Psychological distress in disease-free breast cancer survivors completing tamoxifen therapy: The contribution of illness and treatment representations to psychological morbidity and research portfolio

Whitnall-Pate, Leigh (2006) Psychological distress in disease-free breast cancer survivors completing tamoxifen therapy: The contribution of illness and treatment representations to psychological morbidity and research portfolio. D Clin Psy thesis, University of Glasgow.

Abstract

This retrospective audit aimed to highlight the current demands placed on the existing Adult Mental Health speciality within the Dumfries and Galloway Psychology service in terms of patient and referrer need since the reconfiguration of service provisions and to detail how the needs are currently being met. Specific aims of this audit were; to examine referral characteristics and referral outcomes received during a one-year period (between October 2002 and September 2003), examine service utilisation per geographical area, and to highlight differences in referral characteristics and referral outcome between geographical area and referring agents. Specific referral characteristics examined were: patient characteristics (age and gender) and referring problem (primary problem, chronicity, severity and complexity). Discharge forms, completed by AMH speciality staff as standard, provided the outcome of each referral, detailing reason for discharge, session attendance and subjective clinical judgment of outcome. A total number of 1303 referrals were referred to the speciality within the one-year period. There were three major referral agents to the AMH speciality, namely. General Practitioners (GP) Community Mental Health Teams (CMHT) and Psychiatric Medical Practitioners (PMP). Referrals were sent for a variety of psychological difficulties however one quarter of referrals were primarily experiencing an anxiety disorder (24.9%) and one quarter with a depressive disorder (24.6%). Attendance varied across referrals, however there were a high percentage of referrals discharged due to non-attendance (37.8%). Geographically, referrals did not differ in terms of age, sex, attendance or outcome. They did however differ in terms of severity, complexity, and chronicity of referral, which may be a reflection of referring agents in different areas or differences in AMH speciality staff rating methods. Referrals examined between referral agents did not differ in terms of age, sex, attendance or outcome. They did however differ in terms of severity, complexity, and chronicity of referral, which may be a reflection of primary and secondary caregivers or differences between AMH speciality staff rating methods. The reliability and validity of outcome ratings are questionable due to being subjective and not calibrated. Discrepancies between outcome frequencies were found and interpretations of data were difficult. The need to revise outcome categories, rating procedures, and to implement guidelines for rating referral characteristics and outcome categories for AMH speciality staff was highlighted, which may reduce future discrepancies between reported data. Staff training to enable consistent and appropriate scoring of discharge forms was recommended. AMH speciality staff inter-rater and intra-rater reliability research, with regards to scoring discharge forms, was also recommended for the department to undertake.

• Item Type: Thesis (D Clin Psy)
• Qualification Level: Doctoral
• Additional Information: Adviser: Keith Millar
• Keywords: Clinical psychology
• Date of Award: 2006
• Depositing User: Enlighten Team
• Unique ID: glathesis:2006-74008
• Copyright: Copyright of this thesis is held by the author.
• Date Deposited: 23 Sep 2019 15:33
• Last Modified: 23 Sep 2019 15:33
• URI: https://theses.gla.ac.uk/id/eprint/74008