Date of Award


Document Type

Open Access Dissertation


College of Nursing

First Advisor

DeAnne K. Hilfinger Messias


The purpose of this group randomized intervention trial was to examine the impact of participation in three telephone-based gratitude interventions on the physical, psychological and social functioning of participants in caregiver support groups who are unpaid family caregivers of persons with dementia and Alzheimer’s disease. Fredrickson’s (2001) Broaden-and-Build Theory informed the investigation of the effect of three gratitude interventions on participants’ levels of gratitude, positive aspects of caregiving, subjective well-being, physical health and mental health. This was a randomized, wait-list controlled study involving informal caregivers involved in support groups. The research questions were: 1.) How does gratitude contribute to subjective well-being, mental and physical health and the positive aspects of caregiving among caregivers? 2.) What is the relationship between gratitude, subjective well-being, physical and mental health and the positive aspects of caregiving? 3.) What is the effect of multiple gratitude interventions for the intervention group versus the control group? The total sample (n=55) included caregivers involved in 12 support groups. Support groups were recruited from existing caregiver support groups in Richland, Lexington, Florence, Horry, and Spartanburg counties within the state of South Carolina. Each support group that had consenting participants was randomized using simple randomization by group to either the intervention or wait-list control group.

Intervention group participants (n=-35) continued to attend support group meetings over a 5 week period during which they received three gratitude-based interventions by phone: positive writing about the past, daily gratitude lists, and a letter of gratitude. The wait-listed control group participants (n=20) continued to attend regular support group meetings and had the opportunity to participate in the gratitude activities upon completion of the research. Data collection involved pre-test (baseline) and post-test (2 weeks after last intervention) measures collected by telephone by a trained research assistant using standardized, reliable and valid measures. The primary dependent variables were gratitude, the positive aspects of caregiving, satisfaction with life, physical health and mental health, measured using the Gratitude Questionnaire (GQ-6), the Positive Aspects of Caregiving Scale, the Satisfaction with Life Scale (SWLS) and the WHOQOL-BREF. Data analysis involved a basic structure of repeated measures analysis with pre (baseline) and post-intervention (2 weeks after last intervention). The findings indicated gratitude was a significant predictor for positive mental health and there was a positive correlation between satisfaction of life and positive aspects of caregiving. At follow-up, there were no statistically significant differences on any outcome variables between participants in the intervention and control groups. Participants exposed to the gratitude intervention described being grateful for health, God, family, friends, and nature. These findings suggest the need for further investigations of the role gratitude plays in family caregiving for persons with Alzheimer’s disease and dementia. Implications for nursing education and practice include the incorporation of gratitude and positive psychology interventions in supporting and educating formal and informal family caregivers of individuals with Alzheimer’s and dementia.


© 2014, Cristy DeGregory

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