ingest cdrApp 2018-06-13T21:09:11.582Z 51cd2fe2-3fd7-401f-a923-a97bc3db68a2 modifyDatastreamByValue RELS-EXT fedoraAdmin 2018-06-13T22:39:36.572Z Setting exclusive relation addDatastream MD_TECHNICAL fedoraAdmin 2018-06-13T22:39:47.946Z Adding technical metadata derived by FITS addDatastream MD_FULL_TEXT fedoraAdmin 2018-06-13T22:40:11.306Z Adding full text metadata extracted by Apache Tika modifyDatastreamByValue RELS-EXT fedoraAdmin 2018-06-13T22:40:33.632Z Setting exclusive relation modifyDatastreamByValue MD_DESCRIPTIVE cdrApp 2018-07-10T23:34:07.672Z modifyDatastreamByValue MD_DESCRIPTIVE cdrApp 2018-07-17T19:36:59.220Z modifyDatastreamByValue MD_DESCRIPTIVE cdrApp 2018-08-08T19:04:16.319Z modifyDatastreamByValue MD_DESCRIPTIVE cdrApp 2018-08-15T16:12:40.134Z modifyDatastreamByValue MD_DESCRIPTIVE cdrApp 2018-08-16T19:15:17.753Z modifyDatastreamByValue MD_DESCRIPTIVE cdrApp 2018-09-21T16:41:20.393Z modifyDatastreamByValue MD_DESCRIPTIVE cdrApp 2018-09-26T19:48:22.723Z modifyDatastreamByValue MD_DESCRIPTIVE cdrApp 2018-10-11T20:29:32.598Z modifyDatastreamByValue MD_DESCRIPTIVE cdrApp 2019-03-20T13:36:17.244Z Ahrang Jung Author School of Nursing Relationships among Uncertainty, Post-Traumatic Stress Disorder Symptoms, and Quality of Life in Non-Muscle-Invasive Bladder Cancer Survivors Approximately 75% of patients who are newly diagnosed with bladder cancer present with non-muscle-invasive bladder cancer (NMIBC). NMIBC survivors have unique chronic burdens, including frequent recurrences, repeated surveillance cystoscopies and treatments, and the highest lifetime medical cost per person among all cancers. Hence, the aim of conducting this study was to (1) examine the prevalence of uncertainty, post-traumatic stress disorder symptoms (PTSS), and quality of life (QOL) in NMIBC survivors, (2) identify factors associated with uncertainty, PTSS, and QOL, and (3) explore the relationships among uncertainty, PTSS, and QOL. This dissertation consists of three manuscripts. The first is a systematic review of the literature on QOL in NMIBC survivors. The second and third manuscripts comprise the findings from a population-based survey study in North Carolina. The data from 376 NMIBC survivors were used for the analysis. The NMIBC survivors had urinary and bowel symptoms, sexual problems, and worries about the future, regardless of time since diagnosis. The lower cancer stage at diagnosis was associated with better QOL in several domains, including global health status, physical functioning, role functioning, social functioning, fatigue, dyspnea, and financial difficulties. Male survivors had better sexual function and enjoyment than females, but also higher discomfort with sexual intimacy and more concerns about contaminating their partners. The cystectomy group had worse sexual function, more discomfort with sexual intimacy, lower sexual enjoyment, and more male sexual problems than the non-cystectomy group. The NMIBC survivors had notable burdens of cancer-related uncertainty, and higher uncertainty was associated with males, lower income, the lack of cure, lower cognition-ability, and higher cognition-general concerns. The prevalence of PTSS (28.7 %) was higher than in the general United States (US) adult population (10-20%). Higher PTSS were associated with younger age, lack of cure, more comorbidities, less social support, and more cognition-general concerns. Uncertainty was significantly and negatively associated with QOL, and PTSS completely mediated the effect of uncertainty on QOL. The findings of this dissertation highlight the importance of assessment and management of uncertainty and PTSS in the NMIBC population. Further studies are needed to better understand NMIBC survivors’ unique needs and to develop supportive care interventions for them. Spring 2018 2018 Nursing Oncology Bladder cancer survivors, Non-muscle-invasive bladder cancer, Post-traumatic stress disorder, Quality of life, Uncertainty eng Doctor of Philosophy Dissertation University of North Carolina at Chapel Hill Graduate School Degree granting institution Nursing Deborah Mayer Thesis advisor Matthew Nielsen Thesis advisor Jamie Crandell Thesis advisor Mary Palmer Thesis advisor Ashley Leak Bryant Thesis advisor Sophia Smith Thesis advisor text Ahrang Jung Author School of Nursing Relationships among Uncertainty, Post-Traumatic Stress Disorder Symptoms, and Quality of Life in Non-Muscle-Invasive Bladder Cancer Survivors Approximately 75% of patients who are newly diagnosed with bladder cancer present with non-muscle-invasive bladder cancer (NMIBC). NMIBC survivors have unique chronic burdens, including frequent recurrences, repeated surveillance cystoscopies and treatments, and the highest lifetime medical cost per person among all cancers. Hence, the aim of conducting this study was to (1) examine the prevalence of uncertainty, post-traumatic stress disorder symptoms (PTSS), and quality of life (QOL) in NMIBC survivors, (2) identify factors associated with uncertainty, PTSS, and QOL, and (3) explore the relationships among uncertainty, PTSS, and QOL. This dissertation consists of three manuscripts. The first is a systematic review of the literature on QOL in NMIBC survivors. The second and third manuscripts comprise the findings from a population-based survey study in North Carolina. The data from 376 NMIBC survivors were used for the analysis. The NMIBC survivors had urinary and bowel symptoms, sexual problems, and worries about the future, regardless of time since diagnosis. The lower cancer stage at diagnosis was associated with better QOL in several domains, including global health status, physical functioning, role functioning, social functioning, fatigue, dyspnea, and financial difficulties. Male survivors had better sexual function and enjoyment than females, but also higher discomfort with sexual intimacy and more concerns about contaminating their partners. The cystectomy group had worse sexual function, more discomfort with sexual intimacy, lower sexual enjoyment, and more male sexual problems than the non-cystectomy group. The NMIBC survivors had notable burdens of cancer-related uncertainty, and higher uncertainty was associated with males, lower income, the lack of cure, lower cognition-ability, and higher cognition-general concerns. The prevalence of PTSS (28.7 %) was higher than in the general United States (US) adult population (10-20%). Higher PTSS were associated with younger age, lack of cure, more comorbidities, less social support, and more cognition-general concerns. Uncertainty was significantly and negatively associated with QOL, and PTSS completely mediated the effect of uncertainty on QOL. The findings of this dissertation highlight the importance of assessment and management of uncertainty and PTSS in the NMIBC population. Further studies are needed to better understand NMIBC survivors’ unique needs and to develop supportive care interventions for them. Spring 2018 2018 Nursing Oncology Bladder cancer survivors, Non-muscle-invasive bladder cancer, Post-traumatic stress disorder, Quality of life, Uncertainty eng Doctor of Philosophy Dissertation University of North Carolina at Chapel Hill Graduate School Degree granting institution Nursing Deborah Mayer Thesis advisor Matthew Nielsen Thesis advisor Jamie Crandell Thesis advisor Mary Palmer Thesis advisor Ashley Leak Bryant Thesis advisor Sophia Smith Thesis advisor text Ahrang Jung Author School of Nursing Relationships among Uncertainty, Post-Traumatic Stress Disorder Symptoms, and Quality of Life in Non-Muscle-Invasive Bladder Cancer Survivors Approximately 75% of patients who are newly diagnosed with bladder cancer present with non-muscle-invasive bladder cancer (NMIBC). NMIBC survivors have unique chronic burdens, including frequent recurrences, repeated surveillance cystoscopies and treatments, and the highest lifetime medical cost per person among all cancers. Hence, the aim of conducting this study was to (1) examine the prevalence of uncertainty, post-traumatic stress disorder symptoms (PTSS), and quality of life (QOL) in NMIBC survivors, (2) identify factors associated with uncertainty, PTSS, and QOL, and (3) explore the relationships among uncertainty, PTSS, and QOL. This dissertation consists of three manuscripts. The first is a systematic review of the literature on QOL in NMIBC survivors. The second and third manuscripts comprise the findings from a population-based survey study in North Carolina. The data from 376 NMIBC survivors were used for the analysis. The NMIBC survivors had urinary and bowel symptoms, sexual problems, and worries about the future, regardless of time since diagnosis. The lower cancer stage at diagnosis was associated with better QOL in several domains, including global health status, physical functioning, role functioning, social functioning, fatigue, dyspnea, and financial difficulties. Male survivors had better sexual function and enjoyment than females, but also higher discomfort with sexual intimacy and more concerns about contaminating their partners. The cystectomy group had worse sexual function, more discomfort with sexual intimacy, lower sexual enjoyment, and more male sexual problems than the non-cystectomy group. The NMIBC survivors had notable burdens of cancer-related uncertainty, and higher uncertainty was associated with males, lower income, the lack of cure, lower cognition-ability, and higher cognition-general concerns. The prevalence of PTSS (28.7 %) was higher than in the general United States (US) adult population (10-20%). Higher PTSS were associated with younger age, lack of cure, more comorbidities, less social support, and more cognition-general concerns. Uncertainty was significantly and negatively associated with QOL, and PTSS completely mediated the effect of uncertainty on QOL. The findings of this dissertation highlight the importance of assessment and management of uncertainty and PTSS in the NMIBC population. Further studies are needed to better understand NMIBC survivors’ unique needs and to develop supportive care interventions for them. Spring 2018 2018 Nursing Oncology Bladder cancer survivors, Non-muscle-invasive bladder cancer, Post-traumatic stress disorder, Quality of life, Uncertainty eng Doctor of Philosophy Dissertation University of North Carolina at Chapel Hill Graduate School Degree granting institution Nursing Deborah Mayer Thesis advisor Matthew Nielsen Thesis advisor Jamie Crandell Thesis advisor Mary Palmer Thesis advisor Ashley Leak Bryant Thesis advisor Sophia Smith Thesis advisor text Ahrang Jung Author School of Nursing Relationships among Uncertainty, Post-Traumatic Stress Disorder Symptoms, and Quality of Life in Non-Muscle-Invasive Bladder Cancer Survivors Approximately 75% of patients who are newly diagnosed with bladder cancer present with non-muscle-invasive bladder cancer (NMIBC). NMIBC survivors have unique chronic burdens, including frequent recurrences, repeated surveillance cystoscopies and treatments, and the highest lifetime medical cost per person among all cancers. Hence, the aim of conducting this study was to (1) examine the prevalence of uncertainty, post-traumatic stress disorder symptoms (PTSS), and quality of life (QOL) in NMIBC survivors, (2) identify factors associated with uncertainty, PTSS, and QOL, and (3) explore the relationships among uncertainty, PTSS, and QOL. This dissertation consists of three manuscripts. The first is a systematic review of the literature on QOL in NMIBC survivors. The second and third manuscripts comprise the findings from a population-based survey study in North Carolina. The data from 376 NMIBC survivors were used for the analysis. The NMIBC survivors had urinary and bowel symptoms, sexual problems, and worries about the future, regardless of time since diagnosis. The lower cancer stage at diagnosis was associated with better QOL in several domains, including global health status, physical functioning, role functioning, social functioning, fatigue, dyspnea, and financial difficulties. Male survivors had better sexual function and enjoyment than females, but also higher discomfort with sexual intimacy and more concerns about contaminating their partners. The cystectomy group had worse sexual function, more discomfort with sexual intimacy, lower sexual enjoyment, and more male sexual problems than the non-cystectomy group. The NMIBC survivors had notable burdens of cancer-related uncertainty, and higher uncertainty was associated with males, lower income, the lack of cure, lower cognition-ability, and higher cognition-general concerns. The prevalence of PTSS (28.7 %) was higher than in the general United States (US) adult population (10-20%). Higher PTSS were associated with younger age, lack of cure, more comorbidities, less social support, and more cognition-general concerns. Uncertainty was significantly and negatively associated with QOL, and PTSS completely mediated the effect of uncertainty on QOL. The findings of this dissertation highlight the importance of assessment and management of uncertainty and PTSS in the NMIBC population. Further studies are needed to better understand NMIBC survivors’ unique needs and to develop supportive care interventions for them. Spring 2018 2018 Nursing Oncology Bladder cancer survivors, Non-muscle-invasive bladder cancer, Post-traumatic stress disorder, Quality of life, Uncertainty eng Doctor of Philosophy Dissertation University of North Carolina at Chapel Hill Graduate School Degree granting institution Nursing Deborah Mayer Thesis advisor Matthew Nielsen Thesis advisor Jamie Crandell Thesis advisor Mary Palmer Thesis advisor Ashley Bryant Thesis advisor Sophia Smith Thesis advisor text Ahrang Jung Author School of Nursing Relationships among Uncertainty, Post-Traumatic Stress Disorder Symptoms, and Quality of Life in Non-Muscle-Invasive Bladder Cancer Survivors Approximately 75% of patients who are newly diagnosed with bladder cancer present with non-muscle-invasive bladder cancer (NMIBC). NMIBC survivors have unique chronic burdens, including frequent recurrences, repeated surveillance cystoscopies and treatments, and the highest lifetime medical cost per person among all cancers. Hence, the aim of conducting this study was to (1) examine the prevalence of uncertainty, post-traumatic stress disorder symptoms (PTSS), and quality of life (QOL) in NMIBC survivors, (2) identify factors associated with uncertainty, PTSS, and QOL, and (3) explore the relationships among uncertainty, PTSS, and QOL. This dissertation consists of three manuscripts. The first is a systematic review of the literature on QOL in NMIBC survivors. The second and third manuscripts comprise the findings from a population-based survey study in North Carolina. The data from 376 NMIBC survivors were used for the analysis. The NMIBC survivors had urinary and bowel symptoms, sexual problems, and worries about the future, regardless of time since diagnosis. The lower cancer stage at diagnosis was associated with better QOL in several domains, including global health status, physical functioning, role functioning, social functioning, fatigue, dyspnea, and financial difficulties. Male survivors had better sexual function and enjoyment than females, but also higher discomfort with sexual intimacy and more concerns about contaminating their partners. The cystectomy group had worse sexual function, more discomfort with sexual intimacy, lower sexual enjoyment, and more male sexual problems than the non-cystectomy group. The NMIBC survivors had notable burdens of cancer-related uncertainty, and higher uncertainty was associated with males, lower income, the lack of cure, lower cognition-ability, and higher cognition-general concerns. The prevalence of PTSS (28.7 %) was higher than in the general United States (US) adult population (10-20%). Higher PTSS were associated with younger age, lack of cure, more comorbidities, less social support, and more cognition-general concerns. Uncertainty was significantly and negatively associated with QOL, and PTSS completely mediated the effect of uncertainty on QOL. The findings of this dissertation highlight the importance of assessment and management of uncertainty and PTSS in the NMIBC population. Further studies are needed to better understand NMIBC survivors’ unique needs and to develop supportive care interventions for them. Spring 2018 2018 Nursing Oncology Bladder cancer survivors, Non-muscle-invasive bladder cancer, Post-traumatic stress disorder, Quality of life, Uncertainty eng Doctor of Philosophy Dissertation Nursing Deborah Mayer Thesis advisor Matthew Nielsen Thesis advisor Jamie Crandell Thesis advisor Mary Palmer Thesis advisor Ashley Bryant Thesis advisor Sophia Smith Thesis advisor text University of North Carolina at Chapel Hill Degree granting institution Ahrang Jung Author School of Nursing Relationships among Uncertainty, Post-Traumatic Stress Disorder Symptoms, and Quality of Life in Non-Muscle-Invasive Bladder Cancer Survivors Approximately 75% of patients who are newly diagnosed with bladder cancer present with non-muscle-invasive bladder cancer (NMIBC). NMIBC survivors have unique chronic burdens, including frequent recurrences, repeated surveillance cystoscopies and treatments, and the highest lifetime medical cost per person among all cancers. Hence, the aim of conducting this study was to (1) examine the prevalence of uncertainty, post-traumatic stress disorder symptoms (PTSS), and quality of life (QOL) in NMIBC survivors, (2) identify factors associated with uncertainty, PTSS, and QOL, and (3) explore the relationships among uncertainty, PTSS, and QOL. This dissertation consists of three manuscripts. The first is a systematic review of the literature on QOL in NMIBC survivors. The second and third manuscripts comprise the findings from a population-based survey study in North Carolina. The data from 376 NMIBC survivors were used for the analysis. The NMIBC survivors had urinary and bowel symptoms, sexual problems, and worries about the future, regardless of time since diagnosis. The lower cancer stage at diagnosis was associated with better QOL in several domains, including global health status, physical functioning, role functioning, social functioning, fatigue, dyspnea, and financial difficulties. Male survivors had better sexual function and enjoyment than females, but also higher discomfort with sexual intimacy and more concerns about contaminating their partners. The cystectomy group had worse sexual function, more discomfort with sexual intimacy, lower sexual enjoyment, and more male sexual problems than the non-cystectomy group. The NMIBC survivors had notable burdens of cancer-related uncertainty, and higher uncertainty was associated with males, lower income, the lack of cure, lower cognition-ability, and higher cognition-general concerns. The prevalence of PTSS (28.7 %) was higher than in the general United States (US) adult population (10-20%). Higher PTSS were associated with younger age, lack of cure, more comorbidities, less social support, and more cognition-general concerns. Uncertainty was significantly and negatively associated with QOL, and PTSS completely mediated the effect of uncertainty on QOL. The findings of this dissertation highlight the importance of assessment and management of uncertainty and PTSS in the NMIBC population. Further studies are needed to better understand NMIBC survivors’ unique needs and to develop supportive care interventions for them. Spring 2018 2018 Nursing Oncology Bladder cancer survivors, Non-muscle-invasive bladder cancer, Post-traumatic stress disorder, Quality of life, Uncertainty eng Doctor of Philosophy Dissertation University of North Carolina at Chapel Hill Graduate School Degree granting institution Nursing Deborah Mayer Thesis advisor Matthew Nielsen Thesis advisor Jamie Crandell Thesis advisor Mary Palmer Thesis advisor Ashley Leak Bryant Thesis advisor Sophia Smith Thesis advisor text Ahrang Jung Author School of Nursing Relationships among Uncertainty, Post-Traumatic Stress Disorder Symptoms, and Quality of Life in Non-Muscle-Invasive Bladder Cancer Survivors Approximately 75% of patients who are newly diagnosed with bladder cancer present with non-muscle-invasive bladder cancer (NMIBC). NMIBC survivors have unique chronic burdens, including frequent recurrences, repeated surveillance cystoscopies and treatments, and the highest lifetime medical cost per person among all cancers. Hence, the aim of conducting this study was to (1) examine the prevalence of uncertainty, post-traumatic stress disorder symptoms (PTSS), and quality of life (QOL) in NMIBC survivors, (2) identify factors associated with uncertainty, PTSS, and QOL, and (3) explore the relationships among uncertainty, PTSS, and QOL. This dissertation consists of three manuscripts. The first is a systematic review of the literature on QOL in NMIBC survivors. The second and third manuscripts comprise the findings from a population-based survey study in North Carolina. The data from 376 NMIBC survivors were used for the analysis. The NMIBC survivors had urinary and bowel symptoms, sexual problems, and worries about the future, regardless of time since diagnosis. The lower cancer stage at diagnosis was associated with better QOL in several domains, including global health status, physical functioning, role functioning, social functioning, fatigue, dyspnea, and financial difficulties. Male survivors had better sexual function and enjoyment than females, but also higher discomfort with sexual intimacy and more concerns about contaminating their partners. The cystectomy group had worse sexual function, more discomfort with sexual intimacy, lower sexual enjoyment, and more male sexual problems than the non-cystectomy group. The NMIBC survivors had notable burdens of cancer-related uncertainty, and higher uncertainty was associated with males, lower income, the lack of cure, lower cognition-ability, and higher cognition-general concerns. The prevalence of PTSS (28.7 %) was higher than in the general United States (US) adult population (10-20%). Higher PTSS were associated with younger age, lack of cure, more comorbidities, less social support, and more cognition-general concerns. Uncertainty was significantly and negatively associated with QOL, and PTSS completely mediated the effect of uncertainty on QOL. The findings of this dissertation highlight the importance of assessment and management of uncertainty and PTSS in the NMIBC population. Further studies are needed to better understand NMIBC survivors’ unique needs and to develop supportive care interventions for them. Spring 2018 2018 Nursing Oncology Bladder cancer survivors, Non-muscle-invasive bladder cancer, Post-traumatic stress disorder, Quality of life, Uncertainty eng Doctor of Philosophy Dissertation University of North Carolina at Chapel Hill Graduate School Degree granting institution Nursing Deborah Mayer Thesis advisor Matthew Nielsen Thesis advisor Jamie Crandell Thesis advisor Mary Palmer Thesis advisor Ashley Leak Bryant Thesis advisor Sophia Smith Thesis advisor text Ahrang Jung Creator School of Nursing Relationships among Uncertainty, Post-Traumatic Stress Disorder Symptoms, and Quality of Life in Non-Muscle-Invasive Bladder Cancer Survivors Approximately 75% of patients who are newly diagnosed with bladder cancer present with non-muscle-invasive bladder cancer (NMIBC). NMIBC survivors have unique chronic burdens, including frequent recurrences, repeated surveillance cystoscopies and treatments, and the highest lifetime medical cost per person among all cancers. Hence, the aim of conducting this study was to (1) examine the prevalence of uncertainty, post-traumatic stress disorder symptoms (PTSS), and quality of life (QOL) in NMIBC survivors, (2) identify factors associated with uncertainty, PTSS, and QOL, and (3) explore the relationships among uncertainty, PTSS, and QOL. This dissertation consists of three manuscripts. The first is a systematic review of the literature on QOL in NMIBC survivors. The second and third manuscripts comprise the findings from a population-based survey study in North Carolina. The data from 376 NMIBC survivors were used for the analysis. The NMIBC survivors had urinary and bowel symptoms, sexual problems, and worries about the future, regardless of time since diagnosis. The lower cancer stage at diagnosis was associated with better QOL in several domains, including global health status, physical functioning, role functioning, social functioning, fatigue, dyspnea, and financial difficulties. Male survivors had better sexual function and enjoyment than females, but also higher discomfort with sexual intimacy and more concerns about contaminating their partners. The cystectomy group had worse sexual function, more discomfort with sexual intimacy, lower sexual enjoyment, and more male sexual problems than the non-cystectomy group. The NMIBC survivors had notable burdens of cancer-related uncertainty, and higher uncertainty was associated with males, lower income, the lack of cure, lower cognition-ability, and higher cognition-general concerns. The prevalence of PTSS (28.7 %) was higher than in the general United States (US) adult population (10-20%). Higher PTSS were associated with younger age, lack of cure, more comorbidities, less social support, and more cognition-general concerns. Uncertainty was significantly and negatively associated with QOL, and PTSS completely mediated the effect of uncertainty on QOL. The findings of this dissertation highlight the importance of assessment and management of uncertainty and PTSS in the NMIBC population. Further studies are needed to better understand NMIBC survivors’ unique needs and to develop supportive care interventions for them. Nursing Oncology Bladder cancer survivors; Non-muscle-invasive bladder cancer; Post-traumatic stress disorder; Quality of life; Uncertainty eng Doctor of Philosophy Dissertation University of North Carolina at Chapel Hill Graduate School Degree granting institution Nursing Deborah Mayer Thesis advisor Matthew Nielsen Thesis advisor Jamie Crandell Thesis advisor Mary Palmer Thesis advisor Ashley Leak Bryant Thesis advisor Sophia Smith Thesis advisor text 2018 2018-05 Ahrang Jung Author School of Nursing Relationships among Uncertainty, Post-Traumatic Stress Disorder Symptoms, and Quality of Life in Non-Muscle-Invasive Bladder Cancer Survivors Approximately 75% of patients who are newly diagnosed with bladder cancer present with non-muscle-invasive bladder cancer (NMIBC). NMIBC survivors have unique chronic burdens, including frequent recurrences, repeated surveillance cystoscopies and treatments, and the highest lifetime medical cost per person among all cancers. Hence, the aim of conducting this study was to (1) examine the prevalence of uncertainty, post-traumatic stress disorder symptoms (PTSS), and quality of life (QOL) in NMIBC survivors, (2) identify factors associated with uncertainty, PTSS, and QOL, and (3) explore the relationships among uncertainty, PTSS, and QOL. This dissertation consists of three manuscripts. The first is a systematic review of the literature on QOL in NMIBC survivors. The second and third manuscripts comprise the findings from a population-based survey study in North Carolina. The data from 376 NMIBC survivors were used for the analysis. The NMIBC survivors had urinary and bowel symptoms, sexual problems, and worries about the future, regardless of time since diagnosis. The lower cancer stage at diagnosis was associated with better QOL in several domains, including global health status, physical functioning, role functioning, social functioning, fatigue, dyspnea, and financial difficulties. Male survivors had better sexual function and enjoyment than females, but also higher discomfort with sexual intimacy and more concerns about contaminating their partners. The cystectomy group had worse sexual function, more discomfort with sexual intimacy, lower sexual enjoyment, and more male sexual problems than the non-cystectomy group. The NMIBC survivors had notable burdens of cancer-related uncertainty, and higher uncertainty was associated with males, lower income, the lack of cure, lower cognition-ability, and higher cognition-general concerns. The prevalence of PTSS (28.7 %) was higher than in the general United States (US) adult population (10-20%). Higher PTSS were associated with younger age, lack of cure, more comorbidities, less social support, and more cognition-general concerns. Uncertainty was significantly and negatively associated with QOL, and PTSS completely mediated the effect of uncertainty on QOL. The findings of this dissertation highlight the importance of assessment and management of uncertainty and PTSS in the NMIBC population. Further studies are needed to better understand NMIBC survivors’ unique needs and to develop supportive care interventions for them. Spring 2018 2018 Nursing Oncology Bladder cancer survivors, Non-muscle-invasive bladder cancer, Post-traumatic stress disorder, Quality of life, Uncertainty eng Doctor of Philosophy Dissertation University of North Carolina at Chapel Hill Graduate School Degree granting institution Nursing Deborah Mayer Thesis advisor Matthew Nielsen Thesis advisor Jamie Crandell Thesis advisor Mary Palmer Thesis advisor Ashley Bryant Thesis advisor Sophia Smith Thesis advisor text Ahrang Jung Creator School of Nursing Approximately 75% of patients who are newly diagnosed with bladder cancer present with non-muscle-invasive bladder cancer (NMIBC). NMIBC survivors have unique chronic burdens, including frequent recurrences, repeated surveillance cystoscopies and treatments, and the highest lifetime medical cost per person among all cancers. Hence, the aim of conducting this study was to (1) examine the prevalence of uncertainty, post-traumatic stress disorder symptoms (PTSS), and quality of life (QOL) in NMIBC survivors, (2) identify factors associated with uncertainty, PTSS, and QOL, and (3) explore the relationships among uncertainty, PTSS, and QOL. This dissertation consists of three manuscripts. The first is a systematic review of the literature on QOL in NMIBC survivors. The second and third manuscripts comprise the findings from a population-based survey study in North Carolina. The data from 376 NMIBC survivors were used for the analysis. The NMIBC survivors had urinary and bowel symptoms, sexual problems, and worries about the future, regardless of time since diagnosis. The lower cancer stage at diagnosis was associated with better QOL in several domains, including global health status, physical functioning, role functioning, social functioning, fatigue, dyspnea, and financial difficulties. Male survivors had better sexual function and enjoyment than females, but also higher discomfort with sexual intimacy and more concerns about contaminating their partners. The cystectomy group had worse sexual function, more discomfort with sexual intimacy, lower sexual enjoyment, and more male sexual problems than the non-cystectomy group. The NMIBC survivors had notable burdens of cancer-related uncertainty, and higher uncertainty was associated with males, lower income, the lack of cure, lower cognition-ability, and higher cognition-general concerns. The prevalence of PTSS (28.7 %) was higher than in the general United States (US) adult population (10-20%). Higher PTSS were associated with younger age, lack of cure, more comorbidities, less social support, and more cognition-general concerns. Uncertainty was significantly and negatively associated with QOL, and PTSS completely mediated the effect of uncertainty on QOL. The findings of this dissertation highlight the importance of assessment and management of uncertainty and PTSS in the NMIBC population. Further studies are needed to better understand NMIBC survivors’ unique needs and to develop supportive care interventions for them. 2018-05 2018 Nursing Oncology Bladder cancer survivors; Non-muscle-invasive bladder cancer; Post-traumatic stress disorder; Quality of life; Uncertainty eng Doctor of Philosophy Dissertation University of North Carolina at Chapel Hill Graduate School Degree granting institution Deborah Mayer Thesis advisor Matthew Nielsen Thesis advisor Jamie Crandell Thesis advisor Mary Palmer Thesis advisor Ashley Bryant Thesis advisor Sophia Smith Thesis advisor text Jung_unc_0153D_17826.pdf uuid:7a9b38b5-3c16-4ba1-a22d-660fb0312681 2020-06-13T00:00:00 2018-04-13T12:32:40Z proquest application/pdf 1681668