Medicine and Health Sciences Commons^™

Socioeconomic And Health Impact Of Opioid Overuse On Working-Age Population In Minnesota, Colette Ngum Ngwa

Walden Dissertations and Doctoral Studies

Abstract The United States faces numerous challenges associated with the ongoing opioid crisis. Although the opioid epidemic is complex, opioid overuse affects users’ health and has a far-reaching impact on socioeconomic well-being. This study employed a quantitative cross-sectional design using secondary data from a 2018 national survey of working-age individuals ages 18 to 45. Multivariate regression analysis was used to examine the associations between opioid overuse and socioeconomic status, health status, and perceived need for substance abuse treatment. The addiction career concept and chronic illness model theory were used to analyze these correlations. The findings indicated that people with higher …

The Relationship Between Housing/Living Arrangement And Admission To Drug Treatment Centers In Virginia, Odessa Ochoa

Walden Dissertations and Doctoral Studies

Homeless veterans with substance use disorders are among the most vulnerable and inaccessible populations in Virginia, which is evident by the lack of state and local resources. This cross-sectional study was conducted to present a retrospective assessment of the Treatment Episode Data Set (TEDS) to develop an understanding of the impact of housing arrangements on admission to long-term drug treatment centers among veterans in Virginia. To guide the study, the socioecological model was selected as the theoretical framework to better examine and understand the relationship between housing/living arrangement and admission to drug treatment centers among Virginia veterans. The aim of …

Risk Factors Associated With Type 2 Diabetes Among Adults In Alabama, Peter Okeke

Walden Dissertations and Doctoral Studies

In the 21stcentury Diabetes mellitus is recognized as one of the most important public

health challenges that carry a substantial individual and community burden.

It is necessary to do a detailed search regarding DM2 from adolescence till adulthood is in

Alabama which should aim to provide recent information. T2D is influenced by a many

factors including demographics including age, sex, income level, educational, BMI,

physical activities, etc. Identification of the associated risk factors is very important to

inform decision making by concerned bodies and T2D management. The study aimed to

examine the risk factors associated with T2D in adults aged …

Major Depressive Disorder And Perceived Everyday Discrimination Among The Jamaican Diaspora In The United States., Warren Williams

Walden Dissertations and Doctoral Studies

Overt racial discrimination in the United States has been supplanted by subtle forms of everyday discrimination known as microaggressions. Researchers have found perceived everyday discrimination (PED) to be associated with major depressive disorder (MDD) among African Americans but have often treated the African American subpopulation as a homogeneous group. The purpose of this cross-sectional study grounded in the theory of microaggression was to illuminate probable associations between microaggressions based on weight, age, gender, ethnicity, and race and lifetime MDD among the Jamaican diaspora in the United States. Secondary data from the Collaborative Psychiatric Epidemiologic Surveys were analyzed. Statistically significant associations …

Improving Colonoscopy Bowel Preparation In Adults Undergoing Screening Through Health Literacy Education, Kimmarie James-Ross

Walden Dissertations and Doctoral Studies

Colorectal cancer (CRC) is the third leading cause of cancer-related deaths among men and women in the United States. Colonoscopy is the gold standard for CRC screening; however, the diagnostic efficiency of a colonoscopy is highly dependent on bowel preparation (prep) quality. Up to 30% of colonoscopy patients present with poor bowel prep. Poor bowel prep is a significant clinical practice problem that can lead to missed lesions, increased risk for CRC, increased risks for procedure-related complications, ineffective use of resources, and increased health care costs. A huge barrier to effective colonoscopy is low health literacy. This quality improvement project …

Evidence-Based Approaches To Screening For Polypharmacy In Older Adults, Carmelo Maddy

Walden Dissertations and Doctoral Studies

AbstractPolypharmacy is the concomitant use of five or more medicines and is associated with a higher risk of being prescribed potentially inappropriate or interactive medications. Polypharmacy in adults over 60 years of age may correlate with adverse outcomes of multimorbidity such as functional impairment, low quality of life, high healthcare use, and increased costs. Health practitioners need to be aware of tools and methods to manage polypharmacy-related issues to optimize patient safety. The gap in practice is that a primary care practice did not have a comprehensive clinical guideline for a systematic and ongoing assessment of appropriateness of medication use …

Effectiveness Of Responsible Beverage Service Policies In Reducing Drunk-Driving In Maryland, Rhoda Makinde

Walden Dissertations and Doctoral Studies

In the State of Maryland and across the United States, driving under the influence (DUI) has led to a massive loss of lives and disability cases. Hence, responsible beverage service (RBS) policies and programs have been developed to prevent and control DUI incidence. This study sought to identify the effectiveness of these policies in addressing the DUI-related fatalities and injuries among young adults (18–30 years old) in the State of Maryland. Using program theory to evaluate the effectiveness of RBS policies and programs in reducing DUI, this qualitative research sampled bar patrons, club patrons, and alcohol servers/service staff in Baltimore. …

Perspectives Of Social Barriers To Accessing Health Care Insurance Among The Homeless Population, Abedalhakeem Damin Abukhalil

Walden Dissertations and Doctoral Studies

Access to healthcare services and healthcare insurance has been considered problematic for many populations in the United States. Despite many efforts to solve these issues, there is a significant gap in research related to the perceptions of the population experiencing homelessness associated with the social barriers they face with access to health insurance and health care. The behavioral-ecological framework best suited this study. In this qualitative descriptive study the perceptions of a sample of 10 individuals experiencing homelessness, who accepted to sit for 60-minute interviews, were investigated. Purposeful sampling was used to identify these individuals, whose age 18-60 years old, …

Accessibility To Vaping Products, Vaping, And Use Of Cigarettes Among Adolescents, Sherri Adeosun

Walden Dissertations and Doctoral Studies

There has been a continuous increase in the use of e-cigarettes among adolescents. The growth threatens to nullify the years of successfully reducing cigarette smoking among this age demographic. Additionally, the increase has been a concern for public healthcare workers due to the limited research on the effects of long-term use of e-cigarettes on adolescents. I investigated the possible side effects of exposure to e-cigarette advertisements and the use of e-cigarettes. Additionally, the study reviewed the relationship between the age e-cigarette use was initiated and the subsequent use of cigarettes. The conceptual framework was based on the multi-theory model and …

Medicine Adherence As A Determinant Of Complication Development In Diabetes And Hypertension Patients On A Medical Aid Scheme In Zimbabwe, Tsitsi Moyo

Walden Dissertations and Doctoral Studies

Pharmacotherapy is a significant component of chronic disease management; its efficacy depends on long term, correct, and consistent use; however, medicine adherence rates remain low. The cost of medicines is considered a significant barrier to adherence, especially in low-income settings. This quantitative cross-sectional study was conducted using data from Cimas Medical Aid Society collected between 2015 and 2019. The purpose of the study was to determine the extent of the association between medicine adherence, complication development, and cost of care among diabetic and hypertensive patients while controlling for age and gender on a population that does not experience cost barriers …

Exploring Implementation Strategies Of Iot Technology In Organizations: Technology, Organization, And Environment, Khanhhung Hoang Pham

Walden Dissertations and Doctoral Studies

AbstractAfter organizations successfully adopt the internet of things (IoT) technology, many corporate information technology (IT) leaders face challenges during the implementation phase. Corporate IT leaders' potential failures in implementing IoT devices may impede organizations from integrating IoT solutions and promoting business benefits. Grounded in technology-organization-environment (TOE) theory, the purpose of this qualitative, pragmatic inquiry study was to explore strategies that corporate IT leaders use to implement IoT technology in their organizations. The participants were six corporate healthcare IT leaders who successfully used implementation strategies for implementing IoT solutions for their organizations. Data were collected using semistructured interviews and industry security …

Type Of Union And Reproductive Health Influence On Domestic Violence In Sierra Leone, Yvonne Rowe

Walden Dissertations and Doctoral Studies

Domestic violence (DV) is one of the most hidden but prevalent public health concerns affecting women of childbearing age in Africa, despite ongoing prevention initiatives. Lack of power and control in the household is a significant precursor of DV in women, especially in sub-Saharan Africa. While poverty, gender inequality, and societal norms have been identified as directly related to DV, the factors of type of union and reproductive health choice remain unexplored. This quantitative study with a cross-sectional design assessed the relationship between the type of union, female contraceptive use, and type of DV amongst women in Sierra Leone. Anchored …

The Lived Experience Of Expectant Mothers During The Covid-19 Pandemic, Bridgette Schulman

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic has resulted in many changes to obstetric care practices. While the changes aimed to decrease transmission and protect mothers and infants, the study revealed unintended consequences of the changes put in place during COVID-19. Currently, there is a gap in knowledge and understanding of how the changes in obstetric care practices affect women’s perceptions of the birth experience. The purpose of the study was to explore the lived experience of mothers who gave birth in the health care setting during the COVID-19 pandemic through the eyes of those who experienced it. The research question was: What is …

Addressing Procedure Cancellation In Elective Surgeries, Vicky Marie Deuboue

Walden Dissertations and Doctoral Studies

When conducting elective surgeries, one of the challenges that healthcare providers experience is procedure cancellation. Across various healthcare settings, practitioners are employing relevant strategies to reduce the prevalence of procedure cancellations. The gap addressed in this project was the impact of calling patients to remind them to stay away from NSAIDs and blood thinners a few days prior to elective surgeries to avoid procedure cancellation. The administration of NSAIDs and blood thinners within that period may result in excessive bleeding in patients, which requires attention to improve elective surgery procedure outcomes. Erroneous administration of blood thinners too close to surgical …

Attitudes And Perceptions Of Nursing Graduates Regarding Interest In Gerontological Nursing Practice, Sonia Millicent Donaldson

Walden Dissertations and Doctoral Studies

AbstractAn ongoing increase in the number of older adults means an increased need for specialized health care, creating, in turn, a need for an increase in nurses in the United States to meet the demand. However, there is a problem in that nursing graduates, from the time they are students, do not choose geriatric-gerontological nursing (GN) as is practiced in long-term care and some specialty areas or units. The purpose of this basic qualitative study was to explore nursing graduates’ perceptions of GN as a field for professional practice and to determine how interest in GN may be encouraged. The …

Weight Management Among Postpartum African-Born Immigrant Women In Texas, Ethel Emehel

Walden Dissertations and Doctoral Studies

The growing population of postpartum African-born immigrant women has contributed significantly to the high burden of obesity and poor maternal health outcomes in the state of Texas; however, there is little research on this population. The purpose of this transcendental phenomenological study was to explore the lived experiences of weight management among postpartum African-born immigrant women in Texas based on the concepts of the health belief model. Semistructured interviews sparked the life experience of postpartum weight management of African-born immigrant women ages 18–45 who had a baby within the last year and suffered postpartum overweight or obesity. Interviews were audio-recorded …

Focused Surrogate Decision-Maker Identification In The Traumatically Injured Adult, Kelly Ann Evans

Walden Dissertations and Doctoral Studies

AbstractPatients in the trauma care setting are often dependent on their families and physicians to decide medical treatments when they cannot participate in the process.But in up to one-third of cases, the surrogate decision-maker (SDM)selected by the patient is not the emergency contact listed in the electronic medical record (EMR).SDM identification and documentation will ensure that the patient is best represented by someone who knows their values and goals if they become incapacitated.Nurses can facilitate identifying a patient’s SDM and document this choice in the EMR.The purpose of this study was a staff education program to improve intensive care unit …

Development Of Staff Education On Improved Compliance Adherence In Sleep Apnea, Mayla F. Garcia

Walden Dissertations and Doctoral Studies

The increasing prevalence of sleep disorders such as obstructive sleep apnea (OSA) affects approximately 25% of adults in the United States and an estimated 34% of men and 17% of women in the primary care population. In the clinical project site, the practice problem involved the increasing clinicians’ knowledge about OSA and being able to implement screening tools for further treatment and evaluation. The purpose of this project was to develop an educational training and intervention for staff to increase their knowledge of OSA conditions and have it validated by a panel of experts before dispersing it to the intended …

Policies That Support Emergency Department Staff In Providing Behavioral Health Care, Lizabeth Lepp Hennig

Walden Dissertations and Doctoral Studies

A significant portion of individuals with a behavioral health (BH) condition return to emergency departments (ED) seeking care, resulting in reduced quality of care, and contributing to disproportionate healthcare costs. Care can be improved and return visits to the ED reduced where behavioral health care and follow-up care planning are provided as part of their treatment. However, policies expected to create declines in ED use for behavioral conditions are typically in short duration or are difficult to use given other funding and policy constraints. With little known about how policy is supporting the engagement of ED staff who are critical …

A Comparison Of Treatment Outcomes Among Pediatric Hispanic Clients Using And Not Using Language Interpretation Services, Mohamed Khalif

Walden Dissertations and Doctoral Studies

Many families immigrating to the United States come fleeing adverse conditions in their home countries. Conditions such as war, political oppression, and economic hardship frequently result in a need for mental health services. This includes not only the adults in the family but also the children. However, because of their limited English proficiency, their access to mental health services frequently requires the use of interpretive services (IS). The body of knowledge on the use of IS in counseling is limited. The use of IS must be seen from a cultural perspective, hence Ridley et al.’s process model of multicultural counseling …

The Risk Factors For Hiv In African American Transgender Women In Connecticut, Oliver Kunda

Walden Dissertations and Doctoral Studies

AbstractThe human immunodeficiency virus (HIV) incidence rate is 70 times higher for African American transgender women than in the general population. Despite decades of outreach and intervention effort to reduce HIV incidence in the transgender community by the lesbian, gay, bi-sexual, transexual, queer, plus (LGBTQ+) community and public health organizations, the HIV prevalence rate for transgender women remains high at 38%. The purpose of this qualitative exploratory case study was to gain insights into how attitude, subjective social norms, and perceived behavioral control influence HIV risk behaviors of African American transgender women in Connecticut. Ajzen’s theory of planned behavior provided …

Experiences Of African American Female Offenders On Parole And Under Community Supervision, Shirley Lawson

Walden Dissertations and Doctoral Studies

African American female offenders on parole under community supervision reenter communities as convicted felons and face the challenges of intersectionality and collateral consequences. The purpose of this descriptive phenomenological qualitative study was to explore the experiences of African American female offenders active on parole and under community supervision. General strain theory was used to explore the experiences of African American female offenders on parole and under community supervision. Data were collected through semi-structured telephone interviews with a purposive sample of 10 African American female offenders, ages 18 and above who were on parole and under community supervision. Colaizzi’s seven-step method …

Creating A Clinical Practice Guideline For Patients With Uncontrolled Hypertension, Nar'cissa Mcdonald

Walden Dissertations and Doctoral Studies

Cardiovascular disease is the leading cause of death globally, with hypertension (HTN)the primary causal factor. The nursing professions' role as a critical agent in facilitating the management of patients should be based on best practices. No specific standard exists in the United States for nurses despite the publication of Clinical Practice Guidelines (CPGs) on HTN for adults. A gap in practice was identified in an outpatient primary care clinic located on the Gulf Coast of Mississippi, as there is no comprehensive CPG for nurses to provide patients with complete HTN diagnosis and management care. A literature review revealed that clinical …

An Evidenced-Based Nursing Education Discharge Plan For Prescription Opioids, Josephine J. Messelmani

Walden Dissertations and Doctoral Studies

The reported number of prescription opioid overdoses justifies the need for providing patients with opioid discharge information and follow-up care as recommended. To prevent any misuse of prescription opioid drugs, it was critical for patients to receive a thorough review of their medications prior to being discharged. The purpose of the project was designed to educate nurses on the importance of delivering essential information to patients prescribed opioids. Implementation of an opioid discharge plan integrated with the teach back method increased patients’ understanding of how to properly take prescription opioids compared to the patients who did not receive opioid education …

Experiences Of Nurses Who Provide Advance Care Planning In The Dialysis Setting, Sheree Mullen

Walden Dissertations and Doctoral Studies

AbstractPatients diagnosed with end-stage renal disease (ESRD) receiving dialysis experience increased symptom burden and multiple hospitalizations as the disease progresses. Dialysis nurses are charged with involving ESRD patients in decisions regarding their care and advance care planning for end-of- life; however, discussions about end-of-life care do not consistently occur. Providing advance care planning is important to involve the patient in their end-of-life care needs. The purpose of this qualitative descriptive study guided by the theory of planned behavior was to explore the experiences of nurses who provide advance care planning to patients receiving dialysis therapy. Eight participants volunteered to participate …

Use Of The Hester Davis Falls Risk Assessment Scale In Medical-Surgical Patients, Gideon M. Nyakundi

Walden Dissertations and Doctoral Studies

AbstractIdentifying and containing patient falls before they happen, reporting fall occurrence, and analyzing fall causes could increase patient safety to achieve the triple aim of improved quality, reduced cost, and accessibility in healthcare. Patient falls within the medical-surgical population continue to present challenges to patients, families, hospitals, and society, despite the use of fall-related predictive analysis tools. The purpose of this quantitative study was to determine the extent to which the overall score on the Hester Davis Falls Risk Assessment Scale (HDS), comprised of patient-related factors such as medications, volume/electrolyte status, age, last known fall date, mobility, toileting needs, communication/sensory …

Food Insecurity In Oncology Patients: An Educational Intervention For Nurses, Chinelo Pernilla Onwuazombe

Walden Dissertations and Doctoral Studies

AbstractFood insecurity is not having enough food or resources or not being able to procure nutritious foods. An observation that nurses in one oncology clinic rarely assessed their patients for food insecurity as part of their regular assessment led to the development and testing of an educational intervention for nurses which was to create awareness on the importance of assessing food insecurity among oncology patients and to learn to use the Household Food Insecurity Assess Scale (HFIAS) in assessing patients. Summative evaluation was done using a pre/and posttest. The Maslow’s hierarchy of needs and the Virginia Henderson nursing need theories …

Knowledge And Experiences Of African American Women With Polycystic Ovary Syndrome, Kristy L. Vance

Walden Dissertations and Doctoral Studies

While polycystic ovary syndrome (PCOS) is a nationwide phenomenon, African American or Black women often have little to no information on the education and support available to manage the condition. PCOS is one of the most poorly understood disorders among patients which has led to limited resources and management. The lack of education could contribute to increased risks to many health issues for African American women with PCOS. The purpose of this basic qualitative study was to explore and examine the level of health knowledge related to PCOS among African American women living in or around the Northern Region of …

Understanding Obesity In The Workplace From The Nursing Manager’S Perspective, Francis Taiwo Akinmoladun

Walden Dissertations and Doctoral Studies

AbstractLike other individuals from diverse backgrounds, nurses who work in nursing homes are susceptible to becoming overweight. The way that others see and respond to the overweight person also may vary and even result in some level of discrimination. The purpose of this study was to explore the perspective of nurse managers about obese staff in the workplace. A qualitative phenomenological descriptive study design was used, guided by the theory of interpersonal relations and the relational leadership framework, to examine the lived experiences of managers working with obese nurses in nursing home settings in a large metropolitan region in the …

Nontraditional Former Bachelor Of Science Nursing Students’ Perceptions Of Academic And Social Support Services, Teresa Cowan

Walden Dissertations and Doctoral Studies

Higher education has responded to the nursing shortage by adopting academic and social support services that have increased student retention and promoted higher graduation rates. The purpose of this basic qualitative study was to explore the perceptions of experiences that led nontraditional former Bachelor of Science in Nursing students at a career college to switch from their nursing program to another program within the first 2 years of college, which has contributed to the nursing shortage. This study also explored the perceptions of the participants about the influences, if any, that academic and social support services at the college had …