Guided imagery as treatment for anxiety and depression in breast cancer patients: a pilot study
- Authors: Campbell-Gillies, Lynne
- Date: 2008-10-31T09:12:03Z
- Subjects: Therapeutic use of imagery (Psychology) , Breast cancer patients , Anxiety in women , Depression in women , Clinical health psychology
- Type: Thesis
- Identifier: uj:13926 , http://hdl.handle.net/10210/1427
- Description: M.A. , It is well known that high levels of anxiety and/or depression often accompany the diagnosis and treatment of breast cancer. Literature from various sources, but in particular from the fairly new field of research, Psychoneuroimmunology, also provides ample evidence that excessive anxiety and/or depression can be immunosuppressive. It makes sense, therefore, that any intervention restoring balance to the immuno-regulatory system, thereby allowing the body’s innate healing processes to focus on eliminating cancer, is highly desirable. In line with current thinking based on the mind-body connection as well as cognitive behavioural techniques utilised in many therapeutic settings, various psychological interventions have been found to help the patient gain a better sense of control over distressing symptoms and side-effects of cancer. Some of these include: basic cognitive restructuring, hypnotherapy, relaxation-meditation techniques, art and music therapy, and guided imagery. Substantial international research was found illustrating the beneficial affect that the psychological intervention, guided imagery, provided in such diverse settings including work, sport and health. In this regard, it was decided to run a pilot study to ascertain whether a specifically designed tape recording with relaxing music and dialogue aimed at helping patients manage and cope with negative symptoms of cancer, could significantly reduce anxiety and/or depression levels in women with breast cancer. To operationalise the above, 40 women, aged between 30 and 60, with Stages 1, 2 or 3 breast cancer, who are about to commence adjunctive chemotherapy, were randomly selected to a treatment and a control group. A quasi-experimental design was applied to this study whereby the treatment group was subjected to pre- and post chemotherapy Hospital Anxiety & Depression (HAD) Scale and blood pressure measurements on their 1st, 3rd and final cycle of treatments. The HAD Scale is a well-researched and respected, quick, self-diagnostic assessment utilised abroad and in this country. The measurement of a person’s blood pressure is provided as a physiological backup to the psychometric assessment of the individual’s anxiety levels. For the intervention, each participant was supplied with her own copy of Healing Imagery for Cancer CD or audiotape, produced by a South African medical doctor, specialising in the “wellness” field. The participant was requested to listen to this tape as often as possible, but particularly during her chemotherapy treatments. The control group was tested pre-1st cycle of chemotherapy and post-6th cycle of chemotherapy. The main hypothesis of this pilot study was that there would be statistically significant decreases in levels of anxiety and depression as a result of the intervention of guided imagery tape recording in women with breast cancer undergoing adjuvant chemotherapy. Statistical analysis of the data revealed that the guided imagery intervention correlated with a decrease in blood pressure (systolic and diastolic) measurements, as well as depression and anxiety over a six-cycle period of chemotherapy. The most significant decrease was correlated with the anxiety variable. This pilot study revealed some methodological weaknesses but at the same time results are sufficiently encouraging to warrant further in-depth research regarding the use of guided imagery as a cost-effective, relatively easy method for individuals with cancer to learn and utilise as part of their integrative treatment regimen.
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Group nursing therapy as a resource to assist married women suffering from depression at a mental hospital in Swaziland
- Authors: Dlamini, Phumelele Eunice
- Date: 2010-03-17T06:07:30Z
- Subjects: Group psychotherapy , Depression in women , Anxiety in women
- Type: Mini-Dissertation
- Identifier: uj:6685 , http://hdl.handle.net/10210/3089
- Description: M.Cur. , Group nursing therapy has been acknowledged to have an impact on women suffering from depression by Bellafoire (2005:1). However, there is no written evidence on the effectiveness of group therapy in Swaziland. It is for this reason that the researcher took the initiative of exploring how group therapy could assist women admitted at a psychiatric / mental hospital in Swaziland suffering from depression. The objective of the study was to describe group nursing therapy as a resource to assist married women suffering from depression. Another objective was to describe guidelines that can be utilised by psychiatric nurse-practitioners when assisting married women suffering from depression to mobilise resources to promote their mental health. The study was conducted through group therapy sessions. During group therapy sessions ethical measures were adhered to. Steps to ensure trustworthiness were also followed (Lincoln & Guba, 1985:290). Four aspects of trustworthiness, namely truth value, applicability, consistency and neutrality were taken into consideration. The paradigmatic perspective used in this study was guided by the theory for Health Promotion in Nursing (Rand Afrikaans University, 2002:2-8) which focuses on the whole person. A functional reasoning approach based on Botes’ model (1998:8) was followed. The design of the study utilised is a qualitative, descriptive, exploratory and contextual design (Mouton & Marais, 1990:43-44). Eight sessions of group therapy were conducted with women suffering from depression, admitted at the mental hospital. Field notes were also taken during each session. Data collected was analysed through the descriptive method suggested by Tesch (in Creswell, 1994:155). The services of an independent coder were employed. The results were tabulated according to major themes, categories and subcategories. The first major theme identified was hope among women suffering from depression related to group therapy intervention. The category that was deduced from the theme was increased self-awareness which was evidenced by the subcategory of self-disclosure, introspection, and a reduction of suicidal tendencies. The second category was that of personal growth related to the subcategories of openness, problem sharing and giving feedback. The third category was that of peace of mind related to the subcategories of improved sleep, feelings of relief because of therapy and reduction of sadness. The fourth category was that of positive independent thinking related to positive decision making about self and planning for their own future by the women. The fifth category was that of spiritual enhancement related to group therapy intervention. The subcategory identified was that of recognition of God’s power and the value of confessions. The sixth category that was deduced was that of increased social interaction related to the subcategory of development of social skills and redefinition of the self. The second theme that was deduced was that of recommendations on group therapy as a resource for women suffering from depression. The subcategories were that therapeutic groups be established and conducted in families, hospitals and communities. Guidelines were described from the findings for psychiatric nurses to use when assisting married women suffering from depression to mobilise resources and promote their mental health. Conclusions were drawn and recommendations made in relation to nursing practice, nursing education and nursing research.
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Locus of control and social variables as they relate to depression at abortion
- Authors: Henwick, Athol Frederick
- Date: 2012-01-24
- Subjects: Locus of control , Abortion , Depression in women
- Type: Thesis
- Identifier: uj:1931 , http://hdl.handle.net/10210/4291
- Description: M.A. , Since its legalisation in this country, abortion has become a controversial subject in religious, social and judicial circles. However, little is known about the relationship between depression and the possible side effects that may be produced by the procedure. Indeed, the possible impact of social variables and personality traits have been receiving more attention in recent research in an effort to identify those at risk for negative symptoms. This study was carried out on a group of 42 women from the Soweto and Jeppe Street Marie Stopes clinics. The women were assesse·d according to locus of control, depression and certain psychosocial variables. As expected, the overall levels of depression among these women, who largely represent the underprivileged segment of the community, were very high. Although no significant relationship could be established between locus of control and depression following abortion, certain social variables were identified as possible risk factors for de.ffipession after having an abortion.
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A psychiatric case management approach to facilitate the mental health of women that suffer from depression
- Authors: Liebenberg, Tersia
- Date: 2011-12-06
- Subjects: Depression in women , Women mental health , Psychiatric nursing , Mental depression treatment , Mental health services
- Type: Thesis
- Identifier: uj:1837 , http://hdl.handle.net/10210/4197
- Description: D.Cur. , In South Africa, mood disorders, specifically depression, accounts for the most psychiatric related hospital admissions. The total cost (overt and hidden) of mood disorders that result from lost productivity, can be estimated at billions of rand per year. In addition to economic costs, depression can carry great personal costs because of the social stigma associated with the diagnosis and treatment of a 'mental illness'. This stigma likely plays a big role in women' reluctance to seek, accept and adhere to treatment. The potential savings to be derived from the appropriate treatment of women suffering from depression are socially and economically significant. The focus in this thesis has been on women suffering from depression as it is estimated that at least twenty five percent of women will suffer from a major depressive episode in their life. Based on the problem statement that was included in this thesis, the researcher asked the following questions: 'What is the phenomena that constitutes the restoration process of women suffering from depression? Which processes contribute to the restoration process of women suffering from depression and facilitate these women's quest for mental health as an integral part of wholeness? How can an approach to provide quality care to women suffering from depression be described?" The primary purpose of this thesis was thus to explore and describe the processes contributing to the restoration process of women suffering from depression, in order to develop a mental health nursing approach that will provide quality care to women suffering from depression in their continuous quest for mental health. The psychiatric nurse specialist then developed and described guidelines to operationalise the approach that contributes to quality care of women suffering from depression in mental health nursing. The paradigmatic basis of this study was based on the Nursing for the Whole Person Theory (Oral Roberts University, Anna Vaughn School of Nursing, 1990:136-142) as used by the Rand Afrikaans University. This theory is based on a Judea-Christian philosophy.
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The lived experiences of their treatment by adult females with depression
- Authors: Rademeyer, Anita
- Date: 2015
- Subjects: Patient compliance , Depressed persons - Attitudes , Depression in women
- Language: English
- Type: Masters (Thesis)
- Identifier: http://hdl.handle.net/10210/91030 , uj:20054
- Description: Abstract: Depression has a significant impact on disability, co-morbidity and mortality worldwide. The leading cause of disease-related disability among adult females in the world is major depression. Across all cultures, adult females are more prone and experience depression more frequently than men. Treatment guidelines recommend the continuation of anti-depressants even several months after treatment remission, but there still appears to be low levels of treatment compliance and premature termination of treatment irrespective of recommendations. There are multiple interventions available to improve treatment compliance, but it seems that there is still a need for treatment compliance interventions that are effective. There are a number of studies available that have explored the lived experiences of depression, but there remain questions relating to improved compliance amongst adult females with depression. The researcher having worked in both the public and private sector as a psychiatric professional nurse have noted across all sectors that depression is still very much treated as a biomedical illness where treatment is given to aid recovery. It has appeared to the researcher that this treatment given is rather “something that is done to” the patients with minimal patient input. When the researcher asked questions such as “why do adult females not comply with their treatment?” majority of the answers were still related to the biomedical model and answerers such as “side-effects of medication”. The researcher’s interest was triggered by the attitudes, beliefs and cognitive processes or thought processes why adult females do not comply with their treatment or terminate treatment prematurely. Given the above information, the researcher asked the following research questions: “What is the lived experiences of adult females with depression regarding their treatment?” and “What can be done by the psychiatric nurse to facilitate adult females regarding compliance with their treatment?” The purpose of the study was to explore and describe the lived experiences of adult females with depression regarding their treatment, and to formulate guidelines to assist the psychiatric nurse to facilitate adult females regarding compliance with their treatment... , M.Cur. (Nursing Science)
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Body narrative interrupted: the relationship between body disfigurement, depression and self-concept
- Authors: Watson, Tracy
- Date: 2008-11-14T14:21:29Z
- Subjects: Disfigured persons , Body image disturbance , Self-disclosure , Self-perception , Mastectomy , Hysterectomy , Vulvectomy , Depression in women
- Type: Thesis
- Identifier: uj:14704 , http://hdl.handle.net/10210/1696
- Description: M.A. , Many women who live with body disfigurement as a consequence of illness, continue to suffer from body perceptual disturbances many years following their recovery. Problematic however, is the tendency of disease-specific studies investigating body perceptual disturbances to focus on illness associated body changes. Consequently, this silences the experiences of many women who live with body disfigurement in the absence of illness and more specifically, in instances where body disfigurement is the result of having suffered a common ailment (Francis, 2002; Newell, 2000). Impeding the concerns raised are inferences of earlier studies such as that by Patterson and Craig (1963) who reason that, by virtue of the body's integrity being dependent upon external appearances, hysterectomy, as something internal to the body, fails to feature as a psychological difficulty experienced in women who have this. Recent studies by Newell (2000) and Francis (2002) identify a need for research on body disfigurement following a common ailment and in the absence of illness. In an attempt to address some of the concerns raised, and in keeping with body disfigurement resulting from a common ailment (e.g. cancer, dysmenorrhoea and uterine fibroids, etc), this study compares levels of depression and self-concept in women who have undergone either mastectomy, hysterectomy or vulvectomy. Additionally, this study challenged the inferences by Patterson and Craig (1963) in that the onset of psychopathology in these women is here thought to develop irrespective of the levels of disfigurement visibility (whether disfigurement is internal to the body as in hysterectomy or external to the body as in mastectomy and vulvectomy). In terms of the three areas of participation, of the hysterectomy group (n = 16), of the mastectomy group (n = 8), and of the vulvectomy group (n = 4). Additionally, only participants who had not undergone reconstructive surgery were selected. To investigate for self-concept and body perceptual disturbances, data was collected using the Beck Depression Inventory II, the Self-Description Questionnaire III, the Six Factor Self-Concept Scale and also from open-ended questions posited in a Biographical Questionnaire. The Mann-Whitney, Kruskal-Wallis and Wilcoxon Signed Ranks tests were utilised as nonparametric statistics of choice in the data analyses. The results showed seven areas of significant group differences as this pertains to: levels of depression, physical appearance, spiritual/religious values, general esteem, opposite sex peer relations, parent relations and power. Most striking was the participant responses made in respect to the Importance versus Accuracy subsection of the SDQ-III. Of the 12 statements contained under this section, all were considered to be more important to the participants than the statement was thought accurate of them. Significant differences on this subsection were observed in terms of: parent relations, spiritual/religious values, emotional stability and physical appearance. Although investigating depression and self-concept in women with body disfigurement in South Africa proved to be a complex and difficult research undertaking, the results of this study clearly strengthen its implementation value and demonstrate the need for future research in this area. This pilot study enabled for invaluable insight to be gleaned in terms of the thoughts, feelings and struggles of these women. Similarly the study provided for a method of pre-testing and fine-tuning prior to Phase Two. Additionally, the results of this study contribute to the sparse volume of literature on body disfigurement in the absence of illness. This complex, yet emotionally charged and dynamic terrain is fraught with a magnitude of possibilities for future research and of which can take an infinite number of directions. Altered body appearance and function can invariably result in highly complex psychological and psychosocial disturbances. Francis (2002) echoes what this study commits to when she says: "… when the process of knowing is fractured in a sudden catastrophe, when knowing of the external surfaces of the familiar body is interrupted, the sense of being at home in ones body becomes problematic" (p. 108). As such, this study embraces the possibility that many women in South Africa, who live with body disfigurement in the absence of illness, continue to suffer disturbances in body perception years later and that this is so despite being illness free and irrespective of visibility levels. The study's demonstration of this in real-life intervention serves to highlight this. Similarly, in that 92.3% of participants felt the need to join group therapy or formulate support groups for disfigured individuals as a means by which to voice and better come to terms with past and current traumatic experiences encountered as a result of living with altered body appearance and function, the need for future research in body disfigurement in the absence of illness, is strengthened. It is hoped that, albeit in some small way, this study adds volume to the silenced experience of these women. Similarly, this study hopes to provide a foundation from which many silenced experiences can be voiced.
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