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Lorna Higgins – "Cancer Patient to Survivor


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Lorna Higgins – "Cancer Patient to Survivor

  1. 1. The Development of a Self- Help Guide for Cancer Patients The Transitio n fro m Cance r Patie nt to Survivo r: AGuide to Me ntalWe llne ss
  2. 2. Why?  Patients had identified that after treatment is over they seem to have an abrupt cut of from contact with Health care professionals  It is a real scary time as after treatment patients are not physically or mentally equipped to join the “real” world  It was agreed that a local self help booklet would be really beneficial at this time
  3. 3. Unmet need?  Nearly half (49%) of people living with cancer feel their non-medical cancer needs are currently unmet by the healthcare system,  People living with cancer are optimistic about life; 59% expect to die from something other than cancer (LAF 2005)
  4. 4. Aims and Rationale  To develop a self-help guide to help cancer patients who have recently completed treatment to cope with symptoms of anxiety and depression  To promote and increase awareness of common mental health problems  To increase availability of mental health information to cancer patients
  5. 5. Research  Link between physical and mental health (NSF 1999)  Cancer identified as ‘one of several chronic illnesses that precipitates the need for and use of mental health services’ (Hewitt & Rowland, 2002)  ¾ cancer patients experience an increase in anxiety and nearly half (49%) experience an increase in depression due to their diagnosis (Macmillan 2006)
  6. 6. Research - continued  Healthcare professionals poor at recognising symptoms (Fallowfield, Ratcliffe, Jenkins et al 2001)  6 in 10 cancer patients suffering from depression do not receive any information, advice, support or treatment for this (Macmillan 2006)  Cancer patients still show increased levels of anxiety and depression once treatment has been completed (Deimling et al 2002, Thomas et al 1997)
  7. 7. Why a self help guide?  Studies have shown the benefits of self- help material (Lovell and Richards 2000, Bower, Lovell and Richards 2001)  Stepped care model for Depression and Anxiety facilitated self-help step 2 (NICE 2002)
  8. 8. Development  Developed in conjunction with a Macmillan Library Information Facilitator (who is also a survivor)  Based on Cognitive Behavioural Therapy techniques and existing self- help materials  The contents of the guide are generic
  9. 9. Contents Include:  Psycho-education on anxiety and depression  Goal Setting  Pleasurable Activity Scheduling  Confidence Building  Body Image  Complementary Therapies  Book list
  10. 10. Consultation and Launch  Local support groups and Merseyside and Cheshire Cancer Network  Psychology Working Group for feedback and comments  Launched at Merseyside and Cheshire Cancer Network ‘Cancer Care in Primary Care’ Event in January 2007  Winner of the ‘Overcoming Series Innovations Award’ 2007
  11. 11. Spreading the Word  Local GP Forums & service user groups  ICCP Nurses (Halton)  Local newsletters  Clinical Nurse Specialists at local Hospital Trust  Staff at Clatterbridge Centre of Oncology  Cancer Action Team National Development programme
  12. 12. Reaction  Feedback has been very positive.  Clinical Psychologists very enthusiastic  Pleased that we had recognised mental aspect and thought it would help to reduce stigma  Changes have been made accordingly  Inclusion of service user experiences  Readability scores increased to 62.8 Flesch Reading Ease
  13. 13. Future plans  Professional printing of the guide in A5 format as suggested from consultation this would be more user friendly  Research effectiveness of guide  Produce 1 page summaries for specific topics that can be downloaded from website  To develop further guides for other stages of illness (or other long term illnesses)
  14. 14. References  Bower, P., Richards, D. & Lovell, K. (2001) The clinical and cost effectiveness of self-help treatments for anxiety and depressive disorders in primary care: a systematic review. British Jo urnalo f Ge ne ralPractice , 51, 838-845  Deimling, et al (2006) Cancer-related health worries and psychological distress among older adult, long term cancer survivors, Psycho -O nco lo g y 15: 306–320  Fallowfield, L et al: Psychiatric morbidity and its recognition by doctors in patients with cancer. British Journal of Cancer 84:1011-1015, 2001  Hewitt, M. & Rowland, J. H. (2002) Mental health service use among adult cancer survivors: Analyses of the national health interview survey, Jo urnalo f ClinicalO nco lo g y, 20 (23), 4581 – 4590
  15. 15. References cont …..  Lovell, K. & Richards, D. (2000) Multiple Access Points and Levels of Entry (MAPLE): Ensuring choice accessibility and equity for CBT services, Be havio uraland Co g nitive Psycho the rapy, 28, 379-391  Macmillan (2006) Wo rrie d Sick: The e m o tio nalim pact o f cance r  NICE (2002) Depression: Management of depression in Primary and Secondary Care  Department of Health (1999) Natio nal Se rvice Fram e wo rk fo r Me ntal He alth: m o de rn standards and se rvice m o de ls, London: Department of Health  Thomas et al (1997) Anxiety in long-term cancer survivors influences the acceptability of planned discharge from follow-up Psycho -O nco lo g y 6: 190–196.
  16. 16. For any further information or feedback please contact:  Lorna Higgins – Wirral Primary Care Mental Health Team Greasby Clinic Greasby Road Greasby Wirral CH49 3NH 0151 651 3943  Sue Kernaghan - Birkenhead Central Library Borough Road Birkenhead Wirral CH41 2XB 0151 652 5512Copies of the guide can be downloaded from
  17. 17. Any questions?
  18. 18. Personal Summary – Lorna Higgins  Graduate Mental Health Worker with Wirral PCT since May 2005.   I work with people with mild – moderate mental health problems such as anxiety, depression and panic.   For Postgraduate Certificate in Mental Health project I designed a self-help booklet aimed at helping cancer survivors cope with symptoms of anxiety and depression.   This was awarded the ‘Overcoming Series Innovation Award’ in March 2007  We are currently looking at developing this further to help people at other stages of the cancer journey or with other physical health difficulties