Gerontology - Theses, Dissertations, and other Required Graduate Degree Essays

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The influence of care provider access to structural empowerment on individualized care in long term care facilities

Author: 
Date created: 
2007
Abstract: 

This thesis explores the relationship between care provider access to structural empowerment and the provision of individualized care in long-term care (LTC) facilities. Structural equation models (SEM) were computed to examine the relationship between access to empowerment structures (i.e., informal power, formal power, information, support, resources, and opportunity structures) and the provision of individualized care by RNs/LPNs (n = 242) and care aides (n = 326) recruited from three British Columbia health regions. Invariance analyses were subsequently undertaken to compare SEM models between groups. Access to structural empowerment had a statistically significant, positive effect on the provision of individualized care for both groups (though not statistically different between groups). Findings from this study suggest that improving the provision of individualized care in LTC facilities can be enhanced when RNs, LPNs, and care aides have appreciable access to empowerment structures.

Document type: 
Thesis
File(s): 
Senior supervisor: 
N
Department: 
Gerontology Program - Simon Fraser University
Thesis type: 
Thesis (M.A.)

Modifications to the hospital physical environment: Effect on older adults’ retention of post-discharge instructions

Author: 
Date created: 
2007
Abstract: 

This study was conducted in two (originally identical) hospital bedrooms in a community hospital in Burnaby, British Columbia. For the study, one patient room was left in its original state; the second was modified to reduce visual and auditory distraction. In each room, older adults watched a video recording of different post-discharge instructions. After each viewing, and after approximately 24 hours, their learning/retention was tested. While in each room, video equipment and other non-invasive technology recorded physical movements/fidgeting. A significant interaction was found between room type, instruction type and order. Subsequent analyses found that the oldest participants had the most difficulty when faced with learning more difficult instructions in the “Typical” room. Movement/fidget data suggest that participants were less stressed while receiving instruction in the modified room rather than “typical” room. Participants overwhelmingly preferred the modified room and expressed comfort with the use of video to receive post-discharge instruction.

Document type: 
Thesis
File(s): 
Senior supervisor: 
G
Department: 
Out of date: Gerontology Program - Simon Fraser University
Thesis type: 
Thesis (M.A.)

Characteristics of administrators and quality of care in Ontario care facilities

Date created: 
2007
Abstract: 

This exploratory study investigated administrator and facility predictors of quality of care (QOC) in care facilities (CF). Surveys were mailed to all 602 CF administrators in Ontario; half of whom responded. Quality was measured using the last certification inspection report obtained from the Ontario Ministry of Health and Long-Term Care public report on certified CF. Quality predictors were found using multiple regression analysis. Education and experience as an administrator in current position had a moderate positive influence on quality; however, a negative influence was found between salary and effort devoted to resident care. In addition, smaller facilities, facilities in less populated communities and administrators with a nursing background significantly affected quality in a positive manner. Recommendations for improving QOC in CF include increasing efforts to retain effective administrators, enhancing educational and training programs for administrators, building smaller CF with fewer beds, and renovating large facilities into multiple smaller facilities

Document type: 
Thesis
File(s): 
Senior supervisor: 
A
Department: 
Out of date: Gerontology Program - Simon Fraser University
Thesis type: 
Project (M.A.)

Development and validation of a scale to measure therapeutic misunderstanding with respect to clinical trial research participation

Date created: 
2007
Abstract: 

Clinical trial research participants often exhibit therapeutic misunderstanding. Factor and item analyses of responses by 464 community-dwelling older adults (age 49+) recruited online enabled the development of the 23-item Therapeutic Misunderstanding Scale (TMU). In accord with Horn and Grady’s three facets definition (2003), a three-factor structure was supported by both exploratory and confirmatory factor analyses (n = 164 & n = 300 respectively). Internal consistency of responses to the full TMU as well as the therapeutic misconception, misestimation, and optimism subscales was calculated as alpha = .90, alpha =.87, alpha =.79, and alpha =.75, respectively. Correlations between the TMU and related instruments by 37 clinical trial participants provide support for convergent and discriminant validity of responses to this scale. Test-retest reliability was found to be r = .54 over an average interval of 35 weeks. Results are discussed in context of ongoing challenges to define and measure therapeutic misunderstanding.

Document type: 
Thesis
File(s): 
Senior supervisor: 
N
Department: 
Out of date: Gerontology Program - Simon Fraser University
Thesis type: 
Thesis (M.A.)

Supporting personhood within dementia care: the therapeutic potential of personal photographs

Date created: 
2006
Abstract: 

This qualitative study explored the potential of a photo-based biographical tool designed to familiarize long-term care (LTC) staff with residents’ life stories to support personhood and contribute to person-centred dementia care. Literature on personal photography, life story work, reminiscence, and social constructionist theory in relation to discourses of personhood and self informed this investigation. Data generation entailed creation of two Visual Life Stories (VLS), produced through guided conversations with residents with dementia and their families, and subsequent focus groups conducted with staff from two care facilities that assessed feasibility and therapeutic value of this tool within the LTC context. Analysis revealed that: a) visual prompts supported residents’ ability to recall and share their life stories, b) family members participation was integral to VLS production, and c) despite positive staff feedback on the value of VLS, micro-level demands and macro-level policies were perceived as barriers to implementation.

Document type: 
Thesis
File(s): 
Department: 
Department of Gerontology - Simon Fraser University
Thesis type: 
Thesis (M.A.)

Assisted living in BC: effects of organizational factors on residents’ satisfaction

Author: 
Date created: 
2006
Abstract: 

In British Columbia, Assisted Living has been at the forefront of housing options for older adults due to their growing numbers and inadequate housing and health care resources to accommodate them. Assisted Living is a potential viable alternative for relatively high functioning seniors. Fraser Health Authority, one of the largest health regions, anticipates the creation of up to 1200 units by the end of 2007. This study examines residents’ satisfaction levels in Assisted Living facilities in Fraser Health Authority, and the extent to which organizational factors influence their satisfaction. Data were collected in interviews with 52 residents residing in funded beds in 10 for-profit and non-profit Assisted Living facilities. Site managers/administrators completed organizational factors’ surveys. Results indicate that residents were generally satisfied with the care received. Organizational factors did not appear to influence residents’ satisfaction. This study assists in exploring AL residents’ experiences and identifies areas for further study.

Document type: 
Thesis
File(s): 
Department: 
Department of Gerontology - Simon Fraser University
Thesis type: 
Project (M.A.)

Exploring the potential benefit of adult day centre exercise programs

Date created: 
2006
Abstract: 

This thesis explores the potential physical benefit of exercise programs offered to clients from 54 Adult Day Centres in British Columbia, Canada. The purpose of the research was to determine characteristics of clients, exercise programs and leaders and to establish their relative influence on an exercise classification system (ECS) score, which categorized each program as offering minimal, moderate or optimal potential benefit.

Document type: 
Thesis
File(s): 
Department: 
Department of Gerontology - Simon Fraser University
Thesis type: 
Thesis (M.A.)

Adaptable Design in Five Housing Projects in North Vancouver: Client Use and Satisfaction

Author: 
Date created: 
2004
Abstract: 

In 1997, the City of North Vancouver, British Columbia developed 'Adaptable Design Guidelines'. This was the first qualitative evaluation since guideline implementation that evaluated why tenants moved to Adaptable Designed units, identified changes being made by tenants, and indicated if functional independence was being supported due to the design features. Participants were satisfied with their unit and the decision to move into their unit was primarily guided by location of the building. Also, participants were aware of Adaptable Design; however, some were misled about its uses. Most participants were high functioning; however, several required assistance with household tasks such as cooking and cleaning. Unfortunately, these same support services are being eliminated by the provincial government in British Columbia. Results can be used to guide future revisions pertaining to the guidelines as well as demonstrate what needs to be done in physical environments in order maintain functional independence in older adults.

Document type: 
Thesis
File(s): 
Department: 
Department of Gerontology - Simon Fraser University
Thesis type: 
Project (M.A.)