ORCID Profile
0000-0001-9490-1747
Current Organisations
University of Liverpool
,
Royal Liverpool and Broadgreen University Hospitals NHS Trust
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Publisher: National Institute for Health and Care Research
Date: 10-2013
DOI: 10.3310/HTA17500
Publisher: National Institute for Health and Care Research
Date: 11-2012
DOI: 10.3310/HTA16430
Publisher: American Psychological Association (APA)
Date: 04-2023
DOI: 10.1037/HEA0001270
Publisher: Wiley
Date: 26-04-2022
DOI: 10.1111/HEX.13490
Abstract: Technological advances have led to cancer prognostication that is increasingly accurate but often unalterable. However, a reliable prognosis of limited life expectancy can cause psychological distress. People should carefully consider offers of prognostication, but little is known about how and why they decide on prognostication. Using uveal melanoma (UM) patients, we aimed to identify (i) how and why do people with UM decide to accept prognostication and (ii) alignment and ergence of their decision‐making from conceptualizations of a ‘well‐considered’ decision. UM provides a paradigm to elucidate clinical and ethical perspectives on prognostication, because prognostication is reliable but prognoses are largely nonameliorable. We used qualitative methods to examine how and why 20 UM people with UM chose prognostication. We compared findings to a template of ‘well‐considered’ decision‐making, where ‘well‐considered’ decisions involve consideration of all likely outcomes. Participants wanted prognostication to reduce future worry about uncertain life expectancy. They spontaneously spoke of hoping for a good prognosis when making their decisions, but largely did not consider the 50% possibility of a poor prognosis. When pressed, they argued that a poor outcome at least brings certainty. While respecting decisions as valid expressions of participants' wishes, we are concerned that they did not explicitly consider the realistic possibility of a poor outcome and how this would affect them. Thus, it is difficult to see their decisions as ‘well‐considered’. We propose that nondirective preference exploration techniques could help people to consider the possibility of a poor outcome. This paper is a direct response to a patient‐identified and defined problem that arose in therapeutic and conversational discourse. The research was informed by the responses of patient participants, as we used the material from interviews to dynamically shape the interview guide. Thus, participants' ideas drove the analysis and shaped the interviews to come.
Publisher: Cambridge University Press (CUP)
Date: 18-10-2013
DOI: 10.1017/S0959259813000130
Abstract: Most in iduals with dementia live in the community, receiving care from family or lay carers. Carers’ wellbeing, and the quality of the care they provide, depends on their resilience in the face of the challenges associated with caring for someone with dementia. However, factors associated with carers’ resilience are not yet fully understood. The aim of this review is to present a narrative synthesis of factors, materials and resources associated with carers’ resilience. Electronic and hand searches identified relevant published literature, which was narratively synthesized. A framework consisting of three inter-related domains of factors influencing carers’ resilience emerged, encompassing: social and cultural factors properties of the care relationship and carers’ psychological factors. Holistic assessment based on this framework can help practitioners to identify vulnerable carers and to target help on factors that help to make them vulnerable but that are amenable to change.
Publisher: Informa UK Limited
Date: 06-11-2017
DOI: 10.1080/13607863.2017.1393792
Abstract: Most in iduals with dementia live in the community, receiving care from family or lay carers. Carers' wellbeing, and the quality of the care they provide, partly depends on their ability to derive meaning from caring for someone with dementia. Both carers' previous relationship with their relative and the caregiving process itself contribute to this sense of meaning. However, it remains unclear why some carers derive meaning from these sources, whereas others do not. To further explore the processes by which carers derive a sense of meaning from caring. Representative case s ling was used to recruit a purposive s le of 20 carers for in iduals living with dementia. In-depth semi-structured interviews were audio-recorded and transcribed, and analysed using pluralist qualitative methodology. A framework of three sources from which carers derived meaning from caring was identified, encompassing: carers' perceptions of how 'right' or 'symmetrical' caring felt in light of their current and previous relationship with the person with dementia maintenance of a 'protected' sense of self within the care relationship and carers' perceptions of their 'social connectedness' outside the relationships. Holistic assessment based on this framework could help to tailor in idualised provision of support, foster resilience and safeguard carers' well-being.
Publisher: Springer Science and Business Media LLC
Date: 18-03-2021
DOI: 10.1007/S12671-021-01602-Y
Abstract: Anxiety and depression are common in chronic physical illness populations. Self-compassion, the motivation and the capacity to alleviate one’s own suffering, is associated with reduced anxiety and depression in mental health populations. This review aimed to collate available research showing links between self-compassion and anxiety and depression in chronic physical illness populations. This study is a systematic review of English language studies investigating univariate and multivariate correlates of anxiety and depression by self-compassion constructs in adult chronic physical illness populations. Twenty papers, reporting data from 16 unique studies, were included. Half s led cancer patients. Self-compassion scores consistently showed moderate to large inverse associations with anxiety and depression over both univariate ( r = −.37 to −.53 and r = −.38 to −.66, respectively) and multivariate analyses (β =.01 to β = −.55 and β = −.17 to β = −.59, respectively). Worry and depressive brooding, and shame, mediated relationships between self-compassion and anxiety and depression. Although findings suggest that self-compassion processes may have a role in alleviating anxiety and depression in chronic physical illness populations, methodological limitations limit confidence in this proposition. Prospective studies that identify theoretically plausible mediators and moderators are required before the development or modification of therapeutic interventions.
Publisher: National Institute for Health and Care Research
Date: 03-2012
DOI: 10.3310/HTA16120
Publisher: Springer Science and Business Media LLC
Date: 19-04-2021
DOI: 10.1007/S11764-021-01036-4
Abstract: Prognostication in cancer is growing in importance as increasingly accurate tools are developed. Prognostic accuracy intensifies ethical concerns that a poor prognosis could be psychologically harmful to survivors. Uveal melanoma (UM) prognostication allows survivors to be reliably told that life expectancy is either normal (good prognosis) or severely curtailed because of metastatic disease (poor prognosis). Treatment cannot change life expectancy. To identify whether prognosis is associated with psychological harm, we compared harm in UM survivors with good and poor prognoses and those who declined testing and compared these outcomes to general population norms. Non-randomized 5-year study of a consecutive series of 708 UM survivors (51.6% male, mean age 69.03, SD =12.12) with observations at 6, 12, 24, 36, 48 and 60 months. We operationalized psychological harm as anxiety and depression symptoms, worry about cancer recurrence (WREC) and poor quality of life (QoL). Compared to other groups, survivors with poor prognoses showed initially elevated anxiety and depression and consistently elevated worry about local or distant recurrence over 5 years. Good prognoses were not associated with outcomes. Generally, no prognostic groups reported anxiety, depression and WREC or QoL scores that exceeded general population norms. Using a large s le, we found that harm accruing from a poor prognosis was statistically significant over 5 years, but did not exceed general non-cancer population norms. Survivors desire prognostic information. At a population level, we do not believe that our findings show sufficiently strong links between prognostication outcome and psychological harm to deny patients the option of knowing their prognosis. Nonetheless, it is important that patients are informed of potential adverse psychological consequences of a poor prognosis.
Publisher: National Institute for Health and Care Research
Date: 02-2012
DOI: 10.3310/HTA16030
Publisher: Wiley
Date: 04-12-2019
DOI: 10.1002/CPP.2399
Abstract: Many breast cancer (BCa) patients experience clinically significant anxiety and depression in survivorship. Self-compassion offers a bulwark to anxiety and depression in nonclinical, mental health, and some chronic physical health populations. We examined whether self-compassion predicted lower anxiety and depression symptoms in survivors and whether this might be mediated by lower worry and rumination. The design was a cross-sectional survey using self-report measures. Female adult BCa survivors of mixed stages who had finished primary surgical, radiotherapy, or chemotherapy treatments completed self-compassion subscales and worry, rumination, and anxiety and depression scales. Higher self-compassion subscale scores were negatively associated with anxiety and depression. Depressive brooding and worry mediated any effects of self-kindness and mindfulness on depression and anxiety, whereas common humanity directly predicted lower depression scores. Findings are consistent with the view that self-compassion reduces threat-related rumination and worry in BCa survivors, consequently reducing anxiety and depression. This may form a basis for prevention and treatment.
Publisher: BMJ
Date: 10-2016
Publisher: Springer Science and Business Media LLC
Date: 27-08-2021
DOI: 10.1007/S10865-021-00252-8
Abstract: A number of patient-reported outcomes (PROs) predict increased mortality after primary cancer treatment. Studies, though, are sometimes affected by methodological limitations. They often use control variables that poorly predict life expectancy, examine only one or two PROs thus not controlling potential confounding by unmeasured PROs, and observe PROs at only a single point in time. To predict all-cause mortality, this study used control variables affording good estimates of life expectancy, conducted multivariate analyses of multiple PROs to identify independent predictors, and monitored PROs two years after diagnosis. We recruited a consecutive s le of 824 patients with uveal melanoma between April 2008 and December 2014. PROs were variables shown to predict mortality in previous studies anxiety, depression, visual and ocular symptoms, visual function impairment, worry about cancer recurrence, and physical, emotional, social and functional quality of life (QoL), measured 6, 12 and 24 months after diagnosis. We conducted Cox regression analyses with a census date of December 2018. Covariates were age, gender, marital and employment status, self-reported co-morbidities, tumor diameter and thickness, treatment modality and chromosome 3 mutation status, the latter a genetic mutation strongly associated with mortality. Single predictor analyses (with covariates), showed 6-month depression and poorer functional QoL predicting mortality, as did 6–12 month increases in anxiety and 6–12 month decreases in physical and functional QoL. Multivariate analyses using all PROs showed independent prediction by 6-month depression and decreasing QoL over 6–12 months and 12–24 months. Elevated depression scores six months post-diagnosis constituted an increased mortality risk. Early intervention for depressive symptoms may reduce mortality.
Publisher: Springer Science and Business Media LLC
Date: 12-2014
Publisher: Wiley
Date: 25-08-2020
DOI: 10.1002/PON.5514
Abstract: Cancer survivors commonly experience long‐term anxiety and depression. Anxiety and depression might result from problems emerging during survivorship rather than illness and treatment. This study tested three potential causal paths: (a) concerns about physical symptoms and functional problems and fear of cancer recurrence (FCR) arising during survivorship directly cause anxiety and depression, (b) an indirect path whereby FCR mediates effects of concerns about physical symptoms and functional problems on anxiety and depression, and (c) a reciprocal path whereby anxiety and depression cause concerns about physical symptoms and functional problems and FCR, which exacerbate later anxiety and depression. S le of 453 uveal melanoma survivors who completed observations 6‐, 12‐, 24‐, 36‐, 48‐ and 60‐months post‐diagnosis and did not miss two consecutive observations. Cross‐lagged analyses were conducted to predict Hospital Anxiety and Depression Scale subscale scores. Symptoms and functional problems were measured using the EORTC OPT 30 scale, and FCR operationalised by the EORTC OPT 30 worry about recurrence scale. Covariates were age, gender, treatment modality, and visual acuity of the fellow eye and chromosome‐3 status (which accurately predicts 10‐year survival), worry and anxiety or depression. All paths received some support, although the indirect path emerged only for anxiety in females. Concerns about physical symptoms, functional problems, and FCR originated in survivorship and appeared to both influence and be influenced by anxiety and depression. Findings emphasise the importance of actively monitoring survivors to prevent, detect, and intervene in the development of anxiety and depression during survivorship.
Publisher: Springer Science and Business Media LLC
Date: 30-11-2021
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
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 Mary Cherry.