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Walden Dissertations and Doctoral Studies

2011

Health and Medical Administration

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Articles 1 - 19 of 19

Full-Text Articles in Medicine and Health Sciences

Perspectives Of Close Relatives In Pediatric Palliative Care: A Grounded Theory Approach, Janelle Marie Feyh Jan 2011

Perspectives Of Close Relatives In Pediatric Palliative Care: A Grounded Theory Approach, Janelle Marie Feyh

Walden Dissertations and Doctoral Studies

Pediatric palliative care has recently become a priority in the healthcare field and is implemented at the time of diagnosis rather than days or weeks before the child's death. Social constructivism theory in which humans generate meaning from their experiences was utilized as a general framework to determine the impact of pediatric palliative care on close relatives. The purpose of this grounded theory study was to generate a substantive theory that explains how close relatives such as grandparents, aunts, and uncles of a child with cancer experience palliative care. The participants of the study included close relatives of children in …


Acceptance And Usage Of Electronic Health Record Systems In Small Medical Practices, Ritu Tannan Jan 2011

Acceptance And Usage Of Electronic Health Record Systems In Small Medical Practices, Ritu Tannan

Walden Dissertations and Doctoral Studies

One of the objectives of the U.S. government has been the development of a nationwide health information infrastructure, including adoption and use of an electronic health records (EHR) system. However, a 2008 survey conducted by the National Center for Health Statistics indicated a 41.5% usage of the EHR system by physicians in office-based practices. The purpose of this study was to explore opinions and beliefs on the barriers to the diffusion of an ERH system using Q-methodology. Specifically, the research questions examined the subjectivity in the patterns of perspectives at the preadoption stage of the nonusers and at the postadoption …


A Case Study Of Primary Healthcare Services In Isu, Nigeria, Raymond Ogu. Chimezie Jan 2011

A Case Study Of Primary Healthcare Services In Isu, Nigeria, Raymond Ogu. Chimezie

Walden Dissertations and Doctoral Studies

Access to primary medical care and prevention services in Nigeria is limited, especially in rural areas, despite national and international efforts to improve health service delivery. Using a conceptual framework developed by Penchansky and Thomas, this case study explored the perceptions of community residents and healthcare providers regarding residents' access to primary healthcare services in the rural area of Isu. Using a community-based research approach, semistructured interviews and focus groups were conducted with 27 participants, including government healthcare administrators, nurses and midwives, traditional healers, and residents. Data were analyzed using Colaizzi's 7-step method for qualitative data analysis. Key findings included …


Wage Equality Among Internationally Educated Nurses Working In The United States, Sat Ananda Hayden Jan 2011

Wage Equality Among Internationally Educated Nurses Working In The United States, Sat Ananda Hayden

Walden Dissertations and Doctoral Studies

Discrimination against immigrants based on country of origin, gender, or race is known to contribute to wage inequality, lower morale, and decrease worker satisfaction. Healthcare leaders are just beginning to study the impact of gender and race on the wages of internationally educated nurses (IENs). Grounded in Becker's theory of discrimination, this cross-sectional study examined nursing wages for evidence of wage inequality among IENs working in the United States using secondary data collected in the 2008 quadrennial National Sample Survey of Registered Nurses. Ordinary least square regression coupled with the Blinder-Oaxaca wage decomposition was used to analyze the wages of …


The Influence Of Community Support Services In Reducing Potentially Preventable Readmissions, Camille Rose Bash Jan 2011

The Influence Of Community Support Services In Reducing Potentially Preventable Readmissions, Camille Rose Bash

Walden Dissertations and Doctoral Studies

Recently, the Centers for Medicare and Medicaid Services (CMS) ranked all hospitals based on Medicare readmission rates for heart attacks, heart failure, and pneumonia. CMS offered subsidies to hospitals ranked in the 4th quartile to develop community support services to reduce the problem of potentially preventable readmissions (PPRs). CMS cited 4 of the 5 hospitals in Prince George's County in the 4th quartile. The purpose of this quantitative research study was to investigate the relationship between community support services and the reduction of PPRs in Prince George's County. The Evans and Stoddart field model of health and well-being guided this …


Physician Decision Criteria Regarding Omega-3 Dietary Supplements, Warren P. Lesser Jan 2011

Physician Decision Criteria Regarding Omega-3 Dietary Supplements, Warren P. Lesser

Walden Dissertations and Doctoral Studies

American Heart Association officials and other expert cardiologists recommend omega-3 (n-3) dietary supplementation for the secondary prevention of cardiovascular disease, a prevalent health problem in the United States. Physicians' lack of understanding of possible n-3 preventive health benefits results in underprescribing n-3 dietary supplements and lower n-3 dietary supplement product sales. N-3 dietary supplement marketers do not understand physician n-3 prescribing decision criteria enough to optimize high-impact communication to physicians to increase n-3 dietary supplement product use. The purpose of this phenomenological research study was to improve n-3 marketers' understanding of how physicians reach decisions to prescribe or recommend products …


Learning Style Needs And Effectiveness Of Adult Health Literacy Education, Leah A. Grebner Jan 2011

Learning Style Needs And Effectiveness Of Adult Health Literacy Education, Leah A. Grebner

Walden Dissertations and Doctoral Studies

Low health literacy impacts an individual's ability to comprehend communication from healthcare providers, reduces access to healthcare, and contributes to increased mortality. The purpose of this study was to evaluate the impact of learning style on adult health literacy education. The health belief model, protection motivation theory, the transtheoretical model, and social cognitive theory were used to analyze the data in this study, and to further develop effective health literacy education. The research questions addressed the effectiveness of educational intervention adjusted to their appropriate learning style in comparison to a standardized health literacy intervention and potential difference, according to type …


An Examination Of Awareness Of Over-The-Counter Nonsteroidal Anti-Inflammatory Drugs And Adverse Events, Michelle Popa Jan 2011

An Examination Of Awareness Of Over-The-Counter Nonsteroidal Anti-Inflammatory Drugs And Adverse Events, Michelle Popa

Walden Dissertations and Doctoral Studies

The elderly population is among the fastest growing populations in the United States. Finding and consuming medications safely and effectively are challenging endeavors for this population. Nonsteroidal anti-inflammatory drugs (NSAIDs) are a widely consumed class of medications among the elderly population, with 70% of individuals consuming over-the-counter (OTC) NSAIDs once a week and 34% using them daily. The purpose of this quantitative study was to determine whether (a) patients are aware of the risks associated with the consumption of NSAIDs, and (b) there are differences in awareness based upon specific demographic characteristics and levels of patient-physician communication. The health belief …


Barriers To Healthcare Access For Members Of The Bronx Ghanaian Immigrant Muslim Community In New York City, Adam A. Musah Jan 2011

Barriers To Healthcare Access For Members Of The Bronx Ghanaian Immigrant Muslim Community In New York City, Adam A. Musah

Walden Dissertations and Doctoral Studies

Cultural beliefs on healthcare in the 21st century by the African immigrants in the United States have contributed to the severity of illnesses in their communities. The results of this research identified the healthcare barriers experienced by members of the Bronx Ghanaian Immigrant Muslim Community (BGIMC) in New York City. The purpose of this research was to investigate the influence of education, immigration status, health insurance status, and cultural beliefs on the BGIMC members' perceived access and willingness to use healthcare services for various ailments. A sample of 156 male and female members of the BGIMC completed the survey questionnaire. …


Evolution Of Physician-Centric Business Models Under Patient Protection And Affordable Care Act, Tanya Nix Jan 2011

Evolution Of Physician-Centric Business Models Under Patient Protection And Affordable Care Act, Tanya Nix

Walden Dissertations and Doctoral Studies

For several decades, the cost of medical care in the United States has increased exponentially. Congress enacted the Patient Protection and Affordable Care Act (PPACA) of 2010 to ensure affordable healthcare to the citizens of the United States. The purpose of this case study was to explore physicians' perspectives regarding physician-centric business models evolving under the requirements of PPACA legislation. Complex adaptive systems formed the conceptual framework for this study. Data were gathered through face-to-face, semistructured interviews and e-mail questionnaires with a purposeful sample of 20 participants across 14 medical specialties within Northeast Texas. Participant perceptions were elicited regarding opinions …


Leadership Styles And Nursing Satisfaction Rates, Wilma Lee Jones Jan 2011

Leadership Styles And Nursing Satisfaction Rates, Wilma Lee Jones

Walden Dissertations and Doctoral Studies

The purpose of this project was to translate evidence-based literature into policy and practice guidelines in order to improve leadership standards and skills among nurse managers and improve patient outcomes and the quality of care. Guided by the American Nurses Credentialing Center Magnet Model and Lewin's change theory, which sets the framework for creating exceptional nursing leaders, a literature search was conducted from studies ranging from 2010 to 2012 from several databases. Inclusion criteria were based on the presence of one or more leadership styles discussed in the articles and the impact of leadership style on nursing satisfaction. A total …


Effect Of Clinical Laboratory Practitioner Licensing On Wages, Mary Hotaling Jan 2011

Effect Of Clinical Laboratory Practitioner Licensing On Wages, Mary Hotaling

Walden Dissertations and Doctoral Studies

Professional licensing directly affects about 29% of U.S. workers and is considered a primary means to establish and maintain health care practitioner competence. Clinical laboratory practitioner licensing was largely ignored in the literature with only 2 studies 30 years apart that provided conflicting conclusions regarding wage effects. This research provided the first study of clinical laboratory practitioner licensing effects on wages after controlling for human capital and individual characteristics wage determinants. This nonexperimental correlational study extended the literature on licensing effects on wages, including women's wages and professions not uniformly licensed across 50 states. The theoretical foundation relied on the …


Care Coordination, Family-Centered Care And Functional Ability In Children With Special Health Care Needs In The United States, Madeline Marti-Morales Jan 2011

Care Coordination, Family-Centered Care And Functional Ability In Children With Special Health Care Needs In The United States, Madeline Marti-Morales

Walden Dissertations and Doctoral Studies

Children with special health care needs (CSHCN) generally have physical, mental, or emotional conditions that require a broader range and greater quantity of health and related services compared to typical children. Care coordination (CC) and family-centered care (FCC) are necessary in the quality of health care for CSHCN. A gap exists in the literature regarding the impact of CC and FCC on children's functional ability (FA). Previous researchers have focused on met and unmet health care needs, but not on health outcomes or functionality. The purpose of this study was to determine if there was an association between CC, FCC, …


Hardiness And Attitude On Hypertension Treatment Adherence Among Nigerian Health Care Workers, Chinwe N. Egwuagu-Ndubisi Jan 2011

Hardiness And Attitude On Hypertension Treatment Adherence Among Nigerian Health Care Workers, Chinwe N. Egwuagu-Ndubisi

Walden Dissertations and Doctoral Studies

Racial and ethnic minorities in the United States have higher rates of hypertension than European Americans. In this ethnographic study, 30 Nigerian immigrant health care workers with hypertension described their self-efficacy management of the disease to ascertain the relationship between health-related hardiness, individual attitudes on compliance, and medication adherence self-efficacy. Using a mixed methods designs comprised of survey tools and focus-group questionnaires, the research questions were focused on understanding attitudes and health practices within Nigerian culture that support self-efficacy management. The theoretical framework for this study is the social learning theory and the social cognitive theory postulated by Bandura. Content …


Experiences Of Older African American Women With Breast Cancer Screening And Abnormal Mammogram Results, Marshalee George Jan 2011

Experiences Of Older African American Women With Breast Cancer Screening And Abnormal Mammogram Results, Marshalee George

Walden Dissertations and Doctoral Studies

Even with access to well-known breast cancer treatment centers, older African American women continue to have higher breast cancer mortality compared to their European American counterparts. Researchers have theorized relationships among diagnostic delay, socioeconomic status (SES) factors, beliefs, culture, and breast cancer mortality in African American women ages 40 to 64, but these same relationships among African American women ages 65 to 80 have not been investigated. The purpose of this qualitative study was to describe older African American women's experiences with abnormal mammograms. The quality-caring model and critical race theory were used through narration to show the association of …


A Synthesized Model Of Compliance Based On Physician And Patient Reported Barriers To Hypertension Guidelines, Pamela Ballou-Nelson Jan 2011

A Synthesized Model Of Compliance Based On Physician And Patient Reported Barriers To Hypertension Guidelines, Pamela Ballou-Nelson

Walden Dissertations and Doctoral Studies

Hypertension affects as many as 50-70 million Americans; early and consistent compliance to hypertension guidelines is important to prevent heart attack and stroke, both leading causes of death in the United States. Despite the advances in medicine and health-care technology, the effectiveness with which hypertension is managed at the individual and community level is less than optimal. The research questions in this study addressed the lack of physician compliance to hypertension guidelines and why patients fail to follow guidelines. Improving hypertension management depends on bridging the gap between physician awareness of evidence-based guidelines and patient compliance. Grounded theory was used …


Public Sponsored Health Insurance To Improve Health Outcomes With Implications For Government Health Policy, Design, And Decision Making, Steven M. Wagner Jan 2011

Public Sponsored Health Insurance To Improve Health Outcomes With Implications For Government Health Policy, Design, And Decision Making, Steven M. Wagner

Walden Dissertations and Doctoral Studies

This research sought to ascertain the extent to which providing public sponsored health insurance (PSHI) to previously uninsured Mexican-American Hispanics improves health outcomes among those requiring ongoing treatment to control diabetes. Prior research utilizing insurance access theory; access, equity, and health outcome interrelationship theory; health affordability theory; and financial and resource burden theory suggests the uninsured receive less care than the insured, with delayed treatment, leading to chronic conditions. This research tested each of those major theoretical constructs into a blended conceptual framework based on the notion that providing health insurance helps alleviate the disabling effects of diabetes among this …


Evaluation Of Bureau Practice For Illegal Drugs Use Among Teens, Sharon D. Heard Jan 2011

Evaluation Of Bureau Practice For Illegal Drugs Use Among Teens, Sharon D. Heard

Walden Dissertations and Doctoral Studies

The Bureau of Substance Abuse Treatment Recovery and Prevention, which oversees drug intervention services for Detroit residents, has found the city's illegal drug use among teens to mirror national rates. Illegal drug use is associated with addiction, major health problems, and stigma. Incorporating evidence-based screening during all teen health care visits would decrease missed opportunities to identify at-risk behaviors, the number of teens that do not receive intervention, and the stigma associated with screening. The purpose of this project was to develop evidence-based policy and practice guidelines for teen screening services for illegal drug use. The Plan-Do-Study-Act (PDSA) model was …


Factors Affecting The Job Satisfaction Of Registered Nurses Working In The United States, Ann Marie Huffenberger Jan 2011

Factors Affecting The Job Satisfaction Of Registered Nurses Working In The United States, Ann Marie Huffenberger

Walden Dissertations and Doctoral Studies

As the health care sector in the United States undergoes transformation, job dissatisfaction has become a problem that is confounded by the challenge that nurse executives encounter in understanding the aspirations of an increasingly diverse workforce. A quantitative survey was conducted online using a representative sample of registered nurses (RNs) nationwide. Approximately 127,000 RNs from across the nation received an invitation, and 272 RNs participated. Factorial ANOVAs were performed to answer the research questions of whether aspects of job satisfaction differ across the demographic factors of a diverse RN workforce. No differences exist in personal satisfaction or satisfaction with workload …