Browsing by Author "McGrew, John"
Now showing 1 - 9 of 9
Results Per Page
Sort Options
Item Associations between coping skills practice and symptom change in a psychosocial symptom management intervention for lung cancer patients and their family caregivers(2017) Winger, Joseph G.; Mosher, Catherine; Rand, Kevin; McGrew, John; Frankel, RichardLittle research has explored the degree to which specific intervention components predict improved health outcomes for cancer patients and their family caregivers. The present study examined relations of intervention components (i.e., coping skills) to symptoms in a telephone symptom management (TSM) intervention delivered concurrently to symptomatic lung cancer patients and their family caregivers. Guided by Social Cognitive Theory (SCT) and cognitive behavioral therapy (CBT) frameworks, patient-caregiver dyads were taught coping skills including: a mindfulness exercise (i.e., noticing sounds and thoughts), pursed lips breathing, guided imagery, cognitive restructuring, and assertive communication. Symptom measures were administered at baseline and 2 and 6 weeks post-intervention. The measures assessed patient and caregiver depressive and anxiety symptoms as well as patient pain severity, distress related to breathlessness, and fatigue interference. Data were examined from patient-caregiver dyads enrolled in TSM (N = 51 dyads). Patients and caregivers were predominantly female (55% and 73%, respectively) and Caucasian (87%). The average patient was 63 years of age (SD = 8) and the average caregiver was 56 years of age (SD = 14). Seven autoregressive panel models tested relations of coping skills to symptoms. All models had at least adequate fit to the data (χ2 ps > 0.05, RMSEA values < 0.06). For patients, more assertive communication practice during the intervention was related to less pain severity, fatigue interference, and depressive and anxiety symptoms at 6 weeks post-intervention. Additionally, more guided imagery practice during the intervention was related to less fatigue interference and anxiety at 6 weeks post-intervention. In contrast, more cognitive restructuring practice during the intervention was related to more distress related to breathlessness and depressive and anxiety symptoms at 6 weeks post-intervention. Similarly, more practice of a mindfulness exercise during the intervention was related to more fatigue interference and anxiety at 6 weeks post-intervention. For caregivers, more guided imagery practice was related to more anxiety at 2 weeks post-intervention. All other pathways from coping skills to symptoms at 2 and 6 weeks post-intervention were non-significant for both patients and caregivers. Findings suggest intervention effectiveness may have been reduced by competing effects of certain coping skills. For lung cancer patients, future studies should consider focusing on assertive communication and guided imagery, as these two coping skills were most consistently associated with reduced symptoms. However, more studies are needed to better understand these findings and particular caution should be used when applying CBT-based interventions that have not been validated in lung cancer populations.Item Caregiver Adaptation among Black and White Families of Individuals with Autism Spectrum Disorder and the Comparison of the Two Racial Groups(2020-08) Yu, Yue; McGrew, John; Mosher, Catherine; Zapolski, Tamika; Wu, Wei; Ruble, LisaTo date, only two studies, both using the same sample at two different time points, have quantitatively examined outcomes in Black caregivers of individuals with autism spectrum disorder (ASD). This study examined family adaptational outcomes in Black and White caregivers of individuals with ASD using the double ABCX model of family adaptation to examine the impacts of stressors, the A in the model (e.g., autism symptom severity, general life demands), resources/supports, the B in the model (e.g., social support), and individual coping/stress appraisal styles, the C in the model (e.g., cognitive appraisal, religious coping) on caregiver positive and negative adaptation outcomes, the X in the model, (e.g., caregiver strain, benefit finding, family quality of life). Black and White caregivers were compared on adaptation outcomes at the family, dyadic, and individual level, including both positively valenced (e.g., benefit finding) and negatively valenced outcomes (e.g., depression, caregiver strain). Participants were Black (N = 24) and White (N = 32) primary caregivers of individuals with ASD. Racial differences were found for both the general and racial-specific factors in the ABCX model. White and Black caregivers reported moderate and equal levels of caregiver strain. However, Black caregivers reported greater levels of anxiety and depression and lower levels of life satisfaction. When adjusting for potential ABC covariates, racial differences in outcomes were no longer significant. That is, racial differences in outcomes could be explained by differences in the proximal elements represented by the ABC variables of the model (e.g., passive-avoidance coping, religious coping). Black caregivers reported higher levels of pile-up of demands, formal social support, threat appraisal, passive-avoidance coping, and positive and negative religious coping than White caregivers. Different factors were related to caregiver strain in the two racial groups. Conscientiousness was a protective factor against caregiver strain for Black caregivers, whereas greater use of passive-avoidance coping and threat appraisal, higher levels of neuroticism and barriers to care, and lower levels of satisfaction with services, parenting self-efficacy, and formal social support were explanatory factors for increased caregiver strain among White caregivers. These results are helpful in informing interventions and support the cultural adaptation of care as provided to Black caregivers of individuals with ASD.Item Development of a Patient Centered Outcome Questionnaire for Advanced Lung Cancer Patients(2020-05) Krueger, Ellen F.; Mosher, Catherine; Hirsh, Adam; McGrew, JohnSymptom research with advanced lung cancer patients has primarily focused on symptom severity, frequency, and distress; yet, little is known about advanced lung cancer patients’ priorities and success criteria for symptom improvement. To address these gaps in the literature, this study examined these outcomes using a modified Patient Centered Outcomes Questionnaire (PCOQ), which has largely been used with adults with chronic pain. Advanced lung cancer patients (N = 102) were recruited from the Indiana University Simon Cancer Center to participate in a one-time self-report survey, including demographic and medical questionnaires, symptom treatment history, standardized measures of symptom severity and quality of life, and the modified PCOQ focused on eight common symptoms in advanced lung cancer. Cancer information was collected from medical records. My primary aim was to evaluate the construct validity of the PCOQ. As hypothesized, symptom severity ratings on the PCOQ were positively correlated with standardized assessments of the same symptoms as well as functional status. Greater severity of most symptoms on the PCOQ was also correlated with worse quality of life, and greater severity of four symptoms was correlated with having more medical comorbidities. Positive, moderate correlations were found between the severity and importance of seeing improvement in cough, fatigue, sleep problems, and pain on the PCOQ. Patients considered low levels of symptom severity to be acceptable following symptom treatment; no differences were found across the eight symptoms. Latent profile analysis identified four patient subgroups based on the importance of seeing improvement in each of the symptoms: (1) those who rated all symptoms as low in importance (n = 12); (2) those who rated bronchial symptoms and sleep problems as low in importance and all other symptoms as moderately important (n = 29); (3) those who rated nausea and emotional distress as low in importance and all other symptoms as moderately important (n = 23); and (4) those who rated all symptoms as highly important (n = 33). These subgroups were unrelated to demographic and clinical factors, except for functional status. Findings suggest that symptom severity and importance are related yet distinct aspects of the advanced lung cancer symptom experience. Furthermore, patients have heterogeneous priorities for symptom management, which has implications for tailoring treatment.Item Goal Attainment Scaling: An Idiographic Measure Sensitive to Parent and Teacher Report of IEP Goal Outcome Assessment for Students with ASD(Springer, 2022) Ruble, Lisa; McGrew, John; Dale, Brittany; Yee, Madison; Psychology, School of ScienceYoung students with ASD have instructional needs in social, communication, and learning skills that should be reflected in their Individualized Education Program (IEP). Research suggests that many of these goal areas present a challenge for special educators because of problems with measurability. The current study utilized an idiographic approach called Goal Attainment Scaling (GAS) for measuring IEP progress of individualized skills. Cross-sectional analysis of the associations between GAS ratings from an independent observer were correlated against teacher and parent ratings of IEP progress at the end of the school year and with standardized measures of the Behavior Assessment System for Children and Vineland Adaptive Behavior Scales (VABS). GAS scores were associated with parent and teacher ratings, including the VABS.Item Predicting mental health provider response to BREATHE, a burnout intervention program(2018) Dreison, Kimberly Christine; Salyers, Michelle; McGrew, John; Rand, Kevin; Rollins, AngelaWithin the mental health field, provider burnout is widespread and associated with far-reaching negative outcomes for providers, consumers, and organizations. Over the past four decades, various burnout interventions have been tested and found to be minimally effective, leading several researchers to suggest an increased focus on targeted recruitment (i.e., targeting providers who are most likely to benefit from a particular burnout intervention approach) and/or modifications to the interventions (e.g., format and content). Accordingly, the present study examined several person-related and intervention-related variables that were hypothesized to be predictive of response to BREATHE, a burnout intervention for mental health providers. Data from four prior studies that assessed the effectiveness of the BREATHE intervention were amalgamated. For the primary analyses, hierarchical linear regression was used to determine whether the person-related and/or intervention-related variables were predictive of treatment response. Additionally, the BREATHE studies were examined to determine whether the intervention became less effective at reducing burnout with each subsequent iteration. With respect to person-related predictors of response to the BREATHE intervention, age and turnover intentions were significant. Specifically, younger participants had higher post-intervention levels of depersonalization than older participants (β = -.13, p = .023), and higher baseline intentions to turnover were associated with greater post-intervention levels of emotional exhaustion (β = .11 p = .041) and depersonalization (β = .12, p = .023). In terms of intervention-related predictors of treatment response, participants who received the BREATHE intervention in a multi-session format had higher post-treatment levels of emotional exhaustion than those who received the BREATHE intervention in a single session format (β = .13, p = .015). Notably, across these primary analyses, baseline levels of burnout (i.e., emotional exhaustion, depersonalization, and personal accomplishment) were consistently the strongest predictors of post-intervention levels of burnout. Lastly, the data suggests that the BREATHE intervention became less effective with subsequent iterations. For example, earlier BREATHE studies had larger effect sizes than more recent studies. Additionally, there was a significant difference between the studies with respect to the change in emotional exhaustion (F(3, 230) = 4.86, p = .001, η2 = .06), such that participants in the first BREATHE study had a significantly larger reduction in emotional exhaustion than participants in the three subsequent studies. The present study was the first to examine potential predictors of response to the BREATHE intervention. Although the hypotheses were not supported, the implications of these findings are discussed and suggestions for future research directions are provided.Item Predicting the Outcomes of Parents of Transition-Age Youth or Young Adults with ASD(Springer, 2020-08) Wong, Venus; McGrew, John; Ruble, Lisa; Psychology, School of ScienceThe transition outcomes for individuals with autism spectrum disorder (ASD) and their families are less than desirable. A survey of parent stressors, resources, coping/appraisals, and adaptation to transition was completed by 226 parents. The mediating mechanisms between stressors and parent outcomes were identified. At the indicator level, three stressors (i.e., autism severity, mental health crisis/challenging behaviors, and filial obligation), four resources (i.e., general social support, transition planning quality, parent–teacher alliance, and parenting efficacy), and three coping styles (i.e., problem-focused coping, avoidance-focused coping, and optimism) predicted parents’ outcomes (i.e., burden, transition experience, subjective health, and quality of life). At the structural level, optimism, emotion-coping strategies, and resources mediated the relationships between stressors and parental outcomes. Research and practical applications are discussed.Item Psychological processes and symptom outcomes in cancer survivors following a mindfulness-based stress reduction intervention(2017-07) Chinh, Kelly; Mosher, Catherine E.; McGrew, John; Rand, Kevin L.Mindfulness-based interventions targeting psychological and physical symptoms in cancer survivors have been shown to be efficacious. However, little is known about theory-based psychological processes through which mindfulness-based interventions may decrease symptoms. The present study is a secondary analysis of data from a mindfulness-based stress reduction (MBSR) pilot trial targeting cancer-related fatigue (CRF) in cancer survivors. Thirty-five persistently fatigued cancer survivors were recruited from a university hospital and various community clinics in Indianapolis, Indiana. Participants were randomized to either a 7-week MBSR intervention for CRF or a waitlist control (WC) condition. Measures were administered at pre-intervention, post-intervention, and 1-month follow-up and included levels of mindfulness, acceptance, and self-compassion as well as the symptom outcomes of fatigue interference, sleep disturbance, and distress. I hypothesized that MBSR would lead to increased levels of five facets of mindfulness (i.e., observing, describing, acting with awareness, nonjudging of inner experience, nonreactivity to inner experience), self-compassion, and acceptance as compared to the WC condition. Using a linear mixed modeling approach, significant group by time interactions were only found for observing, acting with awareness, nonjudging, and self-compassion, such that the MBSR group showed steady increases in these processes over time, whereas the WC group’s scores remained relatively stable. In addition, I examined whether positive changes in the five facets of mindfulness were associated with reductions in the three symptoms using multiple linear regression. This hypothesis was partially supported; acting with awareness was the only facet of mindfulness to show a modest association with a decrease in fatigue, but this result fell short of statistical significance. In addition, decreased sleep disturbance was predicted by increases in acting with awareness and nonjudging, while decreased distress was predicted by increases in observing, acting with awareness, nonjudging, and nonreactivity. Results point to specific psychological processes that may be targeted to maximize the efficacy of future MBSR interventions for cancer survivors.Item Socially distanced teaching: The mental health impact of the COVID‐19 pandemic on special education teachers(Wiley, 2022-04) Cormier, Christopher J.; McGrew, John; Ruble, Lisa; Fischer, Melanie; Psychology, School of ScienceLittle is known about the impact of the COVID‐19 pandemic on special education teachers. Of 468 surveyed across the United States, 38.4% met clinical criteria for generalized anxiety disorder, a rate 12.4 times greater than the U.S. population, and 37.6% for major depressive disorder, a rate 5.6 times greater than the population. Race/ethnicity, gender, or school funding was not related to mental health. The impact of the pandemic was moderate to extreme on stress (91%), depression (58%), anxiety (76%), and emotional exhaustion (83%).Item TRANSITION TO ADULTHOOD: THE EXPERIENCE OF YOUTH WITH PHYSICAL DISABILITIES LIVING WITH A SERVICE DOG(2008-04-14T12:15:20Z) Modlin, Susan Jane; Swenson, Melinda M.; Austin, Joan K.; Sims, Sharon L.; McGrew, JohnThe focus of this qualitative descriptive study is the experience of physically disabled young people as they transition into adulthood while living with a service dog. The cornerstone of young adulthood is transition. For any young adult leaving home, the transition involves inter- and intra-personal changes that affect future well-being. Unfortunately, the majority of young adults with congenital disabilities are less likely to be fully employed and to live independently than their non-disabled peers. To date, very little research about living with a disability exists from the point of view of young adults. Even fewer qualitative research studies exist that focus on service dog teams. This research report will add to the body of nursing knowledge about people with disabilities and their experience of transition in the areas of health, work/school, relationships and identity. The findings result from descriptive analysis of interviews with four young adults and one parent. Using qualitative descriptive methods, the researcher identified three themes that defined the experience of transition. It’s different now contained stories regarding life before and after obtaining the service dog. This theme included elements of personality development similar to any young adult in transition, such as identifying “who I am now.” Going places was the most personal theme, describing the social implications of going or not going places and the environmental and personal barriers related to learning to drive. Calling the shots centered on the ability to make choices for themselves and the dog, as well as to participate in age appropriate milestones, such as attending college and living away from home. The findings of this study will be useful to professionals who place service dogs with persons with disabilities, rehabilitation specialists who desire appropriate interventions to facilitate transitions, and nurse researchers and clinicians who desire to understand the bond between animals and human beings.