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Implementing a nurse-delivered cognitive behavioural therapy intervention to reduce the impact of hot flushes/night sweats in women with breast cancer: a qualitative process evaluation of the MENOS4 trial

Implementing a nurse-delivered cognitive behavioural therapy intervention to reduce the impact of hot flushes/night sweats in women with breast cancer: a qualitative process evaluation of the MENOS4 trial
Implementing a nurse-delivered cognitive behavioural therapy intervention to reduce the impact of hot flushes/night sweats in women with breast cancer: a qualitative process evaluation of the MENOS4 trial
Abstract Background Hot flushes and night sweats are life-altering symptoms experienced by many women after breast cancer treatment. A randomised controlled trial (RCT) was conducted to explore the effectiveness of breast care nurse (BCN)-led group cognitive behavioural therapy (CBT). This paper reported findings from a qualitative process evaluation to optimise the CBT intervention and explore the determinants of implementation into routine practice. Methods Qualitative process evaluation occurred in parallel with the RCT to explore patient and healthcare staff experiences and perspectives using semi-structured interviews pre-and post-intervention. Normalisation Process Theory (NPT) informed data collection, analysis, and reporting of findings. The analysis involved inductive thematic analysis, NPT coding manual and subsequent mapping onto NPT constructs. Results BCNs (n = 10), managers (n = 2), surgeons (n = 3) and trial participants (n = 8) across six recruiting sites took part. All stakeholders believed group CBT met a need for non-medical hot flushes/night sweats treatment, however, had little exposure or understanding of CBT before MENOS4. BCNs believed the work fitted with their identity and felt confident in delivering the sessions. Despite little understanding, patients enrolled onto group CBT because the BCNs were trusted to have the knowledge and understanding to support their needs and despite initial scepticism, reported great benefit from group-based participation. Both managers and surgeons were keen for BCNs to take responsibility for all aspects of CBT delivery, but there were some tensions with existing clinical commitments and organisational priorities. Conclusions Both healthcare staff and patient participants believe BCN-led group CBT is a beneficial service but barriers to long-term implementation into routine care suggest there needs to be multi-level organisational support. Trial registration NCT02623374 – Last updated 07/12/2015 on ClinicalTrials.gov PRS.
figshare
May, Carl
17697f8d-98f6-40d3-9cc0-022f04009ae4
Fenlon, Deborah
52f9a9f1-1643-449c-9856-258ef563342c
Boxall, Cherish
62deb102-02d5-4613-bd6c-7f2606367b0a
Nuttall, Jacqui
b4c18569-1ab8-4fb6-b72d-1a61ad271a1a
Hunter, Myra S.
fce15222-f73f-478a-87fd-d480cac6fd2a
May, Carl
17697f8d-98f6-40d3-9cc0-022f04009ae4
Fenlon, Deborah
52f9a9f1-1643-449c-9856-258ef563342c
Boxall, Cherish
62deb102-02d5-4613-bd6c-7f2606367b0a
Nuttall, Jacqui
b4c18569-1ab8-4fb6-b72d-1a61ad271a1a
Hunter, Myra S.
fce15222-f73f-478a-87fd-d480cac6fd2a

(2023) Implementing a nurse-delivered cognitive behavioural therapy intervention to reduce the impact of hot flushes/night sweats in women with breast cancer: a qualitative process evaluation of the MENOS4 trial. figshare doi:10.6084/m9.figshare.c.6838317 [Dataset]

Record type: Dataset

Abstract

Abstract Background Hot flushes and night sweats are life-altering symptoms experienced by many women after breast cancer treatment. A randomised controlled trial (RCT) was conducted to explore the effectiveness of breast care nurse (BCN)-led group cognitive behavioural therapy (CBT). This paper reported findings from a qualitative process evaluation to optimise the CBT intervention and explore the determinants of implementation into routine practice. Methods Qualitative process evaluation occurred in parallel with the RCT to explore patient and healthcare staff experiences and perspectives using semi-structured interviews pre-and post-intervention. Normalisation Process Theory (NPT) informed data collection, analysis, and reporting of findings. The analysis involved inductive thematic analysis, NPT coding manual and subsequent mapping onto NPT constructs. Results BCNs (n = 10), managers (n = 2), surgeons (n = 3) and trial participants (n = 8) across six recruiting sites took part. All stakeholders believed group CBT met a need for non-medical hot flushes/night sweats treatment, however, had little exposure or understanding of CBT before MENOS4. BCNs believed the work fitted with their identity and felt confident in delivering the sessions. Despite little understanding, patients enrolled onto group CBT because the BCNs were trusted to have the knowledge and understanding to support their needs and despite initial scepticism, reported great benefit from group-based participation. Both managers and surgeons were keen for BCNs to take responsibility for all aspects of CBT delivery, but there were some tensions with existing clinical commitments and organisational priorities. Conclusions Both healthcare staff and patient participants believe BCN-led group CBT is a beneficial service but barriers to long-term implementation into routine care suggest there needs to be multi-level organisational support. Trial registration NCT02623374 – Last updated 07/12/2015 on ClinicalTrials.gov PRS.

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Published date: 1 January 2023

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Local EPrints ID: 483993
URI: http://eprints.soton.ac.uk/id/eprint/483993
PURE UUID: fcc1b680-144d-4e4d-a5f0-134ee2eecb12
ORCID for Carl May: ORCID iD orcid.org/0000-0002-0451-2690
ORCID for Cherish Boxall: ORCID iD orcid.org/0000-0002-7850-233X

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Date deposited: 08 Nov 2023 18:16
Last modified: 24 Jan 2024 02:56

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Contributors

Contributor: Carl May ORCID iD
Contributor: Deborah Fenlon
Contributor: Cherish Boxall ORCID iD
Contributor: Jacqui Nuttall
Contributor: Myra S. Hunter

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