Mental health in people living with and beyond colorectal cancer: A patient-oriented constructivist grounded theory

Cancer Med. 2024 Sep;13(17):e70203. doi: 10.1002/cam4.70203.

Abstract

Background: With the burden of colorectal cancer in Canada, there is a need to address the psycho-oncologic challenges, including mental health. This study aims to explore the lived mental health experiences in patients with CRC across the phases of the CRC care continuum.

Methods: We employed a patient-oriented constructivist grounded theory design and recruited English speaking participants ≥18 years, diagnosed with CRC within the last 10 years, residing in Canada. We collected data through semi-structured individual interviews using a guide co-constructed with patient research partners. Data collection and analysis were iterative, employed theoretical sampling, and culminated in a theoretical model.

Results: Twenty-eight participants diagnosed with CRC (18 females, 10 males), aged 18-63 years at time of diagnosis were interviewed, with representation across all CRC stages. There were 10 participants (36%) in treatment, 12 participants (43%) in follow-up, and 6 participants (21%) in the beyond phase. We constructed a patient-oriented theory illustrating the dynamic nature between one's self-identity and their mental health experiences across the CRC care continuum. Mental health experiences encompass emotional and cognitive-behavioral responses, expressed differently across phases. Mental health care experiences are also shaped by barriers, facilitators, and individual contextual factors, all of which influence their access to care.

Conclusion: Our theory provides insight into the mental health experiences of patients with CRC across phases of the CRC care continuum. Understanding patients' emotional and cognitive-behavioral responses and care experiences can help identify opportunities to integrate mental health into CRC care.

Keywords: colorectal cancer; experiences; mental health; patient‐centered; qualitative research.

MeSH terms

  • Adolescent
  • Adult
  • Canada
  • Colorectal Neoplasms* / psychology
  • Colorectal Neoplasms* / therapy
  • Female
  • Grounded Theory*
  • Humans
  • Male
  • Mental Health*
  • Middle Aged
  • Qualitative Research
  • Young Adult