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Health And Relationship Variables Impacting Psychological And Social Well-Being Among Predominantly White Middle Class Adults 65 And Older Who Receive Assistance With Their Care From Family Members, Alyssa C. Ford

Dissertations

The majority of care to persons 65 and older in the United States is provided by family members. Previous research among older adults who receive assistance with their care from family or friends, while sparse, has identified variables that appear to impact the well-being of such persons. These variables include reciprocity, dignity, self-perceived burden, mental health status, and physical health or disability status. However, these variables have not been studied together. The purpose of this dissertation research was to examine these variables individually and collectively as they relate to well-being.

A sample of 71 adults, ages 68 to 97, who …

Social Involvement, Existential Awareness, And Perceived Vulnerability In Older Adults, Maria Zarlengo

Dissertations

The current study explored perceptions of old-age vulnerability by seniors as well as separate and combined effects of social involvement and existential awareness on the level of perceived vulnerability to aging. Two hundred and forty four seniors participated in the study. The data were collected with the use of a 101-question survey based on three published measures plus demographic questions. The dependent (criterion) variable was the vulnerability to old age measured by the Perceived Vulnerability Scale (PVS). The explanatory (predictor) variables included the degree of social involvement measured by the Social Provisions Scale (SPS) and the level of existential awareness …

The Effects Of An Educational Intervention On The Aging Knowlege Of Graduate Counseling Students, Damien Gent Dotson

Dissertations

The purpose of this study was to test the effects of an educational intervention on the aging knowledge of graduate counseling students. Overcoming misconceptions, such as positive and negative stereotypes about older adults, is essential for graduate counseling students to be effectively trained to work with the aging population. Educational interventions have been found to be the most consistently effective way of increasing aging knowledge and helping individuals overcome ageist beliefs rooted in faulty aging knowledge. For this study, it was hypothesized that a comprehensive educational intervention (approximately 2 hours in duration) would increase overall aging knowledge, increase aging and …

Breast Health And Mammography Screening In Older Women, Martha A. Ibarra Phd, Msn, Anp, Rn

Dissertations

Age-related health disparities in breast cancer screening are a public health concern. From 2002 to 2006, the median age for newly diagnosed cases of breast cancer was 61 years and the median age for breast cancer mortality was 68 years of age (Surveillance Epidemiology and End Results [SEER], 2009). Mammography is the best available screening tool for breast cancer detection (Susan G. Komen Foundation, 2008). The Centers for Medicare and Medicaid Services (CMS, 2006) reported that only about half of older women who are eligible for mammograms through Medicare obtain a mammogram every two years. The literature identifies psychosocial barriers, …

Documentation: Delirium In The Hospitalized Older Adult, Jacqueline Fitzgerald Close Phd

Dissertations

Background: Delirium is a common, life threatening and preventable geriatric syndrome. Because this condition is frequently addressed by administering dangerous antipsychotic drugs, it is imperative that accurate systematic assessments are charted to determine the actual need for these medications. The purpose of the study was to describe medical record documentation of a systematic assessment of delirium in older adults who had been administered an antipsychotic medication. Methods: A descriptive correlational retrospective design was used for this medical record data based study. The setting was a 107 bed acute care community hospital located in southern California. Inclusion criteria were medical records …

An Inquiry Into Workplace Incivility: Perceptions Of Working Graduate Students, Ashley E. Greene

Dissertations

The purpose of this sequential mixed methods study was to examine and determine the level of incivility in the workplace as a growing problem from the perceptional views of graduate students enrolled in accelerated degree programs for graduate studies in Business Administration, Criminal Justice Administration, Gerontology, Health Management, and Human Resource Management at a private Midwestern university. Modest research on the subject of incivility in the workplace has emerged only recently to identify the problem exists in today‘s workforce, while studies inclusive of diverse populations of employees with short and long term career paths and ranges of employment service years …

Cultural Competence--Does It Matter?: Lessons From A Mixed-Methods Study Of Wraparound Practice, Jennifer James Rose

Dissertations

This mixed methods study investigated whether caregivers' ratings of wraparound fidelity and satisfaction with the wraparound process differed based upon their facilitators' self-assessed cultural competence and caregivers' reported stress. An explanatory sequential design was used. The quantitative phase was completed first. Survey methodology was used to measure reported cultural competence, wraparound fidelity, satisfaction with the wraparound process, and parental stress. Facilitators (n=58) completed a self-assessment instrument, the Multicultural Counseling Knowledge and Awareness Scale (MCKAS; Ponterotto, 1997). The MCKAS survey yielded a 43% response rate. The MCKAS descriptive data found levels of reported cultural competence comparable to previously published studies. Telephone …

Nutritional Status And Clinical Outcomes Of Residents Admitted To A Nursing Home, Sheryl Nespor Phd

Dissertations

Purpose The purpose of this research study was to describe the nutritional status (well nourished, at risk for malnutrition, or malnourished) of residents admitted to nursing homes and adverse clinical outcomes in those residents after four weeks. Methodology A descriptive, correlational design utilizing medical record data was used to examine the relationship between nutritional status and adverse clinical outcomes of weight loss and pressure ulcers. Results The sample (n=69) was predominately Caucasian (90%) with 38% having one or more pressure ulcers on admission. Most of the residents were admitted from an acute care facility (97%) and were either malnourished or …

Implementation Of The 2009 Cacrep Standards Addiction Competencies, Tiffany K. Lee

Dissertations

Addiction issues have been and continue to be significant problems affecting the United States. Over the past few decades, substantial scholarly attention has been paid to the lack of addictions training in the counseling profession. The purposes of this mixed-method study were to examine the current status of addiction training among institutions that offer counselor education programs accredited by the Council for Accreditation of Counseling and Related Educational Programs (CACREP) and determine how institutions plan to integrate the addiction-related competencies outlined in the 2009 CACREP standards.

The quantitative data were obtained from a 15-item online survey completed by 74 CACREP …

Mentoring As A Professional Development Tool In Preparing The Next Generation Of Leaders In The North Carolina Community College System, Manuel C. Dudley

Dissertations

The North Carolina community college is approaching 50 years of existence in 2013. It is a community college system that is respected both nationally and internationally. The economic downturn of the United States has created a period of record enrollment in the community college, as individuals seek upgrades in training, work skills, and educational attainment. This period of record enrollment is not without challenges. Budgetary constraints, a consumer demand for easier access to classes through online and distance learning, and an increase in the racial, ethnic, and cultural diversity of the student population has created a proverbial perfect storm. Many …

Evaluation Of Verbal Behavior In Older Adults, Amy Gross

Dissertations

Older adults make up a large and increasing portion of the population (U.S. apply those assessments to the evaluation of verbal behavior in older adults with and without dementia. The research addressed two questions. First, in what way do verbal behavior problems differ between older adults with and without dementia? Second, does language deteriorate in a pattern compatible with Skinner's analysis of functionally independent verbal operants? Thirty-one participants were categorized into Control (n=15) and Dementia (n=16) Groups based on their score on the Dementia Rating Scale-2. Verbal behavior assessments were administered to participants on two occasions, separated by one week. …

Preference Assessments For Older Adults With Dementia: Utility Of The Mswo Procedure And Assessment Of The Stability Of Preference, Paige B. Raetz

Dissertations

Individuals with dementia suffer from a variety of cognitive deficits that can lead to a lack of engagement in activities. In recent years, researchers have begun to look at ways to assess preferences in hopes that increased identification of leisure items may lead to increases in engagement. Due to the decline in cognitive status a simple questionnaire may not be sufficient to assess preference for this population. As a result, several recent studies have incorporated the use of systematic preference assessments to assess preference for leisure activities with adults with dementia using a paired stimulus format. The purpose of the …

Policy Determinants And Medicaid Managed Care, Diane Elizabeth Brandt

Dissertations

The U.S. Medicaid program is increasingly challenged by reductions in federal entitlement spending, a faltering private sector health insurance base, escalating health care expenditures and an aging and increasingly diverse population. Converging pressures on state Medicaid programs have challenged state policy makers to find new approaches to enhance program efficiency. One of these policy tools is the adoption of Medicaid managed care programs for individuals with chronic illness and disability, particularly important as these enrollees incur the highest health care costs. The increasing prevalence of chronic illness combined with the growth of households in poverty creates significant implications for Medicaid …

Older Adults And A Writing Workshop: A Phenomenological Study, Jennifer Lynn Alex

Dissertations

This study examines how older adults experience the phenomenon of participating in a writing workshop and how older adults interpret their experiences, understandings, and realities of writing. Ten older adults, ranging in age from 62 to 83 with varying degrees of experiences in writing, participated in this study. Through a semi-structured interview, each participant related his or her experience first as a writer and then as a member of a writing workshop offered through a Community Literacy Center in a mid-sized Appalachian city.

A phenomenological analysis method was used to identify and analyze themes of meaning that emerged in the …

Physician's Experiences With Death And Dying: A Phenomenological Study, Deborah Jo Corker

Dissertations

This qualitative phenomenological study attempts to gain the physician's essences, meanings and understanding surrounding death and dying. Starting with themes revealed in literature, in-depth interviews were used to ask selected physicians providing care: How does death affect them? Are physicians receiving adequate training in end-of-life care? Does the medical culture still see death as failure? How do they find meaning in end-of-life care? Using three different groups of physicians: early in career, mid-career, and retired, this research attempted to examine the phenomena of death and dying over apparent time and developmental experiences of physicians. Results: Physicians have not been adequately …

Later Life Decision-Making: Experiential Adult Learning And Successful Aging, Shauna Pearce Breland

Dissertations

The focus of this study was on how aging adults make critical life decisions such as those involving health care and health care benefits, living arrangements for later life, and organizing personal affairs. The participant group consisted of 8 sexagenarians and 4 septuagenarians who had recently made or were currently making these critical life decisions.

The study employed both qualitative and quantitative methods. A qualitative phenomenological approach was used to allow the researcher to examine the phenomena of decision-making and aging within the context of the life experiences of the individuals being studied. Each subject participated in a single in-depth …

Battery And Abuse In The Elderly: A Forensic Analysis, Amy Y. Carney Phd, Mfs, Np

Dissertations

Elder abuse is a recognized social problem in the United States. First labeled as "granny battering" and originally studied under the umbrella of family violence, maltreatment of the elderly has received more funding and research in recent years. Multiple aspects of elder abuse have been examined in the literature including measures for detection, assessment, and documentation. Although studies have examined the circumstances surrounding abuse as well as theories of causation and characteristics of the abuser and the abused, studies of the relationship between the abuser and the abused are less well documented. The purpose of this research was to examine …

Quality Of Life, Religious/Spiritual Coping, Demoralization And Depression In Heart Failure Patients, Terry Larsen Phd, Rn, Cns

Dissertations

Background: Research suggests that the heart failure (HF) population is particularly vulnerable to depression. Other factors may also affect quality of life such as religious/spiritual coping, and demoralization. Purpose: The purpose of this descriptive correlational study was to examine factors that predict health-related quality of life (HRQoL) in adults with heart failure. Specific Aims: (1) to examine level of religious/spiritual coping, spiritual distress, demoralization, depression and HRQoL among adults with heart failure; (2) to examine the relationships of religious/spiritual coping, spiritual distress demoralization, depression and selected demographic variables (age, gender, race/ethnicity and length of living with HF) with HRQoL. Methods: …

Acceptability Of Interventions To Staff In Long-Term Care Settings For Older Adults: Comparing Ratings And Hierarchical Selection, Jonathan C. Baker

Dissertations

Older adults and their caregivers generally prefer behavioral interventions over medications in treatment acceptability studies (Osterkamp, Mathews, Burgio, & Hardin, 1997). However, previous acceptability studies have primarily examined ratings, which did not force the responder to select between treatment options. Additionally, recent advances in behavioral treatment technologies (Carr & LeBlanc, 2003) and pharmacotherapy (Schneider, 1999) warrant revisiting treatment acceptability for older adults. The present investigation examined treatment acceptability of behavioral, pharmacological, and sensory interventions using a treatment acceptability rating scale, treatment selections, and direct report of treatments used in a six-month window. Fifty-six staff from nursing homes in the Mid-West …

Visual Impairment And Eye Care Among Older Americans: Secondary Analysis Of The Behavioral Risk Factor Surveillance System (Brfss), Amy L. Freeland

Dissertations

The aim of this three-paper format dissertation is to explore three topics relevant to public health and vision loss. The three papers are independent studies, yet build upon each other by first describing the population of people aged 40 years and older in the United States in terms of visual impairment, diagnosed eye disease/injury, and their use of eye care, and then next exploring the factors that influence eye care use for both the general population and the subpopulation of people with diagnosed diabetes. The first paper provides a state-level examination of the characteristics of people aged 40 years and …

Predicting Counseling Psychologists' Attitudes And Clinical Judgments With Respect To Older Adults, Jody K. Tomko

Dissertations

With an emphasis on developmental, strengths-based approaches, as well as a commitment to training multiculturally competent practitioners, the profession of counseling psychology and counseling psychologists are potentially equipped to help address the mental health needs of older adults. Amid projections that Baby Boomers will utilize mental health services at a higher rate than previous cohorts (Rosowsky, 2005), understanding the factors involved in preparing counseling psychologists to provide services to older adults is critical. Older adults, however, have not traditionally been a population served by psychologists (Laganà & Shanks, 2002). Further, possible factors involved in the training and experience of counseling …

Spirituality And Symptom Self Management Of Osteoarthritis, Lois M. Kannan Phd

Dissertations

Healthcare providers need to identify holistic self-care techniques that are endorsed by patients as effective strategies for symptom management of osteoarthritis, which is the single most common cause of disability in older adults. Research in this area may direct the development of interventions to ensure that older adults are afforded every opportunity to remain active and productive, with an improved health related quality of life, despite age related musculoskeletal conditions. The purpose of this study was to describe the relationships among symptom experience, symptom management, and symptom outcome based on spiritual well-being. A quantitative, descriptive, correlational, and noninterventional study design, …

Mortality Prognostication In Long-Term Care Residents: The Mds-Chess Scale, Caroline Etland Phd, Msn, Cns

Dissertations

Quality end of life (EOL) care for the elderly continues to be a challenge, in part due to late referral for palliative and/or hospice services. The purpose of this study was to determine the accuracy of the MDS-CHESS scale (Hirdes, Frijters & Teare, 2003) in predicting 6-month mortality in a stable American nursing home (NH) population. A secondary aim was to determine any differences in mortality between the 2 sites. A sample of 191 residents of two NHs was analyzed in a retrospective, correlational cohort study, using data collected from the federal MDS database. Correlational statistics and logistic regression were …

Effects Of Two Parkinson’S Disease Patient Education Models On Disease Self-Management And Quality Of Life, Lorraine Pearl-Kraus

Dissertations

Purpose. To compare the effects of Parkinson's Disease Collaborative Care (PDCC) and Parkinson's Disease Information Training (PDIT) patient education disease-management models on patients' (a) perceived self-efficacy in PD self-management, and (b) self-reported perceived PD-Health Related Quality of Life.

Methods. 41 middle-stage (Hoehn & Yahr Stages 2 & 3) patients (24 males & 17 females; age range 48-78; mean 67.59 years) were randomized to the PDCC (n = 21) or PDIT (n = 20) group. Prior to inception, 3 withdrew; after the first session, 3 more withdrew. Participants in both groups attended three consecutive weekly, 2-hour patient education sessions with presenters …

E-Portfolios: Their Impact On Preservice Teachers' Self-Directed Learning And Computer Technology Skills, Yufang Carole Huang

Dissertations

Students in the Teacher Education Program at the University of Missouri-St. Louis have to complete their professional E-portfolios to be certified for the program. An E-portfolio demonstrates a future teacher¿s knowledge, skills, and abilities acquired through teaching and learning. Five qualitative case studies were investigated to understand how E-portfolios impact preservice teachers¿ self-directed learning readiness (SDLR) and computer technology skills (CTS). Data were gathered from the preservice teachers¿ pre- and post-questionnaires, interviews, observations, and their completed E-portfolios. Two internship students and three student teachers were observed creating their E-portfolios during a 16-week semester. During the period, some sought assistance from …

Transition To Nursing Home Of Korean-American Elders, Myungja Kim Hahm Phd

Dissertations

The purpose of this study was to explore factors affecting Korean-American (KA) elders during the transition to nursing homes in the first month following admission. The three aims of this proposed study were (1) to explore culture specific factors that affect KA elders' perspectives during the transitional period to a nursing home, (2) to identify thoughts and feelings of KA elders about their admission into a nursing home, (3) to describe the adjustment process associated with admission to a nursing home. A grounded theory design was utilized to explore KA elders' perceptions/experiences associated with adjustment to a nursing home. Open-ended, …

Older Single Women In Transition: Moving To A Supportive Retirement Community, Linda L. Hansen-Kyle Phd

Dissertations

This study explored role changes, resilience, social, and health challenges encountered by older women who transitioned to a retirement community that provided social, health, and safety support structures. The aim of this study was to analyze and describe the transition from the viewpoint of the participants. Although previous research has shown transitions lead to psychosocial, emotional, physical, and health changes, the importance of this study stems from the lack of research on older women moving to supportive communities and their unique challenges. A convenience sample of 39 women, aged 70-94, who had been living alone before moving to a church …

Exercise Self-Efficacy, Stages Of Exercise Change, Health Promotion Behaviors, And Physical Activity In Postmenopausal Hispanic Women, Pamela Wolfe Kohlbry Phd

Dissertations

The purpose of this correlational research is to understand the relationships among the variables of exercise self-efficacy, stages of exercise change, health promotion behaviors, body mass index (BMI), health problems, and the level of physical activity in postmenopausal Hispanic women. The significance of this study is to contribute research that enhances the understanding of the relationship of psychosocial and health promotion correlates and physical activity in postmenopausal Hispanic women. On a national level, this is important because Hispanic women make up one of the fastest growing minority populations and they experience the second highest level of obesity. This research is …

A Behavioral Model For The Assessment And Management Of Dehydration In Older Adults, Leilani Feliciano

Dissertations

Dehydration is a serious health concern in the elderly, constituting 1 of the 10 most common causes for hospitalization in this population (Sanservo, 1997). Previous research on dehydration has typically been conducted within nursing home settings (Chidester & Spangler, 1997; Holbren, Hassell, Williams, & Helle, 1999; Spangler, Risley, & Bilyew, 1984) without specific attention to the variables maintaining dehydration for any given individual. A functional behavioral approach to assessment and prevention or intervention for dehydration would involve identifying maintaining variables in the environment that can be altered to produce effective, non-intrusive interventions to increase healthy fluid consumption. The current project …

Spiritual Well-Being And Quality Of Life As Correlates Of Job Stress Among Academic Chairpersons In Selected Seventh-Day Adventist Tertiary Institutions, Russell Mark Aldridge

Dissertations

Problem . Stress, like pain, begins at birth and remains common to the human condition throughout life, and it is a factor in the experience of every human being who ever lived. It is not merely universal but it is also endemic and omnipresent. Chairpersons, due to the bi-directional demands of administration and students are in a stressful environment. This study was undertaken to identify whether quality of life and spiritual well-being play an important role in occupational stress levels in chairpersons of Seventh-day Adventist Tertiary Institutions.

Method. Three questionnaires were used to get responses from 137 chairpersons in …