Browsing by Author "Johnson, Elizabeth A."

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    Content Validity and Satisfaction With a Stroke Caregiver Intervention Program
    (Wiley, 2009) Bakas, Tamilyn; Farran, Carol J.; Austin, Joan K.; Given, Barbara A.; Johnson, Elizabeth A.; Williams, Linda S.; School of Nursing
    Background and Purpose Establishing evidence of content validity and satisfaction is an integral part of intervention research. The purpose of this article is to describe content validity and satisfaction relative to the Telephone Assessment and Skill-Building Kit (TASK), an 8-week follow-up program based on individualized assessment of stroke caregiver needs. Design and Methods The TASK intervention enables caregivers to develop skills based on assessment of their own needs. During the development of the TASK program, 10 experts rated the validity of the TASK intervention components for accuracy, feasibility, acceptability, and problem relevance. After incorporating feedback from the experts, a randomized controlled clinical trial was instituted using a convenience sample of 40 stroke caregivers to determine satisfaction (usefulness, case of use, and acceptability) with the TASK intervention (n=21) compared with an attention control group (n=19). Data collection occurred between March 2005 and June 2006. Data were analyzed using descriptive statistics, independent sample t tests, and content analysis. Findings Expert ratings on a 1 to 5 scale, with 5 being strongly agree, provided evidence of content validity (accuracy 4.71, feasibility 4.46, acceptability 4.40, problem relevance 4.67). Caregivers in the TASK group scored significantly higher than the attention control group on all satisfaction measures (usefulness p=.02; ease of use p=.02; acceptability p=.05). Qualitative comments from caregivers provided further evidence of satisfaction. Conclusions Evidence of content validity and user satisfaction for the TASK intervention relative to an attention control group was found. Clinical Relevance The TASK program may be a viable telephone-based program that can be implemented by nurses to support family caregivers during the first few months after stroke survivors are discharged home.
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    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.
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    Stroke Caregiver Outcomes from the Telephone Assessment and Skill-Building Kit (TASK)
    (2009-03) Bakas, Tamilyn; Farran, Carol J.; Austin, Joan K.; Given, Barbara A.; Johnson, Elizabeth A.; Williams, Linda S.
    Purpose: Stroke caregivers often express the need for information about stroke and assistance with stroke-related care in the early discharge period. The Telephone Assessment and Skill-Building Kit (TASK) is an 8-week program that addresses caregiver needs. This study explored the efficacy of the TASK program in improving stroke caregiver outcomes. Method: Guided by a conceptual model, 6 outcomes (optimism, task difficulty, threat appraisal, depressive symptoms, life changes, general health perceptions) were measured in 40 caregivers randomized to the TASK (n = 21) or an attention control group (n = 19). Data were analyzed using analysis of covariance (ANCOVA), controlling for baseline scores and minutes spent with the nurse. Results: Significant increases in optimism at 4 weeks, 8 weeks, and 12 weeks were found, with medium effect sizes for the TASK group relative to the control group (p < .05). Significant improvements in task difficulty at 4 weeks, and threat appraisal at both 8 weeks and 12 weeks were also found (p < .05). Conclusion: Caregivers receiving the TASK intervention improved in optimism, task difficulty, and threat appraisal. Further testing of an enhanced version of the TASK program is warranted, with attention directed toward more distal stroke caregiver outcomes.