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Thesis (M.S.)--Boston University

Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01

Aim: To present a literature review of the positive effects and overall reduction of depressive symptoms that an intervention such as therapeutic gardening has on individuals living within memory care facilities. Background: As most humans age, they often lose abilities or skills that they have had for their entire lives (e.g. driving, grooming, toileting, seeing and/or hearing). By implementing programs that involve therapeutic garden therapy, individuals with dementia who are at greater risk for clinical depressive symptoms may find that this alternative approach improves their symptoms. Methods: A comprehensive, electronic, literature search in the CINAHL database was completed and included the keywords therapeutic garden, horticulture therapy, and dementia or Alzheimer's. Information has been extracted from sources based on whether they met specific inclusion and exclusion criteria and if they showed positive effects of alleviating depressive symptoms within the defined population. The literature was critically analyzed and common themes were extracted to gain a deeper understanding of the existing research and presented as a written report. Significance: In 2018, dementia costs in the United States were upwards of $215 billion, and is said to potentially double by 2040 due to an increase in aging within the baby boomer generation (PRB, 2018). These numbers are spiking at a rapid rate which then leads to a rise in elderly individuals with dementia needing more specialized care. Memory care facilities assist with this care and are integrating newer non pharmacological ways to approach managing symptoms of dementia, such as Therapeutic Gardening. Conclusions: This review has shown proof from multiple studies that there are a large amount of positive findings when a therapeutic gardening intervention is applied to help the dementia population. The majority of the findings were related to an increase in an overall quality of life, but there were many other changes noted in individuals receiving this therapy including, but not limited to: reduction in agitation, positive changes in behavior, physical and mental health benefits, alleviation of social isolation, and potential changes in cortisol levels. Key words: Dementia, therapeutic gardening, depression

Heart disease is a major health problem affecting the octogenarian today. As age increases, so does the risk for heart disease. One accepted treatment for heart disease is open-heart surgery. The incidence of open-heart surgery performed on the octogenarian is increasing. Open-heart surgery has risks. It is costly and stressful for the patient and family. A major focus of the last decade has been on healthcare costs, outcomes, and quality of life. While information on functional status of the octogenarian following open-heart surgery is available, there is little information available related to the perceived quality of life in the octogenarian following open-heart surgery. Comprehensive tools specific to this population are also not available. The purpose of this study was to examine the perceived quality of life and functional status in the octogenarian following open-heart surgery. The theoretical framework used for this study was the Quality of Life (QOL) model adapted for cancer survivors (QOL-CS) (Ferrell et al., 1995). A descriptive research design was used. The sample frame included eligible octogenarians, who underwent open-heart surgery between January 1, 1998 and February 1, 1999, by a group of cardiac surgeons in the Central Florida area. The New York Heart Association (NYHA) functional status was used to assess the participant's functional level. To assess quality of life, the Quality of Life Scale/Cancer Survivor (Ferrell, Grant, & Hassey-Dow, 1995), in modified form, was used. Both instruments were assessed by a panel of experts to establish content validity. The QOL-CS tool had established validity, internal consistency, and reliability based on the literature review. Crohnbach's alpha measure of internal consistency was also performed on the revised tool. Pfeiffer's Short Portable Mental Status Questionnaire (SPMQ) was administered to assess the participant's mental status prior to their completing the QOLCS tool. The tools were administered over the phone or at the participants home based on their preference. Inclusion criteria were that the participant be between 80 and 90 years old at the time of having open-heart surgery. They also had to be mentally competent and able to understand the English language. The participants completed the SPMQ, a demographic questionnaire, and the QOL-CS modified for this population. The NYHA functional classification was made based on the participant's reported symptoms. Twenty-five people were operated on that fit the criteria and time frame, ten died prior to initiation of the study. Fifteen people were eligible for inclusion in the study, three were unable to be contacted and one refused to participate. Eleven subjects participated in the study. The QOL-CS tool analyzed the domains of physical, psychological, social, and spiritual well being on a Likert scale of one to ten. The mean results were as follows; physical 7.2, psychological 7.2, social 7.1, and spiritual 5.0. A majority of the subjects (73%) were in a NYHA functional class of I or II. The remaining subjects were in class III. This study revealed that for this group, quality of life was above average following open-heart surgery. Further research is needed on larger samples to confirm these results. As more and more open-heart surgeries are performed on the octogenarian, research should continue on the functional outcomes and quality of life associated with these interventions. A tool to examine quality of life, specific to this unique population should be developed.

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The current research examined the influence of the emotional labor strategies of faking emotion and suppression of emotion, empowerment, and geriatric caregiving self-efficacy on the relationship between work stress and emotional exhaustion—one dimension of burnout—for a sample of nursing staff members employed in a state-level geriatric psychiatric hospital. The total sample included 79 participants, which included registered nurses (n = 15), licensed practical nurses (n = 23) , and human service care workers (n = 41) who completed the Stress in General scale (Stanton, Balzer, Smith, Parra, & Ironson, 2001), Maslach Burnout Inventory (Human Services Survey; Maslach, Jackson & Leiter, 1996), Discrete Emotions Emotional Labor Scale (Glomb & Tews, 2004), Psychological Empowerment Scale (Spreitzer, 1995), and Geriatric Nursing Self-efficacy Scale (Mackenzie & Peragine, 2003). The mean emotional exhaustion score for the sample fell in the moderate range of burnout. First, it was hypothesized that work stress and emotional labor strategies (i.e., faking emotion and suppression of emotion) would have positive relationships with the burnout domain of emotional exhaustion while empowerment and geriatric caregiving self-efficacy would have negative relationships with this outcome. Next, a series of regression analyses tested emotional labor (i.e., faking emotion and suppression of emotion), empowerment, and geriatric caregiving self-efficacy as moderators for the relationship between stress and burnout. Results indicated that study variables were all related to emotional exhaustion in the expected direction, although several relationships fell short of statistical significance. In addition, emotional labor was a significant predictor of emotional exhaustion, with suppression of emotion playing a larger role. There was no support for the potential moderating role of emotional labor or empowerment on the relationship between work stress and burnout. However, geriatric caregiving self-efficacy was a significant moderator of this relationship. More specifically, when staff reported high work stress, those who had low self-efficacy experienced the highest emotional exhaustion values. However, when self-efficacy was high for this group, their emotional exhaustion scores decreased. For this sample, higher levels of self-efficacy appeared to play a protective role from experiencing more emotional exhaustion when in a high stress condition.

Thesis (MEd)(Human Resource Studies)--University South Australia, 1996

Thesis (PhD) -- University of Western Sdyney, 2001. / Bibliography: leaves 163-186.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2006. / Härtill 4 uppsatser.