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Sousa-Leite M, Costa R, Figueiredo B, Gameiro S. Discussing the possibility of fertility treatment being unsuccessful as part of routine care offered at clinics: patients' experiences, willingness, and preferences. Hum Reprod 2023:7169439. [PMID: 37196325 DOI: 10.1093/humrep/dead096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 03/28/2023] [Indexed: 05/19/2023] Open
Abstract
STUDY QUESTION Are patients willing to discuss the possibility of treatment being unsuccessful as part of routine care offered at clinics, and what are the factors associated with this willingness? SUMMARY ANSWER Nine in every 10 patients are willing to discuss this possibility as part of routine care, with willingness being associated with higher perceived benefits, lower barriers, and stronger positive attitudes towards it. WHAT IS KNOWN ALREADY Fifty-eight percent of patients who complete up to three cycles of IVF/ICSI in the UK do not achieve a live birth. Offering psychosocial care for unsuccessful fertility treatment (PCUFT), defined as assistance and guidance on the implications of treatment being unsuccessful, could reduce the psychosocial distress patients experience when it happens, and promote positive adjustment to this loss. Research shows 56% of patients are willing to plan for an unsuccessful cycle, but little is known about their willingness and preferences towards discussing the possibility of definitive unsuccessful treatment. STUDY DESIGN, SIZE, DURATION The study was of cross-sectional design, comprising a theoretically driven and patient-centred bilingual (English, Portuguese) mixed-methods online survey. The survey was disseminated via social media (April 2021-January 2022). Eligibility criteria included being aged 18 or older, waiting to or undergoing an IVF/ICSI cycle, or having completed a cycle within the previous 6 months without achieving a pregnancy. Out of 651 people accessing the survey, 451 (69.3%) consented to participate. From these, 100 did not complete 50% of the survey questions, nine did not report on the primary outcome variable (willingness), and 342 completed the survey (completion rate 75.8%, 338 women). PARTICIPANTS/MATERIALS, SETTING, METHODS The survey was informed by the Health Belief Model (HBM) and Theory of Planned Behaviour (TPB). Quantitative questions covered sociodemographic characteristics and treatment history. Quantitative and qualitative questions gathered data on past experiences, willingness, and preferences (with whom, what, how and when) to receive PCUFT, as well as theory-informed factors hypothesized to be associated with patients' willingness to receive it. Descriptive and inferential statistics were used on quantitative data about PCUFT experiences, willingness, and preferences, and thematic analysis was applied to textual data. Two logistic regressions were used to investigate the factors associated with patients' willingness. MAIN RESULTS AND THE ROLE OF CHANCE Participants were, on average, 36 years old and most resided in Portugal (59.9%) and the UK (38.0%). The majority (97.1%) were in a relationship for around 10 years, and 86.3% were childless. Participants were undergoing treatment for, on average, 2 years [SD = 2.11, range: 0-12 years], with most (71.8%) having completed at least one IVF/ICSI cycle in the past, almost all (93.5%) without success. Around one-third (34.9%) reported having received PCUFT. Thematic analysis showed participants received it mainly from their consultant. The main topic discussed was patients' low prognosis, with the emphasis being put on achieving a positive outcome. Almost all participants (93.3%) would like to receive PCUFT. Reported preferences indicated that 78.6% wanted to receive it from a psychologist/psychiatrist/counsellor, mostly in case of a bad prognosis (79.4%), emotional distress (73.5%), or difficulties in accepting the possibility of treatment being unsuccessful (71.2%). The preferred time to receive PCUFT was before initiating the first cycle (73.3%), while the preferred format was in an individual (mean = 6.37, SD = 1.17; in 1-7 scale) or couple (mean = 6.34, SD = 1.24; in 1-7 scale) session. Thematic analysis showed participants would like PCUFT to provide an overview of treatment and all possible outcomes tailored to each patient's circumstances and to encompass psychosocial support, mainly focused on coping strategies to process loss and sustain hope towards the future. Willingness to receive PCUFT was associated with higher perceived benefit of building psychosocial resources and coping strategies (odds ratios (ORs) 3.40, 95% CI 1.23-9.38), lower perceived barrier of triggering negative emotions (OR 0.49, 95% CI 0.24-0.98), and stronger positive attitudes about PCUFT being beneficial and useful (OR 3.32, 95% CI 2.12-5.20). LIMITATIONS, REASONS FOR CAUTION Self-selected sample, mainly composed of female patients who had not yet achieved their parenthood goals. The small number of participants unwilling to receive PCUFT reduced statistical power. The primary outcome variable was intentions, and research shows a moderate association between intentions and actual behaviour. WIDER IMPLICATIONS OF THE FINDINGS Fertility clinics should provide patients with early opportunities to discuss the possibility of their treatment being unsuccessful as part of routine care. PCUFT should focus on minimizing suffering associated with grief and loss by reassuring patients they can cope with any treatment outcome, promoting coping resources, and signposting to additional support. STUDY FUNDING/COMPETING INTEREST(S) M.S.-L. holds a doctoral fellowship from the Portuguese Foundation for Science and Technology, I.P. [Fundação para a Ciência e a Tecnologia] (FCT; SFRH/BD/144429/2019). R.C. holds a post-doctoral fellowship supported by the European Social Fund (ESF) and FCT (SFRH/BPD/117597/2016). The EPIUnit, ITR and CIPsi (PSI/01662) are also financed by FCT through the Portuguese State Budget, in the scope of the projects UIDB/04750/2020, LA/P/0064/2020 and UIDB/PSI/01662/2020, respectively. Dr Gameiro reports consultancy fees from TMRW Life Sciences and Ferring Pharmaceuticals A/S, speaker fees from Access Fertility, SONA-Pharm LLC, Meridiano Congress International and Gedeon Richter, grants from Merck Serono Ltd, an affiliate of Merck KgaA, Darmstadt, Germany. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- M Sousa-Leite
- School of Psychology, Cardiff University, Cardiff, UK
- Epidemiology Research Unit (EPIUnit), Institute of Public Health, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | - R Costa
- Epidemiology Research Unit (EPIUnit), Institute of Public Health, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | - B Figueiredo
- Psychology Research Centre (CIPsi), School of Psychology, University of Minho, Braga, Portugal
| | - S Gameiro
- School of Psychology, Cardiff University, Cardiff, UK
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Almeida SN, Elliott R, Silva ER, Sales CMD. Developing an emotion‐focused therapy model for fear of cancer recurrence: A case‐level task analysis. COUNSELLING & PSYCHOTHERAPY RESEARCH 2023. [DOI: 10.1002/capr.12624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Affiliation(s)
- Susana N. Almeida
- Psychology Service Portuguese Institute of Oncology of Porto Francisco Gentil, E.P.E. Porto Portugal
- University of Maia – ISMAI Maia Portugal
| | - Robert Elliott
- Counselling Unit, School of Psychological Sciences and Health University of Strathclyde Glasgow UK
| | - Eunice R. Silva
- Psychology Service Portuguese Institute of Oncology of Porto Francisco Gentil, E.P.E. Porto Portugal
| | - Célia M. D. Sales
- Faculty of Psychology and Education Science at the University of Porto (FPCEUP), Center for Psychology at the University of Porto (CPUP) University of Porto Porto Portugal
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Singer S, Kojima E, Deppisch L, Taylor K, Wickert M, Riedel P, Alt J, Heß G, Hechtner M, Bayer O. What is the best time for psychosocial counselling from the perspective of cancer patients and their relatives? A multi‐centre qualitative study. COUNSELLING & PSYCHOTHERAPY RESEARCH 2021. [DOI: 10.1002/capr.12488] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Susanne Singer
- Division of Epidemiology and Health Services Research Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI) University Medical Centre of Johannes Gutenberg University Mainz Germany
- University Cancer Centre Mainz (UCT) Mainz Germany
| | - Erika Kojima
- Division of Epidemiology and Health Services Research Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI) University Medical Centre of Johannes Gutenberg University Mainz Germany
- University Cancer Centre Mainz (UCT) Mainz Germany
| | - Larissa Deppisch
- Division of Epidemiology and Health Services Research Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI) University Medical Centre of Johannes Gutenberg University Mainz Germany
- University Cancer Centre Mainz (UCT) Mainz Germany
| | - Katherine Taylor
- Division of Epidemiology and Health Services Research Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI) University Medical Centre of Johannes Gutenberg University Mainz Germany
- University Cancer Centre Mainz (UCT) Mainz Germany
| | | | | | - Jürgen Alt
- University Cancer Centre Mainz (UCT) Mainz Germany
| | - Georg Heß
- University Cancer Centre Mainz (UCT) Mainz Germany
| | - Marlene Hechtner
- Division of Epidemiology and Health Services Research Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI) University Medical Centre of Johannes Gutenberg University Mainz Germany
- University Cancer Centre Mainz (UCT) Mainz Germany
| | - Oliver Bayer
- Division of Epidemiology and Health Services Research Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI) University Medical Centre of Johannes Gutenberg University Mainz Germany
- University Cancer Centre Mainz (UCT) Mainz Germany
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Lingens SP, Schulz H, Bleich C. Evaluations of psychosocial cancer support services: A scoping review. PLoS One 2021; 16:e0251126. [PMID: 33945585 PMCID: PMC8096026 DOI: 10.1371/journal.pone.0251126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 04/20/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND A diagnosis of cancer leaves most patients with cancer and their relatives with an increased psychological burden. Throughout the course of the illness, social, occupational or legal changes may lead to psychological distress. Psychosocial cancer support services offer psychological, social and legal support. However, little is known about the effectiveness of psychosocial support services implemented in health care. Therefore, this scoping review aims to provide an overview of current literature evaluating out-patient psychosocial support services. METHODS Databases searched were PubMed, PsycINFO, PSYNDEX, PsycArticle, Medline, Web of Science, Google Scholar, Cochrane, and Embase. Two independent researchers conducted the systematic search. We included studies that were published in English and assessed at least one patient reported outcome measure. Studies that assessed psychotherapy, online support or telephone counselling were excluded. The review was reported according to PRISMA-ScR guidelines. A search of the databases identified 2104 articles. After excluding duplicates, screening titles, abstracts and full-texts, 12 studies matching the criteria were identified. RESULTS One study was an RCT, six were prospective with no control group and five studies were cross-sectional with one measurement point. The most common outcome measures across studies were well-being, concerns and satisfaction with the support services. CONCLUSION While the included studies indicate some improvements to well-being for patients with cancer, the low number and lack of high quality of studies indicate these findings should be interpreted with caution. However, high-quality research on the effectiveness of psychosocial support services is needed to determine that the interventions are effective.
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Affiliation(s)
- Solveigh P. Lingens
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Holger Schulz
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Christiane Bleich
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
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Goh K. A qualitative study of the attitudes that most affect the decision of a Singaporean whether to seek counselling or not. ASIA PACIFIC JOURNAL OF COUNSELLING AND PSYCHOTHERAPY 2020. [DOI: 10.1080/21507686.2020.1808800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Khim Goh
- Faculty of Education, Monash University, Melbourne, Australia
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Cherry MG, Salmon P, Byrne A, Ullmer H, Abbey G, Fisher PL. Qualitative Evaluation of Cancer Survivors' Experiences of Metacognitive Therapy: A New Perspective on Psychotherapy in Cancer Care. Front Psychol 2019; 10:949. [PMID: 31118912 PMCID: PMC6506788 DOI: 10.3389/fpsyg.2019.00949] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 04/09/2019] [Indexed: 01/22/2023] Open
Abstract
Background Preliminary evidence suggests that metacognitive therapy (MCT), a brief, process-focused psychological intervention, alleviates distress in cancer survivors. In a longitudinal qualitative study nested in an open trial of MCT for cancer survivors, we explored how patients understood, experienced and applied MCT. Methods Patients received six MCT sessions. Consenting patients provided semi-structured interviews post-intervention (n = 19), and at 3- and 6-months follow-up (n = 14 and 10 respectively). Interviews were audio-recorded and transcribed. Analysis followed a constant comparison approach. Results Participants felt “overwhelmed” by worry before starting MCT and doubted that such brief therapy could help. Their accounts focused on feeling “challenged” to think differently by the psychologist. Those completing therapy were enthusiastic about it. They described having learned that thoughts are “only thoughts,” that feelings of worry or sadness are a normal part of life, and that they were in control of whether and how they engaged with thoughts. Consequently, most described a sense of freedom to live free from worry. A minority described being unable to apply MCT to certain thoughts. Two patients who withdrew before completing MCT did not describe having learned what MCT was intended to achieve. Conclusion MCT is an acceptable brief intervention for distressed cancer survivors. Feeling challenged to understand the processes maintaining their distress was central to their enthusiasm for it, irrespective of their presenting difficulties. Implications for Cancer Survivors The complexity of emotional distress in cancer survivors can potentially be addressed using a transdiagnostic model which focuses on the psychological processes which maintain distress.
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Affiliation(s)
- Mary Gemma Cherry
- Department of Psychological Sciences, Institute of Psychology, Health and Society, University of Liverpool, Liverpool, United Kingdom.,The Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom
| | - Peter Salmon
- Department of Psychological Sciences, Institute of Psychology, Health and Society, University of Liverpool, Liverpool, United Kingdom.,The Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom
| | - Angela Byrne
- Department of Psychological Sciences, Institute of Psychology, Health and Society, University of Liverpool, Liverpool, United Kingdom.,The Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom
| | - Helen Ullmer
- Department of Psychological Sciences, Institute of Psychology, Health and Society, University of Liverpool, Liverpool, United Kingdom.,The Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom
| | - Gareth Abbey
- Department of Psychological Sciences, Institute of Psychology, Health and Society, University of Liverpool, Liverpool, United Kingdom.,The Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom
| | - Peter L Fisher
- Department of Psychological Sciences, Institute of Psychology, Health and Society, University of Liverpool, Liverpool, United Kingdom.,The Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom
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Brandão T, Tavares R, Schulz MS, Matos PM. Experiences of breast cancer patients and helpful aspects of supportive-expressive group therapy: A qualitative study. Eur J Cancer Care (Engl) 2019; 28:e13078. [PMID: 31038245 DOI: 10.1111/ecc.13078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 01/17/2019] [Accepted: 03/25/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study explored the experiences and perceived changes of breast cancer (BC) patients after participating in 16-weekly sessions of Supportive-Expressive Group Therapy (SEGT). METHODS A semi-structured interview adapted from Elliott's Client Change Interview was carried out with 12 women (aged 33-60 years) with BC, about 6 months after completing the treatment. RESULTS Content analysis identified four main themes: expectations and motivations to participate in SEGT, group processes and experiences, perceived changes enhanced by SEGT and perceptions about the therapeutic relationship. The most helpful aspects of SEGT mentioned by participants were as follows: the expression/normalisation of feelings, thoughts and reactions; the improvement of social support; and the learning opportunities obtained through sharing of experiences among participants. Additionally, participants mentioned that SEGT contributed to improve personal and social skills, such as the capacity to express emotions and the ability to establish satisfactory interpersonal relationships. CONCLUSIONS Based on the participants' experiences, SEGT seems to be an effective intervention to support women facing BC during the initial phase of cancer. The use of SEGT by health care professionals is encouraged, but the specific needs/problems of each group member should be carefully attended.
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Affiliation(s)
- Tânia Brandão
- CIP, Departamento de Psicologia, Universidade Autónoma de Lisboa Luís de Camões, Lisboa, Portugal.,Center for Psychology at University of Porto, Porto, Portugal
| | - Rita Tavares
- Center for Psychology at University of Porto, Porto, Portugal.,Faculty of Psychology and Educational Sciences, University of Porto, Porto, Portugal
| | - Marc S Schulz
- Department of Psychology, Bryn Mawr College, Bryn Mawr, Pennsylvania
| | - Paula M Matos
- Center for Psychology at University of Porto, Porto, Portugal.,Faculty of Psychology and Educational Sciences, University of Porto, Porto, Portugal
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8
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Isaksson J, Lilliehorn S, Salander P. Cancer patients' motives for psychosocial consultation-Oncology social workers' perceptions of 226 patient cases. Psychooncology 2018; 27:1180-1184. [PMID: 29314355 DOI: 10.1002/pon.4633] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 12/20/2017] [Accepted: 12/22/2017] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Although oncology social workers (OSWs) have emerged as a core profession in the provision of psychosocial services, there is a lack of empirical studies that describe their daily clinical work with patients. The overall aim of this study was to explore cancer patients' motives for consulting an OSW. METHODS From a nationwide survey, we used data from 226 patient cases that OSWs met face to face. The OSWs were asked to describe how the case was referred to them, the patient's characteristics, and what they perceived as the patient's motives for contacting them as well as additional motives that came up during the consultations. RESULTS Patients have different motives for consulting an OSW, and these motives change over the course of consultations; while feelings associated with being diagnosed with cancer were often the initial motive, questions associated with moving on in life and dealing with relationships and the overall life situation were added over time. CONCLUSIONS The results show that Swedish OSWs' function is multifaceted and that the initial motives among patients rarely predict the content in consultations over time. Based on the diversity of motives, it seems obvious that OSWs (at least in Sweden) need a broad education in the psychology of counselling. It also seems obvious that even if patients initially were referred by health care staff to the OSW due to psychological reactions to being ill, staff should also be attentive to the fact that relational and socio-economic/juridical issues are of great concern for the patients.
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Affiliation(s)
- Joakim Isaksson
- Department of Social Work, Umeå University, Umeå, Sweden.,Department of Social Work, Stockholm University, Stockholm, Sweden
| | - Sara Lilliehorn
- Department of Social Work, Umeå University, Umeå, Sweden.,Department of Radiation Sciences-Oncology, Umeå University, Umeå, Sweden
| | - Pär Salander
- Department of Social Work, Umeå University, Umeå, Sweden
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Hoeck B, Ledderer L, Ploug Hansen H. Dealing with cancer: a meta-synthesis of patients' and relatives' experiences of participating in psychosocial interventions. Eur J Cancer Care (Engl) 2017; 26:e12652. [PMID: 28169475 DOI: 10.1111/ecc.12652] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2016] [Indexed: 11/28/2022]
Abstract
The aim was to synthesise patients' and relatives' experiences of participating in a psychosocial intervention related to having cancer. The study was a meta-synthesis inspired by Noblit & Hare's 'meta-ethnography' approach. We systematically searched six databases and included 33 studies in the meta-synthesis. Inclusion criteria were qualitative studies with relevance to the synthesis topic. The meta-synthesis conceptualised the way in which participants develop their way of living with cancer, and the role psychosocial interventions play in helping them to live through the illness. Five themes symbolising the participants' core experiences were identified: (1) Emotional relief and a sense of well-being, (2) normalisation of experiences and a sense of control, (3) shared experience and a sense of community, (4) a safe place and (5) transformation and adaptability. The findings indicated that psychosocial interventions were used to try to deal with the changes in the human conditions caused by cancer. Sharing their experiences and forming social relationships helped the participants adapt to cancer. An existential perspective may provide a nuanced understanding of patients' and relatives' experiences of participating in psychosocial interventions.
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Affiliation(s)
- B Hoeck
- Research Unit of User Perspectives, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - L Ledderer
- Section for Health Promotion and Health Services, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - H Ploug Hansen
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
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Matthews M, Hughes C, Rogers KMA. Impact of counselling on quality of life and sleep in cancer patients. ACTA ACUST UNITED AC 2014; 23:S11-6. [PMID: 24851803 DOI: 10.12968/bjon.2014.23.sup10.s11] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
It has been acknowledged that poor quality of sleep significantly correlates with poor quality of life; evidence suggests that counselling has a positive impact not only on the cancer patient's quality of life, but also on family members and friends. The aim of this service evaluation was to determine if there was an improvement in clients' quality of life and sleep patterns following counselling as offered by a local cancer charity. A total of 60 matched pre- and post-counselling questionnaires were completed and subjected to statistical analysis. When considering quality of life, in the domains of Role Emotional, Mental Health and Mental Component Summary Score, it can be concluded that counselling has a positive effect on emotional health and mental wellbeing. The mean total number of hours sleep per night significantly increased from 6 hours sleep per night at baseline to 6.8 hours sleep per night at the completion of counselling (p=0.005) showing clients gained an extra 48 minutes sleep per night. The improved emotional and mental wellbeing alongside the extra 48 minutes sleep per night provides evidence that there is a positive outcome for those patients and families who use counselling services. Nurses and other members of the multidisciplinary team should be encouraged to discuss supportive therapies with patients and those affected by cancer at all stages of the cancer trajectory, regardless of social status, gender or cancer type.
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Ekberg K, McDermott J, Moynihan C, Brindle L, Little P, Leydon GM. The role of helplines in cancer care: intertwining emotional support with information or advice-seeking needs. J Psychosoc Oncol 2014; 32:359-81. [PMID: 24611530 DOI: 10.1080/07347332.2014.897294] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Helplines are core feature of the contemporary U.K. health care system, however little is known about callers' experiences of seeking cancer-related telephone help. Qualitative interviews were conducted with 32 cancer helpline callers. The findings suggest cancer helplines offer callers (1) time to discuss their issues, (2) anonymity, (3) convenience, and (4) an open outlet for anyone affected by cancer including family/friends. Further, the findings highlighted that callers' help-seeking behavior was multifaceted, with their psychosocial needs being intrinsically intertwined with their information or advice-seeking needs. The implications are discussed in relation to the role of cancer helplines in the healthcare system.
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Affiliation(s)
- Katie Ekberg
- a School of Health and Rehabilitation Science , The University of Queensland , Queensland , Australia
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Olson R. A time-sovereignty approach to understanding carers of cancer patients' experiences and support preferences. Eur J Cancer Care (Engl) 2013; 23:239-48. [DOI: 10.1111/ecc.12121] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2013] [Indexed: 11/30/2022]
Affiliation(s)
- R.E. Olson
- School of Science and Health; University of Western Sydney; Penrith NSW Australia
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Omylinska-Thurston J, Cooper M. Helpful processes in psychological therapy for patients with primary cancers: A qualitative interview study. COUNSELLING & PSYCHOTHERAPY RESEARCH 2013. [DOI: 10.1080/14733145.2013.813952] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Nekolaichuk CL, Turner J, Collie K, Cumming C, Stevenson A. Cancer patients' experiences of the early phase of individual counseling in an outpatient psycho-oncology setting. QUALITATIVE HEALTH RESEARCH 2013; 23:592-604. [PMID: 23264535 DOI: 10.1177/1049732312470567] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Distress is a common and substantive problem associated with the invasive nature of cancer. Psychosocial interventions can alleviate distress and enhance quality of life, with a wealth of research demonstrating benefits of group interventions. Less is known, however, about the value of individual psychological counseling for cancer patients. The goal of our study was to understand patients' experiences of attending an individual psycho-oncology counseling service in a comprehensive cancer center in Canada. We conducted six focus groups to ask patients about their perceived benefits of the early phase of counseling. The 23 participants were predominantly women living in urban areas who sought counseling for emotional and coping difficulties. Using inductive analysis, we identified four interrelated themes: distress and need for support, challenges to service access, service benefits, and the therapeutic encounter. The therapeutic encounter formed a core component of patients' experiences, highlighting the benefits of specific therapeutic interventions and processes.
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McLeod J. Process and outcome in pluralistic Transactional Analysis counselling for long-term health conditions: A case series. COUNSELLING & PSYCHOTHERAPY RESEARCH 2013. [DOI: 10.1080/14733145.2012.709873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Nissim R, Freeman E, Lo C, Zimmermann C, Gagliese L, Rydall A, Hales S, Rodin G. Managing Cancer and Living Meaningfully (CALM): a qualitative study of a brief individual psychotherapy for individuals with advanced cancer. Palliat Med 2012; 26:713-21. [PMID: 22042225 DOI: 10.1177/0269216311425096] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Although psychosocial care has been regarded as central to palliative and supportive care, there have been few empirically tested approaches to individual intervention. AIM The subjective experience of advanced cancer patients receiving a new manualized brief individual psychotherapy, referred to as Managing Cancer and Living Meaningfully (CALM), was examined prior to the initiation of a randomized controlled trial testing the effectiveness of this intervention. DESIGN Semi-structured interviews were conducted with patients who had a diagnosis of advanced cancer, and who underwent the intervention. SETTING/PARTICIPANTS Patients were recruited from a large urban regional cancer center in Toronto, Canada. The 10 interviewees included seven women and three men. All had completed between three to six CALM sessions prior to the interview. RESULTS The CALM intervention was associated with profound and unique patient-identified benefits and no patient-identified risks or concerns. Five interrelated benefits of the intervention were identified: (1) a safe place to process the experience of advanced cancer; (2) permission to talk about death and dying; (3) assistance in managing the illness and navigating the healthcare system; (4) resolution of relational strain; and (5) an opportunity to 'be seen as a whole person' within the healthcare system. These benefits were regarded by participants as unique in their cancer journey. CONCLUSIONS Findings from a qualitative study suggest that the CALM intervention provides substantial benefits for patients with advanced cancer prior to the end of life. Findings informed the development of a randomized controlled trial to evaluate the effectiveness of this intervention.
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Affiliation(s)
- Rinat Nissim
- Department of Psychosocial Oncology and Palliative Care, Princess Margaret Hospital, University Health Network, Toronto, Canada.
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The prevalence, detection and intervention for depression and anxiety in oncology. JOURNAL OF RADIOTHERAPY IN PRACTICE 2011. [DOI: 10.1017/s146039691100015x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractClinical depression is the most prevalent psychiatric disorder amongst cancer patients and is associated with significant functional impairment, although often under-diagnosed and untreated. In one study, only 6% of patients with clinical depression were identified by their oncologists. The detection of and intervention for anxiety and depression in oncology is widely debated in the literature. Diagnosing clinically significant distress amongst cancer patients requires sensitivity as many symptoms of depression are very similar to those of some cancers themselves. The two detection methods discussed in the literature are either self report questionnaires (i.e., HADS) and diagnostic clinical interviews. There are several techniques described in the literature that have shown to be effective in reducing anxiety and depression in oncology. These can be broken down into four main categories, namely, cognitive behavioural therapy (CBT), counselling, drug therapy and complementary therapies, and it is acknowledged that patients receiving any type of intervention generally cope better than those who receive none at all. The effective management of anxiety and depression is dependent on the ability of health professionals to establish a rapport with patients and pick up on cues, regardless of whether intervention is necessary. However, an obvious lack of time and resources within the NHS can be a limiting factor, thus all health care professionals must take more responsibility for the detection of anxiety and depression, followed by the appropriate referral.
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Ohlén J, Holm AK, Karlsson B, Ahlberg K. Evaluation of a counselling service in psychosocial cancer care. Eur J Oncol Nurs 2005; 9:64-73. [PMID: 15774342 DOI: 10.1016/j.ejon.2004.07.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The aim of the current study was to describe patient-perceived outcomes of a counselling intervention for cancer patients. An individual counselling service was established at a cancer clinic in Sweden. The service offered counselling intervention which consisted of short-term crisis and supportive counselling focused on meeting individual patients' expectations and needs. Of the 72 patients who were included in the study, 43 participated. The findings show that expectations regarding the counselling intervention were fulfilled for 84% of the patients. Four descriptive themes describing perceived outcomes were found: reformulation of the situation with cancer and illness, managing problematic situations, courage to express one's own needs to professional caregivers, and insufficient support. Concerning the outcomes from the counselling, 67% of the participants stated that they had received improved understanding of their own reactions and feelings. Nearly half the group (40%) experienced distance to their disease and life situation. Some participants also said that they experienced increased pleasure in life (44%), had more ability to take action (42%), and were less frightened (37) after the intervention. Insufficient support was reported by 5 patients. Thus, counselling was perceived by the majority of the participants as beneficial. Implications for psychosocial support in cancer care are given.
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Affiliation(s)
- Joakim Ohlén
- Department of Nursing, Karolinska Institutet, SE 141 83 Huddinge, Sweden
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Boudioni M, Mossman J, Boulton M, Hardy P. Differences in enquiries to CancerBACUP information service by living arrangements. Eur J Cancer Care (Engl) 2004; 13:6-10. [PMID: 14961769 DOI: 10.1111/j.1365-2354.2003.00432.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The study's aim was to ascertain whether living alone is associated with the use of an independent cancer information service. An Enquirer Record Form is completed for every fifth enquirer to the service; two questions asking whether enquirers, patients, relatives/friends were living alone or with others where asked in association with the routine questions. A total of 552 callers were asked in a 5-week period, 77% of all callers in these categories. The main findings were: (1) the proportion of enquirers living alone was similar to the general population; (2) among enquirers, patients were more likely to live alone than relatives/friends; (3) requests differed by whether living alone and by type of enquirer, for example, significantly more people living with others requested emotional support than those living alone, and this contrast was most marked for patients than relatives/friends. This study, notwithstanding its limitations, highlights some of the differences in the use of a service and demonstrates the complexity of information and support seeking.
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Westcombe AM, Gambles MA, Wilkinson SM, Barnes K, Fellowes D, Maher EJ, Young T, Love SB, Lucey RA, Cubbin S, Ramirez AJ. Learning the hard way! Setting up an RCT of aromatherapy massage for patients with advanced cancer. Palliat Med 2003; 17:300-7. [PMID: 12822844 DOI: 10.1191/0269216303pm769rr] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Aromatherapy massage is used in cancer palliative care to improve quality of life but there is little evidence for its effectiveness. A large pragmatic multicentre randomized controlled trial was set up to examine the effectiveness of aromatherapy in improving psychological distress and quality of life in patients with cancer. This paper examines the challenges encountered in the design and execution of the study. The original design, i) focused on palliative care patients with advanced disease; ii) had both a no-intervention and a treatment control group (relaxation therapy); and iii) adopted 90% power for sample size calculations. A varied measurement strategy was employed. Recruitment proved difficult, referrers were 'gate-keeping', patients were often too ill to approach and others declined. The trial was modified to ensure viability. Eligibility was extended to all patients with cancer irrespective of stage, the relaxation group was removed and the power reduced to 80%. Although it is not generally good practice to change a study design once recruitment has started, the changes were consistent with the original basic study aims and design principles. The data collection phase was successfully completed in July 2002.
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Affiliation(s)
- A M Westcombe
- Marie Curie Palliative Care Research and Development Unit, Department of Psychiatry & Behavioural Sciences, Royal Free & University College Medical School, Hampstead, London, UK
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Abstract
Many have discussed the importance of using research in practice. To understand this issue, we examined what authors of qualitative research in oncology said about the uses of their research findings. Analysis ofthe authors' implications sections was conducted with 42 articles published between 1995 and 2001 and indexed in either Medline or CINAHL The two categories from this analysis were implications for future research and communication. The categories and related subcategories are illustrated with selected quotes from some of the articles. Findings confirm the importance of language in health and illness.
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Affiliation(s)
- Marlene Zichi Cohen
- The University of Texas at Houston Health Science Center, School of Nursing, USA
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Boudioni M, Mossman J, Boulton M, Ramirez A, Moynihan C, Leydon G. An evaluation of a cancer counselling service. Eur J Cancer Care (Engl) 2000; 9:212-20. [PMID: 11829368 DOI: 10.1046/j.1365-2354.2000.00233.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The CancerBACUP London Counselling Service offered short-term face-to-face counselling to self-referred cancer patients and their relatives and friends, provided by experienced supervised counsellors working within a humanistic theoretical framework. This study aimed to identify its clients' characteristics, use of the service, extent of perceived benefits and satisfaction with the service. Sociodemographic data were collected in Data Sheets from all 384 clients who booked an appointment over 18 months; they were predominantly female, < 50 years old and from non-manual social classes. Significantly more people in those classes and in the 30-59 age group attended three or more sessions. Three hundred and nine clients who attended at least once were sent an Evaluation Form; 142 responded. The probability of the Evaluation Forms' return was greater for those who had completed more sessions; the great majority of respondents felt that they had benefited, and were satisfied with the service. This study, notwithstanding its limitations, shows that a short course of counselling may be perceived by clients to be helpful; it also raises other issues of value to those involved in cancer services and/or counselling provision.
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