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2022

Theses/Dissertations

Walden Dissertations and Doctoral Studies

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Narrative Inquiry Into Postsecondary Transition Outcomes For Young Adults With Intellectual & Developmental Disabilities, Eric R. Sarrett Aug 2022

Narrative Inquiry Into Postsecondary Transition Outcomes For Young Adults With Intellectual & Developmental Disabilities, Eric R. Sarrett

Walden Dissertations and Doctoral Studies

Young adults with intellectual and developmental disabilities (IDD) continue to struggle with community engagement despite decades of research and policy initiatives addressing postsecondary transition. Evidence shows that persons with IDD are engaging in employment, postsecondary education, independent living, socialization, and other roles at significantly diminished rates, yet little data exists describing this participation in the voices of those affected. The purpose of this narrative inquiry was to describe community integration of persons with IDD in the decade following postsecondary transition in their own words. Critical disability theory was used as a lens to explore the successes and failures of public …

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Improving Nurses' Knowledge On The Assessment And Documentation Practices In The Pediatric Settings Of A Jamaican Hospital, Binol Rajesh Balachandar Jan 2022

Improving Nurses' Knowledge On The Assessment And Documentation Practices In The Pediatric Settings Of A Jamaican Hospital, Binol Rajesh Balachandar

Walden Dissertations and Doctoral Studies

AbstractThere have been anecdotal reports from the on-site Quality Assurance team, administrators, and educators that a theory-practice gap exists in pediatric nursing practice settings relating to the specific assessment and documentation. A deidentified chart review confirmed the reported practice gaps in 80% of the patient records. Therefore, in collaboration with the in-service unit, this staff education project and the educational interventions were implemented, and the knowledge improvement was appraised using a pre and posteducation survey. Mozirow’s reflective learning theory formed the basis for staff education, utilizing adult learning principles. Twenty-five consenting nurses completed the preeducation survey (N = 25); however, …

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Relationships Between Stress Self-Management, Social Support, And Health In Hispanic Informal Caregiver Burnout Prevention, Nicole Alexandra Mas Román Jan 2022

Relationships Between Stress Self-Management, Social Support, And Health In Hispanic Informal Caregiver Burnout Prevention, Nicole Alexandra Mas Román

Walden Dissertations and Doctoral Studies

Burnout syndrome is a psychological disorder characterized by physical, emotional, and mental distress and exhaustion resulting in feelings of depression, anxiety, irritability, and negative attitudes. If left unattended, burnout syndrome can lead to new or worsening health outcomes. The purpose of this nonexperimental quantitative study was to examine the relationship between stress self-management, perceived social support, health status, and burden among Puerto Rican informal caregivers. The theoretical foundations for this research were the informal caregiving integrative model and the individual and family self-management theory. Survey data were collected from 415 participants. Multiple regression analyses were performed to determine the relationship …

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Use Of The Hester Davis Falls Risk Assessment Scale In Medical-Surgical Patients, Gideon M. Nyakundi Jan 2022

Use Of The Hester Davis Falls Risk Assessment Scale In Medical-Surgical Patients, Gideon M. Nyakundi

Walden Dissertations and Doctoral Studies

AbstractIdentifying and containing patient falls before they happen, reporting fall occurrence, and analyzing fall causes could increase patient safety to achieve the triple aim of improved quality, reduced cost, and accessibility in healthcare. Patient falls within the medical-surgical population continue to present challenges to patients, families, hospitals, and society, despite the use of fall-related predictive analysis tools. The purpose of this quantitative study was to determine the extent to which the overall score on the Hester Davis Falls Risk Assessment Scale (HDS), comprised of patient-related factors such as medications, volume/electrolyte status, age, last known fall date, mobility, toileting needs, communication/sensory …

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Comprehensive Sex Education, Religious Affiliated Organizations, And Std Knowledge Among Young Adults, Leslie Marie Shaffer Jan 2022

Comprehensive Sex Education, Religious Affiliated Organizations, And Std Knowledge Among Young Adults, Leslie Marie Shaffer

Walden Dissertations and Doctoral Studies

AbstractEvery year there are approximately 20 million new cases of sexually transmitted diseases (STDs) in the United States, and half of these are among young adults. Stark County, Ohio recently experienced an increase in chlamydia, gonorrhea, and syphilis cases among 18- to 24-year-old individuals. Public health practitioners have since called for research regarding factors that affect STD knowledge and perceptions in this population. This cross-sectional study was guided by the social-ecological model and assessed the association between attendance at a religious-affiliated institution, access to comprehensive sex education, and STD knowledge. One hundred thirty-eight (n=138) participants, aged 18 to 24 years, …

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Readiness Of Adolescent And Young Sickle Cell Patients To Transition From Pediatric To Adult Care, Tanisha D. Belton Jan 2022

Readiness Of Adolescent And Young Sickle Cell Patients To Transition From Pediatric To Adult Care, Tanisha D. Belton

Walden Dissertations and Doctoral Studies

Patients with sickle cell disease (SCD) face many challenges as they enter adulthood; therefore, preparing for the transition to adult care is crucial. Assessing the knowledge and skills adolescents and young adults (AYAs) possess before transitioning to adult care can aid in the success of their transition. However, a gap exists regarding factors attributed to guiding patients’ sense of readiness. The purpose of this quantitative study, driven by the theory of self-care management of SCD, was to examine the self-perceived readiness of SCD patients as they prepare to transition to adult care. Cross-sectional survey data were collected from 68 sickle …

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Perceptions Of Associate Degree Nursing Faculty Of A Primary End-Of-Life Care Course Within Prelicensure Nursing Curricula, Katherine Zaharchuk Jan 2022

Perceptions Of Associate Degree Nursing Faculty Of A Primary End-Of-Life Care Course Within Prelicensure Nursing Curricula, Katherine Zaharchuk

Walden Dissertations and Doctoral Studies

AbstractThe responsibility for educating U.S. nursing students on end-of-life (EOL) care concepts lies with prelicensure nursing programs; however, the majority of all prelicensure nursing programs offer only a few lectures, and only a small percentage offer EOL and palliative care courses. The lack of education on EOL care results in greater stress for nurses, poor symptom management for patients, and reduced support for family caregivers. There is limited knowledge on why primary EOL education has not yet been adopted by many Associate Degree in Nursing (ADN) programs. The purpose of this qualitative study was to explore the perceptions of ADN …

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Creating A Clinical Practice Guideline For Patients With Uncontrolled Hypertension, Nar'cissa Mcdonald Jan 2022

Creating A Clinical Practice Guideline For Patients With Uncontrolled Hypertension, Nar'cissa Mcdonald

Walden Dissertations and Doctoral Studies

Cardiovascular disease is the leading cause of death globally, with hypertension (HTN)the primary causal factor. The nursing professions' role as a critical agent in facilitating the management of patients should be based on best practices. No specific standard exists in the United States for nurses despite the publication of Clinical Practice Guidelines (CPGs) on HTN for adults. A gap in practice was identified in an outpatient primary care clinic located on the Gulf Coast of Mississippi, as there is no comprehensive CPG for nurses to provide patients with complete HTN diagnosis and management care. A literature review revealed that clinical …

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Organizational Barriers To Effective University Student Mental Health Services, Felicia Evans-Edwards Jan 2022

Organizational Barriers To Effective University Student Mental Health Services, Felicia Evans-Edwards

Walden Dissertations and Doctoral Studies

This study was focused on organizational barriers to effective university student mental health services access in the department of student resources (DSR) at a for-profit university in the northeastern United States. Once such barriers are addressed, faculty may be more successful in reaching out to students needing mental health services who are not self-identifying as needing these services. The Baldrige excellence framework guided this descriptive case study to examine the organizational barriers that prevent university leadership from creating clear policies and procedures for faculty to refer students to mental health services. Data sources included interviews with the behavioral health leader …

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The Lived Experience Of Individuals Thinking About Food And Coping With Stress, Tobi Martin Jan 2022

The Lived Experience Of Individuals Thinking About Food And Coping With Stress, Tobi Martin

Walden Dissertations and Doctoral Studies

Stress results in many people altering their eating patterns, often consuming food high in sugar and fat. Such behavior is a factor in the growing obesity epidemic and can potentially cause the development of chronic diseases, resulting in employment problems and billions of extra dollars spent on national health care programs. Researchers have focused on the concept of “emotional eating” while overlooking the overarching research question of this study, which was about exploring the experience of individuals using eating behavior as a coping mechanism to deal with stress. All responses were viewed through the lens of social cognitive theory. Interviews …

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Perceived Diabetes Susceptibility Among African American Female College Students, Khaliah India Wilson Jan 2022

Perceived Diabetes Susceptibility Among African American Female College Students, Khaliah India Wilson

Walden Dissertations and Doctoral Studies

Type 2 diabetes is a leading cause of death among African American women ages 20-44 years, and African American female college students are at high risk. Research shows that college students tend to underestimate their susceptibility to Type 2 diabetes, despite their existing risk factors. There is a gap in knowledge concerning African American female college students and their perception of diabetes susceptibility, despite their increased risk. The purpose of this quantitative nonexperimental, correlational study was to identify the factors associated with perceived personal susceptibility to Type 2 diabetes and Type 2 diabetes-related health behavior among African American female college …

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Perceived Barriers To Health Care Access And Delivery Among Arkansas Medicaid Beneficiaries, Kimbra D. Butler Jan 2022

Perceived Barriers To Health Care Access And Delivery Among Arkansas Medicaid Beneficiaries, Kimbra D. Butler

Walden Dissertations and Doctoral Studies

Arkansas has historically been one of the lowest ranking states in the United States in education, economy, opportunity, crime and corrections, and health care. Though more than 3 million Arkansans live in the state, nearly 1 million receive Medicaid-funded health insurance. This phenomenological study employed a constructivist paradigm and focused on the perceptions of underserved Arkansans regarding their health and their access to health care; additionally, within this study, the Health Belief Model shifted the study’s focus to individuals’ perspectives, perceptions, experiences, and opinions through interview responses. The research was intended to identify factors that may relate to the higher …

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Perceived Discrimination As A Moderator Of The Relationship Between Allostatic Load And Asthma Control, Vera Kern Jan 2022

Perceived Discrimination As A Moderator Of The Relationship Between Allostatic Load And Asthma Control, Vera Kern

Walden Dissertations and Doctoral Studies

While asthma prevalence in the United States is generally declining, African Americans tend to experience poorer outcomes regarding asthma severity and control. The purpose of the present study was to test whether discrimination (everyday and lifetime) moderated the relationship between allostatic load and asthma severity/asthma control (dyspnea and peak flow). In previous literature, researchers established the relationship between allostatic load and asthma severity/asthma control among African Americans. The biopsychosocial model and allostatic load theory served as the theoretical frameworks for this study. In this cross-sectional, nonexperimental, quantitative design, 201 African Americans between the ages of 34 and 82 years were …

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The Correlation Between Laura’S Law And The Incarceration Of The Mentally Ill In A Southwestern State, Aaron Alarcon-Bowen Jan 2022

The Correlation Between Laura’S Law And The Incarceration Of The Mentally Ill In A Southwestern State, Aaron Alarcon-Bowen

Walden Dissertations and Doctoral Studies

Assisted outpatient treatment and involuntary outpatient treatment laws refer to the power of the court system to order community-based treatment without hospitalization to individuals with a mental illness diagnosis. Studies have linked these laws to a decrease in the use of incarceration among this population. The effectiveness of the assisted outpatient treatment law in a Southwestern state, known as Laura’s Law, has not been studied. With a theoretical foundation based on the social contract and multiple streams analysis theories, a quantitative, casual, comparative study using an independent t test was centered on determining whether the mean numbers of incarcerated individuals …

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Job Satisfaction Among Nurse Practitioners Who Work At Retail Health Care Centers, Karen Morrissey Jan 2022

Job Satisfaction Among Nurse Practitioners Who Work At Retail Health Care Centers, Karen Morrissey

Walden Dissertations and Doctoral Studies

Retail health care clinics (RHCCs) were designed to ease the shortage of access to primary care by having nurse practitioners (NPs) provide quality care to patients on a walk-in approach. RHCCs can be stressful work environments and when NPs become dissatisfied, they may leave RHCCs which creates a shortage of primary care access. The purpose of this descriptive study, guided by Herzberg’s dual-factor theory, was to determine if there was a relationship between: (a) challenge/autonomy, and professional growth and job satisfaction among NPs who work at RHCCs and (b) intrapractice partnership/collegiality, professional, social and community interaction, time and benefits and …

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Health Department Prevention/Education Plans And Perceived Risks Of Zika Infection, Lacey Jacques Jan 2022

Health Department Prevention/Education Plans And Perceived Risks Of Zika Infection, Lacey Jacques

Walden Dissertations and Doctoral Studies

AbstractZika virus is an infectious disease caused by the bite of an infected mosquito that has been linked to increased rates of microcephaly and other devastating birth defects. The existing body of knowledge has focused on the individual-level factors that influence a person’s decisions about prevention activities and risk perceptions related to Zika virus. The purpose of this study was to determine the relationship between state-level plans for prevention and education and individual-level risk perceptions. Rosenstock’s health belief model lays a foundation for why individuals make the health decisions they do and helps explain how these can be influenced for …

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Association Between Parental Socioeconomic Status And Childhood Obesity In The Southwest Geopolitical Zone Of Nigeria, Omatsola Aboyowa Sifo Jan 2022

Association Between Parental Socioeconomic Status And Childhood Obesity In The Southwest Geopolitical Zone Of Nigeria, Omatsola Aboyowa Sifo

Walden Dissertations and Doctoral Studies

AbstractGlobally, childhood obesity is a major social and public health concern characterized by complications such as high cholesterol and high blood pressure. The purpose of this quantitative cross-sectional study was to examine the association between childhood obesity in children age 6–12 years and the socioeconomic status of their parents in the Southwest geopolitical zone of Nigeria. Social cognitive theory served as the theoretical framework for the study. Questionnaire data were collected from 384 parents/guardians of children age 6–12 years across three states in the Southwest geopolitical zone of Nigeria. Data were analyzed using descriptive statistics and multiple logistic regression at …

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Socioeconomic And Health Impact Of Opioid Overuse On Working-Age Population In Minnesota, Colette Ngum Ngwa Jan 2022

Socioeconomic And Health Impact Of Opioid Overuse On Working-Age Population In Minnesota, Colette Ngum Ngwa

Walden Dissertations and Doctoral Studies

Abstract The United States faces numerous challenges associated with the ongoing opioid crisis. Although the opioid epidemic is complex, opioid overuse affects users’ health and has a far-reaching impact on socioeconomic well-being. This study employed a quantitative cross-sectional design using secondary data from a 2018 national survey of working-age individuals ages 18 to 45. Multivariate regression analysis was used to examine the associations between opioid overuse and socioeconomic status, health status, and perceived need for substance abuse treatment. The addiction career concept and chronic illness model theory were used to analyze these correlations. The findings indicated that people with higher …

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Increasing Nurses’ Knowledge Of Richmond-Agitation Sedation Score Assessment And Documentation Through Education, Kara Jeanne Beaulieu Jan 2022

Increasing Nurses’ Knowledge Of Richmond-Agitation Sedation Score Assessment And Documentation Through Education, Kara Jeanne Beaulieu

Walden Dissertations and Doctoral Studies

Patients in the intensive care unit (ICU) are critically ill and faced with numerous physical and psychological stressors that often require a multidisciplinary approach to improve outcomes and relieve suffering. Patients are given sedation to tolerate invasive treatments and procedures. Using the Richmond-Agitation Sedation Score (RASS), nurses assess objective findings and the level of sedation a patient is experiencing, and titrate sedation according to an ordered RASS score. Ineffective and inaccurate use of the RASS score leads to patients being oversedated and demonstrates a lack of understanding of how to appropriately use the RASS score assessment tool. The purpose of …

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Using Integrated Staff Education To Increase Medication Adherence In A Mentally Ill Population, Tiffany Dawn Burke-Lott Jan 2022

Using Integrated Staff Education To Increase Medication Adherence In A Mentally Ill Population, Tiffany Dawn Burke-Lott

Walden Dissertations and Doctoral Studies

Failure to adhere to medication regimens is a serious problem that affects both the patient and the health care system. Psychiatric patients have the lowest rates of adherence, as low as 24%. The evidence shows that nonadherence to medication is a global challenge in the field of mental illness and is linked with a poor prognosis. Patients who are nonadherent to medications experience exacerbations of their mental illness, which can lead to rehospitalization, poor psychosocial outcomes, relapse of symptoms, reduced effectiveness of subsequent treatment, wastage of limited health care resources, increased substance abuse, poor quality of life, and increased risk …

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Secondary Data Analysis Of The Association Of Screen Time With Selected Health Behaviors, Kellany Cadogan Noland Jan 2022

Secondary Data Analysis Of The Association Of Screen Time With Selected Health Behaviors, Kellany Cadogan Noland

Walden Dissertations and Doctoral Studies

The noticeable disparity in youth access of preventive healthcare and youth’s tendency towards excessive screen time have been linked to poor health outcomes. This issue prompted the current study, which had three core purposes: to identify associations between screen time and selected health behaviors, to identify target sociocultural and personal determinants of youth health, and to provide evidence to prompt innovation in promoting youth health via screen-based strategies. The social cognitive theory provided a context for triadic reciprocity between youth personal factors, environmental factors, and behaviors. A quantitative secondary analysis was completed using SPSS-27 to identify whether there was an …

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Nonpharmacological Pain Control Following Hip And Knee Replacements In Older Adults, Adraine Cox Jan 2022

Nonpharmacological Pain Control Following Hip And Knee Replacements In Older Adults, Adraine Cox

Walden Dissertations and Doctoral Studies

Abstract Over prescribing opioids after hip and knee replacements in older adults is closely linked to the opioid epidemic. Despite being a public health concern associated with increased mortality rates, opioids are the most frequently used method for controlling postoperative pain. Therefore is important to know whether nonpharmacological pain control methods may effectively reduce the burden of opioid addiction, thus reducing the risk of opioid-related fatalities. The purpose of this study was to determine whether a systematic review of the literature provided evidence supporting nonpharmacological methods of pain control following hip and knee replacements in older adults compared to use …

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Lgbtq Patient Funding And Satisfaction On Patient Volume And Hospital Revenue, Kourtney Denise Carter Jan 2022

Lgbtq Patient Funding And Satisfaction On Patient Volume And Hospital Revenue, Kourtney Denise Carter

Walden Dissertations and Doctoral Studies

AbstractHistorically, the lesbian, gay, bisexual, transgender, and queer (LGBTQ) community has reported low patient satisfaction for health care. The purpose of this quantitative study was to examine the statistical relationship between patient satisfaction among LGBTQ patients (independent variable) and patient volume and hospital revenue (dependent variables) in the U.S. state of Georgia. The study was grounded on Andersen's model of healthcare utilization. Two research questions guided this study related to the statistical relationship between hospital revenue and patient satisfaction within health systems and the statistical relationship between patient satisfaction and patient volume. The study included 567 members of the LGBTQ …

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Perceptions Of Instructor Caring Behaviors Between English As A Second Language And Non-English As A Second Language Nursing Students, John Chukwuemeka Dike Jan 2022

Perceptions Of Instructor Caring Behaviors Between English As A Second Language And Non-English As A Second Language Nursing Students, John Chukwuemeka Dike

Walden Dissertations and Doctoral Studies

AbstractEnglish as a second language (ESL) nursing students have a significantly higher attrition rate and lower National Council Licensure Examination (NCLEX) pass rate than their non-ESL counterparts. Instructor caring behaviors (ICBs) are the ways nursing instructors treat students with respect, taking care to avoid prejudices, stereotyping, and judgments in the teaching-learning process which present prelicensure faculty to grapple with the challenge of effectively meeting the learning needs of both ESL and non-ESL students. The purpose of this cross-sectional, comparative study, guided by Watson’s theory of human caring, was to explore the differences in perceptions of ICBs between ESL and non-ESL …

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Focused Surrogate Decision-Maker Identification In The Traumatically Injured Adult, Kelly Ann Evans Jan 2022

Focused Surrogate Decision-Maker Identification In The Traumatically Injured Adult, Kelly Ann Evans

Walden Dissertations and Doctoral Studies

AbstractPatients in the trauma care setting are often dependent on their families and physicians to decide medical treatments when they cannot participate in the process.But in up to one-third of cases, the surrogate decision-maker (SDM)selected by the patient is not the emergency contact listed in the electronic medical record (EMR).SDM identification and documentation will ensure that the patient is best represented by someone who knows their values and goals if they become incapacitated.Nurses can facilitate identifying a patient’s SDM and document this choice in the EMR.The purpose of this study was a staff education program to improve intensive care unit …

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Strategies For Achieving Sustainability Of Home Healthcare Agencies, Robert J. Gagnon Jan 2022

Strategies For Achieving Sustainability Of Home Healthcare Agencies, Robert J. Gagnon

Walden Dissertations and Doctoral Studies

AbstractSome organizational leaders of home healthcare agencies (HHA) experience financial pressures to sustain within the changing regulatory landscape. Organization healthcare leaders who develop sustainability strategies remain competitive and employ the community. Grounded in the balanced scorecard framework, the purpose of this descriptive, qualitative multiple case study was to identify strategies home healthcare agency (HHA) leaders used to maintain sustainability. The participants were five organizational leaders of three HHA and two home health industry consultants in the Northeast United States who implemented sustainability. Data collected came from semistructured interviews, archival records, and organizational documentation. Three themes emerged from the thematic analysis: …

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Health-Related Quality Of Life For Veterans Transitioned Into Civilian Life, Vicki Ann Guerra Jan 2022

Health-Related Quality Of Life For Veterans Transitioned Into Civilian Life, Vicki Ann Guerra

Walden Dissertations and Doctoral Studies

Texas veterans transitioning to civilian life have experienced health issues after discharge. There are processes to follow before seeking treatment or diagnosis for any health issue prior to military discharge. Given the gaps in the literature on veteran health, quality of life and transition to civilian life, scholars lack understanding of the transitional events that take place. Veteran health issues are impacted by medical appointment wait-times, day to day life events, and this can lead to decreased quality of life. The purpose of this mixed-methods study (N=36) was to evaluate veterans’ health related quality of life who had transitioned from …

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Website Accessibility Strategies, Gary W. Hrezo Jan 2022

Website Accessibility Strategies, Gary W. Hrezo

Walden Dissertations and Doctoral Studies

Most websites cannot be readily used by people with disabilities, despite the internet being an essential component for people to be part of a community. Applying web accessibility strategies means that people with disabilities can better interact with the web. Grounded in Davis’s technology acceptance model, the purpose of this qualitative multiple case study was to examine strategies used by web designers to make websites accessible for people with disabilities. The participants were experienced web developers from organizations in Florida with websites that have a Web Content Accessibility Guidelines Level 2 of three levels, i.e., AA- rating. The data collection …

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Hysterectomy And Self-Esteem Among African American Women, Gibson T. Green Jan 2022

Hysterectomy And Self-Esteem Among African American Women, Gibson T. Green

Walden Dissertations and Doctoral Studies

AbstractOver 600,000 hysterectomies are performed each year in the United States. Studies have shown that African American women are disproportionately impacted by hysterectomy and that most African American women treated with hysterectomy are young and of childbearing age. As a result, some African American women’s spouses have negative perceptions about the surgery. The purpose of this study was to examine the impact of hysterectomy on self-esteem or satisfaction among African American women and feelings of partner rejection after a hysterectomy. Sociometer theory (the study of self-esteem) was used to examine an association between hysterectomy and self-esteem or satisfaction. The study …

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Development Of Staff Education On Improved Compliance Adherence In Sleep Apnea, Mayla F. Garcia Jan 2022

Development Of Staff Education On Improved Compliance Adherence In Sleep Apnea, Mayla F. Garcia

Walden Dissertations and Doctoral Studies

The increasing prevalence of sleep disorders such as obstructive sleep apnea (OSA) affects approximately 25% of adults in the United States and an estimated 34% of men and 17% of women in the primary care population. In the clinical project site, the practice problem involved the increasing clinicians’ knowledge about OSA and being able to implement screening tools for further treatment and evaluation. The purpose of this project was to develop an educational training and intervention for staff to increase their knowledge of OSA conditions and have it validated by a panel of experts before dispersing it to the intended …

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