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2020

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Articles 19291 - 19320 of 20660

Full-Text Articles in Medicine and Health Sciences

Quality Of Life, Physical Activity, And Weight Status For A Sample Of Online Students, Walaa Awad Jan 2020

Quality Of Life, Physical Activity, And Weight Status For A Sample Of Online Students, Walaa Awad

Walden Dissertations and Doctoral Studies

Obesity has been identified as a global health problem and a risk factor for many chronic diseases. While previous studies discussed the weight status and factors associated with overweight and obesity among adults enrolled in traditional universities, few studies have yet estimated the obesity rate among adults who choose online education. Guided by the social cognitive theory, this descriptive exploratory quantitative study used a survey to collect primary data from adult online students of three higher educational institutions. The survey examined the effect of quality of life and physical activity level on the weight status of the participants; taking into …

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Comparison Of Advance Care Planning Interventions And Older Adults’ Advance Directive Completion Rates, Tammy Biehler Jan 2020

Comparison Of Advance Care Planning Interventions And Older Adults’ Advance Directive Completion Rates, Tammy Biehler

Walden Dissertations and Doctoral Studies

Despite the benefits of advance care planning (ACP), only one third of older adults in the United States have completed it. To address this gap, health care organizations are implementing ACP programs to engage older adults in the process. These programs can be delivered in various ways, including 1:1 conversations, classes, and web-based tools. The purpose of this quantitative study was to investigate which ACP option was associated with highest participation and advance directive (AD) completion rates in older adults. Social cognitive theory provided the framework to understand the impact the ACP environment and personal characteristics’ have on the odds …

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Student Nurse Perceptions Of Horizontal Violence During Clinical Hospital Rotations, Phoebe Marie Burda Jan 2020

Student Nurse Perceptions Of Horizontal Violence During Clinical Hospital Rotations, Phoebe Marie Burda

Walden Dissertations and Doctoral Studies

The nursing profession is facing its largest professional nurse deficit in history. With nursing schools unable to produce enough new nurses to replace the number of nurses retiring, it becomes increasingly important to retain as many nurses as possible within the profession. Nursing research literature has reported that up to 60% of newly registered nurses will leave their first job within their first year of practice citing horizontal violence as a contributing factor. The literature does not address if or how early student nurses might perceive exposure to horizontal violence. The purpose of this qualitative, interpretive, phenomenological study was to …

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The Relationship Between Mental Illness And Mass Shooting, Priscilla Ngozi Chukwueke Jan 2020

The Relationship Between Mental Illness And Mass Shooting, Priscilla Ngozi Chukwueke

Walden Dissertations and Doctoral Studies

AbstractWhenever a mass shooting occurs, it impacts the immediate families of the perpetrator, victims, and the whole nation: emotionally and financially. The research on the association between mental illness (MI) and mass shooting fatalities is limited. The purpose of this quantitative, cross-sectional study was to explore the association between MI and mass shooting using the archival data of the Stanford University database of mass shootings in America from 2000 to 2016. The theoretical framework was based on Bronfenbrenner’s social-ecological theory and the cognitive-behavioral theory to explain socio-environmental factors that impact human growth and development. The results showed that the proportion …

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Risk Factors Of Infant Mortality Disparity In Indian River County, Florida, Cecilia Miguelina Escorbore Jan 2020

Risk Factors Of Infant Mortality Disparity In Indian River County, Florida, Cecilia Miguelina Escorbore

Walden Dissertations and Doctoral Studies

Infant mortality in the United States is a great concern to families, communities, and professionals in the public health field. More concerning is the infant mortality racial disparity, prevalent throughout the United States. The purpose of this study was to explore risk factors of infant mortality disparity in Indian River County (IRC), Florida. Using socioecological theory as the theoretical framework, this study explored whether there is an association between infant mortality among Black infants and geographic location as well as measures of socioeconomic status (age, educational level, health insurance status, and marital status) associated with infant mortality among Black infants …

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Therapeutic Communication Skills For Nurses Working With People Living With Hiv, Charaine Ferguson Jan 2020

Therapeutic Communication Skills For Nurses Working With People Living With Hiv, Charaine Ferguson

Walden Dissertations and Doctoral Studies

Internalized stigma experienced by people living with HIV (PLWH) has been associated with numerous untoward health outcomes. Nurses' and healthcare professionals’ ability to effectively communicate can significantly affect the experience of stigma in PLWH. The practice-focused question was whether an interactive educational project could improve the knowledge and intent to use collective communication skills in nurses. This project uses concepts from Peplau's interpersonal relationship theory, principles of therapeutic communication, and unconscious bias. Online training content included patient testimonials related to stigma, discussions of unconscious bias by the Institute for Healthcare Improvement and Mayo Clinic professionals, review of Harvard University’s Implicit …

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Racial Disparities In Periconceptual Folic Acid Levels, Kelvin Gibson Jan 2020

Racial Disparities In Periconceptual Folic Acid Levels, Kelvin Gibson

Walden Dissertations and Doctoral Studies

Periconceptional folate level deficiencies are associated with birth defects of the brain and spinal cord, posing a significant public health problem. In 2009, Black and Hispanic women exhibited lower periconceptual folate levels and higher rates of folate-related birth defects compared with non-Hispanic White women, prior to enactment of the Affordable Care Act (ACA) of 2010. It is not known if improved access to prenatal care under the ACA narrowed the gap in mean periconceptual folate levels between non-Hispanic White, Black, and Hispanic women between 2009 and 2017. The purpose of this causal-comparative cross-sectional quantitative study was to determine whether there …

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Socioeconomic And Health-Related Factors Affecting Congestive Heart Failure Readmissions, Jollibyrd Miguel Gusto Jan 2020

Socioeconomic And Health-Related Factors Affecting Congestive Heart Failure Readmissions, Jollibyrd Miguel Gusto

Walden Dissertations and Doctoral Studies

Congestive heart failure (CHF) readmissions are frequent and costly, but preventable. These readmissions not only contribute to rising healthcare cost but also affect the quality of life of these individuals and their loved ones. Guided by the social ecology model for health for health promotion, the purpose of this study was to analyze the socioeconomic and health-related factors of CHF readmissions. The main hypothesis of this study was that there was a relationship between 30-day readmissions of individuals with CHF and their payer status, race, ethnicity, primary language spoken, living arrangement, and comorbidities in the dataset as identified in their …

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Providing Evidence-Based Education About Caring For Patients With Atrial Fibrillation, Rose M. Happy Jan 2020

Providing Evidence-Based Education About Caring For Patients With Atrial Fibrillation, Rose M. Happy

Walden Dissertations and Doctoral Studies

Abstract In a multidisciplinary health care team, nurses are often the initial contact when patients present for clinical evaluation. Thus, it is of great importance that these nurses provide education to patients that is current and evidence-based. The target population of this project was nurses who care for patients with atrial fibrillation (A-Fib). The practice problem was the knowledge gap related to A-Fib. The purpose of the project was to provide an evidence-based, nursing education intervention to increase their knowledge. The practice-focused question sought to determine whether participation in the evidence-based education intervention increased nurses’ knowledge scores about providing care …

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Sexual Education, Sexual Initiation, And Contraceptive Use Among African American Young Women, Kineka J. Hull Jan 2020

Sexual Education, Sexual Initiation, And Contraceptive Use Among African American Young Women, Kineka J. Hull

Walden Dissertations and Doctoral Studies

Unintended pregnancy is associated with adverse social, economic, and health outcomes making it a public health concern. African American (AA) women aged 18–24 are at higher risk of unintended pregnancy due to earlier sexual initiation and non-use, inconsistent, or improper use of contraceptive methods (CM). The purpose of this study was to investigate the extent to which receipt of formal sexual health education (FSHE) impacts age of sexual initiation and contraceptive use and selection of more effective CMs (ECMs) among AA women aged 18–24 (N = 242) who have sex with men. Driven by the reasoned action approach, 2015–2017 National …

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Primary Care Physicians’ Knowledge And Perception Of The Impact Of Health Literacy On Patient Care, Lutrisha S. King Jan 2020

Primary Care Physicians’ Knowledge And Perception Of The Impact Of Health Literacy On Patient Care, Lutrisha S. King

Walden Dissertations and Doctoral Studies

Until recently, many health literacy studies were completed from the patient and nurse perspective, while few focused on the physician perspective, specifically the primary care physician. The purpose of this study was to provide insight into the health literacy knowledge and education of primary care physicians and determine the association, if any, between physicians’ perceptions of patients’ limited health literacy and physicians’ use of health literacy communication techniques. The knowledge, attitudes, and practice (KAP) framework directed this study. This framework posits that knowledge informs or influences attitudes, which leads to practices. The KAP framework was employed to answer the research …

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Microvascular Disease And Chronic Kidney Disease In Persons With Diabetes In Grenada, Jennifer Elizabeth Lewis Jan 2020

Microvascular Disease And Chronic Kidney Disease In Persons With Diabetes In Grenada, Jennifer Elizabeth Lewis

Walden Dissertations and Doctoral Studies

Chronic kidney disease (CKD) is a set of pathophysiological reactions that impact the functionality of the kidney. The association between microvascular disease (MVD) and CKD as it relates to diabetes is important to the evaluation of organizational effectiveness in-hospital services planning as well as improving health outcomes. The purpose of this quantitative, cross-sectional study was to determine if there is an association between MVD and CKD severity in persons with diabetes. Using the socioecological model, the association between gender, age group, cigarette smoke, cigarette smoke frequency, alcoholic drink, alcoholic drink frequency, hypertension, albumin-to-creatinine ratio (ACR) severity, cholesterol, sickling (i.e. persons …

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Exploring Family-Centered Care From The Perspectives Of Home-Health Physical Therapists, James Mathews Jan 2020

Exploring Family-Centered Care From The Perspectives Of Home-Health Physical Therapists, James Mathews

Walden Dissertations and Doctoral Studies

Older adults may need, or desire, caregiver and family involvement to avoid hospitalizations and institutionalizations. The caregivers of these older adults have the highest rates of burnout, injury, and turnover. Family-centered care (FCC) involves collaboration between healthcare practitioners, patients, family members, and caregivers. FCC is both established and effective in pediatric care settings. There is a paucity of evidence on how FCC is applied to older adult populations. Home health physical therapists (HHPTs) work with older adults in their homes and train both family members on how to safely handle and manage the care-dependent older adult. The purpose of this …

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Strategies For Implementing The International Organization For Standardization 15189 For Medical Laboratories, Wilson Mtotela Jan 2020

Strategies For Implementing The International Organization For Standardization 15189 For Medical Laboratories, Wilson Mtotela

Walden Dissertations and Doctoral Studies

Inadequate quality management systems (QMS) in medical laboratories result in errors, which cost the United States healthcare industry approximately $29 billion per year. Healthcare managers who fail to implement the International Organization for Standardization (ISO) 15189 QMS are at high risk of managing costs. Grounded in Lewin’s 3-step organizational change model and the force field analysis, the purpose of this qualitative multiple case study was to explore strategies healthcare managers use to design, develop, and implement an ISO 15189 QMS using a mentorship approach. The participants comprised 5 healthcare managers from the United Republic of Tanzania, East Africa, who implemented …

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Barriers That Influence The Underuse Of Mental Health Services By African Americans Diagnosed With Schizophrenia, Pamela Gail Stackhouse-Hinsey Jan 2020

Barriers That Influence The Underuse Of Mental Health Services By African Americans Diagnosed With Schizophrenia, Pamela Gail Stackhouse-Hinsey

Walden Dissertations and Doctoral Studies

African Americans diagnosed with schizophrenia have longer wait times to be treated by mental health care professionals, resulting in their underuse of mental health services. This problem has motivated medical professionals to reexamine the ways in which services are rendered and then make appropriate improvements. The purpose of the study was to explore the lived experiences of African Americans diagnosed with schizophrenia and identify the reasons for their underuse of mental health services. A phenomenological research design was used to understand and explore the participants’ lived experiences of the phenomenon. Participants were recruited from an independent living facility. Purposive sampling …

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Crisis Intervention Team Training: Full Implementation, Roy Garvin Taylor Jan 2020

Crisis Intervention Team Training: Full Implementation, Roy Garvin Taylor

Walden Dissertations and Doctoral Studies

Law enforcement officers (LEOs) encounter unique challenges when responding to calls involving an emotionally disturbed person (EDP) in crisis. In these situations, the LEOs are not merely acting in a law enforcement capacity but also taking on the roles of mental health workers, social workers, and other community support services. Unfortunately, most LEOs lack clear direction and training to effectively serve this unique population, with the typical encounter resulting in the arrest of the EDP and often ensuing in a vicious circle of arrest, incarceration, and recidivism. This phenomenological qualitative study used the perceptions of active Crisis Intervention Team (CIT) …

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Outpatient Mental Health Service Utilization For Depression And Anxiety Post-Hurricane, Corey Darnell Taylor Jan 2020

Outpatient Mental Health Service Utilization For Depression And Anxiety Post-Hurricane, Corey Darnell Taylor

Walden Dissertations and Doctoral Studies

Increased depression and anxiety diagnoses are a result of the lack of use or underuse of outpatient mental health services, specifically among African Americans, youths, and the homeless, and this is a current issue in New Orleans, Louisiana post-Hurricane Katrina. Funding constraints due to the termination of the Louisiana Spirit Program contributed to deficits in terms of outpatient mental health facilities in New Orleans. The purpose of this quantitative study was to examine the association between the continuum and utilization of outpatient mental health services for African Americans, youth, and the homeless for those diagnosed with depression and anxiety. Andersen’s …

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Assessing School-Based Telehealth Utilization In Medically Underserved Communities, Danielle Wesley Jan 2020

Assessing School-Based Telehealth Utilization In Medically Underserved Communities, Danielle Wesley

Walden Dissertations and Doctoral Studies

Medically underserved communities face challenges accessing health care services, and millions of Americans have no access to primary care. In many areas of the United States, the supply of primary care providers cannot keep up with the demand for health services. Newer healthcare delivery models are needed to address the issue. Using telehealth can augment the physician workforce shortages. The purpose of this quantitative dissertation is to examine the associations of telehealth utilization using a pediatric school-based telehealth model in Health Professional Shortage Areas (HPSAs) in North Texas. Texas has many counties without a primary care provider, making them medically …

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Relationship Between Hospital Performance And Medicare Reimbursement Penalties, Ashley Bays Jan 2020

Relationship Between Hospital Performance And Medicare Reimbursement Penalties, Ashley Bays

Walden Dissertations and Doctoral Studies

Medicare reimbursement penalties are a financial concern for health care leaders when hospitals underperform in the specific measures of hospital performance defined by the Hospital Value-Based Purchasing Program. Grounded in the general contingency theory, the purpose of this correlational study was to determine the relationship between the measures of hospital performance, clinical care, person and community engagement, safety, efficiency and cost reduction, and Medicare reimbursement penalties. Secondary data from the Centers for Medicare and Medicaid Services were collected from 420 acute care urban hospitals designated as teaching facilities with a bed size between 100–299 beds for the fiscal year 2019. …

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Environmental Barriers To Accessing Tertiary Prevention Among Hispanics Diagnosed With Type 2 Diabetes, Stella B. Biira Jan 2020

Environmental Barriers To Accessing Tertiary Prevention Among Hispanics Diagnosed With Type 2 Diabetes, Stella B. Biira

Walden Dissertations and Doctoral Studies

In the United States, Hispanics diagnosed with type 2 diabetes (T2DM) have not accessed tertiary level prevention, which is critical in diabetes management and the prevention of further complications. The purpose of this quantitative study was to examine the association between neighborhood crime, the absence of community health centers, the lack of culturally competent providers, the lack of public transportation, the residential setting, the distance to T2DM education classes, and access to tertiary prevention among Hispanics diagnosed with T2DM. The research was guided by the Andersen behavioral model. A sample size of N = 4,977 was used in the study, …

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Importance Of Early Recognition Of Extrapyramidal Symptoms (Eps) In A Community Mental Health Clinic, Jamil E. Davis Jan 2020

Importance Of Early Recognition Of Extrapyramidal Symptoms (Eps) In A Community Mental Health Clinic, Jamil E. Davis

Walden Dissertations and Doctoral Studies

AbstractThe purpose of this project was to address the lack of knowledge of nurses in recognizing extrapyramidal symptoms during the early stages of clinical presentation in patients taking antipsychotic medication. Nursing staff need to be properly training to be effective. Maslow's hierarchy of human needs informed this project. The primary goal of this project was to identify if an instructional seminar regarding EPS symptoms and management would increase the knowledge of the nursing staff. The project had a sample size of 7 and the criteria for inclusion included licensed professional nurses working in the clinical setting of mental health. The …

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Family Rejection And Unprotected Sex Inlatino Gay Men, Juan Alejandro De Llano Montano Jan 2020

Family Rejection And Unprotected Sex Inlatino Gay Men, Juan Alejandro De Llano Montano

Walden Dissertations and Doctoral Studies

The present work explored the role of family rejection on the sexual behavior of Latino gay men under the guidance of the minority stress model. Family rejection was analyzed as a distal stressor, self-esteem as a proximal stressor, and unprotected sex as the outcome. The hypotheses were tested using regression, mediation, and multiple regression of secondary data from the Latino men who have sex with men (MSM) community involvement project. The results suggested that family rejection is a weak predictor of low self-esteem and engaging in receptive unprotected sex with more partners. Low self-esteem did not mediate the relationship between …

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Treatment Disparities In Black And Hispanic Children With Attention-Deficit Hyperactivity Disorders, Charlotte Seiji Frey Jan 2020

Treatment Disparities In Black And Hispanic Children With Attention-Deficit Hyperactivity Disorders, Charlotte Seiji Frey

Walden Dissertations and Doctoral Studies

Disparity in diagnosis and treatment of attention deficit hyperactivity disorder (ADHD) among children has been studied; however, no known studies examining disparities based on severity of symptoms have been investigated. The purpose of this study was to assess the racial disparities in diagnosis and treatment that exist among children based on severity of symptoms. This cross-sectional quantitative analysis used data from the 2016 National Survey of Children's Health and the theoretical foundation was guided by the behavioral model of healthcare utilization and help-seeking behavior for ADHD. Binomial logistic regression analysis showed an overall association between race and the diagnosis and …

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Effective Strategies To Reduce Employee Absenteeism Amongst Canadian Female Employees, Sue Haywood Jan 2020

Effective Strategies To Reduce Employee Absenteeism Amongst Canadian Female Employees, Sue Haywood

Walden Dissertations and Doctoral Studies

High absenteeism in female employees costs Canadian hospitals millions of dollars annually. Leaders of Canadian hospitals who lack strategies to reduce absenteeism in female employees witness significant financial losses in their organizations. Grounded in Herzberg's two-factor theory, the purpose of this multiple case study was to explore strategies Canadian hospital leaders used to reduce absenteeism in female employees. Data were collected from semistructured interviews, annual reports, and publicly available datasets relating to hospital retention strategies and were analyzed using a thematic analysis. Four themes on strategies to reduce absenteeism emerged: creating a supportive stance towards absenteeism, investing in mental health …

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Neighborhood Factors, Depression, And Body Mass Index Among Patients With Lupus In Georgia, Aisha L. Hill Jan 2020

Neighborhood Factors, Depression, And Body Mass Index Among Patients With Lupus In Georgia, Aisha L. Hill

Walden Dissertations and Doctoral Studies

Elevated BMI (overweight and obesity) is a common health-related issue and affects more than half of the lupus population. Weight issues lead to additional health-related issues, such as heart disease and disabilities in the lupus population. To address the shortage of research focusing on this specific issue in the lupus population, one approach is a novel outlook on how neighborhood factors have the capability of determining or altering behaviors, such as physical activity, healthy eating, and healthy social relationships. Another variable to consider is depression and its capability of altering interactions, relationships, self-esteem, or even the inflammatory state of the …

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Identifying Strategies That Address Race-Based Traumatic Stress Of African Americans In Rural Mississippi, Syrenia Johnson Jan 2020

Identifying Strategies That Address Race-Based Traumatic Stress Of African Americans In Rural Mississippi, Syrenia Johnson

Walden Dissertations and Doctoral Studies

There has been a dramatic increase of race-based encounters that have had an extensive health impact on African Americans. Social workers and other mental health professionals play a crucial role in working with African American adults who experience race-based traumatic stress. The purpose of this qualitative study was to identify strategies to address race-based traumatic stress from a mental health perspective. Racial encounter coping appraisal and socialization theory (RECAST) guided this study where eight social workers from the local community mental health center in rural Mississippi completed an open-ended questionnaire to identify and determine culturally competent treatment strategies for African …

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Exploration Of Ehr Implementation Strategies: A Qualitative Study, Scot Eric Loerch Jan 2020

Exploration Of Ehr Implementation Strategies: A Qualitative Study, Scot Eric Loerch

Walden Dissertations and Doctoral Studies

AbstractElectronic health record system implementations have a high failure rate when properly developed strategies are not used. These implementation failures affect healthcare workers and practitioners core roles through a lack of documentation practices, which decreases the quality of the care of the patients. Grounded in the technology acceptance model, the purpose of this qualitative multiple case study was to explore the strategies information technology systems engineers use for the implementation of Health Information Management Systems. The participants were 10 information technology systems engineers from three healthcare organizations in the greater Tennessee area. The data were collected through recorded participant interviews …

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Exploring Staff Nurse Interactions In Their Role As Student Nurse Educators, Jennifer Nafarrete Jan 2020

Exploring Staff Nurse Interactions In Their Role As Student Nurse Educators, Jennifer Nafarrete

Walden Dissertations and Doctoral Studies

The majority of nurse education occurs in academic settings, but up to 40% can occur in hospital settings. Nurse education programs rely on the staff nurses who work in the hospitals to serve as student nurse educators and fulfill the clinical education requirement of their academic programs. The problem for this study is that staff nurses in their role as student nurse educators often have negative interactions with student nurses that do not promote learning in the clinical setting. The purpose of this qualitative study was to better understand how student nurse educator interactions with student nurses are positively influenced …

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Job Satisfaction, Work Environment, Job Stress, And Professional Identity Among Psychiatric Nurses, Tosin Rabiu-Akewusola Jan 2020

Job Satisfaction, Work Environment, Job Stress, And Professional Identity Among Psychiatric Nurses, Tosin Rabiu-Akewusola

Walden Dissertations and Doctoral Studies

Job satisfaction is one of the most complex issues in the healthcare industry in regard to employees. To boost employees' productivity and job satisfaction, nurse leaders must satisfy their employees' needs by providing the right working conditions, reducing job stress, and promoting professional identity development. This quantitative, cross-sectional correlational study guided by Herzberg et al.s two-factor theory investigated the relationship among work environment, job stress, professional identity, and job satisfaction among 105 registered nurses working in inpatient psychiatric hospitals in the United States. It was determined that the moderating effect of demographic factor (years of experience) on the extent to …

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Factors Associated With Flu Vaccination Status Among Older Hispanics In The United States, William Esteban Toledo Velazquez Jan 2020

Factors Associated With Flu Vaccination Status Among Older Hispanics In The United States, William Esteban Toledo Velazquez

Walden Dissertations and Doctoral Studies

AbstractOlder Hispanics in the United States are less likely to be vaccinated with the flu vaccine compared to older White Americans, despite being at higher risk of influenza-associated deaths and hospitalizations. A quantitative cross-sectional study based on the social ecological model was carried out to evaluate the influence of several sociodemographic and health factors on flu vaccination status among elderly Hispanic individuals in the United States. Logistic regression analyses were conducted using secondary data collected from 95,414 elderly Hispanic and White American 2018 Behavioral Risk Factor Surveillance System participants. Multivariate logistic regressions controlling for other variables revealed health care coverage …

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