Lequerica Doctoral Dissertations

ThD/PhD

Alban, Ary Fernandez (EM). Rethinking Theology in Revolution: A Critical Retrieval of Sergio Arce's Theological Work, its Legacy and Relevance for Re-Articulating Liberation Theologies in Cuba, Latin America, and the Caribbean. ThD/Th. Supervisor: Lee Cormie. Spring 2016.

Basumatary, Shyam Kumar (TR). Bodo Saori as a Resource for an Integrative Model of Christian Religious Education in a Postcolonial Perspective: A Subaltern Approach. PhD/P. Supervisor: Thomas Reynolds. Fall 2015.

Cho, Yongsoon (KN). Christian Education for Public Society: Based on Parker Palmer's Educational Theory. PhD/P. Supervisor: Nam Soon Song. Fall 2105.

Damnyag, Jerome (RG). Violence, the Cross and Social Transformation: Toward a Critical Appropriation of a Theology of Non-Violence for an African Context. PhD/Th. Supervisor: John Dadosky. Fall 2015.

Egger, John Andrew (EM). A Most Troublesome Text: Galatians 4:21-5:1 in the History of Interpretation. PhD/B. Supervisor: Leif Vaage. Fall 2015.

Ezenezi, Francis (RG). Contemporary Challenges For Vatican II’s Theology Of The Laity: The Nigerian Church Experience. PhD/Th. Supervisor: Jaroslav Skira. Fall 2015.

Fuyarchuk, Andrew (TR). Gadamer on the Inner Voice: Mediating Between the Humanities and Sciences. ThD/Th. Co-supervisors: Donald Wiebe and James DiCenso. Spring 2016.

Gauthier, Richard (TR). Turning Loss into Gain: Historical, Theoretical and Practical Approaches to Church Conversions, Guided by the Writings of Walter Benjamin. ThD/Th. Supervisor: Donald Wiebe. Spring 2016.

Maxwell, Drew (SM). Our Present Object: Dynamic and Powerful Eschatology alongside Dynamic and Powerful Political Ideology in the Historical Work of Eusebius and His Continuators. PhD/H. Co-supervisors: T. Allen Smith and Alan Hayes. Fall 2015.

Neufeld, Dane (WY). Scripture, Skepticism and the Character of God: The Theology of Henry Mansel. ThD/Th. Supervisor: Ephraim Radner. Spring 2016.

Ney, David Paul Aikins (WY). Scripture and Providence: The Hutchinsonian Quest to Save the Old Testament. ThD/Th. Supervisor: Ephraim Radner. Spring 2016.

Parkes, Stephen Herndon Persons (EM). My Word Shall Not Return to Me Empty: A Sacramental Homiletic of Appropriation and Action. ThD/P. Supervisor: Paul Wilson. Spring 2016.

Philipps, Kathleen (SM). Hospitality and Emerging Populations: Toward a Theology of Migration in the Context of the Catholic Church in the United States. PhD/Th. Supervisor: Thomas Reynolds. Fall 2015.

Ruso, Domenic (WY). Hermeneutical Themes in the Writings of Richard Hooker: The Complications of Sola Scriptura. PhD/Th. Supervisor: David Neelands. Fall 2015.

Schoon, Christopher (WY). Toward a Communally Embodied Gospel: Exploring the Role of Worship in Cultivating an Evangelistic Character among God's People within the Missional Church Movement. ThD/P. Co-supervisors: David Reed and John Bowen. Spring 2016.

Shaw, Charles Pierson (SM). Toward a Renewed Theology and Practice of Confirmation. PhD/Th. Supervisor: William Kervin. Fall 2015.

Walls, David (TR). The Influence of the Greek Fathers' Doctrine of Pneumatology and Theosis on John Wesley's Doctrine of Pneumatology and Perfection. PhD/Th. Supervisor: Ephraim Radner. Fall 2015.

Woodward, Andrew (TR). Scientific Models for Religious Knowledge: Is the Scientific Study of Religious Activity Compatible with a “Religious Epistemology”? ThD/Th. Supervisor: Donald Wiebe. Spring 2016.

Wright, Catherine Ann (RG). In the Darkness Grows the Green: The Promise of a New Cosmological Horizon of Meaning Within A Critical Inquiry of Human Suffering and the Cross. PhD/Th. Supervisor: Dennis O’Hara. Fall 2015.

DMin

Baldwin, Caroline Maureen (RG). Canadian Roman Catholic Young Adults Who Persevered In Faith. DMin. Supervisor: Joseph Schner. Fall 2015.

Barron, Andrew (WY). A Representation of the Beliefs, Experiences, and Ideals of a Group of Jewish People who Believe in Jesus. DMin. Supervisor: Victor Shepherd. Spring 2016.

Garbin, Jennifer Lynn (EM). The Missing Voice: Discovering the Alternative Faith Practice of Christian Emerging Adults in Canada. DMin. Supervisor: Brian Clarke. Spring 2016.

Jamieson, Anne (RG). Exploring the Ecclesial Identity of the Catechist through the Hermeneutic of "Full, Conscious, and Active Participation". DMin. Supervisor: John Dadosky. Fall 2015.

Kerrigan, Donna (EM). "What Language Shall I Borrow?": How a United Church Congregation Articulates its Choices from the 41st General Council's Recommendations Regarding Peacebuilding in Israel/Palestine. DMin. Supervisor: Pamela Couture. Spring 2016.

Ketelaars, Bernardine (SM). Harkening to the Voices of the “Lost Ones”: Attending to the Stories of Baptized Roman Catholics No Longer Participating in the Worship and Community Life of the Church. DMin. Co-supervisors: Jaroslav Skira and Michael Attridge. Fall 2015.

Leung, Rosa Yuk Chu (KN). The Spiritual Needs of the New Adult Believers at Valencia Chinese Alliance Church in Venezuela. DMin. Supervisor: Andrew Irvine. Spring 2016.

McMaster, John (KN). Scripture's Role in Discerning Theology in the United Church of Canada. DMin. Supervisor: Stuart Macdonald. Spring 2016.

VanderWal Gritter, Wendy (KN). Generous Spaciousness: Influencing the Experience of Participants in Dialogue on Same-Sex Marriage. DMin. Supervisor: Charles Fensham. Spring 2016.

Abstract

Occupational therapy after acquired brain injury (ABI) is an important part of a rehabilitation program, as it is designed to assess and aid patients in regaining independent functioning with activities of daily living (ADL; eating, toileting, etc.) and instrumental ADL (IADL). Engagement in therapy is a patient factor that can limit or enhance the benefits of occupational therapy. Therapy engagement refers to deliberate effort and commitment to working toward the goals of rehabilitation (Lequerica et al., 2006); it encompasses patient participation in rehabilitation activities, such as attendance and completion of prescribed exercises. Low engagement and failure to maximize therapy are associated with increased health costs and disability (Barello et al., 2012). Brain injury can disrupt cognition and emotions, resulting in apathy and low engagement (Lane-Brown & Tate, 2011). Unfortunately, few studies have examined the link between cognitive impairments and engagement in therapy; fewer still have examined this link with endpoints of functional outcome. An important gap in the knowledge base concerns how cognitive impairments associated with ABI disrupt engagement in therapy, and the extent to which this disruption undermines the benefits of rehabilitation therapy. Accordingly, this dissertation study examined neuropsychological predictors of functional outcomes after ABI, and the role of therapy engagement as a potential mediator for the relationship between neuropsychological performance and functional outcomes.

Method: Participants were 94 adults with medically-documented ABI recruited from three outpatient brain injury clinics at the beginning of occupational therapy. The participants (57% men) ranged from 18 to 82 in age with the majority (81%) having completed 12 or more years of education. Participants completed a comprehensive neuropsychological assessment at baseline. It included self-report surveys of emotional functioning and clinician-rated apathy. Occupational therapists (OTs) assessed functional independence and disability with the Barthel Index of ADLs (Mahoney & Barthel, 1965) and Lawton Instrumental Activities of Daily Living Scale (Lawton & Brody, 1969) at the initial intake and after the sixth session. OTs also rated the participants’ level of engagement in therapy after the sixth session using the Rehabilitation Therapy Engagement Scale (Lequerica et al., 2006).

Results: Education was related to functional outcomes (ADL and IADL), whereas age, gender, and estimated premorbid IQ were not. Multiple linear regressions demonstrated that neuropsychological performance was a significant predictor of functional outcomes and therapy engagement. Therapy engagement predicted functional outcomes and was found to mediate the relationship between neuropsychological performance and outcomes. An additional set of regressions showed that therapy engagement accounted for unique variance and served as a mediator for neuropsychological performance predicting outcomes, even after accounting for education, comorbid physical health status, emotional functioning, and apathy.

Conclusions: Engagement in therapy is a crucial characteristic in successful rehabilitation outcome. The findings support the hypothesis that cognitive deficits associated with ABI undermine full engagement in rehabilitation therapy, which in turn diminishes potential gains made in therapy and functional recovery. Neuropsychological assessment can enhance rehabilitation outcomes by identifying characteristics that underlie therapy engagement, which can ultimately be used to maximize the effectiveness of individualized treatment plans.

Recommended Citation

Williams, Michael W., "Neuropsychological Predictors Of Engagement In Rehabilitation Therapy And Functional Independence In Individuals With Acquired Brain Injuries" (2016). Wayne State University Dissertations. 1604.
https://digitalcommons.wayne.edu/oa_dissertations/1604

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