Martin Dempster1, Noleen McCorry2, Emma Brennan1, Michael Donnelly3, Liam Murray3, Brian Johnston4
1School of Psychology, Queen’s University Belfast;2Marie Curie Cancer Care, Belfast 3Centre for Public Health, Queen’s University Belfast; 4Belfast Health & Social Care Trust
Project Funded by Action CancerFacilitated by the Oesophageal Patients’ Association
An approach that is relevant to the psychological needs of people who have received a diagnosis of oesophageal cancer and their carers
A therapeutic intervention that is not resource-intensive
Focus groups
Interviews
Survey at 2 points in time
Publication of findings
Development of intervention
Testing of intervention
Beliefs about Illness / Condition
Coping Strategies
Appraisal of Outcome
Beliefs
Cause Timeline Control ConsequencesCoherence
Ways of Coping
Reflect / relaxPositive focusDiversionPlanningInterpersonal support
Levels of:
Anxiety and Depression
Illness Perceptions Questionnaire - Revised
Cancer Coping Questionnaire
Hospital Anxiety and Depression ScaleFear of Recurrence Scale
To determine which beliefs / coping strategies are strongest predictors of anxiety/depression among people diagnosed with oesophageal cancer and their carers
To determine whether incongruence in carer-patient beliefs is related to distress (i.e. is the relationship between patient beliefs and distress moderated by carer beliefs)
To determine whether coping strategies mediate the relationship between beliefs and distress
Survivors of oesophageal cancer
People identified as carers
Number 458 382
Average age 65 62
Gender 66% male 75% female
91% were the spouse or partner of the person they cared for
Anxiety
Depression
Mild Moderate
Severe
Survivors 16% 11% 8%
Carers 20% 19% 11%
Mild Moderate
Severe
Survivors 13% 7% 3%
Carers 15% 8% 2%Similar to head/neck cancer but higher than other cancers
Potential
Midpoint
Survivors
Mean (SD)
Carers
Mean (SD)
IPQ Acute/chronic timeline 18 23.30 (4.68) 23.03 (4.80)
IPQ Cyclical timeline 14 12.12 (3.65) 12.23 (3.42)
IPQ Treatment control 15 17.17 (3.64) 16.77 (3.53)
IPQ Emotional cause 15 12.12 (3.99) 12.52 (3.83)
IPQ Behavioural cause * 12 10.43 (3.72) 9.98 (3.72)
IPQ Externalised cause 12 14.90 (3.55) 15.08 (3.32)
IPQ Consequences *** 18 21.10 (4.82) 22.19 (4.66) (for survivor)
IPQ Consequences *** 18 21.10 (4.82) 12.65 (3.20) (for self)
IPQ Personal control *** 18 20.05 (4.91) 18.90 (4.74) (for survivor)
IPQ Personal control *** 18 20.05 (4.91) 16.07 (4.13) (for self)
IPQ Illness coherence 15 19.37 (4.28) 19.22 (3.85) (for survivor)
IPQ Illness coherence 15 19.37 (4.28) 19.30 (4.04) (for self)
AnxietyR2 = 0.57: Medical/demographic variables – 12% Beliefs – 37%; Coping – 7%
DepressionR2 = 0.53: Medical/demographic variables – 12% Beliefs – 35%; Coping – 6%
Interventions at the level of the dyad could be useful
Focus on consequences, control and understanding of oesophageal cancer and encourage positive focus coping strategies
Development of intervention based on these cognitions
Possible techniques: normalising the lack of personal control and emotional distress, avoid catastrophising, psychoeducation to improve understanding, positive self-talk
Planned feasibility study, leading to trial
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