Mental health needs in patients with advanced cancer implications for Primary Health Care teams
Contact - Dr Joanne Reeve; joanne.reeve@liv.ac.uk; 0151 794 5609
Academic Lead(s)
CFD/MLW
Researchers
Joanne Reeve
Project Status
Ongoing (end - 30/11/06)
Funding
DoH Primary Care Researcher Development Award £221,066
Aim
- To determine the prevalence of depression in patients with advanced metastatic cancer in a primary care setting
- To explore the impact and meaning of mental health problems for patients with advanced cancer, together with their experiences of dealing with the problems
- To identify areas of overlap and discordance between expert and self-defined mental health needs
Method
- A two stage community survey of patients with advanced metastatic cancer identified from GP Practices across Liverpool to identify the prevalence of depression. Measurement tools: Edinburgh Depression Scale (EDS, stage 1); revised Clinical Interview Schedule (CIS-r, stage 2)
- In-depth interviews with a purposive sample of patients to explore individual experience and meaning of mental and emotional health problems. Analysis: modification of the phenomenographic method described by Marton
Results
111 eligible patients have been identified to date; 55 (50%) have responded to the invitation to join the study. Although 12 (24%) were identified as high risk on the EDS, only 1 has been identified as having depression on the CIS-r.
Preliminary analysis of 14 interviews reveals evidence of 3 patterns of response to a terminal diagnosis: negative biographical disruption, biographical flow and positive biographical disruption. Each is associated with an emotional response which contributes to the biographical story. Depressive symptoms are common but often included as part of the narrative of finding meaning, rather than something abnormal or inappropriate.
Conclusions
Data collection is ongoing to refine the emerging themes. Final results are expected in November 2006.
Published Papers
Reeve J, Lloyd-Williams M, Dowrick CF, Payne S. Linking stories and emotions in patients with advanced metastatic cancer. Family Practice 2005; 22(Supplement 1): 15
Conference Presentations
Oral presentations
Reeve J, Lloyd-Williams M, Payne S, Dowrick CF. Linking stories and emotions in patients with advanced metastatic cancer. Society for Academic Primary Care annual meeting, July 2005
Reeve J, Lloyd-Williams M, Dowrick Cf, Payne S. Emotional health needs of patients with advanced metastatic cancer: implications for primary health care teams. Palliative Care Research Society Scientific Meeting, June 2005.
Posters
Reeve J, Lloyd-Williams M, Dowrick CF, Payne S. Making sense of emotional responses to a terminal diagnosis of cancer. Academic Palliative Care Study Group meeting, Liverpool April 2005.
Reeve J, Dowrick CF, Lloyd-Williams M. Mental health needs in patients with advanced cancer: implications for primary health care teams (Work in progress). Medical Research Society Clinician Scientists in Training meeting, February 2005.
Reeve J, Lloyd Williams M, Dowrick CF. Mental health needs in patients with advanced cancer – implications for primary health care teams. Society for Academic Primary Care annual meeting, July 2004.
Accepted abstracts - forthcoming poster presentations
Reeve J, Lloyd-Williams M, Payne S, Dowrick CF. Linking stories and emotions in patients with advanced metastatic cancer. North American Primary Care Research Group Annual meeting, October 2005.
Reports: None as yet - expected Oct-Nov 2006