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Articles 5011 - 5040 of 5875
Full-Text Articles in Medicine and Health Sciences
Veterans' Perceptions Of Military Stigma And The Shame Associated With Combat-Related Posttraumatic Stress, Alexander J. Buelna
Veterans' Perceptions Of Military Stigma And The Shame Associated With Combat-Related Posttraumatic Stress, Alexander J. Buelna
Walden Dissertations and Doctoral Studies
Military stigma is a heavy burden of social stigma internalized by veterans who are diagnosed with posttraumatic stress disorder (PTSD) during post-deployment psychological screening. PTSD is classified as a mental disorder associated with widespread reluctance to seek medical assistance. Among military veterans who suffer from combat-related posttraumatic stress (PTS), military stigma is considered a widespread problem. The purpose of this phenomenological study was to explore veterans' perceptions of various aspects of military stigma, including post-deployment psychological screening, the diagnosis of PTSD, and factors associated with reluctance to seek medical assistance for PTS. In-depth interviews were conducted with a convenience sample …
Orientation Of Nurses Transitioning Into Hospital Specialty Units, Mary Laly Chacko
Orientation Of Nurses Transitioning Into Hospital Specialty Units, Mary Laly Chacko
Walden Dissertations and Doctoral Studies
Competency-based nurse orientation programs focus on the new nursing graduate and experienced nurse employees' ability to perform skills necessary in a new work setting. The purpose of this project was to develop a learner-focused and competency-based orientation program for new nursing employees at a large urban hospital to enhance patient safety and nurse retention. The Johns Hopkins nursing evidence-based practice model and guideline were used in the selection of articles with higher levels of evidence and research quality for the critical appraisal of literature in support of the program development. The best practices for nursing orientation content and delivery for …
Differences In Treatment-Seeking And Treatment-Adherence Factors For Tuberculosis In Armenian Versus Non-Armenian Populations Of Los Angeles County, Tanya Marie Ferguson
Differences In Treatment-Seeking And Treatment-Adherence Factors For Tuberculosis In Armenian Versus Non-Armenian Populations Of Los Angeles County, Tanya Marie Ferguson
Walden Dissertations and Doctoral Studies
Tuberculosis (TB) is a deadly, yet curable, infectious disease that continues to be a global health threat. Armenia suffers from rising TB incidence and mortality rates. Armenians living in Los Angeles (LA) County, where TB incidence is higher than national averages, is the second largest Armenian community in the world; therefore implications are that many TB cases are attributed to this group. Using the social ecological model as a theoretical framework, this concurrent, mixed-methods study compared Armenians to non-Armenians in LA County about their knowledge of TB and perceived barriers to seeking and adhering to treatment. Bivariate chi-square analysis from …
African American Single Mothers' Perceptions Of Physical Activity, Sheryl Lynn Richard
African American Single Mothers' Perceptions Of Physical Activity, Sheryl Lynn Richard
Walden Dissertations and Doctoral Studies
Insufficient physical activity detracts from healthy living and has a disparate impact on African American women and their female children. The extensive body of prior research addressing preventable chronic disease and other consequences of insufficient physical activity includes limited information specific to African American single mothers. The purpose of this descriptive phenomenological study was to gain an understanding of African American single mothers' perceptions of physical activity. Specifically investigated were African American women's familial influences and potential effects of these influences on their children's health behaviors. The health belief model served as the theoretical framework for this study and provided …
Oral Health Status And Oral Hygiene Knowledge, Attitudes, And Practices Of Jail Inmates, April Lee Wendling
Oral Health Status And Oral Hygiene Knowledge, Attitudes, And Practices Of Jail Inmates, April Lee Wendling
Walden Dissertations and Doctoral Studies
The oral health and hygiene of incarcerated populations, both in the United States and globally, is known to be poorer than that of the general population. This study examined the prevalence of dental caries and periodontal disease and the relationships between oral health status and the oral health knowledge, attitudes, and practices of jail inmates housed in a large metropolitan jail located in the midwestern United States. This cross-sectional study collected data from 100 inmates using a 21-item closed-ended questionnaire in addition to oral examinations conducted by the jail's dentist to determine the extent of dental caries and periodontal disease …
Supervisor Perceptions Of Entry-Level Doctorate And Master's Of Occupational Therapy Degrees, Sherry Lynne Muir
Supervisor Perceptions Of Entry-Level Doctorate And Master's Of Occupational Therapy Degrees, Sherry Lynne Muir
Walden Dissertations and Doctoral Studies
In occupational therapy (OT), there is a push to encourage the entry-level doctorate (eOTD) over the master's of OT (MOT), without having identified which degree develops therapists who can best meet the needs of clients, while providing the fewest negative consequences for stakeholders. This collective case study assessed whether there are differences between OTs with MOT and with eOTD. Each supervisor's experiences with the two degree groups represented a separate case, then all were collectively considered. The central research question was whether OT supervisors, who have observational knowledge of clinical performance, perceived differences between MOTs and eOTDs in factors that …
The Aftermath Of Violence: The Lived Experience Phenomena Of Assault In Nursing, Kathleen Clark
The Aftermath Of Violence: The Lived Experience Phenomena Of Assault In Nursing, Kathleen Clark
Walden Dissertations and Doctoral Studies
Despite the high incidence of violence directed at registered nurses while on duty, there is limited qualitative data that explores the lived experience of returning to the workplace after an assaultive incident. This phenomenological study sought to explore and analyze the phenomena of registered nurses who are employed in high-risk settings. The research questions considered the detailed descriptions of the experiences of nurses returning to the workplace. The conceptual framework was resiliency, as these participants continued to survive and thrive after the adverse assaultive events. Data were collected using in-depth interviews from purposeful sampling. Registered nurses working in the high …
Improving Self-Management In Patients With Chronic Conditions, Jeryl Yvette Horton
Improving Self-Management In Patients With Chronic Conditions, Jeryl Yvette Horton
Walden Dissertations and Doctoral Studies
Care Coordination Home Telehealth (CCHT) maintains a positive impact on the delivery of patient care in the primary care clinic at the Department of Veterans Administration Medical Center (VAMC). This quality improvement initiative targets patients with chronic conditions such as diabetes, hypertension, heart failure, and chronic obstructive pulmonary disease. These patient are frequently seen in the emergency room, and are often admitted to the hospital, where they saturate the outpatient clinics' waiting room with multiple walk-ins. CCHT has, to some extent, reduced walk-ins, emergency room visits, and hospitalization while minimizing the strain on access to care at the VAMC. Sustaining …
Tools That Measure Caring: A Systematic Literature Review Of The Impact Of Caring, Jennifer Drake
Tools That Measure Caring: A Systematic Literature Review Of The Impact Of Caring, Jennifer Drake
Walden Dissertations and Doctoral Studies
Technology and the complexity of the patient care can take the nurse's attention away from caring for the patient to caring for the technology. The purpose of this systematic review was to gather evidence from the literature on tools for measuring caring and the outcomes in order to make that body of knowledge easily accessible to the direct care nurse for implementation. Jean Watson's theory of human caring 'the theoretical framework that guided and informed this DNP project' focuses on human caring processes and experiences. It assumes that effective caring promotes health and outcomes of the nurse and patient. By …
Poverty, Food Insecurity, And Obesity Among Urban And Rural Populations, Tameka Ivory Walls
Poverty, Food Insecurity, And Obesity Among Urban And Rural Populations, Tameka Ivory Walls
Walden Dissertations and Doctoral Studies
Over 17 million food-insecure households are associated with increasing obesity rates across the United States. Although food insecurity and obesity are distinct social concerns, the two are linked and may be influenced by poverty and geographic location. Public health authorities and state leaders responsible for the health and nutrition of rural populations in particular would benefit from this information. The purpose of this quantitative cross-sectional study was to examine whether poverty mediated the relationship between food insecurity and obesity among urban and rural adults. The study was guided by the poverty, food insecurity, and obesity conceptual framework. The study addressed …
Socioeconomic Status As A Predictor Of Chronic Obstructive Pulmonary Disease, Hilaire Saint-Pierre
Socioeconomic Status As A Predictor Of Chronic Obstructive Pulmonary Disease, Hilaire Saint-Pierre
Walden Dissertations and Doctoral Studies
While epidemiological research has generated new knowledge about the treatment and prevention of chronic obstructive pulmonary disease (COPD) through smoking secession, the socioeconomic status (SES) of people with the disease has been under investigated. Thus, the purpose of this study was to determine the predictability of association between SES and COPD. This study was based on the ecological theory, which states that health and disease may have multiple underlying factors. This study was a secondary analysis of archived data from the Inter-University Consortium for Political and Social Research (ICPSR). The dataset was collected for the National Survey of Midlife Development …
An Evidence-Based Strategy To Improve Influenza Vaccination Rates Among Registered Nurses In Hospitals, Terri Lynn Spoltore
An Evidence-Based Strategy To Improve Influenza Vaccination Rates Among Registered Nurses In Hospitals, Terri Lynn Spoltore
Walden Dissertations and Doctoral Studies
Seasonal influenza, or the flu, impacts over 3 million people each year. Within the health sector, nosocomial infection and absenteeism are frequently associated with the flu. The Centers for Disease Control and Prevention (CDC) recommend flu vaccination for all eligible individuals, especially health care workers (HCWs). Interventions associated with increased HCW vaccination include educational programs and occupational health campaigns to address misconceptions regarding vaccine safety and efficacy. This project evaluated the impact of a voluntary, web-based education module to encourage registered nurse (RN) vaccination. The logic and health belief models served as the theoretical frameworks. In a nonequivalent group design, …
The Association Of Smoking With Low Back Pain In Adult Americans: Analysis Of The 2012 National Health Interview Survey, Bart Green
Walden Dissertations and Doctoral Studies
Back pain is a chronic disease epidemic and the most common chronic painful condition in Americans. It is associated with human suffering and enormous financial and social burdens. Smoking is a prevalent and harmful health behavior and is the greatest modifiable risk factor for many chronic diseases. Cigarette smoking is associated with back pain, but there is little research on this relationship among adults in the United States. Using biopsychosocial theory, this study examined (a) the prevalence of back pain (dependent variable) among smokers, former smokers, and never smokers (independent variable), and (b) the influence of age, sex, race, body …
Methylmercury Exposure Via Canned Tuna Fish Consumption And Breast Cancer, Jennifer Bodenrader
Methylmercury Exposure Via Canned Tuna Fish Consumption And Breast Cancer, Jennifer Bodenrader
Walden Dissertations and Doctoral Studies
Widespread consumption of canned tuna fish since the 1950s may explain some of the increase in breast cancer prevalence in the United States and Europe. Although canned tuna is the primary source of human exposure to methylmercury, its role as an estrogen activating metalloestrogen has been overlooked in the etiology and incidence of breast cancer. Carcinogenic theory asserts that increased exposure to estrogen elevates the risk of breast cancer. The purpose of this population-based, case control study was to examine the association between canned tuna consumption, total blood mercury, and breast cancer in the NHANES 2003-2006 surveys. A multivariable logistic …
Nurse Practitioner Residency Programs: An Educational Journey, Gregory Paul Rys
Nurse Practitioner Residency Programs: An Educational Journey, Gregory Paul Rys
Walden Dissertations and Doctoral Studies
Primary care is in a state of crisis due to the lack of clinicians and increasing numbers of insured patients. Encouraging more students to go directly through school for their doctor of nursing practice degree and nurse practitioner (NP) certifications is one proposal to alleviate this crisis. However, this approach would deliver graduates with minimal leadership and clinical experiences directly into practice. One resolution to mitigate this concern would be an NP residency program. Evaluating the knowledge and attitudes of stakeholders prior to the implementation of a NP residency program is an important first step to this implementation plan. The …
Medical Community Distrust And The Influenza Vaccination Rates Of Black Americans, Kenyatte Irby Winston
Medical Community Distrust And The Influenza Vaccination Rates Of Black Americans, Kenyatte Irby Winston
Walden Dissertations and Doctoral Studies
Black Americans experience influenza vaccination rates that are lower than the rates of other ethnic groups. Low influenza vaccination rates among the Black community are associated with higher influenza infection rates, influenza-related hospitalizations, and higher influenza mortality rates. There is a belief within the Black American community that the medical establishment does not have the Black American patient in its best interest, leading to feelings of distrust. The purpose of this study was to determine if the distrust of the medical community is a relevant factor in the low influenza vaccination rates of Black Americans aged 18 and older in …
The Ability To Purchase Organic Food Items Among Participants Of The Women, Infants, And Children Program In Los Angeles County, Brenna Colleen Doran
The Ability To Purchase Organic Food Items Among Participants Of The Women, Infants, And Children Program In Los Angeles County, Brenna Colleen Doran
Walden Dissertations and Doctoral Studies
Lack of accessibility to healthy foods is a factor associated with the increase in obesity, diabetes, and other negative health consequences. While programs such as WIC (Women, Infants, and Children) provide supplemental nutritional access to healthy foods, few organic food items are included in the WIC authorized food list. Government programs and policy makers that provide to the most vulnerable populations are concerned about equal availability of healthy foods. The purpose of this study was to compare variability and cost of organic food items in 24 large chain grocery stores located in high- and low-income areas. The theoretical concepts of …
Diagnosing Fibromyalgia: Using A Diagnostic Screening Tool In Primary Care, Lilo Fink
Diagnosing Fibromyalgia: Using A Diagnostic Screening Tool In Primary Care, Lilo Fink
Walden Dissertations and Doctoral Studies
Fibromyalgia (FMS) goes undiagnosed in as many as 3 out of 4 people who have the disease. Primary care providers (PCPs) are the first to evaluate patients; therefore, PCPs need to be able to recognize FMS, implement initial treatment, and refer for further consultation. The Fibromyalgia Diagnostic Screening Tool (FDST), a validated instrument to identify FMS, can improve the speed and accuracy of FMS diagnosis. The purpose of this project was to familiarize PCPS with the FDST, evaluate their receptiveness to the tool, and train them in its use. The Leventhal, Diefenbach, and Levanthal, common sense model of illness provided …
Socioeconomic Responsibility And Its Effect On Hypertension Among West African Immigrants In The United States, Chryss Arekhandia Okonofua
Socioeconomic Responsibility And Its Effect On Hypertension Among West African Immigrants In The United States, Chryss Arekhandia Okonofua
Walden Dissertations and Doctoral Studies
Native-born African Americans (NBAA) bear a disproportionate burden of the effect of hypertension (HTN) in comparison to other racial groups in the United States. West African immigrants (Foreign-born African Americans) appear to carry a heavier burden than the NBAA in the United States. Using the social support theory as a guide, this study examined the association between the need to meet socioeconomic responsibility of financial and familial obligations (SERFFO) and perceived stress and the increased likelihood of HTN among West African immigrants, aged 25-54 years, in the United States. In this quantitative, cross-sectional design, self-reported data were collected from a …
African American Clergy's Attitude Toward Professional Mental Health Services, Ebony Gaffney
African American Clergy's Attitude Toward Professional Mental Health Services, Ebony Gaffney
Walden Dissertations and Doctoral Studies
Evaluating the attitude of African American clergy toward parishioners seeking professional mental health services for mental illness has important treatment implications. Religion and spirituality are equally important determinants of mental health and can affect African American clergy's attitudes toward professional care for mental illness. Utilizing the health belief model (HBM), this quantitative study examined the role of theological beliefs, education, and personal experience with mental illness as they correlated with clergy's attitudes toward seeking professional mental illness services. Approximately 98 African American Protestant Clergy in the states of Georgia and South Carolina participated in this study. Data were collected using …
Experiences Of Black Msm At An Hbcu Regarding Stigma And Hiv Risk Behavior, Natasha Harden Jeter
Experiences Of Black Msm At An Hbcu Regarding Stigma And Hiv Risk Behavior, Natasha Harden Jeter
Walden Dissertations and Doctoral Studies
Black men who have sex with men (MSM) on Historically Black College/University (HBCU) campuses face a unique set of challenges. In addition to being disproportionately affected by HIV, Black MSM are impacted by risk behavior, stigma, and environmental policies and practices that adversely influence their experiences. The purpose of this study was to explore the experiences of Black MSM at a HBCU and how stigma, culture, social practices and the collegiate environment impact HIV risk-taking behavior. Utilizing the ecological framework and qualitative analysis, the behaviors of 13 Black MSM on a HBCU campus were examined. Personal interviews and risk assessment …
New Graduate Nurses: Evaluating An Innovative Mixed Method Orientation Program, Mary Josette Armendariz-Batiste
New Graduate Nurses: Evaluating An Innovative Mixed Method Orientation Program, Mary Josette Armendariz-Batiste
Walden Dissertations and Doctoral Studies
Institutions are recruiting new graduate nurses to fill their vacancies. The aim of this project was to create a new graduate nurse orientation program that consists of the Essentials of Critical Care Orientation (ECCO) program created by the American Association of Critical Care Nurses (2014), scenarios, and simulation that will result in an increase in nurses' sense of their ability to provide safe patient care, communicate effectively, perform skills, and increase their sense of institutional support. The theoretical framework for this mixed methods project was Benner's "From Novice to Expert." The convenience sample participants consisted of 17 baccalaureate-prepared new graduate …
Awareness Of Clinical Laboratory Sciences And Shortage Of Clinical Laboratory Scientists In The 21st Century, Cynthia Funnye Doby
Awareness Of Clinical Laboratory Sciences And Shortage Of Clinical Laboratory Scientists In The 21st Century, Cynthia Funnye Doby
Walden Dissertations and Doctoral Studies
Retiring baby boomers and the lack of interest and awareness among college students to enroll in an accredited Clinical Laboratory Science (CLS) program have created a shortage of CLS professionals in the 21st century. The U.S. Bureau of Labor Statistics predicts 18,000 CLS vacancies by 2018. However, only about 5,000 students graduate from accredited CLS programs each year. The purpose of this study was to explore students' perceptions of allied health professions and factors that influenced students and CLS professionals to select CLS as a profession. Bandura's social cognitive career theory served as the theoretical framework for this phenomenological study. …
Education And Mentoring Of Staff Nurses In Evidence Based Practice, Sherri L. Smith-Keys
Education And Mentoring Of Staff Nurses In Evidence Based Practice, Sherri L. Smith-Keys
Walden Dissertations and Doctoral Studies
Current gaps in nursing practice can decrease by the translation, implementation, and dissemination of evidence-based practice (EBP). The purpose of this project was to provide staff nurses with EBP education and mentoring in identifying and addressing nursing practice issues using EBP to manage patient care. The Advancing Research & Clinical Practice through Close Collaboration (ARCC) and the social cognitive theory were used as a framework to guide this project development, which addressed if medical surgical nurses receiving education in EBP practice led to improved use, implementation, and improved best practice outcomes. Seven randomly selected medical surgical nurses from a local …
Exploring Leadership Strategy Influence On Nursing Personnel Retention Within Safety-Net Hospitals, Carl Brown
Exploring Leadership Strategy Influence On Nursing Personnel Retention Within Safety-Net Hospitals, Carl Brown
Walden Dissertations and Doctoral Studies
Frequent turnover among a hospital's nursing staff can profoundly impact organizational operating costs. With a national turnover rate of 17% in 2015, understanding the impact of management approaches on nurse attrition is vital to business success. Guided by Homan's social exchange theory, the purpose of this single case study was to explore leadership strategies used by safety-net hospital leaders to increase nursing personnel retention. Data collection consisted of semistructured interviews from a purposive snowball sampling of 8 senior directors working at a safety-net hospital in southern Maryland. Additional information collected involved documents and artifacts related to human resources management policies …
Transcriptome Analysis Of Vaccine Responses To Francisella Tularensis Or Venezuelan Equine Encephalitis Virus, Rebecca Ann Erwin-Cohen
Transcriptome Analysis Of Vaccine Responses To Francisella Tularensis Or Venezuelan Equine Encephalitis Virus, Rebecca Ann Erwin-Cohen
Walden Dissertations and Doctoral Studies
The lack of vaccines for emerging and re-emerging diseases highlights technical gaps and indicates a need for innovative approaches to produce new vaccines. Vaccines may be improved by knowledge of host responses to vaccination, disease pathogenesis, and the effect of age and genetics on vaccine outcome. This study's purpose was to quantitatively assess the molecular epidemiology of Francisella tularensis (Ft) and Venezuelan Equine Encephalitis Virus (VEEV). Study results support the Epidemiology Nexus model which holds that association of changes in gene expression to vaccination facilitate understanding the mechanisms of immune development and link public health and disease epidemiology. My research …
Impact Of Distance, Diagnosis, And Demographics On Attendance For Rural Outpatient Treatment, Trey Howard Jensen
Impact Of Distance, Diagnosis, And Demographics On Attendance For Rural Outpatient Treatment, Trey Howard Jensen
Walden Dissertations and Doctoral Studies
Missed psychotherapy appointments inhibit mental health treatment, limit the availability of treatment to those waiting for care, and reduce clinician revenue. Previous research has revealed that the factors that predict missed appointments vary depending on the geographic location in which that research is conducted. There is not a complete understanding of the characteristics of people who miss appointments in a rural context. This study used information from 281 client records to examine the predictive relationships among missed appointments and the distance traveled to the clinic, mental health diagnosis, age, and gender at a rural outpatient mental health clinic. The purpose …
The Development And Content Validation Of An Adult Obesity Educational Program, Abel Okuma
The Development And Content Validation Of An Adult Obesity Educational Program, Abel Okuma
Walden Dissertations and Doctoral Studies
Overweight and obesity in patients with intellectual and developmental disabilities (IDD) are at epidemic levels in the United States. The problem identified for this DNP project is the incidence of overweight and obesity in IDD. The framework used involved the quality model for improvement. For this DNP project a new program called the Daily-Enhanced Physical Activities Program (DEPA) was developed to promote weight loss, reduce sedentary activities, and optimal body mass index (BMI) for IDD patients. Local experts consisting of two registered nurses, two physical therapists, and one direct support personnel working with IDD patients were recruited. Each expert reviewed …
Parental Perceptions Of Childhood Overweight And Obesity In Four-Year-Olds In Northeastern North Carolina, Crystal Keyes Terry
Parental Perceptions Of Childhood Overweight And Obesity In Four-Year-Olds In Northeastern North Carolina, Crystal Keyes Terry
Walden Dissertations and Doctoral Studies
Childhood obesity has increased due to factors such as more television time, less outside play, parents' lack of education about nutritious meals, and eating more fast food versus home cooked meals. Research has been performed on many school-aged children; however, there is a gap in research as it pertains to preschool children. Preschool age learning is when children are most receptive to habit-forming activities. The purpose of this transcendental phenomenological study was to assess the parental perceptions of 11 preschool parents in rural Northeastern North Carolina of 4-year-old children who have been told by a health care professional that their …
Determinants Of Obesity Among Deaf And Hard Of Hearing Adults, Lindsay Buchko
Determinants Of Obesity Among Deaf And Hard Of Hearing Adults, Lindsay Buchko
Walden Dissertations and Doctoral Studies
Trends of obesity increased over the last 3 decades with the obesity rate doubling from 1980 to 2010. People with disability are more likely to experience health disparities including obesity compared to the general population. Yet research on the determinants of obesity such as self-efficacy, hearing levels, and deaf acculturation styles among those who are deaf or hard of hearing (HoH) is limited. This cross-sectional study, using the social cognitive theory framework, examined BMI and self-efficacy differences between deaf/HoH adults and hearing adults, aged 20 years and older. This study also examined the associations between BMI or self-efficacy and factors …