DSpace Repository :: Browsing by Author "Parmelee, Patricia A."

Browsing by Author "Parmelee, Patricia A."

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Body mass index and its associations with pain, depressive symptoms, and disability in knee osteoarthritis
(University of Alabama Libraries, 2017) Pierpaoli, Christina Marie; Parmelee, Patricia A.; University of Alabama Tuscaloosa
Obesity is a risk factor for osteoarthritis (OA) and both are steadily increasing among older adults. Nevertheless, empirical examinations of the associations of body mass index (BMI) with depressive symptomatology, pain, and disability in OA remain limited. Few studies have described and differentiated functional disability in necessary tasks (basic and instrumental activities of daily living; ADL/IADLs) from discretionary, leisure activities among symptomatic normal, overweight, and obese adults. Therefore, here, associations of BMI with pain, depressive symptoms, and measures of disability among older adults with knee osteoarthritis were examined. A key focus was how BMI influences the form functional disability takes in terms of limiting necessary vs. discretionary activities. Data were collected from a sample of community-dwelling older adults with physician-confirmed knee osteoarthritis (N =353). BMI predicted significant variance in psychological and functional impairment in osteoarthritis, including pain, depressive symptoms, and three functional outcomes measures (specifically, ADL/IADL disability, discretionary activity, and activity limitation). Effects of BMI depended on level and were differentially mediated through pain. For adults with low BMI, engagement in more discretionary activities was associated with fewer depressive symptoms. This research confirms the association of BMI with disability related osteoarthritis, identifying it as a rich intervention target in a comprehensive treatment of OA to interrupt its cycle of excessive weight gain, pain, depressive symptoms, and disability particularly among older adults.
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.
Center for epidemiologic studies depression scale (ces-d) factor structure among older adults with osteoarthritis: associations with pain and disability
(University of Alabama Libraries, 2012) McPherron, Jesse Alan; Parmelee, Patricia A.; University of Alabama Tuscaloosa
This analysis evaluated the association of depressive factors with symptoms of osteoarthritis of the knee including pain and disability. Analyses used a sample of community-dwelling older adults. A comparison of potential confirmatory models for the Center for Epidemiologic Studies Depression (CES-D) Scale was performed. Resultant factors of depression were used to predict cross-sectional and longitudinal pain and disability after controlling for demographic and general health covariates. Results indicated a second-order four-factor model had the best fit in this population for the CES-D. In cross-sectional regressions the somatic/vegetative factor was the sole unique predictor of variance in pain of the CES-D factors individually. In addition, the CES-D factors as a group accounted for significant unique variance in both pain and disability. Longitudinal regressions found that CES-D factors as a group significantly predicted change in disability and change in pain over one year; however, none of the CES-D factors had significant coefficients. Results support a biopsychosocial evaluation of depression in osteoarthritis, suggest depression as a unidimensional construct predicts increased pain and disability, and support the continued use of the CES-D in community populations of older adults with osteoarthritis.
Chronicity among older psychiatric inpatients
(University of Alabama Libraries, 2018) Williams, Jordan Chase; Parmelee, Patricia A.; University of Alabama Tuscaloosa
The goal of this dissertation is to examine factors that could relate to length of stay (LOS), latency to readmission, and number of admissions. Length of stay is generally defined as the amount of time an individual stays in the facility; latency to readmission is the amount of time between the last discharge and the most recent admission for each individual. I examined several factors that related to these outcomes, including number of falls, number of assaults, medical diagnoses, psychological diagnoses, frequency of PRN medication, emergency department visits and seclusion/restraints. Structural equation modeling was used to create statistical models incorporating these variables. Several models were proposed using each variable (LOS, admits, and latency) as outcome variables. Based on these models, integrated models were proposed and analyzed. Results based on these models were discussed and future research projects were proposed.
Communicating violence risk: judicial decision making in involuntary civil commitments
(University of Alabama Libraries, 2012) Evans, Stephanie Ann; Salekin, Karen L.; University of Alabama Tuscaloosa
Beginning in the 1990s, researchers in the field of violence risk assessment recognized that even the most accurate and valid risk assessment could not assist fact-finders if violence risk was not communicated in a clear, precise, and complete manner (Monahan & Steadman, 1996; Schopp, 1996). Due to this growing attention to the importance of risk communication, four empirical studies have investigated how risk messages impact decisions and how decision-makers interpret risk messages (Kwartner, Lyons, & Boccaccini, 2006; Monahan et al., 2002; Slovic & Monahan, 1995; Slovic, Monahan, & MacGregor, 2000). The main purpose of the current study was to investigate judges' opinions regarding the probative value of risk communication messages in civil commitment proceedings. There were five types of risk communication messages that were investigated in this study: (a) description model; (b) prediction model [categorical format]; (c) prediction model [probabilistic format]; (d) prediction model [frequency format]; and (e) management model. Secondary purposes of this study were to investigate whether these risk messages influence judicial decisions and whether the attributes of role orientation, legal philosophy, and Fear of False Negatives (FFN) impact the decision-making process. A national sample of 403 judges completed the study, which produced an 18.28% response rate. Each participant was randomly selected to receive one of ten risk vignettes in which type of risk message and risk level were systematically varied. Participants answered three questions regarding the applicable risk vignette and completed demographic and judicial attribute questionnaires. This study found that the risk models (i.e., description, prediction, and management messages) were viewed as equally probative. However, within the risk prediction model, categorical messages were rated as highest in probative value. Results indicated that risk prediction messages, in general, led to stricter rulings than did the other risk models, but no one risk prediction format (i.e., categorical, probabilistic, or frequency) resulted in higher restrictiveness in judicial ruling. Finally, this study found that legal philosophy and FFN, but not role orientation, impacted the restrictiveness of judicial rulings. Limitations of this study and recommendations for future research are discussed.
Communication Modalities, Personality Traits, and Change in Perceived Control Over Social Life Following Onset of the COVID-19 Pandemic Among Older Americans
(Sage, 2023) Choi, Shinae L.; Hill, Kyrsten C.; Parmelee, Patricia A.; University of Alabama Tuscaloosa
We examined associations between change in social contact communication modalities and change in perceived control over social life (PCOSL) following onset of the COVID-19 pandemic among older Americans and evaluated the extent to which associations were moderated by personality. Data were from the 2016 and 2020 waves of the Health and Retirement Study. Multivariate ordinary least squares regression analyses were computed adjusting for baseline PCOSL, sociodemographic, health, and psychosocial factors. Multiple moderation analyses revealed that extraversion moderated the association between change in social media communication and change in PCOSL before to during COVID-19. As levels of engagement in social media communication increased, those with high extraversion experienced increases in PCOSL, whereas those with low extraversion experienced decreases in PCOSL. Findings suggest that social interventions targeting perceived control and communication modality may be useful for older adults during global health events and that personality characteristics can help to inform intervention choices.
A conceptual model for culture change evaluation in nursing homes
(Elsevier, 2013) Hartmann, Christine W.; Snow, A. Lynn; Allen, Rebecca S.; Parmelee, Patricia A.; Palmer, Jennifer A.; Berlowitz, Dan; Boston University; University of Alabama Tuscaloosa
This article describes the development and particulars of a new, comprehensive model of nursing home culture change, the Nursing Home Integrated Model for Producing and Assessing Cultural Transformation (Nursing Home IMPACT). This model is structured into four categories, "meta constructs," "care practices," "workplace practices," and "environment of care," with multiple domains under each. It includes detailed, triangulated assessment methods capturing various stakeholder perspectives for each of the model's domains. It is hoped that this model will serve two functions: first, to help practitioners guide improvements in resident care by identifying particular areas in which culture change is having positive effects, as well as areas that could benefit from modification; and second, to emphasize the importance in culture change of the innumerable perspectives of residents, family members, staff, management, and leadership. Published by Mosby, Inc.
Determinants of mental health utilization in a palliative care outpatient setting
(University of Alabama Libraries, 2012) Azuero, Casey Balentine; Allen, Rebecca S.; University of Alabama Tuscaloosa
This study examines the determinants of psychology service utilization among a chronically ill population. Data were combined from an outpatient palliative care clinic using two patient outcome studies for a secondary data analysis. Overall, 149 patients were examined with the majority being middle-aged (M = 55, SD = 14.73), female (n=112; 75.2%) and White (n=123; 82.6%) with a primary diagnosis of cancer (n=117; 78.5%) over a 37 month time period. Using the Behavioral Model of Health Service Use (Andersen, 1995), separate logistic regression analyses were conducted to assess for significant predisposing, enabling and need factor determinants of psychology service utilization in outpatient palliative care. The significant determinants from each of these factors were then modeled together. The total number of visits to see a palliative care physician was found to be the strongest determinant of psychology service utilization (p < .001). Seeing multiple providers was also a statistically significant determinant of psychology service utilization (p = .002) as well as not taking a non-opioid analgesic (p = .024). These findings suggest enabling factors from Andersen's model are most strongly associated with psychology service utilization in outpatient palliative care populations. Of note, many factors associated with need for psychology services, such as emotional distress, psychological symptom burden or having a psychological comorbidity, did not reach significance in determining psychology service use. These findings reinforce previous research that indicates chronically ill individuals are not likely to receive mental health care even though it is documented that they have increased distress related to their mental health. Also, these findings indicate the need for further investigation as to who is receiving referrals for psychology services, as it is noted in the scientific literature that many chronically ill individuals are under-recognized as needing mental health care referrals by their physicians.
Development of a New Tool for Systematic Observation of Nursing Home Resident and Staff Engagement and Relationship
(Oxford University Press, 2018) Snow, A. Lynn; Jacobs, M. Lindsey; Palmer, Jennifer A.; Parmelee, Patricia A.; Allen, Rebecca S.; Wewiorski, Nancy J.; Hilgeman, Michelle M.; Vinson, Latrice D.; Berlowitz, Dan R.; Halli-Tierney, Anne D.; Hartmann, Christine W.; University of Alabama Tuscaloosa; Boston University
Purpose of Study: To develop a structured observational tool, the Resident-centered Assessment of Interactions with Staff and Engagement tool (RAISE), to measure 2 critical, multi-faceted, organizational-level aspects of person-centered care (PCC) in nursing homes: (a) resident engagement and (b) the quality and frequency of staff-resident interactions. Design and Methods: In this multi-method psychometric development study, we conducted (a) 120 hr of ethnographic observations in one nursing home and (b) a targeted literature review to enable construct development. Two constructs for which no current structured observation measures existed emerged from this phase: nursing home resident-staff engagement and interaction. We developed the preliminary RAISE to measure these constructs and used the tool in 8 nursing homes at an average of 16 times. We conducted 8 iterative psychometric testing and refinement cycles with multi-disciplinary research team members. Each cycle consisted of observations using the draft tool, results review, and tool modification. Results: The final RAISE included a set of coding rules and procedures enabling simultaneously efficient, non-reactive, and representative quantitative measurement of the interaction and engagement components of nursing home life for staff and residents. It comprised 8 observational variables, each represented by extensive numeric codes. Raters achieved adequate to high reliability with all variables. There is preliminary evidence of face and construct validity via expert panel review. Implications: The RAISE represents a valuable step forward in the measurement of PCC, providing objective, reliable data based on systematic observation.
The effect of staffing variables on nursing home resident outcomes
(University of Alabama Libraries, 2015) Williams, Jordan Chase; Parmelee, Patricia A.; University of Alabama Tuscaloosa
The relationship between nursing home staffing variables and resident outcomes was investigated using a secondary data analysis. Data from the 2004 National Nursing Home Survey (NNHS) was linked with variables obtained from Nursing Home Compare in 2005. Minimum Data Set (MDS) quality indicators of facility-level depression and pain were used as outcome variables. This is a departure from previous studies which used primarily physiological outcome variables. Using a series of regression analyses, NNHS variables related to individual-level job factors, staff benefits, and staff richness were used to predict facility-level pain and depression. It was hypothesized that all three of these constructs would predict better resident outcomes in the form of reduced depression and pain. Staff stability and richness were also investigated as potential mediators. The overall model was not supported, although several interesting relationships were found. As nursing home leadership experience increased, so did facility-level depression scores. The number of volunteers and volunteer hours had a similar relationship to depression. Greater wages, full-time staff turnover, and volunteer duties were associated with decreased depression rates. Staff HPPD, hourly wages, and several control variables were associated with decreased rates of pain. Implications for future studies are discussed, including the need for firsthand data collection and the reduction of measurement bias.
Enhancing sleep quality for nursing home residents with dementia: a pragmatic randomized controlled trial of an evidence-based frontline huddling program
(BMC, 2021) Snow, A. Lynn; Loup, Julia; Morgan, Robert O.; Richards, Kathy; Parmelee, Patricia A.; Baier, Rosa R.; McCreedy, Ellen; Frank, Barbara; Brady, Cathie; Fry, Liam; McCullough, Megan; Hartmann, Christine W.; University of Alabama Tuscaloosa; University of Texas Health Science Center Houston; University of Texas School Public Health; University of Texas Austin; Brown University; University of Massachusetts Lowell
Background: Disturbed sleep places older adults at higher risk for frailty, morbidity, and even mortality. Yet, nursing home routines frequently disturb residents' sleep through use of noise, light, or efforts to reduce incontinence. Nursing home residents with Alzheimer's disease and or related dementias-almost two-thirds of long-stay nursing home residents-are likely to be particularly affected by sleep disturbance. Addressing these issues, this study protocol implements an evidence-based intervention to improve sleep: a nursing home frontline staff huddling program known as LOCK. The LOCK program is derived from evidence supporting strengths-based learning, systematic observation, relationship-based teamwork, and efficiency. Methods: This study protocol outlines a NIH Stage III, real-world hybrid efficacy-effectiveness pragmatic trial of the LOCK sleep intervention. Over two phases, in a total of 27 non-VA nursing homes from 3 corporations, the study will (1) refine the LOCK program to focus on sleep for residents with dementia, (2) test the impact of the LOCK sleep intervention for nursing home residents with dementia, and (3) evaluate the intervention's sustainability. Phase 1 (1 year; n = 3 nursing homes; 1 per corporation) will refine the intervention and train-the-trainer protocol and pilot-tests all study methods. Phase 2 (4 years; n = 24 nursing homes; 8 per corporation) will use the refined intervention to conduct a wedge-design randomized, controlled, clinical trial. Phase 2 results will measure the LOCK sleep intervention's impact on sleep (primary outcome) and on psychotropic medication use, pain and analgesic medication use, and activities of daily living decline (secondary outcomes). Findings will point to inter-facility variation in the program's implementation and sustainability. Discussion: This is the first study to our knowledge that applies a dementia sleep intervention to systematically address known barriers to nursing home quality improvement efforts. This innovative study has future potential to address clinical issues beyond sleep (safety, infection control) and expand to other settings (assisted living, inpatient mental health). The study's strong team, careful consideration of design challenges, and resulting rigorous, pragmatic approach will ensure success of this promising intervention for nursing home residents with dementia.
Ethnoracial disparities in cognition are associated with multiple socioeconomic status-stress pathways
(Springer, 2021) Letang, Sarah K.; Lin, Shayne S-H; Parmelee, Patricia A.; McDonough, Ian M.; University of Alabama Tuscaloosa
Systemic racism can have broad impacts on health in ethnoracial minorities. One way is by suppressing socioeconomic status (SES) levels through barriers to achieve higher income, wealth, and educational attainment. Additionally, the weathering hypothesis proposes that the various stressful adversities faced by ethnoracial minorities lead to greater wear and tear on the body, known as allostatic load. In the present study, we extend these ideas to cognitive health in a tri-ethnic sample of young adults-when cognition and brain health is arguably at their peak. Specifically, we tested competing mediation models that might shed light on how two key factors caused by systemic racism-SES and perceived stress-intersect to explain ethnoracial disparities in cognition. We found evidence for partial mediation via a pathway from SES to stress on episodic memory, working memory capacity, and executive function in Black Americans relative to non-Hispanic White Americans. Additionally, we found that stress partially mediated the ethnoracial disparities in working memory updating for lower SES Black and Hispanic Americans relative to non-Hispanic White Americans, showing that higher SES can sometimes reduce the negative effects stress has on these disparities in some cognitive domains. Overall, these findings suggest that multiple pathways exist in which lower SES creates a stressful environment to impact ethnoracial disparities cognition. These pathways differ depending on the specific ethnoracial category and cognitive domain. The present results may offer insight into strategies to help mitigate the late-life risk for neurocognitive disorders in ethnoracial minorities.
Examining emotional intelligence in older adults with chronic pain: a factor analysis approach
(Routledge, 2021) Condon, Shelley E.; Parmelee, Patricia A.; Smith, Dylan M.; University of Alabama Tuscaloosa; State University of New York (SUNY) Stony Brook
Objective: The current study explored whether the three-factor structure of an emotional intelligence measure (attention to emotions, clarity in understanding emotions, and emotion regulation) developed in a sample of college students would replicate in a sample of older adults with chronic pain. Method: Confirmatory and exploratory factor analyses were conducted to examine the factor structure of the 30-item Trait Meta-Mood Scale among 340 older adults with knee osteoarthritis. Results: Confirmatory factor analyses indicated that the original three-factor model of emotional intelligence did not fit well with the data for older adults. Exploratory factor analyses revealed a four-factor model of emotional intelligence: (1) confusion, (2) acceptance, (3) rejection, and (4) insight. Correlations between the original and new subscales were explored. Conclusion: While the newly derived emotional intelligence scales resembled the original conceptualization of emotional intelligence proposed by Salovey, Mayer, Goldman, Turvey, and Palfai (1995), the current study highlights the differences in emotional intelligence likely representative of older adults with chronic pain.
Examining pathways of the caregiver burden - health relationship in family caregivers of elderly veterans: the importance of caregiver self-efficacy and social support
(University of Alabama Libraries, 2018) Scicolone, Monica Alexandra; Parmelee, Patricia A.; University of Alabama Tuscaloosa
The current study examines the constructs of caregiver burden, self-efficacy, perceived social support, and well-being (physical health and depression) in caregivers of veterans to obtain a better understanding of their interrelationships among this unique population of family caregivers. Much of the literature on family caregivers identifies relationships between burden and both physical and mental health. For informal, untrained, family caregivers, perceived capability in caring for a loved one can strongly affect health outcomes. Additionally, as family caregivers have unique added stressors and vulnerabilities, perceived social support is an important component that impacts the burden-wellbeing relationship. Although there is a substantial amount of research on these important constructs of caregiving (burden, self-efficacy, social support), few studies have examined how these three constructs specifically work together to influence caregiver physical and mental health. Analyses confirmed three hypotheses: burden significantly predicts depression, self-efficacy mediates the relationship between burden and depression, and this mediating effect is solely driven by self-soothing self-efficacy, as compared to instrumental and relational self-efficacy. Analyses for the moderated mediation model disconfirm both hypotheses that perceived social support moderates associations of burden and self-efficacy, and burden on depression.
Experiences of Accumulated Stress Among Aging Parent Caregivers of Adults with Autism Spectrum Disorder
(University of Alabama Libraries, 2022) Scicolone, Monica; Parmelee, Patricia A.; Tomeny, Theodore; University of Alabama Tuscaloosa
With the continuing increased incidence rate of autism spectrum disorder over the decades, there are increasing numbers of adults with autism who require varying levels of lifelong care, typically from parents. It is necessary to understand parents' lived experience of lifelong caregiving, and how their own aging process further impacts life quality. Furthermore, greater understanding of stressors, resources, appraisals, and coping among parent caregivers of children with "high functioning autism" who are transitioning into young adulthood is particularly necessary as services, needs, and experiences for both are nuanced due to functional status, deficits in the service system, and demographic disparities. Given lifespan aspects past research has not addressed, the study focused on development of a measure of parent accumulated stressors, and on interrelations of stressors, perceived social support, future time perspective, burden, satisfaction, and coping on health-related quality of life and meaning in life among 28 parents of young adults with autism. Although proposed quantitative analyses were not completed due to sample size, qualitative analyses on parent experiences and stressors revealed common themes of concern for child's future quality of life, complicated dynamics of providing help to their child overtime, and increased stress related to others' lack of understanding of their child. In total, 10 themes and multiple subthemes were identified in relation to aspects of accumulated stressors. Findings suggest parent stress with this specific population is complex, manifesting in nuanced ways at different life stages. Impacts of the COVID-19 pandemic are also explored, and implications for scientific advancement and clinical services are discussed.
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.
Factor analysis of lateralized auditory perceptual resources
(University of Alabama Libraries, 2015) Greenlee, Eric T.; Boles, David B.; University of Alabama Tuscaloosa
The primary goal of this study was to identify independent, hemispherically lateralized auditory perceptual resources so that they could be used to expand the Multiple Resources Questionnaire (MRQ), an existing measure that assesses the demands that a task places upon multiple resources (Boles & Adair, 2001a). Researchers have demonstrated that the MRQ's subjective ratings of resource demand can be used to predict multi-task interference, and the measure has demonstrated advantages over other subjective measures of task demand (for review Boles & Dillard, in press). Yet, of the 13 perceptual resources represented by the MRQ, only two are auditory. This shortage of auditory resources in the MRQ prevents the accurate measurement of tasks presented within the auditory modality, and the diagnosticity of the MRQ would likely benefit from the addition of items representing auditory resources (Finomore et al., 2008). The methods used to identify auditory resources in the present study were the same as those used to identify the bulk of the resources that are currently represented within the MRQ. A comprehensive survey of auditory perceptual research was conducted to identify the types of processing and tasks that appear to demand hemispherically lateralized perceptual resources. Based on this literature review, 13 tasks were selected for use in the current study. These tasks were administered as a test battery to 124 right-handed, nonmusicians. All significant, reliable performance asymmetries produced by these tasks were factor analyzed in order to identify underlying perceptual resources. Exploratory factor analysis revealed evidence for a novel right-lateralized Auditory Spectral Pitch resource which is specialized for processing and perceiving pitch based on the harmonic content in complex sounds. Results also indicated the possible existence of a right-lateralized Auditory Intensity resource, which is specialized for the processing of perceived intensity (i.e. loudness). However, the existence and independence of this Auditory Resource is suggested cautiously, since the data used to infer the resource was relatively unreliable. Additionally, two previously identified resources were evident in the current results: the Auditory Linguistic and Visual Temporal resources. The theoretical implications and human factors applications of these findings are discussed.
Factors predicting intraindividual cognitive variability in older adults with different degrees of cognitive integrity
(University of Alabama Libraries, 2016) Shoji, Kristy Douglas; Dautovich, Natalie D.; University of Alabama Tuscaloosa
Given the increasing number of older adults in the population, the fact that about 1 in 10 people over the age of 65 will develop mild cognitive impairment, and the substantial individual, familial, and financial burden associated with such disorders, the need for innovative research examining cognitive impairment in older adults is evident. The present study used a microlongitudinal design to assess cognition and contextual factors that may affect cognition for 14 consecutive days using a daily diary method in older adults with varying degrees of cognitive function. This study design enables investigation of concurrent associations between variables, as well as providing unique information not gleaned from the traditional focus on mean values of cognition. The present study had two broad aims: 1) to compare variability in cognition in older adults with varying degrees of cognitive impairment and 2) to investigate relationships between daily cognitive performance, variability in cognitive performance, and contextual factors that may influence daily cognitive performance and variability in older adults with varying degrees of cognitive impairment. Results suggest there was sufficient intraindividual variability in daily cognition to warrant investigation of within-person associations. Furthermore, the contextual factors of pain, stress, and sleep were predictive of cognitive performance, but with significance and directionality of these associations depending on level of measurement (baseline, daily, or mean values). Finally, associations between contextual factors and cognition were frequently conditional upon baseline cognitive status. The findings highlight the need for continued examination of these associations to expand our understanding of cognition in older adults and to discover potential targets for interventions to attenuate cognitive decline.
Global Versus Momentary Osteoarthritis Pain and Emotional Distress: Emotional Intelligence as Moderator
(Oxford University Press, 2018) Parmelee, Patricia A.; Scicolone, Monica A.; Cox, Brian S.; DeCaro, Jason A.; Keefe, Francis J.; Smith, Dylan M.; University of Alabama Tuscaloosa; Duke University; State University of New York (SUNY) Stony Brook
Background Pain and emotional well-being are complexly associated both globally and in the moment. Emotional regulation strategies may contribute to that complexity by shaping the pain-well-being association. Purpose Using emotional intelligence (EI) as an integrative conceptual framework, this study probed the role of emotional regulation in the associations of osteoarthritis pain with emotional well-being in varying time frames. Perceived attention to, clarity, and regulation of emotions were examined as predictors of well-being, and as moderators of the well-being-pain association, at global and momentary (within-day) levels. Methods In a microlongitudinal study, 218 older adults with physician-diagnosed knee osteoarthritis self-reported global pain, depressive symptoms, and EI (mood attention, clarity, and repair). Momentary pain and positive and negative affect were then assessed four times daily for 7 days. EI subscales were examined as moderators of the pain-well-being association at global and momentary levels, controlling demographics and general health. Results Global and momentary pain were positively associated with mood clarity and negatively with attention, but not with repair. Clarity and repair negatively predicted depression, and buffered effects of pain on depression. Momentary negative affect was negatively predicted by mood clarity and repair; again, clarity and mood repair buffered effects of momentary pain on negative affect. Only mood repair predicted positive affect, with no interactions emerging. Conclusions Attention to mood states exacerbates the experience of pain in both short and long terms. In contrast, both mood clarity and ability to repair moods appear important to both momentary and longer-term emotional well-being.

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