV cases and sexually transmitted infections and other comorbidity health problems more than any other social group in the United States. Except for New York; Washington, DC; and Maryland, 65% of all new HIV cases are in the Southern states. The U.S. Southern states make up 38% of the U.S. population, yet approximately 51% of annual HIV diagnoses are from the Southern U.S. states. In the Southern states, AIDS is among the leading cause of death for African American women. A gap exists in the associations of depression, social support, and …

Stigma In Intimate Partner Relationships Among Ebola Survivors In Monrovia, Adam Monah Kyne

Walden Dissertations and Doctoral Studies

Stigmatization among Ebola survivors poses a growing problem in Monrovia, resulting in fractured relationships and broken marriages due to the fear of contracting Ebola during intimate moments. This study explores the lived experience of stigmatization in intimate partner relationships among Ebola virus disease (EVD) survivors in Monrovia, guided by stigma theory. By sharing the experiences of survivors, the study sheds light on the effects of stigmatization on their intimate relationships and provides a platform for expressing their personal experiences. It reveals the profound impact of the disease on survivors’ lives and their relationships with their partners. Using a qualitative approach, …

Covid-19 Social Isolation And Young Adult Mental Well-Being And Socioeconomic Status As A Moderator, Falescia Ware Matlock

Walden Dissertations and Doctoral Studies

AbstractIt is not currently known how social distancing guidelines impact mental health for emerging adults and whether socioeconomic status moderates this relationship. The psychosocial development theory states that emerging adults experience a psychological conflict—intimacy versus isolation—where the goal is to seek connections. Without connection, emerging adults are likely to experience impaired psychological well-being, which was exacerbated by the COVID-19 pandemic. The purpose of this study was to examine the effects of perceived social distancing guidelines on the mental health of emerging adults and if this relationship is moderated by socioeconomic status. This study followed a quantitative comparative design of emerging …

Understanding The Barriers Of Lgbtq Youth Aging Out Of The Foster Care System, Quadasha Mcilwaine

Walden Dissertations and Doctoral Studies

Historically, there have been significant barriers experienced by youths aging out of the foster care system. A new area of focus highlights youths that identify as lesbian, gay, bisexual, transgender, and queer (LGBTQ). In this study, the opinions of LGBTQ youths who have aged out of the foster care system in North Carolina were explored and the barriers these youths may encounter as they transition into adulthood were illuminated. Bronfenbrenner’s ecological systems theory is the framework that was used to guide this study. A basic qualitative approach was used with semistructured interviews of 10 LGBTQ aged-out youths in North Carolina. …

Dietary Changes In Preventing Type Ii Diabetes Mellitus Among Young Hispanic Adults, Taiwo Onipede

Walden Dissertations and Doctoral Studies

Diabetes mellitus continues to be a major chronic disease affecting the global population today with more prevalence amongst minority groups in the United States. The genetic susceptibility to obesity and higher insulin resistance seen in the Hispanic population puts them at the highest risk for development of Type II Diabetes (T2DM). The alarming increase in young adult T2DM diagnosis led to the project question: How can teaching on dietary changes affect Type II Diabetes diagnosis in predisposed young Hispanic adults? The purpose of this project is to accomplish the goal of Healthy People 2020 towards improving the quality of life …

Perceptions Of Hiv-Positive Patients Towards Faith-Based Community Support In A Rural Setting, James D. Rollins

Walden Dissertations and Doctoral Studies

Studies have demonstrated different perspectives on faith-based organizations (FBOs). Various quantitative studies have been performed for many years; however, there is minimal qualitative research literature investigating the phenomenon of attitudes of HIV-positive patients in a faith-based structure. The purpose of this study was to examine the lived experiences of a sample of 7 participants aged 18-65 from rural areas of a southern U.S. state who have lived with HIV and have sought community support. The focus was on various interventions by rural religious community support programs. Patients’ perceptions and experiences regarding the possible improvement of their quality of life were …

Issues Encountered By Parents In Continuing School-Based Obesity Prevention Programs At Home, Prenu Skaria

Walden Dissertations and Doctoral Studies

Childhood obesity is a public health problem that can lead to various chronic health diseases such as cardiovascular disease and diabetes later in life. School-based obesity prevention programs are a public health recommendation to reduce and prevent obesity in schools through increased physical activity and better nutritional habits. This qualitative research involved exploring the reason for the discontinuation of school-based interventions at home using multi-theory model (MTM) constructs for health behavior change. A convenience sample of three focus groups of consenting parents whose children participated in the Wolf Pack Coaches Challenge (WPCC), a school-based obesity prevention program in Nevada, was …

Laboratory Practices And Antimicrobial Resistance In A Florida Hospital, Crispina Marie Sy-Trias

Walden Dissertations and Doctoral Studies

Antibiotic resistance is a health threat affecting millions of Americans. Microorganisms develop resistance to antibiotics, rendering them useless for treating infections. The purpose of this quantitative study was to assess the associations between sample processing time and antibiotic resistance and is based on the health belief model. A retrospective specimen tracking activity of data from November 2019 to November 2020 was obtained by random sampling of 246 bacterial cultures. One hundred ninety-six (80%) samples were processed on time, and 50 (20%) were delayed; 167 (68%) samples were determined to have the presence of antimicrobial resistance (AMR), and 79 (32%) with …

Community Perceptions Of Syringe Service Programs In Charleston, West Virginia: A Qualitative Socioecological Perspective, Kenya M. Burton

Walden Dissertations and Doctoral Studies

In rural areas of the United States, people who inject drugs (PWID) experience an array of obstacles to accessing adequate healthcare. Locations with high rates of drug use normally offer more healthcare options, including needle exchange programs but, in some communities, there is resistance to providing this kind of care. This increases mortality, morbidity, cost, and adds to the stigma experienced by this vulnerable group. The experiences of people with substance dependency, including PWID, has been widely explored throughout studies that reflect a need for increased support. However, the perspectives of the community, especially in rural areas, though equally important, …

Doctoral Study Effects Of Mandatory Staffing Requirements On Quality Indicators In Long-Term Care, Melissa Reed

Walden Dissertations and Doctoral Studies

Long term care facilities continue to struggle to improve the quality of care, which affects publicly reported data and reimbursement. The purpose of this study was to evaluate if state-mandated staffing ratios affected Centers for Medicare and Medicaid Services (CMS) survey ratings for CMS Region 7, which consisted of Iowa, Kansas, Missouri, and Nebraska. The theoretical framework was grounded by Donabedian’s quality theory, which described quality is made up of the elements of structure, process, and outcomes. This study included two research questions evaluating if there was a correlation between minimum staffing ratios and quality of care in long-term care …

Improving Self-Efficacy Of Primary Care Providers With Assessment Of Diabetic Peripheral Neuropathy, Kimberly Paddock Farr

Walden Dissertations and Doctoral Studies

AbstractDiabetic peripheral neuropathy (DPN) is one of the most common complications of diabetes. DPN contributes to significant pain, debility and injury to diabetic patients. The majority of diabetic patients are managed in the primary care practice (PCP) setting. A local chapter of a nurse practitioner association identified a lack of knowledge of current evidence-based guidelines for effective screening and assessment of DPN in the PCP environment. The practice-focused question for this project was to determine if an educational intervention on evidence-based screening and assessment would improve nurse practitioner’s knowledge with DPN screening and diagnosis in PCP. Mezirow’s transformative theory of …

Occupational Stress In Long Term Care In Georgia And Virginia During The Covid-19 Pandemic, Lacountess Renee Hooks

Walden Dissertations and Doctoral Studies

Nursing staff working in long-term care settings experience high levels of occupational stress related to many factors that can lead to poor outcomes for the nursing staff and the residents. In 2020, the World Health Organization declared severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as COVID-19, a pandemic which over the course of 3 years, has added an additional source of work-related stress for long-term care nursing staff. This quantitative cross-sectional study was guided by the job demand-control-support model to explore perceived stress and nursing stress among nursing staff working in the long-term care setting in Georgia and …

The Reconciliation Of Cognitive Dissonance Among Social Workers In Substance Use Treatment Settings, Miranda Ashley Kieler

Walden Dissertations and Doctoral Studies

Although harm reduction (HR) and abstinence-based treatment approaches are both useful in addiction treatment, the former is less accepted and integrated into practice. Social workers who embrace an HR approach but who work at substance abuse treatment facilities that are abstinence based may experience cognitive dissonance because they perceive their work role to be incompatible with social work practice values and education. Little was known regarding how practitioners with a Master of Social Work (MSW) degree experience and reconcile cognitive dissonance related to their HR education and abstinence-only practice in substance use treatment centers. To address this gap in the …

Risk Factors Influencing Poliomyelitis Seroprevalence In Polio High Risk Areas Of Afghanistan, Wasan Abdulaziz Al-Tamimi

Walden Dissertations and Doctoral Studies

Afghanistan is one of the remaining polio endemic countries in the world. Nearly one million children under 5 years of age have missed polio vaccination in Afghanistan from May 2018 until January 2021. This quantitative study used the socioecological model as the theoretical framework and secondary data analysis of the 2020 polio serosurvey (N = 1384) to investigate various risk factors such as gender, parental education, family origin (language/location), wealth, distance to nearest health facility, and number of polio vaccine doses on the level of antibodies (i.e., seroprevalence) against all three types of polioviruses in children of two age groups, …

Strategies To Mitigate Nurse Turnover, James Edward Cooper Jr

Walden Dissertations and Doctoral Studies

Registered nurse turnover is a severe problem for all healthcare organizations because it negatively affects financial growth, patient care, and reputation, ultimately resulting in financial losses. Grounded in Herzberg’ two-factor theory, the purpose of this qualitative multiple-case study was to explore strategies hospital leaders use to mitigate RN turnover. The participants included three hospital leaders from three different hospitals in the southeastern United States who mitigated RN turnover. Data were collected from semistructured interviews and company documents and analyzed using Yin’s five-phase data analysis process. Three themes emerged: nurse engagement, job satisfaction, and trust in leadership mitigated RN turnover. A …

Influences On Influenza Vaccine Uptake Among Older Lebanese Adults, Doha D'Agostini

Walden Dissertations and Doctoral Studies

Influenza is a viral infection that is globally transmitted and that increases the risk for infectious diseases, hospitalization, and morbidity and mortality, especially among the older adult population. Although influenza vaccines are recommended in several countries, influenza vaccine hesitancy remains a challenge. In Lebanon, there is minimal research related to older adults’ attitudes and perceptions associated with influenza vaccination. To explore older Lebanese adults’ vaccination experiences and perceptions of the factors that affect their influenza vaccine uptake, a qualitative investigation was conducted. The theory of planned behaviors served as the theoretical framework for the study. A thematic analysis was conducted …

A Leadership Perspective On Preventing Counselor Burnout In A Behavioral Health Setting During Covid-19, Claudia P. De La Torre

Walden Dissertations and Doctoral Studies

During the COVID-19 pandemic, there was a high need for mental health services, which resulted in a shortage of mental health clinicians. This shortage of mental health clinicians then resulted in a high burnout rate due to client intake. This doctoral case study was grounded in the Baldrige Excellence Framework and focused on how a behavioral health organization in South Texas managed burnout in clinicians during the COVID-19 pandemic. This study aimed to help behavioral health leaders find a solution to preventing burnout during a high demand pandemic. This doctoral study had several data sources, including semistructured interviews with three …

Strategies To Mitigate Inappropriate Test Utilization By Physicians To Improve Efficiency In A Healthcare Setting, Christine C. Wood

Walden Dissertations and Doctoral Studies

Inappropriate test utilization by physicians for clinical decision-making in patient care is a significant problem facing some healthcare leaders. Healthcare leaders are concerned about inappropriate test utilization because it can increase healthcare costs and degrade patient outcomes. Grounded in the complex adaptive system and Lean Six Sigma conceptual frameworks, the purpose of this qualitative single-case study was to identify strategies seven hospital leaders in Maryland and Washington, DC. who implemented successful test utilization strategies for physicians. Data were collected from semistructured virtual interviews and organizational reports and analyzed using Yin’s 5 step process. Five themes emerged: (a) continuing physician education, …

Representation Counts: Intern Teachers Of Color And Their Perspectives Of Teaching In A California County, Girlie M. Hale

University of the Pacific Theses and Dissertations

Intern teachers are more likely to be placed in hard-to-fill content areas, such as math, science, and special education, which exacerbates their initial teaching experiences as teachers of record. For new teachers in their intern credential program, these factors compound the stress of attending coursework while managing their experience as a novice in the classroom. Without proper mentoring and support in these placements, teachers of color may perceive themselves as feeling less successful in the classroom. In this mixed methods study, the researcher investigated the types of support intern teachers of color need in successfully completing their teacher preparation program. …

The Remains Of The Establishment Clause, Ira C. Lupu, Robert W. Tuttle

GW Law Faculty Publications & Other Works

The very first words of the Bill of Rights mark religion as constitutionally distinctive. Congress may not enact laws respecting an establishment of religion – in particular, acts of worship, religious instruction, or proselytizing. A pluralist, liberal democracy requires separation of civil government from these distinctively religious activities.

From the middle of the 20 th Century until Justice O’Connor’s retirement in 2005, the Supreme Court energetically animated that principle of distinctiveness. In a series of decisions in the last decade, however, the Court has upended its longstanding approach to what is distinctive about religion in constitutional law. Notably, this process …

Changes In Distribution Of Severe Neurologic Involvement In Us Pediatric Inpatients With Covid-19 Or Multisystem Inflammatory Syndrome In Children In 2021 Vs 2020., Kerri L. Larovere, Tina Y. Poussaint, Cameron C. Young, Margaret M. Newhams, Suden Kucukak, Katherine Irby, Michele Kong, Stephanie P. Schwartz, Tracie C. Walker, Melania M. Bembea, Kari Wellnitz, Kevin M. Havlin, Natalie Z. Cvijanovich, Mark W. Hall, Julie C. Fitzgerald, Jennifer E. Schuster, Charlotte V. Hobbs, Natasha B. Halasa, Aalok R. Singh, Elizabeth H. Mack, Tamara T. Bradford, Shira J. Gertz, Adam J. Schwarz, Katri V. Typpo, Laura L. Loftis, John S. Giuliano, Steven M. Horwitz, Katherine V. Biagas, Katharine N. Clouser, Courtney M. Rowan, Aline B. Maddux, Vijaya L. Soma, Christopher J. Babbitt, Cassyanne L. Aguiar, Amanda R. Kolmar, Sabrina M. Heidemann, Helen Harvey, Laura D. Zambrano, Angela P. Campbell, Adrienne G. Randolph, Overcoming Covid-19 Investigators

Manuscripts, Articles, Book Chapters and Other Papers

IMPORTANCE: In 2020 during the COVID-19 pandemic, neurologic involvement was common in children and adolescents hospitalized in the United States for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related complications.

OBJECTIVE: To provide an update on the spectrum of SARS-CoV-2-related neurologic involvement among children and adolescents in 2021.

DESIGN, SETTING, AND PARTICIPANTS: Case series investigation of patients reported to public health surveillance hospitalized with SARS-CoV-2-related illness between December 15, 2020, and December 31, 2021, in 55 US hospitals in 31 states with follow-up at hospital discharge. A total of 2253 patients were enrolled during the investigation period. Patients suspected of having …