Clinical Utility of the Two-Factor FOQ-A Based on Item-Level Psychometric Analysis

Introduction: Exploratory factor analysis of the Functional Outcome Questionnaire for Aphasia (FOQ-A) revealed two factors. We sought to determine the item level psychometrics of the two-factor FOQ-A using Rasch analysis and develop computer scoring to enhance its clinical utility. Method: 127 FOQ-A caregiver ratings were retrieved from an approved research database and analyzed using Winsteps. Results: The two-factor FOQ-A demonstrated sound psychometric properties. Item difficulty/person ability were calibrated on interval scales. Conclusions: Results provide further evidence for the FOQ-A’s validity. Item difficulty calibrated on interval scales provide guidance for treatment planning and computer scoring allows efficient documentation of functional change

Measurement Properties of the Functional Outcomes Questionnaire for Aphasia

Aphasia often results in negative social, emotional, and financial consequences endorsing rehabilitation efforts that influence communication beyond the level of impairment. The FOQ-A assesses the impact of aphasia treatment on functional communication, extending measurement into activity and participation. The purpose of this study is to evaluate the measurement properties of the FOQ-A in a sample of 127 individuals with moderate to severe aphasia subsequent to stroke. Results of Rasch analysis indicate that the FOQ-A is unidimensional, has good internal consistency, and contains adequate person separation for measuring change after rehabilitation; however, revisions to the scale may improve its usefulness

Assertiveness Training for Disabled Adults in Wheelchairs Self-Report, Role-Play, and Activity Pattern Outcomes

Thirty-four physically disabled adults participated in an 11-week assertiveness training (AT) program. Ss were randomly assigned to either AT or a waiting-list (WL) condition. Each was asked to complete three self-report measures, a role-play test, and a social and recreational activity diary. The AT Ss showed significant improvements on both self-reported assertiveness and role-play performance from pre- to posttreatment, whereas WL controls showed no changes on these measures. No significant changes in frequency of social or recreational activities were found at posttest for either AT or control Ss. A mixed pattern of results was shown at 6-month follow-up. Posttest gains were maintained across all self-report measures of assertiveness and acceptance of disability, whereas role-play performance approached baseline levels at 6-month follow-up. Overall results support the use of AT in enhancing perceived social efficacy and interpersonal skill of physically disabled adults in wheelchairs

Not so risky business: The use of planning within rock climbing

To understand precautionary behaviour within risk sport, the present study assessed participants’ (n=72) degree of planning for a rock climbing task and its impact on task performance. Participants with varying degrees of climbing experience were randomly assigned to one of three conditions: (a) planning-inhibited, (b) planning, or a (c) control. Results indicated significantly (p<0.01) more planning behaviour by planning and control participants than by those who were planning-inhibited. Additionally, inexperienced participants reported significantly (p<0.01) more pre-task thoughts and mental preparation than experienced participants. Although climbing times were not significantly different among conditions, descriptively planning-inhibited participants climbed the slowest, while participants prompted to plan climbed the fastest. Results suggest that while participants appeared to engage in a degree of planning, the practice did not affect performance. Discussion concerns the use of planning as a precautionary behaviour in rock climbing

Chronic Parenting Stress Moderating Versus Mediating Effects of Social Support

The present study contrasted the widely cited "buffer" model of social support with an alternative mediator model. Distinctions were drawn between the functions of social support under chronic vs. acute stress conditions, and between situation-specific stressors and major life events. Ongoing parenting stress was assessed in 96 mothers of deaf children and 118 matched controls. Tests of the competing models showed no moderating effects for social support. However, path analyses suggested that social support mediated the relationship between stressors and outcomes. Chronic parenting stress was associated with lowered perceptions of emotional support, and greater symptoms of depression and anxiety. Furthermore, parenting stress accounted for a substantial proportion of the variance in psychological distress scores in contrast to life event stress, which was only weakly related to psychological outcomes. The implications of mediational models for understanding adaptation to chronic stress are discussed

Information behavior of rural dementia caregivers over the course of counseling interventions

This poster reports findings from an analysis of 81 qualitative interviews with rural dementia caregivers who participated in two research projects that evaluated cognitive behavioral therapy (CBT) problem-solving interventions designed to help them manage their caregiving and reduce depression. The research questions posed in this analysis are: (RQ1) How do rural dementia caregivers who have participated in a CBT program interact with the information around them and available to them? (RQ2) How do these caregivers manage, explicitly or tacitly, their information needs and uses? The analysis demonstrates similarities and differences in information behaviors and information environments across the caregivers; for example that physical information artifacts are important to different caregivers for varied reasons, and that religious communities fulfill multiple information-related roles. The findings demonstrate the importance of accounting for the unique constraints on older caregivers in designing interventions to improve and support their caregiving experiences. Creating links among people, such as connecting caregivers to similar others facing similar challenges, and providing them with a structure to allow them to focus on their goals, appear critical to the success of such interventions.published or submitted for publicationis peer reviewe

Key Themes in Black Dementia Caregiver Support: Linking Resources, Peer Communication, and Faith Community Outreach

We describe content analysis and present thematic visualizations using semi-structured interviews from participants of the African-American Alzheimer’s Caregiver Training and Support 2 (ACTS 2) Project in Florida. This telephone-based program provides faith worker-led skills training and support for distressed AA dementia caregivers. It facilitates integrated care and reduces dementia stigma through faith community partnerships. ACTS 2 serves North and Central FL. ACTS 2 uses mixed assessment methods including standardized questionnaires of depression, caregiver appraisals of burden and reward, social support and health status; and narrative data on various facets of program delivery and participant satisfaction. Evaluation uses prospective cohort designs, following participants from recruitment past completion. For this thematic analysis, we examined final thesis manuscripts for all 11 collaborating students who worked on ACTS 2 in the course of completing their MS degrees in the Bridge to Clinical Medicine program at FSU College of Medicine. We imported the thesis manuscripts into NVivo qualitative coding software and performed a series of content analyses. Results were cross-checked through manual review of student theses. Our content analyses highlight how ACTS 2 provides skills building and spiritual support for distressed AA dementia caregivers. We showcase thematic visualizations of how program success hinges on linkage of care resources across domains, phone communication to reach people in diverse geographic areas, and sustained outreach through relationships with clergy. We also describe implications for the scalability of ACTS 2 within and beyond Florida, and explore how this model can enrich the lives of AA dementia caregivers nationwide

"My greatest help comes from the Lord": Religion and the information behaviors of dementia caregivers

https://kent-islandora.s3.us-east-2.amazonaws.com/acir/2013/Papers/6/thumbnail.jpgHow do religious beliefs, practices and communities affect how caregivers of loved ones with dementia approach information seeking, information use, and information evaluation with respect to their caregiving activities? </p

African-American Lay Pastoral Care Facilitators’ Perspectives on Dementia Caregiver Education and Training

The African-American Alzheimer’s Caregiver Training and Support Project 2 (ACTS 2) is a faith-integrated, skills-training and support program for distressed African American family caregivers of persons living with dementia across Florida. Caregivers participate in a 12-week, telephone-based, skills-building and support program led by faith community workers (i.e., lay pastoral care facilitators) who provide volunteer services to their denominations. In this case study, we examined facilitators’ perspectives and recommendations for supplementary audiovisual and written training materials to optimize group process and goal-setting skills. Utilizing a qualitative approach, we explored facilitators’ needs, experiences in using current training materials, and recommendations for supplementary education. Data were collected through a telephone-based, focus group interview with nine ACTS 2 facilitators deploying grounded theory techniques. We identified six themes: personal reflections on facilitator roles and responsibilities, satisfaction with existing written materials, desire for supplementary audiovisual training materials, desire for additional training on data management and reporting, importance of peer support, and fostering a faith-integrated culture within the program. Our findings underscore the importance of engaging African American faith communities in fostering dementia caregiving skills training and support. We further highlight the implications of providing community-based training for African American facilitators to foster caregiver emotional well-being and physical health