Competency assessment and evaluation for all psychological therapies are now a common requirement. Recent international research studies have resulted in the development of the phrase ‘death competence’ as “tolerating and managing clients’ problems related to dying, death, and bereavement” with an urging for death work competence to be an ethical imperative (Gamino & Ritter, 2012). A further study of 176 death work professionals using an open ended question and content analysis proposed a model of death work competence that suggests it is dependent on more than knowledge and skills, with the emergence of emotional and existential coping as key elements (Chan & Tin, 2012). This study aims to build on this existing research with an Interpretative Phenomenological Analysis of six existential practitioners` experience of feeling competent in their death work, grounding the research in Heidegger`s notion of being-towards-death. The aim was to get as close as possible to the lived experience of death work competency in a small, purposive sample to investigate the subjective meanings and understandings of their death work competency. Semi structured interviews were conducted with five major themes emerging. These were frameworks for death work competency; existential engagement in competent death work; existential ways of being in death work; the psychological impact of death work on feelings of competency and the elusive essence of death work competency. The significant finding was the primary import placed by all participants on dialogues with personal mortality, suffering and death as providing them with “competency in adversity” and “competency in fragility” that were vital for their competent death work, both personally and professionally. These findings match the identification of existential coping and emotional coping as key elements in death work competency in the previous research. From this research a tentative framework is proposed for death work competency that looks to include these vital elements of an engagement with existential issues and personal mortality, for counselling psychologists and death work practitioners. Further research is suggested with regards to the absence or presence of similar experiences of death work competencies in other fields of death work with wider implications for training in both professional organisations and teaching institutions.

The experience of dealing with end-stage cancer in a family member has been reported to be stressful. One source of stress experienced by family members may be dissatisfaction with care received by the patient and themselves. For health professionals to provide care that promotes family satisfaction, it is essential to measure this phenomenon and understand the elements that contribute to satisfaction. An examination of the literature revealed four competing explanatory theories of satisfaction, none of which has solid empirical support. Moreover, these theories had not been tested with families or those experiencing cancer care in particular. Therefore, the aim of this research was to test these alternative theories using theoretical and empirical modeling with the expectation that a useful model would be identified to guide clinical practice of families in terminal care situations. The theories tested were: (1) Vroom's Fulfillment Theory, (2) Porter's Discrepancy Theory, (3) Thibaut and Kelley's Social Comparison Theory, and (4) Ajzen and Fishbein's Expectancy Value Theory. A correlational design with a causal modeling methodology was used. One hundred and nine family members of patients with advanced cancer were obtained from three different palliative care services. Five instruments were used to collect data: (1) FAMCARE Scale, (2) F-Care Needs Scale, (3) F-Care Expectations Scale, (4) F-Care Perceptions Scale, and (5) a short demographic questionnaire. Data analysis included use of descriptive statistics to summarize the sample in terms of demographic variables, reliability and validity testing of the instruments, and theoretical and empirical model testing using multiple regression techniques and residual analysis. Of the four theories tested, Discrepancy theory was the most credible, accounting for 68 percent of explained variance in family care satisfaction. Empirical modeling resulted in identification of the Family Care Satisfaction Model, which explained 78 percent of the variance in care satisfaction. Implications for theory construction and clinical practice are presented and recommendations for further research offered. The family constitutes perhaps the most important social context within which health and illness occur. As more families are required to care for dependent or ill members at home, understanding the needs, expectations, and satisfactions with care experienced by families will become increasingly important.

by Ho Mun-Wan, Audrey. / Thesis (Ph.D.)--Chinese University of Hong Kong, 1991. / Includes bibliographical references. / Title Page --- p.i / Thesis Committee --- p.ii / Table of Contents --- p.iii / Abstract --- p.ix / List of Figures --- p.xii / List of Tables --- p.xiv / List of Appendices --- p.xviii / Acknowledgements --- p.xxi / Statement of Originality --- p.xxiii / Chapter CHAPTER I --- INTRODUCTION: STATEMENT OF RESEARCH PROBLEM --- p.1-11 / Chapter 1.1 --- Introduction --- p.2 / Chapter 1.2 --- Death and Quality of Life --- p.3 / Chapter 1.3 --- Pain and Quality of Life --- p.6 / Chapter 1.4 --- Measuring Quality of Life in Chinese Population --- p.8 / Chapter 1.5 --- The Research Problem and Sample --- p.10 / Chapter CHAPTER II --- LITERATURE REVIEW AND CONCEPTUAL FRAMEWORK --- p.12-62 / Chapter 2.1 --- Introduction --- p.13 / Chapter Part A: --- The Concept of Quality of Life / Chapter 2.2 --- Definitions of Quality of Life --- p.14 / Chapter 2.3 --- Towards a Structural Definition of Quality of Life --- p.19 / Chapter 2.4 --- Quality of Life: Subjective or Objective? --- p.22 / Chapter 2.5 --- Quality of Life and Social Cultural Context --- p.28 / Chapter Part B: --- Ideology and Psychology of Death and Dying / Chapter 2.6 --- Chinese Ideas on Death and Dying --- p.31 / Chapter 2.7 --- Western Religions in Hong Kong --- p.38 / Chapter 2.8 --- Local Folk Beliefs on Death and Dying --- p.41 / Chapter 2.9 --- Psychology of Death and Dying --- p.42 / Chapter Part C: --- Measuring the Quality of Life of Terminally I11 Patients / Chapter 2.10 --- Quality of Life of End Stage Cancer Patients of the West --- p.48 / Chapter 2.11 --- Factors Affecting Quality of Life of Terminally I11 Patients --- p.51 / Chapter 2.12 --- Existing Measures on Quality of Life and Pain --- p.55 / Chapter 2.13 --- Summary --- p.61 / Chapter CHAPTER III --- TOWARDS CONSTRUCTING A CHINESE QUALITY OF LIFE QUESTIONNAIRE FOR THE THE TERMINALLY ILL PATIENTS --- p.64-107 / Chapter 3.1 --- Introduction: The Need for a Chinese Quality of Life Questionnaire (CQLQ) --- p.65 / Chapter 3.2 --- Preparatory Survey I: Identification of the Needs of Patients by Medical and Health Professionals --- p.67 / Chapter 3.3 --- Preparatory Survey II: Identification of the Needs of Patients by Severely I11 Patients --- p.75 / Chapter 3.4 --- Design of the Chinese Quality of Life Questionnaire (CQLQ) --- p.84 / Chapter 3.5 --- Preparatory Survey III: First Validation of the Chinese Quality of Life Questionnaire --- p.87 / Chapter 3.6 --- Preparatory Survey IV: Second Validation of the Chinese Quality of Life Questionnaire --- p.104 / Chapter 3.7 --- Summary --- p.107 / Chapter CHAPTER IV --- THE DEVELOPMENT OF A CHINESE PAIN QUESTIONNAIRE FROM THE McGILL PAIN QUESTIONNAIRE --- p.108-128 / Chapter 4.1 --- Introduction --- p.109 / Chapter 4.2 --- Preparatory Survey I: Collection of Cantonese Pain Descriptors --- p.110 / Chapter 4.3 --- Preparatory Survey II: Pilot Test of the Preliminary Pain Descriptors --- p.112 / Chapter 4.4 --- Modification of the Cantonese Pain Questionnaire --- p.115 / Chapter 4.5 --- Preparatory Survey III: Pilot Test of the Modified Pain Descriptors --- p.122 / Chapter 4.6 --- Preparatory Survey The Development of A Scoring System --- p.122 / Chapter 4.7 --- Preparatory Survey V: Pilot Test of the Final Draft of the Chinese Pain Questionnaire (CPQ) --- p.126 / Chapter 4.8 --- Summary --- p.128 / Chapter CHAPTER V --- EXPLORING THE VALIDITY OF TWO NEWLY DEVELOPED QUESTIONNAIRES: CQLQ AND CPQ - A FEASIBILITY STUDY --- p.129-161 / Chapter 5.1 --- Introduction --- p.130 / Chapter 5.2 --- The Study Design and Methodology --- p.130 / Chapter 5.3 --- "The Demographic, Social, Economic, and Illness Status of Subjects" --- p.145 / Chapter 5.4 --- Summary --- p.161 / Chapter CHAPTER VI --- THE VALIDATION FINDINGS --- p.162-241 / Chapter 6.1 --- Introduction --- p.163 / Part A / Chapter 6.2 --- Reporting on the Concurrent Validity in a Patient Sample --- p.163 / Chapter 6.3 --- Reporting on the CQLQ Validation Findings --- p.177 / Chapter 6.4 --- Reporting on the CQLQ Reliability --- p.211 / Chapter 6.5 --- Age and Quality of Life --- p.214 / Part B / Chapter 6.6 --- Reporting on the Validation of the CPQ Findings --- p.223 / Chapter 6.7 --- Summary of CPQ Findings --- p.241 / Chapter CHAPTER VII --- "STRUCTURAL, PAIN-ILLNESS, AND PSYCHOLOGICAL DETERMINANTS OF OVERALL QUALITY OF LIFE" --- p.242-286 / Chapter 7.1 --- Introduction --- p.243 / Chapter 7.2 --- Structural Model of Quality of Life --- p.243 / Chapter 7.3 --- Pain-Illness Model of Quality of Life --- p.264 / Chapter 7.4 --- Psychological Model of Quality of Life --- p.282 / Chapter 7.5 --- Summary --- p.286 / Chapter CHAPTER VIII --- CONCLUSION AND FUTURE DIRECTIONS / Chapter 8.1 --- Introduction --- p.288 / Chapter 8.2 --- The Chinese Quality of Life Questionnaire --- p.288 / Chapter 8.3 --- The Validity of the Chinese Quality of Life Questionnaire --- p.291 / Chapter 8.4 --- The Chinese Pain Questionnaire --- p.300 / Chapter 8.5 --- Liimitations and Implications --- p.304 / REFERENCES --- p.306-314 / APPENDICES --- p.315-408