Martin Dempster1, Noleen McCorry2, Emma Brennan1, Michael Donnelly3, Liam Murray3, Brian Johnston4

1School of Psychology, Queen’s University Belfast;2Marie Curie Cancer Care, Belfast 3Centre for Public Health, Queen’s University Belfast; 4Belfast Health & Social Care Trust

Project Funded by Action CancerFacilitated by the Oesophageal Patients’ Association

An approach that is relevant to the psychological needs of people who have received a diagnosis of oesophageal cancer and their carers

A therapeutic intervention that is not resource-intensive

Focus groups

Interviews

Survey at 2 points in time

Publication of findings

Development of intervention

Testing of intervention

Beliefs about Illness / Condition

Coping Strategies

Appraisal of Outcome

Beliefs

Cause Timeline Control ConsequencesCoherence

Ways of Coping

Reflect / relaxPositive focusDiversionPlanningInterpersonal support

Levels of:

Anxiety and Depression

Illness Perceptions Questionnaire - Revised

Cancer Coping Questionnaire

Hospital Anxiety and Depression ScaleFear of Recurrence Scale

To determine which beliefs / coping strategies are strongest predictors of anxiety/depression among people diagnosed with oesophageal cancer and their carers

To determine whether incongruence in carer-patient beliefs is related to distress (i.e. is the relationship between patient beliefs and distress moderated by carer beliefs)

To determine whether coping strategies mediate the relationship between beliefs and distress

Survivors of oesophageal cancer

People identified as carers

Number 458 382

Average age 65 62

Gender 66% male 75% female

91% were the spouse or partner of the person they cared for

Anxiety

Depression

Mild Moderate

Severe

Survivors 16% 11% 8%

Carers 20% 19% 11%

Mild Moderate

Severe

Survivors 13% 7% 3%

Carers 15% 8% 2%Similar to head/neck cancer but higher than other cancers

Potential

Midpoint

Survivors

Mean (SD)

Carers

Mean (SD)

IPQ Acute/chronic timeline 18 23.30 (4.68) 23.03 (4.80)

IPQ Cyclical timeline 14 12.12 (3.65) 12.23 (3.42)

IPQ Treatment control 15 17.17 (3.64) 16.77 (3.53)

IPQ Emotional cause 15 12.12 (3.99) 12.52 (3.83)

IPQ Behavioural cause * 12 10.43 (3.72) 9.98 (3.72)

IPQ Externalised cause 12 14.90 (3.55) 15.08 (3.32)

IPQ Consequences *** 18 21.10 (4.82) 22.19 (4.66) (for survivor)

IPQ Consequences *** 18 21.10 (4.82) 12.65 (3.20) (for self)

IPQ Personal control *** 18 20.05 (4.91) 18.90 (4.74) (for survivor)

IPQ Personal control *** 18 20.05 (4.91) 16.07 (4.13) (for self)

IPQ Illness coherence 15 19.37 (4.28) 19.22 (3.85) (for survivor)

IPQ Illness coherence 15 19.37 (4.28) 19.30 (4.04) (for self)

AnxietyR2 = 0.57: Medical/demographic variables – 12% Beliefs – 37%; Coping – 7%

DepressionR2 = 0.53: Medical/demographic variables – 12% Beliefs – 35%; Coping – 6%

Interventions at the level of the dyad could be useful

Focus on consequences, control and understanding of oesophageal cancer and encourage positive focus coping strategies

Development of intervention based on these cognitions

Possible techniques: normalising the lack of personal control and emotional distress, avoid catastrophising, psychoeducation to improve understanding, positive self-talk

Planned feasibility study, leading to trial