Medicine and Health Sciences Commons^™

Sickle Cell Disease Pain Burden And Quality Of Life Among Black Children In Mississippi, Laquita Nichelle Cooper

Walden Dissertations and Doctoral Studies

Acute and chronic pain is a common hallmark of sickle cell disease (SCD) in children and adolescents, which can have a profound effect on their quality of life (QOL). However, this relationship is not well quantified. The purpose of this quantitative study was to examine the relationship between SCD pain burden and QOL among Black children ages 8-17 in Mississippi with SCD. The secondary aim was to compare children and caregiver reports of SCD pain burden and QOL with SCD. The social ecological model was used to identify personal factors that influence SCD pain burden and QOL of children with …

The Evaluation Of The Relationship Between Racial Health Disparities And The Patient-Provider Relationship, Andrea Nicole Curry

Walden Dissertations and Doctoral Studies

African Americans are adversely affected by health disparities due to the complexities of the patient-provider relationship. The behavioral model of health services was used as the theoretical framework to understand how individuals make healthcare utilization decisions. The purpose of the research was to evaluate how the patient-provider relationship influences inconsistent doctor visits by African American patients despite the prevalence of chronic conditions. 45 African Americans located in Shelby County, Tennessee were included in this study. A cross-sectional quantitative design was used to collect the data via an online survey. The 45 collected responses were analyzed by performing multiple linear regression, …

Effectiveness Of Pressure Ulcer Protocols With The Braden Scale For Elderly Patients In The Intensive Care Unit: A Systematic Review, Natalie A. Floyd

Walden Dissertations and Doctoral Studies

Each year, approximately 3 million people in the United States develop a pressure ulcer. Although a preventable complication, pressure ulcers are among the top 5 adverse outcomes in the acute care setting with the prevalence as high as 42% in the intensive care unit (ICU). The purpose of this systematic review was to evaluate the inclusion of the Braden Scale as part of a multicomponent pressure ulcer intervention protocol, or care bundle, to identify geriatric patients hospitalized in the ICU who were at risk for pressure ulcers. The Cochrane protocol guided this review; findings were reported according to the Preferred …

Smoking Cessation Education For Acute Care Nurses, Dawn Garcia-Brinker

Walden Dissertations and Doctoral Studies

Tobacco use among veterans is significantly higher than among members of the general population. The purpose of this quality-improvement project was to increase acute care staff members' knowledge and confidence in using tobacco cessation interventions to increase quit rates among the inpatients of a veterans' hospital in the midwestern region of the United States. An evidence-based, standardized Tobacco Tactics Toolkit was developed and implemented, and a 6 sigma method guided the quality improvement process to define, measure, analyze, improve, and control the tobacco-cessation education initiative. The reach, effectiveness, adoption, implementation, and maintenance framework was used to ensure that evidence-based interventions …

Using Social Cognitive Theory To Predict Counseling Behaviors In Registered Dietitians, Marianela Guerrero

Walden Dissertations and Doctoral Studies

Obesity and morbid obesity affect more than 30% of Americans, which emulates the rate of smoking as the leading preventable cause of disease and death in the United States. The prevalence of obesity among adults in the United States increased dramatically between 1980 and 2010 (16% to 36%). The integration of the social cognitive theory (SCT) constructs such as self-efficacy, self-control, environment and expectations in the study instrument allowed identifying the impact of personal, social and economic factors on Registered Dietitians (RDs) counseling behaviors with obese clients. The goal of this quantitative cross sectional study was to investigate the association …

Strategies For Increasing Volunteer Engagement In Nonprofit Healthcare Organizations, Sanja Katina Hudson

Walden Dissertations and Doctoral Studies

Implementing effective strategies to address the challenges of volunteer engagement is critical for helping ensure the sustainability of nonprofit healthcare organizations. Nonprofit healthcare leaders seek strategies to increase the volunteer workforce and enhance volunteer engagement. Through the conceptual lens of Deci and Ryan's self-determination theory, the strategies nonprofit healthcare leaders used to reduce volunteer turnover were explored in this single-case study. Data were collected using semistructured interviews with 5 nonprofit healthcare leaders from a single organization in the southwestern United States. Analysis of internal and external organizational documents and publicly available data were manually coded and thematically organized. The use …

Educating Psychiatric Nurses To Improve Medication Adherence Among Schizophrenic Patients, Chandrika Mcqueen

Walden Dissertations and Doctoral Studies

The purpose of this project was to implement an educational program that provided psychiatric nurses with the knowledge and skills to engage patients with a diagnosis of schizophrenia in self-care management regarding medication and treatment adherence. The theory employed in the project was the educational theory. Evidence of effectiveness came from a pre- and postintervention assessment of nurses' knowledge and confidence in teaching about medication, along with a pre- and postassessment of knowledge gained as a result of the educational intervention. Pre- and posteducational rates of patient rehospitalization for medication nonadherence were compared. The results indicated a 15% rate of …

Young Women's Perceptions Of Factors Influencing Eating Disorders, Francisca Masawi

Walden Dissertations and Doctoral Studies

Eating disorders (EDs) cause irreversible physical damage, including organ failure and death. Although EDs receive considerable attention, the number of affected young women who seek help remains low. The purpose of this phenomenological study was to understand the sociocultural and socioenvironmental factors influencing ED development from the perspective of young women, and to explore why the rate of EDs continues to rise in this population. The sociocultural model served as a guide for the study. Ten young women 18-24 years old from Southwest Ohio participated in in-depth, semi structured, face-to-face interviews. Data coding and analysis revealed recurring themes, with findings …

Impact Of End-Of-Life Education On Nurses' Moral Distress, Jenniffer Lynn Mullen

Walden Dissertations and Doctoral Studies

Moral distress is a state of concern or anxiety that occurs when there is a correct action to take but an individual's ability to take that action is constrained in some way. Nurses, especially those who work in intensive care units (ICUs), may struggle with moral distress due to feelings of futility when caring for end-of-life patients. The purpose of this 1-group pretest-posttest quasi-experimental study, guided by Lazarus's theory of stress, coping, and adaptation, was to determine whether End-of-Life Nursing Education Consortium (ELNEC) education reduces moral distress in ICU nurses caring for end-of-life patients. A revised Moral Distress Survey (MDS-R …

Chaplaincy Inclusion In Hospital Interdisciplinary Teams And Its Impact On Chaplains' Well-Being, Chike Nzegwu

Walden Dissertations and Doctoral Studies

Healthcare providers may impede the delivery of spiritual and emotional support to

patients and their families by healthcare professional chaplains if they misunderstand how to effectively use chaplains, who often prefer to be engaged sooner than they are. This issue prevents highly trained, board-certified professional chaplains from providing services, thereby impacting the quality of patient care. The purpose of this phenomenological study was to examine, through the lived experiences of professional chaplains, the extent to which chaplains feel that others perceive them as valued members of an interdisciplinary team (IDT), as well as to determine how team inclusion may impact …

Education Protocol For Type Ii Diabetes Mellitus, Raegan Elizabeth Quandt

Walden Dissertations and Doctoral Studies

Diabetes mellitus is one of the leading causes of death in the United States, contributing to rising health care costs and increased morbidity and mortality rates. Researchers demonstrated that aggressive heath measures involving ongoing diabetes self-management education are paramount in minimizing associated complications of diabetes. The management and prevention of diabetes is not standardized and providers within a health clinic in Illinois reported challenges in providing self-management education during scheduled patient appointments due to limited resources and time. The purpose of this DNP project was to develop a clinical practice guideline to be used by all providers within the health …

Counselors' Knowledge And Attitudes Of The Recovery Paradigm, Kathleen Ruscitto

Walden Dissertations and Doctoral Studies

As of 2014, an estimated 18.1% or approximately 43.6 million adults, 18 years of age or older in the United States experienced a form of mental illness. Professional counselors subscribe to a wellness or holistic paradigm; however the recovery paradigm, using collaborative strategies and unique treatment planning is the directed approach of mental health services in the United Stated. The purpose of this quantitative study was to understand what factors contribute to counselors' knowledge and attitudes of the recovery paradigm. Survey methodology was used to examine whether, among professional counselors, years of experience, gender, professional setting, and licensure status, as …

Dementia-Spcific Education In An Assisted Living Facility, Sharon Dianne Samarin

Walden Dissertations and Doctoral Studies

Providing competent, high-quality, and person-centered care is important in the healthcare environment, including the care for the aging and training of those who provide care. A knowledge gap in dementia-specific training was identified at an assisted living facility. The purpose of this project was to answer the question whether a dementia-specific educational staff training program would improve staff members' knowledge and application of dementia-specific competencies as well as caring behaviors. Watson's theory of human caring, the theory of planned behavior, and Leininger's framework of culture care were used to inform this project. The educational project evaluated the success of implementing …

Educational Outcomes Of Online Registered Nursing To Bachelor Of Science In Nursing Students, Shuba Samuel

Walden Dissertations and Doctoral Studies

The projected nurse workforce shortage and the need for nurses with bachelor's degree has increased the number of accelerated and online programs in nursing education. The evolving healthcare system demands registered nurses (RNs) to demonstrate critical thinking skills and evidence-based practice in varied healthcare settings. The purpose of this quantitative study was to analyze if academic variables, such as preadmission grade point average (GPA), predicted evidence-based skills and research utilization skills among students enrolled in the online RN to Bachelor of Science in nursing program. The theoretical foundations of this study was comprised of Knowles's adult learning theory, Benner's stages …

Nursing Students Experiences Of Career And Technical Education Health Science Programs, Precious Simmons

Walden Dissertations and Doctoral Studies

The state of education in the United States faces many challenges in preparing students for the workforce and postsecondary education. These challenges are heightened at the postsecondary level for schools of nursing. The current shortage of nurses will continue to rise if recruitment and retention strategies are not employed. The purpose of this qualitative hermeneutic phenomenological study was to understand and explore the experiences of former health science program students enrolled in nursing school. Research questions focused on the experience of career and technical education (CTE), motives and perceived benefits of CTE, nursing experience, career choice, and academic interests. The …

Reducing Home Health Copd-Related 30-Day Hospital Readmissions Using Telehealth Technology, Steven Eric Stammer

Walden Dissertations and Doctoral Studies

Chronic obstructive pulmonary disease (COPD) is a collection of chronic conditions that results in irreparable lung damage and stress to patients. COPD also has considerable financial impacts on health care entities due to frequent hospital readmissions of COPD patients. The Centers for Medicare and Medicaid Services penalize care entities for 30-day hospital readmissions. Many rehospitalizations attributed to COPD are due to exacerbations, often preceded by physiologic and emotional changes that can be monitored, allowing action to be taken to prevent readmissions. The practice problem for this quality improvement project explored whether the use of remote home monitoring of COPD patients …

Education Plan To Empower Wound Care Nurses For Evidence-Based Practice, Patricia Stevenson

Walden Dissertations and Doctoral Studies

Non-healing wounds can claim thousands of lives and costs billions of dollars each year, and nurse-led wound clinics are becoming necessary to fill a gap in care for patients with wounds. Even among certified wound nurses using evidence-based clinical protocols, key considerations of care are being missed. Therefore, this project was focused on developing and validating a new biofilm education module for certified or certification eligible wound care nurses. The aim of the module was to boost clinical assessment knowledge and improve patient outcomes. Benners skill acquisition model informed the development of this project. The design of the project also …

Educating Nurse Managers To Create A Culture Of Nurse Retention, Stacey Trotman

Walden Dissertations and Doctoral Studies

Nurse managers are stakeholders in creating a culture of nurse retention. The purpose of this staff education project was to identify evidence-based best practices that promote nurse retention and to educate nurse managers about these strategies. Knowles's theory of adult learning was the theoretical framework for the project. The practice-focused question addressed whether an education program for nurse managers would increase their understanding of evidence-based strategies to create a culture of nurse retention. The education program centered on 4 themes: professional development, communication and relationships, culture and work environment, and organizational structures and support. The concepts of 5 domains-- status, …

Health Care Facilities As A Predictor Of Breast Cancer Survival Rates, Elizabeth Natalie Webster

Walden Dissertations and Doctoral Studies

The disparity between survival rates for Black and White women with breast cancer is well documented and has been examined in terms socioeconomics, environment, tumor type, and genetics. However, there is little examination of the role of health care facilities in cancer disparities. Health care facilities are representative of societal norms and beliefs that include location, quality of care, finance, policies, and staffing; therefore, they are a proxy for social justice and social change. The purpose of this study was to examine correlations between health care facility type; social determinants of cancer such as poverty, culture, and social justice; and …

Teaching Heart Failure Patients A Low-Sodium Diet, Karen Faye Wright

Walden Dissertations and Doctoral Studies

Congestive heart failure (CHF) is a progressive medical condition affecting more than 7 million people in the United States (US) with 700,000 new cases reported annually. More than half of those treated for CHF are readmitted at least once a year. The problem addressed by this quality improvement initiative was lack of adherence to low sodium diet (LSD) among CHF patients, knowledge and skill deficit, and excessive 30-day CHF readmissions. The health belief model and the self-care deficit theory guide nurses in acquiring the skills needed to teach LSD. Twelve months of data were selected from 93 CHF readmissions from …

Causes Of Recidivism Among Mentally Ill Prerelease Offenders From The Perspective Of Former Correctional Mental Health Professionals, Rina Desiree Deneice Bradley Brown

Walden Dissertations and Doctoral Studies

The move toward reducing the prison population was driven by an increase in the number of reentry programs that focused on the needs of the offender, such as the provision of stable housing, employment, education, and sustaining strong familial bonds. While the literature supported these areas as being effective in reducing recidivism, there was no consensus that they were effective for offenders with mental illness (OMI). The purpose of this qualitative study was to analyze the impact of prerelease services for the OMI population from the perspective of former correctional mental health professionals who provided these services. The research questions …

Relationship Between Employee Wages, Number Of Employee Referrals, And Employee Turnover Intention, Robert Brown

Walden Dissertations and Doctoral Studies

Employee turnover is a significant contributor to the overall loss of hundreds of billions of dollars in profitability for many business organizations in the United States and abroad combined. Grounded in Maslow's theory of human motivation, the purpose of this correlational study was to examine the relationship between employee wages, number of employee referrals, and employee turnover intentions. The population was composed of employees working in the Southeastern region of the United States. A convenience sample of 92 participants answered questions regarding their wages, number of employee referrals, and completed the Turnover Intention Scale. Results of the multiple regression analysis …

Training For Advanced Practice Providers In A Heart Failure Unit, Merlyn Chua

Walden Dissertations and Doctoral Studies

Information from anecdotal interviews at a practicum site indicated a lack of training for advanced practice providers (APPs) in core competencies critical for effective practice in a heart failure (HF) unit. The goal of this project was to assess the APPs' verbal reports and develop HF unit-specific training for APPs. The practice-focused question examined whether unit-specific training for HF APPs improved knowledge and skills in HF management. The Johns Hopkins nursing evidence-based practice model and Knowles's adult learning theory were used to create a survey, a focus group, and a pre/posttest assessment of knowledge and skills gap. Descriptive and inferential …

Physical And Psychological Health Outcomes Of Pregnancy-Related Intimate Partner Violence, Darrlyn Waynette Cornelius-Averhart

Walden Dissertations and Doctoral Studies

Intimate partner violence (IPV) is a public health issue that transcends cultures and nationalities. Women and men have been impacted by sexual violence through rape and other types of IPV. Each year, women experience IPV before and during pregnancies and are impacted by physical and psychological outcomes as a result. The purpose of the study was to examine the impact of IPV on the health outcomes of diabetes (Types 1, 2, and gestational), high blood pressure before pregnancy, and depression/anxiety among adult women before and during pregnancy. The social ecological model provided the framework for this quantitative cross-sectional study that …

Association Between Androgen Deprivation Therapy For Prostate Cancer And Alzheimer's Disease, Gina Giannantoni-Ibelli

Walden Dissertations and Doctoral Studies

Alzheimer's disease (AD) is the most common progressive, neurodegenerative disease and form of dementia. The hallmarks of AD are extracellular accumulation of amyloid beta protein, resulting in neuritic, senile plaques and intracellular accumulation of tau protein. AD mainly arises from imbalance of amyloid beta protein production and its clearance in the brain. Testosterone modulates production of amyloid beta protein by decreasing its accumulation. Prostate cancer remains a substantial public health challenge in the United States. While androgen deprivation therapy (ADT) is an effective treatment for prostate cancer, it may be associated with cognitive impairment due to decreased levels of testosterone. …

Using Parent-Identified Strengths Of Autistic Children To Advance Strength-Based Intervention, Angelique Francesca Trigueros

Walden Dissertations and Doctoral Studies

Questions remain about the range of abilities autistic children possess and what constitutes effective treatment. Strength-based intervention contrasts with traditional autistic intervention approaches that focus on children's deficits. Studies on strength-based intervention approaches have not revealed how children's strengths are identified and have not used the insights of parents for this purpose. Neurodiversity serves as the conceptual framework because the tenets of neurodiversity align with those of strength-based approaches and hold that autism is a variation of the human condition rather than a disability. The purpose of this qualitative interpretive phenomenological study was to explore how the parent-identified strengths of …

Advocating Ideal Type Policy For Police Officer Wellness Based On Body Mass Index As A Predictor Of Self-Reported Occupational Stress, Louis Chiappetta

Walden Dissertations and Doctoral Studies

Scholars have validated both the damaging presence of police officer stress and separately, their increasing obese condition in the United States. Previous studies of police officers focus on stress or body weight, but not these variables conjointly. The purpose of this study was to inform policy creation by examining the problem of officer stress in relation to the calculated body mass index (BMI) values and to gain insight into stress outcomes. Lazarus and Folkman's stress-coping theory served as the research lens to examine if BMI would significantly contribute to the percent change of R2 variance accounted for in the predictive …

Factors Influencing Emergency Registered Nurse Satisfaction And Engagement, Catherine Larock-Mcmahon

Walden Dissertations and Doctoral Studies

Employee satisfaction and engagement have a direct impact on customer satisfaction. Dissatisfaction and disengagement lead to an increased intent to leave a job, poor patient outcomes, and decreased productivity. The retention and recruitment of qualified staff becomes an urgent priority to ensure safe and prudent patient care. The purpose of the qualitative research study was to better understand the beliefs, attitudes, perceptions, and reasons for emergency department registered nurses (ED RN) satisfaction and engagement in the workplace focusing on Herzberg's, Vroom's, Yetton's, Maslow's, Benner's, and Kahn's motivation and engagement theoretical frameworks. The qualitative case research study focused on satisfaction and …

Succession Planning And Development Of Nurse Leaders, Christina Martin

Walden Dissertations and Doctoral Studies

Health care organizations can provide comprehensive, formal learning opportunities to develop nurse leaders for advanced leadership roles. The purpose of this doctoral project was to create an evidence-based nursing leadership academy focused on development of advanced leadership skills and competencies to cultivate frontline and midlevel nurse leaders for executive nursing and health care leadership positions. The practice-focused question addressed how an advanced nursing leadership education program would affect the knowledge level and competencies of nurse leader participants. The American Organization of Nurse Executives' (AONE) 5 nurse executive competency domains served as the framework for this project. Data were collected from …

Barriers To Oral Care Among African American Adolescents In Prince George's County, Maryland, Nkiruka Soribe Mcginnis

Walden Dissertations and Doctoral Studies

When adolescents forgo oral health treatment, factors that hinder them from obtaining these services put them at risk of detrimental consequences in their oral and overall health. The purpose of this qualitative phenomenological study was to identify the various barriers that adolescents encounter causing them to defer oral treatment. Through this study, public health officials, school health care providers, the state, and parents could be made aware of these factors and work together to implement programs and supplemental aid to help adolescents become more knowledgeable of the importance of oral care and encourage them to desire and seek treatment. The …