The concept of patient empowerment, although acknowledged by the medical community as important, is rarely understood and seldom given priority in the illness trajectory of the cancer patient. A pilot study of a Shared Care Model amongst haematological cancer patients highlighted the fact that some patients spoke of a sense of empowerment and an overall sense of greater control when more fully included in the treatment and management of their condition. The research which forms the basis of this thesis focused on the role of empowerment in the wellbeing of cancer patients. There were three objectives to be met by completing this research. Firstly, to demonstrate that empowerment is a uniquely identifiable concept and can be measured separately from other quality of life indicators. Secondly, the study sought to explore that concept that empowerment takes into account the way in which patients act upon their prognosis and optimise the outcomes of treatment. Thus it is believed that accessing tailored resources and support structures benefit cancer patients and those who are caring for them such as close family members and friends by helping the patient achieve an individual level of empowerment. Finally, the research sought to explore the concept that empowerment improves psychological outcome in patients. The benefits are increased empowerment and an active use of coping strategies amongst patients in order to regain a measure of control over their illness. The Patient Empowerment Scale was developed to measure empowerment as an individual construct. '...' The Patient Empowerment Scale (15 items) was shown to be a reliable measure of empowerment and fitted the model well. A qualitative methodological approach sought to address and explore the second and third concepts. In addition, the concept of empowerment as it relates to motivation and self-efficacy was investigated qualitatively using in-depth interviewing technique. A phenomenological methodology was used to explore the 'lived experience of cancer patients' in regard to regaining control of their illness and the management thereof. Participants were interviewed using concepts identified for the Patient Empowerment Scale such as support strategies and use of resources. A series of interviews with breast cancer patients were conducted whereby patients responded to a number of questions. The questions explored areas such as support mechanisms in relation to cancer, their relationships with health professionals and significant others and their attitude toward and use of other resources and support systems such as support groups, spirituality, complementary therapies. In addition their views on acceptance and adaptation to their altered health status were explored. Results The research confirmed that it is feasible to measure empowerment as a separate quality of life indicator. Furthermore, that empowerment is linked to motivation and self-efficacy beliefs. The research also demonstrated that there are a number of core areas which are fundamental to regaining control and increasing empowerment for patients. These core areas are linked to support mechanisms, willingness to adapt and to access resources tailored to meet their needs. Patient empowerment emerged as a key aspect of enhanced quality of life regardless of prognosis and improved psychological outlook.

published_or_final_version / Nursing Studies / Master / Master of Nursing in Advanced Practice

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

The purpose of this study was to investigate the influence of gender, time since diagnosis, and the family environment on the psychosocial adaptation of cancer patients. This study was important because there is a deficit in the literature investigating the effects of the family environment on psychosocial adaptation in male and female cancer patients with diverse diagnoses. This study measured psychosocial adaptation by the patient's ability to adjust to cancer-related stressors in the areas of social relationships, involvement in health care, psychological well-being, household and work related duties, and family relationships. The family environment was measured by the patient's perceived level of cohesion, expressiveness, and conflict in the family.The study's sample consisted of 149 stage I or II cancer patients over the age of 50 with no prior cancer diagnosis, recurrence, or metastases. Participants completed a set of questionnaires, including the Psychosocial Adjustment to Illness Scale and the Family Relationship Index. The combination of gender, time since diagnosis, and the family environment, with demographic variables held constant, was significant and accounted for nearly one-third (27 %) of the variance in cancer patients' psychosocial adaptation. Results showed that the family environment is a significant predictor of psychosocial adaptation in cancer patients. Gender and time since diagnosis were not significantly related to psychosocial adaptation. Implications from this study are offered. / Department of Counseling Psychology and Guidance Services

Behavior analysts who study verbal behavior theorize that people derive relationships between stimuli - forming stimulus classes such that psychological functions transfer among stimuli and therefore affect behavior. Verbal processes are thought to play a role in cancer patients' behavioral flexibility. The current study examined if an analogue intervention produced changes in relations between health-relevant stimuli from pre- to post-test in patient and student samples. A matching-to-sample (MTS) task required participants to form three 4-member classes that included health, treatment, or neutral terms. Participants next listened to either an acceptance-based or a control-based rationale and therapy exercise, or a distracter task. Then, they were re-exposed to the MTS task. Latencies and accuracies for learning each class as well as between condition differences were examined. Finally, changes in ratings of stimuli from pre to post analogues were measured. Differences in stimuli ratings were seen in the student sample, reflecting transfer of function and some reduction in responsiveness to stimuli following intervention, but overall no learning performances are found. Discussion explores the consistency of the findings with acceptance and commitment therapy (ACT) theory in light of the seemingly lack of findings.

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

Social support is likely to play an especially important role in coping with a cancer diagnosis as it presents a unique set of stressors to the individual. The purpose of this study was to examine biological sex differences in the perceived availability of three modes of social support (emotional, instrumental, and informational), source of support (friends vs. family), and social support seeking behavior in a population of cancer patients. The sample included 71 men and 71 women who had been diagnosed with cancer within two years of the start of the study. No significant sex differences were found in social support seeking; however, results revealed that women perceived greater availability of emotional support as well as greater support from friends on all modes of social support than did men. Implications of these findings and future directions for research are discussed. / Department of Counseling Psychology and Guidance Services

Please read the abstract in the section 00front of this document Please cite as follows: Opperman JA, 2002, Die emosionele belewenis van 'n beenmurgoorplanting : 'n Maatskaplike Werk perspektief, MA dissertation, University of Pretoria, Pretoria, viewed yymmdd < http://upetd.up.ac.za/thesis/available/etd- 07252005-110248/ > / Dissertation (MA (Social Work))--University of Pretoria, 2002. / Social Work and Criminology / MA (Social Work) / unrestricted

This study addresses the importance of studies of human psychoneuroimmunology in understanding the role of psychological factors in cancer. Research trends in psychosocial aspects of cancer are reviewed, exploring the role of distress and the support group as an intervention which potentially reduces distress through enhancing interpersonal relationships, emotional adjustment and communication with health professionals, in these ways helping the patient to cope with the symptoms of treatment. In South Africa, most hospitals which treat cancer patients medically do not simultaneously have support groups for the newly diagnosed patient to join in order to discuss immediate fears and acquire more knowledge about their particular disease. Following an experimental cancer support group involving patients who had recently undergone a bone marrow transplant (some considerable time after their first cancer diagnosis) in Cape Town's Groote Schuur Hospital, the researcher, as one of the participants in the fortnightly meetings convened to dicuss psychosocial issues related to each patient's experience of the cancer and transplant process, transferred the themes, concepts and questions that arose in that scenario, to a cancer clinic in Pretoria where recently diagnosed patients were asked to volunteer to participate in such a group. It was felt that these patients would derive some benefit early in their treatment programme. Psychosocial concerns are left to the individual patient to seek therapy should it be required. Presently, it is reported in the body of knowledge about cancer, that interventions aimed at alleviating the psychosocial distress of cancer patients highlight hypnosis, guided imagery and relaxation therapy. It is contended that a more appropriate intervention for the majority of people with cancer in South Africa would entail a fellow-patient support group meeting on a regular basis. / Psychology / (M.A. (Psychology)

Abstract not available