published_or_final_version / Social Work / Master / Master of Social Work

published_or_final_version / abstract / Social Work and Administration / Doctoral / Doctor of Philosophy

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

published_or_final_version / Social Work / Master / Master of Social Sciences

This longitudinal, descriptive study based on Bandura's self-efficacy theory (1977), examined the effects of educational activities on self-efficacy and of self-efficacy on functional ability in everyday activities in clients undergoing elective, primary, unilateral, total knee arthroplasty (TKA). Educational activities included: attending a joint replacement class and a physical therapy session, performing exercises, and reading educational materials. Other sources of client information were also discussed. Self efficacy was assessed regarding confidence in ability to perform activities required for discharge home. Cronbach's alpha for the self-efficacy scale was .94 (pre-education) and .81 (post-education). Functional ability in everyday activities was operationalized as length of hospital stay, discharge placement, and perceived health status. Perceived health status was assessed using the three-scale Western Ontario McMasters University Osteoarthritis Index (WOMAC). Cronbach's alpha was: pain .85, joint stiffness .76, and physical function .94 (preoperatively); and pain .86, joint stiffness .80, and physical function .94 (postoperatively).Evidence was collected from a convenience sample of 31 participants: (a) when the process of scheduling surgery began; (b) before surgery, after the client had opportunities to participate in educational activities, and (c) approximately six weeks after surgery. The orthopedic surgeon and professional staff reviewed instruments for validity. Five clients reviewed the questionnaires for understandability and readability. Data were analyzed using Pearson r correlation coefficients, independent samples t-tests, analyses of variance and chi-square tests. An alpha level of .05 was designated as significant.Higher self-efficacy scores were associated with more expected benefits, previous TKA, and greater pain relief. Lower self-efficacy scores correlated with greater improvement in self-efficacy. Shorter lengths of hospital stay were associated with greater joint stiffness reduction, younger age and previous TKA. Discharge home was associated with younger age and living with someone else. Participants that were "very sure" of the need for TKA exhibited higher self-efficacy scores than participants that were "unsure". Improved outcomes were not associated with any one type of educational activity.This study highlighted the need for further refinement of context sensitive self-efficacy instruments, more sophisticated means of assessing the impact of an increasing array of information sources and more longitudinal studies with larger sample sizes. / Department of Educational Leadership

Social support is likely to play an especially important role in coping with a cancer diagnosis as it presents a unique set of stressors to the individual. The purpose of this study was to examine biological sex differences in the perceived availability of three modes of social support (emotional, instrumental, and informational), source of support (friends vs. family), and social support seeking behavior in a population of cancer patients. The sample included 71 men and 71 women who had been diagnosed with cancer within two years of the start of the study. No significant sex differences were found in social support seeking; however, results revealed that women perceived greater availability of emotional support as well as greater support from friends on all modes of social support than did men. Implications of these findings and future directions for research are discussed. / Department of Counseling Psychology and Guidance Services

People living with HIV/AIDS (PLH) struggle with depression. Recent research suggests that depression affects medical regimen adherence, disease progression, and risky sexual behaviors. The present study uses a stress and coping theory viewing HIV-related stigma and physical symptoms as stressors in PLH. Results suggest whereas symptoms and stigma consistently predict negative affect, positive affect, and overall depression, the role of optimism, pessimism, active coping, denial, and behavioral disengagement is not as clear. Pessimism and denial predict negative affect and depression. Optimism and behavioral disengagement predict depression and positive affect. Active coping only predicts positive affect. Focusing on positive and negative affect as distinct components that contribute to overall depression may help researchers develop interventions more effectively.

Spinal cord injury (SCI) is an acute and devastating event that results in significant and permanent life changes for the individuals who are injured, as well as their families and friends. Depression has received more attention from clinicians and researchers than any other psychological issue among persons with SCI. Measurement of depression in this population has a variety of methodological issues, including inconsistent assessments used (self-report versus clinical interviews), varying definitions of depression, inclusion and exclusion of physical symptoms in the assessment process, and use of measures that do not represent DSM-IV criteria for major depressive disorder. The primary goal of this study was to evaluate the Quick Inventory of Depressive Symptomatology - Self-Report (QIDS-SR) and provide descriptive analyses of this measure with persons with SCI. Results showed that somatic symptoms were more frequently endorsed than psychological symptoms in this population. Additionally, scores on the QIDS-SR were significantly associated with a depression diagnosis in the patient's medical chart. However, QIDS-SR scores were not found to be correlated inversely with quality of life scores as predicted. The QIDS-SR was shown to have good internal consistency and convergent validity with patients with SCI. However, it failed to demonstrate construct validity. The QIDS-SR has the potential to be a valid measure with this population and further analysis of the psychometric properties with patients with SCI is warranted.

The primary interest of this investigation concerned the self-injurious thoughts and behaviors (SITBs) of inpatient adolescents. Previous researchers have provided descriptive information regarding either automatic (or intrinsic) and social components using the Self-Injurious Thoughts and Behaviors Interview (SITBI). However, the presence and trends of these components have not firmly been established, suggesting the need to explore this area further. Eighty-two adolescent inpatients were selected and interviewed using the SITBI to evaluate the predictive ability of self-reported self-injurious behavior with regard to social and automatic, negative and positive functions. Results showed that depending on the type of thought or behavior displayed one could discern the motivation behind their actions. Automatic-Negative was seen to have the strongest relationship across all SITB behaviors while Automatic-Negative was not found to be relatively low compared to other SITB behaviors. Both Social-Positive and Social-Negative were found to be present in moderate relationships compared to Automatic in general.