Medicine and Health Sciences Commons^™

The Effect Of Community Health Linkages On Suicide Rates In Veterans, Erica Anderson

Walden Dissertations and Doctoral Studies

Suicide risk is a public health issue. It is a complex and poorly understood mental health and societal threat. This study examined veteran suicide rates and their relationship to family and social support, as measured by the social association rate, mental health funding per capita, and the lethality of the method rate. The interpersonal-psychological theory of suicide and the social-ecological model are the theoretical frameworks that guided the study. Both theories emphasize the complexity surrounding suicide at the state level as it is related to the individual, social, environmental, and political landscape related to veteran suicide. The quantitative bivariate correlation …

Educating Registered Nurses On Interventions To Alleviate Compassion Fatigue, Andre Sabrina Castor

Walden Dissertations and Doctoral Studies

Walden University

College of Nursing

This is to certify that the doctoral study by

Andre Sabrina Castor

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 CommitteeDr. Marilyn Losty, Committee Chairperson, Nursing Faculty Dr. Cheryl Holly, Committee Member, Nursing Faculty Dr. Susan Fowler, University Reviewer, Nursing Faculty

Chief Academic Officer and Provost Sue Subocz, Ph.D.

Walden University2022

Analyzing Veterans Affairs Telehealth Services Between Rural And Urban Centers In West Virginia, Vicki J. Dix

Walden Dissertations and Doctoral Studies

Veterans often have difficulty accessing health care within the Veterans Affairs (VA) system, contributing to the growing need for health care services in rural communities. The increasing demand for health care services in rural communities is driven by the aging population, an increase in life expectancy, and an increase in chronic disease. This quantitative study aimed to explore the relationship between the type of appointment and patient location on initial primary care and telehealth primary care wait times for veterans in West Virginia. The two research questions addressed the independent variables, type of appointment (telehealth or face to face) and …

Diabetes Self-Care Management Education For Advanced Practice Registered Nurses In Primary Care Setting, Rebecca Anne Griggs-Galyean

Walden Dissertations and Doctoral Studies

Type 2 diabetes mellitus is a preventable chronic condition that affects many members of the U.S. population. Diabetes is associated with comorbidities including cardiovascular disease, end-stage renal disease, hypertension, neuropathy, and lower limb amputations, leading to increased mortality. Patient self-care education has been shown to improve adherence to diabetes self-care (DSC) in the primary care setting. However, advanced practice registered nurses (APRN) in the local primary care setting lacked knowledge of DSC. Therefore, nursing knowledge of DSC was needed. The project question asked whether staff education on the use of the Association of Diabetes Care and Education Specialists 7 (ADCES7) …

Native American Registered Nurses Experience In Failing The Nclex-Rn On The First Attempt, Kristine Hilton

Walden Dissertations and Doctoral Studies

Nursing school graduates must pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN) to become licensed and work as a registered nurse. Nurse educators do not understand the experiences of Native American nursing graduates in preparing for the NCLEX and must understand how to support and mentor Native American nursing students to have more success in taking the NCLEX-RN. The purpose of this qualitative descriptive study, guided by Roy’s adaptive model, was to understand the experiences of Native American nurses who failed the NCLEX-RN on the first attempt. The participants in this study were nine Native American nurses who …

Lack Of Leadership Roles And Advancement Opportunities For Black Female Nurses, Mikela Jerilynn Jones

Walden Dissertations and Doctoral Studies

Underrepresentation is a significant issue for Black female nurses to secure nurse leadership positions in healthcare facilities. Leadership by Black female nurses is needed to provide culturally appropriate quality of care, to have a more diverse workplace, and to ensure that the needs of diverse patient populations are met. The purpose of this quantitative study was to explore the barriers and challenges faced by Black female nurses who failed to achieve their advancement goals into leadership roles.Using the National Sample Survey of Registered Nurses (NSSRN) database, the independent variables used were interpersonal differences with colleagues or supervisors, lack of good …

Non-Alcoholic Fatty Liver Disease And Metabolic Syndrome: The Role Of Gender Differences And Menopausal Status Of Women, Kimberly Kushner

Walden Dissertations and Doctoral Studies

There are few studies that investigate the association between non-alcoholic fatty liver disease (NAFLD) and metabolic syndrome (MetS) predominantly in menopausal women. This quantitative study investigated the association between MetS and NAFLD while controlling for age, gender, ethnicity, and menopausal status of women. The theoretical framework that helps establish and guide the research was the diffusion of innovation (DOI). A multivariable logistic regression was conducted using secondary data from the National Health and Nutrition Examination Survey. There is a statistically significant association between MetS, and NAFLD after controlling for age (OR = 2.96, 95% CI = 2.319–3.778, p < 0.001). However, ethnicity was not statistically significant. After further controlling for gender, the relationship remained statistically significant and exhibited a decrease in risk for females compared to males (OR = -.734, 95%CI = .387–.596, p < 0.001). Lastly, focusing on women only, and further controlling for menopausal status, the association between MetS and NAFLD was still statistically significant (OR = 2.227, p < 0.001). Mexican Americans, other Hispanics, and Non-Hispanic Black women were at higher risk (95% CI 1.102–7.039, 1.321–5.351, and 1.255–3.013, respectively). Implications for positive social change include adopting proactive and preventative strategies that can improve the quality of life for vulnerable patients and reduce morbidity and mortality associated with MetS and NAFLD.

A Staff Education Program For Early Fall Detection And Fall Prevention In A Nursing Home Population, Andrew Akueteh Mensah-Sowah

Walden Dissertations and Doctoral Studies

Walden UniversityCollege of Nursing This is to certify that the doctoral study by Andrew Mensah-Sowah 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. Cheryl Holly, Committee Chairperson, Nursing Faculty Dr. Edna Hull, Committee Member, Nursing Faculty Dr. Tracy Andrews, University Reviewer, Nursing Faculty Chief Academic Officer and Provost Sue Subocz, Ph.D. Walden University 2023

A Staff Education Program for Early Fall Detection and Fall Prevention in a Nursing Home Population

by

Andrew Akueteh Mensah-Sowah

MS, Walden University, 2017

BS, Mountain …

The Relationship Between Socioeconomic Factors And Obesity In Adults (25-54 Years) In Guam In 2020, Perinne O'Brien

Walden Dissertations and Doctoral Studies

In Guam, a United States Pacific Island territory, the rate of obesity in adults continues to rise. Relationships between obesity and six socioeconomic factors (health care coverage, education level, employment status, home ownership, household income, and marital status) in adults 25 to 54 years of age living in Guam in 2020 were explored. Because obesity may be affected at multiple levels of influence, the socioecological model grounded this research. Secondary data from the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System was used to carry out a quantitative, cross-sectional study. Complex samples binary logistic regression analyses were …

Providing Health Care To Patients With Intellectual And Developmental Disability During Covid-19, Pauline Andrea Park-Maxwell

Walden Dissertations and Doctoral Studies

AbstractThis project sought to enhance the care offered in a local clinic to individuals with an intellectual and developmental disability (IDD) during the COVID-19 pandemic. Individuals with IDD are faced with the challenges of coping with some social conditions. Mainly waiting for extended periods in a doctor’s office can be challenging. To reduce this population’s waiting time, a staff education program was developed to address this concern. Currently, this local clinic did not have a prescreening exercise that would meet the needs of this population. This DNP project aimed to develop a staff education program for staff in a primary …

Uptake Of Plant-Based Nutrition And Awareness Among Lower Socioeconomic Status Populations In The United States, Tammy Frazier Renault

Walden Dissertations and Doctoral Studies

Chronic disease accounts for 86% of the annual health care expenditures in the United States. Lower socioeconomic status groups are vulnerable to the effects of nutritional deficiencies, and the connection between chronic disease and nutrition may be central to public health initiatives. The current study provided insight into the behaviors of nutritional choice for at-risk populations for many of the chronic diseases associated with nutritional education and policy which influence healthy eating patterns across multiple settings. The purpose of this quantitative study with a retrospective cross-sectional design was to observe any differences for the uptake of plant-based compliant nutrition and …

Behavioral Health Leadership Strategies To Increase Telehealth Engagement, Ramona Singletary-Robertson

Walden Dissertations and Doctoral Studies

One of the challenges brought on by the recent COVID-19 pandemic has been the promotion and use of telehealth services. While recent data from Medicare has depicted an increase in this new service delivery modality (over 4,000%), there has been a stark disparity in the use of telehealth services in lower socioeconomic demographics, such as rural and underrepresented communities, and among Medicare recipients. Equitable, consistent, and optimal service expansion of the telehealth modality requires therapists and leaders of behavioral health organizations to develop and deploy creative tactics to remedy this disparity. In this case study, leaders of Miss Emma's Behavioral …

Directors’ Perceptions Of Supplementing Clinical Requirements With Simulation-Based Education In Paramedic Education, Kimberly Whitten-Chung

Walden Dissertations and Doctoral Studies

The problem for this study was limited clinical site access for paramedic students causing delays in completion and exacerbating critical staffing shortages in healthcare. The purpose of the study was to explore perceptions of paramedic program directors (PD) in Colorado regarding use of simulation-based education (SBE) to supplement program-determined clinical requirements. Kolb’s experiential learning theory was the conceptual framework that guided this study. Research questions focused on Colorado paramedic PDs’ perceptions about advantages, disadvantages, and barriers involved with replacing program-determined clinical education with SBE. A basic qualitative design was used to capture insights of 6 Colorado paramedic PDs through semistructured …

The Rural Inpatient Behavioral Health Delivery System’S Challenges To Access, Catherine L. Williams

Walden Dissertations and Doctoral Studies

Readmissions occurring in rural areas are an operational problem for administrators of state-owned facilities. The number of state-owned psychiatric beds have decreased by more than 96% nationwide. Georgia has 954 state-owned psychiatric beds (9.3 beds per 100,000 people) and ranks 48th in the United States. This is important as health administrators must ensure quality care for patients. The purpose of this study was to understand the relationship between readmission rate, discharge disposition, and rural access for patients who were admitted to an inpatient state-owned behavioral health center with a diagnosis indicating the patient is seriously mentally ill. The theoretical framework …

Moral Injury Themes Involving Criminal Recklessness Among Adults With Alcohol Use Disorder, Sandra Starch

Walden Dissertations and Doctoral Studies

Moral injury (MI) can emerge following transgressive acts against one’s deeply held moral beliefs. Its symptomology involves individual psychological, spiritual, behavioral, and social spheres. It has primarily been studied within the military and in a few select civilian populations. This descriptive phenomenological study involved exploring MI themes among adults with alcohol use disorder (AUD) who had engaged in criminally reckless acts. Data collected from semi-structured interviews with eight participants were coded and analyzed, leading to six major themes revealing the symptomology of MI. Responses from study participants supported Festinger’s theory of cognitive dissonance via their descriptions of alcohol abuse cycles …

Clinical Research Principal Investigators’ Perspectives Of Improving The Diversity Of Clinical Research Participants, Nadine Hyacinth Spring

Walden Dissertations and Doctoral Studies

Clinical trials are needed to make new medications, devices, and diagnostic tools available. Participants in these clinical trials have historically come from a homogeneous group, and there is a recognized need for increased diversity and representation in these clinical research studies. The absence of diversity in clinical trials makes it difficult for clinicians and researchers to know which medications and devices are safe and effective for specific populations. This basic qualitative phenomenological study was conducted to explore the experiences of clinical research principal investigators regarding diversity in clinical research studies and how to improve it. The theoretical framework for this …

Exploring Barriers To Accessing Funding For Individuals With Dementia Who Reside In Long-Term Care Facilities, Gwendolyn Cox Smith

Walden Dissertations and Doctoral Studies

AbstractMedicare and Medicaid are the most used funding sources for long term care (LTC); however, they are insufficient to pay for all social activities needed by individuals with dementia who reside in LTC facilities in the United States. Barriers in accessing funding to provide social activities for these individuals were explored though the theoretical lens of a logic model related to funding. A qualitative exploratory case study design was used to find not only the barriers of accessing funding but also the type of available funding and the eligibility criteria for receiving funds for social activities for those with dementia …

Association Between Childhood Obesity And Cerebral Palsy, Down Syndrome And Epilepsy Or Seizure Disorder, Stephanie Swanson

Walden Dissertations and Doctoral Studies

The purpose of this quantitative correlation study was to examine the association between childhood obesity (dependent variable) and cerebral palsy, Down Syndrome, and epilepsy and seizure disorders (independent variables), while controlling for the child’s age, race, and sex among United States children ages 0-17, as well as the guardian’s education and income levels. There are many studies related to childhood obesity; however, few focus on the independent variables in the current study in relation to overweight children. The Social Cognitive Theory (SCT) was used to understand and interpret the research findings. Secondary analysis of data was conducted using the National …

Perinatal Nursing Education Related To Opioid Use Disorder, Britney Taniguchi

Walden Dissertations and Doctoral Studies

Opioid use disorder (OUD) contributes to severe perinatal and neonatal morbidity and mortality in the United States, leading to alarming complications for pregnant women, mothers, and newborns. Complications the mother experiences with OUD include increased mortality, overdose, infections, endocarditis, narcotic bowel syndrome, and accident-related injury. Complications the newborn can suffer include neonatal abstinence syndrome, respiratory depression, microcephaly, and sudden infant death syndrome. Framed within the analysis, design, development, implementation, and evaluation model of instructional design, this project aimed to plan, implement, and evaluate a staff education program on opioid use disorder. The staff education program was presented to 13 perinatal …

Respiratory Treatments In Post-Covid Patients To Improve Physical Activity, Pamela Gordon Tarver

Walden Dissertations and Doctoral Studies

November 2022Abstract A significant number of individuals affected by the coronavirus (COVID) developed severe acute respiratory syndrome (SARS), causing respiratory dysfunction which led to decreased functional capacity. This project aimed to evaluate the project site’s archival data for post-COVID patients to determine whether respiratory treatments improved physical activity, as evidenced by the results of the pre and post 6-minute walk test (6MWT) and oxygen saturation (SpO2) levels. The Donabedian quality model was utilized to evaluate the resources, the interventions, and the outcomes of post-COVID patients. Sources of evidence used were peer-reviewed articles retrieved from the Walden Library and CINAHL databases …

Strategies To Reduce Turnover Among Black Home Healthcare Aides, Diane Allen Tate

Walden Dissertations and Doctoral Studies

AbstractMany individuals prefer to remain in their homes as they age instead of entering a long-term care facility. As the proportion of older Americans rapidly grows, the demand for delivery of nonmedical services by home healthcare aides (HHAs) is expected to increase. However, the national and local supply of HHAs is insufficient and must be rectified to meet a projected increase of older Americans by 2050. This research study involved exploring this problem for one small home healthcare organization in the Maryland suburbs outside of Washington, DC with an HHA workforce that was comprised predominantly of Black/African American and African …

Role Of Racially Concordant Patient-Physician Relationships In Health Outcomes Among African American Women, Joy Thomas

Walden Dissertations and Doctoral Studies

Abstract There are gaps in the literature regarding how patient-physician racially concordant relationships affect African American women’s health. This quantitative study evaluated the effects of non-minority physician influence on the perceptions of medical mistrust, racial discrimination, and healthcare-specific racial discrimination on African American women. The behavioral model for vulnerable populations guided the study. Two research questions involved understanding the relationship between trust in the physician scale and medical mistrust and the association between racial discrimination and perceived healthcare-specific racial discrimination among African American women living in a Southern U.S. state. A stratified random sampling strategy was used to obtain a …

Nursing Staff Education Program On Using The Ask Suicide-Screening Questions Tool Kit, Camarita Titang

Walden Dissertations and Doctoral Studies

The absence of adequate knowledge, skills, and competencies in screening for suicide risk in adolescent and young adult patients is a significant problem facing nurses in outpatient settings. An evaluation of the project site facility’s main performance metrics revealed shortcomings in locating patients who pose a serious risk of self-harm and suicide. Staff dealing with the patients may, as a result, overlook preemptive measures that could stop a suicide event. The project aimed to create a training program to introduce the ask suicide-screening questions (ASQ) tool kit, an evidence-based suicide screening tool, to ambulatory nurses. The goal of the project …

Impact Of A Workplace Wellness Program On Health Literacy And Type 2 Diabetes Management Among Blue-Collar Workers In South Carolina, Caitlin E. Townsend

Walden Dissertations and Doctoral Studies

The prevalence of chronic diseases and their management is significantly different between blue- and white-collar employees. Social determinants of health are determining factors of health for blue-collar manufacturing employees in South Carolina. Type 2 Diabetes is a complex chronic condition that has been associated with serious co-morbidities, but it can be managed and/or treated. Workplace wellness programs provide an ideal setting for health education and promotion efforts targeted toward population health management. While workplace wellness programs have been proven successful, there is limited research on the relationship and impact on health literacy. This quantitative, descriptive study used secondary data to …

Assessment Of Factors That Affect Men’S Access And Utilization Of Tuberculosis Services In Zululand District In South Africa, Maureen Fatsani Tshabalala

Walden Dissertations and Doctoral Studies

Tuberculosis (TB) remains the leading cause of death in South Africa, with higher mortality rates among men compared to women, despite the availability of free TB services and a reduction in TB death rates. However, research on the factors influencing men's access to and utilization of TB services is limited. The purpose of this study was to assess the factors affecting men's geographical access and quality utilization of TB services in the Zululand district of KwaZulu Natal province, South Africa. A survey questionnaire was used to collect data from 200 men recruited from selected primary health care facilities. Andersen's model …

Nurses’ Experiences With Trauma-Informed Care In Patients With Psychological Trauma, Ade J. Vinton

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic increased the need for research and discussions about trauma, trauma-informed care (TIC), and care delivery processes. Little is known about how nurses recognize, assess, treat, and support patients who experience trauma although knowledge of TIC is important for delivering care to trauma survivors. The purpose of this qualitative descriptive study was to explore nurses’ perceptions of TIC principles and their experiences delivering care to patients with psychological trauma. Harris and Fallot’s TIC theory was used to guide the study. Purposeful sampling was used to recruit ten nurses for individual semi structured interviews using open-ended questions conducted via …

Appropriated Racial Oppression As A Moderator Of Sexual Satisfaction Among Black Women, Jillian Rochelle Watts

Walden Dissertations and Doctoral Studies

Researchers have named pleasure as a form of justice: a reclamation of the body and striving for happiness. For Black women, cultural messaging and lived experiences have led to sexual shame that can impact how individuals experience sexual satisfaction. This quantitative cross-section correlational study was conducted to assess the relationship between sexual shame and sexual satisfaction, the relationship between appropriated racial oppression and sexual satisfaction, and whether appropriated racial oppression moderated the relationship between sexual shame and sexual satisfaction in Black women. Moderating regression analysis was used to examine and understand the relationships between sexual shame and sexual satisfaction and …

Educating Nursing Staff On Code Lavendar, Melanie Gumapas Webb

Walden Dissertations and Doctoral Studies

The role of the nurse has changed considerably over the past decade. Nurses are facing alarming rates of burnout that is causing them to leave the profession prematurely. The practice-focused question was to determine if a nurse staff education program on Code Lavender that focused on wellness and resiliency strategies helped to decrease nurse burnout. The purpose of this doctor of nursing practice project was to educate nurses on an 11-bed inpatient oncology unit at a hospital located in Maryland. A comprehensive literature review was conducted utilizing several databases and using inclusive terms such as nurse burnout, wellness, patient safety …

Lived Experience Of Women Veterans Navigating The Veteran Healthcare System, Candance Willett

Walden Dissertations and Doctoral Studies

Many women veterans who navigate the Veterans Affairs (VA) healthcare system across the United States have felt that their voices have not been heard regarding their input and lived experiences concerning inclusion to the quality-of-care delivery for their health needs. The purpose of this study was to explore the lived experiences of women veterans who were currently facing or had previously faced difficulty navigating the VA healthcare system. The framework used for this qualitative study was interpretive phenomenological analysis. The qualitative method used was hermeneutics which was designed by Edmund Husserl and Martin Heidegger. Semi structured interviews were of 12 …

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 …