Medicine and Health Sciences Commons^™

What Impacts Life Satisfaction Of Aging Adults Following Stressful Life Events?: An Examination Of The Buffering Effect Of Personal Resources, Cassandra Barragan

Wayne State University Dissertations

Purpose: Existing research has shown that elders experience changes in their life satisfaction following stressful life events. There is an abundance of literature supporting the predictive nature of not only stressful life events on life satisfaction, but social support, autonomy, and financial security. What the literature is lacking, is examination of the buffering effect of social support, autonomy, and financial security on the relationship between stressful life events and life satisfaction. This study hypothesizes that increases in social support, autonomy, and financial security will buffer the impact of SLEs for elders and thus, they will experience increases in their life …

Agency And Resistance Strategies Among Black Primary Care Patients, Janella Nicole Hudson

Wayne State University Dissertations

Research has identified marginalized and minority patients as displaying fewer participatory behaviors during the clinical interaction. Using a culture-centered framework, this study examines the process by which patients with a previous history of discrimination employed agency and resistance strategies in order to influence the outcome of their clinical interactions. This study conducted a secondary analysis of the video taped interactions of 25 black primary care patients in an urban low-income clinic. Using qualitative content analysis, I identified five emergent themes for patient agency: interrupting the physician, stating observations of care, expressing needs and desires, constructing identity, and agenda/goal management. Participants …

Toward Enhancing Treatment For Pregnant Smokers: Laying The Groundwork For The Use Of Complementary And Alternative Medicine Approaches, Amy Michele Loree

Wayne State University Dissertations

Tobacco is the most widely used drug of abuse during pregnancy. Despite efforts to reduce perinatal tobacco use, its prevalence has remained steady over at least the past decade, suggesting that efforts to reduce smoking prevalence before and during pregnancy have not been effective. Although a range of effective treatments exist, most pregnant smokers neither seek nor receive any kind of treatment. Complementary and alternative medicine (CAM) treatments may be ideal as alternative, low-cost approaches capable of reaching and assisting a greater proportion of pregnant women with smoking cessation. This study examined characteristics and treatment utilization practices of pregnant smokers …

Engagement In Activities And Cognitive Functioning Among Older Adults In The Health And Retirement Study, Pamela Emily May

Wayne State University Dissertations

The goal of this dissertation is to examine the effect of cognitive and social activities on cognitive performance and health conditions in a national sample of older adults from the Health and Retirement Study (HRS). This dissertation first aimed to identify longitudinal relations between activity frequency and cognitive functioning. Two hypotheses were tested, baseline activity frequency predicts change in cognitive functioning over time, and baseline cognitive performance predicts change in activity frequency over time. The dissertation’s second aim was to identify links between activity frequency and cognitive trajectories. The third aim was to identify longitudinal relations between activity frequency and …

Empathy As A Moderator Of Adolescent Bullying Behavior And Moral Disengagement After Controlling For Social Desirability, Amy Zelidman

Wayne State University Dissertations

The purpose of this study was to assess the moderating influence empathy has on the associations between adolescent bullying behavior and moral disengagement after controlling for social desirability (e.g., response bias). 676 students in 7th and 8th grade from a suburban middle school in Southeast Michigan participated in this study in the fall of 2012.

Results showed male respondents were more likely than female respondents to (a) report engaging in all forms of traditional bullying behavior overall, including physical, verbal, and social bullying and (b) report higher rates of physical victimization and moral disengagement. Female respondents were more likely to …

An Exploration Of The Use Of Objects In The Creation, Maintenance, And Social Performance Of Self Among People With Alzheimer's Disease And Related Disorders, Jayne Marie Yatczak

Wayne State University Dissertations

In the United States individuals with Alzheimer's disease and related disorders (ADRD) are faced with multiple threats to their social lives and to their sense of self. Such threats include the assumption that our sense of self is entirely dependent upon cognition and memory, elements that become impaired in AD (Kontos 2006) and images of Alzheimer's disease as the death before death (Behuniak 2011). The move to a long term care setting with its simultaneous stripping away of possessions that supply one with personal identity also poses such a threat. Although, individuals with ADRD who move to long term care …

Longitudinal Change In Regional Cortices And Fluid Intelligence, Peng Yuan

Wayne State University Dissertations

Fluid intelligence (Gf) and crystalized intelligence (Gc) are two factors of the general intelligence. They have distinct age-related trajectories of change. Jung and Haier proposed Parieto-Frontal Integration Theory (P-FIT, 2007) to account for the inter-person variance in reasoning intelligence. Some brain regions such as prefrontal, parietal, temporal and anterior cingulate cortices were included in the P-FIT model and were hypothesized to be involved in fluid reasoning task. Therefore, in the current study, we examined latent growth curves (LGC) of longitudinal change in Gf, Gc, prefrontal cortex, parietal cortex, anterior cingulate, temporal cortex and primary visual cortex. Forty-six healthy middle-aged and …

Accumulation Of Subcortical Iron As A Modifier Of Volumetric And Cognitive Decline In Healthy Aging: Two Longitudinal Studies, Ana Marie Daugherty

Wayne State University Dissertations

Accumulation of non-heme iron in the brain has been theorized as a cellular mechanism underlying global neural and cognitive decline in normal aging and neurodegenerative disease. Relatively few studies of brain iron in normal aging exist and extant studies are almost exclusively cross-sectional. Here, I estimated iron content via T2* and measured volumes in several brain regions in two independent samples of healthy adults. The first sample (N = 89) was measured twice with a two-year delay; and the second sample (N = 32) was assessed four times over a span of 7 years. Latent models estimated change in iron …

Coping Similarity And Psychosocial Risk Factors In Couples With Chronic Pain, Amy M. Williams

Wayne State University Dissertations

Chronic pain is an important public health problem that is associated with a host of negative individual and relationship outcomes. Chronic pain is a chronic stressor that both the individual in pain and their spouse must cope with. The current study examined how pain coping similarity within the couple predicted not only patient adjustment, but also spouse adjustment in a longitudinal study. Participants were 108 heterosexual couples in which one partner had chronic pain. The participants completed measures at 3 time points at 6 month intervals. Both the patient and spouse individually completed questionnaires pertaining to their marriage, mood, pain …

Subordinate-Supervisor Demographic And Perceived Value Similarity: Relationships To Subordinate Perceptions Of Organizational Justice, Charles Levi Wells, Iv

Wayne State University Dissertations

The purpose of this study was to examine the empirical relationship between subordinate-supervisor demographic and value similarity with subordinate perceptions of organizational justice using three structural equation models. The first model indicated that subordinate-supervisor demographic and value similarity were directly related to subordinate perceptions of organizational justice (Direct Model). The second model indicated that subordinate perceived value similarity with their supervisor mediated the relationship between the subordinate-supervisor demographic similarity and subordinate perceptions of organizational justice (Mediated Model). The last model indicated subordinate perceived value similarity with their supervisor moderated the relationship between subordinate-supervisor demographic similarity and subordinate perceptions of organizational …

Vascular Depression: An Early Indicator Of Decline, Daniel Lee Paulson

Wayne State University Dissertations

Women over the age of 80 represent a rapidly growing demographic group. While older women live longer than men, they do so with more years of disability and frailty. The emergence of geriatric disorders such as vascular disease, depression, frailty and cognitive decline in the aging US population place additional strain and expense on the already over-burdened public health care system. Meanwhile, integrated models of care are associated with preserved functional independence, reduced medical costs, and greater satisfaction for both health care providers and patients. Implementation of integrated care demands process-models of disease that contextualize symptoms within broader patterns of …

Dispositional Mediators Of Burnout Syndrome In A Sample Of Direct Care Staff Employed At Group Homes In A Midwestern State, Cristovao Bartolo Carreira

Wayne State University Dissertations

The current research examined the dispositional characteristics that mediated burnout syndrome in a sample of direct care workers who were employed in group homes for the mentally ill in a Midwestern state. Specifically, the indirect effects that the direct care staff's attachment systems and problem solving ability were examined as they applied to their potential burnout status. Attachment theory, a contemporary psychodynamic theory of personality, was used to provide a context for the study. The researcher studied the interactions between construct subcomponents to address a criticism in the literature stating that only total scores were used to study burnout and …

White Matter Integrity And Age Related Differences In Reaction Time Components, Yiqin Yang

Wayne State University Dissertations

Reduced speed in information processing is a well-documented phenomenon associated with advanced aging. Age-related deterioration in white matter integrity might play a role in age-related increase in reaction time (RT). However, the association between microstructural differences in particular white matter regions or tracts with RT is unclear. Decomposing RT into parts might be a better way to understand the relationship due to multiple processes involved in RT. In a lifespan sample of 90 healthy normotensive participants, this study examined the association between RT components derived from the Ratcliff diffusion model with age related difference in DTI indices of a wide …

Neuropsychological Outcome In Relation To Duration Of Early Orphanage Experience, Jacquelyn Marie Perry Avery

Wayne State University Dissertations

In this sample of 144 children with a history of prior orphanage experience, increasing duration of institutionalization is related to decreasing performance for a number of cognitive domains, most consistently verbal measures and executive Functioning measures. The relationships with duration for measures requiring visual-spatial skills were more mixed and a visual reasoning task was found to significantly relate to duration but not a measure of visual memory or a measure of nonverbal achievement. There was little evidence to support a relationship between the duration of institutionalization and fine-motor dexterity. The strongest relationships with duration were observed for language measures followed …

The Influence Of Gender And Aging On The Neural Circuitry Supporing Facial Emotion Processing In Adults With Major Depressive Disorder, Emily Briceno

Wayne State University Dissertations

Major Depressive Disorder (MDD) is associated with decrements in facial emotion processing (FEP). Previous studies investigating the neural substrates of these decrements have often reported hyperactivity of emotion processing circuitry. Neural circuitry supporting FEP has been shown to be different between healthy men and women, and between young and elder adults. However, no prior studies have investigated how gender and aging affect emotion processing circuitry in individuals with MDD. The present study aimed to investigate the influence of gender and aging on emotion processing circuitry in MDD. One hundred-ten adults, grouped into subgroups according to MDD status, gender, and age …

The Relationship Between Generalized Anxiety Disorder In Women And Hormonal Imbalances, Self-Efficacy And Lifestyle: Implications For Licensed Professional Counselors And Counselor Educators, Gillian Bernadette Robbins

Wayne State University Dissertations

The intent of the study was to conduct a preliminary enquiry of the relationship between Generalized Anxiety Disorder (GAD) in women and hormonal imbalances, self-efficacy, and lifestyle. Key consideration was given to the study as it points to implications for licensed professional counselors and counselor educators. A nonexperimental, correlation design was used in the study and conducted in a large urban city in Ontario, Canada. Participants in the study were female clients receiving bio-identical hormone replacement therapy (BHRT) for a minimum of three month at a Medical Health Spa. A total of 55 participants completed a demographical survey, the Generalized …

The Effects Of Two Group Counseling Interventions On Arab-American High School Students' Perceptions Of Their Primary Relationships (Parent, Teacher, Peer), Nuzmeya Bader Elder

Wayne State University Dissertations

This study specifically investigated the effects of two group counseling interventions on Arab-American high school students' perceptions of the strength of their primary relationships (parent, teachers, and peers). It was designed to help high school students increase their acceptance of the culture of their host society and develop a sense of comfort so they can retain some of their own culture and Arab identity without feeling they will totally lose them. One approach was Choice group theory grounded in the reality of making choices concerning thoughts and behaviors. Choice Theory is described as the idea that people have mental images …

It's A Birth Not A Procedure: An Ethnographic Study Of Intrauterine Fetal Death In A Labor And Delivery Unit Of An American Hospital Setting, Catherine Mcleod Griffin

Wayne State University Dissertations

Life transitions such as birth and death constitute a significant area within anthropological studies of ritual. It is important to investigate how individuals, groups, and communities organize around these events. Birth and death can be considered as rites of passage that mark key life transitions (van Gennep 1909/1960). Thus birth and death related rituals need to be investigated within the social and cultural context of American hospital settings to better understand the social organization of life, death, and personhood. In the American hospital setting, a reproductive loss at any gestational age receives the medical diagnostic label of an intrauterine fetal …

Preterm Birth And The Perception Of Risk Among African Americans, Gwendolyn Simpson Norman

Wayne State University Dissertations

Background: African American women deliver preterm at a rate that is two to three times that of their white counterparts, and after decades of research, this disparity in birth outcomes still remains unexplained. While factors including income, education, neighborhood conditions, infection and stress have all been associated with prematurity, no combination of these factors has explained why the disparity persists. Recently, however, racism-specific stress has emerged as a possible factor contributing to this disparity. This study was designed to learn how preterm birth was explained by African Americans directly impacted by prematurity. Methods: Interviews were conducted with African American women …

"Still Here, Trying To Find My Way": Understanding The Experiences Of Hiv Disruption And Reorganization Among Older African Americans In Detroit, Andrea Nevedal

Wayne State University Dissertations

Adults aged fifty and older are the fastest growing age group with HIV/AIDS. Research on older adults with HIV has focused primarily on health status and physiological changes that occur as people age with HIV. However, little is known about the socio-cultural consequences that occur when older adults are diagnosed with HIV and as they age with HIV. Drawing from an anthropological approach to the life course and Becker's (1997) framework of life disruption, this dissertation research explored to what extent people experienced disruption from living with HIV and reorganized their lives after experiencing disruption.

The specific aims included identifying …

Motivating Adolescents To Chat For Health (Match): Improving Nutrition And Physical Activity In Urban Youth, Jaclyn Beth Issner

Wayne State University Dissertations

Adolescence represents a unique period of development that is filled with both opportunities and challenges. Choices and health patterns, such as sedentary activity or poor dietary intake, which are established during adolescence can set the stage for adulthood. Obesity in youth has emerged as a major health problem in the United States and across the globe (American Academy of Child and Adolescent Psychiatry, 2012). One way to help prevent obesity is by incorporating preventive intervention services into primary care health systems. The current study, therefore, evaluated the effects of a brief 1-session intervention delivered in a primary care setting in …

The Relationship Of Rehabilitation Counselors' Knowledge Of The Americans With Disabilities Act 1990, Attitudes Toward Reasonable Accommodation, And Job Development Efficacy, Joy Elizabeth Inniss-Johnson

Wayne State University Dissertations

The purpose of this research was to evaluate the relationship between the rehabilitation counselors' level of knowledge, attitudes towards reasonable accommodations and job development efficacy. The more knowledgeable rehabilitation counselors are about ADA, reasonable accommodations, and their attitude toward job development, the less likely their attitudes will be expected to fluctuate. In addition, there has been very little research in terms of evaluating rehabilitation counselor's level of job placement efficacy. A survey-based design was utilized to create both a quantitative description of knowledge of the ADA, beliefs about reasonable accommodations and job placement efficacy and qualitative information concerning the barriers …

An Examination Of The Effects Of Medicare Part D On Racial/Ethnic Disparities, Elham Mahmoudi

Wayne State University Dissertations

This dissertation seeks to evaluate whether Medicare Part D has reduced racial/ethnic disparities in prescription drug utilization and spending among Medicare seniors. Using nationally representative data on White, African-American, and Hispanic Medicare seniors from the 2002-2009 Medical Expenditure Panel Survey, this dissertation analyzes eight measures of access and utilization related to prescription medications. This dissertation applies the Institute of Medicine's definition of a racial/ethnic disparity, and adopts a difference-in-differences quasi-experimental design, using a multivariate regression framework. It finds strong evidence that Medicare Part D reduced ethnic disparities in prescription drug use, total prescription drug cost, out-of-pocket prescription drug cost, and …

Perceived And Functional Disability In Adults With Chronic Pain: What Accounts For Discrepancies?, Dana Catharine Nevedal

Wayne State University Dissertations

Disability among patients with chronic pain can be assessed functionally (behaviorally) or subjectively (self-report). However, discrepancies--including low or zero correlations--between these methods are commonly reported. Research suggests that subjective disability may be more influenced by psychosocial factors than disability measured during functional tasks, leading to under/over reporting, but further investigation is needed. This study sought to identify correlates of discrepancies between subjective and functional disability in two samples of patients with chronic pain.

Retrospective data was compiled from clinical records of 389 patients evaluated at a university multidisciplinary chronic spinal pain treatment program (52.7% men; 88.9% White, 9.8% Black; spinal …

Development And Initial Psychometric Evaluation Of A Culturally- Sensitive Beliefs About Personal Weight Survey, Stephanie Pickett

Wayne State University Dissertations

ABSTRACT

DEVELOPMENT AND INITIAL PSYCHOMETRIC EVALUATION OF

A CULTURALLY-SENSITIVE BELIEFS ABOUT PERSONAL WEIGHT SURVEY

by

STEPHANIE PICKETT

December 2012

Advisor: Dr. Rosalind Peters

Major: Nursing

Degree: Doctor of Philosophy

The purpose of this study was to develop and perform initial psychometric evaluation of an instrument that measures beliefs about personal weight in young African American women. Beliefs about personal weight were defined as a multidimensional concept consisting of the convictions regarding the descriptive characteristics, causal attributions, and consequences of one's personal weight. The theory of self-care (Orem, 2001) was used to conceptualize concepts and conceptual relationships.

The Beliefs about Personal …

Using The Protection Motivation Theory To Examine The Effects Of Obesity Fear Arousal On The Physical Activity Of Young Adult Female College Students, Bibia Renee Redd

Wayne State University Dissertations

The national rate of physical activity has been consistently declining while obesity and obesity-related illnesses are on the rise (French, Story, & Jeffrey, 2001; James, Leach, Kalamara, & Shayeghi, 2001; Malnick & Knobler, 2006). The current study employed a 2 (severity) x 2 (susceptibility) x 2 (intention implementation plan) x 3 (time) longitudinal within subject design examining the effects of the Protection Motivation Theory (Rogers, 1975, 1983) on the physical activity among 87 overweight young adult college females. A main effect was hypothesized for short-term severity, personal susceptibility, and the development of an intention implementation plan messages and an interaction …

Examining The Relationship Among Physical And Psychological Health, Parent And Peer Attachment, And Cyberbullying In Adolescents In Urban And Suburban Environments, Jemica Monique Carter

Wayne State University Dissertations

Cyberbullying is a new phenomenon that has received substantial attention via media. An extensive review of the literature revealed limited nursing research on this topic. The purpose of this study was to examine the impact of cyberbullying on adolescents' physical (e.g., headache, stomachache, etc.) and psychosocial (e.g., self-esteem, depression, post traumatic stress syndrome, etc.) outcomes. Individuals who experience repeated traditional bullying are at increased risk for experiencing repeated incidents of cyberbullying. Research has shown that effects of cyberbullying may be more traumatic than traditional bullying because victims can be bullied 24 hours and 7 days a week, on and off …

The Effects Of Racially-Motivated Emotional Arousal On The Eating Behaviors Of African American Women, Lenwood W. Hayman

Wayne State University Dissertations

Disparities between African Americans and Caucasians remain vast across a wide variety of health indicators. Chronic stress has been identified as a risk factor for a variety of chronic illnesses and poor health outcomes. One type of chronic stress that has been linked to health disparities is the stress associated with experiences of racial discrimination. The stress African Americans encounter as a result of their racist experiences contributes to a chronic elevation of their physiological stress response. In addition to stress, a major risk factor for coronary heart disease and diabetes is obesity, which has been established as a major …

Work-Family Boundary Management Strategies: Examining Outcomes, And The Role Of Fit, Madhura Chakrabarti

Wayne State University Dissertations

As more and more people attempt to effectively manage the simultaneous demands of work and family, researchers are now trying to investigate the various ways by which people choose to do so. The present study investigated the concept of boundary management strategies that describes the work-family interface in terms of cognitive, physical, and behavioral boundaries between work and family domains that individuals actively try to manage in order to balance the two worlds. Research in boundary management strategies has been minimal due to the the novelty of the construct. In this study, specific individual and organizational outcomes like work-family conflict, …

Improving Blood Pressure Control In Esrd Through A Supportive Educative Nursing Intervention, Zorica Kauric-Klein

Wayne State University Dissertations

ABSTRACT

IMPROVING BLOOD PRESSURE CONTROL IN ESRD THROUGH A

SUPPORTIVE EDUCATIVE NURSING INTERVENTION

by

ZORICA KAURIC-KLEIN

May 2011

Advisor: Dr. Nancy T. Artinian

Major: Nursing

Degree: Doctor of Philosophy

Problem: Hypertension in chronic hemodialysis (HD) patients contributes significantly to their morbidity and mortality. Statistics indicate the hypertension rate amongst HD patients ranges from 75 to 100 %. Studies have indicated that adherence rates to self-care behaviors related to salt and fluid intake and medication regimens are very poor in the HD population. Traditional hypertension management strategies have been found to be largely ineffective. There is modest evidence indicating that interventions …