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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 …

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 …

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 …

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, …

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 …

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 …

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 …

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 …

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 …

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 …

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. …

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 …

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 …

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, …

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 …

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 …

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) …

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 …

The Experience Of Menopause As Reported By Sedentary Women, April Elizabeth Ann Rietdyk

Walden Dissertations and Doctoral Studies

Limited research exists on the experiences of sedentary women as they transition through menopause. This gap creates difficulty for public health practitioners as they strive to develop resources, implement programs, or influence policy change at the community level for this group of marginalized women. Keeping women healthy throughout the aging process, including menopause, improves their quality of life and decreases the impact aging has on the health care system. This phenomenological study, through in-depth interviews, provided the opportunity for sedentary women to share their thoughts and experiences of menopause. Thirteen sedentary women between the ages of 40 and 60, experiencing …

Religious-Base Social Relationship And The Psychological Well-Being Of The Elderly: Gender And Race Variations, Eugene C. Uche

Walden Dissertations and Doctoral Studies

More people in the United States are approaching retirement age, a trend which has resulted in increased study on life satisfaction and psychological well-being of the elderly. Previous researchers have focused on the relationship between religious social support and life satisfaction; however, there remains a gap in the literature regarding how race and gender may influence this association. Knowledge of interactions between religiosity, gender, and race will enable counselors working with different groups of religiously inclined clients to develop and implement religious-based interventions specific to their clients. Guided by the social ecological model, the purpose of this study was to …

Factors Contributing To The Increase In Hiv/Aids And Late Diagnoses Of The Virus Among Older Adults, Lorraine C. Barnett

Walden Dissertations and Doctoral Studies

The Centers for Disease Control and Prevention predicted that the incidence of HIV/AIDS among the American population aged 50 years and over would account for 50% of all HIV/AIDS cases in the United States by 2015. Yet there is little research available about the reason for the high prevalence or the availability of interventions available for this population. The purpose of this study was to explore factors related to HIV/AIDS awareness in a group of older recipients of health care and their health care providers. This study was intended to help fill the information gaps in this area by using …

Influence Of Coping Styles On Social Support Seeking Among Cancer Patient Family Caregivers, Sandra Renee Rankin

Walden Dissertations and Doctoral Studies

Family caregivers of cancer patients may enter a predeath grief cycle when their loved one is diagnosed with cancer. The emotional upheaval and accompanying stress that define predeath grief may lead to health problems for the caregiver, and also interfere with their ability to provide care for their loved one. The purpose of the present research was to examine the relationship between coping styles of family caregivers and the tendency of those caregivers to seek social support during active caregiving. This study employed a quantitative approach based on the revised coping theory and the process of bereavement, which is grounded …

The Perspectives Of African American Nonprofit Female Executives From The Northeastern Region Of The United States About The Work-Family Balance, Tammy Evans-Colquitt

Walden Dissertations and Doctoral Studies

Although many studies have been conducted on the increased pressure and stress facing women who are trying to fulfill work and family demands, little is known about African American women in executive positions and their perspectives about work-life balance. A particular gap in the research literature exists on the lived experience of African American nonprofit executive women in maintaining work-life balance. The conceptual framework of this phenomenological study was the bidirectional frame of both work interfering with family and family interfering with work. Data were collected through semistructured telephone interviews of 12 African American women ages 30 to 45 and …

The Relationship Between Depression And Cognitive Deterioration In Older Adults, Rakesh Chand

Walden Dissertations and Doctoral Studies

The population structure of the United States is changing; the older age group is increasing in size relative to the younger generation. The trend is expected to continue, especially starting in 2020, when the baby boomer population---estimated at 80 million---will be reaching their 65 th birthday, a time associated with increasing health complications, including depression and dementia. The study employed a holistic paradigm as the conceptual framework to examine the association between depression and dementia in older adults, and generated a grounded theory to illuminate the relationship between depression and dementia. This theory was then used to assess the efficacy …

The Evolution Of The African American Mother-Daughter Relationship: A Grounded Theory Study, Toneka R. Etienne

Walden Dissertations and Doctoral Studies

The mother-daughter relationship holds a special place in the lives of African American women, given the rich history of women of African descent and the complexities of female relationships. However, few studies have discussed the evolution of this relationship and what it means in the lives of African American mothers and daughters. Using relational-cultural theory (RCT) and Black feminist theory, this qualitative grounded theory study described the experiences and evolution of the African American mother-daughter relationship. A sample of 10 mother-daughter dyads was interviewed together about their relationship. Research questions addressed how African American mothers and daughters define, maintain, and …

Emotional Support In Managing Cardiovascular Diseases Among Hispanic And Non- Hispanic Menopausal Women, Claudette Andrea

Walden Dissertations and Doctoral Studies

Effective recognition and proper treatment of cardiovascular diseases (CVDs) in Hispanic woman is a public health problem that needs further investigation. Guided by the stress and coping social support theory, the purpose of this cross-sectional survey study was to examine the relationship between attitudes, emotional support, and the perception of success in managing cardiovascular diseases (CVDs) in 335 Hispanic women living in Atlanta, Georgia. Correlations, independent-sample t tests, simple linear regression, and multiple linear regressions showed ethnicity as a moderating variable between the perception of success in handling CVD and emotional support, while emotional support was shown to be a …