Anecdotal and qualitative evidence suggests that women may experience disrupted adjustment during the months following the end of adjuvant breast cancer treatment, in part due to the loss of a "safety net" associated with regular treatment coupled with uncertainty regarding cancer status. The present study examined distress and quality of life, as well as behavioral and cognitive predictors of adjustment, during the three months following adjuvant treatment for breast cancer. Participants were 89 women with breast cancer who completed measures of distress, quality of life, health behavior, behavior changes, and common-sense beliefs about cancer at three time points: toward the end of adjuvant treatment, 3 weeks following the end of treatment, and 3 months post-treatment. Findings indicated that breast cancer survivors were remarkably well-adjusted following treatment: participants reported low levels of anxiety and depression and good health-related quality of life. Nonetheless, women acknowledged significant concerns about ongoing physical symptoms, potential recurrence, and the process of returning to or building a "new normal." Results further suggested that behavior changes were quite common after the end of treatment, particularly positive changes in health practices. Although good health practices were associated with better adjustment, making positive changes in the same behaviors often predicted greater distress. Women's common-sense beliefs about breast cancer provided insight into whether women decided to make behavior changes and what behaviors they decided to change. Women who perceived greater control over their cancer, saw their cancer as an acute rather than chronic condition, and attributed cancer to controllable causes or believed that behavioral or psychological factors could prevent recurrence were more likely to make behavior changes and engage in positive health practices. Although it was predicted that beliefs and behavior changes would interact to predict distress, no consistent pattern of interactions was found. In sum, breast cancer patients actively attempt to create a "new normal" following treatment, and changes in health practices appear to be an important part of this process. Assessing women's beliefs about their cancer and providing psychoeducational interventions addressing post-treatment behavior changes may assist in promoting breast cancer survivors' psychological and physical well-being.

Föräldrar till barn med typ 1 diabetes mellitus (T1DM) genomgår en rad olika förändringar när deras barn insjuknar. Insjuknandet går fort och föräldrarna hinner inte bli förberedda på det som komma skall. De tvingas utan förvarning hantera de emotionella, psykologiska och fysiologiska förändringar som sjukdomen för med sig. Föräldrarna försöker hantera situationen och genomför på kort tid livsstilsförändringar kring kost, motion, läkemedelshantering, blodsockermätning och hantera medicinteknisk utrustning. Dessutom påverkas den sociala support de tidigare hade, deras egna arbetssituation kan komma att förändras. De ska fortsätta att se syskonen till det insjuknade barnet samtidigt som de ska vårda sitt sjuka barn dygnet runt, året ut och livet ut. Förändringarna och den nya livssituationen kan vara mycket ansträngande för föräldrarna och de riskerar sin egna hälsa för att vårda sitt barn. Syftet med studien var att belysa föräldrars upplevelser att leva med ett barn med typ 1 diabetes. Metoden i litteraturstudien bygger på 12 artiklar. Både kvalitativa och kvantitativa artiklar som belyser området vilka alla sammanställts och bildar resultatet. Tre huvudteman framkom i resultatet: Föräldrarnas tankar och känslor, Vikten av social support och Föräldrarnas egna hälsorisk. Subteman som kom fram under föräldrars tankar och känslor var normalisering, att ha kontroll, oro och rädsla, sorg, mödrar kontra fäder. Det framkom inom vikten av social support tre subteman: diabetsteam/ sjukvården, skola/ barnomsorg samt support från vänner och familj. Subteman under föräldrarnas egna hälsorisk berör sömnbrist och utbrändhet. I studiens resultat framkommer att föräldrarna är oroliga över den bristfälliga kunskap skolan har kring deras barns T1DM. Att föräldrarna saknar stöttning från sjukvården till att nå riktlinjerna för en bra metabol kontroll. Det framkom att sjukvården har en viktig uppgift att bidra med kunskap och information. Det framkom också att diabetesteam bör beakta vad som kan ligga bakom problemet till brister i egenvården. Egenvårdsbalansen bör upprättas på ett mer långsiktigt och konstruktivt sätt än om sjuksköterskan bara inriktar sig på att åtgärda problem. Sjuksköterskans roll bör vara av hjälpande, vägledande, lärande, motiverande, fysiskt eller psykologiskt stödjande funktion eller att bidra till ett sammanhang som stödjer utveckling för föräldrarna till barn med T1DM.

This study evaluated two distinct aspects of social functioning (specifically, social support and social constraint) in an attempt to increase understanding of its bidirectional relationship with distress after cancer diagnosis. Participants in this intensive longitudinal study were all recently diagnosed, first primary cervical or head/neck cancer survivors (n=47). Data collection involved a comprehensive baseline assessment and 30-day period of daily assessment (n=37) of key variables (i.e., social support, social constraint, and distress). Data were analyzed using unconditional and conditional multilevel linear models. None of the variables changed significantly over the 30-day period. On a typical day, social constraint and distress were predictive of one another (ps < .001). Social support and distress did not demonstrate a bidirectional relationship (ps > .05). In the context of cancer adjustment and survivorship, future interventions for distress should consider targeting social constraint and interventions for social constraint should consider targeting distress.

El objetivo de la investigación fue explorar la relación entre calidad de vida y estrategias de afrontamiento en 130 mujeres, entre 30 y 86 años, con diagnóstico de cáncer de mama y tratamiento quirúrgico de mastectomía radical modificada. Los instrumentos psicológicos empleados fueron: Brief COPE para medir las estrategias de afrontamiento y EORTC QLQ-C30 para calidad de vida. Los resultados principales demostraron que existen relaciones significativas entre algunas de las dimensiones de calidad de vida con ciertas estrategias de afrontamiento y que su influencia es positiva para la calidad de vida y salud, en términos globales. Lamentablemente no se encontraron diferencias importantes entre estas dimensiones de calidad de vida y estrategia de afrontamiento según el tratamiento recibido (mastectomía radical modificada o MRM con un tratamiento adicional) ni la edad; sin embargo, existen antecedentes científicos que lo presentarían como una opción interesante en una muestra más amplia.  En conclusión, la hipótesis planteada ha sido comprobada parcialmente, ya que sólo algunas estrategias de afrontamiento se llegan a correlacionar con ciertas dimensiones de calidad de vida significativamente. / The objective of the research was to explore the relationship between quality of life and coping strategies in 130 women, between 30 and 86 years, with a diagnosis of breast cancer and surgical treatment of modified radical mastectomy. The psychological instruments used were: Brief COPE to measure coping strategies and EORTC QLQ-C30 for quality of life. The main results showed that there are significant relationships between some of the dimensions of quality of life with certain coping strategies and their influence is positive, in global terms, for the quality of life and health. Unfortunately, there were not important differences between these dimensions of quality of life and coping strategy according to the treatment received (modified radical mastectomy or MRM with additional treatment) or age; however, there is a scientific background that would present it as an interesting option in a larger sample. In conclusion, the hypothesis raised has been partially verified, since only some coping strategies can be correlated with certain dimensions of quality of life significantly. / Tesis

This research sought to clarify the role of the self in chronic illness by developing and evaluating several new constructs, which intend to describe the extent to which illness permeates the self-concept. Following the works of Lewin and Asch, the concepts of central and peripheral regions of the self were elaborated to describe the state of illness within the self, termed "illness self-concept". Three subsidiary constructs were introduced to further depict illness self-concept: directionality, pervasiveness, and illness self-consciousness. Directionality refers to whether illness drives the self or self drives illness. Pervasiveness refers to whether illness affects many or few regions of the self. Illness self-consciousness refers to the degree of preoccupation with illness. A 23-item scale was developed to assess illness self-concept (ex= .94), with items addressing each construct. A 14-item scale measuring "illness self-concept support" (ISC Support, ex= .89) was developed to assess whether family and friends reinforce illness as central or peripheral to the self. I hypothesized that illness self-concept relates to adjustment such that the more illness is peripheral to the self, the better the adjustment. My second hypothesis was that personal, interpersonal, and illness-related factors would influence illness self-concept. The third hypothesis was that illness self-concept would predict additional variance in adjustment after controlling for each of these factors. Fibromyalgia patients (n = 109) completed measures of illness self-concept, optimism, ISC support, illness intrusiveness, and functional status. Results supported hypothesis one, indicating that illness self-concept significantly predicted quality of life (R2Δ. = .39) and depression (R2Δ = .24). Results supported hypothesis two, indicating that ISC support, optimism, illness intrusiveness and functional status each contribute to illness self-concept. Results supported hypothesis three, indicating that illness self-concept predicted substantial variance in adjustment even after controlling for personal, interpersonal, and illness-related factors. All three hypotheses were strongly supported, indicating that illness self-concept is an important predictor of adjustment in chronic illness. This study demonstrated that the extent to which illness permeates the self-concept has implications for adjustment in fibromyalgia, and may be an important variable in improving psychological adjustment in other chronic illnesses.

Abstract The quality of life of probationers remains low when reestablishing life in society. Research has been conducted on how siblings can provide support to juveniles, yet minimal research supported how adult sibling relationships have affected probationers' quality of life. The purpose of this study was to explore the phenomenon of the effect sibling relationships may have on probationers' quality of life. Attachment theory was used as a theoretical framework to support the factors relating to sibling relationship types. This research study used a qualitative interview design in order to explore probationers' perspective of their sibling relationship type and quality of life. The sample (N = 6) came from Transcendence Foundation, a facility providing support to probationers in the South Central Region of Minnesota. A thematic analysis was used to interpret the perceptions probationers have of their relationship with their sibling and how it affects their quality of life. Based on the results from past research studies and this research study, siblings with supportive, warm, and positive relationships reduce the negative aspects and feelings of probationers. The results of this study could potentially help probationers increase their quality of life through the development of interventions involving sibling support. A higher quality of life can create positive social change for probationers reentering into society by increasing their feelings of self-worth and reducing recidivism.

The number of individuals facing vision loss as adults is increasing, and the need for these adults to have access to training and skills to aid in their adjustment process is prevalent. Guided by the tenets of connectivism, this phenomenological study examined current trends in social networking and the possibilities that are available to adults adjusting to low vision by using technology as a means for continued learning, social interaction, and professional connections. The main research question focused on the participants' perception of the adjustment process and their ability to learn and use technology. Data were collected through semi-structured interviews of 10 adults who had low vision and had attended some form of intervention. The experiences were recorded through the use of reflection that included memoing and inductive coding where themes emerged during the field process. NVivo software was utilized to clarify and present details about themes and patterns presented during the interview discussions. These themes detailed the participants' feelings of confidence and self expressed level of skills needed to use technology; the barriers to using technology, such as cost and time; and benefits of staying connected with technology. The findings from this study suggested that the ability to stay connected and to access information outweighed the barriers, although the participants expressed frustration with technological issues. The study contributed to an area of research that supports the benefits of continued training for adults adjusting to low vision. A process of training could be implemented that would involve general technology as well as assistive technology assisting individuals with continued success in their daily lives.

Home health aides' performance can help home health clients achieve quality of life. This quantitative, cross-sectional study examined which work-related factors of home health aides influence home health clients' quality of life. A socioecological perspective was used to understand influences on behaviors. Participants in this study were 400 home health clients who received services from home health agencies. A binary logistic model was used to determine the predictor variables of home health aides that contributed to home health clients' quality of life. Findings indicated that psychosocial skills were among the most predicted work-related performance of home health aides that lead to quality of life for home health clients. All independent variables (professional care; teaching clients about medication management, pain, and home safety; and social and communication skills) showed significance (p < .05). The implications of this study for positive social change include contributing evidence to support improving home health practices and informing policies, which might increase the quality of life for home health clients.

The type of cancer pain management used may have an effect on the quality of life (QOL) of cancer patients. Researchers have determined that cancer patients are inadequately treated for pain and pain management is an essential determinant of patient survivability and QOL. Numerous clinical studies have been accomplished concerning opioid administration and noncancer and cancer pain management exist. Previous studies have examined the relationship between cannabinoid products, noncancer pain, cancer pain, and related QOL for patients but have not focused on the QOL of cancer patients while also moderating for gender. These relationships were investigated using the health belief model. The cancer pain management treatments (opioids and/or marijuana [cannabis]) and QOL, measured with World Health Organization Quality of Life Survey (WHOQOL-BREF), of 236 cancer patients were analyzed using analysis of variance (ANOVA), planned contrasts, post hoc tests, and moderated ANOVA (PROCESS tool) in the causal-comparative research. Research findings indicated significant benefit in cancer patient physical and psychological QOL in participants using marijuana when compared to participants using opioids and physical QOL for participants using marijuana over participants using both opioids and marijuana combined. Enhanced pain management options for cancer patients in order to reduce opioid side effects, increase pain treatment effectiveness, and improve patient QOL could yield positive social change. Growing rates of opiate addiction, abuse, and mortality are public health concerns and cannabis may be an effective pain treatment to reduce these social costs. This research may be of use to legislators considering rescheduling marijuana to less than Schedule I.

Cancer affects millions of people every year and survivorship has increased substantially recently. Two cancers that affect older adults is non-Hodgkin's lymphoma and breast cancer, yet very little research has focused on cancer and survivorship in late life. Emerging research has suggested that chemotherapy could have deleterious consequences on cognition, but few studies have considered the long-term neurocognitive sequelae of chemotherapy. Furthermore, social support and optimism have been independently examined as predictors of quality of life in cancer patients, but little research has considered the effects of these variables on other outcomes, such as cognition. The aim of this study was to gain a better understanding of the relationship between social support and optimism on cognition, specifically in non-Hodgkin's lymphoma (NHLS) and breast cancer survivors (BCS). It was hypothesized that social support and optimism would be positively related to cognition, and that social support would mediate the optimism-cognition relationship. Twenty-seven BCS (M age = 71.96), twenty-five female (M age = 69.76) and twenty-five male (M age = 65.28) NHLS groups were recruited. Each participant completed a three-hour standardized neuropsychological battery designed to evaluate a range of cognitive abilities involving attention, premorbid and current intellect, memory, language, visuospatial skills, and executive functioning, as well as self-report measures of mood, social support, and optimism. Performances on cognitive tests were within normal limits, but differences were found in aspects of executive functioning (p < .01) with the men outperforming women in the NHLS group. Women in the NHLS group performed better on a measure of executive functioning (p < .05) and visuospatial functioning (p < .01) than women in the BCS group. Women from both groups performed better than the male NHLS group on verbal learning and memory measures (all p's < .05). The groups did not differ on psychosocial variables. Correlations between psychosocial variables (i.e., social support and optimism) were variably related to cognitive measures in both groups. Social support did not mediate the optimism-cognition relationship. This is the first study to consider the relationship between social support, optimism, and cognition and early interventions to improve cognition in cancer survivors is discussed.