Virginia Tech Carilion School of Medicine (VTCSOM)

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https://hdl.handle.net/10919/91912

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Browsing Virginia Tech Carilion School of Medicine (VTCSOM) by Department "Human Development and Family Science"

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    A Long and Winding Road: Dementia Caregiving With Grit and Grace
    Roberto, Karen A.; McCann, Brandy R.; Blieszner, Rosemary; Savla, Jyoti S. (Oxford University Press, 2019)
    Background and Objectives: Many dementia caregivers provide care for numerous years. Exhibiting grit, or commitment and persistence in the face of adversity, may bolster their ability to manage caregiving challenges. We explored grit in relationship to memory and behavior problems and response to stressors among women engaged in long-term dementia care. Research Design and Methods: Informed by a life course perspective, and guided by stress-process theory, we interviewed 10 women with a spouse or parent initially diagnosed with mild cognitive impairment 4 times over 10 years. Using Charmaz’s analysis methods and grit as a sensitizing concept, we employed an unfolding analytic strategy involving (a) thematic analysis to identify expressions of grit in response to caregiving stressors across interviews and (b) case-by-case comparisons to assess associations of grit with the use of care strategies across caregivers over time. Results: Dementia caregivers experienced unrelenting and changing psychosocial and physical challenges. Over time, most women exhibited a sustained commitment to the relationship through the ways in which they protected the identity of the person with dementia, modified their expectations for emotional intimacy, and managed their financial affairs. They persevered as their roles and relationships fluctuated, often finding purpose and relief through employment and leisure pursuits. As care intensified, women who took charge and consciously made decisions in the best interest of the care recipient and themselves minimized stress. Discussion and Implications: While some caregivers exhibited grit from the outset, all showed enhanced perseverance and commitment to the ways they managed memory-related changes over time. Developing confidence in their ability to manage and provide care helped the caregivers respond to stressors with purpose and sustain their roles and responsibilities. Enhancing grit in long-term dementia caregivers may result in better individual and relational outcomes.
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    Reduction of Risk Factors for ACL Re-injuries using an Innovative Biofeedback Approach: Rationale and Design
    Queen, Robin M.; Peebles, Alexander T.; Miller, Thomas K.; Savla, Jyoti S.; Ollendick, Thomas H.; Messier, Stephen P.; Williams, DS Blaise III (Elsevier, 2021-06)
    Nearly 1 in 60 adolescent athletes will suffer anterior cruciate ligament (ACL) injuries with 90% of these athletes electing to undergo an ACL reconstruction (ACLR) at an estimated annual cost of $3 billion. While ACLR and subsequent rehabilitation allow these athletes to return to sports, they have a 15-fold increased risk of second ACL injuries. The modification of post-operative rehabilitation to improve movement and loading symmetry using visual and tactile biofeedback could decrease the risk factors for sustaining a second ACL injury. Participants included 40 adolescent ACLR patients who were intending to return to full sport participation. This preliminary randomized controlled trial (RCT) examined the changes in knee extension moment symmetry, a known risk factor for second ACL injuries, during landing from a stop-jump task between the following time-points: pre-intervention, immediate post-intervention, and subsequent follow-up 6-weeks post-intervention. Participants met twice per week for six-weeks (12-session). The intervention included bilateral squat biofeedback (visual and tactile); the attention control group attended weekly educational sessions. This RCT enrolled and randomize 40 participants over a two-and-a-half-year period. All participants were greater than 4.5 months post-op from a primary, unilateral ACLR and were released to participate by their treating physician. The findings from this pilot biofeedback RCT will provide critical effect size estimates for use in subsequent larger clinical trials.