Files and links (1)
Thomas_AB_Dissertation_Final_0725241.50 MB
Embargoed Access, Embargo ends: 10/11/2026
Dissertation
Evaluating Care Quality and Research Barriers in People with Neurological Impairments
Washington State University
Doctor of Philosophy (PhD), Washington State University
07/2024
DOI:
https://doi.org/10.7273/000007096
Abstract
A growing number of individuals in the US are affected by neurological disorders, with considerable disparities in the burden and trends of these disorders across different patient populations. Stroke and Alzheimer's disease and related dementias (ADRD) are two neurological disorders with the greatest disease burden in the United States. The increasing population of older adults in the US presents a significant public health challenge, as both stroke and ADRD
risk increases with age. Complexities in this challenge require inclusive and accessible solutions for individuals and communities affected by stroke sequelae and ADRD. Further, barriers within the healthcare delivery system impact outcomes and can leave individuals and their families unprepared to manage these chronic conditions. This dissertation consists of three manuscripts exploring structural and systemic barriers in clinical practice and research for stroke and ADRD populations by examining (1) the impact of a post-stroke aphasia diagnosis on the quality of healthcare received from the perspective of the individuals who experience aphasia and those who care for them, and (2) the psychometric performance of the NIH Toolbox Cognition Battery (NIHTB-CB) in older adult populations, specifically focusing on the applicability of utilizing the NIHTB-CB in ADRD and cognitively impaired populations. Manuscript 1 is a Principle-Based Concept Analysis of the use of Supported Conversation for Adults with Aphasia framed within the discipline of nursing. Manuscript 2 is a qualitative descriptive study to understand the barriers and facilitators of communicative access and care transition success for persons with post-stroke aphasia. Manuscript 3 reports findings of a systematic review evaluating the reliability and validity of the NIHTB-CB in older adults. This dissertation project identifies the current barriers to clinical care and research affecting individuals and communities living with stroke sequelae and ADRD, as well as the magnitude of the gap caused by these barriers.
Metrics
19 Record Views
Details
- Title
- Evaluating Care Quality and Research Barriers in People with Neurological Impairments
- Creators
- Amy B. Thomas
- Contributors
- Celestina Barbosa-Leiker (Chair)Catherine Van Son (Committee Member)Lonnie Nelson (Committee Member)Gerasimos Fergadiotis (Committee Member)
- Awarding Institution
- Washington State University
- Academic Unit
- College of Nursing
- Theses and Dissertations
- Doctor of Philosophy (PhD), Washington State University
- Publisher
- Washington State University
- Number of pages
- 190
- Identifiers
- 99901152540301842
- Language
- English
- Resource Type
- Dissertation