Science and Engineering in Derby and Derbyshire
Stephanie Archer is a health psychologist currently based at the University of Derby, and for two years has been running the gynaecological cancer study that Heidi Sowter mentioned a few weeks ago. Stephanie answered some questions about the study, and her career so far.
What is the study hoping to establish?
The yoga study I’ve been working on for the last 2 years is aiming to establish whether yoga can improve the quality of life for gynaecological cancer patients. The randomised controlled trial ran for 18 months, and we’re just doing the analysis now to establish whether our hypothesis (that yoga would have a positive impact on quality of life) is supported by the data.
What type of data collection did the study use?
As the study was a randomised controlled trial, we had 2 groups, a control group and our intervention group. The control group received standard care and were asked to fill in the same questionnaires at the same time points as the intervention group. The intervention group were entitled to 10 consecutive weeks of free yoga (one hour a week) on a Thursday evening.
We used a number of measures to establish whether there was any impact of yoga for the patients. Both the yoga group and the control group were asked to complete a questionnaire at time points 1, 2 and 3. Time point 1 is the day that they started the trial, time point 2 is after 10 weeks (the yoga patients had finished their course of yoga) and time point 3 is 4 months after patients had completed the classes. The questionnaires consisted of 3 questionnaires – the EORTC QLQ C30 – which is a general quality of life questionnaire that was specifically designed for use with cancer patients, the Mental Adjustment to Cancer Scale which assesses how patients are adjusting to their diagnosis of cancer, and the Acceptance of Illness scale which really does measure what it says in the name.
In addition to this, we also did a data collection form from patient’s notes at the hospital. This included information such as age, diagnosis and treatment – and of course this data was anonymised and matched with the participant through the use of a patient identifier assigned at the point of randomisation.
We also used a patient diary which allowed patients to record on a weekly basis how they were feeling and if there was anything significant that happened in the week that may have contributed to their quality of life. Within the diary patients were asked to complete 4 visual analogue scales ( where patients are asked to mark on 10cm long scale that has two polar ends i.e. worst possible quality of life and perfect quality of life) so that we could record their feelings for that week for anxiety, pain, fatigue and quality of life.
The patients who took part in the yoga intervention were also asked to take part in a focus group to further explore patients’ experiences of taking part in the classes. Using qualitative techniques like this allows us to fully evaluate the intervention and to explore both positive and negative experiences further.
What results have come from your data so far?
We are just doing the preliminary analysis of the time point 1 & 2 and visual analogue scale data at the moment. We had a fairly small sample size (which is not surprising when you look at the patient group we were working with) and this has limited some of the statistical tests we would like to have used. We didn’t have enough statistical power to get significant results with some of the questionnaire measures, but the visual analogue scales suggest that yoga does impact on patients quality of life, and that the more classes a patient attends, the greater the improvement in quality of life.
What brought you to health psychology? Is it something you were always interested in? Or did something in your undergraduate degree lead to it?
I have always been interested in people and especially in health – everybody experiences health (both good and bad) so it is easy to relate to. I completed my undergraduate degree in psychology, and then went on to study for an MSc in Health Psychology – both at the University of Derby.
I studied several health related modules at undergraduate level and thoroughly enjoyed them. Modules on the psychology of pain, and topics such as health ergonomics made me want to explore the subject of health psychology further, so I decided to undertake the MSc, which is also a Stage 1 accredited course which is the first step to becoming a chartered Health Psychologist. Whilst completing my MSc the opportunity for a funded PhD studentship became available to look at this specific area, and I was successful in getting the post. So really it was an interest combined with opportunities that bought me into this area of study.
Are you specifically interested in oncology as an area?
Whilst completing my PhD I have really enjoyed working with the gynaecological cancer patients. I have learned so much from them and have such respect for the way that they cope and carry on with their lives throughout their experience of cancer. Through my PhD I have managed to develop a niche area for myself, as there are few health psychologists that have access to such a specialised clinical sample and have the opportunity to work so closely with them on a number of interventions. I have managed to secure a Post Doctoral Research Fellowship at the Royal Derby Hospital for when I finish my PhD. This will be working within the same area, and I will be specifically focusing on areas such as quality of life, experiences of treatment and palliative care and also moving into the area of survivorship.
Did the knowledge that many of your participants are likely to have a poor prognosis make working with them different or difficult in any respect?
I feel very lucky to have worked alongside the gynaecological cancer patients and to have been included in their lives at such an important and intimate time. I have experienced many situations that I would not have been able to if it wasn’t for this opportunity and for the openness of the patients themselves. There are a wide range of patients under the gynaecological cancer patient label, and not all patients have a poor prognosis. I have been privileged to work with patients who have had low grade and stage cervical and endometrial cancer who have gone on to make a full recovery, but I have also worked alongside patients who have had terminal cancer and have died during their time on the trial. Although this is incredibly sad, it is important for me to remember that the work that I am doing is hopefully going to make patients lives better, and that many patients get something out of taking part in research – even if that is just adding to the evidence base before they die – they have given something back and they have may have made someone’s life better in the future.
As a researcher working in a potentially delicate field how important is participant buy-in? Can you research through observation alone?
It really depends on what type of research it is that you are doing and what question you are trying to answer. In the area of oncology there are many different types of question, and observation is a suitable method for research, especially if you are looking at topics such as patient doctor interaction and patient care. Participant buy in is very important in other areas, and in my experience many ladies would like to take part in research, but in some cases they are unable to as they are too unwell, or are unable to meet the inclusion criteria.
You have been teaching one of the more unloved aspects of biological science degrees, the dreaded statistics…do you enjoy teaching in general?
I have taught on many different modules at the University and in other institutions. I really enjoy teaching, and the variation it brings. I have taught things that I never thought I would, and taught on modules that I may have thought I had nothing to contribute to. What I have actually found is that the skills and information that we learn throughout our academic careers (as students and researchers) are very versatile and can be linked to more areas than we originally realise.
As you say I have taught the dreaded STATISTCS (I feel that there should be a red flashing light a siren for this word). Although it is a difficult subject to teach it is very rewarding. The enjoyment comes when you see students eyes light up because they understand. I try hard to remember how I felt when I was an undergraduate and learning statistics for the first time. I felt completely overwhelmed at the time and thought I would never get the hang of it. I never thought I would be doing what I am now. I firmly believe that if I can do it then most people can.
I love to teach and to share the knowledge that I have learned with other people. I think that sharing knowledge is an important part of research, and whether you do that by writing journal articles or teaching on specialist modules, I believe that sharing your findings is the most important part. There isn’t any point in doing research if no-body knows what you found. I think that I will continue to teach on specialist modules throughout my Post Doc, and I would always leave the door open to return to more mainstream academic teaching when I have finished my research post.