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2023

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Full-Text Articles in Medicine and Health Sciences

Nurse Education Regarding Hypertension And Use Of A Follow-Up Call Protocol In Primary Care, Edwin Omar Rivera-Figueroa Jan 2023

Nurse Education Regarding Hypertension And Use Of A Follow-Up Call Protocol In Primary Care, Edwin Omar Rivera-Figueroa

Walden Dissertations and Doctoral Studies

AbstractMany patients whose primary or secondary chronic condition is hypertension present to their first follow-up appointment in a primary care facility in the north of Puerto Rico with uncontrolled high blood pressure. Nurses’ knowledge of hypertension is vital to addressing a gap in practice for this patient population and patient quality of life and the prevention of cardiovascular diseases. The practice-focused question guiding this project focused on a nurse educational session for increasing hypertension management knowledge as well as a follow-up phone call protocol that aimed to improve patient care. The theoretical framework guiding this project was Pender’s health promotion …


Influence Of Staffing Shortages On Safety And Communication In Behavioral Health, Raven Brittany Robinson Jan 2023

Influence Of Staffing Shortages On Safety And Communication In Behavioral Health, Raven Brittany Robinson

Walden Dissertations and Doctoral Studies

At the selected behavioral health organization (BHO), leaders desire to improve patient safety and staff communication to provide quality mental health services. They need strategies to achieve these goals. The Baldrige Excellence Framework was used to identify the workforce challenges and practices that facility leaders can potentially use to improve performance to help achieve success, sustainability, and the mission of the BHO. The data sources consisted of (a) semistructured interviews with the CEO, the leader of the intake department, an intake therapist, an intake coordinator, and an RN and (b) reviews of the BHO’s website, and pertinent academic literature. Data …


Exploring Barriers To Accessing Funding For Individuals With Dementia Who Reside In Long-Term Care Facilities, Gwendolyn Cox Smith Jan 2023

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 …


Educating Nursing Staff On Code Lavendar, Melanie Gumapas Webb Jan 2023

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 …


Implementation Of Night Shift Rounding To Improve Nursing Communication And Reduce Days Of Intubation In The Intensive Care Setting, Lisa Wilkinson Jan 2023

Implementation Of Night Shift Rounding To Improve Nursing Communication And Reduce Days Of Intubation In The Intensive Care Setting, Lisa Wilkinson

Walden Dissertations and Doctoral Studies

Multidisciplinary rounds are the gathering of various health care providers who have a shared interest in a patient’s well-being to discuss the plan of care and the patient’s progress through their hospital stay. This multidisciplinary group of staff can be the providers, the nurse, charge nurse, social worker, pharmacist, dietician, respiratory, chaplaincy, and occupational and physical therapists. On night shift at the project site, this rounding process did not occur, leaving the staff feeling they were not involved in the plan of care. The purpose of this quality improvement evidenced-based project was to create a process change, introduced to the …


Patient-Rated Physician Compassion And Patient Compliance With Colorectal Cancer Screening, Christine Caputo Winn Jan 2023

Patient-Rated Physician Compassion And Patient Compliance With Colorectal Cancer Screening, Christine Caputo Winn

Walden Dissertations and Doctoral Studies

In 2021, colorectal cancer was the second leading cause of cancer deaths in the United States, where screening prevented 46%–63% of colorectal cancer deaths. Compassionate care has been an area of study among scholars since Hippocrates. The purpose of this quantitative research study was to examine whether there was a relationship between the independent variables of provider compassion, patient gender, and length of provider patient relationship with the dependent variable of patient adherence behavior for prescribed colorectal cancer screening tests among primary care patients between 2019 and 2020 in a northeastern U.S. state. Guided by the theory of planned behavior …


Association Between Psychosocial, Obstetric, And Lifestyle Factors And Antenatal Depression, Tomnema Xiong Jan 2023

Association Between Psychosocial, Obstetric, And Lifestyle Factors And Antenatal Depression, Tomnema Xiong

Walden Dissertations and Doctoral Studies

Antenatal depression, or depression during pregnancy, is a mental health concern in the United States that impacts mothers and their infants. This study examined the associations between psychosocial, obstetric, lifestyle factors, and antenatal depression. This study was guided by social cognitive theory, specifically the reciprocal determinism construct. Secondary data from the 2007–2018 National Health and Nutritional Examination Survey (NHANES) were used in this quantitative cross-sectional study. Every participant of the NHANES completed the Patient Health Questionnaire-9 depression screening form. The study sample consisted of 274 women who were pregnant at the time of participating in the NHANES, approximately 28.8% of …


Risk Factors Influencing Poliomyelitis Seroprevalence In Polio High Risk Areas Of Afghanistan, Wasan Abdulaziz Al-Tamimi Jan 2023

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 Effects Of Vesico-Vaginal Fistula In The Lives Of Women In Southeastern Nigeria, Chioma Esther Amutaigwe Jan 2023

The Effects Of Vesico-Vaginal Fistula In The Lives Of Women In Southeastern Nigeria, Chioma Esther Amutaigwe

Walden Dissertations and Doctoral Studies

Vesico-vaginal fistula (VVF) is a maternal health problem faced by women in developing countries. VVF is one of the most devastating consequences of prolonged obstructed labor and is still prevalent in resource-poor countries like Nigeria where fertility is high, the status of women is low, and obstetric services are often inadequate. The objective of this study was to enrich our understanding of the effects of VVF as it relates to women’s experiences in southeastern Nigeria. I adopted the Transactional Model of Stress and Coping in this study; this theory posits that people, when contending with any kind of stressors, are …


Thirty-Second Mindful Body Scan Meditation For Bedside Nurses, Shruti Balwalli-Udyawer Jan 2023

Thirty-Second Mindful Body Scan Meditation For Bedside Nurses, Shruti Balwalli-Udyawer

Walden Dissertations and Doctoral Studies

Compassion fatigue, or secondary traumatic stress, is a state of physical and mental exhaustion caused by an inability to cope with the everyday environment that reduces the ability of the nurse to provide high-quality health care to a patient. The purpose of this staff education project, guided by Selye’s general adaption syndrome , was a 6-week, 30-second mindfulness exercise program to promote stress reduction for cardiac step-down and medical-surgical nurses. In this quantitative, pre- and posttest study, the Perceived Stress Scale was completed by a sample of 24 nurses who met the inclusion criteria. The practice focused whether educating nurses …


Predictors Of Retention Among Individuals With Hiv Initiating Antiretroviral Therapy In Ghana, Ivy Ama Okae Jan 2023

Predictors Of Retention Among Individuals With Hiv Initiating Antiretroviral Therapy In Ghana, Ivy Ama Okae

Walden Dissertations and Doctoral Studies

Abstract Managing HIV requires lifelong therapy. Retaining clients on lifelong therapeutic antiretroviral therapy (ART) ensures the suppression of viral replication and better health outcomes. The time of the start of ART management is also a factor in determining better health outcomes for persons living with HIV. This study examined the association between initiation criteria (treat all, Option B+, and CDC T-cell count < 500) and retention on ART at 12 months for 17,974 randomly selected clients in the Ghana Health Service's HIV patient electronic database. Analyses controlled for age, gender, educational status, alcohol use, treatment/adherence monitoring, and tuberculosis disease treatment. Bronfenbrenner's ecological systems theory guided the interpretation of the findings. Results shows that retention was positively associated with all treatment initiation criteria. Clients initiated with CD4 count ≤ 500 criteria seemed to be retained at 12 months on ART at a higher rate than initiation criteria based on Option B+ and treat all. The study results may contribute to positive social change by supporting CD4 testing for clients before initiation of ART to improve retention and ensure the availability and use of adherence counseling, no tuberculosis disease and its prevention, and low use of alcohol among people living with HIV. The results of this study may also provide opportunities for public health policy intervention efforts requiring a personalized, group-based approach to service delivery at the intrapersonal level, interconnected with interpersonal, meso, and meta factors at the community level.


Nursing Staff Education Program On Using The Ask Suicide-Screening Questions Tool Kit, Camarita Titang Jan 2023

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 …


Hospital-Acquired Infections And Differences Between Magnet And Non-Magnet Hospitals, Linda Mary Valenti Jan 2023

Hospital-Acquired Infections And Differences Between Magnet And Non-Magnet Hospitals, Linda Mary Valenti

Walden Dissertations and Doctoral Studies

Hospital-acquired infections (HAIs), specifically clostridioides difficile (CDI) and methicillin-resistant staphylococcus aureus (MRSA) bacteremia, increase mortality and length of stay and cost the United States billions of dollars each year. Though preventable, continued incidence demonstrates that infection prevention interventions remain challenging for health system administrators. The purpose of this quantitative study was to identify whether there was a significant difference between Magnet accreditation and non-Magnet accreditation and the frequency of HAIs, specifically, CDI and MRSA bacteremia. The independent variable was Magnet accreditation status; the dependent variables were CDI and MRSA bacteremia. The foundation of the study focused on Donabedian’s framework of …


Exploring The Benefits Of A Collaboration Between Behavioral Health Coaches And Clinicians, Devan White Jan 2023

Exploring The Benefits Of A Collaboration Between Behavioral Health Coaches And Clinicians, Devan White

Walden Dissertations and Doctoral Studies

This case study addressed how to best use health coaches in the field of behavioral health to improve the accessibility and outreach of a new program launched by the target organization that emphasizes coaching as an intervention for improving well-being and mental fitness. The purpose of this qualitative case study was to investigate the potential influence of coaching within the behavioral health field and explore how health coaches could partner with clinicians or behavioral health leaders to allow for more collaboration and accessibility to services. The RQs centered on how health coaches might support the treatment of those who have …


The Effects Of Vesico-Vaginal Fistula In The Lives Of Women In Southeastern Nigeria, Chioma Esther Amutaigwe Jan 2023

The Effects Of Vesico-Vaginal Fistula In The Lives Of Women In Southeastern Nigeria, Chioma Esther Amutaigwe

Walden Dissertations and Doctoral Studies

Vesico-vaginal fistula (VVF) is a maternal health problem faced by women in developing countries. VVF is one of the most devastating consequences of prolonged obstructed labor and is still prevalent in resource-poor countries like Nigeria where fertility is high, the status of women is low, and obstetric services are often inadequate. The objective of this study was to enrich our understanding of the effects of VVF as it relates to women’s experiences in southeastern Nigeria. I adopted the Transactional Model of Stress and Coping in this study; this theory posits that people, when contending with any kind of stressors, are …


African American Women And Social Support Networks To Overcome The Strong Black Woman Schema And Depression, Teia Jelisia D. Clements Jan 2023

African American Women And Social Support Networks To Overcome The Strong Black Woman Schema And Depression, Teia Jelisia D. Clements

Walden Dissertations and Doctoral Studies

Mental illness disorders within the United States are on the rise. Researchers have indicated that African Americans are less likely to seek mental health compared to European Americans. The purpose of this basic qualitative study was to understand how social support networks influence African American women between the ages of 25 and 50 in addressing the strong Black woman (SBW) schema and depression. A conceptual framework consisting of the SBW collective theory guided the study. A purposive sample of 16 African American women who use social support networks to address the SBW schema and depression was obtained through flyers posted …


Strategies To Mitigate Nurse Turnover, James Edward Cooper Jr Jan 2023

Strategies To Mitigate Nurse Turnover, James Edward Cooper Jr

Walden Dissertations and Doctoral Studies

Registered nurse turnover is a severe problem for all healthcare organizations because it negatively affects financial growth, patient care, and reputation, ultimately resulting in financial losses. Grounded in Herzberg’ two-factor theory, the purpose of this qualitative multiple-case study was to explore strategies hospital leaders use to mitigate RN turnover. The participants included three hospital leaders from three different hospitals in the southeastern United States who mitigated RN turnover. Data were collected from semistructured interviews and company documents and analyzed using Yin’s five-phase data analysis process. Three themes emerged: nurse engagement, job satisfaction, and trust in leadership mitigated RN turnover. A …


Relationship Between Food Insecurity, Depression, And Race/Ethnicity Among U.S. Adults Aged 60–69 Years, Patrick E. Crandon Jan 2023

Relationship Between Food Insecurity, Depression, And Race/Ethnicity Among U.S. Adults Aged 60–69 Years, Patrick E. Crandon

Walden Dissertations and Doctoral Studies

Abstract Food insecurity (FI) and depression among older populations in the United States are public health concerns. Although FI has declined in the United States, it is a psychosocial stressor prevalent among the growing population of adults over 60. It is unknown to what extent FI contributes to depression among racial/ethnic minorities in this population. The purpose of this quantitative cross-sectional study was to examine the relationships between FI and race and depression among U.S. adults aged 60–69 years when adjusting for other variables. The social-ecological model was used to understand the interplay between individual and environmental factors that may …


Influences On Influenza Vaccine Uptake Among Older Lebanese Adults, Doha D'Agostini Jan 2023

Influences On Influenza Vaccine Uptake Among Older Lebanese Adults, Doha D'Agostini

Walden Dissertations and Doctoral Studies

Influenza is a viral infection that is globally transmitted and that increases the risk for infectious diseases, hospitalization, and morbidity and mortality, especially among the older adult population. Although influenza vaccines are recommended in several countries, influenza vaccine hesitancy remains a challenge. In Lebanon, there is minimal research related to older adults’ attitudes and perceptions associated with influenza vaccination. To explore older Lebanese adults’ vaccination experiences and perceptions of the factors that affect their influenza vaccine uptake, a qualitative investigation was conducted. The theory of planned behaviors served as the theoretical framework for the study. A thematic analysis was conducted …


Occupational Therapists’ Perspectives On Using The Physical Environment In Skilled Nursing Facilities, Jennie L. Digrado Jan 2023

Occupational Therapists’ Perspectives On Using The Physical Environment In Skilled Nursing Facilities, Jennie L. Digrado

Walden Dissertations and Doctoral Studies

Occupational therapists (OTs) are among the health care professionals who assist individuals with neurocognitive disorders (NCDs) to engage in self-care and leisure skills in a skilled nursing facility (SNF) environment. Although the SNF environment has been researched, a gap exists regarding how OTs use the built environment to help clients with a NCD engage in self-care and leisure-related activities. The purpose of this qualitative case study was to understand how OTs use the physical environment in a SNF to help individuals with a NCD engage in self-care and leisure related activities. The conceptual framework that guided this study was the …


Tuberculosis-Associated Knowledge, Stigma, And Health Seeking Behavior Among Traders In Onitsha Main Market, Anambra State, Nigeria, Benedeth N. Ezeosim Jan 2023

Tuberculosis-Associated Knowledge, Stigma, And Health Seeking Behavior Among Traders In Onitsha Main Market, Anambra State, Nigeria, Benedeth N. Ezeosim

Walden Dissertations and Doctoral Studies

The utilization of tuberculosis (TB) health care services in a Nigerian state has not been optimal. Many residents do not utilize available health care resources when they experience symptoms of TB. Although much is known about the determinants of health seeking behavior (HSB), there is a gap on how TB knowledge and TB related stigma among traders in one main market contribute to HSB. This study examined the effect of TB knowledge and TB related stigma on HSB among traders. The health stigma and discrimination and health belif models served as the theoretical foundation. A quantitative cross-sectional analytical survey design …


A Nursing Staff Education Module On Survivorship Care Plans In Primary Care, Janette Francis Jan 2023

A Nursing Staff Education Module On Survivorship Care Plans In Primary Care, Janette Francis

Walden Dissertations and Doctoral Studies

Survivorship care plans (SCPs) bridge the gap in the transition of care from oncology to primary care providers (PCPs) for breast cancer survivors. Despite strong recommendations for SCPs, their use remains limited. Guided by Knowles’ adult learning theory, the project focused on, first, determining whether a predeveloped staff education activity was valid using the Lynn model criteria for validation. Second, if in a rural clinic where SCP were not consistently used providers, nurses, and staff knowledge regarding the importance of SCP would increase following an educational program. An expert panel of 5 educational experts validated the educational module for appropriateness …


Lockdowns During The Covid-19 Pandemic And Domestic Violence Among Virginians, Kenneth G. Gordon Jan 2023

Lockdowns During The Covid-19 Pandemic And Domestic Violence Among Virginians, Kenneth G. Gordon

Walden Dissertations and Doctoral Studies

AbstractThe domestic violence (DV) dilemma spans millennia and has devastated individuals, families, and societies. DV prevalence rose between 20% and 50% worldwide and over 5% among Virginians since early 2020 during COVID-19. Abuse victims’ vulnerability increased during the lockdown periods due to the extended time spent with perpetrators. DV victims visited emergency departments for their nonfatal physical injuries. The purpose of the study was to examine COVID-19-related lockdown effects on DV prevalence, perpetrator characteristics, and hospitalizations among Virginians. Bronfenbrenner’s socioecological model served as the theoretical foundation. Descriptive analyses showed that DV prevalence among Virginians rose from 37.5% in 2019 to …


Perceived Factors Of Intimate Partner Violence On Women Diagnosed With Post-Traumatic Stress Disorder, Angela M. Halcovich Jan 2023

Perceived Factors Of Intimate Partner Violence On Women Diagnosed With Post-Traumatic Stress Disorder, Angela M. Halcovich

Walden Dissertations and Doctoral Studies

Post-Traumatic Stress Disorder (PTSD) is a prevalent diagnosis, and many human and social services professionals strive to understand its components, to ensure that they serve the population properly. However, little is known about how PTSD may influence women’s vulnerabilities to and future experiences of intimate partner violence (IPV). Emphasizing relationship coaching, which provides tools to foster healthy relationships, within the therapeutic curricula on rehabilitation for women with PTSD may result in reduced chances to experience IPV as women integrate back into their everyday life after being diagnosed and treated for PTSD. The purpose of this generic qualitative study was to …


Help-Seeking Behaviors And Employment Hope Among Depressed Black Male Foster Care Alumni, Vanessa Jennings Jan 2023

Help-Seeking Behaviors And Employment Hope Among Depressed Black Male Foster Care Alumni, Vanessa Jennings

Walden Dissertations and Doctoral Studies

Traumatic depression is a system of experiences where the mind, heart, and gut track happenings lingering among systemic models of prevention and intervention and personal stories. This nonexperimental correlational study aimed to provide insights into mental help-seeking and employment hope among depressed Black/African American foster care male alums. The central research question was to what degree, if any, a positive relationship exists between employment hope and seeking access to mental health-related services among male foster care alums who identify with depression. It was hypothesized that a statistically significant relationship exists. The social cognitive career theory and theory of planned behavior …


Occupational Risk Perceptions Among Foreign-Born Construction Workers In Central Florida, Matthew Edison Law Jan 2023

Occupational Risk Perceptions Among Foreign-Born Construction Workers In Central Florida, Matthew Edison Law

Walden Dissertations and Doctoral Studies

Hispanic and Latino foreign-born construction workers in the United States experience higher rates of serious injuries and fatalities in the workplace than their native-born peers. Previous research has pointed to specific vulnerabilities among this population, including birthplace, age of the worker, language barriers, and education level, but little to no research has examined addressable risk factors, such as occupational risk perceptions, among this population. The purpose of this quantitative study was to determine the relationship between birthplace, number of years working in the United States, and occupational risk perceptions while controlling for age of the worker, language barriers, and education …


Experiences Of New Graduate Nurses Who Transitioned To Practice Using Virtual Conferencing Software, Sara Moran Jan 2023

Experiences Of New Graduate Nurses Who Transitioned To Practice Using Virtual Conferencing Software, Sara Moran

Walden Dissertations and Doctoral Studies

Orientation is a pivotal moment for new graduate nurses as they transition into the acute care setting. The COVID-19 pandemic changed in-person orientation to virtual orientation, but little is known about the experiences of new graduate nurses who attended the virtual orientation process. The purpose of this qualitative interpretive descriptive study, guided by Duchscher’s theory and the technology adaptation model 2, was to understand the experiences of new graduate nurses who transitioned to practice utilizing video-based conference software for nursing orientation. Twelve new graduate nurses were interviewed using virtual conferencing software. Data were analyzed using interpretive description and then were …


The Correlation Between Nurse Staffing And Quality Of Care Outcomes Within Nursing Homes In Mississippi, Nyeshia Nelson Jan 2023

The Correlation Between Nurse Staffing And Quality Of Care Outcomes Within Nursing Homes In Mississippi, Nyeshia Nelson

Walden Dissertations and Doctoral Studies

The U.S. population aged 65 years old and older is steadily increasing. Some of thispopulation resides in nursing homes; thus, the necessity for quality care provided in nursing homes has increased. Consistent, quality care remains a constant challenge for the government, nursing home administrators, health care consumers, and researchers. Nurse staffing has been identified as a critical structural measure that affects the quality of care and outcomes in nursing homes. The purpose of this quantitative study was to examine the relationship between nurse staffing and quality of care outcomes in Mississippi’s nursing homes. Donabedian’s structure, process, and outcome (SPO) model …


The Experiences Of Women In The Healthcare Profession With Alcohol Use During The Covid-19 Pandemic, Amber Olsen Jan 2023

The Experiences Of Women In The Healthcare Profession With Alcohol Use During The Covid-19 Pandemic, Amber Olsen

Walden Dissertations and Doctoral Studies

Women have severe health risks associated with drinking alcohol long-term and excessively. The purpose of this qualitative study was to explore the lived experience of women in healthcare positions regarding alcohol use during the COVID-19 pandemic. The study was informed by the theory of planned behavior. Semistructured interviews were used to gather information from participants based on their firsthand experiences with alcohol usage. Understanding women’s attitudes toward alcohol use during the COVID-19 pandemic can improve intervention. Data were analyzed using an inductive, thematic procedure. Participants associated their own use of alcohol with socialization, and all participants reported that they regarded …


Factors Impacting College Students’ Receipt Of Human Papillomavirus Vaccination, Joy Yvette Payne Jan 2023

Factors Impacting College Students’ Receipt Of Human Papillomavirus Vaccination, Joy Yvette Payne

Walden Dissertations and Doctoral Studies

Less than half of U. S. students entering college have had a human papillomavirus (HPV) vaccination, placing them at risk for HPV-related cancers. This study’s purpose was to identify predictors of HPV vaccination initiation in college students. Andersen’s behavioral model of health services use was used to examine the differences in predisposing, enabling, and need factors in U.S. college students ages 18–26 years who received an initial HPV vaccination in college compared to those who never received an HPV vaccination. The study was a quantitative, cross-sectional survey design using multivariable logistic regression for data analyses. Data were collected through an …