Semester

Spring

Date of Graduation

2019

Document Type

Dissertation

Degree Type

PhD

College

School of Nursing

Department

Not Listed

Committee Chair

Georgia L. Narsavage

Committee Co-Chair

Barbara L. Nunley

Committee Member

Barbara L. Nunley

Committee Member

Marilyn Smith

Committee Member

Eric Rankin

Committee Member

Shirley M. Neitch

Abstract

Abstract

Background: The purpose of this current study was to explain factors most strongly associated with Caregiver (CG) of Person with Dementia (PWD) non-use of formal and informal services in Appalachia.

Methods: A correlational explanatory design using validated self-report surveys was used to explain the association of the substructed Andersen’s Behavioral Model for Health Services Use in Appalachian CG non-use of formal and informal services. Data were analyzed using descriptive statistics and ANOVA tests considering eight independent variables in total from each research question, using a sample of 43 CG/CR dyads.

Results: The analyses of four research questions suggested: 1) Data supported the Social Provisions Scale (SPS) explained 8.3% of variance for the Non-Use of Services (Adjusted R2 0.83 - 8.3%); 2) Data supported Caregiving Service Availability explained 11.7% of the variance for Non-Use of Services (Adjusted R2 0.117 - 11.7%); 3) Evaluated Need, a calculated variable that included the health care provider recommending services for the PWD explained 7.9% of the variance for Non-Use of Services (Adjusted R2 0.079 - 7.9%); 4) Non-use of services final regression analysis entering the three significant variables of the SPS, Caregiving Service Availability, and Evaluated Need explained 40% of non-use of services. A theory-based forced-entry logistic regression on a dichotomous variable found the same variables significant, although linear regression offered more explanatory strength.

Implications: To reduce non-use of services, more caregiving support services need to be available and health care providers’ recommendation to use support services would be helpful for CGs of PWD.

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