| Popis: |
Background: Chinese-Australian immigrant patients with cancer report poorer psychosocial outcomes compared to Anglo-Australians. Additionally, Chinese immigrant caregivers experience burden and anxiety associated with caregiving. Presently, there are limited resources available that can support them in coping with these challenges. This thesis aims to address this gap by developing and evaluating the acceptability and feasibility of a culturally appropriate self-management (SM) resource, WeCope, for Chinese-Australian immigrant patients and caregivers affected by cancer. Methods: A systematic review was conducted to identify the unmet supportive care needs of Chinese patients and caregivers with cancer to identify areas of concern requiring support (Chapter 2). An overview of self-management interventions, including theoretical underpinnings and evidence for effectiveness on psychological outcomes and unmet needs was provided (Chapter 3). The cultural sensitivity framework and community participatory approach were explored to guide the methods for developing WeCope with content based on a previous dyadic resource, Coping-Together (Chapter 4). Acceptability among patients, caregivers and community members was explored in a qualitative study (Chapter 5), and feasibility of WeCope as an intervention and the study methods employed were assessed in a mixed methods study (Chapter 6). Results: The systematic review (Chapter 2) showed that health system and information needs was the predominant domain of unmet need frequently reported by Chinese patients and caregivers. The qualitative study (Chapter 4) indicated overall acceptability with suggestions for additional information which informed modifications to the WeCope booklets. The feasibility study (Chapter 5) indicated barriers to the feasibility of WeCope as an intervention across several aspects: demand, acceptability, practicality, and implementation. Preliminary efficacy of WeCope could not be assessed due to low recruitment and response rates, and the study methods were deemed unfeasible for a larger trial. Conclusion: This thesis reports the acceptability and preliminary feasibility of a SM intervention for Chinese-Australian immigrants affected by cancer. While WeCope demonstrated some degree of acceptability, feasibility of the intervention and study methods were limited. Considerable additional resources and refinement of the study methods are needed if a large-scale study is undertaken. |
