Delphi University

Abstract Objective: The purpose of this mixed methods study was to examine what factors may influence emotional suppression and emotional expression in breast cancer patients and how coping styles relate to beliefs about physician-driven referrals to therapy during the cancer treatment process to improve quality of life during and after breast cancer treatment. Methods: A mixed method research design consisting of quantitative methods including a demographics survey, the Courtauld Emotional Control Scale and treatment preference questionnaires followed by optional participation in a semi-structured interview. Sixty-nine participants who met the inclusion criteria were selected as the quantitative study sample and 27 participated in interviews to further discuss their personal views on therapy during breast cancer treatment, beliefs about physician-driven referrals and experiences of coping throughout and post-cancer treatment. Results: Demographic variables including age, marital status, income, and experience of psychotherapy prior to breast cancer diagnosis are statically significant factors that influence CECS scores and coping styles. Thematic narrative analysis of interviews revealed both Expressers and Suppressors recounted experiencing the ‘Elsa effect’, a term coined to describe emotional concealment as a form of emotionally protecting self and others and reported that a physician driven referral to therapy would have been helpful in terms with coping and improving quality of life. Participants universally believed that there should be some level of psychotherapy referrals for supportive mental health care during and after the treatment process. Types of supports to which they wanted to be referred, how referrals are made, why referrals are needed, language used when making referrals, what medium through which therapeutic support should be offered, and whether or not therapy referrals should be mandated were all discussed. Physician stigma related to psychotherapy was also suggested as a possible barrier. Conclusions: Overwhelmingly, participants who fell into either category of emotional suppressor or emotional expresser believed that there should be physician driven referrals to therapy during the breast cancer treatment process as part of best practices for improved quality of life. Both those identified as suppressors and expressers indicated high rates of concealing one’s true emotional experience. This highlights the need for psychological therapy referrals to be integrated as a best practice, regardless of patient’s identified coping style or demographic identities. Referral sources should be mindful of language used, patient ability to access to services and other factors as part of the referral process. Citation Format: Joyce Williams, Beth Counselman-Carpenter, William Burak. Breast cancer patient perspectives on the need for psychotherapy and the roll of physician referrals for improved quality of life during and post treatment [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO1-11-04.

Abstract Preliminary results of a qualitative study of the lived experience of teaching and learning during the Covid-19 pandemic are presented. An instructor, a program director and five doctoral students in different stages of their coursework and dissertation proposal development, wrote a reflective journal. Participants varied in their levels of familiarity with technology-assisted education, personal backgrounds and circumstances including work, family and caring for sick relatives responsibilities. Participants’ journals documenting their reactions, struggles and coping since the abrupt move of the university from face to face to online classes were content analyzed. The analysis was co-conducted by all participants to identify themes and generate understanding of the experience. Two main themes emerged from the analysis: A developmental process of participants’ reactions, perceptions and meaning making of the experience and factors that shaped it. Lessons learned are discussed and recommendations for professional education and directions for future research are suggested.

Mixed martial arts (MMA) is a rapidly growing combat sport with unique development procedures unlike most traditional sports. In this study the development processes at an exemplar MMA gym were examined. Institutional work theory was used to understand how and why the sport is being developed in this setting. The results provide a microlevel account of the processes and operation of the sport as it develops, and indicate that traditional sport development models may not adequately represent all sports. Subcultural values reflecting what it takes to be a fighter along with a fighter’s duty to the gym influence recruitment, retention, and transition strategies of athletes. Two forms of institutional work, refinement and barrier work, were identified as simultaneously aiding and hindering the development of the sport. Along with furthering institutional theory research, this study contributes to the discourse on alternative ways of sport development for MMA and emergent sports.

As part of a larger study, this paper describes teachers’ perspectives and strategies on including overweight and obese students (OWS) in instruction related to motor skill/game play and fitness development in physical education. Using the Social Ecological Constraints framework, a qualitative multicase study was conducted using multiple in-depth interviews, class observations, and artifacts from nine experienced and committed suburban middle school Physical Education teachers. Constant comparison was used to generate themes and trustworthiness procedures were used to confirm findings. Two types of strategies for including OWS in instruction were identified: First-order and Second-order. School resources, shared program goals, and beliefs about students and teaching were factors influencing teachers’ decisions and actions for teaching motor skill/game play and fitness content to OWS.

This single case study (Yin, 2009) compares an established urban physical education/sport/physical activity program with two models: Comprehensive School Physical Activity Program/CSPAP (AAHPERD, 2013; CDC, 2013); and Lawson’s propositions (2005) for sport, exercise and physical education for empowerment and community development to determine their applicability in urban schools. Data include semistructured interviews, multiple observations, and artifacts collected over two academic years. Triangulation, peer debriefing, and interpretative and member checks were used for trustworthiness. Findings indicate that most aspects of both theories were evident in the program, though goals exceeded those of CSPAP as stated, and Lawson’s concept of “community” was limited. Major themes related to establishing this CSPAP are described, including practical strategies for budget, scheduling and staffing, and qualities of leadership. Stakeholders reported that they valued the program not for student wellness, but for personal, social and academic well being, as well as for contributions to the school culture.

Amotivation refers to a state in which individuals cannot perceive a relationship between their behavior and that behavior’s subsequent outcome. With the belief that considering amotivation as a multidimensional construct could reflect the complexity of motivational deficits in physical education, we developed this study to validate an amotivation model. In study 1 (N = 156), an exploratory factor analysis provided preliminary support with the model comprising four dimensions: ability beliefs, effort beliefs, values placed on the task, and characteristics of the task. In study 2 (N = 499), the four-dimensional model was further corroborated through a confirmatory factor analysis. Its construct validity and predictive validity were also confirmed. Overall, the findings lend evidence to the conceptual validation of the four-dimensional structure of amotivation. Lack of motivation in physical education may result from different reasons. The multifaceted nature of amotivation in physical education must be considered and instructionally addressed during teaching and learning.

ABSTRACT This study explored within-dyadic congruence in community service use attitudes of older spousal caregiver–care recipient couples. Primary data collection consisted of in-person, standardized survey interviews with 30 caregiver–care recipient pairs. The study employed the intraclass correlation coefficient (ICC) to examine within-dyadic similarities on caregivers' and care recipients' responses to 29 items from the Community Service Attitude Inventory (CSAI). To measure the degree of match between caregiver and care recipient pairs, ICCs were calculated for each dyad (n = 30) and ranged from −.26 to .84, indicating variation in the degree to which caregivers and care recipients displayed congruence on community service use attitude scores. The distribution of the Index of Dyadic Similarity was highly negatively skewed (skewness = −2.159), indicating overall patterns of similarity at the dyadic level of analysis. Service use preferences and values across the seven attitudinal domains (confidence in service system, wait-and-see attitude, concern for opinion of others, pride in family independence, rejection of government assistance, worry and fear about outside help, and preference for informal care) were similar between dyadically related individuals. Although the overall trend of dyadic similarity was notable in this sample, variation in the Index of Dyadic Similarity suggests the need for future dyadic-level research to better understand within-dyadic congruence on specific attitude constructs and in relationship to service use outcomes. Specific methodological challenges relevant to conducting dyadic-level primary research with older spousal couples are discussed.

With participant observations from peer-facilitated suicide survivor support group meetings, collected over a four-year period, this article applies Shulman's dynamics of mutual aid theory to explain how survivors' healing is facilitated by support group participation. Shulman's principles provide guidance on how survivors help and empower each other to deal with their grief in survivor support groups. Group facilitators can provide more clarity and direction to survivors with Shulman's principles, better helping survivors to navigate the bewildering course of healing after suicide loss. We also suggest ways group facilitation knowledge—an essential resource for enhancing healing—can be more widely distributed.

While economic-oriented theories identify a “homogenized” or “Americanized,” unidirectional model of global sport, figurational theories conceptualize globalization as much more complicated, multifaceted, and interactional. However, the spread of “achievement” sport is seen as central in both approaches. This paper investigates the degree to which “achievement” criteria characterize the sporting behavior and sporting perceptions of adolescents in Berlin and suburban New York. We find evidence that adolescents from both samples accept competition and training as important components of their sport concepts, and examples of some of these components associated with gender differences transcending national boundaries. We also identify differences in the sport concepts of Berlin and suburban New York youth, both in the types of sports they play and in the meaning they attach to these activities. These differences lead us to question the ubiquity of “achievement” sport as a component of globalization, and hence, the efficacy of theories stressing “homogenization” and unidirectionality.