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Articles 4321 - 4350 of 6102

Full-Text Articles in Medicine and Health Sciences

Evaluation Of An Opioid Risk-Assessment Screening Tool, Jacquelyne Guerra Jan 2018

Evaluation Of An Opioid Risk-Assessment Screening Tool, Jacquelyne Guerra

Walden Dissertations and Doctoral Studies

According to the Centers for Disease Control and Prevention, prescribers should evaluate risk factors related to opioid use prior to initiation of opioid medication. The practice problem in this DNP project was that providers failed to consistently assess patients with complaints of pain for risk of opioid misuse and/or abuse prior to initiating opioid medication. An opioid risk-assessment screening tool (ORAST) has the potential to identify patients at high risk for opioid misuse and/or abuse. The purpose of this Doctor of Nursing Practice project was to identify and introduce an ORAST and then develop a policy to guide providers in …

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The Relationship Between The Big Five Personality Traits And Authentic Leadership, Bronti Baptiste Jan 2018

The Relationship Between The Big Five Personality Traits And Authentic Leadership, Bronti Baptiste

Walden Dissertations and Doctoral Studies

Effective leadership, ethical leadership, and leadership emergence have been extensively researched, but there remains a lack of research on the relationship between the big 5 personality traits and authentic leadership. This quantitative study was based on the empirical principles of the big 5 model and guided by the big 5 theory. In addition, this research asked if there was a relationship between the big 5 model and authentic leadership, and which combination of the 5 personality traits best predict authentic leadership. Fifty-five adult participants, employed in various corporations, were recruited from a convenience sample. They rated their leaders by completing …

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Generational Homelessness In New York City Family Homeless Shelters, Deborah Johnson Jan 2018

Generational Homelessness In New York City Family Homeless Shelters, Deborah Johnson

Walden Dissertations and Doctoral Studies

Homelessness has been a problem in New York City (NYC) for decades. Part of the problem is children who grew up in the shelter system and then returned as adults, a phenomenon known as 2nd-generation homelessness. Literature indicates that no researchers have interviewed second-generation homeless adults about their experiences. The purpose of this study was to explore the experience of 2nd-generation homelessness from the perspective of homeless adults returning to the shelter system. The sample included 1 second-generation homeless adult and 10 case managers at Tier II homeless shelters. Interviews were conducted and data were analyzed using hand coding to …

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Sport-Related Concussion And Lower Extremity Musculoskeletal Injuries In High School Athletes, Lisa Koperna Jan 2018

Sport-Related Concussion And Lower Extremity Musculoskeletal Injuries In High School Athletes, Lisa Koperna

Walden Dissertations and Doctoral Studies

Sport-related injuries (SRI) can be foreseen and averted when mechanisms and risk factors are completely understood. An appreciation of the relationship between sport-related concussion (SRC) and lower extremity musculoskeletal injuries (LEMI) is emerging amid professional and collegiate athletes. However, findings of such a relationship in adults may not be generalizable to younger populations, and the literature has not addressed this relationship in adolescents. The purpose of this cross-sectional quantitative study was to examine the relationship between SRC and LEMI in high school athletes. The dynamic model of etiology in sport injury provided the study's conceptual framework. A de-identified secondary dataset …

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Perceptions Of Chiropractors In Mississippi Regarding Obesity, Phelesia Nakita Foster Jan 2018

Perceptions Of Chiropractors In Mississippi Regarding Obesity, Phelesia Nakita Foster

Walden Dissertations and Doctoral Studies

Obesity continues to be a growing problem across the United States. Chiropractors have made claims of providing health promotion services within their treatment protocol; however, there is a lack of empirical research regarding a need for the chiropractic profession to train chiropractors to address Healthy People 2020 public health initiatives. The purpose of this qualitative study was to examine the perceptions of Mississippi Delta Region chiropractors regarding their role in obesity management as nonmedical practitioners that implement public health objectives in their practice. The research questions aimed at addressing possible barriers and limitations that influenced chiropractors' perceptions regarding their role …

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Spatiotemporal Variations In Coexisting Multiple Causes Of Death And The Associated Factors, Emmanuel Oluwatobi Salawu Jan 2018

Spatiotemporal Variations In Coexisting Multiple Causes Of Death And The Associated Factors, Emmanuel Oluwatobi Salawu

Walden Dissertations and Doctoral Studies

The study and practice of epidemiology and public health benefit from the use of mortality statistics, such as mortality rates, which are frequently used as key health indicators. Furthermore, multiple causes of death (MCOD) data offer important information that could not possibly be gathered from other mortality data. This study aimed to describe the interrelationships between various causes of death in the United States in order to improve the understanding of the coexistence of MCOD and thereby improve public health and enhance longevity. The social support theory was used as a framework, and multivariate linear regression analyses were conducted to …

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Elements Of Expatriate Adjustment In Host Country Organizations, Denise Suzanne Schickel Jan 2018

Elements Of Expatriate Adjustment In Host Country Organizations, Denise Suzanne Schickel

Walden Dissertations and Doctoral Studies

Globalization and international business increasingly require the services of skilled expatriates in overseas offices. Over the past 50 years, numerous studies have focused on various factors affecting expatriate adjustment, primarily through quantitative research, reaching no conclusions on what factors in cross-cultural training would guarantee expatriate success. Expatriate failure has high personal and organizational costs. The purpose of this study was to use the qualitative methodology of narrative inquiry to investigate the adjustment, transition, and repatriation experience as a holistic process. Two theoretical constructions, Bandura's social learning theory, applied to the learning process in an international assignment, and social identity theory, …

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A Phenomenological Investigation Of Adult Daughters Of Childhood Paternal Abandonment, Mary Spencer Jan 2018

A Phenomenological Investigation Of Adult Daughters Of Childhood Paternal Abandonment, Mary Spencer

Walden Dissertations and Doctoral Studies

A father's abandonment of his minor daughter can leave an indelible impression on her psyche -- one that can forever affect her intimate romantic relationships. The purpose of this qualitative phenomenological study was to explore where women who were abandoned by their fathers prior to the age of 18 are today as adults in terms of their intimate romantic relationships and how they develop and engage in these relationships. The research questions examined how a daughter being abandoned by her father prior to the age of 18 relates to where she is today in her adult intimate romantic relationships and …

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Social Support, Psychological Distress, And Behavioral Outcomes Among Palliative Care Caregivers, Monique Lashone Aguirre Jan 2018

Social Support, Psychological Distress, And Behavioral Outcomes Among Palliative Care Caregivers, Monique Lashone Aguirre

Walden Dissertations and Doctoral Studies

Social support and acute care facility providers need information about how to help improve the practices and knowledge of caregivers related to the stages of palliative care. The purpose of this study was to examine whether there was a significant association between social support and psychological distress and behavioral outcomes among palliative care caregivers, and to determine to what extent social support buffered psychological distress and behavioral outcomes. The quality-of-life model guided the study. The study used a quantitative cross-sectional research design with secondary data analyses. The sample included 320 adult family caregivers who were part of a telephone survey …

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Reducing Lateral Violence Among Nurses Through Staff Education, Alexandra Lindsay Tripp Jan 2018

Reducing Lateral Violence Among Nurses Through Staff Education, Alexandra Lindsay Tripp

Walden Dissertations and Doctoral Studies

Most nurses experience lateral violence (LV) during their careers. LV can be detrimental to nurses' livelihoods and careers, to facilities due to nurse replacement costs, to the nursing profession due to attrition, and to patient safety. The purpose of this staff education project was to educate registered nurses on the issue of LV and to equip nurses to respond to their aggressors. The project question addressed whether education would increase awareness of LV and empower nurses to stand up to their aggressors. The theory of the nurse as the wounded healer, social learning theory, and the theory of reciprocal determinism …

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Pap Utilization Survey In Nueva Vida, Nicaragua: Professional And Health Promotoras Partnership, Olushola O. Ogunleye, Bethesda J. O'Connell, Megan A. Quinn, Lea C. Florence, Kaitlyn Shirely Jan 2018

Pap Utilization Survey In Nueva Vida, Nicaragua: Professional And Health Promotoras Partnership, Olushola O. Ogunleye, Bethesda J. O'Connell, Megan A. Quinn, Lea C. Florence, Kaitlyn Shirely

Journal of Social, Behavioral, and Health Sciences

Cervical cancer is the second most common cancer affecting women in developing countries and accounted for 84% of the global incidence of cervical cancer in 2012. Nicaragua is one country illustrating this disparity, with an annual cervical cancer mortality six times the U.S. rate. This may be explained by lack and poor utilization of effective screening programs, especially the Papanicolaou, or Pap, smear. This study resulted from a partnership formed by faculty and students from two U.S. universities and a Nicaraguan nonprofit organization to conduct projects to benefit a community in Nicaragua. To promote a free Pap smear program provided …

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Variables That Impact Incidence Of Diarrhea Amongst Under-Five In Uganda, Anne Ngonde Muli Jan 2018

Variables That Impact Incidence Of Diarrhea Amongst Under-Five In Uganda, Anne Ngonde Muli

Walden Dissertations and Doctoral Studies

Diarrhea in children remains a major public health problem in Uganda and other countries in the region and acts as one of the leading contributors to child mortality. Most of the risk factors for diarrhea in children are preventable. This study, guided by the socioecological model, was conducted to investigate the association between the occurrence of diarrhea in children and length of breastfeeding, coinfection with acute respiratory infection (ARI), and vaccination status of the child. These variables were identified in the literature as risk factors for diarrhea that had not been investigated in Uganda. The source of the data for …

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Hardiness, Adult Attachment Style, And Burnout In Nurses, Kristy A. Negri Jan 2018

Hardiness, Adult Attachment Style, And Burnout In Nurses, Kristy A. Negri

Walden Dissertations and Doctoral Studies

The current nursing shortage is a pressing crisis that is expected to worsen over time. A key reason nurses leave nursing is burnout. The purpose of this study was to investigate personality hardiness and adult attachment style in relation to the development of burnout in licensed professional nurses. Hardiness theory and attachment theory indicated that each provided protection against burnout, but no research has been conducted to examine both factors in relation to burnout in nurses. Research Question 1 asked if there was a relationship between attachment style and total hardiness score; Research Question 2 asked if there was a …

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Adherence To The Icu Liberation Abcdef Bundle Improves Patient Outcomes In The Icu, Jennifer Sweeney Jan 2018

Adherence To The Icu Liberation Abcdef Bundle Improves Patient Outcomes In The Icu, Jennifer Sweeney

Walden Dissertations and Doctoral Studies

Delirium is a frequent complication of intensive care unit (ICU) admissions manifesting as acute confusion with inattention and disordered thinking. Patients in the ICU who develop acute delirium are more likely to experience long term disability and mortality. The purpose of this doctoral project was to evaluate an existing organizational quality improvement project to guide recommendations on improving care in the ICU. The practice-focused research question was: Does improving adherence to the ICU Liberation ABCDEF bundle for patients admitted to the ICU decrease incidence of delirium compared to outcomes prior to implementation? The Program Logic Model served as a framework …

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Patient-Centered Medical Homes And Parental Attention-Deficit Hyperactivity Disorder Medication Beliefs And Adherence, Sydney L. Watkins Jan 2018

Patient-Centered Medical Homes And Parental Attention-Deficit Hyperactivity Disorder Medication Beliefs And Adherence, Sydney L. Watkins

Walden Dissertations and Doctoral Studies

As many as 87% of children discontinue ADHD medication, which can lead to clinically significant academic, cognitive, and social impairment. ADHD costs billions of dollars to the healthcare and educational systems, and previous attempts to stem these costs and increase ADHD medication adherence have been unsuccessful. The purpose of this study was to determine if patient-centered medical homes (PCMH), which have been shown to improve patient health outcomes, impact parental beliefs (benefits vs. risks) about ADHD medication and adherence to ADHD medication. The theory of planned behavior was the theoretical framework for this study. There were 294 parents of children …

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Geographic Variations In Antenatal Care Services In Sierra Leone, Eunice Nyambura Chege Jan 2018

Geographic Variations In Antenatal Care Services In Sierra Leone, Eunice Nyambura Chege

Walden Dissertations and Doctoral Studies

Despite antenatal care presenting opportunities to identify and monitor women at risk, use of recommended antenatal care services remains. Barriers preventing use of antenatal services vary between countries, and limited knowledge exists about the link between geographical settings and antenatal service use. The objective of this cross-sectional quantitative study was to explore geographical variations and investigate how social demographic characteristics affect use of antenatal care for women in Sierra Leone using the Andersen behavioral model. The data used were from the 2016 maternal death surveillance report of the whole counrty (N =706). Logistic regression analysis was used to determine the …

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Waste Management Minimization Strategies In Hospitals, Andrea L. Clark Jan 2018

Waste Management Minimization Strategies In Hospitals, Andrea L. Clark

Walden Dissertations and Doctoral Studies

During the delivery of healthcare services, hospital employees use enormous amounts of water, energy, and nonbiodegradable carcinogenic plastics. In the U.S., hospital staff generate an average of over 7,000 tons of waste per day at an average cost of $0.28 per pound for the disposal of regulated medical trash, which if efficiently managed or reduced, could result in substantial cost savings. Using the organizational learning and the transaction cost economics theories as the conceptual frameworks, the purpose of this qualitative case study was to explore strategies healthcare leaders used to minimize their waste management operational costs. Data were collected using …

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Transitional Care For The Cardiac Surgery Population: Development Of A Clinical Practice Guideline, Sheila Davies Jan 2018

Transitional Care For The Cardiac Surgery Population: Development Of A Clinical Practice Guideline, Sheila Davies

Walden Dissertations and Doctoral Studies

Recovering from a cardiac surgery procedure and the transition to home can be an overwhelming experience for patients and caregivers. A tertiary care hospital's cardiothoracic surgery department suspended a nurse-practitioner-coordinated transitional care program in the 1st quarter of 2016. Following this decision, the readmission rate increased from its previous rate of 15.6% in quarter 1 to 20% in quarter 3. The purpose of this scholarly project was to develop a clinical practice guideline (CPG) that can bridge the gap in the transitional care process. The transitional care model informed the design of the project. A draft guideline was distributed to …

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Access To Primary Care In Pennsylvanian Rural Townships, Ann Eneh Jan 2018

Access To Primary Care In Pennsylvanian Rural Townships, Ann Eneh

Walden Dissertations and Doctoral Studies

Access to primary care is limited in rural communities across the United States. Evidence supports primary care as the cornerstone of healthcare. The purpose of this project was to explore community perceptions of barriers to primary care access with the aim of learning about ideas for possible interventions that could improve primary care access for Mifflin County residents. Penchansky and Thomas's model of healthcare access provided the theoretical framework for this qualitative phenomenological study. Using a community-based research approach, semistructured, open-ended telephone interviews and qualitative surveys were conducted with 26 participants, including physicians, nurses, and residents. Data were analyzed using …

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Development Of A Scholarly Educational Intervention To Improve Inpatient Diabetes Care, Sharon.Hasfal Hasfal Jan 2018

Development Of A Scholarly Educational Intervention To Improve Inpatient Diabetes Care, Sharon.Hasfal Hasfal

Walden Dissertations and Doctoral Studies

Advanced practice providers (APPs), consisting of nurse practitioners and physician assistants, face many challenges in the provision of evidence-based practice in their management of hospitalized adult patients with diabetes. Some of the barriers faced by APPs at a Northeast acute care facility are poor communication between disciplines, lack of confidence in initiating insulin, limited understanding of the management of insulin and the insulin pump, and insufficient treatment of the hospitalized patient with diabetes that aligns with current clinical guidelines for the management of inpatient hyperglycemia. This quality improvement project focused on the development of an evidence-based theory supported educational intervention …

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A Diabetic Child's Impact On An African American Family, Silvanus Okeke Jan 2018

A Diabetic Child's Impact On An African American Family, Silvanus Okeke

Walden Dissertations and Doctoral Studies

Diabetes, a chronic disease with devastating but preventable consequences, is common in the United States, especially within African American communities. Earlier research has indicated that 21.7% of African American parents have children diagnosed with Type 1 diabetes in the Mississippi Delta Region. Researchers have examined coping, stress, and behaviors of African American parents of children diagnosed with Type 1 diabetes; however, there is a gap in literature regarding how African American parents can cope with stress and how changes in health behavior due to Type 1 diabetes impact African American families. The purpose of this qualitative phenomenological study was to …

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Evaluation Of A Difficult Urinary Catheter Team In An Academic Medical Center, David Price Jan 2018

Evaluation Of A Difficult Urinary Catheter Team In An Academic Medical Center, David Price

Walden Dissertations and Doctoral Studies

The placement of an indwelling urinary catheter (IUC) is a commonly performed clinical procedure which may become challenging for the clinician and painful for the patient. In response to urologic complications attributed to repeated failed IUC insertion attempts by nurses, a difficult urinary catheter (DUC) team program was launched in October 2012. The purpose of the doctoral project was to conduct a quality improvement evaluation of the effectiveness of the DUC team program using retrospective data from May 1, 2013 through May 31, 2017. Benner's novice to expert model was chosen as the theoretical framework to guide the additional training, …

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Strategies For Improving Healthcare Efficiency While Reducing Costs, Jean Calvin Tchatchoua Jan 2018

Strategies For Improving Healthcare Efficiency While Reducing Costs, Jean Calvin Tchatchoua

Walden Dissertations and Doctoral Studies

In comparison to the European healthcare system, the U.S. healthcare system has lower quality care, higher costs, and covers a smaller percentage of the population. Despite the high costs, the U.S. healthcare system remains dysfunctional. The purpose of this exploratory single case study was to identify the strategies that some healthcare managers in a hospital setting in the midwestern region of the United States use to improve efficiency while decreasing healthcare costs. Complex adaptive systems theory was used to frame this study that included face-to-face interviews with 6 highly experienced healthcare managers. Data were collected from audio recorded interviews and …

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Social Inclusion Outcomes For An Organization's Adolescent Parent Intervention, Anayra Ivette Tua Jan 2018

Social Inclusion Outcomes For An Organization's Adolescent Parent Intervention, Anayra Ivette Tua

Walden Dissertations and Doctoral Studies

The study institution is a non-profit organization with a model developed from the continuous implementation of needs assessments of the families of adolescent parents in Puerto Rico, with the purpose of increasing their social inclusion potential. Addressing social exclusion and stigmatization of adolescent parents is vital because it generates a dual benefit for social interactions and growth. The social inclusion concept used and further elaborated for adolescent mothers is described by researchers as the level of access to engaging with institutions and societal relationships. This program evaluation was developed to understand the outcomes and effectiveness of the organization's social inclusion …

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Perceptions Of First-Time Antiguan And Barbudan Mothers Towards Breastfeeding And Weaning, Janelle Dion Charles-Williams Jan 2018

Perceptions Of First-Time Antiguan And Barbudan Mothers Towards Breastfeeding And Weaning, Janelle Dion Charles-Williams

Walden Dissertations and Doctoral Studies

Antigua and Barbuda, in the eastern Caribbean, is one of several countries with exclusive low breastfeeding rates and premature weaning. Researchers have demonstrated that babies exclusively breastfed for the first 6 months of life are better protected from childhood diseases and experience a better quality of life into adulthood, while early weaning is associated with morbidity and mortality. However, at 6 weeks postpartum, only 30% of Antiguan and Barbudan mothers are exclusively breastfeeding. Researchers have explained why mothers in general cease exclusive breastfeeding prematurely: insufficiency of breast milk, returning to paid employment, lack of social support; but an explanation specific …

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Use Of Antipsychotic Medications In Individuals With Alzheimer's Disease In Nursing Facilities, Michelle M. Dionne-Vahalik Jan 2018

Use Of Antipsychotic Medications In Individuals With Alzheimer's Disease In Nursing Facilities, Michelle M. Dionne-Vahalik

Walden Dissertations and Doctoral Studies

Patients with Alzheimer's disease or other types of dementia often require long-term care in nursing facilities (NF) where they may display out-of-character behaviors complicating their care. While antipsychotic medications are sometimes prescribed for NF residents, their use is considered inappropriate for the control of dementia behaviors. The Centers for Medicare and Medicaid Services have rated Texas the worst state in the country for the inappropriate use of antipsychotic medications for NF residents with dementia. This project was guided by the star model of knowledge transformation with the goal to reduce inappropriate use of antipsychotic medications through NF staff education. The …

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Determining Perceived Barriers Affecting Physicians' Readiness To Disclose Major Medical Errors, Jean-Pierre K. Folligah Jan 2018

Determining Perceived Barriers Affecting Physicians' Readiness To Disclose Major Medical Errors, Jean-Pierre K. Folligah

Walden Dissertations and Doctoral Studies

Medical errors have been detrimental in the field of medicine. They have impacted both patients and doctors. While physicians recognized that error disclosure was an ethical and professional obligation, most remained silent when mistakes happened for different reasons. Guided by the theory of planned behavior and Kant's deontological theory, the purpose of this quantitative study was to investigate the perceived barriers affecting physicians' willingness to report major medical errors. An association was tested between the independent variables physician fear of disclosure of errors, organizational culture toward patient safety, physician apology, professional ethics and transparency, physician education, and the dependent variable …

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Young Female College Millennials' Intent For Behavior Change With Wearable Fitness Technology, Andrea Christine Haney Jan 2018

Young Female College Millennials' Intent For Behavior Change With Wearable Fitness Technology, Andrea Christine Haney

Walden Dissertations and Doctoral Studies

Among young college-aged females, overweight and obesity, type 2 diabetes, uncontrolled hypertension, and high stress levels have increased, causing overall worse health conditions than previous generations. The use of wearable fitness technology (WFT) by young adults assists in fitness and nutrition monitoring, provides feedback in health statistics, and has shown improvements in reducing health-related issues in young college females. A wide body of literature related to physical activity, nutrition, and health issues in young college females exists; however, the experiences and intent of WFT use for behavior change by young college female millennials has not been well researched. The purpose …

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Technology Acceptance And Compliance In Obstructive Sleep Apnea Patients, Asif Kidwai Jan 2018

Technology Acceptance And Compliance In Obstructive Sleep Apnea Patients, Asif Kidwai

Walden Dissertations and Doctoral Studies

The focus of this study is the problem of declining trend in obstructive sleep apnea (OSA) patient compliance. Studies reported improved compliance in patients with chronic diseases due to technology-based interventions. However, researchers have not investigated the advantages of technology to improve the compliance of OSA patients in detail. The specific problem was the lack of engagement between patients and healthcare managers, resulting in low compliance within OSA patients. The purpose of this qualitative study was to evaluate how technology-based interventions can improve OSA patient engagement with the healthcare managers resulting in improved compliance with treatment procedures. In this study, …

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Racial/Ethnic Differences In The Treatment Of Elderly Non-Small Cell Lung Cancer Patients, Cheryl Mokrzecky Jan 2018

Racial/Ethnic Differences In The Treatment Of Elderly Non-Small Cell Lung Cancer Patients, Cheryl Mokrzecky

Walden Dissertations and Doctoral Studies

Racial and ethnic disparities related to lung cancer treatments and outcomes are not fully understood but may be due to individual or institutional factors. Following established national cancer treatment guidelines may improve patients' quality of life, outcome to treatment, and facilitate the eradication of lung cancer. There are limited data on the real-world treatment of racial/ethnic groups with non-small cell lung cancer (NSCLC) according to clinical practice guidelines, therefore this population-based cohort study examined the receipt of first line treatment for advanced or metastatic NSCLC according to the National Comprehensive Cancer Network (NCCN) practice guidelines. The Social Cognitive Theory served …

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