Degree

Doctor of Philosophy (PhD)

Department

Psychology

Document Type

Dissertation

Abstract

Cognitive compensatory strategies (e.g., use of lists, calendars, organizational tools) are important in helping individuals with neurological conditions adapt to longstanding cognitive challenges. Although the independent use of these strategies is an important goal of neurorehabilitation programs, adherence to them in daily life after discharge is often not tracked. The current study sought to use the Health Action Process Approach (HAPA) to assess adherence to compensatory strategies and the daily-life contextual factors that influence adherence.

Fifty-one adults with neurological conditions (e.g., traumatic brain injury, stroke, epilepsy) who were prescribed compensatory strategies by a healthcare provider were recruited. Participants completed 2, 20-minute phone calls 2 to 4 weeks apart assessing HAPA motivational (e.g., outcome expectancies, intentions to adhere) and volitional phase variables (e.g., recovery self-efficacy, daily barriers, adherence), depression symptoms, perceived social support, demographics, and rehabilitation outcome variables (e.g., quality of life, everyday functioning). Exploratory analyses were conducted using Pearson’s correlations and independent samples t-tests, while multiple linear regression was used to evaluate predictive validity of variables with robust relationships across both HAPA phases, and to examine associations between adherence and rehabilitation outcomes.

Exploratory analyses revealed that outcome expectancies and action self-efficacy were significantly related to intentions to adhere while memory barriers, intentions to adhere, and recovery self-efficacy were related to better adherence. Depression symptoms, social support, and demographics were not significantly related. In terms of predictive validity, multiple linear regression revealed only outcome expectancies were independently associated with intentions to adherence while memory barriers, intentions to adhere, and recovery self-efficacy were independently associated with adherence. Adherence was not associated with any rehabilitation outcome variable.

The current study’s findings support the validity of the HAPA model for tracking adherence to cognitive compensatory strategies and its clinical utility as a brief, repeatable, and clinically actionable framework to support adjustment to chronic cognitive difficulties. Future research should explore the clinical implementation of this framework in neurorehabilitation.

Date

7-16-2026

Committee Chair

Calamia, Matthew R.

LSU Acknowledgement

1

LSU Accessibility Acknowledgment

1

Download

Available for download on Monday, July 16, 2029

Share

COinS