The development of a nurse-led psychosocial intervention with peer support for women being treated with radiotherapy for gynaecological cancer (GC)

OBJECTIVES: Radiotherapy for GC has numerous potentially distressing side effects which impact on psychosocial functioning and intimate relationships. Distress associated with diagnosis and treatment can be ameliorated by comprehensive preparation for treatment and addressing informational, physical and psychosocial needs during treatment. The proposed intervention combines tailored specialist nursing consultations with peer support (GC survivor). The objective is to develop, refine and pre-test an intervention package to ensure its relevance and acceptability to patients and clinicians. METHOD: Drawing on extensive literature reviews and consumer input, a 3-stage process for developing complex interventions, based on UK Medical Research Council Framework, was used. This comprised: (1) Problem definition: the nature and extent of unmet supportive care needs. (2) Refining the intervention by iterative clinician, and consumer review: evidence-based content; complexity and tailoring; delivery and dose; and integrity. (3) Pre-testing the intervention with 10 women and conduct interviews to assist in finalizing the intervention. RESULTS: The list of unmet needs was combined with best available evidence for self-care to draft two intervention manuals. The nurse manual specified the content of three nurse-led consultations at the pre-, mid- and end of treatment to provide tailored information, self-care coaching and MDT carecoordination. The peer manual specified the content of five phone calls (pre-, mid-, end of treatment and twice post-treatment) to provide psychosocial support and encourage adherence to the self-care plan. CONCLUSIONS: The intervention package was well-received by consumers and clinicians. The consumer feedback provided indicates that access to accurate and timely medical and self-care information from nurses is critically important, and the unique perspective of a peer lends authenticity to support that facilitates sharing, practical, emotional and meaning-based coping. The next stage is to conduct a multi-site RCT to test the effectiveness of the intervention to reduce psychological distress, psychosocial needs, psychosexual difficulties and symptoms