Medicine and Health Sciences Commons^™

The Barriers Encountered In Telemedicine Implementation By Health Care Practitioners, Olantunji Obikunle

Walden Dissertations and Doctoral Studies

Patients in rural areas in the United States do not have adequate health care facilities for illnesses and injuries not serious enough for emergency care, but telemedicine could have a positive impact both economically and medically to control rapidly rising health care costs, which is a significant percentage of the gross national product. The purpose of this case study was to explore the barriers physicians encountered in telemedicine implementation. Participants included 4 physicians who took part in face-to-face interviews in a clinical setting in Ohio to explore strategies used in implementing telemedicine. The results of these interviews, coupled with observations …

Assessing Clinical Software User Needs For Improved Clinical Decision Support Tools, Kimberly B. Denney

Walden Dissertations and Doctoral Studies

Consolidating patient and clinical data to support better-informed clinical decisions remains a primary function of electronic health records (EHRs). In the United States, nearly 6 million patients receive care from an accountable care organization (ACO). Knowledge of clinical decision support (CDS) tool design for use by physicians participating in ACOs remains limited. The purpose of this quantitative study was to examine whether a significant correlation exists between characteristics of alert content and alert timing (the independent variables) and physician perceptions of improved ACO quality measure adherence during electronic ordering (the dependent variable). Sociotechnical theory supported the theoretical framework for this …

Analysis Of Telephonic Pharmacist Counseling, Katherine N. Swift

Walden Dissertations and Doctoral Studies

Medication complexity and nonadherence are significant risk factors for avoidable hospitalizations and health care spending for older adults in the United States. However, limited empirical research has investigated pharmacist-run telephonic medication management programs as a potential solution to the problem of reducing medication complexity while improving medication adherence. This quantitative study employed the behavioral change model to analyze archival data from a sample of 1,148 participants, examining the relationship of a pharmacist-run telephonic consulting program on medication adherence and medication complexity for one pharmacy benefit management firm's Medicare Part D recipients. The primary research questions investigated the relationship of medication …

A Proposal For The Development Of An Exercise Program To Treat Post Thrombotic Syndrome, Christy Jean Hansen

Walden Dissertations and Doctoral Studies

Healthcare costs continue to escalate and hospitals need to use programs that encourage cost effectiveness, reduce resources and staffing, and increase patient accountability for their own healthcare risk factors, comorbidities, and participation in their healthcare decisions. Post Thrombotic Syndrome (PTS) is a debilitating disease with few treatment options. Allowing patients to have shared decision making in a care plan for this disease process that involves an exercise program may be a significant factor in the success or failure of their own healthcare goals and outcomes. The development of a proposal for an exercise program for PTS should provide patients with …

The Association Between Core Science Course Timing And Completion Of An Associate Degree Nursing Program, Patricia Ann Pfeiffer

Walden Dissertations and Doctoral Studies

The aging population in the United States has led to an increased demand for registered nurses. Nursing program administrators must examine ways to increase nursing program completion, which will increase the supply registered nurses. The purpose of this study was to determine the associations among length of time between core science course completion and nursing program admission, on-time completion, and National Council Licensure Examination for Registered Nurses (NCLEX-RN) success for students at a southeastern community college. A convenience sample of 288 community students admitted to an associate degree level nursing (ADN) program between 2007 and 2012 was selected. The guiding …

School Violence And Teacher Resiliency At A Midwest Elementary/Middle School, Jounice Blackmon Wright

Walden Dissertations and Doctoral Studies

The purpose of this phenomenological study was to investigate, from the perspective of teachers, the possible effect of school violence on teacher resiliency. School violence has been studied with respect to student behavior and academic success, as well as socioeconomic influences, but not with respect to teacher resiliency, as expressed by teachers themselves. Resiliency theory was the conceptual framework. Participants were all teachers of Grades 2-8 at an elementary/middle school in the Midwest. Twelve in-depth interviews were transcribed into text data and analyzed for common themes. Using NVivo, Version 10, I was able to more easily manage the volumes of …

Reducing Emergency Department Length Of Stay By System Change, Brian Dale Haybarker

Walden Dissertations and Doctoral Studies

Emergency departments (ED) are exceeding the Centers for Medicare and Medicaid Services and The Joint Commission's recommended 4-hour door-to-admission and 2-hour door-to-discharge for patients. The purpose of this project was to look for factors that decrease door-to-admission and door-to-discharge times and offer recommendations to the Patient Flow Committee (PFC) at the health care facility that may reduce overcrowding, diversion, and patient boarding. The 7-step Iowa model of evidence-based practice (EBP) was used to concentrate on problem-focused triggers that initiate the need for change. The project focused on decreasing door-to-admission and door-to discharge times: by opening an observation unit run by …

Media Literacy Education Exposure Related To Self-Esteem, Body Esteem, And Sociocultural Ideals In College Students And Graduates, Tammy Stargardt

Walden Dissertations and Doctoral Studies

The prevalence of eating disorders (ED) in the United States has increased while the media consistently presents thinner representations of the body. Scholars have found media to negatively influence factors associated with the development of EDs. The purpose of this quantitative nonexperimental cross-sectional survey design study was to explore relationships between exposure levels to MLE and self-esteem, body esteem, and the internalization societal appearance ideals. Participants included undergraduate students or recent graduates majoring in either communications or an alternative major with comparatively less MLE curriculum. The Body Esteem Scale, Sociocultural Attitudes towards Appearance Questionnaire-3, and Rosenberg Self-Esteem Scale Surveys were …

Fukushima Nuclear Disaster Response Impact On Graduate Students, Sean Eric Kil Patrick Gay

Walden Dissertations and Doctoral Studies

The roles that universities played in the response to the Fukushima nuclear disaster were significant and varied; however, there was limited study on participating graduate students. The purpose of this study was to understand the impact of disaster response on graduate students' personal and academic development. This study examined research questions about the perceived impact on academic and personal identity development. Empowerment, cognitive content engagement, general systems theory, and utilitarianism formed the theoretical foundation. This study used a transcendental phenomenological approach to examine the subjects' experiences in the context of involvement in disaster response. The primary source of data was …

Assessing Spirituality Among Hospice Patients: A Phenomenological Study Of Hospice Nurses, Isabel Esther Kaufman

Walden Dissertations and Doctoral Studies

The shift in health care and nursing philosophy and practice from a holistic approach to a highly technological, cure-oriented approach has been attributed to effective pharmaceuticals made to prolong life. Recently medical professionals have shifted their focus to a combination of spiritual healing and medicine. Hospice care in particular have taken a key interest in integrating spirituality within their health care. The problem is that due to the complications in defining spirituality and appropriate training and education of spirituality within nursing curriculum, assessing patients' spiritual distress may be difficult for many hospice nurses which may be at a loss when …

Fall Prevention Quality Initiative: Implementation Of A Unit Safety Champion (Usc), Susan Lynn Rednak

Walden Dissertations and Doctoral Studies

The literature supports that a Unit Safety Champion (USC) may reduce falls among hospitalized patients. The purpose of this project was to determine if the implementation of a USC would assist in reducing falls on an acute unit in an urban hospital environment. The frequency of patient falls on the unit was collected from the hospital's quality department 3 months before and 3 months after the implementation of the USC. The average number of falls for 3 months before implementation was 5.0 per month (SD = 2.65) and involved a total of 15 individual patients. The average number of falls …

Evidence-Based Mentorship Program: Overview, Review Of Evidence, And Approach, Elizabeth Villanueva

Walden Dissertations and Doctoral Studies

Nurses comprise the largest segment of the healthcare workforce. Adequate numbers of

nurses help to ensure sufficient and safe nursing care in all settings. The current nursing shortage poses a barrier to optimum nursing care, and the nature of recruitment and retention of nurses has generated research interest because of its association with the labor shortage. The purpose of the project was to develop a nurse mentorship program for possible adoption by a northern state correctional facility. Goals are to aid recruitment and improve retention of nurses in the facility. This quality improvement project was informed by Jean Watson's theory …

The Correlation Among Personality Characteristics, Stress, And Coping Of Caregivers Of Individuals With Intellectual And Developmental Disabilities, Natasha O'Connor

Walden Dissertations and Doctoral Studies

There is little research on the coping strategies of direct support professional caregivers working with the intellectually disabled (ID) and developmentally disabled (DD). The study was guided by Lazarus and Folkman's (1984) theory of the transactional model of stress and coping. The purpose of this study was to assess whether there is a correlation among the independent variables of coping and personality characteristics with stress as the dependent variable. A convenience sample of 69 professional caregivers was used. Data were collected using the Ways of Coping Questionnaire, Perceived Stress Scale, NEO-FFI-3, and a demographic questionnaire. A correlational analysis was conducted …

The Influence Of On-Site Surgical Pathology Services In Rural Hospitals On Physician Satisfaction, Belinda D. Presley

Walden Dissertations and Doctoral Studies

Abstract

There is limited information regarding physician satisfaction as it relates to the presence of a surgical pathology department in rural hospitals. Physician satisfaction directly influences the quality of patient care. The theoretical frameworks that informed this study included institutional theory and population ecology. The research questions addressed differences in levels of physician satisfaction between physicians who have access to an on-site surgical pathology department and physicians who do not have such access. The research also examined differences in satisfaction between physician specialties that have or do not have access to an on-site surgical pathology department services. A quantitative, cross-sectional …

Relationships Between A Prenatal Nutrition Education Intervention And Maternal Nutrition In Ethiopia, Divya Lakshmi Selvakumar

Walden Dissertations and Doctoral Studies

In Ethiopia, 17% of pregnant women ages 18-49 are malnourished and have low awareness of prenatal nutrition, which may relate to increasingly high rates of maternal and infant mortality. The purpose of this mixed methods research study was to determine the effects of a community-based prenatal nutrition education intervention program on maternal nutrition knowledge and attitudes in the Alaje district of Ethiopia. The theoretical framework was Sen's capability theory of poverty, in which opportunities can lead to well-being and promote economic development. Research questions focused on the relationships among 8 independent variables-age, income source, degree of program implementation, marital status, …

Effect Of Social Support And Hiv-Related Stigma On Depression In Hiv/Aids Patients, Chinedu Anthony Umeadi

Walden Dissertations and Doctoral Studies

HIV has remained a public health problem in Nigeria. The purpose of this cross-sectional study was to examine the effect of social support and HIV-related stigma on depression in people living with HIV/AIDS (PLWHA) and to examine the moderating effect of sociodemographic factors, Quality of Life (QOL), and time since HIV diagnosis on this relationship. This study was based on the social cognitive theory. Data were collected from 98 PLWHA attending the antiretroviral clinic of Federal Medical Center, Umuahia, Nigeria. Regression analyses were used to examine the relationships between the variables. Some 24.5% of the study participants were depressed. Significant …

The Effect Of Breastfeeding Self-Efficacy On Breastfeeding Initiation, Exclusivity, And Duration, Adria Vincent

Walden Dissertations and Doctoral Studies

Breastfeeding self-efficacy is considered one of the key components of a successful breastfeeding experience. The benefits of breastfeeding are well established in the literature and have been widely communicated to the public, resulting in an increasing trend of breastfeeding initiation. However, the United States still falls short of Healthy People 2020 breastfeeding goals. The purpose of this project was to examine the effects of a standardized hospital-based prenatal breastfeeding class on breastfeeding self-efficacy. Dennis's breastfeeding self-efficacy theory was the foundation for the breastfeeding self-efficacy tool used in this project. A quasi-experimental design used a convenience sample of 30 breastfeeding class …

Hiv Stigma Within Religious Communities In Rural India, Krutarth J. Vyas

Walden Dissertations and Doctoral Studies

This study was conducted to gain a better understanding of HIV/AIDS-related stigma within religious communities in rural Gujarat, India. This study used the hidden distress model of HIV stigma and the HIV peer education model as conceptual frameworks to examine a rural population sample of 100 participants. Regression analysis was conducted to test if school education had a moderating effect on the relationship between illness as punishment for sin (IPS) and HIV stigma. Religiosity was tested for mediating effects on the relationship between early religious involvement (ERI) and HIV stigma. The results of this study indicated that single unemployed men …

The Severity Of Obstructive Sleep Apnea And Hypertension Among Middle Aged Asians, Michel Juson Benin

Walden Dissertations and Doctoral Studies

This study examined the prevalence rate of obstructive sleep apnea (OSA) as an independent variable in association with hypertension as an outcome. Studies conducted outside of the United States suggest that differences in craniofacial features among middle-aged Asians increase the prevalence of OSA in comparison to Caucasians with similar age and lower BMI. No similar study had been conducted in the United States. The sufficient component cause theory guided this study and was able to describe the association between OSA and hypertension among middle-aged Asians. The objective of this cross sectional retrospective study was to determine the prevalence rate of …

Health Literacy And Health Decision Making Attitudes In People With Human Immunodeficiency Virus, Christine Miranda

Walden Dissertations and Doctoral Studies

Health literacy has been recognized as a vital issue in the self-care management of persons living with HIV/AIDS (PLWHA). The purpose of this study was to determine the impact of functional, communicative, and critical health literacy dimensions on positive and negative attitudes toward health decision making. The transtheoretical model of health behavior change (TTM) provided the theoretical framework to explain this association. A culturally-adapted survey was used in this cross-sectional study to measure health literacy dimensions, positive and negatives attitudes toward health decision making, and other factors in 100 Puerto Ricans living with HIV/AIDS. Demographic factors and clinical and immunological …

Perception Of Anal Hpv Infection By Hiv-Positive Men Practicing Male-Male-Sex, Philecia Simone Mullings

Walden Dissertations and Doctoral Studies

Human papillomavirus (HPV) is a preventable, sexually transmitted infection whose prevalence has been rising dramatically among men who have sex with men (MSM) in the United States since 2008. The HPV infection rate for MSM is rising even faster for MSM who are infected with the human immunodeficiency virus (HIV) and for those who have developed acquired immune deficiency syndrome (AIDS). It is not clear whether MSM in general and MSM with HIV have the knowledge necessary to prevent infection of themselves and their partners. This phenomenological study explored the knowledge, health perceptions, attitudes, and norms of the community of …

Understanding Faith Leaders' Perspectives On Breast Health Interventions In The Church, Marsha Ladonna Marshall

Walden Dissertations and Doctoral Studies

The prevalence and incidence of breast cancer is an important issue that is affecting all women, but African American women have the lowest survival rates after breast cancer diagnosis. Historically, the Black church and faith leaders have been essential in promoting health in the African American community. Moreover, faith-based interventions have become more common within the African American community in addressing factors that affect survival rates such as early detection, cultural barriers, and education. Currently, there is not clear information on the perspectives faith leaders have on their experiences with implementing breast health interventions in their places of worship. This …

Youth Assault-Injury Variation Patterns And Their Dimensional Structure, Diana Faissal Wilkerson

Walden Dissertations and Doctoral Studies

Youth assault-injury is 1 of the 5 leading causes of adolescents' death in the United States. Despite public health efforts, the prevalence rates of youth assault-injury and almost all its risk factors have remained consistent in the past 10 years. The purpose in conducting this cross-sectional quantitative study using archival data of the Add Health Wave II in-home survey was to examine the underlying-multidimensional structure of youth assault-injury. Problem behavior theory (PBT) lens and a multidimensional model were used and a structural equation model was conducted to examine the relationships between 22 risk and protection variables, 3 unobserved latent factors, …

Social Determinants Of Health Inequality And Life Expectancy Among Women Of Edo State, Nigeria, Daniel Aromeh Odekina

Walden Dissertations and Doctoral Studies

Health inequality conflates a huge number of economic, social, and political issues. These issues, together described as social determinants, determine a population's health through influencing health status and life expectancy. The research purpose of this study was to examine how social determinants affected the life expectancy of the women of Edo State, based on secondary data from Nigeria's 2008 demographic and health survey (NDHS). The theories that guided the study were self-efficacy beliefs of the social cognitive theory and physical self-concept of the health belief model. This quantitative cross-sectional study examined the associations between socioeconomic status, nutritional status, literacy/educational attainment, …

Factors That Influence Hiv Testing Among African American College Women, Brandi J. Sampson

Walden Dissertations and Doctoral Studies

Human immunodeficiency virus (HIV) has become one of the world's most serious health and development challenges. It is important for African American female students who attend Historically Black Colleges and Universities (HBCUs), to engage in routine HIV testing and know their HIV status based on the high prevalence rate of HIV/AIDS among African American women and the risk of engaging in risky sexual behavior in a college. This qualitative study was developed to help gain a better understanding of how African American female students who attend HBCUs make the decision to engage in HIV testing and their attitudes toward HIV …

Impact Of Goodwill Organizations And Community Collaboration On Aids-Orphans' Needs In Nyanza Province, Kenya, Anthonia Nwagbo

Walden Dissertations and Doctoral Studies

A number of researchers have explored the toll of AIDS on the children who have become orphans as a result of the disease; others have investigated the roles of aid-giving agencies on the alleviation of the orphans' situation. However, despite researchers' pointing to the germaneness of community and goodwill agency liaison, no study had examined the impact of such collaboration on the resources available to the orphans. To this end, the heads-of-household of 532 AIDS orphans under 18 years old in Kenya's Nyanza province were surveyed to investigate the impact of community-referral on the state of AIDS orphans with regard …

Perspectives On Hiv/Aids: American-Based Nigerian Women Who Experienced Polygamy In Rural Nigeria, Christianah Oluseyi Olorunfemi

Walden Dissertations and Doctoral Studies

Traditionally, in Nigeria women play a subservient role in relation to men. While a man can practice polygamy by marrying many wives, women cannot marry more than one husband at a time. Although researchers have documented the effects of polygamy on the spread of HIV/AIDS, little is known about the experiences of polygamy by Nigerian women who stopped practicing polygamy by immigrating to the United States without their husbands. It is important to know the experiences of these women as they pertain specifically to the spread of HIV/AIDS so as to develop a preventive intervention for HIV/AIDS among Nigerian women …

Racism Vs. Social Capital: A Case Study Of Two Majority Black Communities, Bruce W. Strouble

Walden Dissertations and Doctoral Studies

Several researchers have identified social capital as a means to improve the social sustainability of communities. While there have been many studies investigating the benefits of social capital in homogeneous White communities, few have examined it in Black homogeneous communities. Also, there has been limited research on the influence of racism on social capital in African American communities. In this dissertation a comparative case study was used within a critical race theory framework. The purpose was to explore the role of racial oppression in shaping social capital in majority African American communities. Data were collected from 2 majority Black communities …

Impact Of Environmental And Individual Risk Factors On Pregnant And Parenting Teenagers, Lakeasha Thrasher

Walden Dissertations and Doctoral Studies

Teenage pregnancy is both a social and a public health problem in the United States, with approximately 750,000 young women between the ages of 15 and 19 becoming pregnant each year. In addition, teen pregnancy is more prevalent in the African American (15%) and Hispanic (14%) communities than it is in White communities (5%). The purpose of this study was to identify risk factors contributing to teen pregnancy among racially diverse teenagers 15 to 19 years of age living in the rural south. This study, guided by social cognitive theory, used a quantitative, cross-sectional research design to determine whether living …

Contextual Factors And Direct Exposure To Hiv: Influences On Youth Sexual Intention, Hadiza Ladidi Osuji

Walden Dissertations and Doctoral Studies

Youth are having sexual intercourse at an early age and as such, are engaging in risky behaviors that are associated with adverse health outcomes, including HIV infection. Little research has been undertaken to examine the influence of contextual factors on youth intentions to delay sexual involvement. To address that gap, this study aimed to examine the influence of age, gender, race, immigration status, HIV knowledge, HIV-related stigma, concern about HIV, direct exposure to HIV/AIDS, peer pressure, and religious influence on youth intentions to delay sexual involvement. Delayed sexual involvement was conceptualized as youth attitudes towards abstaining from sex, their knowledge …