In this report from the Childhood Cancer Survivor Study (CCSS), we described marriage and divorce rates in survivors of childhood cancer, as compared to a sibling control group and the general U.S. population. We also sought to identify patient and treatment characteristics that were associated with survivor marital status. This study included 8,930 five-year survivors of childhood malignancy and 2,855 sibling controls participating in the CCSS. Data on marital status, sociodemographic factors, and current health status were obtained from questionnaires; detailed disease and treatment histories were available from medical records. Marital status of the U.S. population was obtained from the 2002 Current Population Survey of the U.S. Census. We found that survivors were more likely to have never married than both sibling (odds ratio [OR] = 1.79; 95 % CI = 1.65-1.94; p < 0.0001) and population controls (OR = 2.29; 95 % CI = 2.19-2.38; p < 0.0001), with persistence of trends across age and gender strata. Once married, survivors divorced at rates equivalent to controls. In adjusted analysis, we found that several survivor characteristics predicted never-married status, including treatment involving cranial radiation (OR = 2.41; p < 0.0001), CNS tumor diagnosis (OR = 2.05; p < 0.0001), history of growth hormone deficiency (OR = 2.02; p < 0.0001), and unemployment secondary to disability (OR = 1.78; p = 0.0001). Survivor characteristics predictive of divorce included unemployment (OR = 1.91; p < 0.0001, for unemployed or disabled), lower educational achievement (OR = 1.74; p < 0.0001, for non-college graduates), and psychological distress (OR = 1.60; p < 0.0001). This study confirms prior reports of lower marriage rates in survivors of childhood cancer, providing further evidence that this population struggles with psychosocial adjustment to adult life.

Thesis (Ph.D.)--Indiana University, 2009. / Title from screen (viewed on February 2, 2010). School of Nursing, Indiana University-Purdue University Indianapolis (IUPUI). Advisor(s): Joan E. Haase, Marion E. Broome, Janet S. Carpenter, Richard M. Frankel. Includes vitae. Includes bibliographical references (leaves 227-258).

Objectives: To describe utilization of specialised prenatal care by high-risk survivors and evaluate echocardiogram use in echocardiogram-need survivors, as per survivorship guideline recommendations. Methods: Retrospective population-based matched survivor:control study utilizing Ontario health administrative data. Survivors were classified as high-risk/low-risk for obstetrical outcomes, and as echocardiogram-need (yes/no) for echocardiogram outcomes. Associations were tested using logistic regression. Results: 11% (n=363) of 3,204 pregnant survivors were classified as high-risk. Over 90% received specialized prenatal care. Living in a rural area was associated with lower use. (AOR 0.51; 95% CI 0.44-0.59). Since 2003, 32% (560/1,737) of survivors had an echocardiogram-need. Only 14% (77/560) had ≥1 echocardiogram, this was not associated with rurality nor neighbourhood income quintile. Conclusions: Although the majority of high-risk survivors receive specialized prenatal care, geographic inequality in care persists. Despite survivorship guidelines, >85% of echocardiogram-need pregnant survivors do not have an echocardiogram performed; future work should address this gap in care.

Objectives: To describe utilization of specialised prenatal care by high-risk survivors and evaluate echocardiogram use in echocardiogram-need survivors, as per survivorship guideline recommendations. Methods: Retrospective population-based matched survivor:control study utilizing Ontario health administrative data. Survivors were classified as high-risk/low-risk for obstetrical outcomes, and as echocardiogram-need (yes/no) for echocardiogram outcomes. Associations were tested using logistic regression. Results: 11% (n=363) of 3,204 pregnant survivors were classified as high-risk. Over 90% received specialized prenatal care. Living in a rural area was associated with lower use. (AOR 0.51; 95% CI 0.44-0.59). Since 2003, 32% (560/1,737) of survivors had an echocardiogram-need. Only 14% (77/560) had ≥1 echocardiogram, this was not associated with rurality nor neighbourhood income quintile. Conclusions: Although the majority of high-risk survivors receive specialized prenatal care, geographic inequality in care persists. Despite survivorship guidelines, >85% of echocardiogram-need pregnant survivors do not have an echocardiogram performed; future work should address this gap in care.

Previous research has started the discussion about the impact of unmet needs on the psychosocial adjustment of well-siblings of children and youth diagnosed with cancer. The purpose of this qualitative study was to retrospectively explore the needs of adolescents who had a brother or sister, who was diagnosed with, treated for and who lived through cancer. The findings and knowledge mobilization project from this study will extend the literature and will also bring information to counsellors, social workers, doctors, nurses, cancer support agencies, parents, family members, friends, teachers, and—importantly—to well-siblings themselves. Narrative data were collected from 7 adult sisters who reflected on their adolescent-aged experience of being the well-sibling of a sister (n=4) or brother (n=3) who was diagnosed with and treated for cancer. Data were analyzed using thematic analysis and 7 need-based themes identified from the data are reported. Further research is recommended, and implications from the present study are discussed. / Graduate / 0519 / 0621 / 0992 / genevievestonebridge@gmail.com

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This master thesis is an attempt to illustrate the role of a feminist and abolitionist organization towards the enhancement of women’s social conditions and their representation in society. The study is based on my three months training at an Icelandic organization, Stígamót, which is an “Education and Counselling Centre for Survivors of Sexual Abuse and Violence”. My stay there included a series of interviews with social workers and survivors of prostitution and sexual trafficking.  The centre has a multi-faceted approach, using feminist empowerment as a methodological process for the purpose of increasing the quality of life. Together with feminist theories on intersectionality and empowerment as methodological tools, I am researching the relations between survivors’ empowerment, their agency, with a radical political change, leading to gender-equal society.

Breast cancer is the most common cancer in North America (American Cancer Society [ACS], 2012; Canadian Cancer Society [CCS], 2012). Women diagnosed with breast cancer undergo a traumatic experience that disrupts their quality of life (Holmberg, Scott, Alexy, & Fife, 2001). In the psychological domain of quality of life, body image is disrupted due to the changes associated with breast cancer surgeries and treatments (Hormes et al., 2008). This is important because breast cancer survivors’ quality of life is an essential part of their survivorship (Kaiser, 2008). Evidence has suggested that physical activity shows improvements in body image, survival rates, and decreased risk of mortality (Schmitz, 2011). Furthermore, a unique form of physical activity associated with breast cancer that has risen among this population is endurance sporting events, such as dragon boating and running (Canadian Breast Cancer Foundation [CBCF], 2012; Parry, 2008). Endurance sporting events are common among breast cancer organizations to raise funds and spread breast cancer awareness (Kaiser, 2008). However, they also provide breast cancer survivors with a fun and healthy sporting environment to explore their body image as well as shared experiences with other breast cancer survivors. Researchers have shown endurance sporting events to be a comfortable environment for breast cancer survivors to allow their experiences to unfold (McDonough, Sabiston, & Crocker, 2008; Sabiston, McDonough, & Crocker, 2007). Due to the uniqueness of each woman’s breast cancer experience, it is important to explore their body image experiences to understand their personal stories and provide meaning to enhance their quality of life as breast cancer survivors. The general purpose of this dissertation is to explore the body image and camaraderie experiences of breast cancer survivors in endurance sporting events. Furthermore, the guiding research question of this dissertation is: What are the body image and camaraderie experiences of breast cancer survivors participating in endurance sporting events? Narrative research methodology will be used to provide insight into this research question across two studies. To address the gap in the literature, Study 1 of my dissertation provided narratives of three breast cancer survivors’ body image experiences as they trained for and participated in the CIBC Run for the Cure 5k. Two individual semi-structured interviews, prolonged engagement, and blogging were used as sources of data collection over a time period of 10 weeks. Data analyses led to the emergence of three themes: "new normal", goal setting, and camaraderie. Camaraderie, representing the shared breast cancer survivors’ experiences that allowed the women to focus on their physical capabilities, accept their bodies, and create an overall body image experience, was a particularly salient theme to the women throughout their training. Hence, the purpose of Study 2 was to explore the camaraderie narrative experiences of breast cancer survivors in a season of dragon boating. Focus group interviews and creative practices were conducted with a core group of 11 breast cancer survivors over a six month time period. The women defined camaraderie as fellowship, teamwork, and support shared between women with breast cancer experiences. Subsequent data analyses resulted in five themes: attention please, paddles up, take it away, hold the boat, and reach. Overall, camaraderie was shown to be crucial to the survivorship of the women, as social experiences are an important component to life after breast cancer. The findings were written as a collective (e.g., camaraderie) narrative. Taken together, these two studies demonstrated that body image and camaraderie are important components to breast cancer survivors’ participation in endurance sporting events. More specifically, both studies informed the literature by describing the relationship between the camaraderie and body image experiences for the women involved in both the CIBC Run for the Cure 5k and a season of dragon boating. Camaraderie was the motive that created an overall positive body image experience for the women. Furthermore, endurance sporting events associated with breast cancer formed natural, comfortable, and safe environments for the women to express their experiences. In addition, camaraderie seemed to be a key process through which the women were able to accept their bodies and the body-related changes that resulted from cancer. In both studies, breast cancer survivors’ participation in endurance sports included camaraderie experiences that led to fulfilling the physical, emotional, and social needs as a mode for the women to move beyond their breast cancer experiences.

The purpose of this study was threefold; to examine the unique challenges faced among young breast cancer survivors’ self-concepts; to explore the identity reformulation process as they adjust to a new lifestyle after completing medical treatment; and to identify women’s creative problem solving solution used to mitigate any long-term distress and discontinuity between past, current and ideal selves. In-person semi-structured interviews were conducted with 10 young breast cancer survivors (aged 32-45). The results indicated that exploring women’s narratives through the identity reformulation process created an alternative approach to the four prescribed quality of life domains used to understand survivors’ overall wellbeing. The results also identified three shared domains of social location (gender, youth and health status) that intersected in women’s identity reformulation process. These findings have implications for psychosocial oncology literature, as well as clinical practice for mental health practitioners. Limitations and recommendations for areas of future research were discussed.

Diss. (sammanfattning) Stockholm : Karol. inst., 2002. / Härtill 6 uppsatser.