Medicine and Health Sciences Commons^™

Perception Of Clinic Staff On Weight Reduction Program For Young Adult Females, Ifeyinwa Cordelia Ibeanu

Walden Dissertations and Doctoral Studies

Obesity, a common disease among young people in the United States, is defined as aBMI of 30 or more. Among the most prevalent noncommunicable diseases, obesity is reported as a significant public health issue for the general population. The management of younger adults’ obesity requires advanced skills and knowledge to promote healthier lifestyles while directly addressing the factors that contribute to the condition. As a result, this project was designed to evaluate the staff perception of an evidence-based educational program on weight reduction among young adult females (ages 18-25) diagnosed with obesity at outpatient clinic in a Northeastern mid-Atlantic States. …

Discharge Instructions To Decrease Copd Readmissions, Randee S. Marinaro

Walden Dissertations and Doctoral Studies

AbstractChronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the US. A 301-bed rural hospital in the Midwest had experienced excessive 30-day hospital readmissions with their COPD patients. Two gaps in practice were identified: a lack of uninterrupted time to plan and execute discharge instructions and inconsistent discharge instructions provided to these patients as. The purpose of this project was to educate staff nurses on the importance of implementing a protected time, evidence-based discharge plan for patients diagnosed with COPD. The project explored whether a discharge education program nurses would decrease the 30-day readmission rate for …

Comparison Of Kidney Disease Risks Among African Americans In Maryland And Neighboring Regional States, Nneka A. Offiah

Walden Dissertations and Doctoral Studies

AbstractChronic kidney disease (CKD) is a recognized global health burden that has affected 10-15% of the general adult population, which is caused by diabetes and has disproportionately affected minority populations such as African Americans. Despite the prevalence of diabetes and hypertension, other variables could predispose this racial group to CKD, hence the need for this study. The purpose of this cross-sectional quantitative study using secondary data analysis methods was to investigate to what extent various factors such as gender, diet, age, exercise, socioeconomic status, diabetes, and hypertension were associated with the prevalence of CKD among African Americans residents in Maryland, …

Factors Associated With Electronic Cigarette Use Among Adolescents In Texas, Christie Anuli Okonkwo

Walden Dissertations and Doctoral Studies

The use of electronic cigarettes among adolescents has remained a major public health concern. Reports have shown that the adolescent brain is still growing and can be affected by nicotine and cancer-causing chemicals contained in e-cigarettes. The rising trend of e-cigarette use by adolescents has reportedly reached an epidemic, and there is a knowledge gap in the factors associated with this behavior and the provision of appropriate interventions for the at-risk population. The purpose of this quantitative, cross-sectional study was to investigate the association between sociodemographic factors and the tendency of Texas adolescents to use e-cigarettes. This study was a …

The Combined Impact Of Race And Education On Obesity Among U.S. Adults By Fidelis Okoye, Fidelis Chidi Okoye

Walden Dissertations and Doctoral Studies

Walden University

College of Health Professions

This is to certify that the doctoral dissertation by

Fidelis Okoye

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 Committee Dr. Vasileios Margaritis, Committee Chairperson, Public Health Faculty Dr. Srikanta Banerjee, Committee Member, Public Health Faculty Dr. James Rohrer, University Reviewer, Public Health Faculty

Chief Academic Officer and ProvostSue Subocz, Ph.D.

Walden University2021

AbstractThe Combined Impact of Race and Education on Obesity Among U.S. Adults by Fidelis Okoye

MA, Walden University, 2009BS, Marygrove College, 2001

Dissertation …

An Examination Of The Absence Of A Comprehensive Smokefree Law In Georgia On College And University Campuses, Nakki Price

Walden Dissertations and Doctoral Studies

AbstractCigarette smoking is the number one preventable cause of death and disability in the United States. Although there are policies that govern the use of tobacco products, there are jurisdictions that do not employ these policies. Comprehensive smokefree laws govern private-sector entities and prohibit smoking in public places, specifically restaurants, bars, and workplaces. While states have the authority to implement these laws, some include exceptions that limit the intention of the law. Colleges and universities are specific communities for learning and serve as housing for students and an employer for the greater community. There is a gap in the literature …

Family Texting In The Perioperative Care Setting, Crystal Chantel Vestal

Walden Dissertations and Doctoral Studies

Family members experience anxiety not knowing how their loved one is progressing during the surgical process. Communication between perioperative staff and the family can be challenging due to the operating room being in a restricted location. Communication between perioperative staff and the patient family, as reflected in scores on the Press Ganey evaluation report, was below the benchmark for a hospital located in the Western United States. This report measures how satisfied patients were with the information provided to their family during surgery. To address this gap in practice, the hospital implemented a text messaging quality improvement project from August …

Sociodemographic And Pregnancy Risk Factors Associated With Place Of Delivery Among Northern Nigerian Women, Daniel Ali

Walden Dissertations and Doctoral Studies

AbstractOne out of every 13 women in Nigeria die during childbirth. In Nigeria, over 60% of deliveries that take place at home were attended to by an unskilled person. This study involved using Thaddeus and Maine’s three delays model to determine the influence of sociodemographic factors (woman’s age, woman’s residence [rural/urban], woman’s and husband’s education level, husband’s occupation, household wealth), pregnancy risk factors (antenatal care usage, wanted pregnancy, and birth order) on the choice of place of delivery amongst women of reproductive age (15-49 years) in Northern Nigeria. This quantitative cross-sectional study used the National Demographic Health Survey of 2018. …

Development Of A Preceptorship Program For Novice Nurses In Long-Term Care, Loice Moraa Collins

Walden Dissertations and Doctoral Studies

AbstractThe practice problem is that of high turnover rates of novice Licensed Practical Nurses (LPNs). The practice–focused question addressed whether or not a preceptor program for LPNs in a long-term care facility (LTC) would increase their competency in serving as a preceptor for novice and newly hired LPNs. The purpose of this doctoral project was to address the significant gap in practice that is made evident in the nursing leadership due to a lack of onboarding process which has led to a 62% turnover rate of the novice LPNs. The theories and models used to inform the doctoral project included …

Staff Education Program Assessment Of Violence In An Acute Psychiatric Hospital, Steven Dickson

Walden Dissertations and Doctoral Studies

Physical aggression and violence are sizable concerns for mental health nursing professionals. More than 80% of nurses working in mental health areas have faced verbal or physical abuse from patients. The practicum site noted that patient violence towards staff accounted for 18-20% of workplace injuries involving days away from work, compared to 10-11% in other healthcare settings. The purpose of this project was to develop a program to educate staff on the Brøset violence screen (BVC), an evidence-based, violence-risk screening tool, to increase staff's knowledge about this tool. Five behavioral health experts used the Lynn model to evaluate the project’s …

The Systemic Experiences Of Social Workers In An Inpatient, State Psychiatric Hospital, Kesia Gwaltney

Walden Dissertations and Doctoral Studies

The National Alliance on Mental Illness surmised that 1 in 25 (9.8 million) adults in the United States are diagnosed with a serious mental illness annually. Of the 9.8 million people diagnosed, approximately 63% of them are psychiatrically hospitalized with repeat hospitalizations within 1 year of discharge. Social workers play a vital role in the treatment modalities of the patients they serve in the psychiatric hospital; however, there is no research that examined the professional systemic experiences of social workers in state, inpatient psychiatric hospitals and how these experiences may affect treatment outcomes of patients as it relates to frequent …

Domestic Abuse Against Men In Kenya, Catherine W. Kigaya

Walden Dissertations and Doctoral Studies

Domestic violence, also known as intimate partner violence (IPV), is prevalent globally and causes severe physical, psychological, and social harm to victims. The purpose of this quantitative cross-sectional study was to highlight the predictors of physical and sexual IPV among men in Kenya and examine the influence of media in seeking help. These factors were explored through the lens of the socio-ecological model and the social learning theory. The 2014 Demographic Health Survey archival data obtained through in-depth interviews were used to answer the research questions. Dependent variables were physical abuse, sexual abuse, and seeking help while independent variables were …

Examining Nursing Home Staff Turnover Rate In Long-Term Care Organizations In The United States, Dandrea Vanettra Kittles

Walden Dissertations and Doctoral Studies

AbstractEvery year, many nursing assistants in the United States leave their positions. The high level of turnover can be disruptive to patient care and costly to organizations needing to replace workers; another consequence can be increased job dissatisfaction among remaining staff. Despite the high turnover in nursing facilities, there remains a research gap regarding the factors that promote employee retention. The purpose of this study was to examine nursing assistants’ beliefs about job satisfaction as an approach to prevent job turnover and retain high-achieving staff in nursing homes in the United States among the older adult population. Herzberg’s motivation-hygiene theory …

Nigerian Pensioners’ Knowledge, Attitudes, And Beliefs About Type 2 Diabetes, Nnawuihe Ugochukwu Nwosu

Walden Dissertations and Doctoral Studies

AbstractDiabetes is one of the leading killer diseases globally, and it is on the rise, especially in developing countries like Nigeria. The high prevalence of undiagnosed Type 2 diabetes in developing African countries has been attributed to a lack of knowledge and awareness about the disease, unbelief in modern healthcare efficacy, and limited healthcare services access. The purpose of this study was to explore the knowledge, attitudes, and beliefs about Type 2 diabetes among pensioners in Nigeria. A qualitative phenomenological research design was used for the study. The constructs of the health belief model formed the study’s theoretical framework. Data …

Managers’ Challenges Complying With Environmental Regulations In Ghana’S Mining Sector, Augustin Tandoh

Walden Dissertations and Doctoral Studies

Even though Ghana’s mining industry has been and continues to be of remarkable benefit to the national economy, environmental pollution continues to plague the industry. The purpose of the qualitative case study was to obtain the perceptions of 9 nongovernmental organization (NGO) stakeholders of the challenges faced by managers in the Ghanaian mining industry tasked with complying with Ghana Environmental Protection Agency (GEPA) regulations. Freeman’s stakeholder theory was the theoretical framework of the study. Data were collected from semistructured interviews with a purposive sample of Ghanaian and international NGO representatives who sought to work with, or even shame and pressure, …

A Study Of Public Awareness About The Threat Of Earthquakes, Mike Allen

Walden Dissertations and Doctoral Studies

Noticeably absent from the existing literature was a correlation study which would have gauged individual awareness for earthquakes. The literature search provided one quantifiable narrative that correlated college education with awareness about earthquakes; the study found that college graduates scored higher points on the awareness test for earthquakes than their counterparts who had no college education. The research question for this study examined the possible correlations between personal characteristics and awareness about earthquakes. A survey was developed and used to find hypothesized correlations between public awareness and a number of variables such as age, gender, education, income, and professional leadership. …

Why African American Men Diagnosed With Chronic Obstructive Pulmonary Disease Continue To Smoke, Vashonda Laniece Allen

Walden Dissertations and Doctoral Studies

AbstractThe purpose of this research was to explore why some African American men diagnosed with chronic obstructive pulmonary disease (COPD) continue smoking following their diagnosis. The theory of planned behavior (TPB) guided the development of this research. The research questions were developed to understand the attitudes, behavioral intentions, subjective norms, social norms, perceived power, and perceived behavioral control that influence their continuing or quitting smoking based on the TPB model. The study’s research method was qualitative. A pilot study, using the same criteria as the main study, confirmed the reliability of the interview guide. Participants were informed about the study …

Understanding Female Somali Noncollege Graduate Immigrant’S Experiences With Cervical Cancer Screening Services, Rachel Anyu Anyu-Lainjo

Walden Dissertations and Doctoral Studies

AbstractHealthcare disparities exist in cervical cancer screening worldwide particularly in women of East African descent compared to non-African women. Previous research has investigated the reasons for low participation in cervical cancer screening among Blacks, minorities, and immigrant populations. Limited research has focused on immigrant women in the United States of America, specifically immigrants from Somalia who currently live in St. Cloud, Minnesota. The purpose of this qualitative study was to understand the perception of Somali immigrant women ages 25 - 45 years who have not earned a college degree and their lived experiences with cervical cancer screening. Two conceptual frameworks …

Educational Intervention To Increase Telemedicine Knowledge In Nurses, Jean Sylvestre Ayissi Essono

Walden Dissertations and Doctoral Studies

Limited access to healthcare services is a factor that can reduce quality of care, and it is more pronounced in rural settings. One plausible solution to this concern is telemedicine, the use of electronic information and telecommunication technologies to provide care when an individual and provider are not in the same location. Although telemedicine has been suggested as a solution to the access to care concern, it is not widely integrated into the nursing practice. Using Nightingale’s holistic theory of caring, the purpose of this DNP project was to determine if an educational study geared towards telemedicine increased knowledge and …

An Educational Program For Nursing Home Nurses On Sepsis In Older Adults, Wendy Belden

Walden Dissertations and Doctoral Studies

Elderly nursing home patients’ high rates of hospitalization due to sepsis impact their morbidity and mortality and significantly cost the U.S. healthcare system. Skilled nursing facility (SNF) nurses who have the knowledge to assess older adults for signs and symptoms of sepsis and communicate findings to providers are instrumental in providing improved care for patients. The purpose of this doctoral project was to provide a group evidence-based educational intervention on sepsis care of older adults geared toward nurses working in SNFs. The practice-focused question asked whether an educational intervention focused on the signs and symptoms of sepsis in the elderly …

Sociodemographic Factors, Socioeconomic Factors, And Teenage Pregnancy Outcomes In Guyana, Karen Roslyn Cummings

Walden Dissertations and Doctoral Studies

Teenage pregnancy, a global phenomenon is associated with adverse pregnancy outcomes, owing to the mother’s individual factors, location, education attainment, and service accessibility. Globally, 16 million babies are born to teenage mothers annually. In Guyana, there is a paucity of information on factors associated with teenage pregnancy rate which stands at 74 per 1,000, and its outcomes. Archived data from the 2014 UNICEF Multiple Indicator Cluster Survey 5 (MICS5) was used to identify and examine relationships between the sociodemographic, socio-economic factors, and teenage pregnancy outcomes in Guyana. This quantitative cross-sectional review approach guided by the Bronfenbrenner theoretical framework analyzed data …

Improving Nursing Knowledge On Antibiotic Therapy To Prevent Pneumonia Readmissions, Muskuda Deen

Walden Dissertations and Doctoral Studies

Lack of education on the appropriate use of antibiotic therapy can lead to an increase in early readmissions for patients with community-acquired pneumonia (CAP). The purpose of this project was to educate medical-surgical nurses at an inpatient hospital in the southern region of the United States on the appropriate use of antibiotic therapy to decrease early CAP readmissions. The project practice question was whether the infection control clinical practice guidelines would increase the medical-surgical nurses’ knowledge on the appropriate use of antibiotic therapy to decrease the 30-day readmission rates for patients diagnosed with CAP. The staff education development was guided …

Staff Education On The Use Of The Lace Index In Clinical Settings, Carrole Dorcent

Walden Dissertations and Doctoral Studies

As of 2008, the Centers for Medicare and Medicaid Services has instituted monetary penalties for institutions with excess readmissions. As a result of these initiatives, hospitals are investing resources and efforts to educate their staff to use tools aimed at reducing readmission rates. The LACE index tool is one metric used to identify patients at high risk for readmission. The practice-focused question addressed in this project was whether the use of a teaching module is effective at improving clinical staff knowledge on the LACE index. The purpose of the project was to develop a teaching module to educate advanced practice …

Subclinical Stress On Obesity Among Obese African American Women, Dr. Nosakhare Osasu Idehen

Walden Dissertations and Doctoral Studies

AbstractObesity is a complex disease linked to genetics, health behaviors, upstream social determinants of health, and psychosocial stress. Obesity-related chronic diseases and opportunity cost significantly impact individuals and communities. Current prevention policies focus on diet and exercise without demonstrating the benefits of stress coping strategies in obesity management. Subclinical racial minority and gender stress heighten hypervigilance, psychological overload, poor stress coping strategies, inflammation, and obesity. Subclinical stress varies with race and gender, and it is higher in African American (AA) women. The purpose of this qualitative study was to explore the lived experience of subclinical racial minority and gender stress …

Hpv Vaccination Rates Among Males In Minority Populations, Andrew Lemke

Walden Dissertations and Doctoral Studies

Ethnic minorities are less likely to be vaccinated in comparison to White individuals. As a result, Blacks have one of the highest rates of human papillomavirus (HPV)-related complications. The purpose of the quantitative study was to identify significant factors predicting initiation of HPV vaccination in Black male adolescents. The study was based on the constructs of Ajzen’s theory of planned behavior and used a cross-sectional design that involved weighted data from the 2018 National Immunization Survey (n=395,067) conducted by the Centers for Disease Control and Prevention. The research questions were based on how factors such as fear, family involvement, sexual …

Strategies For Catalyzing Clinicians’ Support Of Telemedicine Programs In Rural Communities, Jonathan Liwag

Walden Dissertations and Doctoral Studies

Clinicians’ failure to accept contemporary technology has been a critical barrier to telemedicine program adoption. Staff technical challenges and resistance to change can affect technology return on investment, which concerns telemedicine program leaders. Grounded in Davis’s technology acceptance model, the purpose of this qualitative, descriptive single case study was to explore strategies used by program leaders in the Marianas Islands who successfully gained clinicians’ acceptance of contemporary technology. The participants were 5 program leaders recommended by their institution because of their leadership role and telemedicine technologies experience. Data were collected from 4 face-to-face and 1 audio teleconference interview with the …

The Relationship Between Leadership Style, Job Satisfaction, Nurse Retention, And Patient Care Outcomes: A Systematic Review, Richard Lazarus Nwaorgu

Walden Dissertations and Doctoral Studies

Poor nurse retention, job dissatisfaction, and reduced patient health outcomes are pervasive issues at the healthcare institution of this project. Institutional data reflects a continual decline in retention and job satisfaction rates, which in 2018 showed a 20% drop in retention and a 25% drop in job satisfaction. The institution’s annual survey identified perceptions about leadership styles that gave rise to negative nursing behaviors and the negative impact on patient care outcomes. The purpose of this systematic review project (SRP) was to identify the relationship between nursing leadership styles, job satisfaction, nurse retention, and patient care outcomes within a hospital …

Effective Postdischarge Communication From Nursing Staff To Mental Health Patients, Paula Renee Garrison

Walden Dissertations and Doctoral Studies

AbstractMental health patients have a history of decreased follow-up appointments, poor diet, and medication noncompliance after discharge from inpatient facilities in addition to multiple co-morbidities, making a return to the community difficult. The practice problem was an increase in hospital readmissions of mental health patients within 30 days postdischarge due to inadequate post-discharge education and follow-up communication. Using Rodgers’s recovery on mental health theory and Revan’s action learning theory, a staff education program was developed to educate 10 nursing staff and two social workers on how to effectively implement postdischarge communication at 3 days and 30 days after discharge from …

Association Between Modifiable Risk Factors And Stroke Among Hispanics, Shanice Williams

Walden Dissertations and Doctoral Studies

Stroke is a significant public health issue that impacts the health of Hispanic adults. Understanding the multiple risk factors of stroke is an essential strategy to control the disease among this population. The purpose of this study was to examine the association between modifiable risk factors and stroke among Hispanics. The public health prevention framework guided this study. The research questions were designed to determine whether an association exists between modifiable risk factors for stroke among Hispanics. A quantitative, cross-sectional research design was used to conduct secondary analysis of the pooled 2017–2019 Behavioral Risk Factor Surveillance System annual surveys. The …

Applying A Staff Education Project To Increase Telemedicine Patient Safety, Kristy Michelle Wolff

Walden Dissertations and Doctoral Studies

A telemedicine education module (TEM) was designed and developed for this staff education project to improve the knowledge of nurses and providers about best practices in telemedicine and patient safety. A pretest and posttest design was used to evaluate if a gain in knowledge occurred after participants reviewed the TEM, which was designed and developed using Knowles theory of andragogy for adult learning outcomes. Thirty-seven potential participants who currently work as clinicians that provide telemedicine services were provided access to the pretest, TEM, and posttest. Nine participants responded, but only three participants’ scores could be used for analysis since there …