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Articles 4531 - 4560 of 5875
Full-Text Articles in Medicine and Health Sciences
Factors Influencing Doctors Ordering Of Clinical Lab Tests: A Qualitative Study, Lakshmanan Suresh
Factors Influencing Doctors Ordering Of Clinical Lab Tests: A Qualitative Study, Lakshmanan Suresh
Walden Dissertations and Doctoral Studies
Qualitative studies exploring the factors behind a doctor's decisions to order clinical laboratory blood testing are lacking. A better understanding of these factors can help in formulating interventions that could improve the quality of health care and limit costs. The purpose of this qualitative case series study was to identify factors that influence a doctor's decision to order routine clinical laboratory blood tests. Fifteen doctors from Western New York, working in different hospital settings, were interviewed. There were 5 doctors in each case type: major, community, and private hospitals. When analyzed by case, there was a difference between the three …
Impact Of Telephone Call On Patient Satisfaction In Adult Oncology Patients, Victoria Maria Frazier-Warmack
Impact Of Telephone Call On Patient Satisfaction In Adult Oncology Patients, Victoria Maria Frazier-Warmack
Walden Dissertations and Doctoral Studies
Patient satisfaction is an ongoing action in which hospitals and health care providers are constantly seeking strategies to improve their satisfaction ratings. In the ambulatory oncology infusion setting, patient satisfaction is also a key metric that is being monitored, but actual patient satisfaction is unknown. Guided by Lewin's change theory and King's theory of goal attainment, the aim of this project was to use a strategy of conducting follow-up telephones calls to determine if patient satisfaction improved in an ambulatory oncology setting. A descriptive comparative approach was used to evaluate patient satisfaction before and after a telephone follow-up intervention. Participants …
Determinants Of Hiv Screening Among Adults In New Jersey After Hurricane Sandy, Nathaniel R. Geyer
Determinants Of Hiv Screening Among Adults In New Jersey After Hurricane Sandy, Nathaniel R. Geyer
Walden Dissertations and Doctoral Studies
HIV screening is recommended to destigmatize the condition, prevent partner transmission, and postpone AIDS progression. However, determinants associated with implementation of opt-out HIV screening are not well understood. The purpose of the study was to examine determinants that predicted odds of HIV screening for persons impacted by Hurricane Sandy, and how these factors differed according to demographic characteristics, geographical attributes, health-related quality of life score, access-to-care, and health insurance status. The social ecologic model provided the framework for this multilevel cross-sectional study that included New Jersey data from the Behavior Risk Factor Surveillance System. Bivariate chi-square, simple logistic regression, and …
Health Care Transition And Patient-Perceived Quality Of Life In Sickle Cell Disease, Karen Alicia Haynes
Health Care Transition And Patient-Perceived Quality Of Life In Sickle Cell Disease, Karen Alicia Haynes
Walden Dissertations and Doctoral Studies
Because of the high mortality rate of sickle cell disease (SCD) patients who do not continue care into adulthood, researchers have paid increasing attention to the health care transition experiences of SCD patients. However, a gap exists regarding patients' perspectives of care transition related to their quality of life. The purpose of this phenomenological study, guided by the biosocial-ecological systems model, was to explore the lived health care transition experiences of SCD patients in relation to their health-related quality of life. Data collection included open-ended interviews with 12 patients in the Southwestern United States. Colaizzi's (1978) method of phenomenological data …
Evaluating Nurses' Self-Efficacy In Caring For Patients With Dementia, Wendy Hopkins
Evaluating Nurses' Self-Efficacy In Caring For Patients With Dementia, Wendy Hopkins
Walden Dissertations and Doctoral Studies
In 2011, 5 million Americans had dementia and this number is predicted to increase. As the number of people with dementia increases, the need for quality nursing care, education, and treatment for patients with dementia increases. To address the need, nurses not only must be prepared with the knowledge, skills, and abilities to care for patients with dementia, but they must also have the self-efficacy to provide quality care. The practice focused question guiding the project was to determine the level of self-efficacy for caring for dementia patients among long-term care nursing staff. Using Bandura's social cognitive theory, the purpose …
Childhood Obesity Comorbitities Awareness Hospital-Based Education, Sandra Mcgrath Mcgrath
Childhood Obesity Comorbitities Awareness Hospital-Based Education, Sandra Mcgrath Mcgrath
Walden Dissertations and Doctoral Studies
As childhood obesity continues to increase, so do the comorbidities and related health issues, putting youth at a greater risk of developing adult-related diseases such as hypertension, Type 2 diabetes, and cardiovascular diseases. Current literature indicates that healthcare organizations have a significant role in the fight against this epidemic, yet most children's hospitals have no policy to accomplish this task. The purpose of this project was to develop a program proposal for a hospital-based, sustainable obesity program that will aid in improving patient and family awareness of the importance of maintaining an ideal body weight to decrease the incidences of …
Assessing Nurses' Demographic Cardiovascular Risk Factors And Pharmacogenetic Testing Knowledge And Acceptance, Stella Chibuzor Ohanuka
Assessing Nurses' Demographic Cardiovascular Risk Factors And Pharmacogenetic Testing Knowledge And Acceptance, Stella Chibuzor Ohanuka
Walden Dissertations and Doctoral Studies
The lack of knowledge of pharmacogenetic testing for cardiovascular disease (CVD), coupled with their increased risk for CVD, may impair nurses' cognitions and attitudes toward pharmacogenetic testing for CVD. The purpose of this quantitative cross-sectional correlational study, conducted with 230 RNs without CVD who worked in acute-care settings in Georgia, was to determine if their years of education, years of experience, and gender significantly influenced their perceived risk for CVD (Questions 1-3) and their perceived knowledge of pharmacogenetic testing for CVD (Questions 4-6), and if their perceived risk for CVD significantly influenced their acceptance of pharmacogenetic testing for CVD (Question …
Noise In The Icu, Fay Goode
Noise In The Icu, Fay Goode
Walden Dissertations and Doctoral Studies
Noise in the Intensive Care Unit (ICU) has been associated with patients experiencing psychological and physical disorders such as anxiety, sleep deprivation, and worsening of hypertension and diabetes. Researchers have suggested that the use of a noise reduction protocol can result in a decrease in noise in the ICU and a subsequent improvement in Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores. The research question for this project examined the effectiveness of a newly developed noise protocol in minimizing noise in the ICU, since the patients at the facility of study reported noise as being a nuisance that …
Barriers To Switching Patients To Second-Line Antiretroviral Treatment Among Clinicians In Tanzania, Peter Charles Mgosha
Barriers To Switching Patients To Second-Line Antiretroviral Treatment Among Clinicians In Tanzania, Peter Charles Mgosha
Walden Dissertations and Doctoral Studies
Poor decision making among clinicians to transferring human immune deficiency virus (HIV) patients into second-line antiretroviral therapy (ART) has led to an increase in morbidity and mortality to people living with HIV (PLHIV). No clear barriers are known for clinicians not switching their patients. This is a descriptive qualitative research aimed to discover obstacles that influence clinicians' decision making to transferring patients into second-line ART despite higher level resistance to first-line ART. The researcher applied a participatory action research framework to solve the identified barriers with clinicians. Using the research questions the researcher explored reasons, perceived barriers and enabling factors …
Health System Predictors Of Access To Maternal Health Medicines In Low And Middle Income Countries, Chinonso Esther Nnorom
Health System Predictors Of Access To Maternal Health Medicines In Low And Middle Income Countries, Chinonso Esther Nnorom
Walden Dissertations and Doctoral Studies
The strength of health systems predict access to medicines that prevent death from pregnancy related complications (essential maternal health medicines). But little is known about the relative impact of each health system building block on access. This quantitative cross-sectional study applied Ishikawa model to examine the relative effect of health systems governance, facilities, service delivery, financing and medicine procurement and distribution (independent variables), on availability, affordability and accessibility (dependent variables) of maternal health medicines in resource poor settings. Data analyzed was pulled from 37 WHO pharmaceutical country profiles and USAID MCHIP survey that assessed national programs for the prevention and …
Relationship Between Caregivers' Quality Of Life And Childhood Tuberculosis In Nigeria, Haruna Ismaila Adamu
Relationship Between Caregivers' Quality Of Life And Childhood Tuberculosis In Nigeria, Haruna Ismaila Adamu
Walden Dissertations and Doctoral Studies
In Nigeria, childhood tuberculosis (TB), a debilitating and deadly disease, is highly prevalent and case reporting is poor due to weak health systems. Globally, children account for at least 10 percent of the TB burden, yet they remain neglected in TB prevention and control efforts. Research studies integrating family and community-centered strategies have been recommended by stakeholders to address the paucity of current local prevention and management strategies for childhood TB. This observational cross-sectional study explored the relationship between caregivers' quality of life (QOL), gender, and socioeconomic status (SES) and the incidence of TB in children aged 0-14 years. Using …
Homelessness In Calgary From The Perspectives Of Those Experiencing Homelessness, Edith N. Ahajumobi
Homelessness In Calgary From The Perspectives Of Those Experiencing Homelessness, Edith N. Ahajumobi
Walden Dissertations and Doctoral Studies
Since the 1990s, homelessness has increased in Canada. The existing strategies of the government and public health service providers to manage the situation have had limited success. Researchers have noted the lack of including those experiencing homelessness to better understand and find a solution to homelessness. The purpose of this phenomenological study, driven by the social cognitive theory, was to understand homelessness from the perspectives of people who do not have homes. Data were collected from open-ended interviews with a purposeful sample of 15 individuals who are homeless. Summarizing and analyzing the interviews, several themes emerged after interview data were …
Impact Of Plans, Finance, And Zoning Policies On What Developers Choose To Build, Michele Ann Williams
Impact Of Plans, Finance, And Zoning Policies On What Developers Choose To Build, Michele Ann Williams
Walden Dissertations and Doctoral Studies
While there is considerable academic research on the intersection of comprehensive plans, finance policies, zoning policies and how these factors influence real estate developers' choice of what land to develop and what buildings to construct on that land, little is understood about whether these three variables promote or hinder real estate developers' choice of whether to build communities that promote healthy living. Using urban planning theory as the foundation, the purpose of this correlational study was to determine how real estate developers' decisions are made to support healthy New Urbanism development in the United States. Secondary data from the Urban …
Perceived Parental Barriers To Preventive Dental Care Programs For Children, Kim Attanasi
Perceived Parental Barriers To Preventive Dental Care Programs For Children, Kim Attanasi
Walden Dissertations and Doctoral Studies
Dental caries is the most prevalent childhood illness and disproportionately affects children from low socioeconomic backgrounds. Dental organizations are collaborating within communities to decrease oral health disparities among children by offering free preventive oral health events. These programs face the problem of low enrollment due to lack of informed parental consent. Also, gaps in the literature indicated the need to examine oral health perceptions and dental-care-seeking practices of culturally diverse low-income parents regarding preventive care for their children. The purpose of this qualitative case study was to explore the reasons why parents are not allowing their children to participate in …
Strategies For Health Care Administration Leaders To Reduce Hospital Employee Turnover, Malee Kirk
Strategies For Health Care Administration Leaders To Reduce Hospital Employee Turnover, Malee Kirk
Walden Dissertations and Doctoral Studies
Staff turnover is high in the hospital industry, influencing health care administration leaders to implement successful strategies to decrease staff turnover. The purpose of this case study was to explore successful strategies to reduce hospital employee turnover. Five health care leaders from Raleigh, North Carolina hospitals were in the sample drawn from the population of medical professionals with successful employee retention in their hospital settings. The conceptual framework for this study was the Herzberg dual-factor theory with the supporting theory, Maslow's hierarchy of needs theory, and the opposing theory, Vroom's expectancy theory. Semistructured interviews occurred with 5 leaders. The review …
Using Health Literacy To Improve Emergency Department Discharge, Alicia Ortiz
Using Health Literacy To Improve Emergency Department Discharge, Alicia Ortiz
Walden Dissertations and Doctoral Studies
Patients with limited health literacy often fail to understand verbal and written discharge instructions, and they frequently return to the emergency department (ED) for care. Patients returning to the ED and 30-day readmission rate are core quality performance measures. The purpose of this project was to decrease repeat visits and readmissions to the ED by implementing components of health literacy programs within the ED on patient education and written discharge instructions. Change implementation consisted of (a) use of teach back method (b) modifying medical terminology to language that patient could understand (c) limiting use of words with more than three …
School Nurses' Role In The Management Of Children With Type 2 Diabetes, Rosaline Jane Martinez-Culpepper
School Nurses' Role In The Management Of Children With Type 2 Diabetes, Rosaline Jane Martinez-Culpepper
Walden Dissertations and Doctoral Studies
An estimated 215,000 children and adolescents younger than 20 years old were diagnosed with Type 1 or Type 2 diabetes in 2011. Management of children with Type 2 diabetes requires 24-hour care provided by health care providers, parents, and school nurses. Guided by the health belief model (HBM), the purpose of this qualitative case study was to explore and describe beliefs, attitudes, and practices of school nurses who manage children with Type 2 diabetes. A pilot study with 2 nurses was conducted to finalize interview guide. Volunteer school nurses were recruited through an e-mail announcement from their school district. Face-to-face, …
Temporary Restaurant Closures And Food Handling Violations: Inspection Reports In British Columbia, Pam Mandarino
Temporary Restaurant Closures And Food Handling Violations: Inspection Reports In British Columbia, Pam Mandarino
Walden Dissertations and Doctoral Studies
Unsafe food handling practices are implicated in many restaurant-associated foodborne disease outbreaks. Factors that contribute to unsafe food handling in restaurants include inadequate food safety knowledge, employees who perceive that safe food handling is not under their control, and restaurant cultures that do not prioritize food safety. The purpose of this study was to determine whether temporary restaurant closures were associated with reduced food handling violations after closure in restaurants from the Vancouver Coastal Health Authority and the Fraser Health Authority, in British Columbia, Canada. The theoretical foundations used were the health action process approach and the theory of planned …
Gender Differences In Health Service Utilization Among Veterans With Acute Kidney Injury, Freneka Fronsha Minter
Gender Differences In Health Service Utilization Among Veterans With Acute Kidney Injury, Freneka Fronsha Minter
Walden Dissertations and Doctoral Studies
The U.S. Department of Veterans Affairs (VA) studies on acute kidney injury (AKI) have focused on defined procedures and outcomes but not on gender differences. The purpose of this study was to investigate differences in health services utilization by gender and other predisposing factors (age and race) among hospitalized veterans with AKI during a 5-year period from 2008 to 2013. The study included a retrospective cohort design and the behavioral model of health services utilization as the underlying theoretical framework. Secondary data were collected from an existing VA cohort. Data from 1,636 hospitalized AKI veterans were subjected to t tests …
The Adequacy And Perceived Impact Of Nigeria's Health Policy, Kennedy Magoma Ongwae
The Adequacy And Perceived Impact Of Nigeria's Health Policy, Kennedy Magoma Ongwae
Walden Dissertations and Doctoral Studies
From 2004 to 2015, the health sector in Nigeria was substantially underfunded despite the existence of a federal health policy committing 15% of the national budget to health care financing. The purpose of this narrative and phenomenological study was to explore the nature and significance of economic claims made in this policy. The central research question examined the extent to which these economic claims were perceived to be realistic, attainable, and successful in meeting their intended policy objectives and impact. The study's conceptual framework combined Kingdon's ambiguity and multiple streams theory, Roe's narrative policy analysis, and Skocpol's policy feedback theory. …
Improving The Nursing Practice Environment With Point Of Care Specimen Collection, April Marie Saathoff
Improving The Nursing Practice Environment With Point Of Care Specimen Collection, April Marie Saathoff
Walden Dissertations and Doctoral Studies
Specimen collection and identification errors are a significant problem in healthcare, contributing to incorrect diagnoses, delayed care, lack of essential treatments, patient injury or death, increased length of stay and increased healthcare costs, and decreased patient satisfaction. The purpose of the project was to evaluate the implementation of specimen collection technology with barcode scanning and bedside label printing in the maternal child health division of a community teaching hospital. The project was driven from Donabedian's quality framework for healthcare implementations, indicating that evaluating the quality of health care can be drawn from the categories of structure, process, and outcomes. The …
Leadership Strategies For Addressing U.S. Pharmaceutical Drug Shortages And Supply Chain Disruptions, Adrian Grant Scioli
Leadership Strategies For Addressing U.S. Pharmaceutical Drug Shortages And Supply Chain Disruptions, Adrian Grant Scioli
Walden Dissertations and Doctoral Studies
Health care providers in the United States expend more than $400 million in unnecessary direct costs annually managing the effects of widespread drug shortages. Based on the theory of complexity and complex adaptive systems, the purpose of this exploratory multiple case study was to identify the strategies that health care pharmaceutical procurement leaders from the Eastern region of the United States use to address widespread drug shortages. Data were collected from 5 semistructured interviews with pharmaceutical procurement leaders, recorded field notes, and a review of public documents from company websites. Data analysis included deductive and open coding techniques. Emergent themes …
African American Pastors' Perspectives On Health Promotion Ministries, Brenda Ivy Watson
African American Pastors' Perspectives On Health Promotion Ministries, Brenda Ivy Watson
Walden Dissertations and Doctoral Studies
The centrality of the church in African American communities makes it a culturally compelling sponsor for health promotion activities targeting health disparities among the medically underserved. Pastoral support is critical in determining whether a church initiates or supports a health promotion agenda, but there is little understanding of the variables that influence this decision. The aim of the qualitative study was to investigate the perceptions of African American pastors regarding the decision to incorporate health promotion programs in their churches. This study was guided by the health belief model using a phenomenological approach. Data were collected using both semi-structured and …
Children's Oncology Group Hospital Membership And Survival Of Pediatric Lymphoblastic Leukemia, Paul David Betts
Children's Oncology Group Hospital Membership And Survival Of Pediatric Lymphoblastic Leukemia, Paul David Betts
Walden Dissertations and Doctoral Studies
Acute lymphoblastic leukemia (ALL) predominates in children ages 0-14 years and has an excellent prognosis for cure with 5-year survival exceeding 90% in the United States. However, not all children experience such positive outcomes. The purpose of this quantitative, retrospective cohort study was to evaluate differences in survival of ALL among children who reside in the 32-county Texas-Mexico border region. While factors such as poverty and health insurance have been strongly associated with poorer cancer outcomes, additional factors such as geographic isolation and treatment disparities are not as well-documented in children. This study examined the association between use of Texas …
College Health Clinic Population Health Improvement Plan Project, Kathryn M. Flynn
College Health Clinic Population Health Improvement Plan Project, Kathryn M. Flynn
Walden Dissertations and Doctoral Studies
A college community health improvement plan (CHIP) focusing on the indicators of nutrition and weight status, and physical activity and fitness is designed with the goal of reducing obesity risk, improving health, and preventing chronic disease. The precede proceed model, logic model, innovative care for chronic conditions model, self-care theory, and Bandura's social cognitive learning theory were used as a research design framework for assessing, planning, and managing sustainability through a two-year college health clinic. The research questions were: what are the current health promotion inputs and activities in terms of environment, ecology, education, and policy and what could be …
A Phenomenological Study Of Correctional Officers' Perceived Emotions On The Job, Heather Susan Grammatico
A Phenomenological Study Of Correctional Officers' Perceived Emotions On The Job, Heather Susan Grammatico
Walden Dissertations and Doctoral Studies
Correctional officers work in a stressful environment and are regularly exposed to dangerous and emotionally charged situations. Researchers have detailed the potential negative outcomes of this occupation, yet little research has examined the extent to which correctional officers experience emotion while on their shifts, and how those emotions may translate into stress, divorce, substance abuse issues, domestic violence, and high mortality rates upon retirement. The purpose of this phenomenological study was to learn how correctional officers experience their felt and expressed emotions while at work. Data collection was done using a 15-item open ended questionnaire designed by the researcher and …
Improving New Nurses' Transition To Practice, Merri Morgan
Improving New Nurses' Transition To Practice, Merri Morgan
Walden Dissertations and Doctoral Studies
Almost 30% of new nurse graduates leave the position within the first year of practice, and almost 60% leave within 2 years. When new nurse graduates do not effectively transition into practice, nursing satisfaction is affected, and additional costs are incurred by their organizations through continual hiring of nurses. The purpose of this project was to develop a comprehensive, evidence-based nurse residency program (NRP) for new nurse graduates working in a 16-bed intensive care unit (ICU) of a 160-bed community hospital in the mid-Atlantic region of the United States. Using a team approach, Rosswurm and Larrabee's model of evidence-based practice …
Religiosity As A Predictor Of Hpv Awareness And Knowledge, Karen Adelheid Reiner
Religiosity As A Predictor Of Hpv Awareness And Knowledge, Karen Adelheid Reiner
Walden Dissertations and Doctoral Studies
The Human Papillomavirus (HPV) is a common sexually transmitted infection (STI) and etiological agent of cervical cancer. It has been suggested that religiosity may promote a generalized disassociation between all STIs/STDs, including HPV, and personal relevance thus contributing to lower levels of HPV awareness and knowledge among certain groups. This study sought to identify the role of religiosity as a predictor of HPV awareness and knowledge among women in a Christian university. Religiosity was defined and measured using the Duke University Religion Index (DUREL). The schemata and social identity theories provided the theoretical framework for this study. A total of …
The Strategic Prevention Framework: Effectiveness Of Substance Abuse Prevention System, John Jinoh Park
The Strategic Prevention Framework: Effectiveness Of Substance Abuse Prevention System, John Jinoh Park
Walden Dissertations and Doctoral Studies
The strategic prevention framework (SPF) is a data-driven operating system to assist designing evidence-based substance abuse prevention programs. The study performed here was to assess the effectiveness of the SPF as a prevention planning system. One purpose of this study was to determine the implementation fidelity of the programs that used the SPF process; the other purpose was to assess effectiveness of the SPF process. This study utilized a set of data collected by the national cross site evaluation team on all jurisdictions that implemented the SPF. A subset of communities collected and reported at least 2 pre-implementation and at …
Consensus In Anesthesia Handoff Reporting, Robin Lee Anselm
Consensus In Anesthesia Handoff Reporting, Robin Lee Anselm
Walden Dissertations and Doctoral Studies
Despite some improvement, no consensus exists to perfect quality in anesthesia handoff practice and policy. This quality improvement project was designed to assist a local anesthesia and perioperative workforce questioning the quality of its current handoff. Theories and models used to inform the project included the Inter-Professional Team Collaborative, Lewin's change theory, the continuous quality improvement theory, and the knowledge to action model. The communication assessment tool (CAT) functioned as a needs assessment yielding a gap in handoff practice of 25 participants. The CAT also served as the post project evaluation survey. The situation, background, assessment, and recommendation (SBAR) tool …