Medicine and Health Sciences Commons^™

Examining Barriers With Implementing Augmentative And Alternative Communication In A Midwest School, Ashley Renee Fields

Walden Dissertations and Doctoral Studies

Many speech-language pathologists (SLPs) in a Midwest urban public school system have experienced barriers that prohibit the effective use of augmentative and alternative communication (AAC). The result has left some students with speech language impairments (SLI) without the communication skills for meaningful relationships and success in and out of school. The purpose of this exploratory case study was to determine the perceived barriers of 8 local school SLPs regarding the successful implementation of AAC and their suggestions for addressing the problem. Data were collected from semi-structured interviews with the SLPs. Data collection and analysis were grounded by Ely's conditions of …

Facilitating Weight Tolerance Among Health And Fitness Majors Toward Obese Persons, Stephanie Boss

Walden Dissertations and Doctoral Studies

Weight bias exists in some health-related degree programs. Overweight and obese persons who experience weight bias in health-related services often delay or avoid medical attention altogether. Guided by the attribution theory, the purpose of this sequential explanatory study was to examine weight bias among health majors at a southwest regional university to illuminate how attitudes can affect the level of care provided to overweight persons. The Attitudes toward Obese Persons (ATOP) scores from a convenience sample of 184 health majors revealed that participants' scores were found to be significantly lower than the midpoint (60) of the ATOP scale, M = …

Health Behaviors, Hardiness, And Burnout In Mental Health Workers, Jeremiah Brian Schimp

Walden Dissertations and Doctoral Studies

Burnout has emerged as a significant and costly issue in the modern workforce. Researchers have not fully explored the role of individual health behaviors and personality in burnout among mental health workers. The knowledge gap addressed in this study was the connection between health behaviors, what mental health workers do to take care of themselves, and hardiness, the characteristic way they perceive and interpret environmental challenges. The purpose of this study was to examine the influence of health behaviors and hardiness among mental health workers on the 3 dimensions of burnout as measured by the MBI-HSS: emotional exhaustion, depersonalization, and …

Clinical Significance Of Response Shift In A Spine Interventional Clinical Trial, Robin Carlson

Walden Dissertations and Doctoral Studies

The effectiveness of treatments for degenerative spine conditions, where the primary symptom is back pain, is typically determined using patient-reported quality of life (QoL) measures. However, patients may adjust their internal standards when scoring QoL based on factors other than their health. This response shift phenomenon could confound the interpretation of study data and impact effectiveness conclusions. In the current study, response shift was examined using structural equation modeling (SEM) and previously collected clinical trial data comparing 2 minimally invasive medical devices in lumbar spinal stenosis patients through 1 year postintervention. In subject QoL results, reprioritization shift between 3 months …

Correlations Between Childhood Obesity And Obesogenic Environmental Variables Within Durham County, North Carolina, Eureka Capri Daye

Walden Dissertations and Doctoral Studies

The application of geographic information systems was used to map obesogenic conditions by zip code tabulation areas in Durham County, North Carolina and evaluated associations between those conditions and the understudied area of early childhood obesity. Of the thirty one percent of the children in Durham County, North Carolina who were considered obese in 2010, four hundred and thirty three (1:5) 2 - 4 year old children who received supplemental nutrition services for women, infants and children were obese with BMI levels greater or equal to the 95th percentile and were used as the criterion variable in the study (N=433). …

The Predictors Of Physician-Patient Discussions Of Sexual Health With Older Adults, Dana Marie Werner

Walden Dissertations and Doctoral Studies

The number of adults aged 65 years and over has been rising quickly, as has the rate of new onset sexually transmitted diseases within this population. Discussions of sexual health between physicians and older adults are currently lacking in frequency and effectiveness. Using the foundation of stereotype embodiment theory, the purpose of this study was to identify the factors that predict frequency of discussing sexual health with older adult patients. A comparative sample of geriatric physicians and family practitioners completed 2 researcher-developed questions and the Sexual Health Care Scale-Attitude tool that assessed their stereotype beliefs toward discussing sexual health with …

Interpersonal Safety Of Active Duty Women In The Deployed Environment Of Bagram Afghanistan, Cynthia Tara Ferguson

Walden Dissertations and Doctoral Studies

In the United States Armed Forces, 30% of women in the military suffer physical assault each year; in 2009, there were 22 reported cases of sexual assault in the U.S. Central Command. Aggravated assault, gang violence, sexual assault, homicide, and suicide can damage the morale of military personnel at a deployed site and collectively cost millions of dollars over time. Interpersonal violence in the United States military is destructive to the military system and directly diminishes mission readiness. This study was designed to illuminate the environmental, cultural, and political influences that affect interpersonal safety among military women in the deployed …

The Effect Of Evaluating A Quality Improvement Initiative On Reducing Hospital Transfers Of Nursing Home Residents, Denise Eileen Jarboe

Walden Dissertations and Doctoral Studies

The Effect of a Quality Improvement Initiative on Reducing Hospital Transfers of Nursing Home Residents

by

Denise Eileen Jarboe

MSN, Walden University, 2010

BS, University of Maryland, 1981

Project Study Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

February 2015

Nursing homes (NH) in the 21st century provide skilled healthcare services for resident populations who are older, frailer, and often suffering from multiple incurable chronic medical conditions. Nurses practicing in this setting must be keen observers and effective communicators with the ability to recognize and report subtle changes in health status …

Perceived Factors Contributing To Coronary Heart Disease In African American Women, Funmilola O. Sholanke

Walden Dissertations and Doctoral Studies

African American women (AAW) suffer from disproportionately high death rates due to coronary heart disease (CHD) compared to Caucasian women. Although there have been a number of studies targeting African American adults with CHD in clinical interventions, very few studies have addressed the social determinants of health and the influence of AAW's perceptions of health factors on health outcomes. The purpose of this phenomenological study was to fill the gap in the existing knowledge base by examining the lived experiences of 10 AAW diagnosed with CHD with a focus on the perceptions of environmental, socioeconomic, and cultural factors related to …

The Center For Total Health: Healthcare Reform In Cook County, Illinois, James Leon Miles

Walden Dissertations and Doctoral Studies

The Patient Protection and Affordable Care Act (PPACA) of 2010 requires hospital systems in the United States to shift the culture of patient care from a focus on sick-care to a focus on prevention and wellness care. Little is known about how hospital systems will make this culture shift while retaining quality patient care. The purpose of this case study of a pioneering hospital-based PPACA-compliant initiative was to answer the research question of how Wallace's revitalization movement theory (RMT) "a rapid culture change model"could serve as a transferable evaluation framework for PPACA prevention and wellness care compliance in hospital-based programs. …

Social Determinants Of Health Inequality And Life Expectancy Among Women Of Edo State, Nigeria, Daniel Aromeh Odekina

Walden Dissertations and Doctoral Studies

Health inequality conflates a huge number of economic, social, and political issues. These issues, together described as social determinants, determine a population's health through influencing health status and life expectancy. The research purpose of this study was to examine how social determinants affected the life expectancy of the women of Edo State, based on secondary data from Nigeria's 2008 demographic and health survey (NDHS). The theories that guided the study were self-efficacy beliefs of the social cognitive theory and physical self-concept of the health belief model. This quantitative cross-sectional study examined the associations between socioeconomic status, nutritional status, literacy/educational attainment, …

Reducing The Surgical Patient's Family Member's Anxiety Using An Electronic Patient Tracking Board, Pamela M. Barberi

Walden Dissertations and Doctoral Studies

Family members of surgical patients experience anxiety due to lack of consistent communication during the surgical process. Attending to the needs of the surgical patient's family members is an important factor easily forgotten in a busy clinical arena. The purpose of this project was to decrease the surgical patient's family member's anxiety by providing family members with timely and consistent information regarding the patient's progress through surgery. The theoretical foundation used was general systems theory showing that a change in one part of a system leads to change in the whole system with the use of improved communication and feedback. …

Personality Factors And Nuclear Power Plant Operators: Initial License Success, Cynthia Catherine Devita-Cochrane

Walden Dissertations and Doctoral Studies

Commercial nuclear power utilities are under pressure to effectively recruit and retain licensed reactor operators in light of poor candidate training completion rates and recent candidate failures on the Nuclear Regulatory Commission (NRC) license exam. One candidate failure can cost a utility over $400,000, making the successful licensing of new operators a critical path to operational excellence. This study was designed to discover if the NEO-PI-3, a 5-factor measure of personality, could improve selection in nuclear utilities by identifying personality factors that predict license candidate success. Two large U.S. commercial nuclear power corporations provided potential participant contact information and candidate …

The Impact Of Supply Chain Logistics Performance Index On The Control Of Neglected Tropical Diseases In Low- And Middle-Income Countries, Farouk Adams Umaru

Walden Dissertations and Doctoral Studies

Neglected tropical diseases (NTD) in low- and middle-income countries are still not on target per the World Health Organization's (WHO) elimination goal of 2020. Mass drug administration (MDA) is one of the effective strategies supported by the WHO for the control and subsequent elimination of NTD. This quantitative study explored how supply chain logistic capacity may be hampering MDA coverage in countries in which the diseases are endemic. The study examined secondary data from WHO data bank for MDA coverage, to quantify the relationship between supply chain logistics capacity, as measured by the World Bank's logistics performance index (LPIs), and …

Hiv Stigma Within Religious Communities In Rural India, Krutarth J. Vyas

Walden Dissertations and Doctoral Studies

This study was conducted to gain a better understanding of HIV/AIDS-related stigma within religious communities in rural Gujarat, India. This study used the hidden distress model of HIV stigma and the HIV peer education model as conceptual frameworks to examine a rural population sample of 100 participants. Regression analysis was conducted to test if school education had a moderating effect on the relationship between illness as punishment for sin (IPS) and HIV stigma. Religiosity was tested for mediating effects on the relationship between early religious involvement (ERI) and HIV stigma. The results of this study indicated that single unemployed men …

Reasons For Living And Self-Reported Suicidal Behavior Among A Sample Of U.S. Army Personnel, Deborah Elaine Willis

Walden Dissertations and Doctoral Studies

Suicidal Behavior in the U.S. Army is a problem that persists despite significant efforts to promote help-seeking behaviors and the investment of millions of dollars to develop resilience-building interventions. Evidence-based literature supports the use of reasons for living as a protective factor against suicidal behavior in clinical and nonclinical samples, yet it has rarely been studied in an active duty (AD) Army population. This study examined the relationship between self-reported reasons for living and self-reported suicidal behavior, to determine if high levels of reasons for living correlated with low risk of suicidal behavior, over and above demographics, depression, stressful life …

Perception Of Anal Hpv Infection By Hiv-Positive Men Practicing Male-Male-Sex, Philecia Simone Mullings

Walden Dissertations and Doctoral Studies

Human papillomavirus (HPV) is a preventable, sexually transmitted infection whose prevalence has been rising dramatically among men who have sex with men (MSM) in the United States since 2008. The HPV infection rate for MSM is rising even faster for MSM who are infected with the human immunodeficiency virus (HIV) and for those who have developed acquired immune deficiency syndrome (AIDS). It is not clear whether MSM in general and MSM with HIV have the knowledge necessary to prevent infection of themselves and their partners. This phenomenological study explored the knowledge, health perceptions, attitudes, and norms of the community of …

Autonomy In The California Disability Services System, Lisa Ann S. Carbone

Walden Dissertations and Doctoral Studies

Legislation concerning California residents with intellectual and developmental disabilities (ID/DD) requires recipients of services to be treated as independent individuals while emphasizing self-determination. At the same time, under regulatory procedures, recipients are considered dependent on the delivered services and not self-determinant. Neither the California Department of Developmental Services nor the trade associations representing community service providers have established a unified, systematic practice to support self-determination. This phenomenological study explored the experience of adults with ID/DD working toward self-determination.

Specifically, it explored how medical and social models contribute to shaping and actualizing the independence of this population. Interviews with eight adults …

Providers' Knowledge Of The U.S. Health Care System And Their Medical Practice Choices: A Study Of Physicians, Residents, And Non-Physician Practitioners, Cora Case

Walden Dissertations and Doctoral Studies

The expansion of health insurance through health care reform has reduced the number of uninsured. but access to providers has not been addressed. Understanding the relationship between practice choices and aptitude of health policy and delivery is essential to determine other factors or motivators that contribute to the development of health care access policies. This descriptive study explored the value-laden elements of health care reform, such as social constructions, to learn whether there are implicit ways to address the issue of access to health care in the United States. Schneider and Ingrams's conceptualization of policy making through social construction was …

The Psychological Resilience Of Spousal Caregivers Of Multiple Sclerosis Family, Marisa Diane Diaz

Walden Dissertations and Doctoral Studies

The purpose of this quantitative study was to examine an under-researched topic: the relationship between psychological resilience and personal growth with spousal caregivers of patients diagnosed with Multiple Sclerosis (MS). Chronic illnesses contribute to potentially stressful changes (i.e., lifestyle, quality of life, financial wellbeing, and interpersonal relationships) for the caregiver. The theoretical foundation for this study was Walsh's family resilience theory, which contends that resilience is vital for coping with stressful life experiences and leading a more successful life. Three separate analyses were conducted to examine the relationship between the total scores of the RS and the PGIS, the SWLS, …

A Comparative Study Of Compliance Among Patients Attending An Opiate Outpatient Treatment Center In Rural Appalachia, Jerry Russell Morris

Walden Dissertations and Doctoral Studies

Adults with an opiate addiction have a higher rate of noncompliance with treatment, which limits its effectiveness and increases the burden of care for society. Effective treatment decreases emergency room visits, and overdoses. The tristate area of Kentucky, West Virginia, and Ohio has experienced increased opiate-related arrests and deaths. This study sought to measure the extent to which treatment type (medical treatment (MS) or faith-based component of service (FBS)) predicts compliance when measured by number of clean urine drug screens (UDSs) and number of kept pill count, over and above dual diagnosis, college education, and income. The on-site records of …

The Role Of Uae Health Professionals In Maternal And Child Health Policy, Immanuel Azaad Moonesar

Walden Dissertations and Doctoral Studies

Maternal and child health (MCH) mortality is a formidable challenge for health systems around the world according to the World Health Organization. Health professionals and practitioners within the United Arab Emirates were studied to determine the extent they were involved in the policy-making process, and the potential impact that analysis may have on new or revised MCH policies. Research on MCH policy-making and development processes are limited. The Andersen model of healthcare services utilization provides an appropriate framework for this research, enabling the analysis that influences the policy-making process in the area of MCH. Independent variables included nationality, education, work …

The Impact Of Crisis Alleviation Lessons And Methods Program On Injuries In Healthcare, Andra Lynn Ferguson

Walden Dissertations and Doctoral Studies

The purpose of this study was to examine whether Crisis Alleviation Lessons and Methods -© (CALM), as a behavioral crisis management program, was effective in reducing patient and healthcare professional injuries in a long-term residential care setting. This research was needed due to the lack of peer-reviewed scholarly literature on the effectiveness of behavioral crisis management programs, especially on programs using both nonphysical and physical de-escalation techniques, such as CALM. An auto-regressive integrated moving average (ARIMA) time series analysis was performed to examine the effect the implementation of the CALM program (independent variable) had on the rate of injuries to …

The Impact Of Self-Imposed Barriers On African Americans Successes, Pennie L. Murray

Walden Dissertations and Doctoral Studies

Researchers and economists have argued that the economic and social stagnation of African Americans is the result of their lack of self-confidence, initiative, and commitment toward their own advancement. This qualitative study examined whether historical conditioning and personal experiences have created a hypersensitivity in this population to events triggering behaviors that mirror the success fearing personality when seeking social, economic, and political advancement. It used Zuckerman and Allison's fear of success scale to identify the range of success fearing in 30 African American men and women aged 35 years or more; this group was also interviewed regarding their lived experiences …

An Evidence-Based Determination Of Whether Effective Leadership Competencies Are Universal And Transferable., John Michael Slade

Walden Dissertations and Doctoral Studies

Poor executive leadership of organizations over the last 20 years has resulted in the destruction of stakeholder value, loss of jobs, and in some cases, risk to the entire enterprise. An executive search firm database, encompassing 16,000 leaders from 300 organizations, was analyzed to determine if the commonality and transferability of leadership competences could be used to improve executive assessment. Implicit leadership theory, where leaders are gauged by the individuals that surround them, served as the theoretical foundation. The study also relies on a leadership competency model used by the executive search firm that constructed the database and is based …

A Comparison Of Regional Health Care Structures For Emergency Preparedness, Leslie Porth

Walden Dissertations and Doctoral Studies

Since 2001, increased policy attention and federal funding mechanisms have required more effective disaster response by government actors and private sector organizations, including the health care system. However, there is limited scholarly evidence documenting which structural elements have been associated with efficacious regional coalitions. This study addressed the gap by examining whether the number of different participating disciplines (a proxy for coalition roles), community setting, and prior weather-related disaster declaration influenced the number of activities (a proxy for coalition responsibilities) conducted by the health care coalition. Social network theory was the theoretical lens with which the study results were used …

The Relationship Between Social Intelligence And Hearing Loss, Deborah Finken

Walden Dissertations and Doctoral Studies

This study was an exploration of adults with long-term hearing loss (LTHL) and how it may relate to social intelligence (SI) proficiency. The outcome of this study was intended to illuminate a gap in the literature, namely, the manner in which those with long-term LTHL were able to understand social situations and communicate with others when auditory comprehension was limited. A quantitative nonexperimental method was used that provided the Tromso Social Intelligence Scale (TSIS) to a group of 66 adults with LTHL who were diagnosed with hearing loss as children, as well as a group of 70 adults with no …

Relationship Between Modality And The Degree Of Knowledge Retention In Bioterrorism Training, Gaylon Rashun Crawford

Walden Dissertations and Doctoral Studies

A public health workforce must be trained to react quickly, especially in the case of terrorist attack. Political leaders and emergency management experts have often cited inadequate emergency training as a contributing factor in the public health system's failed preparations for a bioterrorist event. As a result of these failures, billions of dollars have been allocated towards correcting infrastructure deficiencies including training for public health nurses (PHNs), who are critical to a communitywide medical response. This quantitative study used Pearson's correlation and a multivariate regression analysis to evaluate the most effective modality of bioterrorism training (BTT) for PHNs working in …

Differences Between For-Profit And Nonprofit Hospitals: Perceived Quality And Access, Michael Ray Eiland

Walden Dissertations and Doctoral Studies

Despite a large body of literature addressing the issue, questions remain about whether nonprofit hospitals provide more community benefit than do for-profit hospitals. This lack of information impacts governments, hospitals, and the healthcare industry, as stakeholders attempt to generate requirements to which hospitals should adhere to maintain nonprofit status, and thus tax exemption. This study addressed this lack of information by examining U.S. hospitals through the lens of stewardship theory to determine whether nonprofits are better stewards of the public good than for-profits, and thus likely to provide higher quality and access. The study applied logistic regression to Centers for …

Internal Attributes That Mitigate Perceived Job Insecurity: Improving Employee Satisfaction, Shelly Leigh Rogers-Sharer

Walden Dissertations and Doctoral Studies

Employee satisfaction has been found to have a strong relationship with perceived job security. This study explored job insecurity in an unstable global economy. Specifically, it examined internal attributes of employees, hypothesizing that such attributes would enable employees to better cope with work-related stressors such as job insecurity. Specific attributes of personality and employability were assessed as potential moderators of job satisfaction and security, utilizing the theory of work adjustment and person-environment correspondence as theoretical frameworks. The specific attributes included facets of conscientiousness and neuroticism as well as dispositions of employability including openness to change at work, work and career …