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Articles 1 - 20 of 20
Full-Text Articles in Medicine and Health Sciences
Community Health Worker's Perceptions Of Integration Into The Behavioral Health Care System, Juliette Swanston Jenkins
Community Health Worker's Perceptions Of Integration Into The Behavioral Health Care System, Juliette Swanston Jenkins
Walden Dissertations and Doctoral Studies
Mental illness in the United States is a major public health problem. According to the Substance Abuse and Mental Health Services Administration, in 2017, 18.9% of adults in the United States had a mental illness. The purpose of this study was to gain insight into the perceptions held by community health workers (CHWs) regarding their integration into the behavioral health care system in Maryland. Using a social constructivism paradigm and phenomenological approach, a purposive sample of 11 CHWs who supported patients with behavioral health conditions in 17 counties in the state were interviewed. Howlett, McConnell, and Perl's five stream confluence …
Exploring Healthcare Transitions And Health Equity: An Integrative Review, Susan Ann Jordan
Exploring Healthcare Transitions And Health Equity: An Integrative Review, Susan Ann Jordan
Walden Dissertations and Doctoral Studies
Compared to their typically developing peers, adolescents, and emerging adults with special healthcare needs (AEA-SHCN) disproportionately experience healthcare transition (HCT) disparities and poor access to adult care. Theoretical models that describe how access gaps develop and strategies to address unmet HCT needs are not well understood. While HCT researchers describe both system and patient healthcare barriers, a comprehensive approach that discovers how these factors interact and interfere remains misunderstood. An integrative review (IR) was conducted to understand the multiplicity of these factors. An intersectional theory (IT) provided further clarity on how key findings influence patient HCT experiences. Several themes were …
Patient Satisfaction With Nursing Care Related To Hospital Magnet Designation, Sharon Haylett
Patient Satisfaction With Nursing Care Related To Hospital Magnet Designation, Sharon Haylett
Walden Dissertations and Doctoral Studies
Many U.S. hospitals have historically failed to recognize nursing as essential to quality of care. Given the relationship between the patients' experiences, measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), and government reimbursement, stakeholders now value the role of nurses in the care experience. Some hospitals have pursued Magnet designation, which is a rigorous and costly process, in order to promote patient satisfaction through nurse autonomy and retention. The purpose of this study was to understand whether non-Magnet hospitals received similar HCAHPS scores. Expectancy disconfirmation theory provides a framework to understand the components of patient satisfaction …
Preventing Obesity And Type 2 Diabetes In Immigrant Populations, Maxwell K. Chikuta
Preventing Obesity And Type 2 Diabetes In Immigrant Populations, Maxwell K. Chikuta
Walden Dissertations and Doctoral Studies
Obesity-related diseases have been increasing in African immigrants throughout the United States. Although research has been done to identify risk factors associated with many ethnic groups in the United States, only a few studies exist that explore obesity and type 2 diabetes diseases among Central African immigrants. The conceptual framework for this qualitative case study was social constructivism and the health belief model. The primary research question addressed the potential underlying causes for an increase in obesity and type 2 diabetes among Central African Immigrants. The secondary research questions explored how culture, illiteracy, and religion contribute to the problem of …
Incentive Size Alignment With Accountable Care Organization Performance, Kristie D. Racca
Incentive Size Alignment With Accountable Care Organization Performance, Kristie D. Racca
Walden Dissertations and Doctoral Studies
Changes to the country's health care political landscape in 2012 resulted in the development of federal programs aimed at containing costs and improving the quality of care delivered. Accountable Care Organizations (ACO) emerged linking performance to rewards. Guided by Conrad's value-based performance incentive theory as the theoretical foundation, the purpose of this quantitative study was to determine the relationship between financial incentive size and ACO performance measures. The research questions examined the predictive relationship of incentive size and acute care readmission rates, emergency department (ED) visits, and per capita spending of the ACO Medicare Shared Savings Program population. The study …
The Impact Of Congressional Attention And Policy Mood On Public Health Funding, Evelyn Denise Dunn
The Impact Of Congressional Attention And Policy Mood On Public Health Funding, Evelyn Denise Dunn
Walden Dissertations and Doctoral Studies
Congressional appropriations for federal public health agencies are subjected to external factors throughout the congressional appropriations process, resulting in fluctuations in funding. Recent literature has focused on externals factors, such as political attention and public attitudes, that could influence government funding levels; however, the impact of these factors on federal public health funding was not addressed. The purpose of this study was to determine whether a relationship exists between these external factors and federal public health appropriations. A quantitative study was used to examine congressional attention, policy mood, and the influence on the change in the level of federal public …
Patients' Perceptions Of Quality Of Life And Resource Availability After Critical Illness, Michelle Mcmoon
Patients' Perceptions Of Quality Of Life And Resource Availability After Critical Illness, Michelle Mcmoon
Walden Dissertations and Doctoral Studies
Physical, psychological, and social debilities are common among survivors of critical illness. Survivors of critical illness require rehabilitative services during recovery in order to return to functional independence, but the structure and access of such services remains unclear. The purpose of this qualitative study was to explore the vital issues affecting quality of life from the perspective of critical illness survivors and to understand these patients' experiences with rehabilitative services in the United States. The theoretical framework guiding this study was Weber's rational choice theory, and a phenomenological study design was employed. The research questions focused on the survivors' experiences …
An Analysis Of Employee Motivation After Metamorphose, Conglomerated Public Health Care Systems, Aleta Marie Lymon
An Analysis Of Employee Motivation After Metamorphose, Conglomerated Public Health Care Systems, Aleta Marie Lymon
Walden Dissertations and Doctoral Studies
A global epidemic of metamorphosed, conglomerated health care systems changed the face of public health care organizations. The problem is, public health care organizations merge into new systems, but the culture for each merged organization has not been formed under the new system. Public administrators, health care workers and the Department of Health and Human Services are affected when there are issues in health care behavioral practices and performance outcomes. Research found that employee motivation is hard to achieve when there are issues within the internal structure of a new system. Using Herzberg's motivation-hygiene and Tajfel and Turner's social identity …
Antibullying Definition, Policy, Surveillance, Education, And Training In The Healthcare Field, Adlene Jones Mcelroy
Antibullying Definition, Policy, Surveillance, Education, And Training In The Healthcare Field, Adlene Jones Mcelroy
Walden Dissertations and Doctoral Studies
Workplace bullying in the healthcare field has contributed to decreasing productivity, decreasing employee morale, increasing workplace lawsuits, overall dissatisfaction in the workplace, and potentially compromising care to patients. Little, however, is known about how public policies related to workplace bullying impact the experiences of healthcare workers. Using Cornell and Limber's conceptualization of bullying, the purpose of this general qualitative study was to better understand the experiences of healthcare leaders and workers related to workplace bullying of a single health care facility. Data were principally collected from 9 participants representing three organizational leaders, three nurses, and three ancillary members staff. These …
Survey Of U.S. Undergraduate Self-Reported Opioid Diversion And Heroin Use, Motives, Sources, And Collective Efficacy As Mediating Factors, Mark Francis Plaushin
Survey Of U.S. Undergraduate Self-Reported Opioid Diversion And Heroin Use, Motives, Sources, And Collective Efficacy As Mediating Factors, Mark Francis Plaushin
Walden Dissertations and Doctoral Studies
Epic morbidity and mortality, and intractability make prescription opioid diversion a wicked problem. Meanwhile, college undergraduates are vulnerable to opioid misuse and its consequences. The purpose of this quantitative study was to assess U.S. undergraduate students' opioid misuse and the relationship between mediating factors. The study's theoretical framework rested on Wakeland's et al. opioid system model and Shaw and McKay's social disorganization theory. This study bridged the gap, measuring collective efficacy and testing its relationship to undergraduate decisions to regulate misuse. Thus, research questions focused on gauging the problem's scope and assessing relationships between factors that drive or potentially regulate …
Logistical Resource Capability During A Mass Casualty Event In Washington State, Todd Devin Brauckmiller
Logistical Resource Capability During A Mass Casualty Event In Washington State, Todd Devin Brauckmiller
Walden Dissertations and Doctoral Studies
The need for increasing efficiencies for medical resource delivery during a mass casualty incident/event is a paramount logistical planning factor that could mean life or death to the citizens affected by a disaster. As such, Washington State has prioritized emergency management and preparedness. Using the just-in-time system by way of Baghbanian' s complex adaptive decision-making theory as the foundation, gave purpose to this qualitative study. This was accomplished by analysis of emergency management professional responses, and to what degree, improvements can be made to the medical resource delivery system during a mass casualty incident/event. Data were collected through semi structured …
Integrating Health Care Systems To Maintain Quality Care And To Manage Cost, Marilynn Noble
Integrating Health Care Systems To Maintain Quality Care And To Manage Cost, Marilynn Noble
Walden Dissertations and Doctoral Studies
The rising cost of health care in the Philippines is a concern for the Department of Defense and TRICARE beneficiaries. The purpose of this quantitative cross-sectional research study was to determine the efficacy and acceptability of a different method to deliver health care to increase access to health care and decrease out-of-pocket costs while maintaining quality of care for TOP Standard beneficiaries who receive health care under the Philippine Demonstration. Secondary data was used to determine the acceptability of an alternative reimbursement methodology to decrease cost but maintain access to quality care. The Andersen's behavioral health care model and the …
The Shortage Of Licensed Social Workers In Central Florida, Helen M. Burrows
The Shortage Of Licensed Social Workers In Central Florida, Helen M. Burrows
Walden Dissertations and Doctoral Studies
For several decades, a national shortage of licensed clinical social workers has been growing in the United States. Licensed social workers provide counsel and advocacy for those affected by mental illness, addiction, abuse, and discrimination, among other economic difficulties, and are the largest group of providers of mental and behavioral health services. The research questions for this project addressed what challenges unlicensed social workers in central Florida identify as barriers to pursuing clinical licensure. This study also explored strategies that unlicensed social workers in central Florida reported to address these barriers and encourage the pursuit of clinical licensure. The purpose …
Recruiting Strategies For Increasing The Number Of Emergency Medical Technician Personnel, Carolyn Denise Mack
Recruiting Strategies For Increasing The Number Of Emergency Medical Technician Personnel, Carolyn Denise Mack
Walden Dissertations and Doctoral Studies
Demand for the emergency medical technician (EMT) is 2 times greater than that of all other occupations. Sustainability of ambulance services (AS) personnel is dependent upon the recruitment of EMTs into the industry. The purpose of this multiple case study was the exploration of the recruiting strategies that AS administrators used to increase the number of EMTs. Herzberg's 2 factor theory of motivation was the conceptual framework for this study. The data collection instrument included semistructured interviews with 6 AS company executives in southeastern New Mexico and southwestern Texas. Secondary data and document from each state's emergency medical services personnel …
Effects Of Psychiatric Hospital Closures On Local Jail Administrators, Correctional Staff, And Inmates, Mark Christian Lasko
Effects Of Psychiatric Hospital Closures On Local Jail Administrators, Correctional Staff, And Inmates, Mark Christian Lasko
Walden Dissertations and Doctoral Studies
A series of psychiatric hospital closures has led to a movement of care for individuals with mental illness from state-run facilities to managed care centers. Many of the individuals who no longer reside in psychiatric hospitals have become ensnared in the criminal justice system. Correctional facilities have an increased burden to care for the needs of the mentally ill, but lack the training and facilities to do so adequately. In this study, the lived experiences of correctional staff who have experienced the process of a hospital closure were examined. Psychiatric rehabilitation and gatekeeper theories served as the theoretical framework for …
Perceptions Of Fear Of Falling In Older Adults, Ken Germano
Perceptions Of Fear Of Falling In Older Adults, Ken Germano
Walden Dissertations and Doctoral Studies
Many adults are afraid of falling. While aging can affect one's physical and cognitive abilities related to fear of falling (FOF), research has revealed that FOF increases risk of falls and adversely affects independence levels among older adults. The purpose of this study was to explore older adults' perceptions of FOF and risk of falling. Guided by the health belief model, the research questions focused on older adults' perceptions of FOF, contributing factors of FOF, and how FOF may affect independence levels. How older adults perceive FOF, and how FOF may affect an individual older adult's fall risk and independence …
Florida Adult Trauma Scorecard Methodology And Scene Transportation Choice, Patricia Maher
Florida Adult Trauma Scorecard Methodology And Scene Transportation Choice, Patricia Maher
Walden Dissertations and Doctoral Studies
Prehospital management of patients who are traumatically injured within the state of Florida starts with the use of the Florida Adult Trauma Scorecard Methodology. The scorecard methodology may indicate that a patient is a Trauma Alert based on applied physiological and other judgment criteria. However, patients may be transported via Helicopter Emergency Medical Services (HEMS) without justified physiological needs. Rawls’ theory of justice posits that a fair and equal distribution of social resources is essential to public wellbeing. To evaluate this premise regarding prehospital trauma transports, archival 2015 data from the Florida Department of Health Trauma Registry was obtained. Using …
Understanding The Impact Of Choice Claims In Health Policy Among Veteran Patients, Stacie Marie Rivera
Understanding The Impact Of Choice Claims In Health Policy Among Veteran Patients, Stacie Marie Rivera
Walden Dissertations and Doctoral Studies
The patient-as-consumer has emerged as a narrative in the government health care system that cares for beneficiary veteran patients, elevating the phenomenon of choice in health care legislation and administration. The problem of the submerged state of a health policy was the issue examined within the context of access to health care and what patients experience when choice is present. The purpose of this study was to explore the motivations of beneficiary veteran patients to choose a preventive care option, a seasonal flu shot, at a private sector retail pharmacy rather than at their government health care provider, with the …
Maintaining Confidentiality Among Hiv Infected Couples: Physicians' Patterns Of Decision In Nigeria, Francess Uju Ayaebene
Maintaining Confidentiality Among Hiv Infected Couples: Physicians' Patterns Of Decision In Nigeria, Francess Uju Ayaebene
Walden Dissertations and Doctoral Studies
Policies mandating HIV status disclosure to decrease incidence create ethical challenges for physicians on whether to breach or maintain infected patients' confidentiality. In Sub-Saharan Africa where HIV incidence is high, there is a need for clear guidelines/policies on making confidentiality decisions. The purpose of this quantitative quasi experiment was to determine whether the gender, gender orientation, and sexual relationship of an infected patient and physicians' demographics predicted physicians' decisions to breach confidentiality. In Plateau State, Nigeria, 222 physicians were given vignette questionnaires containing 6 different descriptions of gender, gender orientation, and sexual relationships of a hypothetical patient. Each physician decided …
Effect Of Access To Health Services On Neonatal Mortality In Uganda, Imelda Atai Madgalene Musana
Effect Of Access To Health Services On Neonatal Mortality In Uganda, Imelda Atai Madgalene Musana
Walden Dissertations and Doctoral Studies
Since 2006, Uganda has experienced a nonchanging neonatal mortality rate of 27 out of 1,000 live births, which is higher than the global average of 19 deaths for every 1,000 live births. The purpose of this retrospective cross-sectional study was to determine factors affecting access to health services and their impact on newborn deaths in Uganda. Mosley and Chen's model for child survival in developing nations provided the framework for the study. Secondary data from the 2016 demographic and health survey (UDHS) collected by the Uganda Bureau of Statistics (UBOs) was used. A total of 7,538 cases were used and …