Medicine and Health Sciences Commons^™

Lived Experiences Of Nurse Faculty Teaching Patient Safety Risks From Smartphone Distractions, Nicole Irene Helstowski

Walden Dissertations and Doctoral Studies

Smartphone distractions frequently occur in healthcare, disrupting nurses’ provision of patient care and threatening patient safety. To ensure safe care for patients, nurse faculty must prepare prelicensure nursing students with the knowledge, skills, and behaviors that they need to mitigate patient safety risks. A lack of research regarding how nurse faculty teach nursing students about patient safety risks from smartphone distractions was the concern for this study. The purpose of this qualitative, descriptive phenomenology study was to identify and report the lived experiences of undergraduate nurse faculty regarding teaching about patient safety risks from smartphone distractions in prelicensure nursing programs …

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 …

A Qualitative, Formative Evaluation Of Cultural Competencies In A Baccalaureate Nursing Program, Lorraine J. Mercado

Walden Dissertations and Doctoral Studies

Abstract Nurses are often the first healthcare professionals that patients encounter in a healthcare environment; however, members of the lesbian, gay, bisexual, or transgender (LGBT) community and other diverse populations fail to seek medical attention due to feelings of discrimination and an unwelcoming environment. The focus of this qualitative, formative, program evaluation was that the baccalaureate nursing students at a private 4-year college in the Northeastern United States indicated a lack of academic preparation in cultural competency to properly care for members of the LGBT community and other diverse populations after graduation. Leininger’s theory of cultural care was used in …

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 …

Staff Education To Promote Postpartum Depression Screening, Melony Stokes

Walden Dissertations and Doctoral Studies

Postpartum depression (PPD) is the most frequent cause of maternal morbidity in the United States. PPD is far more prevalent than reported. The literature suggests that more than half of women experiencing PPD are untreated and unrecognized. PPD affects the health of mothers and their newborns and is associated with long-term psychological and socioeconomic implications. Varying factors may influence PPD, and it is often difficult for patients to recognize the symptoms making it critically important for health care staff to screen for PPD. The aim of this project was to determine whether an education program for nurses in an obstetrical …

Merger And Acquisitions: Effects Of Cultural Adaptation On Burnout Over Time Among Middle Managers, Perian Nora Stavrum

Walden Dissertations and Doctoral Studies

Merger and acquisition (M&A) actions are common; however, research on cultural adaptation over time leading to burnout is scarce. The purpose of this quantitative, nonexperimental study was to evaluate the relationships between independent variables defined as organizational and group adjustment, and the criterion variables operationalized as emotional exhaustion and cynicism, and to determine if the adjustment factors and time interact, affecting burnout in middle managers working in a target organization of U.S.-based M&As. The theoretical framework used was organizational socialization, conceptualized as newcomer adaptation, suggesting that individuals must traverse through an adjustment period regardless of the context of the change. …

Missionary Kids And Trauma, Lindsay Elizabeth Stone

Walden Dissertations and Doctoral Studies

AbstractMissionary Kids and Trauma by Lindsay E. Stone

MA, Walden University, 2019MA, Southwestern Baptist Theological Seminary, 2010 BS, Charleston Southern University, 2006

Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Human and Social Services

Walden University February 2021 Abstract Missionary kids (MKs) around the world are more exposed to trauma than non-MKs. MKs often struggle with grief, loss, and stressors of cross-cultural living. Childhood trauma leads to short-and long-term effects of trauma, often into adulthood. The purpose of this basic qualitative study was to explore adult, Christian MKs’ perceptions of external trauma on …

Impact Of The Internet On Young Adult’S Perceptions Of Childhood Vaccinations, Hollie Leigh Xu

Walden Dissertations and Doctoral Studies

The internet and social media have transformed the way people receive information and connect, but the impact on society is still unknown. The purpose of this study was to examine the impact of indirect exposure to vaccine messages via the internet on young adults’ perceptions of childhood vaccinations. The health belief model and the social marketing theory were used as the theoretical framework. Research questions explored the relationship between exposure to anti and pro-vaccination messages and perceptions of participants as well as the relationship between perceptions of vaccination and intent to vaccinate. A quantitative correlational study design was used, with …

Improving Staff Knowledge Of Cultural Competence, Sherry Denise Akins

Walden Dissertations and Doctoral Studies

Professional nurses must demonstrate sensitivity to and understanding of a variety of cultures within United States (US) healthcare systems. Such skillsets are needed for the provision of high-quality nursing care across the entire spectrum of healthcare. Nurses are challenged to provide holistic care that is congruent with each patient’s beliefs, practices, and culture. Guidelines from the constructs of pioneer Madeline Leininger’s Transcultural Theory was used as the conceptual framework for the proposal. The purpose of this project was to validate an evidence-based orientation module to educate nurses and nursing staff within an acute healthcare setting regarding cultural competence during hospital …

Exploring Ethnic And New Orleans Cultural Influences On Health Behaviors Of African American Women, Keneitra Brown-Mayfield

Walden Dissertations and Doctoral Studies

In the United States (U.S.), African American women suffer disproportionately due to obesity and chronic diseases. Many studies have examined the culture of African Americans and its influence on their health behaviors in order to gain knowledge to inform obesity and chronic disease prevention interventions. However, a geographical segment of the U.S. African American population shares a unique culture that had yet to be studied. This qualitative study used in-depth interviews to understand the perceptions of overweight and obese African American women living in the Greater New Orleans region about their culture’s role in the prevalence of obesity and obesity-related …

Relating Overweight/Obesity And Psychosocial Outcomes Among Racial/Ethnic And Sexual Minority Adolescents, Cadene T. Douglas

Walden Dissertations and Doctoral Studies

Adolescents being overweight/obese is a public health crisis that threatens the health and welfare of adolescents going into adulthood and places a significant strain on society. It has been described as one of the most severe public health challenges of the 21st century by the World Health Organization. The pervasiveness of obesity in adolescents rose by 47.1% over the last three decades, and it disproportionally affects racial/ethnic minority lesbian, gay, and bisexual (LGB) persons. Guided by distal and proximal health behaviors, the minority stress model, and intersectionality, the purpose of this study was to examine whether being overweight or obese …

Faculty Perceptions Of Preparing Bachelor Of Science In Nursing-Registered Nurse Students For Primary Health Care, Gloria J. Hopkinson

Walden Dissertations and Doctoral Studies

Healthcare systems rely on nurses to provide essential healthcare services in primary healthcare settings. However, few nursing school graduates seek careers in primary healthcare (PHC). The purposes of this exploratory, qualitative study guided by the patient-centeredness theory were to explore the beliefs and attitudes of nursing faculty who teach Bachelor of Science in nursing level PHC courses, how they incorporate PHC into the nursing curriculum, and what strategies they use to promote student interest in PHC. Participants of this study included seven faculty who teach PHC courses at two universities in the Midwest. The interviews were audio recorded, transcribed, and …

Alzheimer’S Dementia Care: Impact On Family Caregivers, Rose Anne Pierre

Walden Dissertations and Doctoral Studies

Patients with dementia of the Alzheimer’s type increasingly become dependent on caregivers. Researchers have demonstrated that these caregivers experience serious burdens during their caregiving experiences. They face emotional, physical, and financial burdens. The objective of this paper was to discuss the burden and strains of Alzheimer’s disease on the older caregivers in the United States. The stress process model and the quality of life were used in this study. The study used a descriptive and analytical approach to analyze 2015 secondary data retrieved in 2018 from the National Alliance for Caregiving. The adult Alzheimer’s dementia caregivers were selected. A multiple …

Teacher Perception On Integrating School Psychology In The Developing Nation Of Grenada, Carla Erica Maria St. Louis

Walden Dissertations and Doctoral Studies

AbstractInternationally, formalized school psychology and related services strive to address the academic and mental health of students in schools. In developing nations, teachers are the primary professionals to address students’ needs in schools. Little research has focused on teachers’ perceptions of students’ needs, available services’ quality, and how formalized structures with qualified certified professionals can further address students’ needs. Bronfenbrenner’s ecological systems and Nastasi’s participatory culture-specific intervention model are the theoretical underpinnings of this qualitative study and focus group interviews were used to investigate special education needs (SEN) teachers’ perceptions. Data were collected using open ended questions and probes with …

Territoriality As A Factor In Nursing Incivility, Carolyn Wright

Walden Dissertations and Doctoral Studies

AbstractIncivility and hazing in health care results in unsafe environments, not only for the nurse but also for the client, facility, and other health professionals. The project site, a privately owned medical clinic, has a high employee turnover rate with exit interviews indicating bullying and incivility from long-term nursing staff toward new employees as critical reasons for employee resignation. The literature offers minimal information regarding territoriality, a concept associated with aggressive (i.e., alpha) behaviors in animals and humans and incivility in nursing. The purpose of the project was to identify whether territoriality was a behavioral factor that may have contributed …

Factors Predicting Obstetric Fistula Among Women 15-49 Years Old In Uganda, Fatmata Fofanah

Walden Dissertations and Doctoral Studies

Obstetric fistula is among the public health issues that are preventable and treatable, as evidenced by its elimination in industrialized nations. The aim of this quantitative, cross-sectional study was to use Andersen’s behavioral model of health services utilization to examine the factors that predict the likelihood of experiencing obstetric fistula among women ages of 15 and 49 living in Uganda. Demographic risk factors (marital status, age at first pregnancy, level of education and income, and religious affiliation), medical risk factors (access to health care, distance from hospital, parity, and number of antenatal visits), the mode of delivery (C-section), and location …

Using Health Navigators To Reduce Readmission Rates Among Medicaid Or Uninsured Female Patients In The Emergency Department, Susan Renee Ibanez

Walden Dissertations and Doctoral Studies

AbstractThere has not been a significant decrease in hospital readmission rates since the 1980s, which has impacted staffing, operational, and financial resources. Unnecessary 30-day readmissions result in penalties in reimbursement, additional costs, and adverse reactions resulting from the admission for the patient. This quantitative study explored the impact of using health navigators for an emergency department (ED) patient population. The theoretical framework was based on the Donabedian model. The study focused on female patients,some of whom were covered by Medicaid, and some were uninsured. This study posed research questions targeting reducing readmission for female ED patients with no insurance or …

Perception Of Clinic Staff On Weight Reduction Program For Young Adult Females, Ifeyinwa Cordelia Ibeanu

Walden Dissertations and Doctoral Studies

Obesity, a common disease among young people in the United States, is defined as aBMI of 30 or more. Among the most prevalent noncommunicable diseases, obesity is reported as a significant public health issue for the general population. The management of younger adults’ obesity requires advanced skills and knowledge to promote healthier lifestyles while directly addressing the factors that contribute to the condition. As a result, this project was designed to evaluate the staff perception of an evidence-based educational program on weight reduction among young adult females (ages 18-25) diagnosed with obesity at outpatient clinic in a Northeastern mid-Atlantic States. …

Discharge Instructions To Decrease Copd Readmissions, Randee S. Marinaro

Walden Dissertations and Doctoral Studies

AbstractChronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the US. A 301-bed rural hospital in the Midwest had experienced excessive 30-day hospital readmissions with their COPD patients. Two gaps in practice were identified: a lack of uninterrupted time to plan and execute discharge instructions and inconsistent discharge instructions provided to these patients as. The purpose of this project was to educate staff nurses on the importance of implementing a protected time, evidence-based discharge plan for patients diagnosed with COPD. The project explored whether a discharge education program nurses would decrease the 30-day readmission rate for …

Comparison Of Kidney Disease Risks Among African Americans In Maryland And Neighboring Regional States, Nneka A. Offiah

Walden Dissertations and Doctoral Studies

AbstractChronic kidney disease (CKD) is a recognized global health burden that has affected 10-15% of the general adult population, which is caused by diabetes and has disproportionately affected minority populations such as African Americans. Despite the prevalence of diabetes and hypertension, other variables could predispose this racial group to CKD, hence the need for this study. The purpose of this cross-sectional quantitative study using secondary data analysis methods was to investigate to what extent various factors such as gender, diet, age, exercise, socioeconomic status, diabetes, and hypertension were associated with the prevalence of CKD among African Americans residents in Maryland, …

Factors Associated With Electronic Cigarette Use Among Adolescents In Texas, Christie Anuli Okonkwo

Walden Dissertations and Doctoral Studies

The use of electronic cigarettes among adolescents has remained a major public health concern. Reports have shown that the adolescent brain is still growing and can be affected by nicotine and cancer-causing chemicals contained in e-cigarettes. The rising trend of e-cigarette use by adolescents has reportedly reached an epidemic, and there is a knowledge gap in the factors associated with this behavior and the provision of appropriate interventions for the at-risk population. The purpose of this quantitative, cross-sectional study was to investigate the association between sociodemographic factors and the tendency of Texas adolescents to use e-cigarettes. This study was a …

The Combined Impact Of Race And Education On Obesity Among U.S. Adults By Fidelis Okoye, Fidelis Chidi Okoye

Walden Dissertations and Doctoral Studies

Walden University

College of Health Professions

This is to certify that the doctoral dissertation by

Fidelis Okoye

has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made.

Review Committee Dr. Vasileios Margaritis, Committee Chairperson, Public Health Faculty Dr. Srikanta Banerjee, Committee Member, Public Health Faculty Dr. James Rohrer, University Reviewer, Public Health Faculty

Chief Academic Officer and ProvostSue Subocz, Ph.D.

Walden University2021

AbstractThe Combined Impact of Race and Education on Obesity Among U.S. Adults by Fidelis Okoye

MA, Walden University, 2009BS, Marygrove College, 2001

Dissertation …

An Examination Of The Absence Of A Comprehensive Smokefree Law In Georgia On College And University Campuses, Nakki Price

Walden Dissertations and Doctoral Studies

AbstractCigarette smoking is the number one preventable cause of death and disability in the United States. Although there are policies that govern the use of tobacco products, there are jurisdictions that do not employ these policies. Comprehensive smokefree laws govern private-sector entities and prohibit smoking in public places, specifically restaurants, bars, and workplaces. While states have the authority to implement these laws, some include exceptions that limit the intention of the law. Colleges and universities are specific communities for learning and serve as housing for students and an employer for the greater community. There is a gap in the literature …

Family Texting In The Perioperative Care Setting, Crystal Chantel Vestal

Walden Dissertations and Doctoral Studies

Family members experience anxiety not knowing how their loved one is progressing during the surgical process. Communication between perioperative staff and the family can be challenging due to the operating room being in a restricted location. Communication between perioperative staff and the patient family, as reflected in scores on the Press Ganey evaluation report, was below the benchmark for a hospital located in the Western United States. This report measures how satisfied patients were with the information provided to their family during surgery. To address this gap in practice, the hospital implemented a text messaging quality improvement project from August …

Sociodemographic And Pregnancy Risk Factors Associated With Place Of Delivery Among Northern Nigerian Women, Daniel Ali

Walden Dissertations and Doctoral Studies

AbstractOne out of every 13 women in Nigeria die during childbirth. In Nigeria, over 60% of deliveries that take place at home were attended to by an unskilled person. This study involved using Thaddeus and Maine’s three delays model to determine the influence of sociodemographic factors (woman’s age, woman’s residence [rural/urban], woman’s and husband’s education level, husband’s occupation, household wealth), pregnancy risk factors (antenatal care usage, wanted pregnancy, and birth order) on the choice of place of delivery amongst women of reproductive age (15-49 years) in Northern Nigeria. This quantitative cross-sectional study used the National Demographic Health Survey of 2018. …

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 …

Staff Education Program Assessment Of Violence In An Acute Psychiatric Hospital, Steven Dickson

Walden Dissertations and Doctoral Studies

Physical aggression and violence are sizable concerns for mental health nursing professionals. More than 80% of nurses working in mental health areas have faced verbal or physical abuse from patients. The practicum site noted that patient violence towards staff accounted for 18-20% of workplace injuries involving days away from work, compared to 10-11% in other healthcare settings. The purpose of this project was to develop a program to educate staff on the Brøset violence screen (BVC), an evidence-based, violence-risk screening tool, to increase staff's knowledge about this tool. Five behavioral health experts used the Lynn model to evaluate the project’s …

The Systemic Experiences Of Social Workers In An Inpatient, State Psychiatric Hospital, Kesia Gwaltney

Walden Dissertations and Doctoral Studies

The National Alliance on Mental Illness surmised that 1 in 25 (9.8 million) adults in the United States are diagnosed with a serious mental illness annually. Of the 9.8 million people diagnosed, approximately 63% of them are psychiatrically hospitalized with repeat hospitalizations within 1 year of discharge. Social workers play a vital role in the treatment modalities of the patients they serve in the psychiatric hospital; however, there is no research that examined the professional systemic experiences of social workers in state, inpatient psychiatric hospitals and how these experiences may affect treatment outcomes of patients as it relates to frequent …

Domestic Abuse Against Men In Kenya, Catherine W. Kigaya

Walden Dissertations and Doctoral Studies

Domestic violence, also known as intimate partner violence (IPV), is prevalent globally and causes severe physical, psychological, and social harm to victims. The purpose of this quantitative cross-sectional study was to highlight the predictors of physical and sexual IPV among men in Kenya and examine the influence of media in seeking help. These factors were explored through the lens of the socio-ecological model and the social learning theory. The 2014 Demographic Health Survey archival data obtained through in-depth interviews were used to answer the research questions. Dependent variables were physical abuse, sexual abuse, and seeking help while independent variables were …

Examining Nursing Home Staff Turnover Rate In Long-Term Care Organizations In The United States, Dandrea Vanettra Kittles

Walden Dissertations and Doctoral Studies

AbstractEvery year, many nursing assistants in the United States leave their positions. The high level of turnover can be disruptive to patient care and costly to organizations needing to replace workers; another consequence can be increased job dissatisfaction among remaining staff. Despite the high turnover in nursing facilities, there remains a research gap regarding the factors that promote employee retention. The purpose of this study was to examine nursing assistants’ beliefs about job satisfaction as an approach to prevent job turnover and retain high-achieving staff in nursing homes in the United States among the older adult population. Herzberg’s motivation-hygiene theory …