Date of Graduation


Document Type


Degree Type



School of Nursing


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



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.

Included in

Nursing Commons