Medicine and Health Sciences Commons^™

Relationship Between Treatment Comorbidities And Hiv Viral Suppression Among People Who Live With Aids In Johannesburg., Nwogo Immaculata Ekeji, Tolulope A. Osoba, Hebatullah Tawfik, Mehdi Agha

Journal of Social, Behavioral, and Health Sciences

HIV has globally infected over 37.9 million people, of which 28.2 million (73%) are on antiretroviral treatment, and 66% of those on treatment are virally suppressed. In South Africa, however, low rate of viral suppression (47%) among people living with HIV is a major health problem that has continued to fuel HIV prevalence. A cross-sectional quantitative research design was used to investigate the relationship between treatment comorbidities and viral suppression among HIV-infected adults aged 18–49 who were diabetic, had cancer, or tuberculosis in Johannesburg. HIV Care Continuum formed the theoretical framework for this research. An existing HIV-infected patient de-identifiable dataset …

Disparate Access To Medical Coverage Associated With Type 2 Diabetes Care In Low-Income And Rural Communities In Georgia, Crystal Alexis Symone Edwards

Walden Dissertations and Doctoral Studies

Disparate access to diabetes care in rural and low-income communities among older adults has been an ongoing issue among Americans. Type 2 diabetes in low-income and rural communities has continuously burdened many residents due to age, costs of care, income, geographic location, and education levels. Researchers have demonstrated that providing resources and tools to rural and low-income communities would assist in decreasing type 2 diabetes and increase education and awareness. The purpose of this quantitative cross-sectional study using secondary data was to examine the relationship between health insurance status and lack of access to health care resources and delay of …

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 …

Relationship Between Childhood Trauma, ,Adverse Childhood Experiences, And Self-Management Of Type 1 And Type 2 Diabetes, Deserie J. Otoole

Walden Dissertations and Doctoral Studies

AbstractPoorly controlled diabetes is the result of lack of self-care, which contributes to complications, ill quality in life, the rise in health care costs, and early death. The purpose of this quantitative, nonexperimental study was to examine the extent to which diabetes type (Type 1 and Type 2), childhood trauma, and adverse childhood experiences predict diabetes self-management (glucose management, dietary control, physical activity, health care use, total self-management). Contemporary trauma theory suggests that early childhood trauma results in negative health-related consequences in adulthood. Standard multiple regression analyses showed that (a) higher levels of physical neglect and emotional abuse predicted poorer …

Providing Diabetes Education To Improve Staff Nurses' Knowledge, Marcia A. Patterson

Walden Dissertations and Doctoral Studies

Diabetes mellitus is a chronic metabolic disease that affects over 34.2 million or 10.5% of the U.S. population and ranks as the seventh leading cause of death. Tennessee's diabetes prevalence rate is ranked 45th overall in the nation, with 14.9% of the population affected, and in the local area for this project, the rate is greater than 15%, creating a public health concern. Despite its prevalence, there is still a wide gap in knowledge among nurses on diabetes management. The practice-focused question for this project addressed whether a staff education program would improve nurses' knowledge regarding diabetes. The significant gap …

Risk Factors Associated With The Development Of Type Ii Diabetes-Related Complications, Jessica Danielle Lucas Williams

Walden Dissertations and Doctoral Studies

By 2040, it is estimated that 642 million people ages 20 to 79 will have Type II diabetes, thereby making it a heavily studied topic among scholars. As more people are diagnosed with Type II diabetes each year, the literature is slowly shifting to long-term complications. However, the many risk and protective factors that exist have created gaps in the literature. The purpose of this study was to determine the relationship between participation in diabetes self-management classes, mental health, physical health, BMI, smoking status, exercise, and possible diabetes complications (diabetes-related retinopathy and diabetes-related kidney disease). The gap in the literature …

Disparate Access To Medical Coverage Associated With Type 2 Diabetes Care In Low-Income And Rural Communities In Georgia, Crystal Alexis Symone Edwards

Walden Dissertations and Doctoral Studies

Disparate access to diabetes care in rural and low-income communities among older adults has been an ongoing issue among Americans. Type 2 diabetes in low-income and rural communities has continuously burdened many residents due to age, costs of care, income, geographic location, and education levels. Researchers have demonstrated that providing resources and tools to rural and low-income communities would assist in decreasing type 2 diabetes and increase education and awareness. The purpose of this quantitative cross-sectional study using secondary data was to examine the relationship between health insurance status and lack of access to health care resources and delay of …

Improving Self-Efficacy Of Primary Care Providers With Assessment Of Diabetic Peripheral Neuropathy, Kimberly Paddock Farr

Walden Dissertations and Doctoral Studies

AbstractDiabetic peripheral neuropathy (DPN) is one of the most common complications of diabetes. DPN contributes to significant pain, debility and injury to diabetic patients. The majority of diabetic patients are managed in the primary care practice (PCP) setting. A local chapter of a nurse practitioner association identified a lack of knowledge of current evidence-based guidelines for effective screening and assessment of DPN in the PCP environment. The practice-focused question for this project was to determine if an educational intervention on evidence-based screening and assessment would improve nurse practitioner’s knowledge with DPN screening and diagnosis in PCP. Mezirow’s transformative theory of …

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 …

Improving Self-Efficacy Of Primary Care Providers With Assessment Of Diabetic Peripheral Neuropathy, Kimberly Paddock Farr

Walden Dissertations and Doctoral Studies

AbstractDiabetic peripheral neuropathy (DPN) is one of the most common complications of diabetes. DPN contributes to significant pain, debility and injury to diabetic patients. The majority of diabetic patients are managed in the primary care practice (PCP) setting. A local chapter of a nurse practitioner association identified a lack of knowledge of current evidence-based guidelines for effective screening and assessment of DPN in the PCP environment. The practice-focused question for this project was to determine if an educational intervention on evidence-based screening and assessment would improve nurse practitioner’s knowledge with DPN screening and diagnosis in PCP. Mezirow’s transformative theory of …

Medicine Adherence As A Determinant Of Complication Development In Diabetes And Hypertension Patients On A Medical Aid Scheme In Zimbabwe, Tsitsi Moyo

Walden Dissertations and Doctoral Studies

Pharmacotherapy is a significant component of chronic disease management; its efficacy depends on long term, correct, and consistent use; however, medicine adherence rates remain low. The cost of medicines is considered a significant barrier to adherence, especially in low-income settings. This quantitative cross-sectional study was conducted using data from Cimas Medical Aid Society collected between 2015 and 2019. The purpose of the study was to determine the extent of the association between medicine adherence, complication development, and cost of care among diabetic and hypertensive patients while controlling for age and gender on a population that does not experience cost barriers …

Diabetes Self-Management Education In The Urban Low Socioeconomic Status Senior Population, Heather Santa Barbara

Walden Dissertations and Doctoral Studies

This exploratory quantitative study used a survey design to address a gap in the literature concerning primary care team perceptions about diabetes care for urban low socioeconomic status seniors with diabetes. Diabetes is a chronic health problem that is often managed in primary care offices, and primary care teams are often the first source of education and support for patients. Standards of management for seniors with diabetes has changed to eliminate tight control of glucose levels, and primary care team members may have differing perceptions about diabetes care depending upon their role in the primary care team and years of …

Effective Management Of Diabetes Mellitus Type Ii In A Military Treatment Facility, Jozy Merizier Smarth

Walden Dissertations and Doctoral Studies

In the United States, 34 million people have diabetes and 79 million have prediabetes. Currently, one in nine Americans are diagnosed with diabetes and it is projected that one in five will have diabetes by 2025 and one in three by 2050. The practice-focused question answered by this project addressed the question if implementing a staff education program improved staff’s knowledge about self-management education and intent for providers and staff to promote a formal diabetes self-management education (DSME) program in an overseas military treatment facility. The site has 47% of empaneled beneficiaries with diabetes mellitus Type II with an elevated …

Weight Management Clinical Practice Guidelines For The Obese, Pre-Diabetic, And Diabetic Population, Dawn Williams

Walden Dissertations and Doctoral Studies

AbstractDiabetes is among chronic or lifestyle-related illnesses posing health care challenges at epidemic proportions, pressuring health care systems infrastructure for positive outcome-driven practices and sustainable costs, as continued research suggests that obese people are up to 80 times more likely to develop type 2 diabetes. In June 2021, a weight-loss and wellness center serving this high-risk population established recommended guidelines for Hemoglobin A1C (HbA1C) screening and education. During the initial 3 months of implementation, data findings captured 37% in a total of 220 with elevated HbA1C levels. The gap in practice is that the Wellness Center did not have a …

Medicine Adherence As A Determinant Of Complication Development In Diabetes And Hypertension Patients On A Medical Aid Scheme In Zimbabwe, Tsitsi Moyo

Walden Dissertations and Doctoral Studies

Pharmacotherapy is a significant component of chronic disease management; its efficacy depends on long term, correct, and consistent use; however, medicine adherence rates remain low. The cost of medicines is considered a significant barrier to adherence, especially in low-income settings. This quantitative cross-sectional study was conducted using data from Cimas Medical Aid Society collected between 2015 and 2019. The purpose of the study was to determine the extent of the association between medicine adherence, complication development, and cost of care among diabetic and hypertensive patients while controlling for age and gender on a population that does not experience cost barriers …

Adverse Childhood Events And Protective Health Behaviors Among Adults With Diabetes Or Diabetes With Comorbid Heart Disease, Ciara Michelle Rukse

Walden Dissertations and Doctoral Studies

Diabetes is a prevalent and costly chronic condition that can lead to other comorbid conditions such as heart disease. Disease management is essential but can be stressful and complicated, especially for individuals who have developed maladaptive behaviors in response to exposure to adverse childhood events (ACEs), which are chronic stressors that impact physiological and psychological development. There is limited research on the potential relationship between childhood adversity and engagement in protective health behaviors among U.S. populations with diabetes or diabetes with comorbid heart disease. The ACEs pyramid was the theoretical framework of this quantitative cross-sectional study concerning morbidity and early …

Nursing Staff Education On The Use Of The American Diabetes Association Guidelines, Terrie Hattie Allen

Walden Dissertations and Doctoral Studies

AbstractDiabetes mellitus is a complex chronic condition that requires continuous care and management. Approximately 34 million Americans are diagnosed with diabetes and around 90%–95% suffer from Type 2 diabetes. The problem identified in this project was the need to follow the American Diabetes Association guidelines in place at the study site clinic but are not adhered to by the staff. Framed within the analysis, design, development, implementation, and evaluation model of instructional design, the purpose of this project was to plan, implement, and evaluate a nursing staff education program on the use of the American Diabetes Association Guidelines for diabetes. …

Relationship Between Treatment Comorbidities And Viral Suppression Of Hiv Infections In Johannesburg, Nwogo Ekeji, Nwogo Immaculata Ekeji

School of Health Sciences Publications

HIV has globally infected 37.9 million people, of which 23.3 million (62%) are on antiretroviral treatment (ART). In South Africa, low rate of viral suppression among people living with HIV (PLWHIV) is a major health problem that has continued to fuel HIV persistence. A cross-sectional quantitative research design was used to investigate the relationship between treatment of comorbidities and viral suppression among HIV-infected adults aged 18 – 49 who were diabetic, had cancer, or tuberculosis (TB) in Johannesburg. The HIV care continuum formed the framework for this research. A secondary dataset from the national level survey 2017 was used for …

Relationship Between Treatment Comorbidities And Viral Suppression Of Hiv Infections In Johannesburg, Nwogo Ekeji, Nwogo Immaculata Ekeji

Walden Faculty and Staff Publications

HIV has globally infected 37.9 million people, of which 23.3 million (62%) are on antiretroviral treatment (ART). In South Africa, low rate of viral suppression among people living with HIV (PLWHIV) is a major health problem that has continued to fuel HIV persistence. A cross-sectional quantitative research design was used to investigate the relationship between treatment of comorbidities and viral suppression among HIV-infected adults aged 18 – 49 who were diabetic, had cancer, or tuberculosis (TB) in Johannesburg. The HIV care continuum formed the framework for this research. A secondary dataset from the national level survey 2017 was used for …

The Importance Of Staff Education About Implementing Ketogenic Diet In Prediabetic Patients, Clarissa L. Dorsey

Walden Dissertations and Doctoral Studies

Diabetes, a chronic disease that can lead to many complications, is one of the leading causes of death. Obesity tends to increase the risk of diabetes. Nutritional therapy can not only control diabetes but also prevent it in some cases by decreasing weight. The ketogenic diet is a low-carbohydrate, high-fat diet that can prevent and control diabetes. The purpose of this study was to examine the recommendations of medical providers before and after the presentation of educational content on the ketogenic diet as nutritional therapy in prediabetic and diabetic patients. The practice-focused question addressed whether educating medical staff at a …

Analysis Of Hba1c, Medication Compliance, Income Subsidies, And Comorbidity In Medicare Type 2 Diabetics, Robert E. Lazarchik

Walden Dissertations and Doctoral Studies

Diabetes is one of America’s leading chronic diseases with comorbidities contributing to lower health statuses and increased health care costs. While it is known that lowering HbA1c reduces the deleterious effects of diabetes, the capability to identify people with diabetes at risk for uncontrolled HbA1c levels or developing comorbidities based on the compliance rates for different oral antihyperglycemic medication classes (OAMCs) and financial assistance programs does not yet exist. These quantitative longitudinal retrospective studies examined the association between medication compliance, using Proportion of Days Covered (PDC), by OAMC and Medicare financial aid programs, on predicting HbA1c levels and comorbidities in …

Language Acculturation Effect On Diabetes Prevalence And Self-Care Skills In Puerto Ricans, Gerardo Lazaro

Walden Dissertations and Doctoral Studies

Diabetes, a silent, chronic disease that involves demanding long-term self-care skills, affects adult Puerto Ricans disproportionately. Based on the health belief model, a theory that predicts health behavior, and the theory of language barriers, which predicts the effects of language on beliefs and behavior, this quantitative nonexperimental study analyzed the relationship of the preference of Puerto Ricans in Boston to use and speak Spanish (language acculturation) to diabetes prevalence and 4 diabetes self-care skills (healthy eating, being active, taking medication, and healthy coping). Data on 1,506 initial participants in the Boston Puerto Rican Health Study were used from 3 study …

Examining Clinicians' Perspectives Screening For Depression In Patients With Type 2 Diabetes Mellitus, Vickie Lavette Bland

Walden Dissertations and Doctoral Studies

The United States has a significant diabetes problem. This chronic disease affects the body physically and mentally. One of the emotional effects of diabetes is depression. Depression is often present in individuals with diabetes, chiefly in those with type 2 diabetes mellitus (T2DM). While depression is common in T2DM and can interfere with treatment adherence, clinician screening for depression in T2DM patients is low. The purpose of this study was to examine clinicians' attitudes, behaviors, and perceptions concerning screening patients with T2DM for depression. Through a qualitative case study approach centered on reasoned action theory, 3 physicians and 5 nurse …

Social Determinants Of Health And Type 2 Diabetes Among Enrollees Of California Children’S Services Program In Fresno County, California, Daniela Marie Aghadjanian

Walden Dissertations and Doctoral Studies

Despite extensive study in adults, Type 2 diabetes (T2D) has been the subject of little research concerning young adults or children. Doctors believed T2D to develop only in a person’s later years until health care providers found younger individuals developing this disease. The purpose of this cross-sectional quantitative analysis was to determine correlations between T2D and social determinants of health in Fresno County, California, based on children and adolescents. The 2017-19 data came from the Fresno County Department of Public Health. The theoretical foundation for the study was the socio-ecological framework focusing on individuals’ traits having a bidirectional impact on …

Inhaled Insulin, Afrezza, Educational Module For Health Care Providers, Sara Lynn Doolin-Thompson

Walden Dissertations and Doctoral Studies

Abstract Inhaled Insulin, Afrezza, Educational Module for Health Care Providers

bySara Doolin-Thompson

MSN, Walden University, 2014 BSN, University of Phoenix, 2004 ASN, Kentucky Wesleyan College, 1994

Project Submitted in Partial Fulfillmentof the Requirements for the Degree of Doctor of Nursing Practice

Walden University August 2021 Abstract Diabetes is on a global rise and there is a definite gap in providing care for the diabetic population. Two of the largest contributors to this gap in care are the lack of collaboration between health care professionals and the lack of education for health care providers on the evolution of diabetes treatment plans. …

Relationship Among Health Literacy Superstitious Beliefs And Self-Care Among Diabetic Patients In Warri, Nigeria, Nkemakolam Simpson Ukpabi

Walden Dissertations and Doctoral Studies

AbstractDiabetes imposes significant burdens in medical expenditures, medication use, outpatient visits, and treatment of its chronic complications. Self-care behaviors such as medication adherence and foot care have been shown to reduce hospitalizations and complications, and high health literacy levels have been positively associated with self-care adoption. However, the effect of superstition on this relationship has not been studied among diabetic patients in Warri, Nigeria. This study was conducted to determine the moderating effects of superstitious or cultural beliefs on the relationship between health literacy and self-care adoption among diabetes patients in Warri, Nigeria. A quantitative, observational, cross-sectional design guided this …

Access To Preventive Health Care Services And Effects On Health Outcomes For Hispanic Older Adults With Type 2 Diabetes, Shafa Al-Showk

Walden Dissertations and Doctoral Studies

Despite elevated prevalence of diabetes among Hispanic, Hispanic older adults face challenges in self-control and management of their glucose levels, and they have less access to preventive health care services. The purpose of this retrospective quantitative cross-sectional study was to examine the associations between access to preventive health care services and Type 2 diabetes outcomes among Hispanic adults aged 65 years and older. The social-ecological model provided the framework for the study. The research question for this study examined the extent to which doctor visits, diabetes education and blood sugar checks correlate with HbA1c levels. Data were collected from 566 …

Pharmacological Management Of The Diabetic Patient: A Staff Education Project, Wilantha Silva

Walden Dissertations and Doctoral Studies

Poorly controlled diabetes can lead to health complications that impact quality of life, increase healthcare costs, and create a negative impact on communities. Pharmacological management of diabetes was identified by stakeholders as a gap in practice at a clinic in the southeastern United States. The purpose of this project was to develop staff education based on American Diabetes Association (ADA) and American Association of Clinical Endocrinologists (AACE) standards of care, deliver education to primary care nurse practitioners (NPs), and evaluate their learning and confidence levels. The primary framework for this project was the chronic care model. An expert panel, including …

Type 2 Diabetes And Pesticide Exposure Among U.S. Hispanic Migrant Farmworkers, Judith Faustin-Gabriel

Walden Dissertations and Doctoral Studies

AbstractHispanic migrant farmworkers provide indispensable services to the United States, yet they are low-paid, uninsured employees working in extremely hazardous conditions. Public health and other healthcare professionals have worked to address the impact of pesticide exposure in the Hispanic migrant population. Although pesticides have been associated with various chronic diseases, limited evidence and studies have established an association between pesticide exposure and Diabetes Type 2 (DT2) among Hispanic migrant farmworkers. Guided by fundamental causes theory, this study addressed whether there is a relationship between agricultural pesticide exposure and DT2 among Hispanic migrant farmworkers in the United States who participated in …

Association Between Modifiable Risk Factors And Stroke Among Hispanics, Shanice Williams

Walden Dissertations and Doctoral Studies

Stroke is a significant public health issue that impacts the health of Hispanic adults. Understanding the multiple risk factors of stroke is an essential strategy to control the disease among this population. The purpose of this study was to examine the association between modifiable risk factors and stroke among Hispanics. The public health prevention framework guided this study. The research questions were designed to determine whether an association exists between modifiable risk factors for stroke among Hispanics. A quantitative, cross-sectional research design was used to conduct secondary analysis of the pooled 2017–2019 Behavioral Risk Factor Surveillance System annual surveys. The …