Short summary

This PhD project consists of three substudies: 1) A scoping review of factors hindering or contributing to an open dialogue about CAM between cancer patients and their health care professionals 2) Co-producing an intervention that facilitates this dialogue together with patients, relatives and health care providers and 3) A feasibility study and process evaluation of the designed intervention.

Rationale

For years there has been an upward trend in patients' use of complementary and alternative medicine (CAM) as an adjunct to cancer treatment and care in Denmark and internationally. The term CAM refers to therapies such as herbs, acupuncture and meditation not part of the conventional health care system due to insufficient evidence. Despite the name "alternative", patients rarely reject conventional cancer treatment in favour of alternative treatments, but use CAM as a supplement to enhance their physical and mental well-being. Although many patients wish to discuss CAM with a health professional, they rarely do. Patients tend to hold back for fear of being stigmatized by the health professionals and the health professionals often feel they know too little of the subject to address it. This is problematic since some types of CAM interfere with conventional cancer treatment and pose a threat to patient safety. Studies have shown dialogue about CAM requires a non-judgmental, person-oriented approach in order to sufficiently address the patients' concerns and needs. Such dialogue increases quality of life and well-being, patient-centered communication, and certainty towards conventional cancer treatment. The Department of Oncology in Vejle Hospital offers specialized consultations about CAM with a nurse specialist with a Master in evidence-based CAM and the person-centered dialogue about CAM. However, the consultations are separate sessions conducted exclusively by the nurse specialist. Health professionals and patients are still reluctant towards discussing CAM in daily practice. Therefore, to ensure patient safety and high-quality care, dialogue about safe and healthy use of CAM should be integrated in daily cancer treatment and care. With this study, we intend to develop an intervention that expectedly integrates person-oriented, evidence-based CAM dialogues in daily clinical cancer practice.

The purpose of this project is to:

1. Identify barriers and facilitators towards integrating person-oriented and evidence-based dialogue about CAM in daily cancer treatment and care

2. Develop an intervention that facilitates such a dialogue in daily cancer treatment and care

3. Explore the feasibility of the developed intervention and point a direction for future explorative and effect studies.

Description of the cohort

Participants include cancer patients and their relatives as well as health professionals (doctors and nurses) at the department of Oncology and/or department of Urology, Vejle Hospital, Lillebaelt Hospital. In field studies various settings will be observed such as inpatient, outpatient, planned consultations and daily care conversation. Specifically we will observe settings in which the cancer diagnosis is delivered, during surgery, chemo- and radiation treatment and at follow-up visits.

Data and biological material

Data from he patient journal (age, gender, cancer diagnosis)

Collaborating researchers and departments

Department of Oncology, Vejle Hospital

• Lars Henrik Jensen, MD, PhD