The purpose of this study is to investigate the differences and similarities of quality of life (QoL) in American and Portuguese cancer patients with hematological malignancies as well as the robustness of the measures cross-culturally. Portuguese participants were 98 patients and 49 accompanying persons and the American participants were 55 patients and 22 accompanying persons. Fifty (Portuguese sample) to 40% (American sample) of the patients came with an accompanying person who answered the questionnaire concerning the patient's QoL. The two cultural groups were characterized in terms of QoL (measured by the SF-36 and the FLIC), social support (Social Support Scale), socio-demographic and clinical variables. Portuguese patients reported a higher QoL. However, this result could be attributable to the fact that the two cultural samples differ in socio-economic status. The measures seem to be comparable for the Portuguese and American samples, at least in what concerns reliability and concurrent validity.

This thesis was concerned with the psychological adjustment of 67 end-stage cancer patients, and three psychosocial variables considered to influence that adjustment: emotional support from spouse, positive meaning, and working models of attachment. Furthermore, this thesis was also concerned with the psychological adjustment of the patients' spouses, and the influence of emotional support from patient and working models of attachment on their adjustment. It was hypothesised that each of these psychosocial variables would directly influence the psychological adjustment of patients and spouses, measured using the negative affectivity scale of the Positive and Negative Affect Scale (PANAS). Furthermore, it was hypothesised that emotional support would influence positive meaning, and working models of attachment would influence both emotional support and positive meaning. Variables were measured via paper and pencil self-report inventories, with the exception of positive meaning, where verbal responses to an open question were coded. Univariate analyses indicated an association between patients' and spouses' emotional support provided by one another and their psychological adjustment. Univariate results also showed that patients' positive meaning was related to patients' psychological adjustment, and that patients' working models of attachment involving higher levels of attachment anxiety were associated with patients' poorer psychological adjustment. All these individual associations remained statistically significant after three control variables related to the patients' physical condition were taken into account. In addition, univariate analyses indicated that attachment was associated with emotional support, and that emotional support was associated with positive meaning. Following univariate analyses, variables were integrated into one model for patients and another for spouses using path analyses. Results were generally consistent with the prior sets of analyses. However, patients' working models of attachment involving higher levels of attachment anxiety no longer had a direct effect on patients' psychological adjustment to statistically significant levels. Rather, the influence of the working models of attachment on patients' psychological adjustment was mediated by emotional support. In addition, patients' positive meaning no longer had a significant direct effect on patients' psychological adjustment. The insignificant path coefficients between attachment anxiety and psychological adjustment, and between positive meaning and psychological adjustment, were attributed to the large amount of variance in negative affect due to emotional support. In summary, this research indicates that emotional support given and received between patients and spouses is important to the psychological adjustment of each party. Furthermore, emotional support influences patients' ability to construe positive meaning in their illness, although positive meaning does not appear to be as critical to the psychological adjustment of patients as emotional support. Working models of attachment influence the psychological adjustment of patients primarily through their influence on emotional support.

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

published_or_final_version / Social Work / Master / Master of Social Work

published_or_final_version / Social Work / Master / Master of Social Work

published_or_final_version / Clinical Psychology / Doctoral / Doctor of Psychology

published_or_final_version / Clinical Psychology / Master / Master of Social Sciences

published_or_final_version / Community Medicine / Master / Master of Public Health

Cancer, the most common cause of death in Hong King, poses marked psychological impacts through treatment into cancer survivorship. Literature indicated that internal health locus of control was associated with better psychosocial adjustment (Wang et al., 2013). Meanwhile, fatalistic view was related to avoidant coping and poor psychological adjustment (Chan, 2000). However, fatalism might have a different meaning for the Chinese (Ho et al., 2003). The present study examined the relationship of health locus of control, fate Control and subjective well-being among Chinese cancer patients. Ninety-nine cancer patients were assessed with Multidimensional Health Locus of Control Scale, Fate Control Scale from Social Axiom Survey and Functional Assessment of Cancer Therapy Scale-General during active treatment (Time 1) and with WHO-5 Well-Being Index at a six-month follow-up (Time 2). At Time 1, results indicated positive correlation between powerful others health locus of control and functional well-being. At Time 2, internal health locus of control was positively correlated with WHO-5 while social well-being at Time 1 was positively correlated with WHO-5. Implication of findings and limitations of study were discussed. / published_or_final_version / Clinical Psychology / Master / Master of Social Sciences

Although there are many instruments available to assess patient adaptation to cancer, there are few instruments which can be used to assess family members of cancer patients' adaptation to cancer. The present study was conducted to determine the internal structure and factor reliability estimates of a new instrument, the Family Adaptation to Medical ILLness Inventory (FAMILLI). The analysis of the FAMILLI was conducted using respondents (N=139) with family members of cancer. Respondents' ages ranged from 18 to 70 and many types of cancer, such as lung, breast, colorectal, prostate, brain, and cervical, were represented. The study was conducted in two phases, the pilot study and the major investigation.During the pilot study, respondents from a midwestern university setting and the oncology department at a midwestern hospital (N=28) completed the FAMILLI and participated in feedback groups. The pilot study helped to refine the demographic information sheet and to reduce the number of questions on the FAMILLI from 55 to 35 questions. In addition, interesting demographic questions were added to the demographics forms.The major study (N= 117) was conducted to test the initial factor structure of the FAMILLI and to test convergent and discriminant validity. A principal components extraction yielded a six factor solution which was judged best in terms of statistical structure and theoretical parsimony. The six factors to emerge were 1) factor one, "personal needs," 2) factor two, "attitudes toward leisure and work activities," 3) factor three, "anger and blame," 4) factor four, "receiving support," 5) factor five, "seeking medical information," and 6) factor six, "family responsibilities."Convergent and discriminant validity were tested using the Cancer Behavior Inventory (CBI-B) and the Satisfaction With Life Scale (SWLS). It was hypothesized that the FAMILLI would demonstrate convergent validity with the CBI-B. Four of the six factors (factors 2, 3, 4, and 5) significantly correlated with the CBI-B. The SWLS was used to test discriminant validity. Five of the six factors (factors 1, 2, 3, 4, and 6) correlated significantly with the SWLS. Thus, the FAMILLI did not demonstrate discriminant validity with an instrument used to measure global assessment of quality of life. Further research is needed to test the reliability and validity of the FAMILLI. / Department of Counseling Psychology and Guidance Services