Date of Award
Fall 2014
Document Type
Dissertation
Degree Name
Doctor of Philosophy (PhD)
Department
Nursing
First Advisor
Bull, Margaret J.
Second Advisor
Topp, Robert
Third Advisor
Oswald, Debra
Abstract
Mild cognitive impairment (MCI) has an average prevalence of 18.9% and most often affects people 60 years of age or older. It is a cognitive stage between normal functioning and dementia (Petersen, 2003; Petersen, 2011; Petersen et al., 2014). MCI can be broken into two subtypes classified by the presence of memory impairment (amnestic MCI) or the lack thereof (nonamnestic MCI). Medical diagnostic criteria are commonly used to guide research with older adults with MCI. A theoretical framework that addresses the antecedents and consequences of MCI, specifically one examining the relationships among MCI, uncertainty, coping and psychological distress, is essential to guide the development of effective nursing interventions but is unapparent in published literature. The aims of this quantitative, cross-sectional study are to: (1) test select components of a new conceptual framework for MCI by examining the relationships among uncertainty, coping, psychological distress, time since diagnosis, and level of cognitive impairment from MCI; (2) describe the levels of uncertainty, coping, and psychological distress in persons with MCI; (3) examine the differences in scores on uncertainty, coping, and psychological distress between the two subtypes of MCI; and (4) examine the strength and direction of relationships between scores on uncertainty, coping, and psychological distress within the subtypes of MCI. The sample consisted of 91 primarily Caucasian (>85%) older adults receiving care at a neurology clinic, with a relatively even split between genders and MCI subtypes. Positive relationships were found between uncertainty, coping, and psychological distress, supporting the study framework. In addition, subjects reported low to moderate levels of uncertainty and psychological distress, and most often used emotion-focused coping strategies. Subjects with naMCI reported more somatic symptoms than those with aMCI (p<0.05); however, there were no significant relationships between the MCI subtypes or level of cognitive impairment on the other psychological distress subscales, coping instrument, or uncertainty instrument. The long-term goal of this study is to provide a foundation for a program of research centered on the development and evaluation of interventions to assist older adults who have a diagnosis of MCI and their family members with coping and managing their condition.