Degree Name

DSN (Doctor of Science in Nursing)



Date of Award


Committee Chair or Co-Chairs

Jo-Ann Marrs

Committee Members

Joanne Walker Flowers, Judy McCook, Juliet Corbin, Tamera Pearson


The purpose of this descriptive correlational study was to examine the comeback phase of the Trajectory of Chronic Illness Management for Appalachian women stroke survivors. This study predicted comeback as a relationship between physical healing, biographical reengagement, and psychological coming to terms that was mediated by rehabilitation.

The concepts were evaluated through investigation of function and cognitive abilities, self-assessment of recovery, health rating, ability to control life, relationship changes, physical and mental health, and limitations of activities due to poor physical or mental health. Data were collected using, the Stroke Impact Scale (3.0) (Duncan, Bode, Lia, & Perera, 2003), the Relationship Change Scale (Guerney, 1971), and the Health-Related-Quality-of-Life-4 Scale (Morarity, Zack, & Kobau, 2003). Descriptive statistics summarized patient characteristics. Continuous variables were analyzed using bivariate relationships expressed as Pearson correlation coefficients. The difference between groups (stroke severity and stroke type) and measurement variables were analyzed using independent ttest and ANOVA. Multiple linear regressions were completed to evaluate simultaneous effects of the independent variables.

Forty-six English-speaking, Caucasian women ages 40-78 who had experienced stroke at least 1 year prior to enrollment and were independently living in their home environment participated. The mean age was 57 years with survivorship ranging from 1 to 36 years. Function and cognition scores were similar to the established test range for the SIS V 3.0. Women with moderate ischemic stroke scored statistically higher for recovery score (p

Study findings suggest comeback can be predicted by the theoretical propositions of the Trajectory Theory of Chronic Illness Management: physical healing, biographical reengagement, and psychologically coming to terms (Corbin & Strauss, 1991). A strong relationship exists among the phases representative of comeback, while rehabilitation procedures and interpersonal relationships demonstrated only modest significance.

Document Type

Dissertation - unrestricted


Copyright by the authors.

Included in

Nursing Commons