Medicine and Health Sciences Commons^™

Unraveling The Links Between Substance Use And Academic Motivation In Higher Education, Melissa Lynn Goins

STEMPS Theses & Dissertations

Self-Determination Theory (SDT) posits that the quality of students’ motivation regulation (i.e., autonomous versus controlled) shapes both learning and health behavior, yet few studies have examined the relations among motivation regulation, alcohol and cannabis use, and achievement. In this study, I surveyed 459 undergraduates at a mid-sized public university in the southeastern United States. Participants completed the Academic Motivation Scale-College version 28 to assess autonomous and controlled motivation regulation, a typical-week alcohol grid, a seven-day cannabis grid, and self-reported grade point average (GPA). Results indicated that autonomous academic motivation was uniquely related to GPA; however, neither motivation variable related to …

Identifying Alcohol Intervention-Relevant Constructs For Greek Life: Examining Across Greek Membership And Gender Among College Students, Emily Susan Renzoni

Psychology Theses & Dissertations

Among college populations, students who are members of social Greek life organizations (i.e., social fraternities and sororities) drink more and experience higher rates of negative alcohol-related consequences than their non-affiliated peers. Although there has been success of alcohol interventions in general college populations, research has shown that college drinking interventions that are delivered to students in Greek life are not efficacious in reducing alcohol consumption or related consequences. It is meaningful to investigate if the content commonly addressed in these interventions, although well-documented as being linked to drinking in the general college population, has the same associations for students who …

Exploring The Impact Of Identity-Based Bullying On Suicidal Thoughts And Behaviors Among 6th-12th Grade Youth In Virginia, Camille N. Johnson

Psychology Theses & Dissertations

Suicidal thoughts and behaviors (STBs) are a growing public health concern among youth. Bullying victimization is a robust risk factor for STBs and identity-based bullying (IBB) or bullying that occurs due to a person’s actual or perceived social-identity/identities that is ingrained in discrimination, prejudice, or bias, has been found to be more strongly associated with STBs compared to bullying that was unrelated to identity. The current study used data from the Virginia School Survey of Climate and Working Conditions (N=399,493) to examine associations between general bullying, adult-perpetrated bullying, and IBB with depression and STBs among 6th-12th grade youth. This study …

Graduate Physical Therapy Students Perceived Benefit Of Prior Anatomy Experiences Following Their First Semester Graduate Physical Therapy Anatomy Course, Austin Alexander

EVMS School of Health Professions Theses & Dissertations

Human anatomy stands as a cornerstone prerequisite for admission into graduate-level Physical Therapy Programs. As such, prior anatomy experiences need to prepare students for success in graduate-level coursework. However, studies have demonstrated that undergraduate anatomy courses vary in their ability to predict success in graduate Physical Therapy anatomy coursework. This research aimed to utilize students' perceptions of their undergraduate anatomy experiences to predict grades in graduate-level Physical Therapy anatomy coursework. The multinomial logistic regression in this study revealed that the absence of perceived preparedness was a significant predictor of membership in the C graduate anatomy grade group. Students who did …

Implementing Phq-2 In An Outpatient Mental Health Practice, Krishona Poignard

Doctor of Nursing Practice Projects

Depression remains widely underidentified in outpatient behavioral health settings, where variable screening practices limit early recognition and appropriate treatment. This quality improvement project addressed this gap by standardizing screening through targeted clinician education. The purpose was to improve clinician confidence and adherence to validated tools, specifically the Patient Health Questionnaire-2 (PHQ-2) and, when indicated, the Patient Health Questionnaire-9 (PHQ-9). The project aimed to increase consistent tool use through an evidence-based educational intervention guided by Lewin’s Change Theory and the Iowa Implementation for Sustainability Framework. A quasi-experimental, single-group pretest–posttest design was employed with licensed clinical staff, including licensed social workers (LSWs), …

Quality Improvement Project: Nursing Education In Relation To The Use And Effect Of Neuromuscular Blockade Agents, Lauren Danielle Bowen

Doctor of Nursing Practice Projects

Neuromuscular blockade agents are a medication class that requires education and knowledge to ensure protocols, assessments, and tools are utilized in acute care facilities. Quality improvement (QI) project focused on the use of neuromuscular blockage agents to ensure nursing staff, who have direct patient contact, received proper education. A quasi-experimental, pre-post project intervention design was used to evaluate evidence-based practice interventions with a literature review, assessment, and tools used by the population studied. Aim and purpose of the QI project was to increase nursing staff educational knowledge on the use of neuromuscular blockade agents in patients who are sedated requiring …

Quality Improvement Project: Standardized Medication Reconciliation Process Training: A Path To Improve Staff Medication Confidence, Christologus Obi

Doctor of Nursing Practice Projects

Medication reconciliation represents a critical safety process in psychiatric healthcare, where medication discrepancies affect up to 67% of hospitalized patients, with 30-40% potentially causing significant harm. This quality improvement project implemented a standardized medication reconciliation training program at a Texas mental health facility to address knowledge and confidence gaps among clinical staff. Using Kotter's 8-Step Change Model and the Iowa Model of Evidence-Based Practice, this quasi-experimental pre-post intervention study delivered three 30-minute interactive sessions to 12 multidisciplinary healthcare professionals. The evidence-based intervention introduced a 3-phase reconciliation model focused on obtaining accurate medication histories, documentation, and discrepancy resolution. Data collection used …

Assessing The Impact Of Cultural Competence Training For Providers Serving Native Americans, Chinazo Obi

Doctor of Nursing Practice Projects

The United States is a culturally diverse nation, yet many healthcare providers report challenges in delivering care that respects cultural values and traditions. Within mental health settings, this gap is especially concerning for Native American populations, who experience disproportionately high rates of mental health conditions and face barriers to culturally responsive care. The purpose of this quality improvement project was to assess the impact of a cultural competence education and training intervention on mental health providers’ knowledge and self-efficacy in delivering culturally competent care to Native American patients. Guided by Leininger’s Culture Care Theory of Diversity and Universality and the …

Quality Improvement Project: The Impact Of Staff Education On Utilization Of The Phq-9 Tool And Follow-Up Management Protocol, Shuntak Jerideau

Doctor of Nursing Practice Projects

Depression is a prevalent mental health disorder that affects daily functioning. Timely screening enables the identification of symptoms, monitoring treatment efficacy, and informs additional treatment such as referrals. The practice site reported low screening rates of patient’s post-psychiatric hospitalization, which was attributed to inadequate knowledge of the PHQ-9 tool. The purpose of this quality improvement project was to evaluate the impact of staff education on the utilization of the PHQ-9 tool and follow-up management protocol in a mental health clinic. A quasi-experimental design method was used in an outpatient mental health clinic. Pretest knowledge of the PHQ-9 was obtained from …

Quality Improvement Project: Impact Of Simulation Training On The Self-Efficacy Of Registered Nurses During A Code Stroke, Kakeya James

Doctor of Nursing Practice Projects

Self-efficacy levels affect decision-making skills and overall confidence in handling critical situations. However, knowledge gaps often hinder the maintenance of high self-efficacy. (Farčić, et al., 2020). The project site provides limited training opportunities that may not adequately prepare registered nurses with the confidence and skills needed to respond to stroke emergencies, potentially causing delays in patient care and adverse health outcomes. As a result, the quality improvement project aims to examine how simulation-based training impacts registered nurses’ self-efficacy in managing stroke emergencies. The project employed a quasi-experimental pretest/posttest design and was guided by the Plan-Do-Study-Act (PDSA) cycle, the Jeffries Simulation …

Quality Improvement Project: Effects Of Ongoing Clinical Education Training On Nursing Faculty’S Self-Efficacy In Clinical Education, Sarah Ferguson

Doctor of Nursing Practice Projects

Clinical education is essential for bridging theory and practice in nursing education, yet many clinical instructors transition from expert bedside nurses to novice educators without adequate orientation and training. This quality improvement project examined the effects of ongoing clinical education training on nursing faculty self-efficacy at a satellite nursing school in North Texas. This project, guided by Patricia Benner’s Novice to Expert framework and Lewin’s change model, aimed to determine whether continuous professional development throughout the term would increase clinical faculty confidence compared to standard onboarding alone. A descriptive pre/post design was used, with the Clinical Nursing Teacher Self-Efficacy Scale …

Development Of An Evidence-Based Guideline For Nurse-Led Interventions To Improve Medication Adherence In Patients With Severe Mental Illness, Grace Uche Kalu

Walden Dissertations and Doctoral Studies

I conducted this Doctor of Nursing Practice (DNP) project to address medication nonadherence among adults with severe mental illness (SMI) in a psychiatric care setting by developing an evidence-based clinical practice guideline (CPG) for nurse-led interventions. The identified practice gap was the absence of a standardized, evidence-informed framework to guide nurses in enhancing pharmacotherapy adherence, which is a critical issue linked to relapse, rehospitalization, and diminished quality of life in this population. This project was guided by the following practice question: Will an evidence-based guideline on nurse-led interventions to improve medication adherence in patients with SMI be approved by a …

Quality Improvement Project: Improving Providers’ Self-Efficacy In Facilitating Mat Usage Through Educational Training, Joshua W. Moore

Doctor of Nursing Practice Projects

Opioid Use Disorder (OUD) and Alcohol Use Disorder (AUD) are common diseases treated in detox facilities around the world. Medication-assisted treatment (MAT) is the most effective treatment for OUD and AUD. Despite the need for MAT, many providers do not prescribe lifesaving medications due to a lack of knowledge and confidence. The purpose of this quality improvement project at a local detox facility is to answer the question: What effect on providers’ self-efficacy in facilitating MAT usage upon discharge does educational training have? Under the Social Cognitive Theory (SCT), self-efficacy was targeted using the Plan-Do-Study-Act (PDSA) change model. The aim …

Exploring Future Educators’ Roles In Classroom Aac Use: Insight Into Knowledge, Skills, And Attitudes, Katrina M. King

Honors College Theses

The United States public school system requires the provision of a free and appropriate public education (FAPE) in the least restrictive environment (LRE) for qualifying students with disabilities (U.S. Department of Education, n.d.). Speech, language, and hearing related disabilities are among the qualifying categories (U.S. Department of Education, n.d.). Students with these disabilities may have complex communication needs (CCN), or significant limitations in their speech, language, and communication abilities (Communication Rights Australia, 2018). Augmentative and alternative communication (AAC), a type of assistive technology, offers support for these students, however, several barriers inhibit full communicative participation (American Speech-Language-Hearing Association [ASHA], n.d.-a). …

Improving Dynamic Balance And Gait Adaptation With Ischemic Conditioning Post-Stroke, Stephanie Christine Wolfe

Dissertations (1934 -)

The purpose of this dissertation was to quantify the benefits of ischemic conditioning on reactive balance responses and gait adaptation during treadmill walking in chronic stroke survivors. Reactive balance and gait adaptations are believed to be limited in this population. Ischemic conditioning is an emerging adjunct to physical therapy that improves motor function post-stroke via improvements in strength, voluntary muscle activation, walking speed, and fatigability. Here, we quantified how ischemic conditioning could impact performance of a more complex task: altering gait to meet various perturbing conditions. Specifically, we quantified mediolateral margin of stability in response to lateral cable pulls (both …

Exploring The Experiences Of Bahamian Men Diagnosed With Hypertension And Medication Adherence, Bianca Edwards

Walden Dissertations and Doctoral Studies

Hypertension (HTN) is associated with significant health complications, including stroke, myocardial infarction, heart failure, and kidney disease. Despite advances in the treatment and management of HTN, a lack of medication adherence contributes to the persistence of HTN-related morbidity and mortality affecting men in The Bahamas. The purpose of this qualitative descriptive phenomenological study, guided by Pender’s health promotion model and Bandura’s social cognitive theory, was to explore the lived experiences of Bahamian men diagnosed with hypertension regarding their adherence to prescribed medications. Using Giorgi’s descriptive phenomenological method, in-depth, semistructured interviews were conducted with 11 participants. Data were analyzed through repeated …

Impact Of Community Factors On Naloxone Overdose Reduction In Ohio, Theophilus Oduro Frimpong

Walden Dissertations and Doctoral Studies

The opioid crisis in Ohio, driven by fentanyl, persists due to inequitable access to naloxone despite its proven effectiveness. This study examined how socioeconomic status (SES), race/ethnicity, population density, and hospital availability per capita predicted naloxone overdose reversals (dependent variable) in Ohio. Social-ecological theory guided this quantitative historical correlational analysis of Ohio’s Project DAWN index data (N = 5,280). Inclusion criteria included individuals ages 18 to 65 with naloxone-related overdose reversals (dependent), naloxone distribution (moderator), and community factors (independent). Multiple linear regression results showed that SES (p >.50), race/ethnicity (% White, p = .588; % Black, p = .495; % …

Development And Applications Of A Health Equity Summary Score Using The Medical Expenditure Panel Survey, Ronald R. Sanchez

Dissertations and Theses

Despite sustained national efforts, disparities in healthcare delivery persist among racial and ethnic minorities, low-income individuals, and socially at-risk populations. Monitoring modifiable aspects of care delivery, such as the structures and processes that health systems can directly improve, is a key strategy for addressing these gaps. However, most measures evaluate modifiable aspects of care delivery separately, limiting understanding of how improvements in one domain reinforce the other and how their combined effect influences equitable care.

This dissertation addresses this gap by combining patient experience and clinical quality, two modifiable aspects of care that captures how patients interact with the health …

Psychopharmacologic Management Of Serious Mental Illness In State Prisons, Clarel Neuvieme

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project focused on developing and evaluating an evidence-based clinical practice guideline (CPG) for the psychopharmacologic management of serious mental illness (SMI) in a state correctional health system. The project explored a critical practice gap: the unavailability of standardized, evidence-based prescribing and monitoring protocols for incarcerated individuals diagnosed with schizophrenia, major depressive disorder with psychotic features, or bipolar disorder. The evidence-based project was structured around the central question: “Will an interprofessional team achieve consensus on updating the clinical practice guideline for psychopharmacologic management of serious mental illness in state prisons, thereby improving consistency and quality …

Mechanisms Of Correlated Neuronal Activity In The Globus Pallidus, Hamza Albawaliz

Electronic Theses and Dissertations

This thesis investigates the mechanisms of correlated neuronal activity in the globus pallidus externus (GPe), a key structure in the basal ganglia. Neuronal activity in the GPe is reportedly decorrelated in healthy subjects but can become highly correlated in Parkinson’s disease. However, high-density neuronal recordings in the GPe of healthy rats reveal a surprising degree of correlated activity. This raises the question of whether intrinsic properties or network connectivity alone can account for such patterns. To explore this, a computational model was developed in which GPe neurons are represented as coupled phase oscillators influenced by experimentally derived phase-response curves and …

Development Of A Non-Faradaic Impedimetric Biosensor Based On Reduced Graphene Oxide For The Detection Of Brain-Derived Neurotrophic Factor (Bdnf), Mariana N. Martins

Electronic Theses and Dissertations

Neurological disorders affect millions of people worldwide. In the case of Alzheimer’s disease (AD), the rising number of cases significantly increases global healthcare costs. Therefore, early detection of biomarkers at the onset of the disease is essential for early diagnosis. This study presents an electrochemical biosensor designed for the detection of Brain-Derived Neurotrophic Factor (BDNF) in human plasma, incorporating reduced graphene oxide (rGO) to enhance signal sensitivity. Dielectrophoresis (DEP) was employed to deposit rGO flakes on the electrode surface, improving conductivity and sensor performance. Electrochemical impedance spectroscopy (EIS) was used to monitor changes in impedance associated with BDNF binding events, …

Development Of Evidence-Based Clinical Practice Guidelines For Monitoring Diabetic Patients Using Smartphone Technology, Ganiyat Funmilayo Efuntoye

Walden Dissertations and Doctoral Studies

In this doctoral project, I developed and validated an evidence-based clinical practice guideline for implementing smartphone technology to monitor diabetic patients in primary care settings with an 80% threshold. The project addressed a critical gap in standardized guidance for diabetes technology integration, which has resulted in inconsistent adoption and suboptimal patient outcomes. A systematic literature review of four major databases yielded 12 high-quality studies representing all evidence levels (I–V) according to the Johns Hopkins evidence-based practice model. Evidence synthesis revealed strong and compelling evidence with consistent results supporting smartphone technology implementation, including HbA1c improvements of 0.4%–0.8%, sustained patient engagement rates …

Streamlining Sepsis Care And Enhancing Antibiotic Administration Efficiency Through Emergency Department Staff Nurse Education, Dafina Jamillah Skinner

Walden Dissertations and Doctoral Studies

Sepsis is a life-threatening medical emergency that requires rapid identification and treatment. Delays in administering antibiotics are directly associated with increased mortality, longer hospital stays, and higher complication rates. Without intervention, patients faced preventable harm, and the organization risked continued non-compliance with federal quality measures. This Doctor of Nursing Practice (DNP) project implemented a structured educational program for emergency department (ED) nurses to improve knowledge of evidence-based sepsis protocols. The practice-focused question asked: For nurses in the ED, will an educational intervention on sepsis recognition and antibiotic stewardship improve knowledge of timely antibiotic administration and blood culture acquisition? Twenty ED …

Nursing Faculty Demographics, Attitude, Knowledge, And Integration Of Complementary And Alternative Medicine In Nursing Curriculum, Patricia L. Balistreri

Walden Dissertations and Doctoral Studies

Nurses have demonstrated positive attitudes toward complementary and alternative medicine (CAM); however, additional education is limited in nursing programs to prepare them to discuss and educate patients about these practices. Nursing faculty play a significant role in educating, mentoring, and influencing students’ knowledge levels and attitudes toward CAM. The purpose of this quantitative, non-experimental, cross-sectional study, guided by the CAM healthcare model, was to examine relationships among nursing faculty demographics, CAM knowledge, attitudes, and curriculum integration. The Knowledge, Attitudes, and Use of CAM survey was administered to 111 nursing faculty across multiple programs. Data were analyzed using multiple linear regression …

Capacity, Allocation And Update Dynamics Of Human Memory Systems, Shaoying Wang

Electronic Theses and Dissertations

Information is encoded and stored in three types of memory: sensory memory (SM), short-term memory (STM), and long-term memory (LTM). SM has a large capacity but retains information for only a brief period. When information transfers to STM, only a limited amount can be stored. Information in STM can then be transferred to LTM, which has a much larger capacity and longer retention time. STM is often conceptualized as working memory (WM) to highlight its role in active information processing. Due to the limited capacity of STM, it is commonly believed that STM serves as the bottleneck for information processing. …

Understanding The U.S. Maternal Healthcare System At The Intersection Of Asian American Birth Outcomes And The Model Minority Stereotype: A Literature Review, Sophia Hevel

University Honors Theses

This thesis aims to explore the maternal healthcare system in the United States as it pertains to Asian American birthing people, the ways in which their racial, ethnic, and cultural identities are interacted with within the U.S. Healthcare system, and subsequently the detrimental effects of the medical system's devaluation of culturally specific birthing and postpartum practices have on Asian American birthing experiences. This will be accomplished through an exploration of the United States' maternal healthcare system, or rather, its crisis; how Asian Americans navigate a system that has not been structured to support their specific needs; and lastly, a discussion …

Staff Education On Understanding Nurse Burnout, Kathlyn Tracy Mcglynn

Walden Dissertations and Doctoral Studies

Summary This Doctor of Nursing Practice (DNP) project was a staff education program on nurse burnout, which remains a pressing issue in healthcare. Burnout is marked by emotional exhaustion, depersonalization, and a diminished sense of personal achievement. Addressing burnout within the nursing profession is important because burnout leads to job dissatisfaction, absenteeism, and turnover. The project was guided by two practice-focused questions: Will there be a change in knowledge from pre- to posttest after participating in an educational program on nurse burnout? Will the objectives of the educational program be met relative to the curriculum presented? Therefore, the purpose of …

Experiences Of Baccalaureate Prepared Nurses On Their Transition To Novice Faculty Members, Theresa Jade Lombardo

Walden Dissertations and Doctoral Studies

The shortage of qualified nursing faculty in Canada threatens the ability to educate sufficient numbers of nurses to meet healthcare demands. Despite this, limited research explores how baccalaureate-prepared nurses experience the transition into nursing faculty roles. The purpose of this qualitative study, guided by Schoening’s nurse educator transition model, was to explore the experiences of baccalaureate prepared nurses on the transition to novice nurse faculty members teaching in 2-year diploma prepared nursing programs in Northwestern Ontario. Five semi-structured interviews were conducted with baccalaureate-prepared novice nursing faculty members, analyzed, and transcribed using Zoom. Data were coded and analyzed using Saldana’s first …

Incivility Experienced By Males In Nursing Education, Christopher S. Hale

MUSC Theses and Dissertations

Background: Nursing shortages are exacerbated by unhealthy learning environments. Men remain underrepresented among nursing students and faculty, yet their experiences of incivility are rarely examined.

Purpose: Guided by Clark’s Model of Civility in Nursing Education, this dissertation explored how male nursing students and educators in U.S. prelicensure programs experience incivility and how these patterns inform strategies to promote civility and retention.

Methods: This compendium includes (a) an integrative review of nursing faculty mistreatment using Whittemore and Knafl’s method; (b) a cross-sectional survey of male nursing educators and students using the Incivility in Nursing Education–Revised (INE-R) to estimate the prevalence and …

Staff Education On The Timeliness Of Administration Of Insulin For The Hospitalized Diabetic Patient, Precious C. Abidoye

Walden Dissertations and Doctoral Studies

The problem addressed in this DNP project was the necessity for a nursing staff education program (SEP) focused on the prompt administration of insulin and order management as well as the evaluation of the hospital policy regarding diabetes mellitus in nonpregnant adult patients concerning hypoglycemia/hyperglycemia. Timely administration of insulin in the hospital is essential to maintain blood glucose levels within a permissible range, which greatly reduces the chances of encountering complications related to diabetes. The project questions were: Will there be an alteration in the nursing team members’ understanding of the promptness of insulin administration and the associated policy from …