BackgroundThis study aimed to explore barriers to and enablers for future implementation of a draft clinical pathway for anxiety and depression in cancer patients in the Australian context.MethodsHealth professionals reviewed a draft clinical pathway and participated in qualitative interviews about the delivery of psychosocial care in their setting, individual components of the draft pathway, and barriers and enablers for its future implementation.ResultsFive interrelated themes were identified: ownership; resources and responsibility; education and training; patient reluctance; and integration with health services beyond oncology.ConclusionsThe five themes were perceived as both barriers and enablers and provide a basis for an implementation plan that includes strategies to overcome barriers. The next steps are to design and deliver the clinical pathway with specific implementation strategies that address team ownership, endorsement by leaders, education and training modules designed for health professionals and patients and identify ways to integrate the pathway into existing cancer services.

Immigrant cancer survivors' additional requirements to native survivors likely reflect challenges in dealing with foreign environments and varied levels of acculturation within group members. Identification of immigrant cancer survivorship issues may support development of targeted resources for promoting survivors' self-care and capacity for finding, choosing, and using existing support options.

When two conditioned stimuli (CSs) are presented in compound, the response is typically stronger than to the individual CSs, implying that their associative strengths combine. However, to identify exactly how associative strengths combine requires an accurate description of the relationship between associative strength and responding. The authors have used the delta rule (Rescorla & Wagner, 1972) to constrain the predicted growth of associative strength (V) to identify the relationship between V and responding across the course of Pavlovian conditioning of two CSs (one auditory, one visual). Responding to the compound was best predicted as 0.6xV(CS1)+0.6xV(CS2), suggesting that only 60% of the associative strength of each CS generalized to the compound. A second experiment confirmed this result and additionally showed that summation of responding between two same-modality CSs (both auditory or both visual) declined across training. A third experiment applied the procedure to compound conditioning, showing that responding to the compound was equal to the sum of the response rates to the individual CSs. The results are discussed in terms of configural and elemental models of Pavlovian conditioning.

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