Inner Strength and Influencing Factors in Persons Newly Diagnosed with Mild Cognitive Impairment and their Family Care Partners

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Project Summary/Abstract: The purpose of this individual National Research Service Award (NRSA) application is to provide the applicant with essential research training to become an independent investigator focusing on strengths-based interventions for people living with Mild Cognitive Impairment (MCI), specifically those that improve quality of life by enhancing inner strength. This NRSA will ensure that the applicant achieves competence in establishing a conceptual understanding of inner strength, develops foundational skills to commence a program of ethical and rigorous independent research with the vulnerable population of persons with MCI and their family care partners, and gains professional development skills to advance in a rigorous academic setting. This training will occur in a resource rich environment with support from a world-renowned advising team ideally suited to the applicant’s topic and training plan. From her clinical experience as a nurse, the applicant has first-hand knowledge of the importance of and need to incorporate a person’s strengths into their plan of care. One in five people age 60 and older are living with MCI. The vast majority of interventions for persons with MCI focus on minimizing deficits rather than augmenting strengths to improve quality of life. This gap is due to under-characterization of strengths of persons with MCI in the literature. One opportunity to fill this gap is to describe inner strength from the perspective of the person living with MCI. Inner strength is defined as one’s internal process of moving positively through challenging circumstances and is associated with improved quality of life. Inner strength is well described in adults with serious illnesses like cancer and heart disease but is not well characterized in MCI. This study proposes to fill this gap in knowledge through the following aims: 1) To describe the experience of inner strength in persons newly diagnosed with MCI, 2) To explore how family care partners impact the experience of inner strength for persons newly diagnosed with MCI, 3) To identify external factors that influence inner strength for persons newly diagnosed with MCI. This study will use realist, qualitative methodology to focus on the experience of the individual. This study proposes to use thematic analysis that employs voice-centered methods of analysis applied to interviews of persons with MCI and their family care partners. This study has the potential to provide new knowledge about inner strength in persons with MCI and elucidate influencing factors and the role of family care partners. The proposed study aligns with NINR’s strategic plan to improve quality of life for individuals with chronic conditions, like MCI, as this work has the potential to unlock opportunities to enhance inner strength and thereby quality of life. By laying a strong foundational knowledge of inner strength, we can better design interventions that are based in what matters to persons with MCI and their care partners. Future implementation research has the potential to have a significant impact for quality of life.