Medicine and Health Sciences Commons^™

Helping In The Home: Counselors’ Experiences Providing Clients With In-Home Services, Melissa Jane Franzen

Walden Dissertations and Doctoral Studies

Counseling is an essential service that helps individuals work through struggles and live their best lives. Such service now includes providing counseling in clients’ homes. Counselors may require specific training or education to prepare for counseling in a home environment. This need for training and education is due to a lack of knowledge of the lived experiences of counselors providing services in the home. Transcendental phenomenology was used to guide a qualitative exploration into the lived experiences of counselors providing services in clients’ homes. Participants were 7 professional counselors, 5 female and 2 male, having met minimum state licensure requirements …

Educating Staff Nurses On Opioid Use Disorder, Moses Ikejiofor

Walden Dissertations and Doctoral Studies

Opioid use disorder (OUD) is a public health epidemic causing a rise in morbidity and mortality in the United States with disruption of victims and their families’ lives and a financial burden on the nation’s economy. The problem identified for this DNP project was nurses’ lack of knowledge of OUD and the impact on care and attitudes toward OUD patients. Framed within the analysis, design, development, implementation, and evaluation model of instructional design, the purpose was to plan and evaluate a staff education program on OUD. The evidence from the literature to support the need for this project showed that …

Perceptions And Experiences Of Sickle Cell Disease Patients And Parents/Caretakers On Alternative Treatment Options For Pain Management, Elizabeth Hagan Asamoah

Walden Dissertations and Doctoral Studies

Sickle cell disease (SCD) is marked by excruciating chronic pain, commonly known as pain crisis. SCD healthcare practitioners (HCPs) have been employing palliative care as a mainstream treatment option to manage SCD pain crises using mainly opioid analgesics for years. Due to the current opioid crisis, however, it has become imperative to explore alternative regimens to manage the pain and associated comorbidities of SCD. Thus, the goals of this study included exploring alternative treatment options for SCD pain crisis management with the intent of decreasing SCD patients’ dependency on opioid-based or related analgesics while reducing the frequency of pain crises …

Reducing Recidivism Of Psychiatric Inpatient Clients In Behavioral Health Facilities, Cottrell Jacobs

Walden Dissertations and Doctoral Studies

AbstractResearch shows readmitting clients to inpatient psychiatric facilities within 30 days to one year of discharge can be costly for an organization and may represent less than optimal quality care for clients. The purpose of this study was to obtain an in-depth understanding of practices and barriers to reducing inpatient readmissions by completing a qualitative case study of readmission reduction strategies used by a large inpatient psychiatric facility in the southern United States. The Baldrige excellence framework was used to guide the assessment of the organization. Data collection consisted of five semi-structured interviews with organizational leaders, evaluation of internal archival …

Clinical Practice Client Education Guideline For Early Detection Of Thyroid Cancer, Marcia Miller

Walden Dissertations and Doctoral Studies

AbstractThyroid cancer (TC) incidences over the last decade have increased significantly. The practice problem addressed in this project was nurses’ lack of knowledge on how to perform or teach clients how to perform self-exams of the neck region for early detection of TC. This lack of knowledge limits the nurses’ ability to properly educate their clients about TC and recognizing when to seek medical interventions. The purpose of this project was to develop of an evidence-based, clinical practice client education guideline (CPCEG), based on an in-depth literature review, to address the nurses’ lack of knowledge and enable clients to engage …

Medical Practitioners’ Intention To Use Secure Electronic Medical Records In Healthcare Organizations, Omar Enrique Sangurima

Walden Dissertations and Doctoral Studies

Medical practitioners have difficulty fully implementing secure electronic medical records (EMRs). Clinicians and medical technologists alike need to identify motivational factors behind secure EMR implementation to assure the safety of patient data. Grounded in the unified theory of acceptance and use of technology model, the purpose of this quantitative, correlational study was to examine the relationship between medical practitioners’ perceptions of performance expectancy, effort expectancy, social influence, facilitating conditions, and the intention to use secure EMRs in healthcare organizations. Survey data (N = 126) were collected from medical practitioners from the northeastern United States. The results of the multiple regression …

Cell Phone Use And Adolescent Weight Problems, Florence Kenkor Njang

Walden Dissertations and Doctoral Studies

AbstractOverweightinadolescenceincreasestheriskofobesityandmanyadversehealthoutcomeslaterinlife.The purpose of this quantitative cross-sectionalstudy was to investigatetheassociationbetweencell phoneuseandweightstatusinadolescents,ages14 17yearsold,livingintheUnitedStates.Thesocio-ecologicalmodel(SEM)wasusedtoexplainthelinkbetweencellphoneuseandoverweightamongadolescents.Threeresearchquestionswere used to explore(a)therelationshipbetweencellphoneuseandadolescentweightstatusaftercontrollingforage,gender,andrace;(b)the effectofcellphoneuseonoverweightandnormalweightstatusesamongadolescentsaged 14 17yearsaftercontrollingforage,gender,andphysicalactivity;and(c)themodifyingeffectofraceontherelationshipbetweencellphoneuseandadolescentoverweightaftercontrollingforageandgender.Secondary data from the2017YouthRiskBehavioralSurveillanceSystemwere analyzed usingbinarylogisticregressiontoanswer theresearchquestions.Highcellphoneusesignificantlyandpositivelypredictedoverweightinadolescentsaftercontrollingforage,gender,andrace(p<0.001).Afteraccountingforage,gender,andphysicalactivity,highcellphoneusewasasignificantpredictorofoverweight(p<0.001).Similarly,racehadasignificantmodifyingeffectonthepositiveassociationbetweenhighcelluseandoverweightamongadolescents(p<0.001).Thekeypositivesocialchange implication of this studyis the potentialtointegratehealthycellphoneusewithexistingobesitypublichealthinterventionsthatcanreduceoverweightandpositivelyimpactindividuals,families,andcommunities.

Development Of A Detox Clinical Practice Guideline For Pregnant Women Suffering From Opioid Addiction, Becca Ward

Walden Dissertations and Doctoral Studies

AbstractThe number of women suffering from opioid use disorder during pregnancy is a national epidemic. The gap in nursing practice is the lack of detoxification and medication-assisted treatment facilities that are equipped to care for this vulnerable population. The purpose of this project was to develop a clinical practice guideline (CPG) that is safe for both the fetus and the pregnant mother. Opioid dependence during pregnancy is on the rise with the nation’s current opioid epidemic. In this project, a meta-synthesis review was used to gather evidence from various sources and to develop a detox CPG that is safe for …

African American Females And Herpes Simplex Virus 2: A Basic Interpretive Qualitative Study, Cherlisa Jackson

Walden Dissertations and Doctoral Studies

According to recent studies, African American females are most susceptible to HSV-2 and are often asymptomatically diagnosed. Yet, the perceived benefit of discussing sexual health as well as recognizing a need to discuss HSV-2 with a healthcare provider was an identified gap in the existing research and current study findings. The purpose of this qualitative interpretive study was to understand the experiences of African American females who received an asymptomatic HSV-2 diagnosis. The health belief model constructs guided this study. Outlined through semi-structured interviews were the experiences of seven African American females diagnosed with HSV-2 in Fulton County, GA, as …

Staff Education Regarding Breastfeeding For Perinatal Nurses, Shannon Nicole Long

Walden Dissertations and Doctoral Studies

AbstractExclusive breastfeeding in the U.S. is the optimal form of nutrition up to the age of 1 year; however, the current U.S. rate of 49% and Kentucky rate of 39% fall below the Healthy People 2020 goal of 60.6%. Researchers have shown that perinatal nurses often lack knowledge to ensure mothers begin and maintain this optimal form of human nourishment. Framed within the analysis, design, development, implementation, and evaluation model of instructional design, the purpose of this project was to present a continuing education program on breastfeeding for 10 staff nurses at the target hospital. The program presented was the …

Understanding Parent/Child Experiences Affecting Obesogenic Behavior In Children, Jean Gaffney

Walden Dissertations and Doctoral Studies

Families living in an inequitable food environment are impacted by limited access to healthier foods inventory. Habitual consumption of foods lacking adequate nutritional value increasingly contributes to the heightened prevalence of obesity and premature death from non-communicable chronic diseases such as diabetes and heart disease. This basic qualitative analysis examined factors that impact parental decisions in food choices among obese and overweight children. The study explores the level of understanding held by low-income parents/caregivers as it relates to basic nutritional knowledge. Bandura’s Social Cognitive Theory framed the study. A purposeful sample of eight parents/caregiver between the age of 18-50, parenting …

Synthesized Grounded Theory Expansion Of The Quadruple Aim In Acute Care Nursing, O. Ann Ann Fuller

Walden Dissertations and Doctoral Studies

AbstractConflation of moral and compassionate healthcare within the business model that is focused on customer service, disempowers, dehumanizes, and destabilizes nursing as well as the financial stability of healthcare. The purpose of this research was to determine nurses’ perceptions of how their work environment supported or contradicted a potential expansion of the quadruple aim. The quadruple aim was the primary conceptual framework for this research. The overarching research question was about how the environment of care supports professional nurses’ provision of high-quality person- centered care and bolsters meaningful and purposeful careers. The synthesized grounded theory methodology was used to collect …

New Graduate Nurses’ Transfusion Training Views: Reflection On Experiences With Adverse Reactions, Hind Jaber-Daou

Walden Dissertations and Doctoral Studies

Abstract:New graduate nursing students transitioning to becoming professionals undergo education and training to gain knowledge and competence about transfusions. Nonetheless, new graduate nurses experience stress during a blood transfusion adverse reaction, which can be associated with lack of knowledge and inadequate training. The purpose of this qualitative study was to gather data from new graduate nurses who described their lived experiences with patients exhibiting symptoms of adverse reactions, how they reflected on their emotional effects, and the influences of the training on their knowledge and confidence. The research was grounded in social cognitive theory that centers on the concept of …

Diabetic Education For Nurses To Enhance Patient Outcomes, Jacklyn Obeng

Walden Dissertations and Doctoral Studies

AbstractDiabetes mellitus is metabolic disease that causes elevated blood glucose levels resulting in long-term health complications and medical costs. This project was aimed at addressing the lack of confidence and knowledge staff had when teaching patients diabetes self-management interventions. The purpose of this project was to develop an evidence-based educational program for staff working in an outpatient clinic in the northeastern United States. The analysis, design, development, implementation, and evaluation model and Watson’s theory of human caring provided frameworks for the project development and implementation. A diabetic nurse educator, a family nurse practitioner, and the chief medical officer served as …

Evidence-Based Hospice Care Education For Healthcare Clinicians, Nonie E. Weir

Walden Dissertations and Doctoral Studies

Vulnerable populations with a terminal illness, who reside in a nursing home setting, continue to experience psychological, physical, and emotional effects that lead to end-of- life (EOL) suffering and discomfort. Globally, millions of individuals receive care from a hospice provider. By 2030, this figure will triple due to the increased lifespan of the geriatric population. The literature review has revealed that the practical problem is the lack of hospice care education received by healthcare clinicians. It is, therefore, important to prepare and educate healthcare clinicians about a peaceful death through an individualized plan-of-care (POC) from a holistic approach. The purpose …

Exploring Culturally Competent Mental Health Outreach To Black Churches, Michele Marie Fry

Walden Dissertations and Doctoral Studies

Black individuals and communities have held distrust toward mental health services and experience barriers in seeking services. Although the church is a significant support system in the Black community, it can also pose a barrier to congregation members seeking mental health services, as the Black church community has often stigmatized those seeking mental health services as weak. Ways to reach the Black community with trauma-informed, culturally competent, and spiritually sensitive mental health services through establishing connections with Black churches and church leaders were explored in this study. Previous research indicated that the COVID-19 pandemic increased depression and anxiety in the …

Staff Education Inservice For Preventing Discrimination Against Lgbt, Florence Titilola Eze

Walden Dissertations and Doctoral Studies

Lesbian, gay, bisexual and transgender (LGBT) members live in the community, yet they are prone to various types of oppression, mistreatments, and denial of services from most institutions including health care settings. Concerns, such as being denied access to caregivers or being given a lower quality of care continue despite the community’s fighting for their voices to be heard across the globe and various movements that have been established, especially the United States and the United Kingdom, and laws that call for equitable healthcare. The purpose of this project was to explore whether a change in knowledge and attitudes would …

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

Walden Dissertations and Doctoral Studies

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

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

Walden Dissertations and Doctoral Studies

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

Developing A Presimulation Protocol For Prostate Cancer Patients Undergoing Radiotherapy, Jennifer Wieworka

Walden Dissertations and Doctoral Studies

Inadequate preparation of prostate cancer patients undergoing radiation therapy (RT) can damage healthy tissue and cause long-term complications. Proper setup can reduce side effects. Currently, there are no standardized guidelines to help prepare patients for prostate radiation. Guidelines will help nurses coordinate care and manage symptoms for these patients. The purpose of this doctoral project was to address the gap in practice of the lack of a standardized process for implementing presimulation interventions for patients with prostate cancer undergoing RT by developing an evidence-based clinical practice guideline (CPG). The practice question for this project focused on the best practices contributing …

Hospital-Acquired Condition Ranking Score Among Types Of Safety-Net Hospitals, Jude C. Iruka

Walden Dissertations and Doctoral Studies

Abstract The Center for Medicare and Medicaid Services has been shifting from paying hospitals for the volume of services they delivered to paying them for the quality of those services, known as pay-for-performance, to incentivize hospitals to offer improved care at a lower cost. When a patient goes to the hospital to receive care for one condition and develops another condition during that hospital stay, the second condition is referred to as a hospital-acquired condition. It is anticipated that 1.7 million infections are acquired at some point in-hospital stay in the United States annually, resulting in nearly 100,000 deaths in …

Osteoporosis Risk Assessment Impacts Bone Densitometry, And Fall Fractures In Primary Care, Ifeoma Ude-Okoro

Walden Dissertations and Doctoral Studies

Abstract

In the United States, approximately 10 million adults 50 years and older are plagued by osteoporosis; this number has been projected to climb to 14 million by 2020. Osteoporosis is a debilitating disorder characterized by significant loss of bone mass and mineral density. Without proper screening and diagnosis, patients may not receive the appropriate medical treatments to avoid worsening of their condition and its associated complications. Nurses can help identify patients at risk for osteoporosis by administering osteoporosis screening during routine office visits. The practice-focused question asked whether the Fracture Risk Assessment Tool (FRAX) increased the proportion of bone …

The Lived Experiences Of Avoiding Recidivism Among African American Male (First-Time) Former Offenders, Jeff Hines

Walden Dissertations and Doctoral Studies

AbstractThe United States has a high recidivism rate within its criminal population, especially among men of African American descent. However, within this population, some first-time former offenders have used successful approaches to avoid re-incarceration. The objective of this study was to investigate how these first-time former offenders desist from crime and avoid recidivism. This was a phenomenological study, utilizing the Desistance Theory as a framework, to explore how these men survived the consequences of post-incarceration and remained crime-free. In-depth, semi-structured, open-ended interviews were conducted with six African American male first-time former offenders (age 25 and older) who were not on …

Importance Of Childhood Maltreatment On Borderline Personality In Adults: Meta-Analysis, Lisa Nicole Trentacosti

Walden Dissertations and Doctoral Studies

Early childhood maltreatment (CM) is a risk factor for later psychopathology specifically Borderline Personality Disorder (BPD). CM has been found to negatively affect social, emotional, and psychological development as well as the ability to foster and sustain interpersonal relationships throughout all stages of life. There are evidence-based interventions for different kinds of CM including Trauma-Focused Cognitive-Behavior Therapy (TF-CBT), Alternatives for Families - Cognitive Behavioral Therapy (AF-CBT), relaxation training, and social skills training. The current study is a meta-analysis of published research into CM as it contributes to BPD in adults and is designed to examine the effect size of childhood …

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

Walden Dissertations and Doctoral Studies

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

Health Insurance Coverage, Sociodemographic Factors, And Treatment Completion For Opioid Abusers In Indiana, Ibrahim Samna

Walden Dissertations and Doctoral Studies

Many accidental deaths have recently occurred in Indiana due to opioid overdose. The current study sought to assess the association between sociodemographic factors, health insurance, and successful treatment completion for opioids abusers in Indiana based on the existing literature gap. In this study, the dependent variables considered were treatment completion status and opioid abuse. The independent variables included health insurance coverage and sociodemographic factors of education, marital status, employment status, race, gender, and age. I measured both dependent and independent variables as categorical. A cross-sectional and quantitative research approach was used by analyzing data from the 2017-Treatment Episode Data Set …

Isocitrate Dehydrogenase-1 Mutation As A Prognostic Factor In Recurrent Glioblastoma, Haroon R. Hashmi

Walden Dissertations and Doctoral Studies

Glioblastoma (GBM) is an aggressive form of brain cancer that has a high recurrence rate and very poor prognosis. The prognostic value of various molecular markers (e.g., IDH 1 mutation, MGMT promoter methylation, etc.) and clinical factors (e.g., age, KPS, surgery and chemotherapy) has been studied in GBM after initial diagnosis but not as extensively in the recurrent GBM. Utilizing a retrospective cohort design, based on quantitative data collected through medical chart reviews, and the conceptual framework of outcomes research in oncology, this study evaluated the prognostic value of IDH-1 mutation in recurrent GBM in the context of key predictor …

Improving The Patient Experience With Case Management Follow Up Phone Calls: A Quality Improvement Project Evaluation, Karen Jarrell

Walden Dissertations and Doctoral Studies

In January of 2020, a follow-up phone call quality improvement initiative was implemented by the case management department of an acute care facility located in the Mid-Atlantic region of the United States, to improve the patients’ healthcare experience. The intent was to improve the Consumer Assessment of Healthcare Providers and Systems (CAHPS) scores. This quality improvement (QI) project was conducted using the Plan-Do-Check-Act Cycle along with the Kotter’s 8-step change model. The purpose of the QI project evaluation was to determine if a QI initiative using follow up phone calls had a positive effect on increasing CAHPS survey scores. The …

The Impact Of Midwifery On Infant And Maternal Outcomes Among Black Mothers, Joann Honoré

Walden Dissertations and Doctoral Studies

According to recent studies, disparities are prevalent in maternal and fetal outcomes between Black and White mothers in the United States. Researchers have established that using a midwife versus other healthcare practitioners can elicit positive maternal and fetal outcomes for Black mothers. However, no within-race research has been conducted exploring midwifery as an insulating factor against these disparities. The purpose of this quantitative retrospective cohort study was to explore the impact of midwifery on infant and maternal outcomes compared to outcomes associated with other prenatal care models/caregivers among Black mothers in California using secondary data. The ecological model was used …

Professional Nurse Attitudes Of Poverty Before And After Participation In A Poverty Simulation, Beth Mueller

Walden Dissertations and Doctoral Studies

Implicit bias in healthcare toward those living in poverty may contribute to inequalities in care and increase the likelihood of patient noncompliance. The purpose of this study was to determine if participation in a poverty simulation had an impact on the attitudes of professional nurses toward those in poverty. Mezirow’s transformational theory was used to guide the study by allowing the learner to examine meaning and revise perspective after participation in an online module. This module included an online poverty simulation created by The United Way of Connecticut titled Making Tough Choices as well as a pre- and post-simulation survey …