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CHAPTER 25 Helen C. Erickson, Evelyn M. Tomlin, and Mary Ann P. Swain 503

need for harmony (affiliation), and need for autonomy and evolving spiritual identity (Clayton, 2001), the
(individuation) were found when multidimensional quality of life of older adults with urinary inconti-
scaling was used to explore relationships among self- nence (Liang, 2008), and the human-environment
care knowledge, resources, and actions. The author relationship when healing from an episodic illness
concluded that a positive attitude was a major factor (Bowman, 1998).
when health-directed self-care actions were assessed Case study methods have shown relationships
(Rosenow, 1991). Physical activity in patients after among needs, attachment, and developmental resid-
myocardial infarction was shown to be affected by life ual needs (Kinney, 1990, 1992; Kinney & Erickson,
satisfaction (not physical condition); life satisfaction 1990) and coping (Jensen, 1995), and challenges in
was predicted by availability of self-care resources and the treatment of Factitious Disorder (Hagglund,
resources needed; and resources needed served as a 2009).
suppressor for resources available (Baas, 1992). In a Studies revealed relationships among mistrust and
sample of caregivers, social support predicted for stress length of stay in hospitalized subjects (Finch, 1990);
level and self-worth had an indirect effect on hope perceived enactment of autonomy, self-care, and
through self-worth (Irvin, 1993; Irvin & Acton, 1997), holistic health in older adults (Anschutz, 2000; Hertz
whereas persons with diabetes with spiritual well-being & Anschutz, 2002); perceived enactment of autonomy
were better able to cope (Landis, 1991). and self-care resources among senior center users
When the Modeling and Role-Modeling Theory was (Matsui & Capezuti, 2008) ; perceived enactment of
used as a guideline, interviews were used to determine autonomy, self-care, perceived support, control, and
the client’s model of the world. The following seven well being in older adults (Chen, 1996); perceived
themes emerged (Erickson, 1990a): enactment of autonomy and related sociodemo-
1. Cause of the problem, which was unique to the graphic factors among older adults (Hwang & Lin,
individual 2004); loss, morbid grief, and onset of symptoms
2. Related factors, also unique to the individual of Alzheimer’s disease (Erickson, Kinney, Becker,
3. Expectations for the future et al., 1994; Irvin & Acton, 1996); and basic needs
4. Types of perceived control satisfaction and health-promoting self-care behaviors
5. Affiliation in adults (Acton & Malathum, 2000).
6. Lack of affiliation Other studies addressed linkages between role-
7. Trust in the caregiver modeled interventions and outcomes (Erickson,
Each was unique and warranted individualized Kinney, Becker, et al., 1994; Hertz, 1991; Irvin, 1993;
interventions. Other qualitative research studies on Jensen, 1995; Kennedy, 1991, Lamb, 2005; Sung &Yu,
self-care knowledge showed that acutely ill patients 2006). University students who perceived satisfaction
perceived monitoring, caring, presence, touch, and of needs were more successful in school (Smith,
voice tones as comforting (Kennedy, 1991); healthy 1980), older adults who felt supported reported
adults sought need satisfaction from the nurse practi- higher need satisfaction and were better able to cope
tioner in primary care (Boodley, 1990, 1986); and (Keck, 1989), adolescent mothers who felt supported
hospice patients benefited from nurse empathy and perceived need satisfaction had a more positive
(Raudonis, 1991). Additional studies addressed the maternal-infant attachment (Erickson, M., 2006;
experience of persons 85 years of age and older as Erickson, 1996a, 1996b), those with a strong social
they manage their health (Beltz, 1999), the percep- network reported better health (Doornbos, 1983),
tions of hope in elementary school children (Baldwin, and persons convicted of sexual offenses who were
1996), the experiences and perceptions of mothers provided with support to remodel their worlds were
utilizing child health services in South Africa (Jonker, able to develop new behaviors and move on with their
2012), the experiential meaning of well-being and the lives (Scheela, 1991). Families and post–myocardial
lived experience of employed mothers (Weber, 1995, infarction patients who were able to participate in
1999), the meaning and impact of suffering in people planning their own care through contracting had less
with rheumatoid arthritis (Dildy, 1992), the relation- anxiety and better perceived control and perceived
ship between experiences of prolonged family suffering support (Holl, 1992). Caregivers of adults with