No description available.

No description available.

<p><strong>Abstract</strong></p> <p><strong>Purpose: </strong>While most children diagnosed with cancer survive their initial disease, the intensive treatments they receive place them at risk for late effects. Long-term follow-up (LTFU) care is recommended for cancer survivors for surveillance and early detection of late effects. Knowledge, or lack thereof, regarding diagnosis, treatment and late effects is an important barrier and/or facilitator for attending LTFU care in adolescent and young adult (AYA) cancer survivors. The purpose of our study was to examine the extent of knowledge in Canadian AYA survivors of childhood and adolescent cancer, and identify factors associated with such knowledge.</p> <p><strong>Methods: </strong>Survivors of childhood and adolescent cancer, between the ages of 15 and 26 years, were recruited from three pediatric oncology centres. Patients were invited to participate in the study through mail and clinic recruitment. A questionnaire booklet, including the Cancer Knowledge Survey that asked questions about cancer, treatment and late effects, was administered to collect necessary information. Clinical data was extracted from hospital records to validate participants’ answers.</p> <p><strong>Results: </strong>250 (response rate= 75.5 percent) out of 331 patients invited to participate completed the questionnaire booklet. 18 (7.2 percent) participants lacked information regarding their type of cancer, whereas 25 (10.3 percent) participants were ‘not knowledgeable’ of their treatment. Lack of knowledge regarding treatment was associated with being non-white [odds ratio= 0.3 (0.2-0.6)] compared with white. Also, 83 (33.5 percent) participants were unaware of their late effects. Lack of knowledge regarding late effects was associated with younger age [odds ratio= 1.2 (1.1-1.3)], and having leukemia compared with embryonal tumour [odds ratio= 3.41 (1.10-10.6)].</p> <p><strong>Conclusion:</strong> Results from this study highlights important knowledge deficits, especially in terms of understanding risk of late effects from cancer treatments. Findings from this study can be used to design programs and interventions aimed at increasing cancer knowledge in AYA cancer survivors.</p> / Master of Science (MSc)

Thesis (M.A. (Social Work)) -- University of Limpopo, 2021 / Survivors of child sexual abuse experience a lot but various challenges in their everyday lives. The overall aim of the study was to describe the experiences of male adult survivors of child sexual abuse at Ga-Matlala, Limpopo Province. The study objectives were to identify types of child sexual abuse cases at Ga- Matlala uperpetrated prior 1994; to determine how adult male survivors of child sexual abuse handle their life problems; to describe the social impact of child sexual abuse on male adult survivors; and to recommend appropriate professional intervention to male adult survivors of child sexual abuse. The study utilised descriptive research design. The data was collected through semi-structured face-to-face interviews from three (3) survivors of child sexual abuse who were sexually abused prior 1994 who are residing at Ga-Matlala area. The sample consisted of survivors of child sexual abuse drawn from the database of Bakone Tribal Council compiled and administered pre 1994. A thematic analysis method was selected. Thematic analysis organises and describes data set in detail. The data was analysed in eight steps.Ethical considerations such as voluntary participation, permission to conduct the study, anonymity, confidentiality and no harm to respondents were considered.The researcher found that two survivors indicated to be having abilities to resolve their personal problems while one participant has indicated to be having problems in resolving his personal problems. All three survivors indicated to be engaged in an intimate relationships. All there survivors indicated to have had experienced child sexual abuse more than once and they also indicated to have had experienced more than one type of sexual abuse. Two participants out of three survivors had not reported of imitating what they experienced while one has adopted the lifestyle but he is not doing it with children like it was done to him. All survivors indicated to have forgiven their perpetrators. All of survivors indicated that their childhood experience had a negative impact in their childhood lives and it still has a negative influence in their adult life. All three survivors indicated to have not accessed professional assistance in their childhood even during their participation in the study they have not yet accessed professional intervention towards their past traumatic experience. However, all three survivors acknowledged the fact that post traumatic intervention is important to their personal growth with regard to finding closure, gaining confidence and finding coping strategies that will be helpful in facing their personal problems with an open mind and positivity of finding solutions without tracing their childhood past into it. The researcher concluded that all the participants of the study had experienced different kinds or types of child sexual abuse and it has negatively impacted them. Being involved in an intimate relationship was not difficult for the survivors as all of them were engaged in intimate relationships. All three survivors need to access professional help for them to overcome the impact of their past child sexual abuse experience. There is a huge difference/gap regarding the previous findings and the current findings mainly because most of the previous studies were European based than African Based (South Africa) and it was also showing a gap between European based Theories and African based theories when dealing with child sexual abuse. The main recommendation that the researcher had was to motivate the survivors to participate in the process of accessing professional help to enable them to deal with their current lives without tracing everything back to their childhood.

No description available.

After cancer patients have completed active cancer treatment, they have specific follow-up care needs. These needs include ongoing surveillance for new and recurring cancers, managing the side effects of cancer treatment, and psychosocial concerns (Rushton et al., 2015). In the past, cancer centres and oncology specialists provided follow-up care; however, new models of care are needed because cancer centres can no longer provide treatment and follow-up care to all cancer survivors (Jefford et al., 2022). To allocate health care resources, low risk cancer survivors (i.e., breast and colorectal cancer survivors) are being discharged from cancer centres after primary treatment back to their primary care provider (PCP) for follow-up care. Survivorship care plans (SCPs) have been identified as a tool to help survivors and their PCPs with this transition (Rushton et al., 2015). SCPs generally consist of a treatment summary, a schedule for follow-up and surveillance tests, and general health recommendations (i.e., diet and exercise; Howell et al., 2011; Ruston et al., 2015). While SCPs are widely accepted, research on their effectiveness as transition tools has been inconclusive (Hill et al., 2019; Jacobsen et al., 2018). Some studies show positive, neutral, and negative impacts of SCP use, and there are three potential reasons for these mixed findings: 1) there is wide variety in the content, format, delivery, and timing of SCPs which adds considerable variance when studying the impact of SCPs; 2) the use of outcomes to measure the usefulness of SCPs as transition tools that are beyond the scope that information about treatment history and follow-up guidelines could impact and; 3) that SCPs are not effective as transition tools (Hill et al., 2019; Jacobsen et al., 2018). An important first step in clarifying whether SCPs are effective transition tools is to understand how SCPs are being used in real world practice (Hill et al., 2019; Jacobsen et al., 2018). The overall purpose of this study was to develop best practice recommendations for implementing SCPs. This was achieved through three study objectives: 1) to comprehensively identify barriers and facilitators perceived to influence SCP use among cancer survivors and primary care providers (PCPs); 2) to identify evidence-based approaches to address barriers and enhance facilitators of SCP use; and 3) to develop best practice recommendations that can be used by implementors of SCPs that are adaptable across different contexts. Article 1 presents the results of semi-structured interviews with breast and colorectal cancer survivors who had received a SCP at least 12 months prior to the interview. The interviews were based on the Theoretical Domains Framework, version two (TDF-2; Cane et al., 2012) and comprehensively identified barriers and facilitators of SCP use amongst breast and colorectal cancer survivors. Thirty cancer survivors (17 female, 13 male) participated in the 30–45-minute interviews, which were then analyzed using content and thematic analysis. Survivors who had received education about the purpose of SCPs and how to use them reported finding their SCP helpful and that they used it to schedule appointments and communicate with their healthcare providers. Barriers to SCP use that were reported by cancer survivors included having lost or not remembering receiving a SCP, not understanding the importance of their SCP, and wanting information about additional supports to be able to follow the SCP (e.g., regular contact from the cancer centre, avenues for peer support). Overall, study 1 found that in order to SCPs to be used as intended transition tools, survivors benefit from receiving education about how to use them and be informed of the expectation that they be actively involved in their follow-up care. Article 2 presents the TDF-based semi-structured interviews with primary care providers (PCPs). Thirteen PCPs completed 15-20 minute interviews, and content and thematic analysis was conducted. PCPs reported finding SCPs helpful and that they contained relevant information to provide follow-up care. A key facilitator of using the SCP was the table of follow-up tasks (e.g., mammography, colonoscopy) and their frequencies included in the SCP. Two significant barriers for PCPs using SCPs were: a) logistical issues with ordering follow-up tests and receiving results; and b) a lack of clear avenues to consult with oncology specialists (e.g., managing side effects of medications, actions that need to be taken when follow-up tests are abnormal). Overall, article 2 showed that PCPs appreciate and readily use SCPs, and contextual changes to facilitate clear avenues of communication between primary and tertiary care may be beneficial when implementing SCPs. Article 3 is a methodology article that presents a detailed explanation and rationale for the implementation science frameworks used and the data analysis chosen. The TDF-2 and Behaviour Change Techniques Taxonomy (BCTTv1; Michie, et al., 2008; Michie et al., 2013). The Human Behaviour Change Project researchers have empirically linked the 14 TDF domains to behaviour change techniques (BCTs), which allowed for multiple options to be developed to address barriers (and promote facilitators) of SCP use among breast and colorectal cancer survivors and PCPs (https://theoryandtechniquetool.humanbehaviourchange.org/tool; Michie et al., 2021). Using the TDF and BCTTv1 showed a dynamic between oncology specialists (e.g., oncologists, oncology nurses), cancer survivors, and PCPs that is involved in ensuring SCPs are implemented in an optimal way. A logic model was used to organize the barriers and enablers into different phases of SCP development, content, delivery, and use by PCPs and cancer survivors in their follow-up care (Mills et al., 2019). A flowchart organizing the recommendations of implementing SCPs was developed, and comprised 10 steps representing interrelationships between cancer centers, PCPs, and cancer survivors. The detailed methodology article also includes lessons learned and suggestions for implementation science researchers using the TDF and BCTTv1. Finally, article 4 is written for anyone looking for guidance implementing SCPs or improving upon how SCPs have been implemented already. It differs from article 3 in that it provides practical solutions for implementers. Because this work generated many recommendations, article 4 provides a worked example of how to use the results of this study. It is written in a way that outlines who would benefit from using the recommendations, and how to use the flow chart to narrow down the recommendation to those most relevant to implementors. The recommendations are organized into one of the 10 relationships in the flow chart, along with the purpose of the recommendations, how to implement it, to whom the recommendation targets, and those responsible for enacting the recommendations. The core factors associated with facilitating SCP use by PCPs and cancer survivors were: a) a treatment summary and follow-up guidelines included in the SCP; b) SCP provided to both cancer survivors and their PCP; and c) educating cancer survivors about their role as self-managers of their own care and the expectation that they participate in their follow-up cancer care. Future research on the usefulness of SCPs in follow-up care should include detailed information about the content, format, and receivers of SCPs and the outcomes most realistically influenced by the information included in SCPs. Before throwing the proverbial baby out with the bathwater, the implementation of SCPs requires additional standardization before meaningful investigation of their effectiveness as transition tools can be conducted.

No description available.

Support groups for suicide loss survivors are a relatively common resource used by those who are left to cope in the aftermath of a suicide death. Though descriptive studies have been used to provide an overview of support groups in the past, there have been no efforts to understand nuances of these groups and the impact of these groups and differing facilitation styles on the bereavement experience for attendees. This study explores primary data collected between March 2015 and December 2015 with a sample of 138 survivor of suicide loss support group facilitators in the United States and several other countries. Meaning making and meaning reconstruction is presented as the primary theory used to examine the attitudes of support group facilitators. Basic analytic procedures were used to explore sample descriptives, and an Exploratory Factor Analysis (EFA) with an oblique rotation was used to identify the factors within the Survivor of Suicide Loss Support Group Facilitator Scale. Three factors were revealed with a simple structure, representing the latent themes of (1) Facilitator Perspective on the Role of the Story (α=.73), (2) Facilitator Perspective on the Role of the Facilitator (α=.63), and (3) Facilitator Perspective on Role of the Loss Survivor (α.59). Bivariate analyses revealed that factors 1 and 2 both had a significant relationship with length of time the facilitator had been leading the group, facilitator’s level of compassion satisfaction, and facilitator’s level of burnout. The findings of the EFA support the use of the scale as a tool to discern differences in attitudes about the role of meaning making and sharing of stories in the group as well as the role of the facilitator in aiding this process. The findings provide important information for understanding variation in support group facilitation styles and have implications for future exploration of outcomes for group attendees based on facilitator attitude and style. Implications for practice and future research are discussed.

The purpose of this dissertation was to examine whether a breast cancer survivor’s view of God influences her religious coping strategies, depression, anxiety, stress, fear of recurrence, and psychological well-being. These variables were selected based on literature that demonstrates relationships among them for breast cancer survivors. The specific aims of this dissertation were to: 1) identify religious coping strategies common to each of the four views of God; 2) examine the relationship of psychological well-being (Ryff) and religious coping strategies; and 3) examine differences in depression, anxiety, stress, fear of recurrence, and psychological well-being among women holding various views of God. Three manuscripts comprise this dissertation. The first manuscript is a systematic review of the literature describing what is known about the relationships between psychological adjustment and religion/spirituality (R/S) in women with breast cancer. The second manuscript examines the psychometric properties of the Image of God Scale in a population responding to a crisis event, women with breast cancer. The original scale was developed from a general population survey. Finally, the third manuscript investigates the relationships between view of God, religious coping strategies, and psychological adjustment in women with breast cancer. The systematic review identified three primary themes: 1) R/S domains and psychological adjustment; 2) dynamics of R/S conservation and struggle; and 3) reframing the cancer experience. The psychometric analysis confirmed the original 2-factor model with factor loadings ranging from .56 to .83. Cronbach’s alphas for the two subscales – belief in God’s anger (.80) and belief in God’s engagement (.89) – were consistent with those established at development. Differences were found between views of God and use of religious/spiritual coping strategies focused on Spiritual Conservation and Spiritual Struggle. Psychological Well-Being (SPWB) was inversely correlated with Spiritual Struggle. Differences were noted for psychological well-being, Fear of Recurrence, and the Stress subscale in women who viewed God as highly engaged or not. No differences were noted for the same variables in women who view God as more or less angry. Direct comparisons between groups and variations in outcomes based on common views of God could lead to effective screening for persons at risk for particular outcomes and to effective individualized interventions.

Background: Disparities exist in mortality rates in African American breast cancer survivors (AABCS), partly due to modifiable lifestyle behaviors. Gaps remain in developing effective tools to assess AABCS' motivations to prevent weight gain. Conceptual Framework: This research study used the Theory of Planned Behavior (TPB) to guide development of the elicitation study and the AABCS-Weight Gain Prevention Intention Questionnaire (AABCS-WGPIQ). Purpose: Aim One was to use the elicitation approach of the TPB to identify, define and describe AABCS' salient behavioral (advantages/disadvantages), normative (social influence) and control (facilitators/barriers) beliefs related to the prevention of post diagnosis weight gain. Aim Two was to develop and pilot test a questionnaire based on qualitative data to quantify the magnitude of influences of attitudes, subjective norms and perceived behavioral controls related to intentions to prevent weight gain in AABCS. Methods: Guided by the TPB, this cross-sectional, descriptive study used an internet based qualitative elicitation questionnaire to identify salient beliefs of 27 AABCS regarding their motivations to prevent weight gain and inform development of the quantitative AABCS-WGPIQ. Initial psychometric testing of the questionnaire included content and face validity and temporal stability assessment of belief constructs, using the test-retest approach. Findings: Aim One: Motivators to preventing weight gain among AABCS included improving health and well-being (advantages), social support from family and friends (approvals), external support systems, and personal accountability (facilitators). Time and effort required preventing weight gain (disadvantages), lack of social support (disapprovals), and time constraints, lack of accountability, unhealthy eating and health issues (barriers) negatively influenced AABCS' decisions to prevent weight gain. Future interventions aiming to increase motivation to prevent weight gain in AABCS should emphasize positive benefits of preventing weight gain, include social support systems, focus on skill building for time management, planning and goal setting, managing health issues and incorporate weight loss management strategies. Aim Two: The AABCS-WGPIQ has acceptable content validity, face validity and temporal stability of belief constructs. The AABCS-WGPIQ has the potential to be a valid instrument for assessing correlates of weight gain prevention in AABCS. Future research with larger groups of AABCS should include assessing internal consistency and construct validity.