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Articles 4951 - 4980 of 6102

Full-Text Articles in Medicine and Health Sciences

Relationship Between Educational Leisure Motivation And Recovery From Mental Illness Among Members Of Clubhouse International, Dianna Rene Pearce Jan 2017

Relationship Between Educational Leisure Motivation And Recovery From Mental Illness Among Members Of Clubhouse International, Dianna Rene Pearce

Walden Dissertations and Doctoral Studies

Individuals with serious mental illness (SMI) exhibit low motivation to participate in educational leisure activities at Clubhouses accredited by Clubhouse International (CI). This correlational study examined the relationship between each of 4 motives, intellectual, social, competence-mastery, and stimulus-avoidance, to engage in leisure activities, and the perception of recovery from SMI. Knowles's theory of andragogy supported the concept of informal self-directed learning, which occurs with leisure activities. Literature indicates that participating in leisure activities such as those offered at Clubhouses aids in the recovery from SMI. Quantitative data were collected from a convenience sample of 75 individuals at 4 CI clubhouses …

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A Comparative Study Of Cervical Cancer Among Indigenous Amerindian, Afro-Guyanese, And Indo-Guyanese Women In Guyana, Carol Jones-Williams Jan 2017

A Comparative Study Of Cervical Cancer Among Indigenous Amerindian, Afro-Guyanese, And Indo-Guyanese Women In Guyana, Carol Jones-Williams

Walden Dissertations and Doctoral Studies

Cervical cancer is a major public health problem in developing countries. In Guyana, factors associated with increasing cervical cancer cases among Indigenous Amerindian women (IAW), Afro- women (AGW), and Indo-Guyanese women (IGW) have not been fully examined. In this comparative cross-sectional study, 5,800 cervical cancer cases were selected from Guyanese women age 13 and above for ethnicity (Indigenous Amerindian, Afro- and Indo Guyanese women), geographical region, marital status, and year and stage at diagnosis. Secondary data from Guyana Cancer Registry for the 2000-2012 study periods were analyzed using chi-square test, multinomial logistic regression, poisson regression, and relative risk. Geographical region …

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Health System Predictors Of Access To Maternal Health Medicines In Low And Middle Income Countries, Chinonso Esther Nnorom Jan 2017

Health System Predictors Of Access To Maternal Health Medicines In Low And Middle Income Countries, Chinonso Esther Nnorom

Walden Dissertations and Doctoral Studies

The strength of health systems predict access to medicines that prevent death from pregnancy related complications (essential maternal health medicines). But little is known about the relative impact of each health system building block on access. This quantitative cross-sectional study applied Ishikawa model to examine the relative effect of health systems governance, facilities, service delivery, financing and medicine procurement and distribution (independent variables), on availability, affordability and accessibility (dependent variables) of maternal health medicines in resource poor settings. Data analyzed was pulled from 37 WHO pharmaceutical country profiles and USAID MCHIP survey that assessed national programs for the prevention and …

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Risk Perception Of Hiv Infection Among The Nigerian African- Immigrant Population In Houston, Texas, Esther Titilayo Ogunjimi Jan 2017

Risk Perception Of Hiv Infection Among The Nigerian African- Immigrant Population In Houston, Texas, Esther Titilayo Ogunjimi

Walden Dissertations and Doctoral Studies

HIV/AIDS studies mostly lack distinction between the US-born Blacks and non-US-born Blacks while African Americans (AAs) continues to represent the group with the heaviest burden of AIDS deaths and new diagnosis of HIV. A review of studies on HIV infection in the US, Europe, and other Western countries revealed a knowledge gap on HIV infection with non-refugee African immigrants (NRAIs), especially the Nigerian African Immigrants (NAIs) who are non-US-born Blacks. The purpose of this descriptive phenomenological study is to address this gap by exploring the expressed views of NAIs, a sub-group of the NRAIs living in Houston, Texas, on the …

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Impact Of Plans, Finance, And Zoning Policies On What Developers Choose To Build, Michele Ann Williams Jan 2017

Impact Of Plans, Finance, And Zoning Policies On What Developers Choose To Build, Michele Ann Williams

Walden Dissertations and Doctoral Studies

While there is considerable academic research on the intersection of comprehensive plans, finance policies, zoning policies and how these factors influence real estate developers' choice of what land to develop and what buildings to construct on that land, little is understood about whether these three variables promote or hinder real estate developers' choice of whether to build communities that promote healthy living. Using urban planning theory as the foundation, the purpose of this correlational study was to determine how real estate developers' decisions are made to support healthy New Urbanism development in the United States. Secondary data from the Urban …

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Homelessness In Calgary From The Perspectives Of Those Experiencing Homelessness, Edith N. Ahajumobi Jan 2017

Homelessness In Calgary From The Perspectives Of Those Experiencing Homelessness, Edith N. Ahajumobi

Walden Dissertations and Doctoral Studies

Since the 1990s, homelessness has increased in Canada. The existing strategies of the government and public health service providers to manage the situation have had limited success. Researchers have noted the lack of including those experiencing homelessness to better understand and find a solution to homelessness. The purpose of this phenomenological study, driven by the social cognitive theory, was to understand homelessness from the perspectives of people who do not have homes. Data were collected from open-ended interviews with a purposeful sample of 15 individuals who are homeless. Summarizing and analyzing the interviews, several themes emerged after interview data were …

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Perceived Parental Barriers To Preventive Dental Care Programs For Children, Kim Attanasi Jan 2017

Perceived Parental Barriers To Preventive Dental Care Programs For Children, Kim Attanasi

Walden Dissertations and Doctoral Studies

Dental caries is the most prevalent childhood illness and disproportionately affects children from low socioeconomic backgrounds. Dental organizations are collaborating within communities to decrease oral health disparities among children by offering free preventive oral health events. These programs face the problem of low enrollment due to lack of informed parental consent. Also, gaps in the literature indicated the need to examine oral health perceptions and dental-care-seeking practices of culturally diverse low-income parents regarding preventive care for their children. The purpose of this qualitative case study was to explore the reasons why parents are not allowing their children to participate in …

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Enhancing Nurses' Assessment Of Pain Management In Dementia Patients, Norma Jean Boone Jan 2017

Enhancing Nurses' Assessment Of Pain Management In Dementia Patients, Norma Jean Boone

Walden Dissertations and Doctoral Studies

Chronic pain contributes to morbidity, mortality, and disability in millions of people. Prevalence rates for pain are as high as 83% among the 5.2 million older adults living with a diagnosis of dementia. The purpose of the quality improvement project was to assess nurses' knowledge of pain assessment and management in a 45-bed Veterans Health Administration long-term care facility serving older adults with dementia. Knowles' adult learning theory served as the theoretical framework and the knowledge to action model supported the translation of evidence into practice. A convenience sample of 27 licensed and unlicensed nursing staff answered the 16-question, 5-point …

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Non Medical Prescription Drug Use In Rural Communities And Social Work, Izetta Mounice Briggs-Bolling Jan 2017

Non Medical Prescription Drug Use In Rural Communities And Social Work, Izetta Mounice Briggs-Bolling

Walden Dissertations and Doctoral Studies

This study explored the roles and responsibilities of social workers providing services to nonmedical prescription drug users (NMPDU). Researchers have indicated NMPDU disproportionately affects people living in rural communities. The overarching research question sought to explore the concerns of social workers when providing services to patients coping with NMPDU in the rural community of Ulster County, New York. The intention was to examine systemic challenges facing rural social workers when attempting to decrease morbidity risks and increase the health of Ulster County residents. A total of 7 social workers participated in 3 focus groups to explore their ideas for defining, …

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Effect Of Home Telemonitoring On Heart Failure Hospital Readmissions Among Adult Hispanics, Priscilla Liza Caban Jan 2017

Effect Of Home Telemonitoring On Heart Failure Hospital Readmissions Among Adult Hispanics, Priscilla Liza Caban

Walden Dissertations and Doctoral Studies

Heart failure is ranked as one of the leading causes of hospitalizations and mortality among adults of all racial/ethnic groups in the United States. Telemonitoring, as a homecare intervention for heart failure management, has been used across all groups although the benefit for Hispanics not established. The purpose of this retrospective, quantitative study was to determine the differences in hospital readmission between Hispanic, non-Hispanic Black, and non-Hispanic White patients with heart failure disease who either received or did not receive home telemonitoring services from a homecare agency in Connecticut. The research questions for this study examined the effect of home …

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Collaborative Strategies Used To Reduce Billing Administrative Cost, Stella Fayomi-Olaleye Jan 2017

Collaborative Strategies Used To Reduce Billing Administrative Cost, Stella Fayomi-Olaleye

Walden Dissertations and Doctoral Studies

Billing inefficiencies represent 80% of wasteful healthcare administrative costs that are projected to reach $45 billion by 2018. Potentially, a reduced billing administrative cost is estimated to yield an annual savings of $60 billion that could fund other societal needs such as jobs, wage increases, and education. Through the conceptual framework of iceberg change management model, this single case study explored collaborative strategies 3 healthcare billing managers in Dallas, Texas successfully used to reduce billing administrative costs. Data were collected through semistructured interviews and the review of company documents. Using Yin's procedure of examining, comparing, categorizing, and coding data, the …

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'Stand By Me' Designated Tobacco Areas On U.S. Military Installations, Robert Thomas Gobble Jan 2017

'Stand By Me' Designated Tobacco Areas On U.S. Military Installations, Robert Thomas Gobble

Walden Dissertations and Doctoral Studies

U.S. Air Force (USAF) active duty Airmenshowunusually high tobacco prevalence rates (TPR); i.e., smoke, smokeless, both(SSL-B), when compared to civilian publics in the United States. Tobacco control efforts have proven largely ineffective inlowering nicotine habits among Airmen, while outdoor designated tobacco areas (DTAs) sited near worksites and popular localeson USAF bases (USAFBs) likelyswayAirmen to continue riskynicotine habits. The aim of this inquiry was to assess whetherquantities of DTAs on USAFBs and U.S. airbases (USABs) with 4 mediator variables(quality of DTAs,sites of DTAs, execution of a tobacco cessation program, and types of tobacco cessation programs) wereassociated with TPR (SSL-B) among Airmen …

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Alcohol Use Disorder And Withdrawal Syndrome In Correctional Facilities: An Evidence-Based Clinical Practice Guideline To Prevent Alcohol-Related Adverse Events, Wanda Wilma González-Méndez Jan 2017

Alcohol Use Disorder And Withdrawal Syndrome In Correctional Facilities: An Evidence-Based Clinical Practice Guideline To Prevent Alcohol-Related Adverse Events, Wanda Wilma González-Méndez

Walden Dissertations and Doctoral Studies

In the United States, one in every 100 adults is confined to a correctional facility. Approximately 60% of inmates have an alcohol use disorder (AUD). When compared to the general population, inmates are twice as likely to have AUD. As they are unable to readily access alcohol, inmates entering a correctional facility with AUD are at high risk for the lethal alcohol withdrawal syndrome (AWS). AWS is preventable and yet correctional nurses process new inmates without an evidence-based clinical practice guideline (CPG) to assess for AUD, the prerequisite for AWS. The purpose of this project was to develop an evidence-based …

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Influence Of Psychological Empowerment, Leadership, And Climate On Safety Outcomes, Christine Healy Jan 2017

Influence Of Psychological Empowerment, Leadership, And Climate On Safety Outcomes, Christine Healy

Walden Dissertations and Doctoral Studies

Research has demonstrated that safety outcomes are impacted by workplace risk factors, but also supervisory practices and employee actions. An area that has not been explored is the impact of employee cognitions on safety outcomes defined as work-related injuries. Based on the conceptual framework of psychological empowerment (PE), the purpose of this study was to examine the relationship of employee cognitions as measured by PE as related to leadership and safety climate and the occurrence of work-related injury. The research examined the mediating effect of (PE) on the factors of leadership and safety climate and their relationship to work-related injury. …

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Factors Affecting Inadequate Growth During Early Childhood In Guyana, South America, Valescia Xenobia John Jan 2017

Factors Affecting Inadequate Growth During Early Childhood In Guyana, South America, Valescia Xenobia John

Walden Dissertations and Doctoral Studies

Children under 5 years of age in Guyana are at an increased risk for inadequate growth. According to the United Nations Development Programme, 1 out of 3 children of preschool age are undernourished globally. This is a major public health concern as undernourishment in children under 5 years can lead to lifelong health complications. The study assessed the relationship between inadequate growth and urban classification in children under 5 years in Guyana, South America, after controlling for the following variables: mother's level of education, mother's age at birth of the child, household size, wealth, and marital status. The study framework …

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Obstetric Fistula: The Experiences Of Patients And Medical Personnel In Sierra Leone, Sheku Samba Jan 2017

Obstetric Fistula: The Experiences Of Patients And Medical Personnel In Sierra Leone, Sheku Samba

Walden Dissertations and Doctoral Studies

Women face great risks in pregnancy and childbirth, especially in developing countries where there are very few skilled birth attendants and negligible government investments in maternal health programs. As a result, obstetric fistula (OF), a potentially fatal but preventable and treatable condition, affects some 3 million women and girls globally. In Sierra Leone, the prevalence of OF is extremely high, but the absence of quality data to inform decision-making, both on prevalence and risk factors, is a barrier to creating an environment for OF prevention and care. The purpose of this phenomenological study was to explore and document the barriers …

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Challenges To Augmentative And Alternative Communication Interventions With Autism Spectrum Disorder Students, Kristy Jane Singer-Macnair Jan 2017

Challenges To Augmentative And Alternative Communication Interventions With Autism Spectrum Disorder Students, Kristy Jane Singer-Macnair

Walden Dissertations and Doctoral Studies

Students with autism spectrum disorder (ASD) have challenges with communication, social interactions, and behavior, which can limit their functioning in school settings. They need to have functional communication skills to access the curriculum and have their needs met across all social environments. Special education teachers often experience barriers to successful implementation of augmentative and alternative communication (AAC) interventions appropriate for these students. The purpose of this case study was to understand how special education teachers experience AAC intervention processes, and illuminate the conditions for effective AAC implementation. A qualitative case study was conducted using interviews from 6 credentialed special education …

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Development Of A Guideline For Hospice Staff, Patients, And Families On Appropriate Opioid Use, Trenika Alexander-Goreá Jan 2017

Development Of A Guideline For Hospice Staff, Patients, And Families On Appropriate Opioid Use, Trenika Alexander-Goreá

Walden Dissertations and Doctoral Studies

There is an identified problem with patients receiving suboptimal pain management at a hospice agency in the northwestern United States. At this agency, undertreatment of pain is prevalent. Evidence indicates that this may be a result of a lack of guidelines, education, and knowledge of appropriate prescribing. Known barriers to the correct prescription and administration of potent opioids in the hospice setting include prevailing beliefs, knowledge, skills, and attitudes, all of which can impact care negatively. Contextually, hospice principles mandate patient comfort and caregiver involvement in continuous quality improvement, which includes adequate and informed pain management. Moreover, hospice metrics demand …

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Night Shift Work And Weight Gain Among Female Filipino Nurses, Raymundo Mintac Apellido Jan 2017

Night Shift Work And Weight Gain Among Female Filipino Nurses, Raymundo Mintac Apellido

Walden Dissertations and Doctoral Studies

The research problem is the increasing numbers of overweight and obese nurses working the night shift. Study on overweight and obesity among female Filipino nurses has not been conducted. It was important to conduct a research study among female Filipino nurses to find out if there are statistically significant associations between night shift work and weight gain. The purpose of this correlational and cross-sectional study was to determine if there are statistically significant associations between insufficient sleep, abnormal eating patterns, working 12-hour shifts, years of working night shift, age, stress, marital status, nursing units, decreased physical activity, and level of …

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Telemedicine: An Augmentation Strategy To Mitigate The Primary Care Shortage, Kevin Jeffrey Mckinnon Jan 2017

Telemedicine: An Augmentation Strategy To Mitigate The Primary Care Shortage, Kevin Jeffrey Mckinnon

Walden Dissertations and Doctoral Studies

According to the Association of American Medical Colleges, the primary care workforce shortage in 2025 will exceed 46,000 primary care physicians. Healthcare business leaders in Gwinnett County, Georgia have not evaluated the advantages and disadvantages of telemedicine (TM) to mitigate the workforce shortage. The purpose of this qualitative descriptive study was to determine factors primary care physician administrators consider when deciding to implement TM as a potential solution for the growing physician shortage. A purposive sample of 20 primary care physician administrators located in Gwinnett County, Georgia was drawn. The theory of disruptive technology was the conceptual framework. Data collected …

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Dietary Acculturation And Obesity In African Immigrant Adults, Stella Chinyere Onuoha-Obilor Jan 2017

Dietary Acculturation And Obesity In African Immigrant Adults, Stella Chinyere Onuoha-Obilor

Walden Dissertations and Doctoral Studies

Racial/ethnic groups are disproportionately affected by obesity and other risk factors for chronic diseases. African immigrants are an increasing segment of the U.S. population at greater risk for obesity than other immigrants living in the United States. Public health organizations that aid immigrants could benefit from information about changing dietary patterns. The purpose of this study was to explore the association between dietary acculturation and obesity among African immigrant adults living in the United States, controlling for length of stay, English proficiency, region of residence, and other sociodemographic factors. Acculturation theory guided this study. The research design was quantitative cross-sectional …

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Educational Interventions To Improve Aggressive Behavior Recognition For An Acute Psychiatric Setting, Marie Elois Ortiz Jan 2017

Educational Interventions To Improve Aggressive Behavior Recognition For An Acute Psychiatric Setting, Marie Elois Ortiz

Walden Dissertations and Doctoral Studies

Nurses working in an acute psychiatric setting within a veterans' administration hospital must maintain a therapeutic milieu by recognizing and managing aggressive behaviors before violence ensues to reduce injuries to staff nurses and patients. The purpose of this project was to develop an evidence-based and theoretically grounded educational program that will help staff nurses manage escalating aggression, violence, and acting out behaviors to provide a safe environment for patients and staff through high risk identifier recognition and intervention training. During the data and information gathering stage, 23 articles were reviewed, rated, and graded to provide the most significant information used …

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Educating Globally In Medical Imaging In Latin America And Caribbean Via Webinars, Carmen Teresa Saunders Jan 2017

Educating Globally In Medical Imaging In Latin America And Caribbean Via Webinars, Carmen Teresa Saunders

Walden Dissertations and Doctoral Studies

Professional development courses that focus on increasing knowledge and improving skill sets are an integral part of a medical imager's career. This study was a qualitative formative evaluation with purposeful sampling of participants in a professional development webinar course offered to medical imaging professionals in 35 Latin American and Caribbean countries. The goal of this study was to aid the agency with identifying areas in which the efficacy of the program implementation and delivery could improve. The conceptual framework model, interest-problem-based learning (INTEREST-PBL) model, and Malcolm Knowles's theory on adult learning were used to ground this project. The research questions …

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Geospatial Analysis Of Spatial Patterns Of U.S. Hospital Readmission Rates, Yamei Wang Jan 2017

Geospatial Analysis Of Spatial Patterns Of U.S. Hospital Readmission Rates, Yamei Wang

Walden Dissertations and Doctoral Studies

Unplanned hospital readmission after a recent hospitalization is an indication of poor healthcare quality and a waste of healthcare resources. The Centers for Medicare and Medicaid Services (CMS) initiated the Hospital Readmission Reduction Program (HRRP) to improve healthcare quality and reduce costs; however, studies found the risk adjustment method used in calculating the standardized readmission rate was less accurate without hospital region or community factors. Accordingly, this cross-sectional quantitative study was designed to examine spatial patterns in hospital readmission rates following Andersen's behavioral model of health service utilization. This study was the first geospatial analysis on risk standardized hospital readmissions …

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Coping Mechanisms Of Sub-Saharan African Female Immigrants With Breast Cancer, Ernest Opoku Agyeman Jan 2017

Coping Mechanisms Of Sub-Saharan African Female Immigrants With Breast Cancer, Ernest Opoku Agyeman

Walden Dissertations and Doctoral Studies

Coping mechanisms of breast cancer is a public health problem among African females, particularly, the Sub-Saharan African female immigrants. The purpose of this qualitative study was to explore the coping mechanisms of the research group that could be used to develop and implement an intervention program to promote the quality of adaptation to improve the quality of life. The study achieved the objective by the use of 1-to-1 interviews of purposive samples of 2 and 12 using Roy Adaptation Model. Interviewed data were collected from females diagnosed with breast cancer, in treatment, and with remissions. The pilot study (n = …

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Decreasing Primary-Care-Related Emergency Department Visits In The Hispanic Population Using Patient Navigators, Arthur Dominguez Jr. Jan 2017

Decreasing Primary-Care-Related Emergency Department Visits In The Hispanic Population Using Patient Navigators, Arthur Dominguez Jr.

Walden Dissertations and Doctoral Studies

Primary-care-related emergency department (PCR-ED) visits by Hispanic patients enrolled in a not-for-profit Medi-Cal and Medicare health plan resulted in longer wait times in the emergency department (ED) at a regional medical center in Southern California. This congestion decreased access for those with true emergencies, created capacity issues, increased ED length of stay, and resulted in potential safety risks. This project focused on decreasing PCR-ED visits in the Hispanic population using patient navigators in Southern California. Applying the health belief model and Lippitt's theory of change, this doctoral project involved the creation and implementation of a culturally appropriate, population-specific patient navigator …

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Impact Of The Affordable Care Act On The Hiv Care Continuum, Ebere Erugo Jan 2017

Impact Of The Affordable Care Act On The Hiv Care Continuum, Ebere Erugo

Walden Dissertations and Doctoral Studies

People living with human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS; PLWHA) are at increased risk of insufficient medical care due to lack of insurance. Inadequate medical care for PLWHA contributes to increases in HIV transmission rates. The U.S. Surveillance Report noted that in 2015, over 1.2 million people were living with HIV infection, and there were approximately 50,000 new infections every year. The report further stated that about 675,000 people have died from HIV-related illnesses since its discovery in 1981. The implementation of the Affordable Care Act (ACA) in 2014 was intended to provide Americans, including people at …

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Postpartum Mothers' Attitudes Toward Breastfeeding, Jackie Denise Jones Jan 2017

Postpartum Mothers' Attitudes Toward Breastfeeding, Jackie Denise Jones

Walden Dissertations and Doctoral Studies

Breast milk is the optimal source of nourishment for babies, providing positive nutritional and psychosocial benefits for infants' growth and development. Rates for initiation of breastfeeding and exclusive breastfeeding at 6 months in the United States are well below the target rates for the Healthy People 2020 Maternal, Infant, and Children's Health objectives. Using Ajzen's theory of planned behavior, the purpose of this project was to ascertain how knowledge and attitudes influenced a mother's intent to breastfeed during her hospital stay and the likelihood of exclusive breastfeeding continuing after discharge. A convenience sample of 68 postpartum mothers was recruited from …

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Hpv Vaccination, Sociodemographic Variables, And Physician Recommendation In Select U.S. Areas, Rebecca Marie Jungbauer Jan 2017

Hpv Vaccination, Sociodemographic Variables, And Physician Recommendation In Select U.S. Areas, Rebecca Marie Jungbauer

Walden Dissertations and Doctoral Studies

Human papillomavirus (HPV) is the most common sexually transmitted virus, and is causally related to several cancers. HPV vaccination rates are far below HealthyPeople 2020 targets and vary across geographic, socioeconomic, and demographic populations. The purpose of this research was to test the relationships among socioeconomic and demographic variables, HPV vaccination, social vulnerability, and physician recommendation within select local areas in the United States. Fundamental cause theory and behavioral economics informed this quantitative secondary analysis of National Immunization Survey-Teen and Social Vulnerability Index data (n = 43,271). Statistical analyses included chi-square and binomial logistic regression. Teens whose mothers had less …

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Faculty Competence In Facilitating Clinical Simulation, Rose Kronziah-Seme Jan 2017

Faculty Competence In Facilitating Clinical Simulation, Rose Kronziah-Seme

Walden Dissertations and Doctoral Studies

Clinical simulation is a teaching strategy to assist nursing students to connect classroom knowledge to the clinical setting. Teaching clinical simulation requires special training, but many nursing faculty who teach clinical simulation do not receive clinical simulation training. The purpose of this study was to determine if the effects of formal versus informal simulation training impacted nursing faculty's self-ratings of their competency in facilitating simulation and identify areas for needed educational support. A quantitative descriptive approach was used and grounded in the National League for Nursing and Jefferies (NLN/JSF) theoretical framework. This framework focuses on the relationship between teacher, student, …

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