M.A. / A child's life-threatening illness has severe implications for the family. Changes in lifestyle which result from an illness of this nature influence the child-patient's own life, as well as the lives of people who are in close contact with him, i.e. his parents and healthy siblings. Literature on the subject suggests that the healthy siblings suffer due to the illness and that their needs are not addressed during the illness. They often become the victims of emotional neglect, due to the lack of meaningful contact with their parents. Literature also suggests that parents often judge their healthy children to he handling the situation of one child's lifethreatening illness far more successfully than they actually are. Healthy siblings may also develop death anxiety due to this experience. Due to these, and various other reasons, the healthy siblings of children with life-threatening illnesses constitute a population which is at risk of developing moderate and severe personal, social and psychological problems. The aim of this study was to investigate how healthy siblings experience a child's lifethreatening illness and how this experience influences the healthy siblings. The study also aimed to determine the effect of a child's life-threatening illness on healthy siblings' levels of death anxiety. These aims were achieved by conducting interviews with healthy siblings, as well as their parents. The three families which were included in this study were contacted through a local state hospital. In all three families one child had been diagnosed with a life-threatening illness. All the healthy siblings who were interviewed were between the ages of nine and 16. Both qualitative and quantitative data analyses were incorporated by this study. The qualitative data for the study was gathered by means of open-ended interviews with healthy siblings and their parents. These interviews were then analysed according to the phenomenological research method. The quantitative data for the study was gathered by means of the Death Anxiety Questionnaire for Children (Malan, 1996) which was constructed far the study. The results of the qualitative data of all the participants of the study were combined in the final analysis, to determine how healthy siblings experience a child's life-threatening illness and what effect this experience has on them. The quantitative results of the study were analysed and interpreted in association with the qualitative results. The findings of this study suggest that a child's life-threatening illness constitutes a traumatic and emotional experience for the child's healthy siblings. Various conclusions were drawn as to the effects which this experience may have on the healthy siblings. The study also determined that a child's life-threatening illness influences healthy siblings' levels of death anxiety. According to these findings hypotheses may be set for future research. The results of this study is of value to the fields of psychology, social work and medicine. In the .fields of counselling and child psychology, the results serve to improve the understanding of families, and especially , children, who are experiencing the life-threatening disease of a family member. In the fields of social work and medicine the results serve to improve the relations between professionals and families of child-patients with life-threatening illnesses.

published_or_final_version / Nursing Studies / Master / Master of Nursing in Advanced Practice

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Bibliography: leaves 238-253. / xviii, 261 leaves ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Through a methodological blend of hermeneutics, phenomenology and social constructionism the experiences of donor parents are presented. Using a process of dialogical interpretation the themes of Unprepared, Uncertainty, Waiting, Watching, Waiting and Aloneness have been developed to expand our understanding of donor parents experiences. / Thesis (Ph.D.)--University of Adelaide, Dept. of Clinical Nursing, 1999

Background: This thesis examines the impact of dream or wish fulfilment on seriously ill children and their families. Dream or wish fulfilment is operationalised as the actualisation of a seriously ill child’s wish by a charity that provides desired experiences. Anecdotal reports suggest that the experience of having a dream or a wish fulfilled can provide seriously ill children and their families with a sense of hope and time away from illness. However, little empirical research has been conducted in this area. This thesis reports the impact of dream fulfilment on the psychosocial well-being of ill children and their families. The research questions are: what is the experience of having a dream fulfilled for the child? What is the impact of dream fulfilment on the family? Methods: A constructivist grounded theory methodology was adopted, using theoretical sampling to recruit families from across the UK. Twenty-one families were interviewed, including 15 dream recipients, 8 siblings, and 24 parents. Analysis followed the grounded theory methodology of simultaneous data collection and development of theory, resulting in analytic interpretations of participants’ worlds. Results and Conclusions: This thesis reports for the first time a theory and accompanying theoretical model, that explain the impact of dream fulfilment on families’ lives. The generated theory suggests that dream fulfilment was conceptualised as an alternative milestone in seriously ill children and their families’ lives. Additionally, the dream experience shifted perceptions of illness by providing instances and experiences where illness did not underscore family life. Findings additionally suggest that the dream fulfilment process provided families with ill children, who often felt excluded and stigmatised from services, with a period of much needed support. Findings also highlight the unintended negative consequences of dream fulfilment. Implications for Dreams Come True, and other dream and wish fulfilment organisations are discussed.

This essay deals with the experiences of hospital school teachers, when teaching terminally and chronically ill children. Teachers form part of a multidisciplinary team of doctors, nurses, therapists, social workers and other caregivers. As a team they all share the same goal of assisting the child to better health with the minimum disruption to normal development and education. The effects on teachers personally; coping with emotional stresses of children being seriously ill and sometimes, unfortunately dying and professionally; by constantly adapting learning and teaching styles to suit the needs of these learners, are numerous when working in these conditions and often results in burnout. This essay explores these effects by inquiring into the lives of four teachers at one particular hospital school. This phenomenological study comes to a conclusion that hospital teachers need specific and distinctive characteristics to deal with issues out of the norm. They have to own extraordinary commitment and acknowledge the true value of teacher collaboration. Finally teachers needed ongoing support on a personal level; counseling, and on a professional level; teacher training and development in order to remain healthy, personally intact and at the spearhead of developments in the teaching profession. The essay ends with recommendations for hospital school teachers and hospital schools. / Dr. M.P. van der Merwe

Utilizing a collective case study design, I examined and described the filial therapy (FT) process and adaptations discovered to be necessary and unnecessary in working with families who have a child with a life-threatening illness in the hospital setting. Data from a total of 7 parents was utilized, including those who terminated early, in order to gain a greater understanding of adapting FT for families who have a child with a life-threatening illness and their participation patterns. The parents attended 10 one- to two-hour FT sessions. The data was analyzed to examine for themes, patterns and relationships intrinsically with each case participant, as well as across cases. Analysis indicated that parents with a child with a life-threatening illness had great difficulty committing to attend FT; and a high rate of attrition occurred for those who did commit. A theme regarding flexibility was found to be of eminent importance in a variety of manifestations including therapeutic methods, session format, location and time of sessions, and intense vs traditional FT. Therapeutic adaptations in flexibility found to be important including openness to cathartic and personal parenting sessions, tolerance of forgetfulness, and lowering typical therapeutic concerns of dependency in the relationship. An inability for parents in this situation to benefit from intense FT methods was also noted. Changes noted in the child of focus included increased confidence, increased cooperation in the medical setting, increased communication with the parent and with medical staff regarding medical issues, and increased communication with the parent regarding personal feelings and issues. Changes noted in the parents included increased confidence in parenting skills, increased awareness of the child's perceptions of the environment, increased tolerance in allowing the child to struggle in and out of the medical setting, with both emotional and physical pain in order to gain coping skills, increased ability to allow the child to empower self, and increased abilities in limit setting.

When a child is diagnosed with cancer, the roles and responsibilities of family members change to accommodate the demands of the illness. The current study aimed to explore the experiences of mothers of children with cancer, focusing on their constructed roles within the family context and their social support. A case study design within the qualitative research approach was employed, underpinned by social constructionism as a theoretical framework. Three mothers were selected, using a combination of purposive and snowball sample techniques. Rich descriptive data were collected from three mothers through semi-structured interviews and reflective essays, and analysed using thematic analysis techniques. Results showed that although mothers of children with cancer experience some common themes, there are contextual differences influencing how they construct their stories. The following main themes were identified in the comparative analysis: events leading to the diagnosis, emotions, life changes, the effect of the illness and coping. / Psychology / M.A. (Psychology)

Text in Afrikaans / The problem that motivated the study was that siblings of children with cancer may experience the relationships within the family differently after cancer treatment. The purpose was to investigate and describe how family dynamics are experienced by the siblings of a cancer patient after his/her treatment for cancer. The research methodology includes qualitative research of an explorative and descriptive nature. Data were collected through unstructured interviews with siblings of children who had received treatment for cancer. From this data eight categories were identified accordingly. Although the data do not indicate that siblings experienced family dynamics after treatment as problematic, as expected, the information contributes by making parents of cancer patients more aware of the siblings' emotions and needs. / Social Work / M.Diac (Spelterapie)

This study examines through autoethnographic inquiry my research journey in the world of childhood cancer. The unfolding research experience eventually led to the focus of this investigation which is exploring stories of coping with childhood cancer in a support group for parents. Using the principles of ethnographic epistemology this study explores the stories of eight parents whose children were diagnosed with cancer and who decided to join the support group for parents called, TOUCH. An overview of the existing body of knowledge on childhood cancer and the family is presented as well as the value of a social support group in parenting a child with cancer. The need of a conceptual shift in order to understand the problem of parenting a child with cancer is propagated. The stories of eight parents within the setting of a social support group are presented. Through the principles of the qualitative method of ethnography the story of the child's cancer is described by means of emerging themes. The coping mechanisms used to cope in this world of uncertainty and ambiguity, follows. Finally the contribution of the support group is discussed in terms of my relationship with the group member, the group members' communication pattern and what was perceived to be helpful to the group member. The eight stories discussed all follow the same pattern. Four hypotheses emerged from the eight stories described and are presented in the final chapter. The strengths and limitations of the study are discussed as well as recommendations for future research. / Psychology / D. Lit. et Phil. (Psychology)