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A Descriptive Mixed-Methods Study Examining Resilience and Transitioning to Adulthood Among Emerging Adults with Disabilities Jennifer Emilie Mannino Ph.D., R.N

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A Descriptive Mixed-Methods Study Examining Resilience and Transitioning to Adulthood Among Emerging Adults with Disabilities Jennifer Emilie Mannino Ph.D., R.N Molloy College DigitalCommons@Molloy Theses & Dissertations 12-5-2014 A Descriptive Mixed-Methods Study Examining Resilience and Transitioning to Adulthood among Emerging Adults with Disabilities Jennifer Emilie Mannino Ph.D., R.N. Molloy College, [email protected] This research was completed as part of the degree requirements for the Nursing Department at Molloy College. Follow this and additional works at: https://digitalcommons.molloy.edu/etd Part of the Other Nursing Commons, and the Psychiatric and Mental Health Nursing Commons This Dissertation has All Rights Reserved. DigitalCommons@Molloy Feedback Recommended Citation Mannino, Jennifer Emilie Ph.D., R.N., "A Descriptive Mixed-Methods Study Examining Resilience and Transitioning to Adulthood among Emerging Adults with Disabilities" (2014). Theses & Dissertations. 41. https://digitalcommons.molloy.edu/etd/41 This Dissertation is brought to you for free and open access by DigitalCommons@Molloy. It has been accepted for inclusion in Theses & Dissertations by an authorized administrator of DigitalCommons@Molloy. For more information, please contact [email protected],[email protected]. Abstract A DESCRIPTIVE MIXED-METHODS STUDY EXAMINING RESILIENCE AND TRANSITIONING TO ADULTHOOD AMONG EMERGING ADULTS WITH DISABILITIES Principal Investigator: Jennifer Emilie Mannino Molloy College Rockville Centre, NY Dissertation Director: Dr. Veronica D. Feeg Transitioning to adulthood is not without challenges. The move away from family influence towards independence and self-determination is filled with uncertainty. As emerging adults (18-29) transition to adulthood they will encounter various challenges related to their new adult roles (Arnett & Tanner, 2005; Jensen & Arnett, 2012). Increased challenges and vulnerabilities in transitioning are evident among emerging adults with disabilities because they face additional challenges related to their disability over and above what all others of this developmental stage experience (Betz & Redcay, 2002; Blomquist, 2007; Faux & Nehring, 2010; King, Baldwin, Currie, & Evans, 2005; Murray, 2003; National Research Council & Institute of Medicine, 2009; Urbano, 2010). The purpose of this mixed methods convergent parallel study was to understand resilience in a select group of emerging adults with disabilities as they are transitioning to i adulthood by combining both quantitative and qualitative data. In this approach, quantitative instruments were used to measure the relationship between the independent variable of resilience and the dependent variables of physical health, mental health, satisfaction with life, and future orientation. At the same time, the central phenomenon of resilience was explored using qualitative methods of a focus group and interview with a subset of the participants. The aims of this study were twofold: (1) To gain a better understanding of resilience from the emerging adults’ perspective as it relates to managing adversities while transitioning to adulthood; and (2) To characterize the relationship of resilience with indicators of healthy transitioning. This study describes a select group of transitioning emerging adults with disabilities who have been recognized by others for their accomplishments. It explored their level of resilience and resilience attributes; and identified key attributes of resilience, transitioning goals and values, and challenges encountered while transitioning. Given the complexity of the topic and uniqueness of the population, this study has combined quantitative and qualitative methods for data gathering purposes. Variables were measured using survey questionnaires to quantify resilience, physical and mental health, life satisfaction, future orientation and social support resources. In addition to the survey questionnaires, a subset of the sample was invited to participate in a focus group or individual interview to supplement the quantitative data. A purposeful sample of 31 participants was recruited and completed the quantitative phase of the study. Ten of the 31 participants also participated in the qualitative phase; five participated in a focus group and five participated in individual interviews. Following a mixed method convergent parallel design, quantitative and ii qualitative data were collected simultaneously and analyzed independently. The data were then merged to create a matrix reflecting quantitative variables and qualitative themes. Quantitative analyses of instrument measures conclude that participants in this select group of emerging adults with disabilities (n = 31) have a moderate resilience level (M = 79.1), experience average disease burden on physical health (M = 49.7), experience less than average disease burden on mental health (M = 54.1), feel things are going well in their lives (M = 24.9), are future orientated (M = 3.43), and have social support resources (M = 3.9); independently the participants in the qualitative sample (n = 10) have a moderately high resilience level (M = 82.3), experience more than average disease burden on physical health (M = 43.9), experience an average disease burden on mental health (M = 50.1), are generally satisfied with their lives (M = 23.6), are future orientated (M = 3.7), and have social support resources (M = 2.9). No correlation was noted between the variables resilience and physical health ( r = -.277, n = 31, p = n.s. two tailed). Regression analysis indicated that resilience is not a good predictor of physical health ( β = -.277; t = -1.555; p = n.s.). A moderate positive correlation was noted between the variables of resilience and mental health (r = .502, n = 31, p < .01 two tailed). Regression analysis indicated that resilience is a good predictor of mental health ( β = .502; t = 3.125; p < .01). A high positive correlation was noted between the variables of resilience and satisfaction with life (r = .771, n = 31, p = < .001 two tailed). Regression analysis indicated that resilience is a good predictor of satisfaction with life (β = .771; t = 6.519 ; p < .001). A moderate positive correlation was noted between the variables resilience and future orientation (r = .515, n = 31, p < .01 two tailed). Regression analysis indicated that resilience is a good predictor of future orientation (β = .515; t = 3 .234 ; p < .01). No correlation was noted between the variables iii quantity of social support resources and resilience. Regression analysis indicated that quantity of social support resources is not a good predictor of resilience (β = .189; t = -1.034; p = n.s.). Qualitative analyses of focus group and interview data revealed the following themes: standing on my own, longing to create own meaning, altruistic sense of duty towards others with disabilities, challenges specific to me vs. challenges we all face, I am a person with abilities, butterfly’s story…our struggles make us stronger, life is a journey, traits that keep me going, patience is a virtue, and it takes a village. These themes demonstrate transitioning goals and values, challenges encountered while transitioning, and attributes of resilience that have aided in mitigating adversity for these emerging adults with disabilities as they are transitioning to adulthood. Collectively, the themes represent resilience. Purposeful life, self-reliance, perseverance, equanimity and existential aloneness represent individual attributes; and social support resources represent environmental attributes. The mixed method analysis was comprised of combining the data for meaningful interpretation . Findings from the quantitative analyses were concurrent with the findings from the qualitative analyses. Overall the instrument measures for quantitative variables uphold the prominent themes discovered in the qualitative data. A frequency analysis identified the number of times a particular resilient attribute emerged from the qualitative data. The attribute purposeful life emerged most frequently ( f = 16), followed by equanimity ( f = 14), self-reliance ( f = 11), perseverance ( f = 9), and existential aloneness ( f = 6). A cross-tabulation analysis of instrument measures and themes contributed to an enhanced interpretation and understanding of the relationships among the data. Analyses showed that those who contributed to the qualitative theme I am a person with abilities (n = 5) scored the highest on mental health (M = 54.6) iv indicating they are emotionally bothered less than most and experiencing a less than average disease burden on mental health. Although these participants reported a physical impairment and a more than average disease burden on physical health (M = 44.2), other measures indicate a moderately high resilience level (M = 86.8), a high level of satisfaction with life (M = 28.4), that they are future orientated (M = 3.8), and have social support resources (M = 3.2). Participants who contributed to the qualitative theme altruistic sense of duty towards others with disabilities (n = 4) scored the lowest physical health score (M = 37.2) indicating that they are physically impaired and experiencing much more than average disease burden on physical health. These participants also reported having more than average disease burden on mental health (M= 43), and a slightly below average satisfaction with life (M = 18). However, other measures for these qualitative participants indicate a moderate resilience level (M = 80), that they are future orientated (M = 3.5), and have social support resources (M = 3). A hierarchical categorization of resilience attributes was created
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