Exploring patient-related contextual factors and personal reflections about patient engagement in the Managing Cancer and Living Meaningfully (CALM) intervention: A mixed methods study among adults with advanced cancer in Southern Alberta

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dc.contributor.advisorde Groot, Janet
dc.contributor.advisorSimon, Jessica
dc.contributor.authorSears, Carly Sherrington
dc.contributor.committeememberPatten, Scott
dc.contributor.committeememberFeldstain, Andrea
dc.date.accessioned2024-07-09T17:08:01Z
dc.date.available2024-07-09T17:08:01Z
dc.date.issued2024-07-04
dc.description.abstractBackground: The evidence-based Managing Cancer and Living Meaningfully (CALM) psychotherapeutic intervention was designed to address the complex needs of those with advanced cancer. Ample evidence supports the efficacy of CALM therapy; less is known about the patient-specific factors that influence initiation and continuation of CALM sessions. Objective: This study aimed to enhance our understanding of the impacts of patient-specific factors, referral routes, and timing of referral on engagement in CALM therapy, with particular attention to the integration of patient voices through in-depth interviews. Methods: This study used a concurrent triangulation mixed methods design involving analysis of baseline questionnaire data and referral details from participants in the CALM Implementation study (n = 69). Participants who consented to follow-up (n = 24) were invited to participate in brief, virtual interviews after completion of CALM therapy. Thematic analysis, within an Interpretive Description framework, was used to analyze interview responses (n = 10). Results: Triangulation of quantitative and qualitative results suggests that initiation and continuation of CALM sessions is affected by multiple, complex factors including mood symptoms, referral route, need for support outside of family/friends, and decline in health status. Patients directly referred to CALM by healthcare providers (HCP) and those who self-referred (total n = 32) engaged in more CALM sessions (M = 4.97, SD = 3.51) versus those first referred to general Psychosocial Oncology (i.e., indirect referral; M = 3.19, SD = 2.26, p < 0.05). Stratified analysis found this effect was significant among younger participants (<65 years) and those with longer life expectancy (>10 months). Some participants suggested automatic referral to CALM following an advanced cancer diagnosis. Provision of comprehensive intervention information, highlighting benefits while being sensitive to mortality fears, was deemed valuable to allow for informed decision-making. Conclusion: Findings suggest that timing and referral route are important to our understanding of participation in CALM. Greater patient engagement in the CALM intervention following direct referral from a HCP may be based on trust in the HCP-patient relationship. Future health systems research may evaluate an automatic referral system in which CALM is offered to all patients following an advanced cancer diagnosis.
dc.identifier.citationSears, C. S. (2024). Exploring patient-related contextual factors and personal reflections about patient engagement in the Managing Cancer and Living Meaningfully (CALM) intervention: a mixed methods study among adults with advanced cancer in Southern Alberta (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.
dc.identifier.urihttps://hdl.handle.net/1880/119153
dc.language.isoen
dc.publisher.facultyGraduate Studies
dc.publisher.institutionUniversity of Calgary
dc.rightsUniversity of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.
dc.subjectadvanced cancer
dc.subjectpsychosocial oncology
dc.subjectearly palliative care
dc.subjectreferral routes
dc.subjectpsychological intervention
dc.subject.classificationOncology
dc.titleExploring patient-related contextual factors and personal reflections about patient engagement in the Managing Cancer and Living Meaningfully (CALM) intervention: A mixed methods study among adults with advanced cancer in Southern Alberta
dc.typemaster thesis
thesis.degree.disciplineMedicine – Community Health Sciences
thesis.degree.grantorUniversity of Calgary
thesis.degree.nameMaster of Science (MSc)
ucalgary.thesis.accesssetbystudentI do not require a thesis withhold – my thesis will have open access and can be viewed and downloaded publicly as soon as possible.
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