| Description |
Physical therapy (PT) and secondary prevention programs (SPPs) are often prescribed as treatment for Parkinson's disease (PD). As there are presently no cures for PD, understanding key factors that contribute to rehabilitation engagement and patientcentered outcomes remains an important task. Guided by Social Cognitive Theory (SCT), the purpose of this dissertation was to examine the relevance of specific social cognitive variables in better understanding and predicting salient rehabilitation behaviors and patient-centered outcomes among individuals with PD. In study 1, semi-structured interviews were conducted with 10 PD patients attending an SPP in order to examine the characteristics of caring (a personal factor), as well as the potential implications of caring for the quality of their SPP experience and relevant outcomes. Inductive content analysis revealed four themes related to the characteristics of caring (showing interest, creating a supportive atmosphere, benevolence, and paying attention) and two themes related to implications of caring (rehabilitation attendance and rehabilitation effort). Findings from study 1 indicate that practitioners should strive to create caring climates within clinics by cultivating the aforementioned characteristics of caring. Building on study 1, the second study quantitatively examined potential relationships between caring, adherence (behavior), and a salient personal factor commonly assessed in PT/SPP settings, namely, quality of life. Study 2 also examined whether adherence mediated the caring climate/quality of life relationship. Surprisingly, no significant relationships or mediation iv was evident. Reasons for the nonsignificant relationships are explored in greater detail in the discussion section of study 2. Finally, the aim of study 3 was to further explore the value of SCT in explaining salient rehabilitation behaviors by exploring relationships between caring (environmental factor), tripartite efficacy (personal factor), and adherence (behavioral factor). Findings from study 3 included significant correlations between caring and adherence, adherence and tripartite efficacy, as well as tripartite efficacy and adherence. Although a multiple mediation analysis yielded nonsignificant results, further analysis using RISE as the sole mediator of the caring climate/adherence relationship resulted in a significant mediation model. Study 3 findings bolster qualitative results from study 1, indicating the positive benefits of a caring climate. In particular, practitioners should seek to create caring climates in order to promote increased perceptions of RISE and rehabilitation adherence. The concluding chapter offers theoretical and practical implications for all three studies. |
