Browsing by Author "Parker, Michael W."

Now showing 1 - 9 of 9
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    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.
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    Efficacy of an audio-based cognitive behavioral therapy for older adults with depression
    (University of Alabama Libraries, 2010) Shah, Avani; Scogin, Forrest Ray; University of Alabama Tuscaloosa
    The purpose of this study was to develop and assess the efficacy of an audio-based cognitive behavioral therapy (ACBT) intervention for older adults with depressive symptoms. The process of developing this program included: 1) adaptation of a client and therapist manual developed for older adult caregivers (Dick, Gallagher-Thompson, Coon, Powers, & Thompson, 1996); 2) review of the ACBT program by older adults and cognitive behavioral therapists for acceptability; and 3) program revision. The revised program consists of 8 compact discs (CDs) and a workbook on the following topics: 1) introduction to CBT; 2) identifying and changing unhelpful thoughts; 3) addressing feelings; 4) relaxation; 5) engaging in pleasant events; 6) assertiveness; and 7) problem-solving. The next phase of this study entailed testing the efficacy of the ACBT program. Eligible participants (N = 34) were recruited from mainly medical settings and rural communities (e.g. above age 54 with a score greater than 9 on the Geriatric Depression Scale; GDS). Participants were randomly assigned to an immediate treatment group or a minimal contact delayed treatment group. The delayed treatment group waited four weeks to begin treatment while the immediate treatment group received a brief training session and 4 weeks to complete the ACBT program. Both groups received brief weekly contact calls to monitor mood. Outcome analyses assessed change in depression with the Hamilton Rating Scale for Depression (HRSD; Hamilton, 1967) and GDS. Intent-to-treat carry forward analyses revealed significant differences on only the HRSD by group and time. Analyses assessing change on the Somatization subscale of the Brief Symptom Inventory (Derogatis & Spencer, 1983) and GDS by group and time were not significant.
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    Exploring Korean older adults' perceptions of and decisions to volunteer
    (University of Alabama Libraries, 2011) Shin, Hae Jung; Csikai, Ellen L.; University of Alabama Tuscaloosa
    Volunteerism has long been seen as a positive civic engagement activity for people of all ages in the Western countries, but has only relatively recently taken on a similar importance in Korea. Given that the older population has dramatically increased in Korea and is expected to grow even more, from 11% in 2010 to 38% by 2050, senior volunteerism is being promoted by the Korean government (through a series of policies) as a promising way to engage older adults in the community and society. Little is known however about older adults' perceptions of the value of volunteer experiences and how they decide whether or not to volunteer. The purpose of this phenomenological qualitative study was to explore the lived experiences of Korean older adults, ages 60 and older, about the phenomenon of volunteerism. Data were collected from thirty older adults, ages 60 and older, (Volunteers N=20; Non-volunteers N=10), recruited from one senior welfare center in Seoul and one community welfare center in Gwangmyeong City. This study consisted of semi-structured in-depth interviews. Each interview was audio-taped and transcribed in Korean. The transcribed interviews were examined and the meaning units and the essence of the experiences were extracted using the data analysis methodology developed by Moustakas (1994). From these, common themes that emerged were examined for possible theory development. Two exploratory decision-making models were proposed from the data/common themes. The models illuminate the perceptions of volunteerism among these Korean older adults as influenced by background contextual factors and a range of facilitators/barriers, including recruitment and supportive strategies that seem to be linked to the decision to volunteer or to continue to volunteer. The in-depth understanding of volunteer motivations and experiences gained from this study provided insight into social work and gerontology practice strategies, such as creation of collaborative agency networks to promote volunteerism, that can be developed to address the needs of both older adults and the larger society. These efforts can contribute to the recognition of older adults not just as a growing segment of the population in need of care, but as healthy, active, and productive contributors in society.
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    Grandparent caregivers: factors contributing to their experience of life satisfaction
    (University of Alabama Libraries, 2016) Coleman-Reed, Freda Veronica; Nelson-Gardell, Debra M.; University of Alabama Tuscaloosa
    Globally, the number of grandparents providing primary, custodial, or co-parenting for biological and legal grandchildren has grown progressively. Often time examination of grandparent caregiving occurs through the lens of burden and deleterious familial, psychological, and medical outcomes. The present cross-sectional research study is a preliminarily exploration of factors that promote grandparent experience of positive life satisfaction. Bivariate research findings supported an association between grandparent caregivers’ experience of positive life satisfaction and reported resources (rs(94) = .51; p =.000), choice to parent (rs(94) = .26; p =.006), and spirituality (rs(94) = .214; p =.019. Because life satisfaction scores were reversed, the outcome indicated higher life satisfaction is associated with higher reported resources, choice to parent, spirituality, and parental stress. Social support (r(94) = .093; p =.375) and parental stress (r(94) = .181; p =.081) did not demonstrate significant relationships. Multiple Regression Analysis (MRA) found reported resources (β = .45) and choice to parent (β = .21) were the strongest predictors of grandparent caregivers’ positive life satisfaction (F(2, 91) = 26.54, p < .001). However, MRA with caregiver satisfaction interaction terms did not contribute significantly to the model (F(2, 91) = 26.54, p < .001). Study findings evidenced grandparent caregivers experienced positive life satisfaction when they engage in spiritual practices; perceive reduced stress, choice in parenting, adequate personal, social, and familial resources to meet life demands. Implications for social work practice, policy, and research are offered that build on grandparent caregivers’ adaptability, capabilities, and strengths rather than deficits.
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    Older adults conception of a ‘good death’
    (University of Alabama Libraries, 2019) Maynard, Quentin Robert; Csikai, Ellen L.; University of Alabama Tuscaloosa
    Advances in medical care have led to an increasing number of older adults living with at least one chronic illness over a longer period of time. Correspondingly the disease trajectory and dying process may be prolonged, providing individuals with more time to plan for what they consider a ‘good death.’ A ‘good death’ is described through research primarily according to medical and biological aspects. While the psychosocial and spiritual elements are also part of a ‘good death,’ it is difficult to delineate the individual aspects important to individuals near the end of life. This study used descriptive qualitative research methods to describe older adults’ conceptions of a ‘good death,’ specifically the psychosocial and spiritual factors. Data were collected from 12 community-dwelling older adults in central Alabama, utilizing a semi-structured interview guide. Qualitative content analysis guided the data analysis procedures. Corr’s (1992) task-based approach to coping with dying framed the study and served to categorize participant statements. The findings suggested that a number of physical, psychological, social, and spiritual components contributed to the conception of a ‘good death,’ and that these were often interrelated. For example, the type of medical treatment desired at the end of life was influenced by the potential effect on members of the participants’ social network, such as necessity for the participants’ family members to care for them when they were no longer independent and had a poor quality of life. Participants’ motivations and values guided what these individuals believed could help them achieve a ‘good death.’ Conceptions were highly personal with the realization that preparation would allow them to control their situation, although unpredictable, near the end of life. Health social work practice may be strengthened by these findings as it confirms the holistic nature of helping older adults prepare in advance for the end of life. Efforts to maximize quality of life throughout serious illness and near the end of life are essential so that older adults may die a ‘good death.’
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    Predicting the Trajectories of Perceived Pain Intensity in Southern Community-Dwelling Older Adults: The Role of Religiousness
    (Sage, 2013) Sun, Fei; Park, Nan Sook; Wardian, Jana; Lee, Beom S.; Roff, Lucinda L.; Klemmack, David L.; Parker, Michael W.; Koenig, Harold G.; Sawyer, Patricia L.; Allman, Richard M.; Arizona State University; Arizona State University-Downtown Phoenix; University of South Florida; University of Alabama Tuscaloosa; Duke University; King Abdulaziz University; University of Alabama Birmingham; Geriatric Research Education & Clinical Center
    This study focuses on the identification of multiple latent trajectories of pain intensity, and it examines how religiousness is related to different classes of pain trajectory. Participants were 720 community-dwelling older adults who were interviewed at four time points over a 3-year period. Overall, intensity of pain decreased over 3 years. Analysis using latent growth mixture modeling (GMM) identified three classes of pain: (1) increasing (n = 47); (2) consistently unchanging (n = 292); and (3) decreasing (n = 381). Higher levels of intrinsic religiousness (IR) at baseline were associated with higher levels of pain at baseline, although it attenuated the slope of pain trajectories in the increasing pain group. Higher service attendance at baseline was associated with a higher probability of being in the decreasing pain group. The increasing pain group and the consistently unchanging group reported more negative physical and mental health outcomes than the decreasing pain group.
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    Technology assisted intervention for improving mood: a portable computer-assisted therapy program for treating depression in older adults
    (University of Alabama Libraries, 2011) Morthland, Martin Plant; Scogin, Forrest Ray; University of Alabama Tuscaloosa
    The dissertation examined the effectiveness of a newly developed intervention to treat symptoms of depression among a sample of older adults. The study contained in this dissertation furthered the line of research involving self-administered treatments for depressed older adults. The intervention used in this study was developed for the purpose of creating a portable, computer-based self-administered treatment, which could later be explored as a possible intervention in overcoming barriers to mental healthcare access for older adults. This computer-based intervention was developed using a slate-PC as the platform and series of eleven sessions based on the manual Cognitive-Behavioral Therapy for Late Life Depression (Dick, Gallagher-Thompson, Coon, Powers, & Thompson (1995). Thirty-four, older adult participants were randomly assigned to either an immediate treatment group or a one-month waitlist control group. Outcome measures included both a clinician-rated measure of depression (Hamilton Rating Scale for Depression; HRSD) and a self-report measure of depression (Geriatric Depression Scale; GDS-30). Possible mediators were examined using the Dysfunctional Attitudes Scale (DAS) and the California Older Persons Pleasant Events Scale (COPPES). Treatment receipt and treatment enactment were also constructs of interest; measured by CBT knowledge tests, and the number of sessions and percentage of completed homework assignments completed by the participants. Finally, a measure of intervention benefit was administered to evaluate older adults' acceptance of the computer-based intervention used in this study. Results suggested that the older adults in the experimental condition displayed a significant decrease in depressive symptoms compared to those in the control condition. Analyses of clinical significance also suggested that older adults improved in a clinically meaningful way following the intervention. Meditational relations between condition and outcome were not found using the DAS and the COPPES. Additional, uncontrolled, analyses suggested significant relations between post-treatment depression and measures of treatment receipt and treatment enactment. Finally, feedback from the participants indicated that they considered the intervention easy to use, enjoyable, and useful for learning techniques to improve their mood. The implications of this study were discussed as they relate to the treatment of depression for older adults. New technology-based applications for the treatment of depression among older adults may follow the results found in this dissertation.
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    Validation of the self-care utility geriatric African American rating (SUGAAR) for type 2 diabetes
    (University of Alabama Libraries, 2013) McCaskill, Gina Marie; Bolland, Kathleen A.; University of Alabama Tuscaloosa
    The primary purpose of this study was to further develop the SUGAAR, an instrument designed to assess the self-care practices of older African American with type 2 diabetes. The instrument was initiated as a project for a research class and was further assessed, modified, and administered for this dissertation study. The secondary purpose of this study was to draw preliminary conclusions about diabetes self-care, health and functional status of a sample of community-dwelling African Americans 65 years and older with a self-reported diagnosis of type 2 diabetes. Purposive sampling was used to recruit 125 older African Americans across five counties in Alabama. Participants were interviewed in their homes or at a private location of their choosing. Regarding the development of the instrument, findings from the cognitive interviews, pilot test, and earlier developmental work provided support for the face validity and content validity of the SUGAAR. The results from the KR-20 indicate that participants' diabetes self-care is not a unidimensional concept. The results from the factor analysis did not support a stable factor structure for the SUGAAR. The inability to identify multidimensionality in the instrument may indicate that individuals with type 2 diabetes may not accomplish self-care practices in the same clusters of practices that make sense to health care practitioners and researchers. However, findings indicate content and convergent validity of the SUGAAR, which suggests it is a valid checklist for use among African Americans 65 years and older. Regarding diabetes self-care, findings suggest differences between age groups regarding diabetes self-care. Middle-old participants are engaging in more diabetes self-care compared to the youngest-old participants, which supports a trend in the data that suggests participants 75 to 84 years old are healthier than participants 65 to 74 years, except regarding the use or ownership of supportive devices. Overall, participants are receiving messages about the importance of diabetes self-care and health in late life, which they are trying to put into practice.
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    Who’s in, who’s out: a descriptive analysis of demographic and contextual factors related to labor force participation among older adults
    (University of Alabama Libraries, 2018) White-Chapman, Nyshetia; MacNeil, Gordon; University of Alabama Tuscaloosa
    As the proportion of older adults in the United States grows, there are significant concerns surrounding economic well-being in retirement. The two major components of the U.S retirement income system, Social Security and employer-sponsored retirement plans, have undergone significant changes that erode financial security in retirement. Working longer has been proposed to help older adults overcome deficits in retirement income. However, even when motivated to work, many older adults face significant challenges in the labor market, particularly those who are unemployed or displaced. In the current study, secondary data from the Health and Retirement Study (HRS) is used to identify demographic and contextual factors associated with unemployment, displacement, and reemployment (among those who are displaced at Time 2) among older adults. Logistic regression is used to examine the influence of race/ethnicity, gender, education, relationship status, health status, income status, geographical location, eligibility for retirement/age, and sector of employment on unemployment, displacement, and reemployment. Results suggest being of an “other” race, being married, being in fair to poor health, and having household income below the poverty threshold increased the odds of employed while being previously employed in the service sector reduced the odds of unemployment. All else equal, being African American and living in the West increases the likelihood of displacement among older adults while being female, living in poverty, and being eligible for retirement (aged 62 and older) reduces an older adult’s chances of being displaced. Finally, all else equal, being African American, living in the Northeast, and being eligible for retirement (aged 62 and older) reduced the likelihood reemployment at Time 2. The major implications of these findings for research, policy, and practice are discussed.