Joanne Brown

The effectiveness of patient-family carer (couple) intervention for the management of symptoms and other health-related problems in people affected by cancer: a systematic literature search and narrative review

CONTEXT Cancer is widely acknowledged to impact on the whole family. Yet, we do not know if there is benefit (or harm) from patient-family carer interventions in the context of cancer care. OBJECTIVES To report a systematic search for and narrative review of patient-family carer interventions tested in the context of cancer care for effect on symptoms and other health-related problems in patients and/or their family members. METHODS A systematic literature search was carried out using Cochrane principles. Searches were of MEDLINE, EMBASE, PsycINFO, and CINAHL databases for reported trials of patient-family carer focused interventions. Outcomes of interest were health indicators; measures of physical, psychological, social, and quality-of-life status of the patient and/or family member(s). Limits were English language; 1998 to March 2010; and adults. Relevant information was extracted, quality assessed using the Cochrane Collaborations tool for assessing risk of bias, and presented as a narrative synthesis (meta-analysis was not appropriate). RESULTS The review found no empirically tested interventions for family groups (patient and two or more family members), but 22 interventions for patient-family carer partnerships (couple interventions) tested in 23 studies and reported in 27 publications. Recruitment and attrition were problematic in these studies, limiting the reliability and generalizability of their results. CONCLUSION In the trials of cancer couple interventions included in the review, a pattern emerged of improvement in the emotional health of cancer patients and their carers when the intervention included support for the patient-family carer relationship. Further investigation is warranted.

Reflexivity in the Research Process: Psychoanalytic Observations

This paper highlights what psychoanalysis can add to discussions of reflexivity, by specifically describing how reflexivity is conceptualized and fostered on psychoanalytic observation methods courses at the Tavistock Clinic, London. It is demonstrated that this psychological form of reflexivity is relevant to empirical and conceptual work and shown that it shares interesting parallels with debates about reflexivity in social research methods, while also being able to contribute to discussions of what constitutes reflexivity and what kinds of methods course might facilitate it. Reflexivity is often discussed in relation to a researcher’s empirical work, but this paper argues that reflexivity is equally needed in relation to the academic context in which most research and learning takes place. This paper demonstrates how psychoanalytic approaches to learning stimulate a reflexive relation to empirical and conceptual work and it provides examples of reflexivity from a two‐year infant observation and a research project on romantic love (involving conceptual and biographical research).

How money talks

In the introduction to How Money Talks, Lesley Murdin explains that her interest in the emphasis placed on money and in the ethics of acquiring wealth in consumer society was sparked by the global ...