published_or_final_version / Social Work / Master / Master of Social Work

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From the introduction: This investigation examines from a symbolic interactionist perspective, a case of spoiled identity - a segment of the physically disabled who find themselves subject to ostomatic status. Spoiled identity evolves when a person has had, or believes that he has had, the characteristics which normally define his presence in day to day interaction compromised. In these situations, the person is perceived by himself and/or others as possessing characteristics which are often negatively defined. Spoiled identity, as defined by self or others, often serves to create barriers in interaction between the bearer of the spoiled identity and various members of society.

The typical cardiac surgery patient is increasing in age and level of frailty. Frailty can be defined as an increased vulnerability to stressors due to decreased physiological reserve. Previous investigations have demonstrated the benefit of cardiac rehabilitation (CR) programming on surgical outcomes. However, the link between pre-operative frailty and post-operative CR completion is unclear. The purpose of this study was to determine if pre-operative frailty status impacts CR completion post-operatively. A total of 114 cardiac surgery patients with an average age of 71 years were included in the analysis. CR completers were significantly less frail than CR non-completers at baseline based on the Clinical Frailty Scale (CFS; p=0.01), Modified Fried Criteria (MFC; p=0.0005), Short Physical Performance Battery (SPPB; p=0.007) and the Functional Frailty Index (FFI; p=<0.0001). The change in frailty status from baseline to 1-year post-operatively was not statistically different between CR completers and non-completers; CFS (p=0.90), MFC (p=0.70), SPPB (p=0.06) and FFI (p=0.07). However, the MFC frailty domains of cognitive impairment (p=0.0005) and low physical activity (p=0.04), in addition to the FFI physical domain of frailty (p=0.009), did significantly improve among CR completers when compared to non-completers. CR attendance measured by swipe card access did not correlate with frailty modifications. Collectively, these data suggest that participants deemed to be frail at the pre-operative time point attend and complete CR less frequently than non-frail participants. Furthermore, CR completion does not appear to modify frailty status overall; although, some frailty domains appear to be more sensitive to change than others. / February 2017

Tears to the anterior cruciate ligament (ACL) represent a serious sport injury that can be physically and psychologically debilitating for athletes. Recovery from ACL surgery is a six to nine month process, though the first four months of rehabilitation represents the key time of recovery. Thus, psychological interventions should occur during these first four months, but then examine athletes' psychological and physical functioning over the longer term. Past research has supported the efficacy of goal setting and imagery in helping athletes during their ACL recovery, and MSC has been shown to help athletes regulate emotions and improve their sport performance. MSC-based interventions, however, have not been examined in relation to injured athletes' psychological functioning and physical recovery. Thus, I examined the relative effects of three psychological interventions (i.e., GS, IM, and MSC) on athletes' post-ACL responses. Overall, I found no significant differences in the effects of GS, IM, or MSC on athletes' athletic identity, confidence in returning to sport, reinjury anxiety, stress related to sport injury, perceptions of ability to cope with injury, and subjective knee functioning. Although non-significant, athletes in the GS group showed slightly larger rates of change in their reinjury anxiety and cognitive appraisal compared to athletes in the IM and MSC groups, while athletes in the IM group showed slightly greater rates of change in subjective knee functioning compared to athletes in the GS and MSC groups. However, these results did not support the original hypotheses that athletes in the MSC group would demonstrate significantly greater outcomes compared to the GS and IM groups.