Transcript Psychological well-being among carers of survivors of

Martin Dempster1, Noleen McCorry2, Emma
Brennan1, Michael Donnelly3, Liam Murray3, Brian
Johnston4
1School
of Psychology, Queen’s University Belfast;
2Marie Curie Cancer Care, Belfast
3Centre for Public Health, Queen’s University Belfast;
4Belfast Health & Social Care Trust
Project Funded by Action Cancer
Facilitated by the Oesophageal Patients’
Association
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
An approach that is relevant to the
psychological needs of people who have
received a diagnosis of oesophageal cancer
and their carers
A therapeutic intervention that is not
resource-intensive
Survey at 2
points in time
Focus
groups
Development
of intervention
2006 2007 - 2010 2011 2014
Interviews
Publication of
findings
Testing of
intervention
Beliefs about
Illness /
Condition
Coping
Strategies
Appraisal of
Outcome
Cognitions
Demographic
Interpersonal
•Age
•Social support
•Psychiatric history
•Carer
Medical
•Disease course
•Treatment
•Pain
•Stage / grade
Personality
Psychological
Distress
•Optimism
•Neuroticism
•Fatalism
Cognitions
Psychological
Distress
Ways of
Coping
Beliefs
Illness
Perceptions
Questionnaire Revised
Cause
Timeline
Control
Consequences
Coherence
Reflect / relax
Positive focus
Diversion
Planning
Interpersonal
support
Levels of:
Anxiety and Depression
Cancer
Coping
Questionnaire
Hospital Anxiety and
Depression Scale
Fear of Recurrence
Scale
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
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To determine which beliefs / coping
strategies are strongest predictors of
anxiety/depression among people diagnosed
with oesophageal cancer and their carers
To determine whether incongruence in carerpatient beliefs is related to distress (i.e. is the
relationship between patient beliefs and
distress moderated by carer beliefs)
To determine whether coping strategies
mediate the relationship between beliefs and
distress
Survivors of
oesophageal
cancer
People identified
as carers
Number
458
382
Average age
65
62
Gender
66% male
75% female
91% were the spouse
or partner of the
person they cared for
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
Anxiety
Survivors
Mild
16%
Moderate Severe
11%
8%
Carers
20%
19%
11%
Depression
Mild
Survivors 13%
Carers
15%
Moderate Severe
7%
3%
8%
2%
Similar to head/neck cancer but higher than other
cancers
Potential
Survivors
Carers
Midpoint
Mean (SD)
Mean (SD)
IPQ Acute/chronic timeline
18
23.30 (4.68)
23.03 (4.80)
IPQ Cyclical timeline
14
12.12 (3.65)
12.23 (3.42)
IPQ Treatment control
15
17.17 (3.64)
16.77 (3.53)
IPQ Emotional cause
15
12.12 (3.99)
12.52 (3.83)
IPQ Behavioural cause *
12
10.43 (3.72)
9.98 (3.72)
IPQ Externalised cause
12
14.90 (3.55)
15.08 (3.32)
IPQ Consequences ***
18
21.10 (4.82)
22.19 (4.66) (for survivor)
IPQ Consequences ***
18
21.10 (4.82)
12.65 (3.20) (for self)
IPQ Personal control ***
18
20.05 (4.91)
18.90 (4.74) (for survivor)
IPQ Personal control ***
18
20.05 (4.91)
16.07 (4.13) (for self)
IPQ Illness coherence
15
19.37 (4.28)
19.22 (3.85) (for survivor)
IPQ Illness coherence
15
19.37 (4.28)
19.30 (4.04) (for self)
Anxiety
R2 = 0.57:
Medical/demographic variables – 12%
Beliefs – 37%; Coping – 7%

Depression
R2 = 0.53:
Medical/demographic variables – 12%
Beliefs – 35%; Coping – 6%
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Personal
control
Positive
focus
Illness
coherence
No reflection or
diversion
No other
illnesses
Older
Treatment
control (carer)
Consequences
Lower
Anxiety
Interaction
Illness
coherence
Personal
control
Positive
focus
No related
symptoms
No reflection
No other
illnesses
Time
since
diagnosis
Treatment
control (carer)
Consequences
Lower
Depression
Interaction
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Interventions at the level of the dyad could
be useful
Focus on consequences, control and
understanding of oesophageal cancer and
encourage positive focus coping strategies
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Development of intervention based on these
cognitions
Possible techniques: normalising the lack of
personal control and emotional distress,
avoid catastrophising, psychoeducation to
improve understanding, positive self-talk
Planned feasibility study, leading to trial