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Articles 1 - 30 of 465
Full-Text Articles in Medicine and Health Sciences
The Influence Of Community-Based Interventions On Behaviors Of Hiv+ Persons In Congo-Kinshasa, Max Ebengho Bokelo
The Influence Of Community-Based Interventions On Behaviors Of Hiv+ Persons In Congo-Kinshasa, Max Ebengho Bokelo
Walden Dissertations and Doctoral Studies
AbstractSub-Saharan African communities bear the highest burden of HIV/AIDS in the world. Because of identifiable cultural links and local beliefs, people are more likely to engage in sexual mores that could negatively impact their lives. Starting in early 2000, Congolese HIV+ patients have undergone a variety of inputs designed to decrease HIV risk behaviors among people. The purpose of this inquiry was to understand the impact of those actions within the community. Data grounded on the socioecological model were collected regarding any changes in (1) behavioral rejection of condoms, (2) Kintwidi phenomenon, (3) levirate and (4) sororate marriage, (5) sexual …
Improving Nurses’ Knowledge To Provide Diabetes Self-Management Education For African Americans, Jakeyla Reed
Improving Nurses’ Knowledge To Provide Diabetes Self-Management Education For African Americans, Jakeyla Reed
Walden Dissertations and Doctoral Studies
African Americans are at high risk for type II diabetes compared to other ethnic groups due to biological, socioeconomic, and psychosocial risks. Specifically, African American adults are nearly two times more likely than White individuals to develop type II diabetes. The meaningful gap-in-practice addressed by this doctoral project was nurses’ lack of diabetes knowledge affecting their ability to provide diabetes care and diabetes self-management education (DSME) to their patients with diabetes. The clinical practice-focused question asked whether an education intervention for outpatient clinic nurses could improve their knowledge of DSME. Orem’s self-care model, Bandura’s self-efficacy theory, and Lewin’s change theory …
Improving Nursing Knowledge On Antibiotic Therapy To Prevent Pneumonia Readmissions, Muskuda Deen
Improving Nursing Knowledge On Antibiotic Therapy To Prevent Pneumonia Readmissions, Muskuda Deen
Walden Dissertations and Doctoral Studies
Lack of education on the appropriate use of antibiotic therapy can lead to an increase in early readmissions for patients with community-acquired pneumonia (CAP). The purpose of this project was to educate medical-surgical nurses at an inpatient hospital in the southern region of the United States on the appropriate use of antibiotic therapy to decrease early CAP readmissions. The project practice question was whether the infection control clinical practice guidelines would increase the medical-surgical nurses’ knowledge on the appropriate use of antibiotic therapy to decrease the 30-day readmission rates for patients diagnosed with CAP. The staff education development was guided …
Meaningful Use Criteria And Staff Accountability In An Office Setting, Marcia Ionie Pender
Meaningful Use Criteria And Staff Accountability In An Office Setting, Marcia Ionie Pender
Walden Dissertations and Doctoral Studies
Proper documentation for meaningful use (MU) criteria within electronic health records (EHRs) was identified as an issue for office staff at a local primary care office in a metropolitan area of Central Florida. The project question addressed the local gap in knowledge about MU standards necessary to ensure correct documentation of EHRs. The purpose of this doctoral project was to provide an educational program for staff to ensure compliance with the HITECH Act of 2009. Lewin’s Change Theory and Knowles Theory of Adult learning were the conceptual foundations for the educational program. The project question was to determine whether a …
Educational Strategies For Healthcare Providers Of Postpartum Women With Substance Use Disorder, Agnes Denise White
Educational Strategies For Healthcare Providers Of Postpartum Women With Substance Use Disorder, Agnes Denise White
Walden Dissertations and Doctoral Studies
AbstractProviding educational strategies to maternal-child staff members can improve their attitudes, perceptions, and stigma towards the childbearing age women who are substance users. In the United States, an increased number of pregnant women have substance abuse problems. It is important that the maternal child staff have the resources and are equipped to care for women who are substance users struggling with their addictions and motherhood. The purpose of this project was to determine whether an educational program provided to postpartum nurses increased knowledge on the special needs of the new mother with a substance abuse issue. The education of the …
Improving Fall Risk Knowledge Through Staff Education In An Assisted Living Facility, Assumpta Egowure Ike
Improving Fall Risk Knowledge Through Staff Education In An Assisted Living Facility, Assumpta Egowure Ike
Walden Dissertations and Doctoral Studies
AbstractPatient safety and fall prevention are crucial for nurses and healthcare workers especially in assisted living facilities considering the age and health status of the patients. Low staff knowledge of fall risk measures in an assisted living facility may have contributed to an increase in the number of falls recorded in the facility by 20% in the last 2 years. This project addressed the questions of whether an education project could increase staff’s level of knowledge on fall risk measures, and whether any improved knowledge would coincide with the number of falls per patient day in the assisted living facility? …
Evidence-Based Strategies Used By Primary Care Providers In Early Hospice Referrals, May Tanay
Evidence-Based Strategies Used By Primary Care Providers In Early Hospice Referrals, May Tanay
Walden Dissertations and Doctoral Studies
Despite scientific evidence suggesting that hospice care improves quality of life (QOL) at end of life (EOL), terminally ill patients are being referred to hospice too late. A considerable number of terminally ill patients are referred directly from the inpatient unit. Often, these patients have not had a goal-of-care conversation (GOC) with their primary care provider (PCP) nor have they been offered hospice care until hospitalization. It is imperative that PCPs, advocate and support patients and families during all stages of life including EOL. This doctoral project was completed for the purpose of identifying strategies used by PCPs that enhance …
Effectiveness Of 7-Day And 30-Day Interval Aftercare To Reduce Psychiatric Readmissions, Aldrick Dwight Barr
Effectiveness Of 7-Day And 30-Day Interval Aftercare To Reduce Psychiatric Readmissions, Aldrick Dwight Barr
Walden Dissertations and Doctoral Studies
The results for psychiatric readmissions and 7- and 30-day follow-up care post psychiatric discharge are mixed. Psychiatric readmissions of psychiatric patients are costly. The purpose of this quantitative study was to evaluate the association between 7- and 30-day follow-up care percentages and 30-day readmission rates for an inpatient psychiatric facility (IPF). The transtheoretical model was used to assess patient readiness for behavior change and a patient-centered guide that provides strategies for patient progression during hospital readmission and post psychiatric hospital discharge. In this study, a quantitative, correlational research design utilizing public secondary data retrieved from the Centers of Medicaid and …
The Importance Of Staff Education About Implementing Ketogenic Diet In Prediabetic Patients, Clarissa L. Dorsey
The Importance Of Staff Education About Implementing Ketogenic Diet In Prediabetic Patients, Clarissa L. Dorsey
Walden Dissertations and Doctoral Studies
Diabetes, a chronic disease that can lead to many complications, is one of the leading causes of death. Obesity tends to increase the risk of diabetes. Nutritional therapy can not only control diabetes but also prevent it in some cases by decreasing weight. The ketogenic diet is a low-carbohydrate, high-fat diet that can prevent and control diabetes. The purpose of this study was to examine the recommendations of medical providers before and after the presentation of educational content on the ketogenic diet as nutritional therapy in prediabetic and diabetic patients. The practice-focused question addressed whether educating medical staff at a …
Analysis Of Hba1c, Medication Compliance, Income Subsidies, And Comorbidity In Medicare Type 2 Diabetics, Robert E. Lazarchik
Analysis Of Hba1c, Medication Compliance, Income Subsidies, And Comorbidity In Medicare Type 2 Diabetics, Robert E. Lazarchik
Walden Dissertations and Doctoral Studies
Diabetes is one of America’s leading chronic diseases with comorbidities contributing to lower health statuses and increased health care costs. While it is known that lowering HbA1c reduces the deleterious effects of diabetes, the capability to identify people with diabetes at risk for uncontrolled HbA1c levels or developing comorbidities based on the compliance rates for different oral antihyperglycemic medication classes (OAMCs) and financial assistance programs does not yet exist. These quantitative longitudinal retrospective studies examined the association between medication compliance, using Proportion of Days Covered (PDC), by OAMC and Medicare financial aid programs, on predicting HbA1c levels and comorbidities in …
Racial Disparities In Hypertension Self-Awareness And Hospitalizations For Hypertension-Related Illnesses Among Adult Arkansans, Chimfumnanya Nwanze-Smith
Racial Disparities In Hypertension Self-Awareness And Hospitalizations For Hypertension-Related Illnesses Among Adult Arkansans, Chimfumnanya Nwanze-Smith
Walden Dissertations and Doctoral Studies
Black individuals in the United States are twice as likely as White individuals to die of cardiovascular diseases. Between 2010 and 2016 in Arkansas (AR), hypertension (HTN) and HTN-related diseases had an age-adjusted death rate of 230.4 deaths per 100,000 population compared to 173.6 deaths per 100,000 population for Whites. The purpose of this quantitative, cross-sectional study was to explore the potential association between HTN self-awareness and emergency department (ED) visits and hospitalization rates for HTN and HTN-related illnesses between Black and White individuals in AR. The socioecological framework was used to explore sociodemographic (SDF) and socioeconomic (SES) factors as …
Psychosocial Support During Pregnancy: A Narrative Inquiry Of Low-Income Unmarried Women In Iowa, Summer D. Parrott
Psychosocial Support During Pregnancy: A Narrative Inquiry Of Low-Income Unmarried Women In Iowa, Summer D. Parrott
Walden Dissertations and Doctoral Studies
Pregnant women who experience high levels of stress and who lack support are at higher risk for negative birth outcomes for themselves and their offspring including preterm labor, low birthweights, and a myriad of other short- and long-term health and behavioral consequences across the lifespan of the child. Unmarried or socioeconomically disadvantaged women lack the most common resources used to protect against the negative effects of stress during pregnancy. A research gap existed regarding the specific types of psychosocial support perceived by low-income unmarried women to be most beneficial at buffering their perceived prenatal stress. The ecological model and the …
Smoothing Patient Flow By Improving Bed Turnover Time, Carrie Lanasha Percell
Smoothing Patient Flow By Improving Bed Turnover Time, Carrie Lanasha Percell
Walden Dissertations and Doctoral Studies
Bed Management Solutions (BMS) is a bed tracking system that provides real-time data into hospital activities, including admissions, transfers, discharges, bed turnover rates, and processing time frames. When BMS is used appropriately, it has the potential to improve bed turnover rates, reduce stress of clinical staff, improve patient satisfaction, and improve patients’ well-being. Delays in bed turnover times can create overcrowding, extended wait times, bottlenecking, delays in patient care, and significant patient flow problems. The purpose of this DNP project was to develop a staff education program to answer the question if the implementation of an educational training program could …
Effects Of Hepatitis On Human Immunodeficiency Virus Viral Suppression, Andrenita Checoby West
Effects Of Hepatitis On Human Immunodeficiency Virus Viral Suppression, Andrenita Checoby West
Walden Dissertations and Doctoral Studies
Coinfection with human immunodeficiency virus (HIV) and viral hepatitis leads to unfavorable health outcomes, making treatment of HIV difficult and increasing the odds of HIV transmission. The purpose of this study is to assess whether viral hepatitis (B and C) hinders HIV viral suppression and impacts the white blood cell count (CD4) when a person is concurrently infected with both viruses. The syndemics theory guided this study. Two research questions tested whether there was an association between coinfection with viral hepatitis and HIV viral load suppression. The research design was quantitative case-control with secondary data from 65,626 reports of HIV, …
Using Social Cognitive Theory To Explain Cannabidiol Usage For Generalized Anxiety Disorder, Margaret Wenzel
Using Social Cognitive Theory To Explain Cannabidiol Usage For Generalized Anxiety Disorder, Margaret Wenzel
Walden Dissertations and Doctoral Studies
AbstractIn the United States, over 40 million adults suffer from a generalized anxiety disorder (GAD), with a 67% increase in overdose-related deaths. Research substantiates the efficacy and safety of cannabidiol (CBD) for GAD. Findings show that CBD, sourced from industrial hemp, may reduce anxiety symptoms. However, a problem exists for individuals deciding to subscribe to CBD’s oral administration because of the inability to remain compliant with the regimen. The measured steps that occur when a medication is prescribed are lacking when an individual accesses CBD independently. This quantitative cross-sectional study was designed to examine whether social cognitive theory explained the …
Language Acculturation Effect On Diabetes Prevalence And Self-Care Skills In Puerto Ricans, Gerardo Lazaro
Language Acculturation Effect On Diabetes Prevalence And Self-Care Skills In Puerto Ricans, Gerardo Lazaro
Walden Dissertations and Doctoral Studies
Diabetes, a silent, chronic disease that involves demanding long-term self-care skills, affects adult Puerto Ricans disproportionately. Based on the health belief model, a theory that predicts health behavior, and the theory of language barriers, which predicts the effects of language on beliefs and behavior, this quantitative nonexperimental study analyzed the relationship of the preference of Puerto Ricans in Boston to use and speak Spanish (language acculturation) to diabetes prevalence and 4 diabetes self-care skills (healthy eating, being active, taking medication, and healthy coping). Data on 1,506 initial participants in the Boston Puerto Rican Health Study were used from 3 study …
The Effect Of Race, Provider-Location Type, And Region On Adolescent Hpv Vaccination, Erica Sade Hunter
The Effect Of Race, Provider-Location Type, And Region On Adolescent Hpv Vaccination, Erica Sade Hunter
Walden Dissertations and Doctoral Studies
Studies have been conducted on various factors and their effect on human papillomavirus (HPV) vaccination uptake amongst adolescents. However, these studies typically point to communication factors and provider recommendations as having a significant effect on HPV vaccination uptake, ultimately leading to the need for more information on other factors that may increase HPV vaccination amongst adolescents. The purpose of this quantitative cross-sectional study was to determine if race, provider-location type, and region of the United States have a statistically significant effect on HPV uptake amongst adolescents. The 2018 National Immunization Survey (NIS) was used, and 34,980 participants were included in …
Development Of A Preceptorship Program For Novice Nurses In Long-Term Care, Loice Moraa Collins
Development Of A Preceptorship Program For Novice Nurses In Long-Term Care, Loice Moraa Collins
Walden Dissertations and Doctoral Studies
AbstractThe practice problem is that of high turnover rates of novice Licensed Practical Nurses (LPNs). The practice–focused question addressed whether or not a preceptor program for LPNs in a long-term care facility (LTC) would increase their competency in serving as a preceptor for novice and newly hired LPNs. The purpose of this doctoral project was to address the significant gap in practice that is made evident in the nursing leadership due to a lack of onboarding process which has led to a 62% turnover rate of the novice LPNs. The theories and models used to inform the doctoral project included …
Educating Staff Nurses On Opioid Use Disorder, Moses Ikejiofor
Educating Staff Nurses On Opioid Use Disorder, Moses Ikejiofor
Walden Dissertations and Doctoral Studies
Opioid use disorder (OUD) is a public health epidemic causing a rise in morbidity and mortality in the United States with disruption of victims and their families’ lives and a financial burden on the nation’s economy. The problem identified for this DNP project was nurses’ lack of knowledge of OUD and the impact on care and attitudes toward OUD patients. Framed within the analysis, design, development, implementation, and evaluation model of instructional design, the purpose was to plan and evaluate a staff education program on OUD. The evidence from the literature to support the need for this project showed that …
Decreasing Pressure Injuries With Early Mitigation Strategies For The Elderly In The Intensive Care Unit, Janet L. Wilson
Decreasing Pressure Injuries With Early Mitigation Strategies For The Elderly In The Intensive Care Unit, Janet L. Wilson
Walden Dissertations and Doctoral Studies
Healthcare acquired pressure injuries (HAPIs) are a serious and debilitating condition in the elderly, and it is therefore critical to reduce the incidence of HAPIs. Mitigation strategies are often implemented for patients who score in the highest risk categories on the Braden Scale for Predicting Pressure Sore Risk©. Yet, the evidence suggests vulnerable older adults who score in the midrange of the Braden Scale, and specifically, the mobility subscale, develop HAPI more frequently. The review question centered on the evaluation of the current evidence for early mitigation strategies in response to Braden Scale midrange mobility subscale scores. The gap addressed …
Clinical Practice Guideline For Palliative Care Referral, Samantha Jones
Clinical Practice Guideline For Palliative Care Referral, Samantha Jones
Walden Dissertations and Doctoral Studies
Palliative care is a type of specialty care that focuses on the improvement of the quality of life and prevention of suffering of those with progressive serious illnesses by addressing the physical, emotional, and spiritual needs of patients and families. There are many misperceptions about palliative care by providers, patients, and their families. Inconsistent interventions and a lack of palliative care education for providers results in delayed palliative care involvement. Delayed involvement results in patients with unmet palliative care needs. The purpose of this project was to develop clinical practice guidelines to ensure appropriate care based on the best available …
Medical Spas: Ensuring Compliance And Patient Safety, Mike Chammout
Medical Spas: Ensuring Compliance And Patient Safety, Mike Chammout
Walden Dissertations and Doctoral Studies
Nonsurgical aesthetic procedures continue to grow in popularity; however, evidence-based clinical practice guidelines that can assist providers when performing aesthetic treatments are lacking. This gap in practice can result in the increased prevalence of side effects from treatments that can compromise patient safety and result in increased litigation. The goal of this project was the development of a clinical practice guideline (CPG) that can be used by aesthetic providers to standardize care when performing nonsurgical aesthetic procedures that can ultimately improve provider knowledge, which would improve patient safety. This CPG sought to answer the practice-focused question involving whether the development …
Receiving Positive Hiv Test Results From Home Testing And Suicidality, Nekeisha A. Hewitt
Receiving Positive Hiv Test Results From Home Testing And Suicidality, Nekeisha A. Hewitt
Walden Dissertations and Doctoral Studies
Limited studies have been conducted on whether receiving a positive result from at-home HIV testing correlates with suicidality (suicidal attempt or ideation). Based on the Ajzen theory of planned behavior, this cross-sectional study comprises a surveyed convenience sample of (N = 213) HIV -positive or negative adults who either tested for HIV at home or in-clinic. The purpose of this study was to explore any association between testing positive for HIV using the HIV at-home test kit and (a) suicidal attempt and (b) suicidal ideation; also, to discover any association between (c) HIV-negative and suicidality and (d) all HIV-positives …
Understanding Resilience Among Individuals With Adverse Childhood Experiences (Aces), Meghan Larson
Understanding Resilience Among Individuals With Adverse Childhood Experiences (Aces), Meghan Larson
Walden Dissertations and Doctoral Studies
Adverse childhood experiences (ACEs), such as abuse, neglect, and dysfunction in a child’s home are considered a public health crisis due to their correlation to health disparities and psychosocial problems in adulthood such as substance use, relationships, education, and maintaining employment. However, some individuals are resilient and demonstrate the ability to adapt and function well despite experiencing adverse events. To better understand resilience when ACEs are present, I conducted a basic qualitative research study to explore the lived experiences of individuals in Tennessee with elevated ACE and resilience scores. A purposeful sample of 12 participants who scored high on ratings …
Determinants Of Fruit And Vegetable Consumption For Adults In The Panhandle Of Nebraska, Erin Marie Norman
Determinants Of Fruit And Vegetable Consumption For Adults In The Panhandle Of Nebraska, Erin Marie Norman
Walden Dissertations and Doctoral Studies
Low fruit and vegetable (F/V) consumption has been documented and is associated with increased risk of chronic disease. Previous studies have revealed that consuming the recommended servings of F/V per day can be influenced by many determinants including healthy eating self-efficacy, cooking confidence, perceived family support, perceived access, perceived quality, and perceived cost of fruits and vegetables. The purpose of this study was to examine these determinants of F/V consumption at the individual level of the socioecological model for adults ages 18 years and older residing in the panhandle of Nebraska. The socioecological model (SEM) provided the theoretical framework for …
Role Of Case Management In Access To Mental Health Care Among African Americans With Medicaid, Kira-Jai Jayne Taylor
Role Of Case Management In Access To Mental Health Care Among African Americans With Medicaid, Kira-Jai Jayne Taylor
Walden Dissertations and Doctoral Studies
Disparity in access to appropriate mental health care among African Americans compared to non-Hispanic Whites is growing. The purpose of this quantitative retrospective study was to examine the relationship between access to an outpatient mental health facility with case management and access to outpatient mental health services among African Americans with Medicaid compared to non-Hispanic Whites with Medicaid. The theoretical framework was based on the conceptual framework for integration created by PATH. The study addressed whether there is a difference in the number of African Americans compared to non-Hispanic White patients with Medicaid in access to an outpatient mental health …
Black Mothers’ Birthing Center Experiences And Exclusive Breastfeeding Practices, Natashia King-Conner
Black Mothers’ Birthing Center Experiences And Exclusive Breastfeeding Practices, Natashia King-Conner
Walden Dissertations and Doctoral Studies
The persistence of racial disparities in breastfeeding is associated with a range of interconnected factors, such as historical, cultural, social, social, and psychological. The current gap in the prevalence of exclusive breastfeeding among Black mothers and White mothers has led to rising concerns in the United States. A basic qualitative approach was used to conceptualize the multidimensional constructs of the social–ecological model to investigate the individual, interpersonal, institutional, and community-level structures and existing policies in birthing centers that inadvertently harbor biases that impede care for Black mothers. Data were gathered through purposeful sampling and semistructured interviews with 10 Black mothers …
Diabetic Education For Nurses To Enhance Patient Outcomes, Jacklyn Obeng
Diabetic Education For Nurses To Enhance Patient Outcomes, Jacklyn Obeng
Walden Dissertations and Doctoral Studies
AbstractDiabetes mellitus is metabolic disease that causes elevated blood glucose levels resulting in long-term health complications and medical costs. This project was aimed at addressing the lack of confidence and knowledge staff had when teaching patients diabetes self-management interventions. The purpose of this project was to develop an evidence-based educational program for staff working in an outpatient clinic in the northeastern United States. The analysis, design, development, implementation, and evaluation model and Watson’s theory of human caring provided frameworks for the project development and implementation. A diabetic nurse educator, a family nurse practitioner, and the chief medical officer served as …
Medical Brain Drain And Its Effect On The Nigerian Healthcare Sector, Oluwakemi Osigbesan
Medical Brain Drain And Its Effect On The Nigerian Healthcare Sector, Oluwakemi Osigbesan
Walden Dissertations and Doctoral Studies
Nigeria suffers from a huge brain drain issue across different sectors, particularly in the healthcare sector. The WHO assessed that there is a current shortage of 2.8 million physicians in the world A heuristic phenomenological method was used in this study to explore the lived experiences of 12 Nigerian healthcare practitioners that migrated to the United States. The push-pull theory served as the theoretical framework that grounded this study. The central research questions for this study focused primarily on the reasons healthcare practitioners are leaving Nigeria and what the impact of those decisions have on the Nigerian healthcare sector. Qualitative …
Sociodemographic And Psychosocial Factors And Wellbeing Among Adults 65 And Older In England, Dainelle Clark
Sociodemographic And Psychosocial Factors And Wellbeing Among Adults 65 And Older In England, Dainelle Clark
Walden Dissertations and Doctoral Studies
The increased number of older adults living longer parallels with the growth of public health concerns regarding the impact of sociodemographic and psychosocial factors (e.g., loneliness and social isolation) on older adults' wellbeing. The purpose of this quantitative study was to examine the association between loneliness, social isolation, the combined model of loneliness, and social isolation on wellbeing among older adults when accounting for age, gender, ethnicity, and social support. The socioecological model (SEM) was used to evaluate the multiple levels of environmental determinants for loneliness, social isolation, and wellbeing. The target population included older adults 65 years and older …