Medicine and Health Sciences Commons^™

The Effectiveness Of Therapeutic Interventions For The Management Of Vulvodynia: An Integrated Literature Review, Arianna Cohen

Honors Undergraduate Theses

Problem: Vulvodynia, an unexplained vulvar pain, is a medical condition affecting women of all ages, races, and ethnicities and causes pain levels ranging from very mild discomfort to extreme suffering.

Purpose: The purpose of this study was to explore women’s knowledge toward seeking care for vulvodynia and to explore the different types of treatments prescribed after diagnosis. The secondary purpose of this review was to describe the treatments most effective in reducing pain caused by vulvodynia.

Methods: A review of the literature was conducted using articles from 2001 to 2021 that focused on diagnosis of vulvodynia and the relief of …

The Criminal Legal System Doesn’T Care About Your Mental Illness, Fredrick E. Vars

Cardozo Law Review de•novo

Why would a beloved small-town doctor with no history of violence suddenly strangle his father to death? The Other Dr. Gilmer is a gripping account of the search for an answer to this question. It turns out the doctor has a rare neurological disorder that likely caused the killing. If only the diagnosis had come before trial, the author believes, the doctor would not have been convicted of first-degree murder and sentenced to life without parole. That belief is appealing, but naïve. Jails and prisons are full of people with mental illness. Misdiagnosis is not the reason. A close examination …

Identifying Novel Subphenotypes In Covid-19 Using Protein Biomarkers, A Spicer, P A. Verhoef, C Lopez-Espina, A Bhargava, L Schmalz, M Sims, A V. Palagiri, K V. Iyer, M J. Crisp, A Halalau, N Maddens, A Espinosa

Conference Presentation Abstracts

RATIONALE: COVID-19 is widely heterogeneous in presentation, even across patients with similar demographics and medical history. Identification of subphenotypes based on host immune responses that are biologically discrete and predict outcomes may enable personalized COVID-19 therapies. Accordingly, using a composite of electronic health record (EHR) data and 36 research biomarkers, we sought to compare COVID-19 immune responses across patients of varying disease severity, identify subphenotypes within hospitalized COVID-19 patients, and test for heterogeneity of treatment effect (HTE) to intravenous corticosteroids across these subphenotypes. METHODS: In this multicenter retrospective analysis of prospectively collected data, patients presenting to three medical centers from …

Pneumothorax Ex Vacuo As Initial Presentation Of Endobronchial Tuberculosis By Mycobacterium Bovis, Olga Romina Gomez Rojas, Matthew Weatherhead, Matthew Hicks, Christopher Dado, Abdulgadir Adam

Conference Presentation Abstracts

INTRODUCTION: Mycobacterium bovis infection in humans is an extremely rare entity. M. tuberculosis and M. bovis are clinically and radiographically indistinguishable, hence, genotype-based identification is required. Management and outcomes of M. bovis infection are not well described. We present the first case of endobronchial tuberculosis secondary to M. bovis in an immunocompetent host. DESCRIPTION: A 19 year old woman without past medical history presented to the emergency department for sudden onset left-side chest pain and dry cough. A preoccupational evaluation noted a positive tuberculin skin test with normal chest-xray. Physical exam significant for absent breathing sounds in the left upper …

Policy Change To Reduce Active Duty Suicide Rates, Michelle Rae Loper

DSW Capstone Projects

There continues to be a dramatic increase in the rates of suicide within the Active-Duty military population. There have been a number of efforts to curb the rates without any prolonged success. Several actions and studies have been conducted on risk factors, prevention efforts, and treatment interventions in an attempt to reduce the rates. This capstone comprises a sequence of academic papers: a systematic literature review, a conceptualization paper, and a practical application paper. This project aims to identify the essential policy components necessary moving forward within the Department of Defense to address this critical issue. The research question leading …

Herstory: Women’S Professional Career Experiences In Sport Psychology, Rena M. G. Curvey

Theses and Dissertations--Educational, School, and Counseling Psychology

The purpose of this study was to explore women’s professional career experiences in sport psychology. Using qualitative methodology, seventeen female sport psychology practitioners participated in intensive semi-structured interviews from May 2021 to July 2021. This study resulted in two distinct manuscripts. First, guided by constructivist grounded theory methodology, embedded in a feminist standpoint framework, this study developed a grounded theory to help explain what sources attract and retain women in sport psychology. The developed theory includes the following main categories: sources of career attraction, training and professional development, and sources of career retention, and ten subcategories. This theory contributes to …

Policies That Support Emergency Department Staff In Providing Behavioral Health Care, Lizabeth Lepp Hennig

Walden Dissertations and Doctoral Studies

A significant portion of individuals with a behavioral health (BH) condition return to emergency departments (ED) seeking care, resulting in reduced quality of care, and contributing to disproportionate healthcare costs. Care can be improved and return visits to the ED reduced where behavioral health care and follow-up care planning are provided as part of their treatment. However, policies expected to create declines in ED use for behavioral conditions are typically in short duration or are difficult to use given other funding and policy constraints. With little known about how policy is supporting the engagement of ED staff who are critical …

A Comparison Of Treatment Outcomes Among Pediatric Hispanic Clients Using And Not Using Language Interpretation Services, Mohamed Khalif

Walden Dissertations and Doctoral Studies

Many families immigrating to the United States come fleeing adverse conditions in their home countries. Conditions such as war, political oppression, and economic hardship frequently result in a need for mental health services. This includes not only the adults in the family but also the children. However, because of their limited English proficiency, their access to mental health services frequently requires the use of interpretive services (IS). The body of knowledge on the use of IS in counseling is limited. The use of IS must be seen from a cultural perspective, hence Ridley et al.’s process model of multicultural counseling …

The Risk Factors For Hiv In African American Transgender Women In Connecticut, Oliver Kunda

Walden Dissertations and Doctoral Studies

AbstractThe human immunodeficiency virus (HIV) incidence rate is 70 times higher for African American transgender women than in the general population. Despite decades of outreach and intervention effort to reduce HIV incidence in the transgender community by the lesbian, gay, bi-sexual, transexual, queer, plus (LGBTQ+) community and public health organizations, the HIV prevalence rate for transgender women remains high at 38%. The purpose of this qualitative exploratory case study was to gain insights into how attitude, subjective social norms, and perceived behavioral control influence HIV risk behaviors of African American transgender women in Connecticut. Ajzen’s theory of planned behavior provided …

Experiences Of African American Female Offenders On Parole And Under Community Supervision, Shirley Lawson

Walden Dissertations and Doctoral Studies

African American female offenders on parole under community supervision reenter communities as convicted felons and face the challenges of intersectionality and collateral consequences. The purpose of this descriptive phenomenological qualitative study was to explore the experiences of African American female offenders active on parole and under community supervision. General strain theory was used to explore the experiences of African American female offenders on parole and under community supervision. Data were collected through semi-structured telephone interviews with a purposive sample of 10 African American female offenders, ages 18 and above who were on parole and under community supervision. Colaizzi’s seven-step method …

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 …

An Evidenced-Based Nursing Education Discharge Plan For Prescription Opioids, Josephine J. Messelmani

Walden Dissertations and Doctoral Studies

The reported number of prescription opioid overdoses justifies the need for providing patients with opioid discharge information and follow-up care as recommended. To prevent any misuse of prescription opioid drugs, it was critical for patients to receive a thorough review of their medications prior to being discharged. The purpose of the project was designed to educate nurses on the importance of delivering essential information to patients prescribed opioids. Implementation of an opioid discharge plan integrated with the teach back method increased patients’ understanding of how to properly take prescription opioids compared to the patients who did not receive opioid education …

Experiences Of Nurses Who Provide Advance Care Planning In The Dialysis Setting, Sheree Mullen

Walden Dissertations and Doctoral Studies

AbstractPatients diagnosed with end-stage renal disease (ESRD) receiving dialysis experience increased symptom burden and multiple hospitalizations as the disease progresses. Dialysis nurses are charged with involving ESRD patients in decisions regarding their care and advance care planning for end-of- life; however, discussions about end-of-life care do not consistently occur. Providing advance care planning is important to involve the patient in their end-of-life care needs. The purpose of this qualitative descriptive study guided by the theory of planned behavior was to explore the experiences of nurses who provide advance care planning to patients receiving dialysis therapy. Eight participants volunteered to participate …

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 …

Food Insecurity In Oncology Patients: An Educational Intervention For Nurses, Chinelo Pernilla Onwuazombe

Walden Dissertations and Doctoral Studies

AbstractFood insecurity is not having enough food or resources or not being able to procure nutritious foods. An observation that nurses in one oncology clinic rarely assessed their patients for food insecurity as part of their regular assessment led to the development and testing of an educational intervention for nurses which was to create awareness on the importance of assessing food insecurity among oncology patients and to learn to use the Household Food Insecurity Assess Scale (HFIAS) in assessing patients. Summative evaluation was done using a pre/and posttest. The Maslow’s hierarchy of needs and the Virginia Henderson nursing need theories …

Knowledge And Experiences Of African American Women With Polycystic Ovary Syndrome, Kristy L. Vance

Walden Dissertations and Doctoral Studies

While polycystic ovary syndrome (PCOS) is a nationwide phenomenon, African American or Black women often have little to no information on the education and support available to manage the condition. PCOS is one of the most poorly understood disorders among patients which has led to limited resources and management. The lack of education could contribute to increased risks to many health issues for African American women with PCOS. The purpose of this basic qualitative study was to explore and examine the level of health knowledge related to PCOS among African American women living in or around the Northern Region of …

Understanding Obesity In The Workplace From The Nursing Manager’S Perspective, Francis Taiwo Akinmoladun

Walden Dissertations and Doctoral Studies

AbstractLike other individuals from diverse backgrounds, nurses who work in nursing homes are susceptible to becoming overweight. The way that others see and respond to the overweight person also may vary and even result in some level of discrimination. The purpose of this study was to explore the perspective of nurse managers about obese staff in the workplace. A qualitative phenomenological descriptive study design was used, guided by the theory of interpersonal relations and the relational leadership framework, to examine the lived experiences of managers working with obese nurses in nursing home settings in a large metropolitan region in the …

Nontraditional Former Bachelor Of Science Nursing Students’ Perceptions Of Academic And Social Support Services, Teresa Cowan

Walden Dissertations and Doctoral Studies

Higher education has responded to the nursing shortage by adopting academic and social support services that have increased student retention and promoted higher graduation rates. The purpose of this basic qualitative study was to explore the perceptions of experiences that led nontraditional former Bachelor of Science in Nursing students at a career college to switch from their nursing program to another program within the first 2 years of college, which has contributed to the nursing shortage. This study also explored the perceptions of the participants about the influences, if any, that academic and social support services at the college had …

Identification, Treatment, And Management Of Patients With Suicidal Ideation On The Medical-Surgical Unit For Nurses, Renea Crawford

Walden Dissertations and Doctoral Studies

Suicide and suicidal ideations are among the leading causes of death in the United States. The Joint Commission identifies inpatient suicide as a sentinel event that should never happen. Nurses working on the medical/surgical (M/S) unit in a hospital located in the midwestern region of the United States voiced their concern that they were not prepared to recognize the signs that may indicate an escalating emotional situation in patients with suicidal ideation; in addition, there were no guidelines in the hospital to use as a resource. The purpose of this project was to determine whether an evidence-based (EB) clinical practice …

The Lived Experiences Of Group Practice Ownership By Female Licensed Professional Counselors, Ashley Garrett

Walden Dissertations and Doctoral Studies

The U.S. counseling profession is mostly female, with many practitioners interested in starting their own business. However, little is known about women’s lived experiences of owning a group counseling practice. An interpretative phenomenological analysis approach was used to explore the lived experiences of six female licensed professional counselors who have owned a group counseling practice for at least 5 years. Phenomenology and feminist theory provided a framework for the study. Eight themes emerged from the study: (a) factors associated with the decision to create a group practice, (b) a continuum of preparatory engagement for group practice ownership, (c) the influence …

Systematic Review Of Physiologic Assessment Measures For Mobility Readiness Of Adult Patients In Critical Care, Brenda Kepley Hardin-Wike

Walden Dissertations and Doctoral Studies

Nurses play a significant role in mobility management, an essential element of care for critically ill adults. However, the current practice of mobility management comes from patient orders without the adoption of an evidence-based physiologic assessment guide to support safe patient mobility resulting in unreliable outcomes. Physiologic stability may change during mobility and unsafe patient mobilization can result in negative patient outcomes that increase patient recovery time. The purpose of this systematic review was to look at the current practice of physiologic assessment measures and then use the findings to influence safe patient mobility practices in intensive care units. The …

Cost-Containment Strategies Used By Hospital Business Leaders For Pharmaceutical Inventory, Julie Carlene Mccaughan

Walden Dissertations and Doctoral Studies

Ineffective strategies to contain the costs of medical supply inventory can result in financial loss and are a significant challenge for hospital leaders. Grounded in complex adaptive systems theory, the purpose of this qualitative single case study was to explore the cost-containment strategies that private hospital business leaders use to reduce the expense of pharmaceutical inventory. The participants comprised six private hospital business leaders in one healthcare organization in Myanmar. Data were collected from semistructured interviews, internal company documents, and publicly available annual reports. Four themes emerged from Yin’s five-step data analysis method: (a) management controls, (b) specialist engagement and …

Increase Knowledge And Attitude In End-Of-Life For Long-Term Care Nurses, Lisa Mitchell

Walden Dissertations and Doctoral Studies

Nurses are key health professionals in long-term care facilities who have an essential role in providing compassionate care at the end-of-life. The customary education that nurses receive in end-of-life care is inadequate to meet the complex care of dying patients. The purpose of this scholarly project was to implement an evidence-based end-of-life educational program to improve the nursing staff knowledge, attitudes towards care of the dying, and standards in long-term care. The theoretical framework to guide this project is Bandura’s self-efficacy to support the confidence and attitude of nurses caring for the dying. The End-of-Life Nursing Education Consortium (ELNEC) Geriatric …

Effects Of Socioeconomic Status, Demographic Characteristics, And Education On Sarcopenic Obesity, Moruf Oladele Olaleye

Walden Dissertations and Doctoral Studies

The general problem is that although the body of research about obesity is robust, there is a lack of research addressing the problem of sarcopenic obesity. Specifically, there is a lack of research examining the statistical significance of the relationship between the independent variables of socioeconomic status, demographic characteristics, and education and the dependent variable of sarcopenic obesity. This research may advance practice and policy by lending support for developing interventions to address factors that have a statistically significant relationship with sarcopenic obesity. The purpose of this quantitative causal-comparative study was to identify independent variables among socioeconomic, demographic, and education …

Experiences Of Critical Care Nurse Managers In Addressing Nurses' Work-Related Stress, Mariana Tsucuneli

Walden Dissertations and Doctoral Studies

AbstractNurses who work in the critical care unit are more likely to experience work-related stress, fatigue, understaffing, undesirable performance outcomes, and compromised workplace safety than general care nurses. Nurse managers in these units possess insights into nurses' stress-inducing challenges, in addition to managerial and administrative perspectives. Yet there is a lack of available knowledge about the experiences of critical care nurse managers in addressing nurses' work-related stress. The purpose of this study was to explore critical care nurse managers’ experiences of potential strategies to effectively address work-related stress among nurses. The job-demand resource model was the theoretical framework for the …

Servant Leadership On Burnout Among Physicians In Residency Training, Karen Grant-Hewitt

Walden Dissertations and Doctoral Studies

Physicians in residency training (PIRTs) in the United States are facing extreme burnout. The prevalence of burnout among physicians in residency training may cause adverse consequences such as medical malfeasance, alcoholism, or suicide due to physical and mental exhaustion. The purpose of this study was to analyze the servant leadership style of physician trainers and burnout among PIRTs in academic medical centers in the United States to ultimately increase wellness and thereby mitigate burnout. Servant leadership was the theoretical foundation for this study. This research investigated whether servant leadership characteristics of physician trainers played a statistically significant role in burnout …

Nursing Health Care Leadership Strategies To Reduce Homeless Patient 30-Day Readmission Rates, Shavonda L. Greene

Walden Dissertations and Doctoral Studies

AbstractAdult homeless patient 30-day readmission is a concern for nursing healthcare leaders who still have problems in providing effective strategies for revisit reduction in various acute care settings across the United States. The purpose of this quantitative comparative study was to examine the association between nursing healthcare leadership strategies, 30-day homeless patient readmission rates, and hospital discharge rates at hospitals in California. The theoretical foundation for the research study was Pender’s health promotion model theory, which identifies preventative health measures and describes the critical function of nurses in helping patients to prevent illness by self-care and bold alternatives. Research questions …

Age And Experience As Factors For Predicting Emotional Intelligence In Nurse Managers, Patricia Gursky

Walden Dissertations and Doctoral Studies

Emotional intelligence (EI) is defined as the capacity to recognize and manage emotions and feelings to guide behaviors which is an ability that is crucial for nurse mangers to possess. Understanding the key factors for predicting emotional intelligence in nurse managers may influence hiring practices and the appointment of managers who will influence job satisfaction, employee engagement, retention, and turnover. The purpose of this quantitative predictive correlational study, guided by King’s theory of goal attainment and Mayer and Salovey’s four-branch ability model of EI, was to determine whether age, years of experience as a nurse, and years of experience as …

Primary Care Provider Education On Behavioral Interventions For Management Of Adult, Rose Chinasa Kajuru

Walden Dissertations and Doctoral Studies

The high prevalence of obesity continues to pose significant health challenges globally. According to the U.S. Preventive Service Task Force, obesity affects more than 35% of men and 40% of women in the United States. The national annual cost of medical care related to obesity is estimated at $147 to $210 billion. Intensive behavioral interventions in adults with obesity can lead to clinically sufficient improvements. The project aimed to determine if the current evidence-based clinical guideline of behavioral weight loss interventions to prevent obesity-related morbidity and mortality in adults would improve primary care providers’ knowledge of adult obesity management. The …

African American Or Black Nurses’ Perceptions Of Incivility In Nursing Education, Selena M. Murphy

Walden Dissertations and Doctoral Studies

Incivility in nursing education can affect morale, adversely affect patient care, or cause nurses to leave the profession. Bullying, rude comments, and disruptive behaviors are all examples of incivility. These may be perceived as lower in schools like Historically black colleges and universities (HBCUs), where students share the same or similar racial or ethnic background. The purpose of this study was to determine if the perceived levels of incivility experienced in nursing school differ between African American or Black nurses who attended HBCUs and African American or Black nurses who attended non-HBCUs, where the population of nursing students may have …