Testing a model of communication, uncertainty, and emotional well-being in older breast cancer survivors
View File(s)
Visitor Statistics
Visits vs Downloads
Visitors - World Map
Top Visiting Countries
Country | Visits |
---|
Top Visiting Cities
City | Visits |
---|
Visits (last 6 months)
Downloads (last 6 months)
Popular Works for Clayton, Margaret F. by View
Title | Page Views |
---|
Popular Works for Clayton, Margaret F. by Download
Title | Downloads |
---|
View Citations
Citations
The uncertainty and disruption caused by ongoing physical symptoms contributes to emotional distress and thoughts of recurrence for older breast cancer survivors. Uncertainty may be due to a lack of information about whether symptoms indicate recurrence, are related to comorbid conditions, or are part of the normal aging process. The purpose of this research was to assess the influence of physical symptoms, age, ethnicity, and patient-provider communication, on the uncertainty and emotional well-being of older breast cancer survivors. Guided by Uncertainty in Illness Theory, a conceptual model was developed and tested using structural equation modeling techniques. Data from 203 recurrence free Caucasian and African American women age 50–91, and 5–9 years post original treatment were used to test the model. Women reported an average of 5 symptoms, with only 12% of women reporting no physical symptoms. In addition, results suggest that high levels of symptom bother may place survivors at risk for adverse emotional well-being. Women reported high levels of symptom bother from weight gain, fatigue, pain, trouble thinking, and arm problems. These were not the most prevalent symptoms. Age was the strongest predictor of emotional well-being. Increasing age predicted less symptom bother, less uncertainty, less mood disturbance, and fewer troublesome thoughts of recurrence. Ethnicity was not significant in predicting either uncertainty or emotional well-being. Larger amounts of patient-provider communication predicted increased troublesome thoughts of recurrence. Possibly women received a more lengthy discussion of their symptoms than desired or expected. Conversely, it may be that a larger number of troublesome thoughts of recurrence triggered more talk between patient and provider. Communication findings showed that over 40% of women were unable to achieve their desired decision-making role. The high level of discrepancy between desired versus attained decision-making roles raises the issue of whether providers are meeting the ethical responsibility of respecting the autonomy of their patients or still adhering to a paternalistic model of care-giving. Future research is needed to investigate the long-term consequences of persistent uncertainty. Additionally, future research will clarify the mechanism by which patient-provider communication influences troublesome thoughts of recurrence for older breast cancer survivors.
This dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 3111987; ProQuest document ID: 305311739. The author still retains copyright.
This item has not gone through this repository's peer-review process, but has been accepted by the indicated university or college in partial fulfillment of the requirements for the specified degree.
Type | Dissertation |
Acquisition | Proxy-submission |
Review Type | None: Degree-based Submission |
Format | Text-based Document |
Evidence Level | Descriptive/Correlational |
Research Approach | Quantitative Research |
Keywords | Breast Cancer Survivors; Health Anxiety; Patient Education |
CINAHL Subject(s) | Cancer Survivors--Psychosocial Factors; Psychological Well-Being; Uncertainty; Cancer Survivors |
Grantor | The University of North Carolina at Chapel Hill |
Advisor | Michel, Merle H. |
Level | PhD |
Year | 2003 |
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
All permission requests should be directed accordingly and not to the Sigma Repository.
All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Related items
Showing items related by title, author, creator and subjects.
-
A scoping review of the literature addressing psychological well-being of racial and ethnic minority nurses during the COVID-19 pandemic
Abrahim, Heather L.; Holman, E. Alison (Elsevier, 2022-11-17)Background: The COVID-19 pandemic has affected the well-being of nursing professionals, especially long-term and acute care nurses, many of whom are nurses of color. Purpose: We examine the evidence and gaps in the ... -
Health status and psychological well-being in elderly women: The self-system as mediator
Heidrich, Susan M.The purpose of this research was to explain how elderly women manage to maintain high levels of psychological well-being despite losses associated with aging, especially loss of health, and to examine this process in ... -
Inner resources (sense of coherence, hope, and spiritual perspective) as predictors of psychological well-being in African American breast cancer survivors
Gibson, Lynette M. RichardsonNo studies have been found on the psychological effects of applying sense of coherence, hope, and spiritual perspective by African American (AA) breast cancer survivors. These variables have each been positively associated ... -
An examination of the relations amongst power, uncertainty, self-transcendence, and quality of life in breast cancer survivors
Farren, Arlene T.The investigator examined the relations amongst Power, Uncertainty, Self-transcendence, and Quality of Life in breast cancer survivors. The theoretical rationale linked the theories of Barrett, Mishel, and Reed with Ferrans' ... -
Nurse motivation, engagement and well-being before an electronic medical record system implementation: A mixed methods study
Jedwab, Rebecca M.; Hutchinson, Alison M.; Manias, Elizabeth; Calvo, Rafael A.; Dobroff, Naomi; Glozier, Nicholas; Redley, Bernice (International Journal of Environmental Research and Public Health, 18(5), 2726., 2021-03-08)Implementation of an electronic medical record (EMR) is a significant workplace event for nurses in hospitals. Understanding nurses’ key concerns can inform EMR implementation and ongoing optimization strategies to ...