Medicine and Health Sciences Commons^™

Impacts Of White Privilege And Implicit Bias On Treatment Implementation With Black Pediatric Patients, Tara Geer-Leiker

Walden Dissertations and Doctoral Studies

White privilege and implicit bias are known contributing factors to the racial health inequities that exist in the treatment of Black children in U.S. hospitals. There is limited research, however, on the potential for White nurses to engage in self-examination related to either concept. The purpose of this basic qualitative inquiry was to understand how White privilege and/or implicit bias shapes the lived experiences of White nurses as they treat and interact with Black pediatric patients. The conceptual framework included a modified model comprised of Hobbs’s concept of White privilege and Blair et al.’s model of influences of implicit bias …

Help-Seeking Behaviors And Employment Hope Among Depressed Black Male Foster Care Alumni, Vanessa Jennings

Walden Dissertations and Doctoral Studies

Traumatic depression is a system of experiences where the mind, heart, and gut track happenings lingering among systemic models of prevention and intervention and personal stories. This nonexperimental correlational study aimed to provide insights into mental help-seeking and employment hope among depressed Black/African American foster care male alums. The central research question was to what degree, if any, a positive relationship exists between employment hope and seeking access to mental health-related services among male foster care alums who identify with depression. It was hypothesized that a statistically significant relationship exists. The social cognitive career theory and theory of planned behavior …

Factors Influencing Newly Licensed Nurse Position Selection And Retention, Melinda S. Kidder

Walden Dissertations and Doctoral Studies

Newly licensed nurse turnover can be costly, causing a mismatch between supply and demand for nurse staffing needs, lowering quality outcomes, and decreasing patient satisfaction. This quantitative study was conducted to identify the relationship between why newly licensed nurses selected their first position and their retention in that initial position. Other factors examined in relation to retention were unit most worked, age, race, sex, and education level. Irvine and Evans’s theory of job satisfaction and Maslow’s hierarchy of needs guided the analysis of the data. Secondary data used were the Newly Licensed Registered Nurse New Cohort 3 Survey from 2016 …

The Association Between Working Habits And Hypertension Among First Generation African Immigrants, Olalekan Kilo

Walden Dissertations and Doctoral Studies

Even though hypertension affects people of all races, it is more prevalent among African Americans. However, recent research has revealed that the prevalence of hypertension is progressively increasing across Africa. African immigrants in the United States are the least-studied immigrant group prone to health inequalities when compared to their African American counterparts. To help bridge this gap, a secondary data analysis of a cross-sectional study was conducted to investigate the association between working habits (hours worked, diet at work), length of stay in the United States, and hypertension rates for first-generation African immigrants residing in the United States. The study …

Nutrient Pollution And Chlorophyll-A As A Precursor To Harmful Algal Blooms And Cyanotoxins In Rehabilitated Machado Lake, California, Michael E. Shiang

Walden Dissertations and Doctoral Studies

Algal blooms result in the formation of cyanotoxic conditions in a freshwater lake causing severe detrimental impacts to community and public health. Nitrogen, phosphorous, and ammonia stimulate the growth of phytoplankton biomass and algae, as measured by chlorophyll. This retrospective quantitative research study, grounded in the socioecological model, examined the relationship between nutrient pollutants and chlorophyll-a (Chl-a) that forecast harmful algal blooms, a precursor to cyanotoxins. A former impaired lake, Machado Lake in California, provided an ideal setting to assess relationships among nutrient indicators and Chl-a post-lake rehabilitation. Correlation and multiple regression analyses were performed to determine if a relationship …

Clinical Vaccination Education Guideline For The African American Community, Margaret Chinedum Nwoji

Walden Dissertations and Doctoral Studies

AbstractVaccination hesitancy is high among African Americans and other people of color. The practice gap addressed in this project was the lack of a culturally sensitive clinical guideline for vaccination education relevant to the African American community. The practice-focused question was answered by developing an evidence-based Clinical Vaccination Education Guideline for the African American Community (CVEGAAC) that was validated by a group of four content experts using the Appraisal of Guidelines, Research, and Evaluation tool. The content experts scored each of the domains above 90%, implying that the CVEGAAC is of high quality and ready for implementation. The end users …

Experiences Of Older Adults With Hiv/Aids Enrolled In Case Management Programs In Northwest Indiana, Antoinette Cardenas

Walden Dissertations and Doctoral Studies

AbstractIn 2016, more than half of those infected with HIV/AIDS were age 50 years or older. Since the introduction of antiretroviral therapy, the survival rate of HIV patients has been on the rise with a predicted increase by 2030, but this has also contributed to early onset of comorbidities such as cardiovascular disease, osteoporosis, and kidney failure. The purpose of this generic qualitative study, driven by ecological systems theory, was to explore the experiences of older adults (age 50 and older) with HIV/AIDS who were enrolled in case management programs in Northwest Indiana. Data were collected from semi structured interviews …

Self Care Education For Nurses Following An Assault, Barbara Lynn Schwarz

Walden Dissertations and Doctoral Studies

AbstractSelf-Care Education for Nurses Following an Assault by Barbara Lynn Schwarz MS, Nebraska Wesleyan University, 2008 BS, Nebraska Wesleyan University, 2004

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

Walden University August 2023 Abstract Every day, 1 in 4 nurses experience physical and/or verbal assault, surpassing the rates among police officers and prison guards. This issue is particularly widespread among nurses working in mental health settings. The local practice problem for this project was the absence of self-care education for nurses following workplace assaults. The literature revealed that such assaults have traumatic …

Stress And Coping Among Sud Certified Peer Recovery Specialists, Cynthia June Thomas

Walden Dissertations and Doctoral Studies

Certified Peer Recovery Specialists (CPRSs) are individuals with lived experience in the successful recovery of substance use or mental health disorders. CPRSs provide services for individuals seeking or enrolled in substance use disorder (SUD) recovery, provide mentoring and coaching, service and resource connections and lead recovery groups but, the job of a CPRS can have beneficial and detrimental impacts on the CPRS’s personal recovery. The purpose of this quantitative study, guided by Lazarus’s theory of coping and stress, was to determine whether there is (a) a relationship in stress and coping effectiveness among CPRSs, (b) a difference in the level …

Comparison Of Rural Associate Degree Nursing Students’ Clinical Judgment After Curriculum Change, Karen Bowen

Walden Dissertations and Doctoral Studies

New graduate nurses often lack adequate clinical judgment skills to practice competent nursing care, which may result in increased risk of committing practice errors that threaten patient safety. To mitigate errors in patient safety, industry leaders have called for nursing program improvements in preparation of nursing students’ clinical judgement as they transition to professional practice. Guided by Tanner’s clinical judgment theory, the rural state nursing programs in this study implemented a concept-based curriculum to promote clinical judgment which includes thinking skills, priority setting, and management of care. The purpose of this three-part, quantitative, nonexperimental study was to compare the development …

Experiences And Attitudes Regarding The Availability And Usage Of Telemedicine Services Among Providers During A Pandemic, Keya Gaston Brooks

Walden Dissertations and Doctoral Studies

Telehealth became a prominent fixture in the way healthcare was delivered during COVID-19. Providers were forced to offer telehealth as an optional mode of care. Although little research was available, studies about the experiences and attitudes of providers regarding their intention and willingness to use telemedicine before the pandemic was exiguous. The purpose of this study was to understand providers perception and use behavior patterns regarding the acceptance and adoption of telemedicine during the pandemic. Data collected from the COVID-19 Healthcare Coalition Telehealth Impact Survey was used to help characterize the experiences and attitudes of providers regarding telehealth utilization during …

Health Leadership And Management Practices That Support Accountability For Results, Peter Kayiira Byansi

Walden Dissertations and Doctoral Studies

Although leaders are expected to nurture and sustain a culture of accountability for results, little is known about how health leaders in developing countries perceive, interpret, demonstrate, and promote accountability in their day-to-day practices. The purpose of this generic qualitative study was to explore the management and leadership practices that leaders of public and non-profit health support organizations in Uganda utilize to embody and support accountability for key stakeholders’ results. Data from in-depths interviews with 13 participants at the governance, senior management, and middle management levels were analysed using thematic data analysis. Riggio's conceptualization of using multiple perspectives and disciplines …

Improving Veteran’S Care Outcomes With The Implementation Of Care Coordination, Katrina Ann Canady

Walden Dissertations and Doctoral Studies

AbstractAstute care coordination is essential to eliminating fragmented care, duplication of services, medication errors, and unnecessary emergency rooms visits. This Doctor of Nursing practice project was a quality improvement (QI) initiative that addressed the gap in practice regarding RN care managers who were not consistently performing care coordination as outlined by the office of community care at the project site. The purpose of the project was to evaluate the effectiveness that an educational intervention had on the RN care managers’ abilities to perform care coordination. The care coordination model (CCM) served as the project framework because it provides a systematic …

Educating Nurses On Mental Fatigue, Tawanna Ann Canty

Walden Dissertations and Doctoral Studies

Education correlates with nurse performance and avoiding mental fatigue. This project attempted to answer the question, “Educating nurses on mental fatigue will increase knowledge” focusing on educating rehabilitative nurses regarding mental fatigue. The project was guided by the Analysis, Design, Develop, Implement, and Evaluate model. Twenty rehabilitative nurses were administered a pretest consisting of 10 multiple-choice test questions. They received education on mental fatigue through PowerPoint presentations and handouts. After completing the education, participants were administered a posttest with the same 10 questions. An evaluation tool consisting of six questions was completed measuring an increase in knowledge after the posttest. …

Anxiety Risk Factors And Social Isolation Among Young Adults, Jennifer Clancy

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic is a public health concern that impacted the world. Increased feelings of loneliness and social isolation during the pandemic were reported to be associated with those seeking help for symptoms of anxiety and depression. Though symptoms of anxiety have been associated with social isolation, research is limited on the association between the anxiety risk factors and social isolation among young adults in the United States. Using the socioecological model, the association between social isolation (dependent variable) with financial stress, health anxiety, and perceived impact of COVID-19 (independent variable), and the influence of gender, race, and household status …

African American Women And Social Support Networks To Overcome The Strong Black Woman Schema And Depression, Teia Jelisia D. Clements

Walden Dissertations and Doctoral Studies

Mental illness disorders within the United States are on the rise. Researchers have indicated that African Americans are less likely to seek mental health compared to European Americans. The purpose of this basic qualitative study was to understand how social support networks influence African American women between the ages of 25 and 50 in addressing the strong Black woman (SBW) schema and depression. A conceptual framework consisting of the SBW collective theory guided the study. A purposive sample of 16 African American women who use social support networks to address the SBW schema and depression was obtained through flyers posted …

Teach-Back As An Evidence-Based Tool In Patient Education, Andrea Clyne

Walden Dissertations and Doctoral Studies

AbstractDischarge instructions are a valuable component of patient education as they can influence outcomes post-discharge, leading to positive social change through improved morbidity and mortality. The use of teach-back education by registered nurses is a best practice that assures understanding of discharge instructions. However, consistent use of this method relies on the staff’s conviction and confidence in this manner of education. The purpose of this project was to develop, deliver, and evaluate a program to educate staff on the best practice of teach-back to effectively deliver patient education. The logic model helped guide and develop the stages of the project …

Adverse Childhood/Adolescent Experiences And Risk Of Recruitment Into Sex Trafficking, Shwana Coleman

Walden Dissertations and Doctoral Studies

Human trafficking victims are negatively impacted by the process of coercion, kidnapping, and forced sexual interactions. Previous research studies showed that sex trafficking impacts victims’ mental health. The purpose of this quantitative study was to investigate whether adverse childhood/adolescent experiences (i.e., substance abuse, psychological abuse, and physical abuse) influence recruitment to sex trafficking in the United States and whether age acts as a moderator. The health belief model provided the theoretical framework for the study that includes data from 2010–2015 collected by the Polaris Project, a global sex trafficking database. Convenience sampling was done to delineate the study variables and …

Relationship Between Food Insecurity, Depression, And Race/Ethnicity Among U.S. Adults Aged 60–69 Years, Patrick E. Crandon

Walden Dissertations and Doctoral Studies

Abstract Food insecurity (FI) and depression among older populations in the United States are public health concerns. Although FI has declined in the United States, it is a psychosocial stressor prevalent among the growing population of adults over 60. It is unknown to what extent FI contributes to depression among racial/ethnic minorities in this population. The purpose of this quantitative cross-sectional study was to examine the relationships between FI and race and depression among U.S. adults aged 60–69 years when adjusting for other variables. The social-ecological model was used to understand the interplay between individual and environmental factors that may …

Health Education Practices For Middle Eastern Women With Polycystic Ovary Syndrome, Walaa Daffaalla

Walden Dissertations and Doctoral Studies

Polycystic ovarian syndrome (PCOS) is a complex women’s health condition that reduces women’s quality of life, leading to health complications, such as menstruation issues, infertility, insulin resistance, risk of type 2 diabetes, depression, anxiety, emotional stress, being overweight or obese, and more. Research on PCOS has focused on the etiology and complications in women from different ethnicities. But limited research has explored the experiences and perspectives of Middle Eastern (ME) women in the United States with PCOS related to PCOS health education. The purpose of this qualitative study was to explore the perspectives and experiences of ME women of reproductive …

Student Physical Therapy Supervision And Physical Therapy Productivity In Skilled Nursing Facilities, Dionne Degrande

Walden Dissertations and Doctoral Studies

Physical therapy (PT) educational programs are faced with the problem of securing thenecessary clinical experiences for their students, particularly in long-term care settings. Student physical therapists (SPTs) must complete clinical education requirements to graduate and transition from learner to entry-level practitioner. Clinical instructors (CIs) provide SPT supervision and are responsible for meeting industry-standard productivity expectations. There is the notion that SPTs negatively impact PT productivity, creating a reluctance for organizations to host SPTs for clinical experiences. This quantitative pilot study aimed to determine if there was a statistically significant difference between PT productivity with and without SPTs in skilled nursing …

Experience Of Established Mental Health Counselors Working With Adults Who Have Intellectual Disabilities, Margarete Denk

Walden Dissertations and Doctoral Studies

Individuals with disabilities make up the largest minority population in the United States. Individuals with intellectual and developmental disabilities (I/DD) make up a significant portion of this population, yet there are limited studies addressing counseling with the I/DD population. The Council for Accreditation of Counseling and Related Educational Programs has addressed the need for disability competence in their upcoming 2024 standards. The purpose of the phenomenological study was to describe lived experiences of established counselors working with adult clients diagnosed with an I/DD. A descriptive phenomenological approach was used along with the social model of disability. The study involved six …

Long-Term Psychological Adaptation Of U.S. Human Resource Personnel In Response To The Covid-19 Pandemic, Samantha Ann Denson

Walden Dissertations and Doctoral Studies

Previous research indicated that the COVID-19 pandemic negatively impacted employee psychological outcomes in various workforce sectors. Although research showed that U.S. human resource (HR) employees experienced unique occupational challenges during the pandemic, the literature did not explore pandemic-related psychological outcomes in this population. This quantitative survey-based study included a purposive sample of 294 U.S. HR professionals to explore the pandemic’s impact on their psychological well-being. The transactional model of stress and coping served as the theoretical framework to understand the independent effects of appraisal, meaning-based coping, and coping efforts on psychological well-being. A mediation analysis was used to understand the …

Educating Nurses To Implement Serious Illness Conversations, Colleen Patricia Desai

Walden Dissertations and Doctoral Studies

AbstractAs part of investigating staff nurses’ reluctance to have serious illness conversations (SIC) at a local hospital, an educational deficit was noted. Nurses articulated they felt uneducated about how to have a SIC with a patient in need and questioned if the practice of conducting SICs was part of the nurses’ scope of practice in the New England State where they were employed. The purpose of this project was to create an educational tool and have it validated by a multidisciplinary group of experts. Once validated, the goal will be to educate nurses, raise awareness on the topic of SICs, …

Staff Education To Promote Probiotic Breastfeeding Therapy, José Diaz

Walden Dissertations and Doctoral Studies

Preterm birth is the leading cause of death in children under 5. In addition, there are 22 million babies born underweight each year which also contributes to the infant mortality rate. Some reasons for the inability to thrive and survive are the infants' immature system, allostatic load inadaptability, and undiversified and underdeveloped microbiota. Human breast milk (HBM) provides lifesaving nutrients, which prevents necrotizing enterocolitis and mortality. In addition, probiotic supplementation helps reduce late-onset sepsis, morbidities, and mortality. A literature review provided substantial evidence that HBM and probiotics can improve an infant's microbiota, thus improving thrivability and survivability. Probiotics offset the …

Occupational Therapists’ Perspectives On Using The Physical Environment In Skilled Nursing Facilities, Jennie L. Digrado

Walden Dissertations and Doctoral Studies

Occupational therapists (OTs) are among the health care professionals who assist individuals with neurocognitive disorders (NCDs) to engage in self-care and leisure skills in a skilled nursing facility (SNF) environment. Although the SNF environment has been researched, a gap exists regarding how OTs use the built environment to help clients with a NCD engage in self-care and leisure-related activities. The purpose of this qualitative case study was to understand how OTs use the physical environment in a SNF to help individuals with a NCD engage in self-care and leisure related activities. The conceptual framework that guided this study was the …

Examining The Relationship Between Patient Care Quality, Patient Care Safety, And Socioeconomic Status In Chicago's Acute Care Hospitals, Theresa Ann Doby

Walden Dissertations and Doctoral Studies

AbstractEnsuring high quality and safe patient care are among the main goals of all acute care hospitals. This study found that quality of patient care is not consistent across all patient populations, which draws attention to the issue of disparity in access to safe and quality health care. The purpose research questions of this quantitative study examined if patient care quality and safety are related to hospitals’ socioeconomic status (SES) among Chicago’s acute care hospitals. Secondary data were derived from a sample of 20 acute care hospitals (i.e., 10 acute care hospitals of high SES and 10 of low SES) …

Relationship Of Acetaminophen And Alcohol To Incipient Renal Insufficiency: The Role Of Race In Estimating Glomerular Filtration Rate, Preston Eledu

Walden Dissertations and Doctoral Studies

There are increasing concerns about the incorporation of race in the estimated glomerular filtration rate (eGFR) prediction equation. which has been used to measure renal function in studies that have shown a relationship between therapeutic dose of acetaminophen and light-moderate alcohol use to incipient renal insufficiency. The purpose of this study was to assess the same relationship, using a redefinition of renal insufficiency based on the chronic kidney disease–epidemiology collaboration creatinine-based eGFR, with and without race, and exploring the potential impact of race in the hypothesized relationship. Data from the 2003-2004 National Health and Nutrition Examination Survey were analyzed using …

Effect Of Treatment, Stage Of Lung Cancer, And Socioeconomic Status On Life Expectancy Within Marginalized Communities, Elsadig Ahmed Elsharif

Walden Dissertations and Doctoral Studies

Lung cancer is one of the most common cancers in the United States, and it accounts for 25% of cancer deaths. About 70% of cancer cases are diagnosed during late stages, leading to poor outcomes. An estimated 60% of cancer cases involve underserved and disadvantaged communities. However, there are limited studies had addressed effects of treatment, stage of lung cancer, and socioeconomic status on life expectancy within marginalized communities. Research questions examined effect of treatment, stage of lung cancer, and socioeconomic status on life expectancy of lung cancer patients between 2009 and 2019. This study was grounded in the deductive …

Tuberculosis-Associated Knowledge, Stigma, And Health Seeking Behavior Among Traders In Onitsha Main Market, Anambra State, Nigeria, Benedeth N. Ezeosim

Walden Dissertations and Doctoral Studies

The utilization of tuberculosis (TB) health care services in a Nigerian state has not been optimal. Many residents do not utilize available health care resources when they experience symptoms of TB. Although much is known about the determinants of health seeking behavior (HSB), there is a gap on how TB knowledge and TB related stigma among traders in one main market contribute to HSB. This study examined the effect of TB knowledge and TB related stigma on HSB among traders. The health stigma and discrimination and health belif models served as the theoretical foundation. A quantitative cross-sectional analytical survey design …