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Walden Dissertations and Doctoral Studies

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Evaluating U.S. Household Telemedicine Use In Primary Care Settings, Robert Osobase Jan 2023

Evaluating U.S. Household Telemedicine Use In Primary Care Settings, Robert Osobase

Walden Dissertations and Doctoral Studies

AbstractThe COVID-19 pandemic's arrival in the United States restricted access and use of telemedicine in primary care providers (PCPs) settings. Addressing this issue is crucial since telemedicine is a confirmed method of encouraging patients and PCPs to promote quality health care. This quantitative study investigated the association between age, gender, and race, and PCPs offering telemedicine and U.S. household adults using telemedicine during COVID-19 pandemic in 2021. The Donabedian framework, which considers aspects of an organization's structure, process, and outcome, served as the study's foundation, incorporating age, race, and gender as independent variables, and PCPs and US adults as dependent …

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Language Barrier: An Unmet Challenge For Low Screening Of Colorectal Cancer Among Hispanic Americans In Texas, Moses Owusu Jan 2023

Language Barrier: An Unmet Challenge For Low Screening Of Colorectal Cancer Among Hispanic Americans In Texas, Moses Owusu

Walden Dissertations and Doctoral Studies

AbstractHispanic population represents the fastest growing minority group in the United States, and only California surpasses Texas with Hispanic residents in the United States. Overall, non-Hispanic Whites have higher rates of colorectal cancer (CRC) incidence than Hispanics; however, Hispanic Americans have lower survival rates than non-Hispanic Whites. Using cross-sectional analysis, CRC screening modalities were examined to assess disparities among White only, non-Hispanic, Black only, non-Hispanic, and Hispanic populations in Texas to evaluate the impact of limited English proficiency (LEP) on CRC screening among Hispanic Americans residents. The age of study participants ranged from 50 to 79 (mean age = 65.8 …

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Family Perceptions Of Mental Health Service Use Among Mexican Americans, Vickie Gayle Nethercott Jan 2023

Family Perceptions Of Mental Health Service Use Among Mexican Americans, Vickie Gayle Nethercott

Walden Dissertations and Doctoral Studies

AbstractMexican immigrants are less likely to use psychiatric services compared to people from other race or ethnic groups in the United States, yet little is known about the reasons why the Mexican American population are less likely to seek mental health services. A qualitative descriptive study, guided by Leininger's culture care diversity and universality care theory, was used to explore the perceptions of mental health service use and barriers to psychiatric services for Mexican American immigrants living in the United States. After institutional review board approval was obtained, flyers were placed in five churches in a northwestern U.S state where …

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Nurse Education Regarding Hypertension And Use Of A Follow-Up Call Protocol In Primary Care, Edwin Omar Rivera-Figueroa Jan 2023

Nurse Education Regarding Hypertension And Use Of A Follow-Up Call Protocol In Primary Care, Edwin Omar Rivera-Figueroa

Walden Dissertations and Doctoral Studies

AbstractMany patients whose primary or secondary chronic condition is hypertension present to their first follow-up appointment in a primary care facility in the north of Puerto Rico with uncontrolled high blood pressure. Nurses’ knowledge of hypertension is vital to addressing a gap in practice for this patient population and patient quality of life and the prevention of cardiovascular diseases. The practice-focused question guiding this project focused on a nurse educational session for increasing hypertension management knowledge as well as a follow-up phone call protocol that aimed to improve patient care. The theoretical framework guiding this project was Pender’s health promotion …

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Academic Performance And E-Cigarette Use Among Teenagers, Jeremy Tan Rondael Jan 2023

Academic Performance And E-Cigarette Use Among Teenagers, Jeremy Tan Rondael

Walden Dissertations and Doctoral Studies

Early e-cigarette use by youth has the capacity to create an early addiction to nicotine, increasing the risk of life-long dependency and the possible development of multiple cardiovascular and pulmonary diseases. Reinforced by the socioecological model, the purpose of this study was to determine if academic performance is associated with e-cigarette use among teenagers and young people and if the presence of adverse childhood events (e.g., cyberbullying in school and/or the presence of homelessness) mediated this association. This study included all respondents (N = 1,401) from the state of Nevada who answered the 2019 National Youth Risk Behavior Survey. Binary …

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Traditional Healing And Biomedicine Use In Urban American Indians Living With Diabetes, Elin Elise Kambuga Jan 2023

Traditional Healing And Biomedicine Use In Urban American Indians Living With Diabetes, Elin Elise Kambuga

Walden Dissertations and Doctoral Studies

The purpose of this interpretative qualitative study was to describe influences that affect the use of traditional healing and biomedical health services for type 2 diabetes to help health educators develop more culturally competent diabetes education programs for urban American Indian/Alaska Native (AI/AN) communities in the United States. The theoretical framework used for this study was the social ecological model (SEM). Using the SEM, the research questions were crafted to explore experiences of participants connected to personal, interpersonal, community, institutional, policy, and educational factors that influenced the use of traditional healing and biomedical health services. Urban AI/AN adults living in …

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Comparisons Of Impostor Phenomenon Among Nursing Faculty Across Teaching Levels, Teaching Experience, And Gender, Deborah E. Horvath Jan 2023

Comparisons Of Impostor Phenomenon Among Nursing Faculty Across Teaching Levels, Teaching Experience, And Gender, Deborah E. Horvath

Walden Dissertations and Doctoral Studies

Nursing faculty must be effective educators, active nurse researchers, and practicing nurse experts. Feelings of impostor phenomenon (IP), defined as emotions of fraudulence, can lead to faculty deficiencies both as educators and scholars. The purpose of this three-manuscript dissertation, guided by Weiner’s attribution theory, was to determine differences in IP by teaching level, teaching experience, and gender among nursing faculty. A two-tailed t-test was used to analyze data collected from 164 participants who completed the Clance impostor phenomenon scale. Data revealed instructors teaching at the undergraduate level had more feelings of IP than those teaching at the postgraduate and graduate …

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Cross-Functional Team Collaboration For Enhancing Timely And Effective Emergency Department Care, Osaigbovo Osemwegie Jan 2023

Cross-Functional Team Collaboration For Enhancing Timely And Effective Emergency Department Care, Osaigbovo Osemwegie

Walden Dissertations and Doctoral Studies

AbstractMany US hospitals report overcrowding in the emergency department (ED) with increased ambulance diversion. Operating at overcapacity risks staff members' ability to provide timely and effective emergency care to patients, exposing them to poor health outcomes. The purpose of this quantitative study was to evaluate whether a correlation exists between cross-functional team collaboration and timely and effective ED care for patients who left 548 national hospital EDs before being seen between 2020 and 2021. The study's independent variable was cross-functional team collaboration, and the dependent variables were Centers for Medicare and Medicaid Services (CMS) Quality Measure scores: left before being …

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Strategies To Improve Hospital Patient Satisfaction To Increase Performance-Based Reimbursements, Celso G. Silla Iii Jan 2023

Strategies To Improve Hospital Patient Satisfaction To Increase Performance-Based Reimbursements, Celso G. Silla Iii

Walden Dissertations and Doctoral Studies

Officials from the Centers for Medicare and Medicaid Services (CMS) created the hospital valued-based purchasing (VBP) program focused on controlling cost, inefficiencies, and quality-of-care. Hospital leaders are incentivized or penalized based on meeting quality outcomes and risk millions of dollars in reimbursement if they do not meet the quality-of-care standards specified in the CMS hospital VBP program. Grounded in the transformational leadership theory, the purpose of this qualitative multiple case study was to explore strategies hospital leaders used to improve patient satisfaction to increase VBP performance-based reimbursements. Participants included eight hospital leaders from seven hospitals in California who successfully implemented …

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Maternal Folate Status And Risk Factors For Autism Spectrum Disorders, Michael M. Haniff Jan 2023

Maternal Folate Status And Risk Factors For Autism Spectrum Disorders, Michael M. Haniff

Walden Dissertations and Doctoral Studies

Autism spectrum disorders (ASD) are thought to be influenced by environmental, genetic, and maternal factors, including potential links to periconceptional folic acid. This quantitative case-control study, guided by the life course theory, explored the association of maternal risk factors (age, race, education, income, folate status, gestational diabetes, gestational hypertension, and MTHFR mutation) on the precipitation of ASD in offspring. The sample comprised 96 mothers of children with ASD and 143 mothers of children without ASD. Logistic regression analysis indicated no significant association between maternal folate status and ASD (OR = 1.00, 95% CI [1.000, 0.001], p = .755). Mothers with …

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Parents’ Perceptions Of The Traits, Characteristics, And Circumstances Of Modern-Day Mass Shooters, Matt Talbot Jan 2023

Parents’ Perceptions Of The Traits, Characteristics, And Circumstances Of Modern-Day Mass Shooters, Matt Talbot

Walden Dissertations and Doctoral Studies

There is little research on parents’ perceptions about the traits, characteristics, and circumstances ascribed to mass shooters and the sources of information shaping these perceptions. Understanding parents’ beliefs about mass shooters and mass shootings can serve to inform approaches to training and education and recommendations for media reporting on such events. Evidence-based knowledge helps parents become more equipped to serve as early interventionists for those who may be moving along a pathway of violence. Application of Gerbner’s cultivation theory frames the process by which media sources shape perceptions. In this phenomenological qualitative study, semi structured interviews were conducted with 19 …

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Religious Parents’ Awareness Of And Attitudes Toward Their Adolescent Children's Utilization Of Sexual Health Services, Ashley Thompson Jan 2023

Religious Parents’ Awareness Of And Attitudes Toward Their Adolescent Children's Utilization Of Sexual Health Services, Ashley Thompson

Walden Dissertations and Doctoral Studies

Parents are a key influence on their adolescent children's sexual health care decisions. Few researchers have considered the impact of religious environments and parental expectations on adolescents’ use of sexual health services, and research on religious parents’ awareness of adolescents’ use of sexual health services in Christian environments is scarce. The purpose of this basic qualitative study was to explore religious parents' awareness of and attitudes toward their adolescents’ use of sexual health services. The social ecological theory provided the conceptual lens for this study. Eight Christian parents participated in in-depth virtual interviews to discuss their encouragement or discouragement of …

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Effects Of Social Determinants On Access To Care Among Patients With Diabetes In Florida, Nekeisha Latoya Walker Jan 2023

Effects Of Social Determinants On Access To Care Among Patients With Diabetes In Florida, Nekeisha Latoya Walker

Walden Dissertations and Doctoral Studies

Diabetes imposes a major burden on society, especially in the state of Florida, in the form of increased medical costs, lost productivity, early mortality, and intangible costs in the form of diminished quality of life. Access to diabetic care affects health administration in Florida by impacting the overall cost of treating the condition. Limited access to care can lead to an increased risk of complications resulting in a higher cost of treatment. The purpose of this quantitative study was to determine whether access to care dependent variables (access to doctors and length of time since last routine checkup) were associated …

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Influence Of Behavioral Leadership Strategies On Employee Engagement In Hospital Departments, Callie Selner Jan 2023

Influence Of Behavioral Leadership Strategies On Employee Engagement In Hospital Departments, Callie Selner

Walden Dissertations and Doctoral Studies

Lack of employee engagement as a result of deficient behavioral leadership strategies has the potential for adverse business outcomes on productivity, business mission, and strategy. As a result of this qualitative single case study, hospital department managers who apply behavioral leadership strategies are more likely to promote an environment conducive to employee engagement. Grounded in the employee engagement theory, the purpose of this qualitative single case study was to explore behavioral leadership strategies hospital department managers use to promote an environment conducive to employee engagement. The participants were five hospital department managers who had been successful with employee engagement. Data …

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The Court Experiences Of Survivors Of Interpersonal Violence, Angela Cartwright Jan 2023

The Court Experiences Of Survivors Of Interpersonal Violence, Angela Cartwright

Walden Dissertations and Doctoral Studies

AbstractInterpersonal violence (IPV) is a complicated public problem that requires collaborative and coordinated strategies in order to address this issue effectively and appropriately. Although the court system has a significant role in their response, IPV is a complex issue for the justice system to address alone. Court system experiences may significantly impact survivors’ outcomes overall health and well-being. There are a limited number of studies showing that survivor experiences in the court have a significant impact on victim outcomes. The purpose of this study was to describe the lived experiences of female IPV survivors who have encountered IPV, highlighting their …

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Relationship Between Homelessness, Substance Use, Employment, Living On A Reservation And Tuberculosis Among Northern Plains Native Americans, Darla Mccloskey Jan 2023

Relationship Between Homelessness, Substance Use, Employment, Living On A Reservation And Tuberculosis Among Northern Plains Native Americans, Darla Mccloskey

Walden Dissertations and Doctoral Studies

Native Americans in the Northern Plains have a long history of tuberculosis (TB) infections. There is limited research on the causes of latent TB infections (LTBI) and TB in this population. The purpose of this quantitative study was to assess the relationship between latent TB and factors of homelessness, substance use, employment, living on a reservation, and active or latent TB among this population using the eco-social theory as the theoretical framework. Data from 146 TB cases of Native Americans living in the Northern Plains and diagnosed with TB from 1999 to 2019 were analyzed using chi-square tests that showed …

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The Relationship Between Chlamydia, Gonorrhea, Syphilis And Race, Gender, And Age, Johnny James Mcgrew Jan 2023

The Relationship Between Chlamydia, Gonorrhea, Syphilis And Race, Gender, And Age, Johnny James Mcgrew

Walden Dissertations and Doctoral Studies

The purpose of this quantitative correlational design using secondary data from Colorado Department of Public Health and Environment was to examine the relationship between different types of sexually transmitted infections (STIs), specifically, chlamydia, gonorrhea, and syphilis, and race, gender, and age in the United States. This study is significant because it could assist medical personnel to focus on more personally-based STI treatments. This study could also lead to a call for more research regarding sexual health programs across the nation, individuals’ willingness to share personal information regarding STIs, and how sexual health programs could increase testing for STIs. The study …

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Lived Experiences Of Copd Patients With Exertional Hypoxemia Prescribed Supplemental Oxygen, Sarah Ann Evans Jan 2023

Lived Experiences Of Copd Patients With Exertional Hypoxemia Prescribed Supplemental Oxygen, Sarah Ann Evans

Walden Dissertations and Doctoral Studies

Patients with exertional hypoxemia are often prescribed supplemental oxygen therapy to alleviate their symptoms and maintain adequate arterial oxygen saturation; however, little is known about how chronic obstructive pulmonary disease (COPD) patients with exertional hypoxemia experience the addition of supplemental oxygen on their lives. The purpose of this descriptive phenomenological study guided by Roger’s science of unitary human beings was to explore the lived experiences of COPD patients with exertional hypoxemia and who require supplemental oxygen. Purposive sampling was used to recruit participants using a query from the electronic medical records to identify patients prescribed supplemental oxygen for exertional, not …

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Pancreatic Cancer: Quantitative Study Investigating The Regional Risk Factors In North Carolina, Holly Marie Myers Jan 2023

Pancreatic Cancer: Quantitative Study Investigating The Regional Risk Factors In North Carolina, Holly Marie Myers

Walden Dissertations and Doctoral Studies

Pancreatic cancer is the fourth-leading cause of cancer-related deaths in the United States, killing more than 90% of individuals diagnosed within 5 years. Due to the lack of signs and symptoms, 82% of all pancreatic cancer cases are diagnosed in terminal stages. As such, the most powerful method to reducing the morbidity and mortality of pancreatic cancer is to further investigate the risk factors. According to the theoretical framework of the ecosocial theory, long-term exposure to exposures to unfavorable socioecological and environmental factors serve as a “web of causation” for adverse health outcomes. Using data from the North Carolina Department …

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Nurses’ Perception Of Facilitators And Barriers To The Community College Faculty Role, Hallie Roselie Coppi Jan 2023

Nurses’ Perception Of Facilitators And Barriers To The Community College Faculty Role, Hallie Roselie Coppi

Walden Dissertations and Doctoral Studies

There is an increased nursing faculty shortage throughout the United States (U.S.) which can have a significant impact on student enrollment in nursing programs. The purpose of this descriptive qualitative study, which was guided by Herzberg’s two-factor theory, was to explore perceptions of nursing faculty about their role in community college associate degree nursing (ADN) programs in the western U.S. Data were collected via in-depth semi-structured interviews with 14 nurse educators to gain insights regarding experiences with role transition, work expectations, and plans in academia. Transcribed interview data were thematically analyzed to reveal seven overarching themes which were motivation, role …

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Nursing Guideline For Specimen Handoff, Kathleen Marie Pearce Jan 2023

Nursing Guideline For Specimen Handoff, Kathleen Marie Pearce

Walden Dissertations and Doctoral Studies

AbstractThe absence of clinical practice guidelines (CPGs) and collaboration with significant stakeholders may lead to gaps in the delivery of patient care. Specimen handoff in the endoscopy unit plays a critical role in patient diagnosis and treatment plans; errors can compromise patient safety. The purpose of this project was to provide endoscopy nursing staff with a CPG to improve the accuracy of the specimen handoff process during the endoscopy procedure. The practice-focused question addressed the feasibility of developing a quality and usable CPG to improve the accuracy and efficacy of handling the specimen handoff process during endoscopy procedures. Walden University …

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Impact Of Family Health Outcomes And Work Balance On Health Services Organizations’ Workplace Attendance, Marcus Levinsky Wade Jan 2023

Impact Of Family Health Outcomes And Work Balance On Health Services Organizations’ Workplace Attendance, Marcus Levinsky Wade

Walden Dissertations and Doctoral Studies

Work-life balance (WLB) is employees’ ability to effectively manage between job obligations and everyday life activities involving family, health, and social life. Successful WLB has become increasingly important to healthcare administrators due to staff shortages and essentials of job performance, attendance, and satisfaction. The purpose of this quantitative study was to determine if there was a correlation between WLB, workplace stress, and employee workplace attendance. The two research questions were correlational; the dependent variable was workplace attendance, and the independent variables were workplace stress and WLB. The compensation theory served as the foundation for the study, in which both family …

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Strategies To Mitigate Inappropriate Test Utilization By Physicians To Improve Efficiency In A Healthcare Setting, Christine C. Wood Jan 2023

Strategies To Mitigate Inappropriate Test Utilization By Physicians To Improve Efficiency In A Healthcare Setting, Christine C. Wood

Walden Dissertations and Doctoral Studies

Inappropriate test utilization by physicians for clinical decision-making in patient care is a significant problem facing some healthcare leaders. Healthcare leaders are concerned about inappropriate test utilization because it can increase healthcare costs and degrade patient outcomes. Grounded in the complex adaptive system and Lean Six Sigma conceptual frameworks, the purpose of this qualitative single-case study was to identify strategies seven hospital leaders in Maryland and Washington, DC. who implemented successful test utilization strategies for physicians. Data were collected from semistructured virtual interviews and organizational reports and analyzed using Yin’s 5 step process. Five themes emerged: (a) continuing physician education, …

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Thirty-Second Mindful Body Scan Meditation For Bedside Nurses, Shruti Balwalli-Udyawer Jan 2023

Thirty-Second Mindful Body Scan Meditation For Bedside Nurses, Shruti Balwalli-Udyawer

Walden Dissertations and Doctoral Studies

Compassion fatigue, or secondary traumatic stress, is a state of physical and mental exhaustion caused by an inability to cope with the everyday environment that reduces the ability of the nurse to provide high-quality health care to a patient. The purpose of this staff education project, guided by Selye’s general adaption syndrome , was a 6-week, 30-second mindfulness exercise program to promote stress reduction for cardiac step-down and medical-surgical nurses. In this quantitative, pre- and posttest study, the Perceived Stress Scale was completed by a sample of 24 nurses who met the inclusion criteria. The practice focused whether educating nurses …

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Nurses’ Perception Of Pain Assessment In Cognitively Impaired Older Residents In Long-Term Care, Abigail Owolabi Jan 2023

Nurses’ Perception Of Pain Assessment In Cognitively Impaired Older Residents In Long-Term Care, Abigail Owolabi

Walden Dissertations and Doctoral Studies

AbstractPain has been a significant problem in old age and is more problematic in cognitively impaired older residents (CIOR) because of their inability to express themselves. The goal of pain assessment in CIOR is to treat pain before it escalates to behavioral problems. This descriptive qualitative study aimed to explore nurses’ perceptions of pain assessment in CIOR in long-term care facilities. Watson’s theory of human caring was used to frame the study. A purposive sample of eight nurses was recruited from two long-term care facilities for interviews conducted using the telephone and continued until saturation was reached. Data was manually …

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Food Environment As A Moderator In The Relationship Between Ultra-Processed Food Intake And Mortality In The United States, Brandon Jerod Grandy Jan 2023

Food Environment As A Moderator In The Relationship Between Ultra-Processed Food Intake And Mortality In The United States, Brandon Jerod Grandy

Walden Dissertations and Doctoral Studies

According to recent studies, the consumption of ultra-processed food is a major issue that leads to fatal outcomes within the United States, which is relevant because this type of food has become more accessible over the years. Using data from the National Health And Nutrition Examination Survey III (NHANES III), previous researchers found that frequent consumption of ultra-processed foods was associated with greater chances of all-cause mortality in U.S. adults, but little research has focused on factors that can impact ultra-processed food consumption, such as food environment. The purpose of this quantitative longitudinal study was to examine the effect of …

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Black/African American Men’S Lived Experiences Of Workplace Colorism Bullying, Dr. Benjamin K. Spady Ph.D Jan 2023

Black/African American Men’S Lived Experiences Of Workplace Colorism Bullying, Dr. Benjamin K. Spady Ph.D

Walden Dissertations and Doctoral Studies

Bullying in the U.S. workplace is an ongoing issue that transcends industry boundaries due to perpetrators’ ineffectiveness in viewing all coworkers as equals. The purpose of this qualitative interpretative phenomenological analysis study was to explore the lived experiences of Black/African American men who endure workplace colorism bullying. Critical race theory provided the conceptual framework, which labeled racism as an omnipresent systemic force. Semistructured interview data were collected from six Black/African American men who resided in the United States and who were bullied in the workplace within the past 20 years. Data were coded via open coding to discover themes. The …

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Staff Education Program To Reduce Burnout Among Health Care Professionals On A Long-Term Care Unit, Emelda Mati Che Jan 2023

Staff Education Program To Reduce Burnout Among Health Care Professionals On A Long-Term Care Unit, Emelda Mati Che

Walden Dissertations and Doctoral Studies

AbstractBurnout negatively impacts the performance of health care providers, decreasing the quality of care provided to patients and affecting patients’ experience. This problem is evident in health care staff on long-term care units (LTCUs) as they strive to meet their patients’ chronic and acute care needs. Health care professionals often lack adequate knowledge on how to manage work-related stress and reduce the issue of burnout in this work environment. The health care professionals working on the LTCU at the local continuing care retirement facility were identified as lacking knowledge to manage work-related stress and burnout. Addressing this problem is essential …

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A Clinical Practice Guideline For Managing Behavioral Problems In Persons With Dementia, Ken J. Brinker Jan 2023

A Clinical Practice Guideline For Managing Behavioral Problems In Persons With Dementia, Ken J. Brinker

Walden Dissertations and Doctoral Studies

AbstractAs the baby boom generation ages, the demand for effective nursing care for patients diagnosed with dementia has greatly increased. The challenges associated with dementia include a patient’s inability to focus, pay attention, and follow conversations. Patients often become forgetful, angry, frustrated, and aggressive with family members and caregivers. The medical providers and administrators at a long-term care facility needed assistance in developing a clinical practice guideline for managing behaviors demonstrated by patients with dementia. The project question centered on the identification of current evidence supporting a clinical practice guideline for nursing practice for unpredictable behaviors demonstrated by residents diagnosed …

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Strategies To Mitigate Nurse Turnover, James Edward Cooper Jr Jan 2023

Strategies To Mitigate Nurse Turnover, James Edward Cooper Jr

Walden Dissertations and Doctoral Studies

Registered nurse turnover is a severe problem for all healthcare organizations because it negatively affects financial growth, patient care, and reputation, ultimately resulting in financial losses. Grounded in Herzberg’ two-factor theory, the purpose of this qualitative multiple-case study was to explore strategies hospital leaders use to mitigate RN turnover. The participants included three hospital leaders from three different hospitals in the southeastern United States who mitigated RN turnover. Data were collected from semistructured interviews and company documents and analyzed using Yin’s five-phase data analysis process. Three themes emerged: nurse engagement, job satisfaction, and trust in leadership mitigated RN turnover. A …

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