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Walden Dissertations and Doctoral Studies

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Perceptions Of Caregivers Of Parkinson's Patients Regarding Using Advance Directives, Meghan Morgan Jan 2021

Perceptions Of Caregivers Of Parkinson's Patients Regarding Using Advance Directives, Meghan Morgan

Walden Dissertations and Doctoral Studies

The increasing focus on end-of-life (EOL) care is influencing the role of advance directive (AD) documents. Difficult conversations among family caregivers and their loved ones are becoming more and more critical. Considering the value of communicating EOL wishes, family caregivers’ perceptions about ADs for their loved ones with Parkinson’s disease (PD) must be examined. Using the theory of planned behavior (TPB) as a foundation, the purpose of this generic qualitative study was to understand family caregivers of PD patients and their perceptions and experiences relating to AD documents. This study involved using purposeful sampling and semi-structured interviews with 11 family …

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Reproductive Health Factors And Maternal Mortality Of Internally Displaced Women In Nigeria, Fatima Mahmood Jibirilla Jan 2021

Reproductive Health Factors And Maternal Mortality Of Internally Displaced Women In Nigeria, Fatima Mahmood Jibirilla

Walden Dissertations and Doctoral Studies

Approximately 529,000 women die from pregnancy-related causes every year, with 99% of these maternal deaths occurring in developing countries. Each year, about 59,000 maternal deaths occur in Nigeria, with a mortality rate of 576 deaths per 100,000 births. Women constitute about half of the 33.2 million internally displaced persons (IDPs) worldwide. The purpose of this retrospective cross-sectional study was to explore the association between the reproductive health factors and maternal mortality of internally displaced women in Borno state, Nigeria. McCarthy and Maine’s model for determinants of maternal mortality informed this study. A secondary dataset of 400 women (age 14-49 years) …

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Relationship Between Trust, Race, And Health Care Information Sources Among African American Men, Uzochukwu Onukogu Jan 2021

Relationship Between Trust, Race, And Health Care Information Sources Among African American Men, Uzochukwu Onukogu

Walden Dissertations and Doctoral Studies

AbstractAfrican American men have not been sufficiently at the center of research studies, especially when it comes to health. Most researchers have explored African Americans as a whole, and few have looked at African American men specifically, especially when it comes to their perceptions and ability to trust sources of health information. The purpose of this quantitative cross-sectional study was to examine the relationship between race and trust in health information sources, including the relationship between prostate cancer health outreach done through the internet and the acceptance of such information outreach among African American men. The theory of planned behavior …

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Knowledge And Perceptions Of Antibiotic Resistance Stewardship Among Prehealth And Agriculture Students, Claudia Maria Da Silva Carvalho Jan 2021

Knowledge And Perceptions Of Antibiotic Resistance Stewardship Among Prehealth And Agriculture Students, Claudia Maria Da Silva Carvalho

Walden Dissertations and Doctoral Studies

The global threat of antibiotic resistant infection has resulted in health organizations to compile an antibiotic stewardship program, in which the education of current/future medical prescribers and farmers is central for the preservation of current and future antimicrobial treatments. The purpose of this study was to assess and compare the knowledge and perceived threat of antibiotic and antibiotic resistance, as well as the perceived benefit of antibiotic stewardship, among undergraduate students in biology and agriculture at a state university in Kansas. Framed by the health belief model, a cross-sectional study was conducted using a structured online survey of 136 undergraduate …

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Exploring The Influences Of Culture On Hand-Hygiene Beliefs Of Foreign-Born Healthcare Workers, Sheila Blanche Davis Jan 2021

Exploring The Influences Of Culture On Hand-Hygiene Beliefs Of Foreign-Born Healthcare Workers, Sheila Blanche Davis

Walden Dissertations and Doctoral Studies

AbstractThe hand-hygiene practices of nonadherent health care workers (HCWs) are a major threat to patient safety and thus continue to be a concern for healthcare leaders and administrators worldwide. Healthcare-associated infections (HAIs), which are linked to HCWs' unclean hands, are prevalent throughout global healthcare settings. Global migration in the nursing profession and intercontinental travel among direct patient care providers make it challenging for healthcare leaders to sustain HCWs' adherence to hand-hygiene practices. The purpose of this grounded study was to explore the influence of the cultural beliefs about hand-hygiene practices of foreign-born HCWs. The theory of planned behavior was used …

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Leadership, Quality Improvement, Team Functionality, And Hiv Viral Load Suppression In Uganda, Esther Karungi Karamagi Nkolo Jan 2021

Leadership, Quality Improvement, Team Functionality, And Hiv Viral Load Suppression In Uganda, Esther Karungi Karamagi Nkolo

Walden Dissertations and Doctoral Studies

Low viral load suppression rate is a significant public health issue in Uganda and similar countries. A nationwide quality improvement (QI) initiative was implemented from January 2019 to improve viral load suppression. Although QI team characteristics have been shown to influence the success of such QI initiatives, no studies have been found to understand how they influence the success of QI efforts to improve HIV viral load suppression in Uganda. The purpose of this cross-sectional, quantitative study was to determine whether there is a significant association between HIV clinic leader involvement in QI teams, QI team functionality, QI team diversity, …

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The Impact Of Socioeconomic Status And Ethnicity On Chronic Obstructive Pulmonary Disease Patients, Donald Garret Abshier Jan 2021

The Impact Of Socioeconomic Status And Ethnicity On Chronic Obstructive Pulmonary Disease Patients, Donald Garret Abshier

Walden Dissertations and Doctoral Studies

Chronic obstructive pulmonary disease (COPD) is a progressive and debilitating respiratory condition that leads to significant medial and financial burdens. For many patients with COPD, multiple socioeconomic factors contribute to health disparities, including income, education, employment status, and race/ethnicity. The purpose of this study was to examine the impact of SES and race/ethnicity on COPD patients. For this cross-sectional study, using secondary data analysis, the Social-Ecological Model (SEM), which discusses five levels of influence, was utilized. Data from over 3,222 participants aged 18 and over, living in Nevada were obtained from the 2018 Behavioral Risk Factor Surveillance System (BRFSS) study. …

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Melanoma Cancer Survivors: An Online Community Perspective And Prevention Effort, Lisa Marie Chung Jan 2021

Melanoma Cancer Survivors: An Online Community Perspective And Prevention Effort, Lisa Marie Chung

Walden Dissertations and Doctoral Studies

AbstractMelanoma cancer is a major public health issue and has been associated with tanning and exposure to ultraviolet radiation. Minimal information is known about prevention efforts specific to survivors of melanoma cancer who participate in an online community. Surveys of this community differ from previous research of individuals through nononline research; the online community is more likely to be younger in age, comfortable seeking health information using Internet resources, and more advanced in technological capabilities. The main aim of this cross-sectional study was to investigate the impact of age, gender, and race on melanoma prevention efforts (health maintenance and skin …

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Drug-Resistant Neisseria Gonorrhoeae; Identification Of At-Risk Groups In Florida By Regional Variation, Scott August Herber Jan 2021

Drug-Resistant Neisseria Gonorrhoeae; Identification Of At-Risk Groups In Florida By Regional Variation, Scott August Herber

Walden Dissertations and Doctoral Studies

Neisseria gonorrhoeae has been on the rise in the State of Florida since 2013. Florida currently follows the Centers for Disease Control and Prevention guidelines for identifying those at-risk for gonorrhea and drug resistant gonorrhea infections. These groups are narrowly defined and do not consider the different population dynamics throughout the State. This study examined the question of who is at-risk for contracting drug resistant strains of gonorrhea in the eight different regions of Florida based on the prescribed use of last-line-of-antibiotic-defense. Florida’s Surveillance Tools and Reporting System provided 12 years of secondary data from 2007 to 2018. The data …

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Mental Health Literacy Among Rural And Urban Young Adults In Zambia, Etta Y. Mwambwa-Johnson Jan 2021

Mental Health Literacy Among Rural And Urban Young Adults In Zambia, Etta Y. Mwambwa-Johnson

Walden Dissertations and Doctoral Studies

Misconceptions that negatively influence attitudes and beliefs about mental illness are still prevalent in Zambia. Researchers have reported that young adults are the most impacted population for mental disorders in Zambia. Researchers have also highlighted mental health literacy (MHL) as a useful strategy for influencing positive attitudes and beliefs about mental disorders. The purpose of this quantitative cross-sectional study was to investigate the relationship between levels of MHL and attitudes and beliefs about mental illness and health-seeking behaviors of Zambian young adults aged 18 to 24. The study used the health belief theoretical model. A MHL questionnaire was used to …

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The Impact Of Obesity, Race, Age, Education, Income, And Healthcare Coverage On Cervical Cancer Screening Among Mississippi Women, Henrietta Tamika Ross Jan 2021

The Impact Of Obesity, Race, Age, Education, Income, And Healthcare Coverage On Cervical Cancer Screening Among Mississippi Women, Henrietta Tamika Ross

Walden Dissertations and Doctoral Studies

The human papilloma virus is the necessary agent in the development of cervical cancer. It is through screening exams like the Papanicolaou (Pap) test that cervical changes can be identified, and cervical cancer can be diagnosed in the early stage of cancer. The Pap test has aided in decreasing the rate of cervical cancer and the morbidity of cervical cancer. However, cervical cancer rates and mortality rates from cervical cancer are still the highest among women in Mississippi. Additionally, obesity rates among those who reside in Mississippi are the second highest in the United States. The purpose of this quantitative …

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Effects Of Hepatitis On Human Immunodeficiency Virus Viral Suppression, Andrenita Checoby West Jan 2021

Effects Of Hepatitis On Human Immunodeficiency Virus Viral Suppression, Andrenita Checoby West

Walden Dissertations and Doctoral Studies

Coinfection with human immunodeficiency virus (HIV) and viral hepatitis leads to unfavorable health outcomes, making treatment of HIV difficult and increasing the odds of HIV transmission. The purpose of this study is to assess whether viral hepatitis (B and C) hinders HIV viral suppression and impacts the white blood cell count (CD4) when a person is concurrently infected with both viruses. The syndemics theory guided this study. Two research questions tested whether there was an association between coinfection with viral hepatitis and HIV viral load suppression. The research design was quantitative case-control with secondary data from 65,626 reports of HIV, …

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Impact Of Out-Of-Pocket Fees On Under-5 Infant Mortality In Cameroon, Amelie Olga Mafotsing Fopoussi Jan 2021

Impact Of Out-Of-Pocket Fees On Under-5 Infant Mortality In Cameroon, Amelie Olga Mafotsing Fopoussi

Walden Dissertations and Doctoral Studies

Health facilities in Cameroon charge fees for treatment and services, which can affect health outcomes for those unable to pay for services. Some studies have shown that the removal of user fees had a positive impact on child health outcomes in selected African countries. The aim of this quantitative, cross-sectional study was to understand whether there is a link between out-of-pocket expenses and under-5 mortality in Cameron. The study was guided by the social ecological framework. Secondary data from the 2011 Cameroon Demographic Health Survey were used in the study. Chi-square, binary logistic regression, and multicollinearity analyses were used to …

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The Lived Experience Of African American Young Adult Men With Hiv And Self-Care Collaborative Management, Barbara A. Moore Jan 2021

The Lived Experience Of African American Young Adult Men With Hiv And Self-Care Collaborative Management, Barbara A. Moore

Walden Dissertations and Doctoral Studies

AbstractAfrican American young adult (AAYA) men living with HIV often lack interventions that address the influence that HIV has on their quality of life, especially their relationships. Self-care collaborative management (SCCM) concerns related to disclosure and stigmatization complicate social, psychological, and SCCM behaviors. Intervention programs addressing these concerns should be based on relevant, accurate information, but this information is lacking for AAYAs. The purpose of this research was to explore and describe the lived experiences of male AAYAs with HIV and their use of SCCM. The study method was qualitative; Husserl’s transcendental phenomenology was the design. The individual family self-management …

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Effectiveness Of Cancer Survivorship Plans On The Emotional, Psychosocial, And Physical Well-Being Of Breast Cancer Survivors, Amber Renee Purdie Jan 2021

Effectiveness Of Cancer Survivorship Plans On The Emotional, Psychosocial, And Physical Well-Being Of Breast Cancer Survivors, Amber Renee Purdie

Walden Dissertations and Doctoral Studies

AbstractCancer survivorship is essential for the longevity of all cancer survivors, and breast cancer survivorship has become the focus of public health organizations to help address the unmet needs of breast cancer survivors. This quantitative cross-sectional study explored the impact on the Quality of Life (QoL) and health outcomes of female breast cancer survivors in cancer survivorship programs or tertiary care. The ages of the survivors in the study sample ranged from 18 to 80, and all participants were at least 6 months into their cancer survivorship journey. Surveys used were the European Organization for Research and Treatment of Cancer’s …

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Relationship Among Health Literacy Superstitious Beliefs And Self-Care Among Diabetic Patients In Warri, Nigeria, Nkemakolam Simpson Ukpabi Jan 2021

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 …

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Predictors Of Hiv Testing Amongst Women Of Childbearing Age In Nigeria, Hassana Bashir Yakasai Jan 2021

Predictors Of Hiv Testing Amongst Women Of Childbearing Age In Nigeria, Hassana Bashir Yakasai

Walden Dissertations and Doctoral Studies

HIV infection is still a public health issue in Nigeria. One of the sustainable development goal targets is to eliminate new HIV infections by the year 2030. Women of childbearing age are a vital group to focus on in eliminating new infections because HIV infection can be transmitted from women to their partners and their children. Nigeria accounts for about one-third of the cases of mother-to-child infections in the world. The purpose of this three manuscript dissertation was to investigate socioecological factors, demographic factors and knowledge of mother-to-child transmission of HIV infection (MTCT) as they relate to HIV testing in …

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Access To Preventive Health Care Services And Effects On Health Outcomes For Hispanic Older Adults With Type 2 Diabetes, Shafa Al-Showk Jan 2021

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 …

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Social Support, Substance Use, And Mental Health Services Utilization Among African Americans, Thomas Symche Bendu Jan 2021

Social Support, Substance Use, And Mental Health Services Utilization Among African Americans, Thomas Symche Bendu

Walden Dissertations and Doctoral Studies

Mental illness is more prevalent among African Americans than their Non-Hispanic White counterparts; however, this population is less inclined to receive behavioral treatment. The purpose of this study was to examine the association between perceived social support, substance use, and gender with mental health care services utilization among African Americans. The social ecological model and social support theory grounded this study. The research design was a quantitative cross-sectional analysis of the 2016 Behavioral Risk Factor Surveillance Survey. The sample consisted of 486,3030 African American adults that represented the U.S. population using weighted estimates. The overall logistic regression models for the …

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Experiences Of Married, First-Time Pregnant Adolescents When Seeking Care In Kano State, Yashua Alkali Hamza Jan 2021

Experiences Of Married, First-Time Pregnant Adolescents When Seeking Care In Kano State, Yashua Alkali Hamza

Walden Dissertations and Doctoral Studies

Kano State in Northern Nigeria has very high maternal mortality rates. Early marriage and early pregnancies between 15 to 18 years of age are two of the most significant factors in the high maternal mortality rates in Kano State. This phenomenological qualitative research study focused on young first-time mothers’ experiences of seeking care between the ages of 15 and 18. The study’s theoretical framework was the feminist theory of intersectionality. Colaizzi’s seven-step method was the means used for data analysis. This study found that young adolescent first-time pregnant women in Kano City faced significant barriers at home and in health …

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Social Determinants Of Health Influence On Surgical Morbidity After Colorectal Surgery, Koianka J. Ivanova Trencheva Jan 2021

Social Determinants Of Health Influence On Surgical Morbidity After Colorectal Surgery, Koianka J. Ivanova Trencheva

Walden Dissertations and Doctoral Studies

Decreasing surgical morbidity and improving surgical safety is a public health priority. With same-day or early hospital discharge after surgery, knowledge about social determinants of health (SDOH) impact on surgical morbidity is vital for surgical safety improvement. This study’s aim was to evaluate SDOH association with surgery-related morbidity after colorectal surgery in an adult population. This quantitative cross-sectional study used New York Statewide Planning and Research Cooperative System (SPARCS) secondary data from 2006 ⁠–2016 on 130,731 patients linked to SDOH. Dependent variables were anastomotic leak (AL), surgical site infection (SSI), Not SSI related, and overall complications (COMPL) within 30 days …

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Insecticide Treated Nets And Malaria Control Strategy In Sierra Leone, Henry Nk Biayemi Jan 2021

Insecticide Treated Nets And Malaria Control Strategy In Sierra Leone, Henry Nk Biayemi

Walden Dissertations and Doctoral Studies

AbstractMalaria is a deadly disease and endemic in Sierra Leone. It is the leading cause of morbidity and mortality amongst children younger than five years in Sierra Leone. Insecticide treated nets (ITNs) are not used widely despite free distribution, low health risks, and proven ability to reduce malaria. The purpose of this quantitative crosssectional study was to investigate the association between a set of independent variables (parental education, parents' economic status, household size, and residence) and the use of ITNs among children under five years of age in Sierra Leone. The study used a secondary dataset from the Ministry of …

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Strategies To Reduce Fall Rates In A Long-Term Care Facility, Kimberly H. Brewer Jan 2021

Strategies To Reduce Fall Rates In A Long-Term Care Facility, Kimberly H. Brewer

Walden Dissertations and Doctoral Studies

AbstractFalls among residents of long-term care facilities (LTCFs) pose significant threats to their health and quality of life, as falls often lead to life-threatening injuries such as traumatic brain injury and hip fractures. The etiology of the falls is multifactorial and complex; thus, interventions to reduce the falls typically combine two or more evidence-based interventions. The objective of this doctorate project was to develop an evidenced-based clinical practice guideline (CPG) outlining a multifaceted, evidenced-based bundled set of interventions for a fall prevention program to reduce falls for elderly patients living in the LTCFs. Lewin’s 3-step model of change was used …

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Demographic And Socioeconomic Determinants Of Lassa Fever In Edo State, Nigeria, Faith Ogagaroghene Ireye Jan 2021

Demographic And Socioeconomic Determinants Of Lassa Fever In Edo State, Nigeria, Faith Ogagaroghene Ireye

Walden Dissertations and Doctoral Studies

Lassa fever is a viral hemorrhagic fever caused by the Lassa virus and associated with significant morbidity and mortality. Yearly outbreaks of the disease occur in Edo State, Nigeria. The purpose of this study was to examine the demographic and socioeconomic factors that can influence transmission of the disease. The Commission on Social Determinants of Health conceptual framework was used in this research study. This framework describes the relationship between structural and intermediary factors and how they determine health outcomes. To answer the research question of how demographic and socioeconomic factors influence Lassa fever transmission in Edo State, a cross-sectional …

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Social Ecological Factors Affecting Marijuana Use Among Young Adults In The United States, Temple Oritsegbubemi Jagha Jan 2021

Social Ecological Factors Affecting Marijuana Use Among Young Adults In The United States, Temple Oritsegbubemi Jagha

Walden Dissertations and Doctoral Studies

AbstractCurrent knowledge of young adults’ marijuana use centers around individual risk factors and negative health effects (i.e., mental disorder), with less focus on contextual circumstances. In this study, I examined the association between demographic (i.e., gender, race, education, employment, income, and population density), social (i.e., risk perception and religious beliefs influence), living context (i.e., difficulty getting marijuana, poverty level, and county metro status), and marijuana use among young adults. The social-ecological model guided this study. In this quantitative cross-sectional study, data from the 2019 U.S. National Survey on Drug Use and Health that included 14,226 young adults aged 18 to …

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Diabetes Education For Nursing Staff In Primary Health Care, Artemio Pontejos Jan 2021

Diabetes Education For Nursing Staff In Primary Health Care, Artemio Pontejos

Walden Dissertations and Doctoral Studies

The nature of the DNP project was a staff education program for staff nurses and other clinic personnel on diabetes self-care management in a primary health care setting. The goal of this educational program was to improve and update the knowledge on self-care management of primary health care nurses. This education program followed the Walden University DNP Project Manual for Staff Education guidelines. The purpose of this continuing education of professional nurses was to improve nurses’ patient education on self-care management. After a 3-day face-to-face 90-minute lecture, improvement of knowledge was measured with a comparison of a pretest and a …

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Experiences Of Spanish-Speaking Patients Using Interpreter Services With Their Physicians, Rafael Raul Caycho Jan 2021

Experiences Of Spanish-Speaking Patients Using Interpreter Services With Their Physicians, Rafael Raul Caycho

Walden Dissertations and Doctoral Studies

In the United States, many patients cannot speak English well enough to communicate with their medical providers. Many of these patients use professional interpreter services offered by their medical organizations to help with communication, which can lead to miscommunication due to the translation process between patients, interpreters, and physicians, and to incorrect diagnosis and poor health outcomes for the patient. The purpose of this study was to explore the experiences of Spanish-speaking patients who used interpreter services with their physicians. The transmission model was the theoretical framework used to explore the experiences and outcomes for the participants. In this study, …

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Fetal/Infant Mortality: Understanding Race And Ethnicity, Birthing Location, And Prenatal Care, Chelsea Collum Jan 2021

Fetal/Infant Mortality: Understanding Race And Ethnicity, Birthing Location, And Prenatal Care, Chelsea Collum

Walden Dissertations and Doctoral Studies

This study addressed whether race and ethnicity, birthing location, the month the mother begins prenatal care, and pregnancy risk level impact fetal/infant mortality. Infant mortality is a gauge by which the efficacy of the healthcare system and the overall health of the country is measured. The United States falls behind most other developed countries in terms of infant mortality rates. The ecological perspective was used as the theoretical framework. The study design was a cross-sectional cohort design using a sample of births and infant deaths from U.S. Vital Statistics data. Binomial logistic regression analyses were carried out to calculate odds …

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Predictors Of Stunting In Children Under 5 Years Of Age In Zimbabwe, Ranganai Matema Jan 2021

Predictors Of Stunting In Children Under 5 Years Of Age In Zimbabwe, Ranganai Matema

Walden Dissertations and Doctoral Studies

Stunting is the most common form of undernutrition globally and is a major public health concern. Child stunting has both short-term negative effects on children’s health and long-term negative effects on adult health and human capital. Zimbabwe has a high prevalence of stunting, 27% in 2015. Although some of the factors associated with stunting are known, there is a gap on comprehensive evidence on the significant factors associated with persistent high levels of child stunting. The UNICEF conceptual framework for malnutrition was used to guide a cross-sectional study using the 2015 Zimbabwe Demographic and Health Survey data to identify and …

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Association Between Asymptomatic Malaria Infection And Pregnancy Outcome In Delta State, Nigeria, Sadiatu Sally Obi Jan 2021

Association Between Asymptomatic Malaria Infection And Pregnancy Outcome In Delta State, Nigeria, Sadiatu Sally Obi

Walden Dissertations and Doctoral Studies

Pregnant women are vulnerable due to the pregnancy-induced suppressed immunity in malaria-endemic areas. Asymptomatic malaria in pregnancy (MiP) threatens both the mother, fetus, and neonate via chronic placental malaria which impacts maternal-neonatal exchange. Some studies reported that MiP risk factors vary across locations, however, there are few studies on MiP and pregnancy outcome in Nigeria. The purpose of this study was to investigate the association between asymptomatic placental malaria infection and pregnancy outcome among parturients in Asaba, Delta State, Nigeria. This study was developed with a quantitative methodology that utilized primary and secondary healthcare data from 483 subjects aged 18–49 …

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