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Articles 4711 - 4740 of 5875
Full-Text Articles in Medicine and Health Sciences
A Developmental Project Focusing On Young Adult Hispanic-Americans, Tarsicio Gacheru
A Developmental Project Focusing On Young Adult Hispanic-Americans, Tarsicio Gacheru
Walden Dissertations and Doctoral Studies
Reducing diabetes risk among Hispanic-American adults in the United States is a critical public health need and programs targeting young Hispanic-American adults with prediabetes can reduce the risk for developing diabetes. The purpose of this project was twofold: (a) to examine the literature related to diabetes prevention best practices among young adult Hispanic-Americans with prediabetes and (b) create an intervention program to promote these best practices to delay or reverse the trajectory toward diabetes. The inclusion criteria for the literature review were studies with at least a 12-month follow-up and reported outcomes related to changes in diet, increased exercise, and …
The Patient-Centered Medical Home And Diabetes Mellitus Outcomes: A Systematic Review, Lisa Sullivan Mcmanus
The Patient-Centered Medical Home And Diabetes Mellitus Outcomes: A Systematic Review, Lisa Sullivan Mcmanus
Walden Dissertations and Doctoral Studies
Ineffectively managed chronic diseases such as diabetes mellitus (DM) increase overall health care expenditures and negatively affects health outcomes such as exacerbations, functional decline, disability, and death. The purpose of this systematic review (SR) was to review the DM outcomes reported by patient-centered medical homes (PCMHs). The goal was to determine how care coordination and evidence-based clinical management impacted financial and health outcomes. The SR followed the Cochrane protocol and complied with the PRISMA evidence-based minimum set for reporting. Overall, DM management in the PCMH demonstrated statistically significant completion rates for essential screenings and preventive care, including HgA1c (p = …
Associate Degree Nursing Graduates Perceptions Of Nclex Performance, Judy Pulito
Associate Degree Nursing Graduates Perceptions Of Nclex Performance, Judy Pulito
Walden Dissertations and Doctoral Studies
There has been a shortage of registered nurses in the United States for more than a decade, and an aging population is increasing this problem. This study was prompted by the number of associate degree nursing graduates at a Midwestern community college failing the NCLEX-RN licensure exam, which is required for employment. The purpose of this study was to explore associate degree graduate nurses' views of the effectiveness of classroom and clinical training on NCLEX -RN exam performance. Guided by the conceptual framework of Bigg's students' approaches to learning, which maintains deep learning is associated with achievement of learning outcomes, …
Quantifying The Quality Of Antimalarial Drugs In Ghana, Felix Boakye-Agyeman
Quantifying The Quality Of Antimalarial Drugs In Ghana, Felix Boakye-Agyeman
Walden Dissertations and Doctoral Studies
Malaria is still an epidemic in many parts of the world-about 220 million people are still infected with malaria worldwide and about 700 thousand people die from this disease per year. Most of the drugs used to treat malaria work well if they are used as required and they contain the right amounts of the active ingredient; however, it is estimated that more than 10% of drugs traded worldwide are counterfeits including 38% to 53% of antimalarial tablets produced in China and India. Due to the lack of data covering the extent of counterfeit antimalarial drugs in Ghana, the purpose …
Self-Reported Health Status, Perceived Risk For Developing Breast Cancer, And Mammography Screening Use, Idara Sylvanus Mcpartling
Self-Reported Health Status, Perceived Risk For Developing Breast Cancer, And Mammography Screening Use, Idara Sylvanus Mcpartling
Walden Dissertations and Doctoral Studies
Breast cancer is a widespread public health issue in the United States which affects all women. Although mammography is a proven screening tool, screening rates vary widely. Self-reported health status may play a role in how women perceive their risks for developing breast cancer, which may affect mammography use. The purpose of this cross-sectional survey study was to assess the association between self-reported health status and perceived risk for developing breast cancer, as well as perceived barriers towards mammography screening and use. Social action theory, which holds that social and the psychological factors influence health behaviors, served as the theoretical …
Effect Of Home Telemonitoring On Heart Failure Hospital Readmissions Among Adult Hispanics, Priscilla Liza Caban
Effect Of Home Telemonitoring On Heart Failure Hospital Readmissions Among Adult Hispanics, Priscilla Liza Caban
Walden Dissertations and Doctoral Studies
Heart failure is ranked as one of the leading causes of hospitalizations and mortality among adults of all racial/ethnic groups in the United States. Telemonitoring, as a homecare intervention for heart failure management, has been used across all groups although the benefit for Hispanics not established. The purpose of this retrospective, quantitative study was to determine the differences in hospital readmission between Hispanic, non-Hispanic Black, and non-Hispanic White patients with heart failure disease who either received or did not receive home telemonitoring services from a homecare agency in Connecticut. The research questions for this study examined the effect of home …
Obstetric Fistula: The Experiences Of Patients And Medical Personnel In Sierra Leone, Sheku Samba
Obstetric Fistula: The Experiences Of Patients And Medical Personnel In Sierra Leone, Sheku Samba
Walden Dissertations and Doctoral Studies
Women face great risks in pregnancy and childbirth, especially in developing countries where there are very few skilled birth attendants and negligible government investments in maternal health programs. As a result, obstetric fistula (OF), a potentially fatal but preventable and treatable condition, affects some 3 million women and girls globally. In Sierra Leone, the prevalence of OF is extremely high, but the absence of quality data to inform decision-making, both on prevalence and risk factors, is a barrier to creating an environment for OF prevention and care. The purpose of this phenomenological study was to explore and document the barriers …
Educating Globally In Medical Imaging In Latin America And Caribbean Via Webinars, Carmen Teresa Saunders
Educating Globally In Medical Imaging In Latin America And Caribbean Via Webinars, Carmen Teresa Saunders
Walden Dissertations and Doctoral Studies
Professional development courses that focus on increasing knowledge and improving skill sets are an integral part of a medical imager's career. This study was a qualitative formative evaluation with purposeful sampling of participants in a professional development webinar course offered to medical imaging professionals in 35 Latin American and Caribbean countries. The goal of this study was to aid the agency with identifying areas in which the efficacy of the program implementation and delivery could improve. The conceptual framework model, interest-problem-based learning (INTEREST-PBL) model, and Malcolm Knowles's theory on adult learning were used to ground this project. The research questions …
The Association Between Child Abuse And Attempted Suicide In Hong Kong, Hing Sang Wilfred Wong
The Association Between Child Abuse And Attempted Suicide In Hong Kong, Hing Sang Wilfred Wong
Walden Dissertations and Doctoral Studies
Children are the cornerstone of the community as well as the future of society. Child abuse and suicide among the young population is a serious and prevalent problem. Through a number of survey studies undertaken in other countries including Canada, United States, and Australia, researchers demonstrated that child abuse was related to suicidal behavior. However, this association had not been examined in Hong Kong. However, the number of hospital admissions for child abuse in Hong Kong had increased from 15.6 to 61.9 per 100,000 between 1995 and 2015 and 3.7% of child abuse cases had previously recorded suicide attempts. This …
Geospatial Analysis Of Spatial Patterns Of U.S. Hospital Readmission Rates, Yamei Wang
Geospatial Analysis Of Spatial Patterns Of U.S. Hospital Readmission Rates, Yamei Wang
Walden Dissertations and Doctoral Studies
Unplanned hospital readmission after a recent hospitalization is an indication of poor healthcare quality and a waste of healthcare resources. The Centers for Medicare and Medicaid Services (CMS) initiated the Hospital Readmission Reduction Program (HRRP) to improve healthcare quality and reduce costs; however, studies found the risk adjustment method used in calculating the standardized readmission rate was less accurate without hospital region or community factors. Accordingly, this cross-sectional quantitative study was designed to examine spatial patterns in hospital readmission rates following Andersen's behavioral model of health service utilization. This study was the first geospatial analysis on risk standardized hospital readmissions …
Type 2 Diabetes Mellitus And Colorectal Cancer Risk And Survival In Oman, Rose Ngozi Mafiana
Type 2 Diabetes Mellitus And Colorectal Cancer Risk And Survival In Oman, Rose Ngozi Mafiana
Walden Dissertations and Doctoral Studies
Type 2 diabetes mellitus (T2DM) and colorectal cancer (CRC) are 2 chronic diseases with common risk factors related to physical inactivity, obesity, and diet. Literature on T2DM as a risk factor for CRC development and survival in Oman is scarce. Using de-identified archival data provided by Sultan Qaboos University Hospital (SQUH) Oman, a retrospective, case-control, and time-to-event study designs were used to compare odds of developing CRC, and survival rates among adults with and without T2DM. The ecosocial theory provided the theoretical base for this research. Logistic regression was used to examine the odds of developing CRC among 114 cases …
Lived Experiences Of Individuals Quality Of Life On Prolonged Home Mechanical Ventilation, Munyaradzi Ephie Rwakonda
Lived Experiences Of Individuals Quality Of Life On Prolonged Home Mechanical Ventilation, Munyaradzi Ephie Rwakonda
Walden Dissertations and Doctoral Studies
Improvements in technology have allowed people with tracheostomies to live at home on mechanical ventilation (HMV). Quality of life (QOL) for HMV users has been studied quantitatively, but few qualitative studies have been published. The purpose of this phenomenological study was to explore QOL for individuals with tracheostomies on prolonged HMV focusing on activities of daily living (ADLs) and the role of decision- making. The Roper, Logan, and Tierney activities of living theory were used to categorize activities. Ten participants, 18 years and older, with a tracheostomy and on HMV for at least 6 months were enrolled using purposive sampling. …
Beliefs, Costs, And Policies Influencing African American Men's Decisions On Psa Screening, Mary Frances Carter
Beliefs, Costs, And Policies Influencing African American Men's Decisions On Psa Screening, Mary Frances Carter
Walden Dissertations and Doctoral Studies
Despite the growing concerns about routine prostate-specific antigen (PSA) screening in men, little is known about the societal and economic impact of screening among the African American population. The purpose of this qualitative case study was to explore beliefs among African American men about PSA screening, funding for screening, and the role of the United States Preventive Service Task Force in addressing the problem. Guided by rational choice theory, data collection consisted of completion of a health beliefs survey, face-to-face interviews, field notes taken during interview, and interview audio recording. The population for the study included African American men residing …
Empowering Nurses Through Knowledge And Technology To Decrease Fall Rates, Ngozi Doreen Nwaise
Empowering Nurses Through Knowledge And Technology To Decrease Fall Rates, Ngozi Doreen Nwaise
Walden Dissertations and Doctoral Studies
Falls are nurse-sensitive outcome which reflect the quality of nursing care. Nurses, therefore, have a major role to play in efforts to decrease fall rates. The objective of this project is to increase nurses' knowledge on the proper use of the CVVM as an attempt to effectively decrease fall rates. Pretest, post test, and course evaluation data were collected from 30 nurses. A descriptive analysis of the data was performed. Overall, the pretest evaluation showed that nurses had an average score of 43% in the combined assessment of their knowledge on fall prevention strategies, their use of the CVVM, and …
Factors Influencing African American Women To Undergo/Forego Reconstruction After Mastectomy, Senetta Jean Hunt
Factors Influencing African American Women To Undergo/Forego Reconstruction After Mastectomy, Senetta Jean Hunt
Walden Dissertations and Doctoral Studies
The factors associated with the decision of African American women to undergo/forego breast reconstruction after mastectomy has not been well researched. The purpose of this quantitative, correlational study was to determine the extent to which certain factors (age, religion, confidence level, and education) were associated with the decision to forgo or undergo breast reconstruction after mastectomy among African American women. Using the social-cognitive theory as the framework, the study focused on the decision-making process regarding breast reconstruction after mastectomy among African American women in Florida. The research questions for this study were to determine to what extent age, religion, confidence …
Comparing Outcomes Of Laparoscopic Adjustable Banding And Laparoscopic Sleeve Gastrectomy Bariatric Surgery, Seth Kojo Ananse Baffoe
Comparing Outcomes Of Laparoscopic Adjustable Banding And Laparoscopic Sleeve Gastrectomy Bariatric Surgery, Seth Kojo Ananse Baffoe
Walden Dissertations and Doctoral Studies
Bariatric surgery is an effective procedure type for morbidly obese patients when all else fails. Because obesity is a chronic disease, prolonged assessment and understanding of the credibility of procedure types and their effects on bariatric surgery outcomes are essential, yet current evidence shows decreasing utilization of one of the dominant procedure types. To better compare outcomes of procedure type, this research was designed to control for volume, hospital size, age, gender, season, month, year, and ethnicity. The goal of the study was to compare the outcomes of laparoscopic adjustable gastric banding (LAGB) and laparoscopic sleeve gastrectomy (LSG) bariatric surgery …
Barriers To Membership In A Professional Organization For Advanced Practice Nurses, Kesha Renee Walton
Barriers To Membership In A Professional Organization For Advanced Practice Nurses, Kesha Renee Walton
Walden Dissertations and Doctoral Studies
Professional organizations offer nurses services and resources for professional growth throughout their careers; yet, membership has declined over the past 10 years. Accordingly, this study was to understand the barriers in membership and identify positive changes that will increase membership and retain members. A quantitative descriptive design was employed within a convenience sample of 150 advanced practice registered nurses (APRNs) who were past or nonmembers of a professional organization. Exchange theory was applied and the Professional Association Membership Questionnaire (PAMQ) was administered to assess the barriers to APRNs participating in a specific professional organization. Statistical analysis included mean scores for …
Heart Failure Readmission Strategy Via Heart Failure Script, Michael Todd Williams
Heart Failure Readmission Strategy Via Heart Failure Script, Michael Todd Williams
Walden Dissertations and Doctoral Studies
Hospital administrators strive to reduce readmission and over use of the acute care setting for chronic health conditions. Historically hospitals have focused on readmission prevention strategies to improve the transition of patients from the hospital to the community and although the causes of a hospital readmission may span multiple providers along the continuum of care, the hospital is currently the only provider being penalized. The project facility implemented a readmission reduction strategy, Re-Engineered Discharge (Project RED), as a means to reduce readmissions and yet continued to have high readmission rates for heart failure (HF) patients. The continued high rate of …
The Transition Phase Influence On Nursing Career Satisfaction And Retention, Amanda Lee Machesky
The Transition Phase Influence On Nursing Career Satisfaction And Retention, Amanda Lee Machesky
Walden Dissertations and Doctoral Studies
Qualified registered nurses are needed to provide bedside care to patients, yet there is a known registered nurse shortage in the United States, which has a global impact on the healthcare industry. Contributing to the nursing shortage is turnover, which is partly due to the inadequacies of preparation for role transition of newly qualified registered nurses. The purpose of this quantitative descriptive study was to determine if there was a relationship between retention and nursing career satisfaction of registered nurses who experience a transition to practice program and those who did not. Duchscher's transition shock theory served as the theoretical …
The Impact Of Engagement Strategies On The Reduction Of Patient Falls, Rosemary Martin
The Impact Of Engagement Strategies On The Reduction Of Patient Falls, Rosemary Martin
Walden Dissertations and Doctoral Studies
Despite the availability of many fall prevention measures, many patients fall in U.S. hospitals each year. Experts view patient fall rates as the measure that can be most affected by a nurse-led, evidence-based intervention. The purpose of this quality improvement project was to implement and evaluate the impact of patient engagement strategies on patient compliance to fall prevention education and the reduction of falls. The quality improvement framework used for this project was the Iowa Model. Interventions for this project included patient engagement strategies including the teach-back (TB) method and video-based fall prevention education paired with the project site's existing …
Interprofessional Collaborative Care Educational Program For Nurses, Lynn Ann Mcewen
Interprofessional Collaborative Care Educational Program For Nurses, Lynn Ann Mcewen
Walden Dissertations and Doctoral Studies
Interprofessional collaboration and collaborative patient and family-centered practice is increasingly advocated as a means of improving patient outcomes and the cost effectiveness of health care. The Canadian Interprofessional Health Collaborative and Registered Nurses Association of Ontario identified best practices and competencies required for interprofessional collaboration and collaborative practice. Despite the widespread dissemination of these competencies and best practice guidelines to health professional schools, there remains a gap in nursing practice regarding nursing knowledge about the core competencies required for interprofessional collaboration. The purpose of this project was the planning of an education program for nurses on interprofessional collaboration and collaborative …
Prevention And Management Of Postpartum Hemorrhage, Lisa N. Medoh
Prevention And Management Of Postpartum Hemorrhage, Lisa N. Medoh
Walden Dissertations and Doctoral Studies
Postpartum hemorrhage (PPH) remains a major traumatic event that can occur after delivery. All expectant women are considered to be at risk of PPH and its effects. PPH is a preventable condition and primary interventions including active management of the 3rd stage of labor, use of uterotonics, and uterine massage. Analysis of the project site showed that PPH affected approximately 15% of all deliveries that occurred between 2014 and 2015. The overarching aim of the project was to determine how a nursing-focused educational intervention would affect staff nurse knowledge regarding PPH to decrease the incidence rate. The goal of the …
The Impact Of Stigma On Hiv/Aids Testing Among Kenyan Diaspora Women, Phyllis Catherine Nyotta
The Impact Of Stigma On Hiv/Aids Testing Among Kenyan Diaspora Women, Phyllis Catherine Nyotta
Walden Dissertations and Doctoral Studies
Researchers have considered HIV/AIDS in Kenya as the largest HIV pandemic in the world, with about 6.3 million individuals living with the disease as of 2013. About 25% of new HIV patients are adult women, aged 15 to 24 years old. Guided by the health belief model (HBM), the purpose of this quantitative cross-sectional survey research study was to explore the influence of various dimensions of HIV/AIDS stigma (public, self, enacted, and structural) on the uptake of HIV testing among Kenyan Diaspora women in United States. Multiple linear regression analysis was used to test if there was a correlation between …
Challenges To Augmentative And Alternative Communication Interventions With Autism Spectrum Disorder Students, Kristy Jane Singer-Macnair
Challenges To Augmentative And Alternative Communication Interventions With Autism Spectrum Disorder Students, Kristy Jane Singer-Macnair
Walden Dissertations and Doctoral Studies
Students with autism spectrum disorder (ASD) have challenges with communication, social interactions, and behavior, which can limit their functioning in school settings. They need to have functional communication skills to access the curriculum and have their needs met across all social environments. Special education teachers often experience barriers to successful implementation of augmentative and alternative communication (AAC) interventions appropriate for these students. The purpose of this case study was to understand how special education teachers experience AAC intervention processes, and illuminate the conditions for effective AAC implementation. A qualitative case study was conducted using interviews from 6 credentialed special education …
Teamwork Perceptions Of Nurses And Nursing Assistants In A Community Hospital, Iwona Halina Enzinger
Teamwork Perceptions Of Nurses And Nursing Assistants In A Community Hospital, Iwona Halina Enzinger
Walden Dissertations and Doctoral Studies
Teamwork in healthcare is recognized as a significant factor in achieving patient safety and impacting patient outcomes. Despite the general focus on teamwork in healthcare, there has been little research on teamwork among nurses and nursing assistants working on patient care units. The purpose of this doctoral project was to identify, compare, and analyze perceptions of teamwork in a group of nurses and nursing assistants in a community hospital setting where the TeamSTEPPS program has been implemented. The framework of this project was the concept of shared mental model and Imogene King's conceptual system and middle-range theory of goal attainment. …
Concept Of Self: Approach To Behaviors In Mental Health, The Tapout Program, Tina Goodrow
Concept Of Self: Approach To Behaviors In Mental Health, The Tapout Program, Tina Goodrow
Walden Dissertations and Doctoral Studies
Violence in mental health care continues to be a problem. The incidence of violent episodes in healthcare settings with aggressive behavior of patients aimed at staff members or other patients is almost four times greater in healthcare than in other industries. Reducing violent episodes enhances the quality of care and improves safety for staff members and for patients. The project focused on development of a staff education program exploring the practice-focused question: Will this program effectively guide staff member approaches to mental health patients with challenging behaviors? The purpose of this project was to address the identified gap in practice …
Attitudes And Perceptions Of Mental Health Treatment For Native American Clients, Beverly Elaine Johnson
Attitudes And Perceptions Of Mental Health Treatment For Native American Clients, Beverly Elaine Johnson
Walden Dissertations and Doctoral Studies
The need for mental health service is increasing in American Indian/Alaska Native (AI/AN) communities. While research has examined the availability, access, and effectiveness of provided services to the AI/AN, very little is known about the influence of the attitude and perceptions of both clinicians and clients in their therapeutic relationship in the treatment process. Using the frameworks of liberation, oppression, and trauma theory, this qualitative phenomenological study explored mental health service delivery and utilization issues within an AI/AN community. Data were collected through semistructured interviews with 14 clinician and client participants. The data were sorted into themes and subthemes and …
Relationships Between Interprofessional Teamwork And Clinical Management Of, Jacqueline G. Stephens
Relationships Between Interprofessional Teamwork And Clinical Management Of, Jacqueline G. Stephens
Walden Dissertations and Doctoral Studies
Diabetes mellitus (DM) is a highly prevalent chronic disease that affects 29 million people in the United States including over 2 million veterans who receive care through the Veterans Administration. Patient-aligned care teams (PACTs) are an interprofessional teamwork system designed to improve outcomes of chronic illness, but empirical explorations of the efficacy of the PACTs have been insufficient. Utilizing the chronic care model, the purpose of this retrospective study was to determine if PACTs have been efficient in the diabetic management of veterans receiving care through a Southeastern VA. Medical records for 114 veterans with type 2 DM were randomly …
Coping Mechanisms Of Sub-Saharan African Female Immigrants With Breast Cancer, Ernest Opoku Agyeman
Coping Mechanisms Of Sub-Saharan African Female Immigrants With Breast Cancer, Ernest Opoku Agyeman
Walden Dissertations and Doctoral Studies
Coping mechanisms of breast cancer is a public health problem among African females, particularly, the Sub-Saharan African female immigrants. The purpose of this qualitative study was to explore the coping mechanisms of the research group that could be used to develop and implement an intervention program to promote the quality of adaptation to improve the quality of life. The study achieved the objective by the use of 1-to-1 interviews of purposive samples of 2 and 12 using Roy Adaptation Model. Interviewed data were collected from females diagnosed with breast cancer, in treatment, and with remissions. The pilot study (n = …
Knowledge And Barriers To Safe Disposal Of Pharmaceutical Products Entering The Environment, Aldo Francesco Fidora
Knowledge And Barriers To Safe Disposal Of Pharmaceutical Products Entering The Environment, Aldo Francesco Fidora
Walden Dissertations and Doctoral Studies
The use of pharmaceutical products has steadily increased in the United States from 2 billion prescriptions in 1999 to 3.9 billion in 2009. Half of patients do not comply with the recommended prescription regimen and dispose of unused drugs in the environment. The U.S. Environmental Protection Agency and many researchers have highlighted the human-health risks associated with improperly disposing of pharmaceutical products. This quantitative cross-sectional study examined the potential correlations between people's actual disposal practices and their knowledge of the impact of disposal practices on the environment and human health, and availability of disposal options. The conceptual framework selected for …