Medicine and Health Sciences Commons^™

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 …

Family Perceptions Of Mental Health Service Use Among Mexican Americans, Vickie Gayle Nethercott

Walden Dissertations and Doctoral Studies

AbstractMexican immigrants are less likely to use psychiatric services compared to people from other race or ethnic groups in the United States, yet little is known about the reasons why the Mexican American population are less likely to seek mental health services. A qualitative descriptive study, guided by Leininger's culture care diversity and universality care theory, was used to explore the perceptions of mental health service use and barriers to psychiatric services for Mexican American immigrants living in the United States. After institutional review board approval was obtained, flyers were placed in five churches in a northwestern U.S state where …

Language Barrier: An Unmet Challenge For Low Screening Of Colorectal Cancer Among Hispanic Americans In Texas, Moses Owusu

Walden Dissertations and Doctoral Studies

AbstractHispanic population represents the fastest growing minority group in the United States, and only California surpasses Texas with Hispanic residents in the United States. Overall, non-Hispanic Whites have higher rates of colorectal cancer (CRC) incidence than Hispanics; however, Hispanic Americans have lower survival rates than non-Hispanic Whites. Using cross-sectional analysis, CRC screening modalities were examined to assess disparities among White only, non-Hispanic, Black only, non-Hispanic, and Hispanic populations in Texas to evaluate the impact of limited English proficiency (LEP) on CRC screening among Hispanic Americans residents. The age of study participants ranged from 50 to 79 (mean age = 65.8 …

Nurse Education Regarding Hypertension And Use Of A Follow-Up Call Protocol In Primary Care, Edwin Omar Rivera-Figueroa

Walden Dissertations and Doctoral Studies

AbstractMany patients whose primary or secondary chronic condition is hypertension present to their first follow-up appointment in a primary care facility in the north of Puerto Rico with uncontrolled high blood pressure. Nurses’ knowledge of hypertension is vital to addressing a gap in practice for this patient population and patient quality of life and the prevention of cardiovascular diseases. The practice-focused question guiding this project focused on a nurse educational session for increasing hypertension management knowledge as well as a follow-up phone call protocol that aimed to improve patient care. The theoretical framework guiding this project was Pender’s health promotion …

Academic Performance And E-Cigarette Use Among Teenagers, Jeremy Tan Rondael

Walden Dissertations and Doctoral Studies

Early e-cigarette use by youth has the capacity to create an early addiction to nicotine, increasing the risk of life-long dependency and the possible development of multiple cardiovascular and pulmonary diseases. Reinforced by the socioecological model, the purpose of this study was to determine if academic performance is associated with e-cigarette use among teenagers and young people and if the presence of adverse childhood events (e.g., cyberbullying in school and/or the presence of homelessness) mediated this association. This study included all respondents (N = 1,401) from the state of Nevada who answered the 2019 National Youth Risk Behavior Survey. Binary …

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 …

Increasing Organizational Value Of A Private Healthcare Education Academy, Diana Skaff

Walden Dissertations and Doctoral Studies

Amid the dynamic changes and innovations of the healthcare field, healthcare providers seek educational activities that enhance their growth and decrease their knowledge gap. Healthcare education organizations responsible for providing high-quality healthcare education, have opportunities to differentiate their programs to acquire, attract, activate, and retain healthcare providers. Grounded in the five forces of competition and the value chain theories, this mixed method formative program evaluation aimed to improve the business development program by developing a differentiation by quality strategy that will increase its competitive advantage. Participants included three decision-makers and nine leaders in a healthcare education organization in the Kingdom …

Sun Exposure And Protective Behaviors Among U.S. Hispanic Farmworkers, Claudia Marie Delgado Cebollero

Walden Dissertations and Doctoral Studies

Sun exposure increases the risk of sun-related illnesses and skin cancer among U.S. Hispanic farmworkers. Reinforced by the health belief model, the purpose of this study was to determine the association between socio-demographic factors (i.e., age, educational attainment, gender, income, and marital status) and skin cancer with the level of sun exposure (sun’s effect on skin, sunburn reported) and protective behaviors (use of cap/visor, use of sunscreen) among adult Hispanic farmworkers in the United States. The study included Hispanic farmworkers aged 21 or older (N = 112) who responded to the 2015 National Health Interview Survey. Ordinal logistic regression showed …

Clinical Vaccination Education Guideline For The African American Community, Margaret Chinedum Nwoji

Walden Dissertations and Doctoral Studies

AbstractVaccination hesitancy is high among African Americans and other people of color. The practice gap addressed in this project was the lack of a culturally sensitive clinical guideline for vaccination education relevant to the African American community. The practice-focused question was answered by developing an evidence-based Clinical Vaccination Education Guideline for the African American Community (CVEGAAC) that was validated by a group of four content experts using the Appraisal of Guidelines, Research, and Evaluation tool. The content experts scored each of the domains above 90%, implying that the CVEGAAC is of high quality and ready for implementation. The end users …

Experiences Of Older Adults With Hiv/Aids Enrolled In Case Management Programs In Northwest Indiana, Antoinette Cardenas

Walden Dissertations and Doctoral Studies

AbstractIn 2016, more than half of those infected with HIV/AIDS were age 50 years or older. Since the introduction of antiretroviral therapy, the survival rate of HIV patients has been on the rise with a predicted increase by 2030, but this has also contributed to early onset of comorbidities such as cardiovascular disease, osteoporosis, and kidney failure. The purpose of this generic qualitative study, driven by ecological systems theory, was to explore the experiences of older adults (age 50 and older) with HIV/AIDS who were enrolled in case management programs in Northwest Indiana. Data were collected from semi structured interviews …

Improving Access To Diagnostic Medical Services For Children With Autism: Caregiver Perspective, John Nkemakolam Nkwocha

Walden Dissertations and Doctoral Studies

AbstractThe rising prevalence of autism among children in the United States has remained a challenge to caregivers, researchers, and healthcare providers. Medical diagnostic services struggled with inaccurate outcomes, misdiagnosis, inaccessibility, long waitlists, poor coordination, and a lack of expertise and knowledge for early intervention. There are limited studies on problems associated with diagnosing children with autism and the caregivers’ perspective on improving the services. In this qualitative phenomenological study, 10 caregivers’ perspectives on barriers to accessing medical diagnostic services, treatment, and management of children with autism and possible improvement of the services were explored. Resilience and health utilization models provided …

Self Care Education For Nurses Following An Assault, Barbara Lynn Schwarz

Walden Dissertations and Doctoral Studies

AbstractSelf-Care Education for Nurses Following an Assault by Barbara Lynn Schwarz MS, Nebraska Wesleyan University, 2008 BS, Nebraska Wesleyan University, 2004

Project Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice

Walden University August 2023 Abstract Every day, 1 in 4 nurses experience physical and/or verbal assault, surpassing the rates among police officers and prison guards. This issue is particularly widespread among nurses working in mental health settings. The local practice problem for this project was the absence of self-care education for nurses following workplace assaults. The literature revealed that such assaults have traumatic …

Stress And Coping Among Sud Certified Peer Recovery Specialists, Cynthia June Thomas

Walden Dissertations and Doctoral Studies

Certified Peer Recovery Specialists (CPRSs) are individuals with lived experience in the successful recovery of substance use or mental health disorders. CPRSs provide services for individuals seeking or enrolled in substance use disorder (SUD) recovery, provide mentoring and coaching, service and resource connections and lead recovery groups but, the job of a CPRS can have beneficial and detrimental impacts on the CPRS’s personal recovery. The purpose of this quantitative study, guided by Lazarus’s theory of coping and stress, was to determine whether there is (a) a relationship in stress and coping effectiveness among CPRSs, (b) a difference in the level …

A Clinical Practice Guideline For Managing Behavioral Problems In Persons With Dementia, Ken J. Brinker

Walden Dissertations and Doctoral Studies

AbstractAs the baby boom generation ages, the demand for effective nursing care for patients diagnosed with dementia has greatly increased. The challenges associated with dementia include a patient’s inability to focus, pay attention, and follow conversations. Patients often become forgetful, angry, frustrated, and aggressive with family members and caregivers. The medical providers and administrators at a long-term care facility needed assistance in developing a clinical practice guideline for managing behaviors demonstrated by patients with dementia. The project question centered on the identification of current evidence supporting a clinical practice guideline for nursing practice for unpredictable behaviors demonstrated by residents diagnosed …

Impact Of Race And Socioeconomic Factors On Infant Mortality Between Non-Hispanic Black And White Women, Chukuma Clifton Chijioke

Walden Dissertations and Doctoral Studies

Abstract This quantitative retrospective study with a correlational design examined the impact of race and socioeconomic factors on the high infant mortality (IM) among non-Hispanic Black women compared to non-Hispanic White women in one midwestern US state county. Though the IM in the U.S. has consistently decreased, a disparity exists between non-Hispanic Black and non-Hispanic White women. Non-Hispanic Black women are twice as likely to experience infant deaths as non-Hispanic White women. This study utilized secondary data derived from vital records maintained by the county public health department. The research was grounded in the ecological model. Logistic regression was used …

Comparison Of Rural Associate Degree Nursing Students’ Clinical Judgment After Curriculum Change, Karen Bowen

Walden Dissertations and Doctoral Studies

New graduate nurses often lack adequate clinical judgment skills to practice competent nursing care, which may result in increased risk of committing practice errors that threaten patient safety. To mitigate errors in patient safety, industry leaders have called for nursing program improvements in preparation of nursing students’ clinical judgement as they transition to professional practice. Guided by Tanner’s clinical judgment theory, the rural state nursing programs in this study implemented a concept-based curriculum to promote clinical judgment which includes thinking skills, priority setting, and management of care. The purpose of this three-part, quantitative, nonexperimental study was to compare the development …

Experiences And Attitudes Regarding The Availability And Usage Of Telemedicine Services Among Providers During A Pandemic, Keya Gaston Brooks

Walden Dissertations and Doctoral Studies

Telehealth became a prominent fixture in the way healthcare was delivered during COVID-19. Providers were forced to offer telehealth as an optional mode of care. Although little research was available, studies about the experiences and attitudes of providers regarding their intention and willingness to use telemedicine before the pandemic was exiguous. The purpose of this study was to understand providers perception and use behavior patterns regarding the acceptance and adoption of telemedicine during the pandemic. Data collected from the COVID-19 Healthcare Coalition Telehealth Impact Survey was used to help characterize the experiences and attitudes of providers regarding telehealth utilization during …

Health Leadership And Management Practices That Support Accountability For Results, Peter Kayiira Byansi

Walden Dissertations and Doctoral Studies

Although leaders are expected to nurture and sustain a culture of accountability for results, little is known about how health leaders in developing countries perceive, interpret, demonstrate, and promote accountability in their day-to-day practices. The purpose of this generic qualitative study was to explore the management and leadership practices that leaders of public and non-profit health support organizations in Uganda utilize to embody and support accountability for key stakeholders’ results. Data from in-depths interviews with 13 participants at the governance, senior management, and middle management levels were analysed using thematic data analysis. Riggio's conceptualization of using multiple perspectives and disciplines …

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 …

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. …

Anxiety Risk Factors And Social Isolation Among Young Adults, Jennifer Clancy

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic is a public health concern that impacted the world. Increased feelings of loneliness and social isolation during the pandemic were reported to be associated with those seeking help for symptoms of anxiety and depression. Though symptoms of anxiety have been associated with social isolation, research is limited on the association between the anxiety risk factors and social isolation among young adults in the United States. Using the socioecological model, the association between social isolation (dependent variable) with financial stress, health anxiety, and perceived impact of COVID-19 (independent variable), and the influence of gender, race, and household status …

African American Women And Social Support Networks To Overcome The Strong Black Woman Schema And Depression, Teia Jelisia D. Clements

Walden Dissertations and Doctoral Studies

Mental illness disorders within the United States are on the rise. Researchers have indicated that African Americans are less likely to seek mental health compared to European Americans. The purpose of this basic qualitative study was to understand how social support networks influence African American women between the ages of 25 and 50 in addressing the strong Black woman (SBW) schema and depression. A conceptual framework consisting of the SBW collective theory guided the study. A purposive sample of 16 African American women who use social support networks to address the SBW schema and depression was obtained through flyers posted …

Teach-Back As An Evidence-Based Tool In Patient Education, Andrea Clyne

Walden Dissertations and Doctoral Studies

AbstractDischarge instructions are a valuable component of patient education as they can influence outcomes post-discharge, leading to positive social change through improved morbidity and mortality. The use of teach-back education by registered nurses is a best practice that assures understanding of discharge instructions. However, consistent use of this method relies on the staff’s conviction and confidence in this manner of education. The purpose of this project was to develop, deliver, and evaluate a program to educate staff on the best practice of teach-back to effectively deliver patient education. The logic model helped guide and develop the stages of the project …

Adverse Childhood/Adolescent Experiences And Risk Of Recruitment Into Sex Trafficking, Shwana Coleman

Walden Dissertations and Doctoral Studies

Human trafficking victims are negatively impacted by the process of coercion, kidnapping, and forced sexual interactions. Previous research studies showed that sex trafficking impacts victims’ mental health. The purpose of this quantitative study was to investigate whether adverse childhood/adolescent experiences (i.e., substance abuse, psychological abuse, and physical abuse) influence recruitment to sex trafficking in the United States and whether age acts as a moderator. The health belief model provided the theoretical framework for the study that includes data from 2010–2015 collected by the Polaris Project, a global sex trafficking database. Convenience sampling was done to delineate the study variables and …

Relationship Between Food Insecurity, Depression, And Race/Ethnicity Among U.S. Adults Aged 60–69 Years, Patrick E. Crandon

Walden Dissertations and Doctoral Studies

Abstract Food insecurity (FI) and depression among older populations in the United States are public health concerns. Although FI has declined in the United States, it is a psychosocial stressor prevalent among the growing population of adults over 60. It is unknown to what extent FI contributes to depression among racial/ethnic minorities in this population. The purpose of this quantitative cross-sectional study was to examine the relationships between FI and race and depression among U.S. adults aged 60–69 years when adjusting for other variables. The social-ecological model was used to understand the interplay between individual and environmental factors that may …

Health Education Practices For Middle Eastern Women With Polycystic Ovary Syndrome, Walaa Daffaalla

Walden Dissertations and Doctoral Studies

Polycystic ovarian syndrome (PCOS) is a complex women’s health condition that reduces women’s quality of life, leading to health complications, such as menstruation issues, infertility, insulin resistance, risk of type 2 diabetes, depression, anxiety, emotional stress, being overweight or obese, and more. Research on PCOS has focused on the etiology and complications in women from different ethnicities. But limited research has explored the experiences and perspectives of Middle Eastern (ME) women in the United States with PCOS related to PCOS health education. The purpose of this qualitative study was to explore the perspectives and experiences of ME women of reproductive …

Student Physical Therapy Supervision And Physical Therapy Productivity In Skilled Nursing Facilities, Dionne Degrande

Walden Dissertations and Doctoral Studies

Physical therapy (PT) educational programs are faced with the problem of securing thenecessary clinical experiences for their students, particularly in long-term care settings. Student physical therapists (SPTs) must complete clinical education requirements to graduate and transition from learner to entry-level practitioner. Clinical instructors (CIs) provide SPT supervision and are responsible for meeting industry-standard productivity expectations. There is the notion that SPTs negatively impact PT productivity, creating a reluctance for organizations to host SPTs for clinical experiences. This quantitative pilot study aimed to determine if there was a statistically significant difference between PT productivity with and without SPTs in skilled nursing …

Experience Of Established Mental Health Counselors Working With Adults Who Have Intellectual Disabilities, Margarete Denk

Walden Dissertations and Doctoral Studies

Individuals with disabilities make up the largest minority population in the United States. Individuals with intellectual and developmental disabilities (I/DD) make up a significant portion of this population, yet there are limited studies addressing counseling with the I/DD population. The Council for Accreditation of Counseling and Related Educational Programs has addressed the need for disability competence in their upcoming 2024 standards. The purpose of the phenomenological study was to describe lived experiences of established counselors working with adult clients diagnosed with an I/DD. A descriptive phenomenological approach was used along with the social model of disability. The study involved six …

Long-Term Psychological Adaptation Of U.S. Human Resource Personnel In Response To The Covid-19 Pandemic, Samantha Ann Denson

Walden Dissertations and Doctoral Studies

Previous research indicated that the COVID-19 pandemic negatively impacted employee psychological outcomes in various workforce sectors. Although research showed that U.S. human resource (HR) employees experienced unique occupational challenges during the pandemic, the literature did not explore pandemic-related psychological outcomes in this population. This quantitative survey-based study included a purposive sample of 294 U.S. HR professionals to explore the pandemic’s impact on their psychological well-being. The transactional model of stress and coping served as the theoretical framework to understand the independent effects of appraisal, meaning-based coping, and coping efforts on psychological well-being. A mediation analysis was used to understand the …

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, …