dr. ronald e. mcnair acknowledgements - University of St. Thomas

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UST McNair Scholars Program Research Journal interesting about this study was the more wives reported they mattered to their husbands, the more likely they were to report the division of house work was equal, even if this was not the case. In other words, work equality depended upon how much the women felt they mattered to husbands. Mattering has also been shown to be a key factor in mental health and wellness among adolescents (Rayle, 2005). A study conducted with high school students aimed to show the link between mattering to significant others, such as family, and the overall wellness of students. This study defined wellness in terms of physical, emotional, and psychological well-being. Students felt they mattered to their families when they were assured they were significant, viewed as important, depended on by their families, and when their families were concerned with their fate and paid attention to them. It was found that females felt they mattered to their families more than males. Furthermore, it was also reported that mattering significantly predicted wellness for females. In other words, when females scored high for mattering, they also scored high in wellness. Though studies have looked at a wide range of topics pertaining to mattering, little has been done in regards to mattering in a health care context as relating to lifethreatening diseases. Human beings are multi-cellular organisms composed of structural and functional units called cells. Cells grow and divide in a controlled way to produce more cells as they are needed to keep the body healthy. When cells become old or damaged, they die and are replaced with new cells. This work of art called the body, though complex and aweinspiring, is not perfect. There are several diseases which afflict the body without warning and threaten the life and livelihood of the host. Oftentimes, in the division of cells, something goes wrong and abnormal cells divide without control and are able to invade other tissues. The most common term for this abnormality is “cancer.” The National Cancer Institute reports that there are over a hundred types of cancers, among which the most common to women is malignant neoplasms, or breast cancer. According to the National Cancer Institute, there were 207,090 reported new cases of breast cancer in 2010 within the United States alone. Modern advancements in medicine have made it possible for more women to survive breast cancer than ever before (Salonen et al., 2011). Using the 2 latest data available, survival rates for those diagnosed with breast cancer are 89% after 5 years, 81% after 10 years, and 73% after 15 years. This is a significant increase in survival rates compared to previous years (American Cancer Society, 2010). These increased survival rates indicate the need for issues related to survivorship and long-term quality of life to be added to overall treatment considerations (Kaiser et al., 2009). If the patient matters, there could be a shift in efforts to not only wipe out the cancer cells but to try and preserve the livelihood of the patient after treatments are over. Livelihood in this case refers to the patient’s ability to return to their employment or the way in which they make their income. Medical advances allow doctors to provide more personalized care for their patients. During treatment, oftentimes doctors become focused in their work of eradicating the cancer cells they forget treatment, at least in some aspects, should be based on requirements defined by women with breast cancer (Landmark, bohler, Loberg, & Wahl, 2008). Research suggests the women are experts on their own lives and ideal doctors will listen to them and try to find ways to preserve their livelihood post treatment (Theisel, Schielein, & Splebl, 2010). The key topic to preserving the life and livelihood of a patient is whether or not the patient matters to the medical professionals as an individual. One such study that looked at the doctor-patient interaction as a part of mattering did so by studying interpersonal trust (Kaiser et al., 2009). The study looked at breast cancer patients’ trust in several of their health care providers. The study assessed breast cancer patients’ trust in regular providers, diagnosing physicians, and their cancer treatment team. In this study, patient trust was associated with patient satisfaction and treatment adherence. Findings suggest a trusting relationship with a regular provider facilitated higher satisfaction with other specialists (Kaiser et al., 2009). Though this study had important findings, it does not explain why patients were more likely to trust other specialists if they trusted their primary doctor. Mattering could be one of the key components of trust in a doctor-patient relationship. If a patient feels they matter to their primary doctors, they might trust them more. This trust could be carried over to other specialists the doctor recommends. Another qualitative study that assessed the relationship between patients and doctors was conducted with 13
Oluwademilade Adediran Psychology Mattering individuals dying of cancer (Janssen & MacLeod, 2010). Results indicated the patients felt they mattered to the doctors when treated as more than a cancer patient. Patients felt like more than just a cancer patient when doctors sought to find “common ground” with their patients. A common ground for the patients meant the doctors did not only inform patients they have an illness, but sat with them to answer any questions they might have. In some cases, the patients would encourage the doctor to be livelier by telling jokes. The patients remarked that this seemed to make doctors feel more comfortable and in return they seemed to be able to look past patients’ cancer to the patients’ lives. The doctors who made patients feel like they mattered were the ones who sat with the patients and listened for extended periods of time, without trying to rush off to another patient. A woman from the study said, “Doctors should not just say this is a woman of 76 who’s got so and so, past history of such and such. You heal a whole person. We are not just a lump, an amorphous lump; we are body mind and soul” (Janssen & MacLeod, 2010, pg. 252). Doctors who were able to look into the patients lives were seen as caring and made patients feel they mattered. These two studies show ideal doctors are ones who valued or seemed to value the interactions with their patients. Good doctorpatient interactions are essential to the concept of mattering in a health care context. Studies investigating what patients perceive as the ideal doctor indicate patients want someone who is accessible, takes their time, is friendly and congenial, shows commitment and interest, is understanding and sensitive, and is responsive to the needs of patients (Theisel et al., 2010; O’Connor, 2011). Oftentimes, doctors lose sight of the life and livelihood of the individual. Rarely do they take into account patient considerations about how they should be medically treated or what factors need to be considered in order to reduce the negative impact on their livelihood (Landmark et al., 2008). Part of mattering is looking to see how treatments will affect the individual. Do doctors take into account the patient’s life and livelihood when treating the individual? Are treatments specific to the individual or do doctors follow the same protocols for all patients? Dibbelt, Schaidhammer, Fleischer, and Greitemann, (2009) identify that the most important variable in mattering as related to health care is the ability for the doctor to let the patient decide what is next. This study emphasized the need for the doctor to be open to change and let the patients’ physical and emotional conditions, as well as communication, dictate what treatment should follow. In summary, when doctors sought to build a relationship with the patients that involved more than eradicating the cancer, the patients felt cared for, and ultimately reporting they felt as if they mattered to the doctor. The present study on mattering seeks to improve upon previous research in that it is conducted with a specific group in order to see what the patients had to say about their health care providers and identify factors of specialized care that made breast cancer patients feel as if they mattered. This study is also unique in that it focuses on how doctors personalize care for patients. Uncovering whether or not breast cancer patients felt they mattered to their doctors is also an aim of this current research. Mattering, in the context of this research, refers to the “experience of moving through life being noticed by and feeling special to others who also matter to us” (Tucker et al., 2010, p. 135). Oftentimes it is not until a woman moves into survivorship that she realizes her body is no longer the same and her quality of life decreases (Salonen et al., 2011; Sanson-Fisher et al., 2010). This change in quality of life is problematic for musicians because of the direct impact it has on their careers. This current study is unique because it will use a special participant pool comprised of musicians. Being a musician constitutes a livelihood that hinges on the ability to play an instrument or sing at a specific pitch. Breast cancer treatments, including lumpectomies, lymph node removal, mastectomies, radiation, and chemotherapy, often damage physical functions such as lung capacity and upper body strength which can interfere with an artist’s ability to make music. Survivors can have long-term issues with pain, neuropathy, and lymphodema, not to mention chronic fatigue and a plethora of other side effects from treatments (Fisher et al., 2010). Using musicians for this study is critical because a condition such as lymphodema causes swelling of the arms. For a woman who does not have to use her arms at work, this might not be problematic. However, musicians who play string instruments use their arms for instrument support and sound production. Musicians were used for this study based on the direct affects cancer treatments can have on their livelihoods. In 3
Page 1 and 2: DR. RONALD E. MCNAIR Ronald E. McNa
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ABSTRACT This research discusses he
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APPENDIX B INTERVIEW QUESTIONS Back
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