Medicine and Health Sciences Commons^™

The Complete Care Model: Improving Diabetic Patient Outcomes In Correctional Facilities, Chad Williams

Walden Dissertations and Doctoral Studies

Diabetes is a growing problem, becoming an increasing concern within prisons. Research suggests that as many as 4.9% of the inmate population is diagnosed with diabetes. To provide constitutionally required healthcare to the inmate population, corrections officials must identify a validated diabetes treatment modality geared toward improving diabetes outcomes. The purpose of this quantitative study was to evaluate the impact of a patient centered medical home (PCMH) based model of healthcare within the California Correctional Health Care Services (CCHCS) on diabetic prisoners. Using the social construct theory as the framework, the research questions were focused on determining whether there was …

Perception Of Breast Cancer Screening Among African Immigrant Women In Dallas., Phillipa Akuwa Anuwe

Walden Dissertations and Doctoral Studies

Breast cancer is the leading cause of cancer-related deaths in women, and mammography is proven to detect breast cancer at its earliest stage; however, studies show that Black women have the lowest rate of breast cancer screening. The purpose of this descriptive, qualitative study was to explore the perceptions of African-born immigrant women about breast cancer screening. Data were collected by conducting individual interviews with 10 purposefully selected, African, immigrant women in Dallas, between 35 to 65 years old. Data were analyzed using NVivo software and coded based on the conceptual framework, which was the health belief model. Participants’ perception …

Mandibular Attachment Device Effects On African American Veterans With Heart Failure, Tracey T. F. Carter

Walden Dissertations and Doctoral Studies

Heart failure is a growing epidemic that affects people nationwide and is disproportionate to African Americans. The purpose of this quantitative repeated measures study was to determine whether mandibular attachment device (MAD) therapy impacts symptoms of heart failure in African American male veterans diagnosed with obstructive sleep apnea (OSA). The oxidative stress theory was applied in this study to assess whether MAD therapy received from Veterans Affairs (VA) dental clinics impacted heart failure symptoms, after controlling for patient body mass index (BMI) levels and smoking status. Research questions examined whether MAD had a significant effect on symptoms of heart failure …

Predictors Of The Health Effects Of Marijuana Use On The Hepatic Function, Makafui Kokou Gbogbo

Walden Dissertations and Doctoral Studies

The quantity of marijuana use, the length of time it was used, and the age of initiation of the drug are at the core of the discussions about the potential health effects of marijuana use on the liver. Results of recent studies regarding how the drug affects human health have resulted in a number of conflicting conclusions. Nevertheless, based on these findings, marijuana users are being denied liver transplants. The objective of this study was to identify predictors of the health effects of marijuana on the liver and provide guidance in the care management of marijuana users. To address the …

Revisions Of A Clinical Practice Guideline For Diabetes Management Protocol, Daniel O. Huston

Walden Dissertations and Doctoral Studies

Management of type 2 diabetes mellitus (T2DM) is essential from cost and treatment perspectives. In 2017, costs associated with diabetes management in the United States amounted to approximately $327 billion. The treatment of T2DM has been in a dynamic state for the past several years with the arrival of new classes of medications and new data supporting the use of diabetes medications to reduce risks from cardiovascular disease and slow the decline of renal function. This project explored the current evidence on treatment of T2DM to support changing either the flow of the current protocol algorithm or the medications identified …

Obesity, Physical Activity, And The Place Of Residence Among Latinos, Chanda Mcneal

Walden Dissertations and Doctoral Studies

Obesity is one of the most costly chronic, but preventable, diseases that has increased in prevalence in the United States. Obesity is known to be related to a lack of physical activity and the conditions in which people are born and live. Although adult Latino men and women have the second highest obesity rate in the United States, researchers have not explored place of residence as a factor in understanding Latinos’ health status. Therefore, the purpose of this correlational quantitative study was to determine if there is a relationship between obesity and Latinos’ place of residence and physical activity, and …

Qualitative Inquiry Of Resilience In Veterans Transitioning To Civilian Life, Brenda D. Nicholson

Walden Dissertations and Doctoral Studies

This qualitative phenomenological research focused on the resilience of 10 veterans transitioning back to civilian life. An increase in suicide rates among veterans over the last 10 years has become a major concern for the U.S. Congress and Department of Defense (DoD). The theoretical frameworks guiding the study are Durkheim’s suicide theory, Lindenberg and Frey’s social production function theory, and Diener’s deindividuation theory. Many veterans have no self-awareness of their need for psychological and transitional assistance, leaving them vulnerable during a time of potentially increased and unfamiliar stress. Understanding the need for effective psychological adjustment and resilience in military members …

The Relationship Between Practice Environment, Role Overload And Job Satisfaction Of Nurses In Canada, Olabisi Amao Olaniyan

Walden Dissertations and Doctoral Studies

Abstract

The shortage of nurses is a global phenomenon. The problem is particularly pronounced in rural areas and contributes to the health disparities experienced in the healthcare sector. Many factors had been shown to adversely impact the recruitment and retention of nurses, most especially in the rural areas. No study has examined how some factors such as the practice environment variation; geographical locations; and role overload impact job satisfaction of nurses. The Herzberg two-factor theory, with constructs of Motivation and Hygiene factors guided the study. In this quantitative, cross-sectional study, correlational approach was used to examine the association between the …

Mindfulness In Healthcare: Exploring The Gap Between Leadership Practice And Employee Burnout, Bryn Saunders

Walden Dissertations and Doctoral Studies

A healthcare employee’s ability to provide proficient, or quality, care to patients is impeded by burnout. Previous studies showed high levels of burnout is a common problem in healthcare, indicating there is a lack of support for employee health. The purpose of this quantitative study was to determine whether mindfulness training reduced burnout in healthcare professionals. The study focused on increasing knowledge between the leadership practices and programs used to improve healthcare proficiency by analyzing the relationship between mindfulness and three measures of burnout: sense of efficacy, depersonalization, and emotional exhaustion. The Western concept of mindfulness that emphasizes self-awareness and …

Association Between Childhood Secondhand Smoke Exposure And Inflammatory Bowel Disease Development, Stephanie Eve Walsh

Walden Dissertations and Doctoral Studies

Inflammatory bowel disease (IBD) is a group of diseases that affect the gastrointestinal tract. Environmental factors, such as smoking, have been shown to play a role in the development of IBD; however, minimal research regarding secondhand smoke (SHS) exposure and the development of IBD has been conducted. The purpose of this study was to examine whether there was a relationship between childhood SHS exposure and the development of IBD. Bronfenbrenner’s ecological systems theory was used in this study as a basis that the environment can aid in the development of disease. The research questions addressed the potential association between childhood …

Staff Education On Type 2 Diabetes Mellitus, Joan P. Williams

Walden Dissertations and Doctoral Studies

Diabetes mellitus is a major health concern that affects the physical and financial facets of communities. During the past 4 years, a multidisciplinary health care clinic in a northern state reported an increase in the number of type 2 diabetes (T2D) patients. Forty-three percent (43%) of adults with T2D had an elevated glycated hemoglobin A1c of 7.5% or higher. Yet, the staff at the clinic lacked current knowledge of T2D, quality of care, and prevention strategies for patients with T2D. This resulted in increased serious health care issues, associated costs, and increased complications of the patients with T2D. The purpose …

Motivators And Barriers Affecting Physical Activity Participation In Online Graduate Students, Gloria Christine Bales

Walden Dissertations and Doctoral Studies

Physical inactivity is a major contributor to chronic diseases, especially coronary heart disease. The American College Health Association’s National College Health Assessment II showed that only 47.4% of college students are meeting suggested physical activity requirements. As the nontraditional student population increases, research is needed to identify motivators and barriers specifically for online graduate students. The purpose of this case study was to examine the relationships of barriers and motivators for physical activity in online graduate students at Walden University. The study addressed research questions on what physical activity barriers existed in this study sample, (b) what intrinsic motivators and …

Practitioners’ Perceptions Of Medical Compliance Among Homeless Clients With Hiv And A Mental Health Diagnosis, Kyle Samuel Berkley

Walden Dissertations and Doctoral Studies

Previous research on HIV medical adherence has focused on incentive-based interventions, while previous research with the chronically homeless has focused on substance abuse, mental illness, and health disparities. This qualitative study focused on the experiences and perceptions of medical providers in a metropolitan area who work on medical adherence with homeless people living with HIV and mental illness. Ecological systems theory provided foundation to explore how medical providers form interventions based on clients’ ecosystems. The data were collected via audio-recorded, semi-structured interviews with 15 case managers, mental health therapists, nurses, and primary care physicians who worked at outpatient medical centers. …

An Interpretive Phenomenological Study Of Adult Students’ Subjective Theories Of Critical Thinking In Anatomy And Physiology, Elizabeth Anne Dubofsky-Porter

Walden Dissertations and Doctoral Studies

Critical thinking is a vital skill for the success of recent graduates, both to increase academic success and improve employability after graduation, especially in health science fields. However, many adult students fail to engage in critical thinking, especially in core courses such as anatomy and physiology (A&P). The purpose of this interpretive phenomenological qualitative study was to better understand adult students’ subjective theories regarding critical thinking and how adult students perceive the use of and any barriers or challenges to critical thinking in A&P while enrolled at Technical University. The theoretical framework that grounded this study was the Paul-Elder theory …

Health Literacy And Health Beliefs With Adherence To Antihypertensive Medications In An Urban African American Cohort, Karen Ranae Dukes

Walden Dissertations and Doctoral Studies

African Americans aged 40 to 65 are more likely to be diagnosed with hypertension, and adherence to prescribed antihypertensive medication regimens is important in controlling their blood pressure levels. The purpose of this quantitative study was to examine the relationship between health literacy and sociodemographic and clinical factors with adherence to antihypertensive medications among African American adults. The theoretical framework for this study was the health belief model. A quantitative research design was used with participants recruited from churches with African American congregations in the city of Detroit. A convenience sampling method was used to obtain a sample of 79 …

Perceptions Of Nurses’ Abilities To Provide Safe Care In Unhealthy Work Environments, Jacqueline Flannery

Walden Dissertations and Doctoral Studies

As many as 90% of nurses report working in an environment where their peers engage in passively and overtly violent activities against other nurses. Working in such an environment is unhealthy and has consequences for the career trajectory of nursing. There is a lack of literature available that specifically addresses nurses’ perceptions of their abilities to provide safe patient care in unhealthy work environments. The purpose of this phenomenological study was to explore the lived experiences of nurses who have experienced lateral violence and their perceptions of their ability to provide safe care. Husserl’s philosophy of phenomenology was used as …

The Differences In Nurse Preceptor Role-Frequency And Overall Job Satisfaction, Wendy Fordham

Walden Dissertations and Doctoral Studies

For newly licensed registered nurses (NLRNs), a nurse preceptor is an essential resource in a successful transition-to-practice from a nursing education program. Serving in the preceptor role is often performed in addition to a nurse’s primary patient care responsibilities. There is a gap in knowledge about the frequency with which a nurse performs this role and how that frequency affects overall job satisfaction. Using Herzberg’s motivator-hygiene theory as a framework, the purpose of this descriptive, cross‐sectional, comparative study was to examine how frequently nurses serve as preceptors to NLRNs in the hospital inpatient setting and whether the frequency affects their …

Evidence-Based End-Of-Life Care Education For Intensive Care Nurses, Kimberly Ann Hare

Walden Dissertations and Doctoral Studies

Most nurses have limited education on end-of-life care (EoLC), which can affect their ability to provide care to meet the needs of the dying patient. Nurses in a critical care unit in a hospital in the Southeastern United States lacked education on EoLC for their patients. The purpose of this study was to develop a project guided by Kolcaba’s theory on caring. The staff education project addressed the attitudes and knowledge of 36 nurses before and after an educational presentation on EoLC. Data were analyzed descriptively. Results indicated that 56% of the staff nurses had never received prior education on …

Relationship Between Skepticism And Nursing Experiences When Treating Chronic Noncancer Pain Patients, Emily Jabour

Walden Dissertations and Doctoral Studies

Chronic pain is common, costly, challenging to manage, and affects patients’ quality of life. High confidence is placed in the nurses caring these patients. Nurses displaying skepticism or doubt about patients’ motives for seeking pain treatment contribute to the challenges of effective pain management. The purpose of this quantitative study was to determine if there was a relationship among the nurses’ professional skepticism, level of compassion, and years of experience during the treatment of chronic noncancer pain patients in the acute care setting. The communications model of pain guided the understanding of factors influencing nursing treatment of this patient population. …

Predictors Of Larc Use In High School Adolescent Females In The Unitedstates, Gloria J. Mabry

Walden Dissertations and Doctoral Studies

Teen pregnancy is a major public health problem in the United States of America. Among many contraceptive methods, long acting reversible contraception (LARC) is popular and effective. However, there was no adequate research study performed to show if minority teenagers are less likely to use LARC. The purpose of this study was to explore the relationship between adolescent sexual behavior and activity and the use of LARC in females, ages 14 to 19, in high schools across the United States. The theoretical framework used for this study was the health belief model. The study population was 1,496 White, Black/African American, …

The Promotion Of Safety And Quality In Fall Prevention, Sheila J. Mercado

Walden Dissertations and Doctoral Studies

Falls in a hospital setting are considered one of the most frequent, preventable adverse events that need to be addressed through the creation of safer environments. Nurses play a key element in the prevention and management of injuries related to falls. The focus question for this quality improvement initiative (QII) was whether an evidence-based QII program could reduce falls in the inpatient population. The objective of the project was to improve the practices related to fall prevention to reduce the number of inpatients falls. The change model of Kotter and the Preventing Falls in Hospitals: A Toolkit for Improving Quality …

Recognition, Classification, And Help-Seeking Behavior Of Nigerian Immigrants In Minnesota, Frederick Nnabuchionye

Walden Dissertations and Doctoral Studies

Immigrants from non-Western cultures are known to underutilize mental health services in the United States. Part of the problem is in the way how cultures recognize and classify symptoms as a mental disorder. A report from the Minnesota Ombudsman's Office for Mental Health showed that out of every 6 suicide-related deaths in Anoka Regional Treatment Center in Minnesota, 4 are of African descent. The purpose of this quantitative study was to investigate the cultural view of depressive symptoms as possible predictors of attitude toward seeking professional psychiatric help. The theory of reasoned action/ theory of planned behavior provided the framework …

Clostridium Difficile Incidence In Acute Care Hospitals: Patient And Hospital Characteristics, Angela Nwachuku

Walden Dissertations and Doctoral Studies

Hospital acquired infections (HAIs) calls for the attention of public research because it allows for investigation of the health practices, resources, and barriers of different health facilities and their surrounding communities. This research study examined the relationship between hospital acquired clostridium difficile infection (CDI) and patient, socioeconomic, and hospital characteristics in the state of New Mexico to determine their correlation with the increased incidence of CDI between 2013 and 2015 and if significant differences exist. The research questions were explored with the implication of the fundamental cause model and the pathways model. New Mexico patients over the age of 18 …

Men’S Knowledge And Perceptions Of Cervical Cancer: Influence Upon Increase In Cervical Cancer Screening In Rural Kenya, Lydia Oriko

Walden Dissertations and Doctoral Studies

Many facilities in Kendubay, Kenya offer cervical cancer screening and treatment services, yet many women in this rural community do not undergo screening. This lack of preventive care may be attributable to lack of support from men in the community. There exists a gap in the literature concerning the knowledge and perceptions of men about cervical cancer and related screening procedures. The purpose of this qualitative study was to describe the knowledge and perceptions of men in the community about cervical cancer and screening, and how men’s knowledge and perceptions influence women to undergo cervical cancer screening. The study used …

Process, Factors, Resources, And Health Consequences Of Burnout In Psychiatrists, Brittany Elise Plaven

Walden Dissertations and Doctoral Studies

Burnout among psychiatrists in the United States is prevalent; however, scholarly literature lacks studies exploring why psychiatrists are burnt out, what resources mitigate burnout, and the health implications of burnout, which is needed to improve health education programs for psychiatrists. Understanding the reasons for psychiatrist burnout, the resources that can mitigate burnout, and the health implications of burnout provided the purpose for this dissertation and foundation for the four research questions. The multidimensional theory of burnout, job demands-resource model, and the conservation of resources theory grounded the study. A qualitative, exploratory, multiple case study was conducted using data gathered from …

Sociodemographic Factors, Culture, And Suicide In Guyana, Kay Shako

Walden Dissertations and Doctoral Studies

Suicide in younger populations is a major public health concern and it significantly impacts third world countries like Guyana. Some challenges related to suicide are poor recording of suicide risk factors and customized prevention programs to address this significant issue. The purpose of this study was to examine which sociodemographic factors (age, gender, occupation, method of suicide, and region) are associated with suicide and method of suicide among people aged ≥ 15 years in Guyana. Also, because studies show that culture plays a pivotal role in suicide, this study investigated if there is a link between culture (ethnicity/race and religion) …

Clinical Nurse Experts' Experience Of Transitioning To The Novice Nurse Educator Role, Crystal Toll

Walden Dissertations and Doctoral Studies

Clinical nurse experts are often recruited into educator roles based solely on clinical expertise. Without support and mentorship, clinical nurse experts struggled with transitioning into the educator role. The purpose of this study was to understand the experience of new nurse educators’ transition from a clinical nurse expert to novice nurse educator and to examine the perceptions of supports and barriers. Transitional theory provided the conceptual framework and informed the development of the interview protocol. The research questions focused on the experience of transitioning from expert to novice and on identifying supports and barriers that influenced transition. Using a case …

Hiv-Positive Kenyan Women With A Disability: Social Support's Role In Treatment Seeking, Evelyn Williams

Walden Dissertations and Doctoral Studies

Understanding social support from the context of disabled women living in conditions of extreme poverty may be useful in the development of effective interventions to advocate for and improve their likelihood of engagement in HIV-related treatment services. Thus, the purpose of this cross-sectional survey study was to examine the relationship between social support and treatment seeking among a sample of HIV-positive Kenyan women with physical disabilities. Correlations were examined between an individual’s source of social support (family, friend, significant other), type of social support (appraisal, tangible, self-esteem, belonging), and HIV-related treatment seeking. Age, marital status, income availability, and disability type, …

Peers Erecting Barriers To Another Peer’S Success In The Healthcare Setting, Ricky D. Allen

Walden Dissertations and Doctoral Studies

In the healthcare workplace, bullying is shown to negatively impact patient care and safety, workflows, outcomes, interpersonal relationships, performance, mental and physical health, and cause a plethora of other secondary effects. The purpose of this qualitative phenomenological study was to explore the lived experiences of high performers or subject matter experts working in the healthcare field and had encountered peer-to-peer interference. The research questions focused on understanding the behaviors and outcomes of peer interference. Maslow’s hierarchy of needs was used as the conceptual framework. Data collection was achieved by interviewing 10 participants from a variety of healthcare backgrounds. Participants self-identified …

Knowledge And Use Of Health Services Related To Mother-To-Child Transmission Of Hiv In Nigeria, Uduak Bassey

Walden Dissertations and Doctoral Studies

HIV has remained a global public health issue despite efforts to curb the trend; especially in sub-Saharan African countries where more than 50% of those infected are women, creating implications for infant transmission. The purpose of this study was to assess trends in knowledge of prevention of mother-to child transmission (PMTCT) of HIV and use of PMTCT-related maternal health services (measured by antenatal care [ANC] in health facilities, use of HIV counseling and testing [HCT] during ANC, and use of skilled birth attendant at delivery [SBA]); as well as the association between knowledge and use of health services among reproductive …