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Full-Text Articles in Social and Behavioral Sciences

Generalized Anxiety Disorder Symptoms Stratified By Age In Primary Care, Robin E. Mccoy Jan 2023

Generalized Anxiety Disorder Symptoms Stratified By Age In Primary Care, Robin E. Mccoy

Walden Dissertations and Doctoral Studies

Little is known as to the age-related presentation of somatic complaints of those diagnosed with generalized anxiety disorder in primary care settings. A retrospective medical records review sought to identify the affective symptoms of generalized anxiety disorder (GAD) by age as recorded by primary care providers and to test the association of these symptoms by age. Guided by Engle’s (1977) biopsychosocial (BPS) model, a large administrative claim database system was used to derive a sample of 1,336, including 500 patients diagnosed with generalized anxiety disorder between 2018 to 2021. Binary logistics regression, one-way ANOVA, chi-square, correlation, and logistical regression with …


Strategies To Reduce Turnover Among Black Home Healthcare Aides, Diane Allen Tate Jan 2023

Strategies To Reduce Turnover Among Black Home Healthcare Aides, Diane Allen Tate

Walden Dissertations and Doctoral Studies

AbstractMany individuals prefer to remain in their homes as they age instead of entering a long-term care facility. As the proportion of older Americans rapidly grows, the demand for delivery of nonmedical services by home healthcare aides (HHAs) is expected to increase. However, the national and local supply of HHAs is insufficient and must be rectified to meet a projected increase of older Americans by 2050. This research study involved exploring this problem for one small home healthcare organization in the Maryland suburbs outside of Washington, DC with an HHA workforce that was comprised predominantly of Black/African American and African …


Strategies To Reduce Turnover Among Black Home Healthcare Aides, Diane Allen Tate Jan 2023

Strategies To Reduce Turnover Among Black Home Healthcare Aides, Diane Allen Tate

Walden Dissertations and Doctoral Studies

Many individuals prefer to remain in their homes as they age instead of entering a long-term care facility. As the proportion of older Americans rapidly grows, the demand for delivery of nonmedical services by home healthcare aides (HHAs) is expected to increase. However, the national and local supply of HHAs is insufficient and must be rectified to meet a projected increase of older Americans by 2050. This research study involved exploring this problem for one small home healthcare organization in the Maryland suburbs outside of Washington, DC with an HHA workforce that was comprised predominantly of Black/African American and African …


Promotion To Fire Officer: Ems Is An Essential Component Of Promotional Testing, Brenda Kay Farlow Jan 2023

Promotion To Fire Officer: Ems Is An Essential Component Of Promotional Testing, Brenda Kay Farlow

Walden Dissertations and Doctoral Studies

AbstractFor the past 25 years, the number of fire department responses to structure fires nationally has gone down. Structure fires now reflect less than ten percent of the responses of the fire service. In the same period, emergency medical services (EMS) have become the overwhelming activity of most fire departments. The problem is the promotional process focuses on firefighting knowledge and skills while ignoring the absolute need for EMS competencies, in some capacity, for a supervisory position. The lack of change in the promotional process is related to the organizational culture of the individual fire departments and the collective difficulty …


Sociodemographic Predictors Of Veterans’ Health-Related Quality Of Life, Tamala Jones Choice Jan 2023

Sociodemographic Predictors Of Veterans’ Health-Related Quality Of Life, Tamala Jones Choice

Walden Dissertations and Doctoral Studies

Health-related quality of life (HRQoL) is a theoretical concept that intertwines physical, mental, emotional, and social functioning, with a focus on the impact that health status has on quality of life. Although sociodemographic factors are associated with lower HRQoL, how these factors influence HRQoL in military veterans is less understood. The study’s purpose was to examine the relationships between sociodemographic characteristics (gender, military pay grade, military branch, and geographic location) and perceived HRQoL measured by the SF-8 survey among veterans living in a metropolitan community in the Mid-Atlantic region of the United States. A cross-sectional recruitment study design yielded 90 …


Exploring The Benefits Of A Collaboration Between Behavioral Health Coaches And Clinicians, Devan White Jan 2023

Exploring The Benefits Of A Collaboration Between Behavioral Health Coaches And Clinicians, Devan White

Walden Dissertations and Doctoral Studies

This case study addressed how to best use health coaches in the field of behavioral health to improve the accessibility and outreach of a new program launched by the target organization that emphasizes coaching as an intervention for improving well-being and mental fitness. The purpose of this qualitative case study was to investigate the potential influence of coaching within the behavioral health field and explore how health coaches could partner with clinicians or behavioral health leaders to allow for more collaboration and accessibility to services. The RQs centered on how health coaches might support the treatment of those who have …


Generalized Anxiety Disorder Symptoms Stratified By Age In Primary Care, Robin E. Mccoy Jan 2023

Generalized Anxiety Disorder Symptoms Stratified By Age In Primary Care, Robin E. Mccoy

Walden Dissertations and Doctoral Studies

Little is known as to the age-related presentation of somatic complaints of those diagnosed with generalized anxiety disorder in primary care settings. A retrospective medical records review sought to identify the affective symptoms of generalized anxiety disorder (GAD) by age as recorded by primary care providers and to test the association of these symptoms by age. Guided by Engle’s (1977) biopsychosocial (BPS) model, a large administrative claim database system was used to derive a sample of 1,336, including 500 patients diagnosed with generalized anxiety disorder between 2018 to 2021. Binary logistics regression, one-way ANOVA, chi-square, correlation, and logistical regression with …


Promotion To Fire Officer: Ems Is An Essential Component Of Promotional Testing, Brenda Kay Farlow Jan 2023

Promotion To Fire Officer: Ems Is An Essential Component Of Promotional Testing, Brenda Kay Farlow

Walden Dissertations and Doctoral Studies

For the past 25 years, the number of fire department responses to structure fires nationally has gone down. Structure fires now reflect less than ten percent of the responses of the fire service. In the same period, emergency medical services (EMS) have become the overwhelming activity of most fire departments. The problem is the promotional process focuses on firefighting knowledge and skills while ignoring the absolute need for EMS competencies, in some capacity, for a supervisory position. The lack of change in the promotional process is related to the organizational culture of the individual fire departments and the collective difficulty …


The Lived Experience Of Lung Cancer Patients With Psychological Health And Physical Activity, Donna Leeann Homkes Jan 2023

The Lived Experience Of Lung Cancer Patients With Psychological Health And Physical Activity, Donna Leeann Homkes

Walden Dissertations and Doctoral Studies

AbstractPhysical activity (PA) is recognized as a treatment protocol for lung cancer patients that improves physical impairments and reduces symptoms of psychological stress. This qualitative interpretive phenomenological analysis (IPA) study was conducted to explore the lived experience of lung cancer patients and how PA is influenced by anxiety, depression, and fatigue. This study was guided by Bandura’s self-efficacy theory and Engel’s biopsychosocial model. In-depth semi structured interviews were conducted with seven lung cancer participants over Zoom and in person. The data were analyzed using manual hand coding. The analysis revealed themes in patients’ experiences about how PA participation is influenced …


Exploring The Benefits Of A Collaboration Between Behavioral Health Coaches And Clinicians, Devan White Jan 2023

Exploring The Benefits Of A Collaboration Between Behavioral Health Coaches And Clinicians, Devan White

Walden Dissertations and Doctoral Studies

This case study addressed how to best use health coaches in the field of behavioral health to improve the accessibility and outreach of a new program launched by the target organization that emphasizes coaching as an intervention for improving well-being and mental fitness. The purpose of this qualitative case study was to investigate the potential influence of coaching within the behavioral health field and explore how health coaches could partner with clinicians or behavioral health leaders to allow for more collaboration and accessibility to services. The RQs centered on how health coaches might support the treatment of those who have …


The Lived Experience Of Lung Cancer Patients With Psychological Health And Physical Activity, Donna Leeann Homkes Jan 2023

The Lived Experience Of Lung Cancer Patients With Psychological Health And Physical Activity, Donna Leeann Homkes

Walden Dissertations and Doctoral Studies

AbstractPhysical activity (PA) is recognized as a treatment protocol for lung cancer patients that improves physical impairments and reduces symptoms of psychological stress. This qualitative interpretive phenomenological analysis (IPA) study was conducted to explore the lived experience of lung cancer patients and how PA is influenced by anxiety, depression, and fatigue. This study was guided by Bandura’s self-efficacy theory and Engel’s biopsychosocial model. In-depth semi structured interviews were conducted with seven lung cancer participants over Zoom and in person. The data were analyzed using manual hand coding. The analysis revealed themes in patients’ experiences about how PA participation is influenced …


Policies That Support Emergency Department Staff In Providing Behavioral Health Care, Lizabeth Lepp Hennig Jan 2022

Policies That Support Emergency Department Staff In Providing Behavioral Health Care, Lizabeth Lepp Hennig

Walden Dissertations and Doctoral Studies

A significant portion of individuals with a behavioral health (BH) condition return to emergency departments (ED) seeking care, resulting in reduced quality of care, and contributing to disproportionate healthcare costs. Care can be improved and return visits to the ED reduced where behavioral health care and follow-up care planning are provided as part of their treatment. However, policies expected to create declines in ED use for behavioral conditions are typically in short duration or are difficult to use given other funding and policy constraints. With little known about how policy is supporting the engagement of ED staff who are critical …


U.S. Military Treatment Facility Reform: Decision-Based Plan Of Action And Milestones, Sean E. Marshall Jan 2022

U.S. Military Treatment Facility Reform: Decision-Based Plan Of Action And Milestones, Sean E. Marshall

Walden Dissertations and Doctoral Studies

In 2017, the U.S. Congress mandated a specific reorganization and centralized approach in military medicine. The Air Force developed a medical reform construct to organize military treatment facilities (MTFs). The leaders of each unit are required to comply with the reorganization using internal resources with no additional funding or personnel. The purpose of this study was to deliver a plan of action and milestones (POAM) suitable for workgroup implementation to achieve the mandated health unit integration at a medium-sized MTF. The practice-focused question asked how a POAM road map guides effective decision-making. A consultancy approach was used to assist leadership …


Understanding How Healthcare Social Workers Respond To Adult Medical Trauma, Sonya Anthony Jan 2022

Understanding How Healthcare Social Workers Respond To Adult Medical Trauma, Sonya Anthony

Walden Dissertations and Doctoral Studies

Medical trauma in the hospital is a growing health disparity often accompanied by social determinants. Assisting in alleviating disparities and social determinants is a standard of care embedded in social work practice. This research was conducted to examine healthcare social workers’ experiences responding to and managing the psychosocial impacts of adult medical trauma in an acute inpatient environment. The goal of the research was to identify if a need exists for trauma-informed training among healthcare social workers. The research question examined how healthcare social workers respond to medical trauma. The model of case management, trauma-informed care, and systems theory were …


Rising Cost Of Medicare And Its Effect On Recipients 65 And Older, Williesa Toomer Jan 2022

Rising Cost Of Medicare And Its Effect On Recipients 65 And Older, Williesa Toomer

Walden Dissertations and Doctoral Studies

The rising cost of Medicare is a growing concern for recipients. Beneficiaries are often forced to implement a host of strategies to meet rising out-of-pocket expenses. This qualitative study was conducted to address a research gap in methods used by senior citizens to manage rising Medicare coverage costs. Garmezy’s resilience theory was used to contextualize the rising costs of Medicare premiums and copays and strategies used to manage healthcare needs. The purposive sample of 12 socioeconomically diverse respondents included eight women and four men ranging in age between 65 and 77, for an average age of 70.2 years. Participants completed …


Narrative Inquiry Into Postsecondary Transition Outcomes For Young Adults With Intellectual & Developmental Disabilities, Eric Sarrett Jan 2022

Narrative Inquiry Into Postsecondary Transition Outcomes For Young Adults With Intellectual & Developmental Disabilities, Eric Sarrett

Walden Dissertations and Doctoral Studies

Young adults with intellectual and developmental disabilities (IDD) continue to struggle with community engagement despite decades of research and policy initiatives addressing postsecondary transition. Evidence shows that persons with IDD are engaging in employment, postsecondary education, independent living, socialization, and other roles at significantly diminished rates, yet little data exists describing this participation in the voices of those affected. The purpose of this narrative inquiry was to describe community integration of persons with IDD in the decade following postsecondary transition in their own words. Critical disability theory was used as a lens to explore the successes and failures of public …


Providers’ Perceptions Of Chiropractic Care In Treatment Of Opioid Addiction, Rebekah Jan Khan Jan 2022

Providers’ Perceptions Of Chiropractic Care In Treatment Of Opioid Addiction, Rebekah Jan Khan

Walden Dissertations and Doctoral Studies

Fifteen hundred people in the United States die each week from opioid-related overdoses. In addition, the U.S. court system has been inundated with individuals facing legal proceedings, with opioid addiction, impacted competency, and recidivism. There has been a call for alternatives to address the crisis. The purpose of this qualitative study was to explore the perceptions of (addiction) providers regarding chiropractic treatment in the management of opioid addiction. The health belief theory was used to guide the study. Interview data were collected from six participants via Zoom or phone. Thematic analysis resulted in four emergent themes: lack of knowledge of …


Strategies To Implement An Electronic Medical Records System In Health Care Organizations, Ashley Knott Jan 2022

Strategies To Implement An Electronic Medical Records System In Health Care Organizations, Ashley Knott

Walden Dissertations and Doctoral Studies

Despite the 2009 mandate from the U.S. Government that healthcare organizations adopt and implement electronic medical records (EMR) systems to avoid fines and take advantage of the benefits EMR systems provide, adoption of EMR systems in the United States has been low. Since 2011, medical facilities have received incentive payments if they demonstrated “meaningful use” of certified EMR systems; however, medical facilities unable to demonstrate meaningful use beginning in 2015 have faced up to 5% penalties. Grounded in the diffusion of innovation theory, the purpose of this qualitative single case study was to explore strategies that hospital project managers use …


Lived Experiences Of Police Officers And Their Roles During Opioid Overdose, Sean Banks Jan 2021

Lived Experiences Of Police Officers And Their Roles During Opioid Overdose, Sean Banks

Walden Dissertations and Doctoral Studies

Researchers have conducted multiple studies regarding opioid users, opioid addicts, relatives of addicts, and health professional responses. The opioid crisis has been a focus for scholars following the first wave of prescription in 1991 (CDC, 2016). However, there is limited research that examines the lived experiences of law enforcement officers and their roles during an opioid overdose. As the opioid crisis has continued to negatively affect individuals, families, communities, cities, and countries, federal, state, and local policymakers have searched for ways to combat the opioid crisis. For many law enforcement agencies, policymakers have enacted policy that mandates patrol officers carry …


Relationship Between Social Support And Childhood Trauma On Resilience, Carol Krieger Jan 2021

Relationship Between Social Support And Childhood Trauma On Resilience, Carol Krieger

Walden Dissertations and Doctoral Studies

People who have not overcome childhood trauma and who have developed mental illnesses have difficulties dealing with life challenges. The purpose of this quantitative study used a correlational design to test any relationship between childhood trauma experience levels and resilience against life challenges in adulthood. The theoretical framework used for this study was Barnes’ social support theory. Data were collected from 104 participants over a 7-week period. Participants voluntarily answered the ACE questionnaire, 2-way support scale, and resilience scale. Key results indicate that people with mental illness who receive social support are positive impacted by that support. Receiving adequate levels …


Retrospective And Forecasting Analysis Of Increased Long Term Care Demand In Niagara, Breanne Alissa Hines Jan 2021

Retrospective And Forecasting Analysis Of Increased Long Term Care Demand In Niagara, Breanne Alissa Hines

Walden Dissertations and Doctoral Studies

A problem exists within the Canadian healthcare system as many patients experience longer lengths of stay (LOS) in acute care (AC) and complex care (CC) beds within hospitals because of a lack of long term care (LTC) facilities. The purpose of this study was to evaluate the extra days patients wait for placement and assess the benefits of increasing the number of LTC beds. The theoretical framework used was the four-level model of the health care system. Research questions involved 2017-2019 data for the number of LTC beds required to eliminate waits and evaluate beds needed in the future. This …


A Lebanese Health Care Organization’S Strategies To Secure Sustainable Funding, Dania Mahmoud Al Assadi Jan 2021

A Lebanese Health Care Organization’S Strategies To Secure Sustainable Funding, Dania Mahmoud Al Assadi

Walden Dissertations and Doctoral Studies

Fundraising and donations are the main sources of revenue for behavioral health care nonprofit organizations (NPOs) worldwide. Economic, political, social, or health crises impact fundraising and donation sources for behavioral health care NPOs. This qualitative case study addressed strategies that senior leaders of a Lebanese behavioral health care NPO could use in times of crisis. The study also addressed the behavioral health leaders’ experience managing a funding crisis. The Baldrige conceptual framework was used to assess the organization’s effectiveness in seven key areas. Interviews with the senior leaders and analysis of the organization’s archival data were used to inform the …


Coping Strategies Of Dual-Role Informal Caregivers, Lorilee Maldonado Jan 2021

Coping Strategies Of Dual-Role Informal Caregivers, Lorilee Maldonado

Walden Dissertations and Doctoral Studies

There are nearly 43.5 million informal caregivers (ICGs) in the United States, and this number will nearly double by 2030. Trying to fulfill the needs of an aging family member and commitments to work, home, and other relationships create a constant state of stress that may result in either leaving the workforce or placing the care recipient in a facility. Finding strategies that support both roles is economically and socially critical. This study explored the strategies that some ICGs have acquired that enable them to cope with these pressures. Work-family conflict theory, focusing on the conflict between work and family …


Strategies For Establishing A Diverse Workforce Within A University Health System’S Department, Shanee Chantel Morgan Jan 2021

Strategies For Establishing A Diverse Workforce Within A University Health System’S Department, Shanee Chantel Morgan

Walden Dissertations and Doctoral Studies

Balanced diversity in health care promotes patient satisfaction and enhances innovation. Obtaining a culturally balanced workplace requires recruitment strategies that encourage inclusiveness among team members from various backgrounds. The purpose of this doctoral study was to explore the issue of lack of diversity in a behavioral health organization’s (BHO’s) student intern program and identify strategies for creating greater diversity in the workplace. The Baldrige excellence framework, the conceptual framework that guided the research, was designed to help BHOs to improve their overall business performance to accomplish goals and increase organizational sustainability. Three themes emerged from the data analysis: diversity training, …


The Impact Of Community Churches And Barbershops On Preventive Care Utilization Among African American Men, Quiante Chappell Hager Jan 2021

The Impact Of Community Churches And Barbershops On Preventive Care Utilization Among African American Men, Quiante Chappell Hager

Walden Dissertations and Doctoral Studies

Preventive health care screening plays an essential role in reducing chronic diseases and mortality rates; yet, even as health care access has increased, African American men’s utilization of preventive screenings remains low in rural areas. The purpose of this qualitative case study was to investigate why African American men are not utilizing preventive care services and ascertaining the impact that social determinants may have on their utilization of these services. The theoretical framework of this research study comprised the social-ecological modal and health belief model to investigate the barriers to preventive care utilization in the African American community. Twelve African …


Synthesized Grounded Theory Expansion Of The Quadruple Aim In Acute Care Nursing, O. Ann Ann Fuller Jan 2021

Synthesized Grounded Theory Expansion Of The Quadruple Aim In Acute Care Nursing, O. Ann Ann Fuller

Walden Dissertations and Doctoral Studies

AbstractConflation of moral and compassionate healthcare within the business model that is focused on customer service, disempowers, dehumanizes, and destabilizes nursing as well as the financial stability of healthcare. The purpose of this research was to determine nurses’ perceptions of how their work environment supported or contradicted a potential expansion of the quadruple aim. The quadruple aim was the primary conceptual framework for this research. The overarching research question was about how the environment of care supports professional nurses’ provision of high-quality person- centered care and bolsters meaningful and purposeful careers. The synthesized grounded theory methodology was used to collect …


Effect Of Professional Exclusion Among Respiratory Therapists In The Icu, Tiffany Lubken Jan 2021

Effect Of Professional Exclusion Among Respiratory Therapists In The Icu, Tiffany Lubken

Walden Dissertations and Doctoral Studies

This study was conducted to test how social exclusion, experienced through a culture of healthcare hierarchy, influenced the feelings/attitudes of respiratory therapists (RTs) who are excluded from discussions of end-of-life (EOL) care. Data analysis was conducted using a multivariate analysis of variance to address the research questions. A quantitative nonexperimental survey research design incorporating four evidence-based surveys was used. There was no significance found between professional exclusion from EOL care discussions and the abilities of RTs to collaborate with intensive care unit (ICU) team members within the shared decision-making model as it relates to providing care in the ICU. There …


Strategies To Recruit Age-Diverse Volunteers For A Nonprofit Behavioral Health Organization, Karen A. Peters Jan 2021

Strategies To Recruit Age-Diverse Volunteers For A Nonprofit Behavioral Health Organization, Karen A. Peters

Walden Dissertations and Doctoral Studies

Volunteers are a crucial resource for behavioral health organizations, especially those that rely predominantly on a volunteer workforce for delivery of services. In such instances, the inability to maintain an adequate and age-diverse volunteer workforce threatens organizational sustainability and interrupts valued services to the community. A case study was completed to identify volunteer recruitment and retention challenges for a behavioral health nonprofit organization in the southwestern United States. The Baldrige Excellence Framework was used to guide the study, with emphasis placed on the assessment of the organization’s leadership, strategy, and workforce. Data sources included interviews with organizational leaders, organizational records, …


Job-Related Stress And Burnout On Turnover Intention Of Nurses In Dallas, Texas, During Covid-19, George Ochieng Jan 2021

Job-Related Stress And Burnout On Turnover Intention Of Nurses In Dallas, Texas, During Covid-19, George Ochieng

Walden Dissertations and Doctoral Studies

AbstractIn a country with a large aging population such as the United States, nursing is a crucial profession that is also a high-stress and high-turnover occupation, leading to a shortage of nurses and increased healthcare costs. The year 2017 saw a 10-year high in nurse turnover. The general management problem is that current efforts to decrease the turnover of nurses remain ineffective. The specific problem studied was the high turnover of nurses in Dallas, Texas, linked to work-related stress and burnout. This quantitative nonexperimental regression and moderation research study aimed to study factors that predict or reduce turnover intention. This …


Evidence-Informed Health Care Transition Policy In California’S Title V Programs For Medical Complexity, Anthony Pallitto Jan 2021

Evidence-Informed Health Care Transition Policy In California’S Title V Programs For Medical Complexity, Anthony Pallitto

Walden Dissertations and Doctoral Studies

Inadequate health care transition policy continues to cause interruptions or setbacks in the continuity of medical care and lapses in health insurance coverage for adolescents in California's Title V programs for individuals with medically complex cases. Yet, there is a paucity of empirical health care transition research to develop an effective health care transition policy for children with medical complexity who are enrolled in California’s Title V program. The purpose of this explanatory case study was to explore the potentiality of translating evidence from a quasi-experimental health care transition primary research project into evidence-informed health care transition policy. The research …