Nursing School Theses, Dissertations, and Doctoral Papers

Permanent URI for this collection

https://hdl.handle.net/1805/1135

Browse

Browsing Nursing School Theses, Dissertations, and Doctoral Papers by Author "Austin, Joan Kessner"

Now showing 1 - 4 of 4
  • Thumbnail Image
    Item
    The Everyday Lives of Adolescent Girls with Epilepsy: A Qualitative Description
    (2009-11-04T18:21:53Z) MacLeod, Jessica S.; Swenson, Melinda M.; Foote, Carrie; Austin, Joan Kessner; Sims, Sharon L.
    This study is a qualitative description of the everyday lives of adolescent girls with epilepsy. The primary purpose of the research was to determine whether or not elements of stigma were present in narratives about participants’ day-to-day living. The researcher used open-ended and semi-structured interview techniques in a series of interviews with four adolescent girls with epilepsy. Elements of stigma were present in some of the constructed themes; however, the researcher also uncovered other unexpected themes. Themes constructed by the researcher included: 1) I Am Like Everyone Else (Except for my Seizures); 2) There are Worse Things than Epilepsy; 3) My Parents Trust Me; 4) Am I Having a Seizure?; 5) Bullying Because of Seizures; 6) Bullying Because of Something other than Seizures; 7) Coping with Bullying; 8) Academic Difficulties;9) Disclosure Management; 10) Seizures are Scary to Have and to See; and 11)If I have a Seizure, Don’t Attract Attention to Me! The researcher considers topics thought to be important to adolescents with epilepsy about which the participants kept silent. The researcher makes suggestions about how the research can be used to improve health care practice and guide educational policies for adolescent students with epilepsy. Based on the findings, the researcher suggests areas for future research in nursing and educational policy.
  • Thumbnail Image
    Item
    Factors Associated with Post-Stroke Depressive Symptoms and Quality of Life
    (2008-10-13T18:02:08Z) Johnson, Elizabeth A.; Bakas, Tamilyn; Austin, Joan Kessner; Perkins, Susan M.; Pressler, Susan J.; Williams, Linda S.
    Stroke is the leading cause of adult disability with over 5 million American adults experiencing physical, psychological, and/or social limitations related to stroke. Although depressive symptoms and poor quality of life (QOL) are key outcomes for stroke survivors, little is understood about how these outcomes are affected by stroke survivors’ evaluation of their experience. The concept of cognitive appraisal, an evaluation of the meaning of a situation for one’s well-being, may explain some of the factors associated with post-stroke depressive symptoms and QOL. The purpose of this study was to determine factors associated with post-stroke depressive symptoms and QOL using a conceptual model derived from the transactional theory of stress originally proposed by Lazarus and Folkman. Three aims guided this study: to determine whether (a) depressive symptoms at 4 months after stroke are predictive of stroke-specific QOL at 10 months; (b) perceived social support, self-esteem, and optimism at 1 month after stroke predict depressive symptoms among stroke survivors at 4 months; and (c) threat appraisal at 1 month after stroke is a mediating variable between perceived social support, self-esteem, and optimism at 1 month after stroke and depressive symptoms at 4 months. A secondary analysis of data from 392 stroke survivors in the Randomized Trial of Treatment for Post-stroke Depression (AIM study) was conducted. Using a descriptive correlational design and multiple regression analyses, longitudinal associations among perceived social support, self-esteem, optimism, threat appraisal, depressive symptoms and stroke-specific QOL were examined. Perceived social support, self-esteem, and optimism were significantly associated with threat appraisal. Threat appraisal was significantly associated with post-stroke depressive symptoms. Stroke-specific QOL was found to be stable between 4 and 10 months. Partial mediation of the relationship between the explanatory variables and depressive symptoms by threat appraisal at one month post-stroke was demonstrated. In conclusion, threat appraisal is an important factor to consider in future research and intervention development in relation to post-stroke depressive symptoms.
  • Thumbnail Image
    Item
    The Impact of Family Functioning on Children's Adaptation During a Parent's Bone Marrow Transplantation
    (2010-04-08T15:36:40Z) Spath, Mary L.; Fife, Betsy Louise; Austin, Joan Kessner; Monahan, Patrick O.; Bigatti, Silvia M.; Bell, Linda G.
    Bone marrow transplant (BMT) is being used ever more widely for advanced and refractory malignancies. The family unit and individual members are profoundly affected by this treatment process. Few studies have examined the effect of parental BMT on the family, and there are no known studies which have investigated the impact of parental BMT on children. A descriptive design with longitudinal data from 61 children, ages 10-18, examined children’s adaptation, characterized as emotional and behavioral response, during the acute phase of parental BMT. The study included 3 time points: pre-transplant, during parental hospitalization, and one month after transplantation. The Response to Stress Questionnaire, and subscales from the Child Health Questionnaire and Family Environment Scale were used to assess child, parent, and family variables associated with child adaptation. Child emotional and behavioral response significantly improved over the course of the parent’s transplant, and significant changes in children’s use of coping strategies at each time point were found. The model accounted for 27% to 46% of the explained variance in child behavioral response, and accounted for 41% of the explained variance in emotional response prior to the parent’s BMT and one month after BMT. The model did not explain the variance of child emotional response, however, during the parent’s hospitalization. Family structural change, family conflict, and disengagement coping were found to be the predominant variables significantly associated with more negative child behavioral response across the transplant trajectory. Female child gender and increased use of disengagement coping before the parent’s BMT, autologous BMT during the parent’s hospitalization, and increased family structural change when the parent returned home one month later were significantly associated with more negative emotional response in children. Additional cross-sectional and longitudinal studies, using mixed methods, and include both parent and child data, are needed to substantiate the validity of findings. The data also suggests that significant variables in this model could be further studied for their association with one another and for refining a more accurate and inclusive model that may better explain children’s adaptation.
  • Thumbnail Image
    Item
    Predicting Treatment Response of Adolescents with Serious Emotional Disturbance
    (2012-03-19) Oruche, Ukamaka Marian; Gerkensmeyer, Janis E.; Austin, Joan Kessner; Wright, Eric R.; Rawl, Susan M.; Perkins, Susan M.
    Serious emotional disturbance, including disruptive disorders (i.e., attention deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder), affects large numbers of adolescents, with costly and tragic consequences. Adolescents with disruptive disorders are likely to be arrested, drop out of school, and have poor treatment outcomes. There is an urgent need to identify strengths-based factors associated with improvement in adolescents’ behavioral and social functioning to help them achieve their full potential. The purpose of this study was to determine whether change in adolescent personal strengths and change in family functioning over 12 months predicted changes in behavioral and social functioning for adolescents with disruptive disorders who participated in a System of Care (SOC) program and if findings varied by race. De-identified data from 179 adolescents, aged 12-17 years, with disruptive disorders and their caregivers were included in this secondary analysis. Data were analyzed using Pearson correlations, t-tests, chi-square tests, and multivariate multiple regressions. Upon admission to the program, caregiver ratings indicated that African American adolescents had greater personal strengths (p = .001), fewer behavior problems (p < .001), and less functional impairment (p < .001) compared to their Caucasian counterparts. Girls had more behavior problems (p = .05) and fewer personal strengths than boys (p < .001). Increase in caregiver-rated adolescent personal strengths was significantly associated with improvement in caregiver-rated adolescent behavioral and social functioning (p < .001). Change in caregiver-rated family functioning was not significantly associated with change in caregiver-rated adolescent behavioral and social functioning (p = .171). The strength and direction of predictors did not vary by race. The adolescents in the study participated in a SOC program that emphasized their strengths versus, primarily, focusing on their deficits. Change in caregiver ratings of adolescent personal strengths was a significant predictor of change in adolescent behavioral and social functioning over a 12 months period. Findings provide evidence for psychiatric mental health professionals to focus on enhancing adolescent personal strengths to improve behavioral and social functioning in adolescents with disruptive disorders. Future research is needed to understand the impact of family variables on adolescents’ treatment outcomes.