Promise unfulfilled: Implementing web-based psychological therapy in routine cancer care, a qualitative study of oncology health professionals’ attitudes

Fiona Davies, Marnie Harris, Heather L. Shepherd, Phyllis Butow, Lisa Beatty, Emma Kemp, Joanne Shaw

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Abstract

Background: Web-based mental health interventions (e-MhIs) show promise for increasing accessibility and acceptability of therapy for cancer patients. Aim: This study aimed to elicit health professionals' (HPs) views on optimal models for including e-MhIs within standard cancer care. Materials & Method: Cancer HPs who worked in a service where an e-MhI was available to patients, and multi-disciplinary HPs interested in supportive care, were invited to participate via email. In semi-structured phone interviews, participants' views on e-MhIs were elicited. They were then presented with five model vignettes varying in local and centralised staff input, and asked to indicate their preference and views on each. A thematic analysis was applied to the data. Results: Twelve nurses, nine psychologists, seven social workers, and three oncologists participated. Four key themes were identified: looking after patients, relationships and multidisciplinary care, trust, and feasibility, all contributing to a meta-theme of tension. Participants were motivated to ensure optimal patient outcomes and thus needed to trust the intervention content and process. They believed personal relationships increased patient engagement while affording greater work satisfaction for HPs. Most participants preferred a fully integrated model of care involving local HP assessment and design of a tailored therapy incorporating some e-MhI components where appropriate, but recognised this gold standard was likely not feasible given current resources. Discussion and Conclusion: Co-design with local staff of optimal models of care for the content and process of implementing e-MhIs is required, with due consideration of the patient group, staffing levels, local workflows and HP preferences, to ensure sustainability and optimal patient outcomes. Clinical Trial Registration: The ADAPT Cluster RCT is registered with the ANZCTR Registration number: ACTRN12617000411347.

Original languageEnglish
Number of pages9
JournalPsycho-Oncology
Early online date7 Feb 2022
DOIs
Publication statusE-pub ahead of print - 7 Feb 2022

Bibliographical note

Funding Information:
The authors thank the participants for giving up their time to share their views for this study. The ADAPT Program is funded by a Translational Program Grant (14/TPG/1‐02) from the Cancer Institute NSW. The funding bodies had no role in study design, data collection, analysis or writing of the manuscript.

Funding Information:
Ethical approval for this study was provided by the University of Sydney HREC (2018/936) and the Southern Adelaide Clinical HREC (LNR/20./SAC/125). This study also includes data collected within the ADAPT CRCT, a study of the ADAPT Program, funded by the CINSW (14/TPG/1‐02). The ADAPT CRCT was approved by the Sydney Local Health District Human Research Ethics Committee, Protocol X16‐0378 HREC/16/RPAH/522.

Publisher Copyright:
© 2022 The Authors. Psycho-Oncology published by John Wiley & Sons Ltd.

Keywords

  • cancer
  • cancer care professionals
  • implementation
  • models of care
  • oncology
  • routine care
  • web-based psychological therapy

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