Edinburgh Napier University

  Background: The distress thermometer is a valid
measure of distress in cancer. However, there is
less evidence as to what this may mean for the
patient experience of distress (Snowden et al.,
2011). This paper presents a grounded theory of
the patient experience of distress management
(DM) in outpatient cancer care in Scotland.
Aim: To articulate the process of DM in cancer care
from the patient perspective
Method: Constructivist grounded theory (Charmaz,
2006). Nineteen people attending OP clinic with a
diagnosis of cancer for at least 6 months, between
the ages of 51 and 82 were interviewed in late
2010. DT scores ranged from 0-10. These people
were interviewed to ascertain any specific impact
of DM on them. Interviews were concurrently
transcribed, coded for gerunds, and thematically
analysed until data saturation was approached.
Results: Experience of DM ranged from highly
positive to extremely negative. From these experiences
a process of DM was constructed that identified
the various pitfalls described by the interviewees.
These were categorised according to 3
interrelated processes, with successive processes
dependent upon successful experience in the
previous ones. The processes were: 1. Meeting the DT
2. Experiencing DM
3. Enacting DM
Examples will be given from the primary data to
illustrate the positive and negative aspects of the
process. From a clinical perspective it is clear that
the first part of the process is the most important
to get right, as this is where the bulk of disengagement
occurred. Where the process was successfully
managed it was clearly valued by people.
Discusssion: Further longitudinal study is planned
to evaluate the process in practice and to analyse
the clinical, economic and personal impact in a
prospective cohort of cancer survivors.