published_or_final_version / abstract / toc / Clinical Psychology / Master / Master of Social Sciences

Thesis (Ph.D.)--University of Nebraska-Lincoln, 2008. / Title from title screen (site viewed Feb. 17, 2009). PDF text: iv, 173 p. ; 687 K. UMI publication number: AAT 3325857. Includes bibliographical references. Also available in microfilm and microfiche formats.

published_or_final_version / Social Work and Social Administration / Master / Master of Philosophy

陳津利. / "2000年7月" / 論文 (哲學碩士)--香港中文大學, 2000. / 參考文獻 (leaves 138-151) / 附中英文摘要. / "2000 nian 7 yue" / Chen Jinli. / Lun wen (zhe xue shuo shi)--Xianggang Zhong wen da xue, 2000. / Can kao wen xian (leaves 138-151) / Fu Zhong Ying wen zhai yao. / Chapter 第一章 --- 緒論 --- p.1 / Chapter 第一節 --- 中國的乳腺癌患者 --- p.1 / Chapter 第二節 --- 中國內地的癌症自助團體 --- p.3 / Chapter 第三節 --- 硏究意義和主題 --- p.5 / Chapter 一、 --- 硏究意義 --- p.5 / Chapter 二、 --- 硏究主題 --- p.8 / Chapter 第二章 --- 文獻回顧 --- p.9 / Chapter 第一節 --- 乳腺癌和乳腺癌患者 --- p.9 / Chapter 一、 --- 乳腺癌和乳腺癌患者的定義 --- p.9 / Chapter 二、 --- 患者瀕死的心理反應 --- p.10 / Chapter 三、 --- 患者面臨的實際問題和情感需求 --- p.15 / Chapter 第二節 --- 支持的槪念和取向 --- p.21 / Chapter 一、 --- 社會支持的槪念 --- p.21 / Chapter 二、 --- 支持的類型 --- p.23 / Chapter 三、 --- 社會支持的功能 --- p.27 / Chapter 四、 --- 社會支持的測量和指標 --- p.31 / Chapter 第三節 --- 自助團體的定義及功能 --- p.36 / Chapter 一、 --- 自助團體的定義 --- p.36 / Chapter 二、 --- 自助團體作爲社會支持系統的組成部分 --- p.37 / Chapter 第三章 --- 硏究架構 --- p.46 / Chapter 第一節 --- 基本假設 --- p.46 / Chapter 第二節 --- 研究變量名詞的操作性定義 --- p.48 / Chapter 一、 --- 自助團體行爲認知 --- p.48 / Chapter 二、 --- 感受的情感支持 --- p.50 / Chapter 三、 --- 個人特徵 --- p.50 / Chapter 第四章 --- 硏究方法 --- p.51 / Chapter 第一節 --- 研究法的選擇 --- p.51 / Chapter 一、 --- 應用三角測量的思考 --- p.51 / Chapter 二、 --- 量化爲主、質性爲輔的主輔設計 --- p.51 / Chapter 三、 --- 同步三角測量法的采用 --- p.53 / Chapter 第二節 --- 問卷調查硏究設計 --- p.54 / Chapter 一、 --- 樣本策略_ --- p.54 / Chapter 二、 --- 測量工具 --- p.56 / Chapter 三、 --- 資料搜集方法 --- p.59 / Chapter 四、 --- 效度和信度 --- p.59 / Chapter 五、 --- 問卷調查的資料處理及數据分析 --- p.62 / Chapter 第三節 --- 質性硏究方案 --- p.63 / Chapter 一、 --- 硏究樣本及資料收集 --- p.63 / Chapter 二、 --- 資料分析 --- p.63 / Chapter 第四節 --- 硏究局限 --- p.65 / Chapter 第五章 --- 硏究結果 --- p.66 / Chapter 第一節 --- 中國乳腺癌患者的基本特徵 --- p.66 / Chapter 一、 --- 背景結構 --- p.66 / Chapter 二、 --- 身心狀況 --- p.72 / Chapter 三、 --- 病患情感特徵 --- p.77 / Chapter 第二節 --- 患者自助團體行爲認知 --- p.85 / Chapter 一、 --- 患者的自助團體活動參與程度(A1 ) --- p.85 / Chapter 二、 --- 患者的自助團體活動認知程度(A2 ) --- p.90 / Chapter 三、 --- 患者對自助團體的主觀認同(A3) --- p.91 / Chapter 四、 --- 個人基本特徵的作用 --- p.96 / Chapter 第三節 --- 患者自助團體中的情感支持感受(B) --- p.100 / Chapter 一、 --- 患者在自助團體中的情感支持感受 --- p.100 / Chapter 二、 --- 個人特徵對情感支持感受影響 --- p.108 / Chapter 第四節 --- 假設驗証：自助團體行爲認知與情感支持感受的 相關關係 --- p.114 / Chapter 一、 --- 活動參與程度(A1)與情感支持感受的相關關係 --- p.115 / Chapter 二、 --- 活動認知程度(A2)與情感支持感受的相關關係 --- p.119 / Chapter 三、 --- 主觀認同(A3)與情感支持感受的相關關係 --- p.120 / Chapter 四、 --- 個人基本特徵對行爲認知(A)與情感支持感受 關係的影響 --- p.122 / Chapter 五、 --- 小結 --- p.122 / Chapter 第六章 --- 結論、檢討及建議 --- p.123 / Chapter 第一節 --- 硏究結果討論 --- p.123 / Chapter 一、 --- 自助團體情感支持硏究結果與西方 研究的异同及討論 --- p.123 / Chapter 二、 --- 社會支持理論和槪念的适用性討論 --- p.127 / Chapter 第二節 --- 待5幵究或澄淸的議題 --- p.129 / Chapter 一、 --- 患者的情感問題： 乳腺癌是否破坏了患者的婚姻質量？ --- p.129 / Chapter 二、 --- 家庭的支持功能問題： 什么是對患者的“愛´ح ？ --- p.131 / Chapter 三、 --- 來自“大鍋飯´ح的資源： 制度安排帶給乳腺癌患者什么？ --- p.131 / Chapter 四、 --- 未接受乳房再造術： 經濟的？醫療的？制度的？觀念的？ --- p.132 / Chapter 五、 --- 關於自助團體的几點發現 --- p.132 / Chapter 第三節 --- 建議 --- p.134 / Chapter 一、 --- 政府部門與自助團體建立伙伴關係 --- p.134 / Chapter 二、 --- 加強對患者家庭的輔導，引進境外社會工 作理念和實務，開展針對性情感治療 --- p.134 / Chapter 三、 --- 營造新女性文化，關注自身生存質量 --- p.135 / Chapter 四、 --- 未來的硏究 --- p.136 / 參考書目 --- p.138 / 附錄 / 附錄一統計結果列表 --- p.152 / 附錄二 量表信度列表 --- p.173 / 附錄三調查問卷 --- p.177 / 附錄四訪談指引 --- p.185

There is no abstract available for this dissertation. / Department of Counseling Psychology and Guidance Services

published_or_final_version / Social Work / Master / Master of Social Work

Abstract not available

Comorbid chronic insomnia was found highly prevalent in breast cancer patients. It also persisted through survivorship. Negative emotions upon diagnosis and during the course of cancer treatment might complicate the underlying mediating factors between stress and insomnia found in non-cancer population. Cognitive Behavioural Therapy (CBT) has been evidenced in improving insomnia. With the appreciation of Mindfulness training in improving cognitive flexibility and rumination, a novel treatment approach integrating CBT and mindfulness—Mind-Body Intervention (MBI) was developed. 　　　There were three objectives in the research. Firstly, prevalence data on insomnia and clinical profile of Hong Kong Chinese breast cancer survivors were obtained. Secondly, the mediating roles of negative emotions, hyperarousal, pre-sleep arousals in the relationship between perceived stress and insomnia were examined. Thirdly, the effects of CBT and MBI for breast cancer survivors with insomnia were investigated. 　　　In the first study, 1049 women who survived from non-metastatic breast cancer were invited to complete a survey on stress, mental health, arousals and insomnia. Those who met psychophysiological insomnia were invited to participate in the second study, which was a multisite randomized controlled trial. The 73 participants were allocated to CBT (n=24), MBI (n=27) or waiting list control, WLC (n=22). Both treatments were five weekly-session group therapies. Outcomes on insomnia, mental health, arousals, dysfunctional beliefs, quality of life and mindfulness, were obtained on baseline, post-treatment, 3-month and 6-month follow-ups. 　　　Results of the first study revealed 34.6% of the participants suffered from clinical insomnia, while 15.1%, 27.4% and 12.8% endorsed moderate to extremely severe depression, anxiety and stress respectively. Duration of insomnia was correlated with insomnia severity. Hyperarousal was found moderating cognitive ore-sleep arousal and anxiety, these in turn, together with depression mediated the relationship between perceived stress and insomnia severity. Results of the second study supported the hypothesis both CBT and MBI improved insomnia and other psychological symptoms, while WLC did not. After treatment, significant decreases of 59 and 67 minutes of total wake time per night were found for CBT and MBI respectively. Sleep efficiency values significantly increased in CBT (12.2%) and MBI (12.7%). Moderate to large effect sizes and clinically significant differences were found in most sleep and psychological variables. Generally, CBT produced larger effect sizes than MBI on post-treatment. The therapeutic gains were found sustaining through 3-month to 6-month follow-ups in both treatments. However, the effect sizes of CBT were on the declining trend, while those of MBI were more stable. 　　　The results suggested that insomnia and anxiety were frequently experienced in breast cancer even after completing the medical treatments. The longer the survivors suffered from insomnia, the higher the severity was found. In additional to the cognitive pre-sleep arousal, the important mediating roles of depression and anxiety imply that insomnia treatments should incorporate strategies designed to help in decreasing rumination/worry before bedtime and improving mental health conditions. The findings also provided initial evidence for the efficacy of MBI as a viable treatment for insomnia. More vigorous randomized controlled trial and the long-term efficacy could be further studied. / published_or_final_version / Clinical Psychology / Doctoral / Doctor of Psychology

Thesis (M.A.), Memorial University of Newfoundland, 2000. / Bibliography: leaves 124-130.

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences