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2021

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Full-Text Articles in Public Health

Inhaled Insulin, Afrezza, Educational Module For Health Care Providers, Sara Lynn Doolin-Thompson Jan 2021

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. …


Safety Planning: Self-Management Approaches For Intimate Partner Violence In Ohio, Yvette Clemons Jan 2021

Safety Planning: Self-Management Approaches For Intimate Partner Violence In Ohio, Yvette Clemons

Walden Dissertations and Doctoral Studies

AbstractIntimate partner violence (IPV) is a global health education and promotion burden that has affected one in four women in the United States between the ages of 18-24, who are at increased risk of subsequent negative health outcomes of sexually transmitted inflections, mental health and substance abuse disorders, exacerbated suicidal ideations, and death. Exploring the health education needs and learning preferences of women affected by IPV who have utilized self-management strategies during safety planning interventions was the purpose for this phenomenological qualitative study and aligned the four research questions. SurveyMonkey was used to conduct interviews of 30 women align with …


Language Acculturation Effect On Diabetes Prevalence And Self-Care Skills In Puerto Ricans, Gerardo Lazaro Jan 2021

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 …


The Effect Of Race, Provider-Location Type, And Region On Adolescent Hpv Vaccination, Erica Sade Hunter Jan 2021

The Effect Of Race, Provider-Location Type, And Region On Adolescent Hpv Vaccination, Erica Sade Hunter

Walden Dissertations and Doctoral Studies

Studies have been conducted on various factors and their effect on human papillomavirus (HPV) vaccination uptake amongst adolescents. However, these studies typically point to communication factors and provider recommendations as having a significant effect on HPV vaccination uptake, ultimately leading to the need for more information on other factors that may increase HPV vaccination amongst adolescents. The purpose of this quantitative cross-sectional study was to determine if race, provider-location type, and region of the United States have a statistically significant effect on HPV uptake amongst adolescents. The 2018 National Immunization Survey (NIS) was used, and 34,980 participants were included in …


Impact Of The Internet On Young Adult’S Perceptions Of Childhood Vaccinations, Hollie Leigh Xu Jan 2021

Impact Of The Internet On Young Adult’S Perceptions Of Childhood Vaccinations, Hollie Leigh Xu

Walden Dissertations and Doctoral Studies

The internet and social media have transformed the way people receive information and connect, but the impact on society is still unknown. The purpose of this study was to examine the impact of indirect exposure to vaccine messages via the internet on young adults’ perceptions of childhood vaccinations. The health belief model and the social marketing theory were used as the theoretical framework. Research questions explored the relationship between exposure to anti and pro-vaccination messages and perceptions of participants as well as the relationship between perceptions of vaccination and intent to vaccinate. A quantitative correlational study design was used, with …


Exploring Ethnic And New Orleans Cultural Influences On Health Behaviors Of African American Women, Keneitra Brown-Mayfield Jan 2021

Exploring Ethnic And New Orleans Cultural Influences On Health Behaviors Of African American Women, Keneitra Brown-Mayfield

Walden Dissertations and Doctoral Studies

In the United States (U.S.), African American women suffer disproportionately due to obesity and chronic diseases. Many studies have examined the culture of African Americans and its influence on their health behaviors in order to gain knowledge to inform obesity and chronic disease prevention interventions. However, a geographical segment of the U.S. African American population shares a unique culture that had yet to be studied. This qualitative study used in-depth interviews to understand the perceptions of overweight and obese African American women living in the Greater New Orleans region about their culture’s role in the prevalence of obesity and obesity-related …


Relating Overweight/Obesity And Psychosocial Outcomes Among Racial/Ethnic And Sexual Minority Adolescents, Cadene T. Douglas Jan 2021

Relating Overweight/Obesity And Psychosocial Outcomes Among Racial/Ethnic And Sexual Minority Adolescents, Cadene T. Douglas

Walden Dissertations and Doctoral Studies

Adolescents being overweight/obese is a public health crisis that threatens the health and welfare of adolescents going into adulthood and places a significant strain on society. It has been described as one of the most severe public health challenges of the 21st century by the World Health Organization. The pervasiveness of obesity in adolescents rose by 47.1% over the last three decades, and it disproportionally affects racial/ethnic minority lesbian, gay, and bisexual (LGB) persons. Guided by distal and proximal health behaviors, the minority stress model, and intersectionality, the purpose of this study was to examine whether being overweight or obese …


Alzheimer’S Dementia Care: Impact On Family Caregivers, Rose Anne Pierre Jan 2021

Alzheimer’S Dementia Care: Impact On Family Caregivers, Rose Anne Pierre

Walden Dissertations and Doctoral Studies

Patients with dementia of the Alzheimer’s type increasingly become dependent on caregivers. Researchers have demonstrated that these caregivers experience serious burdens during their caregiving experiences. They face emotional, physical, and financial burdens. The objective of this paper was to discuss the burden and strains of Alzheimer’s disease on the older caregivers in the United States. The stress process model and the quality of life were used in this study. The study used a descriptive and analytical approach to analyze 2015 secondary data retrieved in 2018 from the National Alliance for Caregiving. The adult Alzheimer’s dementia caregivers were selected. A multiple …


Factors Predicting Obstetric Fistula Among Women 15-49 Years Old In Uganda, Fatmata Fofanah Jan 2021

Factors Predicting Obstetric Fistula Among Women 15-49 Years Old In Uganda, Fatmata Fofanah

Walden Dissertations and Doctoral Studies

Obstetric fistula is among the public health issues that are preventable and treatable, as evidenced by its elimination in industrialized nations. The aim of this quantitative, cross-sectional study was to use Andersen’s behavioral model of health services utilization to examine the factors that predict the likelihood of experiencing obstetric fistula among women ages of 15 and 49 living in Uganda. Demographic risk factors (marital status, age at first pregnancy, level of education and income, and religious affiliation), medical risk factors (access to health care, distance from hospital, parity, and number of antenatal visits), the mode of delivery (C-section), and location …


Comparison Of Kidney Disease Risks Among African Americans In Maryland And Neighboring Regional States, Nneka A. Offiah Jan 2021

Comparison Of Kidney Disease Risks Among African Americans In Maryland And Neighboring Regional States, Nneka A. Offiah

Walden Dissertations and Doctoral Studies

AbstractChronic kidney disease (CKD) is a recognized global health burden that has affected 10-15% of the general adult population, which is caused by diabetes and has disproportionately affected minority populations such as African Americans. Despite the prevalence of diabetes and hypertension, other variables could predispose this racial group to CKD, hence the need for this study. The purpose of this cross-sectional quantitative study using secondary data analysis methods was to investigate to what extent various factors such as gender, diet, age, exercise, socioeconomic status, diabetes, and hypertension were associated with the prevalence of CKD among African Americans residents in Maryland, …


Factors Associated With Electronic Cigarette Use Among Adolescents In Texas, Christie Anuli Okonkwo Jan 2021

Factors Associated With Electronic Cigarette Use Among Adolescents In Texas, Christie Anuli Okonkwo

Walden Dissertations and Doctoral Studies

The use of electronic cigarettes among adolescents has remained a major public health concern. Reports have shown that the adolescent brain is still growing and can be affected by nicotine and cancer-causing chemicals contained in e-cigarettes. The rising trend of e-cigarette use by adolescents has reportedly reached an epidemic, and there is a knowledge gap in the factors associated with this behavior and the provision of appropriate interventions for the at-risk population. The purpose of this quantitative, cross-sectional study was to investigate the association between sociodemographic factors and the tendency of Texas adolescents to use e-cigarettes. This study was a …


The Combined Impact Of Race And Education On Obesity Among U.S. Adults By Fidelis Okoye, Fidelis Chidi Okoye Jan 2021

The Combined Impact Of Race And Education On Obesity Among U.S. Adults By Fidelis Okoye, Fidelis Chidi Okoye

Walden Dissertations and Doctoral Studies

Walden University

College of Health Professions

This is to certify that the doctoral dissertation by

Fidelis Okoye

has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made.

Review Committee Dr. Vasileios Margaritis, Committee Chairperson, Public Health Faculty Dr. Srikanta Banerjee, Committee Member, Public Health Faculty Dr. James Rohrer, University Reviewer, Public Health Faculty

Chief Academic Officer and ProvostSue Subocz, Ph.D.

Walden University2021

AbstractThe Combined Impact of Race and Education on Obesity Among U.S. Adults by Fidelis Okoye

MA, Walden University, 2009BS, Marygrove College, 2001

Dissertation …


An Examination Of The Absence Of A Comprehensive Smokefree Law In Georgia On College And University Campuses, Nakki Price Jan 2021

An Examination Of The Absence Of A Comprehensive Smokefree Law In Georgia On College And University Campuses, Nakki Price

Walden Dissertations and Doctoral Studies

AbstractCigarette smoking is the number one preventable cause of death and disability in the United States. Although there are policies that govern the use of tobacco products, there are jurisdictions that do not employ these policies. Comprehensive smokefree laws govern private-sector entities and prohibit smoking in public places, specifically restaurants, bars, and workplaces. While states have the authority to implement these laws, some include exceptions that limit the intention of the law. Colleges and universities are specific communities for learning and serve as housing for students and an employer for the greater community. There is a gap in the literature …


Sociodemographic And Pregnancy Risk Factors Associated With Place Of Delivery Among Northern Nigerian Women, Daniel Ali Jan 2021

Sociodemographic And Pregnancy Risk Factors Associated With Place Of Delivery Among Northern Nigerian Women, Daniel Ali

Walden Dissertations and Doctoral Studies

AbstractOne out of every 13 women in Nigeria die during childbirth. In Nigeria, over 60% of deliveries that take place at home were attended to by an unskilled person. This study involved using Thaddeus and Maine’s three delays model to determine the influence of sociodemographic factors (woman’s age, woman’s residence [rural/urban], woman’s and husband’s education level, husband’s occupation, household wealth), pregnancy risk factors (antenatal care usage, wanted pregnancy, and birth order) on the choice of place of delivery amongst women of reproductive age (15-49 years) in Northern Nigeria. This quantitative cross-sectional study used the National Demographic Health Survey of 2018. …


Domestic Abuse Against Men In Kenya, Catherine W. Kigaya Jan 2021

Domestic Abuse Against Men In Kenya, Catherine W. Kigaya

Walden Dissertations and Doctoral Studies

Domestic violence, also known as intimate partner violence (IPV), is prevalent globally and causes severe physical, psychological, and social harm to victims. The purpose of this quantitative cross-sectional study was to highlight the predictors of physical and sexual IPV among men in Kenya and examine the influence of media in seeking help. These factors were explored through the lens of the socio-ecological model and the social learning theory. The 2014 Demographic Health Survey archival data obtained through in-depth interviews were used to answer the research questions. Dependent variables were physical abuse, sexual abuse, and seeking help while independent variables were …


Nigerian Pensioners’ Knowledge, Attitudes, And Beliefs About Type 2 Diabetes, Nnawuihe Ugochukwu Nwosu Jan 2021

Nigerian Pensioners’ Knowledge, Attitudes, And Beliefs About Type 2 Diabetes, Nnawuihe Ugochukwu Nwosu

Walden Dissertations and Doctoral Studies

AbstractDiabetes is one of the leading killer diseases globally, and it is on the rise, especially in developing countries like Nigeria. The high prevalence of undiagnosed Type 2 diabetes in developing African countries has been attributed to a lack of knowledge and awareness about the disease, unbelief in modern healthcare efficacy, and limited healthcare services access. The purpose of this study was to explore the knowledge, attitudes, and beliefs about Type 2 diabetes among pensioners in Nigeria. A qualitative phenomenological research design was used for the study. The constructs of the health belief model formed the study’s theoretical framework. Data …


A Study Of Public Awareness About The Threat Of Earthquakes, Mike Allen Jan 2021

A Study Of Public Awareness About The Threat Of Earthquakes, Mike Allen

Walden Dissertations and Doctoral Studies

Noticeably absent from the existing literature was a correlation study which would have gauged individual awareness for earthquakes. The literature search provided one quantifiable narrative that correlated college education with awareness about earthquakes; the study found that college graduates scored higher points on the awareness test for earthquakes than their counterparts who had no college education. The research question for this study examined the possible correlations between personal characteristics and awareness about earthquakes. A survey was developed and used to find hypothesized correlations between public awareness and a number of variables such as age, gender, education, income, and professional leadership. …


Why African American Men Diagnosed With Chronic Obstructive Pulmonary Disease Continue To Smoke, Vashonda Laniece Allen Jan 2021

Why African American Men Diagnosed With Chronic Obstructive Pulmonary Disease Continue To Smoke, Vashonda Laniece Allen

Walden Dissertations and Doctoral Studies

AbstractThe purpose of this research was to explore why some African American men diagnosed with chronic obstructive pulmonary disease (COPD) continue smoking following their diagnosis. The theory of planned behavior (TPB) guided the development of this research. The research questions were developed to understand the attitudes, behavioral intentions, subjective norms, social norms, perceived power, and perceived behavioral control that influence their continuing or quitting smoking based on the TPB model. The study’s research method was qualitative. A pilot study, using the same criteria as the main study, confirmed the reliability of the interview guide. Participants were informed about the study …


Understanding Female Somali Noncollege Graduate Immigrant’S Experiences With Cervical Cancer Screening Services, Rachel Anyu Anyu-Lainjo Jan 2021

Understanding Female Somali Noncollege Graduate Immigrant’S Experiences With Cervical Cancer Screening Services, Rachel Anyu Anyu-Lainjo

Walden Dissertations and Doctoral Studies

AbstractHealthcare disparities exist in cervical cancer screening worldwide particularly in women of East African descent compared to non-African women. Previous research has investigated the reasons for low participation in cervical cancer screening among Blacks, minorities, and immigrant populations. Limited research has focused on immigrant women in the United States of America, specifically immigrants from Somalia who currently live in St. Cloud, Minnesota. The purpose of this qualitative study was to understand the perception of Somali immigrant women ages 25 - 45 years who have not earned a college degree and their lived experiences with cervical cancer screening. Two conceptual frameworks …


Sociodemographic Factors, Socioeconomic Factors, And Teenage Pregnancy Outcomes In Guyana, Karen Roslyn Cummings Jan 2021

Sociodemographic Factors, Socioeconomic Factors, And Teenage Pregnancy Outcomes In Guyana, Karen Roslyn Cummings

Walden Dissertations and Doctoral Studies

Teenage pregnancy, a global phenomenon is associated with adverse pregnancy outcomes, owing to the mother’s individual factors, location, education attainment, and service accessibility. Globally, 16 million babies are born to teenage mothers annually. In Guyana, there is a paucity of information on factors associated with teenage pregnancy rate which stands at 74 per 1,000, and its outcomes. Archived data from the 2014 UNICEF Multiple Indicator Cluster Survey 5 (MICS5) was used to identify and examine relationships between the sociodemographic, socio-economic factors, and teenage pregnancy outcomes in Guyana. This quantitative cross-sectional review approach guided by the Bronfenbrenner theoretical framework analyzed data …


Subclinical Stress On Obesity Among Obese African American Women, Dr. Nosakhare Osasu Idehen Jan 2021

Subclinical Stress On Obesity Among Obese African American Women, Dr. Nosakhare Osasu Idehen

Walden Dissertations and Doctoral Studies

AbstractObesity is a complex disease linked to genetics, health behaviors, upstream social determinants of health, and psychosocial stress. Obesity-related chronic diseases and opportunity cost significantly impact individuals and communities. Current prevention policies focus on diet and exercise without demonstrating the benefits of stress coping strategies in obesity management. Subclinical racial minority and gender stress heighten hypervigilance, psychological overload, poor stress coping strategies, inflammation, and obesity. Subclinical stress varies with race and gender, and it is higher in African American (AA) women. The purpose of this qualitative study was to explore the lived experience of subclinical racial minority and gender stress …


Hpv Vaccination Rates Among Males In Minority Populations, Andrew Lemke Jan 2021

Hpv Vaccination Rates Among Males In Minority Populations, Andrew Lemke

Walden Dissertations and Doctoral Studies

Ethnic minorities are less likely to be vaccinated in comparison to White individuals. As a result, Blacks have one of the highest rates of human papillomavirus (HPV)-related complications. The purpose of the quantitative study was to identify significant factors predicting initiation of HPV vaccination in Black male adolescents. The study was based on the constructs of Ajzen’s theory of planned behavior and used a cross-sectional design that involved weighted data from the 2018 National Immunization Survey (n=395,067) conducted by the Centers for Disease Control and Prevention. The research questions were based on how factors such as fear, family involvement, sexual …


Association Of Abdominal Obesity And Risk Of Atrial Fibrillation: Findings From The Reasons For Geographic And Racial Differences In Stroke (Regards) Study, Joonseok Kim Jan 2021

Association Of Abdominal Obesity And Risk Of Atrial Fibrillation: Findings From The Reasons For Geographic And Racial Differences In Stroke (Regards) Study, Joonseok Kim

All ETDs from UAB

Background: Our knowledge of the association between abdominal obesity (AO) and the risk of atrial fibrillation (AF) after adjusting for body mass index (BMI) is limited. Methods: We included 11,617 black and white participants (mean age 63.0 + 8.4 years) from the REGARDS (REasons for Geographic and Racial Differences in Stroke) national cohort study who were free of AF at baseline between 2003 and 2007, and completed a follow-up exam between 2013 and 2016 with assessment of AF. A multivariable logistic regression model was used to estimate the odds ratio (OR) with 95% confidence interval of incident AF associated with …


Risk Of Delirium With Opioid Use Among Older Adults In The Emergency Department, Rachel Michelle Skains Jan 2021

Risk Of Delirium With Opioid Use Among Older Adults In The Emergency Department, Rachel Michelle Skains

All ETDs from UAB

Objectives: Delirium affects 7-17% of older Emergency Department (ED) patients. Inadequate pain control and opioid pain management have been reported to increase risk for delirium. The aim of this study was to evaluate the association between pain severity, opioid exposure, and delirium among older ED patients.Methods: A single-center retrospective cohort study was conducted in an academic Geriatric ED. Patients aged ≥65 years with an Identification of Seniors at Risk (ISAR) score ≥2 and an Emergency Severity Index (ESI) level 3 were enrolled into the Geriatric ED Pathway. Those who received a delirium screening using the Nursing Delirium Screening Scale (NuDESC) …


Attitudes, Beliefs, And Perceived Self-Efficacy Pre- And Post- Suicide Prevention Training, Angela Marie Sullivan Jan 2021

Attitudes, Beliefs, And Perceived Self-Efficacy Pre- And Post- Suicide Prevention Training, Angela Marie Sullivan

All ETDs from UAB

A 2017 World Health Organization (WHO) data brief included suicide in the top 20 causes of death worldwide. The WHO also listed suicide as the second leading cause of death for those aged 15 – 29 worldwide. In the US, suicide is the leading cause of violent death and has been consistently ranked as the 10th leading cause of death among all age groups in the US since 2008. In Alabama, the CDC reports suicide as the 11th leading cause of death in the state and the second leading cause of death for those aged 15 – 34. This study …


Effect Of Hearing And Head Protection On The Localization Of Tonal And Broadband Reverse Alarms, Chantal Laroche, Christian Giguère, Véronique Vaillancourt, Claudia Marleau, Marie-France Cadieux, Karina Laprise-Girard, Emily Gula, Véronique Carroll, Manuelle Bibeau, Hugues Nélisse Jan 2021

Effect Of Hearing And Head Protection On The Localization Of Tonal And Broadband Reverse Alarms, Chantal Laroche, Christian Giguère, Véronique Vaillancourt, Claudia Marleau, Marie-France Cadieux, Karina Laprise-Girard, Emily Gula, Véronique Carroll, Manuelle Bibeau, Hugues Nélisse

Études primaires

Objective

This study explored the effects of hearing protection devices (HPDs) and head protection on the ability of normal-hearing individuals to localize reverse alarms in background noise.

Background

Among factors potentially contributing to accidents involving heavy vehicles, reverse alarms can be difficult to localize in space, leading to errors in identifying the source of danger. Previous studies have shown that traditional tonal alarms are more difficult to localize than broadband alarms. In addition, HPDs and safety helmets may further impair localization.

Method

Standing in the middle of an array of eight loudspeakers, participants with and without HPDs (passive and level-dependent) …


Applications Of Longitudinal Machine Learning Methods In Multi-Study Alzheimer's Disease Datasets, Charles F. Murchison Jan 2021

Applications Of Longitudinal Machine Learning Methods In Multi-Study Alzheimer's Disease Datasets, Charles F. Murchison

All ETDs from UAB

Advances in statistical learning models for prediction have led to broader application across a variety of disciplines, granting generalizations and adaptations that were previ-ously intractable even with advanced computational techniques. Among these is the al-lowance of correlated data with inherent paneled structure such as longitudinal or clus-tered data; adjustments which have already begun to be applied to a variety of supervised and unsupervised machine learning methods which had previously focused on cross-sec-tional data. These modifications have seen rudimentary testing in a number of applied disciplines where correlated data is commonly observed, including medical and clinical research. One field in particular …


Multidrug-Resistance, Antibiotic-Associated Acute Kidney Injury, And Poor Disease Prognosis In Community-Acquired Bacterial Pneumonia, Adeniyi J. Idigo Jan 2021

Multidrug-Resistance, Antibiotic-Associated Acute Kidney Injury, And Poor Disease Prognosis In Community-Acquired Bacterial Pneumonia, Adeniyi J. Idigo

All ETDs from UAB

In this dissertation research, I examined the challenges of treating patients with bacterial community-acquired pneumonia (CAP) with the purpose of identifying risk factors linked with multidrug-resistant (MDR) Pseudomonas, treatment toxicity, and poor disease prognosis. I used a retrospective cohort study design to explore a clinical cohort of patients admitted to the University of Alabama at Birmingham hospital network who had bacterial pneumonia diagnosis assessed to be from community transmission between January 2013-December 2019. Electronic medical records were accessed for socio-demographic and clinical information. First, I examined the local prevalence/incidence of Pseudomonas CAP and MDR Pseudomonas CAP, and the relationship between …


Role Of Partnership In Hiv-Related Outcomes In Heterosexual Individuals Newly Diagnosed With Hiv, Maira Sohail Jan 2021

Role Of Partnership In Hiv-Related Outcomes In Heterosexual Individuals Newly Diagnosed With Hiv, Maira Sohail

All ETDs from UAB

A supportive intimate partner has shown to be helpful in HIV care of men who have sex with men, and in some African heterosexual couples; however, knowledge on this phenomenon among heterosexual people with HIV (PWH) is limited in the United States context. This project included two quantitative studies and one qualitative study to examine the role of intimate partnership in HIV care among heterosexual, newly diagnosed PWH. Both quantitative studies were conducted among heterosexual, newly diagnosed (2013-2017) individuals at the University of Alabama at Birmingham (UAB) 1917 Clinic. The first study examined the role of partnership (un-partnered, unmarried-partnered, and …


An Investigation Of Strain And Support Needs Of Caregivers Of Older Adults With Delirium And Allied Health Promotion Interventions, Jasmine Vickers Jan 2021

An Investigation Of Strain And Support Needs Of Caregivers Of Older Adults With Delirium And Allied Health Promotion Interventions, Jasmine Vickers

All ETDs from UAB

Delirium, or the sudden onset of confusion, is common, highly distressing, debilitating, and deadly among hospitalized older adults and is associated with adverse outcomes for their family caregivers. As people are living longer with more complex conditions, more people will face the task of caregiving for older adults with delirium. Family caregivers can make meaningful contributions to delirium care, but high distress, insufficient knowledge, and lack of skills often seen in caregivers can lead to maladaptation and negative health outcomes. A few studies have focused on distress in caregivers from witnessing delirium episodes; however more research is needed to understand …