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Articles 3961 - 3990 of 5875
Full-Text Articles in Medicine and Health Sciences
Association Between Androgen Deprivation Therapy For Prostate Cancer And Alzheimer's Disease, Gina Giannantoni-Ibelli
Association Between Androgen Deprivation Therapy For Prostate Cancer And Alzheimer's Disease, Gina Giannantoni-Ibelli
Walden Dissertations and Doctoral Studies
Alzheimer's disease (AD) is the most common progressive, neurodegenerative disease and form of dementia. The hallmarks of AD are extracellular accumulation of amyloid beta protein, resulting in neuritic, senile plaques and intracellular accumulation of tau protein. AD mainly arises from imbalance of amyloid beta protein production and its clearance in the brain. Testosterone modulates production of amyloid beta protein by decreasing its accumulation. Prostate cancer remains a substantial public health challenge in the United States. While androgen deprivation therapy (ADT) is an effective treatment for prostate cancer, it may be associated with cognitive impairment due to decreased levels of testosterone. …
Using Parent-Identified Strengths Of Autistic Children To Advance Strength-Based Intervention, Angelique Francesca Trigueros
Using Parent-Identified Strengths Of Autistic Children To Advance Strength-Based Intervention, Angelique Francesca Trigueros
Walden Dissertations and Doctoral Studies
Questions remain about the range of abilities autistic children possess and what constitutes effective treatment. Strength-based intervention contrasts with traditional autistic intervention approaches that focus on children's deficits. Studies on strength-based intervention approaches have not revealed how children's strengths are identified and have not used the insights of parents for this purpose. Neurodiversity serves as the conceptual framework because the tenets of neurodiversity align with those of strength-based approaches and hold that autism is a variation of the human condition rather than a disability. The purpose of this qualitative interpretive phenomenological study was to explore how the parent-identified strengths of …
Advocating Ideal Type Policy For Police Officer Wellness Based On Body Mass Index As A Predictor Of Self-Reported Occupational Stress, Louis Chiappetta
Advocating Ideal Type Policy For Police Officer Wellness Based On Body Mass Index As A Predictor Of Self-Reported Occupational Stress, Louis Chiappetta
Walden Dissertations and Doctoral Studies
Scholars have validated both the damaging presence of police officer stress and separately, their increasing obese condition in the United States. Previous studies of police officers focus on stress or body weight, but not these variables conjointly. The purpose of this study was to inform policy creation by examining the problem of officer stress in relation to the calculated body mass index (BMI) values and to gain insight into stress outcomes. Lazarus and Folkman's stress-coping theory served as the research lens to examine if BMI would significantly contribute to the percent change of R2 variance accounted for in the predictive …
Factors Influencing Emergency Registered Nurse Satisfaction And Engagement, Catherine Larock-Mcmahon
Factors Influencing Emergency Registered Nurse Satisfaction And Engagement, Catherine Larock-Mcmahon
Walden Dissertations and Doctoral Studies
Employee satisfaction and engagement have a direct impact on customer satisfaction. Dissatisfaction and disengagement lead to an increased intent to leave a job, poor patient outcomes, and decreased productivity. The retention and recruitment of qualified staff becomes an urgent priority to ensure safe and prudent patient care. The purpose of the qualitative research study was to better understand the beliefs, attitudes, perceptions, and reasons for emergency department registered nurses (ED RN) satisfaction and engagement in the workplace focusing on Herzberg's, Vroom's, Yetton's, Maslow's, Benner's, and Kahn's motivation and engagement theoretical frameworks. The qualitative case research study focused on satisfaction and …
Succession Planning And Development Of Nurse Leaders, Christina Martin
Succession Planning And Development Of Nurse Leaders, Christina Martin
Walden Dissertations and Doctoral Studies
Health care organizations can provide comprehensive, formal learning opportunities to develop nurse leaders for advanced leadership roles. The purpose of this doctoral project was to create an evidence-based nursing leadership academy focused on development of advanced leadership skills and competencies to cultivate frontline and midlevel nurse leaders for executive nursing and health care leadership positions. The practice-focused question addressed how an advanced nursing leadership education program would affect the knowledge level and competencies of nurse leader participants. The American Organization of Nurse Executives' (AONE) 5 nurse executive competency domains served as the framework for this project. Data were collected from …
Barriers To Oral Care Among African American Adolescents In Prince George's County, Maryland, Nkiruka Soribe Mcginnis
Barriers To Oral Care Among African American Adolescents In Prince George's County, Maryland, Nkiruka Soribe Mcginnis
Walden Dissertations and Doctoral Studies
When adolescents forgo oral health treatment, factors that hinder them from obtaining these services put them at risk of detrimental consequences in their oral and overall health. The purpose of this qualitative phenomenological study was to identify the various barriers that adolescents encounter causing them to defer oral treatment. Through this study, public health officials, school health care providers, the state, and parents could be made aware of these factors and work together to implement programs and supplemental aid to help adolescents become more knowledgeable of the importance of oral care and encourage them to desire and seek treatment. The …
Improving Hand Hygiene In An Intensive Care Unit, Charles Chukwuemeka Njenje
Improving Hand Hygiene In An Intensive Care Unit, Charles Chukwuemeka Njenje
Walden Dissertations and Doctoral Studies
Health-care-associated infections (HCAIs) affect hundreds of millions of people worldwide, causing morbidity and mortality among hospitalized patients. About 2 million patients suffer from HCAIs in the United States, and it is estimated that 99,000 of them die each year. Studies have indicated that transmission of health-care-associated microorganisms occurs through contaminated hands of health care workers. Hand hygiene (HH) is the single most effective way to prevent health-care-associated infections, yet health care workers' hand hygiene compliance remains low. One factor responsible for poor compliance with hand hygiene guide-lines are lack of knowledge of good hand hygiene and lack of hand hygiene …
Decreasing Acute Diabetes Complications Through Self-Management Education, Eugene O. Okafor
Decreasing Acute Diabetes Complications Through Self-Management Education, Eugene O. Okafor
Walden Dissertations and Doctoral Studies
Diabetes mellitus is a chronic disease that affects millions of people in the United States. The purpose of this project was to develop a guideline to help clinical staff provide clear and concise diabetes self-management instructions to patients in a community setting. Orem's self-care deficit theory (SCD) and health belief model (HBM) provided a platform to assess how patients' self-care deficit contributes to illness and the effect of patients' perception of illness. SCD theory and the HBM provided the framework for the development of the guideline to decrease diabetes acute complications through self-management education. The practice-focused question was whether the …
Emergency Medical Services First Responder Certification Level's Impact On Ambulance Scene Times, Devin Todd Price
Emergency Medical Services First Responder Certification Level's Impact On Ambulance Scene Times, Devin Todd Price
Walden Dissertations and Doctoral Studies
The foundation of modern-day emergency medical service (EMS) systems began in 1966, based on hospital medical care. Demand for evidence to support prehospital practices that have been in existence for the past half-century has continued to grow; yet, researchers have not adequately explored the relationship between the medical certification level of emergency first responders and the amount of time an ambulance spends on the scene. The purpose of this quantitative study was to examine and compare ambulance scene times for emergency responses when basic life support (BLS) certified first responders or advanced life support (ALS) first responders are first on …
Knowledge And Attitudes Of Emergency Room Nurses Regarding Palliative Care Patients, Pearl Alethea Harrison
Knowledge And Attitudes Of Emergency Room Nurses Regarding Palliative Care Patients, Pearl Alethea Harrison
Walden Dissertations and Doctoral Studies
Palliative care (PC) is the comprehensive management of patients diagnosed with terminal illness. Care for PC patients focuses on relieving symptoms. The purpose of this study was to determine the difference between pretest and posttest scores on the Frommelt Attitude towards the Care of the Dying (FATCOD) and the Palliative Care Quiz for Nurses (PCQN) after an educational intervention to emergency department (ED) nurses. The framework for this project was Bandura's social cognitive theory. The FATCOD was used to assess ED nurses' attitudes toward PC, and the PCQN was used to assess ED nurses' knowledge about PC prior to the …
Affordable Care Act And Human Papilloma Virus Vaccine Among Adolescent Females, Eunice Odaku Nnakwe
Affordable Care Act And Human Papilloma Virus Vaccine Among Adolescent Females, Eunice Odaku Nnakwe
Walden Dissertations and Doctoral Studies
The human papilloma virus (HPV) is the most frequent cause of sexually transmitted diseases (STDs) and cancers for U.S. adults. The Affordable Care Act (ACA), enacted in 2010, eliminated copay expenses for childhood immunizations and expanded access to health care. The purpose of this secondary data analysis study was to determine if there was an association between ACA and the usage of HPV vaccine among adolescent females in Georgia. Data concerning HPV vaccinations from 2011 to 2015 were obtained from the National Immunization Survey-Teen dataset. Andersen's BM of health care use was applied to ascertain the factors that enhanced the …
Substance Abuse And Mental Illness Among Youth In The United States, Emmanuel Xavier Okoro
Substance Abuse And Mental Illness Among Youth In The United States, Emmanuel Xavier Okoro
Walden Dissertations and Doctoral Studies
Despite the trends showing a reduction in the use and abuse of drugs among American adolescents, the prevalence rates remain high. There is also comorbidity of mental illnesses among the adolescents using drugs. The aim of this study was to determine the presence and nature of the association between the use and abuse of marijuana and alcohol and mental illnesses among the American adolescent population. The noted comorbidities and the hypothesized association between the substance abuse and mental illnesses were explained using the expectancy theory. Using a quantitative research methodology, secondary data from the National Survey on Drug Use and …
Women In Mississippi Undergoing Hysterectomies In Absence Of Comprehensive Informed Consent Law, Tammy Shaffer
Women In Mississippi Undergoing Hysterectomies In Absence Of Comprehensive Informed Consent Law, Tammy Shaffer
Walden Dissertations and Doctoral Studies
Only three states have enacted informed consent laws aimed at providing more information concerning any alternative treatments for women who undergo hysterectomy. This study attempted to fill the research gap regarding consent laws and perceptions of women who underwent hysterectomy in a state with no informed consent laws. Supported by the health belief model (HBM), the research questions focused on the perceptions of women and their lived experiences. The purpose of this qualitative study was to examine the beliefs and attitudes of women in a state with no informed consent laws. Interviews were the main data collection technique. The participants …
Medication-Assisted Therapy Interventions And Prescription Opioid Misuse, Stella Kiah Jefferies
Medication-Assisted Therapy Interventions And Prescription Opioid Misuse, Stella Kiah Jefferies
Walden Dissertations and Doctoral Studies
Opioid drug misuse and dependence are a social and public health problem in the United States. Prescription opioid abuse and misuse have been associated with substantial morbidity and mortality rates as well as social and economic costs. The purpose of this project was to provide a systematic review of literature on the effectiveness of medication-assisted therapy interventions in addressing the problem of prescription opioid misuse in health care settings. The systematic review was completed through a literature search conducted across five electronic databases. The review was guided by the health belief model and eligible studies were rated using Johns Hopkins …
Strategies Department Store Managers Use To Increase Employee Engagement, Samara Desir
Strategies Department Store Managers Use To Increase Employee Engagement, Samara Desir
Walden Dissertations and Doctoral Studies
Business leaders are challenged with sustaining an engaged workforce to achieve economic prosperity in their organizations. The implementation of effective strategies to increase employee engagement can mitigate the challenges of employee disengagement. The purpose of this qualitative, single case study was to explore the strategies that department store managers used to increase employee engagement. The conceptual frameworks selected for the research were Vroom's expectancy theory of motivation and Kahn's engagement theory. The research participants consisted of 5 department store managers, from the northeastern United States, who successfully used strategies to increase employee engagement. Data were collected from the participants in …
The Impact Of Shared Governance On Nursing Satisfaction And Retention, Melanie Wetmore
The Impact Of Shared Governance On Nursing Satisfaction And Retention, Melanie Wetmore
Walden Dissertations and Doctoral Studies
Shared governance is a practice model that supports shared decision making between direct care nurses and their leaders. Developed from Kanter's theory of structural empowerment, shared governance allows employees to influence decisions made in an organization. Shared governance has been shown to increase nursing satisfaction, positively impact outcomes, and reduce nursing turnover. The purpose of this project was to examine the relationship between implementation of a system-wide, multihospital shared governance structure and registered nurse (RN) satisfaction, turnover, and perceptions of shared governance. The 3 sources of evidence used in the study were 2016-2017 organizational RN engagement survey results, 2016-2017 organizational …
Medication Reconciliation In The Elderly, Munjanja Yvonne Litell
Medication Reconciliation In The Elderly, Munjanja Yvonne Litell
Walden Dissertations and Doctoral Studies
Medication therapy is the most prevalent and critical intervention of health delivery and the source of most errors in healthcare. Medication errors and associated adverse drug events (ADE) have serious health and economic ramifications, and in elderly patients ADE are the leading cause of morbidity and mortality. Medication reconciliation is the process of evaluating current medication treatment to manage the risk and optimize the outcomes of medication treatment by detecting, solving, and preventing ADEs. This education project answered the question whether education provided to long term care staff would improve knowledge of medication reconciliation and be retained over time. The …
A Clinical Practice Guideline For Pain Management In The Post Anesthesia Care Unit, Susan Mogan
A Clinical Practice Guideline For Pain Management In The Post Anesthesia Care Unit, Susan Mogan
Walden Dissertations and Doctoral Studies
Ineffective pain management in the post anesthesia care unit (PACU) increases patients' risk of adverse effects including decreased mobility, infection, chronic pain, depression, cardiopulmonary complications, increased length of stay, insomnia, fatigue, and overall decrease in quality of life. The PACU in a community hospital did not provide an evidence-based pain management guideline for nurses treating postoperative patients, resulting in nurses' concerns about providing pain management. The purpose of this project was to translate evidence on pain management into an evidence-based guideline for improved nursing practice in a PACU. Evidence was obtained from a detailed literature search using multiple databases and …
Counselors' Perceptions On Adolescent Access And Use Of School-Based Mental Health Services, Samuel C Godwin Okeorji
Counselors' Perceptions On Adolescent Access And Use Of School-Based Mental Health Services, Samuel C Godwin Okeorji
Walden Dissertations and Doctoral Studies
The role of school-based mental health counselors (SBMHCs) is essential in addressing the mental health needs of U.S. adolescents. The purpose of this phenomenological study was to examine SBMHCs' perceptions about factors that affect the use of SBMH services by adolescents from a school district in Connecticut. SBMHCs were chosen for this study because they provide direct mental health services to adolescents. Mechanic's general theory of help-seeking provided the framework to interpret research findings using the 10 interrelated constructs. Fifteen SBMHCs participated in face-to-face semistructured interviews. Colaizzi's 6-steps-guide was used to organize, code, and identify common themes. The following themes …
Impact Of Violent Rapes Among Women In Eastern Democratic Republic Of Congo, Benoit Munganga Mirindi
Impact Of Violent Rapes Among Women In Eastern Democratic Republic Of Congo, Benoit Munganga Mirindi
Walden Dissertations and Doctoral Studies
For the last 22 years, systematic rapes and punitive violence against women in the Democratic Republic of Congo (DRC) were utilized as weapons of war and a control strategy. This quantitative study built upon the ecological model of impact of sexual assault on women's mental health to investigate the relationship between the health impacts and chronic pain and depression among women survivors of sexual rape in eastern DRC. The sample included 156 female rape survivors, between 18-80 years old, and raped between 2010 and 2014 while residing in the conflict area. The research questions focused on the association between fistulas, …
Strategies To Mitigate Information Technology Discrepancies In Health Care Organizations, Oluwatosin Tolulope Oluokun
Strategies To Mitigate Information Technology Discrepancies In Health Care Organizations, Oluwatosin Tolulope Oluokun
Walden Dissertations and Doctoral Studies
Medication errors increased 64.4% from 2015 to 2018 in the United States due to the use of computerized physician order entry (CPOE) systems and the inability to exchange information among health care facilities. Healthcare information exchange (HIE) and subsequent discrepancies resulted in significant medical errors due to the lack of exchangeable health care information using technology software. The purpose of this qualitative multiple case study was to explore the strategies health care business managers used to manage computerized physician order entry systems within health care facilities to reduce medication errors and increase profitability. The population of the study was 8 …
Leadership Strategies For Implementing Quality Improvement Initiatives In Primary Care Facilities, Jose A. Poncevega
Leadership Strategies For Implementing Quality Improvement Initiatives In Primary Care Facilities, Jose A. Poncevega
Walden Dissertations and Doctoral Studies
Health care spending accounts for 17.7% of the gross domestic product in the United States, and it is expected to continue rising at an annual rate of 5.3%. Despite high costs, health care quality lags behind other high-income countries; yet, over 70% of change initiatives fail. The purpose of this multiple case study was to explore strategies primary care leaders use for implementing quality improvement initiatives to improve patient outcomes and reduce waste in primary care facilities. The target population consisted of 3 health care leaders of 3 primary care facilities in southern California who successfully implemented quality improvement initiatives. …
Evaluation Of Use Of Teach-Back For Patient Education, Tamara J. Orr
Evaluation Of Use Of Teach-Back For Patient Education, Tamara J. Orr
Walden Dissertations and Doctoral Studies
The focus of this quality improvement doctoral project was the evaluation of an organization's standardized use of the teach-back process for patient education implemented in February 2018. Teach-back is a process in which the patient restates the key concepts for self-management, so the nurse can assess the effectiveness of the teaching and learning process. The practice-focused question compared 4 questions on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey with literature and recommendations from major health care organizations. The Iowa Model was used to guide the project. The literature review was completed using the Cumulative Index to …
Perceptions Of An Ebp Module Mobile Application By New Graduate Nurses, Kristin Wilson Carlson
Perceptions Of An Ebp Module Mobile Application By New Graduate Nurses, Kristin Wilson Carlson
Walden Dissertations and Doctoral Studies
Evidence-based practice (EBP) is a key driver of care and advancements within nursing. It is essential to emphasize EBP early in a nurse's career to promote inquisitive minds and enthusiasm for seeking evidence. The purpose of this project was to implement an EBP mobile app into a nurse residency program (NRP) to improve the process of providing EBP information and resources to new graduate nurses. The intent of the project was to leverage mobile technology to engage new graduate nurses in evidence-based practice. Roger's diffusion of innovation framework guided the project. The target audience for the project was 16 new …
Female Caribbean Immigrants' Perceptions Of The Influence Of Immigration On Obesity, Kerryann Nelson
Female Caribbean Immigrants' Perceptions Of The Influence Of Immigration On Obesity, Kerryann Nelson
Walden Dissertations and Doctoral Studies
Obesity is a significant global issue, and its incidence has increased over time. A substantial percentage of the U.S. population suffers from this disease with a relatively high prevalence seen in individuals from the Caribbean. The purpose of this phenomenological study was to explore Caribbean women's perception of how migration to South Florida may have impacted the onset of obesity in this population. The social ecological model provided the framework for the study. Data were collected from 1-on-1 interviews held with 12 female participants between the ages of 18 and 35, who previously resided in the Caribbean at a healthy …
Accountable Care Organization Success Strategies: The Importance Of System Changes, Shelly Pierce
Accountable Care Organization Success Strategies: The Importance Of System Changes, Shelly Pierce
Walden Dissertations and Doctoral Studies
Accountable care organizations (ACOs) are a new health care reform initiative that has been highlighted as one of the most important organizational structures that could lead to quality improvements and cost savings in the United States through shared savings. The inability of health care managers to successfully implement ACOs could result in financial losses, reduced patient access to health care, and poor patient outcomes. Grounded by von Bertanlaffy's general systems theory, the purpose of this multiple case study was to explore the system change strategies health care managers used to implement an ACO to meet ACO quality and cost standards. …
Development Of A Quality Improvement Program To Support Evidence-Based Nursing Practice, Heather Richards
Development Of A Quality Improvement Program To Support Evidence-Based Nursing Practice, Heather Richards
Walden Dissertations and Doctoral Studies
Nurses are expected to perform evidence-based practice (EBP) at the point of care (POC) to promote positive outcomes through the quality and safety of patient care. The struggle for nurses on the surgical digestive unit in a hospital to adopt EBP is the lack of access and knowledge to evidence-based research at the POC. The utilization of information technology is an innovated approach to providing access and knowledge for EBP at the POC to improve patient outcomes. The project was to develop a quality improvement program to improve nursing access and knowledge of EBP resources. The program was to identify …
Evaluation Of The N-O-T Program For Smoking Cessation Among High School Students, Whitney Jaye Erickson
Evaluation Of The N-O-T Program For Smoking Cessation Among High School Students, Whitney Jaye Erickson
Walden Dissertations and Doctoral Studies
Adolescents and young adults use more tobacco than all other adults, yet the percentage of this younger population eventually quitting the use of tobacco is lower. There is little evidence-based research to support adolescent smoking cessation programs. Using social learning theory (SLT) and the stages of change model, the purpose of this project was to evaluate the effectiveness of the Not-On-Tobacco (N-O-T) program, an evidence-based adolescent smoking cessation program, in reducing or preventing the number of cigarettes smoked by high school boarding students and to evaluate how best to individualize the program for this high school going forward. The DNP …
The Role Of Empathy In Nursing Assistant Retention, Garlina Finn
The Role Of Empathy In Nursing Assistant Retention, Garlina Finn
Walden Dissertations and Doctoral Studies
It is estimated that by 2020 there will be 2.8 million long-term care beds in residential facilities, staffed primarily with nursing assistants as the front-line care providers. The American Healthcare Association 2012 staffing survey showed that the median annual turnover rate for nursing assistants in the United States is 51.5%. High rates of turnover are associated not only with poorer quality of care but also with increased costs for facilities. The purpose of this project was to understand characteristics that are associated with long-term employment in the nursing assistant role by describing the personality characteristic of empathy in the nursing …
Strategies Rural Hospital Leaders Use To Implement Electronic Health Record, Susan Mejia
Strategies Rural Hospital Leaders Use To Implement Electronic Health Record, Susan Mejia
Walden Dissertations and Doctoral Studies
The Centers for Medicare and Medicaid Services issued over 144,000 payments totaling $7.1 billion to medical facilities that have adopted and successfully demonstrated meaningful use of certified electronic health record (EHR). Hospital organizations can increase cost savings by using the electronic components of EHRs to improve medical coding and reduce medical errors and transcription costs. Despite the incentives, some rural health care facilities are failing to progress. The purpose of this multiple case study was to explore the strategies rural hospital leaders used to implement an EHR. The target population consisted of rural hospital leaders who were involved in the …