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Brett J, Henshall C, Dawson P, Collins GP, Ehlers A, Mitchell-Floyd T, Aspinall A, Gilmour-Hamilton C, Robinson K, Watson E. Examining the levels of psychological support available to patients with haematological cancer in England: a mixed methods study. BMJ Open 2023; 13:e060106. [PMID: 36806143 PMCID: PMC9943904 DOI: 10.1136/bmjopen-2021-060106] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
OBJECTIVES The psychological impact of a haematological malignancy is well documented. However, few studies have assessed the provision of psychological support to people with these diagnoses. This study explores the extent and nature of psychological support for people diagnosed with haematological cancer to inform future service provision. DESIGN This study consisted of an online survey with healthcare professionals (phase 1) and qualitative interviews with patients (phase 2) and key health professionals (phase 3). A descriptive analysis of survey data and thematic analysis of interviews were conducted. PARTICIPANTS Two hundred health professionals practising in England completed the survey. Twenty-five interviews were conducted with people diagnosed with haematological cancer in the past 3 years, and 10 with key health professionals, including haematologists, cancer nurse specialists and psychologists were conducted. PRIMARY OUTCOME MEASURES Level of psychological assessment undertaken with people with haematological cancer, and level and nature of psychological support provided. RESULTS Less than half (47.3%) of survey respondents strongly agreed/agreed that their patients were well supported in terms of their psychological well-being and approximately half (49.4%) reported providing routine assessment of psychological needs of patients, most commonly at the time of diagnosis or relapse. Patients described their need for psychological support, their experiences of support from health professionals and their experiences of support from psychological therapy services. There was considerable variation in the support patients described receiving. Barriers to providing psychological support reported by health professionals included time, skills, resources and patient barriers. Most doctors (85%) and 40% of nurse respondents reported receiving no training for assessing and managing psychological needs. CONCLUSIONS Psychological well-being should be routinely assessed, and person-centred support should be offered regularly throughout the haematological cancer journey. Greater provision of healthcare professional training in this area and better integration of psychological support services into the patient care pathway are required.
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Affiliation(s)
- Jo Brett
- Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Catherine Henshall
- Health and Life Sciences, Oxford Brookes University, Oxford, UK
- Research Delivery, Oxford Health NHS Foundation Trust, Oxford, UK
| | - Paul Dawson
- Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Graham P Collins
- Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Anke Ehlers
- Experimental Psychology, University of Oxford, Oxford, UK
| | - Tracy Mitchell-Floyd
- Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Anya Aspinall
- Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | | | - Kate Robinson
- Patient and Public Involvement, Oxford Brookes University, Oxford, UK
| | - Eila Watson
- Health and Life Sciences, Oxford Brookes University, Oxford, UK
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Matheson L, Nayoan J, Rivas C, Brett J, Wright P, Butcher H, Gavin A, Glaser A, Watson E, Wagland R. A Qualitative Exploration of Prostate Cancer Survivors Experiencing Psychological Distress: Loss of Self, Function, Connection, and Control. Oncol Nurs Forum 2021; 47:318-330. [PMID: 32301932 DOI: 10.1188/20.onf.318-330] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE To explore the experiences of men with prostate cancer identified as having psychological distress and to identify factors influencing distress. PARTICIPANTS & SETTING 28 men with prostate cancer diagnosed 18-42 months earlier, identified as having psychological distress on survey measures. METHODOLOGIC APPROACH Semistructured telephone interviews were conducted. Thematic analysis using a framework approach was used. FINDINGS Men with psychological distress had strong perceptions of loss toward self (identity, sexuality/masculinity, self-confidence), function (physical activities), connection (relational, social, community), and control (future, emotional). Psychological vulnerability appeared heightened in particular groups of men. Maladaptive strategies of emotional concealment, help-seeking avoidance, and withdrawal appeared to contribute to distress. IMPLICATIONS FOR NURSING Distress in men with prostate cancer is multifaceted. Men with distress should be identified and offered support. Nurse- or peer-led interventions are required.
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Affiliation(s)
| | | | | | | | | | - Hugh Butcher
- Life After Prostate Cancer Diagnosis (LAPCD) patient user advisory group
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SmithBattle L, Lorenz R, Reangsing C, Palmer JL, Pitroff G. A methodological review of qualitative longitudinal research in nursing. Nurs Inq 2018; 25:e12248. [DOI: 10.1111/nin.12248] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 05/03/2018] [Accepted: 05/04/2018] [Indexed: 12/22/2022]
Affiliation(s)
- Lee SmithBattle
- School of Nursing; Saint Louis University; St. Louis Missouri
| | - Rebecca Lorenz
- UB School of Nursing; University at Buffalo; Buffalo New York
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Diver S, Avalos G, Rogers ET, Dowling M. The long-term quality of life and information needs of prostate cancer survivors. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2018. [DOI: 10.1111/ijun.12156] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- Sean Diver
- Candidate Advanced Nurse Practitioner, Letterkenny University Hospital, Letterkenny, Co. Donegal; Ireland
| | - Gloria Avalos
- Lecturer, School of Medicine, Medical Informatics and Medical Education, National University of Ireland, Galway; Ireland
| | - Eamonn T Rogers
- Consultant Urologist, Letterkenny University Hospital, Letterkenny, Co. Donegal; Ireland
| | - Maura Dowling
- Senior Lecturer, School of Nursing and Midwifery, National University of Ireland, Galway, University Road, Galway; Ireland
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Unmet Supportive Care Needs of Men With Locally Advanced and Metastatic Prostate Cancer on Hormonal Treatment: A Mixed Methods Study. Cancer Nurs 2017; 40:497-507. [PMID: 28379852 DOI: 10.1097/ncc.0000000000000482] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Men affected by prostate cancer who are undergoing hormone therapy can endure a range of symptoms that can adversely affect quality of life. Little research has been conducted to date, to understand the specific unmet supportive care needs of this patient group within the context of current service delivery. OBJECTIVE The aim of this study was to understand the experiences of unmet supportive care needs of men affected by prostate cancer on hormone therapy in the United Kingdom. METHODS Mixed methods study recruited 31 men with ≥T3 prostate Cancer or worse and treated by hormone therapy. A small cross-sectional survey (European Organization for Research and Treatment of Cancer [EORTC] C30 and PR25, Self-Management Self-Efficacy Scale, and the Supportive Care Needs Survey) was used to inform the interview schedule. Semi-structured interviews were conducted, and framework approach was used to analyze the data. RESULTS Complex unmet supportive care needs that were related to physical, psychological/emotional, intimacy/sexual, practical, health system/informational, existential, and patient/clinician communication needs are experienced. Men articulated that current healthcare delivery is failing to provide a holistic person-centered model of care. CONCLUSION This is one of the few studies that have identified the unmet supportive care needs of men receiving hormone therapy for ≥T3 prostate Cancer or worse. The needs are multiple and far-ranging. IMPLICATIONS FOR PRACTICE Despite national cancer reforms, unmet supportive care needs persist. The findings from this study may be central in the re-design of future services to optimize men's quality of life and satisfaction with care. Clinicians are encouraged to use these finding to help them optimize care delivery and individual quality of life.
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Aldaz BE, Treharne GJ, Knight RG, Conner TS, Perez D. 'It gets into your head as well as your body': The experiences of patients with cancer during oncology treatment with curative intent. J Health Psychol 2016; 23:3-16. [PMID: 27708126 DOI: 10.1177/1359105316671185] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
This study explored the psychosocial experiences of patients with cancer during the course of oncology treatment with curative intent. Our aim was to gather in-depth insights into the shared elements of oncology treatment across a range of cancer types. A total of 10 individuals undergoing oncology treatment participated in semi-structured interviews. Six themes were identified using interpretative phenomenological analysis: diminished well-being, perceived role changes in intimate relationships, heightened awareness of limited time, a new order of priorities, taking things as they come and development of trust in health professionals. These themes indicate relevant areas of patients' well-being, which might be enhanced through psychosocial support services.
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McCaughan E, McKenna S, McSorley O, Parahoo K. The experience and perceptions of men with prostate cancer and their partners of the CONNECT psychosocial intervention: a qualitative exploration. J Adv Nurs 2015; 71:1871-82. [PMID: 25818026 DOI: 10.1111/jan.12648] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2015] [Indexed: 11/30/2022]
Abstract
AIM To explore the experience of prostate cancer survivors and their partners of the CONNECT psychosocial intervention. BACKGROUND There is a scarcity of evidence relating to interventions to help men and their partners cope with the after affects of prostate cancer treatment. DESIGN This study employed a qualitative design for in depth exploration through couple interviews. The addition of a short process evaluation questionnaire was used to supplement the qualitative data. METHODS Semi-structured interviews were conducted between January 2012-October 2012 with a purposive sample of 11 couple dyads who had participated in the CONNECT intervention. Data were analysed using inductive content analysis. Simple descriptive statistics were used to analyse the findings from the questionnaire data. RESULTS Couples perceived benefits of participating in the intervention to include: opportunities to share experiences, gain validation, obtain information and engage in couple care. The expertise of the professional facilitator and group dynamics were highlighted as factors influencing the success of the intervention. Potential areas for improvement of the intervention were identified as being: further development of the sexual dysfunction component; incorporation of a partner specific session to better address their needs; determination of optimal delivery format and timing; and further tailoring of the components of the intervention. CONCLUSION Although there were areas that could be further improved, this psychosocial intervention was valued by the participants. The insight gained from this qualitative exploration can be used to make the necessary changes before the intervention can be tested in a large randomised controlled trial.
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Affiliation(s)
- Eilis McCaughan
- Institute of Nursing and Health Research, University of Ulster, Coleraine, UK
| | - Suzanne McKenna
- Institute of Nursing and Health Research, University of Ulster, Coleraine, UK
| | - Oonagh McSorley
- Institute of Nursing and Health Research, University of Ulster, Coleraine, UK
| | - Kader Parahoo
- Institute of Nursing and Health Research, University of Ulster, Coleraine, UK
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Dong ST, Butow PN, Costa DSJ, Lovell MR, Agar M. Symptom clusters in patients with advanced cancer: a systematic review of observational studies. J Pain Symptom Manage 2014; 48:411-50. [PMID: 24703941 DOI: 10.1016/j.jpainsymman.2013.10.027] [Citation(s) in RCA: 123] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Revised: 10/21/2013] [Accepted: 10/30/2013] [Indexed: 01/08/2023]
Abstract
CONTEXT Advanced cancer patients typically experience multiple symptoms, which may influence patient outcomes synergistically. The composition of these symptom clusters (SCs) differs depending on various clinical variables and the timing and method of their assessment. OBJECTIVES The objective of this systematic review was to examine the composition, longitudinal stability, and consistency across methodologies of common SCs, as well as their common predictors and outcomes. METHODS A search of MEDLINE, CINAHL, Embase, Web of Science, and PsycINFO was conducted using variants of symptom clusters, cancer, and palliative care. RESULTS Thirty-three articles were identified and reviewed. Many SCs were identified, with four common groupings being anxiety-depression, nausea-vomiting, nausea-appetite loss, and fatigue-dyspnea-drowsiness-pain. SCs in most cases were not stable longitudinally. The various statistical methods used (most commonly principal component analysis, exploratory factor analysis, and hierarchical cluster analysis) tended to reveal different SCs. Different measurement tools were used in different studies, each containing a different array of symptoms. The predictors and outcomes of SCs were also inconsistent across studies. No studies of patient experiences of SCs were identified. CONCLUSION Although the articles reviewed revealed four groups of symptoms that tended to cluster, there is limited consistency in the way in which SCs and variables associated with them are identified. This is largely due to a lack of agreement about a robust, clinically relevant definition of SCs. Future research should focus on patients' subjective experience of SCs to inform a clinically relevant definition of SCs and how they are managed over time.
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Affiliation(s)
- Skye Tian Dong
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, New South Wales, Australia.
| | - Phyllis N Butow
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, New South Wales, Australia
| | - Daniel S J Costa
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, New South Wales, Australia
| | - Melanie R Lovell
- HammondCare, The University of Sydney Medical School, Sydney, New South Wales, Australia
| | - Meera Agar
- Department of Palliative Care, Braeside Hospital, HammondCare, Sydney, New South Wales, Australia
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Bennion AE, Molassiotis A. Qualitative research into the symptom experiences of adult cancer patients after treatments: a systematic review and meta-synthesis. Support Care Cancer 2012; 21:9-25. [PMID: 22972487 DOI: 10.1007/s00520-012-1573-x] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2012] [Accepted: 08/13/2012] [Indexed: 12/01/2022]
Abstract
PURPOSE This review paper aimed to draw together the findings of qualitative research into the symptom experience of adult cancer patients in order to develop a better understanding of symptom experiences following cancer treatment. METHODS Systematic review and meta-synthesis techniques were used to identify, appraise and synthesise the relevant literature. RESULTS A thematic account of shared symptom experiences reported across papers is presented. Four main themes are discussed: interaction with health services, changing relationships, changing self and coping. In addition the range of symptoms reported across qualitative cancer research is highlighted. CONCLUSIONS Unexpected symptoms can have negative effects on patients who need to be better prepared for long-term symptom experiences. In addition, it is important to acknowledge that patients' symptom experiences do not happen in isolation and should be addressed holistically within the context of patients' lives.
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Affiliation(s)
- A E Bennion
- School of Nursing, Midwifery & Social Work, University of Manchester, University Place, Manchester, M13 9PL, UK
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