Medicine and Health Sciences Commons^™

Race, Gender, And Retention In A Diabetes Self-Management Program, Marcia Kaye Bygrave

Walden Dissertations and Doctoral Studies

Diabetes has quickly become an epidemic in the United States and affects all genders and races. Some ethnic groups are at greater risk for being diagnosed and face devastating health consequences due to poor diabetes self-management. Diabetes self-management education (DSME) is considered to be a positive step toward patient self-efficacy and diabetes management. The benefits of diabetes self-management education can only be realized if patients diagnosed with diabetes not only enroll, but complete the program. The purpose of this research study was to investigate the association between race and gender and dropout rates among participants enrolled in a DSME program. …

Health Care Services For Child Survival And Performance-Based Management In Three Kosovo Municipalities, James Mugaju

Walden Dissertations and Doctoral Studies

After the Republic of Kosovo's declaration of independence in 2008, new municipal structures were created with the charge of monitoring the delivery of health care services; yet, no mechanism for monitoring performance was ever implemented. With the public value theory as the foundation, the purpose of this multiple case study of 3 Kosovo municipalities was to understand issues surrounding the capacity of local government health department to monitor their performance related to the delivery of services. Relevant data were collected through focus-group discussions with 10 nurses, 9 directors of family medicine centers, and 12 municipal program managers. Purposeful semistructured interviews …

Latent Tuberculosis Infection Treatment Completion And Predictors Of Noncompletion Among Visa Holders In The Rural Setting, Scott Hutton

Walden Dissertations and Doctoral Studies

Latent tuberculosis infection (LTBI), a product of exposure to Mycobacterium tuberculosis (Mtb), can lead to tuberculosis (TB) and further cause death if untreated. Fortunately, TB can be prevented with LTBI treatment. Targeting newly arrived visa holders for LTBI screening and treatment is an effective strategy for decreasing future TB burden. However, LTBI treatment completion rates are low, and researches had primarily focused on the nonrural U.S. setting. This study, using a retrospective cohort design under the epidemiological disease triangle framework evaluated (a) the treatment completion rates for 2 cohorts of visa holders (i.e., immigrants, N = 31 and refugees, N …

Implementation Of Food Safety Regulations In Food Service Establishments, Steve Randolph Mcallister

Walden Dissertations and Doctoral Studies

Food service businesses in the United States have experienced millions of dollars in losses caused by foodborne illness outbreaks, which can lead to bankruptcy and business closures. More than 68% of all foodborne illness outbreaks occur in food service establishments. The purpose of this descriptive case study was to explore the strategies leaders of food service establishments use to implement food safety regulations. Force field analysis was the conceptual framework for this study. The population for the study consisted of 3 leaders of food service establishments located in the southeastern region of the United States. Data were collected using semistructured …

Stress, Anxiety, And Depression: Role Of Campus Connectedness, Social Support, And Coping Among Nepalese Nursing Students, Priscilla Samson

Walden Dissertations and Doctoral Studies

High levels of stress, anxiety, and depression (SAD) can adversely influence physical health, psychological well-being, and academic and clinical performance of nursing students. Numerous studies have identified the factors associated with SAD; however, a paucity of empirical research addresses the relationship of SAD with campus connectedness (CC), perceived social support (PSS), and coping. The purpose of this quantitative cross-sectional study, guided by Lazarus and Folkman's theory of stress, coping, and adaptation, was to determine the prevalence of SAD and examine its relationship with CC, PSS, and coping among undergraduate nursing students of Nepal. Survey research was conducted using depression anxiety …

Nursing Candidates' Perceptions Of The Greatest Challenges To Becoming A Professional Nurse, Lee Ann Williams

Walden Dissertations and Doctoral Studies

Nursing candidates' overall goal is to become a professional nurse. To reach this goal, the student must graduate from an associate or baccalaureate nursing program and pass the state board, National Council Licensure Examination (NCLEX). Student retention in nursing programs and passing the NCLEX continue to be a problem for educational institutions throughout the United States. The purpose of this study was to examine nursing candidates' perceptions of their greatest challenges in becoming a professional nurse. Wenger's social learning systems and the community of practice comprised the conceptual framework that guided this study. The research questions pertained to nursing students' …

Seat Belt Fit A Mechanism Of Injury During A Motor Vehicle Crash, Jacoba Hendrika Viljoen

Walden Dissertations and Doctoral Studies

Seat belts save lives; however, unintentional injuries are still the leading cause of death for those between 1 and 44 years in the United States. Seat belts also cause injuries during motor vehicle crashes (MVCs) and obesity changes how seat belts fit. The purpose of this retrospective causal inference quantitative study was to reduce the knowledge gap in scholarly research on seat belt fit in relation to blunt cerebrovascular injuries (BCVI) during MVCs and seat belt compliance. The theoretical framework used was based on H.W. Heinrich's domino theory. The research questions focused on the following dependent variables: BCVI, compliance, and …

Differences In Coping Strategies Of African American Children With Chronic Pain, Eddie Lee Coleman

Walden Dissertations and Doctoral Studies

Chronic pain is a significant problem in the U.S. pediatric population, conservatively estimated to affect 15% to 20% of children. Few studies have focused on coping strategies African American children use to manage chronic pain. The purpose of this study was to examine coping strategies used by African American children and adolescents ages 11 to 18 years suffering from chronic pain and to examine gender and age differences in this population. The gate control theory provided the framework for the study. The Pain Coping Questionnaire was used to measure coping strategies in a convenience sample of 44 children and adolescents …

The Relationship Between Certified Registered Nurse Anesthetists' Emotional Intelligence And Burnout, Dianna Marie Heikkila

Walden Dissertations and Doctoral Studies

Certified Registered Nurse Anesthetists (CRNAs) administer more than 43 million anesthetics within the United States and practice in every setting where there is anesthesia. Stress and burnout can be a common problem for CRNAs. The purpose of this correlation study was to examine the relationship between emotional intelligence (EI) and burnout syndrome among CRNAs. The research questions assessed CRNAs and the relationship between EI and burnout syndrome, the burnout score and the four dimensions of EI, and EI and the three dimensions of burnout. Certified and recertified CRNAs (N = 506) completed the Wong and Law Emotional Intelligence Scale, the …

Decreasing Operating Room Delays For Surgical Orthopedic Patients, Jacqueline P. Ogunjulugbe

Walden Dissertations and Doctoral Studies

The operating room (OR) at the project site was experiencing surgical delays for orthopedic surgical patients due to unavailable instruments, which led to a decrease in the efficiency of OR utilization. The purpose of this project was to decrease operating room delays for the orthopedic surgical patients. The practice-focused question explored whether a multidisciplinary approach to the procurement of instruments and supplies for the orthopedic surgical patient would help to ensure an on-time surgery start, resulting in increased efficiency in the utilization of the OR from 42% to 65% within a 9-month period. Lewin's change model was used to guide …

Leadership Communications Strategies For Enhancing Virtual Team Performance, Rachel Oludolapo Agbi

Walden Dissertations and Doctoral Studies

The fast-growing trend of using virtual teams comes with challenges including the lack of knowledge by some virtual team leaders for managing virtual teams. The purpose of this single case study was to explore the communication strategies that leaders use to manage virtual teams in real time to enhance team performance. The sample was composed of 4 successful virtual team leaders of a multinational accounting firm whose headquarters is in the northeastern region of the United States of America. The conceptual framework that guided this study was Tuckman's small group developmental model. Data consisted of semistructured interviews and the review …

Patient Self-Assessment For Older Adult Fall Prevention, Deborah Brennan

Walden Dissertations and Doctoral Studies

Falls and falls with injury are a leading contributor to decreased quality of life for adults aged 65 and older. Complications associated with fall occurrences include death, long term disability, decreased mobility, decreased quality of life, and psychological effects.

The practice focused question addressed in the project asked if the use of a standardized publicly available assessment for falls risk will assist registered nurses in learning more about the patient's fall risk. To address the question, the Stay Independent Check Your Risk for Falling Questionnaire (SICRFQ), obtained from the CDC website, was used as the basis for an education program …

Evaluation Of An Opioid Risk-Assessment Screening Tool, Jacquelyne Guerra

Walden Dissertations and Doctoral Studies

According to the Centers for Disease Control and Prevention, prescribers should evaluate risk factors related to opioid use prior to initiation of opioid medication. The practice problem in this DNP project was that providers failed to consistently assess patients with complaints of pain for risk of opioid misuse and/or abuse prior to initiating opioid medication. An opioid risk-assessment screening tool (ORAST) has the potential to identify patients at high risk for opioid misuse and/or abuse. The purpose of this Doctor of Nursing Practice project was to identify and introduce an ORAST and then develop a policy to guide providers in …

The Relationship Between The Big Five Personality Traits And Authentic Leadership, Bronti Baptiste

Walden Dissertations and Doctoral Studies

Effective leadership, ethical leadership, and leadership emergence have been extensively researched, but there remains a lack of research on the relationship between the big 5 personality traits and authentic leadership. This quantitative study was based on the empirical principles of the big 5 model and guided by the big 5 theory. In addition, this research asked if there was a relationship between the big 5 model and authentic leadership, and which combination of the 5 personality traits best predict authentic leadership. Fifty-five adult participants, employed in various corporations, were recruited from a convenience sample. They rated their leaders by completing …

Generational Homelessness In New York City Family Homeless Shelters, Deborah Johnson

Walden Dissertations and Doctoral Studies

Homelessness has been a problem in New York City (NYC) for decades. Part of the problem is children who grew up in the shelter system and then returned as adults, a phenomenon known as 2nd-generation homelessness. Literature indicates that no researchers have interviewed second-generation homeless adults about their experiences. The purpose of this study was to explore the experience of 2nd-generation homelessness from the perspective of homeless adults returning to the shelter system. The sample included 1 second-generation homeless adult and 10 case managers at Tier II homeless shelters. Interviews were conducted and data were analyzed using hand coding to …

Perceptions Of Chiropractors In Mississippi Regarding Obesity, Phelesia Nakita Foster

Walden Dissertations and Doctoral Studies

Obesity continues to be a growing problem across the United States. Chiropractors have made claims of providing health promotion services within their treatment protocol; however, there is a lack of empirical research regarding a need for the chiropractic profession to train chiropractors to address Healthy People 2020 public health initiatives. The purpose of this qualitative study was to examine the perceptions of Mississippi Delta Region chiropractors regarding their role in obesity management as nonmedical practitioners that implement public health objectives in their practice. The research questions aimed at addressing possible barriers and limitations that influenced chiropractors' perceptions regarding their role …

Social Inclusion Outcomes For An Organization's Adolescent Parent Intervention, Anayra Ivette Tua

Walden Dissertations and Doctoral Studies

The study institution is a non-profit organization with a model developed from the continuous implementation of needs assessments of the families of adolescent parents in Puerto Rico, with the purpose of increasing their social inclusion potential. Addressing social exclusion and stigmatization of adolescent parents is vital because it generates a dual benefit for social interactions and growth. The social inclusion concept used and further elaborated for adolescent mothers is described by researchers as the level of access to engaging with institutions and societal relationships. This program evaluation was developed to understand the outcomes and effectiveness of the organization's social inclusion …

Racial/Ethnic Differences In The Treatment Of Elderly Non-Small Cell Lung Cancer Patients, Cheryl Mokrzecky

Walden Dissertations and Doctoral Studies

Racial and ethnic disparities related to lung cancer treatments and outcomes are not fully understood but may be due to individual or institutional factors. Following established national cancer treatment guidelines may improve patients' quality of life, outcome to treatment, and facilitate the eradication of lung cancer. There are limited data on the real-world treatment of racial/ethnic groups with non-small cell lung cancer (NSCLC) according to clinical practice guidelines, therefore this population-based cohort study examined the receipt of first line treatment for advanced or metastatic NSCLC according to the National Comprehensive Cancer Network (NCCN) practice guidelines. The Social Cognitive Theory served …

An Evidence-Based Approach To Percutaneous Coronary Intervention Access, Kemi Funlayo Sanni

Walden Dissertations and Doctoral Studies

Coronary heart disease is a significant cause of mortality and morbidity in the United States; Healthy People 2020 set an objective to reduce the rate of the disease by 20% to the baseline rate of 126 deaths per 100,000 population per year. In the local healthcare setting, heart disease was responsible for a high percentage of mortality and morbidity. To address this, the local site developed a plan to improve outcomes for patients seeking care at the facility. Because the femoral approach to percutaneous coronary intervention (PCI) was used to treat coronary heart conditions at the site and complications were …

Assessment And Treatment Of Postpartum Depression Among Mothers In Imo-State, Nigeria, Allison Chinyere Nnaka

Walden Dissertations and Doctoral Studies

Postpartum depression affects many postpartum mothers. When postpartum depression is not timely assessed, identified, and treated, it can lead to problems with mother child bonding and cause family problems, negligence, and infant death. The purpose of this phenomenological study was to understand Imo State women's lived experiences and perception on sufficiency of the assessment and treatment received for their postpartum depression. The conceptual theory for this study was the empowerment theory. In-depth, face-to-face interviews were conducted to examine 10 Imo State postpartum mothers' lived experiences of assessment processes and to understand if their psychological desires were addressed. The interviews were …

Low Health Literacy And Hpv Vaccine Uptake Of African American And Hispanic American Women, Peter Ntiamoah

Walden Dissertations and Doctoral Studies

Cervical cancer incidence in the United States has declined for the past 40 years, yet the odds of developing cervical cancer is much higher among marginalized women, particularly African American and Hispanic American women. Although preventable through vaccination against the human papillomavirus (HPV) prior to infection, uptake and completion rates of the vaccine among African American and Hispanic American women are low. The purpose of the study was to determine if a significant relationship existed between the health literacy levels of African American and Hispanic American women, ages 18-26, and the low HPV vaccination uptake. The integrated behavioral model, which …

Health Disparities Among Hispanic Americans With Type 2 Diabetes, Nelson Sitton

Walden Dissertations and Doctoral Studies

The ongoing increase in Type 2 diabetes among Hispanic Americans challenges the American public health system, particularly with health issues arising from not following appropriate health directives for the disease. This quantitative, cross-sectional, correlational study used primary data to assess the relationship between diabetes knowledge (as measured by the Diabetes Knowledge Questionnaire), health literacy level (as measured by the Short Assessment of Health Literacy-Spanish and English), education level, self-efficacy (as measured by the Diabetes Self-efficacy questionnaire), and self-reported diabetes self-care behaviors (as measured by the Summary of Diabetes Self-care Activities) among a sample of Hispanic Americans with Type 2 diabetes. …

Community Public-Private Partnership Leadership Synergy In Tanzania, Hawa Yatera Mshana

Walden Dissertations and Doctoral Studies

Although the public-private partnership (PPP) concept in health and social health has been politically accepted as the best pathway to improving health outcomes in many developing nations, implementation lacks leadership synergy. Lack of awareness and engagement of community leaders about PPP interventions and their benefits affect accountability and ownership of health and social care interventions. The purpose of this study was to better understand factors that could promote partnership leadership synergy to enhance ownership and accountability for community health and social welfare initiatives in Tanzania. A qualitative empirical case study design was used; diffusion of innovation and the public-private integrated …

Adherence To Antiretroviral Medicines Among Adolescents And Young Adults In Benue State, Nigeria, Amom Tor-Anyiin

Walden Dissertations and Doctoral Studies

Adherence to ARV medicines is essential to halt HIV progression, increase CD4 counts, decrease virologic impact, and improve quality of life for the infected people. However, sustaining good adherence among adolescents and young adults (AYA) has been a challenge caused by various problems such as distance to clinic, improved CD4 count which lead to complacency in adherence, and the nature of the environment. This was a quantitative, retrospective, correlational, cross-sectional study anchored by the transtheoretical model, which was used to understand how adherence rate among the study population was impacted by the predictive factors. Secondary data was collected from patient's …

Factors Influencing Alzheimer's Disease Healthcare Utilization Patterns In Puerto Rico, Carlamarie Noboa

Walden Dissertations and Doctoral Studies

Alzheimer's disease (AD) is associated with substantial healthcare utilization costs, resulting in a public health priority. In this study, the relationship between the demographic characteristics of age, gender, and type of health insurance; the presence of comorbidities of older Puerto Rican residents diagnosed with AD; and their healthcare utilization patterns (i.e., medical office and emergency room visits and hospital admissions) was examined using Andersen's behavioral model. Data from the 2013 Puerto Rico Health Study was used in this retrospective cohort design study. All AD cases aged -?¥ 60 years were extracted using systematic random sampling. One-way ANOVA-WELCH, Mann-Whitney U test, …

The Impact Of Transmission Mode On Hiv/Aids Medication Adherence, Lindsey Wilde

Walden Dissertations and Doctoral Studies

Medication adherence amongst HIV/AIDS infected individuals can be challenging for many reasons. I examined whether there was an association between mode of HIV transmission, such as sexual intercourse, mother to child, or IV drug use, and medication adherence among HIV+ individuals 18 years and older living in New York City. The theoretical base for this study was the Social Ecological Systems Theory. Logistic regression analyses were conducted on field data obtained from the New York State Medicaid Agency from 2015. Results indicated that transmission mode, age, race, and poverty level all have statistically significant associations with the dependent variable of …

Association Between Genetic Ancestry And Body Mass Index Among A Cohort Of Hispanic American Children, Sahel Hazrati

Walden Dissertations and Doctoral Studies

Childhood obesity is disproportionately higher among children from Hispanic backgrounds. Ethnicity is a social and cultural construct and does not capture true ancestral heterogeneity. Hispanic Americans have a wide variety of genetic admixture proportions of European (EUR), Native American (AMR), and African (AFR) ancestry. The objective of this cross-sectional study was to assess the contribution of ancestral genetic composition to body mass index (BMI), and to evaluate the relationship of obesity risk factors to BMI among 154 2-year-old Hispanic American children. The theory of Evolutionary Developmental Biology was utilized to investigate the relationship between children's growth process and ancestral background. …

Educating Oncology Nurses About The Emotional Impact Of Cancer Diagnosis, Jonnell Ortiz Zayas

Walden Dissertations and Doctoral Studies

Anxiety and depression are common mood disorders in cancer patients, regardless of mental state prior to diagnosis. A gap in the education of oncology nurses in an eastern Caribbean island was discovered regarding their ability to identify anxiety and depression symptoms and to help patients who suffered from these disorders. The purpose of this project was to improve oncology nurses' assessment skills by reviewing appropriate use of the Hospital Anxiety and Depression Scale (HADS) tool and familiarizing nurses with resources to help patients who score high on the HADS. The Levine conservation model was the theoretical framework for this project. …

Kono Members' Perceptions Of Burial Practices And The Spread Of Ebola Virus Disease, Comfort Kenyeh Panda

Walden Dissertations and Doctoral Studies

Sierra Leone was heavily affected by the West African Ebola virus disease (EVD) epidemic from 2013 to 2016. Ongoing EVD transmission during the epidemic was connected to several factors including unsafe traditional burial practices. This phenomenological qualitative study addressed Kono members' perceived knowledge, attitudes, and beliefs regarding how burial practices influenced EVD transmission. Rosenstock's health belief model provided the framework for the study. The participants purposefully selected from various religions and professions were interviewed individually and in focus group settings. Similar phrases and comments were identified from the interview responses resulted which resulted in the following 5 main themes: (a) …

Racial And Cultural Etiology Of Body Satisfaction Among Obese, Young Adult Women, Deirdre Lynnett Moyer

Walden Dissertations and Doctoral Studies

Obesity, a public health issue in the United States, has been linked to numerous chronic diseases. A gap exists in the literature related to racial and cultural etiology of body satisfaction for obese women. The purpose of this qualitative phenomenological study was to describe the racial and cultural etiology of body satisfaction for obese Black women and White women residing in a rural area of the state of North Carolina. Social comparison theory provided the theoretical underpinning for this examination. The central research question was how do obese, young adult Black women and White women describe their perceptions about and …