Psychosocial impact of living with an indwelling pleural catheter in patients with malignant pleural effusions: a thematic analysis
Bibliographic record
Abstract
BACKGROUND: Breathlessness is a frequent and debilitating symptom experienced by patients with malignant pleural effusions (MPEs). Indwelling pleural catheters (IPCs) are a recommended first line treatment option, but the psychological and social impact of living with one is poorly understood. OBJECTIVES: To determine the psychosocial impact of living with an IPC among patients with MPEs. METHODS: 18 adult English-speaking patients undergoing IPC management for MPEs were recruited at a single pleural centre in London, UK, between May 2022 and 2023. 23 semi-structured interviews were conducted at 2 weeks and 6-8 weeks post IPC insertion. Inductive thematic analysis of the interview transcripts was used to identify key psychosocial impacts and modulatory factors. RESULTS: 13 participants completed the semi-structured interviews, mean age 67, 54% female. Seven themes relating to the psychosocial impacts experienced by individuals living with an IPC were identified: anxiety, activities, relationships, independence and control, expectations and adjustments to IPC, acceptance and confidence. These evolved over time, with both positive and negative effects. The effects of the psychosocial impacts were further mediated by three modulatory factors: IPC mediated changes, challenges of IPC care and the overarching impact of cancer. These exerted varying degrees of influence on individuals' psychosocial wellbeing. CONCLUSIONS: This qualitative study highlights for the first time the range of psychosocial impacts experienced by individuals living with an IPC. Identifying the modulatory factors and understanding how these impact patient experience can help to direct future interventions aiming to improve the psychosocial wellbeing for this population. TRIAL REGISTRATION NUMBER: NCT05372055.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.015 | 0.023 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.004 | 0.005 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.002 | 0.005 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".