University of Alabama Repository :: Browsing by Author "Allen, Rebecca S."

Browsing by Author "Allen, Rebecca S."

Now showing 1 - 20 of 99

Adaptation of a Nursing Home Culture Change Research Instrument for Frontline Staff Quality Improvement Use
(American Psychological Association, 2017) Hartmann, Christine W.; Palmer, Jennifer A.; Mills, Whitney L.; Pimentel, Camilla B.; Allen, Rebecca S.; Wewiorski, Nancy J.; Dillon, Kristen R.; Snow, A. Lynn; Boston University; Baylor College of Medicine; University of Massachusetts Amherst; University of Alabama Tuscaloosa
Enhanced interpersonal relationships and meaningful resident engagement in daily life are central to nursing home cultural transformation, yet these critical components of person-centered care may be difficult for frontline staff to measure using traditional research instruments. To address the need for easy-to-use instruments to help nursing home staff members evaluate and improve person-centered care, the psychometric method of cognitive-based interviewing was used to adapt a structured observation instrument originally developed for researchers and nursing home surveyors. Twenty-eight staff members from 2 Veterans Health Administration (VHA) nursing homes participated in 1 of 3 rounds of cognitive-based interviews, using the instrument in real-life situations. Modifications to the original instrument were guided by a cognitive processing model of instrument refinement. Following 2 rounds of cognitive interviews, pretesting of the revised instrument, and another round of cognitive interviews, the resulting set of 3 short instruments mirrored the concepts of the original longer instrument but were significantly easier for frontline staff to understand and use. Final results indicated frontline staff found the revised instruments feasible to use and clinically relevant in measuring and improving the lived experience of a changing culture. This article provides a framework for developing or adapting other measurement tools for frontline culture change efforts in nursing homes, in addition to reporting on a practical set of instruments to measure aspects of person-centered care.
Adult children caregivers of parents with Alzheimer’s Dementia
(University of Alabama Libraries, 2017) Meyer, Grace Helen; Witte, Tricia H.; University of Alabama Tuscaloosa
Dementia is a neurological disease that affects cognitive functioning. Those who suffer from dementia lose their cognitive abilities and the ability to care for themselves, and as the disease progresses, they often require assistance with daily living. The purpose of this study was to examine familial caregivers – specifically adult children -- of Alzheimer patients. This study investigated (1) sociocultural factors that may contribute to the decision to take on the caregiver role (i.e., gender roles and cultural beliefs); (2) family-level factors that may contribute to burden (i.e., family decision making process, family coping), and (3) health habits associated with caregiver burden (i.e., alcohol and drug use). A total of 391 family caregivers of Alzheimer’s patients were recruited from Amazon’s Mechanical Turk website. This study showed that sociocultural factors contribute to the decision to care for a parent, family-level factors contribute to burden, and health habits are associated with that burden.
Age differences in risky decision making: the effects of explicitness, personality, and working memory
(University of Alabama Libraries, 2017) Wood, Meagan Michelle; Black, Sheila R.; University of Alabama Tuscaloosa
In the current study, I examined the effects of age, explicitness of instructional materials, and personality differences on risky decision making while playing the Game of Dice Task (GDT). Participants were randomly assigned to one of two instruction conditions: Explicit vs. Standard. In the explicit condition, the instructions were very straightforward, with respect to risk, while the instructions in the standard condition were not. To describe this game in more detail, in the GDT, participants decide how risky they wish to be on each trial. To optimize performance, participants should make “safe” rather than risky choices. Overall, older adults were riskier than younger adults on the GDT even though they self-report being more risk averse than younger adults in several different risk domains except for social. In regards to the instruction condition, there were no significant age differences in the standard condition. Younger and older adults perform similarly. However, there were age differences in the explicit condition. Older adults were riskier in the explicit condition than younger adults were. In addition, a 3-way interaction between age, instruction, and conscientiousness was discovered. Older adults who are low in conscientiousness perform similar to regular older adults in the standard and explicit conditions. However, the effect of instruction condition disappears for those who are high in conscientiousness.
Aging in a confined place: an exploration of elder inmate health and healthcare
(University of Alabama Libraries, 2009) Jennings, Lisa Kitchens; Roff, Lucinda L.; University of Alabama Tuscaloosa
This qualitative case study investigates and analyzes the health and healthcare experience of elderly offenders. Four substantive areas which were examined included: 1) To explore how changes in an inmate's personal health and functional status influenced the healthcare process, 2) To explore how family relationship awareness and involvement affected prisoner health and healthcare, 3) To explore the influence of policy on prisoner health and healthcare and, 4) To explore the influence of the larger societal discourse on prisoner health and healthcare. The study was conducted within three theoretical frameworks: standpoint theory, Cantor's (2000) model of social care of the elderly, and the social construction of the aging inmate. Face-to-face and phone interviews were conducted with sixteen participants. Four of the participants were elder inmates between the ages of 50 and 90 years of age, and had served time in the state of Alabama's only correctional facility designed for the aged and infirm male prisoner. The additional twelve collateral participants were correctional staff, medical personnel, family members, and church and community volunteers. This research contributes to the literature on elderly offenders, and the understanding of experiencing health changes and healthcare in a correctional institution. The study concludes with several recommendations intended to better prepare prisons, healthcare providers and communities for the growing elderly inmate population.
Aging Prisoners' Treatment Selection: Does Prospect Theory Enhance Understanding of End-of-Life Medical Decisions?
(Oxford University Press, 2011) Phillips, Laura L.; Allen, Rebecca S.; Harris, Grant M.; Presnell, Andrew H.; DeCoster, Jamie; Cavanaugh, Ronald; University of Alabama Tuscaloosa
Purpose: With the rapid growth in the older inmate population and the economic impact of end-of-life treatments within the cash-strapped prison system, consideration should be given to inmate treatment preferences. We examined end-of-life treatment preferences and days of desired life for several health scenarios among male inmates incarcerated primarily for murder. Design and Methods: Inmates over the age of 45 who passed a cognitive screening completed face-to-face interviews (N = 94; mean age = 57.7; SD = 10.68). Results: We found a 3-way interaction indicating that the effect of parole expectation on desire for life-sustaining treatment varied by race/ethnicity and treatment. Minority inmates desired cardiopulmonary resuscitation or feeding tubes only if they believed that they would be paroled. The model predicting desire for palliative care was not significant. Future days of desired life were related to prospective health condition, fear of death, negative affect, and trust in prison health care. Caucasian inmates expressed a desire for more days of life out of prison, whereas minority inmates did not differ in days of desired life either in or out of prison. Minorities wanted more days of life than Caucasians but only if they believed that they would be paroled. Implications: End-of-life care for the burgeoning inmate population is costly, and active life-sustaining treatments may not be desired under certain conditions. Specifically, expectation of parole but not current functional ability interacts with future illness condition in explaining inmates' desire for active treatment or days of desired life in the future.
Applying a Theory-Driven Framework to Guide Quality Improvement Efforts in Nursing Homes: The LOCK Model
(Oxford University Press, 2018) Mills, Whitney L.; Pimentel, Camilla B.; Palmer, Jennifer A.; Snow, A. Lynn; Wewiorski, Nancy J.; Allen, Rebecca S.; Hartmann, Christine W.; Baylor College of Medicine; University of Massachusetts Worcester; University of Alabama Tuscaloosa; Boston University
Purpose of the Study: Implementing quality improvement (QI) programs in nursing homes continues to encounter significant challenges, despite recognized need. QI approaches provide nursing home staff with opportunities to collaborate on developing and testing strategies for improving care delivery. We present a theory-driven and user-friendly adaptable framework and facilitation package to overcome existing challenges and guide QI efforts in nursing homes. Design and development: The framework is grounded in the foundational concepts of strengths-based learning, observation, relationship-based teams, efficiency, and organizational learning. We adapted these concepts to QI in the nursing home setting, creating the "LOCK" framework. The LOCK framework is currently being disseminated across the Veterans Health Administration. Results: The LOCK framework has five tenets: (a) Look for the bright spots, (b) Observe, (c) Collaborate in huddles, (d) Keep it bite-sized, and (e) facilitation. Each tenet is described. We also present a case study documenting how a fictional nursing home can implement the LOCK framework as part of a QI effort to improve engagement between staff and residents. The case study describes sample observations, processes, and outcomes. We also discuss practical applications for nursing home staff, the adaptability of LOCK for different QI projects, the specific role of facilitation, and lessons learned. Implications: The proposed framework complements national efforts to improve quality of care and quality of life for nursing home residents and may be valuable across long-term care settings and QI project types.
Bama perks: the use of simulated context as treatment for adults with aphasia
(University of Alabama Libraries, 2017) Tucker, Marie Louise; Barber, Angela B.; University of Alabama Tuscaloosa
There is a growing interest in examining the efficacy of aphasia treatment programs that examine meaningful real-life outcomes rather than therapeutic outcomes within structured intervention settings (Chapey et al., 2008). This study measured language abilities, social networks, and quality of life for nine patients with aphasia over a ten-week span during a simulated coffee shop social communication intervention called Bama Perks. Using an evaluative approach, strengths and weaknesses were examined and results supported the feasibility of Bama Perks as a supplement to traditional therapy. Clinician and caregiver measures indicated client improvement in language skills and social communication skills, a growth in social networks, and a reduction in burden of diagnosis. Daily rating scales taken during each Bama Perks session revealed variability with marginal growth across measures of communication function, flexibility, and overall communication production. These findings contribute to growing evidence supporting socially simulated environments as therapeutic contexts for individuals with aphasia.
Barriers and facilitators to yoga practice in adults with chronic low back pain
(University of Alabama Libraries, 2015) Combs, Martha Anne; Thorn, Beverly E.; University of Alabama Tuscaloosa
Given the high prevalence of chronic low back pain in the United States and the potential beneficial effects that integrative yoga interventions may have on this condition, the current study sought to examine barriers and facilitators to trying yoga in a population of adults with chronic low back pain. Participants self-reporting chronic low back pain were recruited from community sites in a collegiate town in western Alabama. Primary analyses utilized hierarchical regression and traditional 4-step mediational analyses to examine the predictive influence of catastrophizing and fear of movement on yoga attitudes. Results indicate that fear of movement serves a mediating role between catastrophizing and yoga attitudes. Originally proposed analyses included measurement of "intent to try yoga" as a primary outcome of interest. However, relationships between predictor variables and the unstandardized intent measure were, in general, extremely weak and execution of analyses was not indicated. Measurement of intention is discussed in Appendix A. Participants also responded to items asking them about perceptions of potential barriers and facilitators to trying yoga. Responses were subjected to qualitative thematic analysis and several common themes emerged for both barriers and facilitators: physical issues, cognitive/affective issues, motivational issues, informational issues, practical issues, and social issues. Qualitative analyses are discussed in Appendix B. Identifying cognitive barriers to consideration of yoga as a potential beneficial treatment for chronic low back pain conditions has great importance for clinical treatment of pain, especially as health care focus in the U.S. shifts to be more preventative and emphasizing self-management.
Barriers to mental health service use: variations by age and race/ethnicity
(University of Alabama Libraries, 2013) Ford, Katy Lauren; Kim, Giyeon; University of Alabama Tuscaloosa
This study examines the variation by age and racial/ethnic minority status in factors affecting misuse of mental health services (MHS) to identify barriers to adequate mental healthcare among racially/ethnically diverse older adults. Drawn from the nationally representative Collaborative Psychiatric Epidemiology Surveys (CPES), a racially/ethnically diverse group of adults who demonstrated either an objective (psychiatric diagnosis) or perceived need for MHS (n=5,545) was selected for analyses. Binary logistic regression analyses were conducted, with a focus on the interaction of older age with racial/ethnic minority status. To further explore the issue, we used chi-squared tests of proportional differences to compare the rates at which varying racial/ethnic groups and age groups encountered various attitudinal and structural barriers to proper MHS use. We found that Asian, Hispanic/Latino, and Black respondents were significantly more likely to misuse MHS than non-Hispanic Whites (ORs [95% CIs]=1.960 [1.471, 2.609], 2.362 [1.955, 2.854], & 2.906 [2.475, 3.412], respectively). Older adults were less likely than younger adults to misuse MHS (OR=0.991; 95%CI=0.986, 0.995). All differences were significant at p<0.001. There were significant age by race/ethnicity interactions on overall misuse of MHS. Post hoc analyses indicate that many attitudinal and structural barriers showed greater disparity between racial/ethnic minorities and whites in older adults than in younger adults. These results suggest that older age and membership in a racial/ethnic minority group interact to predict greater deficits in openness and access to MHS. Efforts to improve MHS underutilization by these groups should take their unique obstacles into account in order to reduce existing disparities.
Bereavement services for Hispanics: an exploratory study of Florida hospices
(University of Alabama Libraries, 2009) Arriaza, Pablo; Kosberg, Jordan I.; Csikai, Ellen L.; University of Alabama Tuscaloosa
Hispanics are the fastest growing minority group in the United Sates, numbering over 42 million and making up 15% of the total population. Hispanics are a diverse, intricate, and heterogeneous group that experiences various disparities in health care, including care at the end of life. One specific area, bereavement care, has received minimal attention in the literature, and previous national bereavement studies have not discussed ethnic variations related to the provision of bereavement services. This exploratory study, conducted in Florida, was undertaken to address existing policy, research, and practice gaps regarding bereavement services available to Hispanics. An on-line survey was developed to explore five research questions that centered on bereavement services offered by hospice agencies, bereavement coordinators' perceptions about the needs of Hispanics, and the strengths and challenges of hospice agencies when offering bereavement services to Hispanics. The sample consisted of all hospice bereavement coordinators in Florida. Initial contact was made by telephone to solicit participation and confirm contact information. An electronic survey was responded to by 73% (n = 30) of the total state sample. Results of this study reveal language and cultural barriers as major challenges in communicating with Hispanics and in offering and delivering bereavement services. Embedded within these challenges were reports by bereavement coordinators of the lack of Spanish-speaking personnel available to provide bereavement services. Additionally, results disclose that the number of Hispanics participating in bereavement services was much lower than the estimated number of potential Hispanic families and individuals eligible to participate in these services. Referrals to religious and spiritual support systems were considered an important referral source for Hispanics in bereavement agencies. Implications for social workers include the need to increase access to and the effectiveness of bereavement services for Hispanics through efforts in research, policy, and practice. Social work practitioners and researchers need to focus on the creation of instruments and processes for tracking bereavement services, and establishing practice standards for bereavement services. Needed policy efforts include advocating for more attention to the bereavement needs of Hispanics in state and national venues in addition to securing funds for creating grass-roots interventions.
Blended Facilitation as an Effective Implementation Strategy for Quality Improvement and Research in Nursing Homes
(Lippincott Williams & Wilkins, 2019) Pimentel, Camilla B.; Mills, Whitney L.; Palmer, Jennifer A.; Dillon, Kristen; Sullivan, Jennifer L.; Wewiorski, Nancy J.; Snow, Andrea Lynn; Allen, Rebecca S.; Hopkins, Susan D.; Hartmann, Christine W.; Geriatric Research Education & Clinical Center; University of Massachusetts Worcester; US Department of Veterans Affairs; Veterans Health Administration (VHA); Providence VA Medical Center; Harvard University; Hebrew SeniorLife; VA Boston Healthcare System; Boston University; University of Alabama Tuscaloosa
Background: Blended facilitation, which leverages the complementary skills and expertise of external and internal facilitators, is a powerful strategy that nursing stakeholders and researchers may use to improve implementation of quality improvement (QI) innovations and research performed in nursing homes. Problem: Nursing homes present myriad challenges (eg, time constraints, top-down flow of communication, high staff turnover) to QI implementation and research. Approach: This methods article describes the theory and practical application of blended facilitation and its components (external facilitation, internal facilitation, relationship building, and skill building), using examples from a mixed QI and research intervention in Veterans Health Administration nursing homes. Conclusions: Blended facilitation invites nursing home stakeholders to be equal partners in QI and research processes. Its intentional use may overcome many existing barriers to QI and research performed in nursing homes and, by strengthening relationships between researchers and stakeholders, may accelerate implementation of innovative care practices.
Brief depression literacy intervention with palliative cancer outpatients
(University of Alabama Libraries, 2016) Azuero, Casey Balentine; Allen, Rebecca S.; University of Alabama Tuscaloosa
Cancer patients are at risk for depression due to the nature of their disease. Previous investigations indicate patients meeting screening criteria for depression may be underdiagnosed or undertreated for their symptoms. For cancer patients, psychological distress may exacerbate pain, increase desire for hastened death, and increase disability. A randomized controlled trial (RCT) design was employed to determine feasibility and efficacy of a one-time, in-person psychoeducation and depression literacy intervention by comparing it to a treatment as usual (TAU) control group. Outpatient palliative care patients were eligible with PHQ-9 score ≥5, cancer diagnosis, absence of SMI or cognitive impairment, 19 years or older, able to speak and understand English, and available to be reached and communicate by telephone. Baseline and one month follow-up telephone assessments used vignettes and questionnaires to assess depression literacy, psychological distress, and disability. Forty-three patients enrolled, majority white (65%) females (75%) with mean age of 48 years (SD= 11.08). Three intervention participants dropped out before completing the intervention visit and follow-up interview; therefore, 40 participants were included in analysis. Group differences were controlled using propensity score. Intervention participants demonstrated clinically relevant change in depression literacy including: symptom identification (OR=2.0, 95%CI=0.296-13.511), likelihood to seek MH care with counselors (OR=4.059, 95%CI=0.388-42.491), psychiatrists (OR=4.2, 95%CI=0.397-44.4), and social workers (OR=4.2, 95%CI=0.397-44.401), and improved perceptions toward employees (OR=2.556, 95%CI=0.214-30.469) and parents (OR=15.333, 95%CI=1.711-137.404) with severe depression. Decreased somatic complaints (M=-1.7, SE=1.68, d=-0.378) and more stable level of disability were also found (M=-3.0, SE=3.36, d=-0.319). Although results are promising, future studies with more participants, improved outcome measurement, and diversity in the sample are warranted to improve the understanding of the magnitude of change in depression literacy between groups, and improve the generalizability of findings. Integration of the intervention across time, within the clinical setting may increase uptake and completion of the intervention. Also, long term follow-up would allow researchers to track the effect of the intervention on help-seeking behaviors.
Bringing Art to Life: the Impact of an Experiential Arts Program on Engagement in Persons Living with Alzheimer's Disease and Other Dementias
(University of Alabama Libraries, 2020) Reel, Candice D; Allen, Rebecca S.; University of Alabama Tuscaloosa
ABSTRACT Due to the growing numbers of persons living with dementia (PWD), the U.S. Department of Human Services created a National Plan to address dementia care. One of the goals of the National Plan was to optimize the quality of care. Adult day services often provide person-centered care to PWD to increase dignity, engagement, and creative expression. The Bringing Art to Life (BATL) program was created as an art therapy intervention in an adult day service. This thesis is an evaluation of the BATL program measured by engagement through ethnographic observations of art therapy sessions. Using a published and modified behavioral observation tool, engagements were quantified to test the hypothesis that engagements increase through sessions. While there was an increase in engagement by session, that increase was not significant. The second hypothesis that engagements are more prevalent in social interaction than art interaction was supported. A thematic analysis was conducted on the ethnographic field notes to test the hypothesis that social engagement themes were related to reminiscence and dignity and it uncovered five common themes in the field notes: family, social interaction, humor, art interaction, and advice. From both the quantitative engagement data and qualitative data, we hypothesized that social engagements would be related to reminiscence and dignity. The integration of the quantitative and qualitative data answered the overall research question that the BATL program was effective in engaging participants meaningfully both in activities and socially in intergenerational conversations revolving around reminiscence and personhood and in creative expression using art.
Callous-unemotional traits and emotion in a detained adolescent sample: a mixed methods approach
(University of Alabama Libraries, 2013) Ang, Xinying; Salekin, Randall T.; University of Alabama Tuscaloosa
Callous-Unemotional (CU) traits have been found to be useful in identifying youth who display more stable, severe and aggressive behavior and who are at increased risk for early-onset delinquency and later antisocial and delinquent behavior (Frick & Dickens, 2006; Frick & White,2008). Some studies devoted to understanding how youth with CU traits perceive emotional stimuli have found that youth with these traits have deficits in processing fear and distress in others (Frick and White, 2008). However, there is a paucity of research examining the detailed emotional experiences of youth with CU traits. Thus, the current study aimed to provide a richer understanding of the emotional experiences and perceptions of juvenile delinquents with high CU traits by examining how their emotional reactions and experiences may differ from those with low CU traits. Qualitative and quantitative data analyses were conducted to achieve these aims. It was found that a lower proportion of high CU youth, as compared to low CU youth, were able to identify the scared emotion of the photographed individual. No differences were found between groups on their ability to cite an experience for each emotion, or in their perceived emotional intensity for their experiences. High CU youth were more likely to make plans to evoke negative emotions in others for self-enhancement or to reach a specific goal, more so than low CU participants. A higher number of high CU youth reported that they found emotions hard to express, but perceived anger as easy to express, compared to low CU youth. High CU youth also controlled their fear to a greater extent compared to low CU youth. These findings are important as they shed new light on the relation between CU traits and emotion, and suggest that detained adolescents with CU traits may experience emotions such as guilt and fear, but they may prefer to contain their negative emotions from others.
Can Senior Volunteers Deliver Reminiscence and Creative Activity Interventions? Results of the Legacy Intervention Family Enactment Randomized Controlled Trial
(Elsevier, 2014) Allen, Rebecca S.; Harris, Grant M.; Burgio, Louis D.; Azuero, Casey B.; Miller, Leslie A.; Shin, Hae Jung; Eichorst, Morgan K.; Csikai, Ellen L.; DeCoster, Jamie; Dunn, Linda L.; Kvale, Elizabeth; Parmelee, Patricia; University of Alabama Tuscaloosa; University of Virginia; US Department of Veterans Affairs; Veterans Health Administration (VHA); Geriatric Research Education & Clinical Center
Context. Palliative care patients and their family caregivers may have a foreshortened perspective of the time left to live, or the expectation of the patient's death in the near future. Patients and caregivers may report distress in physical, psychological, or existential/spiritual realms. Objectives. To conduct a randomized controlled trial examining the effectiveness of retired senior volunteers (RSVs) in delivering a reminiscence and creative activity intervention aimed at alleviating palliative care patient and caregiver distress. Methods. Of the 45 dyads that completed baseline assessments, 28 completed postintervention and 24 completed follow-up assessments. The intervention group received three home visits by RSVs; control group families received three supportive telephone calls by the research staff. Measures included symptom assessment and associated burden, depression, religiousness/spirituality, and meaning in life. Results. Patients in the intervention group reported a significantly greater reduction in frequency of emotional symptoms (P = 0.02) and emotional symptom bother (P = 0.04) than the control group, as well as improved spiritual functioning. Family caregivers in the intervention group were more likely than control caregivers to endorse items on the Meaning of Life Scale (P = 0.02). Only improvement in intervention patients' emotional symptom bother maintained at follow-up after discontinuing RSV contact (P = 0.024). Conclusion. Delivery of the intervention by RSVs had a positive impact on palliative care patients' emotional symptoms and burden and caregivers' meaning in life. Meaningful prolonged engagement with palliative care patients and caregivers, possibly through alternative modes of treatment delivery such as continued RSV contact, may be necessary for maintenance of therapeutic effects. (C) 2014 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
Care transitions in outpatient cancer settings: processes and social work roles
(University of Alabama Libraries, 2016) Broussard, Crystal Scroggins; Csikai, Ellen L.; University of Alabama Tuscaloosa
About 1.6 million new cancer diagnoses are expected in 2016 and most individuals will receive treatment in one of 1500 outpatient community cancer centers (ACS, 2016). While many are successfully treated, other individuals will transfer from cancer care to alternative forms of care, including hospice. Positive transitions to new care settings result from good, clear communication between professionals and patients/families. The present study was designed to examine how care transitions are carried out, including team communication (interdisciplinary team and family meetings) about changing goals/plans of care, transition protocols, and follow-up procedures. Also investigated were the specific social work roles and activities that help prepare and support patients and families throughout changes in treatment and care settings, with a particular focus on transitions near the end of life. Distress screening practices were examined along with their impact on social work services. An online quantitative survey constructed for this study was conducted with a national random sample of outpatient oncology social workers drawn from facilities accredited by the Commission on Cancer (CoC) and stratified according to center classification. Of 481 cancer centers contacted, 119 had no social workers on staff. A total of 329 social workers were surveyed; 111 responded for a response rate of 34%. Findings indicated that patients/families were more prepared for the transition to hospice care when patients and families participated in family meetings addressing goals of care and were more involved in decision-making processes. Most centers did not have procedures to follow-up after the transition to another formal care provider. Social workers indicated challenges with the inclusion of distress screening measures (CoC mandate), including variation in administration, interpretation, and notification of distress screening scores. Greater demand for social work services has resulted in higher caseloads, with no promise of increased staff forthcoming. Study implications include the need to improve patient/family preparation for care transitions in cancer centers through improved communication and education, especially for transitions to hospice. Social workers can take the lead in development of clear protocols for care transitions that will ensure continuity of care and positive quality of life outcomes.
Caregiver and care recipient characteristics as predictors of psychotropic medication use in community-dwelling dementia patients
(Routledge, 2016) Grace, Elsie L.; Burgio, Louis D.; Allen, Rebecca S.; DeCoster, Jamie; Aiello, Allison E.; Algase, Donna L.; University of Michigan; University of Alabama Tuscaloosa; University of Virginia; Eli Lilly
Objectives: The current practice of prescribing psychotropic medication for the management of dementia-related behavioral disturbances is under substantial debate. Using Pearlin's stress process model as theoretical underpinning, the aim of this investigation is to identify caregiver and care recipient characteristics as predictors of anxiolytic, antipsychotic, and antidepressant use among community-dwelling dementia patients. We hypothesized that caregiving burden and patient characteristics, particularly behavior disturbances and pain, would be positively associated with psychotropic medication use.Methods: Data for this exploratory, cross-sectional study were drawn from the baseline assessment of the Resources for Enhancing Alzheimer's Caregiver Health II trial. Only participants with full baseline information were examined (N = 598). Caregiver characteristics, such as confidence managing problematic behaviors, and care recipient characteristics including pain, problem behaviors, cognitive impairment, and functional impairment, were examined in relation to care recipient psychotropic medication use.Results: Contrary to our hypothesis, behavioral disturbances and burden associated with these disturbances were not significantly associated with psychotropic use. Rather, caregiver characteristics such as race and overall vigilance, and care recipient characteristics such as cognitive status, functional status, and pain were significantly associated with the use of psychotropic medication. Findings differed by class of medication.Conclusion: These exploratory findings suggest the utility of a holistic approach to understanding the factors associated with pharmacotherapy among community-dwelling elders with dementia. Significant associations between caregiver characteristics and care recipient psychotropic medication use suggest that educating caregivers in non-pharmacologic strategies hold promise for a more balanced biopsychosocial approach to maintaining dementia patients in the community.
Changes in emotional well-being and self-perceived physical health over time among African American and White male caregivers of older adults
(University of Alabama Libraries, 2010) Durkin, Daniel William; Roff, Lucinda L.; University of Alabama Tuscaloosa
This study is a longitudinal, secondary data analysis of the Family Relations in Late Life (FRILL) 2 study. Using the Pearlin stress process model (SPM) as a guide, the purpose of this study was to test whether there was overall change and/or significant individual variability in emotional well-being and self-perceived physical health over 36 months among African American and White male caregivers of older adults living in the community. A two-level Hierarchical Linear Model (HLM) was used to predict individual changes over time for each of the five outcome variables (anger, anxiety, depressed affect, resentment, and self-perceived physical health) and examined the influence of race and constructs suggested by the Pearlin SPM among male caregivers. Race was not a significant predictor of any of the outcome variables. This finding suggests that African American and White male caregivers may be similar in their emotional and physical response to the demands of caregiving. Emotional well-being and health also appear to remain relatively stable over time. An examination of the social context appears to be important to understanding the male caregiving experience and how it changes over time. The quality of the pre-illness relationship was a significant predictor of change over time for every outcome except anger and depression. Caregivers who reported a higher quality pre-illness relationship reported less anxiety and resentment and better self-perceived health over time. Activity restriction was a significant predictor of changes in time for emotional well-being but not health. Caregivers who reported more activity restriction also reported more anger, anxiety, depressed affect, and resentment over time. Social support was a significant predictor of two emotional well-being outcomes. Caregivers who reported greater social support reported less depressed affect and resentment over time. These findings support previous findings that an increased sense of social isolation and lack of support from family and friends contributes to negative emotional well-being. Further, the findings suggest that these deficits may have a cumulative effect over time for both African American and White male caregivers. Findings from this study may be used to develop programs and interventions tailored to meet the needs of male caregivers.
Chronic pain conceptualization within a uniquely marginalized population: exploratory analysis of the relations between biomedical and biopsychosocial perspectives and functioning
(University of Alabama Libraries, 2019) Morais, Calia Arglod; Thorn, Beverly E.; University of Alabama Tuscaloosa
Objective: The goal of the current study was to examine the association of pain beliefs and pain-related outcomes, such as pain interference, physical functioning, depression, and anxiety. The impact of a literacy-adapted psychosocial treatment on the modification of pain beliefs was also explored. Background: Previous research has shown an association between pain beliefs and pain-related outcomes. To date, most studies have found a positive relationship between biomedical pain beliefs and poor psychological and physical outcomes. There is also some evidence to suggest that pain beliefs are a unique predictor for pain outcomes, above and beyond the influence of demographic characteristics. Pain beliefs can be modified through psychosocial treatments for chronic pain, such as Cognitive Behavioral Therapy (CBT). There is a paucity of research examining the biomedical or biopsychosocial pain beliefs of a low-SES population, or whether a psychosocial intervention is effective at changing biomedical or biopsychosocial pain beliefs among this understudied patient population. Method: 290 participants from the Learning About My Pain (LAMP) Study completed questionnaires before starting a 10-week literacy-adapted psychosocial treatment for chronic pain. Participants were randomly assigned to group cognitive-behavioral therapy (CBT), group pain education (EDU) or medical treatment-as-usual (UC). Participants also completed questionnaires at post-treatment. Results: There was a significant positive and weak association between pain beliefs and pain-related outcomes. Regression results revealed that biomedical pain beliefs had a stronger association with physical functioning, while biopsychosocial pain beliefs had a stronger association with psychological functioning. Patient’s biomedical pain beliefs decreased and biopsychosocial pain beliefs increased following participation in a literacy-adapted psychosocial intervention. Conclusions: The findings in this study suggest that certain specific pain beliefs may be more related to particular aspects of physical and psychological functioning. These findings also provide further support for the benefits of literacy-adapted psychosocial treatments and highlight the benefits of providing treatments consistent with a biopsychosocial model of pain. Overall, the results of this study demonstrate the importance of pain belief assessment among an understudied population and its implications to improve our understanding of patient’s pain conceptualization and how it relates to patient outcomes.
The Color Line: the Influence of Race on Aesthetic Experience and its Inferred Connection to Implicit Racial Bias
(University of Alabama Libraries, 2020) Jackson, Barbara Larsha; Black, Sheila; University of Alabama Tuscaloosa
Implicit bias literature widely reports that biases shape perception in a number of real-world situations. However, a review of literature found no existing implicit bias studies that focus on the activation of biases during the process of art assessment. The current study fills this empirical gap. Methods: Eighty-nine students (Black — 33; White — 56) participated in a study on art interpretation where they judged fifteen paintings in four categories— Mainstream, Blackstream, Activist and Political— and reported on three dimensions related to their assessment, like, comfort and valence. Results: An analysis of the data determined that the Blackstream category yielded significant results on the dimension of comfort with White people being less comfortable with images in the Blackstream category than Blacks. No other significant results were found on the dimensions of comfort or like in the other art categories, indicating that there were no significant differences in participant responses to the artworks in these categories. A word analysis on the written interpretations of the paintings was conducted on the dimensions of positive, neutral and negative language usage, which indicated that Whites responded less positively than Blacks to art in the Blackstream category. Discussion and implications: These findings indicate that race plays a role in the interpretation of paintings, specifically those in the Black art category. A future study will examine how age, executive functioning, openness to experience, explicit and implicit racism play a role in mediating the responses of Black and White participants to artworks. Keywords: perception, aesthetic experience, race, art

Browsing by Author "Allen, Rebecca S."

Results Per Page

Sort Options