Medicine and Health Sciences Commons^™

Staff Education To Enhance Nursing Knowledge And Confidence In Withdrawal Management Using The Clinical Institute Withdrawal Assessment And Clinical Opiate Withdrawal Scale, Margaret Sarana Hector

Walden Dissertations and Doctoral Studies

This quality improvement staff education project addressed the inconsistent use of the Clinical Institute Withdrawal Assessment (CIWA) and Clinical Opiate Withdrawal Scale (COWS) assessment tools among nursing staff in an adult psychiatric and addictions unit located in the Mid-Atlantic region of the United States. Inconsistent use of the CIWA and COWS tools may lead to unfavorable patient outcomes. The goal of this project was to enhance nursing familiarity, confidence, and sense of importance in using CIWA and COWS tools for assessing and managing withdrawal symptoms in patients with co-occurring depression and substance use disorders. A pre- and posteducation survey design …

Impact Of Mental Illness On Colon Cancer Screening Participation, Stephanie Tejada

Walden Dissertations and Doctoral Studies

This study analyzed the impact of mental illness on colon cancer screening participation. The research problem centers on the under-screening of colorectal cancer (CRC) in psychiatric patients, leading to delayed diagnoses and poorer treatment outcomes. This quantitative retrospective cohort study examined how demographic factors (age, gender, ethnicity), healthcare access, and support group participation influenced CRC screening among individuals with mental illness. The research used data from 571 adults aged 50 and older from the National Health Interview Survey (NHIS). The Social Ecological Model served as the guiding theoretical framework for this study. Statistical analyses included t-tests, chi-square, logistic regression, and …

An Education Project For Training Nurses On Self-Care Strategies To Prevent Work-Related Burnout, Nsemboowo Effiong Enyong

Walden Dissertations and Doctoral Studies

There is no in this project

Opioid Overdose Bystander Assistance And Harm Reduction In Pennsylvania, Walkirya Peralta

Walden Dissertations and Doctoral Studies

Bystanders play a vital role in reducing opioid overdose deaths by administering naloxone, a medication that can reverse the effects of opioids when used promptly. With opioid-related fatalities considered a public health emergency in the United States, increasing public access to naloxone and education on overdose prevention has become a key strategy in harm reduction. Research shows that these efforts effectively lower overdose deaths in affected communities. As part of this public health approach, many states allow individuals to obtain naloxone without a prescription through standing orders at pharmacies and community programs. Additionally, legal protections such as Good Samaritan laws …

Staff Education To Improve Mental Health Knowledge Among Critical Care Staff, Ashton Barnes

Walden Dissertations and Doctoral Studies

Mental health literacy is increasingly recognized as a critical component of nursing practice, particularly in high-acuity environments. At a local healthcare organization, leadership identified a gap in staff education related to mental health, contributing to elevated incidences of anxiety, depression, posttraumatic stress disorder (PTSD), burnout, and diminished patient outcomes. In response, I conducted this Doctor of Nursing Practice project to evaluate whether a structured educational intervention could enhance mental health knowledge and competency among critical care staff. Participants completed pre- and postintervention assessments to evaluate core concepts in mental health awareness and clinical application, with supplementary qualitative feedback gathered to …

Medication Safety: A Policy Journey To Reduce Medication Errors, Elia M. Campos, Kathleen Klimpel, Joseph Burkhard

Doctor of Nursing Practice Final Manuscripts

Abstract

Medication Safety: A Policy Journey to Reduce Medication Errors

Background: Medication errors have long been a significant concern. Unsafe medication practices and errors can pose serious risks of injury and preventable harm within healthcare systems.

These errors can lead to severe consequences and have the potential to result in injury, disability, or even death. The World Health Organization highlights that in the United States, an estimated 1.3 million people experience medication-related harm, with 7,000-9,000 people dying due to a medication error each year (WHO, 2023). On average, one adverse drug effect (ADE) adds more than $2,000 to the cost …

The Association Between Malnutrition And Gingivitis Among Residents In St. Louis, Missouri, Alyssa Detrick

Walden Dissertations and Doctoral Studies

Malnutrition and gingivitis are common diagnoses in primary medical and dental care. The purpose of this quantitative study was to understand the association between malnutrition and gingivitis among residents in St. Louis, Missouri. The study was based on the social ecological model (SEM). The cross-sectional design involved secondary data (N = 2,553) from a Federally Qualified Health Center in St. Louis, Missouri that included de-identified patient demographic and diagnosis information of St. Louis City residents with a medical and dental visit in 2024. This study examined the relationship between malnutrition and gingivitis while controlling for ethnicity, preferred language, race, and …

Blenderized Tube Feeding Formulas: Attitudes, Barriers, And Clinical Benefits As Perceived By Registered Dietitians In Pediatric Care, Savannah Smiley Keeler

Master's Theses

Blenderized tube feeding formulas (BTFF) are increasingly recognized as a viable alternative to conventional commercial tube feeding formulas (CTFF) for pediatric patients requiring enteral nutrition. This cross-sectional, exploratory study aimed to assess the experiences, attitudes, and perceived clinical benefits of BTFF use among Registered Dietitian Nutritionists (RDNs) working with gastrostomy-tube-dependent pediatric populations in the United States. A total of 146 RDNs completed a 45-item online survey, which gathered quantitative and qualitative data on BTFF familiarity, feasibility, clinical outcomes, caregiver factors, and institutional barriers. Findings revealed that while BTFF use remains variable across clinical settings, 55.8% of RDNs reported increased utilization …

Eating Habits, Eating Behavior Mediators, Body Composition And Physical Fitness Among Rotc Cadets, Kaitlin Renee Hanks

Master's Theses

The physical and mental demands of the military and the requirement to maintain body composition standards make healthful eating essential to military service. Reserve Officer Training Corps (ROTC) cadets are a unique subgroup of the United States military, and the combined demands of their military training and educational pursuits may increase their susceptibility to unhealthy eating patterns. The purpose of this study is to describe the relationship between eating habits, eating behavior mediators, body composition, and physical fitness among ROTC cadets. This study used a cross-sectional design that included an online survey, an inperson body composition assessment, and carotenoid measurements …

Analyzing The Relationship Between Diabetes Duration And Self-Management In Adults With Diabetes, Caroline Noel Stroo

Master's Theses

Diabetes mellitus (DM) is a metabolic disease that affects 14.7% of adults in the United States (Centers for Disease Control and Prevention, 2023). Prevalence of diabetes increases with age, with rates for adults aged 65 and older reaching 29.2% (Centers for Disease Control and Prevention, 2023). Factors such as age, race, obesity, physical activity level, and genetics strongly increase the risk of developing type 2 diabetes (T2DM) (National Institute of Diabetes and Digestive and Kidney Disease, 2016). Diabetes requires complex and comprehensive management to reduce the risk of developing comorbidities (Al-Shabeeb et al., 2021). Factors such as education, familial support, …

Lactation Management Training In Graduate Nutrition And Dietetics Programs: A Preliminary Report, Laura Ashton Gillin

Master's Theses

The American Academy of Pediatrics recommends exclusive breastfeeding (BF) for the first six months and continued breastfeeding for at least two years with complementary food. Despite this recommendation, only 24.9% of infants in the United States are exclusively breastfed at six months (Breastfeeding Report Card 2022). Breastfeeding support and lactation management are critical to promoting a successful breastfeeding experience. Specifically, qualified support from a Registered Dietitian Nutritionist (RDN) is recommended, yet graduate students in Nutrition and Dietetics do not receive adequate training regarding breastfeeding intervention. This study aimed to evaluate graduate Nutrition and Dietetic programs to determine the amount of …

Sleep, Emotion Regulation, And Relationship Satisfaction: A Moderation Analysis, Lakyn Boone

Doctoral Dissertations

Sleep plays a pivotal role in overall health and well-being, influencing mental health, cognitive abilities, memory, emotional balance, and physical well-being (Luyster et al., 2012; Mukherjee et al., 2015). Emotions constitute a natural and indispensable element of human existence but necessitate proper regulation, as any disruption in emotion control has been associated with various mental health disorders (Gross & Jazaieri, 2014; Kring & Gordon, 1998; Phelps, 2006). Furthermore, human connections and relationships are fundamental aspects of the human experience, contributing to emotional support, personal growth, a sense of belonging, and even influencing one's physical health outcomes (Baumeister & Leary, 1995; …

Advancing Rfid Systems: From Head Orientation To Robotic Localization Using Passive Tags, Guilherme Ricardo Mendes Da Silva Barreto De Figueiredo

Doctoral Dissertations

No abstract provided.

Hardiness, Coping, And Well-Being In Trauma-Exposed College Student-Athletes, Kiara Scott

Doctoral Dissertations

College student-athletes (CS-As) face many stressors, such as adjusting to a university setting, academic pressures, and the demands of an elite athlete (e.g., battling at a high level during training and competition and managing mental struggles in their sport) (Barbayannis et al., 2022; Barnard, 2016). Some individuals are exposed to events that may be classified as traumatic, such as physical and sexual assault, natural disasters, and other related forms of human suffering (American Psychiatric Association, 2013). Around 50%-80% of college students have been exposed to at least one traumatic event throughout their lifetime (Frazier et al., 2009; Read et al., …

Vitamin B12 Deficiency: Confidence, Perspectives, And Practices Among Registered Dietitian Nutritionists, Avery Miller Adams

Master's Theses

Vitamin B12 deficiency is common in the United States, occurring in 20% of adults aged 60 and above (Andres et al., 2004). Veterans are susceptible to B12 deficiency due to tobacco product usage, alcohol consumption, and poor diet quality. Megaloblastic anemia is the second most prevalent vitamin deficiency disorder recorded in military personnel from 1997 to 2015 (Knapik et al., 2021). This exploratory, analytic research aims to assess registered dietitian RDN nutritionists’ (RDN) knowledge, perceptions, and intentions regarding treating vitamin B12 deficiency in a clinical setting. Due to population prevalence differences, responses from VA and non-VA practicing registered dietitian-nutritionists (RDNs) …

Is There An Association Between Food Literacy And Diet Quality In Young Adult College Men?, Morgan Claire Mayeux

Master's Theses

Food literacy skills can improve dietary intake in young adults as it provides them with the tools they need to make healthier food-related decisions. The benefits of improving food literacy includes the reduction in the risk of prevalent, preventable dietrelated diseases such as obesity, T2DM, heart disease, and other chronic diseases that plague the Unites States today. Previous literature reports primarily on college female samples. Because a large proportion of the samples in the available studies are female, the current literature may not reflect young adult men’s food literacy and its comparison to their overall diet quality. The purpose of …

The Multicultural Orientation Framework In Couple Therapy, Jasmine R. Davis

Electronic Theses and Dissertations

Couples’ cultural values and beliefs are important to their relational connection. Cultural values and beliefs can be sources of strength in relationships, but they can also lead to impasses. As such, clinicians and researchers could benefit from a cultural framework to inform conceptualization and treatment when working with couples. The Multicultural Orientation (MCO) framework has three pillars: cultural humility, cultural comfort, and cultural opportunities. The MCO framework is empirically supported for use in individual and group psychotherapy but has not been applied to couple therapy. This dissertation includes two parts. First, we outline a conceptual framework for the application of …

A Developmental Evaluation Of A Dental Hygiene Program And A Community Health Partnership, Laura Jacob

Higher Education: Doctoral Research Projects

Today, dental hygiene education commonly occurs in community college settings which are removed from dental schools thus dental hygiene students graduate with relatively little to no exposure to dentistry or directly with a clinically practicing dentist. With dental hygiene workforce shortages at an extremely high level, locally and nationally, it is imperative to matriculate students who are poised to be successful in the changing landscape of healthcare.

The purpose of this program evaluation was to investigate via the developmental program evaluation model, the perceived benefits of a potential collaboration between the Colorado Mountain College (CMC) dental hygiene program and a …

A Phenomenological Study Of Caregivers For Sexual Minority Hospice Patients, Catherine H. Bianchi

Electronic Theses and Dissertations

Lesbian, gay, and bisexual (LGB) individuals face disproportionate barriers in healthcare across the lifespan that persist and often intensify at the end of life. Despite hospice’s mission to provide comfort, dignity, and patient-centered support, it remains unclear whether these services equitably meet the needs of sexual minority patients. Seeking hospice care presents a unique conundrum for many LGB individuals: it necessitates inviting representatives of a historically exclusionary healthcare system into the privacy of their homes - spaces that often serve as sanctuaries of identity, safety, and autonomy. The already vulnerable experience of seeking care in one’s final days can be …

“My Body Was Never Mine”: An Arts-Based Phenomenological Analysis Of Queer And Trans Adolescent Involuntary Psychiatric Hospitalization Experiences, Megan Doyle

Electronic Theses and Dissertations

Involuntary psychiatric hospitalization has life-saving and crisis-stabilizing intentions for queer and trans adolescents experiencing mental health crises; however, there are significant concerns about the adverse effects of this practice. This study employed two interwoven qualitative methods, interpretative phenomenological analysis and arts-based research, to gain a deeper understanding of queer and trans individuals’ adolescent experiences of involuntary psychiatric hospitalization. The theory of abolition was applied to examine the carcerality and identity-based oppression embedded within this procedure. Participant narratives and artwork revealed how involuntary psychiatric hospitalization is non-affirming for queer and trans young people in crisis, and the impacts of experiencing coercion, …

Developing Deep Learning Methods For Cognitive Impairment Detection Based On Non-Invasive Data, Muath Alsuhaibani

Electronic Theses and Dissertations

Cognitive impairment detection is on the rise to help reduce the burden of healthcare costs on institutions and individuals. Mild Cognitive Impairment (MCI) is an early stage of cognitive decline progressing to Alzheimer’s disease (AD) or AD-related Dementia (ADRD). Detecting the early stages of AD/ADRD is crucial for early interventions among older adults to mitigate cognitive decline over time. However, the current diagnostic methods are often costly and/or invasive, such as MRI and PET scans. Thus, the search for non-invasive and cost-effective screening tools for the early detection of cognitive impairment using speech, language, visual, and motor data is growing. …

Transgender Individuals’ Experiences Of Ruptures And Repairs In Group Psychotherapy, Gabrielle W. Kaufman

Electronic Theses and Dissertations

As the political climate across the United States worsens for transgender and gender diverse (TGD) individuals (Harmon, 2025), it has become increasingly important to attend to the mental health needs of this population (James et al., 2016). Group therapy is a widely used treatment modality that is often more accessible than individual therapy (Burlingame & Strauss, 2021) and provides unique interpersonal opportunities (Burlingame et al., 2016). While it is expected that TGD individuals face unique challenges in group therapy due to their gender identities (Chen et al., 2020), very little is actually known about the experiences of TGD individuals participating …

The Journey Of Psychotherapy: Understanding Therapeutic Technique Through Ultralight Thru Hiking, Emma Bossier

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

This paper explores several principles of ultralight backpacking as metaphors for developing one’s therapeutic technique. The tenets of ultralight thru hiking, when interpreted through a clinical lens, offer early clinicians insight into the importance of moving through fear and leaning into exploration, discomfort, and authenticity while on the journey of becoming a therapist. The experiences of numerous thru hikers are synthesized into five principles: Don’t Pack Your Fears, Be Present for the Journey, Slow Simplicity, Embrace the Suck (and The Stink), and Trail Legs. These principles do not define ultralight as carefreeness but rather offer a metaphor for the careful …

A Clinical Pathway For Differential Diagnosis Of Adhd Vs Trauma: Early Childhood Recognition And Intervention, Maria Neiers

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Distinguishing Attention-Deficit/Hyperactivity Disorder (ADHD) from Complex Posttraumatic Stress Disorder (C-PTSD) presents significant diagnostic challenges due to overlapping symptom presentations, shared neurobiological impacts, and frequent comorbidities. This paper explores the nuanced clinical differentiation between ADHD and C-PTSD, and other trauma disorders, in pediatric populations, emphasizing the importance of trauma-informed assessment, early identification, and integrative clinical reasoning. The discussion highlights how structured diagnostic reasoning can reduce uncertainty, enhance diagnostic clarity, and support effective treatment planning. As a central contribution, this paper introduces an original clinical reasoning flowchart and a case conceptualization to illustrate its practical application in real-world diagnostic dilemmas. The need …

Applying Contextual Behavioral Science To Address Addictions In Monsters, Chase Hollander

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

The dominant essentialist paradigm in addiction treatment often conceptualizes addiction as a curse or plague which seizes the individual afflicted by it. Such views are reinforced by neurobiological interventions like Medication-Assisted Treatment (MAT). While MAT can reduce cravings and withdrawal symptoms, its long-term efficacy is mixed, and its emphasis on abstinence as a primary outcome limits its scope. Addiction is a multifaceted phenomenon shaped by physiological, psychological, social, and systemic factors—including stigma, moral judgment, and structural oppression. Essentialist approaches frequently pathologize individuals and obscure these broader influences. In contrast, contextual behavioral sciences and therapies aligned with functional contextualism such as …

Proposed Theoretical Model Of Pediatric Onset Multiple Sclerosis And Restrictive Eating Behaviors, Anna L. Smith

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Multiple Sclerosis (MS), a chronic, demyelinating, autoimmune disease that causes an array of physical and cognitive symptomatology, is commonly diagnosed in adulthood. Pediatric Onset Multiple Sclerosis (POMS) is characterized by diagnosis of the disease before age 18 and accounts for about 5% of MS cases. While there is a growing body of literature examining the impact of adult-onset multiple sclerosis on psychosocial functioning, research specifically addressing POMS remains limited. Moreover, there is a notable gap in the literature regarding the risk of eating disorders among individuals with POMS. This paper will explore a constellation of potential risk factors that may …

Supporting Healthy Siblings In Pediatric Cancer: Advancing Relational Interventions To Heal Invisible Wounds, Kristen K. Wederski

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Healthy siblings of children diagnosed with cancer occupy a uniquely vulnerable position within the pediatric oncology landscape. Individuals within this population often demonstrate significant emotional distress and can experience long-term psychological challenges. Despite their risk, healthy siblings remain under-researched and under-supported compared to pediatric patients and caregivers. Existing interventions tend to prioritize individual coping skills and psychoeducation and often overlook the critical relational dynamics that shape healthy siblings' psychological adjustment. Grounded in systematic and relational theories, this paper proposes a paradigm shift toward relationally focused interventions that strengthen the caregiver-sibling bond as a core mechanism of change to foster resilience …

Surgeon Ergonomics While Performing Total Knee Arthroplasty, Cameron Dahman

Electronic Theses and Dissertations

One of the most prevalent hazards to orthopedic surgeons are musculoskeletal disorders with 97% of arthroplasty surgeons reporting procedural-related musculoskeletal pain and 66% of orthopedic surgeons reporting procedural-related musculoskeletal injury [1], [2], [3]. With the annual number of total knee arthroplasties (TKA) on the rise, orthopedic surgeons are taking on larger annual caseloads and retiring later in life [4], [5]. The goal of this study was to quantify postural demand for 11 discrete surgical steps of TKA to identify ergonomically unfavorable positions surgeons experience while operating. Four orthopedic surgeons performed TKA while their motions were recorded using marker-based motion capture. …

Staff Education Project To Train Charge Nurses On The Use Of The Tsam Framework To Improve Leadership Competencies, Natoya Gaye Langley

Walden Dissertations and Doctoral Studies

The purpose of this doctoral project was to improve charge nurse leadership competencies through education on the tiered skills acquisition model (TSAM), addressing challenges of high turnover, limited orientation, and compromised care quality in an inpatient psychiatric facility. The background reveals a two-year financial loss of over $1.8 million tied to staff attrition, highlighting the urgent need for a structured training framework. TSAM, a progressive, competency-based model, offers a pathway for deliberate skill acquisition, leadership growth, and enhanced role clarity. A staff education program was implemented with ten charge nurses, incorporating a pretest, PowerPoint training, scenario-based roleplays, and a posttest. …

The Residual Impact Of Slavery On How Enslaved Black Females Defined And Made Meaning Of Sexual Violence: A Content Analysis, Suzanne R. Bates

Dissertations

Thompson-Miller & Picca (2016) and Feimster (2023) argued that enslaved African American women, and even free African Americans after the Civil War were victims of non-consensual sexual activity and rape. The NISVS report revealed that before the age of 18 years old, 35.5% of African American women experienced contact sexual violence, 29.5% experienced non-contact unwanted sexual encounters, and 20.7% experienced rape (Basile et al., 2022). Researchers of slave scholarship have made the case for the importance of including discourse on slavery and enslaved Black females’ experiences when discussing present day sexual violence among Black women in the US today (Balfour, …