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2018

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Articles 13651 - 13680 of 15422

Full-Text Articles in Medicine and Health Sciences

Associations Between Substance Abuse And Mental Illness Among Sexual Minority Adults, Blanche O. Wright Jan 2018

Associations Between Substance Abuse And Mental Illness Among Sexual Minority Adults, Blanche O. Wright

Walden Dissertations and Doctoral Studies

Sexual minorities (lesbians, gays, and bisexuals) have a greater risk for substance abuse and mental illness than sexual majorities (heterosexuals). Associations between substance abuse and mental illness among sexual minority adults have not been widely studied. The purpose of this quantitative cross-sectional study was to use the 2015 National Survey on Drug Use and Health data from the Substance Abuse and Mental Health Administration to study the association of substance abuse (alcohol; hard drugs such as heroin, cocaine, methamphetamine; and hallucinogens), prescribed drugs (pain relievers, tranquilizers, sedatives, stimulants, psychotherapeutic, and inhalants, as well as marijuana) and mental illness (no past …

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Progression Of Clinical Self-Efficacy Among Baccalaureate Nursing Students, Christine Lee Hamilton Jan 2018

Progression Of Clinical Self-Efficacy Among Baccalaureate Nursing Students, Christine Lee Hamilton

Walden Dissertations and Doctoral Studies

Clinical self-efficacy, or the confidence that nursing students have in their ability to successfully perform nursing clinical skills, is imperative for the safe and effective practice of nursing. A gap in knowledge exists about the change in clinical self-efficacy as baccalaureate nursing (BSN) students move through a nursing program, in which they learn and practice clinical skills in laboratory and clinical settings. Guided by Bandura's social cognitive theory, the purpose of this quantitative study was to determine the relationship between clinical experience within a nursing program and the reported clinical self-efficacy of BSN students in the sophomore, junior, and senior …

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Perceptions Of Collaboration And Mutual Respect Among Members Of Interprofessional Teams, Brenda Lankhof Jan 2018

Perceptions Of Collaboration And Mutual Respect Among Members Of Interprofessional Teams, Brenda Lankhof

Walden Dissertations and Doctoral Studies

Government agencies are encouraging healthcare practitioners to work in interprofessional teams to address the complex needs of an aging population, to improve client outcomes, and to increase the cost-effectiveness of health care. However, a clearer understanding of the elements required for an effective interprofessional collaborative practice is needed. The purpose of this online, descriptive study was to focus on one component, mutual respect, and determine its relationship to collaboration among members of interprofessional teams working in family health teams (FHTs) and community health centers (CHCs) across Ontario. D'Amour's four-dimensional model of collaboration was used as the theoretical basis. This model …

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Evaluation Of The Bedside Swallow Screen, Ruby Ben Jan 2018

Evaluation Of The Bedside Swallow Screen, Ruby Ben

Walden Dissertations and Doctoral Studies

Dysphagia is a leading complication of a stroke. A nurse-driven bedside swallow screen can identify dysphagia and decrease the risk for complications such as aspiration pneumonia. At the project site, the use of the bedside swallow screen was at 33%; there was noncompliance with the use of the bedside swallow screen by the emergency department nurses. The purpose of the doctoral project was to increase the use of the bedside swallow screen. Published outcomes, research, and reports generated from archived data were the sources of evidence. The six sigma methodology was used to inform the quality improvement doctoral project. At …

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Fall Reduction Among The Geriatric Population In Assisted Living Facilities, Marylyn A. Hagerty Jan 2018

Fall Reduction Among The Geriatric Population In Assisted Living Facilities, Marylyn A. Hagerty

Walden Dissertations and Doctoral Studies

Incidents of falls among the elderly increase with age. About $31 million is spent annually in the United States on medical costs related to fall injuries in the elderly. This project evaluated the outcomes of a fall reduction program implemented in an assisted living facility (ALF). The Stop Elderly Accidents, Death & Injury program developed by the Centers for Disease Control and Prevention was implemented by the ALF for 60 days prior to the outcome evaluation project. The program included a convenience sample of 62 residents and involved medication evaluation, exercises, assistive devices, environmental risk reduction, and evaluation of blood …

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Etiology Of Water Quality Perceptions And Beverage Preferences Of Black Children And Adolescents, Forkpayea K. Johnson Jan 2018

Etiology Of Water Quality Perceptions And Beverage Preferences Of Black Children And Adolescents, Forkpayea K. Johnson

Walden Dissertations and Doctoral Studies

The purpose of this phenomenological qualitative study was to examine the etiology of water quality perceptions and beverage preferences of Black children and adolescents, which addressed a current gap in the literature on this topic. This study was guided by Festinger's social comparison theory, which supports the notion that children and adolescents' perceptions and preferences are influenced by their social network and those with whom they have a close association. In this study, children and adolescents' water quality perceptions were examined as well as the development and factors affecting those perceptions. Whether social factors such as peer or parental influence …

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Oral Glucose Insulin Secretion Test For Identifying Patients With Insulin Resistance, David Kershner Jan 2018

Oral Glucose Insulin Secretion Test For Identifying Patients With Insulin Resistance, David Kershner

Walden Dissertations and Doctoral Studies

Insulin resistance is an increasing public health issue with the current literature, suggesting reduced sensitivity of insulin leads to adult onset diabetes and associated downstream pathologies that reduce life expectancy. The main objectives of this study were to evaluate the ability of the Oral Glucose Insulin Secretion Test (OGIST) to identify insulin resistance and examine differences in the insulin sensitivity based on gender, age, and ethnicity. This study was supported by the insulin resistance theory which focuses on the reduced ability of insulin to bind to the cellular insulin receptor, reducing the sensitivity of insulin. The OGIST lab results of …

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Improving Nutrition Among Supplemental Nutrition Assistance Program Recipients Using A Monetary Incentive Model, Jezabel Urbina Jan 2018

Improving Nutrition Among Supplemental Nutrition Assistance Program Recipients Using A Monetary Incentive Model, Jezabel Urbina

Walden Dissertations and Doctoral Studies

The Supplemental Nutrition Assistance Program (SNAP) is the United States' largest government assistance program that aims to alleviate food insecurity. The SNAP program allows low-income individuals and families the ability to purchase nutritious foods through a monthly benefit. However, the current body of literature presents evidence of the program's counterproductive effect. The purpose of this study was to determine whether incentivizing SNAP recipients to purchase additional fruits and vegetables was beneficial in increasing such purchases. Social cognitive theory was used as a theoretical framework to address research questions associated with shopping patterns and attitudes and beliefs. This quantitative study used …

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Staff Education And Training For The Maternal Cardiac Arrest, Kimberly Sue Gililland Jan 2018

Staff Education And Training For The Maternal Cardiac Arrest, Kimberly Sue Gililland

Walden Dissertations and Doctoral Studies

Maternal cardiac arrest is among the most frightening events that can happen on the labor and delivery unit. A maternal arrest can have catastrophic results. Staff must be vigilant, competent, and ready to handle the maternal arrest emergency at all times. A maternal cardiac arrest requires coordination among multiple disciplines and precise performance is paramount in saving not one life, but two. The purpose of the project was to establish a clinical training course for maternal arrest intended for education to improve staff knowledge during a maternal cardiac arrest. Evaluation of the knowledge and skills were through an exam, participation …

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Early Recognition And Treatment Of Acquired Pneumonia, Michael Lamorgese Jan 2018

Early Recognition And Treatment Of Acquired Pneumonia, Michael Lamorgese

Walden Dissertations and Doctoral Studies

Sepsis is a life-threatening organ dysfunction disease process that costs the healthcare system millions of dollars each year. By using existing assets, the number of patients admitted to the hospital suffering from sepsis secondary to community-acquired pneumonia can be reduced. The purpose of this project was to improve and expand the scope of practice of the registered nurse working in a private medical office to initiate treatment for suspected CAP using evidence-based practice. Data from the last quarter of 2017 and the first quarter of 2018 were compared. The purpose of comparing these data sets was to examine outcomes of …

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Department Structure And Leadership Functions For Advanced Practice Providers, Deondela Love Jan 2018

Department Structure And Leadership Functions For Advanced Practice Providers, Deondela Love

Walden Dissertations and Doctoral Studies

Department structure and leadership functions can influence work climate. In one healthcare system, advanced practice providers (APPs) worked in a decentralized structure with multiple leaders. This project explored the impact of the change to centralized leadership for APPs working in an academic healthcare system in which employee turnover was high and satisfaction was low. An ad hoc committee led by the chief medical officer created a centralized department with a designated leader. Surveys and interviews were used to identify the benefits of the strategies implemented and understand whether the change in organizational structure resulted in an improved work climate for …

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Influence Of An Educational Program On Opioid Drug Abuse, Gloria Nkiru Nnah Jan 2018

Influence Of An Educational Program On Opioid Drug Abuse, Gloria Nkiru Nnah

Walden Dissertations and Doctoral Studies

Prescription opioid abuse in the United States is an alarming health issue. In 2015, approximately 2 million people abused prescription opioids, and 12 million individuals misused their prescription opioid pain relievers. The percentage of individuals who died as a result of opiate abuse increased from 22% in 2013 to 76% in 2014. The purpose of this project was to evaluate the influence of an inner-city drug treatment (DTBF) program on opioid users' behavior. The practice question addressed whether knowledge of signs and symptoms of opioid withdrawal obtained from the DTBF program resulted in a significant behavioral change in opioid use …

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A Transition Quick-Guide For Educating Youth With Hemophilia, Joetta Smith Jan 2018

A Transition Quick-Guide For Educating Youth With Hemophilia, Joetta Smith

Walden Dissertations and Doctoral Studies

A 2009-2010 National Assessment Survey of youth with special needs such as hemophilia showed that 40% of youth between the ages of 12 and 17 had a transition plan before transitioning to adult care services. The lack of a transition plan caused youth to fall into a fragmented care gap when transition services are inadequate. During the gap, youth with hemophilia increased use of the emergency room and were hospitalized for complications such as frequent joint or muscle bleeding and joint disability. As a result, the health status of affected youth becomes fragile and health care costs escalate. The practice …

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Educating Staff Members In An Outpatient Clinic On Hypertension Management, Helen Anyiam Jan 2018

Educating Staff Members In An Outpatient Clinic On Hypertension Management, Helen Anyiam

Walden Dissertations and Doctoral Studies

An educational module on hypertension was created in response to the recurring pattern of patient visits with hypertension and an observed knowledge gap among nursing staff in an outpatient clinic located in the southern United States. The educational module was patterned after Joint National Committee-8 and American College of Cardiology guidelines involving patient lifestyle modification and provided clinic staff with information on hypertension diagnosis and self-management for use in patient education. The module was reviewed by a panel of 3 experts who approved it for appropriateness and clarity of content and made one minor recommendation for revision. The education materials …

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Influence Of Maternal Psychosocial Health On Infant Feeding Practices, Tessy Linda Aguzie Jan 2018

Influence Of Maternal Psychosocial Health On Infant Feeding Practices, Tessy Linda Aguzie

Walden Dissertations and Doctoral Studies

Choice of nutrition has a great effect on the early development of human growth. Despite increased knowledge on the benefit of breastfeeding to both mother and child, some mothers still choose to formula feed. The purpose of this study is to explain how maternal health contributes to choices. The theory of maternal role attainment and the social cognitive theory are used to evaluate these feeding choices. This study tests for the association between maternal weight status and choice of infant feeding practices, the association between postpartum depression and choice of feeding and finally, if depression mediates the relationship between maternal …

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Exploring The Cultural Intelligence Of Nurse Leaders, Valerie D. Campbell Jan 2018

Exploring The Cultural Intelligence Of Nurse Leaders, Valerie D. Campbell

Walden Dissertations and Doctoral Studies

Today, nurses represent many cultures and ethnic backgrounds. In their leadership style, nurse leaders must learn to embrace cultural intelligence or cultural quotient (CQ), that is, an extension of emotional intelligence that affords them the ability to manage a culturally diverse workforce. Historically, CQ has been relevant to business, locally and globally. But it is also important to explore the CQ of nurse leaders. Scholarly studies show that leaders with CQ are responsible for developing innovative employee behaviors, forward-thinking ideas, and creativeness in the workplace. CQ has a theoretical foundation in the 2003 research of Early and Ang who focused …

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Race, Gender, And Retention In A Diabetes Self-Management Program, Marcia Kaye Bygrave Jan 2018

Race, Gender, And Retention In A Diabetes Self-Management Program, Marcia Kaye Bygrave

Walden Dissertations and Doctoral Studies

Diabetes has quickly become an epidemic in the United States and affects all genders and races. Some ethnic groups are at greater risk for being diagnosed and face devastating health consequences due to poor diabetes self-management. Diabetes self-management education (DSME) is considered to be a positive step toward patient self-efficacy and diabetes management. The benefits of diabetes self-management education can only be realized if patients diagnosed with diabetes not only enroll, but complete the program. The purpose of this research study was to investigate the association between race and gender and dropout rates among participants enrolled in a DSME program. …

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Health Care Services For Child Survival And Performance-Based Management In Three Kosovo Municipalities, James Mugaju Jan 2018

Health Care Services For Child Survival And Performance-Based Management In Three Kosovo Municipalities, James Mugaju

Walden Dissertations and Doctoral Studies

After the Republic of Kosovo's declaration of independence in 2008, new municipal structures were created with the charge of monitoring the delivery of health care services; yet, no mechanism for monitoring performance was ever implemented. With the public value theory as the foundation, the purpose of this multiple case study of 3 Kosovo municipalities was to understand issues surrounding the capacity of local government health department to monitor their performance related to the delivery of services. Relevant data were collected through focus-group discussions with 10 nurses, 9 directors of family medicine centers, and 12 municipal program managers. Purposeful semistructured interviews …

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Latent Tuberculosis Infection Treatment Completion And Predictors Of Noncompletion Among Visa Holders In The Rural Setting, Scott Hutton Jan 2018

Latent Tuberculosis Infection Treatment Completion And Predictors Of Noncompletion Among Visa Holders In The Rural Setting, Scott Hutton

Walden Dissertations and Doctoral Studies

Latent tuberculosis infection (LTBI), a product of exposure to Mycobacterium tuberculosis (Mtb), can lead to tuberculosis (TB) and further cause death if untreated. Fortunately, TB can be prevented with LTBI treatment. Targeting newly arrived visa holders for LTBI screening and treatment is an effective strategy for decreasing future TB burden. However, LTBI treatment completion rates are low, and researches had primarily focused on the nonrural U.S. setting. This study, using a retrospective cohort design under the epidemiological disease triangle framework evaluated (a) the treatment completion rates for 2 cohorts of visa holders (i.e., immigrants, N = 31 and refugees, N …

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Implementation Of Food Safety Regulations In Food Service Establishments, Steve Randolph Mcallister Jan 2018

Implementation Of Food Safety Regulations In Food Service Establishments, Steve Randolph Mcallister

Walden Dissertations and Doctoral Studies

Food service businesses in the United States have experienced millions of dollars in losses caused by foodborne illness outbreaks, which can lead to bankruptcy and business closures. More than 68% of all foodborne illness outbreaks occur in food service establishments. The purpose of this descriptive case study was to explore the strategies leaders of food service establishments use to implement food safety regulations. Force field analysis was the conceptual framework for this study. The population for the study consisted of 3 leaders of food service establishments located in the southeastern region of the United States. Data were collected using semistructured …

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Stress, Anxiety, And Depression: Role Of Campus Connectedness, Social Support, And Coping Among Nepalese Nursing Students, Priscilla Samson Jan 2018

Stress, Anxiety, And Depression: Role Of Campus Connectedness, Social Support, And Coping Among Nepalese Nursing Students, Priscilla Samson

Walden Dissertations and Doctoral Studies

High levels of stress, anxiety, and depression (SAD) can adversely influence physical health, psychological well-being, and academic and clinical performance of nursing students. Numerous studies have identified the factors associated with SAD; however, a paucity of empirical research addresses the relationship of SAD with campus connectedness (CC), perceived social support (PSS), and coping. The purpose of this quantitative cross-sectional study, guided by Lazarus and Folkman's theory of stress, coping, and adaptation, was to determine the prevalence of SAD and examine its relationship with CC, PSS, and coping among undergraduate nursing students of Nepal. Survey research was conducted using depression anxiety …

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Nursing Candidates' Perceptions Of The Greatest Challenges To Becoming A Professional Nurse, Lee Ann Williams Jan 2018

Nursing Candidates' Perceptions Of The Greatest Challenges To Becoming A Professional Nurse, Lee Ann Williams

Walden Dissertations and Doctoral Studies

Nursing candidates' overall goal is to become a professional nurse. To reach this goal, the student must graduate from an associate or baccalaureate nursing program and pass the state board, National Council Licensure Examination (NCLEX). Student retention in nursing programs and passing the NCLEX continue to be a problem for educational institutions throughout the United States. The purpose of this study was to examine nursing candidates' perceptions of their greatest challenges in becoming a professional nurse. Wenger's social learning systems and the community of practice comprised the conceptual framework that guided this study. The research questions pertained to nursing students' …

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Early Radiation Therapy And Cervical Cancer Survival In The United States, Olufunmiso Oyetunde Asamu Jan 2018

Early Radiation Therapy And Cervical Cancer Survival In The United States, Olufunmiso Oyetunde Asamu

Walden Dissertations and Doctoral Studies

A paucity of information exists on the benefits of using radiation therapy for treating women with early cervical cancer detection. The purpose of this cross-sectional study was to investigate the association between early versus late testing of Human papilloma virus (HPV), age, race, radiation therapy, and regions in United States, and survival rates among women diagnosed with early cervical cancer. The epidemiological triad of person, time, and space guided this study to explain the regional spread of cervical cancer, and the effect of early testing. Secondary data from Surveillance, Epidemiology, and End Results (SEER) were used (N= 520,153). Statistical analyses …

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Seat Belt Fit A Mechanism Of Injury During A Motor Vehicle Crash, Jacoba Hendrika Viljoen Jan 2018

Seat Belt Fit A Mechanism Of Injury During A Motor Vehicle Crash, Jacoba Hendrika Viljoen

Walden Dissertations and Doctoral Studies

Seat belts save lives; however, unintentional injuries are still the leading cause of death for those between 1 and 44 years in the United States. Seat belts also cause injuries during motor vehicle crashes (MVCs) and obesity changes how seat belts fit. The purpose of this retrospective causal inference quantitative study was to reduce the knowledge gap in scholarly research on seat belt fit in relation to blunt cerebrovascular injuries (BCVI) during MVCs and seat belt compliance. The theoretical framework used was based on H.W. Heinrich's domino theory. The research questions focused on the following dependent variables: BCVI, compliance, and …

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Differences In Coping Strategies Of African American Children With Chronic Pain, Eddie Lee Coleman Jan 2018

Differences In Coping Strategies Of African American Children With Chronic Pain, Eddie Lee Coleman

Walden Dissertations and Doctoral Studies

Chronic pain is a significant problem in the U.S. pediatric population, conservatively estimated to affect 15% to 20% of children. Few studies have focused on coping strategies African American children use to manage chronic pain. The purpose of this study was to examine coping strategies used by African American children and adolescents ages 11 to 18 years suffering from chronic pain and to examine gender and age differences in this population. The gate control theory provided the framework for the study. The Pain Coping Questionnaire was used to measure coping strategies in a convenience sample of 44 children and adolescents …

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Women's Experiences Using Health Facilities For Childbirth In South Sudan, Gillian Magda Garnett Jan 2018

Women's Experiences Using Health Facilities For Childbirth In South Sudan, Gillian Magda Garnett

Walden Dissertations and Doctoral Studies

There is low use of health facilities for childbirth in South Sudan despite the majority of households reporting access to a health facility. South Sudan has a high maternal mortality ratio with 789 maternal deaths for every 100,000 live births. The absence of a midwife during labor and delays in reaching health facilities for childbirth remain the leading contributing factors to the high maternal mortality. Little is known, however, about factors influencing use and non-use of health facilities for delivery in the country. This phenomenological study, therefore, seeks to build a body of evidence by describing the experiences of women …

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The Relationship Between Certified Registered Nurse Anesthetists' Emotional Intelligence And Burnout, Dianna Marie Heikkila Jan 2018

The Relationship Between Certified Registered Nurse Anesthetists' Emotional Intelligence And Burnout, Dianna Marie Heikkila

Walden Dissertations and Doctoral Studies

Certified Registered Nurse Anesthetists (CRNAs) administer more than 43 million anesthetics within the United States and practice in every setting where there is anesthesia. Stress and burnout can be a common problem for CRNAs. The purpose of this correlation study was to examine the relationship between emotional intelligence (EI) and burnout syndrome among CRNAs. The research questions assessed CRNAs and the relationship between EI and burnout syndrome, the burnout score and the four dimensions of EI, and EI and the three dimensions of burnout. Certified and recertified CRNAs (N = 506) completed the Wong and Law Emotional Intelligence Scale, the …

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Individual Understanding Of The Risks Associated With Polypharmacy, Michelle Patricia Mchenry Jan 2018

Individual Understanding Of The Risks Associated With Polypharmacy, Michelle Patricia Mchenry

Walden Dissertations and Doctoral Studies

With many individuals experiencing multimorbidity, individuals are being prescribed more medications. Although there are benefits to taking medications to manage symptoms and treat disease processes, there are also risks to taking multiple medications. The purpose of this phenomenological study was to explore participants' understanding of the risks associated with practicing polypharmacy. Game theory, credibility theory, and belief bias were the conceptual frameworks used to explain how individuals experienced their care and being prescribed 5 or more medications. Eight participants residing in subsidized housing in a small Midwest city, who were taking 5 or more medications volunteered to take part in …

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Decreasing Operating Room Delays For Surgical Orthopedic Patients, Jacqueline P. Ogunjulugbe Jan 2018

Decreasing Operating Room Delays For Surgical Orthopedic Patients, Jacqueline P. Ogunjulugbe

Walden Dissertations and Doctoral Studies

The operating room (OR) at the project site was experiencing surgical delays for orthopedic surgical patients due to unavailable instruments, which led to a decrease in the efficiency of OR utilization. The purpose of this project was to decrease operating room delays for the orthopedic surgical patients. The practice-focused question explored whether a multidisciplinary approach to the procurement of instruments and supplies for the orthopedic surgical patient would help to ensure an on-time surgery start, resulting in increased efficiency in the utilization of the OR from 42% to 65% within a 9-month period. Lewin's change model was used to guide …

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Strategies To Reduce Hospital Readmission Rates After Bariatric Surgery, Catherine Scarlett Jan 2018

Strategies To Reduce Hospital Readmission Rates After Bariatric Surgery, Catherine Scarlett

Walden Dissertations and Doctoral Studies

Bariatric surgery is a major surgery that has become a frequent procedure in North America; growth in the number of bariatric surgery procedures has resulted in an increase in readmissions after the procedure. A systematic review of the literature using the shifting processes model as a guide was used to answer the practice-focused questions regarding reasons for hospital readmissions for postoperative bariatric surgery patients and strategies that reduce complications of the procedure. Providing Innovative Service Models and Assessment chart (PRISMA) was used to quantify 17 studies that met the inclusion criteria. Results demonstrated that the reasons for readmissions after bariatric …

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