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31 matches in the database. These are records: 1 - 30.

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1. Abbott, Katherine Harris. BLENDING RESOURCES: INFORMAL NETWORKS AND HEALTH CARE UTILIZATION BY FRAIL MALE VETERANS.

Degree: PhD, Sociology, 2005, Case Western Reserve University

► Social networks play an important role in monitoring symptoms and managing chronic… (more)

▼ Social networks play an important role in monitoring symptoms and managing chronic conditions for frail elders. Elderly veteran populations are unique because they have an increased risk of chronic conditions and fewer barriers to health care treatment through the Veteran’s Affairs Medical Centers. This research focuses on the role of lay consultants in veterans’ management of their health using the concept of social networks. The purposes of this research are to; describe the characteristics of frail veterans’ informal networks, examine if there are differences between White and African-American frail male veterans’ networks, and to explore the relationship between lay health consultant network characteristics and health care utilization. Using a cross-sectional design, data were collected at the twelve-month time point of an ongoing longitudinal study. Two-hundred frail male community dwelling veterans over the age of 55 with at least 2 activities of daily living impairments were interviewed by phone. Medical chart reviews were conducted to collect data on chronic disease conditions and utilization. Socio-demographic, physical, and psychological health variables were measured as well as network structure (size and composition), network function, (instrumental aid, emotional support, health appraisal, and health monitoring), and network satisfaction. Outcome measures include days hospitalized, emergency department visits, and the receipt of home health care. Based upon logistic and maximum likelihood regression analysis, veterans with more chronic conditions were more likely to be hospitalized, but those having a larger social network were less likely to be hospitalized. Veterans having family-only social networks were more likely to be hospitalized than those who have a mixed network (family, friends, and neighbors) controlling for veteran demographics, depression, and functional health. Being African American and having a larger instrumental support network were predictive of emergency department use. Being African American, having greater functional limitations, and being in the intervention group were predictive of home care use. No moderating relationships were found. Ways in which network members impact utilization are discussed. The opportunity to identify ‘at risk’ veterans with multiple chronic conditions and few network resources can enable formal care providers to assist with monitoring or appraisal support that may prevent hospitalization. Advisors/Committee Members: Stoller, Eleanor Palo.

Keywords: Social Network; Frail Veteran; Race Differences; Health Care Utilization

2. Alemagno, Sonia Annette. Health and illness behavior of Type A individuals.

Degree: PhD, Sociology, 1990, Case Western Reserve University

► This study examines how Type A behavior relates to illness behavior as… (more)

Subjects: Sociology, General

Keywords: illness behavior Type A individuals

3. Andersson, Tanetta E. “Nobody Talks About Suicide, Except If They’re Kidding”: Disenfranchised Grief, Coping Strategies, and Suicide Survivor Identity in Peer Suicide Grievers.

Degree: PhD, Sociology, 2012, Case Western Reserve University

► Since Durkheim’s (1897/1979) classic study, sociologists have understood that while suicide appears… (more)

▼ Since Durkheim’s (1897/1979) classic study, sociologists have understood that while suicide appears to be a highly personal and private act, it is also a social act. In 2009, nearly 37,000 Americans died by suicide (American Association of Suicidology, 2012). Experts estimate that every suicide intimately affects at least six individuals, both family members and friends, connected to the suicide decedent (Shneidman, 1969). A central question in the field of suicide bereavement is how suicide grief differs from other types of loss (Jordan, 2001). However, such a focus has restricted suicide grievers studied to next-of-kin relationships, despite emphasis that suicide grievers constitute several populations (SAMSHA, 2010). By investigating suicide loss in peer relationships through a qualitative study, this dissertation serves to diversify scholarly inquiry of suicide grief. Moreover, employing the disenfranchised grief framework (Doka, 1989; 2002) as a theoretical lens emphasizes the sociality of suicide loss, especially in terms of relational status and stigmatized dimensions of death by suicide (Charmaz and Milligan, 2006). Twenty-six peers were identified through chain referral sampling strategies (Berg, 2007) and in-depth, semi-structured, face-to-face and telephone interviews were conducted. Results identify several new variants of disenfranchised grief in terms of stigmatized loss and relational status. A continuum of intrapersonal, intermediary, and group-based or extrinsic coping behaviors was developed to conceptualize and understand participants’ varied re-enfranchisement experiences. In particular, participants’ involvement in suicide prevention advocacy such as fundraising walks and programs contributes insights into the process and meanings of re-enfranchisement among peer suicide grievers. At the macro-level, this impetus towards advocacy for suicide prevention among participants is considered through the lens of the health social movement literature within medical sociology (Brown et al., 2004). Alternatively, at the micro-level, findings suggest that a suicide survivor identity is a collaboratively-based identity whereby group contexts influence how this status is defined, signified, affirmed, and even policed (Schwalbe and Mason-Schrock, 1996). Moreover, the existence of these group-based remedies for suicide grief raise the question of whether recently proposed changes to the upcoming DSM-V medicalizing (Kleinman, 2012) and privatizing grief under a depression diagnosis will indirectly foreclose suicide grievers accessing these resources. Advisors/Committee Members: Hinze, Susan.

Subjects: Sociology

Keywords: suicidology; suicide grief; disenfranchised grief; suicide loss; re-enfranchised grief; medicalization; sociology of emotions

4. Barrett, Frank J. The development of the cognitive organization.

Degree: PhD, Sociology, 1990, Case Western Reserve University

► Much of organizational theory is rooted in the organism metaphor following the… (more)

▼ Much of organizational theory is rooted in the organism metaphor following the structural-functionalist paradigm (Morgan, 1986). Research has focused on the giveness of the social order, the uncovering of patterns of social life to demonstrate transhistorical, enduring regularities. This thesis is a longitudinal study of a management group, a description of the evolution and transformation of the group's awareness over a five year period. Adopting a hermeneutic perspective, this study is a discourse analysis of the group's language over a five year period as it evolves from bureaucratic to egalitarian. After analyzing the evolution of interpretive repertoires and the expansion and contraction of the cognitive horizon of possible meaning, I propose a framework for understanding the dynamics of meaning expansion in a group. The central thesis here is that a change in social relationships precedes the emergence of new knowledge. This study follows a management group that operates according to bureaucratic rationality. Under this framework for meaning transaction and interaction contexts, discourse focuses on problem identification and short-term solution search. Discourse is marked by negative, debilitating thought. Since agreement is most easily achieved through discussion of troublesome details, bonds between members are reinforced b y the cognitive search for identifying problems and the limits on possible action. Thinking is often deductive, logical, paradigmatic as most assertions require explicit proof and the range of imagined action is constricted. Within an egalitarian context, however, members develop a metacognitive capacity. Under this framework for meaning transaction, members' discourse begins to focus on valuing, in addition to problem solving, creating future scenarios of possible worlds rather than only identifying past problems. As members develop a common script for what constitutes co-authorship and successful meaning transactions in various groups and forums, language transcends its denotative functions and becomes liberated to connote possible worlds. New tacit agreements are achieved without logical, deductive battles. Members become capable of treating speech as playful and creative and are able to separate the person from the expressions. Advisors/Committee Members: Srivastva, Suresh.

Keywords: development cognitive organization

5. Brown, Valerie Slaughter. The effects of poverty environments on elderly subjective well-being.

Degree: PhD, Sociology, 1993, Case Western Reserve University

► Based on an urban ecological model derived from person-environment interaction theory, this… (more)

▼ Based on an urban ecological model derived from person-environment interaction theory, this dissertation analyzes how elderly persons' residential satisfaction and subjective well-being (positive and negative affect) are affected by urban poverty environments (both objective and perceived), additional perceived negative neighborhood conditions (juvenile delinquency, victimization of neighbors, unemployment, female-headed households, welfare assistance and teen births), perceived neighborhood age homogeneity, and characteristics of elder vulnerability (age, sex, race, marital status, income, education, physical function/ADL, perceived and received social support, dwelling age, tenure, number of bathrooms, and length of residency). In addition to examining the main effects of the suprapersonal environment and elder vulnerability characteristics on residential satisfaction and subjective well-being, the study also considers whether the influence of neighborhood poverty type on SWB is greater for persons who are more vulnerable due to lower income, female gender, minority status, single marital status, impaired physical function/ADL, less perceived social support, or less received social support. One hundred and ninety-six subjects were interviewed by telephone. Subjects were non-Hispanic, black and white, male and female, non-institutionalized elderly residents of the City of Cleveland proper. Subjects were 60 years of age or older at the time of their telephone interview, and spoke English as their primary language. Positive affect (PA), negative affect (NA), and residential satisfaction each have distinct predictors. The majority of the predictors were elder vulnerability characteristics, rather than neighborhood poverty and other area social conditions. For PA, the predictors are: perceived neighborhood female-headed households, sex, income, education, and perceived social support; for NA: perceived neighborhood unemployment, sex, race, physical function/ADL, and number of bathrooms; and for residential satisfaction: perceived neighborhood victimization, perceived social support, received social support, dwelling age, and tenure. Additionally, residential satisfaction is predictive of NA, but not PA. Finally, the neighborhood and elder vulnerability characteristics do not interact in their effect on SWB. The study concludes that there is limited support for the urban model in the urban sample analyzed. Alternative models are suggested for future research Advisors/Committee Members: Kercher, Kyle.

Subjects: Sociology, General

Keywords: Elderly, poverty and subjective well-being

6. Burant, Christopher J. OPTIMISM/PESSIMISM AS A MEDIATOR OF SOCIAL STRUCTURAL DISPARITIES EFFECTS ON PHYSICAL HEALTH AND PSYCHOLOGICAL WELL-BEING: A LONGITUDINAL STUDY OF HOSPITALIZED ELDERS.

Degree: PhD, Sociology, 2006, Case Western Reserve University

► Elders hospitalized for acute episodes of illness are often at risk for… (more)

▼ Elders hospitalized for acute episodes of illness are often at risk for functional decline that can lead to “The Disablement Process” (Verbrugge and Jette, 1994). Studies show that one's level of optimism and pessimism impacts the recovery from chronic illnesses. The current study tests optimism and pessimism’s affect on recovery from acute conditions in 944 hospitalized elders at a large Midwest academic university affiliated hospital. This study contributes to the literature in four primary ways. First it expands the research on the relationship between optimism/pessimism and psychological well being and physical health in hospitalized elders. Second, the current study is the first to empirically test social structural disparities as antecedents to optimism and pessimism. Third, this study provides a more rigorous test concerning the dimensionality of the LOT. Finally, the present study uses a recently developed autoregressive latent trajectory (ALT) models to conduct a sophisticated analysis of the trajectory of recovery and the causal relationships between physical health and psychological well-being. Both factor analysis and a distinct pattern of relationships with antecedents and sequella indicate that optimism and pessimism are two distinct constructs – i.e., they are not opposite ends of a single variable. Optimism mediated the effect of ethnicity on the initial levels of depression, Pessimism mediated the effect of education and income on the initial levels of depression. Finally, ALT models found recovery from both depression and physical dysfunction being most rapid initially and then tapering off in later months. In conclusion, an individual’s level of optimism and pessimism does impact their initial level of physical functioning and depression, while also mediating some of the impact of social structural disparities on these outcomes. Further research needs to be developed to understand how elders might differentially recover from chronic illnesses (e.g., cancers, heart diseases, diabetes) and surgeries (e.g., joint replacement) not specifically analyzed in the current study. With regards to the real world, clinical interventions should focus on those who are more susceptible (members of disadvantaged groups and those with low levels of optimism and high levels of pessimism to have lower levels of physical health and psychological well-being. Advisors/Committee Members: Kercher, Kyle.

Keywords: Physical Functioning; Optimism and Pessimism; Depression; Latent Trajectory; Depression and Physical Functioning

7. Bussey, Janet Carole. Women in jail: Perceptions of social support.

Degree: PhD, Sociology, 1993, Case Western Reserve University

► This dissertation examines perceptions of social support among a sample of women… (more)

Keywords: Women jail social support

8. Chang, Sue-Ing. Effect factors of long-term care utilization of elderly stroke patients in Taiwan.

Degree: PhD, Sociology, 1993, Case Western Reserve University

► Health care policy in Taiwan has shifted from a focus on the… (more)

▼ Health care policy in Taiwan has shifted from a focus on the care of short-term acute illness to prevention and long-term care of chronic illness. To date, there have been very few studies of long-term care services or of the people who use these services in Taiwan. This study uses the conceptual framework developed by Andersen and Newman (1973) and adapted by Bass and Noelker (1987) to study long-term care service utilization in a sample of Taiwanese elderly stroke patients. A simple random sample was drawn from a registry of stroke patients who had been discharged from the hospital following a stroke. The study sample included 103 caregivers of these elderly Taiwanese who lived in Taipei metropolitan area. Respondents were interviewed over the telephone. The response rate for the study was 98%. Respondents were asked questions about their elder's use of formal and informal care services, their own attitudes toward using formal and informal care, the characteristics of the elder, characteristics of themselves, and their levels of satisfaction with the care available and the care received. Results of bivariate analysis showed that the number of generations, household income, activities of daily living (ADL), and caregiver's educational level are significantly associated with the u se of formal care. However, multivariate analysis showed that when all five predictors were entered, only household income and ADL were significantly associated with the use of formal care. While this study's findings are limited to stroke patients with caregivers willing to be interviewed, it did show that the conceptual frameworks used in western studies can be applied to urban Taiwanese populations. The degree to which families and elders accept formal care options and the ways in which they learn about and gain access to these services is an area which needs further study. The study's findings highlight the need for social work practitioners in Taiwan to focus on the needs of the disabled elderly and their families, to develop programs to meet their needs, and to become active in developing long-term care policy initiatives which will improve and strengthen the Taiwanese family. (Abstract shortened by UMI.) Advisors/Committee Members: Farkas, Kathleen.

Subjects: Gerontology; Social Work

Keywords: Effect factors; long-term care utilization; elderly stroke patients; Taiwan

9. Chumbler, Neale R. The effects of pre-professional and professional socialization and intergenerational solidarity on podiatric medical students' negative stereotypes and attitudes toward treating the elderly.

Degree: PhD, Sociology, 1994, Case Western Reserve University

► Doctors of Podiatric Medicine (or podiatrists) play a decisive role in the… (more)

▼ Doctors of Podiatric Medicine (or podiatrists) play a decisive role in the disease prevention and health maintenance of older Americans. As health care professionals who examine, diagnose, and treat the human foot, podiatrists aid in alleviating pain and maintaining the mobility of geriatric patients. No sociological studies have examined podiatrists’ or podiatry students’ orientations toward the elderly in general and as patients in particular. Accordingly, this dissertation examines precursors of two dependent variables – podiatry students’ stereotypes of older people and attitudes toward treating elderly patients. Among the set of predictor variables, this dissertation examines podiatry students’ social background traits, intergenerational solidarity with grandparents, motivations for entering podiatry, and professional socialization. Moreover, four theoretical perspectives – socialization theory, cognitive dissonance theory, Allport’s theory of prejudice, and social exchange theory – provide frameworks for interpreting the effects of the predictor variables. The data included a random and nationally representative sample of podiatry students. One-third of the total population of podiatry students were used as the sampling frame. Of the questionnaires distributed to the students, 533 were returned, yielding a total response rate of 77.5 percent. Multiple regression analysis indicated that entering podiatry for extrinsic rewards was a strong predictor of negative stereotypes of the elderly. That is, extrinsic rewards has a statistically significant direct effect on two of the four outcome variables representing negative stereotypes of the elderly – specifically, older people’s personality and health behavior. Similarly, there are two strong predictors of negative attitudes toward treating elderly patients: entering podiatry for intrinsic rewards and close bonds with grandparents. That is, podiatry students who reported close relationships with their grandparents and who entered podiatry for intrinsic rewards were less likely to have both negative stereotypes toward older people and negative attitudes toward treating elderly patients. Implications of the findings are discussed in regards to podiatric medical education, such as recruitment and criteria in admitting prospective students Advisors/Committee Members: Kercher, Kyle.

Keywords: Podiatric medical students, social background; Elderly, stereotypes and treatment

10. Dan, Amy Anne. What are People Doing to Prepare for Retirement? Structural, Personal, Work, and Family Predictors of Planning.

Degree: PhD, Sociology, 2004, Case Western Reserve University

► This dissertation examines non-retirees’ financial expectations and plans for retirement and compares… (more)

▼ This dissertation examines non-retirees’ financial expectations and plans for retirement and compares them to those of current retirees. Outcomes included financial knowledge, retirement age, anticipated sources of income in retirement, age financial preparations were initiated, and the propensity to save. A model of financial planning was tested from a life-course framework, which outlined how social structural, work, family, personal, and income variables predict the expectation and planning outcomes. The life-course model also considered how socio-historical circumstances may have differentially shaped the retirement plans of six cohorts. Data were collected with mailed surveys from 404 randomly selected individuals living in the Cleveland, Ohio area. Respondents were between the ages of 19 and 96 and had wide ranging labor force experiences, financial resources, and retirement plans. While many young people in particular expressed low levels of confidence in the future viability of the Social Security system, a majority of all age groups anticipate they will rely heavily on Social Security income in retirement. The youngest cohorts, however, are more likely than Baby Boomers and current retirees to expect to rely largely on their own assets in retirement. Three-quarters of respondents have begun making financial preparations for retirement, including over half of the respondents in their twenties, suggesting retirement planning is a long-term process. Results demonstrate that many young people have initiated their financial retirement plans early in life, which contrasts the experiences of most current retirees. Income and education were the most highly predictive of retirement preparations. Gender differences in outcomes were largely indirect via measures of work experiences and family composition and responsibilities, with the exception of financial knowledge. Men scored significantly higher than women on the financial knowledge scale. This research highlights the value of considering younger adults in studies of retirement planning and the need to improve people’s financial knowledge. Study findings are considered within the context of the shifting emphasis in U.S. society on individual responsibility for later-life income, given the escalating costs of the Social Security system and because the large cohort of Baby Boomers are approaching retirement age. Advisors/Committee Members: Stoller, Eleanor Palo.

Subjects: Gerontology

Keywords: retirement, planning, preparations, old age income, life course, finances

11. Falletta, Lynn M. “It’s Not Just Pure Science”: Federal Funding of Children’s Mental Health Research through the Request for Applications (RFA) Process.

Degree: PhD, Sociology, 2011, Case Western Reserve University

► In 1979, McKinley called for “re-focusing upstream” to address social contexts responsible… (more)

▼ In 1979, McKinley called for “re-focusing upstream” to address social contexts responsible for manufacturing illness, rather than “downstream” approaches initiated after disease onset. Multiple social/contextual factors are linked to children's mental health problems, including socioeconomic status; neighborhood, school, and family factors; and victimization. Moreover, mental health problems are stratified by race, ethnicity, and gender. This dissertation examines the disjuncture between the need to “focus upstream” and the apparent lack of attention to contextual factors in the domain of children's mental health. Examining how intervention research is funded could provide insight into this phenomenon. Intervention research is constrained and directed by funding, and by the content of funders' announcements, including federal Requests for Applications (RFAs). Using a sociology of science framework, this dissertation investigates three interrelated questions. First, what are the implicit or explicit explanatory foci and/or intervention strategies of child mental health-related RFAs? Second, to what extent do they recognize the importance of upstream factors? Third, what factors might account for their intellectual and analytical foci? Content analysis of 39 RFAs released between 1992 and 2009 reveals that RFAs focused on individual explanations and solutions for children's mental health problems vastly outnumber those examining social factors; upstream social factors are virtually absent. Biological causes and solutions are particularly pervasive: Reductionist approaches dominate federal funding announcements relevant to children's mental health. Interviews were conducted with five National Institutes of Health (NIH) program officers, who concurred that social interventions were few. Program officers embraced a biomedical model of mental health, providing one possible reason for the focus on individual explanations and solutions for children's mental health problems in RFAs. Program officers also identified the difficulty of implementing structural interventions, perceived functionality of the biomedical model, disciplinary divisions in responsibility for attention to environmental factors, and a dearth of sociological influence at NIH, as possible explanations. Potential policy implications include systematic reflexivity on the framing of problems in NIH-funded research, improved engagement of social scientists in federal research policy formation, and re-calibration of child mental health policy to create balance between social and individual factors research, including targeting upstream causes. Advisors/Committee Members: Dannefer, Dale.

Subjects: Sociology

Keywords: children; mental health; research policy; social context

12. Fedirko, Tracy Lee. Structural and socialization attributes of adolescent educational and career aspirations.

Degree: PhD, Sociology, 1994, Case Western Reserve University

► The purpose of this study is to examine the structural, socialization, and… (more)

▼ The purpose of this study is to examine the structural, socialization, and attitudinal/behavioral attributes associated with occupational and educational aspirations of adolescents. Through a survey at six area middle schools and high schools in suburbs of Cleveland, Ohio, I compare aspirations of students in the 8th and 12th grade with respect to differences based on age, sex, race, and household type. These demographic variables plus hypothesized predictors based on structural, socializational, and attitudinal/behavioral variables, are used in two simultaneous regression models to examine their hypothesized direct and interaction effects on the educational and occupational aspirations of teenagers in this sample. Research on socialization of children covers a broad array of factors associated with children's values. With the growth of a post-industrial society, the value orientations of America's youth may be increasingly influenced by sources from outside the family – such as multi-media and tele-communications. Preliminary descriptive findings support the declining significance of gender as a determining factor in aspirations of youths in this sample. It also is found that educational and occupational aspirations do not differ based on age cohort or household type. Race interacts with father's education level for nonwhite students. This has a positive influence on educational aspirations for nonwhite students. Results of regression equations predicting educational and occupational aspirations of young persons, find several structural and attitudinal factors to be associated with higher educational or occupational aspirations. For educational aspirations, the determining factors include: mother's education, orientations toward hard work, and amount of TV viewing on school nights. For occupational aspirations, the significant paths include: mother's occupation, intrinsic and extrinsic work motivations, perceived occupational ability, and educational aspirations. Additionally, when using a sub-sample of youths and parents, it is found that parental expectations of youths has a strong, positive influence on educational and occupational aspirations of the students. Implications for further research utilizing socialization variables in research on values of young persons are discussed Advisors/Committee Members: Uyeki, Eugene S.

Keywords: Socialization attributes/educational aspirations

13. Feldman, Karie Ellen. Post-Parenthood Redefined: Race, Class, and Family Structure Differences.

Degree: PhD, Sociology, 2010, Case Western Reserve University

► This study is a mixed-methods exploration of the way women create meaning… (more)

▼ This study is a mixed-methods exploration of the way women create meaning when children leave home. Survey data was collected from diverse women to better understand cultural differences in norms and expectations surrounding the launching phase of parenting. Focus groups helped to contextualize women’s experiences and confirm results from the quantitative analysis. The research was guided by theoretical perspectives including Identity Theory, Intergenerational Solidarity Theory, the Life Course Perspective, and Feminist Theory on the family. Ultimately, four questions were addressed through this study: (1) In what ways do characteristics of mothers and their children affect the meaning of motherhood; (2) In what ways do aspects of a child’s transition affect the way that women define their parenting roles and relationships and construct meaning around motherhood; (3) In what ways has historical context created differences in the ways that women experience the launching phase of parenthood; and (4) How do women perceive the experience of being an empty nest mother? Results indicated few demographic characteristics of mothers and their children as predictors of parenting identity after children leave home, and those statistically significant relationships that were found were small. Focus groups confirmed limited differences in women based on race, socio-economic status, and marital status. The quantitative study also revealed only a few small but significant relationships between the details of the child’s transition and the mother’s feelings about parenting. In focus group discussions, mothers discussed normative successes of their children at greater length and emphasized transitions as long-term processes rather than acute events. Focus groups also indicated that the availability of new technologies influenced mothers’ experiences, however the lack of differences in norms around empty nest based on age suggested limited changes in how women have experienced this period across time. Overall, women indicated that the empty nest period was positive, involving opportunity for growth, though also intertwined with sadness. The overwhelming similarities in the experience of empty nest by women of varying backgrounds was attributed to both the limitations of this study in only attracting women for whom parenting was highly salient, and the strong ideologies surrounding mothering in society. Advisors/Committee Members: Deimling, Gary.

Subjects: Families and family life; Gender; Sociology

Keywords: motherhood; empty nest; social location; mixed methods

14. Gayer, Colman. Aging and social change in a religious community: A case history.

Degree: PhD, Sociology, 1991, Case Western Reserve University

► While it is a given that changes in society, in organizations and… (more)

▼ While it is a given that changes in society, in organizations and among individuals are always occurring, there has been a rapid social change in the past thirty-five years both within and without the Roman Catholic Church. Although all Catholics have been influenced by them, probably no group within the Church has been as influenced as have the women religious. This study has been focused on the way a specific society (that is one group of Roman Catholic Sisters) have changed and how individuals who have aged within that society have experienced these changes. How the members understand and cope with change in both internal and external structures that have been the parameters of everyday living were the ways the members defined the self. To accomplish these goals three data collection techniques were used. In keeping with the focus on the individual sister's lived experience, sisters were interviewed using the life story format. Participant observation techniques were also utilized to gather data. Finally archival materials were used as the third source of data for the researcher. Two conceptual frameworks were utilized to analyze and present the life stories of the elderly nuns. The first was the age stratification or life course perspective as described by Matilda White Riley. The second was symbolic interactionism as it relates to the self, and particularly to secondary socialization. As a result of the study, it was found that the sisters felt disenfranchised from the process of change, even though they were in some respects responsible for the trends which led to change. Some changes experienced by the elders wrought consequences comparable to the process of modernization in industrializing societies as described by Rosow. Finally because of their early intense secondary socialization, the sisters in the research group viewed many of the changes as suspicious because these changes were responsible for new trends which though less stringent, did not in the sisters' eyes maintain the social equilibrium and continuity of the old way of life. Advisors/Committee Members: Matthews, Sarah H.

Keywords: Aging; social change; religious community

15. Gottfried, George Michael. Qualitative analysis of child-caring experiences of religious sisters.

Degree: PhD, Sociology, 1992, Case Western Reserve University

► This study involves a partial life history ethnographic analysis of child-caring experiences… (more)

Keywords: Qualitative analysis child-caring experiences religious sisters

16. Hund, Andrew. UNCOVERING THE INTERCONNECTION OF SES AND ETHNICITY TO HEALTH RELATED QUALITY OF LIFE: AN INVESTIGATION OF WHITE AND NATIVE ALASKANS.

Degree: PhD, Sociology, 2010, Case Western Reserve University

► This research study examines how ethnic group membership and economic resources influence… (more)

Subjects: Cultural anthropology; Health; Health care; Mental health; Sociology

Keywords: Alaska Native, SES, Alaskans, Ethnicity, HRQOL, BRFSS

17. Kelly, Jo Anna M. Bereavement Responses of Caregivers of Institutionalized vs Community-Living Alzheimer’s Patients.

Degree: PhD, Sociology, 2007, Case Western Reserve University

► This study was designed to determine whether nursing home placement had an… (more)

Keywords: Dementia; Caregiving; Bereavement; Nursing Home

18. Marsiglia, Flavio Francisco. The ethnic warriors: Ethnic identity and school achievement as perceived by a group of selected mainland Puerto Rican students.

Degree: PhD, Sociology, 1991, Case Western Reserve University

► This study explores how a group of young Puerto Rican intermediate school… (more)

Keywords: ethnic identity school achievement Puerto Rican students

19. Martin, Lisa Marie. Socio-Demographic, Clinical, and Social Influences on Health-Related Quality of Life in individuals with Hepatitis C (HCV).

Degree: PhD, Sociology, 2008, Case Western Reserve University

► Approximately 4.1 million Americans are infected with HCV; HCV has infected four… (more)

▼ Approximately 4.1 million Americans are infected with HCV; HCV has infected four times as many people as HIV. It is most prevalent in the younger population (ages 30-49) and 70% are chronically infected. The majority of HCV infection can be traced to individuals' behaviors; intravenous drug use accounts for most infections. Tattoos, body piercing, blood transfusions prior to 1992, and exposure to contaminated blood among health care workers are other routes. HCV is responsible for approximately 8,000 to 10,000 deaths per year; this number is expected to triple in the next 10 to 20 years without effective intervention and prevention. HCV is the most common indication for liver transplant and no preventative vaccination has been developed. HCV is largely asymptomatic and research has focused on medical transmission, prevention, and treatment. Research on the social implications is lacking.Theoretical perspectives of Parsons' sick role, Goffman's stigma, Strauss and Glaser's work on chronic illness, and Bury's biographical disruption will be addressed. This study aims to advance our understanding of the measurement of HRQL among patients with HCV, to develop and test a conceptual model explaining HRQL, and to compare the parameter estimates and explained variation for models predicting HRQL. Cross-sectional analyses of data (N=269) from two clinical pharmaceutical trials involving patients with HCV who presented for treatment is utilized. Data is unique in that it includes two measures of HRQL, a generic measure (SF-36) and a disease-specific measure (CLDQ-HCV) as well as socio-demographic (age, gender, race, marital status, body mass index, social (stigma via route of transmission), and clinical (cirrhosis, HCV-RNA virus level, HCV genotype, treatment status) variables. Confirmatory factor analysis and ordinary least squares regression are utilized. Both the SF-36 and CLDQ-HCV yielded more parsimonious structures. OLS regression found body mass index (BMI) and cirrhosis to be the most significant predictors across all models. Age, other race, married, and a not stigmatized route of transmission were found to be significant in a few of the models. This dissertation expands our knowledge of the HRQL of those with HCV and can be used to help these patients in a treatment setting. Advisors/Committee Members: Hinze, Susan W.

Subjects: Social research; Sociology

Keywords: health-related quality of life; hepatitis C; stigma; sociology

20. Mattern, Jeanne Marie. Life satisfaction in retirement: A study in continuity and change.

Degree: PhD, Sociology, 1993, Case Western Reserve University

► This study hypothesizes that the majority of the cases in this… (more)

Keywords: Retirement, life satisfaction

21. Menne, Heather Lee. A STRESS PROCESS MODEL OF CHRONIC ILLNESS: UNDERSTANDING THE WELL-BEING AND DECISION-MAKING INVOLVEMENT OF INDIVIDUALS WITH DEMENTIA.

Degree: PhD, Sociology, 2006, Case Western Reserve University

► The literature on illness experience burgeoned in the past decades with prominent… (more)

▼ The literature on illness experience burgeoned in the past decades with prominent sociologists articulating the experiences of living with various chronic illnesses. Recently, this literature expanded to the topic of living with dementia and other cognitive impairments. This dissertation melds general literatures on illness experience, stress research, and the experience of dementia, and proposes the sociologically based Stress Process Model of Chronic Illness. Background variables, illness-related variables, role and intrapsychic strains related to the illness, and social support and religiosity mediators are considered as predictors of well-being and decision-making involvement. This model is broad in scope and potentially applicable to various chronic illnesses. The proposed model was tested with data from 211 individuals with dementia (IWDs). Findings support this model as an appropriate conceptualization for considering how background-and-context, primary stressor, secondary strain, and mediator variables influence outcomes. The model predicting quality of life (QoL) indicates that individuals with higher QoL scores are White, have a spousal caregiver, have fewer months since their diagnosis, exhibit more memory problems, have fewer depressive symptoms, have fewer negative and more positive interactions with their caregiver, and place more importance on autonomy / self-identity. Results indicate that IWDs more involved in decision making are female, have more education, have a non-spousal caregiver, have fewer months since their diagnosis, have fewer depressive symptoms and ADL problems, and place more importance on autonomy/ self-identity. The model predicting depression indicates that individuals with more depressive symptomatology have more health conditions, more negative interactions with their caregiver, and feel that their caregiver does not agree with their daily care wishes. This dissertation expands our knowledge about illness experience by proposing and testing a model that is applicable to populations with chronic illness. The research is sociological in scope as it expands and links illness experience and stress research. Linkages between model components serve as potential points of intervention to assist IWDs and their caregivers. Older adults are the most likely to suffer from chronic illnesses, and Aging and Disability Resource Centers (ADRCs) can use this model as a guide for determining resources for these individuals. Advisors/Committee Members: Deimling, Gary T.

Subjects: Gerontology

Keywords: dementia; chronic illness; stress process model; well being; decision making

22. Montoro, Julian. Cooperation and competition among aged parents and adult children.

Degree: PhD, Sociology, 1994, Case Western Reserve University

► This study examines the social structure of cooperation and competition in the… (more)

Keywords: Elderly parent/adult child relationship; Cooperation/Competition

23. Pearce-Novatney, June Elizabeth. Stepparent/stepchild relationships in late life marriages.

Degree: PhD, Sociology, 1993, Case Western Reserve University

► This study examines the older stepparent-adult stepchild relationship. After adulthood, children are… (more)

▼ This study examines the older stepparent-adult stepchild relationship. After adulthood, children are involved with careers and nuclear family obligations. Support for older parents may be difficult to provide. Research conducted with stepfamilies with minor stepchildren have focused on the difficult and ambiguous nature of step relationships and have not considered step relationships as a potential source of support. In this research, three concepts similar to those reported in studies conducted with biological families, were evident in the data obtained through the pilot qualitative study. These concepts are connectedness, dependability, and value consensus. The current research focuses on respondents aged 72 to 90 years, living in a Florida retirement community. Using the three concepts that were identified in the pilot study, the telephone interview was conducted with 60 respondents. Thirty biological parents were matched to the thirty stepparents by age, gender, length of marriage and marital status. Parent responses were compared through the use of univariate and bivariate analysis. Significant differences were found between the parent groups for the concept of "connectedness," (contact, family membership, description of the relationship and emotional closeness). Unlike the biological relationship, the older stepparent though mo st of the stepparents considered stepchildren family members. Significant results were obtained for two of the three variables measuring the concept of "dependability" (perception of available support and satisfaction with support). However, both the step and biological parents who had actually experienced the need for assistance received aid from at least one child. "Value consensus" in this study was measured by one variable that asked respondents if they shared a common point of view with their children. Parents scored similarly on this item. In our society, longevity and childlessness are increasing and the older step relationship may provide an unanticipated source of instrumental and emotional support to an older person. Unlike the negative findings that have been reported in research conducted with younger stepfamilies, the older step relationship may provide a unique blend of friendship and familial support to older family members Advisors/Committee Members: Uyeki, Eugene.

Subjects: Gerontology

Keywords: Stepparents, older; Stepchildren, adult

24. Persse, Linda Jo. The contribution of social role adjustment, employment status and health locus-of-control to psychological distress in women with systemic lupus erythematosus.

Degree: PhD, Sociology, 1993, Case Western Reserve University

► Mild to moderate psychological distress was reported in this sample of 87… (more)

Keywords: contribution social role adjustment employment status health locus-of-control psychological distress women systemic lupus erythematosus

25. Perzynski, Adam Thomas. Between Facts and Voices: Medical and Lay Knowledge of the Spread of Hepatitis C.

Degree: PhD, Sociology, 2008, Case Western Reserve University

► Most social scientific studies of health, illness, and health behavior assume that… (more)

▼ Most social scientific studies of health, illness, and health behavior assume that lay people's knowledge can be adequately described as a matter of ignorance and misinformation judged against the paradigm of biomedical, scientific knowledge. This study seeks to understand the everyday illness knowledge and beliefs of lay people. I investigate the degree to which such folk knowledge varies culturally in ways that cannot be explained solely by comparison with scientific knowledge. I examine patterns in the distribution of knowledge of the spread of hepatitis C (HCV) and investigate how social characteristics influence forms of knowledge. This was a mixed methods study consisting of qualitative textual data from in-depth interviews (N=42) and quantitative secondary data from a large Centers for Disease Control (CDC) telephone survey (N=3092). The in-depth interviews were transcribed and then coded using qualitative data analysis software. The survey data was analyzed with exploratory and confirmatory factor analysis, latent class analysis, and latent class analysis with covariates. The qualitative analysis found that the HCV patients had a broad range of knowledge about how HCV can be spread. The patients discussed many transmission vectors that were not present in the CDC survey of knowledge of how HCV is spread. The quantitative analysis found that knowledge of the spread of HCV takes three forms: HCV is Everywhere, HCV is Nowhere, and "expert" awareness of HCV. Education, income, race, age, marital status, knowing someone with HCV, and perceived risk of HCV significantly influenced the likelihood of having each particular form of knowledge. In synthesizing the qualitative and quantitative results, I conclude that how we describe people's knowledge can be in part a function of which questions we as researchers chose to ask and how we chose to examine the responses. Variation in lay people's knowledge of the spread of HCV is culturally situated and cannot be viewed simply as part of a continuum of fidelity to biomedical and scientific evidence. I further conclude that the forms of knowledge of the spread of HCV are connected to social structure and social inequality. Advisors/Committee Members: Dannefer, Dale.

Subjects: Social research; Sociology

Keywords: lay knowledge; hepatitis c; HCV; inequality; lay expert; latent class analysis

26. Shura, Robin. Intercountry Adoption: A Theoretical Analysis.

Degree: PhD, Sociology, 2010, Case Western Reserve University

► The aim of this research is to engage in a preliminary theoretical… (more)

▼ The aim of this research is to engage in a preliminary theoretical analysis of intercountry adoption as a social and cultural practice, informed by two competing frameworks of sociological theory. Intercountry adoption in general has received little attention as a problem for sociological research, and even less as a topic that may be illuminated by sociological theory. Contrasting views of intercountry adoption that are evident in academic literature, policy and accounts of children’s experts map onto two major, paradigmatically distinct approaches to social theorizing: the functionalist or social capital approach, in which the positive social value of intercountry adoption is highlighted, and the conflict-oriented or critical approach that takes a skeptical or problematic view of the institutional dynamics of intercountry adoption. In this dissertation, I draw on the world of policy analysis – specifically, on the knowledge and perspectives of leading national and international experts on child policy and social practices involving children and the state across the continent of Europe – as a beginning step to garner insight into how the phenomenon of intercountry adoption is constructed and understood by those who are directly involved in seeking to further the welfare of children. Using qualitative methods of discourse analysis, selected sections of three prominent international policies are analyzed to identify themes through which intercountry adoption is constructed in legal discourse. Key informants were selected for semi-structured, in-depth qualitative interviews based on their breadth and depth of professional expertise regarding social issues facing children and their potential influence at the national and international levels over children’s protection and policy. Thirty-one original interviews with thirty-five key informants were conducted, and interview transcripts were analyzed using an inductive qualitative coding process to identify themes within their accounts of intercountry adoption that map onto to the functionalist and critical theoretical frameworks, respectively. Findings indicate a diversity and complexity of perspectives toward intercountry adoption, and analyses indicate salience and limitations of each theoretical paradigm. Descriptive results and theoretical implications of findings are discussed. Advisors/Committee Members: Dannefer, Dale.

Subjects: Sociology

Keywords: intercountry adoption; sociological theory; qualitative analysis

27. Sterns, Samantha. Factors that Impact the Health and Psychological Well-being of Older Adults Shortly Following Institutionalization.

Degree: PhD, Sociology, 2007, Case Western Reserve University

► This longitudinal study examined 168 residents’ perceptions of stressors and adaptation during… (more)

▼ This longitudinal study examined 168 residents’ perceptions of stressors and adaptation during the initial eight-months of living in long-term care facilities. Sample was obtained from 14 facilities in two metropolitan areas using data from a previous study (Kahana, Kahana, and Young, 1987). The study considered stressors including problems related to the person, to interactions between person and environment, and to institutional structure. External resources, including anticipatory socialization and internal resources, including adaptation methods, were investigated. Quality of life outcomes were considered at two-weeks and at eight-months post institutionalization and included health, psychological, and social outcomes. The framework of the research was based on the stress paradigm (Lazarus and Folkman, 1984). Within this paradigm, several theoretical propositions were examined including Hierarchy of Needs (Maslow, 1954), Total Institution (Goffman, 1961), Person-Environment Fit (Kahana, 1982), Role theory (Deutch and Krauss, 1965), and Self Concept (Cooley, 1937). Data analysis included descriptive, bivariate, and regression analyses. Stressors were not found to play a statistically significant role in determining quality of life, possibly due to high levels of anticipatory socialization (e.g. half the sample had six or more months to prepare for the move). Furthermore, initial health was relatively good, with 25% suffering from major functional difficulties, and 20% showing problems in cognitive functioning. Passive adaptations were better suited for institutional settings than proactive adaptation. Proactive adaptation significantly predicted lower morale (beta=-.16, p<.05), while passive adaptation did not. Furthermore, being socially connected with people both inside and outside the institution resulted in better self-rated health (beta=.33, p<.05; beta=.34, p<.05 respectively). However, having experienced negative family events predicted poorer self-rated health (beta=-.16, p<.05). Accordingly, families play a dual role, one of offering beneficial support, and another where their family problems can adversely affect residents. Finally, morale improved for about 40% of respondents over the eight-months of settling into long-term care, possibly due to the tumultuous period that preceded being institutionalized. In conclusion, facilities could help residents deal more effectively with family related stressors and help residents become integrated in the institutional community. Facilities could also address concerns brought to their attention by residents, thus rewarding proactive adaptation. Advisors/Committee Members: Kahana, Eva.

Keywords: institutionalization, long-term care, older adult, Total Institution, Person-Envirnment Fit, Hierarchy of Needs, Anticipatory Socialization, Identity, Role, Self

28. Stuckey, Jon Carl. The relationship between social ties and emotional and physical well-being among spousal caregivers of patients with dementia.

Degree: PhD, Sociology, 1992, Case Western Reserve University

► The importance of the relationship between social ties and emotional well-being can… (more)

Keywords: social ties emotional physical well-being spousal caregivers dementia

29. Webster, Noah James. The Embodiment of Type-2 Diabetes and the Influence on Self-Care Strategies.

Degree: PhD, Sociology, 2011, Case Western Reserve University

► People living with diabetes must engage in a range of self-care behaviors… (more)

▼ People living with diabetes must engage in a range of self-care behaviors to manage their illness in order to prevent future complications. This study examines how specific diabetes complications experienced earlier in the disease trajectory influence the performance of diabetes self-care behaviors. This study utilized a multi-method research design including secondary analysis of two years (2000 and 2007) of quantitative data from the Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System (BRFSS) as well as 60 semi-structured interviews with older diabetics. Results indicate that the experience of feet sores was significantly related to a greater frequency of feet checking, and having diabetes-related eye problems was related to receiving a more recent eye examination and more frequent checking of blood sugar levels. Results also indicate that the relationship between diabetes embodiment and self-care is moderated by key indicators measuring the level of medical involvement in the treatment of the illness. A time comparison of diabetes self-care behaviors between the years 2000 and 2007 indicated that four of the five diabetes self-care behaviors were engaged in more often or at a higher level in 2007 compared to 2000. Secondary analysis of 60 qualitative interviews with diabetics aged 50 and older indicated that respondents think of diabetes embodiment in similar ways as established by the biomedical model. However, additional themes arose from the data including: do not know, general damage to the body, specific body part or organ damage (other than those discussed in biomedical model), effects on normal body functioning, mental health, and positive influences. Also, some respondents made explicit connections to self-care when talking about what diabetes does to the body. The results suggest that people living with diabetes think of and make connections about their diabetes in ways not fully accounted for in the biomedical model. This study contributes to the self-care literature by being the first to test in a quantitative model the role that specific diabetes complications play in shaping self-care behavior. Contributions are also made to policy and clinical settings through informing policy makers and providers about how and why patients manage their diabetes. Advisors/Committee Members: Deimling, Gary.

Subjects: Sociology

Keywords: diabetes; self-care; disease embodiment; lay perspectives of illness

30. Werkner, Janet Elaine. Measuring the family helper costs of disabling osteoarthritis of the hip or knee in older persons.

Degree: PhD, Sociology, 1990, Case Western Reserve University

► To assess 2-week test-retest reliability and construct validity, 56 FHs and their… (more)

Keywords: family costs osteoarthritis

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