Psycho-Oncology Co-operative Research Group, The University of Sydney, Sydney, Australia.
School of Psychology, The University of Sydney, Sydney, Australia.
Psychooncology. 2019 Mar;28(3):533-539. doi: 10.1002/pon.4971. Epub 2019 Jan 15.
ConquerFear is a metacognitive intervention for fear of cancer recurrence (FCR) with proven efficacy immmediately and 6 months post-treatment. This qualitative study documented barriers and facilitators to the sustainability of ConquerFear from the perspective of study therapists.
Fourteen therapists who had delivered ConquerFear in a randomised controlled trial completed a semi-structured phone interview, reaching theoretical saturation. Themes from thematic analysis were mapped to the Promoting Action on Research Implementation in Health Services (PARiHS) implementation framework.
Participants were 13 males and one female with, on average, 14 years psycho-oncology experience. Nine over-arching themes were identified, falling into three domains, which when present, were facilitators, and if absent, were barriers: evidence (intervention credibility, experienced efficacy, perceived need for intervention); context (positive attitude to and capacity for survivorship/FCR care, favourable therapist orientation and flexibility, strong referral pathways); and facilitation of implementation (intervention/service fit, intervention/patient fit, and training, support, and provided resources).
ConquerFear is a sustainable intervention in routine clinical practise. Facilitators included a sound evidence base; a receptive context; good fit between the intervention, therapist orientation, and patient need; and flexibility of delivery. Where absent, these factors served as barriers. These results have implications for enhancing uptake of psycho-oncology interventions in routine care.
ConquerFear 是一种针对癌症复发恐惧（FCR）的元认知干预措施，其疗效已在治疗后即刻和 6 个月得到证实。本定性研究从研究治疗师的角度记录了 ConquerFear 可持续性的障碍和促进因素。
14 名曾在随机对照试验中提供过 ConquerFear 的治疗师完成了半结构化电话访谈，达到了理论饱和。主题分析的主题被映射到促进健康服务研究实施行动（PARiHS）实施框架中。
参与者均为男性，平均有 14 年的心理肿瘤学经验，其中 13 人为男性，1 人为女性。确定了 9 个总体主题，分为三个领域，这些主题如果存在，则为促进因素，如果不存在，则为障碍：证据（干预可信度、经验疗效、感知干预需求）；背景（对生存/ FCR 护理的积极态度和能力、治疗师的有利取向和灵活性、强大的转诊途径）；和实施促进（干预/服务契合度、干预/患者契合度、培训、支持和提供资源）。
ConquerFear 在常规临床实践中是一种可持续的干预措施。促进因素包括坚实的证据基础、接受性的背景、干预、治疗师取向和患者需求之间的良好契合度以及灵活的实施。如果这些因素不存在，则会成为障碍。这些结果对提高心理肿瘤学干预措施在常规护理中的应用具有重要意义。
