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Articles 3811 - 3840 of 5875
Full-Text Articles in Medicine and Health Sciences
Achieving Improved Glycemic Control Among Hispanic Type 2 Diabetic Adults, Morenike Oyegbami
Achieving Improved Glycemic Control Among Hispanic Type 2 Diabetic Adults, Morenike Oyegbami
Walden Dissertations and Doctoral Studies
Type 2 diabetes is a major chronic health disease in the United States. A main concern of clinicians treating patients with Type 2 diabetes is poor glycemic control. The goal of this project was to improve glycemic control in Type 2 diabetic Hispanic adult patients in a private family practice clinic through the implementation of biweekly telephonic intervention focused on diabetes management by an advanced practice nurse/nurse practitioner. The project was guided by the chronic care model as a framework. The intervention was conducted over a 12-week period with 50 patients, ages 18 to 65. Data were collected from chart …
The Effects Of Sexual Education On Sexual Behaviors Of Adolescents In Rural Jamaica, Deborah Simmonds
The Effects Of Sexual Education On Sexual Behaviors Of Adolescents In Rural Jamaica, Deborah Simmonds
Walden Dissertations and Doctoral Studies
Adolescent pregnancy and the sexual behaviors of adolescents continue to be robust public health and social problems in Caribbean countries such as Jamaica. Numerous researchers have conducted studies on the impact of sex education on sexual behaviors and pregnancy patterns among adolescents with mixed results (i.e., a lack of knowledge) especially in rural communities. The purpose of this study was to ascertain the impact of school- or home-based sex education on sexual behavior and pregnancy patterns of adolescents aged 15 —19 years in the rural community of St. Thomas, Jamaica. The parental expansion of the theory of planned behavior and …
Hispanic Parents' Perceptions Of Human Papillomavirus Vaccination For Male Children, Christy Dubuisson
Hispanic Parents' Perceptions Of Human Papillomavirus Vaccination For Male Children, Christy Dubuisson
Walden Dissertations and Doctoral Studies
Hispanic Americans experience a disparate burden of human papillomavirus vaccination (HPV)-related cancers. Despite vaccine availability, HPV vaccine uptake amid Hispanic American adolescent males in the United States is under the national goal. Furthermore, childhood vaccination compliance is driven by the parents; yet, there is little research on parents' perceptions of HPV vaccination of male children. The purpose of this phenomenological study was to explore the attitudes, beliefs, concerns, and decision- making factors of Hispanic American parents of male children aged 11- to 13- years-old surrounding HPV vaccination. The health belief model provided the framework for the study. Face-to-face interviews were …
Prostate Cancer Screening Rates For Haitian Men Based On Demographic Characteristics, Wilgyms St-Hilaire
Prostate Cancer Screening Rates For Haitian Men Based On Demographic Characteristics, Wilgyms St-Hilaire
Walden Dissertations and Doctoral Studies
Cancer screening is useful for improving survival rates and treatment outcomes, which is why there are screening recommendations for the most prevalent types of cancer. Despite gains in the reduction of cancer-related mortality rate worldwide in the past few years, the Haitian community continues to experience high mortality rates due to cancer. The prevalence of prostate cancer in the Haitian population is among the highest worldwide at 767 per 100,000, with a mortality rate of 403 per 100,000. One of the causes may be the low prostate cancer screening rate in the Haitian community; however, no studies have been focused …
Patient Safety Problems, Procedures, And Systems Associated With Safety Reporting And Turnover, Grace Hilario
Patient Safety Problems, Procedures, And Systems Associated With Safety Reporting And Turnover, Grace Hilario
Walden Dissertations and Doctoral Studies
Research has shown that 400,000 people die every year due to preventable medical errors. Medical error reporting and safety is a responsibility of all members of a health care organization. Creating an environment that addresses and prevents potential or actual safety problems can help reduce the incidence of medical errors made by nurses in the workplace. The purpose of this quantitative research study was to determine if nurses' perceptions of safety problems and error-preventing procedures and systems affected their comfort in reporting safety problems and intent to leave. High-reliability theory was the theoretical foundation for this study. Data were obtained …
African American Parents' Perceptions Of Childhood Obesity In Broward County, Kenol Aris
African American Parents' Perceptions Of Childhood Obesity In Broward County, Kenol Aris
Walden Dissertations and Doctoral Studies
Children may become overweight or obese for different reasons, and childhood obesity may have health consequences such as Type 2 diabetes and asthma. The purpose of this qualitative phenomenological study was to describe the perceptions of African American parents of elementary-age children with obesity living in Broward County, Florida about the causes and consequences of childhood obesity. The health belief model (HBM) guided this study. Interview data were gathered from 9 participants who met the criteria of being African American parents of elementary-age children with obesity living in Broward County, Florida. Moustakas- steps to analyze the data collected led to …
The Role Of The Physicians' Assistant In Trinidad And Tobago's Healthcare System, Martha Ann Pamponette
The Role Of The Physicians' Assistant In Trinidad And Tobago's Healthcare System, Martha Ann Pamponette
Walden Dissertations and Doctoral Studies
The profession of physicians' assistant was introduced in the 1960s to assist with physician shortages in the United States of America. Since then, some countries have introduced this profession to fill the gaps that exist in the physician shortages problem in their health care system. Yet, in many countries like Trinidad and Tobago, this role remains absent from the health care system. The objective of this study was to assess how professionalization supports the introduction of the physicians' assistant role in Trinidad and Tobago. Using the theory of profession as a theoretical framework, and through an evaluation of institutional, regulatory, …
Improving Interdepartmental Care Collaboration For Pregnant Patients, Michelle Anne Ott
Improving Interdepartmental Care Collaboration For Pregnant Patients, Michelle Anne Ott
Walden Dissertations and Doctoral Studies
Communication is vital to improve patient care outcomes, especially with high acuity patients. Pregnant patients differ from other patient populations because their care involves 2 entities: the patient (mother-to-be) and her unborn fetus. There has been a noted gap in communication and care collaboration between the emergency department (ED) and obstetric (OB) teams at the project site, resulting in delays for patients and lack of appropriate maternal/fetal assessment and contributing negatively to patients' experiences. Using transitions theory and the Rosswurm and Larrabee model, a clinical practice guideline (CPG) inclusive of an obstetrically focused algorithm was developed and presented for use …
Health Care Leaders' Strategies To Reduce Nursing Turnover, John Clayton Phelps
Health Care Leaders' Strategies To Reduce Nursing Turnover, John Clayton Phelps
Walden Dissertations and Doctoral Studies
Health care leaders who lack effective nurse turnover strategies can negatively affect patient quality of care, productivity, and profitability. The purpose of this single case study was to explore strategies health care leaders used to reduce nursing turnover in a health care organization. The conceptual framework for this study was Herzberg's 2-factor theory. Data were collected from semistructured interviews with 4 health care leaders in the West Texas region who had a history of reducing nurse turnover for a minimum of 5 years from the date of hire, and from review of organizational documents related to the strategies to reduce …
Factors Associated With Prostate Cancer Screening Intentions Among Adult Men In Nigeria, Ifeanyi N. Malu
Factors Associated With Prostate Cancer Screening Intentions Among Adult Men In Nigeria, Ifeanyi N. Malu
Walden Dissertations and Doctoral Studies
Timely detection of prostate cancer (PCA) with prostate-specific antigens (PSA) and digital rectal examinations (DRE) are essential in optimizing incidence, minimizing prevalence, and reducing mortality rates. Given the low levels of participation in cancer screening, this study was conducted to examine the factors men consider when deciding whether to screen for PCA in Nigeria. A cross-sectional, online-based survey of 180 consenting Nigerian men 50 years old and older was carried out. Logistic regression analysis and descriptive statistics were used to analyze the data. Based on the data, there was a moderate positive association between the health belief model constructs and …
Admission Predictors Of Student Success On The Physician Assistant National Certifying Exam, Thomas Frank Moore
Admission Predictors Of Student Success On The Physician Assistant National Certifying Exam, Thomas Frank Moore
Walden Dissertations and Doctoral Studies
In 2009, a local physician assistant (PA) program lost accreditation due to decreased success in licensure pass rates on the Physician Assistant National Certification Examination (PANCE). In response, the program's admissions committee required additional metrics for accepting quality candidates more likely to pass the licensure examination on the first attempt. The purpose of this study was to gain a better understanding of these metrics, specifically the relationship between demographics, prerequisite admission requirements, and PANCE success. The theoretical framework and conceptual model shaping this study was Bordage's illumination and magnify framework and Swail's geometric model of student persistence and achievement. The …
Addressing Human Papillomavirus Vaccination In Primary Care Pediatrics, Natasha Marie Subramaniam
Addressing Human Papillomavirus Vaccination In Primary Care Pediatrics, Natasha Marie Subramaniam
Walden Dissertations and Doctoral Studies
Human papillomavirus (HPV) is the most common sexually transmitted disease in the United States. Despite most common transmission, HPV immunization in adolescents remains below target rates of 80% as outlined by Healthy People 2020 Objectives. Nearly all individuals will contract HPV during their lifetime. The purpose of this project was to educate providers on successfully promoting HPV immunization in adolescents utilizing evidence-based methods. The health belief model (HBM) was the theoretical underpinning utilized to teach providers on discussions about 9vHPV immunization with parents of adolescents. The practice focused question explored whether an education program using concepts from the HBM would …
Improving Retention Strategies For Experienced Nurses, Kimberly M. Hollis
Improving Retention Strategies For Experienced Nurses, Kimberly M. Hollis
Walden Dissertations and Doctoral Studies
Experienced nurses depart the workforce in significant numbers; therefore, it is critical to understand how those departures affect patient care and safety. The focus of this systematic review included appraisal of recent research to provide an understanding of strategies used in acute care settings to retain experienced nurses. Guided by Benner's model of skill acquisition, the purpose of this systematic review was to identify factors that influence the decision of nurses with experience to leave or remain working in acute care work settings. The 19 articles selected for this review were limited to those pertaining to experienced registered nurses who …
Strategies Hospital Administrators Utilize To Optimize Patient Services, Vicente Njoku
Strategies Hospital Administrators Utilize To Optimize Patient Services, Vicente Njoku
Walden Dissertations and Doctoral Studies
Hospital administrators face challenges that arise from environmental factors or psychosocial factors, and lack resources to deliver valuable medical services to stakeholders, including patients and employees. A multicase study served to explore experiences and gain a broader perspective of hospital administrators' use of strategies to optimize patient services. Ten hospital administrators from acute care hospitals in Nevada and California were purposefully selected from the population of hospital managers with a minimum of 2 years of documented experience in successfully implementing management strategies to improve patient services. The conceptual framework was Drucker's management theory. Data were collected from semistructured interviews with …
Predictors Of Rapid Repeat Pregnancy In Zimbabwe, Thenjiwe Sisimayi
Predictors Of Rapid Repeat Pregnancy In Zimbabwe, Thenjiwe Sisimayi
Walden Dissertations and Doctoral Studies
Rapid repeat pregnancy (RRP) is associated with adverse maternal and infant outcomes and a range of undesirable social and economic challenges for the mother, her baby, and society. Although the consequences of RRP are well known, Zimbabweâa country with some of the poorest maternal health indicatorsâhas not investigated or made efforts to directly address this problem. This is confirmed by the lack of targeted programs to curb RRP, the unavailability of documented evidence regarding RRP significant risk factors, and the lack of understanding of the extent of RRP in the country. Using social cognitive theory as the theoretical framework, an …
Breast Cancer Screening Knowledge And Beliefs Of Nigerian Women Living In The United States, Enobong Clement Utin
Breast Cancer Screening Knowledge And Beliefs Of Nigerian Women Living In The United States, Enobong Clement Utin
Walden Dissertations and Doctoral Studies
Breast cancer is one of the leading causes of death and disability globally. Although mammogram has been identified as a significant breast screening tool in the United States, researchers have indicated that African-born women in the United States are diagnosed with advanced stages of breast cancer because of underutilization of mammogram from diverse reasons. The purpose of this quantitative study was to determine the association of demographic factors, breast cancer knowledge, health beliefs, and the utilization of mammogram among Nigerian women, 40 years and older in the United States (N=200). The study was guided by the health belief model and …
A Geographic Study Of Lung And Bronchus Cancer Rates In Kentucky, Gabriel Njoh Dikong
A Geographic Study Of Lung And Bronchus Cancer Rates In Kentucky, Gabriel Njoh Dikong
Walden Dissertations and Doctoral Studies
The average age-adjusted incidence and mortality rates of lung and bronchus cancer is 55% and 56% higher in Kentucky than the national averages in the United States, respectively. Populations with low income and educational attainment, and those who live close to the mining regions across Kentucky are more affected by the high prevalence and resulting mortality rates of lung and bronchus cancer. This study was conducted because of the high incidence of lung and bronchus cancer and resulting mortality rates in the state of Kentucky that may not be caused solely by social and demographic factors. The theoretical foundation for …
Exploring The Mechanisms Of Racial Disparity In Infant Mortality: A Grounded Theory Approach, Barry Chukwugekwu Eneh
Exploring The Mechanisms Of Racial Disparity In Infant Mortality: A Grounded Theory Approach, Barry Chukwugekwu Eneh
Walden Dissertations and Doctoral Studies
Infant mortality (IM) is a critical health-disparity problem in the United States. Of the 23000 infants who die each year, the highest number occurs among African Americans. Previous studies implicated a mix of health determinants and risk factors, but no study has explored the mechanisms by which IM predictably persists among African Americans. This study uncovers the complex network of risk factors that underlies racial death disparities in infants. Two theoretical lenses chosen for this study were social systems theory (SST) and critical race theory (CRT). SST explains human behavior as an intersection of interrelated systems. CRT interrogates inherent social …
Leisure Computer Usage And Perceived Body Weight, Diet, And Physical Activity, Santina Jaronko
Leisure Computer Usage And Perceived Body Weight, Diet, And Physical Activity, Santina Jaronko
Walden Dissertations and Doctoral Studies
Screened media platforms have been blamed for contributing to the childhood obesity epidemic. The purpose of this study was to determine if leisure computer usage, such as engaging in social media, impacted perceived body weight, dietary habits, and physical activity. The social network theory and the social cognitive theory were the theoretical frameworks of this cross-sectional study using secondary data. The data set used was the 2015 Centers for Disease Control and Prevention's Youth Risk Behavior Surveillance Survey including a sample size of 8,241 youths between Grades 9 and 12. Chi-square test and binary logistic regression analysis were performed to …
Patient Awareness And Knowledge Of Medically Induced Radiation Exposure, Travis L. Mann
Patient Awareness And Knowledge Of Medically Induced Radiation Exposure, Travis L. Mann
Walden Dissertations and Doctoral Studies
The level of knowledge and awareness among patients about the concepts and implications of medical radiation is unknown. The purpose of this qualitative, case study was to explore patients' awareness and knowledge of information regarding this topic from their perspectives. The health belief model provided the framework for the study. A total of 20 individuals were recruited using purposive sampling. All participants were above the age of 18 in central North Carolina and had undergone or are currently undergoing medical radiation exams. Data were collected using semistructured interviews and analyzed using Yin's 5-phased cycle, which involved compiling, disassembling, reassembling, interpreting, …
Staff Education For Providers In An Outpatient Hemodialysis Center, Ibijoke Owolabi
Staff Education For Providers In An Outpatient Hemodialysis Center, Ibijoke Owolabi
Walden Dissertations and Doctoral Studies
The impact of end-stage renal disease (ESRD) on healthcare costs is significant. In 2013, the cost of providing care for the ESRD patient population was 7.1% of total Medicare expenses. ESRD patients' non-adherence with the medical plan is a reason for the high cost of care and poor patient outcomes. Staff education can have a positive impact on patient adherence in terms of the management of chronic illnesses, such as ESRD. This DNP project was an education program for hemodialysis (HD) staff regarding empowering patients to learn about self-care strategies aimed at improving ESRD patients' adherence to fluid restriction and …
Director Of Nursing Role Conflict And Ambiguity, Commitment, And Intent To Stay, Amy Elizabeth Thiesse
Director Of Nursing Role Conflict And Ambiguity, Commitment, And Intent To Stay, Amy Elizabeth Thiesse
Walden Dissertations and Doctoral Studies
High rates of turnover and the limited tenure of directors of nursing (DONs) in long-term care creates instability in the nursing workforce and the quality of care provided. Organizations, industry, and stakeholders have made little progress to change this turnover crisis. The purpose of this quantitative study, guided by organizational role and social exchange theories, was to determine if there was a difference in levels of affective organizational commitment and intent to stay mediated by leader-member exchange in long-term care DONs with different levels of role conflict and role ambiguity. The key variables were measured with the Role Questionnaire, Leader-Member …
Medication Reconciliation, Competency, Timely And Effective Care, And Hospital Readmissions, Perry Theodore Nichols
Medication Reconciliation, Competency, Timely And Effective Care, And Hospital Readmissions, Perry Theodore Nichols
Walden Dissertations and Doctoral Studies
Hospital readmissions within 30 days of discharge result in significant multimillion-dollar penalties to thousands of Medicare-eligible hospitals throughout the United States and are indicators of suboptimal patient healthcare leading to less than ideal health outcomes for previously hospitalized patients. The purpose of this correlation study was to examine the relationship between medication reconciliation, nursing workforce competency, timely and effective care, and Medicare-eligible hospital 30-day readmission rates. The sample of 269 hospitals came from the population of Medicare-eligible hospitals throughout the United States. Complexity theory and the general model of readmission were theoretical frameworks grounding this study. Secondary data were from …
Promoting Nursing Communication Competence On A Spinal Cord Injury Unit, Tishon L. Creswell
Promoting Nursing Communication Competence On A Spinal Cord Injury Unit, Tishon L. Creswell
Walden Dissertations and Doctoral Studies
The power to communicate effectively and respectfully in the health care setting promotes job satisfaction, retention, and healthy relationships. Ineffective communication is one of the major causes of sentinel events, incivility, nurse turnover, and workplace hostility in the health care environment. This project examined a communication competence educational program on a spinal cord injury (SCI) nursing department and its potential to improve communication competence. The project question explored whether an educational series on incivility and creating healthy relationships would increase communication competence in nurses on the SCI unit. The project used the high reliability solutions for health care model communications …
Role Of Primary Care Providers And Integrated Disease Surveillance In Chad, Dhoud Stave Gischel Samba
Role Of Primary Care Providers And Integrated Disease Surveillance In Chad, Dhoud Stave Gischel Samba
Walden Dissertations and Doctoral Studies
In the Republic of Chad, primary care physicians play a central role in the detection and control of outbreaks and are critical actors in the integrated disease surveillance system through mandatory reporting. Feedback on such surveillance must reveal the needs and perceptions of these physicians. These needs and perceptions were examined using a questionnaire survey distributed to a sampling of 20 physicians in Chad. The purpose of this qualitative study was to investigate the role of primary care providers in the integrated disease surveillance to identify factors that impact complete, quality, and timely reporting. The theory of planned behavior was …
Female Veterans' Combat Experience And Ptsd On Male Partners' Psychological Distress And Relationship Quality, Theresa Denise Abraham
Female Veterans' Combat Experience And Ptsd On Male Partners' Psychological Distress And Relationship Quality, Theresa Denise Abraham
Walden Dissertations and Doctoral Studies
Female veterans' combat exposure to trauma places them at risk for developing posttraumatic stress disorder (PTSD), which has consequences for healthful reintegration to family and civilian life. Previous research found that wives who provide continuous care to male veterans with PTSD experience symptoms of psychological distress; however, little research has been conducted on the influence of female veterans' PTSD on their intimate male partners' (IMPs) psychological well-being. A multivariate correlational design was used to examine the influence of female veteran PTSD on psychological distress and relationship quality in IMPs. The couples' adaption to traumatic stress model was used as the …
Papanicolaou Test Status Among Inner-City Adolescent Girls In Accra, Ghana, Collins Kwesi Asamoa-Afriyie
Papanicolaou Test Status Among Inner-City Adolescent Girls In Accra, Ghana, Collins Kwesi Asamoa-Afriyie
Walden Dissertations and Doctoral Studies
Cervical cancer is an emerging public health problem in developing countries. Globally, it is the 3rd most common malignancy in women after breast and colorectal cancers and 4th most frequent cancer in women, with an estimated 570,000 new cases and 311,000 deaths in 2018. Cervical cancer screening in the developed countries is credited with the reductions in cervical cancer morbidity and mortality during the last 50 years. However, nearly 90% of cervical cancer deaths occur in less developed countries. Ghana has a cervical cancer rate of 26.4%. Further, it is the highest cancer incidence faced among women 25 to 44 …
Community Education Through A Stroke Champion Program, Michele Gribko
Community Education Through A Stroke Champion Program, Michele Gribko
Walden Dissertations and Doctoral Studies
Stroke is the fifth leading cause of death and primary cause of long-term disability in the United States. Public awareness of stroke symptoms and ability to activate the emergency medical system (EMS) quickly are essential for early treatment. At a large Joint Commission-certified Comprehensive Stroke Center with over 6,000 employees, a stroke champion program that included both clinical and nonclinical volunteers was initiated to determine whether stroke champion volunteers could learn and disseminate information about stroke symptoms and the importance of activating EMS within their community. Roger's diffusion-of- innovation framework was used to design and evaluate the outcome of the …
Geospatial Analysis Of Care And Mortality In The 2014 Liberia Ebola Outbreak, Marion Carlton Kinkade
Geospatial Analysis Of Care And Mortality In The 2014 Liberia Ebola Outbreak, Marion Carlton Kinkade
Walden Dissertations and Doctoral Studies
The Ebola outbreak in West Africa in 2014 to 2016 had more than 28,000 suspected, probable, and confirmed cases. It was the largest Ebola outbreak in history. Of the 28,000 cases in the three Ebola-affected countries, Liberia had 10,000 cases with almost 5,000 deaths. The Ebola Virus Disease (EVD) entered Liberia along the border of Guinea and moved to the capital city of Monrovia where the virus spread. Ebola Treatment Units (ETUs) were constructed throughout the response in locations where there were available facilities versus distance to care challenges. This study examined the association of distance from villages to ETUs …
Pregnant African American Women Breastfeeding Intentions, Beliefs, Attitudes And Perspectives, Janelle S. Mcclain, Phd
Pregnant African American Women Breastfeeding Intentions, Beliefs, Attitudes And Perspectives, Janelle S. Mcclain, Phd
Walden Dissertations and Doctoral Studies
Breastfeeding is the best infant feeding source of nutrition for infants in their early stages of development. However, there is a fundamental gap in the number of African American women that initiate breastfeeding compared to White, Asian, and Hispanic mothers. Social cognitive theory was used to explore the breastfeeding intentions, beliefs, perceived barriers, and perceptions on breastfeeding through a basic qualitative research method. To capture the essence of the lived experiences of African American pregnant women, a purposeful sample of 13 African American pregnant women were invited to participate in the study. Two focus groups discussions pertaining to breastfeeding intentions …