Melbourne School of Psychological Sciences - Theses
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ItemExperiences of ovarian cancer in older women( 2012)The aim of this study was to explore the lived experience of older women with ovarian cancer. It aimed to illuminate how women make sense of an ovarian cancer diagnosis in older age by a) investigating the psychosocial challenges of living with ovarian cancer and b) investigating inner strength factors which have helped or hindered a sense of well-being or resilience for these women. Ovarian cancer is predominantly a disease of older women, and the incidence of ovarian cancer is rising due to the ageing population. The limited primary research that has been conducted focusing on the psychosocial impact of ovarian cancer has highlighted the multi-dimensional nature of women’s experiences of living with cancer. The majority of the current literature includes women of all ages. Older cancer survivors are seldom the focus of research and have been considered the ‘silent population’, as little research has given voice to their experiences. Yet it is important to understand their experiences to identify how older cancer survivors access their various sources of strength to enable them to attain well-being, despite the losses and changes they confront This study used in-depth unstructured interviews to gives voice to the lived experience of nine older women (65+ years) with ovarian cancer. A qualitative, Interpretative Phenomenological Analysis (IPA) research approach enabled the exploration of the women’s’ experiences from a phenomenological perspective, through presenting the 18 essential themes in their experiences. Using the Model of Inner Strength (Roux, Dingley, Lewis & Grubbs, 2004) framework the key findings extended the current thinking about older women’s experiences of ovarian cancer and indicated that the women draw on the dimensions of inner strength, insight, engagement, participation and connectedness, to make ‘sense’ of their experiences and to balance the negative and positive psychosocial effects of the diagnosis, treatment and treatment side effects. The women’s perception of inner strength enabled them to adapt and compensate in order to optimally function and participate in all aspects of life (physical, emotional, social and spiritual). The women’s attitude was to see possibilities in their lives and to fully engage and participate in social, creative and physical activates. The Model of Inner Strength proposes women’s inner strength is impacted by cancer treatment, physical changes with ageing, challenges to quality of life and symptom clusters of distress. Along with these factors for older women with ovarian cancer, cancer symptoms, ageism, concurrent distress, concurrent medical conditions and end of life concerns were also found to be important. Although, the Model of Inner Strength provides a framework for understanding the experiences of cancer in older, the findings suggests a purely IPA study would allow the cultural, social, and individual factors to be further illuminated.
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ItemResilient coping styles: taxonomy, measurement and moderating role in the stress-health relationship( 2012)In this thesis, resilience is reconceptualised as coping styles based on positive emotions that moderate the stress - health relationship, thereby working as protective factors. Three studies were conducted with the aim of (i) creating a taxonomy of resilient coping styles as a conceptual and empirical framework to (ii) develop an instrument to measure said resilient coping styles to be able to (iii) evaluate the protective role of the resilient coping styles in the stress - health relationship. In Study 1a, individual interviews on 44 university students and 10 workers were used to create a list in 314 instances of coping. That list of ways of coping was initially analysed and reduced by the author of this thesis and the supervisor to 186 resilient ways of coping (i.e., coping that is based on positive emotions, flexible and predictive of adaptive outcomes). In Study 1b, 19 independent raters conducted a second content analysis of that 186 resilient coping list. This resulted in a list of 137 instances of coping classified as resilient coping. The 19 independent raters also performed a free sorting of the 137 instances of resilient coping and the product of that was integrated via a hierarchical cluster analysis to create a Taxonomy of Resilient Coping Styles comprised of 11 clusters (Individual Leisure, Social Leisure, Positive Future Outlook, Positive Self-evaluation, Positive Meaning, Acceptance, Situation Management, Effort Management, Emotional Management, Seeking Instrumental Support and Seeking Emotional Support) organised in 10 higher order contrasting categories. In Study 2a, the taxonomy developed was used to create a Resilient Coping Styles Questionnaire. The same 137 instances of coping were administered as a questionnaire to 220 University students. Exploratory factor analyses of their responses were compared with the taxonomy to find the most parsimonious dimensional representation of the resilient coping styles. This process derived in a five factor model: Resources Management, Situation Management, Positive Evaluation, Seeking Social Support and Positive Disengagement. The model was further tested with a confirmatory factor analysis and other psychometric indices. The five scales were also correlated with measures of trait emotions, personality, coping and health obtaining evidence of their concurrent validity. In Study 2b, the moderating role of the five resilient coping styles in the relationship between academic stress and health was evaluated finding support for the protective role of situation management, positive evaluation and positive disengagement in the academic stress-life satisfaction relationship and factors positive evaluation, seeking social support and positive disengagement in the academic stress-depression relationship. Study 3a was a direct replication of Study 2a. The factor structure of the Resilient Coping Styles Questionnaire was replicated. Study 3b was a conceptual replication and extension of Study 2b. The protective role of the five resilient coping styles, in the stress-depression relationship was replicated, as well as the protective effect of situation management, positive evaluation, and positive disengagement in the stress-life satisfaction relationship. Also, in Study 3b the protective role of the resilient coping styles remained after controlling for gender, age, language and dispositional resilience. The results of this thesis highlight the diversity of coping styles that are based on positive emotions that operate as protective factors in the relationship between stress and mental health. These results also have theoretical implications for the understanding of coping styles related to positive emotions as regulatory mechanism in the stress-health relationship.