Dr Anne Arber
Senior Lecturer (Cancer and Palliative Care)
Qualifications: PhD, MSc, RN
Email: a.arber@surrey.ac.uk
Phone: Work: 01483 68 6768
Room no: 20 DK 04
Office hours
Monday - Friday, 9.00 - 5.30 pm by appointment only
Further information
Biography
Anne Arber has a clinical background in cancer nursing. Her research programme entails the examination of interpersonal processes in team meetings, information sharing strategies in clinician patient interactions and interprofessional communication. She also conducts research related to supportive care following a diagnosis of lung cancer and support for informal carers. She has methodological expertise in discourse analysis and mixed method research. She has recently been awarded a grant from the Fund for Researcher Development to develop an innovative, collaborative web-based network for post graduate students, researchers and academic staff.
Research Interests
Research Projects:
A study on fostering empathy between students and older people - a practical approach (AFRESH). Co-researcher funded by Averil Osborne Fund March 2012-October 2012
Nurses’ Decision-Making Practices at the End of Life in the Intensive Care Unit: A cross-cultural exploration. Co –researcher with Brazil, Germany and Ireland (2012-2013)
Carers in the 21st Century. Economic and Social Research Council (October 2012-September 2013)
Information giving and patients receiving oral chemotherapy for Multiple Myeloma (January 09-June 11 Awarded by Myeloma UK)
A project to examine the patient’s experience of their care pathway following a diagnosis of mesothelioma (April 2008-June 2009)
A project to explore the needs of carers of patients with a malignant brain tumour (April 2006-August 2007)
Co Researcher Breaking Bad News (March 2007-September 2008 Nuffield Foundation)
Exploring the patient's experience during the first three months following a diagnosis of pleural mesothelioma. Awarded by Surrey, West Sussex and Hampshire Cancer Network: (2008 to 2010)
A study of informal carers of patients with a primary malignant brain tumour. Awarded by Surrey, West Sussex and Hampshire Cancer Network (2006 to 2007)
Developing web-based information for carers. Awarded by Brain Tumour Foundation (2006 to 2007)
Anne is part of the Faculty's Cancer research theme.
Publications
Journal articles
- .
(2013) 'A CASE REVIEW OF RESPITE CARE AT AN INNER LONDON HOSPICE'. Hayward Medical Communications European Journal of Palliative Care, UK: 20 (2), pp. 72-76.Full text is available at: http://epubs.surrey.ac.uk/745962/
Abstract
Respite care is poorly developed despite the emphasis on allowing patients to be cared for in their preferred place of care – often their own home. It is essential to support informal carers continuing in their roles by providing adequate and timely relief from their duties. Patients who live alone with no informal carers should also be given the opportunity to have a change from their context of care. Respite care programmes should involve referral criteria, multi-disciplinary triaging, pre-determined admission and discharge dates, a thorough review of the patient and their caring context and a structured programme of care and sign posting.
- . (2013) 'Finding the right kind of support: A study of carers of those with a primary malignant brain tumour'. European Journal of Oncology Nursing, 17 (1), pp. 52-58.
- . (2013) 'Malignant fungating wounds - The meaning of living in an unbounded body'. European Journal of Oncology Nursing, 17 (1), pp. 38-45.
- . (2012) 'Caring for a loved one with a malignant fungating wound'. Supportive Care in Cancer, 20 (12), pp. 3065-3070.
- .
(2012) '‘It’s all bad news’: the first 3 months following a diagnosis of malignant pleural mesothelioma'. Published online Edition. Wiley Psycho-Oncolgy, UK: On line (18th August 2012) Article number pon_3162 doi: 10.1002/pon.3162Full text is available at: http://epubs.surrey.ac.uk/721368/
Abstract
Objective: This study explores patient’s experience during the first three months following a diagnosis of malignant pleural mesothelioma. Methods: This study uses a grounded theory approach with semi-structured, face-to- face interviews with ten patients during the first 3 months following diagnosis. Results: The key concept that emerged from the data was this: Uncertainty and lack of control, leading to emotional, physical and psychosocial distress. Three themes informed the key concept: ‘ it’s all bad news’, ‘good and bad days’ and strategies of amelioration. Patients worked with a short-term perspective on their illness but worried about the long-term outcome and the speed of their deterioration. Conclusion: Patients receive insufficient psychosocial support during the first three months following diagnosis. An early palliative care referral would improve support and referral strategies during the first three months of the disease.
- .
(2012) 'Malignant fungating wounds - The meaning of living in an unbounded body.'. Eur J Oncol Nurs, Full text is available at: http://epubs.surrey.ac.uk/533556/
Abstract
BACKGROUND: Malignant fungating wounds may have significant physiological, psychological and emotional consequences on patients and their families. This study focuses on understanding the lived experiences of patients with a malignant fungating breast wound and their informal carers. METHOD: The methodological framework of interpretative phenomenological approach according to Heidegger was used. Nine patients were interviewed from January until November 2009. RESULTS: The results demonstrate that most of the patients and their informal carers were on their own while struggling with the erosion of their physical boundaries. The women report a lack of information and advice about how to manage the wound as well as the physical and social limitations imposed on them because of copious wound exudate, odour and bleeding. The women used many different methods and approaches to maintain the boundedness of the body. CONCLUSION: This study contributes to understanding that losing control over the body meant for the women losing control over themselves and their lives. The unboundedness was demonstrated through the symptom experiences. Therefore the care of women needs strategies that are integrated in a palliative, holistic, empathic approach. In particular skills for palliative wound care among medical and nursing staff need to be developed as the women and their carers report a lack of information and advice about how to manage the wound as well as the physical limitations and psychosocial consequences of struggling to maintain the boundedness of the body.
- .
(2012) 'Caring for a loved one with a malignant fungating wound'. Springer-Verlag Support Care Cancer, 20, pp. 3065-3070.Full text is available at: http://epubs.surrey.ac.uk/533557/
Abstract
Purpose: Caring for a loved one with a malignant fungating wound is very challenging and causes extreme physical and psychological distress. The aim of this study was to explore the experiences of carers who care for a loved one with a fungating breast wound. Method: To explore the lived experiences of carers a methodological framework using Heideggerian hermeneutic phenomenology and semi-structured interviews was used. Seven carers were interviewed from January until November 2009. Results: Having to deal with a situation of a loved one with a visible cancer was hard for all the carers. The visibility of the cancer was one of the most shocking aspects to deal with from the perspective of the patient and the carer. The presence of the visible wound and a cancer at an advanced stage contributed to a change in the relationship and extreme suffering for both the patient and the carer. Despite many problems such as wound odour and copious discharge from the wound, which was difficult to control carers did their best to help their loved one with the wound. Gradually the wound became the centre of the patient and carer’s life and a great deal of time was spent trying to control the wound symptoms. All carers managed the wound on their own without help and advice from health care practitioners. For all of them it was a major burden and they felt isolated. Conclusion: This study contributes to an understanding that the care of women and their carers needs strategies that are integrated in palliative wound care, that takes a holistic and empathic approach that responds to patients and carers psychosocial and emotional needs and a practical need for information to help carers assist in managing the wound related symptoms.
- .
(2012) 'Finding the right kind of support: A study of carers of those with a primary malignant brain tumour.'. Elsevier Eur J Oncol Nurs, 17 (1), pp. 52-58.Full text is available at: http://epubs.surrey.ac.uk/732157/
Abstract
PURPOSE: Caring for someone with a primary malignant brain tumour is very demanding due to the dynamic situation involving changes to personality, short term memory loss and changes in family relationships. The purpose of this qualitative study is to examine the support needs of carers of those with a primary malignant brain tumour. METHODS & SAMPLE: 22 Carers who were currently caring for someone with a primary malignant brain tumour were recruited from one specialist cancer centre in the south east of England. The study took a grounded theory approach and data were analysed using the constant comparative method generating categories and themes that are grounded in the data. KEY RESULTS: A key concept that emerged from the data was: 'Connecting on the caring journey'. The themes that emerged from the key concept were: building helpful relationships; safe places and comfort zones; and threats to connecting. CONCLUSIONS: Many carers do find a great deal of support within the family and from their relationships with friends as well as from cancer and carer support groups. However this is by no means universal and many carers experience a lack of timely access to good quality supportive care services. For some carers supportive care services do not meet their expectations so they spend valuable time searching for the connections they need to continue to care combined with feeling frustrated and under pressure.
- . (2010) 'Service users' experience of receiving bad news about their mental health'. INFORMA HEALTHCARE JOURNAL OF MENTAL HEALTH, 19 (1), pp. 34-42.
- . (2010) 'A study of patients with a primary malignant brain tumour and their carers: symptoms and access to services.'. Mark Allen Healthcare Int J Palliat Nurs, England: 16 (1), pp. 24-30.
- .
(2009) 'GENEROSITY AND THE MORAL IMAGINATION IN THE PRACTICE OF TEAMWORK'. SAGE PUBLICATIONS LTD NURSING ETHICS, 16 (6), pp. 775-785.Full text is available at: http://epubs.surrey.ac.uk/732158/
- . (2009) 'Malignant fungating wounds: A survey of nurses' clinical practice in Switzerland'. ELSEVIER SCI LTD EUROPEAN JOURNAL OF ONCOLOGY NURSING, 13 (4), pp. 295-298.
- .
(2008) 'Team meetings in specialist palliative care: Asking questions as a strategy within interprofessional interaction'. SAGE PUBLICATIONS INC QUALITATIVE HEALTH RESEARCH, 18 (10), pp. 1323-1335.Full text is available at: http://epubs.surrey.ac.uk/732159/
- . (2008) 'The lived experience of patients with pleural mesothelioma.'. Int J Palliat Nurs, England: 14 (2), pp. 66-71.
- .
(2007) '"Pain talk" in hospice and palliative care team meetings: An ethnography'. PERGAMON-ELSEVIER SCIENCE LTD INTERNATIONAL JOURNAL OF NURSING STUDIES, 44 (6), pp. 916-926.Full text is available at: http://epubs.surrey.ac.uk/732160/
- . (2006) 'Forum for Applied Education and Training: Rethinking pain assessment.'. Eur J Cancer Care (Engl), England: 15 (2), pp. 200-207.
- .
(2006) 'The construction of troubled and credible patients: A study of emotion talk in palliative care settings'. Sage Qualitative Health Research, 16 (1), pp. 27-46.Full text is available at: http://epubs.surrey.ac.uk/732161/
Abstract
In this article, the authors select two categories of dying patients, "troubled" and "credible," from two larger studies conducted in three palliative care settings. They explore how nurses construct dying patients' moral identities and how they use emotion talk to interpret patients' behavior. The authors carried out a microanalysis of talk-in-action using discourse analysis and conversation analysis. Strategies used for the construction of moral identities include the production of atrocity stories and emotional editing. The authors identify moments when emotions are made relevant in palliative care nurses' daily practices, which serve to smooth social interaction and give a voice to dying patients' words and actions. The dying trajectory, the deteriorating emotional body, and the sound mind are resources used in the characterization of the credible and troubled patient. The authors argue that emotion talk is significant because it reveals how nurses manage conflict and tension in talk-in-interaction. © 2006 Sage Publications.
Conference papers
- . (2009) 'Malignant fungating wounds: a survey of nurses' clinical practice in Switzerland'. PERGAMON-ELSEVIER SCIENCE LTD EJC SUPPLEMENTS, Berlin, GERMANY: 15th Congress of the European-Cancer-Organization/34th Multidisciplinary Congress of the European-Society-for-Medical-Oncology 7 (2), pp. 232-233.
Teaching
Module leader: Research for Practice (Master’s Level)
Concepts of Advanced Practice (Master’s Level)
Advanced Communication Skills (Masters/ degree level) The Science of Cancer (Cancer Pathophysiology)
Challenges in Pain Management (Masters Level)
Principles and Practice of Palliative Care (LTPP: level 3)
Departmental Duties
Cancer Pathway Leader, Member of Faculty Research Ethics Committee
