Medicine and Health Sciences Commons^™

U.S Marine Corps Veterans' Perceptions Of Screening For Posttraumatic Stress Disorder, Tiffany Lawing Schweitzer

Walden Dissertations and Doctoral Studies

Posttraumatic stress disorder (PTSD) is a serious issue for post-deployment United States Marine Corps (USMC) veterans, especially because PTSD can increase the risk of suicide. Marines are screened post-deployment, yet little is known about Marine veterans' perceptions of the PTSD screening process. The purpose of this phenomenological study was to explore USMC male veterans' perceptions of the Post- Deployment Health Reassessment (PDHRA). The social cognitive theory constructs of a triadic relationship among person, environment, and behavior were the framework for understanding this population's perceptions of the PDHRA and potential stigma. Two research questions focused on how people, culture, and behavior …

Quality Improvement Initiative About Patient Engagement With Clinicians In A Community Hospital, Cheryl Simpson

Walden Dissertations and Doctoral Studies

Chronic kidney disease (CKD) is a global health problem and efforts are needed to improve the care of individuals affected by the disease. A recent strategy for improving care within the healthcare system is patient engagement. Nurses and other health care clinicians can apply patient engagement into their clinical practice to improve the care they provide to their patients. Therefore, the purpose of this project was to increase the knowledge and awareness of patient engagement among clinicians who work with CKD patients. This quality improvement project used Lewin's force field analysis to analyze driving and restraining forces to help develop …

Development Of A Graduate Nurse Residency Program In Women's Services, Dinez Diamond Esmail

Walden Dissertations and Doctoral Studies

Graduate nurses' transition from school to the work place is challenging and often leads to burnout. There was no graduate nurse residency program in women's services at the practicum facility. As a result, this facility had been unable to recruit or hire graduate nurses in the women's services unit. The purpose of this project was to develop a nurse residency program in women's services to address the lack of formal orientation for new graduate nurses at this facility. A graduate nurse residency program will provide further training for nurses to care for a more complicated population of pregnant women. Theoretical …

Mandated Continuing Education And The Competency Of Illinois Physical Therapists, Denise Lynn Hunter Ethington

Walden Dissertations and Doctoral Studies

Continuing education (CE) mandate laws are passed by states because it is in the public interest. The intent behind the passage of Illinois's CE law for physical therapists is to protect public health and safety through ensuring the competency of providers. However, studies into the impact of mandated CE on competency have been mixed. The problem addressed by this study was whether Illinois's CE law was effective in improving the competency of physical therapists and its impact on patient care. The purpose of this study was to understand what role mandated CE played in developing the competency of physical therapists …

Breaking The Silence: Postpartum Depression Among Reproductive-Aged Women In Akwa Ibom State, Nigeria, Atim Henshaw

Walden Dissertations and Doctoral Studies

Postpartum depression (PPD) is internationally recognized as one of the most prevalent and severe but neglected maternal mental health complications of childbirth. Previous studies have indicated that there is a high burden of disease associated with PPD in both developed and developing countries. However, there remain gaps in the current literature regarding the recognition and management of PPD in remote parts of the developing world. Therefore, the purpose of this study was to understand the perceptions, attitudes, and beliefs of health professionals towards PPD and examine the factors that either facilitated or hindered its recognition and management in a remote …

Effect Of Intimate Partner Violence On Children Of Puerto Rican Women, Maria Natal-Gopin

Walden Dissertations and Doctoral Studies

Intimate partner violence [IPV] is a preventable and costly societal issue that has reached epidemic proportions. Women are often the victims of IPV, and millions of children are exposed to it annually. The purpose of this study was to explore experiences of Puerto Rican mothers and their perceptions of how IPV exposure may have impacted their children using resilience theory. Data were collected via audiotaped individual interviews with 9 Puerto Rican mothers who endured an array of escalating IPV, often exacerbated by the perpetrators use of alcohol or drugs, and had IPV-exposed children aged 6 -11 years. Data analysis integrated …

Professional Development And Self-Efficacy Of Nurses Who Care For Patients Requiring Biocontainment, Denise Occhiuzzo

Walden Dissertations and Doctoral Studies

Increasing global occurrences of highly infectious, easily transmissible diseases unfamiliar to nurses affect the learning environment and the required skill set for professional nurses. The global threat of Ebola Virus Disease and other high-risk diseases requiring biocontainment necessitates competency in the management of complex patient needs, while ensuring safety measures that prevent spread of the potentially fatal disease. Guided by Bandura's social cognitive theory, this quantitative correlational study addressed the relationships between nurses' professional characteristics and their perceived self-efficacy when providing care to highly infectious patients requiring biocontainment. A full census of 92 nurses was used to recruit participants from …

Access To Care: Assessment Of Barriers In Two Rural Iowa Communities, Jean M. Osgood

Walden Dissertations and Doctoral Studies

The ability to access primary care services within the local community has a direct impact on the health and wellness of the community. Individuals living in rural settings face multiple challenges when attempting to access care. The purpose of this retrospective project was to identify barriers in 2 rural, underserved communities and make recommendations for process changes that could reduce these barriers. Data were gathered from 2 critical access hospitals and 2 rural health clinics located in rural, underserved areas in Iowa. Both hospitals identified access to health services as an issue within their communities. Administrative data were gathered on …

Low Health Literacy And Preoperative Instruction Compliance Among Patients Undergoing Surgical Procedures, Mariefel Casino Paqueo

Walden Dissertations and Doctoral Studies

In addition to cancelations and delays of needed surgical procedures, serious or fatal complications can occur when patients with low health literacy do not comply with preoperative instructions. The purpose of this quality improvement project was to provide more insight about ways to decrease on cancelled and delayed surgical procedures in low health literacy patients' due to noncompliance with preoperative fasting instructions. The project was informed by the reach, effectiveness, adoption, implementation, and maintenance model (King, D. K., Glasgow, R. E., and Leeman-Castillo, B. (2010). The project question centered on whether health literate preoperative fasting instructions could decrease cancellations and …

An Assessment Of Heart Failure Screening Tools For An Outpatient Arrhythmia Devices Clinic, Lucy Joanne Paul

Walden Dissertations and Doctoral Studies

People living with heart failure (PLHF) should be screened for symptoms at every

healthcare visit since they are 3 times more likely to experience ventricular arrhythmias. This quality improvement project (QIP) compared 3 self-administered HF symptoms questionnaires to determine the best screening tool for a tertiary hospital arrhythmia devices clinic. The instruments included the Minnesota Living with Heart Failure Questionnaire (MLHFQ), the Kansas City Cardiomyopathy Questionnaire (KCCQ), and the Self-Reported Heart Failure Symptoms (SHEFS) questionnaire. For a 30-day period, 76 people were eligible to participate in the QIP, with 55 participants included in the final analysis (72.5% participation). The questionnaires …

Effects Of Authentic Leadership Style And Nurse Engagement On Patient Satisfaction, Kimberly Dawn Washburn

Walden Dissertations and Doctoral Studies

Ineffective leadership and disengaged nurses reduce the quality of care and patient satisfaction in healthcare organizations. Healthcare leaders can benefit from understanding the factors that improve leadership ability and nurse engagement to improve healthcare outcomes. The purpose of this correlational study was to examine the relationship between the demonstration of authentic leadership characteristics and nurse engagement. The study's population comprised acute care registered nurses in a rural hospital in central Washington State. Authentic leadership theory and engagement theory constituted the theoretical framework. Independent variables were the 4 constructs of authentic leadership theory, self-awareness, balanced information processing, relational transparency, and internalized …

Breast Cancer, Mana'olana/Hope, And The Experience Of Native Hawaiian Women, Karla Marie Calumet

Walden Dissertations and Doctoral Studies

Breast cancer is one of the leading causes of morbidity and mortality among women. A diagnosis of cancer is a stressful event that requires an individual to adapt to new stressors. The purpose of this qualitative study was to better understand the perceptions of mana'olana/hope and living with breast cancer among Native Hawaiian women. The conceptual framework of this phenomenological study was positive psychology. Data collection included in-depth interviews with 5 Native Hawaiian women who had been diagnosed with breast cancer. Data coding and analysis resulted in identification of 8 themes.

The themes included: (a) mana'olana /hope is the essence …

The Role That Autism Parent-Led Support Groups Play In Facilitating Advocacy, Carlos Javier Carmona

Walden Dissertations and Doctoral Studies

In this study, autism parent-led support groups and the contribution these groups had in creating parental advocacy were studied. The primary purpose of the study was to determine if autism parent-led support groups promoted advocacy skills of parents of children with autism. The secondary purpose of the study was to evaluate the level and extent of support provided by parent-led support groups. The qualitative data collection was done through individual interviews of parents of children with autism whose children were of any age. Through data analysis 6 major themes were identified: advocacy, emotional support, difficulty with funding, informational support, instrumental …

Health Literacy, Availability, And The Need For Educational Resources On Infertility, Amber Louise Dessellier

Walden Dissertations and Doctoral Studies

There is a gap in infertility research regarding resource availability within rural communities, yet existing research declares infertility a public health concern. This qualitative study was grounded in the Heggerian phenomenological framework by way of assessing participants' perceptions of and experiences with infertility resources in a rural community. The purpose was to analyze the meaning of those experiences within their world. To accomplish this, Antonovsky's salutogenic theory was applied to investigate the strengths and weaknesses of infertility resources including the availability of resources, participant understanding of, and participants' experiences. Purposive sampling was used and in-depth interviews were conducted with 12 …

Parental Self-Efficacy, Feeding Practices And Styles, And Obesity In Mexican American Children, Maria Carmen Goodwin

Walden Dissertations and Doctoral Studies

Childhood obesity rates among Mexican Americans have risen along with the concerns of public health professionals. The purpose of this cross-sectional study, based on social cognitive theory, was to investigate the relationships among parental self-efficacy, parental feeding practices and styles, and childhood obesity, as measured by the parental perception of child weight, among Mexican Americans in Texas. Mothers and fathers (n=83; 33 males, 64 females), with at least 1 child between 8 and10 years, formed the sample. Relationships were assessed using the Tool to Measure Parenting Self-Efficacy questionnaire, the Parental Feeding Practices Questionnaire for Mexican American parents, the Parenting Dimensions …

Developing An Educational Module On Compassion Fatigue, Francisca Chinyere Hennes

Walden Dissertations and Doctoral Studies

Compassion fatigue is viewed as a disconcerting issue facing healthcare professionals in the clinical care milieu, and nurses are identified as the most susceptible population among healthcare professionals. The purpose of this project was to create positive social change by helping oncology nurses find ways to enhance self-care and self-awareness, thereby reducing the risk of compassion fatigue and burnout among healthcare professionals. This project investigated an educational module on compassion fatigue that focused on (a) identifying the occurrence rates of compassion fatigue among oncology nurses, (b) evaluating the demographic features that were associated with the most frequent rates of compassion …

Strategies To Improve Employee Engagement In A U.S. Federal Government Agency, Patrick L. Hyde

Walden Dissertations and Doctoral Studies

Nearly half of all frontline leaders in U.S. federal agencies during 2015 were unprepared to improve employee engagement. The lack of successful strategies to improve employee engagement in federal government agencies has led to decreased operational performance. Guided by the employee engagement theory as the conceptual framework, the single case study design was selected to explore the successful strategies that frontline leaders use to improve employee engagement at a federal agency in central Maryland. Data collection involved face-to-face, semistructured interviews with 4 frontline leaders and federal agency documents indicating employee engagement. The data analysis process included Yin's 5-step method and …

Exploring Security, Privacy, And Reliability Strategies To Enable The Adoption Of Iot, Daud Alyas Kamin

Walden Dissertations and Doctoral Studies

The Internet of things (IoT) is a technology that will enable machine-to-machine communication and eventually set the stage for self-driving cars, smart cities, and remote care for patients. However, some barriers that organizations face prevent them from the adoption of IoT. The purpose of this qualitative exploratory case study was to explore strategies that organization information technology (IT) leaders use for security, privacy, and reliability to enable the adoption of IoT devices. The study population included organization IT leaders who had knowledge or perceptions of security, privacy, and reliability strategies to adopt IoT at an organization in the eastern region …

Risk Perception Of Hiv Infection Among The Nigerian African- Immigrant Population In Houston, Texas, Esther Titilayo Ogunjimi

Walden Dissertations and Doctoral Studies

HIV/AIDS studies mostly lack distinction between the US-born Blacks and non-US-born Blacks while African Americans (AAs) continues to represent the group with the heaviest burden of AIDS deaths and new diagnosis of HIV. A review of studies on HIV infection in the US, Europe, and other Western countries revealed a knowledge gap on HIV infection with non-refugee African immigrants (NRAIs), especially the Nigerian African Immigrants (NAIs) who are non-US-born Blacks. The purpose of this descriptive phenomenological study is to address this gap by exploring the expressed views of NAIs, a sub-group of the NRAIs living in Houston, Texas, on the …

Impact Of Nursing Certification On Patient Perception, Satisfaction, And Outcomes, Rodney Baccus

Walden Dissertations and Doctoral Studies

Increased responsibilities for patient care within the nursing profession leads one to examine the correlation between nursing care and patient satisfaction. Current evidence indicates that higher levels of nursing education are associated with better patient outcomes. The literature further demonstrates that increased expertise and certification within a nursing specialty leads to increased nursing empowerment, improved intrinsic value and better collaborative relationships. However, the relationship between certification status and patient satisfaction remain unclear. This systematic review sought to understand the relationship between nursing certification and patient satisfaction. Guided by Rogers' diffusion of innovation theory this project examined the peer-reviewed literature using …

Enhancing Nurses' Assessment Of Pain Management In Dementia Patients, Norma Jean Boone

Walden Dissertations and Doctoral Studies

Chronic pain contributes to morbidity, mortality, and disability in millions of people. Prevalence rates for pain are as high as 83% among the 5.2 million older adults living with a diagnosis of dementia. The purpose of the quality improvement project was to assess nurses' knowledge of pain assessment and management in a 45-bed Veterans Health Administration long-term care facility serving older adults with dementia. Knowles' adult learning theory served as the theoretical framework and the knowledge to action model supported the translation of evidence into practice. A convenience sample of 27 licensed and unlicensed nursing staff answered the 16-question, 5-point …

Collaborative Strategies Used To Reduce Billing Administrative Cost, Stella Fayomi-Olaleye

Walden Dissertations and Doctoral Studies

Billing inefficiencies represent 80% of wasteful healthcare administrative costs that are projected to reach $45 billion by 2018. Potentially, a reduced billing administrative cost is estimated to yield an annual savings of $60 billion that could fund other societal needs such as jobs, wage increases, and education. Through the conceptual framework of iceberg change management model, this single case study explored collaborative strategies 3 healthcare billing managers in Dallas, Texas successfully used to reduce billing administrative costs. Data were collected through semistructured interviews and the review of company documents. Using Yin's procedure of examining, comparing, categorizing, and coding data, the …

'Stand By Me' Designated Tobacco Areas On U.S. Military Installations, Robert Thomas Gobble

Walden Dissertations and Doctoral Studies

U.S. Air Force (USAF) active duty Airmenshowunusually high tobacco prevalence rates (TPR); i.e., smoke, smokeless, both(SSL-B), when compared to civilian publics in the United States. Tobacco control efforts have proven largely ineffective inlowering nicotine habits among Airmen, while outdoor designated tobacco areas (DTAs) sited near worksites and popular localeson USAF bases (USAFBs) likelyswayAirmen to continue riskynicotine habits. The aim of this inquiry was to assess whetherquantities of DTAs on USAFBs and U.S. airbases (USABs) with 4 mediator variables(quality of DTAs,sites of DTAs, execution of a tobacco cessation program, and types of tobacco cessation programs) wereassociated with TPR (SSL-B) among Airmen …

Influence Of Psychological Empowerment, Leadership, And Climate On Safety Outcomes, Christine Healy

Walden Dissertations and Doctoral Studies

Research has demonstrated that safety outcomes are impacted by workplace risk factors, but also supervisory practices and employee actions. An area that has not been explored is the impact of employee cognitions on safety outcomes defined as work-related injuries. Based on the conceptual framework of psychological empowerment (PE), the purpose of this study was to examine the relationship of employee cognitions as measured by PE as related to leadership and safety climate and the occurrence of work-related injury. The research examined the mediating effect of (PE) on the factors of leadership and safety climate and their relationship to work-related injury. …

Relationship Between Admission Criteria And Program Completion In A Radiation Therapy Program, Adrienne Mae Dougherty

Walden Dissertations and Doctoral Studies

Poor completion rates in the radiation therapy associate's degree program offered through a community college did not meet the standards set by the college and damaged the program's reputation. The relationship between admission criteria and program completion was not known. The purpose of this study was to determine if there were any relationships between the admission criteria (GPA in prerequisite courses, interview scores, writing sample scores, and preadmission testing scores) and students' completion of a radiation therapy associate's degree program. This correlational study used 2 stages of Tinto's retention theory: (a) recruitment and admission to college and (b) pre-entry assessment …

Composite Risk Behaviors That Enhance The Transmission Of Malaria In Pregnancy, John Olusegun Dada

Walden Dissertations and Doctoral Studies

Malaria causes high morbidity and mortality, especially among the most vulnerable populations, including pregnant women. Malaria in pregnancy (MiP) can be prevented by compliance with the 3 core measures: sleeping under insecticide-treated nets (ITNs), 3 doses of sulfadoxine-pyrimethamine as intermittent preventive treatment (IPTp-SP), and effective case management of malaria and anemia. The purpose of this cross-sectional household survey was to examine the composite risk behaviors that enhance the transmission of MiP. Stratified and multistage sampling methods were used to select a sample of 300 pregnant women in Abuja, Nigeria. Bivariate and multivariate analysis were conducted. According to study findings, participants' …

Body Piercing And Health Complications Among College Students In Puerto Rico, Elsie Goicochea

Walden Dissertations and Doctoral Studies

The incidence and prevalence of body piercing health complications among students is a public health matter that has not been researched in Puerto Rico. College students are the most consistent participants in body piercing activities and have reported health complications resulting in visits to medical offices and emergency rooms. Based on the health belief model, which is used to explain and predict health attitudes, the purpose of this quantitative nonexperimental study was to analyze the health risks and possible complications occurring after body piercing and to investigate the association between sex and age and medical complications. Data were collected from …

The Effect Of Health Literacy In Low Estimated Glomerular Filtration And Diabetes, Nicklett Johnston Johnston

Walden Dissertations and Doctoral Studies

Health literacy is widespread, but its potential is not recognized. By not recognizing health literacy, patients have the burden of coping with diabetes with renal complications without full knowledge of their responsibility to their health. The focus of the project was to assess participants with diabetes with low health literacy and low mean glomerular filtration rate (eGFR). The project goal was achieved by the assessment of the participants' health literacy and eGFR before and after education for their diabetes, then assessed to determine if teaching the participants would improve their health literacy, lab values, and overall health. Participants were recruited …

Losing New Graduate Bedside Nurses, A Practice Improvement Initiative, Beverly Elaine Miller

Walden Dissertations and Doctoral Studies

New graduate nurses (NGNs) at bedside are faced with numerous challenges, which prompt them to leave jobs in their first year. The transition from being a student to competent nurse requires a NGN to have the necessary skills and experience. Subsequently, hospitals continue to face shortages of staff because of high turnover and low retention levels. Nonetheless, evidence from reviewed literature has indicated that the use of residency programs can increase NGNs' stay at bedside, improve retention, reduce costs of operations, and return employees' turnover. The purpose of this quality improvement project was to identify the likelihood of NGNs remaining …

Improving Nurse Mentor Retention Through The Use Of Nurse Residency Programs, Morgan Newman

Walden Dissertations and Doctoral Studies

Graduate nurses beginning their nursing career require a collaborative relationship with an expert nurse mentor to make this transition successful. However, high turnover among these experienced nurse mentors is causing a problematic gap in knowledge transfer, experience, and expertise in the nursing workforce. This project investigated whether nurse mentors who mentored in a Nurse Residency Program (NRP) remained with the organization longer and were more satisfied with their mentoring experience than nurse mentors who mentored outside of a NRP. The diffusion of innovations theory was used to support the project and process of dispersing information on the outcome of the …