scholarly journals Mindfulness-Based Cognitive Therapy for Cancer Patients Delivered via Internet: Qualitative Study of Patient and Therapist Barriers and Facilitators

2017 ◽  
Vol 19 (12) ◽  
pp. e407 ◽  
Author(s):  
Félix R Compen ◽  
Else M Bisseling ◽  
Melanie PJ Schellekens ◽  
Ellen TM Jansen ◽  
Marije L van der Lee ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Cognitive Therapy ◽  
Cancer Patients ◽  
Barriers And Facilitators

scholarly journals Mindfulness-Based Cognitive Therapy for Cancer Patients Delivered via Internet: Qualitative Study of Patient and Therapist Barriers and Facilitators (Preprint)

2017 ◽  
Author(s):  
Félix R Compen ◽  
Else M Bisseling ◽  
Melanie PJ Schellekens ◽  
Ellen TM Jansen ◽  
Marije L van der Lee ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Cognitive Therapy ◽  
Cancer Patients ◽  
Qualitative Content Analysis ◽  
Patient Characteristics ◽  
Barriers And Facilitators ◽  
Number Of Patients ◽  
Facilitators And Barriers ◽  
The Individual ◽  
Living With Cancer

BACKGROUND The number of patients living with cancer is growing, and a substantial number of patients suffer from psychological distress. Mindfulness-based interventions (MBIs) seem effective in alleviating psychological distress. Unfortunately, several cancer patients find it difficult, if not impossible, to attend a group-based course. Internet-based MBIs (eMBIs) such as Internet-based mindfulness-based cognitive therapy (eMBCT) may offer solutions. However, it is yet to be studied what facilitators and barriers cancer patients experience during eMBCT. OBJECTIVE This study aimed to explore facilitators and barriers of individual asynchronous therapist-assisted eMBCT as experienced by both patients and therapists. METHODS Patients with heterogeneous cancer diagnoses suffering from psychological distress were offered eMBCT. This 9-week intervention mirrored the group-based MBCT protocol and included weekly asynchronous written therapist feedback. Patients were granted access to a website that contained the eMBCT protocol and a secured inbox, and they were asked to practice and fill out diaries on which the therapist provided feedback. In total, 31 patients participated in an individual posttreatment interview on experienced facilitators and barriers during eMBCT. Moreover, eight therapists were interviewed. The data were analyzed with qualitative content analysis to identify barriers and facilitators in eMBCT. RESULTS Both patients and therapists mentioned four overarching themes as facilitators and barriers: treatment setting (the individual and Internet-based nature of the treatment), treatment format (how the treatment and its guidance were organized and delivered), role of the therapist, and individual patient characteristics. CONCLUSIONS The eMBCT provided flexibility in when, where, and how patients and therapists engage in MBCT. Future studies should assess how different eMBCT designs could further improve barriers that were found.

scholarly journals Barriers and Facilitators to Implementing a Stepped Care Cognitive-behavioral Therapy for Insomnia in Cancer Patients: a Qualitative Study.

2021 ◽  
Author(s):  
Josée Savard ◽  
Catherine Filion ◽  
Marie-Pierre Gagnon ◽  
Aude Caplette-Gingras ◽  
Lynda Bélanger ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Cognitive Behavioral Therapy ◽  
Cancer Patients ◽  
Cancer Care ◽  
Behavioral Therapy ◽  
Stepped Care ◽  
Barriers And Facilitators ◽  
Cognitive Behavioral ◽  
Successful Implementation ◽  
Web Based

Abstract Purpose: Insomnia affects 30-60% of cancer patients and tends to become chronic when left untreated. While cognitive-behavioral therapy for insomnia (CBT-I) is the recommended first-line treatment, this intervention is not readily accessible. This qualitative study investigated current practices in the assessment and management of insomnia in five hospitals offering cancer care and identified the barriers and facilitators to the implementation of a stepped care CBT-I (i.e., web-based CBT-I followed, if needed, by 1-3 booster sessions) in these settings. Methods: Nine focus groups composed of a total of 43 clinicians (e.g., physicians, nurses, technologists, psychologists), six administrators, and 10 cancer patients were held. The Consolidated Framework for Implementing Research (CFIR) was used to develop the semi-structured interview and analyze the data. Results: Sleep difficulties are not systematically discussed in clinical practice and when a treatment is offered, most often, it is a pharmacological one. Barriers and facilitators to the implementation of a stepped care CBT-I included individual characteristics (e.g., lack of knowledge about CBT-I); intervention characteristics (e.g., increased accessibility offered by a web-based format); inner setting characteristics (e.g., resistance to change); and process factors (e.g., motivation to offer a new service). Conclusions: This qualitative study confirms the need to better address insomnia in routine cancer care and suggests that, while some barriers were mentioned, the implementation of a stepped care CBT-I is feasible. Keys to a successful implementation include accessibility, training, inclusion of stakeholders in the process, and ensuring that they are supported throughout the implementation.

A qualitative study informing about barriers and facilitators associated to chemotherapy initiation among breast cancer patients: Next steps for an intervention.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 247-247
Author(s):  
Mariana Chavez Mac Gregor ◽  
Ashley Housten ◽  
Edna Paredes ◽  
Catalina Malinowski ◽  
Cassandra Harris ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Qualitative Study ◽  
Cancer Patients ◽  
Self Efficacy ◽  
Barriers And Facilitators ◽  
System Level ◽  
Breast Cancer Patients ◽  
Neo Adjuvant Chemotherapy ◽  
Chemotherapy Initiation

247 Background: (Neo)Adjuvant chemotherapy decreases the risk of recurrence and improves overall survival among breast cancer patients; however, delays in chemotherapy initiation are associated with adverse outcomes. The causes of delay are complex and include interrelated social, economic, cultural, environmental, and health system factors . Project Start was a qualitative study designed to assess and identify the multilevel factors contributing to the barriers and facilitators of chemotherapy initiation. Methods: English or Spanish-speaking women, ≥18 years, diagnosed with primary invasive breast cancer experiencing (neo)-adjuvant chemotherapy initiation delay ( ≥60 days) were included. Participants completed semi-structured interviews designed to explore perceptions about individual, community, and system-level barriers and facilitators contributing to chemotherapy initiation. Interviews were audio-recorded, transcribed verbatim, and coded using the Sort and Sift, Think and Shift qualitative approach to identify concepts and themes within and across transcripts. To supplement qualitative data, sociodemographic data and health literacy/numeracy, physician trust, and social support questionnaires were obtained. Results: Participants (n = 22) identified as: Latina (n = 8); Black (n = 5); and non-Latina White (n = 9). While the interview guide included questions addressing chemotherapy delays, explicit insight into chemotherapy delay was rare. Participants described barriers and facilitators at the patient, family, medical, and community levels. Barriers at the patient level included patient’s hesitancy to initiate chemo due to shock, fear, and denial. Within the family level, we learned of participant’s family roles (e.g., caregiving, income), treatment costs, and the need for emotional support (e.g., not shutting family members out). Participants sought out and relied heavily on support from their communities (e.g., churches, other patients, survivors). Patients described their reliance on the medical team for information, the trust needed to navigate their treatment process, and the challenge of managing information associated with their treatment. Participants described the importance of self-efficacy to take an active role in treatment. Conclusions: Project Start is informing the design of a pilot study aimed to test the acceptability and feasibility of a navigation intervention. Using facilitators and barriers identified from Project Start, we are developing a checklist that will serve as a tool to identify the support each patient needs. Once areas of need are identified, appropriate referrals will be made in a personalized and culturally sensitive way with the goal of increasing self-efficacy and activating patients to avoid treatment delays.

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