Nutting whole thesis.pdf (2.01 MB)
An exploration of resilience on partners' responses to their loved one's life threatening illness
thesisposted on 2023-05-27, 12:36 authored by Nutting, KS
The experience of a life threatening illness not only impacts upon the patient directly but upon their close others. Partners have been identified as particularly vulnerable to the adverse responses and outcomes associated with their loved one's diagnosis and prognosis. Research on partners' responses to a life threatening illness has predominantly focused on negative aspects stemming from the stressors of their role of caring for the patient together with distress and pathological outcomes from their experiences. What is less known is partners' capacity for resilience and adaptive responses to their loved one's illness. Adopting a salutogenic perspective, this thesis explored partners' responses to their loved one's life threatening illness acknowledging the potential for both positive and negative outcomes. Firstly, a review of the literature regarding partners' responses and outcomes to life threatening illnesses was undertaken to identify research deficits in this area to date. This analysis of existing literature highlighted the need for more balanced investigation of partners' responses, finding an overemphasis on pathogenic outcomes whilst largely neglecting experiences of resilience and adaptive responses in this population. Additionally, the need for more multi-method research design and use of objective physiological measures of adaptation was deemed warranted. Based on review recommendations, an exploration of both positive and negative pre, peri, and post trauma factors known to influence adaptation was conducted with partners identified as high or low in resilience in order to determine whether these groups could be differentiated on self-report, clinical interview of post-trauma symptomatology, and physiological measures of adaptation. Study 1 explored pre trauma factors comprising optimism, mastery, and trauma history. Optimism was found to be the only factor which differentiated partners varying in their degree of resilience. High resilience partners reported greater optimism than partners identified as low in resilience. Partners' psychophysiological and psychological responses to illness related events (diagnoses, treatment, fear of recurrence) comprised the peri-traumatic exploration in Study 2. Against expectations, high and low resilience partners were unable to be differentiated in their responses on these measures. These results are the first to provide an objective measurement of partners peri-traumatic responses based on degree of resilience. An exploration of partners post trauma responses considered the factors of coping style, social support, post-traumatic stress symptomatology, and other psychological symptoms. As anticipated, partners low in resilience scored significantly higher on all negative psychological symptoms measured than partners high in resilience. In line with expectations, a strong trend was found for high resilience partners to report greater satisfaction with the social support received from family and friends. Partners satisfaction with the support received from patients was found to be indistinguishable between the resilience groups. Against expectations and findings from previous studies, however, was a failure to differentiate low and high resilient partners by their coping styles. This exploratory research reflects a novel examination of partners' responses with consideration to resilience in both positive and negative responses to their loved ones' illness. The presented series of studies have expanded existing knowledge regarding factors influenced by partners' resilience, and aided in identifying those struggling to adapt to the experience of their loved one's life threatening illness. In turn, findings from these studies emphasize the need for interventions to bolster resilience, optimism, and support in low resilient partners facing the challenges experienced in their loved one's life threatening illness. However, further research adopting similar intensive designs is warranted to determine whether the results of the current series of studies are replicated with larger scale samples.
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