published_or_final_version / Clinical Psychology / Master / Master of Social Sciences

Patients’ perception of being a burden to others, termed self-perceived burden (SPB), is a phenomenon commonly reported by terminally-ill patients. SPB elicits psychological outcomes such as loss of dignity, hopelessness, anxiety, and depression (Wilson et al., 2005). To extend our knowledge on this understudied construct, this project employed a multi-method approach with three studies to examine the experience of SPB among Chinese cancer patients. Study 1 is the first longitudinal investigation on the relationship between SPB and non-terminal cancer patients’ trajectories of psychological adjustment. Results from hierarchical linear modeling showed that patients with higher levels of SPB reported higher levels of depression and anxiety, as well as lower levels of mental health over time. Results also revealed that SPB predicted cancer patients’ pattern of change in anxiety over time. As the high SPB group had a higher anxiety level at baseline, their anxiety level remained higher than that of the low SPB group despite a sharper decrease. Study 2 is the first quantitative study to scrutinize the psychological process of how cancer patients attempted to cope with SPB. A new Self-perceived Burden Coping Scale was developed. Our findings indicated that the scale displayed good content, construct, and discriminant validities, and most subscales show acceptable reliability. Results from principal components analysis showed that cancer patients adopted six coping modes in an attempt to deal with SPB: (a) positive outlook, (b) managing the needs of others, (c) resigned acceptance, (d) making preparations, (e) entitlement, and (f) concealing need. Specially, the coping modes of resigned acceptance and concealing need were related to poorer adjustment, whereas managing the needs of others and entitlement were related to better adjustment. Stress-buffering effects of managing the needs of others and making preparations were also found. Finally, Study 3 adopted a qualitative paradigm to explore perception as care-receivers, aspects of SPB, and coping with SPB among Chinese non-terminal cancer patients. Narratives from patients revealed four perspectives regarding to their perception as care-receivers: self-reliance, acceptance, overwhelming, and SPB. Results revealed that the SPB experience among Chinese non-terminal cancer patients was similar to those observed in Western terminal cancer patients, with a new aspect of financial burden. In addition to the six coping modes of SPB found in Study 2, a potential new coping mode of being compliant with others was found, which may be unique among Chinese cancer patients in the context of SPB. Findings from these studies may advance our knowledge on SPB, provide insights for future research, as well as shed lights on the development of counseling services, psychological interventions, and public policies for cancer patients. / published_or_final_version / Psychology / Doctoral / Doctor of Philosophy

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No description available.

published_or_final_version / Clinical Psychology / Doctoral / Doctor of Psychology

published_or_final_version / Clinical Psychology / Master / Master of Social Sciences

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

published_or_final_version / Public Health / Master / Master of Public Health

In Hong Kong, there has about 70% patients who attend Accident and Emergency Department (AED) is categorized as semi- or non-urgent cases. The medical conditions with the relative longer waiting time provoke the anxiety level. Furthermore the anxiety is worsen by the noisy waiting environment. These phenomena not only affect the psychological but also the physiological changes of patients. Therefore, there is a need to develop an evidence-based intervention that can effectively reduce the anxiety level during the waiting time. The music intervention is proposed to be implemented to reduce the anxiety in the AED setting as this intervention has been proven with a significant anxiolytic effect in variety of healthcare setting. This dissertation is a translational research that aims to identify the advantages or music intervention, develop an evidence-based practice (EBP) guideline for health care providers, and design an evaluation plan for evaluating the protocol effectiveness. The transferability and feasibility of the literature were high. The target setting is one of the AEDs in Hong Kong and the music intervention can be given in cubicle or waiting room by using Mp3 or speakers respectively. The music album is preferably chosen by patients and the intervention last for about 30-60 minutes. An implementation plan for pilot testing was developed to trying out the guideline and to reduce the potential problems during implementation. Comprehensive evaluation plans on stakeholders were developed. This dissertation contributes to develop an evidence-based protocol for healthcare-providers to follow and demonstrate in real situation. / published_or_final_version / Nursing Studies / Master / Master of Nursing

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