Living Past Your Expiration Date: A Phenomenological Study of Living with Stage IV Cancer Longer than Expected

More treatment options exist today for persons diagnosed with terminal cancerextending lives longer than expected though there is little known about the psychosocial needs or resources for these individuals. This study describes the experience of living past the expiration date and still living with Stage IV cancer. A transcendental phenomenological approach was used to elucidate vivid expressions of this experience in a sample population of five Caucasian women. The women survived beyond their prognoses of an earlier expiration are not close to imminent death and are still living with incurable breast cancer metastases. The aim of this phenomenological inquiry is to illuminate the themes and essences of this phenomenon in hopes of expanding comprehension of the challenges this growing population confronts. Data was collected through individual open-ended, unstructured in-depth interviews. At a second meeting each woman, having been asked to find or create an expressive representation of their experience, verbally described their creations in an unstructured dialogue. All interviews were audio recorded and transcribed verbatim. Through the methodological processes of bracketing, phenomenological reduction, imaginative variation, and synthesis, the themes and essences that surfaced revolved around the constancy of change and duality. Five core themes emerged from the data: awareness of mortality; interaction with medical systems and treatment; living on a roller coaster; feeling different from others; cancer invades and changes how you live. All of the themes are interrelated and together capture the complexity of the lived experience. Living with dying longer than expected is an experience that profoundly impacts every aspect of these women’s lives. It catapults them into a new paradigm where they have to renegotiate life daily. Each woman’s lived experience is both unique and shares collective threads. The essences that emerge from the combined strands are a continuum of hidden suffering and the varying dimensions of fortitude that are experienced while living in a liminal time and space between life and death. Facing mortality all the women accept the challenge to live fully and maintain hope but in their vulnerability few are able to sustain the feeling that the good times outweigh the terrible times. The electronic version of this dissertation is at OhioLink ETD Center www.ohiolink.edu/etd

Living Past Your Expiration Date: A Phenomenological Study of Living with Stage IV Cancer Longer than Expected

More treatment options exist today for persons diagnosed with terminal cancerextending lives longer than expected though there is little known about the psychosocial needs or resources for these individuals. This study describes the experience of living past the expiration date and still living with Stage IV cancer. A transcendental phenomenological approach was used to elucidate vivid expressions of this experience in a sample population of five Caucasian women. The women survived beyond their prognoses of an earlier expiration are not close to imminent death and are still living with incurable breast cancer metastases. The aim of this phenomenological inquiry is to illuminate the themes and essences of this phenomenon in hopes of expanding comprehension of the challenges this growing population confronts. Data was collected through individual open-ended, unstructured in-depth interviews. At a second meeting each woman, having been asked to find or create an expressive representation of their experience, verbally described their creations in an unstructured dialogue. All interviews were audio recorded and transcribed verbatim. Through the methodological processes of bracketing, phenomenological reduction, imaginative variation, and synthesis, the themes and essences that surfaced revolved around the constancy of change and duality. Five core themes emerged from the data: awareness of mortality; interaction with medical systems and treatment; living on a roller coaster; feeling different from others; cancer invades and changes how you live. All of the themes are interrelated and together capture the complexity of the lived experience. Living with dying longer than expected is an experience that profoundly impacts every aspect of these women’s lives. It catapults them into a new paradigm where they have to renegotiate life daily. Each woman’s lived experience is both unique and shares collective threads. The essences that emerge from the combined strands are a continuum of hidden suffering and the varying dimensions of fortitude that are experienced while living in a liminal time and space between life and death. Facing mortality all the women accept the challenge to live fully and maintain hope but in their vulnerability few are able to sustain the feeling that the good times outweigh the terrible times. The electronic version of this dissertation is at OhioLink ETD Center www.ohiolink.edu/etd

Scheduling in the community: Challenging partnerships in mental health

Studies have shown that the experience of involuntary admission to a psychiatric unit is a stressful event that may contribute to secondary morbidity in vulnerable individuals. The experience preceding involuntary admission, commonly known as a "schedule", i.e., the compulsory removal and transportation of a person deemed to be mentally ill or disordered from their environment to a psychiatric facility for further assessment, has had little attention. The aim of this study was to identify the dominant factors of scheduling; the impact these factors have on the relationships between the main participants; and the current needs to develop a humane and consumer focused service. To this end, ten people who were scheduled; ten relatives of people who were scheduled; and ten clinicians involved in scheduling people participated in semi-structured interviews. These interviews evolved into a narrative style that better suited the topic under discussion and generated extensive amounts of data. A multifaceted method of analysis was used, predominantly of a thematic qualitative nature, to interpret the results. The results show that the three groups experience the scheduling event in similar ways. Fear, anxiety, concern, betrayal, and lack of options predominate in all groups. The concepts of power, crime or illness, and information and education challenge assumptions about insight, competence, informed consent and working in partnership, and set the ground rules for effective therapeutic relationships. The need for comprehensive information and education programs; forums for discussion and evaluation of events; increased family involvement; ongoing trust relationships with mental health professionals; and increased resources were identified by those involved in this sensitive area. In order to work in true partnership in mental health, particularly in the highly skilled area of acute interventions, we need to challenge our assumptions and beliefs and listen to the lived experiences of those we work with. Acute community mental health requires high levels of skill, knowledge and clinical acumen based on humanistic principles and ethical values as well as in medical knowledge. This thesis contributes to the knowledge and understanding required to develop partnerships and policies that can make this very human event more human

Silver Linings (Volume 1, Issue 2, 2023-2024)

https://scholarcommons.towerhealth.org/silver_linings/1000/thumbnail.jp

Scheduling in the community: Challenging partnerships in mental health

Studies have shown that the experience of involuntary admission to a psychiatric unit is a stressful event that may contribute to secondary morbidity in vulnerable individuals. The experience preceding involuntary admission, commonly known as a "schedule", i.e., the compulsory removal and transportation of a person deemed to be mentally ill or disordered from their environment to a psychiatric facility for further assessment, has had little attention. The aim of this study was to identify the dominant factors of scheduling; the impact these factors have on the relationships between the main participants; and the current needs to develop a humane and consumer focused service. To this end, ten people who were scheduled; ten relatives of people who were scheduled; and ten clinicians involved in scheduling people participated in semi-structured interviews. These interviews evolved into a narrative style that better suited the topic under discussion and generated extensive amounts of data. A multifaceted method of analysis was used, predominantly of a thematic qualitative nature, to interpret the results. The results show that the three groups experience the scheduling event in similar ways. Fear, anxiety, concern, betrayal, and lack of options predominate in all groups. The concepts of power, crime or illness, and information and education challenge assumptions about insight, competence, informed consent and working in partnership, and set the ground rules for effective therapeutic relationships. The need for comprehensive information and education programs; forums for discussion and evaluation of events; increased family involvement; ongoing trust relationships with mental health professionals; and increased resources were identified by those involved in this sensitive area. In order to work in true partnership in mental health, particularly in the highly skilled area of acute interventions, we need to challenge our assumptions and beliefs and listen to the lived experiences of those we work with. Acute community mental health requires high levels of skill, knowledge and clinical acumen based on humanistic principles and ethical values as well as in medical knowledge. This thesis contributes to the knowledge and understanding required to develop partnerships and policies that can make this very human event more human

A software based mentor system

This thesis describes the architecture, implementation issues and evaluation of Mentor - an educational support system designed to mentor students in their university studies. Students can ask (by typing) natural language questions and Mentor will use several educational paradigms to present information from its Knowledge Base or from data-mined online Web sites to respond. Typically the questions focus on the student’s assignments or in their preparation for their examinations. Mentor is also pro-active in that it prompts the student with questions such as "Have you started your assignment yet?". If the student responds and enters into a dialogue with Mentor, then, based upon the student’s questions and answers, it guides them through a Directed Learning Path planned by the lecturer, specific to that assessment. The objectives of the research were to determine if such a system could be designed, developed and applied in a large-scale, real-world environment and to determine if the resulting system was beneficial to students using it. The study was significant in that it provided an analysis of the design and implementation of the system as well as a detailed evaluation of its use. This research integrated the Computer Science disciplines of network communication, natural language parsing, user interface design and software agents, together with pedagogies from the Computer Aided Instruction and Intelligent Tutoring System fields of Education. Collectively, these disciplines provide the foundation for the two main thesis research areas of Dialogue Management and Tutorial Dialogue Systems. The development and analysis of the Mentor System required the design and implementation of an easy to use text based interface as well as a hyper- and multi-media graphical user interface, a client-server system, and a dialogue management system based on an extensible kernel. The multi-user Java-based client-server system used Perl-5 Regular Expression pattern matching for Natural Language Parsing along with a state-based Dialogue Manager and a Knowledge Base marked up using the XML-based Virtual Human Markup Language. The kernel was also used in other Dialogue Management applications such as with computer generated Talking Heads. The system also enabled a user to easily program their own knowledge into the Knowledge Base as well as to program new information retrieval or management tasks so that the system could grow with the user. The overall framework to integrate and manage the above components into a usable system employed suitable educational pedagogies that helped in the student’s learning process. The thesis outlines the learning paradigms used in, and summarises the evaluation of, three course-based Case Studies of university students’ perception of the system to see how effective and useful it was, and whether students benefited from using it. This thesis will demonstrate that Mentor met its objectives and was very successful in helping students with their university studies. As one participant indicated: ‘I couldn’t have done without it.

1905-02-16 Olive Hill Times

Olive Hill Times published on February 16, 1905

The Chronicle [April 19, 1985]

The Chronicle, April 19, 1985https://repository.stcloudstate.edu/chron/3494/thumbnail.jp