A qualitative analysis of pain mental models in spousal caregivers of veterans with dementia and pain

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dc.contributor Snow, Andrea L.
dc.contributor Allen, Rebecca S.
dc.contributor Hilgeman, Michelle M.
dc.contributor Parmelee, Patricia A.
dc.contributor Roskos, Beverly
dc.contributor.advisor Snow, Andrea L.
dc.contributor.author Block, Phoebe Rose
dc.date.accessioned 2021-05-12T16:28:10Z
dc.date.available 2021-05-12T16:28:10Z
dc.date.issued 2020
dc.identifier.other u0015_0000001_0003692
dc.identifier.other Block_alatus_0004D_14338
dc.identifier.uri http://ir.ua.edu/handle/123456789/7635
dc.description Electronic Thesis or Dissertation
dc.description.abstract Background: Although pain is prevalent among persons with dementia (PWDs), it goes underrecognized and undertreated due to impairments in the cognitive abilities needed to self-report it. Exploring spousal caregivers’ pain mental models may provide valuable insight into how these informal caregivers conceptualize pain, and how such conceptualizations affect their identification of and response to PWDs’ pain. Study Objective: The purpose of this study was to identify and describe the pain mental model(s) of spousal caregivers of community-dwelling veterans with dementia and pain. Research design: Qualitative Participants and research context: Thirty female spousal caregivers (11 Black, 10 non-Hispanic White, and 9 Hispanic) participating in a psychosocial intervention aimed at preventing aggression in veterans with pain and dementia comprised the present sample. The PWDs all received their primary care from the Veterans Health Administration (VHA). Methods: Secondary data analysis of intervention recordings. Data was analyzed using thematic analysis. Results: Two themes were identified: Pain Assessment Beliefs and Knowledge (PA) and Pain Management Beliefs and Knowledge (PM). The PA theme included four subthemes, and the PM theme included seven subthemes. A pain mental model is proposed in which PA and PM affect the ways they answer two PA-related questions (Is there a problem?, Is this problem pain?) and three PM-related questions (Is the pain treatable?, Is it worth treating?, How do I prefer to treat it?). These caregivers are moved to action when they “connect the dots” by identifying a problem in PWDs’ behavior, labeling the problem as pain, and identifying a response (i.e., a treatment approach) they consider worth trying. Conclusion: Caregiver disconnects in understanding of PWDs’ behavior are common in this study sample, and predictably lead to inaction. The proposed mental model provides further explanation about how caregivers do or do not synthesize and apply pain knowledge and experience, allowing for the identification of potential areas of intervention (e.g., pain psychoeducation) to improve pain treatment for the PWDs under their care.
dc.format.extent 209 p.
dc.format.medium electronic
dc.format.mimetype application/pdf
dc.language English
dc.language.iso en_US
dc.publisher University of Alabama Libraries
dc.relation.ispartof The University of Alabama Electronic Theses and Dissertations
dc.relation.ispartof The University of Alabama Libraries Digital Collections
dc.relation.hasversion born digital
dc.rights All rights reserved by the author unless otherwise indicated.
dc.subject.other Clinical psychology
dc.title A qualitative analysis of pain mental models in spousal caregivers of veterans with dementia and pain
dc.type thesis
dc.type text
etdms.degree.department University of Alabama. Department of Psychology
etdms.degree.discipline Psychology
etdms.degree.grantor The University of Alabama
etdms.degree.level doctoral
etdms.degree.name Ph.D.


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