The purposes of this study were: (a) to identify which of four competing theories best accounted for self help as a learned outcome of chronic illness experience, and (b) to generate a Self Help Model that could be used to explicate self help as a learned response to chronic illness. The concepts of severity of chronic illness, intimate dependency reinforcers, self induced dependency reinforcers, cue outcome independence reinforcers, enabling skill, self help and life quality were specified in a causal format that allowed a competitive test of four different theories. The theories tested were instrumental passivity theory, self induced dependency theory, an adaptation of learned helplessness theory and learned resourcefulness theory. The study utilized a causal modeling design to assess a five stage model. A judgment sample of 786 individuals having a diagnosis of arthritis or an arthritis related condition were mailed questionnaires. Two hundred seventy-eight subjects responded, a 36 percent return rate. Seven scales using a visual analogue response format indexed the theoretical concepts. Reliability and validity estimates were conducted to assess psychometric properties of the instruments. Model parameters were estimated using multiple regression statistical techniques. Residual analysis was conducted to estimate violations of the causal model and statistical assumptions. Factors from one theory, the learned resourcefulness theory, emerged as more credible than factors from any single other theory. However, the data did evidence factors from other theories that were significant. Self induced sick role reinforcers and cue outcome independence reinforcers were found to slightly reduce perception of enabling skill (B = -.31 and B = -.12, respectively; R² = .11). Intimate dependency reinforcers and cue outcome independence reinforcers were found to slightly reduce perception of self help (B = -.34 and B = -.24, respectively; R² = .19). These factors helped to identify environmental and intra-person contingencies that led to reduction in self help. The learned resourcefulness factor, enabling skill, demonstrated the mediating skills that worked to enhance self help (B = .44; R² = .29). The Self Help Model generated to explicate self help as a learned response to chronic illness explained 50 percent of the variance in perceived self help. Self help had a direct positive impact on life quality (B = .61; R² = .46). By knowing the factors influencing a patient’s self help response to chronic illness experience, the nurse is better able to plan more effective self help promoting interventions for individuals, or groups of patients. Nurses who promote a self help response in those having a chronic illness could improve their life quality.

No description available.

An experimental design was employed to determine the knowledge gained through use of written Wound Healing Fact Sheets. The study sample consisted of 30 postoperative patients recruited from the accessible population of abdominal and chest surgery patients. Subjects were randomly assigned to experimental and control groups. Experimental subjects were interviewed, received the Fact Sheets and underwent knowledge testing prior to discharge and by telephone approximately one week after discharge. Control subjects did not receive the Fact Sheets but were interviewed and tested identically to the experimental group. Low equivalent reliabilities were demonstrated through use of the KR-20 for the knowledge test. Content validity was established by a panel of three experts. A t-test computed between pre and post test mean scores identified a significant difference in knowledge gained by experimental versus control subjects. Low reliability weakens the significance of this result.

Background. Mothers of children with Autism Spectrum Disorder (ASD) report high levels of stress, depression, marital strain, and divorce, with little time to devote to their own self-care due to the high demands of their child’s care. Despite their well-documented levels of stress and the relationship of stress to negative parenting, there are few observational studies of parenting in this population. Thus, it is critical to examine factors influencing maternal wellbeing and quality of parenting. Two factors to explore include 1) parental use of self-care, as self-care is related to reduced stress and better health and functioning of individuals and is easily modifiable and 2) attachment style, which, while being less modifiable, influences the degree to which an individual engages in self-care and the quality of relationships which are modifiable, including parent-child interactions. Methods. Participants were 42 mother-child dyads, with children ages 2-6 to 5-6 recruited from a preschool utilizing an Applied Behavior Analysis (ABA) approach to schooling. Children had a classification of ASD, verified by the Autism Diagnostic Observation System – Two (ADOS--2) (Lord, Rutter, DiLavore, Risi, Gotham, & Bishop, 2012). Parenting behaviors were observed across three tasks designed to mirror naturalistic mother-child interactions, which were videotaped for later coding using the Psychological Multifactor Care Scale — ASD Adapted Preschool Version (Brassard, Donnelly, Hart, & Johnson, 2016). Mothers completed questionnaires assessing demographic variables, parenting stress with the Parenting Stress Index – Fourth Edition, Short Form (Abidin, 2012), attachment style with the Experience in Close Relationships – Short Form (Wei, Russell, Mallinckrodt, & Vogel, 2007), depression with the Patient Health Questionnaire – 9 (Kroenke, Spitzer, & Williams, 2001), and self-care with items adapted from the Promise Neighborhoods RFA Indicators and the Promise Neighborhoods Research Consortium [PNRC] Measurement System; Promise Neighborhoods Research Consortium: Measures, 2001) concerning exercise, diet, smoking, overweight, and sleep. Results. Mothers in this sample engaged in high levels of positive and infrequent and mild levels of negative parenting. Those who did engage in negative parenting reported higher levels of stress and higher anxious and avoidant attachment. Multiple regression analysis using conditional process analysis (Hayes, 2018) found significant indirect effects of self-care on quality of parenting for both positive (r2=.61) and harsh (r2=.18) observed parenting, when mediated by parental stress. Individuals with a high degree of self-care demonstrated less stress which related to more positive, less harsh parenting. When depressive symptoms were included as a mediator in a casual model the impact of depression was significant. Self-care was significantly related to quality of parenting for both positive and harsh parenting in a mediational model with higher levels of self-care relating to lower levels of maternal depressive symptoms, which related to lower levels of parental stress, which related to more instances of positive parenting (r2=.64) and fewer instances of harsh parenting (r2=.24). Anxious attachment was significantly related to self-care with avoidant attachment as a moderator, explaining 56% of the variance. Anxious attachment related to both positive and harsh parenting directly and indirectly through self-care and stress. Avoidant attachment was not significantly related to quality of parenting, although it interacted significantly with anxious attachment in a model of attachment style, self-care, stress, and quality of parenting. Anxious and avoidant attachment style on self-care showed mothers who were preoccupied (high anxiety/low avoidance) demonstrated the most self-care, followed by secure (low anxiety/low avoidance), dismissing (low anxiety/high avoidance), with fearful parents (high anxiety, high avoidance) demonstrating the least self-care. Regression models controlled parental race (White, Hispanic), household income, number of children in the home, and the number of adults in the home, a proxy for caregiving support, determined by the dependent variable. Observed parenting behaviors were found to be skewed with most mothers using high levels of positive parenting behaviors and low levels of harsh parenting behaviors, Mothers in this sample reported higher levels of stress (20.5% above the cutoff) and maternal depressive symptoms (10% above the cutoff vs. 7% above the cutoff ) compared to normative samples, consistent with the literature on parents of children with ASD. Conclusions. Parent’s use of self-care is a modifiable variable related to reduced stress and depression, and better quality of parenting. Attachment is related to the amount of self-care a mother engages in as well as quality of parenting indicating that a mother’s attachment style should be considered in designing interventions.

School of Nursing

Thesis (Ph. D.)--University of Missouri--Columbia, 2001. / Typescript. Vita. Includes bibliographical references (leaves 65-70). Also available on the Internet.

Thesis (Psy. D.)--Rutgers University, 2009. / "Graduate Program in Clinical Psychology." Includes bibliographic references (p. 101-104).

This study examined the relationship between social support and self-care agency in post myocardial infarction (MI) patients. Hypothesis I stated that total social support and it's three subscales are positively related to total self-care agency and it's six subscales. Hypothesis II stated that the three subscales of social support will predict total selfcare agency in post MI patients. A convenience sample of 28 post myocardial infarction patients from a large midwestern metropolitan hospital participated in the study. The Norbeck Social Support Questionnaire (NSSQ) was used to measure the social support variable. The Denyes Self-Care Agency Instrument (DSCAI) was utilized to measure the self-care agency variable. The study supported a positive and significant relationship between social support and self-care agency. The study further supported significant relationships between the subscales of social support and four of the subscales of self-care agency. Affect (a subscale of social support), contributed to 27% of the variance in selfcare agency. The results demonstrated congruent findings with previous studies, reflecting a positive and significant relationship between social support and self-care agency. The study findings have implications for improving nursing practice for myocardial infarction patients and for further nursing research among this population. / School of Nursing

Diabetes Mellitus is a chronic disorder that requires daily adherence to complex regimens for glucose control. The purpose of this study was to examine the relationship between the capability for self-management of diabetes and the practices of health-promoting behaviors. Instruments used were the Health Promotion Lifestyle Profile to measure health-promoting behaviors, the Insulin Management Diabetes Self-Efficacy Scale to measure self-efficacy in diabetes management, and a demographic questionnaire.Fifty participants from the outpatients of a midwestern veterans hospital responded to the questionnaires. Results showed a moderately positive significant correlation between self-efficacy in diabetes management and health-promoting behaviors (r=.52, p<001).The findings of this study point the importance of higher levels of self-efficacy and participation in health-promoting behaviors for more effective management of diabetes and improved health and well-being. / School of Nursing

Thesis (Ph. D.)--University of Chicago, Dept. of History, December 1997. / Includes bibliographical references. Also available on the Internet.