A trend for conducting parallel data analysis on quantitative and qualitative data in mixed methods healthcare research has been identified in the studies included in this review. Using triangulation as a methodological metaphor can facilitate the integration of qualitative and quantitative findings, help researchers to clarify their theoretical propositions and the basis of their results. This can offer a better understanding of the links between theory and empirical findings, challenge theoretical assumptions and develop new theory.

SummaryA systematic review of the literature about patients' preferences for involvement in cancer treatment decision making was conducted. Establishing preferences is important if the aim is to make health care more sensitive to the needs and expectations of each individual patient. Thirty-one papers were included in the review. Generalising from this literature is problematic because of limitations related to sample size, sample composition and methods used to assess preferences. Whilst we take cognizance of these limitations, research suggests that preferences vary considerably and that whilst most patients prefer a collaborative role, a significant minority prefer a passive or active role. Evidence about the association of factors such as age, gender, level of education, marital status, socioeconomic status and health status with preferences is inconclusive. Only a handful of studies investigated the degree of congruence between patients' role preferences and the actual role that they perceived they had played, which highlight that some patients experience a dissonance between the two. Similarly, few studies investigated the impact of this dissonance on patient anxiety or satisfaction with the treatment decision. We advocate more rigorous investigations before recommendations for health care professionals can be processed with confidence.

This project suggests that a handheld-computer-based symptom management tool is feasible and acceptable to both patients and health professionals in complementing the care of patients receiving chemotherapy.

Fax: +44(0)1786 460060 Word count 7853Dr Gill Hubbard is a senior research fellow who leads the 'Cancer as a long-term condition' research programme at CCRC. She has a background in sociology and social policy.Dr Lisa Kidd is a research fellow at CCRC. She has a background in nursing and has recently been awarded a Doctor of Philosophy for a study of perceived control and involvement in self care for people with cancer.Professor Nora Kearney is Director of CCRC. She has a background in nursing and an extensive track record in cancer care research, in particular, in symptom improvement and patient experiences. 1 Disrupted lives and threats to identity: The experiences of people with colorectal cancer within the first year following diagnosis AbstractIn this paper we focus on the experiences of 18 people with colorectal cancer, involved in a large longitudinal qualitative study to explore people's experiences of cancer within the first year following diagnosis. Three depth interviews over the course of the year were carried out.During analysis, we drew on biographically informed approaches of understanding chronic illness, particularly the work of Bury (1982;2001;1991) and Charmaz (1994;1983;1995;2002) to explore the extent to which people within the first year following diagnosis experience cancer as biographically disruptive. We explore the biographical work that individuals carry out in the context of an assault on their identity and discuss the relevance of the concept biographical disruption for people who experience cancer as an acute, chronic and/or life-threatening condition. We also discuss the concept's relevance for people who have lived a hard life and, hence, may anticipate these types of disruptions in their lives and experience their impact differently. We conclude that universal application of the concept biographical disruption to the experience of cancer within the first year of diagnosis is not appropriate. This study has implications for cancer services, in particular, the findings call for the development of interventions to support those people who experience cancer as an assault on their identity.

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