Medicine and Health Sciences Commons^™

Interprofessional Intentional Empathy Centered Care (Ip-Iecc) In Healthcare Practice, Deepy Sur

Walden Dissertations and Doctoral Studies

Training interprofessional healthcare teams continues to advance practice for patient-centered care. Empathy research is also advancing and has been explored in social work, psychology, and other healthcare areas. In the absence of understanding empathy in an interprofessional setting, educators are limited in preparing teams to develop empathy as part of core competencies This grounded theory study explored for a theory of how interprofessional healthcare teams conceptualize and operationalize empathy in their practice. Azjen's theory of planned behavior and Barrett-Lennard's cyclical model of empathy framed the study. Data were collected using 6 focus groups and 24 semistructured interviews of varied healthcare …

Community Health Worker's Perceptions Of Integration Into The Behavioral Health Care System, Juliette Swanston Jenkins

Walden Dissertations and Doctoral Studies

Mental illness in the United States is a major public health problem. According to the Substance Abuse and Mental Health Services Administration, in 2017, 18.9% of adults in the United States had a mental illness. The purpose of this study was to gain insight into the perceptions held by community health workers (CHWs) regarding their integration into the behavioral health care system in Maryland. Using a social constructivism paradigm and phenomenological approach, a purposive sample of 11 CHWs who supported patients with behavioral health conditions in 17 counties in the state were interviewed. Howlett, McConnell, and Perl'€™s five stream confluence …

The Influence Of Food Insecurity, Low-Income, And Race On Diabetes Self-Management Practices Among Women With Diabetes, Jill La Capria

Walden Dissertations and Doctoral Studies

Diabetes is a chronic condition affecting more than 30 million adults living in the United States. Diabetes self-management (DSM) can prevent or delay the complications of diabetes and improve clinical outcomes; however, data show that low-income, food insecurity, female gender, and race contribute to challenges performing effective DSM. The health belief model was the theoretical framework for this cross-sectional study, which examined how food insecurity, low-income, and race affect DSM activities in women with diabetes. The sample population from the 2017 Behavioral Risk Factor Surveillance System survey consisted of 1,842 women with diabetes who were 18 years of age or …

Demographic, Behavioral, And Cultural Factors On Chlamydia Trachomatis Infection, Philis Grace Palmer

Walden Dissertations and Doctoral Studies

Chlamydia trachomatis is a sexually transmitted disease, and its incidence has been increasing in recent years in the U.S. population. Certain demographic factors have been identified as posing an increased risk to acquire this disease. The purpose of this mixed-methods research was to examine how population demographics (quantitative section) and cultural and behavioral factors (qualitative section) affect risk for contracting chlamydia trachomatis in the Miami-Dade, Florida area. The theory of reasoned behavior was the theoretical framework of the study. The quantitative component used secondary data from Jackson Health System (2012- 2018) pertaining to 333 Miami-Dade young adult individuals with incidents …

The Effects Of Sexual Education On Sexual Behaviors Of Adolescents In Rural Jamaica, Deborah Simmonds

Walden Dissertations and Doctoral Studies

Adolescent pregnancy and the sexual behaviors of adolescents continue to be robust public health and social problems in Caribbean countries such as Jamaica. Numerous researchers have conducted studies on the impact of sex education on sexual behaviors and pregnancy patterns among adolescents with mixed results (i.e., a lack of knowledge) especially in rural communities. The purpose of this study was to ascertain the impact of school- or home-based sex education on sexual behavior and pregnancy patterns of adolescents aged 15 —19 years in the rural community of St. Thomas, Jamaica. The parental expansion of the theory of planned behavior and …

Perceptions Of Access To Healthcare In Cameroon By Women Of Childbearing Age, Wenceslaw Chap Chapnkem

Walden Dissertations and Doctoral Studies

Increased poverty and unemployment rates, minimal investment in social amenities, a shortage of healthcare professionals, poor infrastructure, inadequate social services, and poor institutional and political leadership have weakened the healthcare status of Cameroon's women who have reached the age of childbearing. The World Health Organization expressed increased urgency for healthcare providers and patients to develop new healthcare policies to eliminate health-related disparities. The aim of this phenomenological study was to examine the perceptions of women of childbearing age living in Mamfe rural community in regard to Cameroon's healthcare system and its impact on their lives. The theoretical foundation of the …

Implementation Of A Transcultural Nursing Education Program To Improve Nurses' Cultural Competence, Ann Marie Elizabeth Edwards

Walden Dissertations and Doctoral Studies

The exponential growth of culturally diverse populations in the United States has led to a multicultural patient population while the nursing workforce remains predominantly White. At the project site, managers identified that staff nurses struggled to deliver culturally competent care. The purpose of this project was to improve the cultural competence of registered nurses (RNs) through a transcultural nursing education program. Leininger's transcultural nursing theory guided the project. Sources of evidence used to develop a face-to-face educational program included peer-reviewed journals, credible websites, and the Inventory for Assessing the Process of Cultural Competence Among Healthcare Professionals-R tool. Aggregate pretest and …

Association Of Adaptive Early Phase Study Design And Late Phase Study Results In Oncology, Donna Elise Levy

Walden Dissertations and Doctoral Studies

This quantitative study assessed the association of the design methods used for early phase oncology studies (adaptive versus traditional) and the outcome of late stage clinical trials. Differences by cancer type and by drug classification were also assessed. The theoretical and conceptual frameworks used were the general systems theory and the design and evaluation of complex interventions, respectively. Units of analysis were individual oncology studies in the ClinicalTrials.gov database and Bayesian logistic modeling was applied on a random sample of 381 studies initiated after November 1999 to December 2016. When assessing study design and outcome, there were lower odds of …

Experiences And Attitudes Of Older Homeless Women Toward Healthcare Access, Mary Ann Mueller

Walden Dissertations and Doctoral Studies

Homelessness among older women is a growing problem in many metropolitan areas of the United States. Researchers have indicated that health issues and problems accessing basic care are connected. Older homeless women face increased health issues, multiple challenges related to accessing basic care, and low incomes which put them at higher risk of becoming homeless, staying homeless, and delaying medical treatment. The homeless who lack fulfillment of social support and timely medical care are considered repetitive users of the emergency department and hospital stays. The purpose of this phenomenological study was to explore the experiences and beliefs of older homeless …

Assessing Medical Expenditure Disparities Among U.S. Adults With Hiv Or Cardiovascular Diseases, Lorraine Nnacheta

Walden Dissertations and Doctoral Studies

Older adults with infectious and chronic diseases, such as cardiovascular disease and human immunodeficiency virus (HIV), are at high risk for associated chronic comorbidities, which are associated with increased medical expenditures to cover treatment costs. The purpose of this study was to investigate (a) whether adults 65 or older with either HIV or cardiovascular disease were predisposed to increased medical expenditures versus adults 64 and younger, and (b) the impact of race and type of health service used on total direct medical expenditures incurred among adults with HIV or cardiovascular disease. A quantitative, deductive, retrospective cross-sectional design was used, and …

Experiences And Perceptions Of Staff Providing Substance Use Disorder Treatment For Adolescents, Connie Jean Rendleman

Walden Dissertations and Doctoral Studies

Substance Use Disorder (SUD) is associated with high mortality rates and remains a public health concern in the United States. Although, numerous interventions are offered for adolescents struggling with substance misuse, minimal research is available on the effectiveness of treatments to reduce recidivism. Researching the most effective treatment offered to adolescents is crucial to treatment adherence and recovery. The purpose of this study is to determine the most effective SUD treatment for adolescent patients by exploring the perceptions and experiences of treatment therapists providing treatment. The trans-theoretical model was used with elements of the social cognitive theory as a guide …

The Effects Of Breastfeeding Support On Women Enrolled For Wic Benefits, Judith Marie Khanuja

Walden Dissertations and Doctoral Studies

Breastfeeding has been shown to protect both the mother and infant, and health care professionals consider it to be the best choice for feeding an infant. The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides food, referrals to other social service programs, and nutrition and breastfeeding education for enrolled families. However, community support for the breastfeeding woman once she leaves the hospital is limited, especially in Philadelphia, PA. The purpose of this mixed-methods study was to explore the impact of prenatal breastfeeding education and understand the role that members of the community play in the infant feeding …

Parent Perceptions Of Biofeedback Treatment Effectiveness For Pediatric Migraine, Andrea Grando Weber

Walden Dissertations and Doctoral Studies

Gate control theory posits the idea that the brain and spinal cord have the ability to control the perception of pain sensation throughout the body. Biofeedback provides a proven way to teach a person how they may control their heart rate, breathing, and skin temperature. Through this process, individuals learn to lessen their migraine frequency and intensity. There are no studies to date that have measured the effectiveness of biofeedback in conjunction with medication for migraines in children despite established evidence of success in adults. In this study, an online format via SurveyMonkey was used to document the perceptions of …

Nursing Program Progression Requirements And Student Success At A U.S. Community College, Deborah Joleen Cipale

Walden Dissertations and Doctoral Studies

Although licensed registered nurses (RNs) comprise a significant percentage of the U.S. health care workforce, there is a lack of qualified nurses to meet patient needs. This shortage is expected to intensify as practicing nurses leave the profession. The problem that prompted this study was that an attrition-reduction program implemented in the nursing program at a U.S. midwestern community college did not show a reduction in the average attrition rate. The academic integration construct of Tinto's theory of student departure was used to examine archival academic performance records of 145 students enrolled in the local program from 2010 to 2012. …

Factors Contributing To High Readmissions For Congestive Heart Failure Among African Americans, Shavonda Caprice Devereaux

Walden Dissertations and Doctoral Studies

Abstract

African Americans are disproportionately affected by heart failure, with prevention and treatment of heart failure being a public health concern in the United States. The purpose of this retrospective quantitative study was to examine the primary variable race, specifically African Americans, and how this variable relates to 30-day readmission post discharge when controlled with geographic location (urban vs. rural), gender, and insurance status. The expanded chronic care model was used as a framework to shape health promotion, prevention efforts, and social determinants of health and to enhance community involvement related to chronic disease issues. The research questions were focused …

Utilizing Food Safety Knowledge In Comprehensive Patient Care Among Harlem Hospital Physicians, Sean Alexander Shivers

Walden Dissertations and Doctoral Studies

According to the World Health Organization (WHO), people throughout the world become sick every year from consuming contaminated foods, which impacts countries’ socioeconomic development, straining their healthcare system, travel and tourism, and foreign trade markets. To help alleviate the impact foodborne illness (FBI) has on society, scholars suggest physicians incorporate food safety in their standard work practice. The purpose of this study was to determine if Harlem Hospital physicians utilized food safety knowledge in comprehensive patient care with a diagnosis of FBI, in addition to how physicians passed this food safety information onto the patient. A qualitative methodology using an …

Family Predictive Factors Of Rural Malaria Prevalence In Nsukka, Eastern Nigeria, Gabriel Ugwuja Ugwu

Walden Dissertations and Doctoral Studies

Children in early childhood are still suffering from burdens of malaria-related morbidity and mortality. There have been insufficient studies on how family-level factors may predict the prevalence of malaria (PoM), and negatively impact the control of malaria in rural areas, especially among children. In this study, potential family factors were explored to address the challenges associated with the increase in PoM among the children in rural areas of Nsukka. Socioecological framework guided this study at the interpersonal level. The quantitative cross-sectional study used secondary data from Demographic and Health Surveys (DHS) of 2015 in Nsukka rural communities. Data were analyzed …

Public Health Nurses’ Perceptions Of High School Dropout Rates As A Public Health Issue, Maria Wallace

Walden Dissertations and Doctoral Studies

Education is one of the strongest predictors of health, and well-being. Early termination of education can lead to poorer health, shorter lifespans, and increased stress on the healthcare system. Improving overall high school graduation rates has been debated and discussed by the Toronto District School Board (TDSB) and the Ministry of Education, however, there is a paucity of research on increased graduation rates as they relate to public health in the Canadian context. The purpose of this phenomenological qualitative study was to explore the perceptions of liaison public health nurses (PHNs) who worked directly with the TDSB regarding their roles …

Effects Of Medical Professionals' Communication With Men Sleeping With Men And Hiv/Aids, Dawne D. Dickerson

Walden Dissertations and Doctoral Studies

The human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) initially emerged in the 1980s and ever since, a battle has been underway with regard to understanding some of the root issues attributed to behavior and HIV/AIDS. AIDS is prevalent in the men sleeping with men (MSM) community. There is lack of studies evaluating the quality and quantity of communication between MSM and medical professionals, which can be a catalyst to help reduce HIV/AIDS within this community. The aim of this quantitative study was to evaluate the relationship between quantity and quality of medical professionals' communication and regular HIV …

Oromo Ethiopians Perceptions Of The Prevalence, Causes, Treatment And Prevention Of Trachoma, Linda L. Gross

Walden Dissertations and Doctoral Studies

In Ethiopia, one of the primary contributors to blindness is trachoma, which is an infectious ocular disease. There is no record of any prevention programs in rural Ethiopian villages of Oromia, where the prevalence of trachoma is high. The original purpose of this phenomenological study was to explore the perceptions of rural Oromo villagers in Ethiopia on the causes, treatment, and prevention of trachoma, using the health belief model and the social-ecological model as a theoretical framework. Due to a security situation in Ethiopia, final interviews were conducted with immigrant Ethiopians in the US, all of them from the trachoma-endemic …

Fruit And Vegetable Consumption, Physical Activity, And Colorectal Cancer Among African Americans, Stella Francoise Nanga Ndzana

Walden Dissertations and Doctoral Studies

Colorectal cancer (CRC) is a deadly and costly cancer, especially among African Americans. The purpose of this quantitative, retrospective, cross-sectional study was to examine African Americans' health behaviors that may have an association with CRC. The Health Belief Model was used to guide this study. The study addressed whether there is a statistical association between fruit intake, vegetable intake, and physical activity, and the occurrence of CRC while controlling for confounders, such as body mass index, smoking status, and income level. After conducting an overall analysis, the final research question examined if the association varied by race. In this study, …

The Role Of Glucose Level On The Performance Of The Framingham Risk Score, Uohna June Thiessen

Walden Dissertations and Doctoral Studies

Cardiovascular diseases (CVD) are responsible for more deaths than any other disease, continue to threaten the quality of life for many, and is a major burden to the health care system. The Framingham Heart Study (FHS) identified the major CVD risk factors that became essential to effective CVD screening strategies and the Framingham Risk Score (FRS), is used to assess CVD risk. Based on the concepts of the health behavior model and CVD as a cardiometabolic disorder, multivariate logistic regression analysis was used to evaluate the association between fasting blood glucose (FBG) levels and a CHD event, and to determine …

Mothers' Parenting Discipline Style And Their Early Puberty Daughters' Engagement In High-Risk Behaviors, Yvette C. White

Walden Dissertations and Doctoral Studies

Some early puberty girls engage in high-risk externalizing behaviors such as early sexual activity, delinquent behavior, and disruptive behaviors. Harsh parenting experienced by girls who develop early has been associated with delinquent and disruptive behaviors. The purpose of this quantitative correlational study was to examine predictive relationships between the style of parental discipline by mothers of early puberty girls and the likelihood and frequency of the girls' engagement in high-risk behaviors. Parenting style theory, including the authoritarian, authoritative, and permissive style of parenting, served as the theoretical foundation for the study. Survey data were collected from 28 mothers who identified …

A Geographic Study Of Lung And Bronchus Cancer Rates In Kentucky, Gabriel Njoh Dikong

Walden Dissertations and Doctoral Studies

The average age-adjusted incidence and mortality rates of lung and bronchus cancer is 55% and 56% higher in Kentucky than the national averages in the United States, respectively. Populations with low income and educational attainment, and those who live close to the mining regions across Kentucky are more affected by the high prevalence and resulting mortality rates of lung and bronchus cancer. This study was conducted because of the high incidence of lung and bronchus cancer and resulting mortality rates in the state of Kentucky that may not be caused solely by social and demographic factors. The theoretical foundation for …

Reducing Cost Of Healthcare Facilities By Decreasing Nursing Turnover, Valour Akia Richardson

Walden Dissertations and Doctoral Studies

Registered Nurse (RN) turnover is costly for hospitals and healthcare facilities. The problem that healthcare administrators face today is their inability to retain nurses for long periods of time and the detrimental effects that come from the lack of retention. The purpose of this quantitative secondary data analysis is to explore the relationship between the retention of RNs and the geographic regions in which they work. The theoretical framework for this study was Barney's concept of viewing people as resources. Deidentified secondary data of RNs was utilized from the Healthforce Center at the University of California San Francisco to probe …

A Conflictive Triuvirate Consruct Of Epidemiologic Systems Failure, Ngozi Lois Ulinwa

Walden Dissertations and Doctoral Studies

Epidemiologic systems failure (ESF) is a major hurdle in minimizing the spread of infectious diseases during outbreaks. The reasons for ESF include the technical limitation of personnel handling epidemic crises, strictly defined health policies that limit the actions of epidemiologists, and personal perspective's reservations towards the intentions of health agencies. The purpose of this triumvirate mixed-methods case study was to examine factors of infectious disease control mechanisms useful for determining ESF. Three juxtaposed pre-emptive factors (technical [T], organizational [O], and personal [P] perspectives were used to determine how the multiple perspectives inquiring systems and fuzzy logic revealed factors causing ESF …

Lived Experiences Of African American Females With Breast Cancer Treatment Access, Tamika Chantey Smith

Walden Dissertations and Doctoral Studies

Breast cancer (BC) is a significant condition that can result in devastating outcomes without treatment. The purpose of this phenomenological study was to explore barriers to health care disparities among young African American females. The findings of this study may help to address gaps in knowledge, obtain insights in treatments, and comprehend lived experiences with BC. The theoretical framework for this study was Bronfenbrenner's social ecological theory. Data were collected from face-to-face interviews with 10 African American women ages 20 to 40. Data were then transcribed and coded. The findings of the study indicated that women required treatment plans, informative …

Impact Of Socioeconomic Status And Health-Seeking Behavior On Malaria In Pregnancy, Ifeanyi Livinus Udenweze

Walden Dissertations and Doctoral Studies

Malaria in pregnancy remains a public health challenge in Nigeria despite the fund appropriation for malaria control. The health challenges of malaria in pregnancy vary with populations and there is limited knowledge on the impact of the socioeconomic status and health-seeking behavior on malaria in pregnancy in Nigeria. The objective of this cross-sectional quantitative survey was to examine whether socioeconomic status and health-seeking behavior predict malaria in pregnancy in Nigeria using the social cognitive theoretical model. The data from a 2015 Nigeria Malaria Indicator Survey was used in this study. Data were analyzed using chi-square, binary, and multivariate logistics regression …

Social-Emotional Support As A Mediator Of Household Structure And Mental Distress In Women, Trisha Jeanine Walker

Walden Dissertations and Doctoral Studies

Mental illness affects more women than men in the United States. Poor mental health in reproductive-age women has negative implications on population health. The purpose of this quantitative, correlational study was to examine the relationship between household structure and frequency of mental distress, with consideration of the mediation social-emotional support provides for reproductive-age women. The social ecological model was the theoretical framework for this research, in which frequency of mental distress related to the individual-level of the human-environment interaction construct. Household structure and social-emotional support were examined at the relationship-level. Pearson's correlation coefficient and linear regression were used to conduct …

Trends In Prevalence And Predictors Of Undernutrition Among Children In South Central, Monica Kabahimba Zikusooka

Walden Dissertations and Doctoral Studies

Undernutrition is a global public health challenge. In Somalia, undernutrition is chronic with the situation often graded for emergency response. The purpose of this study was to provide contextual evidence regarding trends of prevalence and predictors of undernutrition in South Central Somalia. Following the UNICEF conceptual framework of determinants of undernutrition, the study examined which individual, household, and society factors were associated with undernutrition. Using secondary data from cross-sectional nutritional surveys implemented by the Somalia Food Security and Nutrition Analysis Unit from 2007 to 2012, a sample of 75,756 and 60,856 children aged 6-59 months was used in analyzing trends …