• Research Evaluating Staff Training Online for Resilience (RESTORE): Protocol for a single-arm feasibility study of an online acceptance and commitment therapy intervention to improve staff wellbeing in palliative care settings

      Finucane, Anne; Hulbert-Williams, Nicholas J.; Swash, Brooke; Spiller, Juliet A.; Lydon, Brigid; Gillanders, David; University of Edinburgh; Marie Curie Hospice Edinburgh; University of Chester (AMRC Open Research, 2021-11-18)
      Background Palliative care workers commonly experience workplace stress and distress. General stressors include unmanageable workloads and staff shortages. Stressors specific to palliative care include regular exposure to death, loss and grief. The COVID pandemic exacerbated exhaustion and burnout across the healthcare system, including for those providing palliative care. Evidence based psychological support interventions, tailored to the needs and context of palliative care workers, are needed. Acceptance and Commitment Therapy (ACT) is an established form of cognitive behavioural therapy which uses behavioural psychology, values, acceptance, and mindfulness techniques to improve mental health and wellbeing. ACT is effective in improving workplace wellbeing in many occupational settings. Our study examines the acceptability and feasibility of an online ACT-based intervention to improve mental health and wellbeing in staff caring for people with an advanced progressive illness. Methods A single-arm feasibility trial. We will seek to recruit 30 participants to take part in an 8- week online ACT-based intervention, consisting of three synchronous facilitated group sessions and five asynchronous self-directed learning modules. We will use convergent mixed methods to evaluate the feasibility of the intervention. Quantitative feasibility outcomes will include participant recruitment and retention rates, alongside completion rates of measures assessing stress, quality of life, wellbeing, and psychological flexibility. Focus groups and interviews will explore participant perspectives on the intervention. We will run a stakeholder workshop to further refine the intervention and identify outcomes for use in a future evaluation. We will describe participant perspectives on intervention acceptability, format, content, and perceived impact alongside rates of intervention recruitment, retention, and outcome measure completion. Conclusion We will show whether a brief, online ACT intervention is acceptable to, and feasible for palliative care workers. Findings will be used to further refine the intervention and provide essential information on outcome assessment prior to a full-scale evaluation.
    • A systematic review of qualitative studies capturing the subjective experiences of Gay and Lesbian individuals’ of faith or religious affiliation.

      Wilkinson, Dean J.; Johnson, Amy; Univeristy of Chester; Univeristy of Worcester
      Individuals identifying as religious tend to report better health and happiness regardless of affiliation, work and family social support or financial status. Evidence suggests that cultural factors are intertwined with these concepts. Exploration of sexual minorities’ experiences has been neglected in previous years. Recently, a body of evidence is developing concerning this population, with theoretical speculation for changes of ‘stressors’ for future generations and implications, particularly, on mental health outcomes. Lesbian and Gay individuals of faith (or spirituality), are susceptible to unique ‘stressors’, whilst others suggest religion can provide a support network providing protective health benefits. This review systematically explores the existing published evidence for the subjective experiences and accounts of LG people of faith. Sexual minority individuals who follow a religion or faith can experience good social support, reducing the risk of negative health outcomes, while for others, potentially serious, negative mental and physical health consequences are experienced (e.g., internalised homophobia, anxiety, rejection and suicidal ideation).
    • The Unmet Psychosocial Needs of Haematological Cancer Patients and their Impact upon Psychological Wellbeing

      Swash, Brooke (University of Chester, 2015-01)
      Unmet psychosocial needs indicate a desire for additional support in cancer patients, having a direct clinical utility in directing the provision of supportive care. There is evidence in wider cancer groups that unmet needs relate to psychological wellbeing but this relationship has yet to be fully explored and factors that may explain or moderate this relationship yet to be examined. There has been little investigation of type or prevalence of unmet need in haematological cancer patients, however, haematological cancers are noteworthy for their high levels of associated distress. Understanding causality of distress is key to the effective implementation of supportive care services. This thesis aimed to highlight the unmet needs most relevant to haematological cancer patients and to explore their impact upon psychological wellbeing. This thesis comprises four interconnected research studies: a systematic review exploring existing knowledge of unmet needs; a qualitative exploration of patient experiences of unmet needs and their impact; a quantitative questionnaire study of unmet need and psychological wellbeing in newly diagnosed haematological cancer patients, placing a special emphasis on the difference between active treatment and watch and wait regimes; and, a second quantitative questionnaire study that explores unmet need, psychological wellbeing, and psychological flexibility as a potential moderator in their relationship in a sample of haematological cancer survivors. This thesis demonstrates a relationship between unmet need and psychological wellbeing in haematological cancer patients. Fear of recurrence, concerns about loved ones, being able to do the things you used to, and a need for information were all found to be of relevance. The qualitative study highlighted that patients feel that, as haematology patients, they are distinct from other cancer patients which impacts upon the perceived acceptability of support services and specific barriers to the accessing of support services are presented. Significant correlations between unmet need and key psychological outcomes such as anxiety, depression and quality of life were observed in both quantitative studies. In addition, the concept of psychological flexibility was found to moderate the relationship between unmet need and psychological wellbeing in haematological cancer survivors. This work has clear implications for both future research and clinical practice. Unmet needs assessment has the potential to be used as a screening tool for overall psychological wellbeing, a way to stratify and understand the specific causes of distress and poor quality of life for this patient group. In the UK, on-going support for cancer patients diminishes at the end of treatment, these findings suggest that further support is needed in order to meet the psychological needs of cancer survivors. Further research is needed to further explore the role of psychological flexibility in cancer-related distress: interventions that target psychological flexibility have the potential to improve both unmet need and distress.