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Martin Dempster1, Noleen McCorry2, Emma Brennan1, Michael Donnelly3, Liam Murray3, Brian Johnston4 1School of Psychology, Queen’s University Belfast; 2Marie Curie Cancer Care, Belfast 3Centre for Public Health, Queen’s University Belfast; 4Belfast Health & Social Care Trust Project Funded by Action Cancer Facilitated by the Oesophageal Patients’ Association An approach that is relevant to the psychological needs of people who have received a diagnosis of oesophageal cancer and their carers A therapeutic intervention that is not resource-intensive Survey at 2 points in time Focus groups Development of intervention 2006 2007 - 2010 2011 2014 Interviews Publication of findings Testing of intervention Beliefs about Illness / Condition Coping Strategies Appraisal of Outcome Cognitions Demographic Interpersonal •Age •Social support •Psychiatric history •Carer Medical •Disease course •Treatment •Pain •Stage / grade Personality Psychological Distress •Optimism •Neuroticism •Fatalism Cognitions Psychological Distress Ways of Coping Beliefs Illness Perceptions Questionnaire Revised Cause Timeline Control Consequences Coherence Reflect / relax Positive focus Diversion Planning Interpersonal support Levels of: Anxiety and Depression Cancer Coping Questionnaire Hospital Anxiety and Depression Scale Fear of Recurrence Scale To determine which beliefs / coping strategies are strongest predictors of anxiety/depression among people diagnosed with oesophageal cancer and their carers To determine whether incongruence in carerpatient beliefs is related to distress (i.e. is the relationship between patient beliefs and distress moderated by carer beliefs) To determine whether coping strategies mediate the relationship between beliefs and distress Survivors of oesophageal cancer People identified as carers Number 458 382 Average age 65 62 Gender 66% male 75% female 91% were the spouse or partner of the person they cared for Anxiety Survivors Mild 16% Moderate Severe 11% 8% Carers 20% 19% 11% Depression Mild Survivors 13% Carers 15% Moderate Severe 7% 3% 8% 2% Similar to head/neck cancer but higher than other cancers Potential Survivors Carers Midpoint Mean (SD) Mean (SD) IPQ Acute/chronic timeline 18 23.30 (4.68) 23.03 (4.80) IPQ Cyclical timeline 14 12.12 (3.65) 12.23 (3.42) IPQ Treatment control 15 17.17 (3.64) 16.77 (3.53) IPQ Emotional cause 15 12.12 (3.99) 12.52 (3.83) IPQ Behavioural cause * 12 10.43 (3.72) 9.98 (3.72) IPQ Externalised cause 12 14.90 (3.55) 15.08 (3.32) IPQ Consequences *** 18 21.10 (4.82) 22.19 (4.66) (for survivor) IPQ Consequences *** 18 21.10 (4.82) 12.65 (3.20) (for self) IPQ Personal control *** 18 20.05 (4.91) 18.90 (4.74) (for survivor) IPQ Personal control *** 18 20.05 (4.91) 16.07 (4.13) (for self) IPQ Illness coherence 15 19.37 (4.28) 19.22 (3.85) (for survivor) IPQ Illness coherence 15 19.37 (4.28) 19.30 (4.04) (for self) Anxiety R2 = 0.57: Medical/demographic variables – 12% Beliefs – 37%; Coping – 7% Depression R2 = 0.53: Medical/demographic variables – 12% Beliefs – 35%; Coping – 6% Personal control Positive focus Illness coherence No reflection or diversion No other illnesses Older Treatment control (carer) Consequences Lower Anxiety Interaction Illness coherence Personal control Positive focus No related symptoms No reflection No other illnesses Time since diagnosis Treatment control (carer) Consequences Lower Depression Interaction Interventions at the level of the dyad could be useful Focus on consequences, control and understanding of oesophageal cancer and encourage positive focus coping strategies Development of intervention based on these cognitions Possible techniques: normalising the lack of personal control and emotional distress, avoid catastrophising, psychoeducation to improve understanding, positive self-talk Planned feasibility study, leading to trial