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Understanding the Importance of Therapeutic Relationships in the Development of Self-Management Behaviours After Cancer Rehabilitation: A Qualitative Mixed-Methods Study / WENDY WILKINSON

Swansea University Author: WENDY WILKINSON

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DOI (Published version): 10.23889/SUthesis.58635

Abstract

This Professional Practice Doctorate research explored the importance and impact of therapeutic relationships in the development of sustainable self-management behaviours during cancer rehabilitation. This research aimed to evidence the need to preserve person-centred cancer rehabilitation. It aimed...

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Published: Swansea 2021
Institution: Swansea University
Degree level: Doctoral
Degree name: Professional Doctorate
Supervisor: Fitzsimmon, Deborah ; Rance, Jaynie
URI: https://cronfa.swan.ac.uk/Record/cronfa58635
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first_indexed 2021-11-12T15:24:01Z
last_indexed 2021-11-13T04:25:42Z
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It aimed to protect local services from organisational pressures to rationalise rehabilitation through standardised, protocol driven practice. Therapeutic relationships are an important aspect of multi-disciplinary healthcare practice. However, they receive inversely proportionate attention in the research literature. Where research exists, it has often focused on elements of the relationship, rather the entire relationship. This is likely reflective of the complexity of therapeutic relationships. This research was undertaken in three phases alongside clinical practice. An integrative literature review was completed in parallel to semi-structured interviews, and a Modified Delphi Technique. The results confirmed the underlying assumption that the local cancer rehabilitation service was effective in supporting the development of self-management behaviours. Participants perceived professionals&#x2019; characteristics and behaviours to be a significant barrier or enabler to the development of therapeutic relationships. Therapeutic relationships were found to have significant roles or functions at different stages of cancer rehabilitation. On completion of cancer rehabilitation, the dissolution of therapeutic relationships was not consistently well managed by professionals, resulting in residual dependency or alienation. Poor participant experiences of previous therapeutic relationships may explain poor early engagement in rehabilitation, protracted rehabilitation duration and poor self-management outcomes. These findings provide insight for decision-making around cancer rehabilitation service design and workforce skills development. This research sets the foundation for future studies to measure the impact of therapeutic relationships on self-management outcomes. 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spelling 2021-11-12T15:53:27.1297148 v2 58635 2021-11-12 Understanding the Importance of Therapeutic Relationships in the Development of Self-Management Behaviours After Cancer Rehabilitation: A Qualitative Mixed-Methods Study 5a33865a72a7e0452123f4c37f680b76 WENDY WILKINSON WENDY WILKINSON true false 2021-11-12 This Professional Practice Doctorate research explored the importance and impact of therapeutic relationships in the development of sustainable self-management behaviours during cancer rehabilitation. This research aimed to evidence the need to preserve person-centred cancer rehabilitation. It aimed to protect local services from organisational pressures to rationalise rehabilitation through standardised, protocol driven practice. Therapeutic relationships are an important aspect of multi-disciplinary healthcare practice. However, they receive inversely proportionate attention in the research literature. Where research exists, it has often focused on elements of the relationship, rather the entire relationship. This is likely reflective of the complexity of therapeutic relationships. This research was undertaken in three phases alongside clinical practice. An integrative literature review was completed in parallel to semi-structured interviews, and a Modified Delphi Technique. The results confirmed the underlying assumption that the local cancer rehabilitation service was effective in supporting the development of self-management behaviours. Participants perceived professionals’ characteristics and behaviours to be a significant barrier or enabler to the development of therapeutic relationships. Therapeutic relationships were found to have significant roles or functions at different stages of cancer rehabilitation. On completion of cancer rehabilitation, the dissolution of therapeutic relationships was not consistently well managed by professionals, resulting in residual dependency or alienation. Poor participant experiences of previous therapeutic relationships may explain poor early engagement in rehabilitation, protracted rehabilitation duration and poor self-management outcomes. These findings provide insight for decision-making around cancer rehabilitation service design and workforce skills development. This research sets the foundation for future studies to measure the impact of therapeutic relationships on self-management outcomes. These insights could also inform the design and evaluation of learning opportunities for professionals, optimising the management of therapeutic relationships. Future research would focus on how to support professionals to meet the long-term needs of people affected by cancer and other LTCs. E-Thesis Swansea oncology; qualitative research; rehabilitation medicine; self-management; survivorship; therapeutic relationship 12 11 2021 2021-11-12 10.23889/SUthesis.58635 A selection of third party content is redacted or is partially redacted from this thesis due to copyright restrictions.ORCID identifier: https://orcid.org/0000-0003-1241-5740 COLLEGE NANME COLLEGE CODE Swansea University Fitzsimmon, Deborah ; Rance, Jaynie Doctoral Professional Doctorate Swansea Bay University Health Board formerly known as Abertawe Bro Morgannwg University Health Board 2021-11-12T15:53:27.1297148 2021-11-12T15:17:58.6339284 Faculty of Medicine, Health and Life Sciences School of Health and Social Care - Nursing WENDY WILKINSON 1 58635__21516__7a9d95cfb3854cc696933e6167a3316d.pdf Wilkinson_Wendy_M_Prof_Doc_Thesis_Final_Redacted.pdf 2021-11-12T15:39:08.8744514 Output 6289917 application/pdf Redacted version - open access true Copyright: The author, Wendy M. Wilkinson, 2020. true eng
title Understanding the Importance of Therapeutic Relationships in the Development of Self-Management Behaviours After Cancer Rehabilitation: A Qualitative Mixed-Methods Study
spellingShingle Understanding the Importance of Therapeutic Relationships in the Development of Self-Management Behaviours After Cancer Rehabilitation: A Qualitative Mixed-Methods Study
WENDY WILKINSON
title_short Understanding the Importance of Therapeutic Relationships in the Development of Self-Management Behaviours After Cancer Rehabilitation: A Qualitative Mixed-Methods Study
title_full Understanding the Importance of Therapeutic Relationships in the Development of Self-Management Behaviours After Cancer Rehabilitation: A Qualitative Mixed-Methods Study
title_fullStr Understanding the Importance of Therapeutic Relationships in the Development of Self-Management Behaviours After Cancer Rehabilitation: A Qualitative Mixed-Methods Study
title_full_unstemmed Understanding the Importance of Therapeutic Relationships in the Development of Self-Management Behaviours After Cancer Rehabilitation: A Qualitative Mixed-Methods Study
title_sort Understanding the Importance of Therapeutic Relationships in the Development of Self-Management Behaviours After Cancer Rehabilitation: A Qualitative Mixed-Methods Study
author_id_str_mv 5a33865a72a7e0452123f4c37f680b76
author_id_fullname_str_mv 5a33865a72a7e0452123f4c37f680b76_***_WENDY WILKINSON
author WENDY WILKINSON
author2 WENDY WILKINSON
format E-Thesis
publishDate 2021
institution Swansea University
doi_str_mv 10.23889/SUthesis.58635
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str School of Health and Social Care - Nursing{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Health and Social Care - Nursing
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description This Professional Practice Doctorate research explored the importance and impact of therapeutic relationships in the development of sustainable self-management behaviours during cancer rehabilitation. This research aimed to evidence the need to preserve person-centred cancer rehabilitation. It aimed to protect local services from organisational pressures to rationalise rehabilitation through standardised, protocol driven practice. Therapeutic relationships are an important aspect of multi-disciplinary healthcare practice. However, they receive inversely proportionate attention in the research literature. Where research exists, it has often focused on elements of the relationship, rather the entire relationship. This is likely reflective of the complexity of therapeutic relationships. This research was undertaken in three phases alongside clinical practice. An integrative literature review was completed in parallel to semi-structured interviews, and a Modified Delphi Technique. The results confirmed the underlying assumption that the local cancer rehabilitation service was effective in supporting the development of self-management behaviours. Participants perceived professionals’ characteristics and behaviours to be a significant barrier or enabler to the development of therapeutic relationships. Therapeutic relationships were found to have significant roles or functions at different stages of cancer rehabilitation. On completion of cancer rehabilitation, the dissolution of therapeutic relationships was not consistently well managed by professionals, resulting in residual dependency or alienation. Poor participant experiences of previous therapeutic relationships may explain poor early engagement in rehabilitation, protracted rehabilitation duration and poor self-management outcomes. These findings provide insight for decision-making around cancer rehabilitation service design and workforce skills development. This research sets the foundation for future studies to measure the impact of therapeutic relationships on self-management outcomes. These insights could also inform the design and evaluation of learning opportunities for professionals, optimising the management of therapeutic relationships. Future research would focus on how to support professionals to meet the long-term needs of people affected by cancer and other LTCs.
published_date 2021-11-12T04:15:19Z
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score 11.013686

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