An Anxiety Self-management Programme for Women with Gynaecological Malignancies

The Northern Gynaecological Oncology Centre (NGOC) is a specialist centre, based in Gateshead, Tyne and Wear, which provides care for women with suspected and/or confirmed gynaecological malignancies diagnosed through tests at their local hospital. Patients are referred from eight different hospitals across the north of England. Geographically patients often travel long distances for review and treatment in the centre and frequently express feelings of anxiety whilst waiting to undergo surgery. Existing methods of managing patient anxiety have not always been successful and this sparked the project team’s initial interest in the development of an anxiety self-management programme. As the project progressed, the overall aim changed as the project team wanted to understand the lived experience of anxiety in women with gynaecological cancers and to use this experience to redesign the service. The experience based design methodology (NHS Institute for Innovation and Improvement, 2009), was used as the framework for the project, with methods such as patient diaries and questionnaires initially used to try and gain an insight into what anxiety meant to the woman experiencing it. However these methods did not yield the in-depth information anticipated and emotional touchpoint interviews (Bate and Robert, 2007a) were then used to gain this level of understanding. Initial attempts at engaging project stakeholders through the use of meetings and presentations were unsuccessful. Stakeholders in the project were ultimately engaged as part of ward away-days and workshop events, using practice development techniques such as fourth generation evaluation (Guba and Lincoln, 1989). Through this process staff were able to identify areas for improvement to the patient experience and the service is currently being redesigned to incorporate these changes. Additional outcomes include a closer working relationship amongst the nursing teams involved in the project and improved facilitation skills of the project team. Recommendations for future practice development initiatives include more thorough exploration of all potential stakeholders at the start of the project with a senior member of staff as part of the project team, use of skilled facilitation techniques earlier in the project to encourage stakeholder engagement, use of digital recording equipment for interviews and the use of a workplace culture analysis tool at the start and end of the project.

This project was supported by the Foundation of Nursing Studies Patients First Programme in partnership with the Burdett Trust for Nursing.