The primary aim of this thesis was to increase healthcare professionals’ understanding surrounding the emotional distress of paediatric oncology patients prior to reaching five-year survivorship status, to inform resource allocation and evidence-based clinical interventions. Paper 1 systematically reviewed the extant literature that has assessed the emotional distress severity of paediatric oncology patients who had not yet reached five-year survivorship status. Contradictory findings were evident from the 21 studies reviewed. These inconsistencies in findings were discussed in relation to methodological limitations present within the studies and the heterogeneous oncology and control groups studied. The review concluded that further multiple-centre studies, using appropriate self-report and parent-proxy standardised measures, and larger, representative samples comprising patients with CNS and non-CNS malignancies at differing points in their treatment journeys, are needed to identify demographic, illness and treatment variables that leave paediatric oncology patients vulnerable to emotional distress. The empirical paper presented in Paper 2 utilised a rigorous methodology to address this need, and additionally explored modifiable psychological risk factors for emotional distress in this population. 74 paediatric oncology patients (aged 12-18 years), who were within five years of treatment completion, completed self-report measures of emotional distress, self-concept and health related quality of life (HRQOL), whilst their parents provided background information regarding patients’ demographics, diagnoses and treatment protocols. 72 parents also provided ratings surrounding patients’ self-concepts and HRQOL. The mean emotional distress rating indicated that the sample was clinically distressed. Demographic, illness and treatment factors explained little variance in emotional distress, whilst global self-concept, global-generic and cancer-specific HRQOL were significant predictors. Provisional analyses indicated that experiencing pain, illness-related worries, communication difficulties and negative self-views in relation to maths abilities, parent relations and opposite-sex peer relations were specific risk factors in the sample studied. Patient- and parent-reports of patients’ self-concepts and HRQOL were highly consistent. These findings suggest that paediatric oncology patients would benefit from frequent routine screening for emotional distress to allow early identification and intervention. Furthermore, prevention-oriented interventions surrounding emotional distress, and indirect interventions targeting global self-concept and HRQOL could be beneficial. Paper 3 critically appraises the systematic review and empirical paper in terms of their methodologies and clinical contexts. It is acknowledged that some of the results are preliminary in nature and need replicating in larger samples. Nevertheless, this research was successful in exploring demographic, illness, treatment and psychological risk factors for emotional distress for paediatric oncology patients prior to reaching five-year survivorship status, providing guidance for future clinical interventions, and making suggestions for future studies, in terms of their aims and methodologies.

The present study investigated whether the presentation of severe psychological injury increased the perceived likelihood of sexual harassment and more plaintiff-friendly verdicts in a hostile environment sexual harassment claim. Four hundred thirty-two participants were presented with a case summary divided into five paragraphs. Within the fifth paragraph, participants were informed that the plaintiff suffered from different severity levels of psychological injury. Gender was monitored to ensure a proportional amount of males and females in each condition. Results indicated that the presentation of psychological injury in any form increased the likelihood of perceived sexual harassment and verdicts for the plaintiff. Participants believed that garden-variety injuries (i.e., embarrassment, humiliation) were more likely to occur from sexual harassment, and had a greater impact on their perceptions and liability determinations. These results suggest that participants may use the presentation of psychological injury as a heuristic that when present, favors the plaintiff. / Department of Psychological Science

A sample of 791 college students between the ages of 18 and 25 years-old completed an online survey. Respondents were administered a series of measures to determine their sexual identity development status, global self-esteem, global psychological distress, sexual esteem and sexual distress. A 2 X 4 MANOVA (Sexual Orientation X Sexual Identity Development Status) was conducted. Results indicated that no significant difference was observed in terms of psychological distress, global self-esteem, sexual esteem or sexual distress between those who identified as gay, lesbian, or bisexual and those who identified as heterosexual. Significant differences were found among participants in relation to sexual identity development status. Specifically, those who were classified as having achieved a sexual identity scored higher on measures of self-esteem and lower on measures of psychological distress. Notably, follow up DFA indicated that sexual distress emerged as a particularly stable and important variable in explaining differences among those in different sexual identity development statuses. Implications for research and practice are discussed. / Department of Counseling Psychology and Guidance Services

Intensivvårdssjuksköterskor uttrycker upplevelser av moralisk stress i det dagliga arbetet och detta kan leda till utbrändhet eller behov av att byta yrke då de inte lyckas bemästra sin situation. Studiens syfte var att kartlägga moralisk stress hos intensivvårdssjuksköterskor med hjälp av Moral Distress Scale(MDS). Studien utfördes med en deskreptiv metod av tvärsnittsdesign där 45 sjusköterskor med intensivvårdsutbildning i västsverige tillfrågades att vid ett tillfälle besvara en enkät med en validerad svensköversatt MDS. Resultatet påvisade att det finns signifikant höga nivåer av moralisk stress hos intensivvårdssjuksköterskor yngre än 45 år(p=0,044) och även i gruppen med kandidat/-magisterexamen(p=0,003). De högsta nivåerna av moralisk stress kunde uppmätas när intensivvårdssjuksköterskorna ställdes inför situationer där de upplevde att ingen var beredd att fatta beslut om att avsluta livsuppehållande behandling. Bristande kompetens, "onödiga" behandlingar och resursbrist medförde också hög moralisk stress. För att motverka moralisk stress behövs enligt studier; debriefing, etiska vårdkonferenser och stöd från arbetsledningen. Denna studie kan bidra till att åskådliggöra moralisk stress och intesnifiera diskussionen samt skapa ett gemesnamt språk kring moralisk atress bland intensivvårdssjuksköterskor.

Diss. (sammanfattning) Umeå : Univ., 2003. / Härtill 4 uppsatser.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2006. / Härtill 5 uppsatser.

Thesis (Ph. D.)--Michigan State University. Dept. of Psychology, 2006. / Title from PDF t.p. (viewed on Nov. 16, 2008) Includes bibliographical references (p. 71-78). Also issued in print.

Thesis (M.A.)--University of Toronto, 2007. / Source: Masters Abstracts International, Volume: 45-06, page: 2734.

Thesis (Ph. D.)--University of Missouri-Columbia, 1997. / Typescript. Vita. Includes bibliographical references (leaves 85-89). Also available on the Internet.

Thesis (Ph. D.)--University of Missouri-Columbia, 1997. / Typescript. Vita. Includes bibliographical references (leaves 85-89). Also available on the Internet.