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Articles 1531 - 1560 of 6102

Full-Text Articles in Medicine and Health Sciences

Perceptions Of Women Of Color Improving Patient Outcomes Through Hospital Leadership Advancement, Benita A. Mclarin Jan 2023

Perceptions Of Women Of Color Improving Patient Outcomes Through Hospital Leadership Advancement, Benita A. Mclarin

Walden Dissertations and Doctoral Studies

Women of color have been underrepresented in hospital leadership positions and face challenges in advancing their careers. The benefit to hospitals providing women of color with training and support to move into leadership positions may be improved patient outcomes. Grounded in the interactional model of cultural diversity framework, the purpose of this basic qualitative study was to explore the perceptions of women of color advancing in leadership roles in hospitals and their impact on patient outcomes. The study participants included 16 women of color in leadership positions from hospitals in a western U.S. state. Data were collected through semi structured …

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Consideration Of Mindfulness Intervention For Hispanic Adolescents In A School Setting, Kierra Mcshine Gregory Jan 2023

Consideration Of Mindfulness Intervention For Hispanic Adolescents In A School Setting, Kierra Mcshine Gregory

Walden Dissertations and Doctoral Studies

Hispanic adolescents’ accessibility to treatment options for depression is met with limitations associated with financial barriers and cultural misalignment. This research study aimed to bring to light an alternative psychotherapy treatment through the foundations of mindfulness interventions. The goal was to understand the experience of Hispanic adolescents when engaging in mindfulness in a school setting. The purpose of this study was to gather information about the experiences of Hispanic adolescents using mindfulness to support mental health practitioners, school counselors, and behavioral interventionists to provide treatment options that are accessible and meet the needs of this culture group. This explanatory case …

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Registered Nurses’ Perceptions Regarding Postoperative Pain Management And Opioids For Adolescents, Susan Miller Jan 2023

Registered Nurses’ Perceptions Regarding Postoperative Pain Management And Opioids For Adolescents, Susan Miller

Walden Dissertations and Doctoral Studies

More than 2.4 million children undergo surgery annually in the United States and many experience postoperative pain. Poor pain management causes negative outcomes to both the individual and society. Increased rates of prescription drug misuse and rising death rates for adolescents from drug overdoses underscore the need for improvements in pain management. However, there is a lack of research, limited guidelines, and significant provider variability in managing adolescents’ acute postoperative pain. The purpose of this qualitative study was to explore the topic of acute postoperative pain management for adolescents through the lens of registered nurses (RNs). Nurses play an essential …

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Referral Source, Visit Modality, And The Delivery Of Diabetes Education In Pennsylvania, Alan Minor Jan 2023

Referral Source, Visit Modality, And The Delivery Of Diabetes Education In Pennsylvania, Alan Minor

Walden Dissertations and Doctoral Studies

Diabetes education is a principal component of optimal diabetes care that is often underutilized despite the known benefits that include reductions in complications as well as improved glycemic control and self-management knowledge. The purpose of this quantitative study was to examine the association between the completion of diabetes education, referral source, and visit modality. Because the completion of diabetes education is multifaceted, Levesque’s theoretical framework of health access, which incorporates dimensions of the accessibility of services and the abilities of potential users in the utilization of health services, was used to ground the study. A retrospective chart review was conducted …

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Health Education Needs For Mortality Surveillance In Machakos County, Kenya, James S. Mwanza Jan 2023

Health Education Needs For Mortality Surveillance In Machakos County, Kenya, James S. Mwanza

Walden Dissertations and Doctoral Studies

Reporting mortality information is the primary data source from which evidence can be drawn to monitor disease trends and inform public health policy to improve population health. Still, only two-thirds of expected annual deaths are reported globally. Health education and promotion play a significant role in empowering communities to uptake public health services such as mortality surveillance. This qualitative descriptive study aimed to understand health workers’ (HWs’) perspectives regarding the need for health education to support mortality surveillance in Machakos County, Kenya. The capabilities, opportunities, and motivation for the behavior change model guided the study. Semi-structured interviews were used to …

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Age, Race/Hispanic Origin, And Covid-19 Mortality Among Sickle Cell Disease Patients In The United States, Joe Lamont Ndula Jan 2023

Age, Race/Hispanic Origin, And Covid-19 Mortality Among Sickle Cell Disease Patients In The United States, Joe Lamont Ndula

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic remains a global health challenge, with 6.7 million deaths worldwide as of January 2023. It has illuminated the health iniquities in underserved communities and populations like those with sickle cell disease (SCD). Researchers have associated the COVID-19 outcome among SCD patients in other regions of the globe. The purpose of this retrospective cross-sectional observational study was to investigate the relationship between age, race/Hispanic origin, and COVID-19 mortality among persons with SCD in the United States from January 2020 to March 2021. The Krieger ecosocial theory of disease distribution framed the study. Data were drawn from an existing …

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The Correlation Between Nurse Staffing And Quality Of Care Outcomes Within Nursing Homes In Mississippi, Nyeshia Nelson Jan 2023

The Correlation Between Nurse Staffing And Quality Of Care Outcomes Within Nursing Homes In Mississippi, Nyeshia Nelson

Walden Dissertations and Doctoral Studies

The U.S. population aged 65 years old and older is steadily increasing. Some of thispopulation resides in nursing homes; thus, the necessity for quality care provided in nursing homes has increased. Consistent, quality care remains a constant challenge for the government, nursing home administrators, health care consumers, and researchers. Nurse staffing has been identified as a critical structural measure that affects the quality of care and outcomes in nursing homes. The purpose of this quantitative study was to examine the relationship between nurse staffing and quality of care outcomes in Mississippi’s nursing homes. Donabedian’s structure, process, and outcome (SPO) model …

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An Association Of The Transgenerational Implications Of Redlining And Obesity On Pediatric Type Ii Diabetes, Carlin Dexter Nelson Jan 2023

An Association Of The Transgenerational Implications Of Redlining And Obesity On Pediatric Type Ii Diabetes, Carlin Dexter Nelson

Walden Dissertations and Doctoral Studies

s the prevalence and incidence of childhood obesity has increased, so has the number of cases of pediatric Type 2 diabetes mellitus (T2DM). Although made unconstitutional in 1968, the transgenerational implications of redlining can be observed in disinvestments resulting in neighborhood detraction. Utilizing the 2019–2020 National Children’s Health Survey, the purpose of the study was to evaluate the relationship between obesity, T2DM, and neighborhood detraction elements as well as assessed indicators of T2DM in non-institutionalized children 6 through17 years of age (N = 34,725). The social determinants of health perspective served as the conceptual framework for the study. Results indicated …

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Staff Education On Diabetes Self-Management For Patients, Happiness Ifeoma Oguariri Jan 2023

Staff Education On Diabetes Self-Management For Patients, Happiness Ifeoma Oguariri

Walden Dissertations and Doctoral Studies

AbstractDiabetes mellitus, a disease in which the body does not metabolize, store, and excrete. glucose appropriately, presents an economic and health burden in the United States. Summary of recent evidence shows that nurses lack adequate education in providing. diabetes self-management education to patients. Research also shows that providing. nurses with education increases their knowledge of the disease and empowers them to teach their patients self-care. Framed within the analysis, design, development, implementation, and evaluation model of instructional design, the purpose of this Doctor of Nursing Practice program was to plan, implement, and evaluate a staff education. program on diabetes self-management. …

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Staff Education For Nurses And Providers On Rapid Mood Screener, Lolade Adekemi Ogunleye Jan 2023

Staff Education For Nurses And Providers On Rapid Mood Screener, Lolade Adekemi Ogunleye

Walden Dissertations and Doctoral Studies

Advances in the psychiatric field have led to the development of valuable tools that can be used in screening patients to understand their condition better. Indeed, instruments such as the Rapid Mood Screener (RMS) have been significantly used to help diagnose conditions such as bipolar disorder. The implication is that such tools need to be appropriately used by health care practitioners such as nurses for better and more accurate diagnostic results. A more accurate diagnosis is a foundation for better patient management and outcomes. Therefore, as part of a bigger plan, mental health facilities should make deliberate efforts to ensure …

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Predictors Of Retention Among Individuals With Hiv Initiating Antiretroviral Therapy In Ghana, Ivy Ama Okae Jan 2023

Predictors Of Retention Among Individuals With Hiv Initiating Antiretroviral Therapy In Ghana, Ivy Ama Okae

Walden Dissertations and Doctoral Studies

Abstract Managing HIV requires lifelong therapy. Retaining clients on lifelong therapeutic antiretroviral therapy (ART) ensures the suppression of viral replication and better health outcomes. The time of the start of ART management is also a factor in determining better health outcomes for persons living with HIV. This study examined the association between initiation criteria (treat all, Option B+, and CDC T-cell count < 500) and retention on ART at 12 months for 17,974 randomly selected clients in the Ghana Health Service's HIV patient electronic database. Analyses controlled for age, gender, educational status, alcohol use, treatment/adherence monitoring, and tuberculosis disease treatment. Bronfenbrenner's ecological systems theory guided the interpretation of the findings. Results shows that retention was positively associated with all treatment initiation criteria. Clients initiated with CD4 count ≤ 500 criteria seemed to be retained at 12 months on ART at a higher rate than initiation criteria based on Option B+ and treat all. The study results may contribute to positive social change by supporting CD4 testing for clients before initiation of ART to improve retention and ensure the availability and use of adherence counseling, no tuberculosis disease and its prevention, and low use of alcohol among people living with HIV. The results of this study may also provide opportunities for public health policy intervention efforts requiring a personalized, group-based approach to service delivery at the intrapersonal level, interconnected with interpersonal, meso, and meta factors at the community level.

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A Quantitative Study On Molecular Cluster Detection In Virally Suppressed Communities, Mariska Belinda Osborne-Wells Jan 2023

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 …

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Evaluating U.S. Household Telemedicine Use In Primary Care Settings, Robert Osobase Jan 2023

Evaluating U.S. Household Telemedicine Use In Primary Care Settings, Robert Osobase

Walden Dissertations and Doctoral Studies

AbstractThe COVID-19 pandemic's arrival in the United States restricted access and use of telemedicine in primary care providers (PCPs) settings. Addressing this issue is crucial since telemedicine is a confirmed method of encouraging patients and PCPs to promote quality health care. This quantitative study investigated the association between age, gender, and race, and PCPs offering telemedicine and U.S. household adults using telemedicine during COVID-19 pandemic in 2021. The Donabedian framework, which considers aspects of an organization's structure, process, and outcome, served as the study's foundation, incorporating age, race, and gender as independent variables, and PCPs and US adults as dependent …

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Differences In Phq-9 Depression Severity Between Adults Receiving Ketamine Or Ketamine-Assisted Psychotherapy, Sophie Lake Oswin Jan 2023

Differences In Phq-9 Depression Severity Between Adults Receiving Ketamine Or Ketamine-Assisted Psychotherapy, Sophie Lake Oswin

Walden Dissertations and Doctoral Studies

Treatment-resistant depression (TRD) affects roughly 2.8 million or 1.1% of the United States population. Many traditional treatments of mental disorders including various types of psychotherapy and pharmacotherapy do not provide adequate symptom reduction for clients, and many clients diagnosed with TRD seek out nontraditional treatments such as ketamine and psychedelics for their antidepressant effects. Due to the dissociative nature of psychedelic medication wherein resistance is reduced, and a trance-like state is induced, ketamine-assisted psychotherapy (KAP) has great potential as an adjunct to ketamine therapy. Procedures of KAP have been in development for the last 7 years and a consensus on …

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Impact Of Telehealth Versus Traditional Visits On Pain Management Patients Utilizing Medical Cannabis During The Covid-19 Pandemic, Todd Pankratz Jan 2023

Impact Of Telehealth Versus Traditional Visits On Pain Management Patients Utilizing Medical Cannabis During The Covid-19 Pandemic, Todd Pankratz

Walden Dissertations and Doctoral Studies

AbstractAlternatives to traditional office visits have become a necessity with the recent COVID-19 outbreak, resulting in an unmatched surge in telehealth adoption. The present study was an investigation of the impact of telehealth versus traditional office visits in medical cannabis clinics treating patients for chronic pain. With 50,000,000 American adults experiencing pain and over 750,000 overdoses attributed to opioid usage, collecting research-driven evidence to increase the availability of safe, effective, and nonopioid treatment options will create positive social change. The Donabedian model was applied to measure the quality of care, focusing on structure (cannabis clinics), process (telehealth vs. traditional office …

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Development Of A Standardized Novice Neonatal Nurse Orientation Program, Joanne Rau Pasinski Jan 2023

Development Of A Standardized Novice Neonatal Nurse Orientation Program, Joanne Rau Pasinski

Walden Dissertations and Doctoral Studies

Abstract Neonatal intensive care units (NICUs) are fast-paced units requiring skilled nurses to care for a unique patient population. Orientation of new nurses to the NICU can be challenging for both the orientee and the preceptor. Offering an evidence-based practice orientation program by an accredited organization that is specific to NICU can be a valuable tool for both the preceptor and the orientee as well as enhance nurse, patient, and organizational outcomes. The project question explored if use of the Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) 15-module nursing orientation program for RNs in a NICU increased their …

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Factors Impacting College Students’ Receipt Of Human Papillomavirus Vaccination, Joy Yvette Payne Jan 2023

Factors Impacting College Students’ Receipt Of Human Papillomavirus Vaccination, Joy Yvette Payne

Walden Dissertations and Doctoral Studies

Less than half of U. S. students entering college have had a human papillomavirus (HPV) vaccination, placing them at risk for HPV-related cancers. This study’s purpose was to identify predictors of HPV vaccination initiation in college students. Andersen’s behavioral model of health services use was used to examine the differences in predisposing, enabling, and need factors in U.S. college students ages 18–26 years who received an initial HPV vaccination in college compared to those who never received an HPV vaccination. The study was a quantitative, cross-sectional survey design using multivariable logistic regression for data analyses. Data were collected through an …

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Nursing Guideline For Specimen Handoff, Kathleen Marie Pearce Jan 2023

Nursing Guideline For Specimen Handoff, Kathleen Marie Pearce

Walden Dissertations and Doctoral Studies

AbstractThe absence of clinical practice guidelines (CPGs) and collaboration with significant stakeholders may lead to gaps in the delivery of patient care. Specimen handoff in the endoscopy unit plays a critical role in patient diagnosis and treatment plans; errors can compromise patient safety. The purpose of this project was to provide endoscopy nursing staff with a CPG to improve the accuracy of the specimen handoff process during the endoscopy procedure. The practice-focused question addressed the feasibility of developing a quality and usable CPG to improve the accuracy and efficacy of handling the specimen handoff process during endoscopy procedures. Walden University …

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Hiv Testing And Counseling Uptake Predictors Among University Students In Southwest Cameroon., Lilian Belole Motia Pencille Jan 2023

Hiv Testing And Counseling Uptake Predictors Among University Students In Southwest Cameroon., Lilian Belole Motia Pencille

Walden Dissertations and Doctoral Studies

AbstractDespite public health efforts to increase human immuno-deficiency virus testing and counseling (HTC) uptake, screening among college students remains low and understudied. The purpose of this cross-sectional correlational quantitative study was to explore the relationship between the constructs of the health belief model (perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy) and HTC uptake while controlling for age, sex settlement type, relationship status, area of residence, religious affiliation, and level of education. Four hundred and eighty-seven (N = 487) university students in Southwest Cameroon were recruited using a convenience sampling method. Data were collected using …

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Exploring Jury Nullification: Its Political History, Current, And Potential Impact On Policy, David Harold Penny Jan 2023

Exploring Jury Nullification: Its Political History, Current, And Potential Impact On Policy, David Harold Penny

Walden Dissertations and Doctoral Studies

Jury nullification (JN) is when a jury knows a defendant is legally guilty, but states they are not guilty, believing that their verdict better serves justice in that case. The problem is the violation of the Constitution’s equal protection clause for all citizens, caused by the intentional omission in most judges’ instructions to juries of JN. The purpose of the study was to fill the gap in the literature on jury behavior and address the problem of JN. The study framework is chaos theory as applied by Horowitz to jury behavior. It describes judges and lawmakers mistrust of juries associated …

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Reducing Opioid Prescribing By Using The Center For Disease Control Guidelines, Christina Marie Peters Jan 2023

Reducing Opioid Prescribing By Using The Center For Disease Control Guidelines, Christina Marie Peters

Walden Dissertations and Doctoral Studies

Opioid abuse is a serious national health crisis resulting in overdose and increased mortality in chronic pain patients. The purpose of this evidenced-based, quality improvement (QI) project was to improve primary care provider’s (PCP) awareness of The Center for Disease Control and Prevention’s (CDC) opioid prescribing guidelines to reduce opioid prescribing at this project site. The Donabedian model of structure, process, and outcome was used as the framework for this QI project. Lewin’s change management model of unfreezing and freezing was used as a guide to implement organization change by creating problem awareness, seeking alternative methods, and integrating the new …

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Examining The Relationship Of Social Inclusion On Job Satisfaction And Turnover Intentions Of Us Post-9/11 Veterans, Sheree' L. Peters Jan 2023

Examining The Relationship Of Social Inclusion On Job Satisfaction And Turnover Intentions Of Us Post-9/11 Veterans, Sheree' L. Peters

Walden Dissertations and Doctoral Studies

Many American veterans return to the civilian workforce and report having problems reintegrating into society, as well as finding their role in the new corporate social realms. Over 80% leave their civilian jobs within the first two years of employment, and over 70% report experiencing feelings of loneliness. Recently, the World Health Organization reported that the lack of perceived social inclusion also has a significant economic impact on both individuals and societies. A quantitative, nonexperimental methodology was used to examine the moderating relationship of social inclusion on the relationship between job employee turnover intentions of post-9/11 enlisted veterans. This study …

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Examining Help-Seeking Intentions Among Female Veterans With Military Sexual Trauma, Elizabeth Pirone Jan 2023

Examining Help-Seeking Intentions Among Female Veterans With Military Sexual Trauma, Elizabeth Pirone

Walden Dissertations and Doctoral Studies

An estimated 38.4% of military women have experienced military sexual trauma (MST) at some point in their careers. Because MST experiences can be confounding, navigating beliefs toward treatment resources and seeking help can be challenging. The problem under study was that no literature examined multiple constructs of the health belief model (HBM) together as a foundational tool to identify perceptions of help-seeking intentions among female veterans with MST experiences. Guided by the HBM, the purpose of this study was to examine the relationship between health motives, perceived severity of emotional or nervous problems, perceived benefits of getting help for emotional …

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African American Women’S Experiences Coping With Stress Through Community-Based Services, Delisa V. Procks Jan 2023

African American Women’S Experiences Coping With Stress Through Community-Based Services, Delisa V. Procks

Walden Dissertations and Doctoral Studies

Few studies have studied how community-based services (CBS) work to mitigate the strong Black woman image (SBWI) coping mechanism for Black women to improve their mental health. The purpose of this generic, qualitative study was to understand the experiences of 10 African American women, ages 18 and older, who identified with the SBWI and had received CBS to address their stress-related coping strategies. Transactional theory of coping with stress and the SBWI approach was used as the framework to help explain how stress in terms of the SBWI impacted the response of the African American women within their environment. Data …

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Oncology Nurses, Compassion Fatigue And General Health: A Mixed-Methods Study, Michelle Rampersad Jan 2023

Oncology Nurses, Compassion Fatigue And General Health: A Mixed-Methods Study, Michelle Rampersad

Walden Dissertations and Doctoral Studies

Current literature on compassion fatigue is expansive, but there is a lack on the relationship between compassion fatigue and general health complaints in oncology nurses; how they perceive compassion fatigue and its relation to their general health. Using Pender’s health promotion model, this mixed methods study addressed how oncology nurses perceive compassion fatigue and whether a correlation exists between compassion fatigue and general health complaints. Data were collected from a sample of 55 oncology nurses through two separate Survey Monkey links. All 55 participants completed quantitative data points including a demographic questionnaire, the Professional Quality of Life 5 tool, and …

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Influence Of Staffing Shortages On Safety And Communication In Behavioral Health, Raven Brittany Robinson Jan 2023

Influence Of Staffing Shortages On Safety And Communication In Behavioral Health, Raven Brittany Robinson

Walden Dissertations and Doctoral Studies

At the selected behavioral health organization (BHO), leaders desire to improve patient safety and staff communication to provide quality mental health services. They need strategies to achieve these goals. The Baldrige Excellence Framework was used to identify the workforce challenges and practices that facility leaders can potentially use to improve performance to help achieve success, sustainability, and the mission of the BHO. The data sources consisted of (a) semistructured interviews with the CEO, the leader of the intake department, an intake therapist, an intake coordinator, and an RN and (b) reviews of the BHO’s website, and pertinent academic literature. Data …

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Catheter Associated Urinary Tract Infection Prevention Education, Mary Jo Roskos Jan 2023

Catheter Associated Urinary Tract Infection Prevention Education, Mary Jo Roskos

Walden Dissertations and Doctoral Studies

AbstractCatheter associated urinary tract infections (CAUTIs) are infections that happen in the urinary tract in men and women when foley catheterization is not done using strict aseptic techniques. Bacteria can then travel up the urinary catheter into the bladder; therefore, contaminating urine in the bladder. This project site’s nursing staff was experiencing a lack of knowledge regarding CAUTI prevention. This lack of knowledge on the importance of sterile technique when inserting urinary catheters can lead to CAUTIs. The project question for this project addressed whether the educational program on the importance of a strict sterile technique on urinary catheter insertion …

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Relationship Between Nurse Managers’ Cultural Humility Practices And Nurse Retention, Jessica Scharfenberg Jan 2023

Relationship Between Nurse Managers’ Cultural Humility Practices And Nurse Retention, Jessica Scharfenberg

Walden Dissertations and Doctoral Studies

Some hospital administrators experience yearly loss of human capital, resulting in economic and noneconomic consequences that require resource reallocation to sustain operations. Grounded in the cultural humility theory, the purpose of this quantitative correlational study was to examine the relationship between nurses’ perceptions of their nurse managers’ (a) openness, (b) self-awareness, (c) egolessness, (d) self-reflection and critique, (e) supportive interaction, and nurse turnover intention. Participants included 142 registered nurses working in the Midwest United States. Data were collected using Foronda’s Cultural Humility Scale and the Michigan Organizational Assessment Questionnaire. Results of multiple regression analysis indicated the model could significantly predict …

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Improving Nurse-Patient Communication Through Motivational Interviewing In A Step-Down Unit, Ana G. Becker Jan 2023

Improving Nurse-Patient Communication Through Motivational Interviewing In A Step-Down Unit, Ana G. Becker

Walden Dissertations and Doctoral Studies

AbstractPatient satisfaction is an essential component in assessing the quality of nursing care. Often monitored through patient satisfaction surveys, this doctorate in nursing practice project (DNP) was developed to improve the problem of low Press Ganey nurse-patient communication scores for a medical-surgical step-down unit. The aim of the project was to develop a staff education program for the purpose of introducing motivational interviewing as an intervention to improve nurse-patient satisfaction scores. Lewin’s change model, Knowles’ adult learning theory, and the analysis, design, develop, implement, and evaluate (ADDIE) model were used to guide the development of the DNP project. Conducted over …

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How Supply Standardization Affects Non-Emergent Laparoscopic Cholecystectomy Costs And Length Of Stay, Marc Lopez Jan 2023

How Supply Standardization Affects Non-Emergent Laparoscopic Cholecystectomy Costs And Length Of Stay, Marc Lopez

Walden Dissertations and Doctoral Studies

This study was conducted to identify if there were practices that could be implemented to decrease costs in the operating room without negatively effecting patient outcomes. With the cost of healthcare in the United States consistently increasing, studies that focus on cost-reduction measures such as this one are crucial to ensure health systems continue to operate with a neutral or positive margin to remain available to provide patient care. This was a retrospective quantitative research study built on the diffusion of innovation theory. It focused on motivating factors such as differences in cost between surgical cases that used a standardized …

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