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How and under which circumstances does a rapid diagnostic pathway for prostate cancer work to reduce anxiety for patients? A realist evaluation based on patient, caregiver and staff perspectives
BMJ Connections Oncology, Volume: 2, Issue: 1, Start page: e000031
Swansea University Authors:
Katie Jones, Jaynie Rance
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DOI (Published version): 10.1136/bmjconc-2025-000031
Abstract
Introduction Referral to a cancer diagnostic pathway is a stressful life event, yet distress may be exacerbated by long waiting times, miscommunications or other avoidable challenges. A model prostate cancer (PCa) rapid diagnostic pathway (RDP) called Prostad has been developed and trialled to reduc...
| Published in: | BMJ Connections Oncology |
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| ISSN: | 3049-5784 |
| Published: |
BMJ
2025
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| Online Access: |
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| URI: | https://cronfa.swan.ac.uk/Record/cronfa70226 |
| Abstract: |
Introduction Referral to a cancer diagnostic pathway is a stressful life event, yet distress may be exacerbated by long waiting times, miscommunications or other avoidable challenges. A model prostate cancer (PCa) rapid diagnostic pathway (RDP) called Prostad has been developed and trialled to reduce the time between referral or diagnosis. This realist evaluation asks how, for whom and under which circumstances this model RDP may reduce anxiety for patients.Research design and methods We conducted semi-structured realist interviews with staff, carers/ partners of patients and patients exploring how, for whom and under which circumstances the PCa RDP produced intended and unintended outcomes. We also attended monthly programme development meetings and had access to documentation regarding the pathway and its development, which we used to produce theories regarding the contextual and mechanistic factors influencing patient experience of the RDP.Results We interviewed staff (n=12), patients (n=15) and partners or carers of patients (n=3) to produce five programme theories regarding how patients interact with Prostad to produce outcomes. These theories are organised under five themes: rapidity; communication and virtual consultations; communication and continuity; disempowerment and distress; agency mitigating anxiety.Conclusions Earlier diagnosis is viewed positively by participants; however, in a context where patients have low expectations of health services, the speed of RDPs needs to be adequately communicated at the time the pathway is introduced to the patient to avoid unnecessary concern regarding the rapidity. Patients value regular and consistent communication, which may help mitigate illness uncertainty and offer a sense of control. |
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| College: |
Faculty of Medicine, Health and Life Sciences |
| Funders: |
Funded by Cancer Research UK [2022/100013] |
| Issue: |
1 |
| Start Page: |
e000031 |