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Articles 5251 - 5280 of 6102

Full-Text Articles in Medicine and Health Sciences

Doctor Of Nursing Practice, Sharon Jean Scott Jan 2016

Doctor Of Nursing Practice, Sharon Jean Scott

Walden Dissertations and Doctoral Studies

Evidence demonstrates the health benefits of early breastfeeding for mothers as well as infants. The World Health Organization states, "Breast milk should be given within the first hour of life." This purpose of this project was to develop a breastfeeding educational toolkit to promote breastfeeding in the hospital environment. The question that guided this project was, "Will the development of a breastfeeding education toolkit, designed to serve as a learning tool to support the breastfeeding mothers, be found to be useful and valid by professional staff and lay end-users?" The goals of the project were to provide an educational toolkit …


Impact Of Pneumococcal Conjugate Vaccine Thirteen Valent On The Reduction Of Invasive Pneumococcal Disease, Aissata Coulibaly Jan 2016

Impact Of Pneumococcal Conjugate Vaccine Thirteen Valent On The Reduction Of Invasive Pneumococcal Disease, Aissata Coulibaly

Walden Dissertations and Doctoral Studies

Many children under the age of 5 die each year of invasive pneumococcal disease. Childhood vaccination against this disease reduces morbidity and mortality. Despite the introduction of a pneumococcal conjugate vaccine (PCV13) in a central African country in 2011, all provinces have not yet been vaccinated. The purpose of this quantitative quasi-experimental study was to determine whether there was an association between the introduction of PCV13 and new cases of pneumococcal disease in 2 provinces in central Africa. The sample size for the study was 380. The theoretical framework for this study was the epidemic model supported by the concept …


An Evaluation Of Service Learning For Associate Degree Nursing Students, Valerie Marie Pauli Jan 2016

An Evaluation Of Service Learning For Associate Degree Nursing Students, Valerie Marie Pauli

Walden Dissertations and Doctoral Studies

The purpose of this study was to evaluate outcomes of the service-learning requirement in the Associate of Science in Nursing (ASN) curriculum at the local college. The problem addressed in this study was that the local ASN program lacked formal evaluation of the service-learning requirement. Guided by Kolb's model of experiential learning, a goal-based, summative evaluation employed as a qualitative case study explored the perceptions of 20 stakeholders including graduates, faculty members, and key community informants. The research questions focused on how service learning influenced a student's learning of cultural competence and the impact service learning had on the community. …


A Concurrent Mixed Method Study Exploring Iraqi Immigrants' Views Of Michigan, Kerry Luise Chamberlain Jan 2016

A Concurrent Mixed Method Study Exploring Iraqi Immigrants' Views Of Michigan, Kerry Luise Chamberlain

Walden Dissertations and Doctoral Studies

Failure of emergency response personnel to communicate effectively with different cultures can have dire consequences during an emergency, including loss of lives and litigation costs. For emergency response personnel to communicate the risk of an emergency, it is important to understand how different groups, especially newly arrived foreign immigrants, perceive warnings and related messages. This study addressed how one of the largest category of immigrants in Michigan perceived severe tornados, influenza pandemics, power outages, severe floods, and snowstorms. The research question examined the degree to which the equation, Risk = Hazard + Outrage, explained perceptions of these hazards in Michigan …


Equine Assisted Activities And Therapies: The Measuring Of Equine Temperament, Thecla M. Helmbrecht Howard Jan 2016

Equine Assisted Activities And Therapies: The Measuring Of Equine Temperament, Thecla M. Helmbrecht Howard

Walden Dissertations and Doctoral Studies

The field of equine assisted activities and therapies (EAAT) is growing in popularity as an alternative healing approach. However, there is a paucity of peer-reviewed research on the horses who serve as equal partners in EAAT. The purpose of this quantitative study was to discover the impact of equine-facilitated therapeutic activities on the temperament of horses, and to determine how to select a better human-to-horse therapeutic match when providing EAAT services. The theoretical framework for this research drew from Romanes' theory of animal intelligence, which predicts that temperament would change as a result of prolonged participation in specific work (EAAT …


Comparing African- And U.S.-Born Blacks At Stage Of Diagnosis And Treatment For Nonsmall Cell Lung Cancer, Relindis K. Fofung Jan 2016

Comparing African- And U.S.-Born Blacks At Stage Of Diagnosis And Treatment For Nonsmall Cell Lung Cancer, Relindis K. Fofung

Walden Dissertations and Doctoral Studies

Lung cancer is a disease with a high mortality rate for the U.S. Black population. There had been considerable research done on different population demographics, necessary to achieve the Healthy People 2020 overarching goals to eliminate health disparities, gain health equity and maintain quality health. Yet, the African-born Black (AFBB) population has been understudied for nonsmall cell lung cancer (NSCLC). This study sought to determine whether within race differences in stage at diagnosis and treatment of NSCLC exists between AFBB and American-born Blacks (AMBB) populations in the United States. The study data is secondary data collected as part of the …


Hypertension Management Through Community Outreach Services For Inmates Released From Jail, Janet Baby Wurie Jan 2016

Hypertension Management Through Community Outreach Services For Inmates Released From Jail, Janet Baby Wurie

Walden Dissertations and Doctoral Studies

Hypertension (HTN) is the most common chronic disease among jail inmates. Many inmates treated for HTN while incarcerated in the Fairfax County Jail do not continue treatment when they return to their communities. Factors that contribute to discontinuing HTN management once the inmate returns to the community include homelessness, low income, and lack of access to care. The purpose of this quality improvement project was to educate inmates with HTN about community-based outreach services for HTN management and continuity of care while in the community. The outcome measured was the number of inmates who returned to jail reporting use of …


The Relationship Between Physical Fitness And Academic Achievement In Sixth Grade Students, Shannon Usco Shook Jan 2016

The Relationship Between Physical Fitness And Academic Achievement In Sixth Grade Students, Shannon Usco Shook

Walden Dissertations and Doctoral Studies

Researchers have reported on the relationship between academic achievement and physical fitness levels. At one rural middle school, 25% of the students enrolled were either overweight or obese and failing at least one course. Educators at the local site were seeking methods to improve the academic achievement of their students. The purpose of this quantitative study was to examine the relationship between academic achievement and physical fitness of middle school students at the study site. Framed by the theoretical connection between improved physical fitness levels and academic achievement, the research questions examined the relationship between physical fitness levels of 6th …


Predictive Ability Of Emotional Intelligence Scores On Employee Self-Reported Perception Of Comprehensive Organizational Credibility Inventory, Leif Allen Ford Jan 2016

Predictive Ability Of Emotional Intelligence Scores On Employee Self-Reported Perception Of Comprehensive Organizational Credibility Inventory, Leif Allen Ford

Walden Dissertations and Doctoral Studies

Research has shown that emotional intelligence (EQ) is positively related to beneficial outcomes in organizations. Research has also found that negative perceptions of organizational credibility (OC) can result in adverse economic and social costs for organizations and communities. To date, the existing research has failed to examine whether employee EQ might affect employee perceptions of OC. A quantitative, non-experimental study was conducted using a sample of employees in large health and medical organizations throughout the United States. The variables in the study were measured using the Assessing Emotions Scale and the Comprehensive Organizational Credibility Inventory. Multiple regression analyses and Pearson …


Perioperative Orientation, Education, And Mentoring (Poem) Program, Esther M. Johnstone Jan 2016

Perioperative Orientation, Education, And Mentoring (Poem) Program, Esther M. Johnstone

Walden Dissertations and Doctoral Studies

Perioperative registered nurses (RNs) are vital to the provision of safe patient care for those undergoing invasive and surgical procedures within acute care settings. Unrealistic transition-to-practice (T2P) expectations for novice RNs (newly licensed and experienced RNs new to perioperative nursing) have resulted in significant turnover and attrition rates as high as 45%. A T2P program, known as the Perioperative Orientation, Education, and Mentoring (POEM) program, was developed to address attrition and turnover through mentoring and professional development. The POEM program was a pilot program implemented at a large academic medical center. An evaluation tool known as the Surgical Skill Assessment …


Direct-To-Consumer Advertisements And Medical Services Utilization Among Adult Dermatology Patients In The United States, Heribert Zouetchou Jan 2016

Direct-To-Consumer Advertisements And Medical Services Utilization Among Adult Dermatology Patients In The United States, Heribert Zouetchou

Walden Dissertations and Doctoral Studies

Pharmaceutical product claim and help-seeking advertisements have prompted the types and purposes of medical dermatology service(s) that patients have used in the United States. Indeed, researchers have demonstrated that 94% of working nurse practitioners affirmed receiving from their patients a request for a cancer drug advertised. However, adult dermatology patients members of Saint Nicholas Catholic Church or/and patients at MedStar Clinic in Houston, Texas, have not been of interest for any study so far. The purpose of this quantitative study was to assess the relationship between product claim, help-seeking, types, and purposes of medical dermatology services used amongst males and …


The Role Of Socio-Demographics Factors In Voluntary Counselling And Testing Uptake In South-Africa., Felix Ikechi Woke Jan 2016

The Role Of Socio-Demographics Factors In Voluntary Counselling And Testing Uptake In South-Africa., Felix Ikechi Woke

Walden Dissertations and Doctoral Studies

Many researchers have alluded to the inequity in distribution of HIV preventive services in South Africa (SA). Other researchers have demonstrated that socio-demographic factors are main determinants of distribution of preventive services like voluntary counseling and testing (VCT) in SA. VCT is a primary HIV prevention tool through which infected persons enter the treatment, care, and support programs; identifying the impact of socio-demographic determinants (SDDs) on VCT uptake in SA could help direct VCT services to areas and individuals that need them most. The research question in this study examined what and how SDDs impact the uptake of VCT in …


The Impact Of Social Determinants On Tuberculosis Incidence Trends In New Jersey, Thomas Larry Brown Jan 2016

The Impact Of Social Determinants On Tuberculosis Incidence Trends In New Jersey, Thomas Larry Brown

Walden Dissertations and Doctoral Studies

Social determinants have impacted disease states. The purpose of this study was to determine the influence of social determinants on the incidence of tuberculosis over a 20-year period for the state of New Jersey to determine interventions that can be developed for the state. The epidemiological triad (host-agent-environment) served as the theoretical foundation for this study. A quantitative series of cross sectional analyses were performed using secondary data from a New Jersey Department of Health database on population tuberculosis incidence for the state. Categorical data analyses were used to describe the data. According to study results, certain social determinants; such …


Healthy Weight Maintenance: Narrative Analysis Of Weight Cycling In The Formerly Obese, Cheri Renee Lewis Jan 2016

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

Walden Dissertations and Doctoral Studies

Medical and economic costs for obesity are estimated at $147 billion per year, yet less than 1/3 of overweight individuals successfully maintain weight loss. The literature is replete with descriptions of the problem and research on treatments, yet demonstrations of effective loss and maintenance are lacking. Missing is an understanding of the experiences of individuals who successfully maintained healthy weight loss, which could provide insights regarding effective psycho-social interventions. The purpose of this qualitative narrative study was to explore key events and experiences in the lives of former weight cyclers. The primary phenomena of interest included weight cycling and sustained …


Issues Affecting Sexual Decisions Among Black Women In The Era Of Hiv/Aids, Saecilia Jackson Jan 2016

Issues Affecting Sexual Decisions Among Black Women In The Era Of Hiv/Aids, Saecilia Jackson

Walden Dissertations and Doctoral Studies

HIV/AIDS became a significant concern in the United States (U.S.) during the 1980s and in recent years has increased the most among people living in underserved urban areas, particularly impacting Black women ages 24-35. Guided by the social learning theory, this phenomenological study explored the lived experiences and behaviors of Black women in the south in order to understand their sexual health decisions and how those decisions impact the spread of HIV/AIDS among this group. The central research question focused on understanding the sexual decision making of Black women in Georgia, from the perspective of the client and provider. Convenience …


Barriers To Breast Cancer Prevention And Screening Among African American Women, Abosede Francisca Obikunle Jan 2016

Barriers To Breast Cancer Prevention And Screening Among African American Women, Abosede Francisca Obikunle

Walden Dissertations and Doctoral Studies

Breast cancer is a serious illness that often has fatal consequences. Adherence to the recommendations for breast cancer surveillance is poorly practiced among African American women. The purpose of this phenomenological study was to seek individual professed barriers to breast cancer screening among African American women to better understand why breast cancer continues to be one of the principal basis of mortality among African American women. The theoretical framework for this study was the behavioral model of health services use. Purposeful selection was used to invite 14 African American women to participate in the in-depth interview process. Interview data were …


An Ecological Approach To African American Adolescent Food Choices In Low Income Neighborhoods, Clarence E. Mcmillan Jan 2016

An Ecological Approach To African American Adolescent Food Choices In Low Income Neighborhoods, Clarence E. Mcmillan

Walden Dissertations and Doctoral Studies

Childhood obesity remains prevalent among African American (AA) adolescents in low income neighborhoods with limited access to a variety of foods from stores. Guided by the ecological framework, the purpose of this study was to examine the impact of neighborhood stores on food choices, and physical activity among AA adolescents in a low income neighborhood. A quantitative research design with cross sectional primary and secondary surveys was used. Participants included 176 high school students and 42 store merchants. Data sources were the 2011 New Jersey Student Health Survey with core questions from the Youth Risk Behavior Survey and the Hmong …


Life Events, Initial Sexual Behaviors, And Teenage Pregnancy Among African American Females, Yonzetta Brook Tillman Jan 2016

Life Events, Initial Sexual Behaviors, And Teenage Pregnancy Among African American Females, Yonzetta Brook Tillman

Walden Dissertations and Doctoral Studies

Teenage pregnancy is disproportionate between African American and Caucasian females. This disproportion is notable because African American teenagers are 3 times more likely to become pregnant than their Caucasian counterparts are. The purpose of this study was to determine whether a relationship exists among major life events, sexual behaviors, and resultant teenage pregnancy among African American females in the United States. The theoretical framework for this study was social learning theory. Three key research questions focused on relationships among (a) major life events and initial sexual behavior, (b) ethnicity, and (c) teenage pregnancy. Independent variables were life event and ethnicity, …


Health System Predictors Of Antenatal Care Compliance Among Rural Congolese Women, Ngashi Ngongo Jan 2016

Health System Predictors Of Antenatal Care Compliance Among Rural Congolese Women, Ngashi Ngongo

Walden Dissertations and Doctoral Studies

Fewer rural Congolese women complete 4 antenatal care (ANC) visits than do urban women, despite high maternal and child mortality rates. This quantitative cross-sectional survey applied Andersen's behavioral model of service utilization to examine whether the ANC facility type, provider type, provider gender, time to ANC facility, cost, and number of services can predict ANC compliance among rural women. The study was a secondary analysis of the 2015 Maternal and Child Health (MCH) survey, which comprised 1,280 eligible women selected through stratified random sampling. The analysis included bivariate and multivariate logistic regressions. The findings showed that women seen in private …


Factors Associated With Late Stage Diagnosis Of Cervical Cancer In The United States, Marianne S. Pelletier Jan 2016

Factors Associated With Late Stage Diagnosis Of Cervical Cancer In The United States, Marianne S. Pelletier

Walden Dissertations and Doctoral Studies

Cervical cancer represents a significant public health problem in the United States. According to the Centers for Disease Control and Prevention, the prognosis is related to stage at diagnosis, with the 5-year survival rate being 91.2% for early stage disease and only 17.0% for those with late stage disease. There is a gap in the literature examining the association of insurance status with late stage cervical cancer diagnosis across a large segment of the United States population. There is also a gap in the literature examining women residing in the United States with late stage cervical cancer diagnosis and identifying …


Developing Policies And Guidelines To Prevent Medication Errors And Ades In Nursing Homes, Marion Johnson Jan 2016

Developing Policies And Guidelines To Prevent Medication Errors And Ades In Nursing Homes, Marion Johnson

Walden Dissertations and Doctoral Studies

According to the National Patient Safety Foundation, more than 1.5 million Americans are affected by medication errors because of varied factors including miscommunication, bad handwriting, name confusion, poor packaging, and metric or other dosing unit errors. This project addressed medication errors and adverse drug events by developing policy and practice guidelines to support and aid the utilization of health information technology (HIT) systems in addressing medication errors and adverse drug events at a local nursing home in Cincinnati, Ohio. The National Quality Strategy Framework was used by a team of interdisciplinary stakeholders as a guide for the development of policies …


Relational Intelligence: A Framework To Enhance Interprofessional Collaborative Care, Elizabeth Ekole Jan 2016

Relational Intelligence: A Framework To Enhance Interprofessional Collaborative Care, Elizabeth Ekole

Walden Dissertations and Doctoral Studies

Many studies have reported that the training for practitioners does not stimulate reflexes that contribute to the tenets of teamwork and collaboration. No studies were found to investigate relational intelligence (RQ) in pharmacist-physician relationships as a catalyst for collaborative and hence cost effective quality care. This study addressed the role and potential opportunity to promote RQ as a critical leadership skill in the collaboration between pharmacists and physicians. Using RQ as the conceptual framework, this phenomenological study explored how pharmacists and physicians in a hospital setting perceive RQ as a leadership skill when working collaboratively. A total of 10 participants …


Development Of A Practice Guideline For Dnp Prepared Nurse Practitoners Working In Long-Term Care Facilities, Ashley M. Marshall Jan 2016

Development Of A Practice Guideline For Dnp Prepared Nurse Practitoners Working In Long-Term Care Facilities, Ashley M. Marshall

Walden Dissertations and Doctoral Studies

Clinical evidence-based practice guidelines providing recommendations for health care decision making have become vital components of long-term health care practice in the United States. Frequently changing guidelines have complicated nurse practitioners' (NPs) efforts to implement evidence-based practice into the daily care that they provide to patients. The purpose of this project was to develop an evidence-based practice guideline for doctoral-prepared NPs working in long-term care facilities. This project is important because practitioners use practice guidelines to provide patients with the most appropriate, evidence-based care. Kolcaba's comfort theory was used to guide this project. Kolcaba's theory holds that comfort exists in …


Infant-Driven Feeding Vs. Scheduled Feeding: The Effect On Hospital Length Of Stay, Lori L. Messer Jan 2016

Infant-Driven Feeding Vs. Scheduled Feeding: The Effect On Hospital Length Of Stay, Lori L. Messer

Walden Dissertations and Doctoral Studies

Developmental delays related to feeding dysfunction in premature infants can lead to lengthy hospitalizations and increased healthcare costs initially and throughout the first year of the child's life. The purpose of this project was to use readiness-to-feed assessments to evaluate the impact of an infant-driven feeding protocol on length of stay. The project compared the length of stay of 2 groups of infants: a demand fed according to a readiness-to-feed protocol (protocol group, n = 14) and a traditionally fed according to scheduled, volume-driven feedings (traditional group, n = 15). The logic model served as the change management framework and …


Comparison Of Neovascular Age-Related Macular Degeneration Populations In The United States, Susan Lynette Coultas Jan 2016

Comparison Of Neovascular Age-Related Macular Degeneration Populations In The United States, Susan Lynette Coultas

Walden Dissertations and Doctoral Studies

Age-related macular degeneration (AMD) is one of the leading causes of blindness in the United States in people who are 50 and older. The safety and efficacy of aflibercept for the treatment of late stage neovascular AMD (NAMD) has been demonstrated by clinical trials among several populations; however, it is unclear whether all NAMD patients respond in the same manner as was studied in the clinical trials. The purpose of this study was to examine if populations of patients treated with aflibercept for the treatment of NAMD were significantly different from one another in terms of health characteristics, treatment regimens, …


Referral And Treatment Settings For Pregnant Women, Linda D. O'Daniel Jan 2016

Referral And Treatment Settings For Pregnant Women, Linda D. O'Daniel

Walden Dissertations and Doctoral Studies

Drug and alcohol addiction in pregnant women is a significant public health issue. The purpose of this study was to assess drug and alcohol addiction in pregnant women and the setting in which they sought service or treatment to determine whether U.S. census regions and race data could predict the type of addiction service or treatment that pregnant addicts chose. The theories of self-efficacy, cognitive behavioral therapy, and rational emotive behavioral therapy were used as the theoretical framework for this study. The research questions were used to examine whether there was a relationship between the source of addiction treatment referral …


Effectiveness Of A Critical Care Nurse Residency Program, Pam Redman Jan 2016

Effectiveness Of A Critical Care Nurse Residency Program, Pam Redman

Walden Dissertations and Doctoral Studies

The importance of nurse residency programs is addressed in the literature; however, a review of residency program outcomes and effectiveness is needed. Guided by Roy's adaptation model and Deming's plan-do-check-act model, the purpose of this quality improvement project was to assess the current state of a longstanding critical care nurse residency program in meeting organizational goals and objectives and to recommend modifications to the program related to external factors, internal challenges, and educational deficits of nurses entering the program. A review of the evidence-based literature and feedback from focus groups of leadership stakeholders were used to develop recommendations for residency …


A Curriculum On Culturally Competent Practices To Prevent Retraumatization In Diverse Survivors, Luana Rodriguez Jan 2016

A Curriculum On Culturally Competent Practices To Prevent Retraumatization In Diverse Survivors, Luana Rodriguez

Walden Dissertations and Doctoral Studies

This DNP project addresses the healthcare issue of intimate partner, domestic, and sexual violence (IPDSV), its impact on survivors, and reducing the potential for retraumatization by those who care for them in the clinical, behavioral, and social settings. Trauma-informed care interventions are designed to address the sequelae of trauma, promote recovery, and support resilience. Since IPDSV is a global health issue, supporting cultural needs of all clients is an essential aspect of trauma-informed care. This project was guided by a central research question that examined if trauma-informed, culturally competent curriculum be viewed by community stakeholders as an appropriate intervention for …


Improving Perinatal Team Communication To Decrease Patient Harm With Team Strategies And Tools To Enhance Performance And Patient Safety Training, Raquel Maria Walker Jan 2016

Improving Perinatal Team Communication To Decrease Patient Harm With Team Strategies And Tools To Enhance Performance And Patient Safety Training, Raquel Maria Walker

Walden Dissertations and Doctoral Studies

During childbirth, multiple providers deliver care at the bedside that requires optimal teamwork and communication to prevent patient harm. The complexity of caring for obstetrical patient demands a well-coordinated team to relay information and respond to conditions that can change quickly during childbirth. A patient safety strategy to prevent perinatal harm is Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) training. TeamSTEPPS is an evidence-based program based on crew resource management (CRM) principles developed in the aviation and military industries. This process improvement project used the Plan-Do-Study-Act framework and Kotter's change theory to implement TeamSTEPPS training after …


Type 2 Diabetes In Offspring Of Diabetic African American Women, Toby Valentino Yak Jan 2016

Type 2 Diabetes In Offspring Of Diabetic African American Women, Toby Valentino Yak

Walden Dissertations and Doctoral Studies

The prevalence of Type 2 diabetes is greater among African American women and their offspring than it is among Caucasian women and their offspring. In Iowa, there has been a gap in public health knowledge regarding risk factors associated with Type 2 diabetes in African American women and their offspring. The behavioral change wheel model was used to guide this study. This research study was a quantitative, retrospective cohort using primary data to investigate the association between a sample of diabetic African American and the occurrence of diabetes in their offspring. The sample included 105 diabetic African American women between …