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

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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Out of date: Gerontology Program - Simon Fraser University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.)

Exploring physical pain and injuries in informal caregivers to older adults

Author: 
Date created: 
2007
Abstract: 

Previous studies document positive and negative effects of informal caregiving on the caregiver’s physical and mental health. Although injuries are highly prevalent in professional home care workers, they have not been fully examined in informal caregivers. This study has explored physical pain and injuries in informal caregivers to frail older adults using the grounded theory approach and symbolic interactionism theoretical background. In-depth interviews have been conducted with twenty primary caregivers. Injuries in study participants included muscle and back strains, falls, sprained ankles, twisted knees, a broken wrist, a dislocated shoulder, and burns and bruises. Female spousal caregivers were especially vulnerable to physical pain and injury. A substantive theory was developed, relating to the social process of “attenuating the caregiver’s well-being while accentuating the care recipient’s well-being in the course of informal care provision.” This will provide a useful conceptual framework for future studies and caregiver interventions.

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

Personality and cognitive adaptation: the absence of neuroticism and its effects on the well-being of widowed women over time

Date created: 
2007
Abstract: 

Widows scoring lower on the trait of neuroticism (N; i.e., negative emotional reactivity) tend to score higher on measures of well-being than high-N widows. This study examined if low-N widows employ adaptive cognitive processes (e.g., positive information processing biases) to mediate the association between personality and well-being. Reports of widowed women's perceptions of their marriage, measured in 2002/2003 by the Marital Aggrandizement Scale (MAS; O'Rourke & Cappeliez, 2002), were compared to their perceptions of their marriage at that time, as recalled three years later, as well as at present (N = 47). It was predicted that low-N widows would have higher MAS responses than high-N widows, and that this difference would increase over time. There was no interaction between neuroticism and time on MAS scores. Scores of high- and low-N widows on measures of psychiatric distress and life satisfaction were different at baseline and demonstrated lesser disparity at Time 2.

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