Background Pancreatic cancer is an aggressive malignancy, with a five-year survival rate of approximately 10%. It carries a high symptom burden across all stages of disease and treatment trajectories. Rehabilitation, which has demonstrated benefits in other cancer populations, remains a relatively underexplored concept in pancreatic cancer. Emerging studies suggest that structured interventions may improve function, treatment tolerance, and quality of life; however, heterogeneity in study design, outcome measurement, and reporting hampers evidence synthesis and the formulation of clinical recommendations. To address this gap, the development of a Core Outcome Set (COS) for pancreatic cancer rehabilitation is warranted. Methods This protocol follows the Core Outcome Set – STandardised Protocol Statement (COS-STAP) guidance and the Core Outcome Set Standards for development (COS-STAD) recommendations. The COS will apply to adults with histologically confirmed pancreatic ductal adenocarcinoma undergoing any rehabilitative intervention across the cancer continuum. The COS will be developed in three sequential phases. In Phase 1, potential outcomes will be identified through a systematic review of existing rehabilitative studies, and semi-structured interviews with key stakeholders (patients, family members/caregivers, and healthcare professionals/researchers). In Phase 2, outcomes identified in Phase 1 will be prioritised using a multi-round electronic Delphi survey. In Phase 3, a consensus meeting with representatives from all stakeholder groups will finalise the COS. Discussion This study will deliver the first COS specific to pancreatic cancer rehabilitation, addressing the current inconsistency in outcome reporting and ensuring that future research captures domains relevant to all stakeholders. The COS will support the generation of high-quality, comparable evidence to inform clinical practice, improve patient-centred care, and optimise resource allocation. Ultimately, it will provide a unifying framework to guide rehabilitation research and care in this high-need population. Registration: COMET database https://www.comet-initiative.org/Studies/Details/3383, PROSPERO database (CRD420250645743).
Background Incident reporting is central to patient safety, yet translating review findings into systemic learning remains challenging. Within the Irish Health Service Executive (HSE) 2020 Incident Management Framework (IMF), Improvement Planning and Monitoring (Step 6) is where findings are intended to become service change. How well reviews achieve this, and how the review methodologies in use shape that performance, has not been systematically examined. This protocol sets out a study examining how these methodologies operate in practice and the perceived quality of the recommendations they produce, by capturing the accounts of multiple stakeholders linked to the same reviews, with particular attention to human factors in the transition from learning to action. Methods The study uses a cross-sectional, mixed-methods survey design. A stratified random sample of 96 incident reviews will be drawn from the National Incident Management System (NIMS): 48 Category 1 (major/severe harm) and 48 Category 2 (moderate harm), equally divided between acute and community settings. Seven role-tailored instruments, mapped to four stakeholder categories (reviewers and commissioners; clinical staff; implementers; patients, service users and families), combine rating-scale and written-response questions organised around the six IMF principles. Quantitative data will be analysed using descriptive and non-parametric methods, qualitative data using reflexive thematic analysis, and the two strands integrated through joint displays. Ethics and dissemination Ethical approval has been granted by the School of Psychology Research Ethics Committee at Trinity College Dublin and the HSE National Research Ethics Committee. A pilot phase of five reviews will precede national administration. Findings will be disseminated through peer-reviewed publication, conference presentation, and a summary report to the HSE, and are intended to identify systemic barriers to improvement planning and inform a national logic model for shared learning.
Background Fear of cancer recurrence (FCR) represents one of the most frequently reported unmet needs among cancer survivors, with young adults demonstrating heightened susceptibility to its effects. Although a range of specialist-delivered psychological interventions has shown efficacy in managing FCR across adult populations, much of this evidence is derived from one-to-one therapeutic formats. Adapting such interventions to a group setting, both to enhance peer support and to improve resource efficiency, necessitates careful adaptation to ensure the programme is appropriately tailored to the group context. The aim of this study is to co-design the adaptation of an existing one-to-one FCR psychological intervention to a group-based setting to support psychosocial distress across the spectrum of FCR needs of young adult cancer survivors in Ireland. Methods This co-design study will use the ADAPT framework to conduct a series of workshops that adopt a modified Nominal Group Technique (NGT) model. Two groups of co-design stakeholders will be recruited nationally (i) Experts by Experience (Cancer survivors and family caregivers); (ii) Experts by Profession (e.g., doctors, nurses, psychologists). Three individual workshops with representatives from both groups will be held in different locations across Ireland. A consensus workshop will be held online to collate results via a voting system and establish the design of an adapted group-based FCR intervention. The workshops will be co-facilitated by the lead researcher, a Patient and Public Involvement (PPI) partner and a member of the project steering committee. Discussion Group-based interventions offer an efficient way to deliver targeted FCR support for young adult cancer survivors, while providing peer connection. The adapted peer-co-designed group-based FCR intervention will subsequently undergo feasibility evaluation to determine its acceptability and potential for broader implementation across Irish cancer centres.
Background Fear of cancer recurrence (FCR) represents one of the most frequently reported unmet needs among cancer survivors, with young adults demonstrating heightened susceptibility to its effects. Although a range of specialist-delivered psychological interventions has shown efficacy in managing FCR across adult populations, much of this evidence is derived from one-to-one therapeutic formats. Adapting such interventions to a group setting, both to enhance peer support and to improve resource efficiency, necessitates careful adaptation to ensure the programme is appropriately tailored to the group context. The aim of this study is to co-design the adaptation of an existing one-to-one FCR psychological intervention to a group-based setting to support psychosocial distress across the spectrum of FCR needs of young adult cancer survivors in Ireland. Methods This co-design study will use the ADAPT framework to conduct a series of workshops that adopt a modified Nominal Group Technique (NGT) model. Two groups of co-design stakeholders will be recruited nationally (i) Experts by Experience (Cancer survivors and family caregivers); (ii) Experts by Profession (e.g., doctors, nurses, psychologists). Three individual workshops with representatives from both groups will be held in different locations across Ireland. A consensus workshop will be held online to collate results via a voting system and establish the design of an adapted group-based FCR intervention. The workshops will be co-facilitated by the lead researcher, a Patient and Public Involvement (PPI) partner and a member of the project steering committee. Discussion Group-based interventions offer an efficient way to deliver targeted FCR support for young adult cancer survivors, while providing peer connection. The adapted peer-co-designed group-based FCR intervention will subsequently undergo feasibility evaluation to determine its acceptability and potential for broader implementation across Irish cancer centres.
Background Stroke is a leading cause of mortality and long-term disability globally and in Ireland, with prevalence rising due to population ageing. Physical activity is a key component of secondary prevention and recovery; however, there is limited evidence on how community-based exercise programmes are implemented, delivered, and sustained in routine practice. Addressing these gaps is essential to inform national policy and service planning, particularly within the context of Sláintecare and the Health Service Executive’s National Stroke Strategy. This implementation evaluation forms part of the broader INsPIRE (Informing National Policy for Physical Activity-based Secondary Prevention of Stroke in Ireland) project, which aims to generate policy-relevant evidence on scalable and sustainable models of community-based physical activity. Methods This protocol outlines a mixed-methods implementation evaluation using ExWell, a community-based exercise programme, as a real-world case study. The study is guided by the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework and the Consolidated Framework for Implementation Research (CFIR 2.0). Quantitative outcomes include referral patterns, programme uptake, retention and engagement with the ExWell programme. Qualitative data will be collected from stroke survivors, programme staff, referring healthcare professionals, and national stroke policy and system representatives through semi-structured interviews and focus groups to explore contextual determinants influencing implementation. Analysis Quantitative data will be analysed using descriptive and inferential statistics, while qualitative data will undergo reflexive thematic analysis. A convergent mixed-methods approach will integrate findings to examine implementation outcomes and contextual influences. Secondary analysis of existing datasets will support benchmarking. Discussion This study will generate implementation-focused evidence on the delivery, uptake, and sustainability of community-based physical activity programmes for stroke survivors in Ireland, informing policy, resource allocation, and equitable service design aligned with national health policy ‘Sláintecare’ objectives.
