Medicine and Health Sciences Commons^™

The Determinants Of Endometrial Cancer Survival Disparities In The United States, Evelyn Anegbe

Walden Dissertations and Doctoral Studies

Endometrial cancer is the most common gynecologic cancer in the United States with recent trends showing a continued increase in incidence and mortality. Prognosis is influenced by cancer stage at diagnosis and differs by race/ethnicity. Researchers have documented poorer survival among Blacks than Whites diagnosed with endometrial cancer. The 5-year survival rates for women with endometrial cancer is 81%; while survival for White and Black women are 84% and 62%, respectively. There is a gap in literature examining the widening disparity in incidence and survival of women diagnosed with advanced stage disease among population subgroups across the United States. The …

Criminal Thinking, Age, Psychological Well-Being, And Recidivism Among Recently Released Female Violent Offenders, Nyasia Monae Belfrom

Walden Dissertations and Doctoral Studies

High rates of incarceration among female inmates as well as high rates of recidivism characterize the U.S. justice system. Though some research has been conducted on gendered differences between prisoners, a gap existed in the application of criminal thinking theory for female offenders following their release. The purpose of this quantitative research study was to analyze the relationship between criminal thinking, age, psychological well-being, and recidivism among recently released female violent offenders in the region of Central Texas through the use of Yochelsen and Samenow’s criminal thinking theory. The sample for this study consisted of N = 98 female participants …

Perceptions Of Midwestern Msn Nps Of The Dnp Degree, Margaret Gallagher

Walden Dissertations and Doctoral Studies

Strong professional forces have emerged within healthcare with expectations for a Doctor of Nursing Practice (DNP) degree for nurse practitioner (NP) practice. While NP contribution to societal healthcare is evident, most of these frontline workers are still only masters’ prepared nurses (MSN). A problem exists in that their views of the DNP have been minimally studied. Hence, the purpose of this study was to investigate perceptions of Midwestern MSN NPs of the DNP. The study was supported by the self-determination theory (SDT) proposing that motivation for goal achievement was driven by perceptions of intrinsic and extrinsic rewards, which set priorities …

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 …

Perceptions Of Caregivers Of Parkinson's Patients Regarding Using Advance Directives, Meghan Morgan

Walden Dissertations and Doctoral Studies

The increasing focus on end-of-life (EOL) care is influencing the role of advance directive (AD) documents. Difficult conversations among family caregivers and their loved ones are becoming more and more critical. Considering the value of communicating EOL wishes, family caregivers’ perceptions about ADs for their loved ones with Parkinson’s disease (PD) must be examined. Using the theory of planned behavior (TPB) as a foundation, the purpose of this generic qualitative study was to understand family caregivers of PD patients and their perceptions and experiences relating to AD documents. This study involved using purposeful sampling and semi-structured interviews with 11 family …

Reproductive Health Factors And Maternal Mortality Of Internally Displaced Women In Nigeria, Fatima Mahmood Jibirilla

Walden Dissertations and Doctoral Studies

Approximately 529,000 women die from pregnancy-related causes every year, with 99% of these maternal deaths occurring in developing countries. Each year, about 59,000 maternal deaths occur in Nigeria, with a mortality rate of 576 deaths per 100,000 births. Women constitute about half of the 33.2 million internally displaced persons (IDPs) worldwide. The purpose of this retrospective cross-sectional study was to explore the association between the reproductive health factors and maternal mortality of internally displaced women in Borno state, Nigeria. McCarthy and Maine’s model for determinants of maternal mortality informed this study. A secondary dataset of 400 women (age 14-49 years) …

Relationship Between Trust, Race, And Health Care Information Sources Among African American Men, Uzochukwu Onukogu

Walden Dissertations and Doctoral Studies

AbstractAfrican American men have not been sufficiently at the center of research studies, especially when it comes to health. Most researchers have explored African Americans as a whole, and few have looked at African American men specifically, especially when it comes to their perceptions and ability to trust sources of health information. The purpose of this quantitative cross-sectional study was to examine the relationship between race and trust in health information sources, including the relationship between prostate cancer health outreach done through the internet and the acceptance of such information outreach among African American men. The theory of planned behavior …

Lived Experiences Of Former Commercialized Sex Workers Seeking Harm Reduction Services In Nevada, Arlynda Yvette Almond

Walden Dissertations and Doctoral Studies

Commercialized sex work has been considered a high-risk profession. Understanding the social context and application of services that foster wellbeing for this population is of research concern. There is a risk of ineffective service when programs are designed by providers who are not formerly of the profession and not familiar with the unique needs of this population. The problem is that commercialized sex workers who need but do not seek harm reduction services may experience ill-health and lack of wellbeing. The purpose of this qualitative phenomenological study was to explore the lived experiences of 10 commercialized sex workers who pursued …

Knowledge And Perceptions Of Antibiotic Resistance Stewardship Among Prehealth And Agriculture Students, Claudia Maria Da Silva Carvalho

Walden Dissertations and Doctoral Studies

The global threat of antibiotic resistant infection has resulted in health organizations to compile an antibiotic stewardship program, in which the education of current/future medical prescribers and farmers is central for the preservation of current and future antimicrobial treatments. The purpose of this study was to assess and compare the knowledge and perceived threat of antibiotic and antibiotic resistance, as well as the perceived benefit of antibiotic stewardship, among undergraduate students in biology and agriculture at a state university in Kansas. Framed by the health belief model, a cross-sectional study was conducted using a structured online survey of 136 undergraduate …

Exploring The Influences Of Culture On Hand-Hygiene Beliefs Of Foreign-Born Healthcare Workers, Sheila Blanche Davis

Walden Dissertations and Doctoral Studies

AbstractThe hand-hygiene practices of nonadherent health care workers (HCWs) are a major threat to patient safety and thus continue to be a concern for healthcare leaders and administrators worldwide. Healthcare-associated infections (HAIs), which are linked to HCWs' unclean hands, are prevalent throughout global healthcare settings. Global migration in the nursing profession and intercontinental travel among direct patient care providers make it challenging for healthcare leaders to sustain HCWs' adherence to hand-hygiene practices. The purpose of this grounded study was to explore the influence of the cultural beliefs about hand-hygiene practices of foreign-born HCWs. The theory of planned behavior was used …

Factors And Pre-/Post Bariatric Surgery Alcohol Behaviors And Attitudes, Tyrease T. Hammond

Walden Dissertations and Doctoral Studies

AbstractBariatric surgery is the only long-term effective treatment for severe obesity and as the use of bariatric surgery has increased there has been an increase in cases of onset and transfer addictions to alcohol. The purpose of this quantitative, correlational study was to examine the relationship between demographics and pre and post bariatric surgery alcohol use consumption behavior. The Alcohol Use Disorder Test (AUDIT) and Alcohol Self-Regulated Questionnaire were used to measure pre and post-surgery alcohol use behaviors and attitudes respectively. The health belief model and theory of planned behavior provided the theoretical framework for this study. Purposeful convenience and …

Leadership, Quality Improvement, Team Functionality, And Hiv Viral Load Suppression In Uganda, Esther Karungi Karamagi Nkolo

Walden Dissertations and Doctoral Studies

Low viral load suppression rate is a significant public health issue in Uganda and similar countries. A nationwide quality improvement (QI) initiative was implemented from January 2019 to improve viral load suppression. Although QI team characteristics have been shown to influence the success of such QI initiatives, no studies have been found to understand how they influence the success of QI efforts to improve HIV viral load suppression in Uganda. The purpose of this cross-sectional, quantitative study was to determine whether there is a significant association between HIV clinic leader involvement in QI teams, QI team functionality, QI team diversity, …

Pharmacological Management Of The Diabetic Patient: A Staff Education Project, Wilantha Silva

Walden Dissertations and Doctoral Studies

Poorly controlled diabetes can lead to health complications that impact quality of life, increase healthcare costs, and create a negative impact on communities. Pharmacological management of diabetes was identified by stakeholders as a gap in practice at a clinic in the southeastern United States. The purpose of this project was to develop staff education based on American Diabetes Association (ADA) and American Association of Clinical Endocrinologists (AACE) standards of care, deliver education to primary care nurse practitioners (NPs), and evaluate their learning and confidence levels. The primary framework for this project was the chronic care model. An expert panel, including …

Staff Education Module On Beers Criteria For Geriatric Patients, Eyvonne Denise Hinton

Walden Dissertations and Doctoral Studies

One of the main problems affecting geriatric patients over the age of 65 is the heightened risks of severe complications and mortality from adverse drug events (ADEs). Beers Criteria is a suitable framework for identifying potentially inappropriate medications (PIMs) for such at-risk population. The purpose of this project was to develop an evidence-based educational intervention for use by health practitioners to increase their knowledge and confidence regarding the 2012 American Geriatrics Society (AGS) Beers Criteria for PIMs. Lewin’s change theory provided the conceptual framework for the project. The method to evaluate the scores used involved a descriptive analysis of scores …

The Relationship Between Cultural Competency And Hospital Quality Measure Outcomes, Linda Nguyen Quach

Walden Dissertations and Doctoral Studies

Healthcare organizations have little evidence concerning how cultural competency impacts hospital quality outcomes of care transition and patients’ overall experience with care. Identifying if cultural competency translates into quality measures is important for healthcare administrators and could contribute to optimizing patient care. The purpose of this quantitative study was to explore the relationship between hospital cultural competency and hospital quality measures and compare California and other states’ acute care hospital cultural competency scores. Donabedian’s lasting framework for health care quality and Campinha-Bacote’s model of cultural competence in health care were used to frame this research. Hospital Consumer Assessment of Healthcare …

Program Evaluation Of A Hospital Patient Transportation Service, James Dion Washington

Walden Dissertations and Doctoral Studies

A hospital inpatient transportation process may decrease the time it takes patients to receive care and improve hospital quality and safety outcomes by providing timely and efficient patient handling. Grounded in agency theory, the purpose of this program evaluation was to evaluate the efficacy of the request for transport to measure against hospital objectives. Two specific program goals were to achieve an average 19-minute transport request-to-completion time and a 10-minute response from the time transport request is received when the transporter arrives. Data were collected from a survey, semistructured interviews, focus groups, and archival data analysis. The one sample t-test …

The Impact Of Socioeconomic Status And Ethnicity On Chronic Obstructive Pulmonary Disease Patients, Donald Garret Abshier

Walden Dissertations and Doctoral Studies

Chronic obstructive pulmonary disease (COPD) is a progressive and debilitating respiratory condition that leads to significant medial and financial burdens. For many patients with COPD, multiple socioeconomic factors contribute to health disparities, including income, education, employment status, and race/ethnicity. The purpose of this study was to examine the impact of SES and race/ethnicity on COPD patients. For this cross-sectional study, using secondary data analysis, the Social-Ecological Model (SEM), which discusses five levels of influence, was utilized. Data from over 3,222 participants aged 18 and over, living in Nevada were obtained from the 2018 Behavioral Risk Factor Surveillance System (BRFSS) study. …

Fairness, Emotional Intelligence, And Ethical Decision-Making In Customer Evaluations Of Providers, Tameka Austin

Walden Dissertations and Doctoral Studies

Customer satisfaction is a topic that organizations must focus on for the success and continued sustainability of their organizations. Emotional intelligence, fairness, and ethical decision-making are areas that businesses must address to identify how their businesses are impacted by the choices that customers make when working with corporations. The gig economy (short- or long-term project in which a contract worker is hired to perform a specific task or long-term consultant assignment) is an area that has not been addressed to a great extent by psychology researchers. The purpose of this study was to examine the relationships between emotional intelligence, ethical …

Melanoma Cancer Survivors: An Online Community Perspective And Prevention Effort, Lisa Marie Chung

Walden Dissertations and Doctoral Studies

AbstractMelanoma cancer is a major public health issue and has been associated with tanning and exposure to ultraviolet radiation. Minimal information is known about prevention efforts specific to survivors of melanoma cancer who participate in an online community. Surveys of this community differ from previous research of individuals through nononline research; the online community is more likely to be younger in age, comfortable seeking health information using Internet resources, and more advanced in technological capabilities. The main aim of this cross-sectional study was to investigate the impact of age, gender, and race on melanoma prevention efforts (health maintenance and skin …

Drug-Resistant Neisseria Gonorrhoeae; Identification Of At-Risk Groups In Florida By Regional Variation, Scott August Herber

Walden Dissertations and Doctoral Studies

Neisseria gonorrhoeae has been on the rise in the State of Florida since 2013. Florida currently follows the Centers for Disease Control and Prevention guidelines for identifying those at-risk for gonorrhea and drug resistant gonorrhea infections. These groups are narrowly defined and do not consider the different population dynamics throughout the State. This study examined the question of who is at-risk for contracting drug resistant strains of gonorrhea in the eight different regions of Florida based on the prescribed use of last-line-of-antibiotic-defense. Florida’s Surveillance Tools and Reporting System provided 12 years of secondary data from 2007 to 2018. The data …

Mental Health Literacy Among Rural And Urban Young Adults In Zambia, Etta Y. Mwambwa-Johnson

Walden Dissertations and Doctoral Studies

Misconceptions that negatively influence attitudes and beliefs about mental illness are still prevalent in Zambia. Researchers have reported that young adults are the most impacted population for mental disorders in Zambia. Researchers have also highlighted mental health literacy (MHL) as a useful strategy for influencing positive attitudes and beliefs about mental disorders. The purpose of this quantitative cross-sectional study was to investigate the relationship between levels of MHL and attitudes and beliefs about mental illness and health-seeking behaviors of Zambian young adults aged 18 to 24. The study used the health belief theoretical model. A MHL questionnaire was used to …

The Impact Of Obesity, Race, Age, Education, Income, And Healthcare Coverage On Cervical Cancer Screening Among Mississippi Women, Henrietta Tamika Ross

Walden Dissertations and Doctoral Studies

The human papilloma virus is the necessary agent in the development of cervical cancer. It is through screening exams like the Papanicolaou (Pap) test that cervical changes can be identified, and cervical cancer can be diagnosed in the early stage of cancer. The Pap test has aided in decreasing the rate of cervical cancer and the morbidity of cervical cancer. However, cervical cancer rates and mortality rates from cervical cancer are still the highest among women in Mississippi. Additionally, obesity rates among those who reside in Mississippi are the second highest in the United States. The purpose of this quantitative …

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, …

An Educational Program For Nursing Home Nurses On Sepsis In Older Adults, Wendy Belden

Walden Dissertations and Doctoral Studies

Elderly nursing home patients’ high rates of hospitalization due to sepsis impact their morbidity and mortality and significantly cost the U.S. healthcare system. Skilled nursing facility (SNF) nurses who have the knowledge to assess older adults for signs and symptoms of sepsis and communicate findings to providers are instrumental in providing improved care for patients. The purpose of this doctoral project was to provide a group evidence-based educational intervention on sepsis care of older adults geared toward nurses working in SNFs. The practice-focused question asked whether an educational intervention focused on the signs and symptoms of sepsis in the elderly …

Strategies For Catalyzing Clinicians’ Support Of Telemedicine Programs In Rural Communities, Jonathan Liwag

Walden Dissertations and Doctoral Studies

Clinicians’ failure to accept contemporary technology has been a critical barrier to telemedicine program adoption. Staff technical challenges and resistance to change can affect technology return on investment, which concerns telemedicine program leaders. Grounded in Davis’s technology acceptance model, the purpose of this qualitative, descriptive single case study was to explore strategies used by program leaders in the Marianas Islands who successfully gained clinicians’ acceptance of contemporary technology. The participants were 5 program leaders recommended by their institution because of their leadership role and telemedicine technologies experience. Data were collected from 4 face-to-face and 1 audio teleconference interview with the …

Staff Education On Diabetes Self-Management For Patients, Gloria Eberechukwu Okoye

Walden Dissertations and Doctoral Studies

Abstract Staff Education on Diabetes Self-Management for Patients by Gloria Okoye MSN, Walden University, 2016 BSN, Walden University, 2015 Project Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University May 2021 Abstract Diabetes mellitus is a chronic disease that poses health and financial burdens to patients, families, and society. An outpatient clinic in the Southeastern United States noted a gap in staff knowledge on diabetes self-management education for high-risk, diabetic patients. The purpose of the project was to educate clinical staff on lifestyle modification practices so that they could better educate diabetic …

Assessing Staff Nurse Knowledge Of Skills To Address Nurse Burnout, Glory Ngum Forbi

Walden Dissertations and Doctoral Studies

The cases of burnout among nurses are increasing. The problem that has been identified for this DNP project relates to the lack of hospital nursing staff knowledge regarding the skills to address nurse burnout. Many staff nurses continue to work as usual despite showing severe symptoms of nurse burnout. The purpose of the DNP project was to fill the identified practice gap, a lack of knowledge and skills among nurses on strategies of preventing and controlling burnout, by implementing an educational program. The focus for this DNP project was to develop an evidence-based nursing staff education program on nurse burnout …

A Clinical Practice Guideline For Measuring Quality Of Life In Patients With Depression And Anxiety, Mary Fowaah Boateng

Walden Dissertations and Doctoral Studies

Mental health conditions affect various aspects of an individual’s quality of life (QOL). Patients with anxiety and depression have a greater risk of having a negative perception of QOL. The gap in practice was the lack of an assessment tool to measure QOL in patients with mental health disorders. The purpose of this Doctor of Nursing Practice project was to develop a clinical practice guideline (CPG) recommending the best evidence-based measurement tool for QOL in patients with anxiety and/or depression. The question that guided the CPG was: How should QOL be measured in patients with anxiety and/or depression in the …

Longitudinal Patterns In Fear Of Cancer Progression In Patients With Rare, Advanced Cancers Undergoing Comprehensive Tumour Genomic Profiling, Phyllis Butow, Fabiola Müller, Christine E. Napier, Nicci Bartley, Mandy L. Ballinger, Barbara Biesecker, Ilona Juraskova, Bettina Meiser, Timothy E. Schlub, David M. Thomas, David Goldstein, Megan C. Best, Members Of The Pigeon Project

IES Papers and Journal Articles

Introduction: Fear of cancer progression (FCP) impacts quality of life and is a prevalent unmet need in patients diagnosed with advanced cancer, particularly as treatment options are reduced. We aimed to identify longitudinal patterns in FCP over 6 months in patients with advanced cancer receiving comprehensive tumour genomic profiling (CTGP) results, and their correlates.

Methods: Patients with pathologically confirmed metastatic disease (∼70% rare cancers) receiving or post their last line of standard therapy completed questionnaires at T0 (prior to CTGP), T1 (immediately post CTGP results) and T2 (2 months later).

Results: High stable (N = 52; 7.3%) and low/moderate …

Multivariate Distributions Of Correlated Binary Variables Generated By Pair-Copulas, Huihui Lin, N. Rao Chaganty

Mathematics & Statistics Faculty Publications

Correlated binary data are prevalent in a wide range of scientific disciplines, including healthcare and medicine. The generalized estimating equations (GEEs) and the multivariate probit (MP) model are two of the popular methods for analyzing such data. However, both methods have some significant drawbacks. The GEEs may not have an underlying likelihood and the MP model may fail to generate a multivariate binary distribution with specified marginals and bivariate correlations. In this paper, we study multivariate binary distributions that are based on D-vine pair-copula models as a superior alternative to these methods. We elucidate the construction of these binary distributions …