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Appears in Collections:Faculty of Health Sciences and Sport Journal Articles
Peer Review Status: Refereed
Title: Specialist Breast Cancer Nurses' views on implementing a fear of cancer recurrence intervention in practice: a mixed methods study
Author(s): Cruickshank, Susanne
Steel, Emma
Fenlon, Deborah
Armes, Jo
Banks, Elspeth
Humphris, Gerald
Keywords: Breast cancer
Fear of cancer recurrence
Normalisation process theory
Mixed methods
Mini-AFTERc intervention
Nurse specialist
Issue Date: Jan-2020
Citation: Cruickshank S, Steel E, Fenlon D, Armes J, Banks E & Humphris G (2020) Specialist Breast Cancer Nurses' views on implementing a fear of cancer recurrence intervention in practice: a mixed methods study. Supportive Care in Cancer, 28 (1), pp. 201-210.
Abstract: Introduction Fear of cancer recurrence (FCR) in people with breast cancer affects treatment recovery, quality of life, service utilisation and relationships. Our aim was to investigate how specialist breast cancer nurses (SBCN) respond to their patients’ fears of cancer recurrence and analyse SBCN’s views about embedding a new psychological intervention, the Mini-AFTERc, into their consultations. Method A mixed methods sequential design was used, informed by normalisation process theory. Phase 1: UK SBCNs were emailed a web-based survey to investigate how breast cancer survivors’ FCR is currently identified and managed, and their willingness to utilise the Mini-AFTERc. Phase 2: a purposive sample of respondents (n = 20) were interviewed to augment phase 1 responses, and explore views on the importance of addressing FCR, interest in the Mini-AFTERc intervention, its content, skills required and challenges to delivering the intervention. Results Ninety nurses responded to the survey. When SBCN’s were asked to identify the proportion of patients experiencing FCR in their caseload, there was no consensus on the size of the problem or unmet need. They estimated that 20–100% people experience moderate FCR and 10–70% severe FCR. The interviews identified that clinical conversations are focused primarily on giving information about signs and symptoms of recurrence rather than addressing the psychological aspects of fear. Conclusion Findings indicate wide variability in how FCR was identified, assessed and supported by a sample of UK SBCNs. The introduction of a structured intervention into practice was viewed favourably and has implications for nursing and health professional ways of working in all cancer services.
DOI Link: 10.1007/s00520-019-04762-9
Rights: © The Author(s) 2019 This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
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