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      Psychological adaptation and recovery in youth with sarcoma: a qualitative study with practical implications for clinical care and research

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          Abstract

          Objectives

          This study explored factors that play a role in psychological adaptation and recovery of young people with sarcoma.

          Design

          Qualitative study.

          Setting

          National Health Service hospitals in the UK.

          Methods

          Using purposive sampling, participants were recruited for semistructured interviews over the telephone or face to face in order to answer questions about how cancer impacted various domains of their life. Data were analysed using a framework approach.

          Results

          Thirty participants, aged 15–39 years with primary sarcoma diagnosis provided in-depth accounts of their experience. Emerging themes from the interviews were grouped into two overarching themes that relate to one’s adaptation to illness: individual level and environmental level. The qualitative nature of our study sheds light on meaningful connections between various factors and their role in one’s psychological adaptation to sarcoma. We devised a visual matrix to illustrate how risk and protective factors in adaptation vary between and within individuals.

          Conclusions

          This study demonstrates that young people with sarcoma report an array of both positive and negative factors related to their illness experience. The route to recovery is a multifactorial process and a one-size-fits-all approach to psychosocial care proves inadequate. We propose that moving beyond the latent constructs of resilience and psychopathology towards a dynamic model of psychological adaptation and recovery in this population can result in optimisation of care. We offer some recommendations for professionals working with young people with sarcoma in clinic and research.

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          Most cited references53

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          Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups.

          Qualitative research explores complex phenomena encountered by clinicians, health care providers, policy makers and consumers. Although partial checklists are available, no consolidated reporting framework exists for any type of qualitative design. To develop a checklist for explicit and comprehensive reporting of qualitative studies (in depth interviews and focus groups). We performed a comprehensive search in Cochrane and Campbell Protocols, Medline, CINAHL, systematic reviews of qualitative studies, author or reviewer guidelines of major medical journals and reference lists of relevant publications for existing checklists used to assess qualitative studies. Seventy-six items from 22 checklists were compiled into a comprehensive list. All items were grouped into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. Duplicate items and those that were ambiguous, too broadly defined and impractical to assess were removed. Items most frequently included in the checklists related to sampling method, setting for data collection, method of data collection, respondent validation of findings, method of recording data, description of the derivation of themes and inclusion of supporting quotations. We grouped all items into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. The criteria included in COREQ, a 32-item checklist, can help researchers to report important aspects of the research team, study methods, context of the study, findings, analysis and interpretations.
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            The qualitative content analysis process.

            This paper is a description of inductive and deductive content analysis. Content analysis is a method that may be used with either qualitative or quantitative data and in an inductive or deductive way. Qualitative content analysis is commonly used in nursing studies but little has been published on the analysis process and many research books generally only provide a short description of this method. When using content analysis, the aim was to build a model to describe the phenomenon in a conceptual form. Both inductive and deductive analysis processes are represented as three main phases: preparation, organizing and reporting. The preparation phase is similar in both approaches. The concepts are derived from the data in inductive content analysis. Deductive content analysis is used when the structure of analysis is operationalized on the basis of previous knowledge. Inductive content analysis is used in cases where there are no previous studies dealing with the phenomenon or when it is fragmented. A deductive approach is useful if the general aim was to test a previous theory in a different situation or to compare categories at different time periods.
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              Using the framework method for the analysis of qualitative data in multi-disciplinary health research

              Background The Framework Method is becoming an increasingly popular approach to the management and analysis of qualitative data in health research. However, there is confusion about its potential application and limitations. Discussion The article discusses when it is appropriate to adopt the Framework Method and explains the procedure for using it in multi-disciplinary health research teams, or those that involve clinicians, patients and lay people. The stages of the method are illustrated using examples from a published study. Summary Used effectively, with the leadership of an experienced qualitative researcher, the Framework Method is a systematic and flexible approach to analysing qualitative data and is appropriate for use in research teams even where not all members have previous experience of conducting qualitative research.
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                Author and article information

                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2020
                23 November 2020
                : 10
                : 11
                : e038799
                Affiliations
                [1 ] departmentDepartment of Experimental Psychology , Oxford University , Oxford, Oxfordshire, UK
                [2 ] departmentCancer Clinical Trials , University College Hospitals NHS Foundation Trust , London, UK
                [3 ] departmentCentre for Nurse, Midwife and AHP Led Research (CNMAR) , University College London Hospitals NHS Foundation Trust , London, UK
                [4 ] departmentSarcoma Service , Royal National Orthopaedic Hospital NHS Trust , Stanmore, UK
                [5 ] departmentPaediatric & Adolescent Division , University College London Hospitals NHS Foundation Trust , London, UK
                Author notes
                [Correspondence to ] Urska Kosir; urska.kosir@ 123456psy.ox.ac.uk
                Author information
                http://orcid.org/0000-0003-2132-4090
                http://orcid.org/0000-0002-0853-0925
                Article
                bmjopen-2020-038799
                10.1136/bmjopen-2020-038799
                7684813
                33234628
                b2fba3b8-9c87-4bb4-8f87-b3b873e6472d
                © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:  http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 24 March 2020
                : 11 October 2020
                : 16 October 2020
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100009756, Sarcoma UK;
                Award ID: Bone Cancer Research Trust
                Award ID: SUK102.2016LG
                Categories
                Oncology
                1506
                1717
                Original research
                Custom metadata
                unlocked

                Medicine
                sarcoma,qualitative research,psychiatry
                Medicine
                sarcoma, qualitative research, psychiatry

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