Doctor of Philosophy
Date of Defense
Ann M. Steffen, Ph.D.
Older adults with neurocognitive disorders are at high risk for medication non-adherence, while being vulnerable to great injury from regimen deviations. Informal caregivers often aid in healthcare management for these individuals. The current study compared the efficacy of two online health education interventions designed to increase caregiver health related knowledge for use with care recipients. Women (N=35) assisting a cognitively impaired older person with medications were randomly assigned to one of two online health education conditions (1) written materials and narrative vignettes depicting actors encountering common medication challenges or (2) written materials and didactic video clips of information from medical experts. It was hypothesized that narrative group participants would show greater improvements in several domains of functioning when compared to didactic group participants. Results showed equivalent participant satisfaction between groups; caregivers did not improve differentially between condition, over time, in the domains of medication hassles, patient-provider communication, medication management adherence, or self-efficacy. There was no main effect of time on caregiver reported hassles, patient- provider communication or medication adherence. There was a significant main effect of time on caregiver self-efficacy for controlling upsetting thoughts about the caregiving situation F (1, 33) = 8.07, p < .001, p = .20, achieved power = .79. Secondary analyses revealed that caregivers in the narrative vignette condition showed significant increases in overall self-efficacy for controlling upsetting thoughts, from pre-treatment (M = 62.95, SD = 33.55), to post treatment (M = 72.38, SD = 31.27), t(17) = -2.53, p =.02. Future directions include introducing a no-treatment control, inclusion of additional post-intervention assessment points to investigate intervention effects over time, and expansion of the study to include older adults in the care dyad.
George, Nika Renee, "Medication Non-Adherence in Community Dwelling Older Adults with Dementia: An Educational Intervention for Family Caregivers" (2015). Dissertations. 163.