Doctor of Philosophy, Case Western Reserve University, 2022, Nursing

Background. Asthma is the most common chronic illness of child. Younger children are at the greatest risk for increased morbidity and mortality. Caregivers of these children take on increased responsibilities compared to caregivers of children without a chronic illness, and it is known that this can increase stress and decrease quality of life. Problem. It is not known what coping strategies or psychosocial interventions are most effective at improving both child and caregiver outcomes. Previous research has focused heavily on caregiver education, and has often considered caregiver quality of life only as a means to ensure better child health outcomes. The few identified caregiver centered psychosocial interventions have had mixed results. Resourcefulness Training© has been effective at reducing stress and improving caregiver quality of life in caregivers in a variety of contexts. It is not currently known if increasing resourcefulness would decrease stress and increase quality of life in the caregivers of children with asthma. Purpose: To understand the relationships among antecedent contextual variables, perceived stress, resourcefulness, and overall quality of life in caregivers of children with asthma in order to better understand the population and determine if there is a need for Resourcefulness Training© for caregivers of children with asthma twelve years old and younger. Methods: A cross-sectional correlational design with one group and data collection at one time point was used. A sample size of 51 participants was obtained online. Pearson correlations, bivariate regressions, and multivariate regressions were used to explore the relationships among antecedent contextual variables, perceived stress, resourcefulness, and quality of life. The study was guided by Zauszniewski's Middle Range Theory of Resourcefulness and Quality of Life©. Results: Resourcefulness was not a significant predictor of overall caregiver quality of life, and did not mediat (open full item for complete abstract)

Committee: Jaclene Zauszniewski (Committee Chair); Sandra Russ (Committee Member); Marguerite DiMarco (Committee Member); Christopher Burant (Committee Member) Subjects: Nursing

Doctor of Philosophy (Ph.D.), Bowling Green State University, 2021, Psychology/Clinical

Following incarceration, youth often experience significant challenges such as an inability to distance themselves from peers involved in criminal behavior, transitioning to a new school, or a change in caregiving (Pratt, 2019; Sullivan, 2004). To navigate these challenges, youth need to be able to set goals, create plans, and follow through on their plans—often with the assistance of others. Youth in the justice system are found to have difficulty setting realistic goals and planning for goal-focused behavior (Lemus et al., 2017; Carrol et al., 2013). They may have particular difficulty with such tasks due to low self-esteem, a lack of models for desired outcomes, and lower perceptions of self-regulatory abilities and academic achievement (Abrams & Aguilar, 2005; Carrol et al., 2013; Clinkinbeard & Zohra, 2012). Help-seeking or resourcefulness is beneficial when an individual is faced with a problem that they cannot solve on their own (Bekhet & Garnier-Villarreal, 2018; Zausniewski, 2016). Such problems are often encountered by court-involved youth. Social support and relationships with parents/caregivers influence behavior, determine social resources available for youth to solve problems, and their ability to seek help (Catalano & Hawkins, 1996; Heaney & Israel, 2008). Existing studies show resourcefulness to be associated with positive outcomes (e.g., academic success, social and adaptive functioning; Bekhet & Garnier-Villarreal, 2018; Li et al., 2018; Zauszniewski, 2006). Limited research is available regarding court-involved youth and their use of resourcefulness for reentry related goals. The present study examined goal-setting and planning abilities of court-involved youth and positioned these abilities as protective factors within the Social Development Model (Catalano & Hawkins, 1996). The study analyzed how goal-setting and planning abilities are related to resourcefulness, and how goal-setting and planning abilities related to social support, psychologi (open full item for complete abstract)

Committee: Carolyn Tompsett Ph.D. (Advisor); Ashley McCoy Ph.D. (Other); Eric Dubow Ph.D. (Committee Member); Dara Musher-Eizenman Ph.D. (Committee Member) Subjects: Clinical Psychology

Doctor of Philosophy, Case Western Reserve University, 2019, Nursing

Currently, the global prevalence of dementia is an estimated 35.6 million people and is expected to rise up to 65.7 million by 2030. Caring for people with dementia can easily lead to a negative feeling such as compassion fatigue and depression, but these could be reduced by cognitive and behavioral skills that constitute resourcefulness. This study examined the current living situation for Thai caregivers of elders with dementia and relationships among contextual factors, resourcefulness, compassion fatigue, and depressive symptoms. Research Questions: 1) What are characteristics of Thai caregivers of elders with dementia, and their perceptions of characteristics of care recipients and their caregiving situation? 2) How do contextual factors impact resourcefulness, compassion fatigue, and depressive symptoms? 3) How are resourcefulness, compassion fatigue, and depressive symptoms related? This study was guided by the Resourcefulness Theory Model by Zauszniewski. A descriptive, correlational, cross-sectional design was used in this study. Study participants were 140 Thai caregivers of elders with dementia from the Prasat Neurological Institute in Thailand. Data were collected using a Demographic Questionnaire, the Compassion Fatigue Scale, and Thai translations of the Resourcefulness Scale and the Center for Epidemiological Studies Depression Scale. Results: The average score of compassion fatigue was 36.76 (SD = 7.43), indicating low compassion fatigue. The average score of resourcefulness was 91.69 (SD = 18.78), indicating use of a moderate level of resourcefulness skills, while the average score on depressive symptoms was 32.40 (SD = 7.88), indicating moderate depressive symptomatology. Caregiving hours had a significant positive impact on resourcefulness. Caregiver burden had a significant positive impact on depressive symptoms. However, marital status and age of care recipient had a significant negative impact on depressive symptoms. Only the age of the care re (open full item for complete abstract)

Committee: Jaclene Zauszniewski (Committee Chair); Christopher Burant (Committee Member); Evanne Juratovac (Committee Member); Eva Kahana (Committee Member) Subjects: Gerontology; Health Care; Nursing

Doctor of Philosophy, Case Western Reserve University, 2018, Nursing

Background: One out of eight women experience depressive symptoms during the postpartum period. In addition, approximately 63.8% of new mothers are affected by fatigue during the postpartum period, making this the most common problems affecting women during that period Aims: The purpose of this study was to explore the relationships among postpartum fatigue, depressive cognitions, resourcefulness, quality of life and life satisfaction of the Arab postpartum mother. Additionally, the study examined if there was a mediating effect of resourcefulness on the relationship between the process regulators (DC and PPF) and the mother's quality of life outcomes (quality of life and life satisfaction) during the postpartum period Theoretical Framework: The conceptual framework for this study based on the middle range theory of resourcefulness, which was developed by Zauszniewski in 2006. Methods: A cross-sectional descriptive design was used with 123 postpartum women who gave birth less than 6 months ago. “What's App” and Facebook were used for recruitment. The survey was constructed in both Arabic and English. The self-administered online survey was developed in Qualtrics and data were collected from January 6th to February 6th, 2017. Linear regression was used to address the research questions and to test the mediating effect of resourcefulness. Results: There were moderate significant correlations between depressive cognitions and resourcefulness (ß = -.38, p < .001), life satisfaction (ß = -.43, p < .001), and quality of life (ß = -.48, p < .001), and small, but significant correlations between postpartum fatigue and life satisfaction (ß= -.25, p < .001), and between resourcefulness and quality of life (ß= .27, p < .001), and life satisfaction (ß= .21, p < .001). Resourcefulness did not mediate the effects of depressive cognitions and postpartum fatigue on quality of life or life satisfaction. Conclusion: The results of this study emphasize the importance of asses (open full item for complete abstract)

Committee: Jaclene Zauszniewski (Advisor); Mary Quinn Griffin (Committee Member); Christopher Burant (Committee Member); Amy Przeworski (Committee Member) Subjects: Health; Nursing; Obstetrics; Psychology

Doctor of Philosophy, Case Western Reserve University, 2014, Nursing

Grandparents caring for grandchildren denote a significant phenomenon in childrearing with increasing numbers of grandparents primarily providing care to their grandchildren due to family breakdown, teen pregnancies, substance abuse, and parental death. Grandmothers caring for grandchildren may experience both negative and positive health and social outcomes. Many studies investigate negative outcomes, but little is known about the positive outcomes for grandmothers caring for grandchildren. This study explored the role reward, particularly the positive psychological outcomes in grandmothers as a result of child caregiving reducing depression and stress, and helping with better coping strategies, health and general well-being. This study 1) investigated differences in intra-family strain, social support (subjective support and instrumental support), resourcefulness, religiosity/spirituality, and role reward among primary caregivers, grandmother caregivers in multigenerational homes, and non-caregiver grandmothers, 2) tested mediating effects of social support (subjective support and instrumental support), resourcefulness, religiosity/spirituality on the relationship between intra-family strain and role reward, 3) explored the relationship of caregiving status and demographics (age, race, marital status, and employment) on the relationship between intra-family strain and role reward, and 4) tested the moderating effects of caregiving status and demographics (age, race, marital status, and employment) on the relationship between intra-family strain and role reward. The Resiliency Model of Family Stress, Adjustment, and Adaptation was used for analyzing relationships among these variables in 369 Ohio grandmothers comprising 3 different groups: primary grandparent caregivers, grandmothers living in a multigenerational home, and non-grandparent caregivers. Secondary analysis was conducted using data from the fourth wave of a longitudinal study. Data were colle (open full item for complete abstract)

Committee: Carol Musil (Committee Chair); Camille Warner (Committee Member); Christopher Burant (Committee Member); Gary Deimling (Committee Member) Subjects: Nursing

Doctor of Philosophy, Case Western Reserve University, 2012, Nursing

Background. Mental illnesses are a cause of concern. About one in four Americans have to deal with mental health issues in their lifetime, and more than 90% of all cases of suicide are associated with mental disorders. Mental health practices aim to facilitate recovery in persons with mental illnesses. However, stigma associated with mental illnesses often deters them from seeking treatment, therefore impeding their recovery. Personal strengths have been linked to positive outcomes in the general population, but have not been a focus for research with persons with mental health issues. Indeed, strengths' self-efficacy (confidence in applying personal strengths) and resourcefulness (ability to perform daily tasks independently or with help from others) may play a role in promoting mental health recovery in persons with serious mental illnesses. Purpose. This study examined the correlations among/ between strengths selfefficacy, resourcefulness, stigma experience and perception of mental health recovery in community-dwelling adults with serious mental illnesses, and if recovery was predicted by the first three variables. Method. A convenience sample of 102 community-dwelling adults with serious mental illnesses aged between 18 to 65 years old participated in a cross-sectional, predictive, mixed methods study. Persons who have taken drugs (not prescribed), since the last relapse of their mental health conditions were excluded. Findings. Strengths self-efficacy and resourcefulness correlated positively with and predicted recovery, R2 = 0.72, F(3,98)= 84.05, p <0.001. The qualitative interview uncovered that participants used their personal strengths to help them cope with mental illnesses, focus on something positive and allowed them time to recover. Although greater stigma correlated inversely with recovery, it was not a significant predictor. Implications. Because the influence of stigma on recovery was diminished in the presence of strengths (open full item for complete abstract)

Committee: Jaclene Zauszniewski PhD (Committee Chair); Burant Christopher PhD (Committee Member); Killion Cheryl PhD (Committee Member); Clegg Kathleen PhD (Committee Member) Subjects: Mental Health; Nursing

Doctor of Philosophy, Case Western Reserve University, 2010, Nursing

Colorectal cancer is one of the most prevalent malignancies in Taiwanese adults and its treatment has been associated with sexual dysfunction. Experiencing sexual dysfunction in conjunction with a cancer diagnosis can produce overwhelming stress and compromise one's ability to adapt to illness and change in sexual function. This study examined relationships among demographic and cancer-related variables and perceived stress, spirituality, resourcefulness, and sexuality in Taiwanese rectal cancer patients using Neuman's systems model, Lazarus's stress and coping theory, and Zauszniewski's theory of resourcefulness. Using a cross-sectional, correlational design, a convenience sample of 120 rectal cancer adults receiving treatment was recruited from a 1,500-bed Medical Center in southern Taiwan. Data were collected during face-to-face interviews. Participants' ages ranged from 29 to 85 (M = 61) years; 32% had cancer classified as stage A; 25% had a colostomy; 9% used a substance/lubricant to improve sexual function; and average length of time since cancer diagnosis/operation was 36 months. Results indicated that greater stress was associated with female gender, younger age, colostomy performed, shorter time since operation, and lower scores on sexuality measures. Higher appraisal of stress was associated with colostomy performed and lower scores on sexuality measures. Lower resourcefulness was found in men and associated with more comorbid conditions, less education, greater stress, lower spirituality, and lower scores on sexuality measures. Lower spirituality was related to greater stress and lower scores on sexuality measures. Lower sexual function was correlated with older age, less education, colostomy performed, higher tumor stage, greater number of cancer treatments and greater stress. The findings have important implications for theory development, clinical practice, nursing education and health policy. Advanced practice nurses should focus on stress reduction w (open full item for complete abstract)

Committee: Jaclene A. Zauszniewski PhD (Committee Chair); Barbara J. Daly PhD (Committee Member); Faye A. Gary PhD (Committee Member); Gary T. Deimling PhD (Committee Member) Subjects: Health Care

Doctor of Philosophy, Case Western Reserve University, 2013, Nursing

Background/Significance: Childhood obesity is a critical health issue worldwide because of its association with adverse health conditions and potentially harmful health consequences in later adulthood. Eating styles that may involve emotional, external, or restrained eating behaviors have been shown to be associated with overweight and obesity and can be influenced by stress, resulting in the use of unhealthy eating styles as a coping strategy. Research in adults has shown that cognitive-behavioral skills constituting resourcefulness are effective for coping with stress and performing health behaviors. However, few studies have examined whether resourcefulness skills are important in children. Purpose: This study examined the associations among academic stress, dispositional optimism, and resourcefulness in relation to eating styles in fifth and sixth graders in Taiwan. Theoretical framework: Rosenbaum's theory of learned resourcefulness and Zauszniewski's middle-range theory of resourcefulness and quality of life provided the context for examining the relationships among the study variables. Method: A descriptive, correlational, cross-sectional approach was used with a convenience sample of 368 dyads of fifth- and sixth-grade children and their caregivers. Findings: 26.24% of the children were overweight or obese. Children with a higher tendency toward emotional eating had greater academic stress and lower resourcefulness. Children with a higher tendency toward external eating had greater academic stress, lower dispositional optimism, and lower resourcefulness. Children's restrained eating was associated with greater academic stress and higher dispositional optimism. Additionally, academic stress mediated the relationship between children's satiety responsiveness and resourcefulness. Children's resourcefulness mediated the relationships between academic stress and emotional or external eating. Conclusion: Findings generated from this study not only contribute to an (open full item for complete abstract)

Committee: Jaclene A. Zauszniewski (Advisor); Christopher J. Burant (Committee Member); Marilyn Lotas (Committee Member); Carolyn E. Ievers-Landis (Committee Member) Subjects: Nursing