Medicine and Health Sciences Commons^™

Perception Of Stress Observed By Family Members Of Dentists Who Have Committed Suicide, Lillian D. Williams

Walden Dissertations and Doctoral Studies

Research aimed at the observed stress from being a dentist, and how it may have

impacted the occurrence of their suicide did not appear to be prevalent among empirical

suicide studies. The purpose of this basic, qualitative study was to explore how the

family members perceived occupational stress as precursor events in dentists who

committed suicide. Using the interpersonal theory of suicide as the conceptual basis, 4

family members of dentists who committed suicide were interviewed to understand how

family members perceived occupational stress in the dentist using semi structured

interviews. Through a series of precoding and recoding, interview data …

Association Between Mentoring Interventions And Drug Abuse Among African Americans Aged 10-24 Years, Anthonia Ifeyinwa Dunkwu

Walden Dissertations and Doctoral Studies

Drug abuse represents a significant public health problem worldwide, with socioeconomic consequences shaped by a cluster of behavioral, cognitive, and physiological phenomena and serious social, physical, emotional problems. The purpose of this study was to assess the association between mentoring interventions and drug abuse among African American young people. The health belief model was the theoretical framework. The secondary data analysis was done using the data set from the 2014 National Survey on Drug Use and Health. The dependent variable was drug abuse, while the independent variable was mentoring interventions. The Chi-square analysis revealed an association between participation in school-based …

Predictors Of Use Of Pap Tests Among Ghanaian Immigrant Women In Ohio, Baaba Forson

Walden Dissertations and Doctoral Studies

In the United States, cervical cancer disproportionately affects members of ethnic minorities, including immigrant women from Ghana. Overall cervical cancer incidence and mortality rates have declined in the United States due to opportunistic screening with Pap tests; however, rates have not declined for Black women and immigrant women, who continue to experience higher than average mortality rates. Immigrant women, including Ghanaian women, use screening less than nonimmigrant women. Several factors including poor acculturation, low educational level, certain personal attitudes, and lack of health insurance are known to reduce participation in screening. Using the theory of planned behavior as a guide, …

Self-Efficacy Of Registered Nurse Faculty To Facilitate A Flipped Classroom Pedagogy, Sharmeta L. Gibbon

Walden Dissertations and Doctoral Studies

Nurse educators struggle with developing innovative teaching strategies that improve learners’ critical thinking, sound clinical judgment, and ability to provide safe patient care. In the local setting, nurse educators relied on passive teaching strategies. The purpose of this study was to explore the perceptions of nursing faculty members concerning their self-efficacy with implementation of a flipped classroom. The conceptual framework was transformative learning theory. The research question explored how nurse educators described their self-efficacy with implementing student-centered, active teaching methods. Participants included 9 experienced nursing faculty members at the local setting from the Associate Science of Nursing program. Data were …

Clinical Practice Guideline: Maintaining Skin Integrity In The Surgical Patient, Erin Renne Price

Walden Dissertations and Doctoral Studies

The purpose of this project was to develop clinical practice guidelines for intraoperative positioning that will help prevent deep tissue injury and skin breakdown. Maintaining skin integrity in the surgical patient by preventing deep tissue injuries and skin breakdown is an identified gap in practice for surgical patients in the Operating Room environment that a clinical practice guideline could positively impact. To assist in achieving the development of a clinical practice guideline to maintain skin integrity, Benner’s novice to expert theory addressing the educational needs for novice operating room nurses was applied. The clinical practice guideline, based on evidence, should …

Relationship Between Clostridium Difficile Testing Method, Antibiotic Treatment, And Clinical Symptoms, Jennifer L. Sanguinet

Walden Dissertations and Doctoral Studies

Clostridium difficile (C. difficile) infection is a leading cause of morbidity and mortality in the United States, making the infection a top public health priority. Early and accurate identification of disease is a critical factor in successful management, including clinical symptomology. The testing methods for C. difficile have improved in efficiency and sensitivity, which potentially causes over- or underprescribing behavior. Guided by the symbolic theory, the purpose of this study was to examine the association between C. difficile testing method by case year (2015 and 2018) and antibiotic treatment with the potential moderation of clinical symptoms. The secondary correlational analysis …

Nursing Students' Perceptions About Membership In Professional Organizations, Kimberly Ann Seaman

Walden Dissertations and Doctoral Studies

The importance of developing professionalism in the new nursing graduate has been discussed in the nursing literature and identified as a goal in the Future of Nursing competencies. However, the understanding of undergraduate nursing students'perceptions of membership in professional organizations is unknown. This study was conducted to better understand nursing students' views of membership. Social identity theory was used to explain how membership in a professional organization promotes exposure and adaptation of preferred professional behaviors. Novice-to-expert theory was selected to explain the maturation process of professionalism in the new graduate. Twelve nursing students enrolled in an undergraduate nursing program participated …

Coping And Support Strategies Portrayed In Rheumatoid Arthritis Illness Blogs, Folasade Bolanle Alagbada

Walden Dissertations and Doctoral Studies

The symptoms of rheumatoid arthritis (RA), such as pain, fatigue, stiffness, and inflammation, limit individuals’ abilities to care for themselves, participate in social events, and complete tasks associated with gender norms. RA is a chronic and debilitating disease that people struggle to cope with physically, mentally, emotionally, socially, and financially, but many have not established effective coping and support strategies. The purpose of this hermeneutic phenomenological qualitative study guided by a combination of Orem’s theory of self-care and Watson’s theory of the human caring was to explore the coping mechanisms and support strategies of women and men with RA as …

Quality Of Life, Physical Activity, And Weight Status For A Sample Of Online Students, Walaa Awad

Walden Dissertations and Doctoral Studies

Obesity has been identified as a global health problem and a risk factor for many chronic diseases. While previous studies discussed the weight status and factors associated with overweight and obesity among adults enrolled in traditional universities, few studies have yet estimated the obesity rate among adults who choose online education. Guided by the social cognitive theory, this descriptive exploratory quantitative study used a survey to collect primary data from adult online students of three higher educational institutions. The survey examined the effect of quality of life and physical activity level on the weight status of the participants; taking into …

Comparison Of Advance Care Planning Interventions And Older Adults’ Advance Directive Completion Rates, Tammy Biehler

Walden Dissertations and Doctoral Studies

Despite the benefits of advance care planning (ACP), only one third of older adults in the United States have completed it. To address this gap, health care organizations are implementing ACP programs to engage older adults in the process. These programs can be delivered in various ways, including 1:1 conversations, classes, and web-based tools. The purpose of this quantitative study was to investigate which ACP option was associated with highest participation and advance directive (AD) completion rates in older adults. Social cognitive theory provided the framework to understand the impact the ACP environment and personal characteristics’ have on the odds …

Student Nurse Perceptions Of Horizontal Violence During Clinical Hospital Rotations, Phoebe Marie Burda

Walden Dissertations and Doctoral Studies

The nursing profession is facing its largest professional nurse deficit in history. With nursing schools unable to produce enough new nurses to replace the number of nurses retiring, it becomes increasingly important to retain as many nurses as possible within the profession. Nursing research literature has reported that up to 60% of newly registered nurses will leave their first job within their first year of practice citing horizontal violence as a contributing factor. The literature does not address if or how early student nurses might perceive exposure to horizontal violence. The purpose of this qualitative, interpretive, phenomenological study was to …

The Relationship Between Mental Illness And Mass Shooting, Priscilla Ngozi Chukwueke

Walden Dissertations and Doctoral Studies

AbstractWhenever a mass shooting occurs, it impacts the immediate families of the perpetrator, victims, and the whole nation: emotionally and financially. The research on the association between mental illness (MI) and mass shooting fatalities is limited. The purpose of this quantitative, cross-sectional study was to explore the association between MI and mass shooting using the archival data of the Stanford University database of mass shootings in America from 2000 to 2016. The theoretical framework was based on Bronfenbrenner’s social-ecological theory and the cognitive-behavioral theory to explain socio-environmental factors that impact human growth and development. The results showed that the proportion …

Risk Factors Of Infant Mortality Disparity In Indian River County, Florida, Cecilia Miguelina Escorbore

Walden Dissertations and Doctoral Studies

Infant mortality in the United States is a great concern to families, communities, and professionals in the public health field. More concerning is the infant mortality racial disparity, prevalent throughout the United States. The purpose of this study was to explore risk factors of infant mortality disparity in Indian River County (IRC), Florida. Using socioecological theory as the theoretical framework, this study explored whether there is an association between infant mortality among Black infants and geographic location as well as measures of socioeconomic status (age, educational level, health insurance status, and marital status) associated with infant mortality among Black infants …

Therapeutic Communication Skills For Nurses Working With People Living With Hiv, Charaine Ferguson

Walden Dissertations and Doctoral Studies

Internalized stigma experienced by people living with HIV (PLWH) has been associated with numerous untoward health outcomes. Nurses' and healthcare professionals’ ability to effectively communicate can significantly affect the experience of stigma in PLWH. The practice-focused question was whether an interactive educational project could improve the knowledge and intent to use collective communication skills in nurses. This project uses concepts from Peplau's interpersonal relationship theory, principles of therapeutic communication, and unconscious bias. Online training content included patient testimonials related to stigma, discussions of unconscious bias by the Institute for Healthcare Improvement and Mayo Clinic professionals, review of Harvard University’s Implicit …

Racial Disparities In Periconceptual Folic Acid Levels, Kelvin Gibson

Walden Dissertations and Doctoral Studies

Periconceptional folate level deficiencies are associated with birth defects of the brain and spinal cord, posing a significant public health problem. In 2009, Black and Hispanic women exhibited lower periconceptual folate levels and higher rates of folate-related birth defects compared with non-Hispanic White women, prior to enactment of the Affordable Care Act (ACA) of 2010. It is not known if improved access to prenatal care under the ACA narrowed the gap in mean periconceptual folate levels between non-Hispanic White, Black, and Hispanic women between 2009 and 2017. The purpose of this causal-comparative cross-sectional quantitative study was to determine whether there …

Socioeconomic And Health-Related Factors Affecting Congestive Heart Failure Readmissions, Jollibyrd Miguel Gusto

Walden Dissertations and Doctoral Studies

Congestive heart failure (CHF) readmissions are frequent and costly, but preventable. These readmissions not only contribute to rising healthcare cost but also affect the quality of life of these individuals and their loved ones. Guided by the social ecology model for health for health promotion, the purpose of this study was to analyze the socioeconomic and health-related factors of CHF readmissions. The main hypothesis of this study was that there was a relationship between 30-day readmissions of individuals with CHF and their payer status, race, ethnicity, primary language spoken, living arrangement, and comorbidities in the dataset as identified in their …

Providing Evidence-Based Education About Caring For Patients With Atrial Fibrillation, Rose M. Happy

Walden Dissertations and Doctoral Studies

Abstract In a multidisciplinary health care team, nurses are often the initial contact when patients present for clinical evaluation. Thus, it is of great importance that these nurses provide education to patients that is current and evidence-based. The target population of this project was nurses who care for patients with atrial fibrillation (A-Fib). The practice problem was the knowledge gap related to A-Fib. The purpose of the project was to provide an evidence-based, nursing education intervention to increase their knowledge. The practice-focused question sought to determine whether participation in the evidence-based education intervention increased nurses’ knowledge scores about providing care …

Sexual Education, Sexual Initiation, And Contraceptive Use Among African American Young Women, Kineka J. Hull

Walden Dissertations and Doctoral Studies

Unintended pregnancy is associated with adverse social, economic, and health outcomes making it a public health concern. African American (AA) women aged 18–24 are at higher risk of unintended pregnancy due to earlier sexual initiation and non-use, inconsistent, or improper use of contraceptive methods (CM). The purpose of this study was to investigate the extent to which receipt of formal sexual health education (FSHE) impacts age of sexual initiation and contraceptive use and selection of more effective CMs (ECMs) among AA women aged 18–24 (N = 242) who have sex with men. Driven by the reasoned action approach, 2015–2017 National …

Primary Care Physicians’ Knowledge And Perception Of The Impact Of Health Literacy On Patient Care, Lutrisha S. King

Walden Dissertations and Doctoral Studies

Until recently, many health literacy studies were completed from the patient and nurse perspective, while few focused on the physician perspective, specifically the primary care physician. The purpose of this study was to provide insight into the health literacy knowledge and education of primary care physicians and determine the association, if any, between physicians’ perceptions of patients’ limited health literacy and physicians’ use of health literacy communication techniques. The knowledge, attitudes, and practice (KAP) framework directed this study. This framework posits that knowledge informs or influences attitudes, which leads to practices. The KAP framework was employed to answer the research …

Microvascular Disease And Chronic Kidney Disease In Persons With Diabetes In Grenada, Jennifer Elizabeth Lewis

Walden Dissertations and Doctoral Studies

Chronic kidney disease (CKD) is a set of pathophysiological reactions that impact the functionality of the kidney. The association between microvascular disease (MVD) and CKD as it relates to diabetes is important to the evaluation of organizational effectiveness in-hospital services planning as well as improving health outcomes. The purpose of this quantitative, cross-sectional study was to determine if there is an association between MVD and CKD severity in persons with diabetes. Using the socioecological model, the association between gender, age group, cigarette smoke, cigarette smoke frequency, alcoholic drink, alcoholic drink frequency, hypertension, albumin-to-creatinine ratio (ACR) severity, cholesterol, sickling (i.e. persons …

Exploring Family-Centered Care From The Perspectives Of Home-Health Physical Therapists, James Mathews

Walden Dissertations and Doctoral Studies

Older adults may need, or desire, caregiver and family involvement to avoid hospitalizations and institutionalizations. The caregivers of these older adults have the highest rates of burnout, injury, and turnover. Family-centered care (FCC) involves collaboration between healthcare practitioners, patients, family members, and caregivers. FCC is both established and effective in pediatric care settings. There is a paucity of evidence on how FCC is applied to older adult populations. Home health physical therapists (HHPTs) work with older adults in their homes and train both family members on how to safely handle and manage the care-dependent older adult. The purpose of this …

Barriers That Influence The Underuse Of Mental Health Services By African Americans Diagnosed With Schizophrenia, Pamela Gail Stackhouse-Hinsey

Walden Dissertations and Doctoral Studies

African Americans diagnosed with schizophrenia have longer wait times to be treated by mental health care professionals, resulting in their underuse of mental health services. This problem has motivated medical professionals to reexamine the ways in which services are rendered and then make appropriate improvements. The purpose of the study was to explore the lived experiences of African Americans diagnosed with schizophrenia and identify the reasons for their underuse of mental health services. A phenomenological research design was used to understand and explore the participants’ lived experiences of the phenomenon. Participants were recruited from an independent living facility. Purposive sampling …

Crisis Intervention Team Training: Full Implementation, Roy Garvin Taylor

Walden Dissertations and Doctoral Studies

Law enforcement officers (LEOs) encounter unique challenges when responding to calls involving an emotionally disturbed person (EDP) in crisis. In these situations, the LEOs are not merely acting in a law enforcement capacity but also taking on the roles of mental health workers, social workers, and other community support services. Unfortunately, most LEOs lack clear direction and training to effectively serve this unique population, with the typical encounter resulting in the arrest of the EDP and often ensuing in a vicious circle of arrest, incarceration, and recidivism. This phenomenological qualitative study used the perceptions of active Crisis Intervention Team (CIT) …

Outpatient Mental Health Service Utilization For Depression And Anxiety Post-Hurricane, Corey Darnell Taylor

Walden Dissertations and Doctoral Studies

Increased depression and anxiety diagnoses are a result of the lack of use or underuse of outpatient mental health services, specifically among African Americans, youths, and the homeless, and this is a current issue in New Orleans, Louisiana post-Hurricane Katrina. Funding constraints due to the termination of the Louisiana Spirit Program contributed to deficits in terms of outpatient mental health facilities in New Orleans. The purpose of this quantitative study was to examine the association between the continuum and utilization of outpatient mental health services for African Americans, youth, and the homeless for those diagnosed with depression and anxiety. Andersen’s …

Assessing School-Based Telehealth Utilization In Medically Underserved Communities, Danielle Wesley

Walden Dissertations and Doctoral Studies

Medically underserved communities face challenges accessing health care services, and millions of Americans have no access to primary care. In many areas of the United States, the supply of primary care providers cannot keep up with the demand for health services. Newer healthcare delivery models are needed to address the issue. Using telehealth can augment the physician workforce shortages. The purpose of this quantitative dissertation is to examine the associations of telehealth utilization using a pediatric school-based telehealth model in Health Professional Shortage Areas (HPSAs) in North Texas. Texas has many counties without a primary care provider, making them medically …

Relationship Between Hospital Performance And Medicare Reimbursement Penalties, Ashley Bays

Walden Dissertations and Doctoral Studies

Medicare reimbursement penalties are a financial concern for health care leaders when hospitals underperform in the specific measures of hospital performance defined by the Hospital Value-Based Purchasing Program. Grounded in the general contingency theory, the purpose of this correlational study was to determine the relationship between the measures of hospital performance, clinical care, person and community engagement, safety, efficiency and cost reduction, and Medicare reimbursement penalties. Secondary data from the Centers for Medicare and Medicaid Services were collected from 420 acute care urban hospitals designated as teaching facilities with a bed size between 100–299 beds for the fiscal year 2019. …

Importance Of Early Recognition Of Extrapyramidal Symptoms (Eps) In A Community Mental Health Clinic, Jamil E. Davis

Walden Dissertations and Doctoral Studies

AbstractThe purpose of this project was to address the lack of knowledge of nurses in recognizing extrapyramidal symptoms during the early stages of clinical presentation in patients taking antipsychotic medication. Nursing staff need to be properly training to be effective. Maslow's hierarchy of human needs informed this project. The primary goal of this project was to identify if an instructional seminar regarding EPS symptoms and management would increase the knowledge of the nursing staff. The project had a sample size of 7 and the criteria for inclusion included licensed professional nurses working in the clinical setting of mental health. The …

Treatment Disparities In Black And Hispanic Children With Attention-Deficit Hyperactivity Disorders, Charlotte Seiji Frey

Walden Dissertations and Doctoral Studies

Disparity in diagnosis and treatment of attention deficit hyperactivity disorder (ADHD) among children has been studied; however, no known studies examining disparities based on severity of symptoms have been investigated. The purpose of this study was to assess the racial disparities in diagnosis and treatment that exist among children based on severity of symptoms. This cross-sectional quantitative analysis used data from the 2016 National Survey of Children's Health and the theoretical foundation was guided by the behavioral model of healthcare utilization and help-seeking behavior for ADHD. Binomial logistic regression analysis showed an overall association between race and the diagnosis and …

Effective Strategies To Reduce Employee Absenteeism Amongst Canadian Female Employees, Sue Haywood

Walden Dissertations and Doctoral Studies

High absenteeism in female employees costs Canadian hospitals millions of dollars annually. Leaders of Canadian hospitals who lack strategies to reduce absenteeism in female employees witness significant financial losses in their organizations. Grounded in Herzberg's two-factor theory, the purpose of this multiple case study was to explore strategies Canadian hospital leaders used to reduce absenteeism in female employees. Data were collected from semistructured interviews, annual reports, and publicly available datasets relating to hospital retention strategies and were analyzed using a thematic analysis. Four themes on strategies to reduce absenteeism emerged: creating a supportive stance towards absenteeism, investing in mental health …

Neighborhood Factors, Depression, And Body Mass Index Among Patients With Lupus In Georgia, Aisha L. Hill

Walden Dissertations and Doctoral Studies

Elevated BMI (overweight and obesity) is a common health-related issue and affects more than half of the lupus population. Weight issues lead to additional health-related issues, such as heart disease and disabilities in the lupus population. To address the shortage of research focusing on this specific issue in the lupus population, one approach is a novel outlook on how neighborhood factors have the capability of determining or altering behaviors, such as physical activity, healthy eating, and healthy social relationships. Another variable to consider is depression and its capability of altering interactions, relationships, self-esteem, or even the inflammatory state of the …