Alzheimer's disease (AD) is a progressive, degenerative disorder that attacks the brain's nerve cells, or neurons, resulting in loss of memory, thinking and language skills, and results in behavioral changes and lack of communication. Family members and caregivers of persons with Alzheimer’s disease can assume added responsibilities and stress due to the progressive and degenerative component of this disability and places an added strain on the family system. This study was designed to examine predictors of quality of life of persons living with AD and to examine caregiver burden and predictors of quality of life of persons living with AD. This study hopes to empower the caregivers and test the resiliency model of family stress, sense of coherence and social support while incorporating individual patient and family needs by surveying caregivers involved with working with patients with AD. Specific aims of the study include validating relationships of the resiliency model while determining the importance of family resiliency, the sense of coherence, social support and the role of psychosocial interventions specifically Validation Communication Intervention (VCI), to reduce caregiver burden and to predict the quality of life in persons with Alzheimer’s disease. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2014. / FAU Electronic Theses and Dissertations Collection

This study is a Time 4 (T4) follow-up interview of ninety-three caregivers of persons who experienced a first stroke between 2 to 4 years (mean = 36 months) prior to the T4 interview. The first wave of data collection occurred within two months after the stroke. The second and third waves occurred six and twelve months, respectively, after the first interview. The caregivers were identified by the person with stroke as being the person closest to him/her who would be responsible for care after the stroke. Data were gathered at all four interviews using reliable and valid measures for depressive symptomatology (CES-D; Radloff, 1977), psychological well-being (IPWB; Berkman, 1971), and caregiver burden (Zarit, 1980). The contribution of social support to caregiver well-being was also investigated. Additional areas of investigation at T4 included coping strategies (F-Copes; McCubbin, Larsen, and Olson, 1981), caregiver adjustment, and the respondents' perception of themselves as "caregivers". The mean scores of depressive symptomatology, perceived burden, negative well-being, and positive well-being did not change significantly over the four points in time. However, the percentage of the sample having CES-D levels of 16 and above (indicating potential diagnosis of clinical depression) decreased by ten percent between T1 and T4. About ten percent of the respondents who were at risk for clinical depression at T4 reported high levels of depressive symptoms at all four interviews. Respondents who specifically thought of themselves as "caregivers" (sixty-two percent) were significantly more likely to report high levels of depressive symptoms, to experience high levels of strain and caregiver burden, and to be caring for persons who were more severely impaired by the stroke than those who did not. Caregiver characteristics contributed more to the variance in depressive symptoms and psychological well-being than did characteristics of the stroke. However, depressive symptomatology and perceived burden were significantly associated with both the functional capacity of the person with stroke and with an index of stroke severity comprised of communication impairments and negative personality/behavior changes since the stroke. The findings from this study have implications for stroke management programs, caregiver intervention planning, and health care policy.

The purpose of this study was to explore how Korean American caregivers view dementia caregiving and analyze the role of culture in their attitude toward caregiving. Demographic characteristics, stressor factors, social support factors, and cultural factors were examined in the model. Stressor factors were measured by care receivers' problem behaviors, duration of caregiving, and amount of caregiving. Social support factors were composed of the amount of social support and the quality of social support. Cultural factors included level of acculturation, years in the U.S., filial piety, and familism. The study compared a group of spouse caregivers with a group of children providing care in order to investigate the differences in their attitude toward caregiving. In addition, the interaction effect between social support and acculturation on dementia caregiver's attitude toward caregiving was examined. Eighty five Korean American dementia caregivers participated in the survey through a convenience sampling method. Among the Korean American dementia caregivers, child caregivers showed a more positive attitude toward caregiving then spouse caregivers. The effects of social support on caregivers' attitude toward caregiving did not vary with the level of acculturation. Hierarchical multiple regression analysis indicated that, among the study factors including stressor factors, social support factors, and cultural factors, only social support factors contributed significantly to Korean American dementia caregivers' positive attitude toward caregiving. Among the predictors of Korean American dementia caregivers' attitude toward caregivng, the amount of caregiving per day was the most significant variable, followed by the quality of social support and care receivers' problem behaviors. Higher levels of daily caregiving and higher quality of social support were positively related to positive attitude toward caregiving. A higher level of care receivers' problem behaviors was negatively related to positive attitude toward caregiving. Comparison of the beta coefficients from the spouse caregiver group and nonspouse caregiver group revealed that there was a discrepancy of predictors of Korean American caregivers' attitude toward caregiving between the two caregiving groups. The model had a better fit for immigrant spouse caregiver groups indicated by significantly different R² from spouse caregivers and non-spouse caregivers, 85% and 33%, respectively. The results of this study imply the importance of incorporating cultural diversity in social policy. Because of the salient findings in this study, inclusion of content on increasing and enhancing quality of social support is recommended for social work practice with Korean American dementia caregivers.

The purpose of this descriptive study was to document and analyze the perceptions of family caregivers of non-institutionalized Alzheimer's patients about the benefits and limitations of Alzheimer's support groups. Survey methodology was used to survey caregivers and support group leaders from eight Alzheimer's support groups in the central Indiana area. Several of the major findings challenge the literature. These findings are as follows: The majority of caregivers attended the support group to receive information. None of the caregivers attended the support group due to frustration, and only one caregiver responded that relieving frustration was a benefit of participating in the support group. A majority of caregivers and support group leaders were positive about mixed (spouses and adult children) support groups. A majority of caregivers responded that they did not have guilt, anger, fears about caregiving in the future, or stress concerning their caregiving responsibilities. The study generated several implications that can be used by planners to improve support groups. / Department of Educational Leadership

Psychology / M.A. (Clinical Psychology)

Text in Afrikaans / Summaries in Afrikaans and English / Psigonefrologie behels die studie von psigologiese faktore wat 'n rot speel by eindstadiumnierversaking. Nierversaking word beskou as 'n lewensbedreigende siekte, wat die lewensverwogting von die pasient verkort indien hy nie behandeling ontvang nie. Nierversaking kan ingedeet word in drie stadiums: Die pre-dialise, diatise, en oorplantingstadiums. Die onderskeibaorheid von hierdie stadiums is die gevotg von verski lie in mediese behandelingsmetodes. Nie een hiervon bring genesing nie, maar vertig simptome van die uremiese sindroom, verleng die tewensverwagting von die pasient, en is veronderstel om sy lewenskwaliteit te verbeter. DepresS,ie en angs, is algemene simptome wat by nierpasiente voorkom. Die redes hiervoor, is die pasient se psigologiese reaksie teenoor nierversaking, dialise, en/of 'n oorplanting. Verder moet hy ook die newe-effekte van die mediese behandeling trotseer. Aanpassings moet ook gemaak word in terme von beroep~ en sosiate funksionering. Nie net het eindstodiumnierversaking 'n psigososiate impok op die nierposient nie, maar word die gesonde moat ook daardeur be"invtoed. Daarom ervoar meeste egpore gesamentlik die impok von nierversaking op hulle huwelik- en gesinslewe. Vir optimale oanpassing by nierversaking moet egpore sekere oanpassingstoke bemeester, soos om nierversoking as 'n gedeetde probteem te hanteer, oan te pas by die rot von pasient en versorger. die verskillende behoeftes oan nobyheid en afstand tussen pasient en versorger, en die verwisseting in beroepsrolle hanteer, asook effektiewe kommunikasie met mekoar en die mediese span doarstel, en mekaor deurlopend instrumenteel en emosioneel ondersteun ten einde die huweliksverbintenis in stand te hou. Die resultate von hierdie ondersoek dui doarop dat huweliksverondertikes, soos 'n afnome in ontsponningsaktiwiteite en seksuatiteit, en gelykmakende rolle 'n belangrike rot speel om oanpassing by nierversaking te vergemaklik. Daarmee soam is gevind dat godsdiens 'n belangrike oanpossende funksie vir egpore het. Deurgoans speel'n ondersteuningsisteem, wat uit famitie en vriende, onder nierpasiente, die mediese span en 'n sielkundige bestoan 'n vernome rol om die egpoar met oanpassing te help. Uiteindelik blyk dit moonttik te wees vir egpare om hulle huwetiksverhouding in stand te hou, of setfs konstruktief te herstruktureer, asook groter huwelikstevredenheid te ervoar, ondanks die bedreiging von eindstadiumnierversaking. Meeste egpore ervoar die moeilike tydperk dan ook met 'n verdieping in hulle huwelik- en geloofslewe. / Psychonephrology is the study of psychological factors which are evident in end-stage renal disease (ESRD). ESRD is regarded as a life-threatening disease, which shortens the life-expectancy of a patient if he does not receive treatment. ESRD can be divided into three stages: the pre-dialysis, dialysis and transplant stages. These stages are signified by differences in medical treatment methods. None of these leads to a cure but all alle.viate symptoms of the uremic syndrome, increase the life-expectancy of the patient and are supposed to improve his quality of life. Depression and anxiety are general symptoms found in end-stage renal patients. The reasons for this are the patient's psychological reaction to renal disease, dialysis and/or transplant. Patients must also endure the side effects of medical treatment. Adjustment in vocational and social functioning is also evident. ESRD not only has a psycho social impact on the patient but also affects the healthy spouse. This is why most married couples together experience the impact of ESRD in their marital and family life. For optimal adjustment to ESRD couples need to master certain adaptational tasks, such as treating ESRD as a shared problem, adopt the roles of patient and caregiver, manage the various needs of closeness and distance between patient and caregiver and change of career roles, as well as effectively communicating with each other and the medical team, and instrumentally and emotionally support eac~ other in order to maintain the marital bonds. The results of this investigation show that marital variables, such as a decrease in recreation and sexuality and role equality, are important to ease the adjustment to ESRD. It was also found that religion has an important adaptational function for the married couples. A support system of family, friends, other renal patients, the medical team and a psychologist are also important to aid the couples' adjustment. Lastly it should be possible for renal couples to maintain, or even to positively reconstruct their marital relationship, and to experience marital satisfaction in the face of the threat of ESRD. Apparently most couples experience this ordeal as a time of intensification of their married and spiritual life. / Psychology / D.Litt. et Phil. (Psychology)

M.Cur. (Psychiatric Nursing) / A diagnosis of cancer causes certain fears to arise in a patient, as well as among his family, activating intense emotional responses in everyone concerned. Examples of such emotions are anger. self-reproach, gUilt, heartache, helplessness and mourning. An acceptance of the circumstances does not necessarily occur, and the phases of the mourning process may be continually interchanging. As a result of all these emotions experienced by the patient with cancer as well as his family, mental discomfort is likely to occur. The family has to adapt its usual mechanism for handling internal discomfort, in order to include the pressure and demands to which they will be exposed as a result of the cancer and treatment thereof. Family cohesion will not necessarily be advanced as a result of this heightened pressure, and additional pressure may be placed on relationships within the family. Members of a family often find it difficult to discuss openly their fears, worries and feelings. for the simple reason that they are scared of becoming upset themselves, or alternately upsetting the rest of the family. Holding themselves back in this way may lead to a feeling of being isolated, which in turn leads to feelings of uncertainty being experienced. In this way the members of a family may find themselves becoming less and less involved with each other and with the patient's treatment, all as a result of not being able to talk about their fears and other intense emotions and therefore not being able to realise all these feelings. As a result of the family's uncertainty concerning their handling of the situation, they experience a loss of control and a change in their ability to handle their situation. These factors contribute to their experience of mental discomfort. Mental discomfort is not visible to others, therefore it is very rarely treated by the multiprofessional team. If the members of the team notice the existence of such discomfort, they will still emphasise the medical treatment, since they themselves may be uncertain as to any effective treatment for such a family. The registered nurse who is in continuous contact with the patient and his family, therefore has the challenge to support the family who suffers from mental discomfort in order to lessen their suffering and facilitate their striving towards achieving wholeness once more, whether in hospital, at home or in a community centre. There are several methods of interaction available for the treatment of such a family. Mental discomfort can be reduced by psychiatric nursing accompaniment. The purpose of this study was to explore and describe the folloWing: the contribution made by psychiatric nursing accompaniment through the medium of a psychiatric nursing specialist, as regards lessening the mental discomfort of the family of a patient being treated in an oncology unit or at home. A further purpose was to set certain guidelines for the registered nurse, concerning her support of the family of a patient in an oncology unit or at home, thereby lessening their mental discomfort. An exploratory, descriptive, contextual study was done on a family with one member who has been diagnosed with cancer, and who received treatment in an oncological unit and at home. This family submitted themselves to psychiatric nursing accompaniment. A purposive, non-selective sample was used and the family had to satisfy certain specific criteria pertaining to mental discomfort...

M.A. / This investigation aims to address and explore the experience of sibling head injury which appears to have been largely neglected in research. It seeks those themes, emotions and thoughts which are central and significant to the sibling's experience. it explores the manner in which the event of sibling head injury is incorporated into the adolescent's emerging identity, sense of self and understanding of the world. Overall, this research aims to provide some understanding of what the experience of living with a head-injured sibling entails and the personal meaning it holds for adolescent siblings. The existential-phenomenological system of inquiry is employed as a mode of research in an effort to study this experience of adolescent siblings of head-injured persons. Siblings are understood as beings-in-the-world who coconstitute their realities and interpret and act upon their own existence. Qualitative access to this subjective realm or individual lifeworld of siblings, is attempted through a qualitative design, where rich data is collected through in-depth, open-ended interviews which facilitate unique and personal descriptions. Eight siblings of an adolescent or young adult age, were sourced through Headway and interviewed for the purpose of this study. The 'Adolescent Coping Scale' was administered to gain further qualitative information which could be incorporated into a greater understanding of sibling coping under such circumstances. Interviews were recorded and transcribed verbatim, providing the database from which intraindividual analyses and discussions were conducted on each participant. Only three of the original eight participants were selected for the purposes of in-depth analysis and final inclusion in the study, for reasons of manageability and research size. These participants were selected on the basis of their rich and varied descriptions. The analyses rendered an understanding of each sibling's perceptions, cognitive conflicts and emotional experience, while an inter-individual analysis of the accounts permitted an exploration of contrasting themes and emerging patterns. An integration of the research data revealed the complexity and ambiguities inherent in the sibling experience of head injury, and the long-term nature of such a phenomenon. This phenomenon was found to be characterised by much change and feelings of loss, by a pervasive sense of helplessness accompanied by anger and depression, by feelings of abandonment and of being alone in their experience. Such themes confirmed many of those explicated in the literature review. However, the research findings also suggest a sense of being overwhelmed by threatening emotions, a strong reliance on avoidance coping, and a specific complexity inherent in the sibling experience, which creates a challenging experience which is long-term and for some, may be perceived as getting worse over time. The value of this research lies primarily in the neuropsychological field of family interventions and rehabilitation. It is hoped that the in-depth description of the experience of ado!escent siblings of head injury, presented here, can promote a greater understanding of this experience, and facilitate the establishment of appropriate interventions which focus on the provision of much-needed education and support. It is also hoped that this understanding can assist in raising awareness of the stressful and long-term nature of such a phenomenon, in schools and universities, among peers, facilitators, counsellors - those who have daily contact with adolescents. It is proposed that future research explores those aspects of the sibling experience which mediate its nature, dynamics and severity. Studies investigating the role played by race, culture and religion, gender and age, as well as those which focus on the long-term consequences of such a phenomenon, are likely to facilitate a deeper and more in-depth understanding of the experience of sibling head injury.

M.A. / A diagnosis with cancer causes certain fears in a patient, as well as, their family. It activates intense emotional responses in everybody concerned. Reach for Recovery play a huge role in mastectomy patients and their family's lives. It is there to support the patient and to understand what the patient is experiencing. Reach for Recovery is a selfhelp group, functioning under the name of the Cancer Association of South Africa. The group was started in 1952 in the USA, at a time when there was a tendency to discourage patients from discussing their operations with other patients. Therese Lasser, a mastectomy patient, realized that not enough was being done for women whose life had changed dramatically in the span of a few hours. The goal of the study was to do training for Reach for Recovery volunteers. To assess if the Reach for Recovery volunteer is fulfilling in the need of the mastectomy patient. A qualitative approach, using an inductive strategy, was followed to achieve the aim of the study. Focus groups are being used to gather information about the functioning of the Reach for Recovery groups at present. Focus groups were held in the Far East Rand and the West Rand with the Reach for Recovery support groups. The purpose of the focus group was to identify the needs of the mastectomy patients, to enable the researcher to identify guidelines for the Reach for Recovery programme. A literature control was done after the central themes were identified. After having compared the results of the focus group with the relevant literature certain conclusions were drawn and recommendations made. In conclusion to this study, guidelines were designed to be used in the Reach for Recovery programme when the training is done.

No description available.