Testing a nurse-led intervention protocol which is designed to reduce psychological distress in lung cancer patients
Aberystwyth University, IBERS
Project ID: AU30034
Annual Stipend: £14,340
Application Deadline: 4th September 2018
Expanding on the title, above, in this proposed project the student will: (1) work with nurses and patients to investigate how lung cancer (LC) nurses would use a tool which screens for patients’ psychological distress and how closely this matches the patients’ needs; (2) qualitatively explore barriers to implementation and adherence to the use of the tool that are currently preventing routine screening from occurring in the health board; (3) develop and test a psychological distress screening implementation process that accounts for nurse and patient perceptions and preferences; and finally, (1-3) would inform the development and evaluation of a training intervention for LC nurses to use the tool effectively, helping reduce patient distress and the associated negative outcomes. Accordingly, this research targets a significant need identified through consultation with Hywel Dda University Health Board (HDUHB) LC Specialists and is representative of a significant challenge faced by NHS Wales.
HDUHB is increasingly emphasising LC as a priority area, given the alarming prevalence rates observed in Wales and the Convergence region in particular. Of more than 200 types of cancer, LC has the third highest incidence rate in the UK (~13%; Office for National Statistics). In Wales, this equated to 2,467 new cases in 2015, of which 68.8% were diagnosed late, which significantly influences the patients’ psychological response and survival rate. In fact, after Bulgaria, LC patients in Wales have the lowest survival rates in Europe (De Angelis et al., 2014). Moreover, in disadvantaged areas of Wales – many of which fall within the Convergence region targeted by KESS2 – the LC rate is 2.6 times higher than in other locations (2010 -2014 statistics; Public Health Wales, 2016). Hence, HDUHB and the healthcare system in Wales would benefit from research which improves LC patient outcomes.
Receiving a LC diagnosis is an unimaginably emotional event, and mental health problems including anxiety and depression often accompany diagnosis and treatment (Mitchell, Ferguson, Gill, Paul, & Symonds, 2013). At the sub-clinical level, psychological distress can contribute to poorer treatment adherence, amplification of physical symptoms, reduced tolerance to pain and related symptoms, and poorer levels of general functioning (Baliousis, Rennoldson, & Snowden, 2016). Conversely, primary care which alleviates psychological distress helps patients adhere to challenging treatments, adapt to lifestyle recommendations which improves their overall health and wellbeing, and ultimately, require less use of other healthcare services (Han et al., 2015). Importantly to HDUHB and NHS Wales, this would provide a substantial cost offset (cf. Carlson & Bultz, 2004).
Understandably, patients often come to LC clinic in a distressed state, and it can take time for the nurse to get to the “root of the problem” – time that is limited and pressured. Consequently, the distress may not be sufficiently alleviated; the patient’s ongoing needs indeed, thwarted, with the concomitant risks described above. Research is underway in IBERS which captures LC nurse and patient perceptions of the usefulness of a screening tool for psychological distress. This tool – administered prior to clinic – should improve the effectiveness and efficiency of the time that nurses and patients spend together. This would help satisfy the patients’ needs whilst reducing the prevalence of and cost associated with onward referral to psychological services. The proposed PhD project will extend this approach through to full implementation, nurse training, and potential insertion into NHS wales policy for LC care.
The prospective applicant should have a minimum of a 1st or good 2:1 in a relevant degree, preferably a relevant Masters degree, and be available to take up the studentship by 1st October 2018. The project is part-funded by the European Social Fund (ESF) through the European Union’s Convergence programme administered by the Welsh Government. KESS II PhD scholarships are collaborative awards with external partners. (Applicants need to only apply, they do not need to search for partners.)
To apply, please submit the following to the Postgraduate Admissions Office (address below) by 4th September 2018:
- A completed Research Programme Application Form, two references. Application and reference forms may be downloaded from http://www.aber.ac.uk/en/postgrad/howtoapply/
- A completed KESS II Participant proposal form (put the reference number AU30034 in the top right hand box of the application form) and an up-to-date CV. KESS II application forms are available to download at the link below.
- A PhD proposal of up to 1,000 words where you expand on your experience and interests and describe why you are a good candidate for this research studentship. Please refer to the Project Description.
Value of Award: A stipend of £14,340 (rising in accordance with inflation for the remaining two years). Each scholarship has an additional budget for travel, equipment/consumables and training to support your research. KESS II PhD Scholarship holders do not pay fees.
Length: Full-time for 3 years. (Theses must be submitted 6 months after the funded three year study period.)
Training: The achievement of a Postgraduate Skills Development Award (PSDA) is compulsory for each KESS II scholar (The PSDA is based on a 60 credit award, which is an additional award to the PhD).
Eligibility: To be eligible to apply for a KESS II award, you must be resident, upon starting the scholarship, in the Convergence Area of Wales and you must be able to take paid employment in the Convergence area on completion of the scholarship.
The Convergence Area means the following counties of Wales:
Isle of Anglesey
Neath Port Talbot
Rhondda Cynon Taff
Informal enquiries should be made to project supervisor Dr Simon Payne, at email@example.com or 01970 628629
Address for applications:
Postgraduate Admissions Office
Recruitment & Admissions
Student Welcome Centre
Quote Reference AU30034
Closing date for applications 4th September 2018