Medicine and Health Sciences Commons^™

The Impact Of Classroom Instruction On Cultural Awareness And Sensitivity In Occupational Therapy Students, Sierra Grady, Kym Brungardt, Joy Doll

Journal of Occupational Therapy Education

As the population in the United States increases, it is essential that occupational therapy students and practitioners be aware of, respond to, and effectively interact with clients from diverse cultural backgrounds. Current literature identifies a gap in the cultural competence education for occupational therapy students and has demonstrated the importance of developing a culturally sensitive curriculum that will prepare students for today’s work environment. This study employed a quasi-experimental approach with a one group pretest-posttest design to explore the development of cultural awareness in occupational therapy students with classroom instruction on culturally sensitive practice. Data was collected from 43 students …

On-Campus Occupational Therapy Clinic Enhances Student Professional Development And Understanding, Kelly Erickson

Journal of Occupational Therapy Education

Changing healthcare systems impact clinical sites that provide fieldwork for occupational therapy programs and require students to be prepared for the pace and demands of the clinical settings. Occupational therapy programs strive to enhance hands-on experiences in didactic curriculum to better prepare students for Level II fieldwork. An on-campus clinic course was implemented over two semesters with students engaging in the occupational therapy process with adult and pediatric clients from the community under the supervision of faculty. Student surveys and focus group data were analyzed over five years. Survey responses to open-ended question were triangulated with data from focus group …

Exploring Students' Use Of Feedback During Occupational Therapy Level Ii Fieldwork Experiences, Karen Snyder

Journal of Occupational Therapy Education

Researchers confirmed that the use of feedback assists with the improvement of students’ confidence and performance. Multiple studies focus on the provision and acceptance of feedback; however, it was not known if, or how, students internalized the feedback to apply it successfully. Since there is a difference between providing feedback and the interpretation of its true message, this phenomenon was studied to add empirical knowledge regarding students’ feedback interpretation. This qualitative study explores the perceptions of how students interpret information received from Level II fieldwork educators and what meanings students attributed to the feedback. The use of phenomenological methodology guided …

Telehealth Experiential Learning: A Pilot Study Of The Client’S Experience, Katrina M. Serwe, Christine Bowman

Journal of Occupational Therapy Education

This research examined the client experience of a student-led occupational therapy pro bono clinic that involved telehealth-delivered treatment sessions. Six clients responded to a survey that included both Likert scale close-ended and open-ended items. The researchers employed descriptive statistics for close-ended items and summarized open-ended responses. All close-ended items had a median score of 4 out of 5, indicating it was easy to communicate, easy to find and use features of the software, and that there were minimal problems with the software in the telehealth delivered sessions. Open ended-responses reflected an overall positive experience.

Preseason Functional Performance Test Measures Are Associated With Injury In Female College Volleyball Players, Jason Brumitt, Alma Mattocks, Jeremy Loew, Phil Lentz

Faculty Publications - College of Physical Therapy

Context: Preseason functional performance test measures have been associated with noncontact time-loss injury in some athletic populations. However, findings have been equivocal with many studies consisting of heterogeneous populations. Objective: To determine if preseason standing long jump and/or single-leg hop test scores are associated with a noncontact time-loss injury to the lower quadrant (LQ = low back or lower-extremities) in female Division III college volleyball (VB) players. Design: Prospective cohort study. Setting: National Collegiate Athletic Association Division III female VB teams. Patients: A total of 82 female college VB players (age = 18.9 [1.0] y). Main Outcome Measures: Standing long …

Validation And Generalizability Of Preoperative Promis Scores To Predict Postoperative Success In Foot And Ankle Patients, Michael R. Anderson, Jeff Houck, Charles L. Saltzman, Man Hung, Florian Nickisch, Alexej Barg, Timothy Beals, Judith F. Baumhauer

Faculty Publications - College of Physical Therapy

Background: A recent publication reported preoperative Patient-Reported Outcomes Measurement Instrumentation System (PROMIS) scores to be highly predictive in identifying patients who would and would not benefit from foot and ankle surgery. Their applicability to other patient populations is unknown. The aim of this study was to assess the validation and generalizability of previously published preoperative PROMIS physical function (PF) and pain interference (PI) threshold t scores as predictors of postoperative clinically meaningful improvement in foot and ankle patients from a geographically unique patient population.

Methods: Prospective PROMIS PF and PI scores of consecutive patient visits to a tertiary foot and …

Subtle Cavus Deformities: Is Isolated Lateral Ankle Ligament Reconstruction Enough For Improved Patient-Reported Outcomes?, Ashlee Macdonald, Meghan Kelly, Jeff Houck, Judith Baumhauer, Irvin Oh, Adolph Flemister, John Ketz

Faculty Publications - College of Physical Therapy

Introduction/Purpose: Lateral ankle ligament injuries are common conditions accounting for 25% of musculoskeletal injuries. Prior reports have found increased risk of failed lateral ankle reconstruction in those with a subtle cavus deformity, and therefore, correcting the deformity is often advocated. However, other studies have been unable to identify subtle cavus deformity as a clear risk factor for recurrent injury. The purpose of this study was to 1) compare PROMIS physical function (PF), pain interference (PI), and depression scores in patients with subtle cavus deformities to those without deformity who underwent lateral ankle ligament reconstruction, 2) compare PROMIS scores in allograft …

Midfoot Power During Walking And Stair Ascent In Healthy Adults, Frank Diliberto, Jeff Houck

Faculty Publications - College of Physical Therapy

Introduction/Purpose: Intrinsic foot muscles have the capacity to attenuate and reverse arch deformation under loaded conditions. This function is proposed to be an important component in generating the midfoot power and stability requisite for gastroc-soleus muscle action at the ankle during forward propulsion. Synergistic activation of intrinsic foot muscles is proposed to function as a ‘foot core’ during weightbearing activity that is analogous to the function of the smaller muscles at the spine. If this theory were sound, midfoot power would be expected to increase, potentially in proportion to ankle power, as the muscular demand of a task increases. The …

Does Identifying Provider Expectations Improve Adoption Of Patient Reported Outcomes?, Jeff Houck, Jillian Santer, Judith Baumhauer

Faculty Publications - College of Physical Therapy

Introduction/Purpose: New instruments like the Patient Reported Outcome Information System (PROMIS) minimize the burden to patients and providers addressing significant barriers to adoption. Despite these advances provider adoption remains lackluster. Models of technology adoption suggest adoption is more likely to occur when PRO’s directly improve patient care (performance expectancy) and it’s easy to implement (effort expectancy). Problems with effort expectancy are dealt with by training and improving logistics (i.e. eHR presentation, alerts), where performance expectancy is addressed through research (i.e. validation of thresholds). The purposes of this study were to: 1) evaluate the proportion of orthopedic rehabilitation providers who use …

Can Foot Exercises And Going Barefoot Improve Function, Muscle Size, Foot Pressure During Walking And Qualitative Reports Of Function In People With Flat Foot?, Marcey Keefer Hutchison, Robin Dorociak, Alison Modafferi, Shanna Howland, Angela Foster, Jean Jarbath, Brenden Thompson, Tyler Whited, Jeff Houck

Faculty Publications - College of Physical Therapy

Introduction/Purpose: Specific exercises to train foot muscles for barefoot running (i.e. doming seated[DS] and standing[DSt]) and post foot and ankle injury (i.e. seated plantar flexion and inversion[SPFI]) are common. Exercise programs specifically for the foot claim improvement in foot posture (foot posture index [FPI]) and foot strength. However, rigorous assessment of foot function as a result of exercise is lacking (i.e. foot posture, strength, and plantar pressure). Further, no studies specifically address patients with flat foot. The purpose of this case series study was to assess the immediate effects of an 8-week foot exercise and barefoot weight bearing program on …

Can Understanding Provider Expectations Improve Provider Adoption Of Patient Reported Outcomes?, Jeff Houck, Jillian Santer, Kostantinos Vasalos, Judith Baumhauer

Faculty Publications - College of Physical Therapy

Introduction/Purpose: New instruments like the Patient Reported Outcome Information System (PROMIS) minimize the burden to patients and providers addressing significant barriers to adoption. Despite these advances provider adoption remains lackluster. Models of technology adoption suggest adoption is more likely to occur when PRO’s directly improve patient care (performance expectancy) and it’s easy to implement (effort expectancy). Problems with effort expectancy are dealt with by training and improving logistics (i.e. eHR presentation, alerts), where performance expectancy is addressed through research (i.e. validation of thresholds). The purposes of this study were to: 1) evaluate the proportion of orthopedic rehabilitation providers who use …

Effect Of Socioeconomic And Neighborhood Factors On Stroke Hospitalization Rate In Virginia, Esther Musu Stephens

Walden Dissertations and Doctoral Studies

The stroke rate in Virginia is above the national rate. Stroke results in poor quality health, morbidity, and mortality. This quantitative epidemiological study was conducted to investigate whether a significant association exists between stroke and (a) socioeconomic and (b) neighborhood factors among people who were admitted to Virginia hospitals between 2010 and 2015. An ecological design, including ecosocial theory, was used to examine associations between environmental factors and stroke. Data (746 census output areas) were acquired using patients' billing zip codes from the Virginia Health Information System in combination with socioeconomic and neighborhood data by Zip Code Tabulation Area from …

Organizational Strategies To Reduce Hospital Readmissions, Steven Warchol

Walden Dissertations and Doctoral Studies

Reducing hospital readmissions is critical to the success and sustainability of both hospitals and the communities in which they reside. The purpose of this multiple case study was to explore organizational strategies hospital leaders use to reduce hospital readmissions. The study was limited to hospitals in Southwest Missouri with readmission rates below the state average. Complex adaptive systems was the conceptual framework for the study because of the complex nature and numerous stakeholders of the healthcare system. Data were collected from a purposive sample of 15 hospital leaders via semistructured interviews and an analysis of organizational artifacts. Member checking was …

Addressing Spiritual Care Needs In Primary Care, Olayinka Akerele-Olufidipe

Walden Dissertations and Doctoral Studies

This DNP project focused on the spiritual aspects of care that are often neglected in the outpatient setting. Most patients value their spiritual health and believe that it is just as important as their mental and physical health. The purpose of this project was to improve the overall spiritual care provided to patients, their families, and/or caregivers in times when they were experiencing spiritual distress. This quality improvement (QI) project was designed to determine whether embedding a chaplain in an outpatient clinic instead of providing a pamphlet about chaplain services increases patient satisfaction. Secondary analysis of the data in this …

Impact Of Social Support On Malaria Management By Burundian Community Health Workers, Bonaventure Bazirutwabo

Walden Dissertations and Doctoral Studies

Malaria is the main cause of mortality for children under the age of 5 in Burundi. The access to malaria diagnostics and treatment is hampered not only because of logistical issues, but also due to the lack of qualified human resources and their inequitable distribution across the country. To mitigate the lack of human resources for health, the government of Burundi, along with its partners, shifted some tasks to community health workers (CHWs) to cover unmet healthcare needs for selected diseases such as malaria, diarrhea, and pneumonia. The purpose of this study was to determine whether the social support provided …

Factors Associated With Menthol Cigarettes Smoking Among Youths Ages 12 To 19, Eniye Emmanuel Eguae

Walden Dissertations and Doctoral Studies

Menthol is added to cigarettes to make smoking more convenient. Menthol is considered a contributing factor that makes smoking appealing to youths and their continuous smoking initiation, which progresses to regular cigarette smoking and addiction, especially among youths ages 12 to 19. Menthol encourages approximately 4,000 youths to experiment with smoking daily in the United States, of which approximately 1,000 become active smokers. Not enough is known regarding the influence of menthol on youth smoking initiation/smoking behavior. A quantitative analysis of data from the 2014 National Youth Tobacco Survey (NYTS) was used to explore the association between age, race/ethnicity, gender, …

Leisure Time Physical Activities Of Older Adults In Senior Housing, Tamiera S. Harris

Walden Dissertations and Doctoral Studies

Increasing physical activity levels of older adults is a public health priority given the associated risks with sedentary lifestyles. Exercise such as walking may positively affect older adults as they age decreasing the risk of heart disease, stroke, or death. The purpose of this study was to examine physical activities of older adults in senior housing and to determine if age correlates with the amount of physical activity. Physical activity studies on older adults are limited due to time and resources. The health belief model and transtheoretical model frames this study theorizing that older adults will take positive steps towards …

Strategies For Applying Electronic Health Records To Achieve Cost Saving Benefits, Daniel Kanyi Ngunyu

Walden Dissertations and Doctoral Studies

The American Recovery and Reinvestment Act (ARRA) of 2009 authorized the distribution of about $30 billion incentive funds to accelerate electronic health record (EHR) applications to improve the quality of care, safety, privacy, care coordination, and patients' involvement in healthcare. EHR use has the potential of saving $731 in costs for hospitals per patient admission; however, most hospitals are not applying EHR to reach the level at which cost savings are possible. The purpose of this single case study was to explore strategies that IT leaders in hospitals can use to apply EHR to achieve the cost saving benefits. The …

Understanding Quality Of Care In A Hospice Setting, Sarah Fese Taylor

Walden Dissertations and Doctoral Studies

Assuring quality of care for patients who face the end of life has been a major concern for those in hospice settings. Limited research is available that has a focus on understanding what quality of care in a hospice setting looks like. This research is important to provide insight into hospice health care providers' perceptions of the quality of care in the hospice setting and on the indicators that influence care quality. A qualitative phenomenological approach was used to answer the research questions on the perspectives of the health care providers in the hospice care setting regarding the quality of …

Use Of Hpv Vaccination For Cervical Cancer Prevention In African American Women, Diamond Diane Hanson

Walden Dissertations and Doctoral Studies

Despite the availability of the human papillomavirus (HPV) vaccine, African American women are still at risk for contracting HPV. This is significant because HPV is one of the main risk factors for cervical cancer. The purpose of this quantitative study was to explore the relationship between the use of HPV vaccination for cervical cancer prevention and personal history of HPV, reduced access to healthcare, and risky sexual behaviors in African American women. The theoretical framework used for this study was the health belief model (HBM). Two hundred twenty-nine (n=229) African American women living in the United States, ages 18-49, who …

The Effects Of Cultural Dissimilarity On Employee Job Attitudes And Productivity, Sherrice Olithia Lyons

Walden Dissertations and Doctoral Studies

Organizations in Jamaica have been impacted by globalization and the opportunities and challenges of cultural incompatibilities. Most previous studies on cultural incompatibilities have focused on the impact on expatriates leaving a gap in the literature with respect to the implications for host country nationals, and specifically Jamaicans. This quantitative study focused on employees of 2 companies in Jamaica, an energy company and a hospitality company. It examined cultural dissimilarity with respect to host country nationals and expatriates, and its effect on the productivity, job satisfaction, affective commitment, and normative commitment of these employees (N = 110). In addition to the …

Health Insurance Literacy Impacts On Enrollment And Satisfaction With Health Insurance, Angela J. Norbeck

Walden Dissertations and Doctoral Studies

Health insurance literacy (HIL) contributes to the lack of understanding basic health insurance (HI) terms, subsidies eligibility, health plan selection, and HI usage. The study is one of few to address the existing gap in the literature regarding the exploration of the relationship between HIL, individuals' HI enrollment, and individuals' satisfaction with their HI. The theoretical framework selected for this study was the prospect theory, which describes the behavior of individuals who make decisions. In this cross-sectional correlational study, secondary data set from the third Quarter 2015 Health Reform Monitoring Survey was used. Binary logistic regression models were used to …

Depression Management In Outpatient Settings: A Systematic Review Of The Literature, Modupe Mary Okonofua

Walden Dissertations and Doctoral Studies

Depression is a mental illness that requires prompt identification and treatment due to grave consequences if untreated. Depression can affect a person's level of functioning, lead to worsening health conditions, comorbid substance abuse, and suicide. Despite these facts, the current state of nursing practice includes an inadequate diagnosis of patients with depression, lack of guidelines for the use of assessment tools and diagnostic tests to identify depression, and insufficient information concerning the accuracy of depression assessment tools. This systematic literature review examined 6 depression assessment tools in regard to their accuracy as identified by specificity, sensitivity, reliability, and validity. This …

Improving Chronic Constipation Health Literacy Proficiency: Animation Versus Traditional Written Pamphlets, Jason Baker

Walden Dissertations and Doctoral Studies

The U.S. health care system is evolving from medical centric to patient centered, augmenting the importance for patients to comprehend and process medical information. The Department of Education indicated that 77 million Americans have a basic or below basic health literacy proficiency and 12% register as health literacy proficient. Animation is a time-tested device for improving health by enhancing comprehension. Chronic constipation (CC) complexity entails physiological, anatomical, and environmental mechanisms. Using the cognitive theory of multimedia learning and dual-channel auditory and visual processing, the primary research question addressed whether an animated educational video improved health literacy for CC more than …

Bleach-It-Away Clostridium Difficile, Kim Ione Hecker

Walden Dissertations and Doctoral Studies

Hospital-associated infections (HAIs) are infections patients contract as a result of being hospitalized. HAI rates decreased for almost all pathogens in the past few years, with the exception of Clostridium difficile infections (CDIs), which have been steadily climbing, placing hospital-acquired CDI at the top of the HAI list. The Center for Disease Control and Prevention reported in 2010 almost a half a million people were infected with CDIs yearly in the United States, and CDIs claimed the lives of approximately 29,000 people, representing a 4-fold increase from 1993. To address the problem in the local hospital, a quality improvement initiative …

Evidence-Based Education Program To Reduce Nurse Manager Burnout, David Howe

Walden Dissertations and Doctoral Studies

Nurse managers face numerous challenges and stressors in their daily practice. The support services offered to managers to facilitate coping in stressful situations vary among employers and may be ineffective depending on the stressors faced. Implementation of evidence-based best practices may positively impact nurse managers' ability to manage stress. The purpose of this project was to develop an evidence-based stress reduction education program to empower nurse managers to handle work-related stressors and reduce burnout. The primary theory used to inform this project was the job demands-resource model, which explains how job demands and resources have multiple effects on job stress, …

Chronic Low Back Pain- A Needs Assessment For Practice Change, Chukwudi Oduah

Walden Dissertations and Doctoral Studies

There is a practice gap in the self-management education of patients with chronic low back pain. Insufficient self-management leads to increased frequency of flare-ups of low back pain, disability, loss of productivity, and increased cost of health care. The guiding practice-focused question was focused on the unmet self-management support needs of the chronic low back pain patients in a Midwestern state local pain clinic. The purpose of this descriptive cross-sectional study was to ascertain the unmet needs of patients' self-management support by analyzing the results of a patient study performed by this clinic. The theoretical principles of the model for …

Educational Program For Parents Of Neonates On Nasal Continuous Positive Airway Pressure, Irina Sher

Walden Dissertations and Doctoral Studies

Parents in the neonatal intensive care unit (NICU) whose term or preterm infants are receiving nasal continuous positive airway pressure (NCPAP) experience stress. They often worry about being able to hold their child and possible complications of NCPAP, such as nasal deformities and compromised organ function. Lacking standard educational programming to provide parents information that they need to understand the care their infant is receiving, parents experience unnecessary stress that affects their capacity to care for their infants. A review of the literature suggested family-centered educational programs are able to decrease stress and increase parental confidence. The purpose of this …

A Nutrition Education Program For Advanced Practice Registered Nurses Caring For Obese Patients, Kathy Lynn Wilson

Walden Dissertations and Doctoral Studies

Obesity is a major U.S. public health epidemic. A review of the current literature identified a lack of obesity counseling with individuals. The gap in practice was a lack of understanding of nutrition, nutrition labeling, and how foods affect health. The objective of this project was to identify the community assessment need related to obesity and then educate APRNs on ways to better communicate with obese patients. This project focused on an education program for advanced practice registered nurses (APRNs) on using the 5 A's framework for obesity counseling to improve their knowledge and skill in counseling their overweight and …

Intensive Outpatient Treatment Program For Patients With Depressive Disorder: A Parental Perspective, Emmanuel Akpan

Walden Dissertations and Doctoral Studies

Psychosocial support from family is important in outpatient treatment programs for individuals with depressive disorder. The purpose of this phenomenological study was to explore the lived experiences and perceptions of parents of patients with depressive disorder regarding intensive outpatient treatment. The research question was what are the experiences and perceptions of parents of patients with depression regarding their role as caretakers in intensive outpatient treatment? The conceptual framework was a biopsychosocial framework and family systems theory. Content analysis was used to analyze data provided from interviews with parent participants (n = 8). Many participants reported high levels of involvement with …