Tag: cancer

October review

Over on the website of Mental Health Nurse Academics UK (MHNAUK) I’ve written this brief review of MHNAUK’s last meeting, which took place at Unite the Union’s offices in Glasgow on October 11th 2019. This was a good meeting, with two guest speakers: Lawrie Elliott, Editor of the Journal of Psychiatric and Mental Health Nursing and David Thomson, Chair of the Mental Health Nursing Forum Scotland. I learned lots from both, and amongst other things ended up thinking how organised mental health nurses in Scotland look to be.

As it happens, MHNAUK is also about to embark on something new: next week we’re inviting nominations for people to lead our Education, Research, and Policy and Practice Standing Groups. Standing Groups are the engines of MHNAUK, and have been led thus far by Anne Felton, Mary Chambers and Neil Brimblecombe (and previously, John Baker) respectively. Big thanks to them for their work: the more that members become involved, the better.

Back in Cardiff, with esteemed co-investigators I’ve again (as I mentioned last month) been pressing on with the NIHR HS&DR-funded MENLOC evidence synthesis into end of life care for people with severe mental illnesses. This is proving to be a big piece of work, but we’re on track to submit our report in spring next year. As a team we’re also thinking carefully about future lines of enquiry, as there is lots still to do in this field.

A final thing to note in this catch-up: I’ve been thinking about what to say at next month’s Making a difference in Wales conference, which is all about taking the Framework for Mental Health Nursing forward. I think there is lots which is distinct about health policy and services in this part of the world, but also recognise the existence of gaps between policy and strategy aspirations, and workplace realities. One to mull over.

Summer research summary

Si3mdrnce returning from a week of walking August has included making final preparations for #MHNR2019, which is looking very exciting. Elsewhere, a big part of my work this month has been writing an analysis of qualitative interview data generated as part of a phase 2 trial of 3MDR for military veterans with treatment-resistant post-traumatic stress disorder. 3MDR, or Modular motion-assisted memory desensitisation and reconsolidation, is a novel psychological intervention involving walking on a treadmill towards personally selected images of trauma whilst in the company of a skilled therapist. The study is led by Jon Bisson, and here are Neil Kitchiner and John Skipper talking about what it involves:

Working on a trial has been an interesting, and new, experience for me, and I’ve been learning lots. My qualitative write-up is destined for inclusion in a final report for the trial’s funding body, Forces in Mind Trust, but during this work as a team we’ve also been planning papers for publication.

menloc logo 5MENLOC, our ongoing evidence synthesis into end of life care for people with severe mental illnesses (about which I have written on this blog before), is in full swing. We’ve reached the stage where we’re writing up syntheses of the research papers and other outputs we’ve included, organised via a series of themes. More on this to follow in due course.

Finally, it’s been good to work in support of colleagues who have led new papers for publications. Here’s Jane Davies‘ latest paper on the experiences of partners of young people living with cancer, and a paper led by Ray Samuriwo on wound care and mental health.

Studying young people’s experiences of cancer

Jane's PhD

Clicking the image of the front page of Jane Davies‘ PhD in this post will download the complete text of this newly completed doctorate. Danny Kelly and I were Jane’s supervisors, and for a flavour of her study and its findings here is its abstract:

This thesis is the result of an in-depth study, which explored the experience of choice and control in decision making when five young people developed and were subsequently treated for cancer. The study was underpinned by the sociological theories of agency and structure against the backdrop of the developmental nature of adolescence and emerging adulthood. The experience of the disease was situated at a time when these young people were in the process of developing their early adult life plans and were at a fundamental crossroad in the life cycle. The diagnosis and subsequent treatment for cancer at this juncture impacted significantly on the lives of these five young people and those close to them.

Exploratory case studies were utilised in an attempt to examine more specifically each young person’s choice, intentionality, control and freedom in deciding all aspects of decision making, beginning with the onset of symptoms followed by diagnosis and treatment. Interviews, observations and documentary analysis were instigated to generate data. Multiple sources were selected to generate further insights and these included family, partners, friends and health care professionals who were close to the young people during their experience.

Three overarching themes were identified during analysis of the data: ‘life then’, ‘life interrupted’ and ‘life reclaimed’. Key elements of these themes included a number of complex and interrelating factors which were interwoven within the everyday lives of the young people. In the ‘life then’ phase, ‘holding on’ to agency prior to diagnosis and the importance of close and intimate relationships was illuminated. In ‘life interrupted’, agentic power during treatment, in terms of the range of decision making and the complexity of the parental role, were prominent. In ‘life reclaimed’ the ‘different but determined’ nature of young people’s behaviour and re-aligned agency was transparent as they made their way towards the end of treatment.

The findings culminated in the illumination of individual trajectories relating to the fluctuating nature of agency during the cancer experience. These incorporated the three overarching themes as three sequential phases. Commonalities in this regard were also identified across the five cases. Several discussions with practice colleagues resulted in the formulation of potential ways in which ultimately these trajectories might be applied to practice in the future.

For those who may need additional persuading: further to my post last week on qualitative research, Jane’s thesis is another example of why this type of study needs to be done. This is an excellent doctorate. The data therein were carefully and sensitively generated, analysed and written up. Jane has already lead authored this paper, which appeared in the Journal of Advanced Nursing last year. Expect more to follow.