Medicine and Health Sciences Commons^™

Association Of Social Support And Patient-Provider Communication And Medication Adherence, Laquasha Arenese Gaddis

Walden Dissertations and Doctoral Studies

The prevalence of hypertension in African Americans is the highest of any population in the United States, and this population also demonstrates lower rates of adherence to mediation. Social support and patient-provider communication have been considered as reinforcing factors to help hypertensive patients achieve optimal blood pressure control. The purpose of this study was to examine the association of social support and patient-provider communication and medication adherence for hypertensive African American men and women. The study was guided by the theory of reasoned action. This study was conducted to determine whether social support and patient-provider communication was associated with medication …

Veteran Administration Disease Model To An Interdisciplinary Healthcare Model, Bertha J. Harris

Walden Dissertations and Doctoral Studies

There is a growing need for healthcare teams within the Veterans Administration (VA) healthcare system to effectively collaborate and communicate to improve patient outcomes. The need to improve patient care in the Patient Aligned Care Team (PACT) has been well established. The scholarly literature does not provide evidence whether using the primary care PACT model on communication and teamwork by an interdisciplinary medical team ameliorates these communication breakdowns. Bronstein's design for interdisciplinary collaboration provided the overarching framework for this study. The purpose of this qualitative case study was to investigate the use of the PACT model on communication and teamwork …

Patient Satisfaction With Nursing Care Related To Hospital Magnet Designation, Sharon Haylett

Walden Dissertations and Doctoral Studies

Many U.S. hospitals have historically failed to recognize nursing as essential to quality of care. Given the relationship between the patients' experiences, measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), and government reimbursement, stakeholders now value the role of nurses in the care experience. Some hospitals have pursued Magnet designation, which is a rigorous and costly process, in order to promote patient satisfaction through nurse autonomy and retention. The purpose of this study was to understand whether non-Magnet hospitals received similar HCAHPS scores. Expectancy disconfirmation theory provides a framework to understand the components of patient satisfaction …

Teach-Back Process As A Best Practice In Patient Education, Laura Hoffman

Walden Dissertations and Doctoral Studies

Limited health literacy is a national problem. Nurses are in a position to address patients' limited health literacy skills using a universal precautions approach through the teach-back process. The purpose of this project was to plan a program to educate nurses on best practices in patient education. The theoretical framework informing this work was Bandura's social cognitive theory, which asserts that increases in knowledge and self-efficacy are precursors to affecting behavior change. The logic model was used to guide the project planning processes. Evidentiary sources included literature obtained online and through database searches, input from a team of experts and …

The Nurse And Certified Nursing Assistant Perception Of Person-Centered Care, Latonya Dickerson Hughes

Walden Dissertations and Doctoral Studies

Over the last decade, long-term care facilities have transitioned from institutional care models that focus on person-centered care, in which the resident is the center of the care. The purpose of this study is to explore the nurse and certified nursing assistant perception of the person-centered care services they deliver. Jean Watson's theory of human caring is the theoretical framework that guided this study. The theory focusing on the human caring experiences and person-centered care is being characterized as a caring feeling. The carative factors of Watson's theory, the fundamental concept of caring, has been associated with improved outcomes for …

Patients' Perceptions Of Diet-Only Therapy In The Prevention Of Diabetes Complications, Cornelia Emmanuel Inyang

Walden Dissertations and Doctoral Studies

Type 2 diabetes is a chronic metabolic disorder and the seventh leading cause of death in the United States. Type 2 diabetes is linked to many chronic diseases, including cardiovascular disease, stroke, and chronic kidney failure. African American adults have a high prevalence of Type 2 diabetes with early onset of diabetes complications. Poor dietary behavior is the primary cause of Type 2 diabetes and its complications, changing dietary behaviors can prevent the onset of diabetes complications or impede existing ones. The purpose of this phenomenological study was to explore patients' perceptions of diet-only therapy in the prevention of diabetes …

Venous Thromboembolism Prevention Education For Practitioners In The Acute Care Setting, Eppie Ann Labiche

Walden Dissertations and Doctoral Studies

During the last several decades, venous thromboembolism (VTE) has been identified as a preventable health condition. The gaps in clinical practice have led to an increased incidence of VTE. The lack of using existing evidence-based VTE prevention guidelines in practice has limited the implementation of VTE risk assessment stratifications and affected the appropriateness and timeliness of addressing pharmacologic and mechanical prophylaxis. The purpose of the scholarly project was to educate practitioners on existing VTE prevention practice guidelines. The practice-focused question explored whether an educational learning activity on evidence-based VTE prevention guidelines improved the awareness, knowledge, and compliance with existing evidence-based …

Cultivating Cultural Competence To Address Childhood Obesity In Ethnic Minority Youth, Tia Knight-Forbes

Walden Dissertations and Doctoral Studies

Obesity is an increasingly prevalent health issue, especially among children who live in high poverty, low income, and low education areas that lack needed resources and health care to promote quality of life. African American youth have a higher rate of obesity than other populations. The purpose of this project was to address an identified gap in practice by improving health care professionals' ability to provide culturally competent care to African American youth. An educational intervention framed by the Purnell model for cultural competence was developed to address the question, Will cultural competency staff education improve knowledge to prevent and …

The Lived Experiences Of Adult Male Trauma Survivors With Dance Movement Therapy, Jeanne Langston

Walden Dissertations and Doctoral Studies

In the United States, approximately 7.7 million individuals are affected by posttraumatic stress disorder (PTSD) at any given time. Though women are likelier to develop PTSD symptoms, men are exposed to more traumatic events in their lifetimes. Empirically- supported PTSD options exist, however clinical application of these treatments may not consistently culminate in beneficial outcomes. Dance Movement Therapy (DMT) has demonstrated positive treatment outcomes for a variety of mental and physical disorders. Nonetheless, there is a lack of robust research related to the treatment experiences of men who have participated in DMT for trauma-related symptoms. The purpose of this phenomenological …

The Meaning Of Instagram Use For Rheumatoid Arthritis Information, Deborah Lewis

Walden Dissertations and Doctoral Studies

Social media use related to chronic disease has become pervasive, yet few researchers have examined the influence of social media on health care message dissemination and health care outcomes. In this study, the use of Instagram, an image-rich social media platform, for sharing health information was examined. Nurses, as key providers of patient information, need to understand the relative effectiveness of different types of social media for health information, how social media is currently used by health care consumers, and how to best use various social media platforms to improve patient outcomes. The purpose of this study was to gain …

Reducing 30-Day Readmission Rates In Chronic Obstructive Pulmonary Disease Patients, Stacey Jerrick Machado

Walden Dissertations and Doctoral Studies

Early avoidable 30-day post discharge readmission among patients diagnosed with chronic obstructive pulmonary disease (COPD) is associated with poor transition care processes. The purpose of this project was to analyze organizational system processes for admission and discharge transition care of patients diagnosed with COPD to identify key intervention strategies that could decrease the rate of 30-day post-discharge readmission by 1%. The project used the transitional care model as the framework to target specific care transition needs and create patient-centered, supportive, evidence-based relationships among the patient, the providers, the community, and the health care system to identify key intervention strategies for …

Perspectives Of Patients With Comorbidity On The Use Of Ehealth Technology For Self-Management At Kenyatta National Hospital, Dorcas Waithira Maina

Walden Dissertations and Doctoral Studies

Health care systems still focus on single disease management and ignore the complexities of multiple conditions management. Though self-management is the focus of chronic disease management, patients with comorbidities face challenges in meeting their self-management goals. The purpose of this study was to explore the perspectives of patients with comorbid conditions on the use of eHealth technology to promote self-management. The research was grounded on the technology acceptance model. I sought to explore the participants' understanding of self-management, the challenges to self-management and their perspectives on the use of eHealth for self-management. In this phenomenological study, 10 interviews were conducted …

Understanding Parents' Disease-Managing Strategies For Children With Sickle Cell Disease, Michelle Noble Mackey

Walden Dissertations and Doctoral Studies

Sickle cell disease (SCD) is one of the most difficult and stressful chronic diseases for parents of afflicted children to manage. Managing SCD can be traumatic for parents particularly if they have no specific coping strategies for managing the disease or ensuring the child visits the doctor as scheduled. The use of certain coping strategies may affect the parents' and patients' perceptions of the illness and influence their decisions regarding treatment, which can have a lasting impact on their lives. Effective parental strategies such as positive thinking can aid in disease management, but there is limited research on the coping …

Health And Nitrate-Contaminated Drinking Water In The Lower Yakima River Valley, Michael David Mcnickle

Walden Dissertations and Doctoral Studies

In the United States, many private wells are used as the only source of potable water. These wells, under current federal and state regulations, are neither monitored nor checked for water purity. The purpose of qualitative case study was to gain an understanding about how the documented nitrate contamination problem in the Lower Yakima Valley River Valley is perceived by members of the community and to measure their willingness to engage in collective action for social change. Purposive samples of 6 participants were interviewed using 10 questions derived from the drinking water disparities framework by Balazs and Ray. Additional historical …

Antibullying Definition, Policy, Surveillance, Education, And Training In The Healthcare Field, Adlene Jones Mcelroy

Walden Dissertations and Doctoral Studies

Workplace bullying in the healthcare field has contributed to decreasing productivity, decreasing employee morale, increasing workplace lawsuits, overall dissatisfaction in the workplace, and potentially compromising care to patients. Little, however, is known about how public policies related to workplace bullying impact the experiences of healthcare workers. Using Cornell and Limber's conceptualization of bullying, the purpose of this general qualitative study was to better understand the experiences of healthcare leaders and workers related to workplace bullying of a single health care facility. Data were principally collected from 9 participants representing three organizational leaders, three nurses, and three ancillary members staff. These …

Successful Billing Strategies In The Hospital Industry, Samirah Merritt

Walden Dissertations and Doctoral Studies

Failure to collect reimbursement because of changing regulations negatively impacts hospital profitability. A multiple case study approach was used to explore the successful strategies billing managers employed to collect reimbursement for all legitimate Medicare claims. The target population for this study included 5 hospital billing managers from 3 organizations in the Northern New Jersey region. The complexity theory was used as a framework for assessing changing Medicare regulations and how the managers adapted to them. The data collection process for this study involved gathering data from participant interviews, documentation from the organizations of the participants, and government documented regulations and …

Developing A Clinical Practice Guideline For Improving Communication During Transitions Of Care, Darla P. Hardy

Walden Dissertations and Doctoral Studies

Transition of care refers to the movement of patients between health care settings; it occurs each time patients move between providers within the same setting or between settings based on the patient's acute or chronic health care needs. Care transition includes the efficient and accurate exchange of information needed to provide high-quality continuity of care. A rural community hospital in in the northeastern region of the United States has a skilled nursing facility and an acute care hospital on one campus. This project focused on the development of a clinical practice guideline (CPG) for the hospital to improve communication during …

Mentoring Relationship Preferences Of Early, Middle, And Late Career Stage Registered Nurses, Tonya M. Harewood-Lawrence

Walden Dissertations and Doctoral Studies

Registered nurses perceive the healthcare work environment as stressful. Stress can have a negative effect on patient care and nurses' attrition and health. In the literature, mentors have been identified as having a positive influence on nurses. This qualitative study was an examination of nurses in mentoring relationships in the early, middle, and late career stage and working in a hospital setting. Two research questions addressed mentoring relationship preferences and mentors' influence on perceived stress. Fourteen nurses were interviewed in the study. The conceptual framework was based on the career and psychosocial mentoring theory, the mentoring the adult learner theory, …

Transitioning From Student To Nurse Practitioner Using The One-Minute-Preceptor Model, Yetrevias Seymour

Walden Dissertations and Doctoral Studies

Nurse practitioners (NPs) are significant members of the health care team. Variation and lack of standardization in the practicum preparation of the NP has been identified as problematic. There is a need to improve NPs preparation to efficiently and independently impact health care. This project presented the 1-minute-preceptor (OMP) model as a standard tool in the practicum preparation of the NP through a preceptor-focused continuing education session. The aim of the OMP is to help ensure that students are exposed to the level of critical thinking and problem solving needed in the role of an independent, efficient NP. Knowles's adult …

Adult Clients' Experience Of Walk-And-Talk Therapy, Denice Crowe Clark

Walden Dissertations and Doctoral Studies

Standards of healthcare exist to promote beneficent treatment; however, treatment approaches are sometimes not supported by research, creating potential ethical issues for clinicians expected to use evidence-based practices. For example, walk-and-talk therapy, where therapy sessions incorporate physical activity in an outdoor setting, is being offered at increasing rates, but research regarding the practice is sparse and primarily reflects the therapists' experiences. Thus, the purpose of this interpretative phenomenological analytic study was to explore the clients' experience of the altered frame of walk-and-talk therapy through the conceptual lenses of therapeutic frame and the biopsychosocial model of well-being. Data were collected through …

Hiv Prevalence And Donor Funding In Ethiopia, Walelign Meheretu Kassahun

Walden Dissertations and Doctoral Studies

Many researchers have documented the trend of decreasing financial support from donors for human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) responses in Ethiopia. Less information is available regarding the correlation between trends of HIV prevalence and external funding and ways to address the impact that funding scarcity could cause. The purpose of this study was to examine the trend of HIV prevalence and donor funding levels, analyzing how the 2 are correlated, and opportunities to improve responses. Using the proximate determinant framework, the research questions examined the changes in HIV prevalence in Ethiopia during the past 10 years; the association …

Promoting Early Mobility Of Patients In The Intensive Care Unit, Sheryl L. Gilson

Walden Dissertations and Doctoral Studies

Deconditioning occurs in critically ill patients as early as 4 days after entering the intensive care unit (ICU) resulting in a loss of up to 25% peripheral muscle tone and 18% body weight by the time the patient is discharged. Early mobility (EM) has been shown to reduce complications such as neuromuscular weakness, muscle wasting, pneumonia, and the effects of prolonged periods of time on the ventilator. No formal education on EM had been provided to nurses at the clinical site. The purpose of this project was to develop an educational program on EM to promote early ambulation of critically …

Staff Education Program To Promote Breast Cancer Prevention Among African American Women, Vanessa Marie Palmer

Walden Dissertations and Doctoral Studies

African American women living in rural Ohio have a history of low mammogram

screening rates and a high incidence of breast cancer identification in the late stage of the

disease, leading to mortality rates exceeding those of Caucasian women. The purpose of

this doctoral project was to establish a breast health educational program for health

providers in a local mammography center that did not provide such a program

specifically targeted for African American women. Three theoretical frameworks, the

health belief model, Knowles's learning theory, and the PEN-3 model, guided the

development of a staff education program based on cultural appropriateness. …

Barriers To Male Faculty In Nursing Education, Troy Jeffrey Palmer

Walden Dissertations and Doctoral Studies

Men are underrepresented among nursing faculty, providing few role models for male students who might benefit from interaction with male faculty. Male nursing faculty may face barriers similar to those faced by women in male-dominated professions. Diehl and Dzubinski's model of gender-based barriers served as the framework for this quantitative study conducted to identify disparities between male and female nursing faculty that may prevent men from entering, continuing, and advancing in nursing education. The association between the percentage of male nursing faculty with geographic region; institution type (i.e., public, private secular, or private religious); and 4 career variables (i.e., education …

Coping Methods Of Caregivers Dealing With Patients Suffering From Geriatric Dementia, Blessing Baridakara Deemua

Walden Dissertations and Doctoral Studies

Dementia is a neurological disorder primarily diagnosed in the geriatric population. A problem for paid caregivers of patients diagnosed with stage-4 dementia is that they may experience caregiving stress while rendering care. However, there was no research that described the lived experiences of paid caregivers. Caregiving stress can be accompanied by behaviors or comorbid conditions and specific symptoms of stress can have a differential wellness impact. This phenomenological study explored the lived experiences of paid caregivers of patients with dementia through Vroom's expectancy theory. Data were gathered through interpretative interviews from a sample of 10 to 15 purposefully selected nursing …

Effect Of Health Information On Food Addiction Among Obese And Overweight Women, Kirsten Elyse Grant

Walden Dissertations and Doctoral Studies

Research on obesity, weight loss, and food addiction (FA) suggested a strong relationship between use of food additives and the brain's addictive response to food. Previous researchers have examined (FA) and have identified certain food additives such as monosodium glutamate (MSG) and high fructose corn syrup (HFCS) as contributors to food addiction and overeating. Social cognitive theory (SCT) has also been effective in addressing addictive behaviors such as drug addiction, alcohol addiction, and smoking cessation (Bricker et al., 2010). However, researchers had not examined food addiction, social cognitive theory, and obesity in the same study. The purpose of this quantitative, …

Optimizing A Disease Severity Scale For Evaluating Travelers' Diarrhea In Adults, Nicole Maier

Walden Dissertations and Doctoral Studies

Primary efficacy endpoints for interventional products targeting travelers’ diarrhea (TD) prevention have been predominately based on stool frequency. However, reliance on stool-based endpoints alone may obscure potentially meaningful differences in illness profiles. A single, standardized scoring system optimized for use in adult travelers is needed to accurately measure TD severity and enable more robust estimates of treatment or intervention effectiveness. The purpose of this quantitative secondary data analysis was to describe the variability in TD signs and symptoms across traditional severity metrics such as stool output, identify which symptoms were significantly associated with a negative impact on activity, and determine …

Nursing Educators' And Nursing Leaders' Views On Practice Readiness In Novice Nurses, Diane Robinson

Walden Dissertations and Doctoral Studies

A perceived discrepancy exists in understanding between nursing educators' and hospital nurse leaders' views on job performance expectations and the reality of current job performance that may contribute to the difficulty experienced by novice nurses during their transition period. Lack of clarity in expectations may lead novice nurses to change jobs or leave the nursing profession within the first year of practice. The purpose of this descriptive study, guided by Benner's novice to expert theory, was to determine whether a difference exists between hospital nurse leaders' beliefs and nursing educators' beliefs about the frequency and competency levels, including leadership for …

Reducing Errors With Blood Administration Transfusion Systems, Kim D. Stevens

Walden Dissertations and Doctoral Studies

The intention of implementing technology into healthcare practices is to reduce opportunity for errors in the delivery of providing health care. However, errors still occur, and many times are preventable. Configurations of health information technology systems should match clinical workflows to promote usage as intended. The purpose of this quality improvement project was to evaluate the impact of revised system configurations and use of a blood product transfusion system for the administration of blood products after one year of implementation. The method of heuristic evaluation is a usability engineering method for finding problems in a user interface design with the …

Assessment Of Cancer-Related Fatigue In Breast Cancer Survivors, Meagan Walker

Walden Dissertations and Doctoral Studies

Cancer-related fatigue (CRF) is a persistent and debilitating problem for many breast cancer survivors. Although many CRF measurement tools are available, no consensus exists on the most appropriate tool to use for breast cancer survivors. The purpose of this project was to identify the best method of assessing CRF in breast cancer survivors. The practice-focused question inquired about the most appropriate way to assess fatigue in breast cancer survivors. The central concepts of the project were CRF and cancer survivorship. This project was informed by the theory of health as expanding consciousness and Mishel's theory of uncertainty in illness. The …