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 Development of the therapeutic alliance and its association with treatment outcome in internet-based Mindfulness-Based Cognitive Therapy (eMBCT) compared to group-based MBCT (MBCT) for distressed cancer patients (Preprint)

2019 ◽  
Author(s):  
Else Bisseling ◽  
Linda Cillessen ◽  
Philip Spinhoven ◽  
Melanie Schellekens ◽  
Félix Compen ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Psychological Distress ◽  
Therapeutic Alliance ◽  
Cognitive Therapy ◽  
Cancer Patients ◽  
Psychological Treatment ◽  
Well Being ◽  
Post Treatment ◽  
Treatment Dropout ◽  
Mental Well Being

BACKGROUND Mindfulness-Based Cognitive Therapy (MBCT) is an evidence-based group-based psychological treatment in oncology, resulting in reduction of depressive and anxiety symptoms. Internet-based Mindfulness-based Cognitive Therapy (eMBCT) has been found to be an effective alternative for MBCT. The therapeutic alliance, i.e. the bond between therapist and patient, is known to have a significant impact on psychological treatment outcomes, including MBCT. A primary concern in the practice of eMBCT is whether a good therapeutic alliance can develop. Although evidence for the beneficial effect of therapist-assistance on treatment outcome in internet-based interventions (IBIs) is accumulating, it is still unclear whether the therapeutic alliance is related to outcome in IBIs. OBJECTIVE The objectives of the present study were: (1) to explore whether early therapeutic alliance predicts treatment dropout in (e)MBCT; (2) to compare the development of the therapeutic alliance during eMBCT and MBCT; and (3) to examine whether early therapeutic alliance is a predictor of the reduction of psychological distress and the increase of mental well-being at post-treatment in both conditions. METHODS The present study was part of a multicentre randomized controlled trial (RCT; n=245) on the effectiveness of (e)MBCT for distressed cancer patients. The therapeutic alliance was measured at the start of week 2 (i.e. early therapeutic alliance), week 5 and week 9. Outcome measures were psychological distress, measured with the Hospital Anxiety and Depression Scale (HADS) and mental-wellbeing, measured with the Mental Health Coninuum-short form (MHC-SF). RESULTS The strength of early therapeutic alliance did not predict treatment dropout in (e)MBCT (B=-0.39, p=.21). Therapeutic alliance increased over time in both conditions (F=16.46,Wilks’ λ=.732, p<.001). This increase did not differ between eMBCT and MBCT (F=0.114, p=.74). Therapeutic alliance at week 2 predicted a reduction of psychological distress (B=-.126, t=-2.656, p=.01) and an increase of in mental well-being (B=.234, t=2.651, p=.01) at post-treatment. The relationship with reduction of psychological distress differed between treatments: a weaker early therapeutic alliance predicted higher psychological distress at post-treatment in MBCT but not in eMBCT(B=.217, t=2.261, p=.03). CONCLUSIONS A therapeutic alliance can develop in both eMBCT and MBCT. Findings revealed that the strength of early alliance did not predict treatment dropout. Furthermore, the level of therapeutic alliance predicted reduced psychological distress and increased mental well-being at post-treatment in both conditions. Interestingly, the strength of therapeutic alliance is appeared to be more related to treatment outcome in group-based MBCT than in eMBCT. CLINICALTRIAL NCT02138513 https://clinicaltrials.gov/ct2/show/NCT02138513

scholarly journals Role of Mindfulness‐Based Cognitive Therapy in Alleviating Psychological Distress among Cancer Patients

2014 ◽  
Vol 2 (1) ◽  
Author(s):  
Fatemeh Abdollahi ◽  
Prof. Mahmood S. Khan
Keyword(s):  
Psychological Distress ◽  
Cognitive Therapy ◽  
Cancer Patients ◽  
Psychological Problem ◽  
Complex Problem ◽  
Research Literature ◽  
Behavioral Approach ◽  
World Health ◽  
Health Organization

The purpose of this research was to examine the research literature on role of Mindfulness-Based Cognitive Therapy in alleviating psychological distress among cancer patients. World Health Organization and medical experts have expressed alarm about constantly the growing problem of cancer patients in the world. The researcher emphasize that the diagnosis of cancer not only has obvious physical ramifications for the patient, but also the trauma of a diagnosis produces psychological problem such as somewhat hardly manageable distress as well, and in the face of psychological stressors that negatively impact the patient’s overall quality of life. The present study examined the results of various studies, for identifying the potential efficacy of MBCT as it could be applied to patients with cancer which presents psychological distress. Research on Mindfulness-Based Cognitive Therapy has supported the safety and effectiveness of this approach might be used with distress associated problems among cancer patients also other studies obtained results signified the effectiveness of this therapy while dealing with cancer patients showed significant impact in alleviating different type of problems associated with this disease. It suggests need for a comprehensive solution that combines medical, psychological, social and behavioral approach to this complex problem in initiating the distress of cancer patients.

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 The perceptions of nurses, patients and family members regarding nurses' empathetic behaviours towards patients suffering from cancer: a descriptive qualitative study

2018 ◽  
Vol 23 (5) ◽  
pp. 428-443 ◽  
Author(s):  
Elaheh Ashouri ◽  
Fariba Taleghani ◽  
Mehrdad Memarzadeh ◽  
Morteza Saburi ◽  
Fatemeh Babashahi
Keyword(s):  
Content Analysis ◽  
Psychological Distress ◽  
Qualitative Study ◽  
Cancer Patients ◽  
Nursing Care ◽  
Qualitative Content Analysis ◽  
Family Members ◽  
Oncology Nurses ◽  
Inductive Approach ◽  
Depth Interviews

Background Although evidence suggests that empathic behaviour is an essential component in nursing care that affects the psychological distress experienced by cancer patients, it remains a neglected issue in nursing in Iran. Methods: This study was conducted on 33 participants selected through purposive sampling. Data were collected using in-depth interviews and were then analysed using qualitative content analysis with an inductive approach. Findings: Three categories of data thus emerged, comprising: (a) empathetic attention; (b) empathetic presence; and (c) the facilitators of empathetic behaviour. Conclusions: The findings can help oncology nurses provide more empathetic care to patients and their family members.

Effects of Intraoral Prostheses on Speech in Oropharyngeal Cancer Patients

1996 ◽  
Vol 5 (4) ◽  
pp. 43-55 ◽  
Author(s):  
Laura A. Colangelo ◽  
Barbara Roa Pauloski ◽  
Jerilyn A. Logemann ◽  
David W. Stein ◽  
Quinter C. Beery ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Soft Palate ◽  
Oropharyngeal Cancer ◽  
Speech Intelligibility ◽  
Patient Characteristics ◽  
Tongue Base ◽  
Speech Language Pathologist ◽  
The Individual ◽  
Obturator Prosthesis ◽  
Posterior Tongue

This study investigates specific articulatory problems and compromised speech intelligibility associated with and without the use of an intraoral prosthesis in 13 surgically treated oropharyngeal cancer patients. Ten patients had tonsil and varying amounts of posterior tongue, tongue base, and soft palate resected. Three other patients had soft palate resected with no involvement of oral tongue or tongue base. Three types of intraoral prostheses were employed. One type was a maxillary reshaping/lowering prosthesis, the second type was a soft palate obturator, and the third type was a combined maxillary reshaping/lowering and soft palate obturator prosthesis. Review of the individual cases in relation to improvements in articulation and conversational understandability revealed mixed success with prosthesis usage in the group of 10 patients with posterior resection. In the group of three patients with soft palate resection, however, two patients benefitted from use of obturators. The results identify the need for some criteria in patient selection for intraoral prosthetic rehabilitation. However, in view of the individuality of each patient case in terms of surgical deficit, patient characteristics, and varied prosthodontic/speech-language pathologist teams, it is impossible to develop prescriptions for prosthodontic construction based on surgical deficit alone.

scholarly journals ‘Stolen Time’—Delivering Nursing at the Bottom of a Hierarchy: An Ethnographic Study of Barriers and Facilitators for Evidence-Based Nursing for Patients with Community-Acquired Pneumonia

Healthcare ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1524
Author(s):  
Signe Eekholm ◽  
Karin Samuelson ◽  
Gerd Ahlström ◽  
Tove Lindhardt
Keyword(s):  
Professional Identity ◽  
Qualitative Content Analysis ◽  
Healthcare Setting ◽  
Community Acquired Pneumonia ◽  
Ethnographic Study ◽  
Barriers And Facilitators ◽  
Evidence Based ◽  
Main Theme ◽  
Changing Practices ◽  
The Individual

The research has reported a high prevalence of low-quality and missed care for patients with community-acquired pneumonia (CAP). Optimised nursing treatment and care will benefit CAP patients. The aim of this study was to describe the barriers and facilitators influencing registered nurses’ (RNs’) adherence to evidence-based guideline (EBG) recommendations for nursing care (NC) for older patients admitted with CAP. Semi-structured focus group interviews (n = 2), field observations (n = 14), and individual follow-up interviews (n = 10) were conducted in three medical units and analysed by a qualitative content analysis. We found a main theme: ‘‘stolen time’—delivering nursing at the bottom of a hierarchy’, and three themes: (1) ‘under the dominance of stronger paradigms’, (2) ‘the loss of professional identity’, and (3) ‘the power of leadership’. These themes, each comprising two to three subthemes, illustrated that RNs’ adherence to EBG recommendations was strongly influenced by the individual RN’s professionalism and professional identity; contextual barriers, including the interdisciplinary team, organisational structure, culture, and evaluation of the NC; and the nurse manager’s leadership skills. This study identified central factors that may help RNs to understand the underlying dynamics in a healthcare setting hindering and facilitating the performance of NC and make them better equipped for changing practices.

The impact of COVID-19 on delivery of systemic anti-cancer treatment in urological cancer patients: A comparison with 2019 data from Guy’s Cancer Center.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e17057-e17057
Author(s):  
Christina Karampera ◽  
Muhammad Khan ◽  
Beth Russell ◽  
Charlotte Moss ◽  
Maria J Monroy-Iglesias ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Severe Pneumonia ◽  
Patient Characteristics ◽  
Cancer Center ◽  
Cancer Type ◽  
Urological Cancer ◽  
Cancer Services ◽  
Number Of Patients ◽  
The Uk ◽  
The Impact

e17057 Background: The provision of cancer services has been strongly impacted by the outbreak of SARS-CoV-2. Our Cancer Centre in South-East London treats approximately 8,800 patients annually and is one of the largest Comprehensive Cancer Centres in the UK. When dealing with the second wave of COVID-19, it is important to further evaluate the safety of cancer treatments whilst balancing the risks of COVID-19 infection and complications. Here, we report on the patient/tumour characteristics of those patients undergoing SACT for a urological cancer diagnosis during the first wave, so as to help establish clinical guidelines for the management of these patients in a SARS-CoV-2 epidemic. Methods: All urological cancer patients receiving at least one SACT between 1st March- 31st May 2020 (COVID-19 period) were compared to the same timeframe in 2019. SARS-CoV2 infection was defined as a positive RT-PCR test; patients with symptoms or radiological changes alone were excluded. As part of Guy’s Cancer Cohort, we collected information on demographics, and cancer type, stage, and treatment. Results: A total of 455 patients (305 prostate, 102 renal, 38 bladder, and 10 testicular) received SACT in 2020 as compared to 535 (353 prostate, 129 renal, 37 bladder, and 15 testicular) in 2019 (15% overall decline). Patient characteristics in terms of demographics were fairly comparable, with 10% female patients in 2019 and 9% in 2020; 49% aged 70+ vs 45%; and 77% in the low socio-economic category vs 78%. There was an increase in patients with stage 4 (89% vs 95% in 2020) and a slight change in distribution of SACT types (2019 vs 2020): chemotherapy (18% vs 14%), immunotherapy (7% vs 10%), biological or targeted (63% vs 66%), combination of biological/targeted (6% vs 5%), other combinations (5% vs 5%). The proportion of SACT delivered as part of radical treatment declined from 3% to 0.2% in 2020. A total of 5 patients (1%) developed COVID-19 (2 prostate, 2 renal, and 1 bladder). All were male and aged 60+; three had 2+ comorbidities. One patient was on immunotherapy and four on biological or targeted treatment. Four patients had severe pneumonia and one died of their COVID-19 (bladder cancer). Conclusions: Whilst there was a decline of number of patients receiving SACT during COVID-19, we were still able to provide a safe high-quality urological cancer SACT pathway during the peak of the COVID-19 pandemic, with very few COVID-19 positive patients. In a next step we will evaluate oncological outcomes at 6 months follow-up

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