Medicine and Health Sciences Commons^™

Laughter Frequency, Pain Perception, And Affect In Fibromyalgia Patients, Deidre Gayl Molchan

Walden Dissertations and Doctoral Studies

Fibromyalgia syndrome (FMS), a common chronic pain condition, is often incompletely treated by conventional medical therapies. It can cause disability, psychological distress, work-related absenteeism, increased use of healthcare resources, and result in the inability to carry out the tasks of daily living. The purpose of this quantitative, correlational study was to investigate the potential influence of laughter on affect and pain in individuals with FMS. Laughter produces beneficial effects on acute pain and on chronic pain in general and has been found to improve temporary affective states, but there have been no studies testing the effects of laughter on the …

Association Between Body Mass Index And Depression On Hbaic Control Among Veterans, Opokua Osei-Yeboah

Walden Dissertations and Doctoral Studies

The study investigated the association between body mass index (BMI) and depression based upon glycated hemoglobin levels (HBA1C) among United States veterans. Based on Bandura's social cognitive theory, a cross-sectional analysis examined the association between BMI and depression on HBA1C regulation, and if the interaction between BMI and depression affects HBAIC regulation among veterans. Multiple regression analysis was used to test the multivariate associations between depression and BMI on the outcome variable of HBA1C. Linearity, normality, and homoscedasticity were assessed using normal probability plots and residual analysis. Durbin-Watson statistics were used to test for autocorrelations, and variance inflation factor was …

Nurse Practitioners' Knowledge, Skills, And Confidence In Providing Tobacco Cessation Education, Indra -. Sinanan

Walden Dissertations and Doctoral Studies

Ceasing tobacco use benefits smokers regardless of age; therefore, it is essential for health care providers to consistently identify smokers and offer evidence-based cessation treatments to those wanting to stop smoking as a proactive approach towards tobacco abstinence. The purpose of this doctoral project, which was underpinned by the knowledge-to-action framework, was to educate nurse practitioners about evidence-based tobacco cessation interventions and assess the impact of the education on their knowledge base, skills, and self-confidence in implementing tobacco-cessation protocols. Participants (n = 14) completed a knowledge-based questionnaire and the Skills and Confidence for Smoking Cessation Tool before and after an …

Decreasing Cauti Rates By Educating Staff On Reinforcing The Cauti Bundle, Yasmin Ali

Walden Dissertations and Doctoral Studies

The Centers for Disease Control and Prevention (CDC) estimates that catheter associated urinary tract infections (CAUTIs) account for 40% of all the hospital acquired infections in the United States. The use of an indwelling catheter is common in hospital settings. Improper placement, assessment, and maintenance can increase the risk for CAUTI, increase the length of stay, and cause harm to the patient. The purpose of this project was to decrease CAUTI rates in a critical care unit by educating nursing staff on the use of the CAUTI bundle and the CAUTI maintenance tool. The practice questions focused on (a) whether …

Nurse's Role Within The Informed Consent Process: A Systematic Review Of The Literature, Maria Faison

Walden Dissertations and Doctoral Studies

Each year, over 50 million surgical and nonsurgical inpatient procedures are performed and yet, shared decision making between patients and health care providers is not achieved. Obtaining patients' informed consent is part of a nurse's daily routine during admissions and before a procedure. The purpose of this project was to evaluate evidence to answer the practice-focused question regarding support for a policy change to implement a nurse-driven informed consent protocol. The systematic literature review was conducted using the adapted literature review by Souz, Silva, and Carvalho, which consisted of 6 levels for evaluating evidence. A total of 15 articles were …

Educating Primary Care Nurses On Phosphorus Management In Chronic Kidney Disease Patients, Lilian Somuah

Walden Dissertations and Doctoral Studies

Fifteen percent of adults in the United States have been diagnosed with chronic kidney disease (CKD). CKD is the slow, progressive, and irreversible loss of kidney function. The most effective means of controlling CKD is by managing dietary phosphorus intake. It is important that staff nurses be educated about effective patient education tools to improve dietary phosphorus management. The purpose of this project was to educate primary care nurses about phosphorus management in CKD patients through the introduction of the phosphorus pyramid as a visual tool. The project sought to understand if an educational intervention regarding phosphorus management in CKD …

Facilitating Factors And Positive Reasons African American Men Attend Psychotherapy, Taia Willis

Walden Dissertations and Doctoral Studies

Researchers have found that African American men are one of the most marginalized, targeted, and disenfranchised groups of people. In the past, African American men were less likely to attend psychotherapy compared to other ethnicities. Barriers to treatment includes the following: distrust in the mental health system, self-reliant behaviors, religious ideologies, cultural stigmas, and the ideology of what it means to be a man and an African American man in America. This study addressed the lack of qualitative studies on the experiences of African American men who attend psychotherapy by exploring the lived experiences of 10 African American men who …

Improving Health Literacy Assessments In Pediatrics, Kristina Michelle Wright

Walden Dissertations and Doctoral Studies

Low health literacy (LHL)--when patients do not understand their treatment or medications--has been linked to poor healthcare outcomes. Nurses need to know how to assess health literacy (HL) and teach pediatric patients and their families to help ensure that patients and family members can understand and follow health education messages. Evidence-based HL tools were obtained from a literature search and used to create a nursing staff education program on pediatric patient HL assessment and education. The project answered the practice-focused question that asked whether a staff education program on HL assessment and management would improve nursing knowledge of HL for …

Etiological Perspectives Of Abdl Behavior From Members Of An Online Abdl Community, Jennie Marie Hilleren

Walden Dissertations and Doctoral Studies

Atypical sexual behavior is often viewed from a perspective of pathology and non-clinical samples are not typically used in research. The current exploratory research is a qualitative study that examined the etiological perspectives of Adult Baby/ Diaper Lover (ABDL) behavior from members of an online ABDL community. Archival survey data from an online sample (N = 1,795) of ABDL participants were used. The theories informing this research included attachment theory and the sexual health model. Research questions included an examination of: (a) what we can be learn from the way an ABDL individual perceives the origin of ABDL behavior, (b) …

Asperger's Syndrome In African American Children, Suzette Bailey

Walden Dissertations and Doctoral Studies

The prevalence of autism in the United States is 1 in 68 children. African American children are less likely to receive advance testing to confirm the diagnosis of Asperger's Syndrome (AS) compared to other ethnic groups. The purpose of this study was to determine if demographic factors (parental education level, family annual income, marital status of custodial parent(s), parent ethnicity, number of children in home, other children with disability, family location, mother age at time of birth, gender of child, birth status of child, adoption status and age, child order, and other disability) have any predictive relationship to AS diagnosis …

Facilitating Collaboration Among School And Community Providers In Children's Mental Health, Holly J. Curran

Walden Dissertations and Doctoral Studies

Interprofessional collaboration among school-based and community-based mental health providers in children's mental has been studied in relation to specific providers and as part of program evaluation; however, limited information exists as to how to overcome barriers to collaborative relationships. This study describes the experiences of school and community mental health service providers and those who supervise them. Using phenomenological methodology, three focus-group interview transcripts were analyzed by identifying recurrent themes relevant to the experience of collaboration from school and community providers' perspectives. Although participants viewed aspects of collaboration positively, barriers frequently interfered with collaborative relationships. Support for collaboration from state, …

Education Models For Teaching Adults About Modifying Dietary Carbohydrate And Controlling Weight, Vincient Cleamons

Walden Dissertations and Doctoral Studies

The prevalence of diabetes and other pathophysiological conditions has been correlated with the incidence of obesity. A large portion of an adult community in the northwestern United States suffers from excessive weight that has been linked to premature mortality rates and certain forms of diabetes. Excess calories from carbohydrate have been shown to increase weight. Therefore, diets that are modified in carbohydrate and calories may help mitigate weight and obesity comorbidities. This qualitative, single case study's purpose was to explore the methods health care professionals use for teaching adults about controlling weight. Altheide and Johnson's analytic realism theory, in which …

Relationship Between The U.S. Air Force Physical Fitness Assessment And Healthcare Utilization, Elena Arushanyan

Walden Dissertations and Doctoral Studies

Escalating health care costs in the military health system are not sustainable long term. Regular physical activity has been shown to improve health and reduce health care costs. Military members serving in the United States Air Force (USAF) are encouraged to maintain physical fitness year-round and undergo mandatory physical fitness assessments (PFAs) annually. The purpose of this quantitative correlational study was to determine the nature of the relationship between the timing of the PFA and health care utilization (HU) by active duty service members assigned to the United Kingdom's USAF military treatment facility. Donabedian's framework and the logic process model …

Improving Workers' Safety And Health In The Zimbabwean Mining And Quarrying Industry, Bernard Mabika

Walden Dissertations and Doctoral Studies

Lack of effective occupational safety and health (OSH) strategies is a reason that

workplace accidents in the mining and quarrying industry remain high, making the

industry one of the riskiest operations worldwide. The purpose of this multiple case study

was to explore successful strategies mining and quarrying leaders in Zimbabwe used to

improve OSH. The key research question addressed successful strategies leaders in the

mining and quarrying industry use to improve employee occupational safety and health in

Zimbabwe. Six successful business leaders from 3 mining and quarrying mines in

Zimbabwe demonstrated an exception to unsafe practices, particularly through their

exceptional …

Household Determinants Of Malaria In Mutasa District Of Zimbabwe, David Takudzwa Zinyengere

Walden Dissertations and Doctoral Studies

Malaria is a vector borne, acute febrile illness, caused by Plasmodium parasites. Malaria impacts the medical and socioeconomic development programs of affected communities, as it diverts both individual and national resources into managing the disease burden. The purpose of this study was to explore and evaluate household determinants of malaria in Mutasa District, Zimbabwe. The precede-proceed theoretical model guided the study. Secondary data from Demographic Health Survey and District Health Management Information System, and current data from household determinant questionnaires, were used to evaluate the influence and significance of identified household determinants. Multiple logistic regression models were used to examine …

Impact Of Empowerment And Autonomy On The Nursing Director's Intent To Stay, Tiffany Bergquist

Walden Dissertations and Doctoral Studies

Retention of nursing directors is important to the viability and success of the healthcare industry because they have a large impact on nursing job satisfaction, overall retention of nurses in an institution, productivity, and patient outcomes. Factors that retain nurse directors, such as autonomy and empowerment, appear to be important to job satisfaction, but there is little in the current research to corroborate these findings. The purpose of this quantitative study was to determine what factors impact nursing directors' intent to stay in their current role and what effect role autonomy and empowerment have on their intent to stay as …

Predictive Relationship Between Treatment Adherence, Glycated Hemoglobin And Diabetic Complications Among Jamaicans, Christian Anaba Nwaukwa

Walden Dissertations and Doctoral Studies

Patient nonadherence to physicians' prescribed therapeutic regimen is the greatest challenge in the effective treatment of patients with diabetes worldwide. Scientific evidence has revealed that nonadherence to prescribed medication could result in diabetic complications such as cardiovascular disease, retinopathy, nephropathy, and neuropathic diabetic foot ulcers. The purpose of this study was to explore predictive relationships between levels of adherence to antidiabetic medications, patient HbA1c levels, and diabetic complications among Jamaicans, an understudied population. The research question that guided this study was: Do the patient level of adherence and HbA1c levels have any predictive relationship with the severity of diabetic complications …

Health Literacy And Hypertension Management In Haitian Immigrants, Suzie Jean

Walden Dissertations and Doctoral Studies

Patient compliance and health care communication are impacted by health literacy. Poor health choices, frequent hospital visits, noncompliance with health regimens, and higher health costs are all associated with low health literacy. The purpose of this cross-sectional study was to determine whether there was an association between health literacy as measured by primary language spoken in the home (Creole vs. English) and hypertension self-management as measured by regular use of medication and cutting down on foods high in salt, and whether there was an association between Haitian men, women, their education level, or level of poverty in relation to health …

Rem Initiative To Develop Educational Strategies For Inductions Of Labor, Chandra Evette Jones-Worthing

Walden Dissertations and Doctoral Studies

Inductions of labor that occur prior to 39 weeks' gestation can pose increased risks for the mother-baby dyad. In the target setting, there is a gap in knowledge among the pregnant women about options for delivery, hospital policies and procedures, and what to expect in the labor and delivery experience. Because of this gap in knowledge, the pregnant patient is unable to make informed decisions regarding her needs, expectations, and care. This lack of knowledge has resulted in a 40-50% rate of inductions of labor at the target site, which is well above the 2014 national average of 25%. In …

Improvement In The Retention Of Graduate Nurses In A Long-Term Acute Care Hospital, Angie Lim Torres

Walden Dissertations and Doctoral Studies

The high turnover rate of graduate nurses is a challenge in the United States' hospitals because of high job dissatisfaction rates. The premature disaffiliation of the graduate nurses is costly for organizations and can significantly affect the quality and safety of patient care due to the inadequate supply of adequately prepared staff nurses, particularly in the long-term acute care hospitals. The purpose of the project was to decrease the turnover rate of graduate nurses in a long-term acute care setting from 40% to 20% through modification of the nurse residency program by applying an intervention based on Bauer and Erdogan's …

Factors Affecting Completion Of Childhood Immunization In North West Nigeria, Sule Abdullahi

Walden Dissertations and Doctoral Studies

North West Nigeria has the lowest vaccination rate of the geopolitical regions of the country. The purpose of this cross-sectional study was to examine associations between the parents'/caregivers' biological, cultural, and socioeconomic factors and the completion or noncompletion of routine immunization schedules. Andersen's behavioral model provided the framework for the study. Data were obtained from the 2013 National Demographic Health Survey. Descriptive statistics were calculated for all variables. Chi-square tests were used for categorical predictor variables, simple logistic regression models were used for the age variable, and multiple linear regression models were used for the biological, cultural, and socioeconomic variables …

Understanding The Lived Experiences Of Hispanic Immigrants With Diabetes Toward Disease Self-Management, Dahlia Connors

Walden Dissertations and Doctoral Studies

The Hispanic population has a higher incidence of diabetes and poorer health outcomes compared to other populations in the United States. Although previous research has reported that cultural and ethnic beliefs play a role in poorer diabetes self-management by Hispanic individuals, limited studies have been focused on the barriers to self-management from the perspectives of Hispanic immigrants. The purpose of this qualitative study was to gain an understanding, through oral history narrative, of the experiences of Hispanic immigrants living with diabetes. In this study, the influence of cultural and ethnic beliefs on diabetes self-management in Hispanic immigrants in the Bronx …

Relationship Between Health Literacy And End-Stage Renal Disease Among Type Ii Diabetics, Joelle M. Stolte

Walden Dissertations and Doctoral Studies

The progression of End Stage Renal Disease (ESRD) among type II diabetics is preventable, yet complications continue to plague many. Reports show that 29.1 million people (9.3%) in the United States have diabetes, and 40% of those individuals develop ESRD. Four research questions explored the relationship between ESRD, health literacy, and healthcare. Data from 2010-2015 from the National Institute of Health (NIH) was quantitatively analyzed. The conceptual framework was the revised health service utilization theory. The target population included 3939 diverse males and females between the ages of 20-75 diagnosed with type II Diabetes. Results from Chi-square, cross-tabulation, binary, and …

Impact Of Acculturation On Body Mass Index In Haitians, Nirva Berthold

Walden Dissertations and Doctoral Studies

Longer-term immigrants residing in the United States exhibit physical health decline related to higher body mass index (BMI). Theories on immigrant acculturation have been used to examine health patterns by length of stay in the United States. The purpose of this cross-sectional study, guided by the Schwartz model of acculturation, was to examine the effect of acculturation and length of stay in the United States on BMI in a sample of Haitian immigrants living in the Northeast Metropolitan area. The research question was used to examine the effects of acculturation and length of stay on BMI in the convenience sample …

Family Relational Experiences During Major Transitions With A Chronic Illness, Juanita Sibayan

Walden Dissertations and Doctoral Studies

Although health care transitions have received some attention in the literature, few researchers have emphasized family relational experiences and communication during major changes while living with a chronic illness. The purpose of this phenomenological study was to understand the lived experience of parents and their adult children while transitioning from pediatric to adult care of a chronic illness. The bio-psychosocial theory, family systems theory, and attachment theory established the context for this study. A criterion-based sampling technique and snowball sampling were used to recruit 7 parents and 6 of their adult children aged 18 to 30 years who were diagnosed …

Improving Care Transitions In Patients With Heart Failure: An Integrative Literature Review, Heather Mae Mclain

Walden Dissertations and Doctoral Studies

Heart failure (HF) hospital readmission reductions are linked to nursing interventions that include scheduling a hospital follow-up appointment with the patient's health care provider within a week of discharge. Yet, patients often leave the hospital without an appointment scheduled. The focus of this integrative literature review was on analyzing data that associated follow-up within 7 days with reduced 30-day readmissions. A search of articles using CINAHL, MEDLINE, Cochrane Database of Systematic Reviews, and ProQuest databases resulted in 4,813 articles retrieved using the following search terms: heart failure, readmissions, follow-up appointments, and heart failure guidelines. Scholarly articles selected for inclusion were …

Effects Of Simulated Clinical Experiences On Empathy, Self-Confidence, And Satisfaction In Nursing Students, Dawn Riess

Walden Dissertations and Doctoral Studies

Empathetic communication enhances the nurse-patient relationship and improves patient outcomes and needs to be taught and evaluated during simulated clinical experiences. Experience in healthcare education has shown students' empathy levels decrease over time. The purpose of this quasi-experimental pretest posttest, study was to compare nursing students' empathy levels, self-confidence, and satisfaction with simulation between the use of the high-fidelity manikin simulator (HFMS) and a standardized patient (SP) used during their simulated clinical experience. Kolb's experiential learning theory was used to guide the study through the four phases specific to simulation and learning. Convenience sampling was used to recruit 135 nursing …

Discharge Calls And Avoiding Hospital Readmissions, Wanda Lee Cassavettes

Walden Dissertations and Doctoral Studies

Hospital readmissions are disruptive and costly for patients and hospitals. As hospital discharge instructions are a key nursing responsibility, this project implemented a nurse follow-up phone call intervention within 12-48 hours of patient discharge from an indigent care facility in the Great Lakes region of the United States. The project was designed to understand whether follow-up phone calls from nurses that clarified discharge instructions, symptom management, and medications would be associated with decreased readmission rates within 30 days post-discharge among chronic care patients. The theoretical framework was the health belief model, which proposes that the patient's knowledge of illness severity, …

How Fine Particulate Matter Modifies Preterm Birth Risks In Korea, Hyun Jin Choi

Walden Dissertations and Doctoral Studies

Despite the increasing interest in preterm birth risk associated with maternal exposure to the current level of fine particulate matter (PM2.5) in Korea, there is little information on differences in PM2.5 exposure and its impact on preterm birth. This study was designed to examine the effects of Korea's air quality on preterm birth, including the possibility of moderation and mediation. This work was also designed to investigate manipulable factors for PM2.5 exposure. The theoretical framework of this quantitative and observational study included the social ecological theory and systems theory. The conceptual framework of this partially ecologic and retrospective cohort study …

A Qualitative Grounded Theory Approach To Reducing Breast Cancer Disparities In The Latina Population, Dbora Schrett

Walden Dissertations and Doctoral Studies

Breast cancer is the leading cause of death among Latinas. Several barriers persist when accessing health care and utilization of healthcare services such as annual mammograms, leading to a late-stage diagnosis or death related to breast cancer illness. Consequently, this study was important to further examine potential risk factors such as beliefs, cultural context, health insurance, and socioeconomic status for this population. Further, gaps in research provide limited evidence of risk factors adversely influencing high morbidity and mortality incidence. The purpose was to focus on disparities in breast cancer experiences within Latina communities in the United States. A qualitative foundation …