Doctor of Philosophy, Case Western Reserve University, 2007, Clinical Psychology (Adult)

The evidence linking the stress of dementia caregiving to negative mental and physical health is compelling and consistent. Research shows that supportive social interaction may help reduce some of the emotional burden experienced by dementia caregivers. However, empirical evidence also suggests that even a few negative social interactions can negate the ameliorative effects of positive social exchanges. Furthermore, the literature suggests that relationships with family and non-familial social contacts are qualitatively disparate. The purpose of this study was to investigate the relationships between positive and negative social exchange in familial and non-familial social contexts. Study variables included aspects of the caregiving situation (i.e., caregiver gender, coresidence with the care recipient), care recipient characteristics (i.e., degree of impairment, behavioral symptoms), caregiver perceived social support and negative interactions with family and non-family contacts, and caregiver emotional distress. The findings of the current investigation provide preliminary evidence that social interactions with family and non-family social network members have differential effects on the emotional well-being of caregivers. Specifically, higher levels of emotional support from family may tend to reduce overall caregiver emotional distress while emotional support from non-familial sources may bolster the caregivers optimistic outlook on the experience of caregiving. Furthermore, negative social interactions with family and non-familial social contacts was not a significant predictor of caregiver outcome variables in the present study, though this finding may have been non-significant due to limited power or restricted range in the negative social interaction scores. Investigation of variables that may reduce the burden experienced by caregivers is essential to the development of effective treatment of the increasing number of individuals that assume the caregiving (open full item for complete abstract)

Committee: TJ McCallum (Advisor) Subjects: Psychology, Clinical

EDD, Kent State University, 2024, College of Education, Health and Human Services / School of Foundations, Leadership and Administration

This qualitative case study is situated in the area of educational leadership. It aims to explore possible strategies for increasing community-integrated employment for graduates of a Job Training Coordination Program at OakVeil High School. It is important to consider the lived experiences, hopes, fears, and barriers experienced from a caregiver's perspective so that a Job Training Coordinator can better assist families during the transition from school to a career. There is a gap in employment between people with disabilities and their non-disabled peers. Caregivers' perspectives on participation in community-integrated employment for their children of transition age with disabilities were examined through the investigation of three sub research questions. Open-ended interviews and record reviews were gathered and analyzed through coding. Data analysis resulted in the following themes: Employer and Person-Centered Values for CIE, JTC as CIE Support, Alternate Settings from CIE, and Family Support Services. Key findings were interpreted to consider safety, transportation, self-determination, caregiver support, and caregiver involvement. This study demonstrates how policies, safety at the workplace, and transportation are common barriers to community-integrated employment from the caregiver's perspective. Suggestions are offered to help Job Training Coordinators, special education teachers, job coaches, employers, and caregivers improve the rate of Community-integrated employment. This study also suggests that barriers, support services, personal preference, civil rights, and familial needs are interwoven and recognition of this is necessary for successful employment in the community for people with disabilities.

Committee: Jennifer Walton-Fisette (Committee Chair); Davison Mupinga (Other); Natasha Levinson (Committee Member); Karl Martin (Committee Member) Subjects: Curriculum Development; Education; Education Policy; Educational Leadership; Families and Family Life; Instructional Design; Secondary Education; Special Education; Vocational Education

Ph.D., Antioch University, 2024, Antioch New England: Marriage and Family Therapy

Parentification, or parent-child role reversal, occurs when children and adolescents take on parental responsibilities within the family (Boszormenyi-Nagy & Spark, 1973). This can include caring for younger siblings, attending to their parents' emotional needs, and assisting with tasks such as translation. Parentification disrupts family dynamics as parents transfer significant responsibilities to the child (Martino & Coburn, 2022). Extensive research consistently demonstrates the negative impact of parentification on children, leading to depression, suicidal feelings, shame, guilt, worry, and social isolation (Jurkovic, 1997). It can also contribute to the development of conduct disorders. Unfortunately, these difficulties often go unnoticed. However, when it comes to language brokering, which can be viewed as a similar experience to parentification as indicated by research, it can yield some positive results, such as developing new skills, improving self-esteem, and contributing to family survival (Kam et al., 2017; Martino & Coburn, 2022). Limited research exists on factors that alleviate the impact of parentification in Latine and Hispanic households, and despite its potential harm, parentification is often rationalized by families for various reasons. Familismo, a cultural value emphasizing loyalty and community within the family (Ayon et al., 2010) may play a significant role in the experiences of Latine parentified individuals. Familismo promotes unity, support, and loyalty within the family, resulting in enhanced self-esteem, a strong sense of belonging, and deep respect for the cultural community and family members (Fuligni et al., 1999; Ayon et al., 2010, Montero & Ceballo, 2021; Walker et al., 2022). This quantitative study demonstrates that familismo acts as a moderator in the relationship between parentification and depression. Specifically, this study reveals that higher levels of familismo weaken the link between parentification and depression. This d (open full item for complete abstract)

Committee: Kevin Lyness Ph.D. (Committee Chair); Denzel Jones Ph.D. (Committee Member); Bryson Greaves Ph.D. (Committee Member) Subjects: Families and Family Life; Hispanic American Studies; Hispanic Americans; Individual and Family Studies; Latin American Studies; Mental Health; Therapy

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

Caring for a person from a distance adds additional complexity and stress to the caregiving role. Distance caregivers (DCGs) are those living more than an hour away from the care recipient. DCGs play a significant role in patient emotional support, assisting with decision-making, and reducing the local caregivers' burden. Since DCGs play a crucial role in a patients care, they, too, report high levels of psychological burden. However, the majority of research has focused on family caregivers of cancer patients who live near the patient and are providing day-to-day care or seeing the patient on a regular basis (known as local caregivers). Although a few studies have investigated caregiver burden in the DCG population, most of the previous work has used qualitative research methods to explore psychological well-being in DCGs. This study examined the relationships between stressors (patient factors that impact caregiver stress), DCG resources that can potentially mediate the impact of stressors upon psychological outcomes, and DCG caregiver burden. The Stress-Appraisal Model of Caregiving guided this study for understanding the relationships between variables. This study was a descriptive cross-sectional study, conducting a secondary data analysis from a parent study “CLOSER_A Videoconference Intervention for Distance Caregivers (DCGs).” The study sample consisted of 314 cancer patient – DCG dyads. The results of this study were: (1) 26.1% of DCGs reported elevated levels of burden, (2) significant negative relationships found between mediators (DCG emotional support and self-efficacy) and DCG burden, (3) significant positive relationships between patient anxiety, depression, and DCG burden. This study contributes to caregiving literature by describing burden in DCGs of patients with cancer, which are an understudied population. The prevalence of burden in DCGs and its related factors were similar to that of local caregivers of cancer patients, which suggests that a si (open full item for complete abstract)

Committee: Sara Douglas PhD, RN (Committee Chair); Christopher Burant PhD (Committee Member); Susan Mazanec PhD, RN, AOCN, FAAN (Committee Member); David Bajor MD (Committee Member) Subjects: Nursing

PhD, University of Cincinnati, 2020, Education, Criminal Justice, and Human Services: Health Education

Study One: Purpose. Identify differences in child mental health factors, perceived neighborhood safety, and child health care access by demographic characteristics. Methods. Secondary data analysis of the 2017 Interact for Health Child Well Being Survey. Primary caregivers (n = 2,757) responded to questions about children. A random-digit dial structured questionnaire was utilized. Results. Caregivers reported that less than two-in-ten children (14.5%, n = 398) had good emotional health, 4.1% (n = 112) had depression, and 9.1% (n = 250) anxiety. Depression was higher among White, female, and 11-17 years, and African American children below 100% FPL. White children, age 11-17 years were diagnosed with anxiety more than African American or Other. Most caregivers felt their child was always safe (62.5%, n = 1,719) with 1.0% (n = 27) feeling their child was never-safe in their neighborhood. Caregiver's reported 98.5% (n = 2,705) had health insurance, 98.8% (n = 2,723) had a medical home, 88.3% (n = 2,426) received preventive care services while 11.7% (n = 322) did not. Statistical analyses revealed several differences. Conclusions. White, suburban, higher income, or children from married families received diagnosis and treatment for depression and anxiety more than low income, urban, or minority children found to have lower mental health scores. Increased screening for mental health disorders among vulnerable populations needs to be addressed as a priority. Study Two: Purpose. Identify differences in child caregiver physical health status, mental health status, level of parent emotional support, and perceived levels of neighborhood safety. Methods. Data (n = 2,757) from the 2017 Child Well Being Survey were utilized. Results. Nearly 7 in 10 caregivers reported their physical health as very good or good (68.1%, n = 1,878). A majority of caregivers reported their mental health as very good or good (62.2%, n = 1,707) and 93.3% (n = 2,571) had someone to provide day-t (open full item for complete abstract)

Committee: Liliana Rojas-Guyler Ph.D. (Committee Chair); Amy Bernard Ph.D. (Committee Member); Tina Stanton-Chapman Ph.D. (Committee Member); Bradley Wilson Ph.D. (Committee Member) Subjects: Health Education

Psy. D., Antioch University, 2017, Antioch Seattle: Clinical Psychology

Infants speak in their own language; sounds, screeches, cries, and howls that help them to communicate their caregiving needs. Unaware, parents may develop a checklist of caregiving approaches to the baby. The infant tells the adult directly what they need, and waits for the parent to respond. Infant talk may change from soft and quiet to loud and aggressive; coos and cries become crying and screams as the infant's caregiver—communicating the intensity of emotion, urgency of their request, or their frustration with varied and sometimes inadequate, failed, or missing caregiving patterns the infant has no choice but to accept. When the caregiver's response is slow, missing, irrelevant, inconsistent, or incorrect, the infant's level of stress increases. Stressed themselves, frustrated, and confused, parents and caregivers may neglect the child, or respond with abuse. According to the U. S. Department of Health and Human Services (2006), abuse and neglect have lasting effects on the child's development. Parents and caregivers of an infant need support. The purpose of this Attune With Baby Intervention is to teach parents and caregivers infant language so they hear, more quickly understand the infant's request, and respond appropriately, coordinating care with the infant before the infant and caregiver become stressed. Parents and caregivers attune with infant in the context of a family support program encompassing training, support, developmental assessment, referrals and connection to community resources, and other families. The program is implemented, developed, and evaluated by psychologists and doctoral students in psychology.

Committee: William Heusler Psy. D. (Committee Chair); Sheldon Berger Ph. D. (Committee Member); Melissa Curran Ph. D. (Committee Member) Subjects: Behavioral Psychology; Developmental Psychology; Early Childhood Education; Language; Linguistics; Personal Relationships; Psychology; Psychotherapy; Social Psychology; Social Research; Social Work; Sociolinguistics

MA, University of Cincinnati, 2010, Allied Health Sciences : Communication Science and Disorders

The purpose of this phenomenological qualitative study was to explore why family member caregivers of stroke survivors with a variety neurogenic communication disorders assimilated into their loved one's stroke support group and continued to participate on a regular basis. Phenomenological research allowed the researchers to explore the caregivers' lived experiences and thus identify themes based upon their perceptions and opinions. Research studies describing the phenomenon of caregiver assimilation and why caregivers are actively involved in the stroke survivors' group were not found. Instead, many research studies have focused upon the social and emotional benefits of support groups for caregivers and support groups for survivors of neurogenic incidents. Caregivers of stroke survivors with a neurogenic communication disorder from different social, economic, and cultural backgrounds participated in semi-structured interviews in order for the researcher to understand their lived experience of participation in their loved ones' stroke support group. The findings suggest that caregivers joined these support groups for a variety of reasons including the goals of learning communication strategies to improve their interactions with the stroke survivors, discovering resources available in the local community and around the country, counteracting the lack of information received upon medical discharge, and the development of social support gleaned from other caregivers present in the group.

Committee: Aimee Dietz PhD (Committee Chair); Krista Beyrer MA (Committee Member); Laura Wilcox Kretschmer EdD (Committee Member); John Clark PhD (Committee Member) Subjects: Speech Therapy

Master of Social Work, The Ohio State University, 2010, Social Work

Memory loss disorders, such as Alzheimer's disease and other dementias, are difficult to diagnose and individuals and families can wait years to receive a definitive diagnosis. Without a diagnosis, questions arise as to when these individuals will be provided information about their condition and whether they will have access to disease-specific resources, such as those offered through the Alzheimer's Association. The majority of the existing research that has been conducted on the diagnostic process for dementia has focused specifically on exploring physician attitudes and practices. As such, little is known regarding the needs of individuals with dementia and their family caregivers following this often devastating diagnosis. In this study, the researchers examined caregivers' experiences with the diagnostic process and with accessing information and community resources. A convenience sample was drawn from caregivers identified through the Alzheimer's Association (N=106). Participants completed either a 25-item written or online version of the questionnaire. A cross-sectional survey design was utilized to investigate the experiences of families during and following the diagnostic process for dementia. Survey items focused on the following: demographic and contextual variables; characteristics surrounding the diagnosis including the type of diagnosis, support service knowledge and use of community resources; and the caregiving role. The results of this study indicated that the majority of individuals were receiving diagnoses within one year of pursuing a memory loss diagnosis; however, caregivers felt they were not adequately supported at the time of diagnosis, nor up to one year following diagnosis. Caregivers stated that they were not provided enough information at the time of diagnosis about the disease or how to provide care for an individual with memory loss. A year following diagnosis, the majority of caregivers still felt they did not understand the disease (open full item for complete abstract)

Committee: Keith Anderson A (Advisor); Holly Dabelko-Schoeny (Committee Member) Subjects: Social Work