Theses and dissertations

This collection includes both ASU Theses and Dissertations, submitted by graduate students, and the Barrett, Honors College theses submitted by undergraduate students. 

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Role of cognitive shift in resilient adaptation to difficult events

Description
Sometimes difficult life events challenge our existing resources in such a way that routinized responses are inadequate to handle the challenge. Some individuals will persist in habitual, automatic behavior, regardless of environmental cues that indicate a mismatch between coping strategy and the demands of the stressor. Other individuals will marshal…

Sometimes difficult life events challenge our existing resources in such a way that routinized responses are inadequate to handle the challenge. Some individuals will persist in habitual, automatic behavior, regardless of environmental cues that indicate a mismatch between coping strategy and the demands of the stressor. Other individuals will marshal adaptive resources to construct new courses of action and reconceptualize the problem, associated goals and/or values. A mixed methods approach was used to describe and operationalize cognitive shift, a relatively unexplored construct in existing literature. The study was conducted using secondary data from a parent multi-year cross-sectional study of resilience with eight hundred mid-aged adults from the Phoenix metro area. Semi-structured telephone interviews were analyzed using a purposive sample (n=136) chosen by type of life event. Participants' beliefs, assumptions, and experiences were examined to understand how they shaped adaptation to adversity. An adaptive mechanism, "cognitive shift," was theorized as the transition from automatic coping to effortful cognitive processes aimed at novel resolution of issues. Aims included understanding when and how cognitive shift emerges and manifests. Cognitive shift was scored as a binary variable and triangulated through correlational and logistic regression analyses. Interaction effects revealed that positive personality attributes influence cognitive shift most when people suffered early adversity. This finding indicates that a certain complexity, self-awareness and flexibility of mind may lead to a greater capacity to find meaning in adversity. This work bridges an acknowledged gap in literature and provides new insights into resilience.
ContributorsRivers, Crystal T (Author) / Zautra, Alex (Thesis advisor) / Davis, Mary (Committee member) / Kurpius, Sharon (Committee member) / Arizona State University (Publisher)
Created2014
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Understanding adaptive behaviors in complex clinical environments

Description
Critical care environments are complex in nature. Fluctuating team dynamics and the plethora of technology and equipment create unforeseen demands on clinicians. Such environments become chaotic very quickly due to the chronic exposure to unpredictable clusters of events. In order to cope with this complexity, clinicians tend to develop ad-hoc…

Critical care environments are complex in nature. Fluctuating team dynamics and the plethora of technology and equipment create unforeseen demands on clinicians. Such environments become chaotic very quickly due to the chronic exposure to unpredictable clusters of events. In order to cope with this complexity, clinicians tend to develop ad-hoc adaptations to function in an effective manner. It is these adaptations or "deviations" from expected behaviors that provide insight into the processes that shape the overall behavior of the complex system. The research described in this manuscript examines the cognitive basis of clinicians' adaptive mechanisms and presents a methodology for studying the same. Examining interactions in complex systems is difficult due to the disassociation between the nature of the environment and the tools available to analyze underlying processes. In this work, the use of a mixed methodology framework to study trauma critical care, a complex environment, is presented. The hybrid framework supplements existing methods of data collection (qualitative observations) with quantitative methods (use of electronic tags) to capture activities in the complex system. Quantitative models of activities (using Hidden Markov Modeling) and theoretical models of deviations were developed to support this mixed methodology framework. The quantitative activity models developed were tested with a set of fifteen simulated activities that represent workflow in trauma care. A mean recognition rate of 87.5% was obtained in automatically recognizing activities. Theoretical models, on the other hand, were developed using field observations of 30 trauma cases. The analysis of the classification schema (with substantial inter-rater reliability) and 161 deviations identified shows that expertise and role played by the clinician in the trauma team influences the nature of deviations made (p<0.01). The results shows that while expert clinicians deviate to innovate, deviations of novices often result in errors. Experts' flexibility and adaptiveness allow their deviations to generate innovative ideas, in particular when dynamic adjustments are required in complex situations. The findings suggest that while adherence to protocols and standards is important for novice practitioners to reduce medical errors and ensure patient safety, there is strong need for training novices in coping with complex situations as well.
ContributorsVankipuram, Mithra (Author) / Greenes, Robert A (Thesis advisor) / Patel, Vimla L. (Thesis advisor) / Petitti, Diana B. (Committee member) / Dinu, Valentin (Committee member) / Smith, Marshall L. (Committee member) / Arizona State University (Publisher)
Created2012