The Lung cancer psychosocial group aimed to provide a space for cancer patients and their carers to gain support on a wide variety of lung cancer issues in an informal setting. It also aimed to educate patients and carers about a range of professionals who provide information and advice within Walsall cancer services.
Walsall community Health NHS Trust
Guidance the shared learning relates to:
Does the example relate to a general implementation of all NICE guidance?
Does the example relate to a specific implementation of a specific piece of NICE guidance?
The lung cancer psychosocial group was established to support lung cancer patients and their families to enable them to share experiences, based on the principles of the Roy Castle Lung Cancer Foundation. Lung cancer patients and their carers may experience emotional difficulties, which may include anxiety, uncertainties and in some cases depression (Macmillan, 2009). 1. To provide emotional support as part of treatment package 2. To sign post services that can provide practical help e.g. Citizens Advice Bureau, Sexual Health counselling, and complimentary therapies. 3. To meet other patients in an informal group setting to normalise the feelings associated with a diagnosis of lung cancer. To additionally provide a forum for carers to meet and discuss issues that affect them.
Prior to the implementation of the lung cancer group, the service was providing a group for cancer survivors which was aimed at patients once they had completed treatment. Clinical Nurse Specialists and the Lead clinical Psychologist had indentified that Lung Cancer patients and their carers were presenting to services with similar needs of requesting psychosocial support and hence the format of the cancer survivors group was modified to suit the requirements of the lung cancer patients and their carers.
Each group session was facilitated by the lead clinical psychologist in oncology and palliative care and the lung clinical nurse specialists. The group was piloted between October - November 2010. The entirety of the group was over 4 sessions with each session lasted 3-35 hours. Quantitative and qualitative data was gathered. Quantitative data was gathered in the form of the Hospital Anxiety and Depression Scale and qualitative feedback was also sought. We also asked participants to complete pre and post Holistic needs assessment which has been identified as an important way to identify distress in cancer patients and signpost patients to appropriate services (Palliative and Supportive care strategy, NICE 2006). The Holistic Needs Assessment has been modified from the national version to suit the local services and implemented for patients at key points of their cancer pathway. Pre and post scores for the screening assessment were recorded. The programme was designed to run with four sessions, which covered different topics. Session 1. The Patient experience of diagnosis. Why me? Finding meaning. Emotions. Treatment plans and questions (short term fix / uncertainties). Shame and Guilt. Benefits advice. Session 2. Anxiety . Depression. Negative automatic thoughts. Complementary therapies. Session 3. Pain, symptom control. Breathlessness. Chemotherapy, other treatments. Spirituality. Session 4. Patient and carer concerns, separately. Round up and endings together with patients and carers.
A total of five patients and their carers were invited into the group. However, a maximum of three patients and their carers attended. The main outcomes highlighted the complex emotions that both patients and carers experienced during their cancer journey. There were some reductions in anxiety and depression scores, however the results remain unclear. What was evident from the qualitative feedback, was that both patients and carers valued the group program. For example one group member stated "The group should be kept going - it seems obvious that those involved get strength and support from other members". This quote highlights the positive impact the group has made on the patients and carers well being.
A group format has been found to be the most cost effective and most beneficial for patients and carers, as they are able to share experiences and learn from each other. This format helps to eradicate feelings of isolation and provides a forum to pass on invaluable information at once to a large audience.
Dr Shradha Lakhani
Lead Clinical Psychologist - Palliative and Oncology service
Walsall community Health NHS Trust
Is the example industry-sponsored in any way?