Medicine and Health Sciences Commons^™

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 …

Internet Use, Perceived Social Support, And Obesity Among African American Young Adults, Cynthia Adams

Walden Dissertations and Doctoral Studies

African Americans are disproportionately affected by obesity. Public health practitioners have an incomplete understanding of the social-environmental risk factors and how they affect obesity. The purpose of this quantitative, cross-sectional study was to explore whether internet use and perceived social support predicted obesity among African American young adults. The social cognitive theory guided this study. Secondary data were analyzed from the 2017 Behavioral Risk Factor Surveillance Survey. The sample consisted of 6,765 African American young adults age 18 to 34 and represented the U.S. population using weighted estimates. A Bonferroni correction was performed to reduce Type I error due to …

Reducing Fall Rates At A Long-Term-Care Facility, Francis Ortego

Walden Dissertations and Doctoral Studies

In the United States, older adults often experience fall events that may result in physical, mental, and financial hardship. Since the project site was experiencing a significant number of patient falls, a fall-prevention quality improvement (QI) program was implemented. Guided by the diffusion of innovation theory and the plan-do-study-act (PDSA) model, the purpose of this doctoral project was to evaluate the effectiveness of that program to determine if the monthly fall rate in the facility would decrease during the next 6 months. The project site provided deidentified data in the form of monthly fall-rate totals as collected from the long-term-care …

Determinants Of Substance Abuse Among Users With Mental Health Issues In Ogun State, Nigeria, Michael Olusegun Adejimi

Walden Dissertations and Doctoral Studies

In Nigeria, about 14.3 million people use drugs without physician prescription and approximately 30% of Nigerians suffer from mental illness, some of which is due to substance abuse. This study examined the associations between (a) socio-demographic factors and substance abuse among users with mental health issues in Ogun State Nigeria, (b) clinical variables and substance abuse among users with mental health issues, (c) negative life events and substance abuse among users with mental health issues, and (d) social supports and substance abuse among users with mental health issues. This study theoretical framework was based on the definition of mental health …

Beliefs About Evidence-Based Practice Among New Graduate Nurses, Julie Bane

Walden Dissertations and Doctoral Studies

It is an expectation that new graduate nurses (NGNs) use evidence-based practices (EBP) in patient care; however, studies indicated that NGNs lack confidence in, belief in, and a full understanding of EBP processes and implementation. The doctoral project practice-focused question addressed whether immersion in EBP education and completion of an EBP project through a quality-improvement pilot program would enhance NGNs’ beliefs about the benefits and processes of EBP as well as increase confidence in their ability to implement EBP in the clinical setting. Knowles’ adult learning theory and Rogers’ diffusion of innovation theory guided the project’s motivation and examination of …

Perspectives Of Physicians Mandated To Complete Cultural Competence Education, Wayne Mccarthy Boatwright

Walden Dissertations and Doctoral Studies

Perspectives of Physicians Mandated to Complete Cultural Competence Educationby Wayne M. Boatwright

Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy in Health Services

Walden University May 2021 Abstract Studies show that ethnic and racial disparities continue to exist in health care delivery. The economics of today’s multicultural world along with changing demographics and persistence of inequality in healthcare have challenged healthcare professionals to consider cultural competency (CC) training to assist in eliminating health disparities. The purpose of this study was to identify the perspectives of physicians who were mandated to complete CC education. …

Type Ii Diabetes Mellitus Risk Factors Among African Immigrants 20 – 45 Years Old Residing In The United States, Abu Bakar Sidique Fofanah

Walden Dissertations and Doctoral Studies

Type 2 diabetes mellitus is highly prevalent among African Americans. Africans born abroad are a subset of the African American population in the U.S., but few studies have been conducted on this population, a gap this study aims to close. The incidence and prevalence of type 2 diabetes continue to rise among this population. This study explored type 2 diabetes risk factors among Africans born abroad who were 20-45 years old in the U.S. This was a retrospective and quantitative cross-sectional study involving National Health and Nutrition Examination Survey (NHANES) 2013-2014 type 2 diabetes data. The total sample size was …

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 …

Association Between Bisphenols, Acrylamide, Glycidamide, Fast Food, And Obesity: An Obesogenic Perspective, Morgan Murphy

Walden Dissertations and Doctoral Studies

Endocrine disrupting chemicals (EDCs) are exogenous man-made substances that have the ability to interfere with hormone action and are believed to be a contributing factor to chronic illnesses, including but not limited to obesity. Recent studies have suggested that environmental agents (environmental obesogens), such as food additives, plasticizers, and personal care products are contributors that aid in the altering of hormone receptors and hormone mimicry. Such environmental obesogens have the potential to promote adipogenesis and fat accumulation. In this study, the social-ecological model was used to determine the factors that can influence the increased exposure to obesogenic chemicals at the …

Strategies To Recruit Age-Diverse Volunteers For A Nonprofit Behavioral Health Organization, Karen A. Peters

Walden Dissertations and Doctoral Studies

Volunteers are a crucial resource for behavioral health organizations, especially those that rely predominantly on a volunteer workforce for delivery of services. In such instances, the inability to maintain an adequate and age-diverse volunteer workforce threatens organizational sustainability and interrupts valued services to the community. A case study was completed to identify volunteer recruitment and retention challenges for a behavioral health nonprofit organization in the southwestern United States. The Baldrige Excellence Framework was used to guide the study, with emphasis placed on the assessment of the organization’s leadership, strategy, and workforce. Data sources included interviews with organizational leaders, organizational records, …

Prevention And Self-Care Education For Osteoporosis In A Rural Orthopedic Clinic, Jean Sanford

Walden Dissertations and Doctoral Studies

Abstract Osteoporosis affects 25 million people in the United States causing over 1.5 million fractures every year. The gap in practice at a rural southeast orthopedic clinic was a lack of patient education on prevention and self-care management of osteoporosis and osteopenia. The purpose of the project was to develop a program to educate clinic providers on prevention and self-care management for osteoporosis and osteopenia. The Knowles theory of adult learning framed the project components. A 10-question pretest/posttest assessing knowledge was administered to 10 registered nurse participants. For the presurvey, five participants demonstrated a lack of knowledge of medication administration …

Substance Use, Mental Health Problems And Missed Appointments By Race, Gender, And Sexual Orientation Among Hiv-Infected Individuals, Abraham Adonis Anderson

Walden Dissertations and Doctoral Studies

Human Immunodeficiency Virus (HIV) disproportionately affects African American men who have sex with men. According to the Centers for Disease Control and Prevention, in 2020 African American adult and adolescent African American men accounted for 42% (16,002) of all HIV diagnoses (37,968). Furthermore, while substance use is common among this population, in previous studies very few individuals with HIV have reported receiving substance abuse treatment or discussing substance use with HIV medical providers. The purpose of this study was to examine the differences in substance use/mental health problems by race, gender, and sexual orientation among HIV-infected individuals. This study also …

Nursing Majors’ Attitudes Toward Suicide And Mental Health Training, Beverly Arleen Burton

Walden Dissertations and Doctoral Studies

AbstractThe mental health training of nursing majors may play a role in their levels of confidence in attending to suicide patients as working professionals. The purpose of this quantitative study was to explore what impact, if any, attitudes toward suicide had on nursing majors’ levels of confidence in their mental health training. Pender’s health promotion theory was the theoretical framework. A descriptive correlational survey was used to explore individuals majoring in nursing confidence and perceived skills in mental health training. The 4 research questions asked the relationship between the level of confidence in helping someone with a mental health problem …

The Relationship Between Quality Score, Generated Savings/Losses And Assigned Beneficiaries Among 2018 Mssp Acos, Crystal Crider

Walden Dissertations and Doctoral Studies

In 2018, Medicare spending in the United States accounted for 15% of the comprehensive federal budget forecasted to exceed $1.5 trillion by the year 2028. To help manage the spending in this sector, the Centers for Medicare and Medicaid Services implemented Medicare Shared Savings Program (MSSP) Accountable Care Organizations (ACOs). There is a need to understand current data as it relates to the correlation between MSSP ACO participants’ costs, quality, and assigned beneficiaries. The purpose of this quantitative study was to examine the relationship between Quality Score, Generated Total Savings/Losses and Total Assigned Beneficiaries for 2018 MSSP ACO participants. General …

Hpv Vaccination And Cervical Cancer Prevention In Women, Ateela Duffy

Walden Dissertations and Doctoral Studies

Cervical cancer is the second most common cancer in women worldwide and is mainly caused by the human papillomavirus (HPV). The purpose of this study was to determine whether there was a statistically significant difference in the diagnosis of cervical cancer in women who received the HPV vaccine compared to women who did not receive the vaccine, while considering demographic factors (race, ethnicity, level of education, household income), personal risk factors (sexual orientation, cigarette use, diet, and type of contraception use), and factors affecting access to healthcare (type of healthcare coverage, delay in receiving medical care). This research study, guided …

Healthcare Access For Elderly African American Type 2 Diabetics On Medicare, William Alexander Floyd

Walden Dissertations and Doctoral Studies

AbstractPrior research has shown that African Americans have less access to healthcare than do White Americans. The study’s purpose was to determine the association between race/ethnicity and quality care measures in a population of Medicare recipients with Type 2 diabetes, aged 65 75 years and over. Covariates predicted satisfaction with doctor care, compassionate doctor care, and indifferent doctor care using Andersen’s health behavior theory. The Medicare Current Beneficiary Survey (MCBS) sample consisted of 1,716 people with Type 2 diabetes, with most (76.6%) being non-Hispanic Whites, and the remainder non-Hispanic Blacks (10.8%) and Hispanics (12.6%). Race/ethnicity were associated with quality-of-care measures …

Strategies For Implementing Self-Service Technologies In Supermarket Retail Operations, Ryan Christopher Gurley

Walden Dissertations and Doctoral Studies

AbstractOrganization leaders who do not adopt self-service technology (SST) are at risk of failure. The adaptation of SST can aid leaders in the supermarket industry improve checkout operations, increase efficiency, and minimize customers’ waiting experiences, reducing the customers’ shopping satisfaction. Grounded in the disruptive innovation theory, the purpose of this multiple case study was to explore strategies supermarket managers use to adapt SST practices. The participants included six supermarket managers in Jackson County of Southern Illinois. Data were collected from face-to-face interviews with managers, company documentation, and observations. Thematic analysis was used to analyze the data. Four themes emerged: cultural …

Analyzing Regional Impact Of Caregiving On Obesity Prevalence Among U.S. Adults, Myra Callis Johnston

Walden Dissertations and Doctoral Studies

Obesity remains one of the leading causes of morbidity and mortality in the United States. Historically, sparse research efforts have focused on informal caregiving as a possible risk factor for developing chronic illnesses across the United States. Identifying additional subgroups at higher risk of becoming obese could provide insights into where public health practitioners, the health care community, and policy makers can direct limited resources through a more targeted approach. The theoretical foundation for the current project was the social cognitive theory. In this secondary correlational analysis using the 2018 Behavioral Risk Factor Surveillance System data set, the relationship between …

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 …

How Cyber Activity Influences Depression And Anxiety In Teenagers, Mary Fridah Gatwiri Muiruri

Walden Dissertations and Doctoral Studies

Both depression and anxiety have been a focus of scholars since their rates have recently skyrocketed from 5.4 % in 2003 to 20 % currently among teenagers in the United States. Although numerous studies have assessed the association between playing video games and depression, few studies have examined how cyberbullying and screen time contribute to depressive symptoms in teenagers. The purpose of this study was to analyze cyberbullying and screen time on depression in teens. . The exploration of associations between the dependent variable, depression, and the independent variables, screen time, video gaming, and cyberbullying, were guided by Bandura’s social …

Reducing Infection Rates Through Handwashing Education, Maureen N. Osegbe

Walden Dissertations and Doctoral Studies

AbstractHealth care-associated infections (HCAIs) affect millions of people worldwide, causing morbidity and mortality among hospitalized patients. Hand hygiene is the single most effective way to prevent HCAIs. This project addressed a gap in practice regarding nurses’ knowledge on the effective use of hand hygiene in a medical/surgical unit in a hospital located in northeastern Maryland. This project addressed the question of whether an educational program on handwashing for nurses reduced HCAI rates. A literature review was conducted to support the development of the educational program; relevant sources included peer-reviewed journal articles, systematic reviews, and guidelines that supported the practice-focused question, …

Lived Experiences Of Lassa Fever Survivors In Southsouth Nigeria, Albert Oamen Oyeribhor

Walden Dissertations and Doctoral Studies

AbstractLassa fever, a viral disease, was first isolated in the late 1960s and affects 300,000 to 500,000 people, causing 5,000 to 10,000 fatalities annually across West Africa. Although there are studies on the causes and prevalence of Lassa fever, there is a paucity of studies regarding the quality of life (QoL) and lived experiences of survivors. The purpose of this qualitative study, guided by Leininger’s culture care theory, was to describe the QoL and meanings of the lived experiences of Lassa fever survivors in the Southsouth region of Nigeria. Fifteen survivors of Lassa disease were interviewed. Data were analyzed using …

The Relationship Between Advanced Payment Model Providers And Patient Behavior, Harry Petaway

Walden Dissertations and Doctoral Studies

Public health initiatives include vaccination and screening efforts to reduce the burden of disease. This study addressed colorectal cancer (CRC) screening behaviors of accountable care organization (ACO) patients with different social determinants of health and providers’ ability to comply with the Medicare Shared Savings Plan (MSSP) quality measure ACO #19. This study followed the socioecological model and a cross-sectional quantitative design to assess data from the MSSP public use file 2019 across three manuscripts to expand on current literature. The purpose was to determine whether patient behavior was the primary driver to improve healthcare quality. Study results showed that performance …

The Impact Of Staff Education On Nurses And Medical Assistants' Knowledge Of Hiv Prevention And Screening, Eurekia Denise Samuel

Walden Dissertations and Doctoral Studies

AbstractIn some U.S. ambulatory clinics, limited time is available for patient education during primary care, which is a barrier to increasing the recommended annual screening for HIV of persons with risk factors between the ages of 13 and 64. One solution to removing this barrier is the expansion of the role of frontline staff so that patient education, particularly in the areas of secondary prevention and routine testing, can occur at the beginning of the visit during initial checking in and assessments. At the project site, a rural ambulatory clinic in the southern United States, however, the frontline staff lacked …

Professional Values Of Corporate Nurses, Kasey Jeanne Sands

Walden Dissertations and Doctoral Studies

Healthcare is comprised of providers, who offer patient services, and payors, who manage the financial reimbursement of providers. Not much is known about registered nurses (RNs) in the corporate payor industry due to a lack of research. Strong professional values (PVs) are expected of all RNs, but research has shown this to vary across the field, meaning that RNs may require support in this area. As little is known about RNs in the payor industry, how these nurses sustain their PVs within the industry has not been evaluated, recognized, or supported. Therefore, the aims of this quantitative, descriptive, and correlational …

Electronic Health Record Adoption, Interoperability, And Consumer Access, Edet Udofia

Walden Dissertations and Doctoral Studies

AbstractElectronic health record (EHR) adoption is necessary across many healthcare settings. The problem identified in the current study is that EHR systems and consumer access to their health records tend to be inconsistently applied across various health care settings which could have adverse effects on health outcomes in the policies, and procedure of healthcare delivery. EHR systems can improve the perceptions of patients on healthcare systems and the operation of health care facilities. More specifically, the issue of interoperability in the context of EHR system implementation was reviewed in the current project. The purpose of this study was to understand …

Emotional Intelligence And Compassion Fatigue In Emergency Nurses, Kylie Yearwood

Walden Dissertations and Doctoral Studies

Compassion fatigue (CF) is mental and emotional exhaustion that occurs over time in nurses who provide care to traumatized individuals and includes both secondary traumatic stress syndrome (STS) as well as burnout (BO), which results from being overwhelmed in the workplace. Emotional intelligence (EI) has shown to be helpful in nurses who work in a fast-paced, high-stakes environment, such as the emergency department. The purpose of this quantitative, cross-sectional, descriptive study, guided by Orem’s self-care deficit nursing theory, was to determine whether there were relationships (a) between EI and CF in emergency nurses, (b) between EI and STS in emergency …

Transition Of Care To Decrease Hospital Readmission After Acute Mi, Patricia Yoon

Walden Dissertations and Doctoral Studies

The time period after an acute myocardial infarction (AMI) can be overwhelming for patients; while glad to be discharged from the hospital, they may not have the knowledge nor resources to properly manage secondary prevention measures and treatment of residual coronary artery disease (CAD). The gap in nursing practice this project addressed is the lack of follow up of care leading to increased rates of readmission. The goal of this quality improvement (QI) initiative was to evaluate pre/post data and synthesize results to make recommendations for possible practice change whether a 30-day transition of care program could decrease readmission rates …

The Lived Experience Of Parents Of Children With Irlen Syndrome: A Biopsychosocial Perspective Of The Effects Of Tinted Lenses And Colored Overlays, Bettina Lenise Young

Walden Dissertations and Doctoral Studies

Reading illiteracy is a continuing problem in society. Irlen purported many individuals struggle with reading due to a perceptual processing problem called Irlen Syndrome (IS). Existing research supports the use of colored overlays and tinted lenses to alleviate reading difficulties but has focused primarily on the biological benefits of improved reading while neglecting the IS child’s psychological and social well-being. Viewed from a biopsychosocial perspective, the purpose of this qualitative phenomenological study was to explore the lived experiences of parents of children with IS who used colored overlays or tinted lenses. Engel’s biopsychosocial theory acted as a guide for the …

Nursing Faculty Experiences With Mobile Technology Use In The Classroom, Sue Ellen Clark

Walden Dissertations and Doctoral Studies

Research to date on faculty use of technology in the classroom has largely focused on student perceptions of technology, technology use in higher education, and benefits of technology use in teaching and learning. A critical factor in integrating technology relates to nursing faculty members’ mobile technology (MT) experience. The aim of this descriptive phenomenological study was to explore the experiences of nursing faculty when integrating MT in the face-to-face classroom. More precisely, this study was designed to explore the reasons for inconsistencies among faculty in the integration of MT in the face-to-face classroom in baccalaureate nursing education programs. Experiences of …