Alexa K Stuifbergen

University of Texas at Austin, Texas City, TX, United States

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Publications (28)30.77 Total impact

  • [show abstract] [hide abstract]
    ABSTRACT: Objective: To explore the feasibility and effects of a computer-assisted cognitive rehabilitation intervention - Memory, Attention, and Problem Solving Skills for Persons with Multiple Sclerosis (MAPSS-MS) - for persons with multiple sclerosis on cognitive performance, memory strategy use, self-efficacy for control of symptoms and neuropsychological competence in activities of daily living (ADL). Design: A randomized controlled single-blinded trial with treatment and wait list control groups. Setting: Southwestern United States. Subjects: Convenience sample of 61 persons (34 treatment, 27 wait list control) with multiple sclerosis (mean age 47.9 years, SD 8.8). Intervention: The eight-week MAPSS-MS intervention program included two components: (a) eight weekly group sessions focused on building efficacy for use of cognitive compensatory strategies and (b) a computer-assisted cognitive rehabilitation program with home-based training. Outcome measures: A neuropsychological battery of performance tests comprising the Minimal Assessment of Cognitive Function in Multiple Sclerosis (MACFIMS) and self-report instruments (use of memory strategies, self-efficacy for control of multiple sclerosis and neuropsychological competence in ADL) were completed at baseline, two months (after classes), and at five months. Results: Both groups improved significantly (P < 0.05) over time on most measures in the MACFIMS battery as well as the measures of strategy use and neuropsychological competence in ADL. There was a significant group-by-time interaction for scores on the measures of verbal memory and the use of compensatory strategies. Conclusions: The MAPSS-MS intervention was feasible and well-accepted by participants. Given the large relative increase in use of compensatory strategies by the intervention group, it holds promise for enhancing cognitive function in persons with multiple sclerosis.
    Clinical Rehabilitation 02/2012; 26(10):882-93. · 2.19 Impact Factor
  • Alexa K Stuifbergen, Tracie Culp Harrison
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    ABSTRACT: Use of complementary and alternative therapies (CATs) is common with both the general population and with people who have multiple sclerosis (MS). The purpose of this study was to describe the reported use and perceived effectiveness of different CATs in a large sample (N = 621) of people with MS. One-third of the participants reported that they were presently using one or more CATs, and 50% had tried one or more CATs in the past. Most CATs were perceived as being helpful. People who were presently using CATs differed little from those who were not with regard to demographic- and illness-related variables. Use of CATs was positively associated with the practice of other health-promoting behaviors. The frequent use of different CATs suggests that clinicians should systematically and nonjudgmentally inquire about CAT use among their patients.
    Rehabilitation nursing: the official journal of the Association of Rehabilitation Nurses 01/2012; 28(5):141-7, 158. · 0.78 Impact Factor
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    ABSTRACT: Persons living with the effects of chronic and disabling conditions are often at increased risk for the development of secondary conditions and disabilities that can lead to further decline in health status, independence, functional status, life satisfaction, and overall quality of life. The purpose of this study was to review the evidence for the benefits of wellness/health promotion interventions for persons with chronic and disabling conditions. The authors conducted a Medline search (1990-2007) using terms related to wellness and health promotion cross-referenced with general terms for chronic and disabling conditions, as well as 15 specific chronic and/or disabling conditions (e.g., multiple sclerosis, spinal cord injury). Selection of studies was limited to those published in English that reported randomized controlled trails or prospective studies that involved adult human subjects with a chronic and/or disabling condition. All selected studies focused on some aspect of a wellness or health promotion intervention and involved a comparison or control group. Of the 5,847 studies initially identified in the search using medical subject heading terms, 190 met the criteria for full review. Data were extracted from these publications and summarized using descriptive statistics. Almost all studies (95%) explored the effects of wellness intervention in a sample diagnosed with a single condition (e.g., cancer, stroke, arthritis). Although the mean sample size was 100, the range in sample size varied widely (6-688); 25% of the studies had sample of 30 or fewer. Almost all studies (89.5%) reported positive effects of the wellness intervention, although the delivery and content of interventions as well as the measurement of outcomes, varied greatly. Our findings support an immediate post-intervention positive impact of wellness interventions across persons with a wide variety of chronic and disabling conditions. Future research that clearly specifies primary study outcomes and follows the CONSORT guidelines will strengthen future reviews of the evidence and facilitate application of the evidence of practice.
    Disability and Health Journal 07/2010; 3(3):133-45. · 1.45 Impact Factor
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    ABSTRACT: To examine the effects of a wellness intervention, Lifestyle Counts, for women with fibromyalgia syndrome on the level of self-efficacy for health-promoting behaviours, health-promoting activity and perceived quality of life. A randomized controlled single-blinded trial with treatment and attention-control groups. Community in the southwestern United States. Convenience sample of 187 women (98 treatment, 89 attention control) with fibromyalgia syndrome (mean age = 53.08 years, SD 9.86). The two-phase Lifestyle Counts intervention programme included lifestyle change classes for eight weeks, with goal-setting and telephone follow-up for three months. Participants in the attention-control group were offered an equivalent amount of contact in classes on general disease-related information and health education topics and unstructured follow-up phone calls. Participants were followed for a total of eight months after baseline. Self-report instruments measuring self-efficacy for health behaviours, health-promotion behaviours and health-related quality of life (SF-36 and the Fibromyalgia Impact Questionnaire) were completed at baseline, two months (after the classes), five months (after telephone follow-up) and at eight months. Both groups improved significantly (P<0.05) over time on the measures of self-efficacy, health behaviours, fibromyalgia impact and quality of life. There were significant group x time interactions for scores on the Health Promoting Lifestyle II subscales of physical activity and stress management. The Lifestyle Counts wellness intervention holds promise for improving health-promoting behaviours and quality of life of women with fibromyalgia syndrome.
    Clinical Rehabilitation 04/2010; 24(4):305-18. · 2.19 Impact Factor
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    Diana Pierini, Alexa K Stuifbergen
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    ABSTRACT: Depression is a serious comorbidity in people with disabilities; however, few studies have focused on depressive symptoms in older adults with post-polio syndrome (PPS). This study used a resilience conceptual framework that focused on patient psychosocial strengths to investigate the relationship between psychological resilience factors (e.g., acceptance, self-efficacy, personal resources, interpersonal relationships, self-rated health, spiritual growth, stress management) and depressive symptoms in a large sample (N = 630) of people older than 65 years who were diagnosed with PPS. Forty percent of the sample scored > or = 10 on the Center for Epidemiologic Studies Short Depression Scale (CES-D10), which is a higher percentage than what has been previously cited in other studies; however, 53% of the sample had good or excellent self-rated health, suggesting psychological resilience. Depression scores were regressed on seven selected resilience factors after controlling for functional limitations. Four of the seven variables accounted for 30% of the variance in depressive symptoms, with spiritual growth representing the main predictor (beta = -.26). The implications for rehabilitation nurses in developing a patient-strengths perspective in the assessment and counseling of older adults with PPS are discussed.
    Rehabilitation nursing: the official journal of the Association of Rehabilitation Nurses 01/2010; 35(4):167-75. · 0.78 Impact Factor
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    Heather Becker, Alexa K Stuifbergen, Sharon L Dormire
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    ABSTRACT: Deciding about hormone therapy (HT) use is particularly complex for women with mobility impairments. While HT controls menopausal symptoms, the potential increased risk of blood clots resulting from physical inactivity can contraindicate HT use. These women, therefore, may benefit from interventions to help them tailor standard information about HT. We randomly assigned women to receive either a tailored decision support intervention or standard menopausal information. Both groups (n = 176) significantly decreased their decisional conflict and uncertainty and increased knowledge after receiving the treatment materials. We interpret the findings in the context of limited medical information about HT for women with disabilities.
    Health Care For Women International 10/2009; 30(9):845-54. · 0.63 Impact Factor
  • Claudia C Beal, Alexa K Stuifbergen, Adama Brown
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    ABSTRACT: The purpose of this study was to describe the health practices of women with fibromyalgia syndrome (FMS) and the predictors of an overall health promoting lifestyle in these individuals. The predictors of a health promoting lifestyle examined in this study were barriers, social support, self-efficacy, demographic characteristics and illness factors. The sample consisted of 198 women who participated in a randomised clinical trial to test the effectiveness of a health promotion intervention for women with FMS. The women in this sample engaged most frequently in health practices in the domains of interpersonal relations and spiritual growth and least frequently in the domain of physical activity. Self-efficacy and social support were significant predictors of an overall health promoting lifestyle.
    Psychology Health and Medicine 06/2009; 14(3):343-53. · 1.38 Impact Factor
  • Lorraine J Phillips, Alexa K Stuifbergen
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    ABSTRACT: Structural equation modeling (SEM), a popular statistical technique for analysis of multivariate data in the social sciences, is increasingly being used in the behavioral and clinical sciences. SEM is appropriate for posing complex models that evaluate the direct and indirect influence of several variables on one or more outcome variables. A biosocial model of disability, the Disablement Process Model, lends itself to evaluation by SEM. Using SEM, this study examined predictors of disability (Age, Education, Duration of Illness, and Economic Adequacy Functional Limitations, Depressive Symptoms, and Social Support) separately in women with multiple sclerosis (MS) and women with fibromyalgia syndrome (FMS) and compared the respective models across groups. Data were analyzed with Analysis of Moment Structures (Amos) 7.0. Problems identified in initial confirmatory model testing included collateral correlated errors, a negative error variance, and poor performance of the disability indicators. After specifying well-fitting confirmatory models for each group, a structural model for the larger FMS group was estimated. Model refinement resulted in the reversal of the path between Depressive Symptoms and Social Support. Further model revisions were based on comparative fit statistics and theoretical logic. The structural model developed from the FMS sample required minimal changes to fit the MS sample. The multisample model explained greater variance in disability in women with FMS than in women with MS. Social support and depressive symptoms mediated the effect of functional limitations on disability. Interventions that target modifiable characteristics, such as depression and social support, may improve outcomes such as disability.
    Western Journal of Nursing Research 03/2009; 31(1):89-109. · 1.22 Impact Factor
  • Lorraine J Phillips, Alexa K Stuifbergen
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    ABSTRACT: This correlational study determined the extent to which positive, rather than negative, experiences influence depressive symptoms and quality of life in persons with multiple sclerosis (MS). Data collected during the 7th year of an ongoing longitudinal study of quality of life in community-dwelling persons with MS were used for this analysis. Higher number of positive experiences was associated with fewer depressive symptoms, less functional limitations, and better quality of life. Using hierarchical multiple regression, age, education, functional limitations, and positive experiences accounted for 21.7% of the variance in depressive symptoms, and functional limitations, positive experiences, and depressive symptoms explained 58% of the variance in quality of life. Higher number of positive experiences predicted lower levels of depressive symptoms, even while taking disease-related functional limitations into account. Incorporating positive experiences into daily life may improve quality of life, even when battling depression and substantial limitations in functioning.
    Journal of Holistic Nursing 04/2008; 26(1):41-8.
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    Claudia C Beal, Alexa K Stuifbergen, Adama Brown
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    ABSTRACT: High rates of depression have been documented in persons with multiple sclerosis (MS), but few studies have examined depression over time. This analysis considered data from 607 persons with MS in a 7-year period as part of an ongoing longitudinal study of quality of life in chronic illness. Latent growth curve analysis was used to examine trajectories in depression and the effects of covariates such as age, time since diagnosis of MS, type of MS, and functional limitations on the extent to which depression changed in the study period. Results of the analysis indicated that depressive symptoms fluctuated over time for individuals but did not show a tendency to an overall significant increase or decrease for the group as a whole. Younger age, longer time since diagnosis of MS, progressive forms of MS, and greater extent of functional limitation were predictive of greater depressive symptoms at Time 1. With the exception of functional limitation, which showed an association with depression at all periods, these variables did not predict changes in depressive symptoms over time. Gender was not a significant predictor of changes in depressive symptoms, nor did women have higher rates of depression as expected from previous research. The results of this analysis indicate the importance of screening for depression in all persons with MS.
    Archives of Psychiatric Nursing 09/2007; 21(4):181-91. · 0.92 Impact Factor
  • Lorraine J Phillips, Alexa K Stuifbergen
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    ABSTRACT: This study examined the influence of metamemory (i.e., self-report of memory ability and skills), in combination with other factors, on quality of life for people with multiple sclerosis (MS). Participants (482 persons with MS) completed instruments to measure functional limitations, depressive symptoms, metamemory, and perceived quality of life. Participants reported greater satisfaction with their memory performance but less frequent use of memory aids and strategies compared with 115 older adults on whom the instrument was originally tested. Components of metamemory were significantly related to neurological disability, duration of disease, depressive symptoms, age, and quality of life. Depressive symptoms had a higher impact than other variables in the final regression model on quality-of-life prediction.
    Journal of Neuroscience Nursing 01/2007; 38(6):428-34. · 0.76 Impact Factor
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    ABSTRACT: To explore the trajectories of functional limitations, health behaviors (exercise), and quality of life (QOL) and their interrelations over a 5-year time period in a sample of persons with multiple sclerosis (MS). Descriptive longitudinal survey study. Southwestern United States. Convenience sample of 611 people with MS (mean age at time 1, 49.4y). Ninety percent of the participants remained enrolled in the study. Response rates at each annual data collection ranged from 85% to 90% of eligible participants. Not applicable. A series of self-report instruments to measure functional limitations, exercise behaviors, and QOL were completed annually over a 5-year period. Using multivariate latent curve modeling techniques, rates of change in functional limitations correlated negatively with rates of exercise behaviors and QOL ratings. The level of exercise behaviors at time 1 and rate of change in functional limitations were negatively related-suggesting that higher exercise levels at time 1 were related to slower accumulation of functional limitations over time. Data analysis methods that allow examination of both the individual and group level of change are particularly appropriate when examining trajectories of change in persons with MS because of the highly individualized progression and presentation of the disease. Findings of this descriptive longitudinal study support the potential positive impact of exercise on the long-term progression of functional limitation and QOL for persons with MS.
    Archives of Physical Medicine and Rehabilitation 08/2006; 87(7):935-43. · 2.36 Impact Factor
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    ABSTRACT: Although previous studies have examined selected factors influencing health promoting behaviors or quality of life, the complex interplay of these variables in persons with different chronic disabling conditions has not been investigated. This study tested an explanatory model of variables influencing health promotion and quality of life originally developed with a sample of persons with multiple sclerosis in a new sample of persons living with post-polio syndrome (PPS) in the USA. The sample of 1603 persons with PPS (1123 females, 478 males and 2 unknown) completed a battery of instruments including measures of severity of polio-related impairment, barriers to health promoting behaviors, resources, self-efficacy, acceptance, health promoting behaviors and perceived quality of life. A model originally developed in a sample of 786 persons with multiple sclerosis was assessed and modified using the weighted least squares procedure (WLS) which is implemented by LISREL8. The structural equation analyses resulted in a proper solution that exhibited adequate fit: chi2 (8, N = 1549)=84.22, p<0.05; GFI=0.96, IFI=0.90, CFI=0.90. The antecedent variables accounted for 65% of the variance in the frequency of health promoting behaviors and 53% of the variance in perceived quality of life. The model test supports the hypothesis that quality of life is the outcome of a complex interplay between contextual factors (severity of impairment), antecedent variables, and health promoting behaviors. It also suggests that the relationships among these variables are similar in samples of persons with two different chronic conditions. Further research using a qualitative approach is needed to clarify other contributors to quality of life in persons with post-polio syndrome.
    Social Science [?] Medicine 01/2005; 60(2):383-93. · 2.73 Impact Factor
  • Hsueh-Fen S Kao, Alexa K Stuifbergen
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    ABSTRACT: This study aims to describe the meaning of the experience of the relationship between young adult traumatic brain injury (TBI) survivors and their mothers using a phenomenological approach. Informants included 9 males and 3 females who were at least 2 years post-TBI, and their mothers, who were their primary caregivers after the injury. TBI informants were 18 to 25 years of age, had motor vehicle accident-induced injury, experienced post-traumatic amnesia longer than 24 hours, and were able to participate in a verbal interview. In addition, all informants currently were living with their mothers, who also participated in this study. Survivors acquired the sense of being abnormal from various sources, including social pressures, dynamics within the family, and intrapersonal changes. Mothers adopted both positive and negative actions during the period of uncertainty and often struggled to balance protecting their children and letting them become independent. They also struggled to maintain harmonious relationships with people both inside and outside of the family. Sometimes, survivors' parents marital relationships were at risk. Health professionals should design more appropriate long-term community interventions to help TBI survivors and their families decrease the burden of injury and the resulting stress, increase survivors' self-esteem, and improve quality of life of both survivors and their families, serving as a foundation for further TBI care.
    Journal of Neuroscience Nursing 05/2004; 36(2):73-81. · 0.76 Impact Factor
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    ABSTRACT: Women with chronic disabling conditions live with multiple symptoms that decrease their ability to function in society, and they may be at elevated risk for further morbidity with age. Despite research indicating that health-promoting behaviors decrease the risk for further morbidity, few interventions have been designed to help women with chronic disabling conditions promote their health. The purpose of this article is to present the results of a pilot study of a wellness intervention adapted for use with women with fibromyalgia syndrome (FMS). First, the development of the original wellness intervention for women with multiple sclerosis (MS) will be described. Next, the steps taken to adapt the intervention to the needs of women with FMS will be described. Finally, it wil be argued that commonalities in symptoms and social experiences and the universal need for health-promoting skills make this intervention adaptable to multiple groups of women with chronic disabling conditions.
    Journal of Holistic Nursing 04/2004; 22(1):12-31.
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    ABSTRACT: Setting goals is a useful strategy for changing behavior. The purpose of this study was to examine the effectiveness of a wellness intervention for women with multiple sclerosis (MS) on achieving health-related goals set individually by each participant in the experimental group (N = 57) using goal attainment scaling. The two-phase intervention included lifestyle-change classes over 8 weeks, then telephone follow-up over 3 months. Participants were followed over an 8-month period. Goal achievement was assessed at baseline, 2 months (following class), 3 1/2 months (6 weeks after class), 5 months (following 3 months of telephone follow-up), and at 8 months. The majority of the women met or exceeded all their individualized goals for changing behavior at the 6-week postclass assessment. Achievement and maintenance of individual goals remained high (59%-84%) over the 5 months after class follow-ups. These data support the positive effects of wellness interventions for helping women with MS to meet their own individualized health goals. Setting goals with incremental steps helped participants to articulate their individual goals and monitor achievement over time.
    Journal of Neuroscience Nursing 05/2003; 35(2):94-9, 106. · 0.76 Impact Factor
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    ABSTRACT: To examine the effects of a wellness intervention program for women with multiple sclerosis (MS) on health behaviors and quality of life (QOL). Randomized clinical trial. Community setting in the southwestern United States. Convenience sample of 113 women with physician-confirmed MS (mean age, 45.79y). The 2-phase intervention program included lifestyle-change classes for 8 weeks, then telephone follow-up for 3 months. Participants were followed over an 8-month period. A series of self-report instruments to measure barriers, resources, self-efficacy for health behaviors, health promotion behaviors, and health-related QOL were completed at baseline, 2 months (after the classes), 5 months (after telephone follow-up), and at 8 months. Principal outcomes measures were health-promoting behaviors (scores on the Health Promoting Lifestyle Profile II) and QOL (scores on the Medical Outcomes Study 36-Item Short-Form Health Survey [SF-36] scales). Hierarchical linear modeling techniques revealed a statistically significant group by time effect for self-efficacy for health behaviors, health-promoting behaviors, and the mental health and pain scales of the SF-36. These data provide initial support for the positive effects of wellness interventions to improve health behaviors and selected dimensions of QOL for women with MS.
    Archives of Physical Medicine and Rehabilitation 05/2003; 84(4):467-76. · 2.36 Impact Factor
  • Heather Becker, Alexa K Stuifbergen, Dorothy Gordon
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    ABSTRACT: Whereas making decisions during menopause can be challenging for all women, those with physical impairments face special issues with respect to menopause in general and hormone replacement therapy (HRT) in particular. In this correlational study the authors explored the factors such women consider when making decisions about HRT One hundred sixty-seven women with physical impairments throughout the United States completed surveys concerning their attitudes and knowledge about HRT Approximately half the menopausal women were currently taking HRT The strongest predictor of HRT use was women's perceptions of their health care providers opinions about their taking HRT, combined with their motivation to comply with the provider's recommendation. Thisfinding points to the significant role that nurses and other health care providers play in assisting women to make informed health care choices during menopause.
    Western Journal of Nursing Research 05/2002; 24(3):264-81. · 1.22 Impact Factor
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    Reflections on nursing leadership / Sigma Theta Tau International, Honor Society of Nursing 02/2002; 28(4):34-7.
  • Heather Becker, Alexa K Stuifbergen, Dorothy Gordon
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    ABSTRACT: This study describes the menopausal experiences of women with physical disabilities and their knowledge and use of hormone replacement therapy (HRT). 166 women completed a mailed survey of demographic and disability characteristics, health history, menopausal information, and HRT knowledge. The typical respondent was a 52-year-old, Anglo, college-educated woman with a neuromuscular disorder. Half of the menopausal women were taking HRT, and 47% had a hysterectomy. HRT use was significantly associated with hysterectomy status, amount of HRT information received from providers, and regular gynecologic examinations. Effective interventions are needed to assist these women in making key health decisions during menopause.
    Women s Health Issues 01/2002; 12(4):212-9. · 1.61 Impact Factor

Publication Stats

231 Citations
184 Downloads
1k Views
30.77 Total Impact Points

Institutions

  • 2003–2012
    • University of Texas at Austin
      • School of Nursing
      Texas City, TX, United States
  • 2008–2009
    • University of Missouri
      Columbia, Missouri, United States
  • 2004
    • University of North Carolina at Charlotte
      • School of Nursing
      Charlotte, NC, United States