Medicine and Health Sciences Commons^™

Interprofessional Teams As A Strategy To Address Physician Shortages In North Dakota, Judy Ann Solberg

Walden Dissertations and Doctoral Studies

North Dakota health care and political leaders are facing pressure to revise health care delivery in the state. A chronic shortage of health care providers, retention issues, an aging population, and a recent population burst, as well as an abnormally high rate of physician retirement, have made health care access problematic for residents of the rural state. The purpose of this study was to explore and understand the main inhibitors and facilitators of employing interprofessional teams as a strategy to address rural physician shortages in North Dakota. Bandura’s social cognitive theory provided the framework for this phenomenological study of issues …

Social And Ecological Determinants Of Physical Activity For Youth With Cerebral Palsy, George E. Gorton

Walden Dissertations and Doctoral Studies

Physical inactivity is a leading cause of morbidity and mortality, increasing risk for noncommunicable disease and compromised physical, social, and mental health. However, fewer than 20% of U.S. youth meet physical activity guidelines; youth with disabilities are even less active. Physical activity is influenced by personal, family, social, organizational, community, and environmental factors acting within a social-ecological framework. To what extent is not well understood. The purpose of this study was to determine the extent to which social and ecological factors are associated with participation of youth with cerebral palsy in physical activity. The research design was a cross-sectional, quantitative …

Living With Multiple Sclerosis, William Witt

Walden Dissertations and Doctoral Studies

Background: Continuity of care is a crucial characteristic of high quality multiple sclerosis (MS) care. Nevertheless, experiences of MS patients with continuing care are currently understudied, particularly through in-depth methods, such as qualitative approaches. This is despite the significance of continuity of care in improving patient satisfaction and the quality of life of patients with chronic diseases.

Aim: To examine the experiences and perceptions of MS patients with continuity of care through a critical exploration of their lives following hospitalization for an exacerbation.

Design of the study: Qualitative using phenomenological approach.

Participants: Eight participants living with MS. All participants were …

Childhood Obesity: The Healthy, Hunger-Free Kids Act And School-Aged Children, Frankie Jean Alstin-Brooks

Walden Dissertations and Doctoral Studies

Obesity among children in America is at an all time high, 57.3% of the nation’s children will be obese by the age of 35. The purpose of this study was to examine the effectiveness of the Healthy, Hunger-Free Kids Act (HHFKA) policy. The HHFKA modified the nutritional and physical policies in order to reduce the obesity rates by changing their expenditures. Schools in all 50 states that are subject to federal, state and local nutrition regulations were researched. This was a quantitative, non-experimental, correlation study that measured state compliance with the USDA guidelines and tested for an association between compliance …

Chronic Pain Management In The Primary Care Setting, Rebecca Ann Day

Walden Dissertations and Doctoral Studies

Chronic pain is pain that lasts longer than 12 weeks, affects an individual physically in some mental or psychological way, influences an individual’s job performance, and may create a social complication over time. Ensuring the best possible care for the patient’s pain with the least possible complications is the responsibility of the health care provider, including nurse practitioners. Providing a clinical practice guideline (CPG) for the management of chronic pain in the primary care setting was the focus of this project. The comfort theory model was used as a framework for this project as well as the basis of nursing …

Severe Maternal Morbidity In Michigan: An Investigation Of Health Disparities, Laura Houdeshell-Putt

Walden Dissertations and Doctoral Studies

Severe maternal morbidity (SMM) rates in Michigan have increased over the past 20 years and continue to affect racial and ethnic women disproportionately. Women experiencing health conditions that complicate pregnancy outcomes have a greater risk of having poor obstetric outcomes that result in a SMM event. To evaluate the distribution of women experiencing health conditions that complicate pregnancy and a SMM event, geographic information systems were utilized in this study. The purpose of this study was to depict trends in the prevalence of 4 health conditions and SMM among women hospitalized for obstetric delivery in Michigan from 2016–2017. The 4 …

Tuberculosis Diagnostics In Ethiopia: Assessment Of Laboratory Procedural Capabilities And Limitations, Yeshimebet Retta

Walden Dissertations and Doctoral Studies

Abstract

Tuberculosis (TB) is a curable and preventable disease; however, in 2015, 10.4 million people were diagnosed with TB, making it one of the top 10 causes of mortality. A major part of the TB disease burden is carried by low and middle-income countries. In Ethiopia, which ranks 15th among 22 countries with a high burden of TB and multidrug resistant TB (MDR-TB), important diagnostic and treatment gaps persist. This quantitative descriptive study was primarily aimed to determine levels of adherence to standardized TB laboratory procedures by calculating and reporting the number of sputum samples, and reporting valid and documented …

Sex Differences In Lyme Disease Symptomatology In The Northeast United States, Jeanine Scotti

Walden Dissertations and Doctoral Studies

Guided by the gender-analysis-matrix theoretical framework, 3 key areas of research inquiries focused on the relationship between sex and Lyme disease, symptoms of Lyme disease and sex, and severity of Lyme disease symptoms on sex. A quantitative secondary data analysis was used to address the research questions. A clinician specializing in caring for individuals with Lyme disease provided the dataset, containing responses to the Horowitz Multiple Systemic Infectious Disease Syndrome Questionnaire for Lyme disease. A cross-sectional, comparative research design incorporating 2 statistical techniques for analysis—the independent samples t test and multivariable regression analyses—was used to examine symptom counts and the …

Evidence-Based Strategies For Improving Medication Adherence Among Psychiatric Patients: A Systematic Review, Omah S. Tsikada

Walden Dissertations and Doctoral Studies

Nonadherence to psychotropic medications among patients with serious and persistent psychiatric disorders, including bipolar disorder and schizophrenia, is approximately 70%. Nonadherence is a common barrier to the treatment of individuals with mental health disorders. However, there is limited awareness of evidence-based interventions and strategies to address this problem. Therefore, the question for this project asks whether a systematic review can identify strategies to improve adherence of psychotropic medications among individuals with serious and persistent mental illness. The purpose of this systematic review was to explore the evidence-based strategies that can aid in increasing medication adherence in patients with mental health …

Social Determinants Of Adherence To Antiretroviral Therapy Among Hiv+ Youth, Wanza Rochelle Bacon

Walden Dissertations and Doctoral Studies

Young adults, especially African American men who have sex with men (MSM) have the lowest rates of antiretroviral therapy (ART) adherence among all age groups; however, they experience greater than 50% of all new Human Immunodeficiency Virus (HIV) infections among individuals 13 to 24 years of age. Despite the availability of ART, young MSM continue to experience suboptimal rates of adherence and are one of the most vulnerable populations for contracting HIV. Grounded in the social cognitive theory, my aim for this quantitative cross-sectional study was to investigate the relationship between diverse social determinants and ART adherence among young adult …

Maternal And Infant Birth Characteristics As Predictors Of Sudden Unexpected Infant Death, Betty Jean Ezell

Walden Dissertations and Doctoral Studies

Sudden Unexpected Infant Death (SUID) is a public health issue recognized by the United States Centers for Disease Control and Prevention (CDC) as the sudden and unexpected death of a baby less than 1 year old, often during sleep, with no obvious cause. Despite known SUID risk factors for infants and mothers, there is limited research on combinations of infant birth characteristics and mother demographics that could be indicative of a higher risk of infant death. The purpose of this cross-sectional quantitative study was to examine the extent to which infant birth characteristics, delivery characteristics, month prenatal care began, and …

Impact Of Food Assistance Programs On Food Insecurity, Diet Quality And Obesity, Jessica Eileen Hill

Walden Dissertations and Doctoral Studies

Obesity remains a public health issue in the United States because it contributes to chronic diseases. The Supplemental Nutrition Assistance Program (SNAP) was designed to increase food security, alleviate hunger, and increase access to a healthful diet; however, it may have the opposite effect and contribute to obesity. The purpose of this study was to examine to what extent participation in SNAP impacts food insecurity, diet quality, and obesity in U.S. adults. The social-ecological model guided the study which was conducted using a quantitative a cross-sectional research design and secondary analyses of the 2013-2014 National Health and Nutrition Examination Survey …

Georgia Government Leaders' Lived Experience Creating And Implementing Health Equity Policies, Tracy M. Clopton

Walden Dissertations and Doctoral Studies

Georgia’s racial and ethnic minority communities have a continual problem of disproportionately worse health outcomes, including higher chronic disease and behavioral risk factors, compared to their nonminority counterparts. The average cost per year for chronic disease between 2016 and 2030 could be $64.6 billion in medical costs and $26.8 billion in lost employee productivity for Georgia. The purpose of this study was to explore the lived experience of Georgia legislators and health program staff to determine policy solutions to reduce chronic disease and behavioral risk factor disparities in the racial and ethnic minority population. The theoretical lens for the study …

Advanced Practice Registered Nurses And Their Knowledge Regarding The Hindrance Of Obesity, Crystal Rainey

Walden Dissertations and Doctoral Studies

Advanced Practice Registered Nurses and Their Knowledge

Regarding the Hindrance of Obesity

by

Crystal N. Rainey

MSN, Walden University, 2014

BSN, University of Arkansas in Little Rock, 2011

AASN, Southeast Arkansas College, 2009

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

February 2020

Self Reported Cardiovascular Disease Risk Factors Among Deaf Users: A Communication Barrier, Dr. Jolene Ayres Ogunjirin

Walden Dissertations and Doctoral Studies

Cardiovascular disease (CVD) is the number one cause of mortality worldwide, and may disproportionately affect the Deaf and Hard of Hearing (DHOH) subpopulation in the United States. It has been suggested that communication barriers among the DHOH subpopulation contribute to the high prevalence of CVD risk factors. To assess this claim, this quantitative study utilized a cross-sectional data set of 400 DHOH and 400 non- DHOH participants taken from the National Health and Nutrition Examination Survey (NHANES) database. The differences of being told by a health professional of having specific CVD risk factors were assessed between the two groups and …

Provider Education Increasing Recommendation For Human Papillomavirus Vaccination, Tiffany Charest Skinner

Walden Dissertations and Doctoral Studies

Human Papillomavirus (HPV) was the most common sexually transmitted disease in the United States in 2018 according to the Centers for Disease Control and Prevention (CDC). The CDC established the Healthy People 2020 initiative for HPV vaccination uptake of 80% to effectively eliminate HPV associated cancers. The project site, a rural multispecialty clinic in the Mid-Atlantic United States reported a 3% vaccination compliance rate, well under the national average and the benchmark of 80% recommended by the CDC. The practice-focused question for this project was to determine how education of primary providers will increase recommendation rates for vaccination of HPV. …

Stroke Prevention Through Education, Laura Lee Ballance

Walden Dissertations and Doctoral Studies

AbstractThis project focused on two concepts: a need for a stroke prevention program and what should be included. The problem with early identification of stroke is not formally addressed at the project site, physician’s office. A physician’s office can play a beginning key role in minimizing the risk of stroke. The purpose of this project was to explore the evidence to support the need for and to determine ideal content for a stroke prevention education program. This program focused on early detection and identification of risk factors to prevent stroke occurrence. The theoretical framework of Pender’s health promotion model aligns …

Age At Diagnosis And Lung Cancer Presentation, Marida Gingras

Walden Dissertations and Doctoral Studies

Lung cancer is the leading cause of cancer-related mortality in the United States because of its lack of symptoms until late stages. It is noted that a 5-year relative survival rate can be improved by earlier cancer detection. The currently recommended age of screening by the U.S. Preventive Services Task Force may not be optimal, and the recommendations are only for smokers. The purpose of this cross-sectional study was to examine the association between the stages of presentation of lung cancer and age at diagnosis using quantitative research. Using the Surveillance, Epidemiology, and End Results (SEER-18) database, 63,107 records were …

Perceptions Of Physician Influence On Healthcare Accessibility, Samuel N. Jacobs-Abbey

Walden Dissertations and Doctoral Studies

A significant portion of the U.S. population across the country has limited access to quality healthcare; however, this situation is more pronounced in rural areas. One potential solution is for healthcare practitioners to move their services to underserved rural areas to improve healthcare coverage. No previous studies have explored the perceptions of practitioners regarding their influence on healthcare access, particularly the potential impact of moving healthcare services to underserved areas. Thus, the purpose of this research was to address this gap. A qualitative phenomenological approach was adopted. A sample of 24 participants was selected using purposive sampling, from the target …

The Association Between Provider Cultural Competence And Type 2 Diabetes Health Behaviors, Bernadette Joyce Mejia-Tran

Walden Dissertations and Doctoral Studies

Provider cultural competence is poorly understood in relation to the outcome of Type 2 diabetes patient health behaviors. The purpose of this study was to examine the association between provider cultural competence and diabetes patient health behaviors. The chronic care model provided the conceptual framework for this study. The research questions were designed to determine whether 5 measures of provider cultural competence play a role in diabetes patient health behavior change. The research design of the study was a quantitative cross-sectional survey using the 2017 National Health Interview Survey. The 2,342 participants included in the study represent a national sample …

Prevention Practices And West Nile Virus Infection Among Ethnic Minorities, Texas, Bayabel Debebe Mengistu

Walden Dissertations and Doctoral Studies

Abstract

West Nile virus (WNV) is a major public health problem and the cause of nearly 25% of the world's economic burden of disease. While the risk factors for developing West Nile fever and West Nile disease from WNV infection have been identified, it is not known how knowledge, attitude, behavior (KAB), access to health care (AHC), and comorbidities are associated with prevention practices of WNV infection among ethnic minorities. The aim of this study was to examine the association between KAB, AHC, comorbidities, and prevention practices of WNV infection among ethnic minorities in Texas. KAB, AHC. Comorbidities were used …

Predicting Behavior To Engage In Fall Prevention Practices: The Role Of Interests And Basic Psychological Needs, Jan Fay Kress

Walden Dissertations and Doctoral Studies

AbstractA fall is associated with adverse outcomes that include occupational, physical, cognitive, and psychological decline together with economic and caregiving burden. Despite the continued increase in prevalence of falls globally, most studies address the well-known risk factors of falls but exclude the behavioral risk factors associated with human actions, emotions, and everyday choices. Following the theory of self-determination and person object of interest framework, this quantitative, nonexperimental study was conducted using face-to-face and web surveys to examine the relationship between motivational, relational, and sociodemographic/medical conditions to predict engagement in fall prevention practices in a sample of 75 community dwellers, 65 …

Ccure: Campus & Community United For Recovery Efforts, Alexandra Schmied

West Chester University Master’s Theses

The CCURE pilot program combats historical stigma and the current lack of support for students in recovery from Substance Use Disorder during their collegiate careers. Using the ideas of Paulo Freire and Michael Oakeshott, the author’s philosophy states education should be continual, communal, and accessible. The CCURE program intervention outlines a Living Learning Community in a six-bed recovery house on campus in conjunction with a seminar course taught by campus partners. Student development theories such as Schlossberg's Mattering and Marginality & Transition Theories; best practices found in public health, and at Rutgers University, Augsburg University, and the University of Delaware …

Chronic Liver Disease, Medha Singhal, Rajendra Prasad, Suresh Babu, Manthappa M

Digital Journal of Clinical Medicine

No abstract provided.

A Case Of Tetanus With Classical Presentations, Maaz Khan, Dr. Bhanukumar M

Digital Journal of Clinical Medicine

No abstract provided.

Airway Management In Case Of Granulomatosis With Polyangiitis, Dr. Pranay Penmetsa, Dr. Subramanian R

Digital Journal of Clinical Medicine

No abstract provided.

Multiple Sclerosis With Depression, Dr. Siri Gangadkar, Dr. Megha Tandure, Dr. Kishor M

Digital Journal of Clinical Medicine

No abstract provided.

Suicide Attempt In Relation To Covid-19 Crisis, Dr. Sreelakshmi Rajeev, Dr. Pranahith Reddy, Ms. Chinmayi K., Dr. Kishor M

Digital Journal of Clinical Medicine

No abstract provided.

A Rare Cause Of Hyponatremia, Dr. Tamanna Gupta, Dr. Pratibha Pereira

Digital Journal of Clinical Medicine

No abstract provided.

A Case Of Pancreatic Pseudocyst Following Acute Pancreatitis, Dr Hitha Suresh, Dr Madhu C P

Digital Journal of Clinical Medicine

No abstract provided.