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Occupational Therapists’ Perspectives On Using The Physical Environment In Skilled Nursing Facilities, Jennie L. Digrado Jan 2023

Occupational Therapists’ Perspectives On Using The Physical Environment In Skilled Nursing Facilities, Jennie L. Digrado

Walden Dissertations and Doctoral Studies

Occupational therapists (OTs) are among the health care professionals who assist individuals with neurocognitive disorders (NCDs) to engage in self-care and leisure skills in a skilled nursing facility (SNF) environment. Although the SNF environment has been researched, a gap exists regarding how OTs use the built environment to help clients with a NCD engage in self-care and leisure-related activities. The purpose of this qualitative case study was to understand how OTs use the physical environment in a SNF to help individuals with a NCD engage in self-care and leisure related activities. The conceptual framework that guided this study was the …


Social Worker Perspectives Of Working With Aging African Americans With Depressive Disorders, Sherian Waite Jan 2023

Social Worker Perspectives Of Working With Aging African Americans With Depressive Disorders, Sherian Waite

Walden Dissertations and Doctoral Studies

Although there is a greater proportion of people living with depressive disorders within the African American older adult population compared to their White counterparts, fewer African Americans are engaging in mental health treatment when compared to the Caucasian community. The purpose of this qualitative study was to explore the experiences and practices of social workers who are providing mental health care treatment to African American older adult patients (aged 65 and over) living with a depressive disorder. The study was framed using both the health belief model and critical race theory. To address the research questions, a generic qualitative design …


Occupational Therapists’ Perspectives On Using The Physical Environment In Skilled Nursing Facilities, Jennie L. Digrado Jan 2023

Occupational Therapists’ Perspectives On Using The Physical Environment In Skilled Nursing Facilities, Jennie L. Digrado

Walden Dissertations and Doctoral Studies

Occupational therapists (OTs) are among the health care professionals who assist individuals with neurocognitive disorders (NCDs) to engage in self-care and leisure skills in a skilled nursing facility (SNF) environment. Although the SNF environment has been researched, a gap exists regarding how OTs use the built environment to help clients with a NCD engage in self-care and leisure-related activities. The purpose of this qualitative case study was to understand how OTs use the physical environment in a SNF to help individuals with a NCD engage in self-care and leisure related activities. The conceptual framework that guided this study was the …


Tell Me More: Parent–Child Sexual Talk And Young Adult Sexual Communication Satisfaction With Romantic Partners, Kelsi N. Wilson, Jakob Jensen, Sharon Ballard, Alan Taylor Mar 2022

Tell Me More: Parent–Child Sexual Talk And Young Adult Sexual Communication Satisfaction With Romantic Partners, Kelsi N. Wilson, Jakob Jensen, Sharon Ballard, Alan Taylor

Journal of Social, Behavioral, and Health Sciences

Young adults (18–30) tend to show insufficient levels of communication about sex with their romantic partners, despite its many benefits to relationships among this age group. Learned sexual shame and guilt can play a role in inhibiting sexual communication with partners, and early messages about sex from parents stemming from narrow cultural boundaries of communication may play a role in fostering sexual shame and guilt from a young age, potentially influencing later sexual communication patterns with partners. We sought to identify whether a significant relationship existed between the sexual communication participants received from parents while growing up and their current …


Relationships Between Stress Self-Management, Social Support, And Health In Hispanic Informal Caregiver Burnout Prevention, Nicole Alexandra Mas Román Jan 2022

Relationships Between Stress Self-Management, Social Support, And Health In Hispanic Informal Caregiver Burnout Prevention, Nicole Alexandra Mas Román

Walden Dissertations and Doctoral Studies

Burnout syndrome is a psychological disorder characterized by physical, emotional, and mental distress and exhaustion resulting in feelings of depression, anxiety, irritability, and negative attitudes. If left unattended, burnout syndrome can lead to new or worsening health outcomes. The purpose of this nonexperimental quantitative study was to examine the relationship between stress self-management, perceived social support, health status, and burden among Puerto Rican informal caregivers. The theoretical foundations for this research were the informal caregiving integrative model and the individual and family self-management theory. Survey data were collected from 415 participants. Multiple regression analyses were performed to determine the relationship …


Diabetes Self-Management Education In The Urban Low Socioeconomic Status Senior Population, Heather Santa Barbara Jan 2022

Diabetes Self-Management Education In The Urban Low Socioeconomic Status Senior Population, Heather Santa Barbara

Walden Dissertations and Doctoral Studies

This exploratory quantitative study used a survey design to address a gap in the literature concerning primary care team perceptions about diabetes care for urban low socioeconomic status seniors with diabetes. Diabetes is a chronic health problem that is often managed in primary care offices, and primary care teams are often the first source of education and support for patients. Standards of management for seniors with diabetes has changed to eliminate tight control of glucose levels, and primary care team members may have differing perceptions about diabetes care depending upon their role in the primary care team and years of …


Rising Cost Of Medicare And Its Effect On Recipients 65 And Older, Williesa Toomer Jan 2022

Rising Cost Of Medicare And Its Effect On Recipients 65 And Older, Williesa Toomer

Walden Dissertations and Doctoral Studies

The rising cost of Medicare is a growing concern for recipients. Beneficiaries are often forced to implement a host of strategies to meet rising out-of-pocket expenses. This qualitative study was conducted to address a research gap in methods used by senior citizens to manage rising Medicare coverage costs. Garmezy’s resilience theory was used to contextualize the rising costs of Medicare premiums and copays and strategies used to manage healthcare needs. The purposive sample of 12 socioeconomically diverse respondents included eight women and four men ranging in age between 65 and 77, for an average age of 70.2 years. Participants completed …


Perceptions Of Contraceptive Practice Among Arab American Victims Of Intimate Partner Violence, Linda Humaidan-Zayed Jan 2022

Perceptions Of Contraceptive Practice Among Arab American Victims Of Intimate Partner Violence, Linda Humaidan-Zayed

Walden Dissertations and Doctoral Studies

There has been limited research on Arab Americans as they are an unidentified minority population. The specific research problem addressed through this study is that there is little research pertaining to the role of intimate partner violence (IPV) in poor contraceptive practice among Arab Americans, contributing to the larger problem of unwanted pregnancies, reproductive coercion, and other aspects of reproductive health. The problem with a high prevalence rate of IPV among Arab American women is that they are more susceptible to becoming pregnant and not accessing the reproductive health services that they may need. Thus, the purpose of this qualitative …


Relationships Between Stress Self-Management, Social Support, And Health In Hispanic Informal Caregiver Burnout Prevention, Nicole Alexandra Mas Román Jan 2022

Relationships Between Stress Self-Management, Social Support, And Health In Hispanic Informal Caregiver Burnout Prevention, Nicole Alexandra Mas Román

Walden Dissertations and Doctoral Studies

Burnout syndrome is a psychological disorder characterized by physical, emotional, and mental distress and exhaustion resulting in feelings of depression, anxiety, irritability, and negative attitudes. If left unattended, burnout syndrome can lead to new or worsening health outcomes. The purpose of this nonexperimental quantitative study was to examine the relationship between stress self-management, perceived social support, health status, and burden among Puerto Rican informal caregivers. The theoretical foundations for this research were the informal caregiving integrative model and the individual and family self-management theory. Survey data were collected from 415 participants. Multiple regression analyses were performed to determine the relationship …


Attitudes And Perceptions Of Nursing Graduates Regarding Interest In Gerontological Nursing Practice, Sonia Millicent Donaldson Jan 2022

Attitudes And Perceptions Of Nursing Graduates Regarding Interest In Gerontological Nursing Practice, Sonia Millicent Donaldson

Walden Dissertations and Doctoral Studies

AbstractAn ongoing increase in the number of older adults means an increased need for specialized health care, creating, in turn, a need for an increase in nurses in the United States to meet the demand. However, there is a problem in that nursing graduates, from the time they are students, do not choose geriatric-gerontological nursing (GN) as is practiced in long-term care and some specialty areas or units. The purpose of this basic qualitative study was to explore nursing graduates’ perceptions of GN as a field for professional practice and to determine how interest in GN may be encouraged. The …


Sociodemographic And Psychosocial Factors And Wellbeing Among Adults 65 And Older In England, Dainelle Clark Jan 2021

Sociodemographic And Psychosocial Factors And Wellbeing Among Adults 65 And Older In England, Dainelle Clark

Walden Dissertations and Doctoral Studies

The increased number of older adults living longer parallels with the growth of public health concerns regarding the impact of sociodemographic and psychosocial factors (e.g., loneliness and social isolation) on older adults' wellbeing. The purpose of this quantitative study was to examine the association between loneliness, social isolation, the combined model of loneliness, and social isolation on wellbeing among older adults when accounting for age, gender, ethnicity, and social support. The socioecological model (SEM) was used to evaluate the multiple levels of environmental determinants for loneliness, social isolation, and wellbeing. The target population included older adults 65 years and older …


Access To Preventive Health Care Services And Effects On Health Outcomes For Hispanic Older Adults With Type 2 Diabetes, Shafa Al-Showk Jan 2021

Access To Preventive Health Care Services And Effects On Health Outcomes For Hispanic Older Adults With Type 2 Diabetes, Shafa Al-Showk

Walden Dissertations and Doctoral Studies

Despite elevated prevalence of diabetes among Hispanic, Hispanic older adults face challenges in self-control and management of their glucose levels, and they have less access to preventive health care services. The purpose of this retrospective quantitative cross-sectional study was to examine the associations between access to preventive health care services and Type 2 diabetes outcomes among Hispanic adults aged 65 years and older. The social-ecological model provided the framework for the study. The research question for this study examined the extent to which doctor visits, diabetes education and blood sugar checks correlate with HbA1c levels. Data were collected from 566 …


Coping Strategies Of Dual-Role Informal Caregivers, Lorilee Maldonado Jan 2021

Coping Strategies Of Dual-Role Informal Caregivers, Lorilee Maldonado

Walden Dissertations and Doctoral Studies

There are nearly 43.5 million informal caregivers (ICGs) in the United States, and this number will nearly double by 2030. Trying to fulfill the needs of an aging family member and commitments to work, home, and other relationships create a constant state of stress that may result in either leaving the workforce or placing the care recipient in a facility. Finding strategies that support both roles is economically and socially critical. This study explored the strategies that some ICGs have acquired that enable them to cope with these pressures. Work-family conflict theory, focusing on the conflict between work and family …


Staff Education On Medication Screening Tool For Nursing Home Residents, Jinkee Sarah Beltran Jan 2021

Staff Education On Medication Screening Tool For Nursing Home Residents, Jinkee Sarah Beltran

Walden Dissertations and Doctoral Studies

The prevalence of potentially inappropriate medications (PIMs) among nursing home residents continues to be high. Researchers have demonstrated that the use of a medication screening tool identifying PIMs can improve medication safety among older adults. Screening tools, such as the Beers criteria and the Screening Tool for Older Persons’ Prescriptions (STOPP), are evidence-based guidelines that use several validated criteria to identify PIMs in older adults’ medication regimens. While the use of these tools is standard in the acute care setting, limited studies have been conducted regarding their use in the nursing home setting. The purpose of this project was to …


An Educational Program For Nursing Home Nurses On Sepsis In Older Adults, Wendy Belden Jan 2021

An Educational Program For Nursing Home Nurses On Sepsis In Older Adults, Wendy Belden

Walden Dissertations and Doctoral Studies

Elderly nursing home patients’ high rates of hospitalization due to sepsis impact their morbidity and mortality and significantly cost the U.S. healthcare system. Skilled nursing facility (SNF) nurses who have the knowledge to assess older adults for signs and symptoms of sepsis and communicate findings to providers are instrumental in providing improved care for patients. The purpose of this doctoral project was to provide a group evidence-based educational intervention on sepsis care of older adults geared toward nurses working in SNFs. The practice-focused question asked whether an educational intervention focused on the signs and symptoms of sepsis in the elderly …


An Educational Program For Nursing Home Nurses On Sepsis In Older Adults, Wendy Belden Jan 2021

An Educational Program For Nursing Home Nurses On Sepsis In Older Adults, Wendy Belden

Walden Dissertations and Doctoral Studies

Elderly nursing home patients’ high rates of hospitalization due to sepsis impact their morbidity and mortality and significantly cost the U.S. healthcare system. Skilled nursing facility (SNF) nurses who have the knowledge to assess older adults for signs and symptoms of sepsis and communicate findings to providers are instrumental in providing improved care for patients. The purpose of this doctoral project was to provide a group evidence-based educational intervention on sepsis care of older adults geared toward nurses working in SNFs. The practice-focused question asked whether an educational intervention focused on the signs and symptoms of sepsis in the elderly …


Systematic Review Of Falls Among Older Individuals In The Long- Term Care Settings, Nonyelum Patience Odenigbo Jan 2020

Systematic Review Of Falls Among Older Individuals In The Long- Term Care Settings, Nonyelum Patience Odenigbo

Walden Dissertations and Doctoral Studies

Falls are common in the older population and can result in disability, increased dependence, or mortality. Falls have received increased attention in the literature as the most common cause of injuries among older individuals. The incidence of falls in the older population has a positive correlation with adverse health issues necessitating major lifestyle adjustments. The problem is magnified for older patients in long-term care settings where they are 3 times more susceptible to falls. The purpose of this project study was to conduct a systematic review of the literature to understand the impact and incidence of fall rates among older …


Evaluation Of Inappropriate Use Of Antibiotics In The Long-Term Care Community, Charlene A. Hughes Jan 2020

Evaluation Of Inappropriate Use Of Antibiotics In The Long-Term Care Community, Charlene A. Hughes

Walden Dissertations and Doctoral Studies

The number of antibiotics prescribed in the 65 and older population significantly increased related to the diagnosis of urinary tract infections (UTIs). Although empiric treatment is necessary at times, it can lead to antibiotic resistance; therefore, clinical symptomology with an active infection verified by diagnostic testing is the requirement for the treatment of a UTI. This project addressed the practice-focused question of how the implementation of an evidenced-based antibiotic stewardship program (ASP) in a nursing home on the East Coast may impact the overuse of antibiotics in that clinical setting. The project, guided by the theory of planned behavior, was …


Predictive Factors Of Determinants Of Health And Services Provided At Adult Day Service Centers, Nardia Anthonalla Aldridge Jan 2020

Predictive Factors Of Determinants Of Health And Services Provided At Adult Day Service Centers, Nardia Anthonalla Aldridge

Walden Dissertations and Doctoral Studies

The National Association of Adult Day Service Centers has suggested that adult day service centers can provide services to meet the complex needs of the older adult and delay nursing home placement. Researchers have yet been able to establish the predictive nature of determinants of health in Adult Day Care Centers (ADSCs). The purpose of this correlational study was to examine the relationship between the determinants of health and the presence of therapeutic services and nursing services at ADSCs. The open system theory guided this study. Data sets from the Centers for Disease Control and Prevention, 2016 Adult Day Services …


Work-Life Balance Of Rotational Workers In The Nigerian Energy Sector, Israel Olalekan Jolaolu Jan 2020

Work-Life Balance Of Rotational Workers In The Nigerian Energy Sector, Israel Olalekan Jolaolu

Walden Dissertations and Doctoral Studies

Rotational workers in the Nigerian oil and gas industry otherwise referred to as the energy sector, are confronted with challenges and stresses of work-life balance (WLB). Using boundary theory, 15 oil and gas workers with more than 5 years of rotational work experience were recruited to examine the strategies they employed to deal with the stresses and work-life balance required for the social well-being of the workers, which translates to improved job performance in the oil and gas sector in Nigeria. The research question was designed to explore the lived experiences of rotational workers with more than 5 years in …


Predicting Behavior To Engage In Fall Prevention Practices: The Role Of Interests And Basic Psychological Needs, Jan Fay Kress Jan 2020

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 …


Veterans' Perceptions Of Behavioral Health Services For Posttraumatic Stress, Larence Kirby Jan 2020

Veterans' Perceptions Of Behavioral Health Services For Posttraumatic Stress, Larence Kirby

Walden Dissertations and Doctoral Studies

Behavioral health services exist for Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF) veterans diagnosed with posttraumatic stress disorder (PTSD); yet, untreated diagnoses may lead to the risk of compromised behavioral health. The purpose of this hermeneutic phenomenological study was to understand the lived experiences of OEF/OIF veterans regarding their decision to seek and retain behavioral health services for addressing PTSD. The research focus and questions were employed through the theoretical concepts of Heidegger’s hermeneutic phenomenological theory, Heider’s attribution theory, and Beck’s cognitive behavioral theory. In-person interviews were conducted to collect data from 8 OEF/OIF veterans who had encounters with behavioral …


Adult Attachment For African American Women Who Have Mothers With Borderline Personality Disorder, Elizabeth Uchechi Onyeali Jan 2020

Adult Attachment For African American Women Who Have Mothers With Borderline Personality Disorder, Elizabeth Uchechi Onyeali

Walden Dissertations and Doctoral Studies

The effects that borderline personality disorder (BPD) can have on the loved ones of those who suffer from the mental illness is significant and can be deleterious and enduring. Maternal BPD can adversely impact mother-daughter relationships by fostering abnormal connections and insecure attachment bonds. This is particularly the case for African American mothers, of whom research suggests that the early attachment bond between them and their daughters significantly shapes how their daughters behave, perceive themselves, and relate to others. The purpose of this qualitative transcendental phenomenological study was to explore how the experiences of being raised by a mother diagnosed …


Comparison Of Advance Care Planning Interventions And Older Adults’ Advance Directive Completion Rates, Tammy Biehler Jan 2020

Comparison Of Advance Care Planning Interventions And Older Adults’ Advance Directive Completion Rates, Tammy Biehler

Walden Dissertations and Doctoral Studies

Despite the benefits of advance care planning (ACP), only one third of older adults in the United States have completed it. To address this gap, health care organizations are implementing ACP programs to engage older adults in the process. These programs can be delivered in various ways, including 1:1 conversations, classes, and web-based tools. The purpose of this quantitative study was to investigate which ACP option was associated with highest participation and advance directive (AD) completion rates in older adults. Social cognitive theory provided the framework to understand the impact the ACP environment and personal characteristics’ have on the odds …


Exploring The Challenges Non-Clinical Departments Encounter During Eden Alternative Implementation, Keith George Jan 2019

Exploring The Challenges Non-Clinical Departments Encounter During Eden Alternative Implementation, Keith George

Walden Dissertations and Doctoral Studies

The Centers for Medicare and Medicaid Services recommends new guidelines that shift healthcare delivery in nursing homes and long-term care facilities from an institutional model to a person-centered care model. Although clinical outcomes are measured and tracked, there was limited literature about the challenges non-clinical departments face in a nursing facility during implementation of a person-centered model. The purpose of this qualitative study was to explore the challenges non-clinical staff experience while transitioning to an Eden Alternative philosophy, a person-centered care model. The theoretical foundation of this study relied upon Bressers' Contextual Interaction Theory. The research questions for this study …


Caregiver Review Of Nonpharmacological Interventions For Behavioral Symptoms Associated With Dementia, Karla Chaney Ballew Jan 2019

Caregiver Review Of Nonpharmacological Interventions For Behavioral Symptoms Associated With Dementia, Karla Chaney Ballew

Walden Dissertations and Doctoral Studies

Alzheimer’s disease (AD) is the most common form of dementia and affects an individual’s overall cognitive function, including orientation, memory, and executive function. Most AD patients in the United States reside in residential care facilities or private homes under the care of individuals with little education on the challenges of the AD patient. Among the challenges faced by caregivers are behavioral and psychological symptoms related to dementia (BPSD). Education has been shown to improve caregivers’ treatment of BPSD in AD patients and to improve caregiver retention. The purpose of this project was to develop an evidence-based education module guided by …


A Comparison Of Motivational Differences Among Older Marathon Runners And Their Injury Status, Marsha Renee Kaufman Jan 2019

A Comparison Of Motivational Differences Among Older Marathon Runners And Their Injury Status, Marsha Renee Kaufman

Walden Dissertations and Doctoral Studies

Despite the high occurrence of running-related injuries, master level runners, those aged 40 years and older, account for 50% of all marathon finishers. What is not known is the common motive sustaining participation, especially among this age demographic. The self-determination theory was the theoretical framework to support how behavior is regulated by the individual. The purpose of this quantitative research was to identify a difference in the motives (psychological, physical, social, and achievement) and their subcategorical motives (health orientation, weight concern, affiliation, recognition, psychological coping, life meaning, self-esteem, competition, and personal goals) via the Motivations of Marathoners Scales by master …


Reducing Antipsychotic Medication Use In Long-Term Care Settings, Martha Ofeibea Agbeli Jan 2019

Reducing Antipsychotic Medication Use In Long-Term Care Settings, Martha Ofeibea Agbeli

Walden Dissertations and Doctoral Studies

The prescription rate of antipsychotics in patients with dementia varies between 20% and 50% for the common and troubling neuropsychiatric symptoms experienced by patients with dementia. The use of these antipsychotic medications has been linked with increased risk of morbidity and mortality due to associated Parkinsonism, over sedation, gait disturbances, cognitive decline, and cardiovascular adverse events. The purpose of this project was to assess whether development of an evidence-based clinical practice guideline (CPG) for a long-term care facility would increase awareness about issues that govern the safe use of antipsychotic medications. The conceptual framework for the project was Watson's model …


The Nurse And Certified Nursing Assistant Perception Of Person-Centered Care, Latonya Dickerson Hughes Jan 2019

The Nurse And Certified Nursing Assistant Perception Of Person-Centered Care, Latonya Dickerson Hughes

Walden Dissertations and Doctoral Studies

Over the last decade, long-term care facilities have transitioned from institutional care models that focus on person-centered care, in which the resident is the center of the care. The purpose of this study is to explore the nurse and certified nursing assistant perception of the person-centered care services they deliver. Jean Watson's theory of human caring is the theoretical framework that guided this study. The theory focusing on the human caring experiences and person-centered care is being characterized as a caring feeling. The carative factors of Watson's theory, the fundamental concept of caring, has been associated with improved outcomes for …


Cancer Treatment Decision Making In Aging Minorities, Patrice Kemp Jan 2019

Cancer Treatment Decision Making In Aging Minorities, Patrice Kemp

Walden Dissertations and Doctoral Studies

Cancer incidence is high for aging minority and underserved populations, yet research is limited about patient-provider communications with aging racial and ethnic minority populations. Achieving high-quality cancer care is crucial to reducing health disparities for this population. However, potential shortages in professional health personnel, the cost to treat cancer, a strained health care system, and large aging populations contribute to the problem. The purpose of this qualitative study was to understand the personal experiences of aging minorities during cancer treatment decision making when communicating with their cancer care providers. Purposive sampling methods were used to recruit 10 minority women and …