Improving Psychological Adjustment Among Late-Stage Ovarian Cancer Patients: Examining the Role of Avoidance in Treatment

Rost, Ann D.; Wilson, Kelly G.; Buchanan, Erin Michelle; Hildebrandt, Mikaela J.; Mutch, David G.

doi:10.1016/j.cbpra.2012.01.003

Cited by 125 publications

(230 citation statements)

References 27 publications

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“…The ACT literature around oncology more widely has produced promising results. Improvements have been demonstrated for both cancer-specific and broader outcomes (Arch & Mitchell, 2016;Rost et al, 2012). Indeed, not only have improvements in both distress and quality of life been found in oncology samples, but improvements have been found to be sustained over time (Feros et al, 2011).…”

Section: Discussionmentioning

confidence: 99%

“…In cancer samples specifically, interventions that utilise ACT-based techniques have been shown to feasible for delivery in community care settings (Arch & Mitchell, 2015) and of benefit in improving mood and quality of life (e.g. Rost et al, 2012;Feros et al, 2013). However, this literature is small and in many cases methodologically poor, and there is a need for further, more robustly designed empirical research (Hulbert-Williams, Storey, & Wilson, 2015).…”

Section: Introductionmentioning

confidence: 99%

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Unmet psychosocial supportive care needs and psychological distress in haematological cancer survivors: The moderating role of psychological flexibility

Swash

Bramwell

Hulbert‐Williams

2017

Journal of Contextual Behavioral Science

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BackgroundThe period immediately after the end of cancer treatment is a time when supportive care for the cancer patient decreases; this is known to increase risk of psychological distress and poor wellbeing.While there is broad recognition that unmet psychological and supportive care needs correlate with psychological wellbeing, little is understood about the factors that influence this relationship. This study explores the role of psychological flexibility, with a particular focus on its potential moderating role between unmet needs and psychological distress in haematological cancer survivors. Materials and MethodHaematological cancer survivors were recruited for this cross-sectional study through two major UK blood cancer charities. Participants (n=91) were all over the age of 16 and had been diagnosed with any sub-type of haematological cancer more than 18 months previously. Participants completed selfreport questionnaires assessing unmet psychological and supportive care needs (SCNS SF34), anxiety and depression (HADS), quality of life (EORTC QLQ-C30) and psychological flexibility (AAQ II). ResultsHigh levels of both unmet need and distress were present in the sample, indicating on-going care needs for these cancer survivors. Statistically significant correlations between unmet needs, psychological flexibility and all outcome variables (anxiety, depression, quality of life) were found.Using regression analysis based on Hayes' methodology (Hayes, 2013), psychological flexibility was found to act as a moderator between unmet need and distress in four out of 15 models; specifically, the statistical relationship between need and distress emerged only when levels of psychological flexibility were at average level or above. DiscussionHaematological cancer survivors have on-going supportive care needs that persist well beyond the end of active treatment. Unmet needs can, in turn, increase levels of anxiety and depression, and reduce quality of life in this patient group. The understanding offered by our data that psychological flexibility plays a moderating relationship between need and psychological distress creates opportunities for the development of theoretically-informed interventions to reduce both unmet need and distress in cancer patients. As such, these findings support the growing emphasis on Acceptance and Commitment based interventions for cancer patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Unmet psychosocial supportive care needs and psychological distress in haematological cancer survivors: The moderating role of psychological flexibility

Swash

Bramwell

Hulbert‐Williams

2017

Journal of Contextual Behavioral Science

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“…Of these 18 studies, six were case studies (or case series) Graham, Gillanders, Stuart, & Gouick, 2014;Masuda, Cohen, Wicksell, Kemani, & Johnson, 2011;Moitra et al, 2011;Nes et al, 2012;Skinta, Lezama, Wells, & Dilley, 2014); four used pre-post designs with no control group (Burke et al, 2014;Feros, Lane, Ciarrochi, & Blackledge, 2013;Goodwin, Forman, Herbert, Butryn, & Ledley, 2011;Sheppard, Forsyth, Hickling, & Bianchi, 2010); and eight were randomised controlled trials (RCT) (Brown, Whittingham, Boyd, McKinlay, & Sofronoff, 2014;Gregg, Callaghan, Hayes, & Glenn-Lawson, 2007;Hawkes, Pakenham, Chambers, Patrao, & Courneya, 2014;Hawkes et al, 2013;Lundgren, Dahl, Melin, & Kies, 2006;Lundgren, Dahl, Yardi, & Melin, 2008;Nordin & Rorsman, 2012;Rost, Wilson, Buchanan, Hildebrandt, & Mutch, 2012;Whittingham, Sanders, McKinlay, & Boyd, 2014). The studies using RCT and pre-post designs involved samples of people with cancer (Feros et al, 2013;Hawkes et al, 2013Hawkes et al, , 2014Rost et al, 2012); epilepsy Lundgren et al, 2008); multiple sclerosis (Nordin & Rorsman, 2012;Sheppard et al, 2010); cardiac disease (Goodwin et al, 2011); type II diabetes (Gregg et al, 2007); paediatric cerebral palsy ); brain injury (Brown et al, 2014): and "life threatening illness" (Burke et al, 2014).…”

Section: Description Of the Included Studiesmentioning

confidence: 99%

A systematic review of the use of Acceptance and Commitment Therapy (ACT) in chronic disease and long-term conditions

Graham

Gouick

Krahé

et al. 2016

Clinical Psychology Review

365

280

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Many have proposed that Acceptance and Commitment Therapy (ACT) may be particularly effective for improving outcomes in chronic disease/long-term conditions, and ACT techniques are now being used clinically. However, reviews of ACT in this context are lacking, and the state of evidence is unclear. This systematic review aimed to: collate all ACT interventions with chronic disease/long-term conditions, evaluate their quality, and comment on efficacy. Ovid MEDLINE, EMBASE and Psych Info were searched. Studies with solely mental health or chronic pain populations were excluded. Study quality was then rated, with a proportion re-rated by a second researcher. Eighteen studies were included: eight were randomised controlled trials (RCTs), four used pre-post designs, and six were case studies. A broad range of applications were observed (e.g. improving quality of life and symptom control, reducing distress) across many diseases/conditions (e.g. HIV, cancer, epilepsy).However, study quality was generally low, and many interventions were of low intensity. The small number of RCTs per application and lower study quality emphasise that ACT is not yet a well-established intervention for chronic disease/long-term conditions. However, there was some promising data supporting certain applications: parenting of children with long-term conditions, seizure-control in epilepsy, psychological flexibility, and possibly disease selfmanagement.

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“…Pos-sible benefits of ACT applied to cancer patients are being highlighted (25)(26)(27)(28)(29) . Promising preliminary data has been presented through case studies (30)(31) and clinical trials (29,(32)(33)(34) . Benefits of ACT are related with improvements in emotional distress (28) , mood (28,33) , quality of life (28,29,32,33) , depression (32,34) , health behavior (35) , posttraumatic growth and spirituality (29) and valued areas (32) .…”

Section: Introductionmentioning

confidence: 99%

Aceptación de miedos a la recaída en pacientes con cáncer de mama: efectos de una intervención abreviada basada en la ACT

Montesinos

Luciano

2016

Psicooncología

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ResumenObjetivo: El miedo a la recidiva es una secuela psicológica habitual en supervivientes de cáncer. El objetivo de este estudio es valorar los efectos de una versión breve de la Terapia de Aceptación y Compromiso (ACT) en pacientes de cáncer de mama.Método: Se realizó un ensayo abierto en el que participaron 12 pacientes no-metastásicas distribuidas en 2 condiciones, ACT y lista de espera. La intervención se aplicó en una única sesión individual y se centró en la aceptación del miedo por medio de un ejercicio de "defusión". Después de cada intervención y en el seguimiento trimestral se midieron la interferencia y la intensidad del miedo mediante escalas subjetivas. Además, las participantes completaron las escalas HADS, MINIMAC e IBQ.Resultados: El 87% de pacientes que recibieron la intervención mostró disminuciones clínicamente significativas en interferencia del miedo a la recidiva en el seguimiento trimestral, lo que no ocurrió en ninguna paciente en lista de espera. Los cambios en interferencia fueron estadísticamente significativos en las comparaciones pre, post y seguimiento, y también en la comparación con lista de espera. Asimismo se observaron cambios en intensidad, malestar emocional, preocupación ansiosa e hipocondría. AbstractObjective: Relapse fear is a common psychological scar in cancer survivors. The aim of this study is to assess the effects of an abridged version of Acceptance and Commitment Therapy (ACT) in breast cancer patients.Method: An open trial was developed with 12 non-metastatic breast cancer patients assigned to 2 conditions, ACT and waiting list. Interventions were applied in just one session and focused on the acceptance of relapse fears through a 'defusion' exercise. Interference and intensity of fear measured through subjective scales were collected after each intervention and again 3 months later. Distress, hypochondria and 'anxious preocupation' were also evaluated through standardized questionnaires.Results: The analysis revealed that 'defusion' contributed to decrease the interference of the fear of recurrence, and these changes were maintained three months after intervention in most subjects. 87% of participants showed clinically significant decreases in interference at follow-up sessions whereas no patient in the waiting list showed such changes. Statistical analysis revealed that the changes in interference were significant when comparing pre, post and follow-up treatment, and also when comparing ACT and waiting list groups. Changes in intensity 8 Francisco Montesinos & Carmen LucianoConclusiones: La exposición mediante téc-nicas de "defusión" puede ser considerada una alternativa terapéutica para el tratamiento de miedos persistentes en pacientes de cáncer. El estudio aporta evidencia de la utilidad de técnicas orientadas a promover la aceptación psicológica en pacientes oncológicos aplicadas mediante métodos terapéuticos breves y sencillos que son bien admitidos por los pacientes.Palabras clave: Terapia de Aceptación y Compromiso, ACT, cáncer, psicooncología, miedo...

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Improving Psychological Adjustment Among Late-Stage Ovarian Cancer Patients: Examining the Role of Avoidance in Treatment

Cited by 125 publications

References 27 publications

Unmet psychosocial supportive care needs and psychological distress in haematological cancer survivors: The moderating role of psychological flexibility

Unmet psychosocial supportive care needs and psychological distress in haematological cancer survivors: The moderating role of psychological flexibility

A systematic review of the use of Acceptance and Commitment Therapy (ACT) in chronic disease and long-term conditions

Aceptación de miedos a la recaída en pacientes con cáncer de mama: efectos de una intervención abreviada basada en la ACT

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