Medicine and Health Sciences Commons^™

Impact Of Resilience On Quality Of Life In Spinal Cord Injured Clients, Crystal D. Glover

Walden Dissertations and Doctoral Studies

Abstract Impact of Resilience on Quality of Life in Spinal Cord Injured Clients by Crystal D. Glover

MSM, Troy University, 2006BSN, University of North Carolina at Greensboro, 1995

Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health

Walden University August 2023

Promotion To Fire Officer: Ems Is An Essential Component Of Promotional Testing, Brenda Kay Farlow

Walden Dissertations and Doctoral Studies

AbstractFor the past 25 years, the number of fire department responses to structure fires nationally has gone down. Structure fires now reflect less than ten percent of the responses of the fire service. In the same period, emergency medical services (EMS) have become the overwhelming activity of most fire departments. The problem is the promotional process focuses on firefighting knowledge and skills while ignoring the absolute need for EMS competencies, in some capacity, for a supervisory position. The lack of change in the promotional process is related to the organizational culture of the individual fire departments and the collective difficulty …

Structural Empowerment Of Nurse Leaders In New York State During The Covid-19 Pandemic, Tracey Braithwaite

Walden Dissertations and Doctoral Studies

The current phenomenological study explored the lived experience of Acting Chief Nursing Officers, Chief Nursing Officers, Chief Nursing Executives (henceforth CNOs) at hospitals in New York State who were charged with responding to executive orders while maintaining quality of patient care despite staffing constraints, inadequate supplies, or lack of additional support for the duties associated with their role. Their experience of structural empowerment in relation to the COVID-19 pandemic was also studied. The theoretical framework was Kanter’s theory of structural empowerment that addressed organizational behavior in the context of employee empowerment. The research question addressed how the CNOs perceived their …

Retention Of Foster Parents For At-Risk Youth In Tennessee, Marvin Amos

Walden Dissertations and Doctoral Studies

Federal legislation with the Family First Prevention Service Act (FFPSA) of 2017 required Tennessee to increase foster parent retention strategies. Tennessee does not have enough available foster homes for adolescents. The purpose of this generic qualitative study was to explore foster parent retention in Tennessee and to inform policymakers on how to adapt policy to increase the retention. The theoretical foundation for this study was based on the policy feedback theory, to identify the policy scope in Tennessee, and the two-factor theory, to guide the data analysis in the context of employee satisfaction and retention measures. Purposive sampling techniques were …

Examining The U.S. Disaster Management Program: A Case Study Of The U.S. Virgin Islands Hurricanes Irma And Maria Evacuation, Victoria F. Vachon

Walden Dissertations and Doctoral Studies

AbstractWhether from natural or human causes, every global community is at risk for overwhelming, destabilizing incidents. Hurricanes Irma and Maria devastated the U.S. Virgin Islands in late August and early September 2017, necessitating the urgent evacuation of hemodialysis patients over 1000 miles to the U.S. mainland. Because the damage and response to the U.S. territory were unprecedented, the public health implications of the government’s strategies on the evacuated population subset were unexplored. However, available information suggested that some evacuees sustained avoidable harm while in the protracted care and custody of the government. This qualitative case study, conceptually framed by Bronfenbrenner’s …

Promotion To Fire Officer: Ems Is An Essential Component Of Promotional Testing, Brenda Kay Farlow

Walden Dissertations and Doctoral Studies

For the past 25 years, the number of fire department responses to structure fires nationally has gone down. Structure fires now reflect less than ten percent of the responses of the fire service. In the same period, emergency medical services (EMS) have become the overwhelming activity of most fire departments. The problem is the promotional process focuses on firefighting knowledge and skills while ignoring the absolute need for EMS competencies, in some capacity, for a supervisory position. The lack of change in the promotional process is related to the organizational culture of the individual fire departments and the collective difficulty …

Exploring Jury Nullification: Its Political History, Current, And Potential Impact On Policy, David Harold Penny

Walden Dissertations and Doctoral Studies

Jury nullification (JN) is when a jury knows a defendant is legally guilty, but states they are not guilty, believing that their verdict better serves justice in that case. The problem is the violation of the Constitution’s equal protection clause for all citizens, caused by the intentional omission in most judges’ instructions to juries of JN. The purpose of the study was to fill the gap in the literature on jury behavior and address the problem of JN. The study framework is chaos theory as applied by Horowitz to jury behavior. It describes judges and lawmakers mistrust of juries associated …

The Effect Of Community Health Linkages On Suicide Rates In Veterans, Erica Anderson

Walden Dissertations and Doctoral Studies

Suicide risk is a public health issue. It is a complex and poorly understood mental health and societal threat. This study examined veteran suicide rates and their relationship to family and social support, as measured by the social association rate, mental health funding per capita, and the lethality of the method rate. The interpersonal-psychological theory of suicide and the social-ecological model are the theoretical frameworks that guided the study. Both theories emphasize the complexity surrounding suicide at the state level as it is related to the individual, social, environmental, and political landscape related to veteran suicide. The quantitative bivariate correlation …

Sociodemographic Predictors Of Veterans’ Health-Related Quality Of Life, Tamala Jones Choice

Walden Dissertations and Doctoral Studies

Health-related quality of life (HRQoL) is a theoretical concept that intertwines physical, mental, emotional, and social functioning, with a focus on the impact that health status has on quality of life. Although sociodemographic factors are associated with lower HRQoL, how these factors influence HRQoL in military veterans is less understood. The study’s purpose was to examine the relationships between sociodemographic characteristics (gender, military pay grade, military branch, and geographic location) and perceived HRQoL measured by the SF-8 survey among veterans living in a metropolitan community in the Mid-Atlantic region of the United States. A cross-sectional recruitment study design yielded 90 …

False Advertising And Young Girls’ Self Esteem, Caitlin Bohannon

Walden Dissertations and Doctoral Studies

It is becoming impossible to recognize the level of photoshop on advertisements. However, little is known how continuous exposure to such images can negatively impact the short- and long-term psyche of young girls aged 6 to 14 years old. The study’s theoretical framework was Benet’s polarities of democracy, emphasizing freedom and authority and human rights and communal obligations. The research question focused on the negative impacts false advertising has on young girls and what public policies could assist in mitigating these short- and long-term impacts. A general qualitative design, with semistructured interviews of seven adult participants with relevant insight on …

Self-Care And Psychosocial Factors That Predict Sickle Cell Disease-Related Outcomes Among African Americans In The Usa, Datonye Agina-Obu

Walden Dissertations and Doctoral Studies

Existing beliefs and conceptions regarding sickle cell disease (SCD) have had a significant impact on the appropriate management of the condition, including self-care and psychosocial factors, particularly among African Americans. The aim of this study was to examine the influence of self-care and psychosocial factors on SCD-related outcomes among African Americans in the United States. The study was grounded in the self-care management theory and employed a cross-sectional, quantitative design. Regression analyses were conducted to explore the associations between self-care and psychosocial factors and SCD-related outcomes sample of 180 individuals. The results indicated three factors showed significant relationships for sickle …

Exploring Jury Nullification: Its Political History, Current, And Potential Impact On Policy, David Harold Penny

Walden Dissertations and Doctoral Studies

Jury nullification (JN) is when a jury knows a defendant is legally guilty, but states they are not guilty, believing that their verdict better serves justice in that case. The problem is the violation of the Constitution’s equal protection clause for all citizens, caused by the intentional omission in most judges’ instructions to juries of JN. The purpose of the study was to fill the gap in the literature on jury behavior and address the problem of JN. The study framework is chaos theory as applied by Horowitz to jury behavior. It describes judges and lawmakers mistrust of juries associated …

False Advertising And Young Girls’ Self Esteem, Caitlin Bohannon

Walden Dissertations and Doctoral Studies

It is becoming impossible to recognize the level of photoshop on advertisements. However, little is known how continuous exposure to such images can negatively impact the short- and long-term psyche of young girls aged 6 to 14 years old. The study’s theoretical framework was Benet’s polarities of democracy, emphasizing freedom and authority and human rights and communal obligations. The research question focused on the negative impacts false advertising has on young girls and what public policies could assist in mitigating these short- and long-term impacts. A general qualitative design, with semistructured interviews of seven adult participants with relevant insight on …

Lived Experiences Of Nurse Leaders, Catherine Jeannette Mohammed

Walden Dissertations and Doctoral Studies

AbstractThe National Academy of Medicine (NAM) has called for more leadership, more accountability, and increased education and training of health care leaders. The NAM has demanded that nurses participate in health care policy making, increase their knowledge of research and data collection, advise leaders across the business world, train and educate seamlessly, and practice to the full extent of their licensure. The purpose of this qualitative phenomenological study was to explore the lived experiences of 12 influential nurse leaders from the state of Arizona. Transformational leadership theory provided the framework for the study. Semi-structured interview data were transcribed, coded, and …

Stakeholder Success Measures Of A Safe Parking Pilot Program For Individuals Sheltering In Vehicles, Obiageri Constance Aginam

Walden Dissertations and Doctoral Studies

The Safe Parking Pilot Program was a crisis response to the recent increase in vehicular homelessness in a Northern Californian city. The city identified issues of unsheltered individuals due to the increase housing cost and unaffordable housing. The city partnered with faith-based organizations to provide safe locations for individuals sheltering in vehicles. The current research aimed to evaluate benchmarks and metrics to measure the safe parking pilot program. The purpose of the study was to help the city leaders and the key stakeholders identify measures of success and how they might improve the program in one Northern Californian city. Semistructured …

Mental Health Professionals And Family Burden: Ways To Improve Training And Treatment, Johnnie Lee Jenkins, Iii

Walden Dissertations and Doctoral Studies

During deinstitutionalization, schizophrenia treatment shifted from state facilities to communities and families. This change stressed families. This study investigated mental health professionals' (MHPs) knowledge and training about this stress also called family burden (FB). The study had three research questions. These addressed MHPs’ view of FB, what barriers exist in treating FB, can multiple viewpoints define FB, and if these views influence MHPs to reduce it. This grounded theory study used 22 MHPs in seven focus groups (FGs). The participant recruitment process included email, list serves, phone calls, and one state conference. The participants were MHPs licensed for 3 years …

Exploring African American Single Mothers’ Experiences With Child Welfare System, Paul J. Melbourne

Walden Dissertations and Doctoral Studies

African Americans are overrepresented in the child welfare system in New York City (NYC). They face racial and ethnic bias, complex procedures, and policies that govern child welfare. The main research question for this study explored the experiences of African American single mothers with the child welfare system. This qualitative study was guided by policy feedback theory; data were gathered from 10 African American single mothers who have had experiences with child welfare investigation within the past 10 years. Participants were interviewed using semistructured questions designed to capture their experiences with the child welfare system. The data were coded for …

Appraisal Of Institutional Antimicrobial Stewardship In Selected Public Health Facilities In Nigeria, Joshua Olusegun Obasanya

Walden Dissertations and Doctoral Studies

The misuse of antimicrobials (AM) constitutes a huge problem in developing countries, including Nigeria, posing severe public health threats to the populace’s health. Misuse contributes to the high consumption of AM, driving the emergence and spread of antimicrobial resistance (AMR). Establishing functional antimicrobial stewardship (AMS) programs at the health facility levels is recognized as an effective and efficient strategies to tackle AMR. Literature is replete with evidence of poor prescription practices, but few studies assessing the factors contributing to inappropriate use of AM in Nigeria exist. The purpose of this study was to improve the understanding of AMS practice at …

Rising Cost Of Medicare And Its Effect On Recipients 65 And Older, Williesa Toomer

Walden Dissertations and Doctoral Studies

The rising cost of Medicare is a growing concern for recipients. Beneficiaries are often forced to implement a host of strategies to meet rising out-of-pocket expenses. This qualitative study was conducted to address a research gap in methods used by senior citizens to manage rising Medicare coverage costs. Garmezy’s resilience theory was used to contextualize the rising costs of Medicare premiums and copays and strategies used to manage healthcare needs. The purposive sample of 12 socioeconomically diverse respondents included eight women and four men ranging in age between 65 and 77, for an average age of 70.2 years. Participants completed …

Legislative Efforts And Community Change To Combat Female Genital Mutilation In Egypt, Maryam Berkshire

Walden Dissertations and Doctoral Studies

Female genital mutilation is recognized as a violation of human rights as it violates the bodily rights of young girls by cutting part of their bodies without their consent and leaves long term psychological, physical and sexual harm to women who were exposed to the practice. The World Health Organization estimates that 130 million girls and women are subjected to Female Genital Mutilation/Cutting (FGM/C) in African and Middle Eastern Countries. According to a UNICEF 2020 report, Egypt will not meet the SDG goal of eradicating FGM as the decrease in the practice is too slow despite the policy and community …

Stakeholder Success Measures Of A Safe Parking Pilot Program For Individuals Sheltering In Vehicles, Obiageri Constance Aginam

Walden Dissertations and Doctoral Studies

The Safe Parking Pilot Program was a crisis response to the recent increase in vehicular homelessness in a Northern Californian city. The city identified issues of unsheltered individuals due to the increase housing cost and unaffordable housing. The city partnered with faith-based organizations to provide safe locations for individuals sheltering in vehicles. The current research aimed to evaluate benchmarks and metrics to measure the safe parking pilot program. The purpose of the study was to help the city leaders and the key stakeholders identify measures of success and how they might improve the program in one Northern Californian city. Semistructured …

Factors That Predict Prescription Opioid Misuse By Type Of Healthcare Insurance Coverage, Keon Green

Walden Dissertations and Doctoral Studies

The opioid epidemic remains one of the leading causes of unintended deaths in the United States and is still one of the focal points of the public health field. Previous research has increased awareness of the opioid crisis and has focused on sociodemographic factors that may cause or predict prescription opioid misuse. The purpose of this study was to investigate sociodemographic factors that may predict prescription opioid misuse while controlling for healthcare insurance. The theoretical foundation for this secondary data analysis project was the socioecological model using the 2019 National Survey on Drug Use and Health. The population was 56,136 …

Exploring Infant Massage As Standard Nonpharmacological Treatment For Neonatal Opioid Withdrawal Syndrome, Christine Ann Perez

Walden Dissertations and Doctoral Studies

The opioid epidemic in the United States has increased opioid use in women of reproductive age, leading to in utero exposure causing withdrawal symptoms in newborns known as neonatal opioid withdrawal syndrome (NOWS). State perinatal quality collaboratives (SPQCs) have been used in hospitals with quality initiatives (QIs) to improve standardization for NOWS; however, there remains a gap in knowledge in interventions to support the mother-infant dyad such as infant massage. This general qualitative research study explored the process and experiences of implementing infant massage as a standard practice for NOWS to inform national, state, and local policy. Participants in the …

Chronic Obstructive Pulmonary Disease 30-Day Readmission Rates In California, Illinois, And New York, Theresa Teverbaugh

Walden Dissertations and Doctoral Studies

AbstractThe Centers for Medicare and Medicaid Services (CMS) have implemented financial penalties to reduce hospital readmissions for various conditions, including chronic obstructive pulmonary disease (COPD). As a result, hospital administrators explore ways to prevent financial penalties for excessive COPD 30-day hospital readmissions. The purpose of this quantitative study was to determine if there was a correlation between hospital Medicare reimbursement, quality-of-care measures related to patient satisfaction, and 30-day readmissions rates for COPD patients in California, Illinois, and New York. The quality-of-care measures included communication with nurses, communication with doctors, the hospital staff's responsiveness, and medicine communication. The secondary data were …

Perceptions Of Implicit Bias In New York City Healthcare System During Covid-19, Kiesha Jackson

Walden Dissertations and Doctoral Studies

Implicit bias has been identified as a significant problem that hinders effective healthcare delivery. The purpose of this qualitative exploratory phenomenological study was to examine whether implicit bias influenced healthcare services for African Americans with comorbidities aged 30 and over living in New York City during the COVID-19 pandemic. Current studies show healthcare disparities, revealing barriers with healthcare delivery; however, they do not disclose a patient’s lived experience qualitatively, which constituted a gap in the literature. The frameworks of the behavioral model of health services use, and social construction and policy design guided this study. Research questions addressed (a) whether …

Medical Brain Drain And Its Effect On The Nigerian Healthcare Sector, Oluwakemi Osigbesan

Walden Dissertations and Doctoral Studies

Nigeria suffers from a huge brain drain issue across different sectors, particularly in the healthcare sector. The WHO assessed that there is a current shortage of 2.8 million physicians in the world A heuristic phenomenological method was used in this study to explore the lived experiences of 12 Nigerian healthcare practitioners that migrated to the United States. The push-pull theory served as the theoretical framework that grounded this study. The central research questions for this study focused primarily on the reasons healthcare practitioners are leaving Nigeria and what the impact of those decisions have on the Nigerian healthcare sector. Qualitative …

Post-Conflict Mental Health Policy And Substance Use Among Liberian Adults, Ekua Amonoo-Lartson

Walden Dissertations and Doctoral Studies

AbstractThe objective of post-conflict countries after an extended period of war and trauma is to maintain peace and stability. However, the physical and psychological effects of substance use to cope with the devastation of war remains long after the crisis has ended. The purpose of this qualitative phenomenological study was to examine substance use among Liberian working-age adults, including their substance use habits, experiences with substance use, and access to mental health rehabilitative treatment. The access to medical care theoretical framework was used to guide the study. Data were collected from face-to-face semistructured interviews with 15 individuals regarding their experiences …

Retrospective And Forecasting Analysis Of Increased Long Term Care Demand In Niagara, Breanne Alissa Hines

Walden Dissertations and Doctoral Studies

A problem exists within the Canadian healthcare system as many patients experience longer lengths of stay (LOS) in acute care (AC) and complex care (CC) beds within hospitals because of a lack of long term care (LTC) facilities. The purpose of this study was to evaluate the extra days patients wait for placement and assess the benefits of increasing the number of LTC beds. The theoretical framework used was the four-level model of the health care system. Research questions involved 2017-2019 data for the number of LTC beds required to eliminate waits and evaluate beds needed in the future. This …

The Impact Of Community Churches And Barbershops On Preventive Care Utilization Among African American Men, Quiante Chappell Hager

Walden Dissertations and Doctoral Studies

Preventive health care screening plays an essential role in reducing chronic diseases and mortality rates; yet, even as health care access has increased, African American men’s utilization of preventive screenings remains low in rural areas. The purpose of this qualitative case study was to investigate why African American men are not utilizing preventive care services and ascertaining the impact that social determinants may have on their utilization of these services. The theoretical framework of this research study comprised the social-ecological modal and health belief model to investigate the barriers to preventive care utilization in the African American community. Twelve African …

Challenges To Successful Health Care Transition Among Hiv Positive Youth With Perinatal Acquisition, Tyler Andrew Termeer

Walden Dissertations and Doctoral Studies

To ensure stability in the continuum of health care for HIV-positive youth with perinatal acquisition, there is a need for a successful transition from pediatric to adult primary care. However, there are a growing number of perinatally infected HIV-positive young persons remaining in pediatric care beyond the age of 21. Using Mohr’s program theory and a phenomenological approach, the lived experiences of Ohio HIV clinicians were examined to determine why many perinatally infected HIV-positive youths are remaining in pediatric care beyond the age of 21. Audio recorded video interviews via SKYPE were conducted with 12 participants, transcribed, underwent thematic analysis, …