Cancer patients worldwide receive care from multidisciplinary teams, and patients sometimes have little or no knowledge about the different treatment options available, making communication with their care providers an important influence in how they perceive their care. Patient satisfaction with care is an important factor in determining survivorship. The increasing prevalence of cancer worldwide has become a huge public health issue. The World Health Organization has warned that the potential gains from combatting infectious diseases in Nigeria might be lost because of the increasing prevalence of cancer. The purpose of this grounded theory study was to obtain the perceptions of 30 cancer survivors in Nigeria about their care in federally funded hospitals to improve cancer care in the country. Through a constructivist grounded theory (CGT) approach, data from 30 in-depth interviews with the cancer survivors were analyzed. Data analysis included open coding, selective coding, theoretical coding, and memo writing. Three themes emerged from the data analysis: positive perception of care (P), service improvement (S), and good care experience (G), all of which were cyclically related to form the PSG substantive theory, which indicates that better health care to cancer patients will improve preventative and curative cancer care services in Nigeria. This theory was validated by relating it to 3 theories in the literature as recommended in CGT research. The implication for positive social change is that the results might provide information that can help health care professionals to improve how they communicate with, relate to, and care for cancer patients and their families in Nigeria and other countries.

Breastfeeding is the best infant feeding source of nutrition for infants in their early stages of development. However, there is a fundamental gap in the number of African American women that initiate breastfeeding compared to White, Asian, and Hispanic mothers. Social cognitive theory was used to explore the breastfeeding intentions, beliefs, perceived barriers, and perceptions on breastfeeding through a basic qualitative research method. To capture the essence of the lived experiences of African American pregnant women, a purposeful sample of 13 African American pregnant women were invited to participate in the study. Two focus groups discussions pertaining to breastfeeding intentions and perceptions were conducted. Data were collected using hand-written notes and audio-taped responses from participants. The data were analyzed using NVivo12 Plus qualitative software program to discover themes and patterns. The findings resulted in 3 themes and 2 subthemes. The themes that emerged from the responses were (a) breastfeeding is the best feeding option, (b) breastfeeding barriers, and (c) breastfeeding intentions and duration. There was identified support in terms of intentions to initiate breastfeeding immediate postpartum and continuing some breastfeeding through 6 months. Further results include subthemes of encouragement and outside influences and recommended future breastfeeding support. Breastfeeding barriers ranged from previous negative experiences, negative comments and advice from family and friends, perceived lack of milk, and pain. This study contributes to positive social change within the community by providing some insight into possible interventions or approaches to improve breastfeeding intentions and to ultimately improve the lives of infants.

Nonadherence to best practice guidelines in early mobilization in acute stroke increases the time from admission to mobilization and may increase residual long-term stroke effects. Early mobilization following an acute stroke is known to decrease long-term and secondary disability. The purpose of this project was to decrease the time from admission to mobilization in the acute stroke patient population by improving knowledge of best-practice guidelines in early mobility using an educational intervention for advanced practice nurse practitioners, physicians, and registered nurses. The practice-focused question for this project asked whether a staff educational program based on best-practice guidelines would decrease the time from admission to early mobilization in the acute stroke patient within the first 48 hours of admission. Rosswurm and Larrabee 6-step model was used for this staff education project. A review of the literature indicated sources of evidence from peer-reviewed journals, which were used to support the staff education project and establish best practices in mobilization for the acute stroke patient. A before-and-after design was used to evaluate time from admission to mobilization within the first 48 hours in 40 acute ischemic stroke adult patients following educational intervention for 35 acute stroke staff. Data were collected and analyzed using descriptive statistics. Findings revealed a decrease in time from admission to mobilization by 18.59%. Findings may be used to promote best practices in other units within the hospital and may be used to decrease the residual long-term effects of a stroke, improve activities of daily living, decrease the length of hospital stay, and decrease the long-term cost and burden of stroke.

The purpose of this study was to gain insight into the risk within the African American population of developing diabetes, its complications, and the benefits associated with timely management and treatment of diabetes. The study also looked at how such knowledge may be related to preventive health behaviors. The Risk Perception Survey-Developing Diabetes and the Behavioral Risk Factor Surveillance System questionnaires were employed in this study. The theoretical basis of this study was the health belief model. This was a cross sectional, quantitative study with 126 participants. Descriptive analysis was employed to calculate the mean scores and frequencies across each sub-scale of the scoring tool. Among the participants, only 28.57% were found to be knowledgeable of the risk factors of diabetes, and 74.60% were found to be knowledgeable of the benefits of treating diabetes. Although 75.40%, 61.11%, and 64.29% of participants were found to be knowledgeable of healthy dieting, physical exercise, and body weight control, respectively, fewer than 10% in each group indicated they had implemented any of such behaviors. These data suggest a lack of knowledge of the risk factors of diabetes amongst this population. These results remained unchanged even when considering those with diabetes and their counterparts without the disease separately and also across the different socio-economic groups of the sample. The outcomes of this study may enhance understanding of diabetes among the African American population. Similarly, the above findings might be able to facilitate interventions that promote diabetes management within this population.

HIV/AIDS became a significant concern in the United States (U.S.) during the 1980s and in recent years has increased the most among people living in underserved urban areas, particularly impacting Black women ages 24-35. Guided by the social learning theory, this phenomenological study explored the lived experiences and behaviors of Black women in the south in order to understand their sexual health decisions and how those decisions impact the spread of HIV/AIDS among this group. The central research question focused on understanding the sexual decision making of Black women in Georgia, from the perspective of the client and provider. Convenience sampling was used to recruit 21 participants at 2 HIV testing facilities. Interview data were collected from 9 clients, consisting of Black women ages 24-35, and 12 providers, consisting of HIV testing coordinators and administrators. Data were subjected to an inductive coding procedure and were then organized around themes. Findings suggest that clients perceived a lack of education and limited access to healthcare, due to socioeconomic status and rising medical costs, as contributing factors to the sexual decisions of Black women. Providers differed in suggesting that community distrust and lack of provider empathy and awareness were the primary factors due to broken relationships between provider and client. By understanding the sexual decision making of Black women in Georgia, this research can foster social change by identifying and creating educational programs heavily focused on the delivery of positive sexual health messages aimed at reducing the spread of HIV/AIDS among this group.

In the United States, there is an issue with low-income uninsured patients using emergency services for nonurgent conditions instead of using primary care services. Primary care services are more beneficial than emergency services for such patients, in that they can receive continual or follow-up care through primary care and thus achieve better health outcomes over the long term. Though information is available concerning factors in (or the rationale for) low-income uninsured patients choosing the emergency department (ED) instead of primary services for nonurgent conditions, research focusing on low-income uninsured patients' perspectives, beliefs, and level of knowledge about this matter is missing from the literature. The purpose of this qualitative phenomenological study was to gain an understanding of the perspectives, beliefs, and level of knowledge of low-income uninsured patients about primary care services and to explore whether patient education can improve access to primary care. The health belief model was used to explore 6 concepts: perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy. Criterion sampling was used to recruit 10 participants, an interview tool was used to collect data, and the data was analyzed deductively. Results revealed that members of the low-income uninsured population believed primary care to be better than the ED because it offers cost-effectiveness, preventative care, efficiency, and familiarity. Results indicated that lack of money or insurance prevented participants from using primary services. This study may bring awareness that leads to the improvement of patient education and navigation, the reduction of ED usage, and an increase in primary care utilization.

Access to oral health care remains problematic for millions of Americans. Factors such as socioeconomic status, age, race, and lack of dental insurance benefits inhibit the ability of many to obtain preventative oral health care. The aim of this study was to explore the effect of preventive oral health treatment and education at reduced-fee dental hygiene facilities on the oral health behaviors and perceptions of socioeconomically deprived persons within the state of Georgia. This study was based on the health belief model constructs. A convenience sample of 102 participants was recruited from the individuals who visited two dental hygiene colleges to seek treatment for the first time. The independent variable was the receipt of reduced-fee dental hygiene treatment/education. The dependent variables were the oral health perceptions and behaviors of socioeconomically deprived persons, as well as the perceptions and behaviors of patients provided with a referral for follow-up treatment with a dentist. Mediating variables were sex, age, race, and socioeconomic status. Wilcoxon Signed Rank test and logistic regression were applied to detect potential differences in the dependent variables before and after treatment. The most significant changes were found in categories dealing with self-efficacy measures that patients could take to improve their own oral health. Also, the oral health behaviors and perceptions of younger, African-American of low educational and financial background were significantly more improved after treatment. The social change implication of this research may be that oral health practitioners can use these results to create preventative interventions more tailored for socioeconomically deprived persons who face complicated oral health issues.

Obesity-related diseases have been increasing in African immigrants throughout the United States. Although research has been done to identify risk factors associated with many ethnic groups in the United States, only a few studies exist that explore obesity and type 2 diabetes diseases among Central African immigrants. The conceptual framework for this qualitative case study was social constructivism and the health belief model. The primary research question addressed the potential underlying causes for an increase in obesity and type 2 diabetes among Central African Immigrants. The secondary research questions explored how culture, illiteracy, and religion contribute to the problem of obesity in Central African immigrants, and what strategies could be effective in preventing and reducing the increase of obesity and type 2 diabetes in this population. Interviews with 17 Central African immigrants living in the northeastern U.S. were conducted to explore their social, cultural, and behavioral factors that influence the prevalence of obesity. Interview responses were transcribed and entered into NVivo software for data analysis. The results revealed that socioeconomic issues, cultural differences, and language gaps were the primary risk factors. Feeling stressed and overwhelmed and a lack of communication were also found to be significant. The results could provide health administrators and health educators with a platform for advancing policies and programs to foster greater health and well-being among Central African immigrants and thus contribute to the overall social welfare of Central African immigrants.

Cesarean section (CS) rates have generally increased across the world in the past decade. Reducing elective cesarean section (ECS) rates is imperative as many countries aim to maintain threshold CS rates at or below 15%, the level recommended by the United States' National Institutes of Health. Women are believed to consider ECS for various interconnected psychosocial reasons, but few quantitative studies have investigated these factors. This prospective cohort study was based on the social ecological model (SEM) and the theory of planned behavior (TPB) models, and identified the psychosocial predictors of ECS among 1,268 expectant women in 2 hospitals in Nairobi. Participants completed a structured questionnaire consisting of 10 validated psychosocial scales and were followed for actual mode of delivery (MoD) from hospital records and postnatal telephone interviews. The overall prevalence of CS and ECS were 16.0% and 6.4%, respectively; the CS rate was not statistically higher than the recommended 15% (p > 0.05). The combined CS incidence rate for these 2 hospitals was 83 per 1,000 births per month. Autonomy, fear of childbirth, pregnancy related anxiety, perceived social support from friends, and outcome expectancy for birth were statistically significant predictors of ECS, given the parity and age at first pregnancy, Ï?2(df = 19) = 77.735, p

Genetically modified (GM) foods technology is a novel idea for improving food and crop production, but the supposed health risk of GM foods, such as possible negative long-term health effects to humans, animals and the environment, have provoked the European Union to create assessment protocols to monitor and regulate the safety of GM foods and crops. This research investigates the perception and attitudes of unlabeled GM foods of the WKU faculty and staff. A survey was administered via WKU Qualtrics, and chi-square tests were performed to see how the benefits and disadvantages of GM foods may affect the purchasing decisions of the educated consumer, and to see if the WKU faculty and staff wants GM foods to be labeled or not. The research confirms that the benefits and disadvantages of GM foods do affect the purchasing decisions of the educated consumer. The survey revealed that about 60% of the WKU faculty and staff buys GM foods, and 40% do not buy GM foods, and approximately 92% of the WKU faculty and staff wants GM foods to have proper labeling and information. The research provides information about how the educated consumer of Kentucky may feel about unlabeled GM foods. The research also recommends some trade-off benefits of GM foods, including that approximately 35% of the WKU faculty and staff reported that they would buy GM foods if it helps to lower cholesterol and fight diabetes, and 20% say they would buy GM foods if it is cheaper than other foods. Some of the disadvantages of GM foods are that the pesticide chemicals used in the production methods of GM foods are toxic to humans, animals, and the environment. Approximately 54% of the participants say they would not buy GM foods because they are concerned about how it may affect their long-term health, and about 35% reported that they don’t buy GM foods because of improper labeling and information.