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Thesis (M.S.)--Boston University, 1956 / This thesis represents one part of a group study conducted jointly by four Boston University social work students. The purpose of this group study is to examine first same of the social and emotional factors that affect the rehabilitation of cancer patients, and second, the role of social service in this rehabilitation. The study is based on the cases comprising the Harvard Medical School project.

The purpose of this mixed method study was to determine the extent of physical problems, rehabilitation needs, and cancer rehabilitation experiences after breast cancer treatment. Women diagnosed with breast cancer were surveyed to examine physical morbidities, disability, and quality of life. An interpretive descriptive approach was used in the conduction of a focus group. The percentage of women experiencing physical problems after breast cancer treatment was high, physical disability was low and there was a moderately high quality of life. Despite the high report of physical problems, less than half received physical rehabilitation. Themes from the focus group data were difficulty in finding clear/consistent information, financial issues and the need for integration of cancer rehabilitation services. This research adds to the better understanding of cancer rehabilitation needs and practices and may be used to improve the delivery of cancer rehabilitation services to address the physical needs of breast cancer survivors.

This study employed a case study research design to explore how family caregivers experience caring for an advanced cancer patient enrolled in a palliative rehabilitation program. Demographic, case note, pre-post quality of life scores, and interview data sets were collected from four family caregivers throughout patient enrollment in the 8-week Ottawa Palliative Rehabilitation Program. Thematic analysis of the interview data revealed caregivers’ perceived caregiving as: 1) Being a Witness of the Patient’s Struggles, 2) A Duty Paired with a Desire to Support Patients - Regardless of the Challenges, and 3) A Role Which Requires Tailored Knowledge, Support, and Resources to Aid in Improving Patient Functioning and in Managing Caregiving Tasks. Involving family caregivers in palliative rehabilitation programs provides them an opportunity to engage with the patient and health care professionals in order to develop a shared understanding of the illness implications, learn tailored caregiving approaches, and gain social support.

Purpose: To test whether a psycho-educational program affects mental wellbeing in persons treated for colorectal cancer and their next-of-kin. Design: A prospective, longitudinal, randomized controlled trial. Setting: Surgical clinic at a university hospital in Sweden. Sample: 105 colorectal cancer patients and 71 next-of-kin were allocated to a psycho­educational program or to standard care. Methods: Mental wellbeing was evaluated with the Mood Adjective Check List and The Hospital Anxiety and Depression Scale at baseline and at 1, 6, and 12 months. The program consisted of seven meetings, including lecture and time for reflection with other patients/next­of-kin. Main Research Variable: Overall mood, activity, calmness, pleasantness, anxiety, and depression. Findings: The psycho-educational program increased overall mood, calmness, and pleasantness among patients after one month but had no effect on activity, anxiety, or depression. The program had no effect on the overall mood, activity, calmness, pleasantness, anxiety, or depression among next-of-kin. Conclusion: The psycho-educational program had a short-term effect on overall patient mood, calmness, and pleasantness but not on next-of-kin. Implications for Nursing: A psycho-educational program including lecture and time for reflection can be used with a colorectal cancer patient population to improve some aspects of their mental wellbeing.

This study is based on 6 in-depth interviews with professional social workers working as counsellors in two different municipalities in Skåne county, Sweden. The counsellors are all working within the field of cancer rehabilitation. The aim of the study is to investigate how the counsellors perceive the work-related psychological stress that their work entails. The study also aims to examine the coping strategies and personal resources related to resilience that the counsellors use to manage what is perceived to be psychologically stressful within the work. The result of the information collected shows that the counsellors experience the profession as psychologically demanding and that they frequently use different coping strategies. It appears that the counsellors use the support of colleagues and their workplace. They also use strategies related to self-care through self-reflection and self-awareness as well as different types of attendance exercises such as meditation and yoga. Some of the counsellors frequently use a local coping strategy which entail to “feel your weight in the chair”. The results also show that the counsellors consciously create an active and rewarding leisure time with a clear boundary to their working life. It appears that their abilities as well as their personal resources related to resilience have been developed with age and experience. The results of the interviews have been analyzed through the theory of resilience, the coping theory and a number of research articles.

京都大学 / 0048 / 新制・課程博士 / 博士(社会健康医学) / 甲第21701号 / 社医博第92号 / 新制||社医||10(附属図書館) / 京都大学大学院医学研究科社会健康医学系専攻 / (主査)教授 平井 豊博, 教授 小西 靖彦, 教授 伊達 洋至 / 学位規則第4条第1項該当 / Doctor of Public Health / Kyoto University / DFAM

Instruments for measuring health-related quality of life (HRQoL) generally do not consider the subjective importance of the dimensions they comprise. The aims of this study were to analyze the subjectively perceived importance of the dimension of HRQoL and to investigate their relationship to the satisfaction ratings with these dimensions. A total of 1108 participants enrolled in a cancer rehabilitation program were surveyed. Patients rated eight dimensions of HRQoL (physical functioning, autonomy, emotional stability, cognitive functioning, social relationships, vitality, absence of pain, and sleep quality), as well as global health in terms of how important those dimensions are to them, and how satisfied they are with them. The dimensions with the highest importance ratings were autonomy and social relationships. There were only small sex differences in the importance ratings, but younger patients rated health as being more important than older patients did. The correlations between the importance ratings and the satisfaction ratings of the specific HRQoL dimensions ranged from 0.06 to 0.40, and the correlation between importance and satisfaction for global health was 0.01. Importance ratings provide relevant information for health care professionals in addition to the HRQoL assessments in the context of cancer rehabilitation.

Background Compared with other malignancies, head and neck cancer (HNC) increases the risk of not returning to work (RTW). Methods Within a cross-sectional study, patients with HNC filled out the OncoFunction questionnaire, a version of the International Classification of Functioning Core Sets for HNC. In 231 patients below 65 years of age, associations of sociodemographic, clinical, functional, and psychological factors with employment and participation in rehabilitation program were explored. Results Unemployed patients reported more swallowing difficulties and speaking problems. Being unemployed was associated with higher levels of depressive and anxiety symptoms, fatigue, and lower global health. Rehabilitation participation was not significantly associated with any of the assessed factors except for smoking. Conclusions Unemployed patients with HNC are more burdened than employed patients with HNC regarding clinical, psychological, and functional factors. These differences are more evident later in recovery. Rehabilitation participation was not associated with psychological and functional burden which indicates the need for tailored HNC rehabilitation programs.

Syftet med studien var att undersöka vilka faktorer som påverkar hur primärvårdens fysioterapeuter ser på sin roll inom cancerrehabiliteringen. Följande faktorer undersöktes: ålder, tidsmässig erfarenhet inom yrket och specifikt inom primärvården, hur ofta fysioterapeuter möter cancerpatienter, upplevd kunskap, upplevd tillgång på resurser, uppskattning från cancerpatienter samt läkares uppfattning om fysioterapeutens roll/kompetens. Studien utfördes med en elektronisk enkät och skickades ut via mail till chefer vid hälsocentraler placerade i Region Västerbotten, Region Norrbotten, Region Jönköpings län samt Region Sörmland. Cheferna ombads vidarebefordra mailet till de fysioterapeuter som arbetade vid hälsocentralerna och sedan återkoppla i ett svarsmail hur många fysioterapeuter som mottagit mailet. Totalt 66 personer besvarade enkäten. Samband analyserades mellan de ovan nämnda faktorerna och utgångsvariabeln “Självklar del”, som handlar om i vilken utsträckning fysioterapeuterna känner sig som en självklar del inom cancerrehabiliteringen. Vid analysen genomfördes en dikotomisering för att få en ökad statistisk power. Signifikansnivån sattes till 0,05 och när analysen genomfördes påträffades två statistiskt signifikanta samband. Det första sambandet innebar att fysioterapeuter som känner sig mer uppskattade av cancerpatienter också känner sig som en mer självklar del inom cancerrehabiliteringen (p<0,001 vid ursprunglig variabel ochp=0,004 dikotomiserad). Det andra sambandet innebar att de som upplever att läkare i större utsträckning är medvetna om fysioterapeutens kompetens också känner sig som en mer självklar del inom cancerrehabiliteringen (p=0,030 vid ursprunglig variabel, p=0,160 respektive 0,007 beroende på hur dikotomiseringen genomfördes).