ORCID Profile
0000-0002-9549-1177
Current Organisation
University of Manchester
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Publisher: BMJ
Date: 04-2018
Publisher: Wiley
Date: 08-03-2018
DOI: 10.1002/PON.4670
Abstract: US-based evidence suggests that lay-health worker (LHW) interventions can increase awareness around cancer risk-related lifestyles, symptom recognition, and screening programme uptake. The suitability of LHW interventions in the UK and the potential barriers and facilitators for implementation is currently unknown. This study explored the acceptability and feasibility of developing LHW interventions for cancer prevention, screening, and early diagnosis. Purposive s ling recruited 5 separate lay groups: (1) completed cancer treatment (2) friends/family of cancer patients (3) cancer hospital volunteers (4) cancer charity volunteers and (5) members of the public. Audio-recorded focus groups and semi-structured interviews were transcribed for thematic analysis using framework matrices. Forty-one people (66% female, aged 23-84 years) participated. Three main themes are reported: (1) scope of LHW roles, with a clear remit embedded within communities or primary care practices (2) defining LHW tasks, with a focus on supporting people overcome barriers including lack of cancer symptom knowledge and non-attendance at screening and (3) clear boundaries, with LHW training and on-going support from healthcare staff seen as key for intervention success. All groups were uncomfortable about having lifestyle-related risk conversations and potentially inflicting guilt. The post-treatment group expressed less concern about the possible emotional impact of discussing cancer symptoms, compared with the other groups. LHW interventions to promote early diagnosis or screening were generally considered acceptable in a UK context. LHW interventions focussing on reducing cancer risk may be less feasible.
Publisher: Wiley
Date: 23-11-2017
DOI: 10.1002/PON.4575
Abstract: This systematic review aimed to assess the effectiveness of community-based health worker (CBHW) interventions for early detection of cancer. Secondary aims were to consider the extent that interventions were based on theory, and potential moderators including behaviour change techniques (BCTs). Six databases were searched for randomized controlled trials. Random-effects meta-analyses were applied to 30 eligible studies with a cancer screening outcome. Participation in CBHW interventions was associated with increased receipt of screening (OR = 1.901, 95% CI: 1.60-2.26, P < 0.001) for breast, cervical, and bowel cancer. Larger effect sizes were observed in participants previously non-adherent with recommended schedules of cancer screening. Twenty-five out of 30 studies were conducted with ethnic minority groups. Only 15 (45%) studies explicitly reported a theoretical foundation for intervention. The number of BCTs used by CBHWs had a trend level association with observed effect size (P = 0.08). Study quality was generally poor, and common limitations were inadequate blinding and reliance on self-reported outcomes. Community-based health worker interventions are an effective resource for increasing uptake of all 3 types of cancer screening in ethnic minority groups. Those previously non-adherent with recommended schedules of cancer screening benefitted the most from the CBHW approach. However, better quality studies based on more explicit evidence-based theory are needed to optimise the effectiveness of CBHW interventions on screening uptake. Further research is needed to ascertain whether CBHWs can help promote symptom recognition and help-seeking behaviour to facilitate early diagnosis of cancer.
Publisher: Mary Ann Liebert Inc
Date: 09-2020
Publisher: Elsevier BV
Date: 02-2021
Publisher: Cambridge University Press (CUP)
Date: 25-10-2018
DOI: 10.1017/S0144686X18001411
Abstract: The risk of living with dementia and, separately, cancer, increases exponentially with age. However, to date, there is a paucity of research investigating the experiences of people living with both these conditions. This study used semi-structured interviews to explore the decision-making and treatment options for people who live with both dementia and cancer. In total, ten people living with both dementia and cancer (aged 39–93 years) and nine family carers were interviewed. Braun and Clarke's approach to thematic analysis was used together with framework matrices to organise the data. In this article four sequential and descriptive themes are presented. ‘Reaching a diagnosis of cancer’ describes the vital role that family carers play in encouraging the person with dementia to seek an explanation for their presenting (undiagnosed cancer) symptoms to their general practitioner. ‘Adjusting to the cancer diagnosis when living with dementia’ outlines a variety of emotional and practical responses to receiving news of the diagnosis. ‘Weighing up the cancer treatment options’ highlights the different decisions and circumstances that family carers and people living with both dementia and cancer are faced with post-diagnosis. ‘Undergoing cancer treatment’ shares the finding that cancer treatment decision-making was not straightforward and that people living with both dementia and cancer would often forget about their cancer and what procedures they had been through.
Publisher: BMJ
Date: 29-11-2019
DOI: 10.1136/BMJSPCARE-2019-001919
Abstract: In recent years, a simultaneous care model for advanced cancer patients has been recommended meaning that palliative care services are offered throughout their cancer journey. To inform the successful adoption of this model in a phase I trial context, the study aimed to explore patients’ care needs and their perceptions of specialist palliative care. Semi-structured interviews were conducted with 10 advanced cancer patients referred to the Experimental Cancer Medicine team. Interviews were transcribed verbatim and thematically analysed with a framework approach to data organisation. Despite reporting considerable physical and psychological impacts from cancer and cancer treatment, participants did not recognise a need for specialist palliative care support. Understanding of the role of specialist palliative care was largely limited to end of life care. There was perceived conflict between considering a phase I trial and receiving specialist palliative care. Participants felt specialist palliative care should be introduced earlier and educational resources developed to increase patient acceptability of palliative care services. Patients with advanced cancer referred for phase I trials are likely to benefit from specialist palliative care. However, this study suggests patients may not recognise a need for support nor accept this support due to misperceptions about the role of palliative care. Developing a specific educational resource about specialist palliative care for this population would help overcome barriers to engaging with a simultaneous care model.
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Sarah Hindmarch.