Towards a paradigm shift: psycho-social stress in cancer patients living in rural regions, following active therapy, with care not augmented by a formal Survivorship Care Program (#328)
Background: Improvements in cancer therapies is reflected in the number of survivors. These patients are left with issues on how to cope with psychosocial concerns following therapy. Identification of vulnerable individuals for early and timely intervention efforts may influence their adjustment to life.
Objectives: This research aims to describe how psychosocial concerns following active cancer therapy may change over time and to identify the implications of negative coping mechanisms. The research also aims to identify issues specific to gender-specific malignancies (prostate and breast) and gender non-specific malignancies (lung and CRC).
Methods: The planned accrual was 240 (cohorts 1 and 2) and actual was 123 (cohort 1) and an interim of 50 for cohort 2 (recruitment continuing). The research aligned with perspectives associated with the triangulation methodology to show the potential to discover areas of both convergence and divergence. There are two cohorts. Cohort one will complete a series of three paper questionnaires using the validated PROMIS-29 and mini-MAC tools. A small subset of 30 patients in this cohort will also undertake semi-structured, recorded interviews (until the point of saturation). Cohort two includes 100 patients, who completed therapy for one of the malignancies 5 years previously, to gain cross-sectional data of psychosocial issues over the longer term.
Results: The first questionnaire data entry and statistical analysis is complete (cohort 1) . The second and third questionnaires and the questionnaire for cohort two have commenced. At this early stage in the research there are minimal statistical results, however it is noted that females are significantly less satisfied with their Physical Ability immediately following therapy.
There was statistically significant difference in Physical Ability, Sleep and Satisfaction with Daily Role when between-group analysis was performed.
Conclusion: Disparities between gender have shown to encompass the physical effects of therapy. The degree of satisfaction with daily role may become more evident as the study continues. Exploring the sub-groups within the demographics, such as differentiation of therapy (e.g. type of surgery, gender and age) within tumour groups as well as between groups may explain some observed outcomes, as well as effects of residential locality and juncture in time, although these will become more evident as the research progresses.It is anticipated that this research will recommend proactive strategies for identifying and managing psychosocial issues in individual patients. Implications for research may be the re-evaluation of individual survivorship plans based on tumour group, gender, age, type of therapy within and between groups and prognosis.
- Assoc. Prof Patricia Valery, Menzies School of Health Research/Charles Darwin Universty
- Dr. Christina Bernades, Menzies School of Health Research/Charles Darwin University
- Mr. Simon Biggs, Registrar Medical Physicist, The Riverina Cancer Care Centre