Medicine and Health Sciences Commons^™

Type 2 Diabetes Management For Geriatric Veterans, Fachecia L. Fort

Walden Dissertations and Doctoral Studies

Managing diabetes in the geriatric long-term care population can be challenging, yet important because diabetes is a chronic, progressive disease. The purpose of this project was to identify clinical practice guidelines for managing Type 2 diabetes in geriatric veterans and to develop a class to educate providers on diabetes management in the geriatric long-term care population at a community living and rehabilitation center. The practice focused question asked if providing education to providers about the clinical practice guidelines for managing Type 2 diabetes in geriatric long-term care veterans would improve knowledge as measured by a pre- and posttest. The project …

Impact Of Free Maternal And Child Health Services On Health Care Utilization In Jigawa State, Nigeria, Nura Ibrahim Kazaure

Walden Dissertations and Doctoral Studies

In spite of a decrease globally, the maternal mortality rate (MMR) in Nigeria and its

Jigawa State has remained persistently high. Few efforts to address the MMR in Nigeria have been undertaken. The purpose of this study was to investigate the impact of Jigawa State's Free Maternal and Child Health Program (JSFMCHP), education, employment, and parity of pregnant women on health care utilization (the outcome variable), as measured by antenatal care (ANC) visits. Anderson's behavioral model served as the study's theoretical framework. The sample size included 400 antenatal records of pregnant women who were randomly selected from the state's Health …

Parental Influence On Hiv Vertical Transmission In Kenya, Hussein Abdi Nunow

Walden Dissertations and Doctoral Studies

Mother-to-infant vertical transmission of HIV usually occurs during pregnancy, labor, delivery or breastfeeding. It is the third leading cause of transmission of HIV after sexual intercourse and blood transfusions. In 2008, 12 million women aged 15 years and above were anticipated to be living with HIV in countries within Sub-Saharan Africa. In this study, the association between parental HIV knowledge, attitudes and risk reduction practices, and HIV vertical transmission in Kenya were explored. The health belief model was used to help understand and interpret the findings. For this quantitative study, data were collected via surveys from 212 participants in 3 …

A Limited Rational Choice Theory In Local Public Health Decision Making, Lona Bryan

Walden Dissertations and Doctoral Studies

The threat and occurrence of terrorist attacks have increased in the United States since September 2011, heightening concerns for weaponized anthrax, other biological pathogens, and epidemics and pandemics. Early decisions and funding levels in local public health agencies can be the first line of defense or first point of failure; yet little is understood about how decisions are made when there are budget cuts before a biological event happens. Using Lindblom's conceptualization of limited rational choice theory, the purpose of this single case study was to understand how a local public health official made decisions after budget cuts in a …

Determinants Of Low Birth Weight In A Population-Based Sample Of Zimbabwe, Paul Nesara

Walden Dissertations and Doctoral Studies

Low birth weight (LBW) is a major public health concern globally. Despite its negative social and economic impact on the family and community at large, it has remained relatively unexplored at population level in Zimbabwe. The purpose of the study was to establish determinants of LBW using data from the 2015 Zimbabwe Demographic and Health Survey. The socioecological model was the conceptual framework for the study. A secondary analysis was conducted on 4,227 mother-infant dyads. Independent variables were duration of pregnancy, number of births within the past 5-year period, exposure to mass media, type of fuel used for cooking in …

Women's Perceptions Of Malaria In The Western Rural Areas Of Sierra Leone, Marcella Davies

Walden Dissertations and Doctoral Studies

Malaria is one of the leading causes of death for children and women in Sierra Leone. The purpose of this qualitative study was to explore and understand the lived experiences of women from the rural areas of Sierra Leone regarding malaria. A purposive sample of Krio women from the western rural area, aged 21-55 years, spoke English, and had taken care of someone with malaria described their perceptions and lived experiences with the disease in face-to-face interviews. The research questions were based on the health belief model and focused on knowledge, beliefs, and perceptions about malaria prevention and treatment. Interpretative …

Illegal Drug Use, Suicidal Ideation, And Attempted Suicide Among New York Adolescents, Jacqueline Taylor

Walden Dissertations and Doctoral Studies

Suicide, ranked as one of the top five causes of death among adolescents, aged 15 to 19, claims numerous lives within the state of New York. Driven by the social cognitive theory, the objective of this quantitative cross-sectional study was to investigate the association among being offered, sold, or given illegal drugs, illegal drug use, being bullied, age, gender, ethnicity, suicidal ideation, and attempted suicide among adolescents in New York. The Centers for Disease Control 2015 Youth Risk Behavior Surveillance data for 89,068 New York adolescents, Grades 9-12, were utilized in this study. There was increased risk of suicide ideation …

Using Social Cognitive Theory To Predict Obesity Behaviors In Hispanic American Children, Augustina Anyikwa

Walden Dissertations and Doctoral Studies

Childhood obesity is a growing challenge in the U.S. Hispanic American population. There is a need for evidence-based approaches to combat this problem. Social Cognitive Theory (SCT) is one such approach. The purpose of this study was to examine the extent to which selected constructs of SCT (expectations, self-efficacy, self-efficacy in overcoming barriers and self-control) could predict five childhood obesity prevention behaviors, namely time spent on television watching, time spent on physical activities, water consumption, consumption of fruits and vegetables, and meal portion size among Hispanic American children. A quantitative cross-sectional research design was employed for this study. Data were …

Assessing Condom Use Among Navajo Men In The Southwest, Terra E. Yabeny

Walden Dissertations and Doctoral Studies

The Navajo tribe reports extraordinarily high number of cases of sexually transmitted diseases (STDs), such as gonorrhea, chlamydia, and human immunodeficiency virus (HIV) among men who have sex with men (MSM) and heterosexual populations. The purpose of this qualitative study was to explore the cultural value of adil' idli (self-respect) and how this cultural practice might influence health behaviors in sexual activity, condoms use, and acquiring of STDs among Navajo men. The Health Belief Model (HBM) was the theoretical foundation for providing a deeper understanding of the social, environmental, and cultural factors of condom use among Navajo men. Research questions …

Awareness And Attitudes Of Young Nigerian Immigrants In The United States To Sickle Cell Screening And Premarital Genetic Testing, Timothy Atolagbe

Walden Dissertations and Doctoral Studies

The carrier frequency for sickle cell anemia among Nigerians, who account for a high percentage of African immigrants in the United States, is high, according to the World Health Organization. Even though sickle cell disease contributes $2.4 billion annually to U.S. health care expenditures, ascertaining the number of affected individuals in the U.S. is difficult because sickle cell is not a reportable genetic disease. However, according to the Census Bureau, the number of African immigrants continues to grow at a steady pace among the foreign-born immigrant population in the U.S. There is a lack of research on the contribution of …

Exploring The Role Of Religious Leaders In Preventing Sickle Cell Disease In Nigeria, Grace Awe

Walden Dissertations and Doctoral Studies

Nigeria has high rates of sickle cell disease (SCD), which is attributed to the lack of awareness of the disease among the reproductive age in the country. The purpose of this cross-sectional study was to explore the role of religious leaders in contributing to awareness and prevention of SCD in Nigeria. Religious leaders' knowledge, attitude, and prevention and awareness practices of SCD, and how they translated to the prevention of SCD through improved counseling of premarital couples, were explored. A stratified random sampling was employed in selecting a sample of 150 religious leaders from different religious affiliations. Data were collected …

Head Start Parent Perspectives On Child Exposure To Secondhand Smoke At Home, Christiana Abani Bekie

Walden Dissertations and Doctoral Studies

Children exposed to secondhand smoke (SHS) are at risk of developing ear infections, asthma, wheezing, bronchitis, as well as retarded lung growth. Indoor smoking is the main source of children's exposure to SHS. Despite a downward trend in smoking, children from low income families, especially African American and Hispanic children, continue to be exposed to SHS at a higher rate than their wealthier counterparts. This multiple case study explored the perceptions of 15 parents of 3- to 5-year-old children currently enrolled in Head Start regarding children's exposure to SHS. This study relied on the social ecological model, the theory of …

Pain Management, Gender, And Quality Of Life In Cancer Patients, John Robert Buhmeyer

Walden Dissertations and Doctoral Studies

The type of cancer pain management used may have an effect on the quality of life (QOL) of cancer patients. Researchers have determined that cancer patients are inadequately treated for pain and pain management is an essential determinant of patient survivability and QOL. Numerous clinical studies have been accomplished concerning opioid administration and noncancer and cancer pain management exist. Previous studies have examined the relationship between cannabinoid products, noncancer pain, cancer pain, and related QOL for patients but have not focused on the QOL of cancer patients while also moderating for gender. These relationships were investigated using the health belief …

Alzheimer's Disease Dementia: Stress, Female Caregiver Burden, And Older Caregiver Health Outcomes, Nadia Muhammad

Walden Dissertations and Doctoral Studies

Alzheimer's disease dementia caregivers are heavily engaged in providing daily assistance to individuals encumbered with Alzheimer's disease, but these caregiving duties can have a devastating effect on caregivers' self-reported health and mental outcomes. The purpose of this study was to evaluate older female caregivers' background and contextual stressors and care stressors on caregivers' self-reported harm to health resulting from the stress of caregiving, health status and emotional stress. The stress process model for Alzheimer's caregivers served as the theoretical foundation for this study. Correlation and logistic and linear regression analysis were used to evaluate if a relationship exists between the …

Improving Glycemic Control In Adult With Type 2 Diabetes, Basirat Romoke Triplett

Walden Dissertations and Doctoral Studies

Ninety percent of people with diabetes have Type 2 diabetes mellitus (T2DM). T2DM is a complex disease that affects every organ in the body, which makes effective management of the disease imperative. The American Association of Clinical Endocrinologist (AACE) and American College of Endocrinology (ACE) strongly recommended early treatment initiation among the target population to delay disease progression and complications. The purpose of this evidence-based project was to examine the impact of using the T2DM management algorithm for effective management of adults with T2DM over a 3-month period. The shared experience decision-making model and the chronic care model were used …

A Story To Tell Among Minority Alzheimer's Patient Caregivers: A Phenomenological Study, Albertina Lashonda Walker

Walden Dissertations and Doctoral Studies

The level of burden experienced by caregivers of patients diagnosed with Alzheimer's disease is high. Studies that examine this burden by taking into account cultural and spiritual differences are limited, particularly with regard to minority populations. The purpose of this study was to investigate the burden and challenges faced by minority caregivers providing in-home care to Alzheimer's patients. Guided by social support theory, a phenomenological study design was used with semi-structured interviews of 12 caregivers to examine their perspectives on the burden and challenges they face, including their lived experiences, cultural and spiritual values, and interaction with health professionals. Thematic …

Improving Human Papillomavirus Vaccination Rates Through Evidence-Based Interventions, Deidra Thompson

Walden Dissertations and Doctoral Studies

Cervical cancer is the most common human papilloma virus (HPV) -associated cancer and is the second leading cause of death in the world. Vaccination against HPV is essential to reduce the incidence of HPV and subsequent morbidity and mortality. According to the Centers for Disease Control and Prevention (CDC), approximately 79 million Americans are currently infected with HPV. The site for this DNP project was a 163-bed facility with inpatient and outpatient services in the southern United States. The vaccination rate at the site was 48%. The facility lacked educational interventions to prepare and remind providers to offer HPV vaccine. …

Poverty Rate And Occurrence Of Foodborne Illness Risk Factors In Retail Facilities, Margolite Joseph Cesar

Walden Dissertations and Doctoral Studies

Despite the efforts of food safety regulations and rules, food contamination remains a public health concern and prevalent vehicle of pathogens. This study identifies the predictors of food risk in different types of food establishments in Miami Dade County, Florida during the period November 2014 - November 2016. Guided by the epidemiologic triangle model, this correlational study analyzed the log number of risk factor violations and failure rates controlling for US Census sociodemographic data (2010 to 2014) for the food establishment neighborhoods by using linear and logistic regression. Results indicated that most of food entity types are significant predictors of …

Self-Care Management Of African American Men With Type 2 Diabetes, Kevin Konstantinos

Walden Dissertations and Doctoral Studies

African American men are disproportionately affected by type 2 diabetes and have a 3 times higher rate of 3 serious complications of diabetes, including blindness, amputations, and end-stage renal disease, compared to other groups. The purpose of this project was to address the gap-in-practice disparity that exists in care of African American men with diabetes by providing one-on-one self-care management education in an outpatient clinic setting. The behavior change theories that supported the project intervention were Orem's self-care theory and Bandura's self-efficacy theory. Employing a quasi-experimental design, 33 participants between the ages of 40 and 65 were divided into an …

Physical Activity And Veteran Status In Obesity And Chronic Obstructive Pulmonary Disease, Erin Mcguire Kren

Walden Dissertations and Doctoral Studies

There are few data available regarding the relationship between physical activity and veteran status in those with combined chronic obstructive pulmonary disease (COPD) and obesity. COPD is a common illness and a leading cause of death in the United States. Veterans represent a distinct subpopulation in the United States and are more likely to have COPD, which is a disease with a high rate of comorbidities such as obesity. Physical activity can improve outcomes for those with COPD and obesity. However, recommendations for physical activity for those with COPD and obesity are vague. This study, based on the self-determination theory, …

Workplace Violence Among Nurses And Nursing Assistants In Texas, Tamala Norris

Walden Dissertations and Doctoral Studies

Workplace violence (WPV) is ranked as one of the leading causes of occupational injury in the United States and is common in health settings. Nurses have the highest rate of violent victimization reported in the U.S., thus presenting a significant issue for healthcare leaders. Various researchers focus on prevalence rates of WPV among nurses discussing types of violence, location, and the setting where the WPV occurred. Less information exists regarding time taken off work and factors associated with WPV among nurses versus nursing assistants (NAs). This information is important due to the impact on safe work environments for nursing employees. …

Time Banks As Aging-In-Place Initiatives, Calli Sajnani

Walden Dissertations and Doctoral Studies

There has been growing concern over how state and federal governments can support the increasing population of aging Americans and their need for long-term care. Current insurance funding models cover acute hospitalization and skilled care only, leaving unskilled care needs and homemaker services at the full expense of those in need. Time banking allows individuals to exchange or barter time for goods or services without monetary payment. There is insufficient evidence to determine if members believe time banks to be a viable alternative to support aging-in-place care needs. This phenomenological study explored time banking as a potential vehicle for nonskilled …

Spiritual Wellness As A Predictor For Moral Injury In Combat Veterans, Steve Zappalla

Walden Dissertations and Doctoral Studies

Many combat veterans face difficulties coping with their personal lives, relationships, and families when they leave the service and return to civilian life. Most studies examining the effects of combat on veterans focus on posttraumatic stress disorder (PTSD) as well as a collection of related consequences. Interest in the term moral injury of military veterans as a related mental health construct has grown. Researchers have investigated the effects of spiritual wellness of combat veterans. However, there is a paucity of counseling literature on the relationship between spiritual wellness and moral injury when combat veterans return to civilian life. Investigating the …

Evidence-Based Practice Guideline For Peripheral Artery Disease, Jenny Ann Salve Managbanag

Walden Dissertations and Doctoral Studies

The absence of a practice guideline for peripheral artery disease (PAD) in the cardiology department creates differing practice preferences among providers, leading to deviations in practice among staff. Variations in practice can affect the quality of care that is provided to patients. This project was guided by research statements indicating that there was a difference in the screening approach for PAD among health practitioners at preimplementation and postimplementation and that an 85% compliance with the guideline would signify consistency in the provision of care. Rogers' theory of diffusion of innovations was used to facilitate the adoption of the guideline. This …

An Educational Program For Using The Distress Themometer, Mabel M. Che-Tuma

Walden Dissertations and Doctoral Studies

The distress thermometer (DT) is a screening tool designed to measure the level of stress in oncology patients. Clinical oncology nurses (CONs) at the local site lacked knowledge and training on how to administer and apply the DT. Because of this practice gap, patients were not receiving referrals to the necessary support services. The purpose of this project was to design and validate a CON staff education program on the use of the DT. The diffusion of innovation theory along with the theory of interpersonal relations served as the conceptual framework for the project. The project was organized into a …

Strategies To Reduce Occupational Injuries And Illnesses In Government Agencies, Sandra Montgomery

Walden Dissertations and Doctoral Studies

Despite regulatory efforts of the Occupational Safety and Health Administration (OSHA), 104 cases of nonfatal occupational illnesses and injuries (OIIs) per 10,000 full-time workers required time away from work in 2015. Although OII rates in private and public sectors are high, the rates among state and local government agencies were over 50% higher than private sector rates in 2015, especially in the healthcare industry. OIIs can lead to reduced organizational productivity and performance. Guided by the leader member exchange theory (LMXT) and risk homeostasis theory (RHT), the purpose of this single case study was to explore effective strategies that supervisors …

Nonpharmacological Behavioral Interventions For Patients With Dementia: An Integrative Literature Review, Michelle Monique Spears

Walden Dissertations and Doctoral Studies

The use of antipsychotic medications in older adults with dementia increases risk of

mortality; therefore, it is critical that nurses use nonpharmacological interventions in dementia care. The nurses' role is integral to implementation of treatment strategies to dementia patients and efforts to improve care in patients with dementia using a nonpharmacological approach are necessary. Therefore, guidelines outlining nonpharmacologic dementia care management will enable nurses to provide a wider spectrum of care to dementia patients. The purpose of this project was to make recommendations for the development and implementation of interdisciplinary practice guidelines to standardize care in the organizational setting. An …

Development Of A Sexual Assault Support Group For Female Rape Victims, Ann Marie Nichole Willoughby

Walden Dissertations and Doctoral Studies

Survivors of sexual assault struggle to cope with subsequent psychological disturbances. The project facility was a rural hospital in the southwestern United States in which postasault care was initially provided, but survivors later returned to the emergency department. Support groups can be a powerful tool to alleviate long-term consequences of assault by helping individuals cope and improving socialization. This project used the social-ecological theory to explore whether a sexual assault support group would impact the progress of survivors toward improved social interaction, improved socialization, and decreased psychological disturbance. The purpose of the quality improvement (QI) project was the development of …

Understanding Parenting Styles Of Second-Generation Parents Of Residential School Survivors Within Treaty 8 Reserves, Judy Kim-Meneen

Walden Dissertations and Doctoral Studies

Approximately 150,000 First Nation, Metis, and Inuit children attended Canadian residential schools from the 1840s to 1996. Most residential school children had negative experiences of physical, verbal, and sexual abuse that led to parenting repercussions once these children became parents. These repercussions of residential schools led to a rate of neglect for First Nation children 12 times higher than non-First Nation children. The purpose of this qualitative phenomenological descriptive study was to explore the lived experiences of second generation parents, who were schooled in residential schools as children and their current parenting styles. The conceptual frameworks of trauma theory and …

Emotional Self-Management Experiences Of Practical Nursing Students, Cindy Ko

Walden Dissertations and Doctoral Studies

In Ontario, Canada, practical nurses (PN) are educated through a 2-year diploma program. A review of PN program curricula in Ontario suggested that emotional intelligence (EI) and the core concept of emotional self-management are not specified in curriculum outcomes or courses. The study explored PN students' lived experiences with emotional self-management in the clinical settings where they are exposed to stress related situations using van Manen's orientation to hermeneutic phenomenology. The original four-branch ability model of EI by Mayer and Salovey was used as the theoretical framework to guide the explorative and interpretative processes of the study. Face-to-face interviews were …