Diss. (sammanfattning) Uppsala : Univ., 2001. / Härtill 5 uppsatser.

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Anticipatory grief has been described as a grief reaction which occurs prior to an expected loss. If cancer is perceived as a threat to life, relatives of patients diagnosed with cancer may experience anticipatory grief upon learning of the patient's diagnosis. Health professionals must have a greater awareness of the manifestations of this syndrome if they are to provide comprehensive care to these patients and their families. This study was designed to determine if a diagnosis of cancer does precipitate the manifestations of anticipatory grief first described by E. Lindemann in members of the patient's family. These manifestations include heightened preoccupation with the patient, depression, a review of the possible forms of death which may befall the patient and anticipation of the modes of readjustment that would be necessitated by his death. Using a semi-structured interview guide with open-ended questions, the investigator interviewed twenty family members of fourteen patients. The sample included spouses, children and parents of the patients. All of the interviews were recorded on audiotapes which were used for content analysis of the data. Of the twenty subjects, seven described all four manifestations, six mentioned three, three mentioned two, three mentioned one, and one subject did not mention any of the manifestations. Heightened preoccupation was described by seventeen subjects, depression by sixteen, reviewing forms of death by thirteen and anticipation of modes of readjustment by nine. Other common reactions expressed were fear of the disease and it consequences, hope inspired by knowledge gained from the clinic' specialists, and a feeling of ambivalence toward the disease and its treatment. Family differences were emphasized by the subjects' expressions of concern about the reactions of other members of the family. The results of this study indicate that Lindemann's theory can be used as a framework for assessing the anticipatory grief reactions of this population and suggest that it may also be applicable in a wider range of life-threatening situations. The fact that anticipatory grief was not experienced universally by this group was contrary to statements made in the literature that anticipatory grief is inevitable following a diagnosis of cancer and suggests that the attitude toward this disease may be changing. Further study is needed to determine if knowledge level or perception of the disease are significantly related to the experience of anticipatory grief in the early stages of the disease and if there are other factors which may be influential. / Applied Science, Faculty of / Nursing, School of / Graduate

Lin Kwok Yin. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2000. / Includes bibliographical references (leaves 116-124). / Abstracts in English and Chinese. / ACKNOWLEDGMENT --- p.i / ABSTRACT --- p.ii / LIST OF CONTENTS --- p.vii / LIST OF APPENDIX --- p.x / LIST OF TABLES --- p.xi / Chapter CHAPTER 1 --- INTRODUCTION --- p.1 / Chapter CHAPTER 2 --- LITERATURE REVIEW --- p.3 / Introduction --- p.3 / Impact of childhood cancer on the family in general --- p.4 / Impact of childhood cancer on children with the disease --- p.10 / Impact of childhood cancer on the well siblings --- p.16 / Impact of childhood cancer on parents --- p.21 / Impact on families with terminally ill children --- p.25 / Impact of the disease on families who have lost children with cancer --- p.29 / Summary of literature review --- p.32 / Chapter CHAPTER 3 --- OBJECTIVES AND METHODOLOGY --- p.35 / Aim and objectives --- p.35 / Methodology and research design --- p.35 / Subjects for study --- p.36 / Data collection method --- p.38 / Data collection procedure --- p.42 / Data analysis --- p.45 / Validity --- p.47 / Reliability --- p.48 / Pilot study --- p.50 / Ethics --- p.51 / Chapter CHAPTER 4 --- FINDINGS AND DISCUSSION --- p.54 / Introduction --- p.54 / Parents --- p.55 / Summary of the findings obtained from parents' data --- p.75 / Children with cancer --- p.76 / Summary of the findings obtained from children's data --- p.85 / Siblings --- p.86 / Summary of the findings obtained from siblings' data --- p.98 / A comparison of the findings obtained from parents' and children's data --- p.99 / Chapter CHAPTER 5 --- CONCLUSION --- p.104 / Limitations --- p.104 / Implications for nursing practice --- p.107 / Recommendations for nursing practice and further research --- p.112 / Conclusion --- p.114 / REFERENCES --- p.116 / APPENDIX --- p.125

Carmen Wing Han Chan. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1997. / Includes bibliographical references (leaves 98-107). / Questionnaire also in Chinese. / Chapter One： --- Introduction --- p.8 / Chinese Perspectives --- p.9 / Chapter Two: --- Literature Review --- p.12 / The Impact of Cancer on the Family --- p.12 / The Effect of Caregiver Stress on the Family --- p.15 / Caregiver Tasks --- p.22 / Chapter - --- Physical and Comforting Care --- p.24 / Chapter - --- Being available --- p.26 / Chapter - --- Uncertainty --- p.28 / Chapter - --- Finances --- p.31 / Chapter - --- Existential Concerns and Meaning of Cancer --- p.32 / Chapter - --- Supportive Services and Family Resources --- p.34 / Chapter - --- Altered Role and Lifestyle --- p.37 / Stress Symptoms --- p.39 / Chapter - --- Physical Symptoms --- p.40 / Chapter - --- Psychological Symptoms --- p.42 / Summary --- p.44 / Chapter Three： --- Methodology --- p.46 / Aim of the Study --- p.46 / Research Objectives --- p.46 / Design --- p.47 / Sample --- p.48 / Instruments --- p.49 / Chapter - --- Patient's Demographic Information --- p.50 / Chapter - --- Caregiver's Demographic Information --- p.50 / Chapter - --- Caregiver Tasks --- p.50 / Chapter - --- Stress Symptoms --- p.52 / Translation of Instruments --- p.53 / Data Collection Procedure --- p.54 / Ethical Consideration --- p.55 / Data Analysis --- p.56 / Chapter Four: --- Results --- p.58 / Caregivers' Characteristics --- p.58 / Patients' Characteristics --- p.59 / Caregiver Tasks --- p.60 / Stress Symptoms --- p.62 / Correlation among Stress Symptoms and Caregiver Tasks --- p.64 / Chapter - --- The Stress Symptoms Scale and its Sub-Scales --- p.64 / Chapter - --- The Caregiver Tasks Scale and its Sub-Scale --- p.64 / Chapter - --- Stress Symptoms and Caregiver Tasks --- p.65 / "Caregivers' Age, Education Level, Patients' Age, and Study Variables" --- p.66 / Chapter - --- "Caregivers' Age, Education Level and Caregiver Tasks" --- p.66 / Chapter - --- "Caregivers' Age, Education Level, and Stress Symptoms" --- p.66 / Chapter - --- "Patients' Age, Caregiver Tasks, and Stress Symptoms" --- p.67 / Other Caregivers' Demographic Variables and Study Variables --- p.67 / Other Patients' Demographic Variables and Study Variables --- p.68 / Chapter Five： --- Discussion --- p.70 / Introduction --- p.70 / Caregiver Tasks --- p.70 / Stress Symptoms --- p.76 / Relationship between Caregiver Tasks and Stress Symptoms --- p.79 / Caregivers' Demographic Characteristics and Study Variables --- p.81 / Patients' Demographic Characteristics and Study Variables --- p.86 / Limitations --- p.88 / Chapter - --- Cross-sectional Design --- p.88 / Chapter - --- Sample --- p.90 / Chapter - --- Instruments --- p.91 / Chapter - --- Translation --- p.91 / Recommendations for Future Research --- p.92 / Conclusion --- p.96 / REFERENCES --- p.98 / Appendix / Chapter I. --- Informed Consent Form --- p.108 / Chapter II. --- Characteristics of Patient --- p.109 / Chapter III. --- Narrative for Consent --- p.110 / Chapter IV. --- Caregiver's Profile --- p.111 / Chapter V. --- Caregiver Tasks --- p.112 / Chapter VI. --- Stress Symptoms --- p.115 / Chapter VII. --- Translated copies of Instrument --- p.117

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Objectives: To identify correlates of psychological distress and to investigate how coping skills, anxiety and depression are related in a group of head and neck cancer patients 6-12 months after their diagnosis. Methods: We evaluated in 107 head and neck cancer patients their anxiety and depression levels using the Hospital Anxiety and Depression Scale, and their Coping strategies using the Ways of Coping Checklist. Results: There were statistically significant associations between gender and anxiety level, and between living arrangements, cancer site, time since treatment, tumor stage and depressive symptoms. Results also showed that patients used a variety of coping strategies. Different coping strategies were used in subjects with high versus those with low levels of anxiety or depressive symptoms. Conclusion: Data show several correlates of psychological distress in head and neck cancer patients. They also suggest that coping strategies of these patients vary according to their level of psychological distress.

Seeking cancer information is key in coping with the feelings (e.g., fear, uncertainty) and other challenges (e.g., treatment decision-making) confronting individuals diagnosed with cancer. Despite recognition of a variation in why, when, how, and where individuals diagnosed with cancer seek information, few efforts have been made to systematically document patterns in information-seeking. Aim: To explore individuals' patterns of health information-seeking behaviors (HIS B) including the type, amount, and sources ofinforn1ation and the strategies used to process and/or manage cancer information. / La recherche d'information sur Ie cancer est d'une importance determinante pour les personnes atteintes de cette maladie dans Ie contexte OU elles ont gerer des emotions intenses (p. ex. : peur, incertitude) et font face plusieurs defis (p. ex. : processus de decision relatif au traitement). Des variations concernant la recherche d'information par les individus diagnostiques avec un cancer ont ete observees et reconnues notamment en termes des raisons qui motivent la recherche d'information et des moyens utilises pour obtenir l'infomlation desiree. Cependant, a ce jour, peu d'efforts ont ete deployes pour documenter de maniere systematique les differents types de comportements de recherche d'information.

The use of behavioral therapies, such as relaxation therapy, is well documented in the literature as an intervention which may control some of the symptoms and symptom distress associated with the use of chemotherapy within the experience of cancer. However, over 50% of individuals with cancer are also treated with radiation therapy, either alone or in combination with chemotherapy. Individuals being treated with radiation therapy experience symptoms and related distress similar to those associated with chemotherapy as well as a loss of personal control. The purpose of this study was to determine the effect of relaxation therapy on symptom distress and personal control as perceived by adults receiving abdominal/pelvic external radiation treatment for a diagnosis of cancer. A quasiexperimental design, the nonequivalent control-group, was used to achieve the purpose of this study. It was hypothesized that the daily use of relaxation therapy by individuals receiving radiation therapy would decrease the amount of symptom distress and increase the amount of personal control perceived. The sample consisted of twenty eight individuals, fourteen in the control group and fourteen in the intervention group. Data were gathered by interview, two sets of questionnaires, and written diaries. The interview was done before the participants began their radiation treatment. The questionnaires were also completed at this time and then again three weeks after the treatment began. A diary was kept by those in the intervention group who were also taught a specific relaxation technique and asked to record the number of times they used the technique and any comments. To answer the two hypotheses, summary statistics were used. The results indicated that individuals who used relaxation therapy perceived a decreased amount of symptom distress than those in the control group. The Mann-Whitney U Test indicated that this difference was at the .05 level of significance. On this basis the first hypothesis was accepted. The results also indicated that there was no significant difference between the groups in the amount of perceived personal control. On this basis, the second hypothesis was not accepted. A recommendation based on this research study was for nurses to become knowledgeable in the use of relaxation techniques. Further research to better understand the cancer experience in relation to personal control was also recommended to enable nurses to provide appropriate and effective care to these individuals. / Applied Science, Faculty of / Nursing, School of / Graduate

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