published_or_final_version / Clinical Psychology / Master / Master of Social Sciences

Cancer has long been a prevalent illness in Hong Kong which caused tremendous stress on patients and their families. This study examined the cognitive process and behavioral efforts which related to cancer patients’ subjective well-being. Three hypotheses were proposed. First, higher internal locus of control over the cause of illness was hypothesized to relate to poorer subjective well-being through maladaptive coping. Second, higher internal locus of control over the course of illness may result in better subjective well-being through adaptive coping. Third, higher levels of hope may relate to better subjective well-being through adaptive coping. Ninety-eight patients with different types of cancers were recruited in this study. The results showed that internal locus of control over the cause of illness was not directly related to subjective well-being. The relationship between internal locus of control over the course of illness and social/family well-being was fully mediated by adaptive cognitive-behavioral coping and social and activity-engagement coping respectively in two separate mediation analyses. The relationship between levels of hope and social/family well-being was partially mediated by social and activity-engagement coping, while levels of hope significantly associated with social/family, emotional, functional and overall well-being. The study findings enhance understanding of close relationship between cognitive process and behavioral efforts in enhancing cancer patients’ adjustment to the illness. / published_or_final_version / Clinical Psychology / Master / Master of Social Sciences

In support of Snyder’s cognitive theory, hope has been found to be a positive factor in psychological adjustment among adult cancer patients and non-cancer paediatric patients with various illnesses. Nonetheless, Snyder’s cognitive theory of hope has not been specifically examined among childhood cancer patients and survivors. Unlike adult cancer patients, childhood cancer patients and survivors are characterized by early onset age in their cancer diagnosis which may mean that they face different psychological and physiological challenges. The identification of positive factors that attenuate negative psychological adjustment outcomes may be crucial in the development of effective therapeutic interventions. Despite that previous studies support the correlation between hope and positive adjustment outcomes, the exact cognitive mechanism that underpins the cognitive theory of hope remains underexplored. Although Snyder postulated that hope is goal-directed thinking which comprises willpower and waypower, he failed to establish any association between hope and rumination. The role of rumination in predicting the onset of mood symptoms and maintaining psychopathology has been well-researched, but it is conceptually meaningful to investigate the potential association between hope and rumination and their respective roles in affecting psychological adjustments in cancer experiences. The current thesis improves on the understanding of relationships between hope, rumination and cancer adjustment, and expands on studies of cancer adjustment by tapping into both positive and negative psychological outcomes, and examines how these two juxtaposed outcomes are associated with hope as mediated by positive and negative ruminations respectively. Eighty-nine childhood cancer survivors from the Children’s Cancer Foundation in Hong Kong took part in questionnaires that measured their levels of hope, rumination, mood symptoms and self-perceived positive changes or post-traumatic growth (PTG). The findings suggest that hope is negatively correlated with depression and anxiety, which are specifically mediated by negative cancer-related rumination. Hope is also positively correlated with PTG, which is specifically mediated by positive cancer-related rumination. These results provide empirical evidence to support the postulation by Snyder that low hope individuals adjust poorly because they are more likely to have negative rumination. High hope individuals adjust better as they are more likely to engage in positive rumination which is associated with PTG. The overall findings provide a possible explanation for the cognitive mechanism that underlies hope. A supplementary pilot study conducted measuring 20 childhood cancer patients’ hope level and mood symptoms over a period of nine months post-acute treatment also suggests patients have fewer prospective depressive symptoms have higher hope level in early measurement. The findings of the current thesis have important clinical implications. The understanding of hope and its association with rumination and cancer adjustment may inform the specific development of hope-based therapeutic interventions for childhood cancer patients and survivors, such as the hope-based storybook developed in this study with the aim to increase the hope levels of childhood cancer patients. / published_or_final_version / Clinical Psychology / Doctoral / Doctor of Psychology

Hui Chi Wing Josephine. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2003. / Includes bibliographical references (leaves 91-97). / Abstracts in English and Chinese. / Abstract --- p.i / Acknowledgement --- p.iv / List of Tables --- p.vii / List of Figures --- p.ix / Chapter Chapter 1: --- Hope in the Literature --- p.1 / Chapter Chapter 2: --- Hope and Adjustment --- p.19 / Chapter Chapter 3: --- The Proposed Study - Methodology --- p.26 / Chapter Chapter 4: --- Result I - The Construct of Hope --- p.37 / Chapter Chapter 5: --- Result II - Hope and Adjustment in Community Sample --- p.59 / Chapter Chapter 6: --- Result III - Hope and Adjustment in Clinical Sample --- p.74 / Chapter Chapter 7: --- Conclusion --- p.87 / References --- p.91 / Appendices --- p.98 / Appendix A: Interview Form for the Thalassemic Children --- p.98 / Appendix B: Invitation Letters and Consent Forms for the Community Sample --- p.103 / Appendix C: Children Questionnaire for the Community Sample --- p.104 / Appendix D: Parent Questionnaire for the Community Sample --- p.110 / Appendix E: Consent Forms for the Clinical Sample --- p.116 / Appendix F: Children Questionnaire for the Clinical Sample --- p.118 / Appendix G: Parent Questionnaire for the Clinical Sample --- p.127 / Appendix H: Coding Protocol --- p.138

published_or_final_version / Clinical Psychology / Master / Master of Social Sciences