This survey examined anticipatory grief as a process of grieving that occurs when a loved-one has been diagnosed with a life-threatening illness. The inevitability of loss creates certain needs and feelings for the survivor. The study examined these needs, the extent to which these needs were satisfied, and the feelings. Finally, the relationship between dissatisfaction of important needs and certain feelings was observed. Findings show that certain needs, such as the need to gain knowledge about illness and to feel emotional support from family members rate as extremely important by the greatest number of respondents. These needs were not, however, rated as highly satisfied. It was also found that feelings such as anger, loneliness, and frustration were rated as occurring frequently when prognosis of death was within a year. Lastly, there was found to be a positive relationship between dissatisfaction of needs and these feelings.

published_or_final_version / Nursing Studies / Master / Master of Nursing

D.Cur.( Psychiatric Nursing Science) / Please refer to full text to view abstract

Indiana University-Purdue University Indianapolis (IUPUI) / Greater levels of loneliness have shown consistent associations with poorer mental and physical health; however, the reason for these relationships is unknown. Engagement in poorer health behaviors among individuals with higher levels of loneliness is one potential explanation for this relationship. Self-regulation theory suggests that coping with feelings of loneliness may impair attempts to control health behaviors. Caregivers of cancer patients have been found to have poor health behaviors (e.g., inadequate exercise) and high levels of loneliness. Thus, the aim of the study is to examine whether health behaviors mediate the relationships between loneliness and mental and physical health outcomes among caregivers of cancer patients. Methods: A secondary data analysis was conducted using data from a longitudinal study of cancer patients and their family caregivers who were staying at the American Cancer Society’s Hope Lodge. Participants completed self-report questionnaires measuring levels of loneliness, engagement in health behaviors (i.e., exercise and fruit and vegetable consumption), mental and physical health, and demographic and medical characteristics at three time points over a 4-month period. A bootstrapping macro was used to examine the indirect effect of loneliness on mental and physical health via health behaviors. Results: Contrary to hypotheses, exercise and fruit and vegetable consumption did not mediate the relationships between loneliness and physical and mental health among cancer patients’ caregivers. Additional research is needed to determine whether health behaviors partially account for the relationships between loneliness and health outcomes or whether alternate explanations for these relationships should be considered.

There is minimal research into families where a person who is receiving palliative care has dependent children. In particular, there is a lack of information about the work that palliative care social workers undertake with such families. This study examines the role of the palliative care social worker in safeguarding and promoting the welfare of children of adults receiving specialist palliative care. This is a qualitative study involving the collection of information from a total of 57 palliative care social workers in three ways: focus groups, survey and semi-structured interviews. The analysis demonstrates that palliative care social workers understand the term 'safeguarding children' to mean more than child protection alone. The analysis also focuses on the process of referral, institutional barriers, supports for their work with children, and inter-agency collaboration. An equally important aspect of the analysis, and one generally neglected in psycho-social studies, relates to the socio-economic context of the palliative care social workers' work, including the effects of the immigration status of families on children. In the main, concerns about the present and future care of children come to the attention of palliative care social workers via members of the multidisciplinary team in which they are based. The numbers are reported to be relatively small in contrast to the total number of referrals received. The extent to which support to children is provided varies considerably; some palliative care agencies do not encourage palliative care social workers to work directly with children prior to bereavement and others restrict direct work with children post-bereavement. The main emphasis for all workers, however, is on support to the parents to help them understand their children's needs during the terminal phase of the illness. The well-being of children at this time of emotional stress is included in the palliative care social workers' definition of 'safeguarding children'. In addition, the wide-ranging examination of the palliative care social workers' involvement with the families illustrates the extent of the dedication involved in an under-resourced and little understood area of their work. Whilst palliative care social workers reported receiving basic training on child protection within their agency, with some themselves providing this training, further training on safeguarding children is not always available or known about. The amount and type of professional supervision and support is also varied, particularly in relation to child-care matters; not all have access to supervision from another social work professional. There are a small number of examples given in the study where children are considered to be at risk in some way. Children cared for by lone parents are recognised as being especially vulnerable, particularly if future care plans are not in place before the death of the parent. Also identified as vulnerable are children of parents whose immigration status is in question as their future location may be in doubt, placing children and the surviving parent under additional stress. One of the major difficulties for palliative care social workers is securing support services from local authority children's services. Whilst there are examples of collaboration and co-operation, the findings in this study echo those of others which examine the relationship between adult and children's services. In this study, palliative care social workers speak of frustration and disappointment in the responses they receive, and they are concerned that the needs of children of dying parents are not understood. This study contributes to the debate about the focus of children in care services for adults and how staff may be supported in their task of safeguarding and promoting the welfare of children. This study also adds to the limited existing knowledge about palliative care social work practice.

Text in Afrikaans / Summaries in Afrikaans and English / Vigs is 'n "sluipende moordenaar "_ Dit toon geen respek vir kultuur, status,ouderdom of geslag nie. Vigs veroorsaak 'n onnnatuurlike dood wat vriende en familie bedreig en vervreem, lank na die dood van die vigsslagoffer. Die navorsingsdoel van hierdie studie was om riglyne daar te stel vir die psigoterapeutiese hantering van die vigslyer en sy gesin. Die navorsing het getoon dat 'n stigma en skuldgevoelens rondom die vigslyer en sy gesin ontstaan het, en dat hulle direk verantwoordelik gehou word vir die siekte bloot omdat hulle betrokke is by mekaar. 'n Vraelys wat aspekte (soos dit uit die literatuurstudie geblyk het) inkorporeer, is opgestel en aan die vigslyer en sy gesin gegee om te voltooi. Van die belangrikste elemente wat na vore gekom het, is die vrees vir die onbekende, die stigma verbonde aan die siekte en die pad wat die siekte loop ten opsigte van naiwiteit en valse gerugte ten opsigte van die siekte. 'n Verdere hoofstuk fokus op die literatuur om die hoofaspekte van die probleem vas le stel, en sodoende riglyne vir 'n terapieprogram daar te stel om die vrese te onderskep en die familie te help om die siekte beter te begryp_ Die doel is om die samelewing te laat begryp dat vigs nie 'n kulturele of "klas" siekte is nie, maar dat dit alle lae van die samelewing kan tref. 'n Afdeling is gewy aan 'n wye verskeidenheid terapeutiese tegnieke wat geimplimenteer kan word tydens hulpverlening aan die vigslyer en sy gesinslede. Verder verskaf hierdie studie ook riglyne om ondersteuning en hulp aan die vigslyer en sy gesin te bied, om sodoende hulle selfkonsep te verbeter. / Aids is a "stalking killer''. It has no respect for culture, breeding, age or sex. It is an unnatural death which offends and alienates many friends and family, even after the victim has died. A questionnaire incorporating important aspects of the cause and effect of aids was compiled and given to the aids sufferers and family to complete. From the responses it was clearly evident that the fears of the unknown, the stigma attached to the victim's close associates and family, was a problem, and the route course of incredible naive and false rumours. A chapter of the research focused on literature to establish what was the major aspects of the problem expressed by the media. Guidelines were provided whereby therapy could address and allay these fears to assist the family to better understand the illness and it's effects. This chapter has in mind to provide the Psychologist with guidelines to provide therapy to both the victim and the family in this regard. This study confirms that the survivors are the actual victims. / Educational studies / M.Ed. (Voorligting)

Text in Afrikaans / Summaries in Afrikaans and English / Vigs is 'n "sluipende moordenaar "_ Dit toon geen respek vir kultuur, status,ouderdom of geslag nie. Vigs veroorsaak 'n onnnatuurlike dood wat vriende en familie bedreig en vervreem, lank na die dood van die vigsslagoffer. Die navorsingsdoel van hierdie studie was om riglyne daar te stel vir die psigoterapeutiese hantering van die vigslyer en sy gesin. Die navorsing het getoon dat 'n stigma en skuldgevoelens rondom die vigslyer en sy gesin ontstaan het, en dat hulle direk verantwoordelik gehou word vir die siekte bloot omdat hulle betrokke is by mekaar. 'n Vraelys wat aspekte (soos dit uit die literatuurstudie geblyk het) inkorporeer, is opgestel en aan die vigslyer en sy gesin gegee om te voltooi. Van die belangrikste elemente wat na vore gekom het, is die vrees vir die onbekende, die stigma verbonde aan die siekte en die pad wat die siekte loop ten opsigte van naiwiteit en valse gerugte ten opsigte van die siekte. 'n Verdere hoofstuk fokus op die literatuur om die hoofaspekte van die probleem vas le stel, en sodoende riglyne vir 'n terapieprogram daar te stel om die vrese te onderskep en die familie te help om die siekte beter te begryp_ Die doel is om die samelewing te laat begryp dat vigs nie 'n kulturele of "klas" siekte is nie, maar dat dit alle lae van die samelewing kan tref. 'n Afdeling is gewy aan 'n wye verskeidenheid terapeutiese tegnieke wat geimplimenteer kan word tydens hulpverlening aan die vigslyer en sy gesinslede. Verder verskaf hierdie studie ook riglyne om ondersteuning en hulp aan die vigslyer en sy gesin te bied, om sodoende hulle selfkonsep te verbeter. / Aids is a "stalking killer''. It has no respect for culture, breeding, age or sex. It is an unnatural death which offends and alienates many friends and family, even after the victim has died. A questionnaire incorporating important aspects of the cause and effect of aids was compiled and given to the aids sufferers and family to complete. From the responses it was clearly evident that the fears of the unknown, the stigma attached to the victim's close associates and family, was a problem, and the route course of incredible naive and false rumours. A chapter of the research focused on literature to establish what was the major aspects of the problem expressed by the media. Guidelines were provided whereby therapy could address and allay these fears to assist the family to better understand the illness and it's effects. This chapter has in mind to provide the Psychologist with guidelines to provide therapy to both the victim and the family in this regard. This study confirms that the survivors are the actual victims. / Educational studies / M.Ed. (Voorligting)