Graduation date: 1975

Graduation date: 1971

Graduation date: 1979

Graduation date: 1979

Typescript. / Thesis (Ph. D.)--University of Hawaii at Manoa, 1983. / Bibliography: leaves [202]-221. / Microfiche. / lMaster negative: Microfiche MS33197. / xv, 221 leaves, bound ill. 29 cm

Thesis (Ph. D.)--University of Hawaii at Manoa, 1991. / Includes bibliographical references (leaves 68-75) / Microfiche. / ix, 75 leaves, bound ill. 29 cm

Thesis (Ph. D.)--University of Hawaii at Manoa, 1990. / Includes bibliographical references (leaves 145-158) / Microfiche. / viii, 158 leaves, bound 29 cm

Thesis (M.S.)--University of Hawaii at Manoa, 2006. / Includes bibliographical references (leaves 86-88). / viii, [89] leaves, bound ill. 29 cm

The increased intensity and complexity of cancer treatment has an impact on the lives of the adolescents undergoing such treatments. Living with cancer is a distinct experience for them which include physical, psychological, spiritual and social dimensions. The cancer experience comprises more than the measurement of symptom occurrence, frequency, duration and severity, or the ratings of quality oflife. The meanings of the lived experience from the adolescent's perspective and self-report can give a more accurate, holistic picture of the nature and scope of the experience. Practitioners need to know and understand the meaning of the experience from the adolescent's perspective in order to design appropriate interventions to prevent or relieve distress in these patients. The purpose of this study was to describe the meanings of the lived experience ofhaving cancer for adolescents undergoing treatment. Phenomenology was the qualitative research methodology used. As outlined by Patricia Munhall, this methodology seeks to understand the meaning of lived experiences. Seven adolescents, 14 to 18 years of age, in treatment for cancer were interviewed. Six males and one female participated in this study. Six were receiving treatment for acute lymphocytic leukemia and one for a solid tumor. All participants were of Pacific Island origin; two live in Hawaii and five were temporary residents. The audio taped interviews were transcribed and analyzed to understand the meaning of the cancer experience. The essence of the experience for the individual adolescent was described and a composite interpretation of the meaning derived. Recommendations to healthcare providers for improving communication with adolescents in treatment for cancer are provided, including discussing death and dying early in the illness trajectory. The interdisciplinary concept of care is stressed, as well as the importance of a thorough physical examination. The importance of social support and techniques to potentially strengthen and increase this support are outlined. Solutions to the problems of school reintegration are introduced.

This research was a pilot study at improving the medical, psychiatric and addiction care provided to women detainees at the jail. Few studies have been completed with women atjail intake, yet the population is suspected of having a multitude of medical, psychiatric and addiction in jail treatment and community reentry needs. Utilizing a descriptive, cross-sectional survey design, the following aims were completed for this pilot study: documented the creation of a nursing research infrastructure within a large jail; compared the results of the traditional 16- item paper and pencil Intake Service Center Screen with the 8-item paperless Brief Jail Mental Health Screen obtained via Audio Computer Assisted Self Interviewing (ACASI) technology; compared Addiction Severity Index scores and addiction treatment motivation and readiness scores obtained via ACASI technology with normative data; assessed the frequency of HIV risk behaviors and the medical, psychiatric and addiction treatment needs obtained via ACASI technology; while assessing the frequency and the average length of time for screening by providers at the jail via medical chart review. The results showed that the ACASI technology proved to be more effective than paper and pencil methods. This technology not only assessed detainee treatment needs, but simultaneously created reentry/discharge plans. The study demonstrated that HIV risk behaviors and the prevalence of past suicide attempts were high among the participants. The Addiction Severity Index scores and the Circumstance Motivation and Readiness scores demonstrated that methamphetamine addiction, and mental health severity is high among this population however motivation and readiness for treatment arc low. Therefore, recommendations for the most suitable jail psychiatric Advanced Practice Registered Nurse candidates could be given as a result of the study. This study was the first phase at improving the medical, psychiatric and addiction care provided to detainees at the jail. In future phases of this study more valid and reliable assessment tools and treatment planning aimed at reduced recidivism rates will be established. Future phases will build on the lessons learned here about working with security staff, collaborating with experienced researchers in the community, and seeking advice from the Department of Justice recognized experts.