The experience of cancer challenges the body and the mind. A solid body of evidence has amassed on what help breast cancer patients cope with adversities. In the field of positive psychology, the concepts of hope and optimism further our understanding of the role future expectancies play in goal-directed pursuits and in psychological adjustment to adverse events. 　　Snyder’s theory of hope (2002) conceptualizes that goal directed behaviours have two components -- pathways and agency thinking. Pathways thinking is associated with finding the routes to achieve a desired goal. Agency thinking provides the mental energy to initiate and persist in pursuing goals. Hope is consistently linked with better outcomes in academics, athletic, health care and community settings (Snyder et al., 2005). 　　The literature on optimism (Scheier & Carver, 1985) describes the characteristics of optimists and pessimists. Optimists hold positive future expectancies with positive emotions keeping individuals actively engaged in their goals despite frustrations. Pessimists are more inclined to use avoidant coping in response to the negative emotions engendered in their negative expectancies. 　　In the present project, hope and optimism are investigated in a group of breast cancer patients who are recently diagnosed with recurrent, advanced or metastatic disease in Hong Kong. To the best of the author’s knowledge, no other studies have investigated future expectancies in advanced breast cancer patients in a longitudinal design. Findings suggested that agency hope and optimism together account for 27 - 29% of the variation in concurrent distress; and 52 - 54% of the distress three months later. Optimism was an independent predictor of concurrent and three-month psychological distress. However agency hope was not an independent predictor. The results of the present study are compared with a published study (Ho, et al., 2011) of hope and optimism in a group of oral cavity cancer survivors, who did not have an active disease. In both the advanced breast and oral cavity cancer patient groups, hope and optimism together predicted distress. But optimism was a stronger predictor relative to agency hope in the advanced breast cancer patients whose disease outcome was less certain. 　　The present study also attempts to decipher the cognitive processes postulated to be mediators in the relationship between future expectancies and psychological adjustment. In the advanced breast cancer group, attention to negative information mediated the relationship between optimism and concurrent anxiety and depression. In the oral cavity cancer survivors, negative cancer-related rumination mediated in the relationship between agency hope and depression, and in the relationship between optimism and anxiety and depression. The implications of the findings are discussed in light of the possible different cognitive processes of patients who are faced with two different disease conditions. / published_or_final_version / Clinical Psychology / Doctoral / Doctor of Psychology

Aggressive behavior has been repeatedly observed in patients with schizophrenia and related psychotic disorders. However, there is little known about the underlying psychological mechanisms, especially the role of social cognition, in contributing to the exhibition of aggression. The aim of this study was to investigate whether aggression was associated with theory of mind (ToM) deficiency and the presence of hostility bias. Thirty individuals with a DSM-IV-TR diagnosis of schizophrenia or other psychotic disorders were asked to complete the Faux Pas Recognition Test, the Ambiguous Intentions Hostility Questionnaire, and the Conflict Tactic Scale. Results suggested that psychotic patients with predominately referential or persecutory delusions were more susceptible to theory of mind anomalies and hostility bias, and had a higher frequency of the demonstration of aggressive behavior relative to patients with auditory hallucination and remitted patients. Correlational analysis revealed significant associations among ToM, hostility bias, and aggression. Multiple regression analyses showed that hostility bias was neither a mediator nor a moderator in the relationship between ToM and aggression. The present study provided preliminary evidence that social cognition and social-cognitive attributional styles are related to the demonstration of aggressive behavior. / published_or_final_version / Clinical Psychology / Master / Master of Social Sciences

Breast cancer patients consistently reported psychosocial adjustment difficulty in their sense of femininity after breast removal surgery. In view of this, the present study aimed to explore the effects of three femininity-related concepts on emotional reactions towards breast removal surgery – femininity schema, femininity loss appraisals, and femininity contingency of self-worth. 212 women without breast cancer history participated in this study. They completed a questionnaire which included a hypothetical scenario of breast removal. Results showed that women who considered the breast of a high relative importance in femininity schema, and depended their self-worth highly on sense of femininity, reported greater increase in negative emotions after hypothetical breast removal. This effect was mediated by femininity loss appraisals. Implications and future directions were discussed. / published_or_final_version / Clinical Psychology / Master / Master of Social Sciences

published_or_final_version / abstract / toc / Clinical Psychology / Master / Master of Social Sciences

No description available.

Substantial studies have investigated homogeneity of psychological distress level among cancer patients by using cross-sectional and longitudinal study design. Nonetheless, as proposed by Bonnano (2004), heterogeneity characteristics of psychological distress following stressful event could not be neglected and he further suggested that the majority of individuals were resilient in response to stressful events. To test this postulation, recent studies employed growth mixture modelling method to examine the heterogeneity characteristics of psychological distress trajectory among cancer patients. Furthermore, identifying relevant factors differentiate the psychological distress trajectories is an integral part for developing effective interventions for cancer patients in dealing with illness demands. However, only a few studies have examined these issues among Chinese colorectal cancer patients, a second most common cancer in Hong Kong. Therefore, it is of important need to address this knowledge gap. This study had two major aims: 1) to explore the patterns of psychological distress among Chinese patients with colorectal cancer from shortly after diagnosis but before surgery (i.e. 1-day prior operation) to 1-year post-surgery and to testify Bonnano’s theory on resilience; 2) to identify the effects of cancer-related intrusive thoughts, physical symptom intrusiveness and dispositional optimism on differentiating psychological distress trajectories. A total of 246 Chinese patients with colorectal cancer were recruited for the current study. Altogether, 5 consecutive face-to-face interviews were conducted on one day prior to surgery (baseline), 1-, 4-, 8- and 12-month post-surgery (T2-T5). Patients’ psychological distress (i.e. anxiety and depression), physical symptom intrusiveness, cancer-related intrusive thoughts, dispositional optimism, demographic and medical information were assessed by a standardised questionnaire with valid and reliable psychometric instruments. Growth mixture modelling was used to estimate and specify the psychological distress trajectories. Multinomial logistic regression was adopted to assess the proposed factors in relation to differentiate the trajectory patterns. Growth mixture modelling suggested three distinct trajectories were identified for both anxiety and depression model. The majority of patients with colorectal cancer were identified as resilient (i.e. maintaining low and stable distress level across time) for both models (anxiety: 82.3%, depression: 82.7%). Additionally, for anxiety trajectory model, the remaining 12.3% and 5.4% of patients were classified as moderately-low anxiety group (i.e. maintaining moderate to low distress level) and increasing anxiety group (i.e. increased from moderate level of distress at initial to subsequently high distress level) respectively. For depression trajectory model, the remaining 12.6% and 4.7% of the patients were grouped as delayed depression (i.e. delayed level of distress over time) and recovery depression (i.e. recovered from high distress level to low across time). Multinomial logistic regression showed that cancer-related negative intrusive thoughts, physical symptom intrusiveness and dispositional optimism were significant factors to differentiate anxiety and depression trajectories respectively. This study highlighted the heterogeneous feature of psychological distress among Chinese patients with colorectal cancer. Physical symptom intrusiveness, cancer-related negative intrusive thoughts and dispositional optimism played important role on predicting cancer patient’s psychological distress respectively. Nonetheless, further investigations are much needed to clarify the underlying mechanism. / published_or_final_version / Public Health / Master / Master of Philosophy

The purpose of this study W8S to explore and describe the experience of waiting for coronary artery bypass graft (CABG) surgery from the perspective of the individual who h8s a prolonged wait for this surgery. A phenomenological approach was used to guide the study. Data were collected through 17 semi-structured, audio-taped interviews with 7 men and 2 women awaiting CABG surgery. Analysis occurred concurrently with data collection. It was found that there were three interrelated core facets of the experience: the illness, the prospective surgery, and the wait. Each facet held distinct meaning: the illness represented a loss of normalcy and a threat to life; the surgery, both an opportunity to regain normalcy and a threat; and the wait, a "no control" situation which enhanced the losses and threats of the other facets, engendered further losses, and delayed the expected gain from surgery. Within each facet, representative emotional reactions, and coping strategies were identified. The findings indicate that these clients require regular contact and that nursing care must address all three facets of the experience. / Applied Science, Faculty of / Nursing, School of / Graduate

Loss of control is a well-documented human response to hospitalization. The purpose of this study was to construct and test a theoretical model of perceived territorial control among hospitalized adults. Territorial control was defined as the freedom or choice one has in regulating or influencing the objects, activities, and social intereactions within a particular space claimed or identified as one's own. The space of concern in this study was the patient's hospital room. The study focused not on the negative aspects of a loss of control but on the positive outcomes of having a sense of control. A three-stage, multivariate, causal-modeling design was used to estimate the impact of perceived territorial control on state anxiety and satisfaction with care in a convenience sample of 80 Hispanic and Anglo-American males and females between the ages of 18 and 79 who were in the hospital for short-term orthopedic care. Attitudinal, self-report measures were used predominantly. Instruments were constructed to index centrality of territory and territorial control perceptions. Correlational and multiple regression statistical techniques were used to estimate the theoretical model. Tests for violations of the statistical and causal assumptions were performed. Centrality of territory, assistance needs, and the powerful others locus of control significantly influenced patient territorial control perceptions. Temporal duration, internal locus of control, and chance locus of control made no significant impact on perceived territorial control. Patient territorial control perceptions significantly decreased state anxiety and significantly increased satisfaction with care. Perceived territorial control explained 24 percent of the variance in patient state anxiety and 21 percent of the variance in satisfaction with care. An unstaged, empirical test of the model increased the explained variance to 32 percent for state anxiety and 40 percent for satisfaction with care. There was a positive relationship (r = .41) between age and centrality of territory and a negative relationship (r = -.31) between age and state anxiety. The implications were related primarily to continued theory-building and the development of nursing practice theories.

This study examined changes in adult learning, adaptation, and anxiety that occurred as the result of the adult cancer education program "I Can Cope." The study utilized a repeated measures descriptive design. A volunteer sample of 19 subjects participated in this study. Changes in each person's pre-mid-post-test scores were measured against their pre-mid-post-test scores on three instruments: (a) Course Inquiry Test; (b) Purpose in Life Test; and (c) A-State Anxiety Inventory. A comparison of scores measured whether any short-term adult learning, adaptation and change in anxiety occurred as a result of the "I Can Cope" Program. The study did demonstrate that an organized adult patient education program could foster and enhance adult learning and adaptation as well as influence anxiety of participants.

The purpose of this study was to identify events that give a sense of control (decisional, behavioral, and cognitive) to clients during hospitalization, and to identify commonalities among patients related to the importance attached to selected hospitalization events and a sense of control. Bandura's social learning theory provided the conceptual framework for the study.A non probability convenience sampling of 45 adult patients hospitalized for the treatment of genitourinary, gastrointestinal, thyroid disease, or cancer of any origin, completed the instruments which measure client control: The Client Control Q Set (CCQS;) and, The Health Opinion Survey (HOS.) A semi-structured interview validated the CCQS and a background data form provided demographic information. Q factor analysis was used to identify factors of client control. The emerging factors were analyzed in relationship to the results of the HOS and patient demographic information. Subjects' human rights were protected.This study was a modified replication of Dennis' (1985) investigation to determine if a sense of control was important to hospitalized patients. The investigation supported Dennis' (1985) findings that cognitive control over diagnostic tests, surgery, treatment and illness care was important to hospitalized patients. Another important dimension of control was identified through behavioral means involving the environment. Health Opinion Survey scores identified a need to be actively involved in the health care process by patients who also desired cognitive control over diagnosis, surgery, and tests. Also, commonalities of occupation, sex, age, and diagnosis emerged among patients who identified a need for cognitive control. Likenesses emerged in nonprofessional females between the age of 21-40 receiving treatment for gastrointestinal disease.The study supported the assumption that patients do desire a senseof control during hospitalization and also supported the need to recognize other patients may not desire a sense of control. It is important to recognize the difference and respond appropriately to individual patients. The study revealed the need for nurses to facilitate a flow of information to patients regarding diagnosis, surgery and impending tests. / School of Nursing