FEATURE AND REVIEW PAPER
Seeking, accepting and declining help for emotional distress in cancer: A systematic review and thematic synthesis of qualitative evidence
C.M. Carolan MB ChB, MRCP, MRCGP, MSc,
A. Smith RN, RNT, BA, MA, PhD,
G.R. Davies BSc, PG Cert, MSc, FHEA, PhD, CPsychol,
L. Forbat BA, PG Cert, MSc, PhD,
Corresponding Author
C.M. Carolan MB ChB, MRCP, MRCGP, MSc
Lecturer, Sessional GP, GP Appraiser, Appraisal Lead (Primary Care)
Faculty of Health Sciences and Sport, University of Stirling (Western Isles Campus), Stornoway, UK
NHS Western Isles, Stornoway, UK
Correspondence
Clare M. Carolan, Faculty of Health Sciences and Sport, University of Stirling, Western Isles Hospital, Stornoway, UK.
Email: [email protected]
Search for more papers by this authorA. Smith RN, RNT, BA, MA, PhD
Senior Lecturer/Head Life Sciences
Faculty of Health Sciences and Sport, University of Stirling (Western Isles Campus), Stornoway, UK
Search for more papers by this authorG.R. Davies BSc, PG Cert, MSc, FHEA, PhD, CPsychol
Lecturer and Scheme Co-Ordinator, UHI Honorary Research Fellow
PGT Tertiary & Higher Education, Faculty of Arts, Humanities and Business, Lews Castle College UHI, Stornoway, UK
Search for more papers by this authorL. Forbat BA, PG Cert, MSc, PhD
Professor
Palliative Care, Australian Catholic University and Calvary Health Care, Australian Catholic University, Canberra, ACT, Australia
Search for more papers by this authorC.M. Carolan MB ChB, MRCP, MRCGP, MSc,
A. Smith RN, RNT, BA, MA, PhD,
G.R. Davies BSc, PG Cert, MSc, FHEA, PhD, CPsychol,
L. Forbat BA, PG Cert, MSc, PhD,
Corresponding Author
C.M. Carolan MB ChB, MRCP, MRCGP, MSc
Lecturer, Sessional GP, GP Appraiser, Appraisal Lead (Primary Care)
Faculty of Health Sciences and Sport, University of Stirling (Western Isles Campus), Stornoway, UK
NHS Western Isles, Stornoway, UK
Correspondence
Clare M. Carolan, Faculty of Health Sciences and Sport, University of Stirling, Western Isles Hospital, Stornoway, UK.
Email: [email protected]
Search for more papers by this authorA. Smith RN, RNT, BA, MA, PhD
Senior Lecturer/Head Life Sciences
Faculty of Health Sciences and Sport, University of Stirling (Western Isles Campus), Stornoway, UK
Search for more papers by this authorG.R. Davies BSc, PG Cert, MSc, FHEA, PhD, CPsychol
Lecturer and Scheme Co-Ordinator, UHI Honorary Research Fellow
PGT Tertiary & Higher Education, Faculty of Arts, Humanities and Business, Lews Castle College UHI, Stornoway, UK
Search for more papers by this authorL. Forbat BA, PG Cert, MSc, PhD
Professor
Palliative Care, Australian Catholic University and Calvary Health Care, Australian Catholic University, Canberra, ACT, Australia
Search for more papers by this authorAbstract
Many individuals affected by cancer who experience emotional distress report not wanting help. This review aims to understand why individuals affected by cancer seek, accept or decline help for emotional distress and what influences these actions. A systematic review and thematic synthesis of the qualitative literature was conducted. Using pre-defined search terms, four electronic databases were searched from January 2000 to May 2016. Pre-determined inclusion and exclusion criteria were then applied. Identified papers were quality appraised. In total, 32 papers were included in the synthesis. Four themes emerged from data synthesis: attaining normality—the normality paradox; being emotionally literate; perceptions of help; needs-support gap. Attaining normality is ideographic, context dependent and temporally situated; some individuals maintain normality by not seeking/declining help whereas others seek/accept help to achieve a new normality. Thus, attaining normality paradoxically functions to explain both why individuals sought/accepted help or did not seek/declined help. Data indicate that a context dependent, systems thinking approach is merited to enhance psychosocial care. In particular, clinicians must actively explore the personal context of an individual's distress to ensure that help desired and help offered are mutually understood. Further research must address the limitations of the current evidence base to advance theoretical understanding.
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