Medicine and Health Sciences Commons^™

Quantitative Study Of Clostridium Difficile Incidence Related To Influenza And Antimicrobial Use, Eileen M. Yaeger

Walden Dissertations and Doctoral Studies

In the United States, influenza causes approximately 36,000 deaths and over 200,000 hospitalizations each year with elderly most often affected. Clostridium difficile infection (CDI) is another major health care challenge and pressing public health issue associated with 14,000 deaths and over 335,000 hospitalizations annually. The use of antibiotics has been implicated in the development of CDI. This study's purpose was to test the relationship of seasonal influenza incidence and antiviral/antibiotic use in CDI development among hospitalized patients. Grounded in the epidemiologic wheel model of man-environment interactions, this retrospective observational study described and analyzed data from a proprietary, laboratory, and pharmacy-based …

Temporality Of Risk Factors And The Gender Differential Related To Autism Spectrum Disorder Diagnosis, Donna L. Sullivan

Walden Dissertations and Doctoral Studies

Autism spectrum disorders (ASD) constitute life-long neurodevelopmental conditions. Globally, ASD risk for males remains 2 to 4 times greater than for females. Critical exposure mechanisms, their timing on ASD risk, and associations with the ASD gender differential remain elusive. The purpose of this study was to describe the relationship between preconception, pregnancy, recalled lactation practice, and infant traits, on ASD risk and the gender differential of ASD. A recently published temporal framework was adapted to study effects of maternal smoking and vitamin use, and recalled lactation practice on offspring ASD diagnosis with adjustment for preconception health and infant breathing traits. …

A Cross-Sectional Study: Dietary Micronutrient Levels In Allied Health And Nursing Students, Grisseel A. Cruz-Espaillat

Walden Dissertations and Doctoral Studies

The adequate intake of micronutrients is important to maintain optimal health and prevent nutritional disorders and chronic disease. Studies have shown that medical students often reduce self-care behaviors and lack adequate dietary intake, leading to nutritional deficiencies. In this quantitative cross-sectional study, measurements of micronutrient levels in a sample of allied health and nursing students were compared to Recommended Daily Allowance (RDA) values. NutritionQuest Data-on-Demand System was used to analyze nutrients and food group intake. The postpositivist paradigm was used to examine how the independent and dependent variables relate to each other. Using a one-sample t test, a comparison of …

Implementing Relationship Based Care In An Emergency Department, Ruthie Waters Rogers

Walden Dissertations and Doctoral Studies

When patients and families come to the emergency department seeking medical attention, they come in with many mixed emotions and thoughts. The fast paced, rapid turnover of patients and the chaotic atmosphere may leave patients who visit the emergency department with the perception that staff is uncaring. The purpose of this project was to implement a patient care delivery model, relationship-based care, in the emergency department. The model is comprised of several caring theories including Jean Watson's model of human care and Kristen Swanson's middle range theory of caring. The main goals of the project were to help staff enhance …

The Impact Of Caring For Seniors On The Caregiver's Stress Level, Georgina Ugochi Njoku

Walden Dissertations and Doctoral Studies

The number of Canadian seniors with 2 or more chronic health conditions living into their late 90s or older has never been greater. As such, concerns have been raised that the Canadian healthcare system will be unable to meet the growing healthcare needs of the aging population. In this project, an Advanced Practice Nursing needs assessment was used to identify the impact that caring for a senior has on caregivers' stress levels, and what resources caregivers need to in order to cope with their role. Guided by Neuman's system model theory and Rogers' diffusion of innovation model, a convenience sampling …

Self-Efficacy, Cultural Competence, And Perception Of Learning Environment In Traditional And Interprofessional Education Physical Therapy Curricula, Laura Smith

Walden Dissertations and Doctoral Studies

Interprofessional education (IPE), a concept that brings students from different health care professions together in the learning process, has been adopted by some physical therapy (PT) schools as an alternative to traditional PT-only curricula. Both approaches have the goal of improving patient outcomes for an increasingly diverse population. There was a void in the research comparing IPE and traditional curricula in PT education. Grounded in the theoretical frameworks of adult and social learning theory, the purpose of this study was to examine differences in students' self-efficacy, cultural competence, and perceptions of the learning environment based on curricular type and prior …

Mental Health Disorders As Predictors Of Relapse In Previously Detoxified Individuals, Toni Lee Simonson

Walden Dissertations and Doctoral Studies

Researchers have shown a relationship between mental health disorders and alcohol dependence. However, only 5-10% of individuals with substance use problems co-occurring with mental health problems are correctly identified. The purpose of this research was to identify predictors of relapse using three different instruments of varying complexity: the Patient Health Questionnaire-9 (PHQ-9), the Modified Mini Screen (MMS), and the Millon Clinical Multiaxial Inventory-III (MCMI-III). Researchers have found that using alcohol produces relief, similar to a pharmacological intervention, from troublesome mental health symptoms that individuals experience. Considering this association, the self-medication hypothesis was the conceptual lens used for the study as …

Midcareer Women Leaving Information Technology: An Examination Of The Phenomenon, Susan F. Way

Walden Dissertations and Doctoral Studies

Midcareer women are leaving the information technology (IT) career field at a much higher rate than are men. This attrition has contributed to a decreasing percentage of women in the IT field, hindering the creativity, innovation, and productivity that can result from a diverse workforce. This phenomenological study addressed a gap in the current research by examining the lived experience of women who have left the IT field. The conceptual frameworks of the study included Rhodes and Doering's integrated career change model based on traditional turnover theory, a model of gender and power in careers by Ragins and Sundstrom, and …

The Association Of Lead With Cataracts And Vision-Related Problems In Perimenopausal Women, Imogene Drakes

Walden Dissertations and Doctoral Studies

Around the world, women are subject to an earlier incidence of cataracts, have a higher risk for cataracts, and also have a higher risk for other vision-related problems than men. Previous research has indicated an association between endogenous lead stored in long bones and cataracts in men over 60 years of age; however, a similar study in women did not reveal an association. This case control study was conducted to investigate whether perimenopausal mobilization of endogenous lead serves as a possible causative factor for women's generalized vision issues and cataract incidence in particular. Secondary data were gathered from 1,416 women …

The Use Of A Standardized System Of Communication To Change The Perception Of Handoff Communication In A Psychiatric Setting, Alicia Renee' Plunkett

Walden Dissertations and Doctoral Studies

The Use of a Standardized System of Communication to Change the Perception of Handoff Communication in a Psychiatric Setting

by

Alicia Renee' Plunkett

MSN, Walden University 2007

MSHA, University of St. Francis, 2005

BSN, University of Memphis, 1995

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

December 2014

The Joint Commission's review of sentinel events indicated that communication errors were the cause of over 65% of the sentinel events occurring in healthcare. The nursing profession has the responsibility of providing 24-hour care in an acute care setting and nurses are …

Relationship Between Adverse Childhood Experiences And Illness Perceptions Among Individuals With Fibromyalgia, Susan D. Fay

Walden Dissertations and Doctoral Studies

Relationship between Adverse Childhood Experiences and Illness Perceptions among Individuals with Fibromyalgia

by

Susan D. Fay

MS, Drexel University, 1994

BS, Metropolitan State University of Denver, 1983

Dissertation Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Philosophy

Psychology

Walden University

February 2015

Adverse childhood experiences (ACEs), including abuse and neglect, are a significant social health problem. Exposure to ACEs can place a child at a high risk for developing different diseases or illnesses in adulthood, including fibromyalgia. The purpose of this study was to determine if exposure to ACEs, moderated by perceived social support and/or …

One Hospital's Patient Satisfaction Plans In Response, Valerie A. Smart Shoup

Walden Dissertations and Doctoral Studies

Recent changes in the Centers for Medicare and Medicaid Services (CMS) reimbursement programs resulted in $1 billion in payments to hospitals based on Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores. Approximately 50% of the 3,000 hospitals currently receiving Medicare supplements may receive increases in reimbursement payments while 50% will receive decreases in payments. This case study explored how one hospital team in North Texas achieved high HCAHPS scores. The primary provider theory, Deming's model of plan-do-study-act (PDSA), and disruptive innovation theory framed the study. The data collection process included administrator interviews (n = 7), hospital document analysis …

Obesity Surveillance In Childhood, Jessica Garcia

Walden Dissertations and Doctoral Studies

Current practice behaviors for obesity management have remained refractory. Research has shown that lack of time and poor training/skills by primary care providers has led to poor or absent obesity counseling in practice. The purpose of this intervention was to facilitate obesity counseling in a pediatric office by using an evidence-based model called the 5As model of behavioral change. Lewin's change theory was the framework for this project to help clinicians transition their practice to include the 5As model in practice. The project consisted of a 30-minute power point presentation that included 2 case samples demonstrating how the 5As would …

The Psychological Resilience Of Spousal Caregivers Of Multiple Sclerosis Family, Marisa Diane Diaz

Walden Dissertations and Doctoral Studies

The purpose of this quantitative study was to examine an under-researched topic: the relationship between psychological resilience and personal growth with spousal caregivers of patients diagnosed with Multiple Sclerosis (MS). Chronic illnesses contribute to potentially stressful changes (i.e., lifestyle, quality of life, financial wellbeing, and interpersonal relationships) for the caregiver. The theoretical foundation for this study was Walsh's family resilience theory, which contends that resilience is vital for coping with stressful life experiences and leading a more successful life. Three separate analyses were conducted to examine the relationship between the total scores of the RS and the PGIS, the SWLS, …

A Qualitative Analysis Of Migrant Women Farmworkers' A Qualit Ative Analysis Of Migrant Women Farmworkers’ Perceptions Of Maternal Care Management, Stacey A. Pilling

Walden Dissertations and Doctoral Studies

The purpose of this phenomenological study was to examine migrant women farmworkers' views of perinatal care management while working in the fields. Like men, women migrant farmworkers are exposed to many physical, chemical, and biological hazards that pose human health risks. However, women of childbearing age are at an increased risk of having reproductive health difficulties and adverse pregnancy outcomes, and the infant mortality rate among migrant farmworkers is estimated to be twice the national average. Perinatal care is a critical factor in reducing adverse outcomes for perinatal and newborn mortality. Face-to-face interviews were conducted with 15 migrant women farmworkers …

Prostate Cancer And Afro-Caribbean Men: Experiences, Perceptions, And Beliefs, Harold Evelyn Taitt

Walden Dissertations and Doctoral Studies

Despite the high incidence of prostate cancer (PC) amongst men of African descent, there is a paucity of qualitative data that explores how Afro-Caribbean men perceive their risk, susceptibility to, and management of this disease. This phenomenological study sought to explore and analyze beliefs about PC in a sample of Afro-Caribbean men who reside in the United States (U.S.). The research questions considered the perceptions, beliefs, and lived experiences of participants. The conceptual framework is a synthesis of the health belief model (HBM) and the theory of reasoned action (TRA), primarily because the TRA allows for a culturally-based relevance and …

A Meta-Analysis Of Association Between One-Carbon Metabolism Gene Polymorphisms And Risk Of Prostate Cancer, Mahmood Tazari

Walden Dissertations and Doctoral Studies

Prostate cancer is the most common cancer among men. The purpose of this quantitative, meta-analysis study was to examine one-carbon metabolism gene polymorphisms in a group of genes to determine their association with prostate cancer risk. The genetic epidemiology theory provided the framework for the study. The data collected were from published articles. From over 2,800 individual studies, 20 articles were retained for results and data abstraction, following the title, abstract screen, and full text screening in the second phase. The data were analyzed by a meta-analysis statistical method, combining the results from selected studies to estimate the overall association. …

Mental Health Professionals' Attitude And Perception Of Their Role In Tackling Substance Abuse And Related Disorders In Nigeria, Olubusayo Ruth Akinola

Walden Dissertations and Doctoral Studies

Mental health professionals (MHPs) play a pivotal role in enhancing treatment outcomes for drug-using populations and minimizing their harm to the public. In response to a gap in the literature, this study sought to (a) assess MHPs' attitudes about the use and abuse of substances and their perception of their role in tackling substance abuse and related disorders in Nigeria, (b) identify predictors of perception, and (c) explore regional variations in attitude. Based on the validated drug and drug users' problems perception questionnaire and the substance abuse attitude survey, a cross-sectional survey was conducted in a randomized sample of 292 …

The Effects Of A Sickle Cell Disease Education Intervention Among College Students, Edwin Ahunwan Guobadia

Walden Dissertations and Doctoral Studies

Sickle cell disease (SCD) is a genetic disorder that affects millions of people worldwide. According to the Centers for Disease Control and Prevention, over 100,000 Americans have SCD, and more than 2 million Americans have a sickle cell trait (SCT). People with SCD are more likely than others to suffer premature mortality. Genetic screening is an important step in improving quality of life and increasing longevity for those with SCD. Early detection may lead to effective management of the disease and reduction of complicating factors. The purpose of this quasi-experimental study was to determine whether health education about SCD would …

A Case Study On The Process Of Passing A Radiography Registry Examination, Encarnita Antonia Chamberlain

Walden Dissertations and Doctoral Studies

This project study addressed the problem of the low percentage of a Mid-Atlantic university's radiography graduates passing their credentialing registry examination. The cohort had a 2014 pass rate of 83% while the majority of surrounding schools had pass rates of 100%. In order to become registered radiographers, graduates must be able to take what they have learned in their educational program and directly apply it to their professional skill set. The conceptual framework for the study was social constructivism, adapting and transforming what was new information to previous experiences and group activities. A qualitative case study research design was chosen, …

The Center For Total Health: Healthcare Reform In Cook County, Illinois, James Leon Miles

Walden Dissertations and Doctoral Studies

The Patient Protection and Affordable Care Act (PPACA) of 2010 requires hospital systems in the United States to shift the culture of patient care from a focus on sick-care to a focus on prevention and wellness care. Little is known about how hospital systems will make this culture shift while retaining quality patient care. The purpose of this case study of a pioneering hospital-based PPACA-compliant initiative was to answer the research question of how Wallace's revitalization movement theory (RMT) "a rapid culture change model"could serve as a transferable evaluation framework for PPACA prevention and wellness care compliance in hospital-based programs. …

The Role Of Uae Health Professionals In Maternal And Child Health Policy, Immanuel Azaad Moonesar

Walden Dissertations and Doctoral Studies

Maternal and child health (MCH) mortality is a formidable challenge for health systems around the world according to the World Health Organization. Health professionals and practitioners within the United Arab Emirates were studied to determine the extent they were involved in the policy-making process, and the potential impact that analysis may have on new or revised MCH policies. Research on MCH policy-making and development processes are limited. The Andersen model of healthcare services utilization provides an appropriate framework for this research, enabling the analysis that influences the policy-making process in the area of MCH. Independent variables included nationality, education, work …

Sewer Overflows And The Vector Mosquito Proximity To Human West Nile Virus Infections, Andrea Simone Bowers

Walden Dissertations and Doctoral Studies

DeKalb and Fulton Counties, which share the metropolitan Atlanta area, have seen an increase in West Nile infected vector mosquitoes; the increase is associated with close proximity to combined sewer overflow facilities. Despite completion of the remediation system in 2008, the mosquito population testing positive for West Nile virus has increased each year from 2010 through 2012. Guided by the Geographical Information System framework and using spatial analysis and regression analyses, this study described and quantified the relationship between sewer system overflows and amplification of vector mosquitoes; an additional goal was to investigate their proximity to human cases of West …

Early Childhood Mental Health Consultation: A Comparison Of Unlicensed And Licensed Professionals, Pamela A. Morrison

Walden Dissertations and Doctoral Studies

This study was conducted to comparatively examine child specific expulsion rates and parent satisfaction of children who received early childhood mental health consultation (ECMHC) services delivered in 2 states for the 2012 program year: Maryland (unlicensed) and Delaware (licensed) . This current study examined secondary data to determine whether unlicensed (Maryland) ECMHC professionals are equally or more effective than licensed (Delaware) ECMHC professionals. Of the total number of child specific consultations or cases referred for services in Maryland (unlicensed), N = 370, n = 266 children avoided expulsion and were able to remain at their childcare placements while n = …

Southeastern United States' Parental Perspectives To Promote Adolescent Sleep Health, Steven Mark Tompa

Walden Dissertations and Doctoral Studies

Many U.S. adolescents suffer from sleep disorders. Although poor sleep habits may contribute to health issues, less is known about how parental perspectives influence sleep health in adolescents. The purpose of this descriptive phenomenological study was to address a knowledge gap in understanding parental views to promote better sleep habits in adolescents. The blended theoretical framework included the theories of caring science, social learning, advocacy paradigm, and repair and restoration of sleep. Twenty parents in the Southeastern United States participated in open-ended interviews. Research questions were designed to elicit parental perspectives about recognizing unhealthy sleep habits, improving daily sleep health …

The Association Between Dietary Patterns And Diabetes Status Among U.S. Adults, Latonia Richardson

Walden Dissertations and Doctoral Studies

Type 2 diabetes mellitus, or T2DM, is a leading cause of preventable death in the United States. Multiple studies have found that certain dietary patterns can significantly influence the risk of T2DM. The purpose of this study was to understand the dietary patterns associated with diabetes by comparing the relative adherence to these dietary patterns by individuals in 5 stages of diabetes: no diabetes, undiagnosed prediabetes, diagnosed prediabetes, undiagnosed diabetes, and diagnosed diabetes. Using the health belief model as the theoretical foundation, the primary research question examined whether adherence to specific dietary patterns significantly differed between individuals in different stages …

The Impact Of Supply Chain Logistics Performance Index On The Control Of Neglected Tropical Diseases In Low- And Middle-Income Countries, Farouk Adams Umaru

Walden Dissertations and Doctoral Studies

Neglected tropical diseases (NTD) in low- and middle-income countries are still not on target per the World Health Organization's (WHO) elimination goal of 2020. Mass drug administration (MDA) is one of the effective strategies supported by the WHO for the control and subsequent elimination of NTD. This quantitative study explored how supply chain logistic capacity may be hampering MDA coverage in countries in which the diseases are endemic. The study examined secondary data from WHO data bank for MDA coverage, to quantify the relationship between supply chain logistics capacity, as measured by the World Bank's logistics performance index (LPIs), and …

Screening And Intervention For Women With Hyperglycemia During Pregnancy, Ladonna Lynn Williams

Walden Dissertations and Doctoral Studies

Gestational diabetes mellitus occurs in up to 10% of pregnancies and often leads to labor and delivery complications for both the mother and the baby. Early identification of gestational diabetes and educational intervention are needed to improve the self-management and knowledge among pregnant women. The purpose of the project was to implement newly established national guidelines to ensure that women with gestational diabetes are identified during the first trimester of pregnancy and begin diabetes education early in gestation. Lewin's planned change theory was selected as the theoretical framework, and the six sigma approach was used to facilitate the change process. …

Attitudes And Beliefs Of Registered Retired And Registry Nurses Regarding Holistic Spiritual Care, Beverly S. Ward

Walden Dissertations and Doctoral Studies

The purpose of holistic spiritual care is to assess and provide for the spiritual needs of patients. Current literature indicates that holistic spiritual care is important to the healthcare of patients. Researchers suggest that nurses who practice holistic spiritual care are more aware of the attributes of caring, respect, and emotional support. This project study addressed a problem at the research site reported by local community nurses and holistic spiritual care experts of nurses not practicing holistic spiritual care. Mezirow's transformational learning theory was used as the theoretical foundation for this qualitative study, which was designed to examine the attitudes …

Emergency Medical Service Worker Knowledge Of And Compliance With Occupational Exposures To Infectious Diseases, Debra Ann Wrentz-Hudson

Walden Dissertations and Doctoral Studies

Firefighter Emergency Medical Service (EMS) responder personnel are at a high risk for occupational exposures to bloodborne and airborne infectious pathogens due to their unpredictable work duties in the pre-hospital environment. Not much is known about the compliance with Universal Precautions (UP) among firefighter EMS responders' personnel with regards to occupational exposures to infectious diseases. The purpose of this cross-sectional research study was to determine the relationship between compliance with UP, knowledge of UP, attitudes towards UP, occupational practices, and occupational exposures to bloodborne and airborne pathogens to prevent transmission of infectious disease among firefighter EMS responder personnel in the …