Medicine and Health Sciences Commons^™

The Effect Of Confirmation Bias In Criminal Investigative Decision Making, Wayne A. Wallace

Harold L. Hodgkinson Award for Outstanding Dissertation

Confirmation bias occurs when a person believes in or searches for evidence to support his or her favored theory while ignoring or excusing disconfirmatory evidence and is disinclined to change his or her belief once he or she arrives at a conclusion. The purpose of this quantitative study was to examine whether emotionally charged evidence and evidence presentation order could influence an investigator's belief in a suspect's guilt. The study included 166 sworn police officers (basic training recruits, patrol officers, and criminal investigators) who completed online surveys in response to criminal vignettes across different scenarios to record their measure of …

Development And Testing Of An Instrument To Measure Informatics Knowledge, Skills, And Attitudes Among Entry-Level Nursing Students, Diane K. Whitehead, Lynne E. Bryant, Jo Ann Kleier

Walden Faculty and Staff Publications

Informatics competencies in nursing education have long been and continue to be a concern. This article reports on the development and psychometric testing of the Knowledge, Skills, and Attitudes towards Nursing Informatics (KSANI) Scale to measure these constructs among entry-level nursing students. A measurement instrument was developed based on the Quality and Safety Education for Nurses (QSEN) Institute informatics competencies for pre-licensure students (Cronenwett et al., 2007). Survey data were collected from a convenience sample of 300 undergraduate nursing students attending the 2014 Florida Student Nurses Association’s annual convention. The data were subjected to Cronbach’s test to estimate the level …

Physical Activity Improves Depressive Symptoms In Older Adults, Karen Lee Fahey

Walden Dissertations and Doctoral Studies

Engaging in physical activity can help older adults to take part in community activities, maintain relationships, and initiate new friendships, thus preventing loneliness and depression. The purpose of this quality improvement (QI) project was to evaluate whether participation in physical activity improved depressive symptoms in 15 older adults at a local senior center. Pender’s health promotion model was used to determine nursing and behavioral science views on components that affect health behavior. The Exercise Benefit/Barrier Scale (EBBS) survey was evaluated before implementation of the walking program to measure the benefits of and barriers to exercise. The EBBS results showed that …

Health Literacy Among Elderly Hispanics And Medication Usage, Wilda Parker

Walden Dissertations and Doctoral Studies

Health literacy among the elderly Hispanics is a problem for 44% who read at the lowest level due to issues with recognition, cognition, or vision. The purpose of this study was to determine the extent that elderly Hispanics have problems with medication adherence due to health literacy. The social cognitive theory was the framework for this study. Inclusion criteria consisted of being 65-75 years of age, and speaking and/or reading English and/or Spanish. Questionnaires from 156 individuals were completed in Cobb County/Atlanta GA and analyzed using multiple regression to determine the relationship between health literacy and medication usage. Medication adherence …

Health Care Clinicians' Compliance With Conducting Spiritual Assessments And Providing Spiritual Care To Infertile Women, Lesa Miller

Walden Dissertations and Doctoral Studies

Infertility is a disease that can cause psychological impairments in women, and the inability to achieve motherhood brings about cultural and social stigma. Spirituality is a protective element that may provide consolation to women experiencing infertility, yet the literature has shown that few clinicians conduct spirituality assessments or provide spiritual care to patients. The objectives of this scholarly project were to conduct an assessment to determine the needs of health care clinicians in regard to spirituality and spiritual patient care and to develop an educational module based on identified knowledge deficits. Guided by the knowledge-to-action cycle, a needs assessment was …

A Model For Hiv Disclosure Of A Parent's And/Or A Child's Illness, Gary J. Burkholder Jr, Grace Gachanja

Walden Faculty and Staff Publications

HIV prevalence in Kenya remains steady at 5.6% for adults 15 years and older, and 0.9% among children aged below 14 years. Parents and children are known to practice unprotected sex, which has implications for continued HIV spread within the country. Additionally, due to increased accessibility of antiretroviral therapy, more HIV-positive persons are living longer. Therefore, the need for HIV disclosure of a parent's and/or a child's HIV status within the country will continue for years to come. We conducted a qualitative phenomenological study to understand the entire process of disclosure from the time of initial HIV diagnosis of an …

Transforming Care Of The Behavioral Health Patient In An Emergency Department Setting, Theresa J. Kubiel

Walden Faculty and Staff Publications

Abstract

Transforming Care of the Behavioral Health Patient in an Emergency Department Setting

by

Theresa J. Kubiel

MSN, Walden University, 2009

BSN, Bloomfield College, 2002

AAS, Ocean County College, 1992

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

January 2016

Abstract

Behavioral and mental health issues contribute to the needs of many patients presenting to emergency departments, and yet these needs often go unrecognized. Patient processing procedures in emergency departments may not include mechanisms to consistently identify and triage patients whose care is complicated by behavioral illness. The purpose of …

Intravenous Immunoglobulin Treatment, Illness Intrusiveness, And Quality Of Life In Neurological Autoimmune Patients, Pamela Jane Gennari

2010-2016 Archived Posters

There is scant literature regarding the psychological effects of intravenous immunoglobulin (IVIG) treatment experience on quality of life (QOL) for neurological autoimmune disease patients diagnosed with multiple sclerosis, multifocal motor neuropathy, myasthenia gravis, and chronic inflammatory demyelinating polyneuropathy. IVIG treatment experience predicted QOL in 1 Neuro-QOL subscale; illness intrusiveness mediated 9 of the Neuro-QOL subscales using bias-corrected bootstrapping for statistical significance; and person control did not mediate the relationship between illness intrusiveness and QOL.

Evaluation Of A Temporary, Immersive Learning Community Based On Worldschooling, Aimee Ferraro

Walden Faculty and Staff Publications

Learning communities are a proven method for engaging groups of people who share common goals for personal growth and knowledge acquisition (Gabelnick, MacGregor, Matthews, & Smith, 1990; Taylor, Moore, MacGregor, & Lindblad, 2003). However, little is known about the usefulness of this approach in the context of alternative education. This article describes the evaluation of a temporary, immersive learning community for self-directed teen learners, Project World School (PWS), which was based on a new, pedagogical approach to learning called worldschooling. Findings indicate that regardless of demographic characteristics and personal interests, PWS attendees experienced learning and progress in three main areas: …

Pregnancy With Psoriasis: What New Parents Need To Know, Debra Henline Sullivan, Deborah Weatherspoon, Christopher Weatherspoon

Walden Faculty and Staff Publications

Psoriasis is a common, chronic, autoimmune inflammatory disease that affects a substantial number of women annually during pregnancy and childbirth. Some of these women will need and seek guidance before or during their pregnancies and during lactation. The childbirth educator needs a basic knowledge base and ability to answer questions that may arise regarding psoriasis during the childbirth experience. This article will define psoriasis and its effects on pregnancy and childbirth, consider genetic concerns, and explore treatment options.

Gender Differences In Cardiometabolic Syndrome Among U.S. Rural And Non-Rural Adults, Srikanta Banerjee, Raymond Panas

2010-2016 Archived Posters

Cardiometabolic syndrome (CMS) places an individual at a higher risk of stroke and heart failure. The 2013 Behavior Risk Surveillance System survey, the largest national population-based survey, was used for logistic regression modeling. An effect-modifying relationship was found among women between rural residence and CMS.

The Difference Between Cacrep And Non-Cacrep Scores On Professional Counselor Licensure Examinations, Jason King

2010-2016 Archived Posters

This study compared a nine-year period of scores from the National Counselor Examination (NCE), the National Clinical Mental Health Counselor Examination (NCMHCE), and the state jurisprudence examination (SJE). with graduates (n=1,740) from a Council for Accreditation of Counseling and Related Educational Programs (CACREP) mental health counseling (MHC) specialization and with graduates (n=200) from a non-CACREP professional counseling specialization. Results from a t-test, Chi-Square, and Levene's test for equality of variances indicated a better performance from the non-CACREP graduates.

Comparative Analysis Of Eating Patterns Of Individuals With Obese Vs. Normal Bmi And With And Without Type 2 Diabetes, David A. Hernandez, Cheri Ann Hernandez, Chris M. Wellington, Arthur Kidd

2010-2016 Archived Posters

This study explored eating patterns of obese-weight (OB) and normal-weight (NW) individuals with and without Type 2 diabetes (T2D). The dietary intakes of OB-T2D individuals were significantly higher than those of NW individuals. Health care professionals can use this knowledge to provide direction for treatment modalities (e.g., different dietary strategies, more intensive dietary therapy, lifestyle counseling).

Healthy Weight Maintenance: A Narrative Analysis Of Weight Cycling In The Formerly Obese, Cheri Renee Lewis

2010-2016 Archived Posters

This study addressed weight cycling and sustained weight loss among 6 formerly obese weight cyclers. Self-determination theory (SDT) and social cognitive theory (SCT) provided theoretical frameworks. Findings revealed five overarching themes and that no single solution exists for successful sustained weight loss in this population.

Evolution Of Physician-Centric Business Models Under The Patient Protection And Affordable Care Act, Tanya Nix, Lynn Szostek

International Journal of Applied Management and Technology

For decades, the cost of medical care in the United States has increased exponentially. United States citizens spend twice as much as their European counterparts on medical care. Congress enacted the Patient Protection and Affordable Care Act (PPACA) to ensure affordable healthcare to the citizens of the United States. PPACA legislation is creating a new paradigm in healthcare delivery and provider business models. The purpose of this case study was to explore physicians’ perspectives regarding physician-centric business models evolving under the requirements of the PPACA legislation. Data were gathered through semistructured interviews and questionnaires with a purposive sample of 75 …

Examining The Impact Of Accreditation On A Primary Healthcare Organization In Qatar, Alia G. Banna

2010-2016 Archived Posters

While a modest body of literature exists on accreditation, little research has been conducted on the impact of accreditation on primary care in the Middle East. This descriptive correlational study assessed the changes resulting from the integration of Accreditation Canada International’s (ACI) program at Primary Health Care Corporation (PHCC) in the State of Qatar.

Maternal And Child Health Access Disparities Among Recent African Immigrants In The United States, Bakali Mukasa

2010-2016 Archived Posters

Health care disparities and U.S. national public health concerns and disproportionately affect minority populations. Analysis of published studies on the health of larger immigrant populations from Europe, Asia, South American, and the Caribbean revealed a knowledge gap on the health of African and other minority immigrants. This phenomenological study of 11 recent African immigrants concerned access to maternal and child health (MCH) care as well as the causes and effects of disparities to care-seeking experiences. The results may support interventions to improve health care access and health outcomes of minority immigrants in the United States and beyond.

Mental Health Service Use Among Older African Americans And Caribbean Blacks Who Experience Traumatic Events, Camille Huggins

2010-2016 Archived Posters

This study identifies factors associated with mental health service use among older African American and Caribbean Blacks who have experienced a traumatic event. Method: Data drawn from the Research on Depression and Anxiety Disorders in Elders Clinical Correlation project (RDADE). Hierarchical logistic regressions were used to compute odds ratio. Result: Age, gender, spirituality, depression and access to medical insurance determines the utilization of mental health services. Implications for depression screening in this population.

The Association Between Osteoporosis And Early Menopause Following Hysterectomy, Mia Meeyaong-Won Botkin

2010-2016 Archived Posters

This study is to examine the association between osteoporosis and demographic and behavioral factors in women of age 50 and older who had undergone hysterectomies prior to reaching natural menopause. The 2009-2010 National Health and Nutrition Examination Survey (NHANES) was analyzed using multiple logistic regressions analysis. Osteoporosis was inversely associated with demographic and behavioral factors. Non-Hispanic Whites of the age of 36-45 at the time of the hysterectomies were significantly associated with osteoporosis. This study may drive positive social change by facilitating public health to promote and implement effective behavioral interventions in women.

Airline Pilots In Recovery From Alcoholism: A Quantitative Study Of Cognitive Change, Heather Christina Hamilton

Walden Dissertations and Doctoral Studies

In order to perform their duties, airline pilots must have no clinical diagnosis of mental illness or any substance use disorder. However, provisions have been in place since the 1970s that provide for a return to work for airline pilots with alcohol problems. To date, over 5,000 airline pilots have undergone rehabilitation for Alcohol Use Disorder (AUD) and successfully returned to work. An important gap in the literature remains with regard to what extent improvements in cognitive performance may be experienced by airline pilots who complete treatment and to what extent age influences the amount of change. This study examined …

Risk Factors For Tuberculosis And Multidrug-Resistant Tuberculosis Complications Among Foreign-Born Persons In Houston, Texas, James N. Isaboke

Walden Dissertations and Doctoral Studies

Tuberculosis (TB) is a leading public health problem across the world. For various reasons, TB and multidrug-resistant tuberculosis (MDR-TB) have increased. Clarification on TB/HIV co-infection and homelessness as risk factors for TB and MDR-TB is required to inform policy interventions to reduce TB-related morbidity, mortality, and healthcare costs. In this quantitative study, data from the Houston Health Department (N = 341) were analyzed to explore the relationship between TB and MDR-TB outcomes and TB/HIV co-infection and type of housing/homelessness. Foreign-born persons are disproportionately affected in the United States. The socio-ecological model provided a theoretical framework for the investigation. Multiple and …

Relationship Between Nurse Staffing And Quality Of Care In Louisiana Nursing Homes, Veronica Kercado

Walden Dissertations and Doctoral Studies

In 2014, Louisiana experienced substantive issues with quality of care in nursing homes. The state had the lowest nurse staffing level among all states, and 7,666 deficiencies for immediate jeopardy violations were recorded from 2011 to 2013. Despite ample research on nurse staffing and quality of care, there is no consensus on how higher nurse staffing relates to quality. The purpose of this quantitative, correlational research was to determine the relationship between nurse staffing levels and quality measures in Louisiana. Donabedian's category structure, process, and outcome was the conceptual framework used to develop the research questions. The data included the …

Perceptions Of Cameroonian Women Regarding Cervical Cancer Prevention, Anna Nkapsah Nji

Walden Dissertations and Doctoral Studies

Women in Cameroon as well as those residing in the Maryland-Washington Metropolitan area and the Diasporas suffer a disproportionate rate of cervical cancer morbidity and mortality due to the vast disproportion in the distribution of healthcare services. The widespread human papillomavirus (HPV) vaccination holds promise for helping to attenuate the disproportion in cervical cancer screening and prevention services. Literature from other countries including Cameroon suggests that barriers to the uptake of cervical cancer screening include: culture, religion, the psychological impact of embarrassment, the influence of husbands, cost, discomfort, and vulnerability. The purpose of this study was to gain an understanding …

16pf® Traits As Predictors Of Emergency Medical Service Worker Tenure, Beverly J. Paschal

Walden Dissertations and Doctoral Studies

The United States is experiencing a severe shortage of Emergency Medical Service (EMS) paramedics. The job outlook for paramedics (EMT-P) for the years 2012-2022 is predicted to increase by 23%-33%, which is much faster than the 4% average increase of other first-response professions. The average tenure of paramedics is less than 4 years. There is a significant gap in the literature concerning paramedic personality traits and tenure. The primary objective of the current study is to provide empirical data on the personality traits possessed by long-term paramedics (5+ years), and compare them to those with shorter tenure (< 5 years). Using Allport's Trait Theory, I predicted that personality would affect paramedic longevity. The 6 personality traits tested were warmth, reasoning, emotional stability, liveliness, social boldness and openness to change. A socio-demographic questionnaire, determined the length of their EMS career, while the 16PF® Assessment, tested their personality traits. Using t tests, Mann-Whitney U tests, and a set of regression analyses, data were examined to determine if length of career and personality traits predicted paramedic tenure. The research sample consisted of long term paramedics and former paramedics. The results showed that of the 6 personality traits, only warmth was a significant predictor of paramedic tenure. A logistic regression showed for every additional point in warmth, the odds of leaving EMS prior to 5 years increased by a factor of 2.77. This study provides support for positive social change by helping EMS to learn how to increase recruitment and tenure. It also helps by advising EMS agencies to attend to the mental and emotional health of their paramedics by being aware of the level of their warmth personality trait.

Socioeconomic Status-Related Inequities On Maternal Health Services: Trends, Associations, And Outcomes, Nibretie Gobezie Workneh

Walden Dissertations and Doctoral Studies

Maternal Mortality Rate (MMR) in Ethiopia remains one of the highest in the world due in part to very limited use of maternal health services. However, the underlying factors for limited use of the services and hence the high MMR are not well known. The purpose of this study was to identify factors associated with use of maternal health services and maternal health risks, to analyze inequity patterns between use of maternal health services and maternal health risks, and to measure the magnitude and trends in inequity. Behavioral-cultural and structural theories of health inequalities were used to frame the study. …

Hiv Risk Perceptions Of Hiv-Infected Adults Ages 30 To 49 Years In Atlanta, Georgia, Esther Nduta Mune-Ashford

Walden Dissertations and Doctoral Studies

More than 49,081 people were diagnosed with HIV in the United States in 2011. Of those 49,081 HIV-infected persons, 1 in 6 was not aware of being HIV positive. In 2011, Georgia had the 5th highest number of HIV diagnoses among the 50 U.S. states. This phenomenological study aimed to understand the lived experiences of HIV-infected adults, ages 30 to 49 years in Atlanta, Georgia, by understanding their perceptions of risk prior to contracting HIV. The health belief model was used to guide this study because it explains and predicts health-related behaviors and it has been used in previous studies …

Development And Content Validation Of An Emergency Department Ehr Safety Educational Program, Ursula Renee Jernigan

Walden Dissertations and Doctoral Studies

Emergency Department (ED) providers and staff experience challenges with using electronic health record (EHR) software to document and communicate about patient care. These difficulties are often caused by inadequate training in the use of the organization's EHR system. Challenges with EHR use have been linked to increased ED patient wait times, which impacts patient safety by delaying care and increasing the potential for medication errors. Providing education that addresses EHR software; EHR usability; and collaboration among staff, providers, and EHR system managers has been shown to reduce ED wait times and decrease the risk of medication errors. The purpose of …

Public Health Leaders' Perceptions Of And Attitudes Concerning Eating Disorders, Karin L. Lightfoot

Walden Dissertations and Doctoral Studies

Eating disorders are associated with high mortality rates. Most eating disorder prevention research is conducted within the fields of psychology and psychiatry, not in public health. This gap in public health research can lead to insufficient attention to the root causes of eating disorders and minimal upstream prevention efforts. The purpose of this phenomenological study was to identify public health leaders' perceptions of and attitudes concerning eating disorders as a public health issue. Objectification theory was used to describe how societal expectations have created an environment in which people's self-worth is based on their outward physical appearance. Ecological theory was …

Job Satisfaction, Organizational Culture, And British Nurses' Intention To Leave Employment, Brendan Edward Williams

Walden Dissertations and Doctoral Studies

In spite of decades of research, concerning nurse's intention to leave their employer (ITL), in 2011, 31.2% of the British nurses surveyed indicated they had formed an ITL. Grounded in reasoned action theory as developed by Ajzen and Fishbein, the purpose of the correlational study was to provide hospital managers with information regarding the relationship among nurse's job satisfaction (JS), organizational culture (OC), and ITL. The archival data from the 2011 NHS Staff Survey included responses from nurses (n = 21,257) across the British National Health Service. The Spearman's rho correlates rs (21,257) indicated relationships among nurse's job satisfaction, organizational …

Relationship Between Family Income And Obesity Among African American Adults, Charles Dadzie Boison

Walden Dissertations and Doctoral Studies

Obesity is a chronic disease that is caused by a number of factors such as diet, genetics, physical inactivity, and poor dietary habits. This research focused on how income affects obesity among a target population in the African American community in Durham, North Carolina (NC). It has been noted that chronic diseases that are diet-related, for example, obesity, diabetes, hypertension, and high cholesterol, affect African Americans disproportionately, especially those who earn low income. Some studies have also reported that those who make higher income have higher rates of obesity. This inconsistency and gap in the literature prompted research on this …