Medicine and Health Sciences Commons^™

Chronic Care Model Staff Education And Adherence With End-Stage Renal Disease Patients, Emilia K. Addo

Walden Dissertations and Doctoral Studies

The management and treatment of chronic diseases, such as end-stage renal disease, is often unproductive because of patients' poor adherence to treatment. The chronic care model toolkit is an Agency for Healthcare Research and Quality supported framework, associated with improved outcomes in patients living with chronic disease. The purpose of this project was to develop and plan an educational program using the chronic care model toolkit for the interdisciplinary clinical staff of a renal hemodialysis center. The goal of this project was to adapt team building between patients and their clinicians through the use of the chronic care model in …

Understanding Faith Leaders' Perspectives On Breast Health Interventions In The Church, Marsha Ladonna Marshall

Walden Dissertations and Doctoral Studies

The prevalence and incidence of breast cancer is an important issue that is affecting all women, but African American women have the lowest survival rates after breast cancer diagnosis. Historically, the Black church and faith leaders have been essential in promoting health in the African American community. Moreover, faith-based interventions have become more common within the African American community in addressing factors that affect survival rates such as early detection, cultural barriers, and education. Currently, there is not clear information on the perspectives faith leaders have on their experiences with implementing breast health interventions in their places of worship. This …

Social Determinants Of Health Inequality And Life Expectancy Among Women Of Edo State, Nigeria, Daniel Aromeh Odekina

Walden Dissertations and Doctoral Studies

Health inequality conflates a huge number of economic, social, and political issues. These issues, together described as social determinants, determine a population's health through influencing health status and life expectancy. The research purpose of this study was to examine how social determinants affected the life expectancy of the women of Edo State, based on secondary data from Nigeria's 2008 demographic and health survey (NDHS). The theories that guided the study were self-efficacy beliefs of the social cognitive theory and physical self-concept of the health belief model. This quantitative cross-sectional study examined the associations between socioeconomic status, nutritional status, literacy/educational attainment, …

Barriers To The Influenza Vaccination In Veterans, Zina Floyd

Walden Dissertations and Doctoral Studies

Influenza is the eighth leading cause of death in the United States, accounting for 56,000 deaths annually and leading to an average of more than 200,000 hospitalizations every year. Adults 65 years of age and older account for 50% to 60% of influenza-related hospital admissions and an estimated 90% of influenza-associated deaths occur in people age 65 and older. During the 2011 to 2012 influenza season, approximately 50 % of veterans between 45 and 70 years of age refused the influenza vaccine within the metro-area outpatient Veteran Administration (VA) facility in Atlanta, Georgia. The aim of this project was to …

Pregnant Obese Women And Factors Which Impact Their Social And Physiological Well-Being, Stephanie Denise Morgan Frye

Walden Dissertations and Doctoral Studies

For more than 50 years, researchers have recognized complications associated with obesity and pregnancy as a problem for mothers and their unborn children. Despite this recognition, the rates of obesity and mortality in pregnant women have continued to rise. Using the health belief model, the transtheoretical model of behavior change, and the social cognitive theory as the theoretical frameworks, this phenomenological study examined barriers that might hinder the health of obese pregnant women and their unborn children. Semi-structured interviews were conducted with 12 women who had a body mass index of 30 to 50, were between the ages of 18-55, …

The Impact Of Implementing Bedside Report To Transition Patients Across Units, Tonya Johnson

Walden Dissertations and Doctoral Studies

Evidence supports bedside report as a mechanism to improve communication, patient safety, quality of report, and nurse and patient satisfaction when implemented in a closed unit. The purpose of this project was to examine the impact of implementing a bedside report process to transition patients from the emergency department to a medical-surgical unit. Specifically, the goal was to analyze the impact of a bedside- reporting process on patient progression and on nurse and patient satisfaction. Lewin's change model provided the theoretical framework for this quasi-experimental study. Patient progression data consisted of 706 patient transitions from the emergency department to the …

Clinical Significance Of Response Shift In A Spine Interventional Clinical Trial, Robin Carlson

Walden Dissertations and Doctoral Studies

The effectiveness of treatments for degenerative spine conditions, where the primary symptom is back pain, is typically determined using patient-reported quality of life (QoL) measures. However, patients may adjust their internal standards when scoring QoL based on factors other than their health. This response shift phenomenon could confound the interpretation of study data and impact effectiveness conclusions. In the current study, response shift was examined using structural equation modeling (SEM) and previously collected clinical trial data comparing 2 minimally invasive medical devices in lumbar spinal stenosis patients through 1 year postintervention. In subject QoL results, reprioritization shift between 3 months …

Current Capacity Building Needs Of Occupational Therapists Related To Older Driver Screening, Assessment, And Intervention, Ranyouri Hines Senia

Walden Dissertations and Doctoral Studies

Older adult safe driving is a growing public health issue; however, the skill set of occupational therapists that provide services to these older clients is unclear. The extent to which occupational therapists possess the skills to evaluate an elderly person's ability to operate safely an automobile is unclear. Therefore, the purpose of this quantitative, cross-sectional survey was to determine the current capacity building needs of occupational therapists (OT) related to older driver screening, assessment, and intervention. The ecology of human performance framework was the theoretical base of the study. The independent variables were the OTs' training related to older drivers, …

Third-Degree Family Health History And Perception Of Disease Risk, Liana Carrasco Romero

Walden Dissertations and Doctoral Studies

Chronic diseases are a significant cause of illness and mortality in the United States. Hereditary predisposition to chronic diseases is a useful indicator for identifying people at risk for disease development. An ideal tool for determining this predisposition is the CDC, NIH, and AAFP recommended third-degree family health history (FHH). The aim of this quantitative, cross-sectional study, based on the theoretical frameworks of social constructivism and the health belief model, was to assess the possible influence between the completed third-degree FHH and the participant's perception of disease risk. Two-hundred seventy-three participants were recruited from health care facilities and from the …

Effect Of A Cardiology Nurse Practitioner Service On The Reduction In Length Of Stay For Low Risk Chest Pain Patients, Marcia Andrea Reid

Walden Dissertations and Doctoral Studies

Healthcare organizations are responding to changes in reimbursements by redesigning and re-evaluating existing programs to improve patient outcomes. .One such intervention at the project setting was the re-evaluation of the treatment of patients with low risk for chest pain and implementing a cardiology nurse practitioner (NP) service focusing on the reduction of length of stay (LOS) with the goal of improving patient outcomes. The purpose of this doctor of nursing practice project was to evaluate the effectiveness of a nurse practitioner-led service on the reduction of LOS of patients with low risk for chest pain. An established evidenced-based guideline developed …

Female Genital Mutilation/Circumcision: Culture And Sexual Health In Igbo Women In Dallas-Fort Worth, Texas, Dorothy Ebere Ukoha

Walden Dissertations and Doctoral Studies

Female genital mutilation (FGM) is practiced primarily in many African countries as well as some in Asia and the Arab Peninsula; however, it also takes place elsewhere around the globe among those who migrate from countries to which it is indigenous. This study was designed (a) to investigate the prevalence of FGM among the Igbo women in the Dallas-Fort Worth (DFW) area in Texas and (b) to understand the factors that support the continuation of the practice and the effects on women's sexual health. Using a quantitative approach to examine a variety of social variables aligning with the ecological framework, …

Attitudes And Beliefs Of Registered Retired And Registry Nurses Regarding Holistic Spiritual Care, Beverly S. Ward

Walden Dissertations and Doctoral Studies

The purpose of holistic spiritual care is to assess and provide for the spiritual needs of patients. Current literature indicates that holistic spiritual care is important to the healthcare of patients. Researchers suggest that nurses who practice holistic spiritual care are more aware of the attributes of caring, respect, and emotional support. This project study addressed a problem at the research site reported by local community nurses and holistic spiritual care experts of nurses not practicing holistic spiritual care. Mezirow's transformational learning theory was used as the theoretical foundation for this qualitative study, which was designed to examine the attitudes …

Decreasing Attrition Of Novice And Newly Hired Professional Nurses Through Preceptorship, Brenda Gould-Johnson

Walden Dissertations and Doctoral Studies

Approval

Walden University

College of Health Sciences

This is to certify that the doctoral study by

Brenda Gould-Johnson

has been found to be complete and satisfactory in all respects,

and that any and all revisions required by

the review committee have been made.

Review Committee

Dr. Eric Anderson, Committee Chairperson, Health Services Faculty

Dr. Patti Urso, Committee Member, Health Services Faculty

Dr. Jonas Nguh, University Reviewer, Health Services Faculty

Chief Academic Officer

Eric Riedel, Ph.D.

Walden University

2015

Walden University

College of Health Sciences

This is to certify that the doctoral study by

Brenda Gould-Johnson

has been found to be …

An Evidence-Based Determination Of Whether Effective Leadership Competencies Are Universal And Transferable., John Michael Slade

Walden Dissertations and Doctoral Studies

Poor executive leadership of organizations over the last 20 years has resulted in the destruction of stakeholder value, loss of jobs, and in some cases, risk to the entire enterprise. An executive search firm database, encompassing 16,000 leaders from 300 organizations, was analyzed to determine if the commonality and transferability of leadership competences could be used to improve executive assessment. Implicit leadership theory, where leaders are gauged by the individuals that surround them, served as the theoretical foundation. The study also relies on a leadership competency model used by the executive search firm that constructed the database and is based …

Women's Perspectives On Adequacy Of Screening And Treatment For Postpartum Depression, Gloria Marcia Watson

Walden Dissertations and Doctoral Studies

Postpartum depression affects some 10% to 20% of mothers. Its impact on the health and well-being of mothers and their infants is well documented. If not identified and addressed early, it can result in emotional burden, costly hospitalization and treatment, and, at worst, suicide and or infanticide. Empowerment theory was the conceptual framework for this hermeneutic phenomenological study. The purpose was to understand the lived experiences of the screening and treatment processes of 10 women from New York City experiencing postpartum depression and their perceived adequacy of the treatment received. In-depth interviews were used to investigate participants' lived experiences of …

Identifying Cultural Themes In A Shared Experience Of Water Hygiene Education Partners, Sarah M. Etheridge-Criswell

Walden Dissertations and Doctoral Studies

Lack of safe drinking water and lack of water hygiene literacy contribute to a large disease burden in rural areas of Africa, and children suffer disproportionately more than adults from diarrheal diseases caused by nonpotable water. Research is needed to help merge education and water sanitation to provide more effective methods of preventing diarrheal diseases. The ecological model and hygiene improvement framework were used to guide the study. The purpose of this phenomenological study was to describe the shared experiences of people participating in the water hygiene education program provided by Lifewater International. Lifewater is a nonprofit organization focused on …

Examining The Impact Of Accreditation On A Primary Healthcare Organization In Qatar, Alia Ghareeb

Walden Dissertations and Doctoral Studies

Although a modest body of literature exists on accreditation, little research was conducted on the impact of accreditation on primary healthcare organizations in the Middle East. This study assessed the changes resulting from the integration of Accreditation Canada International's accreditation program in a primary healthcare organization in the State of Qatar. The study also investigated how accreditation helped introduce organizational changes through promoting organizational learning as well as quality improvement initiatives. Pomey's Dimension of Change framework and questionnaire was used to measure the effect of Accreditation Canada International standards on the perceived quality performance and the progress towards organizational learning. …

Success Experiences Of Hispanic Nursing Students Who Persisted And Graduated After Academic Failure, Barbara Ninan

Walden Dissertations and Doctoral Studies

Twenty percent of Hispanic nursing students at a west coast university are being dismissed from the nursing program due to repeated failures in nursing courses. The purpose of this study was to gain a better understanding of Hispanic nursing students' experiences of successfully completing a nursing program, earning a baccalaureate of science degree, and passing the state licensing examination for registered nurses despite having failed a nursing course and having been placed on academic probation. Guided by Tinto's theory of academic integration, a descriptive phenomenological design was used to explore Hispanic nursing graduates' success experiences. Purposive sampling was used to …

Building Resilience And Coping Effectiveness (Brace): A Program For Military Families, Linda Pauline Zarrett

Walden Dissertations and Doctoral Studies

Building Resiliency and Coping Effectiveness (BRACE): A Program for Military Families

by

Linda Zarrett

MSN, University of Cincinnati, 2012

BSN, Minnesota State University, Moorhead, 1985

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

August 2015

Veterans returning from combat report significant family strain and Post Traumatic Stress Symptoms (PTSS) yet have limited access to care resources. Family members, including children, report very similar symptoms to those of veterans and have yet fewer health care resources. The purpose of this project was to apply principles from existing research on post-traumatic stress …

The Influence Of Religion On Attitudes Toward Alcohol Use In Jewish Adolescents, Toby R. Levin

Walden Dissertations and Doctoral Studies

Historically, the Jewish faith has used alcohol in rituals and religious holidays in which adolescents are permitted to fully participate and this exposure to alcohol may influence attitudes and beliefs about underage drinking among Jewish adolescents. The purpose of this study was to determine if there was a relationship between the Jewish religion and attitudes toward alcohol among Jewish adolescents. The theoretical frameworks, on which this study was based, were the social bond theory and the social development theory. Each of these theories indicates that community is important to the individual. Using a cross sectional study design, 160 adolescents participated …

Patient Safety Culture And High Reliability Organizations, Jared D. Padgett

Walden Dissertations and Doctoral Studies

A 1999 evaluation of case studies performed by staff from the Institute of Medicine found that between 40,000 and 98,000 patients died from preventable errors, while 43,598 individuals died in car accidents that year. A 2011 report increased that estimate nearly 10 times. Widespread preventable patient harm still occurs despite an increase in healthcare regulations. High-reliability organization theory has contributed to improved safety and may potentially reverse this trend. This explorative single case study explored how the perceptions and experiences of nursing and respiratory staff affected the successful transition of a healthcare organization into a reliability-seeking organization. Fourteen participants from …

Factors Associated With Tuberculin Skin Test Positivity Prevalence In U.S. Medical Laboratory Microbiologists, Julie Ann West

Walden Dissertations and Doctoral Studies

Prior research has indicated that healthcare personnel (HCP) who work in areas where Mycobacterium tuberculosis poses an occupational hazard are at high risk of tuberculin skin test (TST) positivity and subsequent conversion to active tuberculosis (TB). U.S. medical laboratory microbiologists confront similar hazards but have not been studied outside of the HCP aggregate. The purpose of this study was to fill this gap by examining the relationships between the predictor variables of self-reported history of bacille Calmette-Guerin (BCG) immunization, place of birth, and years of laboratory experience and the outcomes of self-reported lifetime TST positivity, preventive treatment noninitiation, and barriers …

Drug Use And Sexual Risk Behaviors Of Msm With Syphilis In Atlanta, Tarneisha Shantelle Means

Walden Dissertations and Doctoral Studies

Many men who have sex with men (MSM) engage in alcohol and drug use. Drug use, particularly methamphetamines, amyl nitrates (poppers), and drugs used to treat erectile dysfunction among MSM may also contribute to risks such as unprotected sex, which leads to the possibility of contracting syphilis, Human immunodeficiency virus (HIV), and other Sexually Transmitted Infections (STIs). In the Metro Atlanta Area (Fulton and Dekalb Counties), primary and secondary syphilis rates among MSM are still rising and rank highest among the other counties in the area. Guided by the risk and protective factor theory, the purpose of this study was …

Work Group Composition Effects On Leadership Styles In Aircraft Manufacturing Organizations., Monica Lynn Dunnagan

Walden Dissertations and Doctoral Studies

leadership styles

homogeneous versus heterogeneous

manufacturing leaders

contractor workforce

The Effects Of Holistic Coping Strategies On Perceived Stress And Absenteeism In Hospital Nurses, Mary Alice Ayon

Walden Dissertations and Doctoral Studies

The demanding work environments of professional nurses often contribute to high levels of stress that impact their professional practice and well-being. Although there is a significant amount of research regarding stress and absenteeism, a gap in the literature exists about the effects of holistic coping strategies on nurses' perceived stress and absenteeism. Based on the biopsychosocial model, the purpose of this quantitative study was to investigate effects of holistic coping strategies on perceived stress and absenteeism in 128 hospital nurses. An online cross-sectional survey design used the Perceived Stress Scale-10 to measure nurses' perceptions of stress. The independent grouping variable …

Adolescent And Community Adult Perceptions Of Adolescent Tobacco Use, Susan M. Franko

Walden Dissertations and Doctoral Studies

In 1964, the Surgeon General issued the first report that linked smoking cigarettes as a direct cause of emphysema, heart disease, and lung cancer. Despite this landmark publication, the primary cause of preventable deaths each year in the United States continues to be related to the use of tobacco. Regardless of decades of health education and resources available to inform society that the use of tobacco products can have deleterious effects on health, adolescents continue to experiment with them. The purpose of this study was to gain a better understanding of the influences of adolescent tobacco use. Based on the …

The Innovation Of Simulation Laboratories And The Novice Nurses In The Clinical Setting, Brenda Washington Moore

Walden Dissertations and Doctoral Studies

The push to generate professional nurses has raised questions about the competency level of the novice nurses that are entering the workforce. Utilization of simulation laboratories is being viewed as an option for bridging the gap for the shortage of nurses, nurse educators, and clinical sites. The theory of goal attainment was used to guide this project, which aimed to develop and validate an ER simulation scenario that mimics a clinical setting as a tool for measuring nursing skills. An additional purpose, to be accomplished after graduation, will be to implement a pilot project to determine the impact of the …

Predictors Of Hiv Testing Among Individuals Diagnosed With Bipolar Disorder, Marie Denise Decoline

Walden Dissertations and Doctoral Studies

Research on rates of HIV testing among individuals diagnosed with Bipolar Disorder (BPD) is limited, while HIV infection continues to rise among BPD individuals. The problem is that BPD individuals are at high risk for HIV infection due to non-adherence to treatment for bipolar disorder and manic episodes that can lead to high-risk behaviors. The goal of the study was to examine the association between selected demographic variables, having a bipolar diagnosis, engaging in high-risk behaviors, inability to afford treatment for bipolar disorder, non-adherence to treatment for bipolar disorder, and substance abuse, and their relationship to obtaining an HIV test …

Decreasing Central Line Complications With A Dedicated Team Approach, Donna Degennaro

Walden Dissertations and Doctoral Studies

Central-line catheters save lives, but they can also bring about complications, such as hospital-acquired infections. The Institute of Healthcare Improvement has collected data indicating that using proper insertion techniques and maintenance care, known as "the bundle," can prevent bloodstream infections associated with central lines. Progress has been made toward that end: The bundle has been used in intensive care units in a variety of hospitals and reportable central-line infections have decreased by 38%. However, because infections continue to occur inside and outside intensive care units, more needs to be done to protect all patients from these deadly infections. The purpose …

Talent Retention In Organizations Facing Staff Reductions Via Layoffs, George Edward Lightfoot

Walden Dissertations and Doctoral Studies

High voluntary attrition threatens the future of downsizing organizations. The purpose of this phenomenological study was to explore how employee layoff announcements reduces the perception of organizational commitment to experienced, skilled workers in central Wisconsin. The conceptual framework integrated stress response theories including Cannon's cognitive activation theory of stress. Face-to-face interviews were conducted with 20 journeyman level artisans who had witnessed the layoff process within 50 miles of Wausau Wisconsin. These interviews were analyzed via the modified van Kaam method to code, cluster, and group the findings into significant themes. Nine themes emerged from the analyses suggesting layoff implementation strategies …