Jane Cockle-Hearne

Self-management for men surviving prostate cancer: a review of behavioural and psychosocial interventions to understand what strategies can work, for whom and in what circumstances

Objective: In the context of increasing prostate cancer survivorship, evidence of unmet supportive care needs and growing economic health‐care restraints, this review examined and evaluated best approaches for developing self‐management programmes to meet mens survivorship needs.

Nurse led telephone follow up in ovarian cancer: A psychosocial perspective

Survivorship is a relatively new concept in ovarian cancer due to improvements in diagnosis, surgery and chemotherapy. As more women require long term follow up for ovarian cancer the pressure on these services is increased and the question of how best to care for these women needs to be addressed. This paper considers the results of a pilot study of nurse led telephone follow up in ovarian cancer from a psychosocial perspective. Fifty-two women received telephone follow up over a 10-month period; one aspect of this intervention was the opportunity for women to discuss psychosocial concerns with the clinical nurse specialist. A nurse database held records of patient discussions, and patient feedback regarding the service was collected using FACT Ovarian quality of life questionnaire, plus the satisfaction and experience with follow up questionnaire. Thirty-three women were recorded as discussing psychological concerns with the nurse, 42% discussed feelings of anxiety or depression and 33% discussed fear of disease recurrence. Thirty-nine women were recorded as having discussed social concerns with the nurse, 56% discussed their family (husband, children, etc.), 51% discussed work and/or finances, and 41% discussed sexual intimacy. The majority of women (73%) expressed a preference for nurse led telephone follow up, the main advantages were reported as the relationship and discussions between the patient and the nurse, and the convenience of having follow up appointments over the phone instead of attending clinic. This pilot study suggests that nurse led telephone follow up offers an acceptable opportunity for psychosocial support for women with ovarian cancer.

The impact of supportive nursing care on the needs of men with prostate cancer: a study across seven European countries.

Background:Prostate cancer is for many men a chronic disease with a long life expectancy after treatment. The impact of prostate cancer therapy on men has been well defined, however, explanation of the consequences of cancer treatment has not been modelled against the wider variables of long-term health-care provision. The aim of this study was to explore the parameters of unmet supportive care needs in men with prostate cancer in relation to the experience of nursing care.Methods:A survey was conducted among a volunteer sample of 1001 men with prostate cancer living in seven European countries.Results:At the time of the survey, 81% of the men had some unmet supportive care needs including psychological, sexual and health system and information needs. Logistic regression indicated that lack of post-treatment nursing care significantly predicted unmet need. Critically, men’s contact with nurses and/or receipt of advice and support from nurses, for several different aspects of nursing care significantly had an impact on men’s outcomes.Conclusion:Unmet need is related not only to disease and treatment factors but is also associated with the supportive care men received. Imperative to improving men’s treatment outcomes is to also consider the access to nursing and the components of supportive care provided, especially after therapy.

Self-management after prostate cancer treatment: evaluating the feasibility of providing a cognitive and behavioural programme for lower urinary tract symptoms

Study Type – Therapy (case series)

Using the Barnes Language Assessment with older ethnic minority groups.

There are many issues concerning the assessment of older people from ethnic minority groups, the most significant being the language barrier experienced by those whose English is an additional language (EAL). This study aimed to test the hypothesis that EAL participants would score less well than those with English as a first language (EFL) on the sub‐tests of the Barnes Language Assessment (BLA), elucidate the reasons for any such differences and discuss the implications.

Developing peer support in film for cancer self-management: what do men want other men to know?

PurposeThis study reports an innovative theory-driven approach for developing filmed peer support for cancer self-management. Peer support conventionally includes empathetic interaction between people with shared experiences. This unique study considers how to authentically communicate peer empathy in a one-way film narrative.MethodsWe co-created a film based on phenomenological interviews with seven men who had volunteered to support other men by sharing their experiences of coping with prostate cancer. The film contributed to successful engagement with self-management. Interpretative phenomenological analysis of the interview data was conducted to explore the components of experiential empathy that the men had communicated.ResultsFour themes were identified illustrating what men wanted other men to know about coping with prostate cancer: Going into the unknown, it was difficult but I got through highlighted trauma and the importance of having a determined attitude; Only you can do it illustrated the triumph of their journey and of regaining control; I haven’t changed massively reflected the importance of a constant self; and Stay involved represented the overriding need to remain part of pre-cancer social environments.ConclusionsWe propose a construct framework of experiential empathy for men with prostate cancer: Resilience, Regaining Control, Continuity-of-Self, and Social Connectedness. Filmed peer support that communicates these constructs will offer wide-ranging benefit to meet the needs of this group of men in both e-health and face-to-face self-management contexts. Further research could develop this theory-driven approach to filmed peer support for other cancer groups.

A Web-Based Intervention to Reduce Distress After Prostate Cancer Treatment: Development and Feasibility of the Getting Down to Coping Program in Two Different Clinical Settings

Background Distress after prostate cancer treatment is a substantial burden for up to one-third of men diagnosed. Physical and emotional symptoms and health service use can intensify, yet men are reticent to accept support. To provide accessible support that can be cost effectively integrated into care pathways, we developed a unique, Web-based, self-guided, cognitive-behavior program incorporating filmed and interactive peer support. Objective To assess feasibility of the intervention among men experiencing distress after prostate cancer treatment. Demand, acceptability, change in distress and self-efficacy, and challenges for implementation in clinical practice were measured. Methods A pre-post, within-participant comparison, mixed-methods research design was followed. Phase I and II were conducted in primary care psychological service and secondary care cancer service, respectively. Men received clinician-generated postal invitations: phase I, 432 men diagnosed <5 years; phase II, 606 men diagnosed <3.5 years. Consent was Web-based. Men with mild and moderate distress were enrolled. Web-based assessment included demographic, disease, treatment characteristics; distress (General Health Questionnaire-28); depression (Patient Health Questionnaire-9); anxiety (General Anxiety Disorder Scale-7); self-efficacy (Self-Efficacy for Symptom Control Inventory); satisfaction (author-generated, Likert-type questionnaire). Uptake and adherence were assessed with reference to the persuasive systems design model. Telephone interviews explored participant experience (phase II, n=10); interviews with health care professionals (n=3) explored implementation issues. Results A total of 135 men consented (phase I, 61/432, 14.1%; phase II, 74/606, 12.2%); from 96 eligible men screened for distress, 32% (30/96) entered the intervention (phase I, n=10; phase II, n=20). Twenty-four completed the Web-based program and assessments (phase I, n=8; phase II, n=16). Adherence for phase I and II was module completion rate 63% (mean 2.5, SD 1.9) versus 92% (mean 3.7, SD 1.0); rate of completing cognitive behavior therapy exercises 77% (mean 16.1, SD 6.2) versus 88% (mean 18.6, SD 3.9). Chat room activity occurred among 63% (5/8) and 75% (12/16) of men, respectively. In phase I, 75% (6/8) of men viewed all the films; in phase II, the total number of unique views weekly was 16, 11, 11, and 10, respectively. The phase II mood diary was completed by 100% (16/16) of men. Satisfaction was high for the program and films. Limited efficacy testing indicated improvement in distress baseline to post intervention: phase I, P=.03, r=−.55; phase II, P=.001, r=−.59. Self-efficacy improved for coping P=.02, r=−.41. Service assessment confirmed ease of assimilation into clinical practice and clarified health care practitioner roles. Conclusions The Web-based program is acceptable and innovative in clinical practice. It was endorsed by patients and has potential to positively impact the experience of men with distress after prostate cancer treatment. It can potentially be delivered in a stepped model of psychological support in primary or secondary care. Feasibility evidence is compelling, supporting further evaluative research to determine clinical and cost effectiveness.