SOCIAL, EMOTIONAL, COGNITIVE, AND PHYSIOLOGICAL CORRELATES OF ELECTRONIC SOCIAL BEHAVIOR

There has been very little research that has studied the capacities that can be fostered to mitigate the risk for involvement in electronic bullying or victimization and almost no research examining positive electronic behavior. The primary goal of this dissertation was to use the General Aggression Model and Anxious Apprehension Model of Trauma to explore the underlying cognitive, emotional, and self-regulation processes that are related to electronic bullying, victimization, and prosocial behavior. In Study 1, we explored several potential interpretations of the General Aggression Model that would accurately describe the relationship that electronic self-conscious appraisal, cognitive reappraisal, and activational control may have with electronic bullying and victimization. In Study 2, we used the Anxious Apprehension Model of Trauma to explore rejection cognitions as the mediator of the relationships among emotionality (emotionality, shame, state emotion responses, and physiological arousal) and electronic bullying and victimization using structural equation modelling. In addition, we explored the role of rejection cognitions in mediating the relationship of moral disengagement with electronic bullying. In Study 3, we examined predictors of electronic prosocial behavior, such as bullying, victimization, time online, electronic proficiency, electronic self-conscious appraisals, emotionality, and self-regulation. All three studies supported the General Aggression Model as a framework to guide the study of electronic behavior, and suggest the importance of cognitive, emotional, and behavioral means of regulation in shaping electronic behavior. In addition, each study has implications for the development of high quality electronic bullying prevention and intervention research.

Challenges, Strengths and Opportunities Related to Implementing Comprehensive Evidence-Based Guidelines on Breast Cancer Survivorship Care by Primary Care Physicians and Nurse Practitioners in Southeastern Ontario

Background Many breast cancer survivors continue to have a broad range of physical and psychosocial problems after breast cancer treatment. As cancer centres move forward with earlier discharge of stable breast cancer survivors to primary care follow-up it is important that comprehensive evidence-based breast cancer survivorship care is implemented to effectively address these needs. Research suggests primary care providers are willing to provide breast cancer survivorship care but many lack the knowledge and confidence to provide evidence-based care. Purpose The overall purpose of this thesis was to determine the challenges, strengths and opportunities related to implementing comprehensive evidence-based breast cancer survivorship guidelines by primary care physicians and nurse practitioners in southeastern Ontario. Methods This mixed-methods research was conducted in three phases: (1) synthesis and appraisal of clinical practice guidelines relevant to provision of breast cancer survivorship care within the primary care practice setting; (2) a brief quantitative survey of primary care providers to determine actual practices related to provision of evidence-based breast cancer survivorship care; and (3) individual interviews with primary care providers about the challenges, strengths and opportunities related to provision of comprehensive evidence-based breast cancer survivorship care. Results and Conclusions In the first phase, a comprehensive clinical practice framework was created to guide provision of breast cancer survivorship care and consisted of a one-page checklist outlining breast cancer survivorship issues relevant to primary care, a three-page summary of key recommendations, and a one-page list of guideline sources. The second phase identified several knowledge and practice gaps, and it was determined that guideline implementation rates were higher for recommendations related to prevention and surveillance aspects of survivorship care and lowest related to screening for and management of long-term effects. The third phase identified three major challenges to providing breast cancer survivorship care: inconsistent educational preparation, provider anxieties, and primary care burden; and three major strengths or opportunities to facilitate implementation of survivorship care guidelines: tools and technology, empowering survivors, and optimizing nursing roles. A better understanding of these challenges, strengths and opportunities will inform development of targeted knowledge translation interventions to provide support and education to primary care providers.