Maintaining psychosocial wellbeing for post-treatment haematological cancer survivors: Strategies and potential barriers
Introduction
Haematological cancers are a diverse group of cancers, which differ markedly in their progression and prognosis, resulting in varying approaches to treatment and treatment intensity (National Institute for Clinical Excellence, 2003). The most aggressive therapies can cause both late and long term physical and psychosocial effects that can appear years after treatment ends (Klemm, 2008). It is therefore surprising that a review conducted by the authors (Raphael et al., 2017) found a paucity of studies that focus on psychosocial issues among post-treatment haematological cancer survivors. The limited evidence there is available demonstrates that haematological cancer survivors may experience a number of psychological and social problems such as anxiety and depression (Molassiotis et al., 2011), distress and poorer quality of life (Korszun et al., 2014).
Worldwide, haematological cancers are the fourth most diagnosed cancer in economically developed countries (Smith et al., 2011) and in New Zealand, where the study presented in this paper is set, approximately 1500 people are diagnosed with haematological cancer each year (Ministry of Health, 2014). A key issue for post-treatment survivors is that they are less likely than those in treatment to have frequent contact with health professionals who may be able to monitor and assist with concerns (Parry et al., 2010). Furthermore, there is evidence that limited attention is paid to psychosocial needs during follow-up appointments (Recklitis and Syrjala, 2017). Therefore it is important to identify those factors that affect psychosocial wellbeing for post-treatment survivors. The aim of this research was to explore the strategies used by haematological cancer survivors to maintain psychosocial wellbeing in the post-treatment period, and examine the barriers they identify to maintaining wellbeing. For the purpose of this study post-treatment haematological cancer survivors are considered those who had completed treatment and were currently in remission.
Section snippets
Sample
Ethical approval for this research was granted by the Southern Health and Disability Ethics Committee. (Ref: 15/STH/82). Participants were recruited through the New Zealand Cancer Registry (NZCR). The NZCR provided a data base with the names and addresses of all people diagnosed with a haematological cancer between July 2007–July 2015. Recruitment was targeted at those who had finished their primary treatment within 5 years or less. This period was chosen because it is within this time frame
Results
Interviews were conducted with 23 participants from all around New Zealand (Table 1.). Participants ranged in age from 33 to 77 years. The majority of participants were NZ European (52%), and had Non-Hodgkin's Lymphoma (61%). Participants reported being between two and eight year's post-treatment (mean 4.1 years) at the time of the interview. Eighteen participants fell within the previously discussed 0–5 year post-treatment range, and there were five participants who had completed treatment 6–8
Discussion
This study explored the strategies haematological cancer survivors use to maintain psychosocial wellbeing in the post-treatment period, and also examined the barriers they face when trying to maintain wellbeing. This paper makes an important contribution to understanding the psychosocial issues experienced by post-treatment haematological cancer survivors and their perceptions of the support they need to deal with these issues. Overall, we identified a gap in current support, particularly for
Conclusion
Haematological cancer survivors have their own set of unique psychosocial needs that carry through to the post-treatment period. Many of the participants in this study had ready support from family and friends, and those with strong support from family and friends reported needing less psychosocial support from other sources. However, those who needed more psychosocial support did not always receive it, or know where to find it. The key barriers to this type of support were informational gaps
Conflicts of interest
We wish to confirm that there are no known conflicts of interest associated with this publication and there has been no significant financial support for this work that could have influenced its outcome.
References (36)
- et al.
Experiences of inner strength in critically ill patients – a hermeneutical approach
Intensive Crit. Care Nurs.
(2012) - et al.
A qualitative study of the post-treatment experiences and support needs of survivors of lymphoma
Eur. J. Oncol. Nurs.
(2017) - et al.
Provision of integrated psychosocial services for cancer survivors post-treatment
Lancet Oncol.
(2017) - et al.
Perceived helpfulness and impact of social support provided by family, friends, and health care providers to women newly diagnosed with breast cancer
Psycho Oncol.
(2007) - et al.
Like a cleansing fire: exploring the impact of short-term support groups for women with breast cancer
J. Psychosoc. Oncol.
(2003) - et al.
Interviewing by telephone: specific considerations, opportunities, and challenges
Int. J. Qual. Methods
(2012) - et al.
Using thematic analysis in psychology
Qual. Res. Psychol.
(2006) - et al.
Successful Qualitative Research: a Practical Guide for Beginners
(2013) - et al.
Survivorship care plans in cancer: a systematic review of care plan outcomes
Br. J. Canc.
(2014) - et al.
What is the ideal support group? Views of Australian people with cancer and their carers
Psycho Oncol.
(2007)
Survivorship care provision for patients with hematologic malignancies: the quest for quality evidence
Cancer Nurs.
Inner strength in women recovering from coronary artery disease: a grounded theory
J. Theor. Construct. Test.
The role of inner strength in quality of life and self-management in women survivors of cancer
Res. Nurs. Health
Perspectives on psychosocial and spiritual cancer support services in New Zealand
J. Psychosoc. Oncol.
Code saturation versus meaning saturation: how many interviews are enough?
Qual. Health Res.
Ongoing care of patients after primary treatment for their cancer
CA A Cancer J. Clin.
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PhD Student, School of Nursing, The University of Auckland.
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- 3
Professor of Health Sciences, School of Nursing, The University of Auckland.