Medicine and Health Sciences Commons^™

Neighborhood Factors, Cardiovascular Illness, Mental Health, And Aging In The United States, Brenda Billings

Walden Dissertations and Doctoral Studies

The inability to age in place among people 65 years old and older is a public health problem in the United States. However, it is unknown what neighborhood factors (i.e., trust, safety, shared values) impact the communities that are struggling to support individuals looking to stay in their homes as they age. The purpose of this quantitative correlational study was to examine the relationship between neighborhood factors (i.e., trust, safety, and shared values), cardiovascular illness (i.e., heart attack and stroke), mental health (i.e., depression), and aging in place, controlling for sex, age, marital status, educational level, employment status, and race. …

The Role Of Parental Military Status And Educational Attainment On Mental Health Service Usage Among Children And Adolescents, Cierra Jones Williams

Walden Dissertations and Doctoral Studies

A lack of mental health services for children and adolescents has been linked to significant health problems in adulthood. Researchers have investigated factors that influence usage of mental health services among children and adolescence, but significant gaps persist regarding use of mental health service among military-connected youth. This quantitative study was conducted to examine if parental military status and parental education affected the usage of mental health services among children and adolescents ages 3–17 in the United States. Multivariable logistic regression was used to analyze secondary data from the combined 2019–2020 National Survey of Children’s Health. After adjusting for income, …

Challenges In Discharge Planning For Adults Transitioning From An Inpatient Psychiatric Level Of Care Experiencing Homelessness, Deanna` R. Mccaskill

Walden Dissertations and Doctoral Studies

Mental illness and the homeless population are a growing concern in the United States. Homeless individuals utilize emergency rooms and acute inpatient stays more than those with housing. Social workers play a vital role in discharge planning, starting on the first day of admission. This action research study explored the challenges of social workers developing discharge plans for adults transitioning from an inpatient psychiatric level of care experiencing homeless. The theoretical framework implemented in this study was systems theory. Data were collected from 12 purposively selected master’s level social workers in the format of individual and focus group interviews. Eight …

Comparison Of Cultural Self-Efficacy Between Urban And Rural Nurse Educators, Denise Rene Morris

Walden Dissertations and Doctoral Studies

Integration of an inclusive educational environment requires nursing faculty to embrace a transformational change in academics. The cultural interactions of an educator teaching in an urban district may differ from the relations experienced by a rural nurse educator. The purpose of this quantitative study, guided by Bandura’s social cognitive theory, was to determine whether there is a difference between the cultural self-efficacy scores of nurse faculty teaching in a rural location compared to those in an urban location as well as whether the demographics of age, ethnic background, and years in the nursing profession predict cultural self-efficacy scores. Nursing faculty …

Relationship Between Homelessness, Substance Use, Employment, Living On A Reservation And Tuberculosis Among Northern Plains Native Americans, Darla Mccloskey

Walden Dissertations and Doctoral Studies

Native Americans in the Northern Plains have a long history of tuberculosis (TB) infections. There is limited research on the causes of latent TB infections (LTBI) and TB in this population. The purpose of this quantitative study was to assess the relationship between latent TB and factors of homelessness, substance use, employment, living on a reservation, and active or latent TB among this population using the eco-social theory as the theoretical framework. Data from 146 TB cases of Native Americans living in the Northern Plains and diagnosed with TB from 1999 to 2019 were analyzed using chi-square tests that showed …

Sexually Transmitted Disease Awareness Amongst Adolescents 13 To 18 Years Of Age, Ngwanma Nwokoro

Walden Dissertations and Doctoral Studies

Abstract Sexually transmitted infections or diseases (STIs/STDs) acquired through sexual activities lead to compromised sexual health. The adolescent population is at high risk of acquiring STIs/STDs due to their lack of knowledge. The gap in practice was that the nurse practitioners (NPs) were deficient in standard of care; adolescent patients lacked consistent evaluation, education, or documentation of the education in their medical records. The practice-focused question focused on the evaluation of the effectiveness of a quality improvement (QI) initiative that incorporated the use of the American Association for Pediatrics screening and Center for Disease Prevention and Control (CDC) treatment guidelines …

Improving Veteran’S Care Outcomes With The Implementation Of Care Coordination, Katrina Ann Canady

Walden Dissertations and Doctoral Studies

AbstractAstute care coordination is essential to eliminating fragmented care, duplication of services, medication errors, and unnecessary emergency rooms visits. This Doctor of Nursing practice project was a quality improvement (QI) initiative that addressed the gap in practice regarding RN care managers who were not consistently performing care coordination as outlined by the office of community care at the project site. The purpose of the project was to evaluate the effectiveness that an educational intervention had on the RN care managers’ abilities to perform care coordination. The care coordination model (CCM) served as the project framework because it provides a systematic …

African American Baby Boomers’ Lived Experiences In Skilled Nursing Facilities For Post-Acute Care Admissions, Dr. Charles A. Fraiser

Walden Dissertations and Doctoral Studies

AbstractPrevious studies have examined the quality of elderly healthcare offered in skilled nursing facilities (SNFs) among older adults, in general, but the studies have not emphasized ex-periences unique to African America baby boomers and the factors they consider when making SNF-related decisions for post-acute care. The purpose of the study was to exam-ine the lived experiences of African American baby boomers who are currently in or have been treated in SNFs for post-acute care to learn about their decisions to select an SNF. Andersen’s behavioral model of health services served as the conceptual framework. A descriptive phenomenological qualitative design was …

Improving Advanced Practice Registered Nursing Knowledge Of Shingles Management, Kyla Gilbert

Walden Dissertations and Doctoral Studies

AbstractShingles is a viral infection that can adversely impact patients if not promptly treated. In the project facility, a gap in practice was identified when a 6-month facility chart review noted a delay in shingles diagnosis 60% of the time. It is important for the Advanced Practice Registered Nursing (APRN) to be knowledgeable regarding diagnoses and best practices for treatment of shingles. However, the local facility had no available education on shingles. The practice-focused question asked whether APRN knowledge of shingles could be improved through staff education. The doctoral project provided shingles education to address the identified knowledge gap. The …

Fall Prevention On The In-Patient Neurological Stroke Unit, Syvol Letwan Middleton

Walden Dissertations and Doctoral Studies

AbstractThe purpose of this quality improvement (QI) evaluation project was to decrease patient falls on a neurological stroke unit. This unit had the most falls throughout the hospital system. The unit averaged 50-60 falls per year with an average of 4.75 falls per month. Guided by Neumann’s system model, the project targeted those patients at the highest risk for falling related to deficits post-stroke and post-neurological disease process. Staff were informed about Last fall, Express needs, Awareness of safety, and Frequency of bowel and bladder (LEAF) to determine if this tool could decrease falls in the neurological stroke population patients. …

Nutrient Pollution And Chlorophyll-A As A Precursor To Harmful Algal Blooms And Cyanotoxins In Rehabilitated Machado Lake, California, Michael E. Shiang

Walden Dissertations and Doctoral Studies

Algal blooms result in the formation of cyanotoxic conditions in a freshwater lake causing severe detrimental impacts to community and public health. Nitrogen, phosphorous, and ammonia stimulate the growth of phytoplankton biomass and algae, as measured by chlorophyll. This retrospective quantitative research study, grounded in the socioecological model, examined the relationship between nutrient pollutants and chlorophyll-a (Chl-a) that forecast harmful algal blooms, a precursor to cyanotoxins. A former impaired lake, Machado Lake in California, provided an ideal setting to assess relationships among nutrient indicators and Chl-a post-lake rehabilitation. Correlation and multiple regression analyses were performed to determine if a relationship …

Nurses’ Experiences With Trauma-Informed Care In Patients With Psychological Trauma, Ade J. Vinton

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic increased the need for research and discussions about trauma, trauma-informed care (TIC), and care delivery processes. Little is known about how nurses recognize, assess, treat, and support patients who experience trauma although knowledge of TIC is important for delivering care to trauma survivors. The purpose of this qualitative descriptive study was to explore nurses’ perceptions of TIC principles and their experiences delivering care to patients with psychological trauma. Harris and Fallot’s TIC theory was used to guide the study. Purposeful sampling was used to recruit ten nurses for individual semi structured interviews using open-ended questions conducted via …

Educating Nurses On Mental Fatigue, Tawanna Ann Canty

Walden Dissertations and Doctoral Studies

Education correlates with nurse performance and avoiding mental fatigue. This project attempted to answer the question, “Educating nurses on mental fatigue will increase knowledge” focusing on educating rehabilitative nurses regarding mental fatigue. The project was guided by the Analysis, Design, Develop, Implement, and Evaluate model. Twenty rehabilitative nurses were administered a pretest consisting of 10 multiple-choice test questions. They received education on mental fatigue through PowerPoint presentations and handouts. After completing the education, participants were administered a posttest with the same 10 questions. An evaluation tool consisting of six questions was completed measuring an increase in knowledge after the posttest. …

Organizational Factors Of Emergency Room Fast-Track Admission Duplicate Data Entry Errors In An Alabama Health System, Shannon Harris

Walden Dissertations and Doctoral Studies

Inaccurate patient information resulting from duplicate record data entry errors can compromise patient safety. Emergency room (ER) visits in the United States have increased by 15% over the last decade, and the increase has prompted hospitals to implement fast-track admissions in the ER to mitigate overcrowding and expedite the admission process for patients with low-acuity symptoms. Although duplicate record data entry errors occur frequently in ER admissions, there is a lack of information about fast-track ER admissions and the predictors of different types of confirmed duplicate record data entry errors. This correlational quantitative study examined the associations between work shift …

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 …

Impact Of An Outpatient Chronic Care Model On Uninsured Inpatient And Emergency Department Utilization, Jamie L. Judd

Walden Dissertations and Doctoral Studies

Healthcare systems incur significant uncompensated costs due to uninsured chronic disease patients’ overutilization of urgent and emergent emergency care. This study was important because there was very little literature addressing the impact of the chronic care model (CCM) on reducing uncompensated healthcare system costs regarding patients with chronic disease. The purpose of the study was to investigate whether the Healthy Education Lifestyles Program (HELP) was of any significance to healthcare system’s cost of uninsured chronic disease patients. The theoretical foundation for the study was the CCM espoused by Wagner and colleagues. The research questions were to determine significant differences in …

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 …

A Quantitative Study On Molecular Cluster Detection In Virally Suppressed Communities, Mariska Belinda Osborne-Wells

Walden Dissertations and Doctoral Studies

Viral suppression within human immunodeficiency virus (HIV) care and treatment planning is the gold standard of care for most providers when engaging with their patients. In many settings, the patient has received a positive lab that is indicative of HIV antibodies being detected; this in turn means they need additional medical attention to manage the infection. Upon receiving linkage to care services and attending an initial appointment, an initial genetic sequence is usually completed to assess the patient’s strain of HIV and how antiretroviral medications may antagonize or complement the HIV strain. It is possible that access, bias, and colorism …

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 …

Educating Nurses To Implement Serious Illness Conversations, Colleen Patricia Desai

Walden Dissertations and Doctoral Studies

AbstractAs part of investigating staff nurses’ reluctance to have serious illness conversations (SIC) at a local hospital, an educational deficit was noted. Nurses articulated they felt uneducated about how to have a SIC with a patient in need and questioned if the practice of conducting SICs was part of the nurses’ scope of practice in the New England State where they were employed. The purpose of this project was to create an educational tool and have it validated by a multidisciplinary group of experts. Once validated, the goal will be to educate nurses, raise awareness on the topic of SICs, …

Staff Education To Promote Probiotic Breastfeeding Therapy, José Diaz

Walden Dissertations and Doctoral Studies

Preterm birth is the leading cause of death in children under 5. In addition, there are 22 million babies born underweight each year which also contributes to the infant mortality rate. Some reasons for the inability to thrive and survive are the infants' immature system, allostatic load inadaptability, and undiversified and underdeveloped microbiota. Human breast milk (HBM) provides lifesaving nutrients, which prevents necrotizing enterocolitis and mortality. In addition, probiotic supplementation helps reduce late-onset sepsis, morbidities, and mortality. A literature review provided substantial evidence that HBM and probiotics can improve an infant's microbiota, thus improving thrivability and survivability. Probiotics offset the …

Facilitating Staff Education To Improve Effective Styles Of Nursing Leadership In An Orientation Setting, Tammy Melinda Finney

Walden Dissertations and Doctoral Studies

Nursing leadership is the cornerstone of the ever-changing landscape of healthcare. Minimal courses are included in nursing curriculums to prepare nurses to become proficient and develop knowledge of nursing leadership styles. There is a direct correlation of evidence-based leadership styles that impact effective communication, improved patient outcomes, succession planning, nursing retention, and relationship management. In an effort to bridge the gap of knowledge, an educational face-to-face training was developed and presented to new nursing staff in an orientation setting. The project practice question focused on commitment from nursing staff to implement increased knowledge of nursing leadership styles into their practice. …

Food Environment As A Moderator In The Relationship Between Ultra-Processed Food Intake And Mortality In The United States, Brandon Jerod Grandy

Walden Dissertations and Doctoral Studies

According to recent studies, the consumption of ultra-processed food is a major issue that leads to fatal outcomes within the United States, which is relevant because this type of food has become more accessible over the years. Using data from the National Health And Nutrition Examination Survey III (NHANES III), previous researchers found that frequent consumption of ultra-processed foods was associated with greater chances of all-cause mortality in U.S. adults, but little research has focused on factors that can impact ultra-processed food consumption, such as food environment. The purpose of this quantitative longitudinal study was to examine the effect of …

Clinicians' Perceptions Of Telehealth Services During The Covid-19 Pandemic In Virginia, Johnetta Hill Guishard

Walden Dissertations and Doctoral Studies

The onset of COVID-19 introduced unprecedented changes to how U.S. public health services were delivered. Many public and private agencies faced mandatory closures, social distancing mandates, and rapid transitions to telehealth interventions and treatment. Mental health clinicians witnessed disruptions in continuity of care and an increase in mental health risks overall. Although some studies have been conducted to survey clinicians’ perceptions of the usefulness and ease of use of technology-based interventions, knowledge about mental health clinicians’ experiences and perceptions in Virginia was sparse. The purpose of this generic qualitative study was to explore how mental health clinicians in Virginia described …

Traditional Healing And Biomedicine Use In Urban American Indians Living With Diabetes, Elin Elise Kambuga

Walden Dissertations and Doctoral Studies

The purpose of this interpretative qualitative study was to describe influences that affect the use of traditional healing and biomedical health services for type 2 diabetes to help health educators develop more culturally competent diabetes education programs for urban American Indian/Alaska Native (AI/AN) communities in the United States. The theoretical framework used for this study was the social ecological model (SEM). Using the SEM, the research questions were crafted to explore experiences of participants connected to personal, interpersonal, community, institutional, policy, and educational factors that influenced the use of traditional healing and biomedical health services. Urban AI/AN adults living in …

The Association Between Working Habits And Hypertension Among First Generation African Immigrants, Olalekan Kilo

Walden Dissertations and Doctoral Studies

Even though hypertension affects people of all races, it is more prevalent among African Americans. However, recent research has revealed that the prevalence of hypertension is progressively increasing across Africa. African immigrants in the United States are the least-studied immigrant group prone to health inequalities when compared to their African American counterparts. To help bridge this gap, a secondary data analysis of a cross-sectional study was conducted to investigate the association between working habits (hours worked, diet at work), length of stay in the United States, and hypertension rates for first-generation African immigrants residing in the United States. The study …

Discipline Without Punishment For African American Male Juveniles: From The Eyes Of A Mental Health Professional, Mia Nichole Lee

Walden Dissertations and Doctoral Studies

Juvenile rehabilitation and incarceration among African Americans are not equal and up to the standards and recommendations of society. This study focused on identifying the differences between the juvenile rehabilitation and incarceration punishment among African American offenders, with the goal of helping improve the way that the society looks at African Americans. The paper followed qualitative research methodology, which provided social evidence and helped in breaking down information. Data were collected from focus groups, observations, questionnaires, and interviews. The research highlights issues regarding juvenile rehabilitation and incarceration of African Americans, which can encourage change.

Organizational Strategies And Best Practices For Telehealth Delivery During Covid-19, Maria D. Mejia

Walden Dissertations and Doctoral Studies

Organizational Strategies and Best Practices for Telehealth Delivery during COVID-19

Staff Education For Enhancing Radiation Oncology Nurse Competency, Rebecca A. Mcclelland

Walden Dissertations and Doctoral Studies

Walden University

College of Nursing

This is to certify that the doctoral study by

Rebecca McClelland

has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made.

Review Committee Dr. Francisca Farrar, Committee Chairperson, Nursing Faculty Dr. Anna Hubbard, Committee Member, Nursing Faculty Dr. Corinne Wheeler, University Reviewer, Nursing Faculty

Chief Academic Officer and Provost Sue Subocz, Ph.D.

Walden University2023

Abstract Staff Education for Enhancing Radiation Oncology Nurse Competency by Rebecca McClelland

MSN, University of Phoenix, 2016BSN, South University, 2011

Project Submitted in Fulfillment of the …

Associations Of Stress, Health Behaviors, And Obesity Among African American Immigrants, Wole David Akinsola

Walden Dissertations and Doctoral Studies

AbstractObesity has been identified as a predisposing factor that poses a serious threat for the development of chronic diseases and contributes to health disparities affecting both minority and vulnerable populations. Though previous studies reported the association of stress with health status and behavior, there is little or no research on the heterogeneity of obesity predictors in specific minority populations in the United States. The purpose of this study was to examine the predictors of obesity among adult African American immigrant populations in the United States. Studying obesity in this population may help policymakers tailor interventions that could reduce obesity prevalence. …