Medicine and Health Sciences Commons^™

Invasive Needling Therapy For Myofascial Pain Syndrome, Katelyn Krueger

Physician Assistant Scholarly Project Posters

Myofascial pain syndrome (MPS) is one of the most common musculoskeletal conditions characterized by tight bands of fascia and muscle fibers known as myofascial trigger points (MTrP’s). Empirical evidence suggests that deactivation of MTrP’s is best accomplished with invasive needling therapy such as dry needling, trigger point injections (TPI’s), and botulinum toxin (BTX-A) injections. The objective of this systemic review is to compare the efficacy of various needling therapies on pain intensity and additionally determine if ultrasound guidance and obtaining an LTR improves clinical outcomes. A comprehensive search of five databases including PubMed, Science Direct, Google Scholar, Cochran, and CINHAL …

Comparative Research Of Effective Treatment Measures For Postpartum Depression, Aunica Novacek

Physician Assistant Scholarly Project Posters

Postpartum depression is a mood disorder that includes depressive symptoms during the time period following childbirth. There are various possibilities for what may cause this disorder, but the drastic change in hormones after delivery can play a role. With the chance this disorder may be fatal to both the mother and child, an appropriate, effective, and safe treatment is necessary to control depressive symptoms. The standard, first line pharmacotherapeutic option is a selective serotonin reuptake inhibitor (SSRI) antidepressant. SSRI antidepressants are well understood, but these medications may take time to become effective. Knowing this, medical professionals can find a more …

Integration Of Palliative Care In Chronic Obstructive Pulmonary Disease Management, Christina Rasanen

Physician Assistant Scholarly Project Posters

The purpose of this scholarly project is to determine if the integration of palliative care (PC) into COPD management provides an improvement in symptom burden associated with quality of life and end of life care when compared to the standard of care. A review of the literature was performed using the following electronic databases, and the use of keywords and mesh terms were used to define the set of literature that would be critically analyzed. A total of 16 articles achieved the necessary criteria for review and critical assessment. The literature reviewed various aspects related to symptom burden and symptom …

Cholinergic Antagonist Use And The Risk Of Developing Dementia In Persons Aged 65 Years And Olders, Heidi N. Artz Schmaltz

Physician Assistant Scholarly Project Posters

Anticholinergic medications cause a therapeutic or negative effect in the human body by blocking neuronal cholinergic receptors, thereby inhibiting the binding of acetylcholine in the central nervous system and the peripheral nervous system. These medications have short-term side effects including dry mouth, constipation, visual impairments, or delirium; however, research regarding the long-term side effects is limited. The purpose of this systemic literature review is to determine the correlation between prolonged exposure to anticholinergic medications and the development of dementia. The literature databases PubMed, Cochrane Review, Science Direct (Elsevier), and DynaMed were utilized in this review. Journal articles published within the …

Childhood Obesity: Adding Metformin To Lifestyle Modification For Weight Reduction, Kelli Strege

Physician Assistant Scholarly Project Posters

One of the most challenging health conditions primary care providers face is combating the ever-rising incidence of obesity, especially among children. The objective of this literature review is to determine the effects of metformin implemented in addition to lifestyle modification for the treatment of childhood obesity. Efficacy, to include change in weight, BMI, insulin resistance, and overall safety of metformin was studied. The online databases searched in this review were PubMed, Cochrane Library, Embase, and CINAHL. Literature chosen for review included randomized control trials, meta-analysis, and systematic reviews published between 2015 and 2020. Much of the studied research indicates positive …

A Quality Improvement Evaluation Of An Emergency Department Response System For Psychiatric Patients, Kathryn J. Clagg

Walden Dissertations and Doctoral Studies

The DNP project was a quality improvement evaluation of an emergency department (ED) response system for psychiatric patients. The identified problem within the organization was a breakdown in care for psychiatric patients in the ED. The practice-focused question was twofold to address whether: (a) the development of a new ED response team would significantly reduce ED wait times, positively affect the left without being seen (LWBS) rates, and improve patient satisfaction for psychiatric patients and (b) the development of a new emergency room response team would improve the perceptions of ED staff on the process. The context, input, process, and …

Motivations And Barriers To Pursue Cancer Genomic Testing: A Systematic Review, Megan Smith-Uffen, Nicci Bartley, Grace Davies, Megan Best

IES Papers and Journal Articles

Objectives: Single-gene testing is associated with psycho-social challenges for cancer patients. Genomic testing may amplify these. The aim of this study was to understand patients’ motivations and barriers to pursue cancer genomic testing, to enable healthcare providers to support their patients throughout the testing process and interpretation of test results.

Methods: Five databases were searched for original peer reviewed research articles published between January 2001 and September 2018 addressing motivation for genomic cancer testing. QualSyst was used to assess quality.

Results: 182 studies were identified and 17 were included for review. Studies were heterogenous. Both somatic and germline testing were …

Testing A Model Of Resilience In Family Members Of Relatives With Traumatic Brain Injury Vs Spinal Cord Injury: Multigroup Analysis, Grahame K. Simpson, Malcolm I. Anderson, Maysaa Daher, Kate F. Jones, Peter Morey

IES Papers and Journal Articles

Objective: To test a model comprising explanatory (neurologic impairment, coping, personality) and mediating (resilience, self-efficacy, hope, social support) variables on psychological adjustment and burden among family caregivers of individuals with traumatic brain injury (TBI) vs spinal cord injury (SCI).

Design: Structural equation modeling with multigroup analysis.

Setting: Six rehabilitation centers across New South Wales and Queensland, Australia.

Participants: A total of 181 family members (N=181; 131 TBI, 50 SCI). Interventions: Not applicable.

Main Outcome Measures: Connor-Davidson Resilience Scale, Eysenck Personality Questionnaire, Ways of Coping Questionnaire, General SelfEfficacy Scale, Herth Hope Scale, Medical Outcome Study Social Support Survey; and 4 measures …

Pilot Study Of An Online Training Program To Increase Genetic Literacy And Communication Skills In Oncology Healthcare Professionals Discussing Brca1/2 Genetic Testing With Breast And Ovarian Cancer Patients, Bettina Meiser, Paula Woodward, Margaret Gleeson, Maira Kentwell, Helen Mar Fan, Yoland Antill, Phyllis N. Butow, Frances Boyle, Megan Best, Natalie Taylor, Katy Bell, Kathy Tucker

IES Papers and Journal Articles

The increasing use of genetic testing for BRCA1/2 and other pathogenic variants in the management of women with breast and ovarian cancer necessitates increased genetic literacy in oncology healthcare professionals. This pilot study aimed to evaluate an online training program to increase genetic literacy and communication skills in Australian oncology healthcare professionals tasked with discussing and coordinating mainstream genetic testing with breast and ovarian cancer patients. A training website with embedded videos was developed. This study assesses the website’s acceptability and user-friendliness; suggestions for improvement were also elicited. Oncology healthcare professionals were recruited through relevant professional organisations, invited to the …

Reducing The Rate Of Physical Interventions By Increasing Staff Confidence When Using Verbal De-Escalation Techniques, Elizabeth Pavlesich

Walden Dissertations and Doctoral Studies

When working with patients who have the potential to become physically aggressive, verbal de-escalation is an important technique that can defuse a dangerous situation. At the project site in the mental health emergency department (MHED), workplace violence was on the rise based on the reported use of physical interventions (rates of brief holds and physical restraint use). The purpose of this quality improvement evaluation project was to determine whether an educational training program on verbal de-escalation techniques would increase staff's confidence in the use of verbal de-escalation and decrease the rate of physical interventions used in the MHED. The change …

Previously Incarcerated Individuals' Perception Of Job Acquisition Post Transitional Program Participation, Arbutas Antinet Washington

Walden Dissertations and Doctoral Studies

AbstractTransitional programs prepare previously incarcerated individuals (PIIs) to re-enter society and acquire employment. However, many such programs have failed to offset the effects of prisonization, a process that affects the social skills needed for the job interview process and employment acquisition. The purpose of this generic qualitative research study was to explore the experiences and perceptions of PIIs after participation in a transitional program and a job interview. The theoretical foundation for the study included the theories of prisonization and self-efficacy. The research question concerned experiences and perceptions of 23 to 39-year-old PIIs regarding the job interview process after serving …

Association Between Learning Methods And Analgesic Opioid Abuse, Nicole Marie Blanchard

Walden Dissertations and Doctoral Studies

Opioids are an extremely addictive class of medication used to treat pain; overprescribing practices and chronic misuse has led to an epidemic that continues to grow. The opioid epidemic not only has the potential to cause injury or even death but also has a large impact on the U.S. economy. Research regarding determinants of abuse are needed to improve safeguards for opioid abuse prevention. The purpose of this quantitative study was to determine if learning capabilities and/or learning medium preference are correlated with analgesic opioid abuse. The social-ecological model was used to evaluate the social levels of influence for abuse …

Physical Distress And Psychological Outcomes: An Examination Of Hurricane Katrina Rebuilders, Danita M. Muse

Walden Dissertations and Doctoral Studies

AbstractHurricane Katrina made land fall in New Orleans on August 29, 2005. When Hurricane Katrina came ashore at the mouth of the Mississippi River it struck with such vengeance that the protective levees surrounding the New Orleans area were breached. The purpose of this quantitative research is to broaden the understanding the relationship between two phenomena: physical distress and posttraumatic growth among Hurricane Katrina rebuilders who rebuilt their lives 15 years following a natural disaster along the Gulf Coast. The Conservation of Resources and Self-Efficacy Theory were the theoretical framework for this study. The research questions examined if statistically significant …

Generation X And Millennial Registered Nurse Job Satisfaction, Germika Brandon

Walden Dissertations and Doctoral Studies

AbstractThe healthcare sector in the United States faces challenges in recruiting and retaining nurses, resulting in a shortage of professional nurses to provide care. Workplace job dissatisfaction among generations has been recognized as a contributor to the ongoing nursing shortage problem. The purpose of this quantitative comparative study, guided by Maslow’s and Herzberg’s theories, was to compare registered nurse (RN) job satisfaction by gender, generation, union and Magnet affiliations, and nurse turnover using secondary data obtained from the Robert Woods Johnson Foundation Newly Licensed Registered Nurses (NLRN) Work Study Project. The random sample of 220 cases was drawn from the …

Helping In The Home: Counselors’ Experiences Providing Clients With In-Home Services, Melissa Jane Franzen

Walden Dissertations and Doctoral Studies

Counseling is an essential service that helps individuals work through struggles and live their best lives. Such service now includes providing counseling in clients’ homes. Counselors may require specific training or education to prepare for counseling in a home environment. This need for training and education is due to a lack of knowledge of the lived experiences of counselors providing services in the home. Transcendental phenomenology was used to guide a qualitative exploration into the lived experiences of counselors providing services in clients’ homes. Participants were 7 professional counselors, 5 female and 2 male, having met minimum state licensure requirements …

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 …

Perceptions And Experiences Of Sickle Cell Disease Patients And Parents/Caretakers On Alternative Treatment Options For Pain Management, Elizabeth Hagan Asamoah

Walden Dissertations and Doctoral Studies

Sickle cell disease (SCD) is marked by excruciating chronic pain, commonly known as pain crisis. SCD healthcare practitioners (HCPs) have been employing palliative care as a mainstream treatment option to manage SCD pain crises using mainly opioid analgesics for years. Due to the current opioid crisis, however, it has become imperative to explore alternative regimens to manage the pain and associated comorbidities of SCD. Thus, the goals of this study included exploring alternative treatment options for SCD pain crisis management with the intent of decreasing SCD patients’ dependency on opioid-based or related analgesics while reducing the frequency of pain crises …

Reducing Recidivism Of Psychiatric Inpatient Clients In Behavioral Health Facilities, Cottrell Jacobs

Walden Dissertations and Doctoral Studies

AbstractResearch shows readmitting clients to inpatient psychiatric facilities within 30 days to one year of discharge can be costly for an organization and may represent less than optimal quality care for clients. The purpose of this study was to obtain an in-depth understanding of practices and barriers to reducing inpatient readmissions by completing a qualitative case study of readmission reduction strategies used by a large inpatient psychiatric facility in the southern United States. The Baldrige excellence framework was used to guide the assessment of the organization. Data collection consisted of five semi-structured interviews with organizational leaders, evaluation of internal archival …

Clinical Practice Client Education Guideline For Early Detection Of Thyroid Cancer, Marcia Miller

Walden Dissertations and Doctoral Studies

AbstractThyroid cancer (TC) incidences over the last decade have increased significantly. The practice problem addressed in this project was nurses’ lack of knowledge on how to perform or teach clients how to perform self-exams of the neck region for early detection of TC. This lack of knowledge limits the nurses’ ability to properly educate their clients about TC and recognizing when to seek medical interventions. The purpose of this project was to develop of an evidence-based, clinical practice client education guideline (CPCEG), based on an in-depth literature review, to address the nurses’ lack of knowledge and enable clients to engage …

Medical Practitioners’ Intention To Use Secure Electronic Medical Records In Healthcare Organizations, Omar Enrique Sangurima

Walden Dissertations and Doctoral Studies

Medical practitioners have difficulty fully implementing secure electronic medical records (EMRs). Clinicians and medical technologists alike need to identify motivational factors behind secure EMR implementation to assure the safety of patient data. Grounded in the unified theory of acceptance and use of technology model, the purpose of this quantitative, correlational study was to examine the relationship between medical practitioners’ perceptions of performance expectancy, effort expectancy, social influence, facilitating conditions, and the intention to use secure EMRs in healthcare organizations. Survey data (N = 126) were collected from medical practitioners from the northeastern United States. The results of the multiple regression …

Cell Phone Use And Adolescent Weight Problems, Florence Kenkor Njang

Walden Dissertations and Doctoral Studies

AbstractOverweightinadolescenceincreasestheriskofobesityandmanyadversehealthoutcomeslaterinlife.The purpose of this quantitative cross-sectionalstudy was to investigatetheassociationbetweencell phoneuseandweightstatusinadolescents,ages14 17yearsold,livingintheUnitedStates.Thesocio-ecologicalmodel(SEM)wasusedtoexplainthelinkbetweencellphoneuseandoverweightamongadolescents.Threeresearchquestionswere used to explore(a)therelationshipbetweencellphoneuseandadolescentweightstatusaftercontrollingforage,gender,andrace;(b)the effectofcellphoneuseonoverweightandnormalweightstatusesamongadolescentsaged 14 17yearsaftercontrollingforage,gender,andphysicalactivity;and(c)themodifyingeffectofraceontherelationshipbetweencellphoneuseandadolescentoverweightaftercontrollingforageandgender.Secondary data from the2017YouthRiskBehavioralSurveillanceSystemwere analyzed usingbinarylogisticregressiontoanswer theresearchquestions.Highcellphoneusesignificantlyandpositivelypredictedoverweightinadolescentsaftercontrollingforage,gender,andrace(p<0.001).Afteraccountingforage,gender,andphysicalactivity,highcellphoneusewasasignificantpredictorofoverweight(p<0.001).Similarly,racehadasignificantmodifyingeffectonthepositiveassociationbetweenhighcelluseandoverweightamongadolescents(p<0.001).Thekeypositivesocialchange implication of this studyis the potentialtointegratehealthycellphoneusewithexistingobesitypublichealthinterventionsthatcanreduceoverweightandpositivelyimpactindividuals,families,andcommunities.

Development Of A Detox Clinical Practice Guideline For Pregnant Women Suffering From Opioid Addiction, Becca Ward

Walden Dissertations and Doctoral Studies

AbstractThe number of women suffering from opioid use disorder during pregnancy is a national epidemic. The gap in nursing practice is the lack of detoxification and medication-assisted treatment facilities that are equipped to care for this vulnerable population. The purpose of this project was to develop a clinical practice guideline (CPG) that is safe for both the fetus and the pregnant mother. Opioid dependence during pregnancy is on the rise with the nation’s current opioid epidemic. In this project, a meta-synthesis review was used to gather evidence from various sources and to develop a detox CPG that is safe for …

African American Females And Herpes Simplex Virus 2: A Basic Interpretive Qualitative Study, Cherlisa Jackson

Walden Dissertations and Doctoral Studies

According to recent studies, African American females are most susceptible to HSV-2 and are often asymptomatically diagnosed. Yet, the perceived benefit of discussing sexual health as well as recognizing a need to discuss HSV-2 with a healthcare provider was an identified gap in the existing research and current study findings. The purpose of this qualitative interpretive study was to understand the experiences of African American females who received an asymptomatic HSV-2 diagnosis. The health belief model constructs guided this study. Outlined through semi-structured interviews were the experiences of seven African American females diagnosed with HSV-2 in Fulton County, GA, as …

Staff Education Regarding Breastfeeding For Perinatal Nurses, Shannon Nicole Long

Walden Dissertations and Doctoral Studies

AbstractExclusive breastfeeding in the U.S. is the optimal form of nutrition up to the age of 1 year; however, the current U.S. rate of 49% and Kentucky rate of 39% fall below the Healthy People 2020 goal of 60.6%. Researchers have shown that perinatal nurses often lack knowledge to ensure mothers begin and maintain this optimal form of human nourishment. Framed within the analysis, design, development, implementation, and evaluation model of instructional design, the purpose of this project was to present a continuing education program on breastfeeding for 10 staff nurses at the target hospital. The program presented was the …

Understanding Parent/Child Experiences Affecting Obesogenic Behavior In Children, Jean Gaffney

Walden Dissertations and Doctoral Studies

Families living in an inequitable food environment are impacted by limited access to healthier foods inventory. Habitual consumption of foods lacking adequate nutritional value increasingly contributes to the heightened prevalence of obesity and premature death from non-communicable chronic diseases such as diabetes and heart disease. This basic qualitative analysis examined factors that impact parental decisions in food choices among obese and overweight children. The study explores the level of understanding held by low-income parents/caregivers as it relates to basic nutritional knowledge. Bandura’s Social Cognitive Theory framed the study. A purposeful sample of eight parents/caregiver between the age of 18-50, parenting …

Synthesized Grounded Theory Expansion Of The Quadruple Aim In Acute Care Nursing, O. Ann Ann Fuller

Walden Dissertations and Doctoral Studies

AbstractConflation of moral and compassionate healthcare within the business model that is focused on customer service, disempowers, dehumanizes, and destabilizes nursing as well as the financial stability of healthcare. The purpose of this research was to determine nurses’ perceptions of how their work environment supported or contradicted a potential expansion of the quadruple aim. The quadruple aim was the primary conceptual framework for this research. The overarching research question was about how the environment of care supports professional nurses’ provision of high-quality person- centered care and bolsters meaningful and purposeful careers. The synthesized grounded theory methodology was used to collect …

New Graduate Nurses’ Transfusion Training Views: Reflection On Experiences With Adverse Reactions, Hind Jaber-Daou

Walden Dissertations and Doctoral Studies

Abstract:New graduate nursing students transitioning to becoming professionals undergo education and training to gain knowledge and competence about transfusions. Nonetheless, new graduate nurses experience stress during a blood transfusion adverse reaction, which can be associated with lack of knowledge and inadequate training. The purpose of this qualitative study was to gather data from new graduate nurses who described their lived experiences with patients exhibiting symptoms of adverse reactions, how they reflected on their emotional effects, and the influences of the training on their knowledge and confidence. The research was grounded in social cognitive theory that centers on the concept of …

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 …

Evidence-Based Hospice Care Education For Healthcare Clinicians, Nonie E. Weir

Walden Dissertations and Doctoral Studies

Vulnerable populations with a terminal illness, who reside in a nursing home setting, continue to experience psychological, physical, and emotional effects that lead to end-of- life (EOL) suffering and discomfort. Globally, millions of individuals receive care from a hospice provider. By 2030, this figure will triple due to the increased lifespan of the geriatric population. The literature review has revealed that the practical problem is the lack of hospice care education received by healthcare clinicians. It is, therefore, important to prepare and educate healthcare clinicians about a peaceful death through an individualized plan-of-care (POC) from a holistic approach. The purpose …

Exploring Culturally Competent Mental Health Outreach To Black Churches, Michele Marie Fry

Walden Dissertations and Doctoral Studies

Black individuals and communities have held distrust toward mental health services and experience barriers in seeking services. Although the church is a significant support system in the Black community, it can also pose a barrier to congregation members seeking mental health services, as the Black church community has often stigmatized those seeking mental health services as weak. Ways to reach the Black community with trauma-informed, culturally competent, and spiritually sensitive mental health services through establishing connections with Black churches and church leaders were explored in this study. Previous research indicated that the COVID-19 pandemic increased depression and anxiety in the …