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Title: Cancer survivorship : the development of a psychoeducational intervention to improve quality of life in women after treatment for gynaecological cancers
Author: Randolph-Stephens, Anuska S.
ISNI:       0000 0004 7960 9037
Awarding Body: University of Surrey
Current Institution: University of Surrey
Date of Award: 2019
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The impact of gynaecological cancers is multifaceted. Whilst many women enjoy good quality of life post treatment, a significant minority continue to experience poor emotional and physical wellbeing. Ineffective management of these consequences in follow-up care leads to lack of support and information contributing to ongoing unmet needs. This thesis explores the experience of women in the survivorship phase and efficacy of a psychosocial intervention to improve quality of life. Six studies were carried out. Study 1 (N=150), a Service Evaluation using the Holistic Needs Assessment (HNA), indicates women diagnosed with gynaecological cancers have heterogeneous concerns across the cancer trajectory, with varying levels of distress. Study 2, a systematic review of psychosocial interventions demonstrates promising results for use in women with gynaecological cancers, with most effective studies using relaxation or counselling/CBT techniques. Study 3 (N=49), a feasibility study, showed health and wellbeing events (HWE) were well received by patients and women intended to make behavioural changes post intervention. In study 4 (N=7), a focus group explored the experience of attending a HWE and, using thematic analysis, four themes emerged: 1) Sharing and validation of experience, (2) Individual and specific information, (3) Adjusting to a new self, (4) Behaviour change. Study 5 (N=216), a quasi-experimental design study on HWE's indicated short-term improvements in social functioning, increases in fruit consumption, and trend for improvement in physical activity, yet a reduction in perceived social support and increase in depression; whilst long-term improvements in emotional/social/cognitive functioning, fatigue and financial difficulties were seen, increases in vegetable consumption, and the intervention may protect against depression and decreased resilience over time. In study 6 (N=12) focus group data explored patients' experience of attending the HWE and thematic analysis revealed four themes: (1) Support; (2) Timing; (3) Reticence; (4) Understanding disease and the cancer experience. In summary, the results from this thesis suggest benefits in the use of health and wellbeing event interventions in a gynaecological cancer sample. However, further research is required to identify key intervention components suitable in this sample. Additional strategies may need to be considered to meet the unmet needs and ongoing physical and psychological sequelae these women face.
Supervisor: Cropley, Mark ; Fife-Schaw, Christopher ; Banerjee, Susana Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral