This study explores how cancer patients in remission derive meaning in their lives. A need for social work intervention was identified with cancer survivors, especially those patients who are in remission and who have to continue their lives, in spite of the incurable status of their cancer. In line with literature, the researcher, in her role as social worker at a radiation oncology clinic, observed that patients often report that they find benefit in the cancer experience. The framework for conducting this study is based on the existential theory and the ultimate concern of human existence, that life has meaning under all circumstances. Meaning and meaning-centeredness is described. The role of a meaning-centered approach to oncology social work was argued. The Meaning-Centered Counselling and Therapy (MCCT) model was described from a literature perspective, and proposed as an intervention model. MCCT offers a model that includes the existential domain in interventions. Within the context of this study, remission refers to the period that the cancer is under control. It may be that there is no indication of the cancer, but the cancer is expected to recur, or that some of the symptoms have disappeared, or that the progression of the cancer has slowed down. During remission, patients are under surveillance only, or on maintenance treatment. Thus, they do not have regular contact with the oncology team. Patients live with uncertainty and ambiguity, resuming activities, responsibilities, careers and relationships that were influenced by the cancer diagnosis and treatments. The demands of living in remission are described. This research study explores the quest for meaning in patients who are living with incurable, recurrent cancer. The goal of this research study was to explore meaning-centeredness in adult cancer patients who are in remission. This research study was guided by the following research question: “Does meaning-centeredness play a role in adult cancer patients’ coping with remission?” The research population included oncology patients who are in remission, and have experienced one or more recurrences, and where the cancer has metastasised. A qualitative approach was followed, using the collective case study design. The research was conducted at the Radiation Clinic, Sandton Oncology Centre in Morningside, Johannesburg. Data was collected using an interview schedule to guide 4 focus group interviews, totalling 21 participants, who were selected by means of purposive sampling. All participants gave voluntary and informed consent to take part, and the focus group interviews were voice-recorded, with their permission. The researcher transcribed these recordings. Creswell’s steps for qualitative data analysis were implemented. From the findings, the following themes and sub-themes were identified, demonstrating the search for meaning amongst these participants who are in remission and answering the research question: Theme 1: Meaning-construal associated with attribution with the sub-themes of hope, spirituality, and death awareness and a foreshortened future. Theme 2: Meaning-construal associated with appraisal, with the sub-themes of benefit finding, growth, relationships, and an increased appreciation of life, and prioritising. Theme 3: Meaning-construal associated with reappraisals, with sub-themes of sense of self, sense of coherence, assumptive world, adapting to new normal, and transcendence. The findings demonstrated that a perspective that provided the participants with the means to explore their unique meanings, purposes, and life tasks helped them to cope with remission and the fear or reality of recurrence or metastases. Participants were able to derive meaning in their lives despite living with incurable cancer. Participants, who had integrated the knowledge that their cancer is incurable and recurrent into their meaning-system, were able to adapt and adjust to living in remission. They had a sense of purpose and maintained realistic hope. Their hopes were proportional to the prognosis. They did not dwell on their own death, but focused on what life offers them each day. They developed a new normal that incorporates the knowledge of a foreshortened future, coping with side effects and late effects of treatment, and the uncertainty that the cancer is expected to recur or metastasise again. They were aware of their life tasks, and embraced life to the full. Intervention strategies, based on the existential oriented proposition that life has meaning under all circumstances, were recommended. This included the Meaning-Centered Counselling and Therapy (MCCT) model for integration in oncology social work. Recommendations in this study include enhancing the understanding of members of the transdisciplinary team regarding the needs and experiences of patients in remission. Furthermore, a better understanding of the role of meaning-centeredness intervention amongst oncology social workers can improve interventions, specifically for patients in remission. / Dissertation (MA)--University of Pretoria, 2014. / lk2014 / Social Work and Criminology / MA / Unrestricted

Made available in DSpace on 2016-04-28T20:39:00Z (GMT). No. of bitstreams: 1 Camila Carrascoza Vasco.pdf: 1951005 bytes, checksum: cf5505bf2f339658761dd0509afec551 (MD5) Previous issue date: 2015-03-19 / Conselho Nacional de Desenvolvimento Científico e Tecnológico / The acquisition of a physical disability involves not only the changes related to body aspects, but also the emotional repercussion of such an event. Whereas the loss of previous living conditions generates a grieving process and the need to review the assumptive world, the research aimed to investigate the meaning-making by the paraplegic individuals for the traumatic spinal cord injury, and analyze the process of resumption of their life project after physical disability. The qualitative approach was adopted and a research through semi-structured interviews with four paraplegics individuals, between 18 and 22 years old. Was used content analysis and then the results were discussed with the theoretical foundation, including spinal cord injury, assumptive world, mourning, meaning-making and family repercussions. Facing the multiple losses imposed by the physical disability, it was required that each participant revisit their presumed world, because them was challenged by the occurred. It was noticed that the meanings constructed by the participants to the event in their lives were positive, denoting growth, transformation, evolution, recovery and learning. Such meanings contributed in directing the new life s project, which had to adapt to the current reality of paraplegics. It was also observed that the spinal cord injury enable them to discover new interests and showed how they were able to face the disability. The process experienced by those participants highlighted the importance of physical rehabilitation, from family, which along them suffer repercussions and support network, because the physical disability afflicts on the individuals identity, which needs support to reorganize their lives, to elaborate mourning and reinvest in future plans / A aquisição de uma deficiência física envolve não só as mudanças referentes aos aspectos do corpo, como também a repercussão emocional de tal acontecimento. Considerando que a perda da condição de vida anterior gera um processo de luto e a necessidade de revisão do mundo presumido, a pesquisa teve por objetivo investigar o significado construído pelo indivíduo paraplégico à lesão medular traumática, e analisar o processo de retomada de seu projeto de vida após a instalação da deficiência física. Foi adotada a abordagem qualitativa e realizou-se uma pesquisa de campo por meio de entrevista semiestruturada com quatro indivíduos paraplégicos, entre 18 e 22 anos. Utilizou-se análise de conteúdo e posteriormente os resultados foram discutidos com a fundamentação teórica, abrangendo lesão medular, mundo presumido, luto, construção de significado e a repercussão na família. Diante das múltiplas perdas impostas pela deficiência física, fez-se necessário que cada participante revisitasse seu mundo presumido, pois este fora desafiado face ao ocorrido. Percebeu-se que os significados construídos pelos participantes para o acontecimento em suas vidas foram positivos, denotando crescimento, transformação, evolução, valorização e aprendizado. Tais significados contribuíram no direcionamento dado ao novo projeto de vida, o qual precisou adequar-se à realidade atual, na condição de paraplégicos. Observou-se ainda que a lesão medular sofrida lhes possibilitou a descoberta de novos interesses e revelou-lhes o quanto eram capazes de enfrentar a situação. O processo vivenciado pelos participantes evidenciou a importância da reabilitação física e da família, a qual juntamente a eles sofre repercussões, e da rede de suporte, pois a deficiência física impacta também na identidade do indivíduo, que precisa de apoio para reorganizar sua vida, elaborar o luto e reinvestir novamente nos planos futuros

In his thesis, Re-authoring life narratives of trauma survivors in KwaZulu-Natal: Spiritual perspective, the researcher investigates a holistic understanding of the effects of trauma on surviving individuals and communities historically affected by political violence in KwaZulu-Natal, South Africa. Traditionally, the exploration of the impact of trauma on survivors in South Africa has been focused mainly on the bio-psycho-social aspects. The Bio-psycho-social approach recognises that trauma affects people on several dimensions- biological, social and psychological. However, Nevid (et al 2006:19) and Kaminer (et al 2012) acknowledge that these bio-psychosocial factors are incomplete for us to understand the effects of trauma on the individual and call for consideration of all possible pathways and account for multiple factors, influences, and interactions. Using qualitative and narrative approach, personal life narratives were listened to with the aim of looking in depth at the effects of traumatic experiences on the research participants, and specifically investigate whether, and how trauma affected their spirituality. The findings show that the research participants sustained psychological, moral and spiritual injuries during and after traumatic experiences. The results concur with Buckenham’s (1999:7-8) argument that trauma wreaks its toll in the life of a person emotionally, psychologically, spiritually, in our relationships with ourselves, others and with God. The study also established that regardless of religious affiliation, research participants turned to spiritual resources for answers, healing and recovery in traumatic situations. Therefore, the study recommends the integration of the spiritual perspective to reach a holistic model of understanding and treating traumatized individuals and communities. Although the study is localised in the South African context, the results have a much wider relevance in understanding the role of ‘posttraumatic spirituality’ in the re-authoring of life narratives shattered by trauma. / Thesis (PhD)--University of Pretoria, 2013. / gm2014 / Practical Theology / unrestricted