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Purpose: A majority of childhood and adolescent cancer survivors face life-long cancer- and treatment-related sequelae. Long-term follow-up is necessary to facilitate timely diagnosis and management of these health conditions. As part of strategic long-term follow-up, provider continuity of care (PCOC) may improve outcomes through appropriate use of surveillance, screening, and coordination of services. The purpose of this thesis was to assess physician services utilization and PCOC among survivors of childhood cancer compared with general population subjects, and to examine factors associated with survivors' use of physician services and PCOC scores. Methods: Physician services utilization and PCOC were assessed in a population-based cohort of 1322 five-year cancer survivors diagnosed between 1981 and 1995 under age 20 in British Columbia, and a group of 13,220 age- and gender-frequency matched, randomly selected population-based subjects, whose records were linked to individual-level administrative healthcare datasets. Effects of clinical and sociodemographic modifiers on utilization and PCOC were examined using generalized linear modeling. Changes in utilization and PCOC by age were estimated using a longitudinal, repeated measures modeling approach. Results: Survivors incurred an average of 8.94 medical visits per year: 4.82 to primary care physicians, 2.69 to specialists, and 1.43 to non-physician providers. Survivors had more visits than comparators in all visit categories (p<0.0001 for all). As they age, survivors' use of primary care services increases significantly, while their use of specialist services declines, trends that are not mirrored by the comparison population. The average PCOC score for survivors was 0.54 ± 0.22, indicating survivors saw the same primary care provider for only 50% of their primary care visits. Mean score did not differ between survivors and comparators; however, in the population sample scores improved with age (p=0.02), while among survivors, scores worsened (p=0.05). Conclusions: The dramatic age-related increase in primary care visits observed in the survivor group suggests that primary care physicians play a key role in ensuring quality long-term follow-up care. Survivors are at heightened risk for poor PCOC as they age and transition into adult-oriented community care, raising concerns about whether they are receiving the appropriate follow-up care encompassing screening, surveillance and psychosocial support.

Background: Each year, over one million people around the world die as a result of suicide. About 1500 of those are in Sweden. In each case an estimated six kindred’s are to be affected. These people are in great need of support. Despite this, research shows that nurses experience difficulties to support the suicide survivors. Aim: The aim of this study was to describe kindred’s experiences after the loss of someone close as a result of suicide. Method: In order to capture the kindred’s experience of losing someone close as a result of suicide, a literature-based study were chosen, where nine scientific qualitative articles were analyzed. Results: The results are presented in four different themes, and eight subthemes, which all highlights kindred’s experience of losing someone close as a result of suicide. The themes where to feel an overwhelming grief; to feel judged by others and themselves; to feel the need of support; that life changes. Conclusion: Being related to someone who has died as a result of suicide causes great suffering and a changed life-world. The following study shows that most suicide survivors don’t get the support they need after the suicide. A better understanding of the suicide survivor’s experiences may lead to improved care and support. To prevent the suffering and to support the kindred’s health process this study shows that a caring science way of caring is required. Thus it applies to each nurse to be open and responsive to each individual’s life-world and its ambiguity

In today’s business environment, cost-cutting practices such as downsizing and layoffs remains a widespread phenomenon. Although, the understanding of the effects that these practices has on the remaining individuals, defined as the survivors, is poor. The focus in this paper is therefore to examine how survivors of layoffs can be affected on an individual level, and by what causes. The study was conducted using open-ended, qualitative interviews with three individuals with different experiences of layoffs. The empirical data was analyzed by extracting quotations from the interviews. The study found that layoffs affected the morale and attitude towards management of the individual, and that perceived justice and uncertainty are two causes of negative effects from layoffs.

Purpose: A majority of childhood and adolescent cancer survivors face life-long cancer- and treatment-related sequelae. Long-term follow-up is necessary to facilitate timely diagnosis and management of these health conditions. As part of strategic long-term follow-up, provider continuity of care (PCOC) may improve outcomes through appropriate use of surveillance, screening, and coordination of services. The purpose of this thesis was to assess physician services utilization and PCOC among survivors of childhood cancer compared with general population subjects, and to examine factors associated with survivors' use of physician services and PCOC scores. Methods: Physician services utilization and PCOC were assessed in a population-based cohort of 1322 five-year cancer survivors diagnosed between 1981 and 1995 under age 20 in British Columbia, and a group of 13,220 age- and gender-frequency matched, randomly selected population-based subjects, whose records were linked to individual-level administrative healthcare datasets. Effects of clinical and sociodemographic modifiers on utilization and PCOC were examined using generalized linear modeling. Changes in utilization and PCOC by age were estimated using a longitudinal, repeated measures modeling approach. Results: Survivors incurred an average of 8.94 medical visits per year: 4.82 to primary care physicians, 2.69 to specialists, and 1.43 to non-physician providers. Survivors had more visits than comparators in all visit categories (p<0.0001 for all). As they age, survivors' use of primary care services increases significantly, while their use of specialist services declines, trends that are not mirrored by the comparison population. The average PCOC score for survivors was 0.54 ± 0.22, indicating survivors saw the same primary care provider for only 50% of their primary care visits. Mean score did not differ between survivors and comparators; however, in the population sample scores improved with age (p=0.02), while among survivors, scores worsened (p=0.05). Conclusions: The dramatic age-related increase in primary care visits observed in the survivor group suggests that primary care physicians play a key role in ensuring quality long-term follow-up care. Survivors are at heightened risk for poor PCOC as they age and transition into adult-oriented community care, raising concerns about whether they are receiving the appropriate follow-up care encompassing screening, surveillance and psychosocial support.

Thesis (Ph. D.)--University of Chicago, Dept. of Romance Languages and Literatures, August 1997. / Includes bibliographical references. Also available on the Internet.

Thesis (M.S.)--University of Wisconsin-Madison, 1993. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 250-265).

Thesis (Ph.D.)--Indiana University, 2008. / Title from screen (viewed on June 1, 2009). School of Nursing, Indiana University-Purdue University Indianapolis (IUPUI). ADVISOR(S): Janet S. Carpenter. Includes vita. Includes bibliographical references (leaves 227-243).

Thesis (Ph. D.)--University of Wisconsin--Madison, 2002. / eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 145-165).

Thesis (M.S.)--University of Wisconsin-Madison, 1994. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 42-43).