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

Previous studies suggest that the reasons that Hispanics do not use support groups might include utilizing the family as an informal support group structure, the use of spiritual support, language barriers, the lack of access to a computer and the Internet, the lack of face-to-face interactions in Internet groups, and the lack of cultural competence. Therefore, the purpose of this study was to explore the attitudes of Hispanics toward Internet cancer support groups (ICSGs) and reasons for the lack of participation in ICSGs. In this feminist qualitative study, 30 Hispanic individuals who were receiving cancer care were contacted for telephone interviews. The participants were interviewed to obtain their responses to questions related to current use and interest in using ICSGs. The researcher used qualitative thematic analysis to analyze the data. Four major themes arose. They were the need for a strong social network, attitudes about information access, concrete barriers to obtaining support, and the need for respect and empowerment. The major theme of “a strong social network” includes five sub-themes: (a) differences in online and face-to-face communication; (b) loneliness, isolation; (c) existence or lack of familial support; (d) spiritual support; and (e) informal support. Participants had mixed attitudes about information access. Positive attitudes were more common and included wanting to learn about their disease and learn how to obtain information and support via computer. Some participants did not want to obtain information, and some had negative attitudes about learning to use the computer. Many participants did not own a computer and had transportation problems that limited their access to a computer. The theme involving the need for respect and empowerment addressed the empowering use of Spanish in support of Hispanic cancer patients and empowerment via the group leader, who was Hispanic. The findings suggest a need to develop culturally competent ICSGs for Hispanics. One goal would be to augment instead of replace support. For example, an ICSG could have a spiritual basis, or there might be several ICSGs—one each for patients, families, and supporters such as friends from church. ICSGs also could target people without these supports. The existing knowledge should be used to provide direction for future research and for the development of cancer support groups that could meet the unique needs of Hispanic cancer patients. / text

<p>Aim: The overall aim of this thesis was to acquire knowledge about daily life with focus on eating problems during the trajectory of care for patients with head and neck cancer treated with radiotherapy. Method: The data in study I were gained from medical and nursing records of 50 patients. Documented parameters of eating problems, their causes and consequences, and undertaken interventions were collected before treatment, during radiotherapy, and one, six, and twelve months after completion of treatment, using a study-specific audit instrument. Data were analysed with descriptive and inferential non-parametric statistics. In study II eight patients were interviewed during the radiotherapy treatment period with focus on experiences of eating problems. In study III nine patients were interviewed six to twelve weeks after treatment with the focus on experiences of daily life during the trajectory of care having eating problems. In study IV twelve patients were interviewed about their conceptions of the significance of a supportive nursing care clinic during the whole trajectory of care. Data were analysed with interpretative phenomenology (II, III) and phenomenography (IV). Findings: The four studies showed that being a patient in the trajectory of care often meant that life was disturbed and threatened. This was partly due to the eating problems and their consequences, which could occur during the whole trajectory of care (I, III, IV) but was experienced as most intense and severe during radiotherapy (II) and the nearest weeks after completion of radiotherapy (III, IV). The disturbances and threats experienced due to eating problems could affect the whole person as they were physical (I-IV), psychological, social and existential (II, III). The experiences of eating problems due to the tumour and its treatment and the experience of having cancer per se were strongly connected as one phenomenon, which disturbed and threatened the informants’ daily life. The other part that disturbed the patients’ life was the waiting in suspense. A long and trying waiting in uncertainty was experienced due to lack of knowledge and support, practical as well as emotional. This was most pronounced during pauses in radiotherapy (III) and after completion of the treatment when the lack of support from the health care was obvious (I, II, III). The patients were then most often left to their own devices. In order to endure, they needed both inner strength, described as own coping strategies, and strength from outside, described as support from family, friends and health care professionals (II, III). The nurse clinic was found to give a hand to hold during the whole trajectory of care (IV). It could meet these patients’ needs of knowledge, care and support, both concerning practical measures related to the eating problems and other side-effects of the treatment, and concerning their emotional needs. In addition the nurse clinic could support the relatives in their worries and anxiety (IV). Conclusion: This thesis showed the necessity of continuous assessment, treatment and evaluation of patients’ problems, and the patients’ needs of information and support throughout the trajectory of care.</p>

The purpose of this retrospective study was to investigate some psychosocial factors that may be related to the development of childhood cancer. The questions that guided the study were: When compared to families of healthy children (1) Do the family structure, dynamics and atmosphere present any commonalities among children with cancer? (2) Are there any personality characteristics common to children with cancer? (3) Have children with cancer experienced more of stressful events during the year that preceded diagnosis? (4) Have children with cancer experienced a major loss? Twelve children between the ages of 2 to 13 who were diagnosed with a form of cancer were compared to twelve healthy but accidently injured children of the same age, and sex and socioeconomic background hospitalized at the 2nd Pediatric Department of The University of Athens. A semistructured interview was used to gather information from their mothers within the month that followed the child's diagnosis or accident. Chi-square and T-test analyses were used at the .05 level of significance to determine differences between groups on each of the variables. Findings revealed that, compared to healthy children, children with cancer tended to belong to "broken home" families in which most had experienced (a) the loss or absence of a significant person (particularly the father) early in their life or (b) an unhappy marriage between their parents, frequently resulting from an "arranged" marriage. Within their family children occupied a special status and were raised as "only" or "first-borns." A major upcoming event was anticipated in most of their families within the same month that the diagnosis was pronounced; this event was aborted as a result of the child's diagnosis. Limitations of the study, discussion of the methodology and recommendations for further research are presented.

No description available.

The use of quality of life instruments to evaluate the effect of cancer and its treatment on individuals has increased but the process by which the patient comes to make these quality of life evaluations has not been addressed. Earlier studies have shown the reporting of physical symptoms and the evaluation of one's health to be related to negative affect. The purpose of this study was to investigate whether the relationship between negative affect and the evaluation of ones health would remain the same in a group of cancer patients, when a major disease and treatment symptom, fatigue was controlled for. The current study found no relationship between negative affect and the evaluation of health once fatigue was controlled for. Negative affect and fatigue were found to be moderately correlated and fatigue accounted for a large proportion of the variance in the quality of life domains of physical, functional and emotional well-being. Both empirical and theoretical issues are discussed. / Department of Counseling Psychology and Guidance Services

Health Locus of Control (HLOC) and other predictors of Quality of Life (QL) were examined for women with an initial versus recurrent breast cancer diagnosis. Twenty-eight women with an initial breast cancer (IBC) diagnoses and twenty-eight women with recurrent breast cancer (RBC) diagnoses were recruited from doctors' offices and cancer support groups. Correlational analyses were used to assess the relationships between variables. No significant differences were found between women with IBC and RBC on Psychological QL. Doctor HLOC and Psychological QL were related for women with RBC (r = .481, p = .01) and marginally so for women with IBC (r = .329, p = .09). A positive correlation was also found between Doctor HLOC and Functional QL for both women with IBC (r = .464, p = .01) and women with RBC (r = .390, p = .04). After controlling for stage of cancer, women with RBC reported higher Functional QL than did women with IBC. Advanced (stages III or IV) versus early (stages I or II) cancer stage related to lower Functional QL, controlling for initial versus recurrent diagnosis (r = -.283, p = .01). A marginally significant relationship was also found for cancer stage, regardless of initial versus recurrent diagnosis, with higher Overall QL for women with early stages of breast cancer (r = -.157, p = .09). No significant differences in Optimism or Overall QL were found between women with IBC versus RBC. No differences were found between married and single women. This research begins to explore differences in Quality of Life for women with a new versus a recurrent breast cancer diagnosis.

This dissertation presents an ethnographic account of a socially diverse, public breast cancer clinic in Johannesburg. The findings of this qualitative research radically challenge the unproblematised and overdetermined use of the categories of race and gender in existing literature concerning this disease. The growing breast cancer epidemic in South Africa affects all demographic categories of women including young women. Yet, previous research frames this as a racialised and gendered crisis. Black women have been depicted as ignorant “problem patients” who resist biomedical treatment, and all women are described as having a particular relationship to their breasted bodies and a deep fear of mastectomy. Departing from these stereotypes, this ethnography reveals unanticipated data showing, firstly, that race, class, age and level of education did not determine women’s relationship to breast cancer and biomedicine. Secondly, socially diverse women commonly experienced breast cancer as a life-threatening disease that evoked confrontation with existential concerns regarding suffering, death, family, and faith. Due to these commonalities, an intimate and powerful sociality existed amongst women at this clinic. Thirdly, within this sociality, women accepted mastectomy as a necessity in creating a healthy body. Breastlessness was normalised and women generally were reluctant of breast reconstruction, thus destabilising the conceptual relationship between breasts and gender. This dissertation’s deconstruction of the use of hegemonic social categories is a significant intervention in a context where these categories are often viewed as absolute determinants of social and health phenomena, and therefore prompts more nuanced approaches to understanding experiences of illness in post-apartheid South Africa.

O objetivo deste estudo foi avaliar a frequência e o grau de fadiga e depressão nos pacientes oncológicos submetidos a tratamento quimioterápico, no início, no meio e no final do tratamento e determinar a influência destes sintomas na qualidade de vida destes pacientes. Trata-se de um estudo descritivo prospectivo, com abordagem quantitativa e foram utilizados os instrumentos para levantar os dados sócio-demográficos e clínicos, Escala de Fadiga de Piper- revisada, Inventário de depressão de Beck e o Instrumento da Organização Européia de Pesquisa e Tratamento do Câncer - EORTC QLQ C30, para avaliar respectivamente a fadiga, depressão e qualidade de vida relacionada a sáude nos três momentos. Verificou-se que os instrumentos foram confiáveis para a amostra estudada. Amostra inicial foi constituída de 40 pacientes, sendo que 34 pacientes foram avaliados nos três momentos. Quanto as características sócio-demográficas e clínicas, verificou-se homogenia em relação ao sexo; houve um predominio de pacientes acima de 40 anos, casados, nível de escolaridade fundamental, religião católica e em relação ao diagnóstico, houve um predomínio de cancer gastrointestinal nos homens e cancer de mama nas mulheres. Os resultados demonstraram aumento da frequencia de fadiga e depressão nos três momentos. A depressão aumentou em torno de 10,15% dos pacientes do primeiro até o terceiro momento e a fadiga houve um aumento de 59,7% dos pacientes do primeiro até o terceiro momento. O conjunto dos resultados permitiu visualizar aumento da frequência de fadiga e depressão nos pacientes oncológicos submetidos a tratamento quimioterápico nos três momentos e uma influencia negativa de ambos na qualidade de vida destes pacientes. / The aim of this study was to assess the frequency and degree of fatigue and depression in cancer patients who underwent chemotherapy. The assessment was conducted at the beginning, middle and end of treatment to determine the influence of symptoms on quality of life of these patients. This is a descriptive and prospective study with a quantitative approach. Data was collected using socio-demographic and clinical data, revised Piper Fatigue Scale, Beck Depression Inventory and the European Organization Research and Treatment of Cancer Quality of Life Questionnaire C30 - EORTC QLQ C30, respectively used to assess fatigue, depression and quality of life related to health at the three mentioned moments. The instruments were reliable for the studied sample. The study started with 40 patients, 36 of them were assessed at the three moments. Regarding socio-demographic and clinical data, gender was homogenous, most were 40-years-old or older, were married, studied an average of 8 schooling years and were catholic. Most men were diagnosed with gastrointestinal cancer and most women were diagnosed with breast cancer. Results showed increased fatigue and depression frequency at the three moments. At the third moment, depression had increased in 10.15% patients and fatigue had increased in 59.7% of patients. The pooled results allowed visualizing the increase in frequency of fatigue and depression in cancer patients who underwent chemotherapy at the three assessed moments, and a negative influence of both on the quality of life of these patients.

張時飛. / 論文(哲學博士)--香港中文大學, 2001. / 參考文獻 (p. 338-366) / 中英文摘要. / Available also through the Internet via Dissertations & theses @ Chinese University of Hong Kong. / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. Ann Arbor, MI : ProQuest Information and Learning Company, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Zhang Shifei. / Lun wen (Zhe xue bo shi)--Xianggang Zhong wen da xue, 2001. / Can kao wen xian (p. 338-366) / Zhong Ying wen zhai yao.