Medicine and Health Sciences Commons^™

African American Women's Experiences And Understanding Of Secondary Infertility, Claudelle Parchment

Walden Dissertations and Doctoral Studies

The purpose of this phenomenological study was to describe the lived experiences of African American women with secondary infertility, defined as an inability to conceive or carry a baby to term after a previous conception. Research on secondary infertility has ignored the prevalence of the condition in African American women. The implications of secondary infertility in African American women have immediate and far-reaching health and psychosocial consequences. African American women rely on interconnectedness and social networks; therefore, social networks and social support served as the key concepts underwriting the study's conceptual framework. Social networks and social support underscore the connection …

A Comparison Of The Safety And Efficacy Of Three Medical Abortion Protocols, Dhammika Perera

Walden Dissertations and Doctoral Studies

Unsafe abortions pose serious threats to women's health. Medical abortion provides safer abortion access to many. The lengthy interval between misoprostol and mifepristone creates multiple barriers for women and providers.

A paucity of research exists about medical abortion protocols that allow single day procedures. The efficacy and the safety of 3 medical abortion protocols of varying lengths were explored in this study.

A secondary data set of over 55,000 patients from the United Kingdom was retrospectively analyzed using binomial logistic regression. Efficacy results showed no significant difference between the conventional and the simultaneous protocols; when compared to those, the 6- …

Reduction Of Centers For Medicare And Medicaid Services Reimbursement Penalty Risk, Christopher Douglas Poteet

Walden Dissertations and Doctoral Studies

Healthcare centers face increasing revenue risk under the Medicare Access and Children's Health Insurance Program Reauthorization Act (MACRA). The purpose of this multiple case study was to explore strategies that successful leaders of healthcare centers use to mitigate the risk of reimbursement penalties under MACRA. The conceptual framework of this study was Generation 3 cultural-historical activity theory (CHAT-III), and the analysis process used was Yin's recursive and iterative phases. Participants of this study were 6 leaders of healthcare centers in the United States identified as having high quality and low cost via the Centers for Medicare and Medicaid public use …

Rural Environmental Factors And Lesbian, Gay, Bisexual, And Transgender Mental Health Services Utilization, Terri Rorie

Walden Dissertations and Doctoral Studies

The rates of mental health issues in the lesbian, gay, bisexual, and transgender (LGBT) communities are twice that of individuals who identify as heterosexual. Research in urban communities show lower mental health services utilization rates for LGBT individuals compared to their heterosexual counterparts. The purpose of the study was to examine how rural environmental factors affect the use of mental health services by LGBT individuals and provide information to improve mental health outcomes. Andersen's healthcare utilization model and the minority stress theory were the foundations of this study. This study examined the association of mental health providers' availability/characteristics and utilization …

Living Arrangements, Referral Source And Young Adult Admissions To Drug Treatment, Daniel Samaila

Walden Dissertations and Doctoral Studies

Abuse of painkiller drugs and non-medical use of drugs among young adults continues to be a public health crisis in the United States. Living arrangements and source of treatment referral were considered as the social context that could contribute to increased admissions to treatment for drug abuse. The purpose of this study was to examine the relationship between, independent living arrangement, the principal source of referral, and abuse of opioid, heroin, and cocaine. Steered by the conceptual framework of the biopsychosocial model, this study used the data from the 2015 Treatment Episode Data Set: Admissions managed by the Substance Abuse …

Staff Education Intervention To Enhance Care Planning For Older Adults, Mozhgan Peiravi

Walden Dissertations and Doctoral Studies

The increased prevalence of cognitive deterioration has increased the challenges of caring for older adults. This study's project site offers a psychiatric program for older adults with customized care for complex geriatric mental health patients. Clinical assessment and care management are often overlooked in geriatric mental health patients diagnosed with behavioral and psychological symptoms of dementia (BPSD). The purpose of this project was to deliver an education program developed from the Staff Training in Assisted Living Residences-Veterans Administration, P.I.E.C.E.S model and the Castle framework to 42 nursing and allied health staff of the project site. The project question explored whether …

Strategies To Reduce Employee Turnover In Clinical Logistics, Brenda Marc Simon

Walden Dissertations and Doctoral Studies

Clinical supply chain managers who do not apply effective employee turnover strategies could negatively affect team performance, employee morale, employee well-being, patient outcomes, productivity, profitability, and the sustainability of organizational activities. The purpose of this multiple case study was to explore strategies that supply chain managers used to decrease employee turnover in clinical logistics organizations. The targeted population consisted of 6 clinical logistics supply chain managers working in 6 community hospitals located in Maryland who had experience implementing successful strategies to decrease employee turnover. The servant leadership theory served as the study's framework. Data collection included semistructured interviews and a …

Educating Medical--Surgical Nurses To Improve Nursing Knowledge And Understanding Of Health Literacy, Heather Smith

Walden Dissertations and Doctoral Studies

Low health literacy levels put patients at greater risk for poorer compliance and access to care, which leads to worse patient outcomes. Nurses must understand health literacy to improve health literacy for their medical surgical patient population. It is necessary for a formal education program on this topic. The purpose of this project was to increase medical surgical nurses' awareness and knowledge of the importance of health literacy and to introduce the REALM-SF tool to assess a patient's literacy level, allowing a nurse to better individualize the education provided to the patient. Lewin's change management theory was key in the …

Home Health Aides' Performance And Home Health Clients' Quality Of Life, Ronny Terrell Smith

Walden Dissertations and Doctoral Studies

Home health aides' performance can help home health clients achieve quality of life. This quantitative, cross-sectional study examined which work-related factors of home health aides influence home health clients' quality of life. A socioecological perspective was used to understand influences on behaviors. Participants in this study were 400 home health clients who received services from home health agencies. A binary logistic model was used to determine the predictor variables of home health aides that contributed to home health clients' quality of life. Findings indicated that psychosocial skills were among the most predicted work-related performance of home health aides that lead …

Geographically Distributed Employees' Perceptions Of Employee Assistance Program Access, Davina Smith

Walden Dissertations and Doctoral Studies

Many investigators have documented high levels of stress in the U.S. workplace and the underutilization of employee assistance programs (EAP). Researchers in other studies have concluded that an employee's perception of a service influences participation and service use. However, the perceptions of geographically distributed employees, who represent a growing population, have not been sufficiently examined. The purpose of this study was to investigate geographically distributed employees' perceptions regarding access to EAP stress management services to address the problem of EAP underutilization. Organizational justice theory served as the theoretical framework. The study design was generic qualitative. A purposeful sample of 15 …

Stress, Social Support, And Mindfulness In Parents Of Children With Neurodevelopmental Deficits: A Quantitative Analysis, Branden D. Syrotchen

Walden Dissertations and Doctoral Studies

Parenting children with neurodevelopmental deficits (NDDs) is very stressful, more so than the parenting of typically developing children. There is considerable research on the topic of chronic stress experienced by caregivers; however, less is understood of parental stress experienced when raising children with NDDs. The purpose of this study was to examine how parental traits and habits, in the forms of mindfulness and social support levels, affect this cohort's general stress levels. The study was guided by Self-Determination Theory, which explored how parental acts could be classified along a continuum of being intrinsically or extrinsically derived. A convenience sample of …

The Experiences Of Counseling Graduate Students Who Participated In Professional Legislative Advocacy Training, Nakpangi Thomas

Walden Dissertations and Doctoral Studies

Legislative advocacy efforts are increasingly becoming part of a counselor's professional identity, yet scholarly literature lacks studies about experiences of counseling students involved in legislative advocacy for the counseling profession. The purpose of this study was to gain an understanding of the meaning counseling students ascribe to their involvement in legislative advocacy for the counseling profession. Astin's student involvement theory was the conceptual framework utilized to explore the lived experiences of counseling graduate students and recent graduates who participated in a 4-day long American Counseling Association Institute for Leadership Training on legislative advocacy and leadership or in professional legislative advocacy …

Differences Between Nontraditional And Traditional College Students' Perceptions Of Transition Preparedness, Laila Erika Turner

Walden Dissertations and Doctoral Studies

While scholars have used Schlossberg's transition theory for more than 35 years to study college-to-work transition, researchers have yet to establish if there are meaningful differences in the perceptions of traditional and nontraditional college students regarding transition preparedness from college-to-work. Following the career transition model, this quantitative study was conducted to compare traditional and nontraditional college students' perceptions of transition preparedness, specifically the concepts of readiness, confidence, control, perceived support, and decision independence. The nontraditional students in this study were military veterans. The dependent variables were measured by the Career Transition Inventory (CTI) survey. Participants were selected via a web-based …

Psychological Effects Of Training In Martial Arts After Interpersonal Trauma, Alexandro Garcia Vargas

Walden Dissertations and Doctoral Studies

Individuals who experience a traumatic event may have an adverse emotional reaction that negatively impacts their quality of life. The purpose of this qualitative phenomenological study was to explore the influence of training in the martial arts as an intervention in the treatment of interpersonal trauma. The biopsychosocial model provided the framework for the study. The research questions addressed the effects of training in the martial arts and the biological, psychological, and social functioning of individuals who had sustained a form of interpersonal trauma. Data were collected from semistructured interviews with 9 participants. Data were analyzed using Moustakas's modified van …

Decreasing Catheter-Associated Urinary Tract Infections In The Acute Care Setting, Marshanell Wright

Walden Dissertations and Doctoral Studies

The most important risk factor for developing a catheter-associated urinary tract infection (CAUTI) is the prolonged use of the urinary catheter. To address the CAUTI rate at the project site, which was higher than the national benchmark, a team of healthcare practice leaders developed an evidence-based algorithm addressing the appropriate indications for inserting or discontinuing a patient's Foley catheter. Using the plan-do-study-act model, the purpose of this quality improvement evaluation project was to evaluate the effectiveness of the evidence-based Foley algorithm for decreasing the use of Foley catheters and reducing the CAUTI rate and to explore whether using the Foley …

Development Of An Online Resource Manual And Online Protocol To Facilitate Care Coordination, Leonore Bingham

Walden Dissertations and Doctoral Studies

Persons with disabilities tend to be in poorer health compared to those without disabilities, and timely coordination of care is essential for maintaining optimal health and wellness. The problem addressed in the Care Coordination Referral Project was the lack of timely access to health care and preventive care services for clients with disabilities in the organization for which this project was developed. Using the appraisal of guidelines research and evaluation II model, the purpose of this DNP project was to analyze and synthesize the evidence-based literature to support the project and develop an online health care resource manual and protocol. …

A Quantitative Assessment Of Empathy After An Art Prime With Counseling Students, Annette Lisa Coletta

Walden Dissertations and Doctoral Studies

Empathy skills are necessary to form therapeutic relationships. Previous research showed that participating in the arts engaged similar neuropathways as those needed to produce empathy. The theoretical framework for this study was art therapy relational neuroscience. The purpose of this pretest, posttest quantitative research study, using the Toronto Empathy Questionnaire, was to examine if a single art session could effectively prime for empathy. Using nonprobability, convenience sampling method, 74 graduate counseling students completed online surveys. Four findings are of note: (a) a t-test showed a significant difference between mean values of pre-post test scores, (b) an independent groups t-test indicated …

Examining Congestive Heart Failure Hospital Readmissions From Skilled Nursing Facilities, Katherine Mary Day

Walden Dissertations and Doctoral Studies

In the United States, congestive heart failure (CHF) is a cardiac condition with increasing hospitalization and rehospitalization burden to patients, families, and the healthcare system. This chronic condition is expected to affect more than 8 million people by 2030; however, not much is known about the relationship between risk factors and hospital readmissions once CHF patients are discharged to a skilled nursing facility (SNF). Applying a systems theory unbounded systems thinking, coupled with a systems-thinking approach the purpose of this quantitative, retrospective cohort study was to examine CHF hospital readmissions from SNFs within a 90-day period using a secondary data …

Patient's Compliance With Diabetes Self-Management In The Primary Care Setting, Chidinma Onyegwu

Walden Dissertations and Doctoral Studies

Diabetes is a chronic disease that can be self-managed to control the disease and its adverse consequence. The purpose of this systematic literature review was to examine the barriers to patients' successful adherence to the self-management plan and to examine strategies used to improve patients' compliance with self-care behaviors. Three practice-focused questions focused on the personal characteristics or factors influencing patients' compliance with self-management, the barriers to patient compliance regarding diabetes self-management, and the effective strategies used to improve patients' compliance with diabetes self-management at primary care clinics. The literature review used the preferred reporting items for systematic reviews and …

Hemoglobin A1c And The Development Of Heart Disease In African American Men, Heather Walzel

Walden Dissertations and Doctoral Studies

Several studies have been conducted that link poor control of hemoglobin A1c (HbA1c) to an increased risk of heart disease. However, there are limited published studies that link HbA1c and heart disease based on ethnicity and gender. To address this gap in literature, the purpose of this study was to assess the association between HbA1c and heart disease in African American males (aged 30-64 years old) while controlling for education, income, and access to care. The research questions were focused on establishing an association between HbA1c values and heart disease in African American men through the lens of the health …

Social-Ecological Predictors Of Contraceptive Use In Ethiopia, Mekonen Fisseha Gebrekidan

Walden Dissertations and Doctoral Studies

Unintended pregnancy is a global public health threat that affects the lives of women, families, communities, and society. In 2008, the rate of unintended pregnancy in Ethiopia was 101 per 1,000 women aged 14 to 44 years. Although Ethiopia has experienced a steady increase in modern contraceptive use since 2004, this increase did not result in a proportional decline in unintended pregnancy, total fertility rates, or rapid population growth. In this cross-sectional study, associations between individual, interpersonal, community, and societal factors and contraceptive uptake were tested using a sample of 3,863 women aged 15 to 49 years who participated in …

The Shortage Of Licensed Social Workers In Central Florida, Helen M. Burrows

Walden Dissertations and Doctoral Studies

For several decades, a national shortage of licensed clinical social workers has been growing in the United States. Licensed social workers provide counsel and advocacy for those affected by mental illness, addiction, abuse, and discrimination, among other economic difficulties, and are the largest group of providers of mental and behavioral health services. The research questions for this project addressed what challenges unlicensed social workers in central Florida identify as barriers to pursuing clinical licensure. This study also explored strategies that unlicensed social workers in central Florida reported to address these barriers and encourage the pursuit of clinical licensure. The purpose …

Development Of An Interactive Game For Education Regarding Sexually Transmitted Infections, Sherri Arrington

Walden Dissertations and Doctoral Studies

Sexually transmitted infection (STI) prevalence rates are increasing in the United States and globally. Education has been found to be an important strategy for increasing STI testing and treatment rates among sexually active young adults. The goal of this project was to develop an interactive educational game suitable for young adults to decrease the social and economic burden of STIs. The health belief model informed the project. A moderated usability evaluation was conducted using the concurrent think-aloud technique. The participants (N = 5) were a purposive sample of professionals who played the interactive game and then completed Schnall, Cho, and …

Systematic Review Of Alternative Therapies To Treat Cancer Pain, Karla Michelle Bonilla Carmona

Walden Dissertations and Doctoral Studies

Cancer pain is a complex symptom that affects the quality of life of oncology patients, caregivers, and families. The limitations of pain management treatment for cancer patients can be attributed to the lack of knowledge and availability of nonpharmacological treatments. The purpose of this project was to identify and gather evidence on the effectiveness of nonpharmacological interventions in the treatment of cancer pain using the methodology of a systematic review. Watson's theory of human caring supported the project by incorporating the perception of treating the human being holistically during the illness process. The Johns Hopkins nursing evidence-based practice model provided …

Importance Of Perceived Social Support For Black Mothers Of Preterm Babies, Anita Lynn Brentley

Walden Dissertations and Doctoral Studies

Social support represents a network that provides for family, relatives, and friends and is an important predictor of future health and well-being. A knowledge gap exists in the literature regarding a need for social support for Black mothers of preterm babies. This qualitative study explored the perception of social support for Black mothers of preterm babies in Southwest Ohio. The phenomenological method of inquiry was used to gain an in-depth understanding of social support Black mothers receive after preterm birth. The social ecological theory provided a framework for understanding how individual, interpersonal, community, organizations, and policy affect a Black mother's …

The Influence Of Food Choices, Eating Habits, And Body Image Of African American Mothers On Childhood Obesity, Debrua Perniece Coleman

Walden Dissertations and Doctoral Studies

The food decisions, dietary patterns, physical activity, and weight-related convictions of African American mothers are affected by their self-perceptions and views of body weight. The gap in the literature regarding the impact of these perceptions on children's food choices, eating habits, and body image is significant. Using the health belief model as the theoretical foundation and a cross-sectional survey as the research design, this study assessed the potential relationship between mothers' and children's eating habits and whether mothers' perceptions of their children's body image were reliable indicators of childhood obesity. Eighty-six mothers provided demographic information and completed the Child Feeding …

The Impact Of Congressional Attention And Policy Mood On Public Health Funding, Evelyn Denise Dunn

Walden Dissertations and Doctoral Studies

Congressional appropriations for federal public health agencies are subjected to external factors throughout the congressional appropriations process, resulting in fluctuations in funding. Recent literature has focused on externals factors, such as political attention and public attitudes, that could influence government funding levels; however, the impact of these factors on federal public health funding was not addressed. The purpose of this study was to determine whether a relationship exists between these external factors and federal public health appropriations. A quantitative study was used to examine congressional attention, policy mood, and the influence on the change in the level of federal public …

Relationships Between Vocational Identity, Substance Use And Criminal Thinking Among Emerging Adults, Eileen Marie Delzell

Walden Dissertations and Doctoral Studies

Successful formation of a self-chosen, purposeful identity in personal, social, educational and vocational areas is a primary task for emerging adults, with failure to do so often resulting in cycles of substance use, unemployment, and delinquent/criminal behavior. The purpose of this quantitative study was to examine relationships between vocational identity, substance use, and criminal thinking within the population of emerging adults. The expectancy value theory of motivation, which states that identity may be a motivational construct between self-efficacy and subjective self-values, provided the foundation for the study. The online inventory platform PsychData was used to garner data from a sample …

Nurses' Perceptions Of Patient Encounters During Bariatric Weight Loss Surgery Education, Traci Edwynne Cullins-Clark

Walden Dissertations and Doctoral Studies

Many researchers have suggested positive patient-health provider relationships can positively impact patient outcomes. A few focused explicitly on bariatric weight loss surgery (BWLS) professional-patient interactions. This study is significant because BWLS is a recommended tool to combat obesity. The purpose of this study was to analyze the perceptions of BWLS education nurses regarding their patient encounters. This mixed methods research study used an online survey combining quantitative Likert scale questions and open-ended qualitative questions, with social cognitive theory as the theoretical foundation. These explored viewpoints relate to their patient relations expressed by a health professional. Health professional beliefs incorporated into …

Educating Nurses About Nurse Residency Program, Tammy Lea Franklin

Walden Dissertations and Doctoral Studies

Educating Nurses About a Nurse Residency Program

by

Tammy Lea Franklin

MSN, Walden University, 2012

BSN, Oklahoma City University, 2010

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

May 2019

The problem addressed in this project was the challenges related to retention of new graduate nurses. This includes Registered Nurses (RNs), Licensed Practical Nurses (LPNs), and Bachelor of Science Nurses (BSNs) on two medical/surgical units in an acute care facility. The purpose was to work with a project team to develop an education module and accompanying resources to present to …