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165 Pages·2017·1.31 MB·English
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South Dakota State University Open PRIRIE: Open Public Research Access Institutional Repository and Information Exchange Teses and Dissertations 2017 Health-Promoting Behaviors, Hope, and Health- Related Quality of Life in Persons Impacted by Parkinson’s Disease Amy K. Forbes South Dakota State University Follow this and additional works at: htp://openprairie.sdstate.edu/etd Part of the Nursing Commons Recommended Citation Forbes, Amy K., "Health-Promoting Behaviors, Hope, and Health-Related Quality of Life in Persons Impacted by Parkinson’s Disease" (2017).Teses and Dissertations. 1219. htp://openprairie.sdstate.edu/etd/1219 Tis Tesis - Open Access is brought to you for free and open access by Open PRIRIE: Open Public Research Access Institutional Repository and Information Exchange. It has been accepted for inclusion in Teses and Dissertations by an authorized administrator of Open PRIRIE: Open Public Research Access Institutional Repository and Information Exchange. For more information, please contact HEALTH-PROMOTING BEHAVIORS, HOPE, AND HEALTH-RELATED QUALITY OF LIFE IN PERSONS IMPACTED BY PARKINSON’S DISEASE BY AMY K. FORBES A dissertation submitted in partial fulfillment of the requirements for the degree Doctor of Philosophy Major in Nursing South Dakota State University 2017 ii iii This dissertation is dedicated to my mom. And for others with chronic illness who struggle to maintain quality of life. “Hope” is the thing with feathers – That perches in the soul – And sings the tune without the words – And never stops – at all – And sweetest – in the Gale – is heard – And sore must be the storm – That could abash the little Bird That kept so many warm I’ve heard it in the chilliest land – And on the strangest Sea – Yet, never in Extremity, It asked a crumb – of Me. Emily Dickinson (C.1891/1960) iv ACKNOWLEDGMENTS Thank you to my committee: Dr. Kay Foland, Dr. Cynthia Elverson, Dr. Linda Burdette, and Dr. Renee Oscarson. I also wish to thank Dr. Kay Herthe, Dr. Nola Pender, and Dr. Jenkinson for the use of their instruments, and Dr. Stuifbergen for the use of her Explanatory Model of Health Promotion and Quality of Life in Chronic Disabling Conditions. A special thank you to my colleagues and PhD sistas in the doctoral program. The joy, laughter, and tears together has made this journey more meaningful than I could have imagined. Thank you to my husband and children who were patient every time I said I needed to write just five more minutes. Thank you to my dad for encouraging me and for saying, “Education is something no one can take away from you.” Thank you for the life lessons that you teach me every day. I love you to the moon and back. Finally, I want to thank the persons with Parkinson’s disease that shared their time and experiences with me, and my mother who had such tough days with Parkinson’s disease, yet always put on a smile. Thank you for being my inspiration, Mom, for being the wind beneath my wings. Your love is always with me and eternally supports me. v CONTENTS ABBREVIATIONS ....................................................................................................viii LIST OF FIGURES .....................................................................................................ix LIST OF TABLES .......................................................................................................x ABSTRACT ................................................................................................................xii CHAPTER 1: INTRODUCTION AND BACKGROUND ........................................1 PURPOSE OF THE STUDY ..........................................................................9 RESEARCH QUESTIONS ...........................................................................9 RESEARCH HYPOTHESES ........................................................................10 DEFINITIONS ...............................................................................................13 CHAPTER 2: REVIEW OF LITERATURE .............................................................16 PREVALENCE OF PARKINSON’S DISEASE...........................................16 HOPE .............................................................................................................18 HEALTH-RELATED QUALITY OF LIFE ..................................................22 HEALTH-PROMOTING BEHAVIORS ......................................................28 THEORETICAL FRAMEWORK .................................................................33 CHAPTER 3: RESEARCH METHODOLOGY .......................................................42 RESEARCH DESIGN ...................................................................................42 SAMPLE ........................................................................................................42 SETTING .......................................................................................................44 INSTRUMENTS............................................................................................45 DATA COLLECTION ..................................................................................49 vi ANALYSIS ....................................................................................................50 THREATS TO RELIABILITY AND VALIDITY ........................................52 CHAPTER 4: RESULTS AND ANALSYIS ............................................................54 RESULTS AND ANALYSIS ........................................................................55 ANALYSIS OF MULTIVARIATE METHODS ..........................................61 FACTOR ANALYSIS ...................................................................................62 SUMMARY OF PATH ANALYSIS ...........................................................88 ANALYSIS OF QUESTION 1 ......................................................................89 ANALYSIS OF QUESTION 2 ......................................................................92 ANALYSIS OF QUESTION 3 ......................................................................96 CHAPTER 5: SUMMARY OF FINDINGS ...............................................................102 SUMMARY OF FINDINGS .........................................................................102 IMPLICATIONS FOR NURSING PRACTICE ...........................................104 IMPLICATIONS FOR THEORETICAL FRAMEWORK ...........................108 STRENGTHS OF THE STUDY ...................................................................111 LIMITATIONS OF THE STUDY.................................................................112 RECOMMENDATIONS FOR FUTURE STUDY .......................................113 CONCLUSION ..............................................................................................115 REFERENCES ...........................................................................................................116 APPENDICES ..........................................................................................................137 A. DEMOGRAPHHIC INSTRUMENT FOR BACKGROUND …….……….137 B. HOEHN AND YAHR DISEASE SEVERITY SCALE ................................138 vii C. HEALTH PROMOTING LIFESTYLE PROFILE (HPLP II).......................139 D. HERTH HOPE INDEX .................................................................................144 E. PARKINSON’S DISEASE QUALITY OF LIFE QUESTIONNAIRE ........146 F. PRE-NOTICE STUDY LETTER CONTACT .............................................147 G. FIRST LETTER CONTACT .........................................................................148 H. THANK YOU LETTER CONTACT ............................................................149 I. PERMISSION EMAIL DR. NOLA PENDER ..............................................150 J. PERMISSION EMAIL DR. KAYE HERTH ................................................151 viii ABBREVIATIONS B Beta Coefficien df Degrees of Freedom M Mean N Total Sample P Significance level r Pearson Product-moment Correlation Coefficient SD Standard Deviation SEM Standard Error of the Mean t Statistical test to compare difference om group means PDF Parkinson’s Disease Foundation HRQOL Health-Related Quality of Life PDQ Parkinson’s Disease Questionnaire (measures quality of life) HHI Herth Hope Index- measures hope HPLP Health-Promoting Lifestyle Profile (measures health-promoting behaviors) H&Y Hoehn and Yahr (stage of Parkinson’s disease score) ix LIST OF FIGURES Figure 1. Study Framework .......................................................................................10 Figure 2. Explanatory Model of Health Promotion and Quality of Life in Chronic Disabling Conditions .................................................................................................37 Figure 3. Scree Plot ....................................................................................................63 Figure 4. Confirmatory Factor Model Diagram .........................................................72 Figure 5. Histograms with Fitted Curves ...................................................................78 Figure 6. Boxplots ......................................................................................................79 Figure 7. Scatterplot Matrix .......................................................................................82 Figure 8. Visual Inspection of the Residual Terms (Errors) ......................................86 Figure 9. Conceptual Diagram of the Hypothesized Path Model ..............................92 Figure 10. Final Path Analysis Model for Hypothesis 2 ............................................96 Figure 11. Final Path Analysis Model for Hypothesis 3 ............................................101 Figure 12. New Model for Variables- Hope, Health-Promoting Behaviors and HRQOL ...............................................................................................................108

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