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Walden Dissertations and Doctoral Studies

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Staff Education On Psychosocial Rehabilitation Management Of Individuals Diagnosed With Severe Mental Health Illness, Evarist O. Oguguo Jan 2022

Staff Education On Psychosocial Rehabilitation Management Of Individuals Diagnosed With Severe Mental Health Illness, Evarist O. Oguguo

Walden Dissertations and Doctoral Studies

Serious mental illness (SMI) is common in America and is associated with behavioral and emotional conditions that can lead to serious functional impairment and interfere with a person's decision making and general life activities, negatively impacting themselves and their caregivers, families, and communities. Psychosocial rehabilitation (PSR) is one evidence-based, person-centered approach known to be effective in helping individuals diagnosed with SMI manage their symptoms and improve their daily functioning. To effectively participate in providing PSR, caregivers must have special PSR knowledge. A staff education program was developed to educate and increase staff knowledge about PSR. The purpose of the project …


Assessing The Risk Of Developing Liver Cancer Among Adults In The United States, Magbor Oben Jan 2021

Assessing The Risk Of Developing Liver Cancer Among Adults In The United States, Magbor Oben

Walden Dissertations and Doctoral Studies

The risk of developing liver cancer among adults in the United States remains asignificant threat due to an increasing prevalence of the disease. Despite the identification of some biological, environmental, and socioeconomic risk factors, uncertainty exists as to the role of sociodemographic factors. In this study, participants (N=27,804), age 18 and over, were assessed for liver cancer outcome specific to three factors liver disease, insurance coverage, and access to healthcare. With the person-centered care model as the framework, data from the 2016 National Health and Interview Surveys were subjected to the selection criteria and quantitatively analyzed using binary logistic regression. …


Blood Culture Staff Education To Improve Knowledge And Contamination Prevention, Christina Michelle Harvey Jan 2021

Blood Culture Staff Education To Improve Knowledge And Contamination Prevention, Christina Michelle Harvey

Walden Dissertations and Doctoral Studies

AbstractThere was an underlying issue with nurses improperly drawing blood cultures resulting in false results that impact patient care. The project examined the question whether a staff education program for Veteran’s Affairs Registered Nurses on the effects of correct blood culture specimen collection can demonstrate an increase in knowledge in the VA’s collection procedure leading toward increasing compliance. The purpose was to correct a knowledge deficit leading to a lack of compliance of the VA nurses on the target unit. The project was directed by the principles of the Knowles’ adult learning model. The sources that generated evidence for the …


Sociodemographic And Obstetric Predictors Of Cesarean Section In Ghana, Nana Mireku-Gyimah Jan 2021

Sociodemographic And Obstetric Predictors Of Cesarean Section In Ghana, Nana Mireku-Gyimah

Walden Dissertations and Doctoral Studies

The increasing cesarean section (CS) rate in Ghana has severe public health implications as it results in significant maternal and child morbidity and mortality. An assessment of the factors contributing to the increasing CS rate in different settings is imperative to guide the development of interventions. The purpose of this study was to identify the sociodemographic and obstetric predictors of CS in a major referral health facility in Accra, Ghana. This research was grounded in the systems thinking approach and involved the use of a case-control design whereby 2,704 pairs of cases (delivered by CS) and controls (delivered by vaginal …


Racial Disparities In Hypertension Self-Awareness And Hospitalizations For Hypertension-Related Illnesses Among Adult Arkansans, Chimfumnanya Nwanze-Smith Jan 2021

Racial Disparities In Hypertension Self-Awareness And Hospitalizations For Hypertension-Related Illnesses Among Adult Arkansans, Chimfumnanya Nwanze-Smith

Walden Dissertations and Doctoral Studies

Black individuals in the United States are twice as likely as White individuals to die of cardiovascular diseases. Between 2010 and 2016 in Arkansas (AR), hypertension (HTN) and HTN-related diseases had an age-adjusted death rate of 230.4 deaths per 100,000 population compared to 173.6 deaths per 100,000 population for Whites. The purpose of this quantitative, cross-sectional study was to explore the potential association between HTN self-awareness and emergency department (ED) visits and hospitalization rates for HTN and HTN-related illnesses between Black and White individuals in AR. The socioecological framework was used to explore sociodemographic (SDF) and socioeconomic (SES) factors as …


Resilience As A Moderator Between Food And Housing Insecurity And Mental Distress, Denise Mchugh Loggie Jan 2021

Resilience As A Moderator Between Food And Housing Insecurity And Mental Distress, Denise Mchugh Loggie

Walden Dissertations and Doctoral Studies

The prevalence of food insecurity (FI) and housing insecurity (HI) in college students has increased over the last decade along with an associated increase in mental health problems. Studies show significant increases in many markers for mental distress in this population including a higher prevalence of mood disorders, non-lethal self-harm, and attempted and completed suicides, particularly over the last decade. Compounding these challenges is the low level of resilience found in college-age young adults, potentially limiting their ability to cope with and recover from the hardship of FI and HI. This quantitative study, guided by resilience theory and Maslow’s hierarchy …


Service-Level Factors Affecting Completion Of Antenatal Care Attendance In Uganda, Lorna Barungi Muhirwe Jan 2021

Service-Level Factors Affecting Completion Of Antenatal Care Attendance In Uganda, Lorna Barungi Muhirwe

Walden Dissertations and Doctoral Studies

Lack of universal coverage of proven, low-cost, high-impact interventions—particularly for underserved and rural populations—remains a key reason for the high rates of maternal deaths in Uganda. Antenatal care (ANC) ensures early detection and treatment of pregnancy-related complications. Completion of recommended ANC visits remains suboptimal, particularly for rural women in Uganda. The purpose of this quantitative, cross-sectional study was to assess facility-level factors affecting completion of ANC attendance among women of reproductive age in a rural district in Uganda. The Dutton theory for initial and continued health services utilization was used to analyze the relationship between facility level factors and ANC …


Relationship Between Trust, Race, And Health Care Information Sources Among African American Men, Uzochukwu Onukogu Jan 2021

Relationship Between Trust, Race, And Health Care Information Sources Among African American Men, Uzochukwu Onukogu

Walden Dissertations and Doctoral Studies

AbstractAfrican American men have not been sufficiently at the center of research studies, especially when it comes to health. Most researchers have explored African Americans as a whole, and few have looked at African American men specifically, especially when it comes to their perceptions and ability to trust sources of health information. The purpose of this quantitative cross-sectional study was to examine the relationship between race and trust in health information sources, including the relationship between prostate cancer health outreach done through the internet and the acceptance of such information outreach among African American men. The theory of planned behavior …


Health Beliefs And Nonadherence To Prescribed Medication Among African Americans Diagnosed With Hypertension, Monique D. Porter Jan 2021

Health Beliefs And Nonadherence To Prescribed Medication Among African Americans Diagnosed With Hypertension, Monique D. Porter

Walden Dissertations and Doctoral Studies

Perceptions of high blood pressure among African Americans and medicationnonadherence contribute to worsening cardiovascular disease compared to other racial groups; thus, they may suffer an increased lack of control of hypertension due to their subjective health beliefs. This study aimed to uncover health beliefs that result in nonadherence to medication advice, building on existing research associated with high blood pressure disparities despite recommendations for high blood pressure medication use. In this qualitative phenomenological study, the health belief model was used to identify the health beliefs of 12 African American patients with hypertension who were non-adherent to taking their prescribed medication. …


Misuse Of Prescription Pain Relievers Among Pregnant Women In The United States, Winnie Chebet Rono Jan 2021

Misuse Of Prescription Pain Relievers Among Pregnant Women In The United States, Winnie Chebet Rono

Walden Dissertations and Doctoral Studies

The non-medical use of prescription pain relievers has increased remarkably, posing social and public health concerns particularly in developed countries such as the United States. The management of pain experienced by pregnant women poses a challenge to clinicians considering the effects of the regimen on unborn babies. Guided by the health belief model, which aims to predict health-related behavior in terms of certain health beliefs and explain change and behavior maintenance as well as to guide health behavior interventions, this cross-sectional study aimed to understand the associations between misusing pain relievers and social determinants of health such as education level …


Parental Education As A Potential Predictor Of Adolescent Substance Use Status, Haruna Bida Aliyu Jan 2021

Parental Education As A Potential Predictor Of Adolescent Substance Use Status, Haruna Bida Aliyu

Walden Dissertations and Doctoral Studies

AbstractAdolescents in the United States commence substance use as early as 12 to 14 years old and as late as 15 to 17 years old. Several factors influence adolescent substance use/abuse status, including environment, boredom, friends, teachers, and parental influence. The influence of parental communication with adolescents about the danger of substance use/abuse (SUA) required further study. The purpose of this quantitative cross-sectional study was to understand the influence of parental knowledge and communication with adolescents as potential predictors of substance use/abuse status. The social cognitive theory and social determinants of adolescent risky behavior provided the theoretical framework of this …


Effects Of Attribution And Appraisal Of Control On Emergency Department Nurse Stress When Treating Patients With Severe Mental Illness, Cynthia Lynn Bentzen-Mercer Jan 2021

Effects Of Attribution And Appraisal Of Control On Emergency Department Nurse Stress When Treating Patients With Severe Mental Illness, Cynthia Lynn Bentzen-Mercer

Walden Dissertations and Doctoral Studies

AbstractAs the prevalence of severe mental illness continues to rise and access to mental health care is scarce, an increasing number of U.S. adults seek treatment in emergency departments. Nurses who triage the severity of a medical emergency may appraise the situation both through the lens of mental illness stigma and the degree of confidence they have to control the outcome. However, the research community knows little about the extent to which attribution and appraisal of control affect nurses’ appraisal of stress. The purpose of this quantitative nonexperimental, canonical correlational study was to examine the extent to which various combinations …


Social/Cultural Factors In Preschool Immunizations, Mozambique, Kristine Gayle Bernabe Jan 2021

Social/Cultural Factors In Preschool Immunizations, Mozambique, Kristine Gayle Bernabe

Walden Dissertations and Doctoral Studies

Immunizations are scientifically proven, effective global health interventions that prevent infectious diseases and save lives. Yet, in Mozambique at the national level, less than 65% of children are fully immunized, i.e., received all the basic/routine vaccinations. The overall purpose of the doctoral study was to conduct quantitative research examining the sociocultural factors that may impact childhood immunization status in the context of the social ecological model. The study examined the relationship between child’s gender, mother’s and her husband/partner’s educational level, household wealth index, religion, ethnicity/language, urban-rural residency, and province/region with the child’s full immunization status in Mozambique. Secondary analysis of …


Educating Staff To Reduce Hospitalization Of Individuals Living In A Group Home, Caroline Aina Ibijemilusi Jan 2021

Educating Staff To Reduce Hospitalization Of Individuals Living In A Group Home, Caroline Aina Ibijemilusi

Walden Dissertations and Doctoral Studies

AbstractPersons with intellectual and developmental disabilities (IDD) have significant health disparity in terms of high numbers of hospitalizations compared to the general population. The purpose of the project was to improve staff ability to recognize and respond to the changes in the health status of intellectually and developmentally disabled individuals living in a group home. The project utilized Knowles’s theory of adult learning to develop a curriculum suitable for adult learners and the Kirkpatrick model to guide the assessment of the training. Pre- and post-perception of learning and satisfaction surveys were provided to the participants online. A paired t test …


Breastfeeding Information And Breastfeeding Duration Among African American Women With A Family History Of Breast Or Ovarian Cancer, Aleatha Johnson Jan 2021

Breastfeeding Information And Breastfeeding Duration Among African American Women With A Family History Of Breast Or Ovarian Cancer, Aleatha Johnson

Walden Dissertations and Doctoral Studies

Decades of research supports the notion that breastfeeding may help prevent breast and ovarian cancer in women. Women with a family history of these cancers are at greater risk. African American women have the lowest breastfeeding rates, yet the highest breast and ovarian cancer mortality rates. No studies have been conducted exploring the impact of being informed about breastfeeding from health care providers, breastfeeding support services, or family and friends and the relationship between their knowledge of family history of breast or ovarian cancer and breastfeeding duration for African American women. The purpose of this quantitative study was to determine …


State Consent Policies And The Meaningful Use Of Electronic Health Records Among Nonfederal Acute Care Hospitals In The United States, Adetoro Kafilat Longe Jan 2021

State Consent Policies And The Meaningful Use Of Electronic Health Records Among Nonfederal Acute Care Hospitals In The United States, Adetoro Kafilat Longe

Walden Dissertations and Doctoral Studies

The less-than-nationwide use of electronic health record (EHR) systems to send, receive, and integrate (SRI) patient summary of care (PSC) records limits the ability of hospital administrators to maximize efficiency and improve quality in the continuum of care. Despite obvious differences in state health information exchange (HIE) consent policies, there is no known research that has determined if and what aspects of state-level HIE legislation affect the use of EHR systems to SRI PSC records. Guided by the unified theory of acceptance and use of technology (UTAUT), the purpose of this quantitative cross-sectional research study was to examine the relationship …


Interrelationships Of Sociodemographic And Biological Factors In Breast Cancer Mortality Disparity Affecting Young Black Women, Richard Mutyabule Jan 2021

Interrelationships Of Sociodemographic And Biological Factors In Breast Cancer Mortality Disparity Affecting Young Black Women, Richard Mutyabule

Walden Dissertations and Doctoral Studies

Despite improved overall survival among breast cancer patients, race and biological subtype-specific disparities persist. Subsequently, this retrospective longitudinal study, guided by ecosocial theory, examined associations between biological subtypes of breast cancer and patient-level sociodemographic factors on survival outcomes in women 25 to 44 years of age. Using Surveillance, Epidemiology, and End Results (SEER) database, 34,007 breast cancer cases between 2013 and 2018 were extracted. Kaplan Meier method and Cox proportional hazards model were used to examine time to event and the adjusted mortality risk by race and breast cancer subtype. There was a statistically significant difference in survival among young …


Social Support, Substance Use, And Mental Health Services Utilization Among African Americans, Thomas Symche Bendu Jan 2021

Social Support, Substance Use, And Mental Health Services Utilization Among African Americans, Thomas Symche Bendu

Walden Dissertations and Doctoral Studies

Mental illness is more prevalent among African Americans than their Non-Hispanic White counterparts; however, this population is less inclined to receive behavioral treatment. The purpose of this study was to examine the association between perceived social support, substance use, and gender with mental health care services utilization among African Americans. The social ecological model and social support theory grounded this study. The research design was a quantitative cross-sectional analysis of the 2016 Behavioral Risk Factor Surveillance Survey. The sample consisted of 486,3030 African American adults that represented the U.S. population using weighted estimates. The overall logistic regression models for the …


Lived Experiences Of Newly Graduated Registered Nurses, Tonya Lyn Chancey Jan 2021

Lived Experiences Of Newly Graduated Registered Nurses, Tonya Lyn Chancey

Walden Dissertations and Doctoral Studies

Attrition rates for first year newly graduated registered nurses (NGRNs) are between 30% to 60%; high level of attrition negatively affects hospital organizations, other nurses, and patient outcomes. Transitioning from student nurse to clinical nurse poses challenges for NGRNs which includes assuming responsibilities for a full patient load, communicating with physicians, and adjusting to shift work. The purpose of this phenomenological study, guided by Kramer’s reality shock theory and Duffy’s quality caring model, was to examine the lived experiences of a first-year cohort of NGRNs working in the acute care setting of a Florida hospital. Thirteen NGRNs were interviewed using …


Diabetes Self-Management Of Adults With Diabetes In Grenada During The Covid-19, Pauline Smith Jan 2021

Diabetes Self-Management Of Adults With Diabetes In Grenada During The Covid-19, Pauline Smith

Walden Dissertations and Doctoral Studies

Diabetes self-management involves several behaviors to prevent complications and ensure a good quality of life. Several studies addressed how the COVID-19 lockdown impacted diabetes self-management practices worldwide, yet little was known about self-management experiences in Grenada and the Caribbean region. The purpose of this phenomenological and directed content analysis study was to gain insight into the lived diabetes self-management experiences during the COVID-19 lockdown in Grenada. The theory of planned behavior was used as the theoretical framework for this study. The research questions addressed lived self-management experiences and attitudes, subjective norms, and perceived behavioral control toward diabetes self-management. Semistructured interviews …


A Systematic Review Of Tobacco Cessation Strategies Tailored For Military Personnel, Ni Ketut Supiyati Jan 2021

A Systematic Review Of Tobacco Cessation Strategies Tailored For Military Personnel, Ni Ketut Supiyati

Walden Dissertations and Doctoral Studies

AbstractA Systematic Review of Tobacco Cessation Strategies Tailored for Military Personnel by Ni Ketut Supiyati

MS, Walden University, 2000

Project Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice

Walden University August 2021


A Delphi Study On The Use Of Simulation In Undergraduate Nursing Education, Diana L. Bailey Jan 2021

A Delphi Study On The Use Of Simulation In Undergraduate Nursing Education, Diana L. Bailey

Walden Dissertations and Doctoral Studies

AbstractThe lack of traditional clinical sites for nursing students has prompted a surge in simulation as an innovative teaching strategy in undergraduate nursing education. The International Nursing Association for Clinical Simulation and Learning (INASCL) developed the INACSL Standards of Best Practice: SimulationSM to direct schools of nursing in implementing high-quality simulations. As simulated experiences replace traditional clinical experiences, it is imperative that simulated experiences replicate real-life patient scenarios. The purpose of this Delphi study was to establish consensus on the use of the INACSL Standards of Best Practice: Simulation in undergraduate nursing education. The conceptual frameworks guiding this study were …


Effective Physician Engagement Strategies For Improving Healthcare, Auriesheaua Bell Jan 2021

Effective Physician Engagement Strategies For Improving Healthcare, Auriesheaua Bell

Walden Dissertations and Doctoral Studies

Middle and senior-level healthcare managers lack physician engagement strategies to help avoid physician burnout. Many physicians leave the healthcare profession due to disengagement, which could cause a significant healthcare crisis. Grounded in the transformational leadership theory, the purpose of this qualitative single case study was to explore the engagement strategies healthcare middle and senior-level managers used to help avoid physician burnout. Participants comprised seven middle and senior-level healthcare managers with a minimum of five years of employee management experience who effectively used physician engagement strategies to help avoid physician burnout at a Central Pacific United States healthcare organization. Data were …


The Relationship Between Hospitals’ Electronic Health Records Maturity And Excess Readmission Ratio, Cynthia Saint-Ulysse Jan 2021

The Relationship Between Hospitals’ Electronic Health Records Maturity And Excess Readmission Ratio, Cynthia Saint-Ulysse

Walden Dissertations and Doctoral Studies

Since the Health Information Technology for Economic and Clinical Health Act was enacted in 2009, a majority of U.S. hospitals have adopted electronic health records (EHR) to improve quality of care. However, variations exist in the technology's capability and maturity, making it difficult for researchers to analyze the full impact. The purpose of this quantitative study was to explore the relationship between hospitals' EHR maturity and the quality measure of excess readmissions, as well as the relationship between hospital characteristics, specifically, hospital location and the number of licensed beds in Medicare hospitals (N = 1,006). Both the chi-square statistical test …


Exploring Quality Management Strategies To Mitigate Culture Shock Among Cochlear Implant Users, Victor Mulume' Ambila Jan 2021

Exploring Quality Management Strategies To Mitigate Culture Shock Among Cochlear Implant Users, Victor Mulume' Ambila

Walden Dissertations and Doctoral Studies

AbstractAfter the cochlear implant (CI) activation period and therapy, adult CI users who travel overseas encounter culture shock factors that paralyze their coping capability, which need normalization through management strategies during the post-cochlear-implantation process (PCIP). In the structure of the conceptual framework, a plan is presented for addressing the management strategy. An integrated system of product-process-service-care portrays the product as an active implant within an individual bearer fostering a CI user’s physical, physiological, and psychological traits. The problematic aspects alter the end users’ coping capability in an unfamiliar host environment abroad. The qualitative research approach used was a single case …


Experiences Of Spanish-Speaking Patients Using Interpreter Services With Their Physicians, Rafael Raul Caycho Jan 2021

Experiences Of Spanish-Speaking Patients Using Interpreter Services With Their Physicians, Rafael Raul Caycho

Walden Dissertations and Doctoral Studies

In the United States, many patients cannot speak English well enough to communicate with their medical providers. Many of these patients use professional interpreter services offered by their medical organizations to help with communication, which can lead to miscommunication due to the translation process between patients, interpreters, and physicians, and to incorrect diagnosis and poor health outcomes for the patient. The purpose of this study was to explore the experiences of Spanish-speaking patients who used interpreter services with their physicians. The transmission model was the theoretical framework used to explore the experiences and outcomes for the participants. In this study, …


Psychosocial Support During Pregnancy: A Narrative Inquiry Of Low-Income Unmarried Women In Iowa, Summer D. Parrott Jan 2021

Psychosocial Support During Pregnancy: A Narrative Inquiry Of Low-Income Unmarried Women In Iowa, Summer D. Parrott

Walden Dissertations and Doctoral Studies

Pregnant women who experience high levels of stress and who lack support are at higher risk for negative birth outcomes for themselves and their offspring including preterm labor, low birthweights, and a myriad of other short- and long-term health and behavioral consequences across the lifespan of the child. Unmarried or socioeconomically disadvantaged women lack the most common resources used to protect against the negative effects of stress during pregnancy. A research gap existed regarding the specific types of psychosocial support perceived by low-income unmarried women to be most beneficial at buffering their perceived prenatal stress. The ecological model and the …


Alzheimer’S Dementia Care: Impact On Family Caregivers, Rose Anne Pierre Jan 2021

Alzheimer’S Dementia Care: Impact On Family Caregivers, Rose Anne Pierre

Walden Dissertations and Doctoral Studies

Patients with dementia of the Alzheimer’s type increasingly become dependent on caregivers. Researchers have demonstrated that these caregivers experience serious burdens during their caregiving experiences. They face emotional, physical, and financial burdens. The objective of this paper was to discuss the burden and strains of Alzheimer’s disease on the older caregivers in the United States. The stress process model and the quality of life were used in this study. The study used a descriptive and analytical approach to analyze 2015 secondary data retrieved in 2018 from the National Alliance for Caregiving. The adult Alzheimer’s dementia caregivers were selected. A multiple …


Teacher Perception On Integrating School Psychology In The Developing Nation Of Grenada, Carla Erica Maria St. Louis Jan 2021

Teacher Perception On Integrating School Psychology In The Developing Nation Of Grenada, Carla Erica Maria St. Louis

Walden Dissertations and Doctoral Studies

AbstractInternationally, formalized school psychology and related services strive to address the academic and mental health of students in schools. In developing nations, teachers are the primary professionals to address students’ needs in schools. Little research has focused on teachers’ perceptions of students’ needs, available services’ quality, and how formalized structures with qualified certified professionals can further address students’ needs. Bronfenbrenner’s ecological systems and Nastasi’s participatory culture-specific intervention model are the theoretical underpinnings of this qualitative study and focus group interviews were used to investigate special education needs (SEN) teachers’ perceptions. Data were collected using open ended questions and probes with …


Territoriality As A Factor In Nursing Incivility, Carolyn Wright Jan 2021

Territoriality As A Factor In Nursing Incivility, Carolyn Wright

Walden Dissertations and Doctoral Studies

AbstractIncivility and hazing in health care results in unsafe environments, not only for the nurse but also for the client, facility, and other health professionals. The project site, a privately owned medical clinic, has a high employee turnover rate with exit interviews indicating bullying and incivility from long-term nursing staff toward new employees as critical reasons for employee resignation. The literature offers minimal information regarding territoriality, a concept associated with aggressive (i.e., alpha) behaviors in animals and humans and incivility in nursing. The purpose of the project was to identify whether territoriality was a behavioral factor that may have contributed …