[Truncated abstract] A diagnosis of breast cancer is a life-changing event for any woman. For young women and their families it can be devastating. Women aged less than 45 years make up 20% of new cases of breast cancer diagnosed annually in Australia. With the trend for women to delay pregnancy, young women diagnosed with breast cancer may want at least the option to become pregnant after diagnosis and treatment but little is known about how pregnancy affects breast cancer or how breast cancer affects pregnancy. The aims of this thesis were to investigate how concurrent and subsequent pregnancy affects the development and outcomes of breast cancer and how breast cancer affects a concurrent or subsequent pregnancy. This study describes two groups of women identified from the entire Western Australian population less than 45 years of age when diagnosed with: 1. Gestational breast cancer, defined as breast cancer diagnosed while a woman is pregnant or in the first twelve months after completion of a pregnancy; and 2. Breast cancer who subsequently conceive. This study focused on three main areas; patterns of care and outcomes for women diagnosed with gestational breast cancer and those women diagnosed with breast cancer who subsequently conceived; the imaging and pathological characteristics of gestational breast cancer; and lastly the psychosocial issues associated with gestational breast cancer. ... This result was statistically significant. In an age and staged matched case control study lymph node negativity did not purvey a survival advantage for women diagnosed with gestational breast cancer as it did for the non- gestational breast cancer controls. Women diagnosed with breast cancer who have good prognosis tumours need not necessarily wait two years to become pregnant. In an age matched case control study women diagnosed with gestational breast cancer were more likely to have extensive insitu carcinoma, higher mitotic rates and tumours with medullary like features than their age matched controls. In a Cox's proportional hazards regression model which included pathological characteristics, there was no significant difference in survival for women diagnosed with gestational breast cancer were compared to women diagnosed with non-gestational breast cancers. The psychosocial issues for women diagnosed with gestational breast cancer are similar to other young women diagnosed with breast cancer but the effect on the 9 lives of women dealing with pregnancy and breast cancer simultaneously was much greater. The issues of breast cancer and pregnancy are complex at both a physical and psychological level. Much more research is needed to understand the mechanisms of how pregnancy affects breast cancer and its spread. Women who are pregnant when diagnosed with breast cancer or who consider pregnancy after their diagnosis need unbiased support from those around them. Survival is important but other survivorship issues may be just as important. To translate these findings into clinical practice and offer directions for future research eleven recommendations are proposed.

The following study is a phenomenological inquiry into five white, middle classwomen's experiences living with HIV and AIDS in British Columbia. The purpose, rather than describing AIDS as a medical phenomenon, is to document how being diagnosed HIV positive has affected the women's lives, health, relationships and livelihoods. A context for the women's stories is provided through a critical review of the biomedical model, as well as biomedical and community organizing perspectives on women and AIDS. Mostly verbatim accounts drawn from taped interviews conducted with the five women describes their lives with HIV and AIDS. Experiences surrounding their diagnosis, sources of information about their illness, strategies for coping, management of health, and management of personal and social identities are the themes explored. The women's participation, the role of the researcher, and the work produced are considered parts of an interactive process, demonstrating shared authority between the researcher and participants in the ethnographic process. Documentation of the women's experiences leads to a discussion of the ways in which they successfully manage and control their own health care and well being within the context of larger social forces of sexism, medical bias and stigma. The women are given the last word in the study. In conclusion, a review oftheir situations three years after their initial interviews contributes a significant emotional and descriptive time-depth to the study. / Arts, Faculty of / Sociology, Department of / Graduate

Please read the abstract (Summary) in the section 00front of this document. Please note: The Errata list is included as last page of each chapter / Dissertation (MA (Clinical Psychology))--University of Pretoria, 2007. / Psychology / unrestricted

This study using a quantitative, descriptive design with a questionnaire investigated cultural, religious and social factors that might impact on ARV treatment in HIV/AIDS-infected women in Botswana. The study found that the majority never missed any doses, a few missed doses once or twice, and a small minority missed more than three times. The respondents’ perception of cultural influence on treatment of HIV/AIDS in women revealed that the majority (70%) believe culture has an influence on the treatment. Social factors also impacted on ARV adherence. A few of the respondents indicated that side effects and the number of pills prevented ARV medication adherence. The main reason for non-adherence, however, was forgetfulness. There had been an improvement in the majority of the respondents’ health status and quality of life. Maximizing adherence is essential. Providers and patients both have responsibilities in this regard. / Health Studies / M.A.(Health Studies)

published_or_final_version / Social Work / Master / Master of Social Work

published_or_final_version / Social Work / Master / Master of Social Work

This study using a quantitative, descriptive design with a questionnaire investigated cultural, religious and social factors that might impact on ARV treatment in HIV/AIDS-infected women in Botswana. The study found that the majority never missed any doses, a few missed doses once or twice, and a small minority missed more than three times. The respondents’ perception of cultural influence on treatment of HIV/AIDS in women revealed that the majority (70%) believe culture has an influence on the treatment. Social factors also impacted on ARV adherence. A few of the respondents indicated that side effects and the number of pills prevented ARV medication adherence. The main reason for non-adherence, however, was forgetfulness. There had been an improvement in the majority of the respondents’ health status and quality of life. Maximizing adherence is essential. Providers and patients both have responsibilities in this regard. / Health Studies / M.A.(Health Studies)

This study explores and describes the perceived needs of women living with HIV/AIDS in Saskatchewan. A purposive sample was used to recruit women to participate in three focus groups. A total of eleven women from urban and rural areas of Saskatchewan participated. Based on seroprevalence estimates this number may represent one third to one half of all expected cases of women with HIV/AIDS in Saskatchewan. Recursive analysis was used to validate the themes identified in the first two focus groups with participants in a third focus group. Content analysis of the data identified four themes from the women's experiences: 1) medical needs, 2) economic needs, 3) mental health needs, and 4) service needs. The results support previous studies which indicate that women with HIV have a number of unmet heeds. Women from rural areas were found to have more unmet needs and limited access to appropriate services and supports than urban women. Three types of coping strategies were found to be used by the women in getting their needs met: avoidance, maintenance, and mastery. Those who utilized a mastery coping strategy were more successful in having their needs met than those who did not. A number of individual, organizational, systemic, and policy interventions are identified to assist women in moving towards mastery coping strategies. Social workers can work at the clinical, family group, and policy levels to improve the situation for women living with HIV/AIDS in Saskatchewan.

This study explores and describes the perceived needs of women living with HIV/AIDS in Saskatchewan. A purposive sample was used to recruit women to participate in three focus groups. A total of eleven women from urban and rural areas of Saskatchewan participated. Based on seroprevalence estimates this number may represent one third to one half of all expected cases of women with HIV/AIDS in Saskatchewan. Recursive analysis was used to validate the themes identified in the first two focus groups with participants in a third focus group. Content analysis of the data identified four themes from the women's experiences: 1) medical needs, 2) economic needs, 3) mental health needs, and 4) service needs. The results support previous studies which indicate that women with HIV have a number of unmet heeds. Women from rural areas were found to have more unmet needs and limited access to appropriate services and supports than urban women. Three types of coping strategies were found to be used by the women in getting their needs met: avoidance, maintenance, and mastery. Those who utilized a mastery coping strategy were more successful in having their needs met than those who did not. A number of individual, organizational, systemic, and policy interventions are identified to assist women in moving towards mastery coping strategies. Social workers can work at the clinical, family group, and policy levels to improve the situation for women living with HIV/AIDS in Saskatchewan. / Arts, Faculty of / Social Work, School of / Graduate

MPH / Department of Public Health