The general aim was to explore philosophy of life, expectations and optimism in patients and spouses in two different cancer situations, and to determine whether these aspects had relevance for psychological distress and quality of life. The first situation was being newly diagnosed with advanced cancer. Data on philosophy of life, optimism and psychological distress were gathered on one occasion (I). In addition, changes in life were described using a qualitative approach in a sub-sample (II). The second situation was having completed curative cancer treatment. Data on expectations for the recovery period, optimism, psychological distress and quality of life were gathered on three occasions (III). Moreover, expectations and how these turned out were described using a qualitative approach in a sub-sample (IV). The results show that being diagnosed with an advanced cancer influenced aspects of patients’ and spouses’ philosophy of life, including that existential questions were common and were related to higher psychological distress (I). All experienced substantial mental changes in life, often also physical, practical and sometimes positive changes. Patients more often seemed to accept their situation and prepared themselves for death, whereas spouses had more difficulties in handling the situation (II). Patients who had completed curative treatment generally had higher expectations for the recovery period than did their spouses, and patients expectations were fulfilled to a lesser degree, however, this generally had little importance for psychological distress or quality of life (III). Patients’ expectation for their recovery period was generally that they would get well. For those whose recovery period had been tough, expectations were often unfulfilled, but they were often satisfied with their current life anyway owing to positive changes (IV). Being optimistic was the most beneficial for decreased psychological distress in both samples, as well as for better quality of life in the recovery group (I, III).

Psykisk ohälsa är ett samhällsproblem som kräver mer uppmärksamhet från sjukvårdens sida. En kronisk sjukdom drabbar både patienter och deras livskamrater och präglas av olika förluster som förändrar livet. Förlusterna skapar en klyfta mellan det liv patienter och livskamrater lever och de liv de egentligen vill leva. Det är i denna klyfta som den kroniska sorgen skapas. Kronisk sorg skiljer sig från vanlig sorg då den återkommer i perioder och växlar i intensitet. Syftet med studien var att beskriva upplevelsen av kronisk sorg hos patienter och livskamrater i samband med en kronisk sjukdom. Studien är genomförd som en litteraturstudie där 15 vetenskapliga artiklar samlades in och granskades. Resultatet visar att patienter och livskamrater upplever olika typer förluster, både fysiska, sociala och psykiska. Dessa förluster ligger till grund för upplevelsen av kronisk sorg. Genom att få kunskap om patienter och livskamraters upplevelse av kronisk sorg i samband med kronisk sjukdom kan sjuksköterskan få förståelse för dessa patienter och utifrån det hjälpa dem att hantera sorgen. Kronisk sorg är ett relativt nytt begrepp inom sjukvården och det krävs därför mer forskning för att öka kunskapen om begreppet. / Mental health is a problem in society and it requires more attention from the healthcare side. A chronic disease means that both patients and spouses undergo different periods of losses that change their lives in different ways. These losses create a gap between the patients and spouse’s ongoing lives and the life they really want to live. It is in this gap that the chronic sorrow is created. Chronic sorrow differs from normal grief when it recurs in periods and switches in intensity. The aim of this study was to describe the experience of chronic sorrow in patients and spouses related to a chronic disease. The study was conducted as a literature review where 15 research articles were collected and examined. The results show that patients and spouses experience different types of losses, physical, social and psychological. These losses create their chronic sorrow. By gaining knowledge of patients and spouses experiences of chronic sorrow the nurse can obtain an understanding of their situations and based on that help they cope with grief. Chronic sorrow is a relatively new concept in healthcare and therefore more research is required to increase understanding of the concept.

När en man diagnostiseras med prostatacancer innebär det en psykisk påfrestning för mannen och hans kvinnliga partner. Reaktioner som chock, meningsförlust, ensamhet och ångest är vanligt förekommande. Syftet med denna litteraturstudie var att beskriva hur det vardagliga livet upplevs och påverkas hos par där mannen lever med diagnostiserad prostatacancer. Resultaten i studien baseras på tio vetenskapliga artiklar med fokus på parens erfarenheter av sjukdomen. Impotens, inkontinens och fatigue var symtom som drabbade mannen till följd av sjukdomen. Dessa förändringar inverkade på parets vardag och relation. Förändringarna var psykiskt påfrestande för parets hälsa och både mannens och kvinnans livskvalitet försämrades på grund av cancersjukdomen. Psykiska problem som depression, oro, ångest och skuld var dock mer förekommande hos kvinnan. Trots att paren var i stort behov av information upplevde de att hälso- och sjukvården inte uppmärksammade deras behov. Tydligare riktlinjer inom sjukvården för hur par som lever med prostatacancer ska bemötas efterlyses. På så sätt kan sjuksköterskan lättare tillgodose parets behov av information och stöd. Sjuksköterskan bör uppmärksamma och bemöta kvinnans individuella önskemål samt visa en öppenhet gentemot de sexuella problem som kan drabba paren. Mer forskning, speciellt i Skandinavien, efterlyses för att få en klarare bild över hur både en homosexuellt och heterosexuell relation påverkas av prostatacancer. / When a man is diagnosed with prostate cancer it implies a psychological strain for the man and his female partner where reactions such as shock, loss of meaning, loneliness and anxiety are common. The purpose of this literature review was to describe how everyday life is perceived and influenced in couples where the man has been diagnosed with prostate cancer. The results of the study are based on ten scientific articles focused on exploring couple’s experiences of the disease and how they are affected by the situation. Symptoms such as impotence, incontinence and fatigue were changes that affected the couple’s everyday life and their relationship. These changes were psychologically trying for the couple’s health and their quality of life decreased because of the cancer.  Psychological problems like depression, anxiety and guilt were more common for the woman. Despite the fact that the couples were in great need of information, they felt that health care providers were not attentive to these needs. Clearer guidelines are needed within the health-care system for how couples living with prostate cancer should be treated. The nurse would thereafter be better equipped to meet the couple’s needs for information and support. The nurse should highlight and approach women’s individual needs and show openness towards the sexual problems that can befall couples. More research is needed, particularly in Scandinavia, in order to get a clearer picture of how a homosexual and heterosexual relationship is affected by prostate cancer.

The incidence of Chronic Obstructive Pulmonary Disease (COPD) is expected to rise in the coming years. Presently, in health care there has been a shift of the provision of care to the home therefore, the major burden of care falls on informal caregivers. The challenges that these caregivers face may be compounded by residing in a rural area where the provision of health care services has been increasingly compromised. In the literature, there has been an abundance of information looking at the experiences of caregivers of people with other chronic illnesses. However, the information on the lived experience of caregivers of people with severe COPD has been minimal. The purpose of this study was to explore the lived experience and meaning of that experience for spousal caregivers providing care to a person with severe COPD living in rural Saskatchewan. Face-to-face, conversational interviews, along with observations of the caregivers and their spouses interactions and environment, were utilized to collect information from five women caring for their husbands with severe COPD living in rural Saskatchewan. Hermeneutic phenomenological reflection, as guided by the works of van Manen, utilized writing, collaborative discussion, life world existentials, and imaginative variation to illuminate themes and the overall essence of this experience. Five overlapping themes identified stemmed from the essence of unrelenting responsibility: 1) Assuming additional roles; 2) Ongoing vigilance; 3) Unfulfilled expectations; 4) Emotional burden; 5) Intermittent reprieve. This study assists in understanding the challenges faced by COPD caregivers and further aids in our understanding of how COPD patients manage their condition. In addition, it will facilitate the identification of strategies and actions to meet the needs sensitive to this population.

The incidence of Chronic Obstructive Pulmonary Disease (COPD) is expected to rise in the coming years. Presently, in health care there has been a shift of the provision of care to the home therefore, the major burden of care falls on informal caregivers. The challenges that these caregivers face may be compounded by residing in a rural area where the provision of health care services has been increasingly compromised. In the literature, there has been an abundance of information looking at the experiences of caregivers of people with other chronic illnesses. However, the information on the lived experience of caregivers of people with severe COPD has been minimal. The purpose of this study was to explore the lived experience and meaning of that experience for spousal caregivers providing care to a person with severe COPD living in rural Saskatchewan. Face-to-face, conversational interviews, along with observations of the caregivers and their spouses interactions and environment, were utilized to collect information from five women caring for their husbands with severe COPD living in rural Saskatchewan. Hermeneutic phenomenological reflection, as guided by the works of van Manen, utilized writing, collaborative discussion, life world existentials, and imaginative variation to illuminate themes and the overall essence of this experience. Five overlapping themes identified stemmed from the essence of unrelenting responsibility: 1) Assuming additional roles; 2) Ongoing vigilance; 3) Unfulfilled expectations; 4) Emotional burden; 5) Intermittent reprieve. This study assists in understanding the challenges faced by COPD caregivers and further aids in our understanding of how COPD patients manage their condition. In addition, it will facilitate the identification of strategies and actions to meet the needs sensitive to this population.

The purpose of this study was to explore foreign spouse children¡¦s mandarin capability, learning attitudes and social interactions, and analyzed the significant differences and predictors of their mandarin capability, learning attitudes and social interactions We conducted a purposive sampling selection to recruit 335 foreign spouse children who are 3rd to 6th graders in Kaohsiung city. All participants completed three scales of ¡§Mandarin Capability Scale¡¨, ¡§Learning Attitude Scale¡¨ and ¡§Interpersonal Relationships Scale¡¨ that developed by the investigator. In addition, 6 children with the highest total scores and the other 6 children with the lowest total scores on the three scales were interviewed for triangulation and consolidation of quantitative results. Descriptive statistics, independent t-test, one-way ANOVA, Pearson¡¦s product-moment correlation, and multiple stepwise regression analysis were used to assess the similarities and differences among groups. The initial findings were as follows: 1. Children came from families of higher education parents presented significantly higher Mandarin capability than these children came from families of lower education parents. 2. Children came from democratic parenting practice presented significantly higher mandarin capability scores than those children with permissive parenting practices. 3. Younger children¡¦s learning attitudes scores were significantly higher than the elder children. 4. Children came from families of higher education parents presented significantly higher learning attitudes scores than those children came from families of lower education parents. 5.Girls¡¦ interpersonal relationships scores were significantly higher than those of the boys. 6. Children came from families of higher education parents presented significantly higher interpersonal relationships scores than those children came from families of lower education parents. 7. Children came from democratic parenting practice presented significantly higher scores on the dimension of ¡§interaction with family members¡¨ than those children with authoritarian parenting practice. 8. There were significantly positive correlations among children¡¦s Mandarin capability, learning attitude and interpersonal relationships. 9. The significant predictors of children¡¦s learning attitude scores were ¡§listening comprehension¡¨, ¡§grammar rhetorical ability¡¨, ¡§language use ability¡¨ and ¡§language expression ability¡¨ . 10. The significant predictors of children¡¦s interpersonal relationships scores were ¡§listening comprehension¡¨, ¡§language use ability¡¨ and ¡§language expression ability¡¨ . Recommendation from research results were suggested to further study of foreign spouses children¡¦s Mandarin capability, learning attitudes and social interactions.

Thesis (D. Min.)--Western Seminary, Portland, OR, 2007. / Abstract. Typescript. Date on approval sheet, March 17 and 18, 2008; date on title page, November 13, 2007. Description based on print version record. Includes bibliographical references (leaves 195-198).

Thesis (M. Sc.)--Acadia University, 2001. / Includes bibliographical references (leaves 87-91). Also available on the Internet via the World Wide Web.

The purpose of the present study was to explore the ways that spouses of persons with ABI experience a process of change in roles, routine, and overall lifestyle and the subsequent implications for their support needs. The present study used a qualitative narrative inquiry methodology to examine the process of the experiences of this population of spouses. In-depth semi-structured interviews were conducted with 15 spouses, each of whom was engaged in a heterosexual relationship. There were 10 female and five male participants whose ages ranged from 40 to 61. Twelve of the participants were formally married, and three were in a common law relationship. In the interviews, the participants were asked about the changes in their lives after the onset of their spouses’ brain injuries. The data analysis was informed by narrative inquiry with attention paid to the structure of the participants’ stories. A three phase trajectory of caregiving emerged from the analysis which provided details regarding the process of change in the spousal caregiving role and how various role transitions within this role were intertwined with stressors and other feelings. The research highlighted three phases of caregiving including an Embryonic, Immersed and Modified Caregiver phase. The findings were theoretically important for identifying: how these spouses situate themselves within role transitions; coping strategies; various support needs; and future directions for research in this area.

The purpose of the present study was to explore the ways that spouses of persons with ABI experience a process of change in roles, routine, and overall lifestyle and the subsequent implications for their support needs. The present study used a qualitative narrative inquiry methodology to examine the process of the experiences of this population of spouses. In-depth semi-structured interviews were conducted with 15 spouses, each of whom was engaged in a heterosexual relationship. There were 10 female and five male participants whose ages ranged from 40 to 61. Twelve of the participants were formally married, and three were in a common law relationship. In the interviews, the participants were asked about the changes in their lives after the onset of their spouses’ brain injuries. The data analysis was informed by narrative inquiry with attention paid to the structure of the participants’ stories. A three phase trajectory of caregiving emerged from the analysis which provided details regarding the process of change in the spousal caregiving role and how various role transitions within this role were intertwined with stressors and other feelings. The research highlighted three phases of caregiving including an Embryonic, Immersed and Modified Caregiver phase. The findings were theoretically important for identifying: how these spouses situate themselves within role transitions; coping strategies; various support needs; and future directions for research in this area.