Family, Life Course, and Society Commons^™

Decoding Metacommunication Patterns From African American Single Mothers To Sons, Michael-Kamau Henderson

Walden Dissertations and Doctoral Studies

With a significant number of African American single-parent families responsible for raising a generation of male children, the focus of this qualitative case study was on exploring the African American single mother-son dyad to identify metacommunicative signals delivered from mothers to sons. This study was grounded in a theoretical framework combining attachment theory and social learning theory. The research questions focused on identifying metacommunication messages passed from mothers to sons and how metacommunication patterns influence the youth's social identity. Four single mothers with adolescent sons and 4 unrelated adult sons of single mothers participated in semistructured interviews. Data were collected …

Adopting The Lifelong Communities Initiative In The Atlanta Metropolitan Area, Corneil Montgomery

Walden Dissertations and Doctoral Studies

The older adult population has been growing since 1950. The quality of life of older Atlanta citizens may be reduced if adopted Lifelong Communities (LLC) initiative principles are executed poorly or not at all. The purpose of this case study was to describe and explore the experiences of local government officials in Atlanta, Georgia who have adopted LLC initiatives. Research questions focused on local government officials' experiences adopting the LLC initiative, their use of the LLC principles, as well as the benefits and challenges encountered when integrating principles within organizations and communities to ensure quality of life for persons served. …

Improving The Completion Rate Of Advance Directives In Home Health Agencies, Ndidiamaka Ezinne Mbakpuo

Walden Dissertations and Doctoral Studies

The number of individuals aged more than 65 years in the United States and their life expectancy has been increasing in the past decades. In spite of the presence of federal and accreditation policies recommending completion of advance directive documents by patients admitted to health care settings, advance directive completion rates are low in most health care organizations. The purpose of this study was to determine the level of advance directive completion among home health patients. The health belief model provided the theoretical framework that guided this study. A retrospective chart review was carried out in a home health agency …

Strategies For Managing An Age-Diverse Workforce In Curaçao, Yamil Walid Lasten

Walden Dissertations and Doctoral Studies

Some business leaders find it challenging to manage individuals from different age groups; this is an issue, as organizations in many developed countries become more age-diverse. The purpose of this single case study was to provide business leaders with information about strategies top-level business executives and team leaders at a large company in Curaçao (a developed island nation in the Caribbean) use for enhancing productivity of an age-diverse workforce. The conceptual framework of this study consisted of generational theory of Mannheim. A key tenet of the generational theory includes that belonging to the same generational unit, generational location, and generational …

Comparative Memory/Behavioral Symptoms Of Alzheimer's Disease: Eoad Vs. Load, Marcia Gale Roberson

Walden Dissertations and Doctoral Studies

Alzheimer's disease (AD) is a fatal disorder with no apparent cure. Early-onset AD (EOAD) occurs in individuals before the age of 65, and late-onset AD (LOAD) occurs in individuals age 65 and older. Past studies have proven that AD is fatal among Americans age 65 and older. The disease is characterized by impairments in memory and executive function as well as other cognitive and behavioral problems. The research questions addressed by this sequential, mixed-method study compared EOAD and LOAD by exploring common behavioral/cognitive symptoms and stage levels of AD. Research participants were recruited from the Alzheimer's Association who were members …

Long-Term Hiv Survivors' Beliefs About Aging And A Cure, Geary William Brewer

Walden Dissertations and Doctoral Studies

Prior to 1996, the prognosis of HIV disease was near-certain death; however, biomedical advancements in the past 20 years established HIV as a chronic manageable disease with a nearly normal life span. Recent advancements suggest the potential for a cure. One outcome of current medical treatments is that 50% of all HIV positive individuals are older (-?¥ 50years), and a substantial number of those individuals are long-term (-?¥ 20 years) survivors. Existing research Qualitative research has provided little insight about what older long-term HIV survivors believe about their disease circumstances and aging with the disease. A qualitative method in the …

The Predictive Relationship Between Emotional Expressiveness And Discussing Death With Children: An Exploratory Study With Online College Parents, Sally A. Gill

Walden Dissertations and Doctoral Studies

Death is a sensitive topic, and discussing death with children may be difficult for parents, especially parents who are uncomfortable with emotional expression. Many factors are associated with parents' decision to discuss death; however, a dearth of recent literature existed examining the role of parental emotional expressiveness and discussing death with children. Using Jackson's communications theory within the broader family systems theory, this exploratory non-experimental quantitative study examined if one or more of the selected variables of parents' emotional expressiveness, parents' gender, and any previous discussions about death with a child adequately predicted the age of a child when parents …

Development Of A Practice Guideline For Dnp Prepared Nurse Practitoners Working In Long-Term Care Facilities, Ashley M. Marshall

Walden Dissertations and Doctoral Studies

Clinical evidence-based practice guidelines providing recommendations for health care decision making have become vital components of long-term health care practice in the United States. Frequently changing guidelines have complicated nurse practitioners' (NPs) efforts to implement evidence-based practice into the daily care that they provide to patients. The purpose of this project was to develop an evidence-based practice guideline for doctoral-prepared NPs working in long-term care facilities. This project is important because practitioners use practice guidelines to provide patients with the most appropriate, evidence-based care. Kolcaba's comfort theory was used to guide this project. Kolcaba's theory holds that comfort exists in …

Improving The Experiences Of Informal And Formal Alzheimer's Disease And Dementias Caregivers, Roxroy Anthony Reid

Walden Dissertations and Doctoral Studies

Informal and formal caregivers of persons with Alzheimer's disease and related dementias (ADRD) encounter a more difficult and unique set of challenges than do caregivers of individuals with general disabilities. If adequate caregiver supports are not provided, caregivers may experience increased strain as the disease progresses, increasing the likelihood of unnecessary institutionalization of their care recipients and increasing the cost to the public. Using rational choice theory and political systems theory, the purpose of this study was to differentiate between the phenomenological experiences of formal and informal caregivers of ADRD patients. The overall research was a qualitative design that used …

Alleviating Risks Of Parental Incarceration Through Mentorship, Sonia Murrey

Walden Dissertations and Doctoral Studies

The focus of the present study was on the lack of positive socialization of children affected by parental incarceration. Researchers have indicated the need to broaden the examination of the effects of parental incarceration on children. Mentorship has demonstrated a positive influence for youth who display at-risk behaviors. However, there is little research regarding the effectiveness of mentorship programs for youth who have experienced the negative effects of parental incarceration. The purpose of this transcendental phenomenological study was to describe the experiences of youth who have completed an individualized mentorship program following parental imprisonment. Flyers were distributed to case managers …

Implications Of Maternal Perpetrated Interparent Violence For The Behavior Of Female Adolescents: A Phenomenological Study, Georgette Merlena Percy Hinds

Walden Dissertations and Doctoral Studies

Interparent violence (IPV) is a global family issue. Witnessing IPV confuses children and adolescents about the parental relationship. Adolescent females often perceived fathers as strong and depend on them for safety, security, and support. It is unclear how witnessing maternal perpetrated IPV (MPIPV) affects adolescent females' socialization and development, the perception they have of their fathers, and the meaning they ascribe to father abuse. The purpose of this phenomenological study was to contribute to the literature, provide an understanding of MPIPV implications for adolescent females' social development, and bring more awareness to the lived experiences of witnessing MPIPV. Social learning, …

The Effects Of Stress And Burden On Caregivers Of Individuals With A Chronic Illness, Betty Wilborn-Lee

Walden Dissertations and Doctoral Studies

Informal caregivers have played a significant social and economic role in the care and treatment of individuals diagnosed with chronic illness. However, caregiving can have harmful effects on a caregiver's physical, psychological, and emotional well-being. Using caregiver stress theory as the theoretical framework, the purpose of this archival research was to determine the predictive relationship of stress in relation to caregiver quality of life for 309 selected cases. Correlational and hierarchical multiple linear regression analyses were used to examine the relationship between the independent variables and the dependent variable. The independent variables examined were environment and context, stressors related to …

Nursing Care Of Terminal Patients In Intensive Care Units, Pervell Velethia Dunbar

Walden Dissertations and Doctoral Studies

Nursing Care for Terminal Patients in Intensive Care Units

by

Pervell Dunbar

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

August 2015

Although the goal of the ICU has always been to save lives, ICU now additionally provides end-of life (EOL) care. The objective of this project was to provide ICU nurses with a comprehensive awareness of physical, emotional, and spiritual EOL care issues of patients and their families in order to be better equipped to handle EOL care. The framework used was Jean Watson's Caring model (10 Caritas). A …

Predictors Of Physician Use Of The New Nia Alzheimer's Assessment Protocols, Richard Norman Schultz

Walden Dissertations and Doctoral Studies

Consensus is lacking on early diagnostic criteria and the exact symptoms of Alzheimer's disease (AD). A new, in-office test may help physicians detect the early symptoms of AD, based upon new National Institute of Aging (NIA) criteria. However, a gap exists in knowledge regarding physicians' current use or intent to use the new protocols. Choreographing the descriptive AD terminology in the Diagnostic and Statistical Manual of Mental Disorders IV-TR and the International Classification of Diseases (ICD-10) is recommended. Thus, the purpose of this study was to understand possible contributing factors to physician's use or intent to use of the new …

The Influence Of Nursing Home Administrator Turnover On Resident Quality Of Life, Juliet Iheoma Madubata

Walden Dissertations and Doctoral Studies

By 2040, 79.7 million older adults will live in the US, and nearly 40% will need nursing home services that are primarily funded by Medicare and Medicaid. Researchers have underscored the importance of leadership in quality healthcare care delivery, suggesting that nursing home administrator turnover could influence resident quality of life, causing ill-health for the residents and preventable medical costs for taxpayers. In spite of the suggested association, little research has specifically examined the role of administrator turnover on resident quality of life. As such, the purpose and central research questions of this case study were designed specifically to address …

A Couple’S Marital Disharmony And Its Psychological Effects On Their Children During The Hiv Disclosure Process In Kenya, Grace Gachanja

Walden Faculty and Staff Publications

Limited published data exists on how HIV-positive parents perform disclosure to all their children. A couple’s HIV disclosure experience to all their children is presented. They participated in a larger study conducted to understand the lived experiences of HIV-positive parents and their children during the disclosure process. Each underwent individualized in-depth semi-structured interviews. Interviews were transcribed and transferred into NVivo 8 for analysis using the Van Kaam method. Three themes emerged including HIV testing, full disclosure delivery accompanied by marital disharmony, and postdisclosure psychological effects on the family. Marital disharmony and non-involvement of the father caused the mother to fully …

Exploring The Lived Experiences Of Seniors Aging In Place, Magaly C. Dante

Walden Dissertations and Doctoral Studies

Baby boomers are living longer, and as they age, they will need more supportive services that may include housing, mobility, nutrition, personal care, or health care. Despite the studies that have been conducted on baby boomers aging in place (choosing to stay in their home versus move to an institution), the focus has been on the old and frail and very little has been done to address the lifestyle of active (physically functioning) baby boomers. The purpose of this phenomenological study was to understand the lived, shared experiences of active baby boomers regarding their beliefs and attitudes about aging in …

Use Of Flexible Work Arrangements By Race And Ethnicity: Examining The Mediating Role Of Organizational Diversity Climate Perceptions, Imani S. Owens

Walden Dissertations and Doctoral Studies

This study investigated whether women of color faced additional challenges in using flexible work arrangements (FWAs) when workplaces lacked an affirming diversity climate. Researchers found that use of FWAs was associated with organizational climate, race was correlated with diversity climate perception, and diversity climate perceptions were associated with organizational outcomes such as job satisfaction and retention. Limited empirical evidence existed that demonstrated that race/ethnicity predicted use of FWAs or that diversity climate mediated this relationship. This quasi-experimental study examined the hypotheses that (a) race/ethnicity predicted diversity climate perceptions, (b) race/ethnicity predicted use of FWAs, and (c) diversity climate mediated the …

The Effect Of Evaluating A Quality Improvement Initiative On Reducing Hospital Transfers Of Nursing Home Residents, Denise Eileen Jarboe

Walden Dissertations and Doctoral Studies

The Effect of a Quality Improvement Initiative on Reducing Hospital Transfers of Nursing Home Residents

by

Denise Eileen Jarboe

MSN, Walden University, 2010

BS, University of Maryland, 1981

Project Study Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

February 2015

Nursing homes (NH) in the 21st century provide skilled healthcare services for resident populations who are older, frailer, and often suffering from multiple incurable chronic medical conditions. Nurses practicing in this setting must be keen observers and effective communicators with the ability to recognize and report subtle changes in health status …

The Predictors Of Physician-Patient Discussions Of Sexual Health With Older Adults, Dana Marie Werner

Walden Dissertations and Doctoral Studies

The number of adults aged 65 years and over has been rising quickly, as has the rate of new onset sexually transmitted diseases within this population. Discussions of sexual health between physicians and older adults are currently lacking in frequency and effectiveness. Using the foundation of stereotype embodiment theory, the purpose of this study was to identify the factors that predict frequency of discussing sexual health with older adult patients. A comparative sample of geriatric physicians and family practitioners completed 2 researcher-developed questions and the Sexual Health Care Scale-Attitude tool that assessed their stereotype beliefs toward discussing sexual health with …

Learned Helplessness And Depression: Comparison Of Skilled Nursing And Assisted Living Facilities, Paul Lynn Susic

Walden Dissertations and Doctoral Studies

Research with geriatric populations suggests high levels of clinical depression and greater financial and psychological costs of treatment in long-term care facilities with more restrictive care. Research on learned helplessness, a construct separate from depression, suggests learned helplessness and perceived control are useful theories for the study of elder depression, but the relationship between depression and learned helplessness in this population is not clear. This cross-sectional quantitative study examined the relationship between depression and learned helplessness by comparing residents over age 65 in less restrictive assisted living (n =42) versus those in more restrictive skilled nursing facilities (n =63). Data …

Current Capacity Building Needs Of Occupational Therapists Related To Older Driver Screening, Assessment, And Intervention, Ranyouri Hines Senia

Walden Dissertations and Doctoral Studies

Older adult safe driving is a growing public health issue; however, the skill set of occupational therapists that provide services to these older clients is unclear. The extent to which occupational therapists possess the skills to evaluate an elderly person's ability to operate safely an automobile is unclear. Therefore, the purpose of this quantitative, cross-sectional survey was to determine the current capacity building needs of occupational therapists (OT) related to older driver screening, assessment, and intervention. The ecology of human performance framework was the theoretical base of the study. The independent variables were the OTs' training related to older drivers, …

The Impact Of Caring For Seniors On The Caregiver's Stress Level, Georgina Ugochi Njoku

Walden Dissertations and Doctoral Studies

The number of Canadian seniors with 2 or more chronic health conditions living into their late 90s or older has never been greater. As such, concerns have been raised that the Canadian healthcare system will be unable to meet the growing healthcare needs of the aging population. In this project, an Advanced Practice Nursing needs assessment was used to identify the impact that caring for a senior has on caregivers' stress levels, and what resources caregivers need to in order to cope with their role. Guided by Neuman's system model theory and Rogers' diffusion of innovation model, a convenience sampling …

The Psychological Resilience Of Spousal Caregivers Of Multiple Sclerosis Family, Marisa Diane Diaz

Walden Dissertations and Doctoral Studies

The purpose of this quantitative study was to examine an under-researched topic: the relationship between psychological resilience and personal growth with spousal caregivers of patients diagnosed with Multiple Sclerosis (MS). Chronic illnesses contribute to potentially stressful changes (i.e., lifestyle, quality of life, financial wellbeing, and interpersonal relationships) for the caregiver. The theoretical foundation for this study was Walsh's family resilience theory, which contends that resilience is vital for coping with stressful life experiences and leading a more successful life. Three separate analyses were conducted to examine the relationship between the total scores of the RS and the PGIS, the SWLS, …

Relationship Between Stress Burden And Perceived Support Among Elderly Male Spousal Caregivers, Stephanie Fitzsimmons Sexton

Walden Dissertations and Doctoral Studies

As older couples age, often one partner becomes more competent and able to care for the other, in which case they are able to remain in their homes. In one township in the northeastern United States, the caregiving role had a significant effect on the lives of elderly men who care for their wives. The purpose of this quantitative project study was to determine the relationship between perceived stress burden and perceived level of social support services and between perceived stress burden and use of support services by elderly male spousal caregivers residing in active adult communities. Watson's theory of …

Depression And Psychotherapy For Adults In Long-Term Care Facilities, Jasper Joseph Watts

Walden Dissertations and Doctoral Studies

The purpose of this study was to investigate depression and psychotherapy for adults who are in long-term care facilities. Depression is a serious problem for the elderly in general and for residents of nursing homes in particular. The current study drew on the dynamic stress vulnerability approach to explain how illness occurs in older people, using evidence obtained from the biological, social, and psychological domains with respect to depression. The research question addressed the difference in posttreatment depressive symptoms among 6 types of psychotherapy as measured by the Hamilton rating scale for depression (HRSD)? The 6 therapy techniques were (a) …

The Emotional Impact On Elderly Spouses Who Placed Their Loved Ones In Long-Term, Barbara Hunt

Walden Dissertations and Doctoral Studies

Aging may bring mental and/or physical decline. There may come a point when a loved

one needs long-term care in a nursing home. The purpose of this phenomenological study

was to examine the community dwelling spouses' emotional state. A study was

conducted with 10 individuals (5 men and 5 women) who had a spouse in long-term

nursing care. Inclusion criteria was to be at least 65-years old, have been married at least

30 years, and reside alone in his or her own home. The social emotional selectivity theory

and the construct of boundary ambiguity were applied to view the epoch. …

Knowledge Of Domestic Minor Sex Trafficking Among African American Parents, Jamille T. Harrell

Walden Dissertations and Doctoral Studies

Abstract Domestic minor sex trafficking in the United States is a human rights issue and social problem affecting over 300,000 children ages 12-17, 43% of whom are African American girls. This survey was an exploration of domestic minor sex trafficking knowledge among African American parents and their protective strategies to prevent victimization. Ecological systems theory provided a conceptual framework to examine the environmental factors shaping parental knowledge. The sample consisted of 2 Southern California African American churches (n = 38, n = 32) that served different socioeconomic groups. The African American Sex Trafficking Knowledge survey was researcher designed and pretested …

A Study Of Nurses' Attitudes Toward Medical Ageism, Stephanie Cameron

Walden Dissertations and Doctoral Studies

Medical ageism in the United States affects senior citizens' activities of daily living (ADL) and the quality of their medical care. Medical ageism refers to discrimination against, abuse of, stereotyping of, contempt for, and avoidance of older people. Nurses who take care of the elderly are responsible for ensuring that older patients are treated fairly and in a timely manner, so it is important to know whether or not nurses have any bias regarding the elderly. The research questions addressed in this quantitative study explored whether or not there were differences in nurses' perceptions of ageism as moderated by the …

Second-Parent Adoption: North Carolina Same-Sex Couples And Foster Care Adoptions, Mark Maxwell

2010-2016 Archived Posters

A qualitative phenomenological study about the experiences of same-sex couples with children adopted from foster care in a southeastern U.S. state. Interview data from 8 couples were coded and analyzed. Emerging themes included legal, social, and financial struggles and the couple􀀂s trailblazing experiences to become their children􀀂s legal parents. Implications for positive social change included informing same-sex parents, policy makers and social workers about the families􀀂 experiences and needs.