Medicine and Health Sciences Commons^™

Developing And Validating A Type 2 Diabetic Patient Drug Telephone Reminder Program, Perpetua E. Okoh

Walden Dissertations and Doctoral Studies

Research has shown that telephone drug reminder scripts can be an effective way to increase drug adherence and decrease health care costs for persons with Type 2 diabetes. The purpose of this project was to develop and validate a telephone drug reminder script for Type 2 diabetes patients based on evidence-based practice. Following a review of the literature, a telephone drug reminder script was developed for Type 2 diabetic patients to educate and improve drug adherence. Five local experts with at least 10 years' experience in diabetes treatment, education, and or research were asked to participate in the validation of …

H2h Strategies Associated With Reduced Heart Failure Readmission Rates In Georgia Hospitals, Carisa Sellers

Walden Dissertations and Doctoral Studies

Reducing heart failure risk standardized readmissions rates (RSRRs) continues to be a challenge in the United States. Among Medicare beneficiaries, the U.S. national rate for heart failure RSRRs is 23, and Georgia only has 3 hospitals with heart failure RSRRs that are better than the national rate. The hospital component of the chronic care model (CCM) was the theoretical framework used in this study because the model was designed to assist heath care organizations in improving chronic care outcomes. Researchers have indicated that the Hospital to Home Initiative (H2H), a national quality improvement campaign launched in 2009, is effective in …

How Nursing Educators Address The Differing Learning Styles Of Students, Kimmie Sue Gore

Walden Dissertations and Doctoral Studies

Educational research has shown that student learning styles, and educators' consideration of learning styles, significantly influence the academic success of adult learners. This project study was designed to identify the perceptions and attitudes of nursing faculty concerning student learning styles and consideration of student learning styles in their praxis. The study was guided by Malcolm Knowles' theory of andragogy, and investigated nursing educators' knowledge about learning styles and course delivery with regards to students with different learning styles. It used a descriptive multiple case study approach and collected data among nursing educators using the Principles of Adult Learning Survey (PALS) …

Exploring The Risk Factors That Influence The Parental Dental Deferment Decision, Megan White

Walden Dissertations and Doctoral Studies

When caregivers defer their personal routine dental care (RDC) in order to provide RDC for their children, they risk detrimental consequences in their personal health and the health of their children. The purpose of this qualitative case study was to identify the risk factors that led to the parental dental deferment decision. The oral health and personal care services conceptual models guided the development of the research questions, facilitated the selection of risk factors on the decision-making process, and provided the basis for the data analysis thematic categories. Ten caregivers who made the decision to defer their personal RDC for …

The Effectiveness Of Educational Methods On Medication Adherence, Prema David

Walden Dissertations and Doctoral Studies

Nonadherence to medications for chronic illnesses is a public health problem that requires education related to its illnesses and medications in order to reduce morbidity, mortality, and health care costs, and to improve quality of life. Scholars have identified that morbidity and mortality are much higher among African Americans due to poor medication adherence when compared to Euro-Americans. This study focused on African Americans to increase their medication adherence with chronic illnesses. The purpose of this study was to analyze the effectiveness of using different educational methods to enhance medication adherence. The social cognitive theory and the theory of planned …

Uric Acid Level Is Associated With Postprandial Lipemic Response To A High Saturated Fat Meal, Roy Gail Cutler

Walden Dissertations and Doctoral Studies

Hyperlipidemia caused by a diet high in saturated fat can lead to visceral fat weight gain, obesity, and metabolic syndrome. Being over-weight from visceral fat has been linked to increased risk of developing most age-related diseases and disability, along with a lower income potential and quality of life. However, researchers are just beginning to understand the biological mechanisms that regulate the conversion of excess calories into visceral fat storage rather than glycogen or muscle. Epidemiological studies have repeatedly shown a comorbid association between age-related diseases involving hyperlipemia and circulating levels of uric acid, but not a direct association. This study …

The Predictors Of Obesity In Young Adults, Dominic Richard Tarinelli

Walden Dissertations and Doctoral Studies

Obesity is becoming an increasing health concern for young adults. There have been numerous studies on the potential predictors of obesity. However, few studies have researched the predictors of obesity in young adults. Guided by the health belief model, this quantitative cross sectional study investigated the potential predictors of obesity in young adults. The 2011 Behavioral Risk Factor Surveillance System was used to gather data on the potential predictors of obesity, including physical activity, health care coverage, excessive alcohol consumption, and demographic characteristics on 1,511 young adults, aged 18-34 years, who were living in New York State. Data were analyzed …

A Study On The Relationship Between Emotional Intelligence And Mental Illness Stigma, E. Nicole Armstrong

Walden Dissertations and Doctoral Studies

Stigmatizing mental illness involves negative perceptions or attitudes about mental illness and the individuals who have mental illness, generating problematic consequences for both the general population and for people with mental illness. The theory of multiple intelligences proposes that intelligence includes skills and abilities in any area; emotional intelligence (EI), therefore, includes an individual's ability to identify, interpret, and regulate emotions and emotional responses. This study was designed to evaluate level of familiarity with mental illness as a potential predictor for stigmatizing mental illness, to assist in evaluating the relationship between stigmatizing mental illness and EI. The study was specifically …

Investigation Of Reasons Children Are Unvaccinated, Tracy L. Clawson

Walden Dissertations and Doctoral Studies

Many communicable diseases can be prevented with the use of immunizations. The issue this study addressed was the use of vaccinations and the rise of continued preventable communicable disease. Researchers have recommended that children be vaccinated, a recommendation that is bolstered by the readily available supply of vaccinations worldwide. However, even with vaccine promotions, availability, and education, children continue to be unvaccinated and outbreaks have continued to occur. For this study, data will be collected from the Iowa Registry of Immunization Records and a local community health center pediatric clinic. Examples of data that will be collected are vaccine records, …

Evaluation Of The System Attributes Of Timeliness And Completeness Of The West Virginia Electronic Disease Surveillance System' Nationaledss Based System, Rebecca Lee Fahey

Walden Dissertations and Doctoral Studies

Despite technological advances in public health informatics, the evaluation of infectious

disease surveillance systems data remains incomplete. In this study, a thorough

evaluation was performed of the West Virginia Electronic Disease Surveillance System

(WVEDSS, 2007-2010) and the West Virginia Electronic Disease Surveillance System NationalEDSS -Based System (WVEDSS-NBS; March 2012 - March 2014) for Category II infectious diseases in West Virginia. The purpose was to identify key areas in the surveillance system process from disease diagnosis to disease prevention that need improvement. Grounded in the diffusion of innovation theory, a quasi-experimental, interrupted, time-series design was used to evaluate the 2 data …

The Role Of Nursing Practice In Promoting Sleep During Brain Injury Rehabilitation, Jill Massengale

Walden Dissertations and Doctoral Studies

During hospitalization, sleep can be interrupted or even elusive. It has been established that quality sleep is essential in neural repair. Previous research has indicated that many nurses are unaware of the impact of sleep disturbance on brain injury recovery and do not understand how to promote sleep in the neurorehabilitation setting. The purpose of this project was to determine whether educational intervention would influence nurses' knowledge and attitudes toward sleep. Benner's (2001) novice to expert theory provided a framework for the project. With the collaboration of a neuropsychologist, this study produced a sleep knowledge and attitudes instrument. Pulmonary sleep …

The Healthy, Hunger-Free Kids Act And High School Obesity, Derek Grills

Walden Dissertations and Doctoral Studies

United States high school student obesity rates have doubled in the past 30 years to 13%, threatening the health of millions of adolescents. To mitigate the epidemic, Congress passed the Healthy, Hunger-Free Kids Act (HHFKA) in 2010, which mandated significant changes to school nutrition and physical education. From a public policy perspective, the HHFKA changed school nutrition and exercise policy to affect obesity rates by changing intake and energy expenditure at school, though no study using national-level data examined this relationship. As such, the purpose of the study was to examine whether HHFKA policy compliance had a statistically significant effect …

Nursing Staff Participation In Chart Audits Increases Documentation Compliance, Susan Elaine Nelson

Walden Dissertations and Doctoral Studies

Clinical documentation is an essential quality element that is often not adequately completed. Current data demonstrate that 32% of home health claims do not meet the requirements for federal reimbursement. Rogers's diffusion of innovation was used as a conceptual framework to guide this quality improvement project which determined whether home health nurses with education and chart audit experience demonstrate increased documentation compliance relative to nurses with education only. After completing a 1-hour education program on documentation, a convenience sample of home health nurses (n = 8) was divided between a chart-audit group (n = 4) and a no-chart-audit group (n …

Evaluation Of Empowerment Levels Of The Cleveland Clinic Nurse, Cynthia J. Willis

Walden Dissertations and Doctoral Studies

Nurses' perceptions of their work environment and empowerment in relationship to patient satisfaction are well explored in the literature. Empowerment has been linked to improved job satisfaction and improving the elements of empowerment cam improve overall patient satisfaction. This project examined 2 nursing units, 1 with lower patient satisfaction scores (Unit A) and 1 with higher patient satisfaction scores (Unit B), in order to compare their structural empowerment scores as measured by the Conditions of Work Effectiveness Questionnaire II (CWEQ-II). A total of 29 nurses who worked full-time, part-time, or per diem on 1 of the 2 units were recruited …

Student Success And Reading Comprehension, Laura Theresa Lottes-Bishop

Walden Dissertations and Doctoral Studies

Nursing administrators are exploring interventions to increase student retention rates in order to decrease college costs, improve faculty effort and time developing courses, decrease administrative resources, and to continue their accreditation. The purpose of this study was to determine whether or not there was a correlation between the Test of Essential Academic Skills (TEAS) reading comprehension scores, American College Test (ACT) reading comprehension scores, Comprehensive Computer-Adaptive Testing (COMPASS) reading comprehension scores, and the cumulative college grade point average (GPA) of the first-year nursing student. The theoretical foundation for this study was Tinto's retention theory, which claims that students' past academic …

Leveraging The Power Of Shared Governance, Cynthia S. Cohen

Walden Dissertations and Doctoral Studies

Shared governance (SG) creates an evidence-based framework to support decision making in healthcare organizations by encouraging nursing staff ownership of nursing practice issues. This project assessed the current state of shared governance at a community hospital through: (a) deployment of Hess's Index of Professional Nursing Governance (IPNG) and the National Database of Nursing Quality Indicators (NDNQI) nursing satisfaction surveys which were open to nurses working in areas included in the SG framework at the project site, and (b) retrospective review of Unit Practice Council (UPC) and Nursing Senate (NS) minutes and agendas. Kotter's theory of change and the logic model …

An Assessment Of Sexually Transmitted Disease Knowledge Among 7th Grade Students, Racquel D. Weaver

Walden Dissertations and Doctoral Studies

Sexually transmitted diseases (STDs) continue to remain a public health concern in the United States, especially among young people. Levels of knowledge with regard to STDs have been investigated in prior research; however, these investigations have been limited primarily to older adolescents and young adults. Grounded in the social cognitive and subjective culture theories, this quantitative, cross-sectional study assessed STD knowledge (other than HIV/AIDS) among 7th grade students attending a public middle school in the United States. Demographic differences (age, gender, and ethnicity) in STD knowledge were examined to determine if these demographic variables predict STD knowledge scores and if …

Assessment Practices At An Associate Degree Nursing Program, Tracey Jane Siegel

Walden Dissertations and Doctoral Studies

Nursing programs have traditionally used teacher-developed multiple-choice (MCQ) examinations to prepare students for licensure. Researchers have determined that poorly constructed MCQ tests used as formative and summative evaluations may penalize nursing students and impact progression and retention in nursing programs. The purpose of this exploratory case study was to examine issues related to the use of teacher-developed MCQ examinations as the only method of student assessment in the theory component of nursing courses. The National League for Nursing Core Competencies for Nurse Educators and the revised Bloom's Taxonomy were used as the conceptual frameworks for this study. The Director of …

Bright Facet Sign And Its Association With Demographic And Clinical Variables, Gary Andrew Longmuir

Walden Dissertations and Doctoral Studies

Low back pain has a significant impact on global public health and economics. The bright facet sign (BFS), a common finding on magnetic resonance imaging (MRI) of the lumbar spine, is associated with low back pain. While degenerative joint disease (DJD) affects low back pain, its presence appears independent of the BFS at the disc and facet joints at the same spinal level. Increased BMI, considered a risk factor for DJD, has an inverse association with the BFS. The independent relationship of DJD and the BFS is poorly understood and may represent a previously unreported pain pathway. In this nested …

Determinants Of Usage Of Age-Appropriate Child Safety Seats In Connecticut, Giuseppina Mendillo Violano

Walden Dissertations and Doctoral Studies

In the United States, motor vehicle crashes are one of the leading causes of unintentional injury death and disability for children ages 1'15 years. Despite local, state, and federal legislative and educational efforts, children continue to be restrained improperly and thus face harm. Identifying behaviors and barriers that place child occupants at risk is crucial for implementing focused, injury-prevention programs and policies. The purpose of this study was to evaluate the effectiveness of Connecticut's child passenger safety law that was strengthened in 2005. This study involved a multifactorial approach to predicting child seat use, guided by Roger's diffusion of innovations …

Physician Assistants' Preventive Medicine Practices And Related Habits, Attitudes, And Beliefs, Judia Yael Malachi

Walden Dissertations and Doctoral Studies

Physician assistants play a pivotal role in expanding access to care, yet research on their preventive medicine practices is limited. Guided by Lewis's conceptual model for predicting counseling practices, this cross-sectional study examined the relationship between physician assistants' preventive medicine practices, personal health habits, prevention and counseling attitudes, and perceived barriers to the delivery of clinical preventive services. A 104-item self-administered survey was used to collect data from 314 physician assistants attending the American Academy of Physician Assistants' 42nd Annual Conference. Data were analyzed using descriptive statistics, Pearson's correlation, and stepwise multiple regression. Results indicated that physician assistants engaged in …

Critical Care Nurses' Perceptions Of Their Knowledge And Self-Efficacy About Providing End-Of-Life Care, Mary Kathryn Gaffney

Walden Dissertations and Doctoral Studies

Most nurses receive limited formal education regarding end-of-life (EOL) care, which affects their ability to meet dying patients' needs. Guided by Bandura's social learning theory, this explanatory correlational study examined the relationships between critical care nurses' personal and professional characteristics and their perceived knowledge and self-efficacy when providing EOL care at an academic medical center. Convenience sampling was used to recruit participants from the eligible adult, pediatric, and neonatal critical care nurses for this study. The 67 participants completed the End-of-Life Professional Caregiver Survey (EPCS) to assess EOL care knowledge and self-confidence. Total EPCS scores revealed only moderate levels of …

Electronic Benefit Transfer: Food Choices, Food Insecurity, And Type 2 Diabetes, Diana Louise Malkin-Washeim

Walden Dissertations and Doctoral Studies

The purpose of this research was to examine food security for people with prediabetes participating in the Supplemental Nutrition Assistance Program (SNAP), focusing on their food choice decisions and coping strategies over a 30-day benefit cycle that potentially increases the risk of Type 2 diabetes. A cross-sectional, quantitative design based on food choice process model constructs was used. SNAP participants (n = 36) with prediabetes, aged 21-70 years, were recruited as outpatients from Bronx Lebanon Hospital and completed self-reported questionnaires on demographics and health, food security, and food frequency. Descriptive statistics, Pearson chi square tests, and regression analysis were performed …

Understanding Health Literacy Skills Of Patients With Cardiovascular Disease And Diabetes, Patrick J. Dunn

Walden Dissertations and Doctoral Studies

Health literacy is the ability to understand and act on health information and is linked to health outcomes. It is unclear how health literacy skills are developed in patients with complex conditions, such as cardiovascular disease and diabetes. The purpose of this grounded theory study was to gain perspectives of both patients and healthcare professionals on how health literacy skills were developed in patients with cardiovascular disease or diabetes. The research questions addressed how knowledge and skills were acquired, the role of digital tools, instructional strategies used by healthcare professionals, and how the instructional strategies of the healthcare professionals matched …

Nursing Students' And Novice Clinical Instructors' Experiences With Clinical Instruction And Assessment, Bridgett Alveta Jackson

Walden Dissertations and Doctoral Studies

Adjunct faculty members make up a growing proportion of nursing school clinical faculty in the United States due to a nurse educator shortage in higher education. Many of the nurses hired as clinical faculty members have years of experience providing patient care, but they lack experience in clinical instruction and assessment. At a state community college in the southeastern United States, nursing students have expressed dissatisfaction in their course evaluations with inexperienced faculty in clinical programs. The experiences of both nursing students under the guidance of novice clinical instructors and clinical faculty were examined in this case study. The National …

The Effect Of The Implementation Of Relationship-Based Care On Patient Satisfaction, Laura Ellen Field

Walden Dissertations and Doctoral Studies

The purpose of this project was to evaluate the effects of relationship-based care (RBC) on patient satisfaction. RBC is a caring model that promotes a caring and healing environment by establishing and maintaining therapeutic relationships between patient, self, and coworker. The Centers for Medicare & Medicaid Services links Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores with reimbursement to hospitals. It is essential to not only achieve high patient satisfaction scores in order to ensure full financial reimbursement, but also to ensure high quality, patient-centered care. The current project assessed samples from 2 medical surgical groups, one system-wide …

Factors That Influence Empowerment In Adjunct Faculty Members, Lisa Murthy

Walden Dissertations and Doctoral Studies

To offset the cost and meet the demand for high quality nursing graduates, adjunct faculty members are hired to educate students in the practice settings. Adjunct faculty may not have access to the resources allocated to full-time faculty and may not feel empowered to provide the most effective educational experiences for the students. The purpose of this quantitative study was to measure factors that influence empowerment in adjunct faculty members teaching in an associate degree nursing program at a community college located in the Midwestern United States. The study also examined whether there is a difference in the empowerment of …

A Staff Development Program: Diabetes And Tb Education And Screening, Relyndo Manalo Salcedo

Walden Dissertations and Doctoral Studies

There is a growing body of evidence on the positive association between diabetes and tuberculosis (TB), especially in populations with low socioeconomic status. According to the CDC and the WHO, diabetes is increasingly seen as a global epidemic, one that poses a threat to global TB control. The goal of this DNP project was to develop a program to educate clinical staff on the importance of early identification of diabetic and TB patients. The logic model was chosen as the framework for this project because it allows the planner to rationally observe each stage of a project's development. The program …

Female Parents' Attitudes, Beliefs, And Perceptions About Youth Gun Crimes, Karen Annmaurisa Sylva-Givens

Walden Dissertations and Doctoral Studies

Youth gun crime is an important public health issue that affects many communities in the United States. Since 2012, there were over 30,000 gun-related deaths in the United States. Gun violence remains the leading cause of death for young people ages 15-24. This phenomenological study examined single female parents' attitudes, beliefs, and perceptions of the influences and causes of youth gun crimes. The purposive sample drew from 10 single female parents of youth ages 14-17 charged with gun crimes. Sutherlands' (1974) differential association theory provided the theoretical framework for the study. The mothers participated in a series of in-depth, face-to-face …

Racial Differences In The Impact Of A Worksite Wellness Program On Cardiovascular Biomarkers, Ceabert Joseph Griffith

Walden Dissertations and Doctoral Studies

Cardiovascular disease (CVD) is responsible for approximately 600,000 deaths in the United States each year, with African Americans (AAs) disproportionately affected. Individual-level approaches to reducing CVD remain ineffective, mobilizing a movement that advocates for population-based solutions. Workplace wellness programs (WWPs) have gained considerable traction as a viable strategy for ameliorating CVD burden among workers in general. However, no studies have looked at the efficacy of WWPs in ameliorating CVD specifically among AA employees--a knowledge gap that this investigation aimed to close. Based on the health belief model and the social cognitive theory, this retrospective cohort study used de-identified secondary data …