Browsing by Author "Fruhauf, Christine A., committee member"
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Item Open Access A qualitative study: the influence of occupational therapy for pelvic floor dysfunction on functioning, disability, and health(Colorado State University. Libraries, 2022) Pearce, Delaney M., author; Schmid, Arlene A., advisor; Atler, Karen E., committee member; Fruhauf, Christine A., committee memberIntroduction: Approximately one quarter of all women in the United States experience symptoms of pelvic floor dysfunction (PFD). Occupational therapy (OT) for PFD is a relatively new area of expertise within the field, resulting in limited research on its efficacy. Objectives: Explore the ways in which OT for PFD influences health using the International Classification of Functioning, Disability, and Health (ICF) as a guide. Method: Four participants completed the study. Eligibility criteria included: >18 years old, biologically female, English speaking, self-reported pelvic floor issue, completed OT intervention for PFD within the last two years. Electronic medical records and Pelvic Floor Distress Inventory Questionnaire-10 (PFDI-20) scores prior to and after completing OT intervention for PFD were reviewed, and semi-structured interviews were conducted. Results: Four themes emerged: 1) improved mental health and physiological function, 2) promotion of the mind-body connection, 3) reintroduction of meaning, and 4) relationships with healthcare professionals and sociocultural influences. Each theme is tied to a component of the ICF. Conclusion: OT for PFD has a positive impact on health per the ICF. This may result in better function and participation in everyday life. More research is needed to investigate the generalizability of these findings.Item Open Access Do participants with chronic pain have improved self-efficacy after completing the MY-Skills intervention?(Colorado State University. Libraries, 2020) Kinkel, Charla, author; Schmid, Arlene A., advisor; Atler, Karen E., committee member; Fruhauf, Christine A., committee memberPurpose: The aim of this study was to explore if participants with chronic pain have improved self-efficacy in performing daily activities and managing pain symptoms after completing the Merging Yoga and self-management Skills program (MY-Skills). Method: Care dyads, comprised of caregivers and care-recipients with chronic pain were recruited to complete the 8-week MY-Skills intervention. Twice each week, participants engaged in a one-hour group self-management course followed by a one-hour group yoga session developed for care dyads with chronic pain. Self-efficacy outcomes were collected using the Chronic Pain Self-Efficacy Scale (pain management, physical function, coping with symptoms); the PROMIS® Self-Efficacy for Managing Daily Activities Short Form 4a; and the PROMIS Self-Efficacy for Managing Symptoms Short Form 4a. Data for all participants were analyzed using a paired t-test. A post hoc exploratory analysis of separate caregiver and care-recipient outcomes was conducted using a Wilcoxon signed ranks test. Results: Eight participants completed the study (50.23±14.77 avg. age, 77% female, 69% with pain for > 10 years). The participants reported increased self-efficacy across all measures and domains, with significant improvement found for self-efficacy for physical function (38.97±19.45 vs. 59.10±18.60, p = .004). The post hoc exploratory analysis showed increased self-efficacy in all caregiver outcomes. Care-recipients reported increased self-efficacy in all areas except pain management, which significantly decreased. Conclusion: MY-Skills improved self-efficacy to varying degrees for participants in aggregate. Improvements in self-efficacy related to physical function demonstrated that MY-Skills increased participants' confidence in performing everyday occupations such as running errands, doing chores, working, and socializing. Interventions that improve self-efficacy, like MY-Skills, may help people with chronic pain gain function, problem-solving, and coping skills to reclaim a sense of control and enhance quality of life.Item Open Access It's a whole new world: self-esteem and widowhood in older women in a retirement community(Colorado State University. Libraries, 2010) Archibald, Krystle Balhan, author; Vacha-Haase, Tammi, advisor; Fruhauf, Christine A., committee member; Stallones, Lorann, committee member; Rickard, Kathryn Marie, 1957-, committee memberWith estimates of nearly 50% of all women over age 65 becoming widows, the transition into widowhood is an expected life event for older women (Bradsher, 2001; Hanson & Hayslip, 2000). Nonetheless, widowhood is often an extremely disruptive life event for women, involving loss in many life domains including status, social connections, psychological well-being, and self-esteem (Carr, 2004; Carr, Nesse, & Wortman, 2006; Chamber, 2005). The current interpretive phenomenological study explored widows' lived experiences in relation to their self-esteem after the loss of their spouses. Thirteen women from a retirement community in Arizona were interviewed. A core theme of multiple identity construction emerged from their narratives. Other important subthemes arose from the data including "the widowhood experience," "relationships," "self-esteem definitions and sources," and "independence."Item Open Access Life after caregiving: understanding everyday resilience in the context of the bereavement phase of the caregiver journey(Colorado State University. Libraries, 2020) Seidle, Julie Silver, author; Sample, Pat, advisor; Atler, Karen, committee member; Eakman, Aaron, committee member; Fruhauf, Christine A., committee memberDementia is a progressive illness that results in cognitive decline for aging adults requiring increased assistance with everyday life as symptoms worsen over time. An illness that is found largely in older adults, dementia rates are rising with the aging population. Dementia often is considered one of the most challenging illnesses for caregivers, given its progressive nature and the individual's subsequent, increased, and complex care needs. Much of the daily care for individuals with dementia is carried out by family members including spouses. Due to the ever-changing complexity of dementia care, spousal dementia caregivers (SDCs) are at an increased risk for negative health and well-being impacts, compared to their non-caregiving cohorts. The caregiving trajectory for SDCs inevitably includes the loss of the spouse, which ushers in one of the most difficult and disruptive role transitions experienced during the life course. The caregiver journey, however, does not necessarily end when the individual with dementia dies, but begins the final bereavement phase of the caregiver journey. This dissertation examines the experience of SDCs and the role of resilience during the bereavement phase of the caregiver journey. I conducted a phenomenological study to increase our understanding of the everyday lived experience of resilience for SDCs during the bereavement phase of the caregiver journey. I also completed a phenomenographical study to capture how SDCs conceptualized their experience during the bereavement phase of the caregiver journey. I offer key takeaways from the studies, then discuss my research approach and recommendations for future research and practice addressing resilience and dementia caregiving. I end this dissertation by situating my work within Occupational Science and Rehabilitation Science.Item Open Access Merging yoga and occupational therapy for Parkinson's disease(Colorado State University. Libraries, 2019) Swink, Laura A., author; Schmid, Arlene A., advisor; Atler, Karen E., committee member; Fruhauf, Christine A., committee member; Fling, Brett W., committee memberPurpose: The purpose of this dissertation was to develop a fall risk self-management program for people with Parkinson's disease (Merging Yoga and Occupational Therapy for Parkinson's Disease [MY-OT for PD]), conduct a feasibility and pilot study, and analyze outcomes following the MY-OT for PD program. Method: This dissertation includes three studies. Study One was a qualitative study which focused on the adaptation of a program originally designed for individuals with chronic stroke (i.e. Merging Yoga and Occupational Therapy) and development of a new program to specifically meet the needs of people with Parkinson's disease (PwP) (i.e. MY-OT for PD). To complete Study One, we conducted a focus group with PwP and nine expert interviews. Study One results led to the creation of Stage 1 manuals to guide the MY-OT for PD program. In Study Two, we completed the 8-week (14-session) MY-OT for PD program and focused on feasibility and pilot testing. Feasibility was assessed related to the process, resources, management, and scientific basis of the program. The following outcome measures were collected: five fall management scales, concern about falling, balance, balance confidence, and self-reported falls. Study Three was a mixed-methods analysis of health-related quality of life following the MY-OT for PD program. The quantitative outcome was a HRQoL standardized assessment specifically for PwP. The qualitative data were collected via two focus groups with participants after the program in which participants were asked about eight HRQoL domains from the quantitative assessment. Results: In the qualitative development study, three themes were identified related to revision of the MY-OT program (and development of Stage 1 manuals): revisions to the guiding model, revisions to content, revisions to delivery. We outlined changes to the manuals in relation to each theme and developed a new guiding model (the PD Fall Risk Model), altered manual content, and altered delivery aspects of the manual to create the PD-specific MY-OT for PD Stage 1 program manuals. We then implemented and tested the 8-week, 14-session MY-OT for PD program. Eighteen participants enrolled, one dropped out during the control period, and 17 participants completed an average of 12.82/14 sessions. Improvements were seen on all outcome measures, and significant differences were seen between the control and intervention periods on one of the fall management scales and balance, with significantly greater scores improvements during the intervention period as compared to the control period. HRQoL results were mixed because quantitative results showed no significant differences in HRQoL following the MY-OT for PD program, while qualitative results showed noted improvements in all HRQoL domains. Conclusion: MY-OT for PD is one promising program that decreased the number of self-reported falls during the intervention, improved balance, and participants reported improvements in HRQoL. In order to complete future trials, MY-OT for PD would need to be modified based on participant feedback and analysis of outcomes following the feasibility and pilot testing in Studies Two and Three.Item Embargo Occupational therapists' perspectives on their unique role in pelvic health(Colorado State University. Libraries, 2023) Fyhrie, Jennifer, author; Schmid, Arlene A., advisor; Weaver, Jennifer, committee member; Fruhauf, Christine A., committee memberIntroduction: Pelvic floor dysfunction (PFD) may present as urinary/fecal incontinence, pelvic organ prolapse, and/or pelvic pain. These symptoms have been shown to cause disruption to individuals' activities of daily living and decrease quality of life. Conservative estimates indicate 28 million women are affected by PFD worldwide. The core of occupational therapy (OT) is to mitigate barriers to engagement in occupations of one's choosing, yet there is a gap in the literature detailing occupational therapy practitioners' (OTP) perspectives on their unique contributions in pelvic health. Methods: This exploratory descriptive study utilized an online survey to purposively recruit OTPs and screen individuals for an interview. Inclusion criteria required that participants a) be a licensed or retired OTP, b) have at least one year experience as an OTP, and c) have any professional experience in pelvic health. One-on-one semi-structured interviews occurred on a virtual platform, were audio-recorded, and transcribed. Using Dedoose software, thematic inductive analysis was conducted. Results: Thirty-one individuals completed the survey, 21 were eligible to participate, and 13 participated in an interview. It was found that OTPs believe they offer a unique contribution to the pelvic health field. Three primary qualitative themes were generated that elaborate on this belief: OTPs apply a psychosocial lens, the OT approach is comprehensive, and OTPs use occupation-focused interventions when working with people with PFD (e.g., consider the influence of client mental health as client preferences, culture, and lifestyle). Conclusion: This study identified the perceptions of OTPs regarding their unique approach to working with clients in pelvic health. Data suggests that OTPs complement the biomechanical focus of other pelvic health providers by recognizing the role of mental health and intervening to down-regulate the nervous system.Item Open Access Statistical modeling of caregiver burden and distress among informal caregivers of individuals with amyotrophic lateral sclerosis, Alzheimer's disease, and cancer(Colorado State University. Libraries, 2011) Cumming, John McClure, author; De Miranda, Michael A., advisor; Gloeckner, Gene W., committee member; Morgan, George A., committee member; Fruhauf, Christine A., committee memberCaregiver burden and distress have been associated with informal caregivers. Research findings on the specific aspects of the caregiving role that influence burden are mixed. Factors such as amount of time per day giving care and specific characteristics about the disease progression have been linked to caregiver burden and distress. Other findings suggest that caregiver burden and distress may be associated with disease characteristics, but caregiver personality traits are the major factor that influences caregiver burden. The purpose of this study was to use a variety of instruments to assess the relationship between traits that the caregiver comes into the caring situation with (resiliency, social support, spirituality, hope) and caregiver burden, within different caregiving populations. Caregivers giving care to individuals with Alzheimer's disease, Amyotrophic Lateral Sclerosis, or cancer were the caregiving groups of interest. A convenient sample of 95 informal caregivers completed the battery of instruments through an online survey tool. Differences between the three caregiving samples were assessed in terms of burden and distress. Hierarchical regression models were created to understand the roles gender, time giving care, activities assisted with, resiliency, social support, spirituality, and hope play in predicting caregiver burden and distress. Psychometric properties were assessed on all six instruments used in this study. Cluster analytic techniques were used to cluster caregivers based on a number of attributes to better understand the caregiving population. Results from this research indicate that resiliency, social support, spirituality, and hope significantly predict caregiver burden and distress. Amount of time giving care per day, number of months giving care, and activities that the caregiver assists with did not play a significant role in predicting caregiver burden or caregiver distress. The three caregiving groups were unequal in size, but reported similar levels of burden and distress. Two caregiving clusters were created based on this sample. Caregivers who had higher levels of resiliency, social support, spirituality, and hope (cluster one) were significantly less burdened and distressed than caregivers who reported lower levels of resiliency, social support, spirituality, and hope (cluster two). This research adds to the body of work within caregiver burden and distress. The findings suggest that burden is a factor of different aspects of the caregiver rather than the disease characteristics and progression of the person receiving care.Item Open Access Women's experience receiving occupational therapy for pelvic floor dysfunction: a case series(Colorado State University. Libraries, 2021) Schmitz, Johanna R., author; Schmid, Arlene A., advisor; Atler, Karen E., committee member; Fruhauf, Christine A., committee memberIntroduction: Pelvic floor dysfunction (PFD) is a condition that affects one third of women, greatly impacting their quality of life (QoL). There is limited research on occupational therapy (OT) and pelvic floor health as pelvic floor therapy is a relatively new topic in the field of OT. Objectives: Explore the experiences of women who have received OT for PFD. Method: Eligibility criteria included: ≥18 years old; biologically female participants; self-reported pelvic floor health issue; English speaking; completed OT intervention for PFD within the past two years. Four participants completed a semi-structured interview about their treatment and qualitative analyses were completed using inductive coding techniques. Participants' electronic medical records were reviewed. The Pelvic Floor Distress Inventory Questionnaire-20 (PFDI-20) was completed to assess changes in PFD symptoms and impact on QoL. Results: Qualitatively, three main themes emerged from the data across participants: 1) OT changed the course of women's ongoing journey with pelvic health, 2) women experienced relief through discovering OT, and 3) OT empowered women to be the experts of their own bodies. There were clinically significant changes in participants PFDI-20 scores indicating a decrease in PFD symptoms and impact of PFD symptoms on QOL following OT intervention. Conclusion: In conclusion, it appears that OT interventions may play an important role in positively impacting women's life with PFD. More research is needed to investigate the mechanisms of what makes OT interventions effective in treating PFD.