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Why Giving Up The Keys Can Be Terrifying: Examining Driving Retirement Through A Terror Management Theory Paradigm, Perri Navarro

Dissertations

Driving retirement, or giving up the keys, is a current topic of interest in the gerontological literature. Most adults will outlive their ability to drive safely, yet do not plan for driving retirement, although planning for driving retirement appears to result in better outcomes. The current study examined the possibility that older adults avoid driving retirement because it is a mortality prime (reminder of death), as well as the possible role of implicit self-esteem in buffering against mortality concerns specifically in an older adult population. Participants in the current study (n=90) were randomly assigned into one of three …

Assessment For Mild Cognitive Impairment: Striving For Best Practice, Julie Leigh Dalmasso

Dissertations

This dissertation is a series of three studies aimed at determining the best assessment practices for mild cognitive impairment (MCI) that can employed by speech-language pathologists (SLPs). The first study was non-experimental and descriptive examining whether three commonly used assessment instruments yielded similar categorical results. The data were analyzed to determine whether the Eight-Item Interview to Differentiate Aging and Dementia (AD8), the Mini-Mental State Examination (MMSE), and the Cognitive-Linguistic Quick Test (CLQT) identified the same participants from a neurotypical sample as having cognitive deficits. Very little agreement was found amongst the three tools.

Study two was modified to include two …

Predictors Of Cognitive Function Among Cognitively Impaired Older African Americans Living In Congregate Residential Settings, Zyra Daffodil Apugan

Dissertations

The purpose of this secondary data analysis was to identify potential psychosocial predictors of cognition, including social support, depression, and functional activity, among older African Americans, ≥ 65 years, with a diagnosis of Alzheimer’s disease and living in congregate residential settings. Guided by the main effect model of social support, this study used existing data from the National Alzheimer’s Coordinating Center Uniform Data Set, an NIH-funded multicenter study. Results showed that on average, the participants (n=56) were 81.7 years of age with 13.8 years of education. All, but six, were married. Bivariate Pearson correlations indicate a moderately strong negative relationship …

A Video Intervention For Professionals Working With Transgender And Gender Nonconforming Older Adults, Allison R. Warren

Dissertations

Abstract

There is consensus that providers who work with transgender and gender nonconforming (TGNC) older adults should use the language preferred by the older adult; however, self-efficacy in this particular context is unexplored. The current study compared the efficacy of three online interventions for aging-focused professionals designed to increase knowledge of TGNC-related terminology, decrease self-reported negative attitudes towards TGNC individuals, and increase self-efficacy for affirmative interactions. Employees and volunteers of area agencies on aging across the United States (N = 155) were randomly assigned to one of three interventions: written educational information, a video demonstration, or both the written educational …

The Influence Of Participation In Socially Engaging Or Complex Physical Activities On Executive Function Among Older Adults, Lyndsie M. Koon

Dissertations

The preservation of cognitive function is of particular importance for the maintenance of independence and functional autonomy for older adults (Hertzog, Kramer, Wilson, & Lindenberger, 2008). Physical activity is a behavioral intervention that contributes to mental and physical health; it has also been found to promote cognitive function across a lifespan. Cognitive processes that assist with goal-directed behavior to successfully complete everyday tasks known as executive functions are susceptible to physical activity participation especially among youth, adolescent, and older adult populations. Various aspects of the physical activity context might help mediate improvements to executive function including the task complexity of …

The Acute Care Pediatric Nurse Practitioner In Missouri: An Analysis Of Needs Assessment, Jessica L. Mann

Dissertations

Introduction: Due to an increasing number of acutely ill pediatric patients and changing healthcare demands, there is an even greater need for nurse practitioners (NPs) to work in the area of pediatric acute care (AC). There is a lack of alignment of education and certification with the scope of practice of the AC Pediatric Nurse Practitioner (PNP). The development and implementation of a graduate level AC PNP program in Missouri will support the alignment of education, clinical training, and certification with the scope of practice of the AC PNP and improve access to a quality program for nurses that currently …

Investigating Personality Traits Of Registered Nurses: Implications For Personnel Evaluation, Stephanie N. Means

Dissertations

The United States is currently facing a registered nurse (RN) shortage that is expected to reach the millions in the next few years. Since the beginning of the century, healthcare professionals and administrators have strived to develop and implement ways to increase recruitment and retention in the nursing field. It has been recognized that the key to recruitment and retention is to get the right nurse in the right place, which means focusing on clinical proficiencies as well as personality qualities and characteristics. Personality assessment has long been used to evaluate person-job (P-J) fit of applicants for positions across the …

The Hidden Morbidity Of Cancer: An Exploratory Study Of Burden In Caregivers Of Cancer Patients With Brain Metastases, Marlon Garzo Saria

Dissertations

The aim of this dissertation was to explore the antecedents and outcomes of caregiver burden within the context of brain metastases using the Comprehensive Health Seeking and Coping Paradigm as a framework to describe the highly interactive iii relationship among the variables. The first paper derived from this dissertation is a literature review that describes the challenges of caring for a patient with brain metastases and highlights the implications for healthcare professionals. The second paper presents the analysis of the relationships between caregiver burden and the affective disorders anxiety and depression. It describes the higher risk of screening positive for …

Aging Well In 21st Century America: Towards A Theological Ethics Of Aging, Chrisitan Cintron

Dissertations

As Third Agers transition into life after work they are faced with a renewed challenge, living the good life. The normative images emanating from the social and cultural landscape allow Third Agers to either envision and live their new life, or adopt a course set out for them. These new lives require a re-discovery and re-defining of the self, a reinterpretation of one's role in society, and relationship to others. As with other phases of life, individuals need guidance when confronted with images of living well that are contradictory or perhaps antithetical to what they imagined for themselves. Various social …

An Evaluation Of The Acceptability And Effects Of A Computer-Delivered Values-Based Behavioral Activation Treatment For Depression Among Older Adults, Kellie Reynolds

Dissertations

Depression is a common psychological disorder among older adults and is associated with serious secondary effects to health and social well-being. Behavioral activation has been found to be an efficacious treatment for depression. However, there is limited research on the treatment effects of behavioral activation with older adults. In general, older adults under-utilize mental health treatments. Computer-delivered treatments have been developed to address access and under-utilization. The purpose of this dissertation was to evaluate the acceptability and effects of a computer-delivered values-based behavioral activation treatment for depression in older adults. This study consisted of two phases. Phase I consisted of …

Narrating Transitions: Experiences Of Individuals And Couples Regarding Relocation Into Assisted Living Communities, John Scott Branson

Dissertations

The purpose of this qualitative study was to better understand the experiences of older adults regarding the process of transitioning into assisted living facilities. A constructivist epistemology, narrative methodology, purposeful sampling, and dialogic performance analysis were used to generate the final representations. Data for the study were collected through transcribed video and audio-recorded interviews, member checks, and researcher journals. Data analysis involved recursive movement between written transcripts, video recordings, researcher journals, and cultural contexts. The initial outcome of this this study was a written narrative that interweaves data analysis with narratives of gaining access, sampling, conducting interviews, and member checking. …

Readiness Of Counselor Education And Supervision To Provide Master's-Level Suicide Training, Jenny L. Cureton

Dissertations

The Counselor Education and Supervision field serves to prepare counselors-in-training to practice counseling. The Council for the Accreditation of Counseling and Related Educational Programs includes suicide training in its standards for accredited counseling programs (2009, 2015). Counselor educators and supervisors have an obligation to use the latest knowledge in the counseling profession and their professional competence to provide counselor training on ethical practice (American Counseling Association, 2014) including suicide-related counseling situations. The Counselor Education and Supervision field needs to change master’s-level suicide training. The field’s previous master’s-level suicide training appears lacking. Recent developments impact the field and master’s-level suicide training, …

Evaluation Of The Phase Training Model Of Cancer Rehabilitation, Jessica Marlene Brown

Dissertations

Exercise is a well-established method of alleviating cancer-related toxicities during and following treatment in cancer survivors. Due to this clear evidence, exercise-based rehabilitation programs have begun to emerge. Of concern, specific recommendations of exercise prescription for patients at different time points on the cancer continuum have not been developed, and available guidelines are broad and unclear. The Phase Training Model of cancer rehabilitation was created to address this issue and replace our previously used method of exercise-based prescription and intervention. Purpose: To evaluate the effects of the Phase Training Model on cardiorespiratory endurance, muscular strength (MS), and cancer-related fatigue (CRF) …

Exploring The Relationships Between Spiritual Well-Being, Team Regard And Turnover Intention Of Hospice Social Workers: The Mediating Role Of Job Satisfaction, Kimberly Lynn Sangster

Dissertations

According to the US census bureau there are approximately 15,500,000 million Americans over the age of 65 years in 2015. As the population ages and prepares to die, people will need access to quality hospice and end-of-life care. Key to delivery of quality care is experienced hospice social workers. Multiple regression and mediation analysis were applied to explain the path relationships involving the variables of spiritual well-being, an innovative operationalization of the concept of team regard, job satisfaction and turnover intentions of hospice social workers in Medicare-certified hospice programs in the state of Illinois. Other variables in this study included …

Transitions To Assisted Living Within A Continuing Care Retirement Community, Judith H. Scott

Dissertations

Purpose/Aims: The purpose of this study was to explore the lived experience of older single women who moved from their independent homes to the assisted living setting, both situated within a Continuing Care Retirement Community (CCRC).

Rationale: Anecdotally, CCRC transitions have been viewed as either one dreaded possible step toward the end of life or a supportive place to open a new chapter in older adults’ lives. However, no studies have actually examined this experience among older single women, who comprise a large proportion of people making this transition.

Background: Older adults move to assisted living within a CCRC when …

Oxidative Stress In Avian Embyros, Toshi Tsunekage

Dissertations

Oxidative stress has been implicated in mediating trade-offs in the evolution of life histories. Oxidative stress results from an imbalance in the production of free radicals and an organism’s antioxidant defenses. Higher metabolic rates associated with more rapid growth and shorter development periods may increase oxidative stress and accumulated cellular damage in embryonic tissues. In my dissertation I explored oxidative stress and antioxidant defenses in avian embryos. I measured levels of oxidative stress in tissues of different stage embryos of Japanese quail (Coturnix japonica), and tested if patterns of lipid peroxidation could be explained by changes in the developing embryo’s …

Memory Deficits In Older Adults: Evaluating Spaced Retrieval With Multiple Probe Techniques, Christopher Walmsley

Dissertations

Difficulties in recognizing and remembering the names of individuals are a common behavioral symptom of major neurocognitive disorder. A number of behavioral strategies have been proposed to improve memory deficits, including spaced retrieval, an intervention that emphasizes delayed recall of target information. Unfortunately, many of the studies that report beneficial effects of spaced retrieval use a very limited range of outcome measures, thus calling into question the magnitude and generality of any reported memory improvement. This study reports on the impact of spaced retrieval using four older adults with cognitive impairment living in an assisted living facility. All participants demonstrated …

Outcomes Of Prediabetes And Diabetes Education Programs Tailored For Vulnerable Popuations, Diana Al Sayed Hassan

Dissertations

Diabetes is a debilitating disease and if not managed properly it can lead to multiple complications and even premature death. Diabetes continues to disproportionately affect vulnerable populations. The purpose of this three-paper method dissertation was to examine the implementation of a prediabetes and diabetes programs in a community setting to serve vulnerable populations in addition to understanding future diabetes-related educational needs.

The first paper is an evaluation of a shortened five-week diabetes prevention program for older adults with prediabetes or at a high risk for developing type 2 diabetes mellitus (T2DM). Chang in nutrition knowledge, eating and physical activity behaviors, …

Evaluation Of Equivalence Relations: Models Of Assessment And Best Practice, Dawn Amber Seefeldt

Dissertations

Due to changing age demographics in the United States, by 2050, an estimated 62.1 Americans will be over the age of 65 and the number of Americans with cognitive impairment, such as Alzheimer’s disease, will increase drastically as well (Alzheimer’s Association, 2014; Ortman, Velkoff, & Hogan, 2014). Once a diagnosis or behavioral indicators of cognitive impairment are present, it would be beneficial to apply a treatment package that promotes the maintenance or re-establishment of stimulus control in the environment. From a behavioral perspective, stimulus control aids in learning and memory through both respondent and operant conditioning. In the current study, …

Co-Construction Of Personal Narratives In Supporting Identity And Communication In Adults With Aphasia: The ‘My Story’ Project, Katie A. Strong

Dissertations

Stroke and subsequent aphasia can impact a person’s identity negatively, interfering with quality of life. Co-constructing personal narratives about stroke and other aspects of a person’s life is a promising intervention for addressing identity issues. This series of three dissertation studies explored key aspects related to identity, personal narratives, and the perceived impact of telling one’s story.

Study 1 involved a survey examining whether speech-language pathologists view themselves as having a role in supporting the reconstruction of self-identity in adults with aphasia through the use of personal narratives. Results revealed that, whereas the majority of respondents viewed themselves as having …

Heroes And Horses: Veteran And Equine Experiences With Equine Facilitated Learning And Therapy, Karen Elizabeth Krob

Dissertations

No abstract provided.

Exploring How Older Adults Who Qualify For The Association On Aging With Developmental Disabilities (Aadd) Programs And Services Learn To Successfully Age In Place, Tina Grosso

Dissertations

This qualitative case study explored the ways in which older adults with developmental disabilities (DD) learn to successfully age in place. As more persons with DD reach old age and outlive their natural caretakers, such as parents, it is becoming apparent that there are a multitude of age-related challenges and educational needs that must be addressed. However, information pertaining to the unique learning needs of older adults with DD is scarce. Andragogy (the art and science of teaching adults) and geragogy (teaching the elderly) provided the theoretical frameworks for this study. The main research question in this study was: How …

Choices Related To Maximizing Quality Of Life At End Of Life, Theresa Lynn

Dissertations

Humans, including those residing in the United States, can live in denial of their own mortality. Because of this, futile care is sometimes provided, often at great monetary expense and for little or no return in terms of quality or length of life. At least two opportunities exist for making choices regarding care at the end of life in the U.S.: completing advance directives and choosing hospice care. This dissertation consists of three studies related to this topic. The first is a quantitative study about advance directives and attitude toward death. The advance directive completion rate among adults in the …

Validation Of The Transportation Burden Questionnaire Among Family Caregivers Of Older Adults, Bryant James Price

Dissertations

Because family caregivers provide a substantial amount of informal care to dependent loved ones, the potential burden such care may place on family members is an important area for clinical research and intervention. While the provision of transportation is recognized in the literature as a caregiving task and a component of global burden, few studies, to date, have addressed this as a distinct concern for measurement and intervention. The purpose of this study was to determine if an item set focused specifically on transportation burden would be additive to accepted global measures of burden in a volunteer sample of caregivers. …

Staff Perceptions Of Work-Environment Factors Affecting Morale In Southeastern Registrar's Offices, Rheanna Plemons

Dissertations

Studies on morale are prevalent in industry, healthcare, and public educational systems. However, morale studies are limited within higher education and focusing on the support staff at universities. This qualitative study used focus groups to identify themes among support staff in selected Registrar’s Offices in the Southeastern region of the United States. Institutions were chosen based on comparable enrollments and similar organizational structure. The researcher asked participants to discuss their perceptions on current morale levels in the office and how different work responsibilities affect morale. In addition, participants were asked to discuss motivators used by leaders and whether those motivators …

Gdnf Content And Nmj Plasticity In Slow And Fast Twitch Myofibers Follows Recruitment In Exercise, Amy Morrison Gyorkos

Dissertations

Glial cell-line derived neurotrophic factor (GDNF) supports and maintains the neuromuscular system during development and through adulthood by promoting neuroplasticity. GDNF may play a role in delaying the onset of aging and help compress morbidity by preventing motor unit degeneration. Exercise has been shown to alter GDNF expression differently in slow and fast twitch myofibers. The aim of this dissertation project is to determine if different intensities of exercise can promote changes in GDNF expression and neuromuscular junction (NMJ) morphology in slow and fast twitch muscle fibers. Skeletal muscle fibers were analyzed from adult Sprague Dawley rats aged 4 weeks …

Life, Love, And Hegemony On Daytime Tv: A Critical Analysis Of Three Popular Soap Operas, Elizabeth Ann Worden

Dissertations

This study examined the worlds of three popular soap operas: Days of Our Lives, General Hospital, and Young and the Restless. Someone who has not watched the three soap operas examined for this study might think that soap operas are all alike. Yet this study has demonstrated how different they really are. These soap operas are created by different teams of writers, producers, and editors—different real authors. Days of Our Lives, General Hospital, and Young and the Restless are really distinct and different from each other in a number of ways. These programs depict different classes of people with different …

A Description Of Group Supervision In Internships: A National Study Of Programs Accredited By Cacrep, Robert Powell

Dissertations

Counselor Education programs that are accredited by The Council for Accreditation of Counseling and Related Educational Programs (CACREP) must provide group supervision for students during their internship experience. To gain an understanding of what is currently taking place in group supervision during a student’s internship experience in CACREP-accredited counselor education programs, descriptive and qualitative data were collected utilizing an online survey. To capture a profile of who is teaching group supervision as well as their qualifications and experience, the researcher gathered demographic data from 62 participants. All participants in the study had taught group supervision in a CACREP program within …

An Examination Of Executive Function, Mild Cognitive Impairment And Fall Risk In Community Dwelling Older Adults, Jennifer A. Blackwood

Dissertations

The aim of this three-paper dissertation was to examine the relationship between fall risk, executive function (EF) and mild cognitive impairment (MCI) in community dwelling older adults. Papers one and two describe how mild changes in cognition influence performance on four measures of fall risk, the Five Times Sit to Stand Test (FTSTS), usual gait speed, the Timed Up and Go (TUG) test, and the Activities Specific Balance Confidence Scale (ABC) in a group of community dwelling older adults. The third paper describes if participation in a progressively challenging domain specific computerized cognitive training intervention influenced performance on measures of …

The Effects Of An Experiential Learning And Mentorship Program Pairing Medical Students And Persons With Cognitive Impairment: A Qualitative Content Analysis, Darby J. Morhardt

Dissertations

The United States population is aging rapidly and with it a tremendous rise in the number of people with dementia. In the future, as now, physicians and other health care professionals will likely provide the majority of health care for older people and those with dementia. The non-geriatric trained workforce must have the attitudes, knowledge and skills needed to provide high quality care for this aging and increasingly cognitively impaired population. There is evidence that prevailing stigma regarding older adults can be modified with experiential opportunities early in students' career. Few of these programs are aimed at persons with dementia. …