A Narrative Care Intervention to Support the Post-Cancer Treatment Transition from Primary to Follow-up Care: Analysis of Outcomes and Content

The needs and ways of supporting individuals during the transitional phase after completion of treatment for primary cancer are less well-studied compared to other phases of the cancer journey. It is important to better understand this transitional juncture as it is one where individuals experience pronounced distress and grapple with various existential concerns. Thus, the current study implemented and evaluated a narrative care-informed intervention, the Narrative Care Interview (NCI), to allow participants to story their experience of being diagnosed with and treated for a primary cancer and to share their outlook on life moving forward. The NCIs goal was to support participants in constructing a cohesive narrative that incorporated their confrontation with cancer into their broader life story, with the intention of aiding adaptation to cancer-related changes.

The studys primary objective was to evaluate the NCIs effectiveness and acceptability by assessing whether it led to any changes on various relevant psychosocial variables including resilience, overall affect, quality of life, anxiety and depressive symptoms, self-efficacy, life satisfaction, and perceived personal meaning, and by assessing treatment satisfaction. A secondary objective was to better understand changes in self, life-perspective, and outlook on relationships during the transition following treatment.

Twenty-seven adults who had completed treatment for primary cancer within the past two years completed questionnaires assessing the variables listed above and participated in the NCI, and 20 participants completed the post-intervention questionnaires. Results showed a moderate improvement in social wellbeing and a generally favourable review of the NCI. With respect to the secondary objective, a modified grounded theory analysis of interview content led to the development of the core category, Transience as a Catalyst for Change, which consisted of three main categories: Woundedness and Healing; Refining and Solidifying Identity; and Maximizing Time. The core category, or theory of change, represented realizations about the impermanence of life, health, and time, which sparked changes in participants sense of self, life-perspective, and outlook on relationships. Overall, the current study demonstrated the potential utility and benefit of a brief, narrative care-based intervention in providing support to individuals during the uncertain transitional period between primary cancer treatment and follow-up.