Mental health in people living with and beyond colorectal cancer: A patient-oriented constructivist grounded theory

IF 2.9 2区医学 Q2 ONCOLOGY Cancer Medicine Pub Date : 2024-09-05 DOI:10.1002/cam4.70203

Vicki Cheng, Helen McTaggart-Cowan, Jonathan M. Loree, Rachel A. Murphy, Mikaela Barnes, Haydn Bechthold, Norman Jansen, Mary A. De Vera

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Abstract

Background

With the burden of colorectal cancer in Canada, there is a need to address the psycho-oncologic challenges, including mental health. This study aims to explore the lived mental health experiences in patients with CRC across the phases of the CRC care continuum.

Methods

We employed a patient-oriented constructivist grounded theory design and recruited English speaking participants ≥18 years, diagnosed with CRC within the last 10 years, residing in Canada. We collected data through semi-structured individual interviews using a guide co-constructed with patient research partners. Data collection and analysis were iterative, employed theoretical sampling, and culminated in a theoretical model.

Results

Twenty-eight participants diagnosed with CRC (18 females, 10 males), aged 18–63 years at time of diagnosis were interviewed, with representation across all CRC stages. There were 10 participants (36%) in treatment, 12 participants (43%) in follow-up, and 6 participants (21%) in the beyond phase. We constructed a patient-oriented theory illustrating the dynamic nature between one's self-identity and their mental health experiences across the CRC care continuum. Mental health experiences encompass emotional and cognitive-behavioral responses, expressed differently across phases. Mental health care experiences are also shaped by barriers, facilitators, and individual contextual factors, all of which influence their access to care.

Conclusion

Our theory provides insight into the mental health experiences of patients with CRC across phases of the CRC care continuum. Understanding patients' emotional and cognitive-behavioral responses and care experiences can help identify opportunities to integrate mental health into CRC care.

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结直肠癌患者的心理健康：以患者为导向的建构主义基础理论。

背景：在加拿大，结直肠癌的发病率居高不下，因此有必要应对包括心理健康在内的肿瘤心理挑战。本研究旨在探讨 CRC 患者在 CRC 连续护理阶段的心理健康生活经历：我们采用了以患者为导向的建构主义基础理论设计，并招募了年龄≥18 岁、在过去 10 年中被诊断为 CRC 且居住在加拿大的英语参与者。我们使用与患者研究伙伴共同制定的指南，通过半结构化个人访谈收集数据。数据收集和分析是反复进行的，采用了理论抽样，并最终形成了一个理论模型：28 名确诊为 CRC 的参与者（18 名女性，10 名男性）接受了访谈，他们确诊时的年龄在 18-63 岁之间，代表了 CRC 的各个阶段。其中 10 人（36%）处于治疗阶段，12 人（43%）处于随访阶段，6 人（21%）处于超越阶段。我们构建了一个以患者为导向的理论，说明在整个 CRC 治疗过程中，患者的自我认同与心理健康体验之间的动态关系。心理健康体验包括情绪和认知行为反应，在不同阶段有不同的表现形式。心理健康护理体验还受到障碍、促进因素和个人背景因素的影响，所有这些因素都会影响他们获得护理的机会：我们的理论有助于深入了解 CRC 患者在 CRC 连续护理过程中不同阶段的心理健康体验。了解患者的情绪和认知行为反应以及护理体验有助于发现将心理健康融入 CRC 护理的机会。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.