Medicine and Health Sciences Commons^™

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

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

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

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

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

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 …

The Role Of Illness Intrusiveness And Personal Control In Mediating The Relationship Between The Intravenous Immunoglobulin Treatment Experience And Quality Of Life In Neurological Autoimmune Patients, Pamela Jane Gennari

Walden Dissertations and Doctoral Studies

Intravenous immunoglobulin (IVIG) is a common treatment for the neurological autoimmune diseases multiple sclerosis, multifocal motor neuropathy, myasthenia gravis, and chronic inflammatory demyelinating polyneuropathy. However, there is scant literature regarding the psychological effects of this treatment on quality of life (QOL). Using illness intrusiveness theory and personal control theory, this correlational, cross-sectional study examined the relationship between the IVIG treatment experience and QOL in neurological autoimmune patients. Surveys were employed to collect data from 79 patients at a neurological infusion center in Phoenix, AZ. Quantitative analyses included correlation, multiple regression, and mediation analyses to determine whether (a) IVIG treatment experience …

Development Of A Teach-Back Educational Module For Heart Failure Discharge Teaching, Marissa Blair Jamarik

Walden Dissertations and Doctoral Studies

Heart failure (HF) readmissions create a financial burden for healthcare nationwide and speak to the lack of effective discharge preparation for patients to be successful with self-care at home. The 183-bed hospital where this DNP quality initiative will take place currently reports an observed-over-expected (O/E) readmission rate for HF patients (Centers for Medicare and Medicaid [CMS]). Core measures on HF developed by the Joint Commission and the Centers for Medicare and Medicaid Services do not appear to be enough to ensure successful transitions of care from hospital to home. Guided by the LOGIC model, the purpose of this quality improvement …

Parents Perception Of Safety In Pennsylvania And Children's Activity And Weight, Linda C. Carr

Walden Dissertations and Doctoral Studies

Physical activity is associated with many health benefits to include weight management, lower risk for chronic diseases, and improved mental health and self esteem. The built environment has been linked to lower physical activity levels and overweight and obesity in children living in low income communities but the exact causes need further investigation. The purpose of this quantitative, cross sectional study was to examine the association between parents' perception of safety and body mass index (BMI) percentile and children's physical activity/ inactivity levels and children's BMI as measured by the National Survey of Children's Health (2011/12 NSCH). The sample consisted …

Biological Markers For Pulpal Inflammation: A Systematic Review., Dan-Krister Rechenberg, Johnah C. Galicia, Ove A. Peters

All Dugoni School of Dentistry Faculty Articles

BACKGROUND AND OBJECTIVE: Pulpitis is mainly caused by an opportunistic infection of the pulp space with commensal oral microorganisms. Depending on the state of inflammation, different treatment regimes are currently advocated. Predictable vital pulp therapy depends on accurate determination of the pulpal status that will allow repair to occur. The role of several players of the host response in pulpitis is well documented: cytokines, proteases, inflammatory mediators, growth factors, antimicrobial peptides and others contribute to pulpal defense mechanisms; these factors may serve as biomarkers that indicate the status of the pulp. Therefore, the aim of this systematic review was to …

Health Care Leaders' Experiences Of Electronic Medical Record Adoption And Use, Joseph B. Weagraff

Walden Dissertations and Doctoral Studies

Adoption of electronic medical record (EMR) technology systems of meaningful use has been slow despite the mandate by the U.S. government. The purpose of this single case study was to explore strategies used by health care leaders to implement EMR technology systems of meaningful use to take advantage of federal incentive payments. Diffusion of innovation theory provided the conceptual framework for the study. Semistructured interviews were conducted with 6 health care leaders from a military installation in the Southeast United States. Data were analyzed using software, coding, and inductive analyses. The 3 prominent themes were patient, provider, and champion. Alerts …

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

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

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

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 …

Insecticide Treated Nets As An Effective Malaria Control Strategy In Liberia, Taiyee Nelson Quenneh

Walden Dissertations and Doctoral Studies

Malaria is a vector-borne disease that presents the most persistent and serious public health burden in Liberia. Numerous studies have examined the relationship between ITN use and malaria prevalence. However, little research has explored the effectiveness of ITNs in controlling malaria among children in postwar Liberia. The aim of this study was to examine the association between ITN ownership, parental economic status, ITN installation support, and malaria prevalence among children. This was a quantitative cross-sectional study guided by the health belief model. The study used secondary data from the 2011 Liberia Malaria Indicator Survey. Chi-square for association and Logistic regression …

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

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 Pharmaceutical Industry's Effect On Rheumatologists' Patterns Of Care, Frank Bailey

Walden Dissertations and Doctoral Studies

Drug makers have developed numerous techniques to influence treatment choices. Almost no information exists regarding the pharmaceutical industry's influence on rheumatologists and how these pressures could affect patient care. This phenomenological research, conducted within the framework of social exchange theory, explored the lived experiences of rheumatologists regarding their interactions with agents of the pharmaceutical industry. A researcher-designed interview protocol was used to gather feedback from 10 rheumatologists regarding how interactions with agents of the pharmaceutical industry made them feel. Using horizonalization, meaningful statements made by rheumatologists were condensed into specific themes and patterns, which provided a composite summary of their …

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

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 …

Assessing Knowledge Of Evidence-Basedpractice Among Nurses, Suja Merin John

Walden Dissertations and Doctoral Studies

Evidence-based practice (EBP) is used worldwide to improve the quality of patient care to provide cost-effective care. EBP is a mandate for nursing practice combining individual clinical judgment with available expertise to generate a positive outcome for the patient. Investigators have documented that nurses have varying degrees of confidence and knowledge about EBP. The purpose of this project was to improve knowledge of EBP among registered nurses (RNs). The ACE Star Model of Knowledge transformation was used as the conceptual model. The key project question was to assess the level of knowledge and confidence about EBP among RNs in a …

Evaluation Of Active And Passive Neonatal Tetanus Surveillance Systems In Katsina State, Nigeria, Shafique Sani Nass

Walden Dissertations and Doctoral Studies

The incidence and mortality rates of neonatal tetanus (NNT) remain underreported in Nigeria. This cross-sectional study was guided by the Mosley and Chen's model for the elements of child survival in developing countries. The goals of the study were twofold: (a) to compare the NNT prevalence and the mortality rates from the existing surveillance system and active surveillance of health facility records in 7 selected health facilities from 2010 to 2014 in Katsina state, Nigeria and (b) to assess the associations between selected NNT risk factors, number of maternal tetanus toxoid injections, frequency of antenatal visits, place of delivery, and …

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

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

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

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 …

Trigger Point Dry Needling For Musculoskeletal Pain And Disability: A Systematic Review Of Comparative Effectiveness Research, Megan D. Jackson, Kylie Rowe, Todd E. Davenport

School of Pharmacy Faculty Articles

Background: Dry needling (DN) has been proposed to reduce pain and improve function related to myofascial trigger points (MTrPs). Several primary studies and systematic reviews have been conducted to examine the effect of DN versus placebo. However the comparative effectiveness of DN and established interventions has yet to be established.

Purpose: The purpose of this systematic review was to determine whether DN was more effective than other established therapies to treat MTrPs.

Data Sources: MEDLINE Complete, EBSCO, CINAHL, Sport Discus and Cochrane library databases were searched.

Study Selection: Randomized controlled trials that used DN directed to MTrPs and used at …

Comparing Energy Expenditures Between A Circuit Weight Training Protocol And A Steady State Aerobic Activity, Breann M. Booher

EWU Masters Thesis Collection

"Circuit weight training (CWT) is currently at the forefront of the fitness industry. During the past 10 years, its popularity has increased due to its ability to combat common deterrents of exercise program adhesion. Many individuals that utilize CWT not only use it to fulfill their weekly exercise requirements, but are looking to maintain or lose weight as well. The purpose of this study was to compare the energy expenditures (EE) in total kcals and average rate of perceived exertion (RPE) values of a 20 min CWT protocol and a 20 min steady state aerobic protocol of equivalent intensity based …