published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

published_or_final_version / abstract / toc / Social Work and Social Administration / Doctoral / Doctor of Philosophy

published_or_final_version / Obstetrics and Gynaecology / Master / Master of Philosophy

published_or_final_version / Social Work and Social Administration / Doctoral / Doctor of Philosophy

No description available.

The purpose of this qualitative research is to provide an in-depth exploration of the impact that a diagnosis of a terminal illness has on family functioning. The goal is to gain insight into adult children's personal experience when a parent is diagnosed with a terminal form of cancer. This study explores how families respond, adapt and cope when this specific family member is diagnosed with a terminal illness. It also explores any significant changes in relationships within the family and any shifts in the roles of the members and how they adjusted to such shifts. / The study is informed by a phenomenological paradigm and used an explorative, qualitative design, which included semi-structured interviews. Participant text and "found poetry" is used in order to present a more accurate account of the participants' experiences. Found poetry provides an opportunity to hear the participant's voices by taking direct quotes from their transcripts and forming them into a poem. Themes of denial, anger, helplessness, hope and anticipatory grief/mourning are portrayed in the findings of this study. The difficult emotional dilemmas and tensions that people have to work through when faced with a family member dying are discussed. The realization of the loss of future relationships will be identified as one of the greatest impacts of the illness. This study shows the lack of professional supports and resources that are available for each participant's family in being faced with the diagnosis of a terminal illness, and will address a needed consideration for social work practice.

This interpretive descriptive study explored the meaning and lived experience of breast cancer for 5 mothers and their 5 adolescent daughters, and for these mother-daughter relationships. Mothers had been diagnosed with breast cancer between 2 and 6 years ago, and their daughters were between 11 and 13 years old at the time of the diagnosis. A series of six in-depth interviews with mothers and daughters, conducted both jointly and separately, afforded a view of aspects of experience that were shared and privately held. Interview data were supplemented with participants' drawings of their experience, and the researcher's observations. The interpretive descriptive framework employed was augmented with the lens of portraiture in the conduct of study, data analysis, and composition of the product of inquiry. Portraiture utilizes five essential features: voice, relationship, context, emergent themes, and aesthetic whole. Individual and relational experience and meaning were described in four themes: (a) Inhabiting Another Landscape, (b) Intending and Acting, (c) Acquiring Wisdom, and (d) Enduring Mother-Daughter Relationships. The theme of Inhabiting Another Landscape described a trajectory of experience and meaning that began with diagnosis, persisted through prolonged effects of treatment, and continued in the present and into imagined futures. Mothers and daughters had privately held concerns about the mothers' breast cancer and the possibility that breast cancer might one day visit daughters as well. The most prominent reminder of vulnerability was recurrence among friends in the social networks of breast cancer. The theme of Intending and Acting described the mutual caring and protectiveness of these mothers and daughters. Mothers and daughters described actions and strategies to minimize the threat of breast cancer for themselves and for the other person. Actions included attempts by both persons to create and maintain a sense of normalcy. Conversations between mothers and daughters on the experience of breast cancer were limited, in particular around prognosis and the possibility of death. The theme of Acquiring Wisdom described personal growth and change after the diagnosis of breast cancer. For both persons, realizations of mortality brought a new perspective on what was important in life. Mothers passed on the wisdom gained from their experience either directly in what was said to daughters or indirectly in the attitudes and behaviours they modelled. The theme of Enduring Mother-Daughter Relationships described the quality of mother-daughter relationships and the import of breast cancer for these relationships. Mothers and daughters described their relationships as close. Daughters described their relationships as closer than most, in part because of their experience with breast cancer. Parenting and being parented was in some cases complicated by breast cancer. Friction between mothers and daughters was described as par for the course during the teen years, but one source of friction was the unexpected and prolonged effects of treatment. The findings in this study indicate the value in attending to the voices of teenage daughters, which remain largely absent in the literature. Mothers and daughters have needs for information and support that are not being met. The emotional landscape of breast cancer, which entails prolonged uncertainty for both mothers and daughters, deserves further study. Personal growth described by both mothers and daughters provides an alternative view of the largely problem-focused perspective in the literature of the meaning and experience of breast cancer.

As breast cancer incidence and survival rates increase, there is an urgent need to make appropriate psychosocial support available to all women with breast cancer. In this qualitative study, narrative inquiry was used to examine how women with breast cancer used visual creative expression (art therapy and/or independent art making) to address psychosocial needs that arose for them after their diagnoses. Seventeen women, aged 37-82, participated in this investigation. Data analysis of in-depth interviews with these women focused on narratives they constructed about why they turned to art therapy and/or independent art making and how it helped to be involved in these activities. Particular attention was given to the issue of meaning making. Four storylines emerged from the analysis. "Art and art therapy as a haven" came from narratives about using art making or art therapy for comfort and affirmation. The narratives that comprised "getting a clearer view" were about using visual creative expression to create a clear picture of emotional experience. "Clearing the way emotionally" came from narratives about self-expression and about processing difficult emotions. The narratives that yielded "expanding and enlivening the self were about the women fortifying and energizing themselves through visual creative expression. Two minor themes related to the role of the art therapist and negative experiences with art therapy also emerged. In their narratives, the women portrayed visual creative expression as flexible, compelling, and powerful means of addressing multiple psychosocial needs simultaneously. Above all, the storylines show that the women valued visual creative expression as a way to reduce the feeling of threat to existence, to affirm present existence, and to promote the ongoing existence of both their psyches and their bodies. The results of this study contribute to the field of psycho-oncology by extending understandings of meaning making in relation to breast cancer, supplying detailed explanations from the perspectives of women with breast cancer of how visual creative expression can be helpful, and providing valuable insight into how psychosocial support services based on visual creative expression might meet needs of women with breast cancer that would not be met through other types of services.

There is considerable evidence that delays in diagnosing and treating breast cancer reduce long-term survival. The purpose of this study was to assess the waiting time between diagnosis and treatment for Alberta women with breast cancer and to examine the influence of age, cancer stage, Regional Health Authority (RHA), community size, and year of diagnosis on this time interval. The data were obtained from the Alberta Cancer Board. The information included approximately all Alberta women with breast cancer between 1997 and 2000. The overall median waiting time was 17 days. The mean and median delay increased by an average of two days each year. Only 43.8% of cases were treated within the recommended 14 days. The delay was significantly longer for women younger than 70, with stage 1 disease and from Northern RHAs. Efforts must be made to decrease delay and ensure that all women receive equal access to health services. / xii, 106 leaves : ill. ; 28 cm.