An ethnographic study was utilized to identify coping strategies of women with breast cancer. Five women were interviewed; four were interviewed on three separate occasions, and one was interviewed twice. The data were analyzed for specific coping strategies taken by the women to deal with the stresses of breast cancer. These strategies were compared and organized into categories of coping strategies: Actions Taken, Emotional Support, Positive Outcomes, Getting Control, and Keeping a Positive Attitude. These five categories were integrated as new coping incidents appeared in the data. The original five categories were merged into three categories: Getting Control, Compensating, and Emotional Support. From these three categories the theory was written: Women with breast cancer will obtain support, get control over what they can control, and compensate for what they cannot control.

Medication adherence in individuals taking multiple medications has received little research attention, despite its importance in clinical treatment and its relevance to achieving optimal health outcomes. With the growth of the aging population and prevalence of chronic diseases, adherence to multiple medication regimens has become a critical issue. This project, consisting of three related studies, investigated medication adherence of cancer patients who received an allogeneic hematopoietic cell transplant (alloHCT) and whose conditions require adherence to complex, multiple medication regimens for prolonged periods of time. The Information-Motivation-Behavioral Skills (IMB) model was the theoretical framework for the study. This model posits that well-informed, highly motivated individuals have better adherence behaviors. In addition to having optimal information and motivation, patients also need to develop the appropriate behavioral skills to maximize the value of information, motivation and aid adherence. Thus, within this framework, the link between information, motivation, and adherence is mediated by behavioral skills. Using the IMB model, the aim of this project was to examine different approaches to facilitating medication adherence after transplant. The first study used a mixed-methods approach to examine the feasibility of using an electronic pillbox for assessing adherence to multiple medications. The second study utilized patient interview data to assess the link between social support and adherence to multiple medications. The third study also used patient interview data to identify adherence determinants and strategies that patients used after transplant. The results of the first study show that even though some features of the electronic pillbox need to be modified, it is feasible to use it to facilitate medication adherence for patients after transplant. The second study demonstrated the importance of social support from lay caregivers, such as spouse and family members, as well as healthcare providers, for adherence tasks after transplant. Lay caregivers provided emotional and practical support, whereas healthcare providers were the main source of informational and medical support. The third study identified various determinants that facilitated and hindered medication adherence. The study also suggests practical lessons for adherence to multiple medications. Collectively, the findings provide a foundation for developing intervention approaches for this particular patient population.

Very little work has been undertaken that explores pain as a part of human existence and the inherent knowledge that accompanies it. What pain means to people and how they know their own pain is the subject of this research study.The research sought to identify ways of knowing cancer pain of six participants, each receiving palliative care at the time of this study. The themes of, balancing conflict, living with threat, always there and making sense are identified and examined to provide understanding of the ways these people know their pain. A new model of pain assessment is offered that incorporates an ontological way of knowing, and the meaning that the findings have for nursing practice is explored. Implications for nursing practice and education that are derived from the study are offered. The rigour of the study is promoted through an audit process / Doctor of Philosophy (PhD)

This Heideggerian phenomenological hermeneutic study explores the lived experience of those coming to terms with the diagnosis of a life-threatening form of cancer. It offers an interpretation of the narratives of eight adult New Zealanders, three men and five women, aged between 25 and 60 years of age who had been recently diagnosed. The study, based upon van Manen's (1990) six-step method, uncovers the experience of the person facing up to being told they have a life-threatening form of cancer within New Zealand society. It is informed by the writing of Heidegger. The study explores the meaning of cancer to the person involved and how this meaning affects them and their world. The study explores the changes within the person and how this change in the person subsequently changes the understanding they have of themselves and the world. The narratives of participants reveal a journey that is undertaken, a journey they thought they would never undertake and were not prepared to take. The cancer journey begins suddenly, is frightening in its intensity, towards a perceived destination of probable death. The real journey for many takes an unforeseen detour along the way, a detour of hope and eventual enlightenment. The final journey for all human beings will always end in death. The realisation that all human journeys must and do end in death and learning to live with the reality of this one fact in life is the major lesson learnt by those who experience the cancer journey. The journey is made more difficult and lonely by a society that wishes to fool itself that this journey does not happen or wishes to believe that one day this journey may be totally avoided. Society, and the people that make up society, need to face the reality of the cancer journey for many of its members in order to better prepare the person for the journey and to support the person while on this journey.

<p>One third of all Swedish people will suffer in cancer. Pain is a common symptom in cancer patients. The pain is subjective and includes several dimensions. The dimensions of pain are the physical, psychological, social and spiritual. This is a literature review and the aim with this study was to identify the pain experience in patients with cancer receiving palliative care. Nineteen articles were analysed. The result shows that the physical pain was experienced as chronicle or episodic pain.</p><p>Psychological pain included fear, distress and anxiety. Social pain was a result of loss of relationships and ability to take part of activities. Spiritual pain was expressed as feelings of meaningless, hopelessness and fear for the future. Different kinds of dimensions cooperate with each other. They can strengthen each other and one dimension of pain can lead to another. The articles that have been analysed focus on several dimension of pain. To be able to relieve the pain and other symptoms, the nurse needs to have a holistic view of patients and to be aware of how all dimensions of pain that is expressed by the patient.</p>

<p><strong>Aim: </strong>The aim of present study was to determine the frequency of taste and smell disorders occuring in patients receiving chemotherapy for cancer.<strong> Methods: </strong>The study was of an empirical cross sectional quantitative descriptive design. During one month, consecutive cancer patients at outpatient units in two Swedish hospitals were asked to participate in the study by completing a questionnaire that had been developed previously for a similar study. All participants had undergone at least 1 cycle of intravenous chemotherapy or  a minimum of seven days of oral chemotherapy. <strong>Results: </strong>A total of<strong> </strong>102 patients completed the questionnaire. Results show that 55 % experienced taste disorders and  42 % experienced smell disorders. Both disorders are more common in women than in men. Of patients with taste disorders 47 % reported that it  impacted on their daily life to some degree and of patients with smell disorders the corresponding number was 33%. Patients with smell disorders reported a smaller degree of impact on their daily life than did patients with taste disorders.<strong> Conclusion: </strong>Both taste and smell disorders are common in cancer patients treated within chemotherapy. More research into factors that might eliminate or dimnish these problems is needed.<strong> </strong></p>

One third of all Swedish people will suffer in cancer. Pain is a common symptom in cancer patients. The pain is subjective and includes several dimensions. The dimensions of pain are the physical, psychological, social and spiritual. This is a literature review and the aim with this study was to identify the pain experience in patients with cancer receiving palliative care. Nineteen articles were analysed. The result shows that the physical pain was experienced as chronicle or episodic pain. Psychological pain included fear, distress and anxiety. Social pain was a result of loss of relationships and ability to take part of activities. Spiritual pain was expressed as feelings of meaningless, hopelessness and fear for the future. Different kinds of dimensions cooperate with each other. They can strengthen each other and one dimension of pain can lead to another. The articles that have been analysed focus on several dimension of pain. To be able to relieve the pain and other symptoms, the nurse needs to have a holistic view of patients and to be aware of how all dimensions of pain that is expressed by the patient.

Aim: The aim of present study was to determine the frequency of taste and smell disorders occuring in patients receiving chemotherapy for cancer. Methods: The study was of an empirical cross sectional quantitative descriptive design. During one month, consecutive cancer patients at outpatient units in two Swedish hospitals were asked to participate in the study by completing a questionnaire that had been developed previously for a similar study. All participants had undergone at least 1 cycle of intravenous chemotherapy or  a minimum of seven days of oral chemotherapy. Results: A total of 102 patients completed the questionnaire. Results show that 55 % experienced taste disorders and  42 % experienced smell disorders. Both disorders are more common in women than in men. Of patients with taste disorders 47 % reported that it  impacted on their daily life to some degree and of patients with smell disorders the corresponding number was 33%. Patients with smell disorders reported a smaller degree of impact on their daily life than did patients with taste disorders. Conclusion: Both taste and smell disorders are common in cancer patients treated within chemotherapy. More research into factors that might eliminate or dimnish these problems is needed.

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

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences