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 rep...
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| Format: | Article |
| Language: | English |
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BMC
2023-09-01
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| Series: | BMC Nursing |
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| Online Access: | https://doi.org/10.1186/s12912-023-01441-3 |
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| author | Cherish Boxall Deborah Fenlon Carl May Jacqui Nuttall Myra S. Hunter |
| author_facet | Cherish Boxall Deborah Fenlon Carl May Jacqui Nuttall Myra S. Hunter |
| author_sort | Cherish Boxall |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-10T22:03:40Z |
| format | Article |
| id | doaj.art-c787c9de8a0a4903944ff2a880465aee |
| institution | Directory Open Access Journal |
| issn | 1472-6955 |
| language | English |
| last_indexed | 2024-03-10T22:03:40Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nursing |
| spelling | doaj.art-c787c9de8a0a4903944ff2a880465aee2023-11-19T12:51:58ZengBMCBMC Nursing1472-69552023-09-0122111110.1186/s12912-023-01441-3Implementing 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 trialCherish Boxall0Deborah Fenlon1Carl May2Jacqui Nuttall3Myra S. Hunter4Southampton Clinical Trials Unit, University of SouthamptonDepartment of Nursing, School of Health and Social Care, Faculty of Medicine, Health and Life Science, University of SwanseaFaculty of Public Health and Policy, London School of Hygiene and Tropical MedicineSouthampton Clinical Trials Unit, University of SouthamptonDepartment of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College LondonAbstract 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.https://doi.org/10.1186/s12912-023-01441-3NurseCBTImplementationBreast cancerGroupQualitative |
| spellingShingle | Cherish Boxall Deborah Fenlon Carl May Jacqui Nuttall Myra S. Hunter 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 BMC Nursing Nurse CBT Implementation Breast cancer Group Qualitative |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | Nurse CBT Implementation Breast cancer Group Qualitative |
| url | https://doi.org/10.1186/s12912-023-01441-3 |
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