Medicine and Health Sciences Commons^™

Development Of Practice Guidelines Based On Need-Driven Dementia-Compromised Behavior Model, Amy Marie Nolan

Walden Dissertations and Doctoral Studies

People with dementia, who experience cognitive decline, memory loss, and reasoning difficulties, often exhibit compromised behaviors such as agitation or aggressive behavior that impact negatively upon the person’s quality of life and increase safety risks. The purpose of this project was to develop an evidence-based clinical practice guideline (CPG) to improve the use of effective evidence-based interventions by staff in a skilled long-term care nursing facility to manage the compromised behavior of residents with dementia. The Need-Driven Behavioral Model, which suggests that compromised behaviors occur when patient attempts to accomplish a goal or express a need, provided the framework CPG …

Reducing Readmissions For Patients Hospitalized With Congestive Heart Failure, Morgan B. Morgan

Walden Dissertations and Doctoral Studies

Congestive heart failure (CHF) is the leading cause for readmission in hospitals and has a

high mortality and morbidity rate, with implications for hospitals and third-party payers.

Readmissions of patients with CHF are related to inadequate patient knowledge at

discharge, inadequate follow-up with a health care provider, and treatment regimen

nonadherence. Patients report feeling ill prepared to provide appropriate self-care during

the transition from inpatient hospital stay to the home setting. One strategy to assess the

patient's understanding following discharge education is through a process known as

teach-back. The purpose of this quality improvement initiative guided by Knowles's

theory was …

Nursing Faculties’ Perceptions Of Teaching Students Who Speak English As Second Language, Natalia S. Ruiz Muniz

Walden Dissertations and Doctoral Studies

Nursing students who speak English as a second language (ESL) often struggle due to language barriers, the complexity of the medical vocabulary, and the knowledge base that they must develop in a short time. These struggles may be due in part to the preparation of nursing educators to meet the specific needs of the ESL student population. The purpose of this qualitative research study was to develop a greater understanding of nurse educators' perceptions when teaching ESL nursing students. The conceptual framework used was Cummins' framework for the development of language proficiency. Four research questions guided this basic qualitative research …

Relationship Between Burnout And Academic Teaching Level Among Nursing Faculty, Erica Lynn Sciarra

Walden Dissertations and Doctoral Studies

Nursing faculty function as healthcare providers, educators, mentors, advisors, and researchers, which contributes to the development of emotional exhaustion or burnout due to role overload. Symptoms of burnout may vary among nursing faculty depending on academic teaching level, tenure status, and educational preparation and may influence the physical and psychological health of nursing faculty, potentially affecting work productivity, career longevity, and the number of future nurses educated. The purposes of this study, guided by Maslach’s multidimensional burnout theory and the job demands resources model, were to determine (a) if there was a difference in level of burnout between graduate and …

Associate Degree Nursing Graduates’ Experiences Of The Transition From Student To Nurse, Katherine Margaret Slusser

Walden Dissertations and Doctoral Studies

Attrition among newly graduated nurses remains a top concern among nursing leaders in the United States. Many published studies about new graduate nurses focus on bachelors-prepared nurses or on mixed populations of nurses that include both associate and baccalaureate degree graduates. No published studies were located that focused specifically on the Associate Degree Nursing (ADN) graduate. The purpose of this qualitative, interpretive phenomenological study was to understand the experiences of transition after graduation and into professional nursing of newly employed nurses who graduated from an ADN program. The theoretical basis for this study was Meleis’s transition theory. The research question …

Burden And Coping Strategies Of Caregivers Of Persons With Alzheimer's Disease, Annette Laverne Tucker Osborne

Walden Dissertations and Doctoral Studies

Alzheimer’s disease (AD) currently presents a huge burden to individuals and families, a burden that is increasing in incidence with the aging of the baby boomer generation. Caring for a spouse diagnosed with AD holds potentially severe negative consequences for the caregiver’s physical and psychological well-being. The current study used secondary data from the 2017 New York State Department of Health/Behavior Risk Factor Surveillance System to identify a relationship, if any, between the time and activities a caregiver spends with the AD person and the caregiver’s self-reported level of general and mental health. A logistic regression was used for RQ1 …

Provider Perspectives Of Equine Assisted Psychotherapy For Social Skills, Rachel Young

Walden Dissertations and Doctoral Studies

Animal assisted therapy has been used for years and has been researched primarily for autism but researchers have not focused specifically on the experiences of children with Attention Deficit Hyperactivity Disorder (ADHD) and their social skills after involvement in animal assisted therapy. Children with ADHD frequently struggle expressing their emotions and communicating effectively, primarily in social settings, which can have an extensive impact on their functioning that can extend into adulthood. The theoretical attachment framework from Ainsworth and Bowlby, when applied through the retrospective multiple case study model allowed for a greater understanding of the experiences of children involved in …

Newly Licensed Registered Nurse Generation Cohorts And Retention In First Registered Nurse Positions, Elizabeth S. Gizenski

Walden Dissertations and Doctoral Studies

The purpose of this quantitative study was to evaluate the association between newly licensed registered nurses (NLRN) generational cohorts and NLRN who plan to leave or have left their first nursing position. The research problem focused on the generational cohorts of NLRN and retention. The research questions addressed different generations of NLRN, their intent to stay in their first job, and whether poor orientation was a factor for those who already left their first nursing position. The theoretical foundation was Strauss–Howe’s generational theory explaining how each generation views the world based on what they experienced in their lifetime. Data retrieved …

Relationship Of Complementary Modes Of Agency In The Self-Management Of Diabetes, Andrew Romo

Walden Dissertations and Doctoral Studies

Effective control of type-2 diabetes mellitus (DM2) is essential for minimizing the likelihood of developing comorbidities that result from poor glycemic control. Extensive self-management considerations are required of people with DM because they must actively participate in their own care and engage with other socially-based sources of self-management support. The purposes of this quantitative study were to determine if there is an association between (a) the extent that the individual mode of human agency is employed and quality of diabetes control among adults who have been diagnosed with DM2 for at least one year and (b) the extent that the …

Inpatient Stays Involving Mental Illness And Substance Use Disorders, Latonya Smith

Walden Dissertations and Doctoral Studies

Nearly one-third of Americans suffer from a mental illness. Twenty-three million people are affected by substance use or a dependency issue and the length of stay for patients enrolled in treatment services is rising. Mental health issues and substance use are rising within the United States and are associated with increased healthcare costs and the need for healthcare services. The purpose of this quantitative study was to determine the association between inpatient services, residential, outpatient, age, and payer source on substance use and mental health services using the 2017 Substance Abuse and National Mental Health Services Administration survey. The Donadebian …

Amyotrophic Lateral Sclerosis Patients' Sociological Resilience, Self-Determination, And Decision-Making For Life-Sustaining Treatments, Jeremy Jon Van Tress

Walden Dissertations and Doctoral Studies

People with amyotrophic lateral sclerosis (ALS) suffer from a rare, progressive, untreatable, and fatal neuromuscular disease. Their decision-making for life-sustaining treatments may not be fully self-deterministic. While researchers have examined resilience and self-determination in people with mental health problems and chronic illness, none have researched these variables in ALS patients from a socioecological framework. The purpose of this study was to explore the relationships between people with ALS socioecological resilience, self-determination, and decision-making for life-sustaining treatments. A cross-sectional concurrent mixed-methods design was used, with online surveys completed by 197 people with ALS who were solicited through the National ALS Registry. …

Area-Level Factors Linked To Obesity In African American And Caucasian Women In Michigan, Marjorie Arrey

Walden Dissertations and Doctoral Studies

Obesity is a major public health crisis, affecting every segment of the U.S. population. African American women have higher prevalence of obesity than all other subpopulations and are disproportionately burdened by the disease and its comorbidities. Despite this disparity, African American women are often underrepresented in obesity research. This research examined obesity-related risk factors specific to African American women compared to those for Caucasian women. The design was based on the socioecological model and social cognitive theory, both emphasizing the impact of social factors on health outcomes. The data set included only adult Michigan women from the NHANES study. Multiple …

Methamphetamine Screening And Brief Intervention In A Hospital Heart Failure Program, Tamra Chavez

Walden Dissertations and Doctoral Studies

AbstractThe efficacy of screening, brief, intervention, referral to treatment (SBIRT) in reducing or eliminating methamphetamine use has not been investigated and addressed among patients with heart failure. According to urine toxicology screens at admission at a county hospital, approximately 50% of patients in a heart failure program were positive for illicit substance use, and the majority of these tests (>60%) were for methamphetamine use, one of the most cardiotoxic drugs available. This quantitative study used an existing dataset to test the theory of intentional behavior by examining whether SBIRT intervention increases the patient’s ability to make a behavioral change …

Successful Retention Strategies By Perfusion Managers To Reduce Perfusionist Attrition, Krysta Lynne Gleeson

Walden Dissertations and Doctoral Studies

Perfusion managers who lack strategies to mitigate perfusionist attrition place a strain on their remaining employees and incur replacement costs for their organization. Grounded in Vroom’s expectancy model, the purpose of this multiple case study was to explore strategies perfusion managers use to mitigate perfusionists attrition within open-heart centers in a northeast U.S. city. Data were collected through digital semistructured interviews with 5 licensed perfusionists who demonstrated successful staff retention. Perfusionist job listings were used as a secondary data source. Data were analyzed using Yin’s 5 step process. Four significant themes emerged: job satisfaction, work-life balance, surveys, and compensation. Perfusion …

Predicting Behavior To Engage In Fall Prevention Practices: The Role Of Interests And Basic Psychological Needs, Jan Fay Kress

Walden Dissertations and Doctoral Studies

AbstractA fall is associated with adverse outcomes that include occupational, physical, cognitive, and psychological decline together with economic and caregiving burden. Despite the continued increase in prevalence of falls globally, most studies address the well-known risk factors of falls but exclude the behavioral risk factors associated with human actions, emotions, and everyday choices. Following the theory of self-determination and person object of interest framework, this quantitative, nonexperimental study was conducted using face-to-face and web surveys to examine the relationship between motivational, relational, and sociodemographic/medical conditions to predict engagement in fall prevention practices in a sample of 75 community dwellers, 65 …

Examining The Mortality Risk Of A Population With Mental Illness, Glorimar Ortiz

Walden Dissertations and Doctoral Studies

Individuals with mental illness experience increased mortality and premature death. In a sample composed of 88% decedents with mental illness who were Black, the findings from three research studies provided insight about excess and premature mortality, odds of dying by cause of death, and risk factors associated with premature mortality. The purpose of this quantitative study was to examine the mortality of a population group with mental illness that was served in a public mental health system (PMHS). The ecoepidemiological life course framework for health, disease, and mortality was used to link mechanisms that may influence health and longevity in …

Exploring The Lived Experiences Of The Prelicensure Hispanic Nursing Student, Mary Valerie Santos

Walden Dissertations and Doctoral Studies

AbstractNursing constitutes the largest group of healthcare professionals in the United States. Despite decades of discussion about the need to diversify the nursing profession, there continues to be a significant lack of diversity, particularly in the number of Hispanic nurses. The purpose of this qualitative study was to explore the lived experiences of Hispanic nursing students who have enrolled in a pre-licensure nursing program using Leininger’s culture care theory as the theoretical framework for this phenomenological study. This study sought to explore the lived experiences of the prelicensure Hispanic nursing student attempting to complete nursing school successfully and what factors …

Hiv Prevention: Pre-Exposure Prophylaxis, Sexual Decision Making, Risk Taking, And Condoms, Jonathan D. Spencer

Walden Dissertations and Doctoral Studies

HIV is an infectious disease that continues to have new cases each year within high-risk populations, such as men who have sex with men (MSM). To help in the fight against new HIV infections within the MSM population, new medications such as pre-exposure prophylaxis (PrEP) are being used. The purpose of this cross-sectional online survey study was to address whether PrEP use had any relationship with (a) sexual decision-making, (b) risk-taking, and (c) condom use in the MSM population 18-64 years of age, after controlling for socioeconomic status, race, and age while using the behavioral disinhibition and risk compensation models. …

Willingness To Pay For Improved Vision In Mozambique, Stephen Thompson, Kovin Naidoo, Carmen Gonzalez-Alvarez, Geoff Harris, James Loughman

Articles

The burden of vision impairment due to uncorrected refractive error (needing spectacles) in Mozambique is known to be significant. To improve the planning and provision of eye health services, a better understanding of how vision is valued by patients is needed. The willingness to pay (WTP) for improved vision through correcting refractive error was investigated in Nampula, Mozambique, using stated choice and bidding game methodologies. The mean WTP values were found to be 388.92 Meticals (US$13) for stated choice and 469.89 Meticals (US$16) for the bidding game. The mean WTP values for rural dwellers were found to be lower than …

Effect Of Graded Repetitive Arm Supplementary Programme (Grasp) On Upper Limb Function Among Stroke Patients, Priyanka Noble Ms, Sindhu L Ms

Manipal Journal of Nursing and Health Sciences

Introduction: Stroke is the rapid loss of brain function due to disturbance in the blood supply to the brain. More than 70 % of individuals who have a stroke experience upper limb deficits that impact daily activities. The objective of this study was to evaluate the effect of GRASP on upper limb function among patients with stroke. Methods: It was a quasi-intervention pretest-posttest control group design. The sample consisted of 61 patients with stroke, 31 in the intervention and 30 in the control group attending the outpatient Department of Neurology, Medical College Hospital, Thiruvananthapuram. The upper limb function of patients …

Effectiveness Of Glycerine Magnesium Sulphate Versus Topical Heparin Application In Patients With Peripheral Intravenous Cannula Induced Phlebitis, Neethu M Ms, Sajith B. Pillai

Manipal Journal of Nursing and Health Sciences

Introduction: Peripheral intravenous cannula induced phlebitis is a common and significant problem in clinical practice. Objectives To compare the effectiveness of glycerine magnesium sulphate and topical heparin application and to find the association between the pre-test Visual Infusion Phlebitis (VIP) scores and selected demographic variables. Method: Quasi experimental with two group pre-test post-test design was used. This study was conducted in Bishop Benziger Hospital, Kerala for one month. Using purposive sampling technique 60 patients were selected and assigned randomly into glycerine magnesium sulphate group and heparin group. In glycerine magnesium sulphate group, glycerine magnesium sulphate paste and in heparin group …

Readiness To Train: Return To Baseline Strength And Velocity Following Strength Or Power Training, Alexander Vernon, Christopher Joyce, Harry G. Banyard

Health Sciences Papers and Journal Articles

This study investigated the return to baseline of movement velocity and maximal strength following a strength-orientated session and power-orientated session in the free-weight back-squat performed with maximal concentric velocity. Fourteen strength-trained males completed a strength-orientated session (five sets of five repetitions @80% of a one-repetition maximum) and a power-orientated session (three sets of six repetitions @50% one-repetition maximum ) in a randomised order over two weeks (e.g. strength week 1, power week 2). The back-squat was then performed with loads of 20%, 40%, 60%, 80%, 90% and 100% one-repetition maximum at 24, 48, 72 and 96 h following the strength …

Comparative Survival Of Asian And White Metastatic Castration-Resistant Prostate Cancer Men Treated With Docetaxel, Susan Halabi, Sandipan Dutta, Catherine M. Tangen, Mark Rosenthal, Daniel P. Petrylak, Ian M. Thompson Jr., Kim N. Chi, Johann S. De Bono, John C. Araujo, Christopher Logothetis, Mario A. Eisenberger, David I. Quinn, Karim Fizazi, Michael J. Morris, Celestia S. Higano, Ian F. Tannock, Eric J. Small, William Kevin Kelly

Mathematics & Statistics Faculty Publications

There are few data regarding disparities in overall survival (OS) between Asian and white men with metastatic castration-resistant prostate cancer (mCRPC). We compared OS of Asian and white mCRPC men treated in phase III clinical trials with docetaxel and prednisone (DP) or a DP-containing regimen. Individual participant data from 8820 men with mCRPC randomly assigned on nine phase III trials to receive DP or a DP-containing regimen were combined. Men enrolled in these trials had a diagnosis of prostate adenocarcinoma. The median overall survival was 18.8 months (95% confidence interval [CI] = 17.4 to 22.1 months) and 21.2 months (95% …

The Relationship Of Cognitive Load And Different Participant Roles On Knowledge Retention In Simulation-Based Learning Among Undergraduate Nursing Students, Amanda Houston

Electronic Theses and Dissertations, 2020-2023

Background: High-fidelity simulation (HFS) is a cognitive load inducing educational tool that gives participants an opportunity to emulate clinical scenarios by assuming various roles. HFS offers opportunities for undergraduate nursing students to build fundamental knowledge that can replace, or enhance, clinical experiences. Cognitive load exists on a spectrum and negatively impacts learning when learners are at either extreme of the spectrum. Cognitive load is comprised of the three subcomponents of intrinsic, extraneous, and germane load. Not much is known about different subcomponents or their ability to prediction immediate knowledge and knowledge retention in students who play fundamentally different roles, as …

Undergraduate Nursing Students' Depth Of Reflection And Perceptions Of Self-Debriefing Following Virtual Simulation: A Multi-Method Descriptive Study, Valorie Mackenna

Electronic Theses and Dissertations, 2020-2023

Virtual simulation is a method of simulation-based education in which students participate in a clinical experience within a computer program and away from a clinical environment or classroom. This innovation makes simulation more accessible for learning, but also more challenging when it comes to providing a debriefing activity directly afterward by a facilitator. The purpose of debriefing is to afford learners the opportunity to reflect on the experience with a goal toward improvement. From the best practice standards, two recommendations stipulate that a debriefing session should occur soon after a simulation and should promote reflection. Self-debriefing is uniquely capable of …

Geographic Access To Community Mental Healthcare And Adherence To Treatment Among Patients With Schizophrenia Spectrum Disorders, Marie Smith-East

Electronic Theses and Dissertations, 2020-2023

Disparities in access to mental health care for individuals with schizophrenia spectrum disorders continue to exist in the United States despite the creation of mental health policies seeking to improve access to care. As an integral element of healthcare system delivery, access is influenced by spatial (location) and non-spatial (sociodemographic) factors. Highlighting both spatial and non-spatial dimensions of access to mental healthcare, this study employed an innovative approach encompassing the geography of access and the integration of location analyses to bridge the gap between psychosocial dynamics and mental health services for improving cost-effective continuity of care. The aims were as …

Patients With A Left Ventricular Device And Factors Affecting Readmission, Diana Pitcher

Electronic Theses and Dissertations, 2020-2023

Patients with a left ventricular assist device have a high rate of hospital readmissions after their index (placement of left ventricular device) discharge. With these devices becoming more common providers of care must understand why this population is being readmitted in order to promote well-being and keep patients out of the hospital. The purpose of this study was to identify and describe characteristics of the hospital readmission. This research study was a retrospective analysis of aggregate data from 2013-2019 with a sample size n = 32. The summary of data was described with descriptive statistics. The data was grouped and …

Differences In Treatment For Substance Use Disorders By Insurance Status: Self-Help Only Versus Outpatient Medical Treatment, Huyen Pham, Lauryn Walker Phd Rn, Andrew J. Barnes Phd, Peter Cunningham Phd

Graduate Research Posters

Background: The role of insurance on substance use disorders (SUD) treatment utilization generally is poorly understood and still less is known on how insurance status relates to the use of evidence-based treatment (i.e., medicalization approach) compared to other treatments, like single self-help groups, where the research on effectiveness is less supportive. This study examines associations between health insurance and any SUD treatment utilization as well as use of single self- help versus medicalization approach.

Methods: A cross-sectional study design was used. Data were from the 2015-2017, public use National Surveys on Drug Use and Health (NSDUH). Adjusted logistic regressions were …

Paroxetine Is Pro-Inflammatory In Human Brain Microvascular Endothelial Cells, Syeda Hashimi, Sulay Patel, Omar Hassan, Bukola Odeniyi

Graduate Research Posters

BACKGROUND: Paroxetine is an antidepressant that is widely used. However, Paroxetine possesses anticholinergic properties which may contribute to cognitive decline in older adults. Surprisingly, the mechanisms of the cognitive decline of anticholinergic drugs in older adults remains elusive. A hypothesis is that a loss of cholinergic signaling is pro-inflammatory in the brain. We designed experiments to determine if Paroxetine is pro-inflammatory in Normal Human Brain Microvascular Endothelial Cells (NHBMECs).

METHOD: NHBMECs were grown at 5% CO2, 37C and 95% relative humidity until 90% confluent. NHBMECs were treated with the RNA free water as control, Paroxetine as 1.67x 10 4 mM/mol, …

Perceptions Of Using Smart Speaker Technology For Improving The Health And Wellness Of Older Adults Living In A Low-Income Community, Brooke Saba Mcdowell, Jane Chung, Johnathan Bennett

Graduate Research Posters

There is a growing interest in the usage of smart speakers in various settings with older adults for improved quality of life and health. Residents who live within a low-income housing development may benefit from the use of smart speaker technology for creating a more engaging and healthier lifestyle. Because technology acceptance is critical; this study aims to examine smart speaker acceptance among low-income senior housing residents. A cross-sectional survey (n=46) was conducted to assess smart speaker acceptance, perceived usefulness, perceived ease, and privacy concerns. Individuals were recruited through varying methodologies, including group information sessions, sign-up sheets, word of mouth, …