Thesis (Ph. D.)--School of Nursing. University of Missouri--Kansas City, 2007. / "A dissertation in nursing." Advisor: Peggy Ward-Smith. Typescript. Vita. Title from "catalog record" of the print edition Description based on contents viewed Dec. 19, 2007. Includes bibliographical references (leaves 74-83). Online version of the print edition.

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Thesis (Ph.D.)--York University, 2004. Graduate Programme in Psychology. / Typescript. Includes bibliographical references (leaves 164-184). Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL: http://wwwlib.umi.com/cr/yorku/fullcit?pNQ99148

Thesis (Ph. D.)--University of Rhode Island, 2006. / Typescript. Includes bibliographical references (leaves 114-119).

Thesis (Ph.D.)--Indiana University, 2009. / Title from screen (viewed on February 2, 2010). School of Nursing, Indiana University-Purdue University Indianapolis (IUPUI). Advisor(s): Joan E. Haase, Marion E. Broome, Janet S. Carpenter, Richard M. Frankel. Includes vitae. Includes bibliographical references (leaves 227-258).

Indiana University-Purdue University Indianapolis (IUPUI) / Research has shown that adolescents with cancer (AWC) face treatment that is complex, invasive, and onerous. Coming during a time with major developmental changes, it brings the potential of making high demands on the coping capacity of these adolescents. Using the theoretical frameworks of stress and coping, life-span development and Haase's (1996) Adolescent Resilience Model (ARM), this study explored the influences of social support and family environment on coping for AWC.

The overall purpose of this mixed method study was to describe adolescents’ experiences of ease while enduring treatment for cancer. Specifically, the study used avatar image-guided story-sharing (AIGSS) to explore adolescent sense-of-self, experiences of feeling uneasy, descriptions of qualities of ease, and best places for finding ease during treatment. The innovative research approach used in this study incorporated avatar images representing ‘ease’ in typical environments. By testing a developmentally relevant approach, AIGSS, to explore ease for adolescents enduring cancer, this study addressed a pressing need for meaningful approaches to engage adolescents in health-related dialogue about what matters most. While 10 qualities captured adolescent ease (beauty, fun, safety, strength, connectedness, calmness, rest, comfort, independence, and familiarity), connectedness, strength, fun, rest, and safety were the most significant qualities of ease threaded throughout stories. Two themes of self-reflected identity emerged: (a) valued personal qualities (extrinsic/admired) and (b) infused unique demeanors. Three themes described adolescent uneasiness during cancer treatment: (a) persistent uncertainty, (b) fearful anticipation, and (c) disrupted self. While home was most conducive for ease, personal meaning was given to the hospital enabling finding ease. This new knowledge is foundational for nurses who support adolescents during cancer treatment. This research lays the groundwork to re-define ease as a relevant outcome of quality nursing care, focusing on positive outcomes rather than catastrophic ones such as infection and death. Advancing caring science with interactive participative research enhanced communication with adolescents, having implications for both clinical research and pediatric oncology nursing practice. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2016. / FAU Electronic Theses and Dissertations Collection

Background: Despite advances in cancer prognosis and increased survival rates for childhood cancer, having a child diagnosed with cancer can be considered one of the most stressful life events in a parent’s life. The adverse psychological impact of childhood cancer on parents has been found to be higher than in any other childhood chronic illness. Parents can find it difficult to adjust and use effective coping strategies to deal with the illness-related demands. Dispositional optimism (i.e. positive outcome expectancies for the future) has become a key theoretical component in positive and health psychological research, aiming to explain adjustment and coping in distressing life situations. However, optimism in the context of caregiving for a child with chronic illness and especially cancer has received little research attention, but may be important as optimistic people tend to show greater psychological adjustment and effective coping. Aims: To identify the characteristics of optimistic parents of children with cancer. To examine the relationship between optimism, anxiety, depression, life satisfaction, coping and subjective health perception in parents of children with cancer and parents of healthy children. Also, to provide a more in-depth understanding of the needs and experiences of parents in relation to their level of optimism/pessimism. Methods: A mixed methodological approach (quantitative and qualitative methods) was adopted to study optimism as well as the impact and the experiences of parents caring for their child with cancer. The mixed method design comprised two phases of data collection and analysis. In Phase I, quantitative methods were used. 100 parents of children with cancer were recruited during attendance at Oncology Out-patients Clinics at a UK regional Cancer Centre. A comparison group of 117 parents of healthy children were also recruited. All parents completed a questionnaire, providing demographic and medical information relating to their child, dispositional optimism, psychological distress, life satisfaction, coping and subjective health perception. Descriptive statistics, unrelated t-tests and x2 tests were used where appropriate to examine differences on optimism, psychological distress, life satisfaction and coping variables between the SG and CG. Bivariate Pearson correlations were used to identify any possible differences between the two groups. In Phase II, qualitative data were collected and analysed using Interpretative Phenomenological Analysis (IPA). 10 semi-structured interviews were conducted with 5 high optimistic and 5 high pessimistic parents of children with cancer given their optimism score in the quantitative study. Results: In the Phase I of the study, findings showed that the parents of children with cancer had higher levels of anxiety, depression, lower levels of optimism, satisfaction with life and subjective health perception than the comparison group. Optimism was significantly correlated with satisfaction with life, subjective health perception, anxiety and depression in both groups. The interviews in Phase II of the study explained better the role of optimism and pessimism in parental experience of adjusting to and coping with childhood cancer. Interviewees described the way that their child’s diagnosis of cancer had affected their lives and their journey from shock to acceptance and adjustment for the optimistic parents or despair and feelings of helplessness and inability to cope for the pessimistic parents. Regardless of level optimism/pessimism, interviews underlined the importance and parents’ need for social support, ongoing communication with health professionals and contact with other parents of children with cancer. Conclusion: The findings highlight the importance of optimism and pessimism in relationship to psychological distress in parents of children with cancer. Interventions targeting parents’ optimism are recommended as a potential source of coping with adversity within this population.

Differences in self-reported depression, anxiety, self-esteem, and coping were evaluated in two groups of pediatric oncology patients: newly diagnosed (less than six months post-diagnosis) (n=5) and patients on cancer treatment for seven months or longer (n=5). Participants (6 males, 4 females, ages 7-17 years) completed the Children's Depression Inventory (CDI), the State-Trait Anxiety Inventory for Children (STAIC), and the Culture-Free Self-Esteem Inventory (CFSEI-2); nine of the ten participants discussed in a semi-structured interview their personal experiences and feelings about having cancer. Although the newly diagnosed group had a higher mean score on the CDI than the 7 months or greater group, the difference was not significant (p = .054). The newly diagnosed group also had higher mean state and trait anxiety scores on the STAIC, indicating higher anxiety levels, and a slightly lower CFSEI-2 mean score, indicating slightly lower self-esteem than the 7 months or greater group, but differences were not at a statistically significant level (p>.05).

Recent medical advances in cancer screening and treatments have led to dramatically decreasing mortality rates from cancer among children and adolescents. However, the cancer itself and the adverse effects of treatments remain severely devastating to their physical and psychological well-being, both during and after treatments. Numerous studies have demonstrated that regular physical activity is related to various physiological and psychological benefits for children and adolescents under cancer treatments. Nevertheless, a review of the literature reveals that children and adolescents commonly present declining levels of physical activity throughout their cancer treatments. There is so far no study has investigated the physical activity level and behaviour in particular, the influencing factors affecting the physical activity level among Hong Kong Chinese children and adolescents with cancer. Therefore, this study aimed (1) to assess and compare the physical activity levels and behaviour of healthy children and adolescents with those of children and adolescents undergoing cancer treatments and (2) to explore the various factors that influence the physical activity levels of children and adolescents with cancer in Hong Kong. A cross-sectional study, using both quantitative and qualitative approaches, was conducted. A total of 76 children and adolescents (9-to 18-year-olds) who were admitted for treatment of cancer in a paediatric oncology unit and 148 healthy counterparts who were participated in two health carnivals in Hong Kong were invited to participate in the study. Their physical activity levels, stages of change for exercise, self-efficacy for physical activity and quality of life were assessed and compared. A total of 25 participants with cancer were purposively selected for semi-structured interviews. The results of this study indicated that children and adolescents with cancer in current situation had significantly decreased levels of physical activity when compared with the premorbid situation or the healthy counterparts. The study also showed that children and adolescents with cancer presented significantly lower levels of physical activity, self-efficacy, stage of change for exercise and quality of life than the healthy participants. Furthermore, qualitative interviews revealed that the negative impacts from cancer and its treatments, the discouragement of and misunderstanding concerning physical activity, and the space limitations in Hong Kong were important factors that disengaged these young people from regular physical activity while under treatment. This study has addressed an literature gap by assessing the levels of physical activity, self-efficacy, stage of change, and quality of life among children and adolescents with cancer as compared to their healthy counterparts. The results provide further evidence that cancer and its treatments induce negative impact on the physical, psychological well-being and the quality of life in children and adolescents with cancer. It is essential for healthcare professionals to detect physical inactivity at an early stage so that appropriate interventions can be applied to correct any misunderstandings about physical activity among children and adolescents with cancer and their parents. Most importantly, interventions should be designed to promote the adoption of regular physical activity for these patients, with the aim of enhancing their physical and psychological well-being. / published_or_final_version / Nursing Studies / Master / Master of Philosophy