Medicine and Health Sciences Commons^™

Providing Optimal Nutrition In Critical Care, Jo Anne Foley

Walden Dissertations and Doctoral Studies

Malnutrition among hospitalized patients is prevalent and associated with adverse outcomes. At the health care facility for which this quality improvement (QI) initiative was developed, patients were not consistently fed within the nationally recommended 48 hours. The purpose of this project was to facilitate the early initiation of enteral feedings to prevent malnutrition in a vulnerable patient group by development of an evidence-based enteral feeding policy, algorithm, and nursing education module. The find, organize, clarify, understand, select, plan, do, check, and act model provided a systematic approach for development of the project. Validation of the QI initiative was through the …

Effect Of Healthy Food Demonstration On Minority Women's Dietary Habits In San Antonio, Texas, Staria Hudson Black

Walden Dissertations and Doctoral Studies

Obesity has become a global epidemic. Healthcare cost continues to increase due to co-morbidities such as diabetes, hypertension, and coronary artery disease associated with obesity. The purpose of this project was to examine whether teaching nutritious food choices to obese African American and Hispanic females in healthy cooking demonstrations would have an effect on their dietary behavior. The holistic self-care model was used to develop healthy strategies for weight loss. The model guided the development of nutritional support, exercise, and spiritual strategies for weight reduction. African American and Hispanic females between the ages of 25 to 64 were solicited from …

Prevalence And Predictors Of Complementary And Alternative Medicine Use Among Lebanese College Students, Lama Jizi

Walden Dissertations and Doctoral Studies

In Lebanon, estimates of Complementary and Alternative Medicine (CAM) use among college students are not available. CAM practices are not well regulated and some products contain unsafe substances. The purpose of this study was to estimate the prevalence and predictors of CAM use among Lebanese college students using the health belief model. A quantitative cross sectional research design was used. An online survey was administered to 126 Lebanese college students with the aim of determining the most important predictors of CAM use. A majority (89%) of surveyed students reported the use of CAM in the last 12 months. Based on …

Nurses' Occupational Trauma Exposure, Resilience, And Coping Education, Sherry Lynn Jones

Walden Dissertations and Doctoral Studies

Nursing education courses and professional development (PD) do not include coping and resilience training for registered nurses (RNs) who work in emergency departments (EDs). Exposure to traumatic events, death, and dying may lead to health issues, substance abuse, stress symptoms, nursing staff turnover, and compassion fatigue among ED RNs. Without training, the pattern of adverse outcomes may continue. The purpose of this study was to explore ED RNs' experiences with occupational traumatic stress (OTS), and their recommendations for change to nursing PD programs, using a qualitative bounded intrinsic case study. The conceptual framework for this study included social learning and …

Hiv-Positive Status Disclosure Barriers In Stable Heterosexual Partners In Warri, Nigeria., Edith Nkechinyere Ogbozor

Walden Dissertations and Doctoral Studies

Nondisclosure of positive status drives the secondary transmission of human immunodeficiency virus (HIV) infection. This cross sectional quantitative survey study grounded by the consequence theory evaluates fear of stigma, lack of social support, and level of HIV-related knowledge as barriers to self-disclosure of HIV-positive status to stable heterosexual partners. A sample of 303 HIV-infected respondents (111 men and 192 women) accessing antiretroviral therapy at 4 designated centers in Warri, Nigeria, completed the self-administered questionnaires. Logistic regression analysis was used to assess the association between these factors and spousal HIV-positive status disclosure. Results demonstrated: (a) social support availability significantly predicted HIV …

Experiences Of Colorado Parents As They Recognized Their Child's Mental Illness, Lori Salgado

Walden Dissertations and Doctoral Studies

Mental illness is not only the leading cause of disability among adults, but there is also an emerging public health crisis in childhood mental illness. A majority of parents do not recognize symptoms of psychological disorder in their children, and current policies and programs for mental health service delivery are not sufficiently responsive to the early help-seeking dynamics of families. Using a concurrent mixed methods design, this study explored how parents in the Pikes Peak region of Colorado learned to recognize their child's mental illness. Phenomenological interviews, augmented by poetic inquiry and quantitative measurements, were used to discover factors that …

Utilization And Intensity Of Integrated Behavioral Health Services Within A Primary Care Setting, Joseph Aron Shafer

Walden Dissertations and Doctoral Studies

Integrated behavioral health care within primary care has become a popular style of health care delivery within the United States. However, individuals with a behavioral health concern face several barriers in using these services. The purpose of this quantitative study was to identify key factors accounting for individuals' utilization and intensity of behavioral health services. Andersen's behavioral model of health care use and the integrated theory of health behavior change served as the theoretical framework. It was hypothesized that gender, age, race, ethnicity, family size, payer type, poverty level, and certain preexisting medical conditions (obesity, diabetes, hypertension, and tobacco use) …

Improving Pain Management For Hospitalized Patients, Ronda Sweet

Walden Dissertations and Doctoral Studies

Uncontrolled pain has proven effects on both physiological and psychological responses of hospitalized patients. These incapacitating sequelae most often negatively impact patient outcomes resulting in unnecessary suffering and prolong hospitalizations. First line nurses often have preconceived notions about a patient's pain without developing an individualized patient context that considers appropriate pain management knowledge translated from best practice standards. Guided by Bandura's social learning theory and Lippitt's change theory, the purpose of this quality improvement project was to determine if use of the Curriculum Outline on Pain for Nursing from the International Association for the Study of Pain (IASP) improved nursing …

Assessing Nurse Manager Competencies In A Military Hospital, Ruby O. Anderson

Walden Dissertations and Doctoral Studies

Military health care organizations need competent frontline managers with knowledge and skills to manage health care complexity and ensure evidence-based practice. With systematic, planned turn over of military managers, more civilian managers are needed to fill permanent positions in military hospitals. The purpose of this project was to provide a better understanding of the competencies perceived by nurse managers at a military medical center and whether they differed by military or civilian status. The American Organization of Nurse Executives competency model and framework provided the theoretical framework for the project. The design was nonexperimental, with an observational, descriptive, cross-sectional approach. …

The Indian Pharmaceutical Industry's Supply Chain Management Strategies, Prasad Bolineni

Walden Dissertations and Doctoral Studies

Indian pharmaceutical companies spend one-third of their revenue from supply chain management (SCM) activities due to inherently poor transportation infrastructure. SCM is a vital function for many companies, as it is usually employed to lower expenses and increase sales for the company. SCM costs are higher in India than they are in other areas of the world, amounting to 13% of India's GDP. The purpose of this study was to explore SCM strategies Indian business leaders in the pharmaceutical industry have used to reduce the high costs associated with SCM. This study used a single case study research design and …

Influence Of Overweight, Obesity, Social Support, And Self-Efficacy On Breastfeeding Outcomes Among African-American Women, Elizabeth Hoo

Walden Dissertations and Doctoral Studies

Breastfeeding reduces morbidity and mortality among mothers and children, yet African-American women breastfeed at lower rates than women of other racial and ethnic groups do. Higher rates of overweight, obesity, and low socioeconomic status may be contributing factors in this population; however, limited research exists regarding the roles of maternal overweight and obesity on breastfeeding outcomes. The purpose of this study was to examine whether social support and self-efficacy positively influence breastfeeding outcomes among overweight and obese African American women. Self-efficacy and social support theories provided the theoretical framework for the study. Research questions examined whether (a) maternal overweight and …

Hiv Knowledge, Intoxication, Risky Behaviors, And Sexual Communication Among Nigeria University Students, Johnpaul Chukwuemeka Ezeonyido

Walden Dissertations and Doctoral Studies

Poor sexual communication among Nigerian youth can create problems for health workers, medical practitioners, and the government in determining what is and is not working in their attempts to reduce sexually-related diseases. This quantitative study used self-administered questionnaires among 107 Nigerian university students, aged 18 to 35, to determine if a statistically significant predictive relationship existed between: (a) beliefs about alcohol, (b) HIV knowledge, (c) risk behaviors, (d) age, (e) religion, (f) gender, (g) sexual activity status, (h) dating status, (i) language, (j) sexual orientation, and (k) tribes of Nigerian university students and their sexual communication with partners. Previous studies …

Case Study Of Learning And Instruction For Members Of An Online Reflex Sympathetic Dystrophy Support Group, Heather Rae Gilmore

Walden Dissertations and Doctoral Studies

Research has shown that individual members of traditional support groups gain a sense of identity and community and feelings of respect and support. Online support groups provide individuals avenues to find medical information and thus learn more about a given condition or illness. Little has been studied about the learning and instruction that occurs in online social support groups, especially in groups about chronic pain. The purpose of this qualitative case study was to explore the perceptions and experiences of members who participated in one open social support group. Siemen's constructivism theory served as the basis for comprehending the learning …

Implementation And Evaluation Of Dietary Modification With Gestational Diabetes, Celia T. Ojeaga

Walden Dissertations and Doctoral Studies

Gestational diabetes mellitus (GDM) negatively affects the health of both mothers and babies, and is the most common pregnancy complication in the United States. Many dietary modification programs for pregnant women diagnosed with GDM rely on a one-size-fits-all approach to menu planning. The purpose of this project was to develop a diet modification program for GDM management using a patient-centered approach. The project objective was to develop the policies, procedures, and supporting documents needed to implement a successful GDM management program for pregnant women receiving antenatal care at an obstetrical clinic. The developed program incorporated strategies for clinic nursing staff …

A Plan For The Implementation And Evaluation Of Diet Education In Type 2 Diabetes, Soy Ramsumeer

Walden Dissertations and Doctoral Studies

Abstract

Type 2 Diabetes Mellitus (T2DM) is the seventh leading cause of death in the United States with a projected increase of 552 million people worldwide who will be affected with this illness by 2030. The need to address this issue is vital to prevent complications and reduce healthcare spending. The DNP project is aimed at planning and designing a nutritional education program tailored toward specific ethnic groups in order to increase knowledge in making healthy food choices. This project is intended to educate Registered Nurses (RNs) on nutrition so that they can offer dietary knowledge to T2DM patients. Additional …

Improving Patient Care Delivery In A Small Alaska Native Health Care Organization, Annette Cecile Siemens

Walden Dissertations and Doctoral Studies

Chronic diseases impose heavy burdens on the United States health care system, particularly among some ethnic/racial groups such as American Indian and Alaska Natives who experience higher incidence of these diseases than non-Native population. In an effort to improve the health status of its patients, the Ukudigaunal Wellness Center (UWC) partnered with the Improving Patient Care (IPC) Collaborative to implement changes designed to improve chronic disease care for Native Alaskans through intensive monitoring of screening for chronic disease and selected chronic disease outcomes. For this program evaluation, the units of analysis were the changes in health service delivery and the …

The Impact Of Post Traumatic Stress Disorder On Recurrent Violent Behavior Among African American Males, Adrian Cox

Walden Dissertations and Doctoral Studies

African American men in their late teens to early 20s account for nearly half the victims of violent crimes. This mixed methods social epidemiological study was designed to identify the social determinants of violence as described by a purposive sample of young adult African American men (n=353) who have experience as a victim or witness to any type of violence to determine the impact post traumatic stress disorder (PTSD) symptoms have on recurrent violent injury. The pathways to recurrence model shaped the theoretical framework of this study. Quantitative data were collected using the Past Feelings and Acts of Violence (PFAV) …

Adherence To Self-Care Management Of Sickle Cell Disease Among Caregivers, Muinah Adenike Fowora

Walden Dissertations and Doctoral Studies

The self-care management of sickle cell disease (SCD) improves mortality rate; however, compliance with SCD self-care management remains a problem. The purpose of this study was to examine the knowledge and factors that influence compliance with SCD self-care management recommendations among caregivers of children with SCD. The health belief model was used as the theoretical foundation of this study, theorizing that caregivers' perceived susceptibility, severity, and benefits of SCD self-care management will influence compliance. The study used a quantitative research design. A cross-sectional survey was administered to 100 caregivers of children with SCD attending sickle cell clinics in Lagos, Nigeria …

Association Between Diabetes/Chronic Disease Incidence And Lifestyle Factors Among African-Born Populations, James Walakerwon Gbala

Walden Dissertations and Doctoral Studies

Numerous studies have revealed that immigrants' health and well-being is challenged by an increased susceptibility to diabetes/chronic disease as they settle in the United States. This study investigated a potential association between the incidence of diabetes/chronic disease and various lifestyles factors among Sub-Saharan African immigrants and refugees. The lifestyle factors studied were sociodemographics, food practices and dietary habits, access to healthcare and insurance, acculturation, and the length of stay in the United States among these immigrants and refugees residing in Minnesota. The health belief and the socioecological models guided this study to improve understanding of Sub-Saharan African's health behavior and …

Relationship Between Stress And Young Adults' Complementary And Alternative Medicine Use, Anupama Kizhakkeveettil

Walden Dissertations and Doctoral Studies

Complementary and alternative medicine (CAM) refers to a group of diverse medical and healthcare systems, practices, and products not treated as conventional medicine. The body of literature on stress and stress management among young adults has not addressed the use of CAM modalities for stress management among this population. The theoretical foundation of the study was based upon the transactional model of stress and coping, which describes stress as an interaction between an external stressor and the resources available to eliminate the stressor. The purpose of this quantitative study was to examine whether variables such as exposure to CAM, stress …

Identifying The Beliefs And Barriers To Mammography In Rural African Women, Linda Harper Mangum

Walden Dissertations and Doctoral Studies

Breast cancer is the most commonly diagnosed cancer in African-American (AA) women and is the second leading cause of cancer-related deaths in the United States among AA women ages 40 to 55 years of age. The 5-year breast cancer survival rates for AA women (78%) are lower than are those of Caucasian women (90%). The purpose of this project was to describe the benefits and barriers toward screening mammograms for breast cancer in AA women living in the Southside Health District in Virginia. The subscales of The Champion's Mammography Beliefs and Attitudes Questionnaire (MBAQ, 1999), which is based on the …

The Association Between Osteoporosis And Early Menopause Following Hysterectomy, Mia Meeyaong-Won Botkin

Walden Dissertations and Doctoral Studies

Osteoporosis is considered to be the most adverse public health disease associated with substantial mortality among postmenopausal women. Hysterectomy, surgically induced menopause, contributes to the early onset of menopause. However, there was no evidence of an association between early menopause following hysterectomy and osteoporosis among postmenopausal women. The purpose of this quantitative study was to examine the association between demographic and behavioral factors and the prevalence of osteoporosis among hysterectomized postmenopausal women. The integrated theory of health behavior change theoretical framework guided study. Cross-sectional secondary data from the 2009-2010 National Health and Nutrition Examination Survey were used. Multiple logistic regression …

Lived Experiences Of Women From The Odi Community In Nigeria Of Female Genital Mutilation, Doris Atibinye Dotimi

Walden Dissertations and Doctoral Studies

Female genital mutilation (FGM) is a public health challenge because it jeopardizes the health of women and girls. FGM is condemned worldwide but, it is still practiced in the Odi community of Nigeria. The literature on women's lived experiences of FGM in other parts of the world was reviewed, but knowledge is lacking on the lived experiences of women from Odi community in Nigeria. The purpose of this phenomenological study was to explore their lived experiences, their perspectives on the current legislation for the prevention of FGM, and their perspectives on the cultural myths surrounding the practice. The phenomenological lens …

Caregivers' Perceptions Of An Early Diagnosis Of Alzheimer's Disease In African Americans, Stanita Jackson

Walden Dissertations and Doctoral Studies

Alzheimer's disease (AD) is significantly more prevalent among African Americans than within the general population, but rates of early detection are lower in the African American community. Researchers have demonstrated that both pessimistic Alzheimer's-directed health beliefs, and negative perceptions of the effectiveness and the accessibility of medical care act as barriers to care seeking by African American family members of individuals with the disease. Recent research into causal judgments made by potential caregivers about individuals with undiagnosed AD suggests that gender bias and errors in attribution may constitute covert barriers to both lay and professional interpretations regarding the need for …

Maternal And Child Health Access Disparities Among Recent African Immigrants In The United States, Bakali Mukasa

Walden Dissertations and Doctoral Studies

Health care disparities are U.S. national public health concerns that disproportionately affect minority populations. The focus of published studies on the health of larger immigrant populations from Europe, Asia, South America, and the Caribbean has revealed a knowledge gap on the health of African and other minority immigrants. The purpose of this phenomenological study was to explore disparities in access to maternal and child health (MCH) care as well as the causes and effects of such disparities to care-seeking experiences of recent African immigrants. Andersen's behavioral model of health services use provided the theoretical lenses to interpret study findings. Eleven …

Nurses' Knowledge Of Pain Assessments And Reassessments Impacts Hospitalized Patients' Reporting Of Pain, M. Michele Potter Williams Williams

Walden Dissertations and Doctoral Studies

Ineffective pain management can prolong a patient's length of stay and increase cost of care. Inadequate pain control decreases the patient's quality of life and contributes to poor health outcomes. A recent record audit showed that documentation of pain reassessments occurred only 20% of the time within an hour after administering pain medication. Furthermore, nurses may have insufficient knowledge regarding pain assessments and reassessments or hold irrational fears about addiction leading to inadequate treatment of pain. The purpose of this quality improvement project was to evaluate the effectiveness of an educational program for acute care nurses for the assessment and …

Perceptions And Behaviors Of Caribbean And South American Women Of Color Living In The United States Towards Breast Cancer, Bernadette Serena Loncke

Walden Dissertations and Doctoral Studies

Breast cancer is a global public health issue, and even though the incidence and mortality rates for this disease have declined, a substantial gap in mortality rates between U.S. women of color and European American women remains. Strategies have been initiated to decrease this gap, but they have not addressed the special needs of women of color residing in the United States, who tend to be diagnosed only after they have developed late-stage breast cancer. The purpose of this phenomenological study was to understand the perceptions and behaviors of 20 first-generation Caribbean and South American-born women of color living in …

The Associated Risk Factors That Lead To The Onset Of Sarcoidosis In Black American Women, Tiffany Mcintyre Simmons

Walden Dissertations and Doctoral Studies

Sarcoidosis is a disease characterized as noncaseation granulomas. Granulomas are clusters of cells that form a discrete nodule. This research was important because Black American women develop saroidosis at a higher rate than any other race. The purpose of this phenomenological qualitative study was to examine the impact of sarcoidosis in the lives of Black American women diagnosed with the disease and to consider how occupational experiences may have contributed to participants' development of sarcoidosis. Research states that domestic work such as cleaning, when performed on a daily basis or as an occupation, can contribute to adverse health effects. The …

In Vivo-Expressed Proteins Of Virulent Leptospira Interrogans Serovar Autumnalis N2 Elicit Strong Igm Responses Of Value In Conclusive Diagnosis, Veerapandian Raja, Santhanam Shanmughapriya, Murugesan Kanagavel, Sergey Artiushin, Sridhar Velineni, John F. Timoney, Kalimuthusamy Natarajaseenivasan

Maxwell H. Gluck Equine Research Center Faculty Publications

Leptospirosis is a serious zoonosis that is underdiagnosed because of limited access to laboratory facilities in Southeast Asia, Central and South America, and Oceania. Timely diagnosis of locally distributed serovars of high virulence is crucial for successful care and outbreak management. Using pooled patient sera, an expression gene library of a virulent Leptospira interrogans serovar Autumnalis strain N2 isolated in South India was screened. The identified genes were characterized, and the purified recombinant proteins were used as antigens in IgM enzyme-linked immunosorbent assay (ELISA) either singly or in combination. Sera (n = 118) from cases of acute leptospirosis along …

Reflections On Leadership In Nursing Education: A Minority Perspective, Angela Banks, Chenit Ong-Flaherty, Claire Sharifi

Nursing and Health Professions Faculty Research and Publications

Academic leadership is at once engaging and stimulating, demanding and overwhelming. This article discusses the experiences and perspectives of minority faculty members working at a Jesuit institution. In this article, the authors use Ignatian pedagogical values as the foundation to guide their responses to the challenges they experience in leadership roles and to turn these challenges into opportunities for growth.