Brief Engagement and Acceptance Coaching for Hospice Settings (the BEACHeS study): Results from a Phase I study of acceptability and initial effectiveness in people with non-curative cancer

Nicholas Hulbert-Williams*, Sabrina F. Norwood, David Gillanders, Anne Finucane, Juliet Spiller, Jenny Strachan, Susan Millington, Joseph Kreft, Brooke Swash

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives
Transitioning into palliative care is psychologically demanding for people with advanced cancer, and there is a need for acceptable and effective interventions to support this. We aimed to develop and pilot test a brief Acceptance and Commitment Therapy (ACT) based intervention to improve quality of life and distress.

Methods
Our mixed-method design included: (i) quantitative effectiveness testing using Single Case Experimental Design (SCED), (ii) qualitative interviews with participants, and (iii) focus groups with hospice staff. The five-session, in-person intervention was delivered to 10 participants; five completed at least 80%.

Results
At baseline, participants reported poor quality of life but low distress. Most experienced substantial physical health deterioration during the study. SCED analysis methods did not show conclusively significant effects, but there was some indication that outcome improvement followed changes in expected intervention processes variables. Quantitative and qualitative data together demonstrates acceptability, perceived effectiveness and safety of the intervention. Qualitative interviews and focus groups were also used to gain feedback on intervention content and to make design recommendations to maximise success of later feasibility trials.

Conclusions
This study adds to the growing evidence base for ACT in people with advanced cancer. A number of potential intervention mechanisms, for example a distress-buffering hypothesis, are raised by our data and these should be addressed in future research using randomised controlled trial designs. Our methodological recommendations—including recruiting non-cancer diagnoses, and earlier in the treatment trajectory—likely apply more broadly to the delivery of psychological intervention in the palliative care setting.
Original languageEnglish
Article number96
Number of pages13
JournalBMC palliative care
Volume20
Issue number1
Early online date25 Jun 2021
DOIs
Publication statusE-pub ahead of print - 25 Jun 2021

Keywords

  • acceptance and commitment therapy
  • coaching
  • quality of life
  • distress
  • palliative
  • cancer
  • hospice

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