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Objectives: the objective of this study is to systematically review the literature with the following aims: to survey the art and music interventions offered to the stem cell transplant population; to define the interventions' beneficial properties by conceptualising themes; to analyse these themes using behavioural activation principles as a lens and explore their value in alleviating isolation-related distress.Background: patients undergoing stem cell transplant are at great risk of psychological morbidity, partly on account of prolonged hospital stays in protective isolation. This risk extends beyond discharge and into ambulatory care, negatively affecting quality-of-life and survival rates of the transplant recipients.Design: integrative review methodology.Methods: a systematic search of 10 bibliographic databases was undertaken using terms relating to art, music and stem cell transplantation for the years 2012 to 2019. Records were assessed for quality and risk-of-bias using a critical appraisal tool and following the PRISMA Systematic Review checklist to guide reporting. Studies were analysed narratively and thematically.Results: the 16 papers were of mixed quality. Findings and treatment effects differed between and within studies. The beneficial attributes of the treatments were clustered and divided into two groups. The first consisted of intrinsic, patient-focussed factors: (1) Creative outlet or acquisition of a new skill; (2) achievement of normality; (3) mutual or peer-support; (4) relationship-building and (5) meaningful recreation, distraction and diversion. The second group considered extrinsic factors: (6) Improved communication; (7) enhanced spiritual care and (8) better healthcare experience.Conclusions: several art and music interventions have been attempted which were beneficial to patients and generated a sense of achievement, connection and enjoyment. The interventions appear to uphold the principles of person-centred holistic care and have potential to generate a high-quality, supportive healthcare and working environment.Relevance to Clinical Practice: psychosocial interventions with art and music have improved the care and experience of patients undergoing stem cell transplant.

Background: Many older people who are living with cancer do so with concurrent complex health and social issues. Assessment and treatment planning for cancer often focus primarily on the disease, missing opportunities to identify and address these significant wider concerns.Aim: To gain an understanding of the factors that can increase or reduce older people’s capacity to manage the workload associated with the self-management of cancer and other conditions.Method: Secondary analysis of questionnaire data comprising 224 responses to 19 structured items covering health and daily living issues and analysis of free-text responses, focusing on factors affecting an individual’s capacity to manage their workload associated with living with cancer.Results: Reduced physical function affected many respondents’ capacity to manage their health and other responsibilities and to live their everyday lives. Many respondents were concerned about continuing to care for those dependent on them and identified factors that enhanced their capacity in their social network and from healthcare professionals. Organisational factors such as scheduled appointments, transport and availability of parking further affected respondents’ capacity.Conclusion: There is an implicit need to identify and address the main factors that can increase an individual’s capacity to manage their health and to support the delivery of person-centred cancer treatment and care plans.

Introduction: people with dementia have poorer cancer outcomes than those without, and experience inequalities in access to, and quality of, care. Outpatient environments, where radiotherapy, chemotherapy and immunotherapy cancer treatments typically take place, have largely been excluded from research. This study was conducted to understand provision of treatment and support and experiences of care for people with dementia undergoing cancer treatment in the outpatient setting. Materials and methods: using observation, interviews and document analysis, data were collected to scrutinise the cultural environment of ambulatory care, comprising the physical fabric of the care setting; interactions, behaviours and perceptions of those in the care setting; and the organizational, clinical and interactional processes involved in care delivery. The study was conducted in the outpatient oncology departments of two large teaching hospitals in England between January 2019-July 2021. Results: data were gathered from a wide range of sources, including 15 hours of observation, and interviews with patients (n=2), caregivers (n=7) and staff (n=20). Evidence from this study suggests the cultural environment of the outpatient care setting reflects and supports the standardised processing of people for cancer treatment. Dementia introduces a wider set of care requirements not catered for by this standardised treatment model and associated processes. Data showed the needs of patients with dementia could be addressed most effectively when individualised, as opposed to standardised care, was offered.Conclusion: there is work to be done in outpatient cancer services to ensure responsiveness to individual patient need. This could be achieved by having an established way (or ways) of eliciting needs, preferences and expectations, a belief that a person’s needs and expectations are legitimate, and that effort should be made to address them, with the ability to accommodate these needs and expectations.Patient or public contribution: patients and caregivers were involved in the study design and development of study materials including the interview topic guide. They also assisted with discussion and clarification of study findings.

ObjectiveMany older people with cancer live with multimorbidity. Little is understood about the cumulative impact of old age, cancer and multimorbidity on self‐management. This qualitative systematic review and synthesis aimed to identify what influences self‐management from the perspective of older adults living with cancer and multimorbidity.MethodsSix databases were systematically searched for primary qualitative research reporting older adults' experiences of living with cancer and multimorbidity (eg, Medline, Embase, and CINAHL). A thematic synthesis was guided by Shippee's model of cumulative complexity. Text labelled as results in the included papers was treated as data.ResultsTwenty‐eight studies were included. While the included studies varied in their focus, our analysis highlighted a number of important themes consistent across the studies. Health conditions with the greatest negative impact on independent living assumed the greatest importance, sometimes meaning their cancer was a low priority. Self‐management practices seen as likely to interfere with quality of life were deprioritized unless viewed as necessary to maintain independence. When burden outweighed capacity, people were reluctant to ask for help from others in their social network. The contribution of formal healthcare services to supporting self‐management was relatively peripheral.ConclusionsOld age and multimorbidity together may complicate self‐management after cancer, threatening health and well‐being, creating burden and diminishing capacity. Older adults prioritized self‐management practices they considered most likely to enable them to continue to live independently.The protocol was registered with Prospero (CRD42018107272).