Medicine and Health Sciences Commons^™

Ambivalence Over Emotion Expression And The Effects Of Religious Coping In African American Christians, Anya Loraine Dobbs

Walden Dissertations and Doctoral Studies

African Americans are 10% more likely than non-Hispanic Whites to report having serious mental health issues from psychological stressors. Mental health concerns, such as depression and anxiety, that arise from psychological stressors, are more than likely to go untreated in African Americans. African Americans are more likely to turn to religion- their church, their pastors, and fellow parishioners to address these concerns. Religion and religious coping has influenced African Americans’ attitudes regarding help-seeking and mental health treatment, with the “Black Church” historically being a source of many things, including mental health care. Pargament’s theory of religious coping served as a …

Leader’S Relational Transparency And Team-Level Trust And Distrust, Jiri Krejci

Walden Dissertations and Doctoral Studies

Team trust in teams of collaborative knowledge workers has been identified as one of the main mediators of team effectiveness, and one of the most important outcomes of effective team leadership. The purpose of this quantitative nonexperimental study was to explore the relationships among relational transparency as a component of authentic leader’s behavior, and the levels of affect-based trust and distrust, as well as the relationship between both outcomes in context of the process of their emergence in a team setting. A total of 176 knowledge workers from a commercial business contact database participated. The relationships between these variables were …

Educating Staff To Reduce Hospitalization Of Individuals Living In A Group Home, Caroline Aina Ibijemilusi

Walden Dissertations and Doctoral Studies

AbstractPersons with intellectual and developmental disabilities (IDD) have significant health disparity in terms of high numbers of hospitalizations compared to the general population. The purpose of the project was to improve staff ability to recognize and respond to the changes in the health status of intellectually and developmentally disabled individuals living in a group home. The project utilized Knowles’s theory of adult learning to develop a curriculum suitable for adult learners and the Kirkpatrick model to guide the assessment of the training. Pre- and post-perception of learning and satisfaction surveys were provided to the participants online. A paired t test …

Impact Of Out-Of-Pocket Fees On Under-5 Infant Mortality In Cameroon, Amelie Olga Mafotsing Fopoussi

Walden Dissertations and Doctoral Studies

Health facilities in Cameroon charge fees for treatment and services, which can affect health outcomes for those unable to pay for services. Some studies have shown that the removal of user fees had a positive impact on child health outcomes in selected African countries. The aim of this quantitative, cross-sectional study was to understand whether there is a link between out-of-pocket expenses and under-5 mortality in Cameron. The study was guided by the social ecological framework. Secondary data from the 2011 Cameroon Demographic Health Survey were used in the study. Chi-square, binary logistic regression, and multicollinearity analyses were used to …

The Lived Experience Of African American Young Adult Men With Hiv And Self-Care Collaborative Management, Barbara A. Moore

Walden Dissertations and Doctoral Studies

AbstractAfrican American young adult (AAYA) men living with HIV often lack interventions that address the influence that HIV has on their quality of life, especially their relationships. Self-care collaborative management (SCCM) concerns related to disclosure and stigmatization complicate social, psychological, and SCCM behaviors. Intervention programs addressing these concerns should be based on relevant, accurate information, but this information is lacking for AAYAs. The purpose of this research was to explore and describe the lived experiences of male AAYAs with HIV and their use of SCCM. The study method was qualitative; Husserl’s transcendental phenomenology was the design. The individual family self-management …

The Impact Of Effective Patient Advocacy In Ghana Health Care Reform, Gladys Opong-Tetteh

Walden Dissertations and Doctoral Studies

AbstractPatient advocacy has become a vital concept for healthcare providers all over the world. There is evidence that the concept of patient advocacy is not new in Ghana. However, the degree of its practice continues to be negative and quite narrow in Ghana and even in Africa as a whole. It has also been argued that effective patience advocacy practice is either scarce or non-existent in Ghana. To address this issue, an assessment of the medical policies in Ghana was conducted, informed by the applied psychology theoretical framework. This study focused on using phenomenological inquiry to better understand patients’ experiences …

Improving Nurses’ Knowledge To Provide Diabetes Self-Management Education For African Americans, Jakeyla Reed

Walden Dissertations and Doctoral Studies

African Americans are at high risk for type II diabetes compared to other ethnic groups due to biological, socioeconomic, and psychosocial risks. Specifically, African American adults are nearly two times more likely than White individuals to develop type II diabetes. The meaningful gap-in-practice addressed by this doctoral project was nurses’ lack of diabetes knowledge affecting their ability to provide diabetes care and diabetes self-management education (DSME) to their patients with diabetes. The clinical practice-focused question asked whether an education intervention for outpatient clinic nurses could improve their knowledge of DSME. Orem’s self-care model, Bandura’s self-efficacy theory, and Lewin’s change theory …

Relationship Among Health Literacy Superstitious Beliefs And Self-Care Among Diabetic Patients In Warri, Nigeria, Nkemakolam Simpson Ukpabi

Walden Dissertations and Doctoral Studies

AbstractDiabetes imposes significant burdens in medical expenditures, medication use, outpatient visits, and treatment of its chronic complications. Self-care behaviors such as medication adherence and foot care have been shown to reduce hospitalizations and complications, and high health literacy levels have been positively associated with self-care adoption. However, the effect of superstition on this relationship has not been studied among diabetic patients in Warri, Nigeria. This study was conducted to determine the moderating effects of superstitious or cultural beliefs on the relationship between health literacy and self-care adoption among diabetes patients in Warri, Nigeria. A quantitative, observational, cross-sectional design guided this …

Access To Preventive Health Care Services And Effects On Health Outcomes For Hispanic Older Adults With Type 2 Diabetes, Shafa Al-Showk

Walden Dissertations and Doctoral Studies

Despite elevated prevalence of diabetes among Hispanic, Hispanic older adults face challenges in self-control and management of their glucose levels, and they have less access to preventive health care services. The purpose of this retrospective quantitative cross-sectional study was to examine the associations between access to preventive health care services and Type 2 diabetes outcomes among Hispanic adults aged 65 years and older. The social-ecological model provided the framework for the study. The research question for this study examined the extent to which doctor visits, diabetes education and blood sugar checks correlate with HbA1c levels. Data were collected from 566 …

Social Support, Substance Use, And Mental Health Services Utilization Among African Americans, Thomas Symche Bendu

Walden Dissertations and Doctoral Studies

Mental illness is more prevalent among African Americans than their Non-Hispanic White counterparts; however, this population is less inclined to receive behavioral treatment. The purpose of this study was to examine the association between perceived social support, substance use, and gender with mental health care services utilization among African Americans. The social ecological model and social support theory grounded this study. The research design was a quantitative cross-sectional analysis of the 2016 Behavioral Risk Factor Surveillance Survey. The sample consisted of 486,3030 African American adults that represented the U.S. population using weighted estimates. The overall logistic regression models for the …

Medical Spas: Ensuring Compliance And Patient Safety, Mike Chammout

Walden Dissertations and Doctoral Studies

Nonsurgical aesthetic procedures continue to grow in popularity; however, evidence-based clinical practice guidelines that can assist providers when performing aesthetic treatments are lacking. This gap in practice can result in the increased prevalence of side effects from treatments that can compromise patient safety and result in increased litigation. The goal of this project was the development of a clinical practice guideline (CPG) that can be used by aesthetic providers to standardize care when performing nonsurgical aesthetic procedures that can ultimately improve provider knowledge, which would improve patient safety. This CPG sought to answer the practice-focused question involving whether the development …

Lived Experiences Of Newly Graduated Registered Nurses, Tonya Lyn Chancey

Walden Dissertations and Doctoral Studies

Attrition rates for first year newly graduated registered nurses (NGRNs) are between 30% to 60%; high level of attrition negatively affects hospital organizations, other nurses, and patient outcomes. Transitioning from student nurse to clinical nurse poses challenges for NGRNs which includes assuming responsibilities for a full patient load, communicating with physicians, and adjusting to shift work. The purpose of this phenomenological study, guided by Kramer’s reality shock theory and Duffy’s quality caring model, was to examine the lived experiences of a first-year cohort of NGRNs working in the acute care setting of a Florida hospital. Thirteen NGRNs were interviewed using …

Experiences Of Married, First-Time Pregnant Adolescents When Seeking Care In Kano State, Yashua Alkali Hamza

Walden Dissertations and Doctoral Studies

Kano State in Northern Nigeria has very high maternal mortality rates. Early marriage and early pregnancies between 15 to 18 years of age are two of the most significant factors in the high maternal mortality rates in Kano State. This phenomenological qualitative research study focused on young first-time mothers’ experiences of seeking care between the ages of 15 and 18. The study’s theoretical framework was the feminist theory of intersectionality. Colaizzi’s seven-step method was the means used for data analysis. This study found that young adolescent first-time pregnant women in Kano City faced significant barriers at home and in health …

Improving Fall Risk Knowledge Through Staff Education In An Assisted Living Facility, Assumpta Egowure Ike

Walden Dissertations and Doctoral Studies

AbstractPatient safety and fall prevention are crucial for nurses and healthcare workers especially in assisted living facilities considering the age and health status of the patients. Low staff knowledge of fall risk measures in an assisted living facility may have contributed to an increase in the number of falls recorded in the facility by 20% in the last 2 years. This project addressed the questions of whether an education project could increase staff’s level of knowledge on fall risk measures, and whether any improved knowledge would coincide with the number of falls per patient day in the assisted living facility? …

Social Determinants Of Health Influence On Surgical Morbidity After Colorectal Surgery, Koianka J. Ivanova Trencheva

Walden Dissertations and Doctoral Studies

Decreasing surgical morbidity and improving surgical safety is a public health priority. With same-day or early hospital discharge after surgery, knowledge about social determinants of health (SDOH) impact on surgical morbidity is vital for surgical safety improvement. This study’s aim was to evaluate SDOH association with surgery-related morbidity after colorectal surgery in an adult population. This quantitative cross-sectional study used New York Statewide Planning and Research Cooperative System (SPARCS) secondary data from 2006 ⁠–2016 on 130,731 patients linked to SDOH. Dependent variables were anastomotic leak (AL), surgical site infection (SSI), Not SSI related, and overall complications (COMPL) within 30 days …

Reducing The Readmissions Through Multidisciplinary Rounds In Older Adults, Fatima Rajapathy Tisseverasinghe

Walden Dissertations and Doctoral Studies

Hospital readmissions are a reflection of poor quality of care. The readmission rate in an acute care for the elderly (ACE) unit was above the national benchmark in 2017. The specific problem includes lack of communication, collaboration, and coordination among the interdisciplinary team. Further, in older adults, the problem is accentuated by health illiteracy, comorbidities, cognitive impairment, polypharmacy, and unclear discharge and follow-up care instructions. Poor care transition costs Medicare 17.4 billion dollars a year. Multidisciplinary rounds (MDRs) have been adopted by many hospitals as evidence-based interventions to reduce readmissions within 30 days. This Doctor of Nursing Practice (DNP) project …

A Delphi Study On The Use Of Simulation In Undergraduate Nursing Education, Diana L. Bailey

Walden Dissertations and Doctoral Studies

AbstractThe lack of traditional clinical sites for nursing students has prompted a surge in simulation as an innovative teaching strategy in undergraduate nursing education. The International Nursing Association for Clinical Simulation and Learning (INASCL) developed the INACSL Standards of Best Practice: SimulationSM to direct schools of nursing in implementing high-quality simulations. As simulated experiences replace traditional clinical experiences, it is imperative that simulated experiences replicate real-life patient scenarios. The purpose of this Delphi study was to establish consensus on the use of the INACSL Standards of Best Practice: Simulation in undergraduate nursing education. The conceptual frameworks guiding this study were …

Strategies To Reduce Fall Rates In A Long-Term Care Facility, Kimberly H. Brewer

Walden Dissertations and Doctoral Studies

AbstractFalls among residents of long-term care facilities (LTCFs) pose significant threats to their health and quality of life, as falls often lead to life-threatening injuries such as traumatic brain injury and hip fractures. The etiology of the falls is multifactorial and complex; thus, interventions to reduce the falls typically combine two or more evidence-based interventions. The objective of this doctorate project was to develop an evidenced-based clinical practice guideline (CPG) outlining a multifaceted, evidenced-based bundled set of interventions for a fall prevention program to reduce falls for elderly patients living in the LTCFs. Lewin’s 3-step model of change was used …

Experience Of The Obese Population With Weight Bias/Stigma, Gary Mathew Brown

Walden Dissertations and Doctoral Studies

Obesity management has been identified as an important issue in health promotion, and some researchers have also reported that people who are obese often do not seek health care. Yet, current research is lacking on the complexities of weight stigma from the perspective of people who are obese. The purpose of this qualitive descriptive study was to understand the perceptions of weight bias/stigma of obese individuals. Guided by Goffman’s Theory of Social Stigma and the Health Belief Model, purposive sampling was used to recruit 10 participants who had a body mass index greater than 30 and who lived in West …

Increasing Fall Awareness Through Nursing Staff Education, Evelyn Ahiante Dennis

Walden Dissertations and Doctoral Studies

Patient falls are a significant healthcare concern, with the highest risk being among older adults aged 65 and older. A lack of nursing knowledge can contribute to patient falls. This DNP project was conducted in the medical-surgical trauma unit of a 137-bed local rehabilitation center in Northern Georgia. The intention of the project was to understand if a nursing staff education program would increase knowledge regarding falls prevention. Kurt Lewin’s change theory provided the framework for the project. The project participants were nine medical surgical nurses. Using the analysis, design, development, implementation (ADDIE) model, a falls prevention education program was …

Strategies For Managing Work-Related Stress In The Petroleum Industry, Esang Lazarus Esitikot

Walden Dissertations and Doctoral Studies

High work-related stress negatively impacts workers’ health and productivity in the Nigerian petroleum industry. Supervisors in the Nigerian petroleum industry who lack strategies to reduce work-related stress significantly lose worker health and organizational productivity. Grounded in person-environment fit theory, the purpose of this qualitative multiple case study was to explore strategies Nigerian petroleum industry supervisors use to manage work-related stress. Participants were six supervisors who have successfully used strategies to reduce work-related stress in the Nigerian petroleum industry. Data were collected from semistructured interviews and internal company documents relevant to reducing work-related stress and analyzed using thematic analysis. Three major …

Influence Of Parenting Style On Frequency Of Alcohol Consumption By Jewish Male And Female Emerging Adults, Thomas Gross

Walden Dissertations and Doctoral Studies

Abstract

The health hazards associated with young adults’ frequency of alcohol consumption have been well documented. It has been shown that 40.1% of emerging adults have been involved in binge drinking (i.e., consumption of more than five drinks in a row). The current prevalence rates of alcohol use among young male and female adults are 19% and 26%, respectively. The purpose of the study was to examine the influence of perceived parenting style (i.e., permissive, authoritarian, or authoritative/flexible) on the self-reported frequency of alcohol consumption of 138 U.S. Jewish male and female college students ages 19 to 27 years. The …

Demographic And Socioeconomic Determinants Of Lassa Fever In Edo State, Nigeria, Faith Ogagaroghene Ireye

Walden Dissertations and Doctoral Studies

Lassa fever is a viral hemorrhagic fever caused by the Lassa virus and associated with significant morbidity and mortality. Yearly outbreaks of the disease occur in Edo State, Nigeria. The purpose of this study was to examine the demographic and socioeconomic factors that can influence transmission of the disease. The Commission on Social Determinants of Health conceptual framework was used in this research study. This framework describes the relationship between structural and intermediary factors and how they determine health outcomes. To answer the research question of how demographic and socioeconomic factors influence Lassa fever transmission in Edo State, a cross-sectional …

Examining The Impact Of Mental Health Education On Bias And Stigma In Cit Trained Officers, Jennifer L. Krause

Walden Dissertations and Doctoral Studies

The purpose of this quantitative, correlational nonexperimental research was to examine the relationship between the mental health education received through Crisis Intervention Team (CIT) training and the perceptions of public mental health stigma, self-stigma, and attitudes toward seeking mental health services among law enforcement officers. The study’s theoretical framework integrated gender-role conflict theory and Goffman’s stigma theory in explaining the influence of the police culture on officers’ adoption of more traditional masculine roles. This research used three instruments: the Attitudes to Mental Illness questionnaire to measure perceptions of public stigma, the Self-Stigma of Seeking Help Scale to measure self-stigma, and …

Analysis Of Hba1c, Medication Compliance, Income Subsidies, And Comorbidity In Medicare Type 2 Diabetics, Robert E. Lazarchik

Walden Dissertations and Doctoral Studies

Diabetes is one of America’s leading chronic diseases with comorbidities contributing to lower health statuses and increased health care costs. While it is known that lowering HbA1c reduces the deleterious effects of diabetes, the capability to identify people with diabetes at risk for uncontrolled HbA1c levels or developing comorbidities based on the compliance rates for different oral antihyperglycemic medication classes (OAMCs) and financial assistance programs does not yet exist. These quantitative longitudinal retrospective studies examined the association between medication compliance, using Proportion of Days Covered (PDC), by OAMC and Medicare financial aid programs, on predicting HbA1c levels and comorbidities in …

Coping Strategies Of Dual-Role Informal Caregivers, Lorilee Maldonado

Walden Dissertations and Doctoral Studies

There are nearly 43.5 million informal caregivers (ICGs) in the United States, and this number will nearly double by 2030. Trying to fulfill the needs of an aging family member and commitments to work, home, and other relationships create a constant state of stress that may result in either leaving the workforce or placing the care recipient in a facility. Finding strategies that support both roles is economically and socially critical. This study explored the strategies that some ICGs have acquired that enable them to cope with these pressures. Work-family conflict theory, focusing on the conflict between work and family …

Diabetes Education For Nursing Staff In Primary Health Care, Artemio Pontejos

Walden Dissertations and Doctoral Studies

The nature of the DNP project was a staff education program for staff nurses and other clinic personnel on diabetes self-care management in a primary health care setting. The goal of this educational program was to improve and update the knowledge on self-care management of primary health care nurses. This education program followed the Walden University DNP Project Manual for Staff Education guidelines. The purpose of this continuing education of professional nurses was to improve nurses’ patient education on self-care management. After a 3-day face-to-face 90-minute lecture, improvement of knowledge was measured with a comparison of a pretest and a …

30-Day Hospital Readmission Rates In Illinois Hospitals For Patients With Heart Failure And Pneumonia, Kristine Rucker-Morrow

Walden Dissertations and Doctoral Studies

Despite efforts from hospitals across the United States, 30-day hospital readmission rates for patients with chronic conditions are on the rise. The purpose of this quantitative study was to examine the relationships in Illinois hospitals between patients with heart failure (HF) and pneumonia (PN) and 30-day hospital readmission rates by using the Pearson’s product-moment correlation test, focusing on how often these patients were readmitted and whether the hospital-wide rate of readmission after discharge changed. Andersen-Newman’s behavioral model with health services utilization was the theoretical framework, and a pre-collected Centers for Medicaid Services dataset was used for analysis. Results found a …

A Retrospective Analysis Of Integrative Group Medical Visits For Low-Income Patients With Anxiety Disorders In Primary Care, Annamma Udaya Thomas

Walden Dissertations and Doctoral Studies

High utilization of the emergency department (ED) by patients with anxiety symptoms has brought attention to mental health access disparities among low-income racially/ethnically diverse populations. The health system in this study attempted to increase access to mental health care with integrative group medical visits (IGMVs), a nonpharmacological intervention with biomedical care consultation, health education, and peer support. The purpose of this retrospective comparative analysis, guided by integrative health equity in primary care framework, was to determine whether patients with diagnoses of anxiety who attended four or more IGMVs had reduced nonemergent ED utilization, reduced prescribed doses of benzodiazepine (BZD), and …

Effect Of Clinical Trial Participation On Patient Experience And Overall Hospital Scores, Bridget Tyrka

Walden Dissertations and Doctoral Studies

AbstractDespite groundbreaking advances in technology and medicine in the United States and intensive examination of health services quality initiatives, issues of quality and patient-reported experience measures in the hospital sector remain unimproved. Although evidence-based medicine has improved through innovation in clinical research, healthcare systems have reportedly struggled to implement advances in medicine and lack the skill sets to become learning health systems. As clinical practice and clinical trials (CTs) have rarely intersected in the past, a significant lack of quantitative research has been dedicated to correlate improved patient outcomes with participation in CTs. The analysis sought a correlation, if any, …