Medicine and Health Sciences Commons^™

Survival Rates And Clinical Trial Participation Among Rural Cancer Patients, Tatiana Kurilo

Walden Dissertations and Doctoral Studies

The literature indicates that cancer patients in rural areas lack adequate access to clinical trials and may experience more harmful consequences than patients residing in urban areas. The purpose of the study was to compare cancer survival rates among patients living in rural and urban counties in a southeastern U.S. state with breast cancer and lung cancer. Analysis was conducted using secondary data from the National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) Program tumor registry, Comprehensive Cancer Center (CCC) tumor registry, and CCC OnCore Subject Accrual Data. A series of independent samples t-tests and factorial ANOVA were conducted …

Quality Improvement Initiatives And Interventions For Decreasing Falls In The Hospital Setting, Fredlyn Lolange

Walden Dissertations and Doctoral Studies

Patient falls in health care settings are a widespread and severe problem, and they often happen as a result of a complex set of causes. In the United States, between 3.3 and 11.5 falls occur per 1,000 patient days. Reducing the incidence of falls in a health care setting would bring significant positive change and decrease the incidence of harm to patients in the hospital setting. This staff education project’s purpose is based on addressing falls, a safety concern and a health issue that continues to put patients at an increased risk. Theories used to inform the project include the …

Relationship Between Homelessness, Substance Use, Employment, Living On A Reservation And Tuberculosis Among Northern Plains Native Americans, Darla Mccloskey

Walden Dissertations and Doctoral Studies

Native Americans in the Northern Plains have a long history of tuberculosis (TB) infections. There is limited research on the causes of latent TB infections (LTBI) and TB in this population. The purpose of this quantitative study was to assess the relationship between latent TB and factors of homelessness, substance use, employment, living on a reservation, and active or latent TB among this population using the eco-social theory as the theoretical framework. Data from 146 TB cases of Native Americans living in the Northern Plains and diagnosed with TB from 1999 to 2019 were analyzed using chi-square tests that showed …

Maternal-Early-Warning-System Education To Improve Registered Nurse Knowledge Of And Appropriate Responses To Triggers, Dawn Marie Moore

Walden Dissertations and Doctoral Studies

The maternal early warning system (MEWS) is the single most reliable response tool to improve maternal outcomes in obstetrics. Recognition and response by nurses to the MEWS triggers was worrisome at the project site as the MEWS trigger to detect changes in the clinical conditions in obstetric patients was not applied consistently at the bedside. This project was developed to evaluate whether providing an education program on the application of MEWS to nurses in obstetrics at the practicum site would improve registered nurses’ knowledge of and appropriate responses to the MEWS trigger alarms. A literature search targeting the key words …

Sexually Transmitted Disease Awareness Amongst Adolescents 13 To 18 Years Of Age, Ngwanma Nwokoro

Walden Dissertations and Doctoral Studies

Abstract Sexually transmitted infections or diseases (STIs/STDs) acquired through sexual activities lead to compromised sexual health. The adolescent population is at high risk of acquiring STIs/STDs due to their lack of knowledge. The gap in practice was that the nurse practitioners (NPs) were deficient in standard of care; adolescent patients lacked consistent evaluation, education, or documentation of the education in their medical records. The practice-focused question focused on the evaluation of the effectiveness of a quality improvement (QI) initiative that incorporated the use of the American Association for Pediatrics screening and Center for Disease Prevention and Control (CDC) treatment guidelines …

Effects Of Social Determinants On Access To Care Among Patients With Diabetes In Florida, Nekeisha Latoya Walker

Walden Dissertations and Doctoral Studies

Diabetes imposes a major burden on society, especially in the state of Florida, in the form of increased medical costs, lost productivity, early mortality, and intangible costs in the form of diminished quality of life. Access to diabetic care affects health administration in Florida by impacting the overall cost of treating the condition. Limited access to care can lead to an increased risk of complications resulting in a higher cost of treatment. The purpose of this quantitative study was to determine whether access to care dependent variables (access to doctors and length of time since last routine checkup) were associated …

Risk Factors Influencing Poliomyelitis Seroprevalence In Polio High Risk Areas Of Afghanistan, Wasan Abdulaziz Al-Tamimi

Walden Dissertations and Doctoral Studies

Afghanistan is one of the remaining polio endemic countries in the world. Nearly one million children under 5 years of age have missed polio vaccination in Afghanistan from May 2018 until January 2021. This quantitative study used the socioecological model as the theoretical framework and secondary data analysis of the 2020 polio serosurvey (N = 1384) to investigate various risk factors such as gender, parental education, family origin (language/location), wealth, distance to nearest health facility, and number of polio vaccine doses on the level of antibodies (i.e., seroprevalence) against all three types of polioviruses in children of two age groups, …

The Role Of Mistrust In African American Organ Donation, Gina M. Williams

Walden Dissertations and Doctoral Studies

AbstractAfrican Americans (AAs) who suffer from life-threatening organ failure often need an organ transplant to sustain or to improve their quality of life. The shortage of donor organs, and AAs willing to become organ donors, limits the number of organs available for transplant. The purpose of this study was to understand the lived experience of AAs regarding the role of mistrust and to understand its influence on their organ donation decision-making. Social cognitive theory guided this qualitative descriptive phenomenological study designed to gain an understanding of the lived experiences of the AAs related to the role of mistrust in their …

The Impact Of The Spinning Babies Method On Labor Duration And Delivery Outcome, Darlene Sears

Walden Dissertations and Doctoral Studies

Proper maternal positioning has been studied for many years and identified as a critical factor in reducing the risk of labor dystocia and Cesarean births. The Spinning Babies method is a nonpharmacological technique that helps to support a physiological delivery by assisting women with position changes throughout labor. However, there was no literature on the difference between the duration of labor or Cesarean section rates when utilizing the Spinning Babies exercises. This quantitative comparative study examined whether the Spinning Babies method was associated with the duration of the first and second stages of labor and the delivery outcome in low-risk …

Evaluation Of The Implementation Of Primary Prevention Guidelines For The Treatment Of Hypertension, Aramide Alayande

Walden Dissertations and Doctoral Studies

AbstractHypertension is a chronic disease that is associated with increased risk of cardiovascular mortality. This Doctor of Nursing Practice project was a quality improvement initiative that addressed the gap in practice that the nurse practitioners (NPs) were not consistently following the American College of Cardiology (ACC) and American Heart Association (AHA) recommended guidelines for the treatment of hypertension. The purpose of the project was to evaluate whether the NPs were consistently using the guidelines to treat patients with hypertension after an educational intervention. The project used a before-after approach to evaluate the consistency of using the guidelines in treatment of …

Risk Factors Influencing Poliomyelitis Seroprevalence In Polio High Risk Areas Of Afghanistan, Wasan Abdulaziz Al-Tamimi

Walden Dissertations and Doctoral Studies

Afghanistan is one of the remaining polio endemic countries in the world. Nearly one million children under 5 years of age have missed polio vaccination in Afghanistan from May 2018 until January 2021. This quantitative study used the socioecological model as the theoretical framework and secondary data analysis of the 2020 polio serosurvey (N = 1384) to investigate various risk factors such as gender, parental education, family origin (language/location), wealth, distance to nearest health facility, and number of polio vaccine doses on the level of antibodies (i.e., seroprevalence) against all three types of polioviruses in children of two age groups, …

Burnout And Positive Thinking Skills Among Critical Care Nurses, Evangeline Ani

Walden Dissertations and Doctoral Studies

AbstractBurnout is a global health problem with a significant negative impact on the physical, mental, and emotional health and well-being of critical care nurses, which in turn has serious effects on the critical care work environment. Positive thinking has the potential of transforming the work environment. The purposes of this quantitative, correlational study, guided by Lazarus’s theory of stress, were to determine (a) if there was a relationship between the use of positive thinking skills and burnout among critical care nurses, and (b) if there was a difference between the use of positive thinking skills and burnout among critical care …

Differences Between Nurse-Led Intervention Topics, Longevity, Changed Practices, And Sustainability Planning, Robin Anselm

Walden Dissertations and Doctoral Studies

Though health care providers use evidence-based interventions (EBIs), a knowledge gap exists regarding lasting change associated with doctorate-prepared nurse interventions and sustainability planning. This quantitative cross-sectional descriptive design guided by the five pillars of the United Nations sustainable development goals (SDGs) was used to examine the differences between doctorate-prepared nurses’ sustainable EBI topics, intervention longevity, changed clinical practices, and sustainability planning. The dynamic sustainability framework, the adult learning theory, and the social learning theory framed this study. The design included a survey of 1,365 nurse anesthesiologists using a questionnaire composed of the Program Sustainability Assessment Tool (PSAT) version 2 and …

Experiences Of Non-Tenured African American Female Nursing Faculty At Predominately White Institutions, Allison R. Bethune

Walden Dissertations and Doctoral Studies

The proportionally fewer female African American nursing faculty at predominately White institutions (PWIs) have frequently reported adverse employment conditions in academia. The faculty within nursing schools at PWIs does not reflect society’s diversity. The problem addressed through this study is the low number of female African American nursing faculty in PWIs. The purpose of this basic qualitative study was to examine the experiences of non-tenured female African American nursing faculty at PWIs. The conceptual framework that informed this study is Crenshaw’s intersectionality. The research question addressed the experiences of non-tenured female African American nursing faculty at PWIs. Six non-tenured female …

Sexual Violence And University Campus Response To Sexual Violence, Jennifer Bivins

Walden Dissertations and Doctoral Studies

While anyone can be a victim of sexual violence, college-aged females between the ages of 18 and 21 are more likely to be victimized than any other group. Sexual violence continues to be a barrier to education, and colleges/universities make it challenging for students to report on campus. The purpose of this study is to explore the factors, intervention/prevention strategies, and policies/procedures used to address sexual violence on a university campus. The framework used was the ecological model, which focuses on factors and influences within the environment that affected individual behavior. The research questions focused on participants describing their experiences …

Physical Therapy Management Of A Patient With Bilateral Knee Pain And Long Covid: A Case Report, Maxwell Smith, William Kesler, Todd E. Davenport

School of Pharmacy Faculty Articles

Background: The purpose of this case study is to describe how post-exertional symptom exacerbation (PESE), a hallmark of long COVID, may affect the clinical course of physical therapy. Physical therapists can provide patient education and activity guidance to individuals with long COVID to improve clinical outcomes. Case Description: The patient was a 39-year-old female with a 20-year history of bilateral knee pain. Following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, the patient developed PESE and increased bilateral knee joint effusion and pain, affecting her ability to perform cognitive tasks and walk, respectively. Outcomes: Following 8 weeks of intervention, the …

Using Clinical Decision Making To Identify The Appropriateness Of Telehealth Physical Therapy: A Case Series, S. Weissman, A. Gladin, Todd E. Davenport

School of Pharmacy Faculty Articles

Background: The purpose of this case series is to highlight the shared decisionmaking process made between clinician and patient when determining the appropriateness of telehealth, in-person care, or a hybrid model. Case Descriptions: This case series describes 3 patients diagnosed with various musculoskeletal conditions causing pain and participation restrictions. Two patients received a hybrid model of care and one patient received telehealth physical therapy only. Outcomes: Two patients achieved desired goals and resumed participation in previously restricted activities. One patient did not achieve desired goals and eventually underwent total hip arthroplasty. Discussion: Case complexity, symptom irritability and severity, and changes …

Application Of Clinical Practice Guideline Recommendations In The Clinical Management Of Chronic Ankle Instability: A Case Report, Todd Gallagher, Amy Gladin, Todd E. Davenport

School of Pharmacy Faculty Articles

Background: Clinical practice guidelines (CPG) are helpful in improving patient care by translating current research into clinical recommendations to assist in clinical decision making. The purpose of this case report is to clinically apply the recommendations from the Academy of Orthopaedic Physical Therapy’s Ankle Stability and Movement Coordination Impairments: Lateral Ankle Sprains (LAS) Revision 2021 CPG.8 Case Description: A 34-year-old man was referred to physical therapy with a 16-year history of recurrent left ankle sprains and a diagnosis of chronic ankle instability (CAI). Chronic ankle stability is a condition characterized by ongoing ankle instability. The patient had decreased ankle dorsiflexion …

Identification And Management Of Venous Thromboembolism In A Patient Following Anterior Cruciate Ligament Reconstruction: A Case Report, Mallory Lent, Todd E. Davenport

School of Pharmacy Faculty Articles

Background: Venous thromboembolism may be an under-appreciated complication of arthroscopic orthopaedic procedures in the rehabilitation setting. The purpose of this case report is to describe the physical therapist’s role in identifying and managing venous thromboembolism (VTE) alongside rehabilitation following anterior cruciate ligament reconstruction (ACLR). Case Description: The patient was a 40-yearold male who presented to physical therapy following right knee arthroscopic ACLR and medial/lateral meniscectomy. Approximately 2 weeks post operatively, he developed bilateral lower extremity deep vein thromboses (DVTs). The patient received manual therapy, exercise, and education regarding DVT. Outcome: The patient was discharged after 43 visits over 7 months. …

Mental Health Treatment And The Criminal Justice System, Susana Lehan-Trasente

Walden Dissertations and Doctoral Studies

The criminal justice system has established interventions for those who have mental illness and have been charged with criminal complaints. In New York State, the Mental Health Court has been established to address these issues and is to be used by all counties. However, the treatment and probation interventions vary from county to county. Saratoga County uses a Single Point of Access (SPOA) which receives referrals from the general court and probation officers. SPOA refers clients to a variety of treatment interventions available in the county. In Monroe County, the Mental Health Court refers the criminally involved/mentally ill individual to …

Strategies To Improve Hospital Patient Satisfaction To Increase Performance-Based Reimbursements, Celso G. Silla Iii

Walden Dissertations and Doctoral Studies

Officials from the Centers for Medicare and Medicaid Services (CMS) created the hospital valued-based purchasing (VBP) program focused on controlling cost, inefficiencies, and quality-of-care. Hospital leaders are incentivized or penalized based on meeting quality outcomes and risk millions of dollars in reimbursement if they do not meet the quality-of-care standards specified in the CMS hospital VBP program. Grounded in the transformational leadership theory, the purpose of this qualitative multiple case study was to explore strategies hospital leaders used to improve patient satisfaction to increase VBP performance-based reimbursements. Participants included eight hospital leaders from seven hospitals in California who successfully implemented …

The Perceived Impact Of Childbirth Related Ptsd And Maternal Bonding, Sheila Baez

Walden Dissertations and Doctoral Studies

AbstractChildbirth has been increasingly viewed as a potentially traumatic event and process impacting both mother and infant. Previous research on childbirth has concentrated on the development of postpartum depression and its impact; research on posttraumatic stress disorder (PTSD) after childbirth has been limited. However, the results of this research study suggested that the development of childbirth-related PTSD may be a far more common phenomenon than previously suggested. Bowlby’s attachment theory and Ainsworth’s further development and expansion of the theory served as a framework which investigated the experiences of 10 biological females, aged 21 and over previously diagnosed with PTSD after …

The Relationship Between Preterm Birth Rates, Sociodemographic Factors, And Prenatal Care, Natasha Grant

Walden Dissertations and Doctoral Studies

Reducing preterm births is a local, national, and global public health priority. Preterm birth rates continue to rise with evident racial and ethnic differences. The purpose of the quantitative study was to analyze the Mississippi Pregnancy Risk Assessment Monitoring System (PRAMS) Phase 8 data to investigate the association between preterm births, timing of prenatal care, insurance types, and marital status among 5,666 women who gave birth in Mississippi between 2016 - 2020 using logistic regression. The social-ecological model was used to explain the impact of preterm births at the individual, interpersonal, and policy levels. Marital status was shown to be …

Practice Size And Geographical Location And Annual Merit-Based Incentive Payment System Scores In Dermatology, Issam H. Harmouch

Walden Dissertations and Doctoral Studies

Despite the transition to value-based care in the healthcare industry using the Merit-Based Incentive Payment Systems (MIPS), small and rural physician practices still score in the poor category annually. These poor performances negatively impact funding for staffing and service availability; further, little research has focused on the factors behind these poor performance scores. The purpose of this study was to examine the relationship between practice size and organization geographical location on annual MIPS scores among dermatologists in the South-Central United States. The Donabedian model was used as the theoretical framework for this study that focused on the three qualities of …

Associations Of Stress, Health Behaviors, And Obesity Among African American Immigrants, Wole David Akinsola

Walden Dissertations and Doctoral Studies

AbstractObesity has been identified as a predisposing factor that poses a serious threat for the development of chronic diseases and contributes to health disparities affecting both minority and vulnerable populations. Though previous studies reported the association of stress with health status and behavior, there is little or no research on the heterogeneity of obesity predictors in specific minority populations in the United States. The purpose of this study was to examine the predictors of obesity among adult African American immigrant populations in the United States. Studying obesity in this population may help policymakers tailor interventions that could reduce obesity prevalence. …

A Comparison By Ethnicity Of Usage Of Medication, Intubation Use, And Mortality Rates Of Covid-19 Patients In An Urban Hospital, Howard Rubin Baruch

Walden Dissertations and Doctoral Studies

Evidence from an urban hospital initially revealed that ethnicity had no bearing on treatment modalities or mortality among patients admitted and diagnosed with COVID-19 symptoms from January 1, 2020 to January 1, 2021. The purpose of this study was focused on answering three principal research questions concerning evidence at one hospital of differences in medication used, whether intubation was used, and mortality by ethnicity for those treated for COVID-19 while controlling for age, gender, and co-morbidities. The health belief model served as the theoretical framework. Data was collected from 1188 patient charts, and binary logistic regression was used to test …

Educating Oncology Nurses On Identifying And Managing Cancer-Related Distress, Rosemary Vivella Irish

Walden Dissertations and Doctoral Studies

AbstractUp to 50% of patients diagnosed with cancer will experience significant levels of distress. Cancer is related to psychological distress and can negatively impact recovery from surgery, increase treatment side effects, and decrease overall quality of life. The National Comprehensive Cancer Network recommended screening for distress as part of comprehensive cancer care. In the practice setting, there was a need for better assessment of distress in cancer patients. The purpose of this staff education project was to address a gap in practice regarding the lack of knowledge of screening for distress by providing education to oncology nurses on how to …

Defining And Exploring Animal Sentience, Andrew N. Rowan, Joyce M. D'Silva Mrs, Ian J.H. Duncan, Nicholas Palmer

Animal Sentience

One of the commentaries on the target article notes that "animal sentience" is difficult to define operationally. This response to the commentaries develops a working, usable definition of animal sentience and examines the relationships between animal emotions and sentience.

Staff Education Plan For Treatment Of Obstetrical Hypertension In The Emergency Department, Ashley Dawn Delia

Walden Dissertations and Doctoral Studies

The United States has the highest childbearing morbidity and mortality rate of any industrialized nation, and the rate has steadily increased over the last three decades. It is estimated that at least half of all maternal deaths are preventable. Hypertensive disorders that present during pregnancy, regardless of etiology, are associated with this increased maternal morbidity and mortality. Obstetrical hypertension, when recognized in settings like the emergency department, readily responds to medical intervention. While guidelines for recognition and treatment of severe and high range blood pressure readings have been defined, hospital emergency departments do not consistently have a related education program …

Incog 2.0 Guidelines For Cognitive Rehabilitation Following Traumatic Brain Injury, Part Iv: Cognitive-Communication And Social Cognition Disorders, Leanne Togher, Jacinta Douglas, Lyn S. Turkstra, Penny Welch-West, Shannon Janzen, Amber Harnett, Mary Kennedy, Ailene Kua, Eleni Patsakos, Jennie Ponsford, Robert Teasell, Mark Theodore Bayley, Catherine Wiseman-Hakes

Communication Sciences and Disorders Faculty Articles and Research

Introduction:

Moderate to severe traumatic brain injury causes significant cognitive impairments, including impairments in social cognition, the ability to recognize others' emotions, and infer others' thoughts. These cognitive impairments can have profound negative effects on communication functions, resulting in a cognitive-communication disorder. Cognitive-communication disorders can significantly limit a person's ability to socialize, work, and study, and thus are critical targets for intervention. This article presents the updated INCOG 2.0 recommendations for management of cognitive-communication disorders. As social cognition is central to cognitive-communication disorders, this update includes interventions for social cognition.

Methods:

An expert panel of clinicians/researchers reviewed evidence published since …