• Development of a compassion-based training for cancer (CforC) curriculum for female breast cancer patients in stages I-III and cancer survivors. Origins, rationale and initial observations.

      Wahl, Julia; Sheffield, David; Maratos, Frances A.; Archer, Stephanie; University of Derby; Imperial College London (Elsevier, 2018-07-20)
      Compassion is an intrinsic trait and is linked to psychological and physiological well-being. It can be trained and improved through a systematic contemplative training programme. The purpose of this paper is to present a new training programme for cancer patients and survivors (CforC) that was designed and tested in a pilot study. We review the potential benefits of CforC which include attention regulation, self-regulation, mental awareness, and acceptance of physical sensations (including pain experiences). We also consider limitations. Results of the pilot suggest that the current intervention is feasible and provides potential psychological benefits for female breast cancer patients/survivors. Future research may benefit from examining other potential effects of the CforC programme, including emotional and physical outcomes in cancer patients and survivors, and the application of the intervention to other populations of chronically ill patients.
    • 'Do you mean I'm not whole?: Exploring the role of support in womens experiences of mastectomy without reconstruction

      Archer, Stephanie; Holland, Fiona G.; Montague, Jane; Imperial College London; University of Derby (Sage, 2016-09-05)
      This study explores the role of others in supporting younger women who opt not to reconstruct their breast post-mastectomy. Semi-structured interviews were conducted with six women diagnosed with breast cancer in their 30s/40s. The women lived in England, had been diagnosed a minimum of 5 years previously and had undergone unilateral mastectomy. An interpretative phenomenological analysis revealed three themes: Assuring the self: ‘I’ll love you whatever’, Challenging the self: ‘Do you mean I’m not whole?’ and Accepting the self: ‘I’ve come out the other side’. The women’s experiences of positive support and challenges to their sense of self are discussed.
    • The effect of creative psychological interventions on psychological outcomes for adult cancer patients: a systematic review of randomised controlled trials

      Archer, Stephanie; Buxton, Sarah; Sheffield, David; University of Derby; University of Derby; Derby UK; University of Derby; Derby UK; University of Derby; Derby UK (Wiley, 2014-06-21)
      Objective This systematic review examined the effectiveness of creative psychological interventions (CPIs) for adult cancer patients. In particular, the findings of randomised controlled trials of art, drama, dance/movement and music therapies on psychological outcomes were examined. Methods The review yielded 10 original studies analysing data from a total of 488 patients. Data extraction and quality assessment were conducted by two independent reviewers. Results Four of the papers focused on the use of art therapy, three studies used music therapy, one paper utilised dance therapy, one study used dance/movement therapy and the remaining paper used creative arts therapies, which was a combination of different art-based therapy approaches. Eight papers focused solely on breast cancer patients, and the remaining studies included mixed cancer sites/stages. The studies reported improvements in anxiety and depression, quality of life, coping, stress, anger and mood. However, few physical benefits of CPIs were reported; there was no significant impact of a CPI on physical aspects of quality of life, vigour-activity or fatigue-inertia or physical functioning. One study was assessed as high quality, seven studies were assessed as satisfactory and two studies were assessed to be of poorer quality. Conclusions There is initial evidence that CPIs benefit adult cancer patients with respect to anxiety and depression, quality of life, coping, stress, anger and mood; there was no evidence to suggest that any one type of CPI was especially beneficial. However, more and better quality research needs to be conducted, particularly in the areas of drama and dance/movement therapies.
    • Experiences of enhanced recovery after surgery in general gynaecology patients: An interpretative phenomenological analysis.

      Phillips, Elly; Archer, Stephanie; Montague, Jane; Bali, Anish; University of Derby (Sage, 2019-07-03)
      There is little qualitative research exploring non-cancer gynaecology patients’ experiences of enhanced recovery after surgery (ERAS) protocols. Seven women participated in audio-recorded interviews, discussing their experiences of enhanced recovery after surgery for gynaecological surgery. Data were transcribed and analysed using interpretative phenomenological analysis. Three themes were identified: meeting informational needs, taking control of pain, and mobilising when feeling fragile. Control emerged as a key element throughout the themes and was supported by provision of factual information. While participants were generally satisfied with their experience, topics such as concerns about analgesic use, the informal role of staff in mobilisation, and the expressed desire for more experiential information for participants require further research.
    • "I'm 100% for it! I'm a convert!": Women's experiences of a yoga programme during treatment for gynaecological cancer; an interpretative phenomenological analysis.

      Archer, Stephanie; Phillips, Elly; Montague, Jane; Bali, Anish; Sowter, Heidi M.; University of Derby; Royal Derby Hospital, Derby (Elsevier, 2015-02)
      To explore patients' experiences of taking part in a yoga intervention while undergoing treatment for gynaecological cancer.
    • “A peculiar time in my life”: making sense of illness and recovery with gynaecological cancer

      Phillips, Eleanor; Montague, Jane; Archer, Stephanie; University of Derby; Imperial College London; Psychology, University of Derby, Derby, UK; Psychology, University of Derby, Derby, UK; NIHR Imperial Patient Safety Translational Research Centre, Imperial College London, St Mary’s Hospital, London, UK (Taylor and Francis, 2017-08-31)
      Purpose: Worldwide there are nearly 1.1 million new cases of gynaecological cancer annually. In England, uterine, ovarian and cervical cancers comprize the third most common type of new cancer in women. Research with gynaecological cancer patients within 6 months of diagnosis is rare, as is data collection that is roughly contemporaneous with treatment. Our aim was to explore the experiences of women who were, at study entry, within 6 weeks of surgery or were undergoing chemotherapy or radiotherapy. Methods: An interpretative phenomenological analysis (IPA) of data from 16 women in five focus groups was conducted in the UK, exploring women’s experiences of being diagnosed with and treated for gynaecological cancer. Results: Participants conceptualized their experiences temporally, from the shock of diagnosis, through their cancer treatment, to thinking about recovery. They tried to make sense of diagnosis, even with treatment being complete. In the context of the Self-Regulation Model, these women were struggling to interpret a changing and multi-faceted illness identity, and attempting to return to pre-illness levels of health. Conclusions: This study adds to this under-studied time period in cancer survivorship. The results suggest that survivors’ goals may change from returning to pre-illness status to reformulating goals as survival time increases.
    • Thresholds of size: An interpretative phenomenological analysis of childhood messages around food, body, health and weight.

      Holland, Fiona G.; Peterson, Karin; Archer, Stephanie; University of Derby; University of North Carolina Asheville; Imperial College London (Open Journal Systems, 2018-05-04)
      This study explores the lived experiences of non-dieting, middle-aged Western women classified as ‘overweight’ or ‘obese’ on BMI charts. Qualitative research that has focused on non-weight loss experiences with this population has been rare. This study aims to allow their experiences to be heard within the mainstream health literature. Four women from aged 40-55 were interviewed about their early messages and experiences around food, body, health and weight. An interpretative phenomenological analysis was conducted. Three themes were identified: 1) family culture and body norms 2) thresholds of size and 3) action and outcome. Participants identified a range of influences upon their early body appraisal, with parents, extended family, peers and community members contributing to their understanding of what constituted as an acceptable size. The impact upon their sense of identity and emotional wellbeing is discussed. This study contributes to the role of the modelling and messages around size and value given by important others and the psychological ramifications these can have over time.
    • Worlds within worlds: a strategy for using interpretative phenomenological analysis with focus groups

      Phillips, Eleanor; Montague, Jane; Archer, Stephanie; University of Derby; Imperial College London (Taylor and Francis, 2016-06-29)
      There is increasing interest in applying interpretative phenomenological analysis (IPA) to focus group data and in developing appropriate strategies for doing so. These strategies should exploit the unique features of focus groups, which provide a rich canvas of experiences not seen in individual interviews, while remaining true to the personal, phenomenological perspective of IPA. We present a four-stage approach with specific group focused analytical strategies: looking for “groupness,” clustering reoccurring group interactions, identifying interactional relationships, and incorporating group elements into an analysis. These stages are illustrated with worked examples developed while working with data from focus groups of women with gynaecological cancer discussing a yoga intervention, and explain how these can enrich our understanding of participants’ lived experiences. This approach demonstrates a suggested framework for developing IPA themes from focus group data by analysing and interpreting the group setting. We discuss links to psychological concepts, potential applications and limitations. This empirically based methodology is presented as a practical guide for other researchers grappling with this type of data.
    • Younger women’s experiences of deciding against delayed breast reconstruction post-mastectomy following breast cancer: An interpretative phenomenological analysis

      Holland, Fiona G.; Archer, Stephanie; Montague, Jane; University of Derby (Sage Publications, 2014-12-16)
      Most women do not reconstruct their breast(s) post-mastectomy. The experiences of younger women who maintain this decision, although important to understand, are largely absent in the research literature. This interview-based study uses interpretative phenomenological analysis to explore the experiences of six women, diagnosed with primary breast cancer in their 30s/40s, who decided against delayed reconstruction. Findings reported here focus on one superordinate theme (decision-making) from a larger analysis, illustrating that the women’s drive to survive clearly influenced their initial decision-making process. Their tenacity in maintaining their decision is highlighted, despite non-reconstruction sometimes being presented negatively by medical teams. Patient-centred support recommendations are made.