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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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Health Insurance Coverage, Sociodemographic Factors, And Treatment Completion For Opioid Abusers In Indiana, Ibrahim Samna Jan 2021

Health Insurance Coverage, Sociodemographic Factors, And Treatment Completion For Opioid Abusers In Indiana, Ibrahim Samna

Walden Dissertations and Doctoral Studies

Many accidental deaths have recently occurred in Indiana due to opioid overdose. The current study sought to assess the association between sociodemographic factors, health insurance, and successful treatment completion for opioids abusers in Indiana based on the existing literature gap. In this study, the dependent variables considered were treatment completion status and opioid abuse. The independent variables included health insurance coverage and sociodemographic factors of education, marital status, employment status, race, gender, and age. I measured both dependent and independent variables as categorical. A cross-sectional and quantitative research approach was used by analyzing data from the 2017-Treatment Episode Data Set …

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Contraceptives Use Among Reproductive-Age Women In New Juaben Municipality, Ghana, Phyllis Abrah Jan 2021

Contraceptives Use Among Reproductive-Age Women In New Juaben Municipality, Ghana, Phyllis Abrah

Walden Dissertations and Doctoral Studies

This research study was an investigation into the factors associated with the use of modern contraceptives among reproductive-age women in the New Juaben Municipality of the Eastern Region of Ghana. Reproductive-age women in the Municipality have been found to have a high rate of unplanned pregnancies despite the availability of modern contraceptives. Telephone interviews were conducted with 15 reproductive-age women (20 to 39 years) from the New Juaben Municipality who were recruited voluntarily using purposive sampling technique. The research was based on the health belief model to explore the knowledge, perceived threats, perceived barriers, perceived benefits, self-efficacy, and cues to …

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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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The Impact Of Midwifery On Infant And Maternal Outcomes Among Black Mothers, Joann Honoré Jan 2021

The Impact Of Midwifery On Infant And Maternal Outcomes Among Black Mothers, Joann Honoré

Walden Dissertations and Doctoral Studies

According to recent studies, disparities are prevalent in maternal and fetal outcomes between Black and White mothers in the United States. Researchers have established that using a midwife versus other healthcare practitioners can elicit positive maternal and fetal outcomes for Black mothers. However, no within-race research has been conducted exploring midwifery as an insulating factor against these disparities. The purpose of this quantitative retrospective cohort study was to explore the impact of midwifery on infant and maternal outcomes compared to outcomes associated with other prenatal care models/caregivers among Black mothers in California using secondary data. The ecological model was used …

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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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Examining Clinicians' Perspectives Screening For Depression In Patients With Type 2 Diabetes Mellitus, Vickie Lavette Bland Jan 2021

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

Walden Dissertations and Doctoral Studies

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

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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 …

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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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Impact Of Social Barrier Removal On Primary Care Use By Managed Care Enrollees, Pamme Lyons-Taylor Jan 2021

Impact Of Social Barrier Removal On Primary Care Use By Managed Care Enrollees, Pamme Lyons-Taylor

Walden Dissertations and Doctoral Studies

Personal health represents a complex relationship among social, physical, and emotional factors that can be influenced by health-seeking behaviors. Prior research indicates that greater use of preventive services leads to longer life and lower healthcare costs. For some populations, evidence suggests that social barriers hinder access to preventive services. To better understand the relationship between social factors and the other personal-health factors, de-identified healthcare claims and social service encounter data for 4,480 low-income individuals enrolled in Medicare Advantage or Managed Medicaid at one national health insurance were examined using a retrospective, quasi-experimental design for services rendered between October 1, 2014 …

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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 …

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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 …

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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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Association Between Learning Methods And Analgesic Opioid Abuse, Nicole Marie Blanchard Jan 2021

Association Between Learning Methods And Analgesic Opioid Abuse, Nicole Marie Blanchard

Walden Dissertations and Doctoral Studies

Opioids are an extremely addictive class of medication used to treat pain; overprescribing practices and chronic misuse has led to an epidemic that continues to grow. The opioid epidemic not only has the potential to cause injury or even death but also has a large impact on the U.S. economy. Research regarding determinants of abuse are needed to improve safeguards for opioid abuse prevention. The purpose of this quantitative study was to determine if learning capabilities and/or learning medium preference are correlated with analgesic opioid abuse. The social-ecological model was used to evaluate the social levels of influence for abuse …

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Lived Experiences Of African American Women Coping With Breast Cancer In Rural Northeastern North Carolina, Denise Germaine Belle Jan 2021

Lived Experiences Of African American Women Coping With Breast Cancer In Rural Northeastern North Carolina, Denise Germaine Belle

Walden Dissertations and Doctoral Studies

This qualitative study examined the phenomenology of breast cancer among seven African American female participants who reside in rural, medically underserved communities in Northeastern North Carolina. The aim of this descriptive study was to explore the answers to the overarching question of how African American women with breast cancer self-manage the emotional, physical, financial, and social issues associated with the diagnosis and treatment. The transactional model of stress and coping provided the theoretical framework for examining the role of social reinforcements, beliefs, attitudes, and intentions on the health behavior of African American women with breast cancer in some rural, resource-stricken …

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The Use Of Technology For Seeking Health Information In Persons With Cancer, Jasvir Zonobi Jan 2021

The Use Of Technology For Seeking Health Information In Persons With Cancer, Jasvir Zonobi

Walden Dissertations and Doctoral Studies

Cancer is a growing public health concern. The U.S. cancer prevalence nearly doubled from 8.1 million in 1996 to 15.5 million in 2016 and is expected to rise by an additional 68% from 2016 to 2040. Many cancer survivors use technology (e.g., smartphones) for health information seeking (HIS) for health-related self-efficacy (HRSE) to self-manage the health issues (e.g., physical impairment, chronic disease) they face. However, limited research exists regarding cancer survivors' use of HIS technology for HRSE. The self-efficacy theoretical framework, multiple logistic regression analyses, and the data from 2019 Health Information National Trends Survey were used in the current …

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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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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 …

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Exploring Barriers To Care: Provider Efforts To Improve Retention In Urban-Rural Clusters, Kenyata M. Fletcher Jan 2021

Exploring Barriers To Care: Provider Efforts To Improve Retention In Urban-Rural Clusters, Kenyata M. Fletcher

Walden Dissertations and Doctoral Studies

AbstractOver the years, the infection rates for HIV in the United States has changed partly due to lack of engagement and medication adherence which can lead to substantial declines in individual health. Factors that contribute to the individual’s adherence can include transportation cost, childcare, and lack of finances to name a few. These barriers can often be decreased with the help of supportive service providers and improvement in the patient-provider relationship. Currently, there is limited research that explores how to reduce patient barriers to care, specifically in rural areas. This qualitative study examines how Illinois health care providers help HIV-positive …

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The Determinants Of Endometrial Cancer Survival Disparities In The United States, Evelyn Anegbe Jan 2021

The Determinants Of Endometrial Cancer Survival Disparities In The United States, Evelyn Anegbe

Walden Dissertations and Doctoral Studies

Endometrial cancer is the most common gynecologic cancer in the United States with recent trends showing a continued increase in incidence and mortality. Prognosis is influenced by cancer stage at diagnosis and differs by race/ethnicity. Researchers have documented poorer survival among Blacks than Whites diagnosed with endometrial cancer. The 5-year survival rates for women with endometrial cancer is 81%; while survival for White and Black women are 84% and 62%, respectively. There is a gap in literature examining the widening disparity in incidence and survival of women diagnosed with advanced stage disease among population subgroups across the United States. The …

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Understanding Resilience Among Individuals With Adverse Childhood Experiences (Aces), Meghan Larson Jan 2021

Understanding Resilience Among Individuals With Adverse Childhood Experiences (Aces), Meghan Larson

Walden Dissertations and Doctoral Studies

Adverse childhood experiences (ACEs), such as abuse, neglect, and dysfunction in a child’s home are considered a public health crisis due to their correlation to health disparities and psychosocial problems in adulthood such as substance use, relationships, education, and maintaining employment. However, some individuals are resilient and demonstrate the ability to adapt and function well despite experiencing adverse events. To better understand resilience when ACEs are present, I conducted a basic qualitative research study to explore the lived experiences of individuals in Tennessee with elevated ACE and resilience scores. A purposeful sample of 12 participants who scored high on ratings …

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Determinants Of Fruit And Vegetable Consumption For Adults In The Panhandle Of Nebraska, Erin Marie Norman Jan 2021

Determinants Of Fruit And Vegetable Consumption For Adults In The Panhandle Of Nebraska, Erin Marie Norman

Walden Dissertations and Doctoral Studies

Low fruit and vegetable (F/V) consumption has been documented and is associated with increased risk of chronic disease. Previous studies have revealed that consuming the recommended servings of F/V per day can be influenced by many determinants including healthy eating self-efficacy, cooking confidence, perceived family support, perceived access, perceived quality, and perceived cost of fruits and vegetables. The purpose of this study was to examine these determinants of F/V consumption at the individual level of the socioecological model for adults ages 18 years and older residing in the panhandle of Nebraska. The socioecological model (SEM) provided the theoretical framework for …

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Racial Disparities In Hypertension Self-Awareness And Hospitalizations For Hypertension-Related Illnesses Among Adult Arkansans, Chimfumnanya Nwanze-Smith Jan 2021

Racial Disparities In Hypertension Self-Awareness And Hospitalizations For Hypertension-Related Illnesses Among Adult Arkansans, Chimfumnanya Nwanze-Smith

Walden Dissertations and Doctoral Studies

Black individuals in the United States are twice as likely as White individuals to die of cardiovascular diseases. Between 2010 and 2016 in Arkansas (AR), hypertension (HTN) and HTN-related diseases had an age-adjusted death rate of 230.4 deaths per 100,000 population compared to 173.6 deaths per 100,000 population for Whites. The purpose of this quantitative, cross-sectional study was to explore the potential association between HTN self-awareness and emergency department (ED) visits and hospitalization rates for HTN and HTN-related illnesses between Black and White individuals in AR. The socioecological framework was used to explore sociodemographic (SDF) and socioeconomic (SES) factors as …

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Socioeconomic Factors And Comorbid Conditions In Children With Autism Spectrum Disorder, William Paris Jan 2021

Socioeconomic Factors And Comorbid Conditions In Children With Autism Spectrum Disorder, William Paris

Walden Dissertations and Doctoral Studies

Autism spectrum disorder (ASD) is a neurodevelopmental disorder that impacts children and adults. Comorbid conditions such as anxiety, depression, behavioral issues, and low socioeconomic status negatively impact health care quality in children with ASD. Missing from the academic literature is the quantification of the relationship between parental education and employment and health insurance coverage on the prevalence of comorbid conditions in children with ASD. The purpose of this cross-sectional quantitative analysis was to examine and quantify the relationship between parental education and employment, health insurance coverage, and the reporting of comorbid conditions (anxiety, depression, behavioral issues) in a nationally representative …

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Meaningful Use Criteria And Staff Accountability In An Office Setting, Marcia Ionie Pender Jan 2021

Meaningful Use Criteria And Staff Accountability In An Office Setting, Marcia Ionie Pender

Walden Dissertations and Doctoral Studies

Proper documentation for meaningful use (MU) criteria within electronic health records (EHRs) was identified as an issue for office staff at a local primary care office in a metropolitan area of Central Florida. The project question addressed the local gap in knowledge about MU standards necessary to ensure correct documentation of EHRs. The purpose of this doctoral project was to provide an educational program for staff to ensure compliance with the HITECH Act of 2009. Lewin’s Change Theory and Knowles Theory of Adult learning were the conceptual foundations for the educational program. The project question was to determine whether a …

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An Integrated Approach To Hand Hygiene, Tarsha Renee Stewart Jan 2021

An Integrated Approach To Hand Hygiene, Tarsha Renee Stewart

Walden Dissertations and Doctoral Studies

AbstractHealthcare-associated infections (HCAIs) threaten the quality and safety of the services provided. HCAIs are infections that occur while a patient is receiving treatment for another condition in any type of healthcare. The Centers for Disease Control estimates that approximately one in every 20 inpatients will become infected with an HCAI during their hospital stay. Proper hand hygiene is the most significant intervention in preventing HCAIs. Despite hand hygiene's effectiveness, evidence suggests that only 50% of healthcare workers are compliant with proper hand hygiene techniques. The purpose of this project is to increase nurse’s knowledge the via education. Kotter's eight-step change …

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Patient Perceptions Of Access To Chronic Pain Medications, Lauren Amy Durham Jan 2021

Patient Perceptions Of Access To Chronic Pain Medications, Lauren Amy Durham

Walden Dissertations and Doctoral Studies

AbstractThe 2014 Drug Enforcement Administration’s reclassification of hydrocodone combination products caused significant unintentional consequences to patients with chronic pain. Although a few researchers have looked at the problems that resulted immediately following the reclassification, none have as yet repeated their studies, creating a knowledge gap. Additionally, previous researchers have shown that most of the current opioid restricting policies in place today were not created using a strong evidence-based or ethically inclusive approach. The purpose of this study was to assess whether common factors identified as issues impacting care for these patients immediately following the reclassification continue to affect care standards. …

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Social Determinants Of Maternal And Neonatal Birth Outcomes Among Syrian Refugees In Lebanon, Mona Charbel Kiwan Jan 2021

Social Determinants Of Maternal And Neonatal Birth Outcomes Among Syrian Refugees In Lebanon, Mona Charbel Kiwan

Walden Dissertations and Doctoral Studies

Neonatal and maternal health indicators have been impacted due to Syrian refugees’ displacement in Lebanon and an increase in child marriage rates from 13% in pre-conflict Syria to 41%. Using the causal continuum framework, the retrospective cross-sectional study’s purpose was to examine whether there is a statistically significant association between adverse maternal and birth health outcomes among Syrian refugees in Lebanon and social determinants of health. The sample size drawn from UNHCR database included 48,083 maternal and 4,288 neonatal refugees admitted to the secondary health care in 2018. Pearson chi-square and binomial logistic regression results showed that employed, newcomers mothers …

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Factors Associated With Help-Seeking Behaviors Among Persons With Serious Psychological Distress, Minn A. Oh Jan 2021

Factors Associated With Help-Seeking Behaviors Among Persons With Serious Psychological Distress, Minn A. Oh

Walden Dissertations and Doctoral Studies

Serious psychological distress (SPD) is an important individual and public health concern, but inconsistent results exist in the literature in terms of help-seeking behaviors and health-related outcomes among persons with SPD. The purpose of this study was to address this issue and understand clinical factors, access and quality of care factors, and sociodemographic factors associated with help-seeking behaviors among adults with SPD using the California Health Interview Survey (CHIS). CHIS data were collected in 2015 as a part of a two-year cycle (2015-2016) and surveyed 42,089 adults. For multivariable analyses, logistic regression analyses were performed. Participants with chronic health conditions …

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