Teresa Corbett

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More than just a place to stay: Inis Aoibhinn residents' experiences of services at Cancer Care West. Report on qualitative research for service improvement

Feasibility and pilot testing of an online intervention for post-treatment cancer survivors

Background: Many post-treatment cancer survivors experience persistent fatigue that can disrupt a... more Background: Many post-treatment cancer survivors experience persistent fatigue that can disrupt attempts to resume normal everyday activities after treatment. Interventions to address these symptoms are therefore, of value. A theory-based intervention aimed to facilitate self-management and enhance coping with fatigue following cancer treatment was developed. The trial has been registered (ISRCTN55763085) and the protocol has been published. Methods: An 8-week cognitive–behavioural therapy intervention was designed based on a review of existing literature and qualitative research. Inductive qualitative research assessed the usability of the website. A 2-armed randomised controlled pilot trial assessed the feasibility of the online intervention . Forty participants were included for analysis at baseline (intervention N = 21, control N =19), and 24 filled out the follow-up questionnaire. A pilot trial is ongoing to assess the potential effectiveness of the online intervention Particip...

Health Psychology in the UK and Ireland

The European health psychologist, 2013

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The person-based approach in practice: Methods for intervention development

Psychosocial interventions for cancer-related fatigue in post-treatment cancer survivors: a systematic review of the literature

The European health psychologist, 2015

Cancer-related fatigue (CRF) is a persistent, distressing symptom that can extend into long-term ... more Cancer-related fatigue (CRF) is a persistent, distressing symptom that can extend into long-term survivorship. A systematic literature review using Cochrane methodology was conducted to evaluate psychosocial interventions to reduce fatigue in samples comprised exclusively of post-treatment cancer survivors. Databases were searched extensively and two authors independently screened titles and abstracts for their eligibility for inclusion. Randomised controlled trials which evaluated psychosocial interventions for adults with post –treatment CRF were included. Two authors independently extracted data using a standard data extraction form and assessed the risk of bias of selected studies. The search returned 6,380 papers. Following an assessment of the titles and abstracts, 12 papers remained. These included interventions employing CBT, sleep hygiene and psychoeducation techniques. The review highlighted heterogeneity in terms of sampling, methodology, and study quality. The findings s...

mHealth Research Group NUI Galway: Using mobile technologies for effective health behaviour change

The European health psychologist, 2015

ehps.net/ehp The European Health Psychologist mHealth (mobile health) is the practice of medicine... more ehps.net/ehp The European Health Psychologist mHealth (mobile health) is the practice of medicine, public health and allied healthcare or self-care supported by mobile devices (e.g. smartphones, tablet computers, wearable activity monitors). Among the world’s population of 7 billion there are over 5 billion mobile devices and over 90% of users have their mobile device near them 24 hours a day (European Commission, 2014). Mobile health apps have captured the public imagination allowing for unobtrusive self-monitoring and the dawn of the ‘quantified self’ movement as a potentially major aspect of health improvement (Commission for Communications Regulation, 2014). The development of these apps provides a unique opportunity for researchers in population health to track real-time, continuous, accurate and objective measures of health indices and related behaviour. Mobile devices provide a potentially very powerful platform for delivering behavioural interventions and providing health re...

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Development of a theory based online intervention for post-treatment cancer survivors

The European health psychologist, 2016

Background: This talk will outline the rationale, decision-making processes, methods and findings... more Background: This talk will outline the rationale, decision-making processes, methods and findings which led to the development of an online intervention to be tested in a feasibility trial. The theory-based, online intervention aimed to facilitate self-management and enhance coping with fatigue following cancer treatment. Methods: A review of existing literature was conducted and findings suggested that cognitive-behavioural therapy may be an effective intervention. Qualitative research indicated that using the Self-regulation Model to describe fatigue after cancer may provide an integrated theoretical model for developing interventions for fatigue based on cognitive–behavioural principles. The findings of the preparatory deductive and inductive research were collated to create a draft content manual and plan for the structure of the website. An iterative review process then took place with the design team examining the different sessions. Inductive qualitative research was conducte...

On the Road Again: the Impact of an Exercise Intervention on Wellbeing in a Clinical Sample: Preliminary Results

The European health psychologist, 2014

Background: There is significant evidence for the impact of exercise programmes on mental and phy... more Background: There is significant evidence for the impact of exercise programmes on mental and physical health, including individuals with mental health difficulties. On The Road Again is a personal development programme designed to deliver such a programme to vulnerable individuals. Methods: Baseline data was collected for 31 participants, follow-up data was collected for 12 at half-way point in programme (i.e. after 12 weeks of a running programme 3 times a week) Results: Results indicated that over half participants had BMI’s above 25 (i.e. overweight or obese). Sixty percent reported that they been diagnosed with anxiety, depression or both and 50% of participants did not rate their health as good. Follow-up data suggest that Social Support has increased from Time 1 (M= 12.31) to Time 2 (M= 16.46), t(12)= (-2.21, p<.05), fitness has increased (resting pulse) (M= 72.19 at T1, M= 68.13 at T2), t(15)=2.18, p=0.05). Positive trends were observed in exercise, self-efficacy and phys...

The development of an online intervention for post-treatment cancer survivors with cancer-related fatigue

Background The number of post-treatment cancer survivors in Ireland is set to increase in coming ... more Background The number of post-treatment cancer survivors in Ireland is set to increase in coming years, due to advances in screening and treatment. This group will require ongoing supportive care as many will experience persistent negative side-effects that can impair quality of life. Cancer-related fatigue (CrF) is the most common and disruptive symptom experienced by cancer survivors. Fatigue is extremely complex, and likely to involve the interaction of several physiologic and psychological mechanisms. Current evidence supports the use of nonpharmacological treatment strategies for reducing CrF. In order to develop evidencebased psychological interventions there is a need to understand the biological, psychological, and social contributors to positive adjustment in post-treatment cancer survivors. Online interventions have been shown to be an effective mode of delivery and can facilitate selfmanagement of long-term conditions. Aim This thesis will outline the rationale, decision-making processes, methods, and findings which led to the development of an online intervention that was tested in a feasibility trial. This theory-based intervention aimed to facilitate self-management and enhance coping with fatigue following cancer treatment. Methods The studies conducted in this research were based on the development phase of the UK Medical Research Council Framework for developing complex interventions. In the first study a systematic review and meta-analysis was conducted to identify the evidence base xiii List of Appendices See Volume II of thesis submitted for the Degree of Doctor of Philosophy Contents in Volume II Appendices Appendix 1. Characteristics of studies in systematic review Appendix 2. Subgroup Analyses from Systematic Review Appendix 3. Ethical Approval for Ph.D. Research Appendix 4. Press Release for Focus Groups Nurses/ psychologist Wait list Ritterband 2012 CBTinsomnia The development of an online intervention for post-treatment cancer survivors with cancer-related fatigue: Appendices

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Mobile health interventions to support long-term health conditions

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Crafting Stories:Workshop on Innovative Strategies for Writing Scientific Papers

Responding to Reviews, Including Rejection". The day long workshop took place on Tuesday 1st Sept... more

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Systematic Review and Meta-analysis of Randomised Controlled Trials of Psychosocial Interventions for Cancer-Related Fatigue in Adult Post-treatment Cancer Survivors

There is evidence to suggest that psychosocial interventions may be effective in reducing fatigue... more There is evidence to suggest that psychosocial interventions may be effective in reducing fatigue during active treatment in cancer patients.It is still unclear how effective such interventions may be post-treatment. The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL PsycINFO, Web of Science and CancerLit were searched. RCTs were included which evaluated psychosocial interventions for fatigue in adults post cancer-treatment. One author screened titles. Two authors independently screened the remaining abstracts for their eligibility for inclusion. The search returned 6,380 papers. Following an assessment of the abstracts approximately 24 papers remained. Two authors independently extracted data from studies using a standard data extraction form and assessed the risk of bias of the selected studies. Education and CBT were the most commonly used psychosocial interventions for this group. This review is the first to evaluate the effectiveness of psycho...

Self-management by older people living with cancer and multi-morbidity: a qualitative study

Supportive Care in Cancer

Purpose Over half of individuals diagnosed with cancer are aged over 70 years, and more than 75% ... more Purpose Over half of individuals diagnosed with cancer are aged over 70 years, and more than 75% of those with cancer report at least one other medical condition. Having multiple conditions alongside cancer in old age may lower functional status, greater likelihood of treatment complications and less favourable prognoses. This qualitative study explored how older people with long-term chronic conditions manage their health and meet their health-related goals after they have completed treatment for cancer. Methods One-to-one face-to-face qualitative interviews were conducted with 8 older people and 2 informal caregivers based in the UK. Older adults were eligible to participate if they were over 70 and had completed primary cancer treatment with curative intent and had at least one other chronic health condition. A semi-structured interview schedule developed a priori based on Shippee's cumulative complexity model was used. We aimed to explore experiences that could influence self-management, utilisation of healthcare services and health outcomes. A framework analysis was used to describe and interpret the data. Results Four overarching themes were identified in the analysis. These themes related to factors that influenced the everyday health-related workload and capacity of the participants. These factors included their health, resources, and opportunities, as well their motivation and sense of perceived control over their lives. Conclusions Fragmented healthcare systems and relationships with healthcare professionals also influenced the participants' self-management of their health. Our findings highlight the interaction between an individuals' needs, capacity, treatment burden, and the services and resources available to them. These findings support calls to promote person-centred care to better support older adults to manage their health. Cancer survivorship • Multimorbidity • Qualitative research • Late effects • Complex conditions • Older adults

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Health Psychology and life after cancer: Recognizing the need for continued support

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Exploring maintenance of physical activity behaviour change among people living with and beyond gastrointestinal cancer: a cross-sectional qualitative study and typology

Objectives In the last decade, there has been a rapid expansion of physical activity (PA) promoti... more Objectives In the last decade, there has been a rapid expansion of physical activity (PA) promotion programmes and interventions targeting people living with and beyond cancer (LWBC). The impact that these initiatives have on long-term maintenance of PA remains under-researched. This study sought to explore the experiences of participants in order to characterise those who have and have not successfully sustained increases in PA following participation in a PA intervention after a diagnosis of gastrointestinal (GI) cancer, and identify barriers and facilitators of this behaviour. Design Cross-sectional qualitative study. Semi-structured interviews with participants who had previously taken part in a PA programme in the UK, explored current and past PA behaviour and factors that promoted or inhibited regular PA participation. Interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis. Themes and subthemes were identified. Differences between individuals...

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Self‐management in older people living with cancer and multi‐morbidity: A systematic review and synthesis of qualitative studies

Psycho-Oncology

Planning and optimising CHAT A conversation-based intervention to promote person-centred care for older people living with multimorbidity

PLOS ONE

Wessex Acute Frailty Audit: applying quality improvement methodology to design and implement a regional frailty audit using a collaborative, multiprofessional approach

BMJ Open Quality

IntroductionAn acute hospital stay increases the risk of negative outcomes for those living with ... more IntroductionAn acute hospital stay increases the risk of negative outcomes for those living with frailty. This paper describes the application of quality improvement methodology to design and implement a regional audit to gain an understanding of care provision.MethodsSmall scale tests of change (Plan–Do–Study–Act cycles) were used to design the audit structure and questions. Data collectors met face to face with 2–3 multiprofessional clinicians on 58 wards in 10 hospitals across the region, using an electronic tool to gather data. Outcomes were analysed manually in Excel by extracting from the electronic audit tool.Results58 wards across 10 hospitals participated in the audit, which identified three key themes: lack of awareness and frailty training outside medicine for older people specialties, and significant variability of both frailty identification and comprehensive geriatric assessment.ConclusionCombining quality improvement methodology with a collaborative, regional approach...

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The effectiveness of psychological interventions for fatigue in cancer survivors: systematic review of randomised controlled trials

Systematic Reviews

Background Fatigue is a common symptom in cancer patients that can persist beyond the curative tr... more Background Fatigue is a common symptom in cancer patients that can persist beyond the curative treatment phase. This systematic review evaluated the effectiveness of psychological interventions for cancer-related fatigue in post-treatment cancer survivors. Methods We searched relevant online databases and sources of grey literature. Randomised controlled trials (RCTs) evaluating psychological interventions in adult cancer patients after the completion of treatment, with fatigue as an outcome measure, were included. Two review authors extracted data independently from the selected studies and assessed the methodological quality using the Cochrane Collaboration Risk of Bias Tool. Results Thirty-three psychological interventions were identified. The sample size of the included studies varied between 28 and 409, with 4525 participants overall. Twenty-three of the included studies reported a significant effect of the interventions on reducing fatigue in cancer survivors. Most interventio...

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Developing a digital intervention for cancer survivors: an evidence-, theory- and person-based approach

npj Digital Medicine

This paper illustrates a rigorous approach to developing digital interventions using an evidence-... more This paper illustrates a rigorous approach to developing digital interventions using an evidence-, theory-and person-based approach. Intervention planning included a rapid scoping review that identified cancer survivors' needs, including barriers and facilitators to intervention success. Review evidence (N = 49 papers) informed the intervention's Guiding Principles, theory-based behavioural analysis and logic model. The intervention was optimised based on feedback on a prototype intervention through interviews (N = 96) with cancer survivors and focus groups with NHS staff and cancer charity workers (N = 31). Interviews with cancer survivors highlighted barriers to engagement, such as concerns about physical activity worsening fatigue. Focus groups highlighted concerns about support appointment length and how to support distressed participants. Feedback informed intervention modifications, to maximise acceptability, feasibility and likelihood of behaviour change. Our systematic method for understanding user views enabled us to anticipate and address important barriers to engagement. This methodology may be useful to others developing digital interventions.

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Teresa Corbett

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