Medicine and Health Sciences Commons^™

The Effectiveness Of Course-Based Health Education Interventions Towards Increased Physical Activity Among College Students, Jay Morris Martin

Walden Dissertations and Doctoral Studies

Despite the many health benefits, physical activity participation among those between 18 to 24 years is in significant decline during the college-age years. Postsecondary education has been identified as an ideal environment where young adults should be targeted for physical activity participation. However, a limited number of studies have assessed the effectiveness of college-level health education and physical education program interventions to increase physical activity levels among college students. The purpose of this study was to examine current physical activity levels of college age students who have completed a college-level health education course and laboratory to gain a better understanding …

Health Disparity In Preventive Care Among Nigerian Immigrants In The United States, Loveday E. Nwobilor

Walden Dissertations and Doctoral Studies

The roles of immigration status in preventive health care services among Nigerian immigrants in the United States were investigated in this quantitative, cross-sectional survey study. About 260,724 Nigerian immigrants reside in the Unites States, but many do not complete lifesaving preventive health services such as immunization and screening, a major factor contributing to the rise in the cost of healthcare resultant from their use of emergency room services. This study investigated the extent to which immigration status independently explains the relationship between health disparities and risks in non-completion of preventive health care among Nigerian immigrants in the United States by …

New Graduate Nurses' Perceptions Of Their Delay To Professional Practice, Ruth Ann Obregon

Walden Dissertations and Doctoral Studies

This project study addressed the problem of knowledge and skills lost by new graduate RNs while delayed in transitioning to professional nursing practice. There is a paucity of knowledge about how new RNs experience their delay and how a delay may affect their future clinical performance. Mezirow's transformation learning theory was the conceptual framework for this qualitative case study. Research questions addressed new RNs' understanding of their experiences during a delay to professional practice. A purposeful sample included 8 new RNs who had completed a New Graduate Residency Transition Program (NGRTP) after a delay to practice of 6 months to …

Retired, Unmarried, Male Baby Boomer Attitudes And Behaviors Toward Disease Prevention, Irene Nyawira Ruminjo

Walden Dissertations and Doctoral Studies

Preventive health care is effective in reducing both infectious diseases and chronic conditions among the elderly. Despite efforts to prevent or decrease the risk of illness, unmarried men are less likely to receive selected preventive services compared to married men. The purpose of this cross-sectional survey was to describe disease prevention attitudes and behaviors of retired, unmarried, male baby boomers residing in Harlingen, Texas. Further, the study examined the effects of socioeconomic status on disease prevention attitudes and behaviors. The health belief theory framed the study. A validated questionnaire collected disease prevention attitudes, behaviors, and sociodemographic characteristics data. Data inquiry …

Lived Experiences Of Pre-Menopausal African American Women With Advanced Breast Cancer, Carmelita Whitfield

Walden Dissertations and Doctoral Studies

This qualitative study examined the phenomenology of advanced breast cancer (ABC) among 7 female participants between the ages of 20 and 45. Oral data were collected to extract participants' interpretations of their spiritual and psychosocial experiences of living with ABC. Findings suggest that these women experienced a dichotomous relationship with regard to their bodies and their relationships with others; this served as a means of making sense of their experiences and as a coping mechanism. Positive psychology and the theory of reasoned action and planned behavior provided the theoretical framework for examining the role of social reinforcements, beliefs, and attitudes …

Discovering Opportunities To Improve Profitability At A Federally Qualified Health Center, Robert Jackson Jackson

Walden Dissertations and Doctoral Studies

Federally Qualified Health Center (FQHC) organizations, which provide health care services to low-income, underserved patients, are underfunded. From 2000 to 2007, the cost of treating an FQHC patient increased by $146, while federal compensation to FQHCs increased by only $44 per patient. One FQHC organization in rural Alabama experienced financial losses from the fiscal year 2011 through 2014, jeopardizing services to approximately 6,000 low-income patients. The purpose of this qualitative case study was to analyze the subject organization and discover opportunities to improve financial performance. The research question pertained to the opportunities for improving profitability at the subject organization. The …

Impact Of Osteoarthritis Self-Efficacy Toolkit On Adults With Osteoarthritis, Connie Hutley Kiser

Walden Dissertations and Doctoral Studies

Over 26 million U.S. citizens have a form of arthritis; osteoarthritis (OA) is the most common form. Self-efficacy (SE) is defined as a psychological construct which identifies an individual's confidence when performing a behavior. SE is deemed a vital judge of self-management (SM) in those with OA. The purpose of this evidence-based practice, quality improvement project was to improve SE in OA patients. The identified gap in nursing practice was the lack of SE in OA patients. The project question asked whether a toolkit with information regarding SE in OA can improve SE of management of disease-associated symptoms in adults …

Advanced Triage Protocols In The Emergency Department, Lijuan Zhao

Walden Dissertations and Doctoral Studies

Overcrowded emergency departments (EDs) are a major problem in the United States resulting in inefficiency in operation and performance. A Southern California hospital ED was the site for this project because it had operated over its maximum capacity during the last decade. Advanced triage protocols integrating standard order sets were implemented to improve quality of care; however, no evaluation of the protocols had been done. The purpose of this project was to evaluate the effect of the advanced triage protocols. Two project questions determined whether advanced triage protocols reduced ED length of stay (LOS), number of patients who left without …

Health Promotion Behavior Among Hypertensive And Normotensive Armenian Americans, Zoya Minasyan

Walden Dissertations and Doctoral Studies

Hypertension presents a significant health risk to both developed and developing countries, affecting approximately 78 million Americans of various ethnic backgrounds. Though a great deal of research about hypertension and minority groups has been published, few studies have examined hypertension in the Armenian American population in the Los Angeles area, one of the most concentrated Armenian American communities in the United States. The purpose of this study was to examine the differences in health promotion behavior between hypertensive and normotensive Armenian Americans. The theoretical basis for this study was Pender's health promotion model and the health promoting lifestyle profile (HPLP-II), …

Perceived Job Stress And Life Style Behaviors' Effects On The Quality Of Life Of Registered Nurses, Jennifer Rose Limongiello

Walden Dissertations and Doctoral Studies

The purpose of this quantitative study was to examine to what extent work demands as measured by perceived job stress affected the health-related quality of life (HRQOL) as determined by the number of unhealthy days of registered nurses in the United States. This study was also an investigation of the extent to which other variables such as body-mass index (BMI) and certain lifestyle behaviors affected the HRQOL (number of unhealthy days). The independent variables were perceived job stress, weight (BMI), and lifestyle factors such as tobacco and alcohol use, physical inactivity, and the mindful eating score, and the dependent variable …

Standardized Communication At The Bedside: A Review For Reimplementation, Eunice Rosas

Walden Dissertations and Doctoral Studies

This paper discusses a developmental, interdisciplinary quality improvement project that seeks to improve healthcare communication by standardizing clinician communication across all levels of care. The purpose of this project was to develop an organizational policy and interdisciplinary practice guidelines to standardize the patient handoff at the bedside. The initiative intended to use processes already in place in the organization and to integrate the knowledge from a literature review to plan the implementation of bedside handoff procedures. The quality improvement project process included assembling an interdisciplinary committee; reviewing relevant peer-reviewed literature; and developing policy, relevant guidelines, as well as long-term plans …

Professionals' Perspective On Mental Health Courts, Martha M. Amos

Walden Dissertations and Doctoral Studies

In recent years, the percentage of incarcerated individuals with mental illness has dramatically increased. It is very hard to provide treatment and care for these defendants in jails or prisons. Currently, there are more mentally ill individuals incarcerated than in psychiatric hospitals. Furthermore, as budget cuts are being decided, urban and rural communities in America are looking at ways to help the mentally ill by initiating a mental health court (MHC) or continuing to fund an already existing MHC. Guided by the therapeutic jurisprudence theory, the purpose of this study was to elicit the opinions from MHC professionals regarding the …

Development Of A Transformational, Relationship-Based Charge Nurse Program, Kimetha D. Broussard

Walden Dissertations and Doctoral Studies

Leaders of a rural Southwest Oklahoma hospital requested the development of an evidence-based program that could transform unit charge nurses into effective leaders in order to improve the leadership of direct care nurses. Nursing executive leadership discovered staff members were demonstrating high levels of stress, dissatisfaction, and burnout. Press-Ganey survey results revealed that staff felt they were not supported and did not believe nurses cared for patients' or other co-workers' well-being or safety. The Hospital Consumer Assessment of Healthcare Providers and Systems outcome scores, which were below hospital and national desired benchmarks, revealed that patients were not satisfied with the …

A Nursing-Driven Pathway To Lung Cancer Screening; A Push For Prevention, Teresa Elizabeth Giamboy

Walden Dissertations and Doctoral Studies

Lung cancer affects many individuals each year and accounts for many deaths around the globe. Lung cancer screening is a preventative health measure that has the ability to detect lung cancer earlier. The purpose of this project was to focus on the education of nursing staff within a community health system, with subsequent implementation of an electronic health record clinical decision support system, to create a direct referral pathway to lung cancer screening, delivered through patient education. The concept of prevention was the framework for this project design, which was further organized around the plan-do-study -act model, while taking into …

Nursing Staff Responsiveness To Patients And Hourly Rounding, Lucretia Wilson Wilson

Walden Dissertations and Doctoral Studies

The Center for Medicare/Medicaid Services reduced the hospital's reimbursement by $500,000 due to patient care linked to the poor outcomes of marginal fall rates and low patient satisfaction survey scores as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). The scores for fiscal years 2013 and 2014 for the medical-surgical unit fluctuated between 40-42.9%, without significant improvement, while the house-wide scores were 63.17%. To address the problem, a quality improvement project (QIP) was implemented. An evidence-based (EB) hourly rounding intervention was initiated following an education program for nursing staff (n=47) tailored to enrich patient communication. The …

Improving Adherence To Hepatitis C Screening: A Pilot Project, Thuy Vu

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Purpose: The purpose of this project was to determine whether implementing a clinical prompt reminder in the electronic medical record (EMR) would improve provider's adherence to Hepatitis C Viral (HCV) screening per the United States Preventive Services Task Force (USPSTF) guideline. Background: Nearly four million Americans are infected with HCV, but the majority are unaware of their status (CDC, 2012). HCV is a chronic progressive disease and is strongly associated with liver cancer and other HCV complications in untreated individuals (El-Serag, 2012). Although HCV can be cured, the lack of HCV screening makes the disease underdiagnosed and undertreated. Methodology: A …

Social Communication And Technology, Lesli G. Hughes

Murray State Theses and Dissertations

Research has been well documented as to the effects of screen time on mental health, physical health, cognitive development, and social development. However, little research exists as to the effects of screen time on the nonverbal aspects of communication, specifically eye gaze. In order to inform speech language pathologists when treating children with language and pragmatic disorders, this study examined the eye gaze of participants during physical play. Twenty-six participants from 5 to 8 years of age were recruited from a western Kentucky school. Results of eye gaze durations in participants were compared to screen time amounts in the home. …

Emotional And Relationship Dynamics Between Hiv Serodiscordance And Concordance Couples: A Narrative Literature Review And Theoretical Framework, Amani Mwakalapuka, Ipyana Mwampagatwa, Theodora Bali, Masumbuko Mwashambwa, Stephen Kibusi, Tumbwene Mwansisya

School of Nursing & Midwifery, East Africa

Tanzania is among the countries with high prevalence of HIV prevalence in the World. Despite the fact that the epidemic has been, and still is a threat to persons of all ages, recent studies have suggested that most new infections occur among couples in stable relationships. Infected couples are categorised into two: the positive concordant, where both the partners are HIV positive; and sero-discordant couples, where one partner is HIV positive while the other is negative. Recently, researchers and many other stake-holders working on the HIV/AIDS epidemic have given a remarkable attention to this astonishing reality. For instance one study …

Care Coordination For Better Outcomes, Chad Dunavan

Walden Dissertations and Doctoral Studies

A deficiency of care coordination and delayed discharge planning has contributed to increased lengths of stay for telemetry patients and has pressed staff to discharge patients expeditiously, potentially leading to increased 30-day readmissions. Rushing the discharge process on the day of discharge has resulted in breakdowns in communication and lack of collaboration amongst the health care team of this study, contributing to extended lengths of stay, increased readmissions, and low Hospital Consumer Assessment of Healthcare Providers and Systems (HCAPHS) scores. This project highlighted a patient-centered care coordination team approach with 2 clinical registered nurses and a social worker who coordinated …

Association Between Physician Characteristics And Surgical Errors In U.S. Hospitals, Obumneke A. Amadi

Walden Dissertations and Doctoral Studies

The high incidence of medical and surgical errors in U.S. hospitals and clinics affects patients' safety. Not enough is known about the relationship between physician characteristics and medical error rates. The purpose of this quantitative correlational study was to examine the relationship between selected physician characteristics and surgical errors in U.S. hospitals. The ecological model was used to understand personal and systemic factors that might be related to the incidence of surgical errors. Archived data from the National Practitioner Data Bank database of physician surgical errors were analyzed using bivariate and multivariate logistic regression analyses. Independent variables included physicians' home …

Using Music Intervention To Reduce Anxiety And Agitation For Dementia Residents In Long Term Setting, Sonia Brown

Walden Dissertations and Doctoral Studies

Abstract

Dementia is one of the degenerative conditions that present in old age with a decline in cognitive function resulting in changes in personality and the ability to carry out activities of daily living and social functions. Dementia is usually associated with behavioral disturbances that include anxiety and agitation that pose a challenge for family members or caregivers in an alternate home or care-related facility. The purpose of this project was to design and implement a quality improvement program to evaluate music therapy intervention for residents in a long-term care who have dementia. The aim was to evaluate if music …

Introducing The Health Coach Method Of Motivational Interviewing To Medical Assistants To Improve The Patient Care Approach, Allison Marlene Souza

Walden Dissertations and Doctoral Studies

The emerging health care culture of accountability for patient outcomes compounds problems for already overwhelmed clinicians struggling to fit everything entailed in complicated office visits into 15-minute appointments. Unprocessed frustrations tempt clinicians to use ineffective and outdated methods for trying to get their patients to comply or adhere to their care plans, undermining effective health care management. The intention of this project was to evaluate whether educating medical assistants in the health coaching method of motivational interviewing can improve the patient care approach while simultaneously assisting clinicians struggling with insufficient time. Several individual scheduling conflicts limited the target population into …

Spiritual Leadership: Achieving Positive Health Outcomes In African-American Christian Churches, Cynthia Bracey

Walden Dissertations and Doctoral Studies

In the United States, African-American residents are an underserved population with evidence of higher health disparities than those associated with any other race, contributing to escalating health care costs. Despite the absence of health promotion and wellness training, pastors in predominately Black churches accept the responsibility for addressing more than the spiritual needs of their church members. The purpose of this qualitative grounded theory research study was to explore the perspectives of African-American Christian pastors on giving health guidance and their lived experiences as health promotion advocates. A total of 10 African-American Christian pastors were voluntarily recruited from 3 southern …

The Effects Of Hurricane And Tornado Disasters On Pregnancy Outcomes, Kenneth E. Christopher

Walden Dissertations and Doctoral Studies

Maternal prenatal exposure to hurricanes and tornadoes could contribute to an increased risk for adverse birth outcomes. Little is known about the effects of Hurricane Katrina of August 2005, on pregnancy outcomes in Mississippi. Additionally, little is known about the influence of the April 2011 Alabama tornado disaster on births in that state. The purpose of this study was to bridge this knowledge gap by examining the relationship between maternal prenatal exposure to these storms and adverse infant health outcomes. The theoretical framework guiding this retrospective, cross-sectional study was the life course approach. Data for this investigation included 2,000 records …

A Minority Perspective On The Public Health Response To The Obesity Epidemic, Rickey L. Ford

Walden Dissertations and Doctoral Studies

Obesity is currently viewed as one of the most important health concerns in the United States. Researchers have minimally investigated perspectives surrounding obesity within the African-American female population. This lack of research presented a gap in knowledge concerning the perceived social, environmental, and cultural influences of obesity within this population. The research questions asked African-American females about their views toward these influences. This research was guided by tenets of the social cognitive theory and the transtheoretical model for behavioral change. Thirteen African-American females participated in the interviews. The data collected were reviewed and coded using word frequencies and themes. Findings …

Association Between Age-Related Macular Degeneration And Sleep-Disordered Breathing, Jeffrey A. Nau

Walden Dissertations and Doctoral Studies

Age-related macular degeneration (AMD) is a chronic, irreversible disease that robs individuals of vision, quality of life, and independence. It is the leading cause of blindness in industrialized countries. Sleep-disordered breathing (SDB) is a condition characterized by repeated episodes of apnea and/or hypopnea, insomnia, short sleep duration, and/or sleep disturbances (snoring, gasping, etc.). Because SDB has been shown to cause chronic hypoxia resulting in oxidative stress on the retina, it has been proposed that SDB may be associated with AMD. Based on the life course theory of chronic disease, this quantitative, cross-sectional study used data from the 2005-2008 National Health …

Exploring The Role Of Faith In Survival Of Breast Cancer, Franklin D. Lewis, Jr.

Walden Dissertations and Doctoral Studies

In 2013, approximately 232,340 women were diagnosed with breast cancer, and an estimated 39,620 women would die as a result of breast cancer. Stage I breast cancer can often be treated, but Stage IV breast cancer presents more difficulties in treatment, as it spreads to the bones, liver, or other areas of the body. Consequently, women with Stage IV breast cancer have very low 18 month and 5-year survival rates. According to some statistics, 79.5% of the United States population claim to be Christian. Much of this segment of the population uses faith to guide most aspects of their lives, …

Implementation Of An Early Progressive Mobility Program In The Intensive Care Units, Rene Merced Rodriguez

Walden Dissertations and Doctoral Studies

In the United States, adult ICU patient care consumes $90 billion annually, or 1% of the gross national product. In the ICU, about 40% of the patients are mechanically ventilated resulting in an 11% greater length of stay (LOS) that requires 35% more resources. And, an estimated 60% of these patients are adversely impacted for as long as five years following discharge. Patient immobility while ventilated contributes to poor quality and financial outcomes. The Institute of Healthcare Improvement (IHI) reports on average early patient mobility (EPM) reduces a 4.5-day LOS by as much as 1.3 days; and reduces the risk …

Identifying Stressors Experienced By Single Fathers Who Are Parenting In New York City, Stacey Theresa Melhado

Walden Dissertations and Doctoral Studies

Fathers face difficulties when taking on the single parent role, including having to prove their ability to care for their children alone. Existing research does not address issues concerning single fathers and the stressors they experience in raising their children. This study addresses these issues and helps researchers understand single fathers by using a qualitative approach to understand their perception of parenting. Fourteen participants from New York City participated in semi-structured interviews to elicit information about this phenomenon. This study focused on experiences the men have while being a single parent, the impact of living in New York City on …

Perceptions Of Childhood Obesity Among African Americans In A Low-Income Community, Cotella Wilkes Wilkes

Walden Dissertations and Doctoral Studies

Childhood obesity is a prevalent chronic condition affecting millions of children and adolescents in the United States and is rising in record-breaking numbers among African Americans in low-income communities. Guided by the social cognitive theory, the purpose of this evidence-based project was to understand the impact of an educational intervention on parents' perceptions of childhood obesity risk factors, weight status, and prevention strategies in a rural South Carolina community. A convenience sample of parents who attended a church-based community health promotion service in a low-income area (n = 10), aged 28 to 54, completed The Childhood Obesity Perceptions survey before …