Medicine and Health Sciences Commons^™

Evidence-Based Alternative Therapy To Reduce Anxiety In Ambulatory Mental Health Patients, Renee Ann Denobrega

Walden Dissertations and Doctoral Studies

Evidence-Based Alternative Therapy to Reduce Anxiety in Ambulatory Mental Health Patients

by

Renee Denobrega

MS, Widener University, 2013

BS, Alvernia University, 2007

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

January 2016

The Relationship Between Physical Fitness And School Performance In Middle School Girls, Jamie Anne Donnelly

Walden Dissertations and Doctoral Studies

Past research has indicated a significant relationship between physical fitness and standardized test scores; however, the relationship between physical fitness and other aspects of school performance has yet to be empirically examined in a population specifically composed of middle school girls. This study examined several factors that contribute to school success, such as classroom behavior, attendance, and grades, in relation to physical fitness among a group of adolescent girls. It was specifically designed to examine the statistical relationship between physical fitness, as measured by the Fitnessgram, and quantitative data on school performance including grades, standardized test scores, school behavior, and …

Meaningfulness Of Work As Perceived By Women From Diverse Social Classes: A Grounded Theory Exploration, Jennifer L. Hutmire

Walden Dissertations and Doctoral Studies

Despite research connecting the meaningfulness of work with positive organizational outcomes, such as increased employee well-being, job satisfaction, engagement, and retention, there remains a lack of adequate, inclusive research explaining differences in women's perceptions of the meaningfulness of work. The purpose of this qualitative grounded theory study was to address this gap in the literature by developing a theory about the formation of perceptions of the meaningfulness of work and about the impact of those perceptions. Research questions explored perceptions that women from diverse social classes have of the meaningfulness of work, what influenced those perceptions, the impact of those …

Falls And Related Injuries Based On Surveillance Data: U.S. Hospital Emergency Departments, George K. Quarranttey

Walden Dissertations and Doctoral Studies

Falls can lead to unintentional injuries and possibly death, making falls an important public health problem in terms of related health care cost, incurred disabilities, and years of life lost. Approximately 1 in every 3 Americans ages 65 years and older is at risk of falling at least once every year. Children, young adults, and middle-aged adults are also vulnerable to falls. The purpose of this study was to examine the epidemiology of falls and fall-related injuries using surveillance data from nationally representative samples of hospital emergency departments in United States. The study was guided by a social-ecological model on …

Influence Of The Patient Protection And Affordable Care Act On Small Businesses, Sean Gallman

Walden Dissertations and Doctoral Studies

Business leaders lack strategies to implement the employer shared responsibility provision of the Patient Protection and Affordable Care Act (ACA). Small businesses pay approximately 18% more than larger companies for the same health coverage. Within a conceptual framework of management by objectives, the purpose of this qualitative multiple case study was to explore the strategies small business leaders use to implement the employer shared responsibility provision of the ACA. Data were gathered from the review of company documents, observations, and semistructured interviews with 5 senior business leaders from small business organizations in the Mid-Atlantic region of the United States. Data …

Employee Engagement In A Cardiac Catherization Lab, Rhonda J. Smith

Walden Dissertations and Doctoral Studies

Employee Engagement in a Cardiac Catheterization Lab

by

Rhonda J. Smith

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

February 2016

This study adds to the existing body of knowledge on employee engagement and workplace climate in the catheter laboratory setting. The study goals were to discover the current state of workplace satisfaction and then to share the results with the staff to determine what to improve and how to guide them through the Lean process. This study was guided by Kanter's structural empowerment theory, which holds that structural factors …

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

Walden Dissertations and Doctoral Studies

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 this project was to plan a program to improve early identification and management of behavioral health patients presenting to the emergency department. The objective of this project was to develop a rapid mental health screening tool and policies guiding use of the tool in the emergency department. A multi-disciplinary team of …

The Relationships Among Job Satisfaction, Length Of Employment, And Mentoring Of Nursing Faculty, Zelda Suzan

Walden Dissertations and Doctoral Studies

The shortage of faculty in nursing education programs has been well documented by the National League for Nursing. Job satisfaction is important in retaining nurse educators, and one New York nursing program was interested in examining the potential impact of mentoring on satisfaction. The purpose of this quantitative study was to examine job satisfaction, measured by the Job Descriptive Index/Job in General scale (JDI/JIG), between nurse faculty participants in formal mentoring programs compared to participants receiving an informal type of mentoring. In addition, the length of employment was examined as a possible factor in predicting job satisfaction. The theoretical framework …

The Effectiveness Of An Organizational Hospital-Acquired Pressure Ulcer Prevention Workshop On Pressure Ulcer Prevalence Rates, Stacey Johnson

Walden Dissertations and Doctoral Studies

The goal of this project was to evaluate a hospital acquired pressure ulcer (HAPU) prevention program implemented in a New York City hospital in 2012. The program objective was to encourage collaboration of team members to prevent HAPUs in order to reduce prevalence rates to national target benchmarks. The program provided caregivers information about epidemiology, etiology, prevention, and treatment of HAPUs, and presented HAPU prevention as a collaborative process in order to foster greater awareness in each participant's role as an agent of change by emphasizing the importance of communication between members of the health care team. This project evaluated …

Comparison Of Thyroid Disease Mortality Between Urban And Rural Populations In Southwest Georgia, Donyale Bouie Childs

Walden Dissertations and Doctoral Studies

Twenty million people in the United States have some form of thyroid disease. In 2014, there were 62,980 new cases of thyroid cancer and 1,890 deaths. Water source is a known risk factor for thyroid disease. Pollutants that are known to alter thyroid function can find their way into water sources. The effect of various water sources on thyroid- related mortality has not been determined in the state of Georgia. The purpose of this correlational study was to investigate whether invasive thyroid disease mortality differs between urban participants who drank municipal water and rural participants who drank untreated water in …

Initiating Nicotine Cessation In A Community Mental Health Center, Rosalind R. Keith

Walden Dissertations and Doctoral Studies

Individuals suffering from mental illness are often adversely affected by tobacco use. Historically, clinicians are reluctant and inadequately prepared to recognize and treat comorbid nicotine addiction in the chronic mentally ill (CMI) client. As evidenced by a review of the literature, healthcare providers are missing opportunities for nicotine cessation treatment. There is a lack of educational preparation amongst clinicians to treat nicotine addition and a concern that treatment of nicotine addiction can negatively impact existing psychiatric disorders. The purpose of this project was to create an educational plan for nicotine cessation for CMI clients at a community health center. The …

The Experience Of Being Unsheltered In Atlanta, Ikeranda Smith

Walden Dissertations and Doctoral Studies

In the United States, it is estimated that millions of adults are homeless. Some individuals choose not to use homeless shelters or are ineligible for their use. Researchers have indicated that many unsheltered homeless are men over the age of 45 years. The purpose of this phenomenological study was to examine the experiences with social services providers among unsheltered men. Understanding the social networks of unsheltered homeless and the use of spirituality or faith as a resource for coping was also examined, as a significant gap exists in the research on unsheltered homeless. Face-to-face, in-depth interviews were conducted with 8 …

Educating Nurses About Spirituality's Effects On Quality Of Life With Chronic Illness, April Gant

Walden Dissertations and Doctoral Studies

Spirituality has been associated with wholeness, inner peace, and key elements of well-being or quality of life. Spirituality support is particularly important for patients with chronic illness and patients who view spirituality as a way of coping with suffering. Evidence-based education is lacking in schools of nursing and in places of nursing employment on spirituality interventions that nurses can use to improve patient quality of life. The purpose of this project was to determine whether an educational intervention would increase knowledge of spiritual care in a small sample of clinic nurses (n = 37). This project used Watson's caring theory, …

Improving Quality Of Life In Older Adults With Depression And Diabetes Through Medication Compliance Education, Valreen Hinds-Beharrie

Walden Dissertations and Doctoral Studies

Improving Quality-of-Life in Older Adults with Depression and Diabetes through Medication Compliance Education

by

Valreen Hinds-Beharrie

MSN, Adelphi University, 1997

BSN, Adelphi University, 1986

Project Submitted in Partial Fulfillment

of the Requirement for the Degree of

Doctor of Nursing Practice

Walden University

March 2016

Diabetes and depression are prevalent diseases that cause morbidity and mortality. Diabetes is a heterogeneous metabolic disease in which hypoglycemia is a central feature. Depression is associated with increased counter-regulatory, hormone release, and alteration in glucose transport function. Depression occurs in some individuals with diabetes and is associated with poor metabolic control, inadequate control of diet, …

The Connection Between Wellness Programs And Employee Job Satisfaction In Higher Education, Donel J. Richemond

Walden Dissertations and Doctoral Studies

Job dissatisfaction is becoming a fundamental concern for employers. Employee engagement makes an organization more productive and can reduce absenteeism. The purpose of this quantitative study was to examine the relationship between employer-sponsored wellness-program participation and job satisfaction among for-profit college and university leaders. Data collection involved an online survey of 400 faculty members' from for-profit universities in the United States contacted using the Job Satisfaction Survey; 103 participants completed the survey. The theoretical framework was the need-satisfaction theory, which includes the factors that promote job satisfaction and job dissatisfaction. The results came from a multiple regression analysis that indicated …

Predictive Factors Of Compassion Fatigue Among Firefighters, Teresa Michelle Robinson

Walden Dissertations and Doctoral Studies

Few existing studies have examined compassion fatigue among emergency responders even though firefighters and emergency medical service (EMS) professionals have repetitive direct exposure to traumatic events. This study focused on identifying predictor variables for the development of compassion fatigue in firefighters. Karasek's demand-control model, a commonly used work stress model, was the study's theoretical framework as it focuses on specific construct interactions that predict employee well-being. Accordingly, this correlational study examined the predictive nature of EMS license level, years of service, and personality type on the development of compassion fatigue in career firefighters. Data collection occurred with surveys incorporating the …

An Integrative Review Focusing On Accuracy And Reliability Of Clinical Thermometers, Julie Black Black

Walden Dissertations and Doctoral Studies

Technological advances in clinical thermometers have resulted in a variety of minimally invasive devices that give rapid results but may not have the accuracy necessary for use in acutely ill adults. Inaccurate temperatures can result in missed opportunities for the early identification and treatment of infection and sepsis. Following the methodology outlined by Whittemore and Knafl, the purpose of this project was to conduct an integrative review of the research on the accuracy of clinical thermometers used for acutely ill adults. The evidence was categorized using the Hierarchy of Evidence for Interventional Studies, and the quality of the studies was …

Social Demography Of Health Seeking Experiences Among Transgender African Americans, Alicia Cutrice Fritz

Walden Dissertations and Doctoral Studies

Access to and receipt of health care is an essential human right; however, transgender people often have negative health seeking experiences that give way to the many health disparities seen in the transgender community. Using the social ecological model, this study determined, through multiple logistic regressions, that correlations existed between socioeconomic, health behaviors, and sociocultural variables and 6 measures of health seeking experiences among transgender African Americans. Secondary data from the 2010 National Transgender Discrimination Survey were used, yielding a sample size of 253 transgender African Americans. Those in the African American transgender community at most risk for negative health …

Evaluation Of Low Immunization Coverage Among The Amish Population In Rural Ohio, Christine Marie Kettunen

Walden Dissertations and Doctoral Studies

Amish communities have persistently low childhood immunization rates. Prior to this study, reasons for low rates had not been clearly identified. Researchers have speculated that access to health care, religious factors, and fear might be reasons that Amish parents refuse childhood immunizations, but more empirical evidence was warranted.The purpose of this study was to gather that empirical evidence regarding the knowledge, attitudes, opinions, and beliefs of Amish parents residing in Ashtabula County Ohio, an additional purpose was to examine how these factors influence timely immunizations of Amish children. The theoretical framework was the PEN-3-Cultural Model, focusing on cultural influences, beliefs, …

Outcomes Of Aggression Replacement Training For U.S. Adolescents In Residential Facilities, Coral Ann Ondrus

Walden Dissertations and Doctoral Studies

A National Survey indicated that 1.6 million adolescents in the U.S. were arrested in 2010 and 1.5 million in 2011 for erratic aggressive behaviors, thus showing a decline from the 2.18 million adolescent arrests in 2007. Residential facilities in the state of Pennsylvania offer a group intervention called Aggression Replacement Training (ART) to help adjudicated adolescents regain control of erratic behaviors. The purpose of this study was to examine the extent to which level of group participation in ART and certain demographic factors (age, gender, ethnicity, family socioeconomic status, parental involvement, and education) predict decreased aggression and increased anger control …

Is There An Association Between Non-Va Medical Care Coordination And Utilization Of Care?, Brenda Joyce Robisnon

Walden Dissertations and Doctoral Studies

The Non-Veteran Administration Care (NVC) is a program in which the Veterans Health Administration purchases health care when it cannot provide the health services needed for eligible Veterans. The rising cost of this program led to audits by the Office of the Inspector General and other entities. The scholarly problem for this DNP Project was the lack of oversight, accountability, and management, found throughout the audits of NVC, as well as a lack of evaluation of NVC. The purpose of this project was to ascertain if there was a relationship between the Non-VA Care Coordination program (NVCC) and utilization of …

Perspectives Of Young Adults Toward Tobacco Use, Caroline Oluwatosin Omoalako-Adesanya

Walden Dissertations and Doctoral Studies

Conditions related to tobacco use constitute the single most preventable cause of death in the United States. Approximately 443,000 U.S. adults die each year from smoking-related illnesses. During young adulthood, social and behavioral changes occur; experimentation with tobacco products such as cigarettes is common and may lead to a habit of smoking. A gap was identified in the literature on the perceived impact of family communication on young adults' decisions regarding smoking. The purpose of this descriptive phenomenological study was to address this gap by gathering information on the perspectives of young adults toward tobacco use. Fifteen young adults aged …

Master's Students' Self-Assessment Of Competency In Grief Education And Training In Cacrep-Accredited Counseling Programs, Jane Earline Wood

Walden Dissertations and Doctoral Studies

Counseling can promote positive outcomes for grieving clients by addressing personal loss and helping the client process their grief. However, a lack of understanding on the part of counselors of how people grieve may result in negative client outcomes such as psychological stress, poor health, or an increased risk of depression. Education and training in grief counseling can improve counselors' problem recognition and skills in treatment planning. The purpose of this study was to examine whether Council for Accreditation of Counseling and Related Educational Programs (CACREP) master's degree counseling students view themselves as having been adequately trained in grief theories …

Chronic Disease Self-Management Program, Raquel Marie Biati

Walden Dissertations and Doctoral Studies

The World Health Organization noted that 2 global health problems have reached epidemic proportions: obesity and type 2 diabetes. These conditions affect nearly 170 million people worldwide. The clinical practice problem addressed by this project was the prevalence of adults ages 50 and older in an ambulatory care setting who suffer from obesity and diabetes and may benefit from a tailored weight management and nutrition education intervention. The purpose of this project was to design a program that would decrease body mass index and hemoglobin A1c in older patients through adaption of the Chronic Disease Self-Management Program. The evidence supporting …

Best Practices For Controlling Tuberculosis - Training In Correctional Facilities: A Mixed Methods Evaluation, Ellen Reynolds Murray

Walden Dissertations and Doctoral Studies

According to the literature, identifying and treating tuberculosis (TB) in correctional facilities have been problematic for the inmates and also for the communities into which inmates are released. The importance of training those who can identify this disease early into incarceration is vital to halt the transmission. Although some training has been done by public health authorities for corrections, there is little to no evaluation of such training. The aim of this mixed methods retrospective study was to evaluate the effectiveness of a training to control TB in correctional facilities. The Southeastern National Tuberculosis Center (SNTC) conducted 12 trainings between …

Health Literacy Program Proposal For Health Care Workers, Shevon Naomi Howard

Walden Dissertations and Doctoral Studies

Health information literacy influences patient health outcomes, yet almost 90% of adults

struggle to understand health information. This study explored the impact of an education course in health literacy on healthcare professionals' methods of providing information to patients in order to increase effective communication and improve patient outcomes. This study drew from an integrated theoretical framework that suggests development and validation of tools to measure health literacy. Access to and understanding of reliable, high-quality health care information equalizes many other variables that impact health outcomes, including age, economic class, and cultural background. This study analyzed survey data collected from 2 …

Effects Of An Integrated Electronic Health Record On An Academic Medical Center, Kenneth E. Koppenhaver Ii

Walden Dissertations and Doctoral Studies

The debate about healthcare reform revolves around a triple aim of improving the health of populations, improving the patient experience, and reducing the cost of care. A major tool discussed in this debate has been the adoption of electronic health record (EHR) systems to record and guide care delivery. Due to low adoption rates and limited examples of success, the problem was a lack of understanding by healthcare organizations of how the EHR fundamentally changes an organization through the interactions of people, processes, and technology over time. The purpose of this case study was to explore the people, processes, and …

Use Of Social Networking Websites And Receipt Of Cervical Cancer Screening, Patricia Drayton Drayton

Walden Dissertations and Doctoral Studies

Pap smear screening detects cervical cancer in its earliest stages, yet thousands of women in the United States die annually from this disease. Social networking websites commonly provide information about recommended health screenings. In this quantitative study, the Health Belief Model provided the theoretical framework to determine if the use of social networking websites affected nurses' decisions to receive Pap smear screening. A convenience sample of nurses was used, with the rationale that they were knowledgeable of and receptive to participating in a relevant health study. A total of 2,336 registered nurses practicing in Durham, North Carolina were invited to …

Influence Of Patient Engagement Protocol On Health Outcomes And Medication Adherence Of Patients With Metabolic Syndrome, Angela H. Mcconnell

Walden Dissertations and Doctoral Studies

August 2016

Management of metabolic syndrome (MetS) may be enhanced by promoting patient engagement. Training health care providers in the conceptual and practical application of integrative patient centered care tools may promote patient lifestyle behaviors for better management of MetS. The purpose of this quantitative quasi-experimental study was to assess the impact of training providers in integrative patient centered care for patients with MetS. The biopsychosocial construct provided the conceptual framework for the study. Two groups of physicians were included; one received training in an integrative model (IM) while the second received no training and provided usual care (UC). Following …

Perceptions Of Licensed Pharmacist Managers Regarding Formally Versus Informally Trained Pharmacy Technicians, Shalonica Marie Cluse

Walden Dissertations and Doctoral Studies

Pharmacists rely on pharmacy technicians to assist with accurately dispensing prescriptions and providing information to clients. Texas does not have regulations for the education or training of pharmacy technicians, which may result in mistakes when dispensing prescriptions, causing significant harm to customers. The purpose of this qualitative phenomenological study was assessing formally and informally trained pharmacy technicians' job performance as perceived by licensed pharmacists/managers. Data were collected via face to face interviews with 9 pharmacy managers in Texas to gain insight into their lived experiences of supervising not formally and formally trained technicians. Audio recorded interview data were transcribed and …