Abstract

People with advanced cancer and their carers experience stress and uncertainty during their illness. This affects quality of life and physical and mental health. These health issues are a burden to patients and careers, and can lead to increased NHS costs if professional interventions are required. Accceptable, patient and carer centred, cost-effective interventions to promote the maintenance of well being are needed. Currently, most health care professionals assess patients to identify symptoms such as anxiety and distress, but do not routinely identify what someone is doing to cope, or whether these are effective coping strategies. Most people have coping strategies that they use to help them deal with these feelings, and it may be that some interventions by health care professionals may undermine such strategies. We want to develop approaches that stimulate and facilitate patients' own resources and strategies, adn understand how health care professionals can best work to support these.

Our aim is to understand how people with advanced cancer and their carers learn about and develop positive coping strategies to self-manage stress and uncertainty in their lives and thus recover or maintain psychological well being.

We will be talking to people with advanced cancer and their carers in depth to understand more about the details of what people actually do to cope, and what hindered or facilitated a return to feeling better, expecially what healthcare professionals can do to help people use better coping strategies.

We will use this information to work with patients and carers to develop a patient and carer centred intervention to enable sharing and using effective coping strategies. Our approach is novel, pragmatic, and patient and carer centred in its focus on self management of well-being rather than ill-health.