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Walden Dissertations and Doctoral Studies

2018

Articles 61 - 90 of 516

Full-Text Articles in Medicine and Health Sciences

Relationship Between The U.S. Air Force Physical Fitness Assessment And Healthcare Utilization, Elena Arushanyan Jan 2018

Relationship Between The U.S. Air Force Physical Fitness Assessment And Healthcare Utilization, Elena Arushanyan

Walden Dissertations and Doctoral Studies

Escalating health care costs in the military health system are not sustainable long term. Regular physical activity has been shown to improve health and reduce health care costs. Military members serving in the United States Air Force (USAF) are encouraged to maintain physical fitness year-round and undergo mandatory physical fitness assessments (PFAs) annually. The purpose of this quantitative correlational study was to determine the nature of the relationship between the timing of the PFA and health care utilization (HU) by active duty service members assigned to the United Kingdom's USAF military treatment facility. Donabedian's framework and the logic process model …

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Elements Of Expatriate Adjustment In Host Country Organizations, Denise Suzanne Schickel Jan 2018

Elements Of Expatriate Adjustment In Host Country Organizations, Denise Suzanne Schickel

Walden Dissertations and Doctoral Studies

Globalization and international business increasingly require the services of skilled expatriates in overseas offices. Over the past 50 years, numerous studies have focused on various factors affecting expatriate adjustment, primarily through quantitative research, reaching no conclusions on what factors in cross-cultural training would guarantee expatriate success. Expatriate failure has high personal and organizational costs. The purpose of this study was to use the qualitative methodology of narrative inquiry to investigate the adjustment, transition, and repatriation experience as a holistic process. Two theoretical constructions, Bandura's social learning theory, applied to the learning process in an international assignment, and social identity theory, …

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Education Plan To Empower Wound Care Nurses For Evidence-Based Practice, Patricia Stevenson Jan 2018

Education Plan To Empower Wound Care Nurses For Evidence-Based Practice, Patricia Stevenson

Walden Dissertations and Doctoral Studies

Non-healing wounds can claim thousands of lives and costs billions of dollars each year, and nurse-led wound clinics are becoming necessary to fill a gap in care for patients with wounds. Even among certified wound nurses using evidence-based clinical protocols, key considerations of care are being missed. Therefore, this project was focused on developing and validating a new biofilm education module for certified or certification eligible wound care nurses. The aim of the module was to boost clinical assessment knowledge and improve patient outcomes. Benners skill acquisition model informed the development of this project. The design of the project also …

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Tobacco Cessation Education For Primary Care Nurses And Advanced Practice Providers, Stephanie Scammell Jan 2018

Tobacco Cessation Education For Primary Care Nurses And Advanced Practice Providers, Stephanie Scammell

Walden Dissertations and Doctoral Studies

Tobacco use is the leading cause of premature and preventable death in the United States, yet millions of Americans continue to use tobacco. Nursing professionals comprise the largest health care provider group and can help improve tobacco cessation among their patients. The purpose of this doctoral project was to increase nursing staff and advanced practice providers knowledge, skills, and confidence related to tobacco cessation interventions. The project took place in a family medicine clinic in Central Texas. The nursing staff (which included 1 registered nurse and 3 licensed vocational nurses) and advanced practice providers (which included 3 nurse practitioners and …

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Educating Oncology Nurses About The Emotional Impact Of Cancer Diagnosis, Jonnell Ortiz Zayas Jan 2018

Educating Oncology Nurses About The Emotional Impact Of Cancer Diagnosis, Jonnell Ortiz Zayas

Walden Dissertations and Doctoral Studies

Anxiety and depression are common mood disorders in cancer patients, regardless of mental state prior to diagnosis. A gap in the education of oncology nurses in an eastern Caribbean island was discovered regarding their ability to identify anxiety and depression symptoms and to help patients who suffered from these disorders. The purpose of this project was to improve oncology nurses' assessment skills by reviewing appropriate use of the Hospital Anxiety and Depression Scale (HADS) tool and familiarizing nurses with resources to help patients who score high on the HADS. The Levine conservation model was the theoretical framework for this project. …

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A Phenomenological Investigation Of Adult Daughters Of Childhood Paternal Abandonment, Mary Spencer Jan 2018

A Phenomenological Investigation Of Adult Daughters Of Childhood Paternal Abandonment, Mary Spencer

Walden Dissertations and Doctoral Studies

A father's abandonment of his minor daughter can leave an indelible impression on her psyche -- one that can forever affect her intimate romantic relationships. The purpose of this qualitative phenomenological study was to explore where women who were abandoned by their fathers prior to the age of 18 are today as adults in terms of their intimate romantic relationships and how they develop and engage in these relationships. The research questions examined how a daughter being abandoned by her father prior to the age of 18 relates to where she is today in her adult intimate romantic relationships and …

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Health Care Facilities As A Predictor Of Breast Cancer Survival Rates, Elizabeth Natalie Webster Jan 2018

Health Care Facilities As A Predictor Of Breast Cancer Survival Rates, Elizabeth Natalie Webster

Walden Dissertations and Doctoral Studies

The disparity between survival rates for Black and White women with breast cancer is well documented and has been examined in terms socioeconomics, environment, tumor type, and genetics. However, there is little examination of the role of health care facilities in cancer disparities. Health care facilities are representative of societal norms and beliefs that include location, quality of care, finance, policies, and staffing; therefore, they are a proxy for social justice and social change. The purpose of this study was to examine correlations between health care facility type; social determinants of cancer such as poverty, culture, and social justice; and …

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Reducing Home Health Copd-Related 30-Day Hospital Readmissions Using Telehealth Technology, Steven Eric Stammer Jan 2018

Reducing Home Health Copd-Related 30-Day Hospital Readmissions Using Telehealth Technology, Steven Eric Stammer

Walden Dissertations and Doctoral Studies

Chronic obstructive pulmonary disease (COPD) is a collection of chronic conditions that results in irreparable lung damage and stress to patients. COPD also has considerable financial impacts on health care entities due to frequent hospital readmissions of COPD patients. The Centers for Medicare and Medicaid Services penalize care entities for 30-day hospital readmissions. Many rehospitalizations attributed to COPD are due to exacerbations, often preceded by physiologic and emotional changes that can be monitored, allowing action to be taken to prevent readmissions. The practice problem for this quality improvement project explored whether the use of remote home monitoring of COPD patients …

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Spatiotemporal Variations In Coexisting Multiple Causes Of Death And The Associated Factors, Emmanuel Oluwatobi Salawu Jan 2018

Spatiotemporal Variations In Coexisting Multiple Causes Of Death And The Associated Factors, Emmanuel Oluwatobi Salawu

Walden Dissertations and Doctoral Studies

The study and practice of epidemiology and public health benefit from the use of mortality statistics, such as mortality rates, which are frequently used as key health indicators. Furthermore, multiple causes of death (MCOD) data offer important information that could not possibly be gathered from other mortality data. This study aimed to describe the interrelationships between various causes of death in the United States in order to improve the understanding of the coexistence of MCOD and thereby improve public health and enhance longevity. The social support theory was used as a framework, and multivariate linear regression analyses were conducted to …

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Association Between Androgen Deprivation Therapy For Prostate Cancer And Alzheimer's Disease, Gina Giannantoni-Ibelli Jan 2018

Association Between Androgen Deprivation Therapy For Prostate Cancer And Alzheimer's Disease, Gina Giannantoni-Ibelli

Walden Dissertations and Doctoral Studies

Alzheimer's disease (AD) is the most common progressive, neurodegenerative disease and form of dementia. The hallmarks of AD are extracellular accumulation of amyloid beta protein, resulting in neuritic, senile plaques and intracellular accumulation of tau protein. AD mainly arises from imbalance of amyloid beta protein production and its clearance in the brain. Testosterone modulates production of amyloid beta protein by decreasing its accumulation. Prostate cancer remains a substantial public health challenge in the United States. While androgen deprivation therapy (ADT) is an effective treatment for prostate cancer, it may be associated with cognitive impairment due to decreased levels of testosterone. …

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Etiological Perspectives Of Abdl Behavior From Members Of An Online Abdl Community, Jennie Marie Hilleren Jan 2018

Etiological Perspectives Of Abdl Behavior From Members Of An Online Abdl Community, Jennie Marie Hilleren

Walden Dissertations and Doctoral Studies

Atypical sexual behavior is often viewed from a perspective of pathology and non-clinical samples are not typically used in research. The current exploratory research is a qualitative study that examined the etiological perspectives of Adult Baby/ Diaper Lover (ABDL) behavior from members of an online ABDL community. Archival survey data from an online sample (N = 1,795) of ABDL participants were used. The theories informing this research included attachment theory and the sexual health model. Research questions included an examination of: (a) what we can be learn from the way an ABDL individual perceives the origin of ABDL behavior, (b) …

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Exploring Disaster Preparedness For The Aging Population, Gladysmarie W.R. Harris Jan 2018

Exploring Disaster Preparedness For The Aging Population, Gladysmarie W.R. Harris

Walden Dissertations and Doctoral Studies

Older adults are encountering harsh recovery after disasters, and compounding this problem is the lack of research on older adults' perceptions on disaster preparedness as aging affects the ability to react to emergency situations. To partially address that gap, the purpose of this general qualitative research study was to use Rotter's spectrum of locus of control theory to examine the level of preparation regarding disaster preparation of older adults who were living independently in single-family homes in a state affected by Hurricane Sandy. Data were collected through a qualitative survey distributed to adults aged 65 to 80-years (N=88) and publicly …

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Medication-Assisted Therapy Interventions And Prescription Opioid Misuse, Stella Kiah Jefferies Jan 2018

Medication-Assisted Therapy Interventions And Prescription Opioid Misuse, Stella Kiah Jefferies

Walden Dissertations and Doctoral Studies

Opioid drug misuse and dependence are a social and public health problem in the United States. Prescription opioid abuse and misuse have been associated with substantial morbidity and mortality rates as well as social and economic costs. The purpose of this project was to provide a systematic review of literature on the effectiveness of medication-assisted therapy interventions in addressing the problem of prescription opioid misuse in health care settings. The systematic review was completed through a literature search conducted across five electronic databases. The review was guided by the health belief model and eligible studies were rated using Johns Hopkins …

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Health Literacy And Hypertension Management In Haitian Immigrants, Suzie Jean Jan 2018

Health Literacy And Hypertension Management In Haitian Immigrants, Suzie Jean

Walden Dissertations and Doctoral Studies

Patient compliance and health care communication are impacted by health literacy. Poor health choices, frequent hospital visits, noncompliance with health regimens, and higher health costs are all associated with low health literacy. The purpose of this cross-sectional study was to determine whether there was an association between health literacy as measured by primary language spoken in the home (Creole vs. English) and hypertension self-management as measured by regular use of medication and cutting down on foods high in salt, and whether there was an association between Haitian men, women, their education level, or level of poverty in relation to health …

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Evaluation Of Use Of Teach-Back For Patient Education, Tamara J. Orr Jan 2018

Evaluation Of Use Of Teach-Back For Patient Education, Tamara J. Orr

Walden Dissertations and Doctoral Studies

The focus of this quality improvement doctoral project was the evaluation of an organization's standardized use of the teach-back process for patient education implemented in February 2018. Teach-back is a process in which the patient restates the key concepts for self-management, so the nurse can assess the effectiveness of the teaching and learning process. The practice-focused question compared 4 questions on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey with literature and recommendations from major health care organizations. The Iowa Model was used to guide the project. The literature review was completed using the Cumulative Index to …

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Women In Mississippi Undergoing Hysterectomies In Absence Of Comprehensive Informed Consent Law, Tammy Shaffer Jan 2018

Women In Mississippi Undergoing Hysterectomies In Absence Of Comprehensive Informed Consent Law, Tammy Shaffer

Walden Dissertations and Doctoral Studies

Only three states have enacted informed consent laws aimed at providing more information concerning any alternative treatments for women who undergo hysterectomy. This study attempted to fill the research gap regarding consent laws and perceptions of women who underwent hysterectomy in a state with no informed consent laws. Supported by the health belief model (HBM), the research questions focused on the perceptions of women and their lived experiences. The purpose of this qualitative study was to examine the beliefs and attitudes of women in a state with no informed consent laws. Interviews were the main data collection technique. The participants …

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Reducing Lateral Violence Among Nurses Through Staff Education, Alexandra Lindsay Tripp Jan 2018

Reducing Lateral Violence Among Nurses Through Staff Education, Alexandra Lindsay Tripp

Walden Dissertations and Doctoral Studies

Most nurses experience lateral violence (LV) during their careers. LV can be detrimental to nurses' livelihoods and careers, to facilities due to nurse replacement costs, to the nursing profession due to attrition, and to patient safety. The purpose of this staff education project was to educate registered nurses on the issue of LV and to equip nurses to respond to their aggressors. The project question addressed whether education would increase awareness of LV and empower nurses to stand up to their aggressors. The theory of the nurse as the wounded healer, social learning theory, and the theory of reciprocal determinism …

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Challenges For Providers Working In Assertive Community Treatment, Ngozi Nkechi Orabueze Jan 2018

Challenges For Providers Working In Assertive Community Treatment, Ngozi Nkechi Orabueze

Walden Dissertations and Doctoral Studies

This project explored the challenges confronting clinicians who work with the Assertive Community Treatment Program (ACT), a government-sponsored clinic-based program providing services for individuals with persistent and recurrent mental health challenges in a large metropolitan city in the southern United States. The project involved semi-structured interviews with 15 health care clinicians to explore what they perceived as challenges and their recommendations for addressing them. Themes were organized around the 6 dimensions of the the relationship-based care model: leadership, teamwork, professional nursing, care delivery, resources, and outcomes. Identified patient challenges included transportation, lack of health insurance, housing, acceptance of certified peer …

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Educating Preoperative Staff On Operative Glycemic Control Guideline, Valerie Braddock Jan 2018

Educating Preoperative Staff On Operative Glycemic Control Guideline, Valerie Braddock

Walden Dissertations and Doctoral Studies

Glycemic control of the perioperative patient improves patient outcomes, specifically prevention of surgical-site infections. The prevention of surgical-site infections helps to reduce complications that can increase length of stay and readmissions, thereby increasing healthcare costs. The purpose of this project was to provide an educational module to the same-day surgery nurses on a clinical guideline to maintain glycemic control of the perioperative patient to prevent surgical-site infections. Lewin's change theory guided the development of a clinical practice guideline (CPG) for nurses to standardize the glycemic management of the perioperative patient. This project was conducted to determine whether educating nurses through …

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Sickle Cell Disease Pain Burden And Quality Of Life Among Black Children In Mississippi, Laquita Nichelle Cooper Jan 2018

Sickle Cell Disease Pain Burden And Quality Of Life Among Black Children In Mississippi, Laquita Nichelle Cooper

Walden Dissertations and Doctoral Studies

Acute and chronic pain is a common hallmark of sickle cell disease (SCD) in children and adolescents, which can have a profound effect on their quality of life (QOL). However, this relationship is not well quantified. The purpose of this quantitative study was to examine the relationship between SCD pain burden and QOL among Black children ages 8-17 in Mississippi with SCD. The secondary aim was to compare children and caregiver reports of SCD pain burden and QOL with SCD. The social ecological model was used to identify personal factors that influence SCD pain burden and QOL of children with …

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Intimate Partner Violence And Posttraumatic Stress Disorder Symptoms Among College Women, Crystal Bowler Jan 2018

Intimate Partner Violence And Posttraumatic Stress Disorder Symptoms Among College Women, Crystal Bowler

Walden Dissertations and Doctoral Studies

Approximately 35% of women in the United States experience intimate partner violence (IPV). IPV could be linked to symptoms of posttraumatic stress disorder (PTSD) that result in long-term mental health issues. Public health professionals, college counselors, and educators require information to assist in identifying college-age women who may be affected by IPV. The purpose of the study was to explore the association between the occurrence of symptoms of PTSD and IPV among college-aged women. The socioecological model was the theoretical framework for the study. A total of 199 cases were selected from National Intimate Partner & Sexual Violence Survey dataset …

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Korean Immigrant Women's Perceptions Of Cervical Cancer Screening In Hawaii, Eurina Yujin Cha Jan 2018

Korean Immigrant Women's Perceptions Of Cervical Cancer Screening In Hawaii, Eurina Yujin Cha

Walden Dissertations and Doctoral Studies

Minority immigrant women are more likely to be diagnosed with and suffer from cervical cancer compared to other minority women in the United States. The purpose of this qualitative ethnographic study was to explore cultural health perceptions, behaviors, and barriers to cervical cancer prevention among Korean immigrant women (KIW) in Hawaii. The health belief model and the social-ecological model were used to guide the study. Data were collected using individual structured interviews with 20 KIW ages 21 to 65 who are first-generation KIW immigrant to Hawaii. Data were coded and analyzed to identify themes. Findings revealed that participants (a) prefer …

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Emergency Room Nurse Perceptions Of Emotional Intelligence, Ingrid Astralaga Jan 2018

Emergency Room Nurse Perceptions Of Emotional Intelligence, Ingrid Astralaga

Walden Dissertations and Doctoral Studies

The delivery of quality care has been a priority for the health care industry in the United States. Researchers have established positive correlations between the levels of emotional intelligence of registered nurses and their clinical performances. However, new evidence suggests the need to enhance the use of emotional intelligence (EI) in high-risk clinical units. With the intent to understand the use of EI, a phenomenological research approach was used to identify the emergency room nurse's understanding of EI. The Four-branch Model of Emotional Intelligence was used as the theoretical framework, while the research question identified the emergency room nurse's perception …

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Effects Of Menafrivac® Introduction In The African Meningitis Belt, 2010-2017, Andre Arsene Bita Fouda Jan 2018

Effects Of Menafrivac® Introduction In The African Meningitis Belt, 2010-2017, Andre Arsene Bita Fouda

Walden Dissertations and Doctoral Studies

Meningococcal meningitis is a burden in the African meningitis belt. Before 2010, Neisseria meningitidis serogroup A (N. meningitidis A) was the predominant pathogen causing deathly epidemics. MenAfriVac® vaccine protects against N. meningitidis A. It was introduced in 2010 into highest meningitis risk health districts. There was limited data on the effects of MenAfriVac®, mainly on the degree of relationship between N. meningitidis A and the MenAfriVac® immunization. The social ecological model was used as a theoretical framework for this study. The purpose of this quantitative study was to assess the effectiveness of MenAfriVac® from 2010 to 2017 in 21 out …

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Smoking Cessation Education For Acute Care Nurses, Dawn Garcia-Brinker Jan 2018

Smoking Cessation Education For Acute Care Nurses, Dawn Garcia-Brinker

Walden Dissertations and Doctoral Studies

Tobacco use among veterans is significantly higher than among members of the general population. The purpose of this quality-improvement project was to increase acute care staff members' knowledge and confidence in using tobacco cessation interventions to increase quit rates among the inpatients of a veterans' hospital in the midwestern region of the United States. An evidence-based, standardized Tobacco Tactics Toolkit was developed and implemented, and a 6 sigma method guided the quality improvement process to define, measure, analyze, improve, and control the tobacco-cessation education initiative. The reach, effectiveness, adoption, implementation, and maintenance framework was used to ensure that evidence-based interventions …

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Under-Reporting Of Adverse Drug Reactions To The Food & Drug Administration, James Alexander Lamb Jan 2018

Under-Reporting Of Adverse Drug Reactions To The Food & Drug Administration, James Alexander Lamb

Walden Dissertations and Doctoral Studies

This study examined the potential significant differences in the distribution of adverse drug reactions (ADRs) by reporter (consumer versus physician) and patient outcome at case and event level. This study also contains exploratory questions to evaluate reporting of ADRs by consumers versus physician by system organ class (SOC) and reporter demographics within the United States Food & Drug Administration Adverse Event Reporting System (FAERS). The theoretical foundation applied in this quantitative study was the social amplification of risk framework. Data from the second quarter of 2016 were obtained from FAERS, and a total of 87,807 ADR reports corresponding to 143,399 …

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Intensive Care Unit Nurse Education To Reduce Sepsis Mortality Rates, Corina Meade Jan 2018

Intensive Care Unit Nurse Education To Reduce Sepsis Mortality Rates, Corina Meade

Walden Dissertations and Doctoral Studies

Sepsis causes major health care problems in the United States, resulting in long hospitalizations, complications, and even patient death. Lack of nursing knowledge regarding sepsis signs and symptoms is a significant problem at a hospital in the northeast. Local hospital data showed a high patient mortality rate for patients diagnosed with sepsis. The purpose of this project was to develop an educational module on sepsis for intensive care nurses. The educational module was developed using current sepsis evidence-based guidelines. The practice-focused question for the project asked whether an educational module on sepsis would increase the intensive care nurse's knowledge on …

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Transitional Care For The Cardiac Surgery Population: Development Of A Clinical Practice Guideline, Sheila Davies Jan 2018

Transitional Care For The Cardiac Surgery Population: Development Of A Clinical Practice Guideline, Sheila Davies

Walden Dissertations and Doctoral Studies

Recovering from a cardiac surgery procedure and the transition to home can be an overwhelming experience for patients and caregivers. A tertiary care hospital's cardiothoracic surgery department suspended a nurse-practitioner-coordinated transitional care program in the 1st quarter of 2016. Following this decision, the readmission rate increased from its previous rate of 15.6% in quarter 1 to 20% in quarter 3. The purpose of this scholarly project was to develop a clinical practice guideline (CPG) that can bridge the gap in the transitional care process. The transitional care model informed the design of the project. A draft guideline was distributed to …

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Emergency Medical Services First Responder Certification Level's Impact On Ambulance Scene Times, Devin Todd Price Jan 2018

Emergency Medical Services First Responder Certification Level's Impact On Ambulance Scene Times, Devin Todd Price

Walden Dissertations and Doctoral Studies

The foundation of modern-day emergency medical service (EMS) systems began in 1966, based on hospital medical care. Demand for evidence to support prehospital practices that have been in existence for the past half-century has continued to grow; yet, researchers have not adequately explored the relationship between the medical certification level of emergency first responders and the amount of time an ambulance spends on the scene. The purpose of this quantitative study was to examine and compare ambulance scene times for emergency responses when basic life support (BLS) certified first responders or advanced life support (ALS) first responders are first on …

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Education Models For Teaching Adults About Modifying Dietary Carbohydrate And Controlling Weight, Vincient Cleamons Jan 2018

Education Models For Teaching Adults About Modifying Dietary Carbohydrate And Controlling Weight, Vincient Cleamons

Walden Dissertations and Doctoral Studies

The prevalence of diabetes and other pathophysiological conditions has been correlated with the incidence of obesity. A large portion of an adult community in the northwestern United States suffers from excessive weight that has been linked to premature mortality rates and certain forms of diabetes. Excess calories from carbohydrate have been shown to increase weight. Therefore, diets that are modified in carbohydrate and calories may help mitigate weight and obesity comorbidities. This qualitative, single case study's purpose was to explore the methods health care professionals use for teaching adults about controlling weight. Altheide and Johnson's analytic realism theory, in which …

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