Bea$ng'the'blues'against'cancer:' - - PowerPoint PPT Presentation

bea ng the blues against cancer
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Bea$ng'the'blues'against'cancer:' - - PowerPoint PPT Presentation

Bea$ng'the'blues'against'cancer:' a'community'approach'to'psychological' care' ! ! Jeff'Dunn' ! ! Griffith!Health!Ins/tute,!Griffith!University! Centre!for!Research!in!Cancer!Control,!Cancer!Council!Queensland! ' ' ! ! ! Background'


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SLIDE 1

Bea$ng'the'blues'against'cancer:'

a'community'approach'to'psychological' care'

! !

Jeff'Dunn'

! !

Griffith!Health!Ins/tute,!Griffith!University! Centre!for!Research!in!Cancer!Control,!Cancer!Council!Queensland! ' '

! !

!

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SLIDE 2

Background'

  • Substan/al!subgroup!of!pa/ents!and!carers!

experience!heightened!psychological! distress!

  • Need!to!/trate!care!to!level!of!distress!

However….!

  • Psychological!care!needs!to!be!accessible!

and!cost!effec/ve!

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SLIDE 3

The'Tiered'Model'

Suppor$ve'Care:'Emo/onal,!prac/cal,! spiritual,!psychoeduca/on,!decision! support,!peer!support!eg.'social!worker,! peers,!chaplain Universal'Care:'Informa/on,!brief! emo/onal!and!prac/cal!support! eg.!health!care!team,!QCF!Cancer! Helpline.

Hutchison, Steginga, Dunn (2005)

Extended'Care:'Counselling,!/me!limited! therapy,!skills!training!eg.!psychologist,! social!work,!QCF!teleKbased!Cancer! Counselling!Service.!

Minimal'to'mild'distress' Mild'to'moderate'distress' Moderate'distress'

Moderate'' to'severe'' distress'

Acute'Care:!!Intensive!or!comprehensive! therapy!for!acute!and!complex!problems! eg.!mental!health!team,!psychiatrist. Specialist'Care:'Specialised'therapy!for! depression,!anxiety,!rela/onship! problems!eg.!psychologist,!psychiatrist.

Severe' distress'

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SLIDE 4

The'Bea$ng'the'Blues'ADer' Cancer'Project'

  • Randomised!control!trial!of!psychological!

interven/on!for!high!distress!Cancer! Helpline!pa/ent!and!carer!callers!(>4!on!DT)!

  • Compares!two!low!intensity!interven/ons:!

single!nurse!session!and!self!management! vs.!five!psychologist!sessions!(CBT)!

  • TeleKbased!
  • Twelve!months!follow!up!
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SLIDE 5

Inclusion'Criteria'

  • Cancer!pa/ent!or!carer!over!18years!who!

called!the!Cancer!Helpline!

  • Have!a!score!of!4!or!more!on!the!Brief!

Distress!Thermometer!when!Helpline! contacted!

  • Be!able!to!read!and!speak!English!
  • No!previous!history!of!head!injury,!

demen/a!or!psychiatric!illness!

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SLIDE 6

Background'details'for'Pa$ents'and'Carers'

Demographic'Variable' Pa$ents' N=354' Carers' N=336' Mean'(SD)' Mean'(SD)' Age'' 58.25'(11.23)' 52.52'(12.71)' %' %' Gender' Female' 82.5' 87.8' Male' 17.5' 12.2' Marital'Status'' Married/defacto' 39.5' 20.9' Not'married'(single,'widowed,'divorced)' 60.5' 79.1' Educa$on'' School'(<'grade'12)' 42.6' 34.0' Ter$ary' 57.4' 66.0' Income' <$20,000'' 18.6' 11.5' $20,000'a'less'than'$40,000'' 27.7' 27.1' $40,000'a'less'than'$60,000'' 14.1' 13.1' $60,000'a'less'than'$80,000'' 9.9' 9.7' $80,000'+'' 23.4' 33.0'

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SLIDE 7

Sample'Characteris$cs'

Time!since!diagnosis!(M=1.74years;!SD=2.19)! Half!the!sample!(49.4%;!53.4%!pa/ents!&!45.2%! carers)!reached!caseness!for!distress!in!one!or!more!

  • f!the!BSI!subscales:!

K Pa/ents:!33.5%!caseness!in!soma/sa/on,!31.5%!in! depression,!and!32.0%!in!anxiety.!! K Carers:!17.7%!displayed!caseness!in!soma/sa/on,! 31.1%!in!depression,!and!35.9%!in!anxiety!

! !

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SLIDE 8

Results'

Support!Service!Use!

Prior!to!entering!the!trial,!only!21.5%!of!par/cipants!had!sought!psychosocial! services!in!the!past!month! !

!

Support'Service'Use' N'(%)' Have!you!seen!a!psychiatrist,!psychologist,!counsellor!or!social! worker!in!the!past!month?! 149!(21.5%)!

Psychiatrist!

15!(10.1%)!

Psychologist!

53!(35.6%)!

Counsellor!

24!(16.1%)!

Social!Worker!

76!(51.0%)!

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SLIDE 9

Results'

Sources!of!Emo/onal!Support!

Most!frequent!sources!of!emo/onal!support!were!family!and!friends,! followed!by!the!doctor,!and!nurse!

Sources'of'Emo$onal'Support' N'(%)' Have!you!accessed!any!of!the!following!services!for!emo/onal!support!in!the!past! month?! Doctor! 155!(22.4%)! Nurse/other!health!professional! 98!(14.2%)! Family/friends! 567!(81.9%)! Online!cancer!support!group! 31!(4.5%)! Face!to!face!cancer!support!group! 28!(4.0%)! Other!support!groups! 32!(4.6%)! Community!counselling!services!(e.g.,!Lifeline,!Centacare)! 20!(2.9%)! Government!organisa/ons!(e.g.,!Veteran’s!Affairs)! 10!(1.4%)! Community!organisa/ons!(e.g.,!Red!Cross,!Salva/on!Army)! 12!(1.7%)! Other! 149!(21.5%)!

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SLIDE 10

Results'

Study!Reten/on!PostKInterven/on!(3!months)!

!

Reten/on!rates!were!high!(84.4%)! K Greater!for!par/cipants!comple/ng!the!brief!nurse!session! (89%)!compared!to!the!five!session!psychologist! interven/on!(79.8%;!p!=!.0009)!! K Poorer!for!carers!(79.6%)!compared!to!pa/ents!(89%;!p!=!. 0007)!

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SLIDE 11

Conclusions'

  • Both!interven/on!approaches!highly!

acceptable:!brief!session!bemer!reten/on!

  • Most!callers!had!not!sought!out!specialist!

mental!health!services;!and!relied!for! support!on!family!and!friends!

  • Analysisis!will!focus!what!is!effec/ve,!for!

whom!and!at!what!cost/benefit.!