Medicine and Health Sciences Commons^™

Neighborhood Factors, Cardiovascular Illness, Mental Health, And Aging In The United States, Brenda Billings

Walden Dissertations and Doctoral Studies

The inability to age in place among people 65 years old and older is a public health problem in the United States. However, it is unknown what neighborhood factors (i.e., trust, safety, shared values) impact the communities that are struggling to support individuals looking to stay in their homes as they age. The purpose of this quantitative correlational study was to examine the relationship between neighborhood factors (i.e., trust, safety, and shared values), cardiovascular illness (i.e., heart attack and stroke), mental health (i.e., depression), and aging in place, controlling for sex, age, marital status, educational level, employment status, and race. …

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 …

Association Between Covid-19 Health Knowledge, Self-Efficacy And Preventive Behaviors Among Nursing Students, Josephine Miane Britanico

Walden Dissertations and Doctoral Studies

Abstract Nursing students possess valuable public health knowledge to prevent the spread of COVID-19 infection. They can provide health education to the public with reliable information and adequate resources. To better understand the role nursing students can take in prevention efforts, the purpose of this quantitative correlational study was to examine the association between COVID-19 health knowledge, self-efficacy, and preventive behavior among undergraduate nursing students. The health belief model was the theoretical framework that guided this study. The primary research questions assessed (a) if there was a statistically significant association between COVID-19 health knowledge and preventive behavior among nursing students, …

Educator Preparedness In The Use Of Simulation In Nursing Education, Marcelene E. Hart

Walden Dissertations and Doctoral Studies

AbstractNurse educators lack preparation when using simulation as a teaching modality in educating nurses and nursing students within their clinical environment. The purpose of this basic qualitative study was to understand nurse educators’ perceptions of the challenges in preparing for simulation-based training experiences for nurses and nursing students. Vygotsky’s constructivist theory was used as the conceptual framework for the study to emphasize students’ innate ability to learn using active and hands-on processes through simulation experiences. Questions were developed to explore the challenges nurse educators encounter when preparing for simulation activities. Survey questionnaire invitations were sent through email to hundreds of …

Exploration Of Nurses' Knowledge About Healthcare For Transgender Patients, Elizabeth Kempt

Walden Dissertations and Doctoral Studies

AbstractThe transgender population is growing, and along with the population growth, the healthcare needs for gender transitioning of both medical and surgical procedures. Registered nurses (RNs) who care for hospitalized transgender patients are required to be knowledgeable about their care, yet little is known about what nurses know about the healthcare of the transgender patient. The purpose of this basic qualitative study, guided by Benner’s novice to expert theory, was to explore the knowledge and perceptions of RNs regarding healthcare of transgender persons undergoing transition to the opposite gender. Social media and snowball sampling were used to recruit 10 RNs …

Perceptions Of Women Of Color Improving Patient Outcomes Through Hospital Leadership Advancement, Benita A. Mclarin

Walden Dissertations and Doctoral Studies

Women of color have been underrepresented in hospital leadership positions and face challenges in advancing their careers. The benefit to hospitals providing women of color with training and support to move into leadership positions may be improved patient outcomes. Grounded in the interactional model of cultural diversity framework, the purpose of this basic qualitative study was to explore the perceptions of women of color advancing in leadership roles in hospitals and their impact on patient outcomes. The study participants included 16 women of color in leadership positions from hospitals in a western U.S. state. Data were collected through semi structured …

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 …

Transitional Care For The End Stage Renal Disease Patient, Elaine Vitto

Walden Dissertations and Doctoral Studies

AbstractThe prevalence rates for end stage renal disease (ESRD) have continued to rise by approximately 20,000 cases per year, and the number of patients with kidney failure requiring dialysis in the United States had reached 554,038 at the end of 2018. Transition of care for patients between acute care facilities and other care facilities such as dialysis centers remains challenging for providers. Lack of clear communication between providers, poor patient understanding of post-hospital self-care, and gaps in healthcare scheduling contribute to a high rate of adverse events. This facility did not have a detailed clinical guideline for ESRD communication between …

Evaluation Of The Implementation Of Primary Prevention Guidelines For The Treatment Of Hypertension, Aramide Alayande

Walden Dissertations and Doctoral Studies

AbstractHypertension is a chronic disease that is associated with increased risk of cardiovascular mortality. This Doctor of Nursing Practice project was a quality improvement initiative that addressed the gap in practice that the nurse practitioners (NPs) were not consistently following the American College of Cardiology (ACC) and American Heart Association (AHA) recommended guidelines for the treatment of hypertension. The purpose of the project was to evaluate whether the NPs were consistently using the guidelines to treat patients with hypertension after an educational intervention. The project used a before-after approach to evaluate the consistency of using the guidelines in treatment of …

Marijuana Cultivation Laws And Admissions For Cannabis Use Disorder In Us Substance Abuse Treatment Facilities, Nada Al-Rubaiee

Walden Dissertations and Doctoral Studies

With approximately 4.4 million Americans addicted to cannabis, it is considered a dominant non-medical drug that is common in the US. The purpose of this study was to investigate the possible contribution of the state laws that allow the cultivation of marijuana to Marijuana Medical (MM) program cardholders on cannabis addiction. This study was conducted to address the issue of the increase in demand for cannabis-related admissions that contribute to an upsurge in the unmet treatment needs. The study is founded on the Ecological Models proposed by Urie. The key research question explored the association between state laws that allow …

Burnout And Positive Thinking Skills Among Critical Care Nurses, Evangeline Ani

Walden Dissertations and Doctoral Studies

AbstractBurnout is a global health problem with a significant negative impact on the physical, mental, and emotional health and well-being of critical care nurses, which in turn has serious effects on the critical care work environment. Positive thinking has the potential of transforming the work environment. The purposes of this quantitative, correlational study, guided by Lazarus’s theory of stress, were to determine (a) if there was a relationship between the use of positive thinking skills and burnout among critical care nurses, and (b) if there was a difference between the use of positive thinking skills and burnout among critical care …

Screening For Depression In Immigrants In Their Host Country, Hortense Bissila

Walden Dissertations and Doctoral Studies

AbstractThe initial need for care for depression is greater for immigrants, who encounter linguistic, cultural, structural, and attitudinal hurdles to mental health care that render them more susceptible to increased levels of depressive symptoms compared to populations of hosting country. The aim of this Doctor of Nursing Practice project was to educate frontliners in the community on how to assess for depression in immigrants in culturally congruent ways. This project addresses gap in mental health care practice that needs urgent redress in promoting self-cultural competence and raising awareness to assess for depression on immigrants. To meet the aims of the …

Sexual Violence And University Campus Response To Sexual Violence, Jennifer Bivins

Walden Dissertations and Doctoral Studies

While anyone can be a victim of sexual violence, college-aged females between the ages of 18 and 21 are more likely to be victimized than any other group. Sexual violence continues to be a barrier to education, and colleges/universities make it challenging for students to report on campus. The purpose of this study is to explore the factors, intervention/prevention strategies, and policies/procedures used to address sexual violence on a university campus. The framework used was the ecological model, which focuses on factors and influences within the environment that affected individual behavior. The research questions focused on participants describing their experiences …

Personal Hardiness As An Unexamined Component Of The Healthy Volunteer Effect, Angelique E. Blann

Walden Dissertations and Doctoral Studies

Clinical trials are the standard for approving medicines for public use. To conduct trials, researchers depend on a declining number of volunteers. The healthy volunteer effect, a phenomenon in which participants demonstrate better outcomes than their peers, limits the generalizability of trial outcomes. The healthy volunteer effect does not fully explain the outcome difference between volunteers and nonvolunteers. The purpose of this cross-sectional quantitative study was to examine personal hardiness as an unexplored component of the healthy volunteer effect and determine whether personal hardiness is associated with willingness to participate. Hardiness was a personality construct that represented resilience to stress. …

Comparison Of The Effects Of Telehealth Versus N95 On Nurse-Patient Communication, Tony Christopher Bloomfield

Walden Dissertations and Doctoral Studies

Telehealth and face masks are some of the infection control measures nurses use while attending to patients. Nurses provide the most patient care in hospital settings and thus spend the most time with patients in their recovery journey. Because communication is paramount to the role nurses play as health care professionals, there is a substantial need to investigate how infection control measures affect the quality of nurse-patient communication. The purpose of this quantitative cross-sectional study was to describe the relationship of methods aimed at maintaining social distancing between nurses and patients to nurse-patient communication and to compare differences in the …

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 …

Impacts Of Mobile Health Technology On The African American Millennial Health Care Experience, Antoine J. Campbell

Walden Dissertations and Doctoral Studies

African Americans are underrepresented and have limited access to health care in the United States due to systemic disparities. The purpose of this qualitative phenomenological study was to develop a better understanding of the relationship that African Americans have with the health care system and the way they interact with it as well as to examine the impacts of mobile health (mHealth) patient engagement applications and their impact on shaping health experiences amongst millennial African Americans. Research questions addressed African American millennials’ perspectives on potential barriers to utilizing health care in the U.S. health care system as well as consideration …

Pharmacy Manager System Implementation Strategies To Mitigate The Cost Of Prescription Errors, Tunde Abiodun Cardozo

Walden Dissertations and Doctoral Studies

AbstractOne of the most frequent medical errors in contemporary medicine is incorrect prescriptions, and the profits from retail pharmacy operations are adversely impacted by the costs associated with prescription errors. Independent pharmacy managers are interested in finding workable strategies to mitigate the cost of prescription errors and increase profit. Using the resource-based theory of competitive advantage (RBTCA), the purpose of this qualitative multiple-case study was to explore strategies some independent pharmacy managers in Texas use to mitigate the cost of pharmacy employee prescription errors and increase profitability. The participants were five independent pharmacy managers who implemented strategies to mitigate the …

Education On Protective Measures For Primary Care Staff During Covid Outbreaks, Lenina Ochioza Ukeju Chi-Ukpai

Walden Dissertations and Doctoral Studies

Since the emergence of COVID-19, healthcare workers have been in continuous risk of infection because of the way the disease is transmitted. Hence, the proper use of personal protective equipment (PPE) is important during the pandemic. The aim of this project was to increase healthcare workers’ and patients’ disease protection and prevention. This staff education project assessed the knowledge of proper PPE practice among healthcare workers who were in close contact with COVID-19 patients and provided lectures and practice in proper donning and doffing of PPE. Guided by the Lewin theory of change, the knowledge of the 9 health care …

Environmental Factors And Breast Cancer Mortality, Joel Collazo Rodriguez

Walden Dissertations and Doctoral Studies

Breast cancer is a public health problem in the United States that impacts diverse ethnic female groups in different ways regarding incidence and mortality. Much is known about the factors increasing the risk of developing breast cancer, but little is known about those that increase the chances of dying from it, other than access to health care, screening, and appropriate treatment. This study aimed to understand the association between exposure to Environmental Protection Agency-regulated air pollutants and breast cancer mortality, including how the interaction between these air contaminants impacts the outcome of interest, considering median income, education level, and percentage …

Effect Of Drug Medi-Cal Organized Delivery System Access To Substance Use Disorder Treatment, Ana Y. Davies

Walden Dissertations and Doctoral Studies

Drug addiction, mental health disorders, and homelessness has impacted communities nationwide increasing mortality and morbidity and is a public health threat. But access to substance use treatment has been a problem due to the lack of the ability by many to pay for services. This observational quantitative research design utilized administrative secondary data collected between July 2017 and June 2022. The key variables are Insurance Status, Number of Admissions, and Successful Discharges in outpatient substance use treatment. The purpose of the study and research questions involved evaluating the effects Drug Medi-Cal (DMC) Organized Delivery System program by analyzing program admissions …

Determining Strategies For Cost Effectiveness In Sustainable Healthcare Delivery – An Emerging Market Study, Francis Ikechukwu Igbo

Walden Dissertations and Doctoral Studies

AbstractSome South African healthcare managers and physicians find sustaining quality, cost-effective healthcare services challenging. Healthcare leaders are concerned about the high cost of healthcare as it can negatively impact sustainability and patient outcomes. Grounded in the cost-effectiveness theory and complex adaptive system theory, the purpose of this qualitative multiple-case study was to explore strategies some South African healthcare leaders use to sustain healthcare delivery in lower- and middle-income countries. The participants were five healthcare practitioners in rural areas of South Africa. Data were collected through semistructured interviews and secondary data sources. Thematic analysis of the data yielded four themes: patients’ …

First Responder And Veteran Yoga For Posttraumatic Stress, Coping, And Anxiety, Nicole M. Mckenna

Walden Dissertations and Doctoral Studies

Constant exposures to trauma and violence often impact the wellbeing of veterans and first responders. Related heavy tolls have created an urgent need for wellness programs and coping strategies. This study utilized organismic valuing process theory as a lens to explore two research questions with a purpose to describe participants’ lived experiences and related perceptions of effectiveness. Specifically, the research was an exploration of (a) how first responders and veterans using yoga for posttraumatic stress, anxiety, and coping described their lived experiences with the intervention and (b) how first responders and veterans perceived the effectiveness of yoga for symptom improvement, …

Strategies For Maximizing The Use Of Electronic Health Records Systems In Medical Clinics, Alexandra Nieves Rivera

Walden Dissertations and Doctoral Studies

Ineffective leadership can negatively impact the use of electronic health records (EHR) systems in medical clinics. Healthcare managers who fail to maximize the use of EHR systems are missing out on the opportunity to optimize the quality of medical care that their clinic provides. Grounded in complexity leadership theory, the purpose of this qualitative multiple-case study was to explore strategies healthcare managers use to maximize the use of EHRs systems. Participants comprised six healthcare managers who successfully implemented strategies to maximize the use of EHRs systems. Data were collected from semistructured interviews and publicly available information. Thematic analysis was used …

Comparing Accelerated Bachelor Of Science In Nursing Rns’ And Traditional Bachelor Of Science In Nursing Rns’ Professional Socialization, Motivation, Resilience, And Intent To Stay, Dorothy Uhurebor

Walden Dissertations and Doctoral Studies

AbstractProfessional socialization is an adaptation process during which RNs learn new roles and adapt to becoming members of the nursing profession, which creates a significant effect on the RN’s professional development. Demographic factors such as prior work-related experience, gender, and education affect an RN’s intent to stay in the nursing profession. The purposes of this three manuscript study, guided by the London career motivation model and Grotberg’s resilience theory, were to determine (a) if there are differences in accelerated Bachelor of Science in Nursing (ABSN) RNs’ and traditional Bachelor of Science in Nursing (TBSN) RNs’ professional socialization process as measured …

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 …

Educating Registered Nurses On Interventions To Alleviate Compassion Fatigue, Andre Sabrina Castor

Walden Dissertations and Doctoral Studies

Walden University

College of Nursing

This is to certify that the doctoral study by

Andre Sabrina Castor

has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made.

Review CommitteeDr. Marilyn Losty, Committee Chairperson, Nursing Faculty Dr. Cheryl Holly, Committee Member, Nursing Faculty Dr. Susan Fowler, University Reviewer, Nursing Faculty

Chief Academic Officer and Provost Sue Subocz, Ph.D.

Walden University2022

Analyzing Veterans Affairs Telehealth Services Between Rural And Urban Centers In West Virginia, Vicki J. Dix

Walden Dissertations and Doctoral Studies

Veterans often have difficulty accessing health care within the Veterans Affairs (VA) system, contributing to the growing need for health care services in rural communities. The increasing demand for health care services in rural communities is driven by the aging population, an increase in life expectancy, and an increase in chronic disease. This quantitative study aimed to explore the relationship between the type of appointment and patient location on initial primary care and telehealth primary care wait times for veterans in West Virginia. The two research questions addressed the independent variables, type of appointment (telehealth or face to face) and …

Diabetes Self-Care Management Education For Advanced Practice Registered Nurses In Primary Care Setting, Rebecca Anne Griggs-Galyean

Walden Dissertations and Doctoral Studies

Type 2 diabetes mellitus is a preventable chronic condition that affects many members of the U.S. population. Diabetes is associated with comorbidities including cardiovascular disease, end-stage renal disease, hypertension, neuropathy, and lower limb amputations, leading to increased mortality. Patient self-care education has been shown to improve adherence to diabetes self-care (DSC) in the primary care setting. However, advanced practice registered nurses (APRN) in the local primary care setting lacked knowledge of DSC. Therefore, nursing knowledge of DSC was needed. The project question asked whether staff education on the use of the Association of Diabetes Care and Education Specialists 7 (ADCES7) …

Native American Registered Nurses Experience In Failing The Nclex-Rn On The First Attempt, Kristine Hilton

Walden Dissertations and Doctoral Studies

Nursing school graduates must pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN) to become licensed and work as a registered nurse. Nurse educators do not understand the experiences of Native American nursing graduates in preparing for the NCLEX and must understand how to support and mentor Native American nursing students to have more success in taking the NCLEX-RN. The purpose of this qualitative descriptive study, guided by Roy’s adaptive model, was to understand the experiences of Native American nurses who failed the NCLEX-RN on the first attempt. The participants in this study were nine Native American nurses who …