Access to abstract permanently restricted to Ball State community only / Access to thesis permanently restricted to Ball State community only / Department of Educational Psychology

Social Skills Training for Head Injured Adults Research has demonstrated numerous personality and behavioral disturbances resulting from head injury (Lezak,1978). It is these changes rather than the physical disabilities that create the stress, in the long term for the relatives of the head injured (MeKinley,1981). Therefore, social skills training is a important part of intervention with this population. This study evaluates a social skills training program "Stacking the Deck" (Braunling-McMorrow et al 1986) which has been modified to include structured learning assignments. This is a single case evaluation (A - Baseline, B - Treatment) with replication. The subjects are four males with severe head injuries, ages 19,22,34,and 36. Social skills were described as requiring an action or reaction within six skill areas: compliments, social interaction, politeness, criticism, social confrontation, and questions/answers. Measures include the baseline developed in the "Stacking the Deck" program, Staff Questionnaire on Social Behavior (Spence,1979) and the Social Skills Assessment Chart (Spence,1980). Results indicate that this is an effective program for social skills training with the adult head injured population. / Arts, Faculty of / Social Work, School of / Graduate

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

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.

published_or_final_version / Social Work / Master / Master of Social Work

No description available.

The study purposes were to identify changes in resilience, satisfaction with life (SWL), depression, spirituality, and functional independence (FI) and to examine the relationship between these variables, during the inpatient rehabilitation for a spinal cord injury (SCI). The sample included 42 individuals with a SCI, 33 males and 9 females, who were inpatients with a mean stay of 52 days (SD = 15.78). A repeated measures design was employed with questionnaires completed at three times during rehabilitation. Results indicated that there were significant changes in depression, satisfaction with life, spirituality, and FI during inpatient rehabilitation. Findings also indicated significant correlations between resilience, SWL, spirituality, and depression. Future studies developing interventions, and examining factors that predict resilience could help build resilience and may improve rehabilitation outcomes.

Thesis (MA)--Stellenbosch University, 2004. / ENGLISH ABSTRACT: The traumatic nature of spinal cord injury (SCI) imposes major and permanent life changes that necessitate physical, social and vocational adjustments for the individual, as well as placing strain on the family. The importance of psychological aspects of adjustment and rehabilitation has progressively become recognised as an integral part of facilitating a higher quality of life for individuals and their families living with SCI. While it has been established that psychological disturbance is not an inevitable long-term consequence of SCI, researchers have found that a proportion of this population has marked difficulty adapting psychologically to their new lifestyle and the challenges it poses. It has been found that the SCI population has an increased risk for divorce, substance abuse, self-neglect and suicide. In the mid-1990's, researchers involved in SCI rehabilitation started developing cognitivebehaviour therapy (CBT) interventions to assist individuals with their psychological adjustment to the traumatic injury. Lazarus and Folkman's (1984) cognitive theory of stress and coping has been the theoretical grounding for some of these interventions. The primary objective of this literature review is to ascertain the effectiveness of CBT in assisting individuals with their psychological adjustment to SCI and to make recommendations for future research in this area. / AFRIKAANSE OPSOMMING: Die traumatiese aard van 'n spinale koord besering (SKB) veroorsaak 'n beduidende en permanente lewensverandering, wat fisieke-, sosiale- en werksaanpassing vir die individu verg, asook spanning op die familie plaas. Die belangrikheid van sielkundige aspekte rakende aanpassing en rehabilitasie word toenemend herken as 'n integrale deel in die fasilitering van 'n hoër kwaliteit van lewe vir die individue en hulle families wat lewe met 'n SKB. Alhoewel daar gevind is dat sielkundige versteuring nie 'n noodwendige langtermyn gevolg van 'n SKB is nie, het navorsers wel gevind dat 'n gedeelte van die populasie beduidende sielkundige aanpassingsprobleme ervaar ten opsigte van hul nuwe lewenstyl en uitdagings. Daar is gevind dat die SKB populasie 'n verhoogde risiko loop vir egskeidings, substansmisbruik, self-verwaarlosing en selfmoord. In die middel van die 1990's, het SKB- en rehabilitasie-navorsers kognitiewe-gedragsterapie (KGT) intervensies ontwikkelom individue te help met sielkundige aanpassing na 'n SKB. Lazarus en Folkman's (1984) se kognitiewe teorie oor stres en streshantering, het die teoretiese grondslag gevorm vir sommige van hierdie intervensies. Die primêre doel van hierdie literatuuroorsig is om die effektiwiteit van KGT te bepaal in die ondersteuning van individue met sielkundige aanpassing na SKB, en om voorstelle te maak oor toekomstige navorsing wat met hierdie onderwerp verband hou.

This exploratory study was designed to discover the culture of living with a head injured spouse. Using the ethnographic approach, five spouses of head injured survivors were interviewed. Analysis of data yielded five domains of meaning: concerns as a result of role transition, social isolation, loss, future and coping. Two cultural themes emerged as "no one understands" and a "wish list." Implications for nursing practice include increasing awareness of health care professionals regarding perceptions and needs of spouses of head injured survivors.

Research has begun to explore the presence and role of health-related injustice perceptions in samples of individuals who experience chronic pain associated with traumatic injury. Existing studies indicate that higher level of injustice perception is associated with poorer physical and psychosocial outcomes. However, to date, few clinical populations have been addressed. The aim of the current study was to explore injustice perceptions in a sample of individuals who have sustained a spinal cord injury (SCI), as research suggests that such individuals are likely to experience cognitive elements characteristic of injustice perception (e.g., perceptions of irreparable loss, blame, and unfairness). The study explored the relationship between participants’ level of perceived injustice and several variables associated with outcomes following SCI (depression, pain, and disability) at initial admission to a rehabilitation unit and at three months following discharge. The Injustice Experience Questionnaire was used to measure injustice perceptions. IEQ was found to significantly contribute to depression and anger at baseline. IEQ significantly contributed to depression, present pain intensity, and anger at follow-up. The implication of these preliminary findings may be beneficial for development of future interventions, as many individuals in the United States experience the lifelong physical and psychological consequences of SCI at a high personal and public cost.