Date of Award


Document Type


Degree Name

Doctor of Philosophy (PhD)


Mennonite College of Nursing

First Advisor

Kim Schafer Astroth

Second Advisor

Stephen J. Stapleton


This dissertation is comprised of three manuscripts for publication reporting on adults living with cystic fibrosis, self-management behaviors and health outcomes. Chapter I explores what is known about adults living with cystic fibrosis (CF) and the factors impacting their self-management, including the complexities of a health maintenance regime required for survival while integrating and balancing the realities of adulthood. The review of literature provides direction for future research and implications for adult-focused CF studies. Chapter II is a manuscript describing the characteristics of prognostic survival models utilized in adult CF research and provides an overview of their development, validation, predictive values, and prognostic outcomes. Models were evaluated for applicability to research and clinical practice and it is suggested a reliable prognostic survival model which is easily adaptable to research and practice exists. This prognostic survival model is highlighted further as the health outcomes measure utilized in Chapter III. In this chapter, the findings of a longitudinal, descriptive repeated measures study exploring improved health outcomes among adults living with cystic fibrosis who reported adherent self-management behaviors regarding their prescribed treatment plan are described. Health outcomes improved for those participants in our study who adhered to their disease modifying treatments, showing a statistically significant reduction in risk for transplant or death within the next four years. Additional inquiry into adherence levels and barriers to maintaining adherence among adults with CF is warranted.


Imported from ProQuest Lambie_ilstu_0092E_11119.pdf


Page Count


Included in

Nursing Commons