Dealing with cancer: a meta-synthesis of patients' and relatives' experiences of participating in psychosocial interventions

Qualitative exploration of the perceptions of exercise in patients with cancer initiated during chemotherapy: a meta-synthesis

OBJECTIVE

To synthesise qualitative literature on (1) the perceptions of patients with cancer of participating in an exercise intervention while undergoing chemotherapy and (2) to inform and guide professionals in oncology and haematology practice.

DESIGN

A qualitative meta-synthesis based on Noblit and Hare's seven-step meta-ethnography.

DATA SOURCES

Six electronic databases: Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, EMBASE, PubMed, SCI-Expanded-SSCI and Scopus (final search June 2022) were used to identify qualitative literature containing individual or focus group interviews. The transparency of reporting for each study was assessed using the Consolidated criteria for Reporting Qualitative research checklist.

RESULTS

The search identified 5002 articles, 107 of which were selected for full-text review. Seventeen articles from five countries with patients undergoing chemotherapy during exercise interventions were included. Eleven articles were included in the meta-synthesis, which comprised 193 patients with various cancer diagnoses, disease stages, sexes and ages. Four main themes were identified: chemotherapy overpowers the body; exercise in battle with side effects; a break from gloomy thoughts; and a question of survivorship.

CONCLUSIONS AND IMPLICATIONS

The meta-synthesis emphasised that patients with cancer undergoing chemotherapy and simultaneously participating in exercise interventions may experience momentary relief from overwhelming side effects, even though full bodily recovery may be perceived as a distant prospect. The synthesis offers a sparse empirical basis for gaining insight into what patients experience existentially following exercise interventions. It is up to patients to independently apply the transfer value of exercise to their own existential circumstances.

Experiences and views of people with diabetes during Ramadan fasting: A qualitative meta-synthesis

Objectives

To review and appraise the existing qualitative studies on Ramadan fasting in participants with diabetes and to integrate valuable qualitative evidence for optimizing diabetes management.

Methods

Twelve databases (PubMed, Embase, Cochrane Library, Science Direct, CINAHL, PsycINFO, JBI (Joanna Briggs institute), Web of Science, and four Chinese databases) were searched to identify qualitative studies on experiences and perspectives of Ramadan fasting in participants with diabetes. CASP (Critical Appraisal Skills Program) Qualitative Checklists were applied to appraise the included studies. A meta-synthesis approach was used to analyze the included studies. Through the strategy of inductive thematic synthesis and reciprocal interpretation, the findings and quotations of the included studies were integrated into new themes and categories. The CERQual (Confidence in the Evidence from Reviews of Qualitative Research) tool was used to grade the confidence of the new themes.

Results

A total of 11 qualitative studies were included, and 43 findings were isolated. Ten new themes were identified and synthesized from the findings. Finally, four new categories were integrated, including the knowledge and understanding of observing Ramadan fasting, well-being and challenges, self-efficacy, and needs and expectations of participants with diabetes during Ramadan.

Conclusions

Insulin-dependent individuals call for special concern during Ramadan fasting. Ramadan-focused education needs to be developed and generalized, and existing guidelines should be improved to optimize the management of diabetes. Professional HCPs contribute to weigh the health risks and mental satisfaction for their patients, partly, to balance health and religion. Participants’ psychological construction is another concern for religious scholars and psychologists.

Qualitative Evaluation of Cancer Survivors' Experiences of Metacognitive Therapy: A New Perspective on Psychotherapy in Cancer Care

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.

What does an oncology social worker deal with in patient consultations? - An empirical study

The oncology social worker is a core profession in the psychosocial care of cancer patients, and has been scrutinised according to its role, function, and delivery of care, primarily from an Anglo-Saxon perspective. There is, however, a lack of studies outside this context, and empirical studies based on individual data. This study is a contribution by exploring the variability in clinical practice from a Swedish perspective. It is based on documentation from one oncology social worker's (OSW's) patient contacts over the course of one year. The essence of the majority of contacts was counseling and the patients displayed a wide variety of motives for seeing an OSW. The function of the OSW is thus multifaceted, and the findings suggest that the OSW, in addition to guiding patients in social legislation issues, also should be prepared to act as an anchor in an acute crisis, contain despair in different phases of the trajectory, and facilitate the 'carrying on as before' or finding a 'new normal'. The paper discusses the importance of the OSW being acquainted with different counseling/psychotherapy perspectives in the illness context, but primarily the importance of having the ability to establish a 'working alliance' with their patients.

Cancer patients' motives for psychosocial consultation-Oncology social workers' perceptions of 226 patient cases

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.