Medicine and Health Sciences Commons^™

Increasing Self-Awareness In Nursing, Adrienne Irene Abbot

Walden Dissertations and Doctoral Studies

Nursing self-awareness is essential for nurses to develop relationships with co-workers and patients. In the local organization, the practice problem for this doctoral project is a perceived low level of self-awareness in nursing. This Doctor of Nursing project aimed to determine if an educational intervention focused on self-awareness and the benefit of self-awareness increased knowledge among nurses working on a medical-surgical unit. A comprehensive literature review of peer-reviewed evidence provided evidence to support this project. A total of 26 individuals (N = 26) participated in the educational intervention. Eighty-nine percent (89%) of the participants (n = 23) were female, and …

Internal Population Displacement And Vaccination Completion, Malnutrition, And Respiratory Infections Among Children In The Central African Republic, Francois Xavier Batalingaya

Walden Dissertations and Doctoral Studies

Forced displacement in fragile and conflict-affected countries has the potential to disrupt access to basic primary healthcare services such as immunization. The purpose of this study was to assess the association between internal population displacement and vaccination completion, malnutrition, and acute respiratory infections (ARIs) while controlling for maternal characteristics of wealth index, education level, and residence status in the Central African Republic. The socioecological model underpinned this cross-sectional study that used a secondary dataset collected in 2018 – 2019 and maintained by UNICEF. Descriptive statistics and logistic regression tests were used to analyze the data. The findings of this study …

Association Between Dietary Phytoestrogen Intake And Xenoestrogen Exposure And Estrogen-Dependent Cancers, Pisita Bolsue

Walden Dissertations and Doctoral Studies

The role of circulating estrogens and the impact of lifetime exposure to multiple sources of exogenous estrogens as factors in carcinogenesis were not well understood. Research showed conflicting results when dietary phytoestrogen (PE) intake and xenoestrogen (XE) exposure occurred independently and when co-exposed. The purpose of this quantitative cross-sectional study was to investigate the association between dietary PE intake and XE exposure and the development of estrogen-dependent cancers in an epidemiological context. The advanced model of the epidemiology triangle was the theoretical framework for the current study in which binary logistic regression was employed on secondary data from the 2003–2006 …

Sociodemographic Predictors Of Veterans’ Health-Related Quality Of Life, Tamala Jones Choice

Walden Dissertations and Doctoral Studies

Health-related quality of life (HRQoL) is a theoretical concept that intertwines physical, mental, emotional, and social functioning, with a focus on the impact that health status has on quality of life. Although sociodemographic factors are associated with lower HRQoL, how these factors influence HRQoL in military veterans is less understood. The study’s purpose was to examine the relationships between sociodemographic characteristics (gender, military pay grade, military branch, and geographic location) and perceived HRQoL measured by the SF-8 survey among veterans living in a metropolitan community in the Mid-Atlantic region of the United States. A cross-sectional recruitment study design yielded 90 …

Relationship Between Childhood Trauma, ,Adverse Childhood Experiences, And Self-Management Of Type 1 And Type 2 Diabetes, Deserie J. Otoole

Walden Dissertations and Doctoral Studies

AbstractPoorly controlled diabetes is the result of lack of self-care, which contributes to complications, ill quality in life, the rise in health care costs, and early death. The purpose of this quantitative, nonexperimental study was to examine the extent to which diabetes type (Type 1 and Type 2), childhood trauma, and adverse childhood experiences predict diabetes self-management (glucose management, dietary control, physical activity, health care use, total self-management). Contemporary trauma theory suggests that early childhood trauma results in negative health-related consequences in adulthood. Standard multiple regression analyses showed that (a) higher levels of physical neglect and emotional abuse predicted poorer …

Providing Diabetes Education To Improve Staff Nurses' Knowledge, Marcia A. Patterson

Walden Dissertations and Doctoral Studies

Diabetes mellitus is a chronic metabolic disease that affects over 34.2 million or 10.5% of the U.S. population and ranks as the seventh leading cause of death. Tennessee's diabetes prevalence rate is ranked 45th overall in the nation, with 14.9% of the population affected, and in the local area for this project, the rate is greater than 15%, creating a public health concern. Despite its prevalence, there is still a wide gap in knowledge among nurses on diabetes management. The practice-focused question for this project addressed whether a staff education program would improve nurses' knowledge regarding diabetes. The significant gap …

Generalized Anxiety Disorder Symptoms Stratified By Age In Primary Care, Robin E. Mccoy

Walden Dissertations and Doctoral Studies

Little is known as to the age-related presentation of somatic complaints of those diagnosed with generalized anxiety disorder in primary care settings. A retrospective medical records review sought to identify the affective symptoms of generalized anxiety disorder (GAD) by age as recorded by primary care providers and to test the association of these symptoms by age. Guided by Engle’s (1977) biopsychosocial (BPS) model, a large administrative claim database system was used to derive a sample of 1,336, including 500 patients diagnosed with generalized anxiety disorder between 2018 to 2021. Binary logistics regression, one-way ANOVA, chi-square, correlation, and logistical regression with …

The Relationship Between Chlamydia, Gonorrhea, Syphilis And Race, Gender, And Age, Johnny James Mcgrew

Walden Dissertations and Doctoral Studies

The purpose of this quantitative correlational design using secondary data from Colorado Department of Public Health and Environment was to examine the relationship between different types of sexually transmitted infections (STIs), specifically, chlamydia, gonorrhea, and syphilis, and race, gender, and age in the United States. This study is significant because it could assist medical personnel to focus on more personally-based STI treatments. This study could also lead to a call for more research regarding sexual health programs across the nation, individuals’ willingness to share personal information regarding STIs, and how sexual health programs could increase testing for STIs. The study …

Experiences Of New Graduate Nurses Who Transitioned To Practice Using Virtual Conferencing Software, Sara Moran

Walden Dissertations and Doctoral Studies

Orientation is a pivotal moment for new graduate nurses as they transition into the acute care setting. The COVID-19 pandemic changed in-person orientation to virtual orientation, but little is known about the experiences of new graduate nurses who attended the virtual orientation process. The purpose of this qualitative interpretive descriptive study, guided by Duchscher’s theory and the technology adaptation model 2, was to understand the experiences of new graduate nurses who transitioned to practice utilizing video-based conference software for nursing orientation. Twelve new graduate nurses were interviewed using virtual conferencing software. Data were analyzed using interpretive description and then were …

Pancreatic Cancer: Quantitative Study Investigating The Regional Risk Factors In North Carolina, Holly Marie Myers

Walden Dissertations and Doctoral Studies

Pancreatic cancer is the fourth-leading cause of cancer-related deaths in the United States, killing more than 90% of individuals diagnosed within 5 years. Due to the lack of signs and symptoms, 82% of all pancreatic cancer cases are diagnosed in terminal stages. As such, the most powerful method to reducing the morbidity and mortality of pancreatic cancer is to further investigate the risk factors. According to the theoretical framework of the ecosocial theory, long-term exposure to exposures to unfavorable socioecological and environmental factors serve as a “web of causation” for adverse health outcomes. Using data from the North Carolina Department …

Staff Education Of Diabetic Foot Care In An Ambulatory Setting, Riza Grace Nielsen

Walden Dissertations and Doctoral Studies

One of the most important factors affecting the quality of diabetes care is the association between a patient’s knowledge and their practices. The practice gap in this primary care clinic was a lack of standardized diabetic foot care. The purpose of this DNP project was to provide nursing staff with an evidence- based, culturally congruent diabetic footcare curriculum that could help decrease inconsistencies in care. The practice-focused question for this project addressed whether an educational program for nursing staff on diabetic footcare would increase their knowledge and translate this knowledge into practice to prevent diabetic foot infections and its complications. …

A Staff Education Project On The Administration Of Clinical Practice Guidelines For The Treatment Of Obesity And Overweight Children And Adolescents, Emilia Ochiabuto Okoye

Walden Dissertations and Doctoral Studies

AbstractObesity among children and adolescents has reached epidemic proportions in the United States (U.S). Nurses in pediatric settings have a critical role to play in assessing and managing childhood obesity. The partner site for this project has a childhood obesity rate of 35% compared to the national average of 19%. However, the nursing staff lacked adequate knowledge, competence, and confidence in assessing and managing childhood obesity in line with the recommended guidelines. The problem was addressed by implementing the Clinical Practice Guideline for the Treatment of Obesity and Overweight Children and Adolescents via an education program. The program’s content was …

Cardiomems Staff Education To Improve Use Of Pulmonary Artery Sensor Data In An Emergency Department, Betty Sue Reynolds

Walden Dissertations and Doctoral Studies

Assessing volume status in patients with congestive heart failure (CHF) remains a difficult task. Newer technology, such as CardioMEMS, allows providers to download pulmonary artery pressure measurements from an implanted sensor. In a large rural emergency department (ED), lack of staff education on CardioMEMS made the device useless when a patient presented to the ED. The purpose of this project was to develop a staff education in-service to address the gap in practice. The theory used to guide development of an effective curricular program and instruction method was Knowles’ theory of andragogy. Application of the analysis, design, development, implementation, and …

Education To Increase Nurse Knowledge And Compliance With Social Determinants Of Health Screening, Bonnie Rieger

Walden Dissertations and Doctoral Studies

To provide holistic care and ensure positive patient health outcomes, the social determinants of health (SDOH) must be addressed. Research demonstrates that while medical care is a contributor to wellness, the SDOH serve an influential role in patient health outcomes. There is limited literature describing how to best educate practicing nurses about SDOH concepts. The purpose of this DNP project was to provide an educational intervention to increase inpatient staff nursing knowledge of the SDOH. Sources of evidence used to create the education module included scholarly literature describing the SDOH concepts and their application to patient, community, and population health. …

Black/African American Men’S Lived Experiences Of Workplace Colorism Bullying, Dr. Benjamin K. Spady Ph.D

Walden Dissertations and Doctoral Studies

Bullying in the U.S. workplace is an ongoing issue that transcends industry boundaries due to perpetrators’ ineffectiveness in viewing all coworkers as equals. The purpose of this qualitative interpretative phenomenological analysis study was to explore the lived experiences of Black/African American men who endure workplace colorism bullying. Critical race theory provided the conceptual framework, which labeled racism as an omnipresent systemic force. Semistructured interview data were collected from six Black/African American men who resided in the United States and who were bullied in the workplace within the past 20 years. Data were coded via open coding to discover themes. The …

Individuals’ Lived Experiences With Pharmaceutical Patient Assistant Programs, Marcia Clarke-Burke

Walden Dissertations and Doctoral Studies

AbstractPharmaceutical patient assistance programs (PAPs) were introduced as an alternative to address patients’ inability to obtain necessary prescription drugs. However, individuals were not fully exploring the beneficial nature of PAPs due to a poor understanding of the programs. Additional research is needed to understand how PAPs impact patients’ outcomes and costs of care. Grounded in Andersen and Newman’s model of health care utilization, this qualitative research was guided by the hermeneutic phenomenological research design. Data were collected during interviews with 11 participants located in various states regarding their participation in PAPs and their lived experiences in using PAPs. Collected data …

An Educational Intervention For Perioperative Nurses On Venous Thromboembolism Prophylaxis, Joann Mcghee-Evans

Walden Dissertations and Doctoral Studies

AbstractResearch has demonstrated that enhancing a nurse’s knowledge and awareness may result in positive patient, provider, and organizational outcomes. In a local organization, there had been a 25% increase of postoperative venous thromboembolisms (VTEs) within the last 12 months. The purpose of this doctor of nursing practice (DNP) project was to determine whether an educational intervention focused on VTE and the standards of care for VTE prevention increased knowledge and awareness among perioperative nurses working in the local organization. Benner’s novice to expert theory and King’s goal attainment theory provided the framework for the DNP project. Thirty-eight nurses were invited …

Reducing Same-Day Procedure Cancellations At An Interventional Spine And Pain Management Center, Adriene Smith

Walden Dissertations and Doctoral Studies

AbstractReducing Same-Day Procedure Cancellations at an Interventional Spine and Pain Management Center by Adriene Smith

Walden UniversityOctober 2023   Abstract The practice problem at a local interventional spine and pain management center was that the nurses lacked sufficient knowledge of the facility’s preoperative screening tool. The problem resulted in inadequate patient preparation for surgical procedures that led to a 33% same-day surgery cancellation rate. A staff education project was conducted to educate the nurses on how to properly use the facility’s preoperative screening tool and assess their knowledge of common blood thinner medications included in the preoperative screening process. Failure to …

The Geographic Pattern And Socioecological Factors Of Helicobacter Pylori Infections In The United States, Judith Ann Merryweather

Walden Dissertations and Doctoral Studies

AbstractHelicobacter pylori (H. pylori) is one of the most common human pathogens and may play a role in the development of several distinct diseases, which include gastric ulcer, duodenal ulcer, and gastric cancer. Studying geographic territories of the United States may reveal clusters with high rates of H. pylori infection and perhaps the prevalence of gastric cancer; however, geographic mapping of patterns in the United States is scarce. The purpose of this study was to investigate changes in H pylori infection patterns in the United States between two different time points (2000–2002 and 2016–2018). The primary hypotheses of this study …

Mental Health Experiences Of Black Males Beyond Juvenile Delinquency, Jasmine D. Spratling

Walden Dissertations and Doctoral Studies

Incarceration rates around the United States continue to increase for Black male adolescents. These numbers are even more significant in Atlanta, where youth spend time in juvenile detention centers and return soon once released. Summary findings from existing research showed the lack of mental health services provided once a youth has been released from incarceration, but a lack of specifics around the services needed remains. The purpose of the current study was to explore the experiences of Black male adolescents who received little to no trauma informed care post-incarceration. A qualitative, phenomenological approach was used to conduct semistructured interviews with …

Nurse Educators' Experiences Of Student Remediation, Holly A Dever

Walden Dissertations and Doctoral Studies

Little is known about the nurse educator's experiences in remediating novice undergraduate nursing students who failed an exam early in the program of study. While numerous strategies have been used by faculty for remediation, no evidence-based methodology for student remediation has been identified in published literature. The aim of this study was to build a foundation of qualitative research on nurse educators' experiences in the remediation of a student who failed an exam. This basic qualitative study, guided by Smith and Liehr's story theory, explored the nurse educator's experiences with remediation using interview data collected from six nurse educators. Interviews …

Education Program To Increase Nurses' Knowledge Of Faith Community Nursing, Lovell Thurmon Sweeten Cartwright

Walden Dissertations and Doctoral Studies

AbstractThe practice problem was a group of nurses practicing as faith community nurses (FCNs) who had no training in FCN practice, a specialty recognized by the American Nurses Association. This problem was important to address within the context of nursing practice because the nurses could have acted outside of their scope of practice and caused harm. The practice-focused question addressed whether a staff education program for FCNs would increase their knowledge of their role in a church setting with the goal of developing independent FCNs. The model guiding the project was the health promotion model. Eleven registered nurses were recruited …

Environmental Factors And Breast Cancer Mortality, Joel Collazo Rodriguez

Walden Dissertations and Doctoral Studies

Breast cancer is a public health problem in the United States that impacts diverse ethnic female groups in different ways regarding incidence and mortality. Much is known about the factors increasing the risk of developing breast cancer, but little is known about those that increase the chances of dying from it, other than access to health care, screening, and appropriate treatment. This study aimed to understand the association between exposure to Environmental Protection Agency-regulated air pollutants and breast cancer mortality, including how the interaction between these air contaminants impacts the outcome of interest, considering median income, education level, and percentage …

The Human-Canine Bond: Levels Of Stress Among Military Spouses During Deployments, Angela L. De Leon-Muniz

Walden Dissertations and Doctoral Studies

Previous research has found that deployment may impact military spouses’ emotional wellbeing and attachment with family members. There remains a critical gap in the literature regarding difference in stress levels between military spouses who own canines and those who do not. The theoretical foundations for this study were Bowlby’s attachment theory and Bowen’s family systems theory. Research questions included exploring the relationships between (a) pet canine ownership, deployment length of time, and military spouses’ stress levels, and (b) pet canine owners’ pet attachment and stress experienced, when their significant others are deployed. The sample comprised 82 spouses with deployed military …

Lived Experiences Of Copd Patients With Exertional Hypoxemia Prescribed Supplemental Oxygen, Sarah Ann Evans

Walden Dissertations and Doctoral Studies

Patients with exertional hypoxemia are often prescribed supplemental oxygen therapy to alleviate their symptoms and maintain adequate arterial oxygen saturation; however, little is known about how chronic obstructive pulmonary disease (COPD) patients with exertional hypoxemia experience the addition of supplemental oxygen on their lives. The purpose of this descriptive phenomenological study guided by Roger’s science of unitary human beings was to explore the lived experiences of COPD patients with exertional hypoxemia and who require supplemental oxygen. Purposive sampling was used to recruit participants using a query from the electronic medical records to identify patients prescribed supplemental oxygen for exertional, not …

Managing Nurse Leader Stress To Promote Leader Retention, Rebecca Sue Hawkins

Walden Dissertations and Doctoral Studies

Nurse leaders are a health care group that has been provided limited support to managestress and burnout symptoms, yet the impact of leader stress burden on staff satisfaction, patient outcomes, and their own health is vital to the provision of safe, high-quality health care. The problem of leader fatigue and burnout is the ability to retain current leaders and recruit the next generation. The purpose of this staff education project was to address leadership burnout due to stress and the lack of knowledge of how to manage stress in the moment. A combination of Watson’s theory of caring and Ray’s …

Association Between Antidepressant Adherence And Major Depressive Disorder Complications, Philip Lisinge

Walden Dissertations and Doctoral Studies

Despite evidence that antidepressants are more effective at treating major depressive disorder (MDD) symptoms, there is growing evidence that MDD management is still hampered by nonadherence to antidepressant treatment regimens. Researchers have suggested that MDD, if untreated, might lead to MDD-related complications, but other researchers have argued that adherence to antidepressants can lead to these same MDD-related complications. This quantitative cross-sectional study used primary data collected from 298 volunteers to examine the association between MDD-related complications and antidepressant adherence to clarify these diverging opinions. The study’s objective was to provide evidence to accept or reject the premise that antidepressant adherence …

Examination Of Exposure Types Association With Stigma And Impacts On Sharps Injury Reporting In Ambulatory Surgical Centers, Timothy William Lynch

Walden Dissertations and Doctoral Studies

Public health depends on the efficiency of work delivery among healthcare workers (HCWs) and their positive goal orientation in healthcare. Effective minimizing of needlestick and sharp injuries (NSSIs) and timely reporting are fundamental to meeting public health goals. The specific research problem addressed through this study is whether the independent variable of exposure type (needle stick injury, splash exposure injury, other sharp injuries) has an association with stigma associated with sharps injury reporting (dependent variable) among HCWs in ambulatory surgical centers. A quantitative, cross-sectional design involving secondary data analysis was used. Regression was used to analyze pre- and post-workshop survey …

Moral Injury Themes Involving Criminal Recklessness Among Adults With Alcohol Use Disorder, Sandra Starch

Walden Dissertations and Doctoral Studies

Moral injury (MI) can emerge following transgressive acts against one’s deeply held moral beliefs. Its symptomology involves individual psychological, spiritual, behavioral, and social spheres. It has primarily been studied within the military and in a few select civilian populations. This descriptive phenomenological study involved exploring MI themes among adults with alcohol use disorder (AUD) who had engaged in criminally reckless acts. Data collected from semi-structured interviews with eight participants were coded and analyzed, leading to six major themes revealing the symptomology of MI. Responses from study participants supported Festinger’s theory of cognitive dissonance via their descriptions of alcohol abuse cycles …

Nurse Educators' Experiences Of Student Remediation, Holly A Dever

Walden Dissertations and Doctoral Studies

Little is known about the nurse educator's experiences in remediating novice undergraduate nursing students who failed an exam early in the program of study. While numerous strategies have been used by faculty for remediation, no evidence-based methodology for student remediation has been identified in published literature. The aim of this study was to build a foundation of qualitative research on nurse educators' experiences in the remediation of a student who failed an exam. This basic qualitative study, guided by Smith and Liehr's story theory, explored the nurse educator's experiences with remediation using interview data collected from six nurse educators. Interviews …