An account of the Joint BPOS & NCRI Psychosocial Oncology and Survivorship Clinical Studies Grou
In March, I attended the joint British Psychosocial Oncology Society and National Cancer Research Institute’s Psychosocial Oncology and Survivorship Clinical Studies Group annual conference. It took place across two days in Chester, UK, and brought together practitioners, researchers, patient advocates, as well as students, all with the shared interest of enhancing supportive care in oncology and, ultimately, the quality of life of those affected by cancer.
Joint BPOS & NCRI Psychosocial Oncology and Survivorship Clinical Studies Group Conference Programme
Having attended this conference last year in Southampton, I was very much looking forward to a renewed opportunity to connect with this network, talk a little about my research and importantly engage in lively discussions surrounding the latest research evidence and practice innovations in psychosocial care and support in oncology, and how these impact healthcare service improvement design and delivery. This year, I was also able to partake in a pre-conference event held for students and early career researchers in order to provide a friendly platform in which to share our research ideas and receive both expert and peer mentoring.
Pre-conference overview presentation of my PhD (left) and title of my poster displayed at the conference (right)
Again this year, this conference did not disappoint! For those who were not able to attend, or those who would like to know more about the conference in general, here is a brief account of what I took away from the conference.
The conference, which focussed on innovation in psychosocial oncology research and practice, was divided into sessions surrounding: the psychological wellbeing of patients and carers; their access to, and experiences of, clinical services; self-management and late effects. Across the keynote and oral presentations, service innovation sessions and posters, I found that similar trends and challenges in research and practice in psychosocial oncology were emerging and could be divided into the following take-home messages:
Psychological Care is not a Luxury.
The Need for Psychologically-Minded Healthcare Provisions
Undertaking Person-Centred Research and its Implications for Practice
1. Psychological care is not a luxury
The first message highlighted at the conference, was that formal psychological support should be integrated within patient care in oncology, and available for long-term self-management and quality of life. As such, it should not be a luxury but instead available to all who need it. It was demonstrated across conference presentations that formal psychological support can facilitate treatment decision-making, treatment adherence, lifestyle changes, and reduce symptom burden across the stages of care. However despite undertaking holistic needs assessments, other presented studies have found that the needs of people affected by cancer and their loved-ones are not being fully met and that healthcare professionals do not always feel fully equipped to address these needs. One such need that was raised across many presentations related to sexual functioning in men, women and older adults. Furthermore discussions around challenges in managing co-morbidities in older adults with cancer, highlighted the need for healthcare to be person-centered rather than disease-centered.
2. The Need for Psychologically-Minded Healthcare Provision
Across the UK, healthcare services in oncology provide a model of care which includes professional psychological assessment and support based on NICE’S s 2004 Supportive and Palliative Care Guidance. In this four-tiered model of support, all healthcare professionals have a role to play in psychological support provision. However psychological training needs to be optimised within the cancer workforce,and psychology specialist training needs to contain a cancer curriculum in order to appropriately and effectively meet patients’ needs.
"Healthcare provision should be psychologically-minded, meaningful to the patient, and take into account the whole person."
A theme that arose from the conference was the language used by healthcare professionals’ during consultations. For example, the communication of risk is often done with statistical probabilities and with the use of ambiguous terms. While these are an accurate report of the facts for the clinician, there is a need to share this information in a way that is meaningful to the patient. As such, conference delegates called for healthcare provision and dialogue to be relational and not transactional.
To promote more psychologically-minded healthcare provision, there is a need to go beyond enhancing communication skills by ensuring the patient and their loved ones feel safe within the doctor-patient relationship. This more relational interaction is founded on trust. While patients enter a consultation with their own beliefs about healthcare, trust can still be influenced by a calm, confident, authoritative and authentic clinician. This can be achieved through trust for trust is a key factor in the relationship between clinician and patient.
3. Ensuring Person-Centred Research and its Implications for Practice
Current research trends in psychosocial oncology have been looking at enhancing patient-reported outcomes (PROMs), particularly in long-term self-management in order to integrate quality of life assessments into routine care and clinical assessment and as a result, create better after-care services. Across the research being presented at the conference, there was also a trend for qualitative research to be applied to understand the needs and experiences of people affected by cancer and their families in greater depth. The patient voice was also included in co-design activities for service design developments, including digital innovations.
Two parallel workshops, both addressing the importance of putting the person at the centre of research and service design and delivery, were held on the first day of the conference: A Patient and Public Involvement (PPI) Workshop, and a Single-Subject Research Design (SSRD) Workshop.
PPI focusses on involving the patient or other members of the public in a meaningful way from an initial research or development proposal to its final evaluation and implementation. While this workshop focussed on how and when to include PPI with discussions surrounding the impact and challenges of PPI, the second workshop provided a whistle-stop tour in a specific type of person-centred research designs: SSRDs. These design methodologies allow for research to be undertaken with small sample sizes, and enable the identification of individual change over time with an increased degree of sensitivity and specificity. As a methodology, while it does not replace the need for randomized clinical trials, they can be particularly useful in the early stages of intervention development and design.
This conference was an excellent opportunity to hear from both service users and experts in psychosocial oncology and healthcare service improvement, on their views and priorities for the successful implementation of psychologically-minded and person-centred care in oncology.