A thematic exploration of patient and radiation therapist solutions to improve comfort during radiotherapy: A qualitative study

Abstract

PURPOSE: Patients undergoing radiotherapy are positioned to restrict motion, ensuring treatment accuracy. Immobilisation can be uncomfortable which may impact treatment accuracy. Therapeutic radiographers (TR) are responsible for managing patient comfort, yet there is little evidence to guide practice. The objective was to explore patient and RT experience of comfort management during radiotherapy and identify solutions for how comfort may be managed. MATERIALS AND METHODS: Twenty-five adult patients were purposefully recruited from Somerset NHS FT (SFT NHS) from those referred for, receiving or who had received radiotherapy within 3 months. Further criteria were that treatment delivery time on the couch exceeded 10 min (the time the patient was immobilised on the radiotherapy couch). 25 practicing TRs were recruited across the United Kingdom (UK) with experience of treatment delivery times exceeding 10 min. Semi structured interviews were conducted by the researcher at SFT NHS or in patients own homes and via telephone for TRs. Interviews were audio-recorded and transcribed verbatim. Thematic analysis was performed by SG and after familiarisation with data, generation of codes, the themes defined were reviewed by researchers and patient partners. FINDINGS: For patients, the three themes were: Supported Coping, Modification to Position or Immobilisation and Information Communication and Preparation. For TRs three main themes emerged: Supported Coping, Supporting and Adjusting Patients to Maintain Position and Preparational Approaches. CONCLUSION: This qualitative paper provided a shared voice of how comfort can be best managed from the perspective of patients and TRs. Patient and TR views of how comfort is best managed has provided solutions that may be used during radiotherapy. The study has highlighted some of the positive and negative experiences of comfort solutions based on current UK practice. This information will be used to develop recommendations in a radiotherapy comfort intervention package.