Now showing items 1-20 of 291

    • The views of the few or the voices of many: Methods of exploring leadership roles through alternative approaches within Higher Education.

      Lafferty, Moira E.; University of Chester
      In the following chapter I begin by discussing the changing landscape in higher education and argue why “leadership” is an important part of every academic’s journey. I discuss why we need to challenge traditional views of leadership and critically how we need to explore individuals’ views and reflections on their own leadership journeys. Furthermore, I will critically reflect on how we need to adopt different research methods to allow leadership journeys to emerge with a focus on the use of Q-methodology and why such approaches allow not only the emergence of understanding but can serve a dual purpose and contribute not only to a global understanding but also an individual’s personal development.
    • Gut thinking and eye tracking: Evidence for a central preference heuristic

      Thoma, Volker; Rodway, Paul; Tamlyn, Guy; University of East London; University of Chester (Taylor and Francis, 2021-09-01)
      People prefer the central item in an array of items. This could be due to applying a decision heuristic or greater visual attention to the central item. We manipulated task instructions as participants chose one from three consumer items. The instructions were to “think carefully” in one block and to “use gut feeling” in another. A centrality preference appeared only in the “gut” condition, which was also negatively correlated with self-reported reflective thinking disposition (Need-for-Cognition). Eye-movement patterns, however, were equivalent across both instruction conditions with more frequent and longer fixations on the middle items. The findings demonstrate an effect of instructions on the centrality preference for non-identical consumer items, and provide evidence for a heuristic cause of the centrality preference rather than the allocation of visual attention. The results also show that the centrality preference is more likely to be present when people choose quickly and intuitively.
    • A Systematic Review Exploring the Reflective Accounts of Applied Sport Psychology Practitioners

      Wadsworth, Nick; McEwan, Hayley; Lafferty, Moira; Tod, David; Eubank, Martin; University of Bolton; University of the West of Scotland; University of Chester; Liverpool John Moores
      This systematic review explores the reflective accounts of applied sport psychology practitioners. The aim of this review was to synthesize the reflective accounts of applied sport psychology practitioners and highlight common themes that provide focus to their reflective practice. The insight into current progress on reflective content in applied sport psychology provides a foundation to build on as we continue to understand this topic. Following a systematic search of the literature, a total of 73 studies were included within the review, which were analyzed using thematic content analysis. Analysis of the reflective accounts resulted in the creation of nine higher-order themes: Process and Purpose of Reflective Practice; Ethical Practice; Supporting Person and Performer; Practitioner Individuation; Relationships with Clients; Cultural Awareness; Competence-Related Angst; Support of Practitioner Development; and Evaluating Practitioner Effectiveness. The review includes recommendations for future research, such as the use of narrative analysis to provide further insight into applied practitioners’ experiences. We also provide practical implications, which are tailored to match the specific demands of practitioners at different stages of development and include increased engagement in critical reflection for trainee practitioners and engaging with ‘critical friends’ to facilitate the process of meta-reflection for newly qualified practitioners.
    • Between-task consistency, temporal stability and the role of posture in simple reach and fishing hand preference in chimpanzees (Pan troglodytes)

      Diaz, Sergio; Murray, Lindsay; Roberts, Sam; Rodway, Paul; Universidad Autónoma de Madrid; University of Chester: Liverpool John Moores University (Elsevier, 2021-07-31)
      Studying hand preferences in chimpanzees can provide insights into the evolutionary origins of human hemispheric specialization. Research on chimpanzee hand preference requires careful examination of important factors such as posture, between-task consistency and temporal stability, although few studies have investigated all of these factors in combination. We investigated hand preference in simple reach and fishing behaviours in a group of 19 chimpanzees at Chester Zoo in the UK. Simple reach was defined as extending a hand to grasp a small object, then flexing the limb in a continuous motion, and was examined in quadrupedal, sitting and climbing postures. Fish in hole was defined as inserting a stick into a hole in the wall with one hand and then extracting it with the same hand. Between-task consistency of hand preference was assessed by comparing simple reach and fish in hole, while temporal stability was assessed by comparing simple reach from two points in time: 2017 and 2019. The data showed no significant influence of posture on the strength of hand preference, which contrasts with previous research. The findings of this study show temporal stability in simple reach, although only partial between-task consistency. Overall, the results indicate that simple reach elicits laterality at the individual level and is consistent across postures and stable over time, which is consistent with the literature. These results suggest that posture stability may be important in affecting hand preference. Further, whilst there was overall stability in hand preference across time periods, some individuals changed their preferred hand, suggesting there may be individual level temporal instability of hand preference for certain tasks.
    • Valence of agents and recipients moderates the side-effect effect: Two within-subjects, multi-item conceptual replications

      Stewart, Suzanne L. K.; Kennedy, Bradley J.; Haigh, Matthew.; University of Chester; Northumbria University (Taylor & Francis, 2021-08-27)
      The side-effect effect (SEE) demonstrates that the valence of an unintended side effect influences intentionality judgements; people assess harmful (helpful) side effects as (un)intentional. Some evidence suggests that the SEE can be moderated by factors relating to the side effect’s causal agent and to its recipient. However, these findings are often derived from between-subjects studies with a single or few items, limiting generalisability. Our two within-subjects experiments utilised multiple items and successfully conceptually replicated these patterns of findings. Cumulative link mixed models showed the valence of both the agent and the recipient moderated intentionality and accountability ratings. This supports the view that people represent and consider multiple factors of a SEE scenario when judging intentionality. Importantly, it also demonstrates the applicability of multi-vignette, within-subjects approaches for generalising the effect to the wider population, within individuals, and to a multitude of potential scenarios. For open materials, data, and code, see https://www.doi.org/10.17605/OSF.IO/5MGKN.
    • Specialist palliative and end-of-life care for patients with cancer and SARS-CoV-2 infection: a European perspective

      Soosaipillai, G; Wu, A; Dettorre, GM; Diamantis, J; Chester, J; Moss, C; Aguilar-Company, J; Bower, M; Sng, CCT; Salazar, R; et al. (Sage, 2021-09-02)
      Background: Specialist palliative care team (SPCT) involvement has been shown to improve symptom control and end-of-life care for patients with cancer, but little is known as to how these have been impacted by the COVID-19 pandemic. Here, we report SPCT involvement during the first wave of the pandemic and compare outcomes for patients with cancer who received and did not receive SPCT input from multiple European cancer centres. Methods: From the OnCovid repository (n=1,318), we analysed cancer patients aged ≥18 diagnosed with COVID-19 between 26th February and 22nd June 2020 who had complete specialist palliative care team (SPCT) data (SPCT+ referred; SPCT- not referred). Results: Of 555 eligible patients, 317 were male (57.1%), with a median age of 70 (IQR 20). At COVID-19 diagnosis, 44.7% were on anti-cancer therapy and 53.3% had >1 co-morbidity. 206 patients received SPCT input for symptom control (80.1%), psychological support (54.4%), and/or advance care planning (51%). SPCT+ patients had more DNACPR orders completed prior to (12.6% vs. 3.7%) and during admission (50% vs 22.1%, P<0.001), with more SPCT+ patients deemed suitable for treatment escalation (50% vs. 22.1%, P<0.001). SPCT involvement was associated with higher discharge rates from hospital for end-of-life care (9.7% vs. 0%, P<0.001). End-of-life anticipatory prescribing was higher in SPCT+ patients, with opioids (96.3% vs. 47.1%) and benzodiazepines (82.9% vs. 41.2%) being used frequently for symptom control. Conclusions: SPCT referral facilitated symptom control, emergency care and discharge planning, as well as high rates of referral for psychological support than previously reported. Our study highlighted the critical need of SPCT for patients with cancer during the pandemic and should inform service planning for this population.
    • The Finding My Way UK Clinical Trial: Adaptation report and protocol for a replication randomised controlled efficacy trial of a web-based psychological programme to support cancer survivors

      Hulbert-Williams, Nicholas J; Leslie, Monica; Hulbert-Williams, Lee; Koczwara, Bogda; Watson, Eila K; Hall, Peter S; Ashley, Laura; Coulson, Neil S; Jackson, Richard; Millington, Sue; et al. (JMIR, 2021-07-12)
      Background: Cancer survivors frequently report a range of unmet psychological and supportive care needs; these often continue after treatment has finished, and are predictive of psychological distress and poor health-related quality of life. Online interventions demonstrate good efficacy in addressing these concerns and are more accessible than face to face interventions. Finding My Way is an online, psycho-educational and cognitive behaviour therapy intervention for cancer survivors developed in Australia. Previous trials have demonstrated Finding My Way to be acceptable, highly adhered to, and effective in reducing the impact of distress on quality of life, whilst leading to cost-savings through health-resource use reduction. Objectives: Our study will adapt the Australian Finding My Way website for a UK cancer care context, and then undertake a single-blinded, randomised controlled trial (RCT) of Finding My Way UK against a treatment-as-usual waitlist control. Methods: As much as possible, our trial design replicates the existing Australian RCT of Finding My Way. Following a comprehensive adaptation of the web-resource, we will recruit 294 participants (147 per study arm) from across clinical sites in North West England and North Wales. Participants will: (i) have been diagnosed with cancer of any type in the last six months, (ii) have received anti-cancer treatment with curative intent, (iii) be over 16 years of age, (iv) be proficient in English and (v) have access to the internet and an active email address. Participants will be identified and recruited through the NIHR Clinical Research Network. Measures of distress, quality of life, and health economic outcomes will be collected using a self-report online questionnaire at baseline, mid-treatment, post-treatment and both three- and six-month follow-up. Quantitative data will be analysed using intention-to-treat Mixed-Model Repeated Measures analysis. Embedded semi-structured qualitative interviews will probe engagement with, and experiences of using, Finding My Way UK and suggestions for future improvements. Results: Website adaptation work was completed in January 2021. A panel of cancer survivors and healthcare professionals provided feedback on the test version of Finding My Way UK. Feedback was positive overall, though minor updates were made to website navigation, inclusivity, terminology and the wording of the Improving Communication and Sexuality and Intimacy content. Recruitment for the clinical trial commenced in April 2021. We aim to report on findings from mid 2023. Conclusions: Replication studies are an important aspect of the scientific process, particularly in psychological and clinical trial literatures, and especially in different geographical settings. Prior to replicating the Finding My Way trial in the UK setting, some content updating was required. If Finding My Way UK now replicates Australian findings, we will have identified a novel and cost-effective method of psychosocial care delivery for UK cancer survivors.
    • The Neural Correlates of a Central Coherence Task in Young Women with Anorexia Nervosa

      Leslie, Monica; Halls, Daniel; Leppanen, Jenni; Sedgewick, Felicity; Lang, Katie; Fonville, Leon; Simic, Mima; Mandy, William; Nicholls, Dasha; Williams, Steven; et al. (Wiley, 2021-07-18)
      Objective: Heightened detail-processing and low levels of central coherence are common in individuals with anorexia nervosa (AN) and predict poorer prognosis. However, it is unclear whether these processing styles predate the disorder or, rather, emerge during later stages of AN. The current study aimed to address this question by investigating central coherence, and the neural correlates of central coherence, in a sample of young women with AN with shorter duration of illness than previous studies recruiting adult samples. Methods: We recruited 186 participants, including: 73 young women with AN, 45 young women weight-recovered from AN, and 68 age-matched controls. Participants completed the Embedded Figures Task during an fMRI scan. Results: There were no significant differences between the participant groups in performance accuracy or reaction time. There were no other between-groups differences in neural response to the Embedded Figures Task. Conclusions: These findings contrast with evidence from older adults demonstrating differences in the neural underpinning of central coherence amongst participants with AN versus control participants. The current study adds to an increasing literature base demonstrating the resilience of neuropsychological traits and associated brain systems in the early stages of AN.
    • 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.

      Hulbert-Williams, NJ; Norwood, S; Gillanders, D; Finucane, AM; Spiller, J; Strachen, J; Millington, S; Kreft, J; Swash, B; University of Chester; The University of Edinburgh; Marie Curie Hospice Edinburgh (BMC, 2021-06-25)
      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.
    • OVPSYCH2: A randomized controlled trial of psychological support versus standard of care following chemotherapy for ovarian cancer

      Frangou, E; Bertelli, G; Love, S; Mackean, MJ; Glasspool, RM; Fotopoulou, C; Cook, A; Nicum, S; Lord, R; Ferguson, M; et al. (Elsevier, 2021-05-29)
      Background: Fear of disease progression (FOP) is a rational concern for women with Ovarian Cancer (OC) and depression is also common. To date there have been no randomized trials assessing the impact of psychological intervention on depression and FOP in this patient group. Patients and methods: Patients with primary or recurrent OC who had recently completed chemotherapy were eligible if they scored between 5 and 19 on the PHQ-9 depression and were randomized 1:1 to Intervention (3 standardized CBT-based sessions in the 6 -12 weeks post-chemotherapy) or Control (standard of care). PHQ-9, FOP-Q-SF, EORTC QLQ C30 and OV28 questionnaires were then completed every 3 months for up to 2 years. The primary endpoint was change in PHQ-9 at 3 months. Secondary endpoints were change in other scores at 3 months and all scores at later timepoints. Results: 182 patients registered; 107 were randomized; 54 to Intervention and 53 to Control; mean age 59 years; 75 (70%) had completed chemotherapy for primary and 32 (30%) for relapsed OC and 67 patients completed both baseline and 3-month questionnaires. Improvement in PHQ-9 was observed for patients in both study arms at three months compared to baseline but there was no significant difference in change between Intervention and Control. A significant improvement on FOP-Q-SF scores was seen in the Intervention arm, whereas for those in the Control arm FOP-Q-SF scores deteriorated at 3 months (intervention effect= -4.4 (-7.57,-1.22), p-value = 0.008). Conclusions: CBT-based psychological support provided after chemotherapy did not significantly alter the spontaneously improving trajectory of depression scores at three months but caused a significant improvement in FOP. Our findings call for the routine implementation of FOP support for ovarian cancer patients.
    • Acceptance and values clarification versus cognitive restructuring and relaxation: A randomized controlled trial of ultra-brief non-expert-delivered coaching interventions for social resilience.

      Hochard, Kevin; Hulbert-Williams, Lee; Ashcroft, Sam; McLoughlin, Shane; University of Chester; Liverpool John Moores University
      Low social resilience (e.g., susceptibility to social anxiety, and social avoidance) has been associated with poor mental and physical health outcomes, and can lead to ostracism. Support services such as university counselling centres, which deal with non-diagnosable psychological distress, linked to low social resilience, require effective yet brief interventions deliverable by non-experts to meet service demands. As it is not always possible to prevent subjectively negative experiences, acceptance-based interventions aim to change how we respond behaviourally to such experiences. The present study tests the efficacy of an ultra-brief (1hr) non-expert delivered acceptance and values-based (AV) coaching intervention to increase resilience to negative social interactions. This was compared to a comparable dose of a cognitive restructuring and relaxation-based (CRR) analogue, and a psycho-education and progressive muscle relaxation-based (PE-PMR) control. Participants ( N =60) were assessed on perceived burdensomeness, belonging, and 3 scenarios measuring anxiety and likelihood to engage in social situations. Participants then played Cyberball, an ostracising task, before recompleting the aforementioned measures. Physiological measures indicated Cyberball was an aversive experience. In the AV condition only, we observed an improved behavioral intention to engage with social scenarios ( dppc2 = .57). Ultra-brief AV-based coaching interventions delivered by non-expert coaches appear promising in increasing participant’s likelihood to continue engaging in social interactions after a stressful social experience. We tentatively conclude that gains in committed action may increase the propensity of at-risk individuals to seek social support.
    • Development and usability testing of a web-based psychosocial intervention for women living with metastatic breast cancer: Finding My Way-Advanced

      Beatty, Lisa; Koczwara, Bogda; Butow, Phyllis; Turner, Jane; Girgis, Afaf; Schofield, Penelope; Hulbert-Williams, Nicholas J; Kaambwa, Billingsley; Kemp, Emma; Flinders University; Flinders Medical Centre; Sydney University; University of Queensland; University of New South Wales; Swinburne University of Technology; University of Chester (Springer, 2021-03-15)
      Purpose: Women living with metastatic breast cancer (MBC) face significant distress and unmet needs, yet few resources have been developed for this population. The current study aimed to develop and evaluate the usability of Finding My Way-Advanced (FMW-A), a web-based self-guided psychosocial program for women with MBC. Methods: FMW-A was co-designed through (a) adapting an efficacious online program for people with curatively treated cancer, and (b) receiving iterative rounds of input and feedback from a multidisciplinary co-design team including consumers, clinicians and academics. A think-aloud protocol was then implemented to test the usability of the resulting 6-module prototype, with women living with MBC accessing up to three modules with an interviewer sitting along-side. Participants were recruited until saturation of themes occurred. Data were analysed thematically. Results: Participants (n=8) were, on average, 65.3 years old, mostly partnered (n=5), retired (n=6), post-secondary school educated (n=6), with non-dependent children (n=7). Feedback fell into 6 themes. Positive feedback about FMW-A summarised the supportive and informative nature of the programme, supplemented by comments about broadly relatable content. However, one size clearly did not fit all: within themes, diverging experiences emerged regarding navigability, worksheets and layout. Participants noted that having/making time for the intervention would be important to program engagement. Conclusions: Usability testing indicated participants found content helpful and relatable, and identified significant pragmatic improvements to be made prior to further testing. Implications for cancer survivors: The development of FMW-A represents an important step in providing acceptable resources to support women living with MBC.
    • The Emotional Face of Anorexia Nervosa: The Neural Correlates of Emotional Processing

      Halls, Daniel; Leslie, Monica; Leppanen, Jenni; Sedgewick, Felicity; Surguladze, Simon; Fonville, Leon; Lang, Katie; Simic, Mima; Nicholls, Dasha; Williams, Steven; et al. (Wiley, 2021-03-19)
      Social-emotional processing difficulties have been reported in Anorexia Nervosa (AN), yet the neural correlates remain unclear. Previous neuroimaging work is sparse and has not used functional connectivity paradigms to more fully explore the neural correlates of emotional difficulties. Fifty-seven acutely unwell AN (AAN) women, 60 weight-recovered AN (WR) women and 69 healthy control (HC) women categorised the gender of a series of emotional faces while undergoing Functional Magnetic Resonance Imaging. The mean age of the AAN group was 19.40 (2.83), WR 18.37 (3.59) and HC 19.37 (3.36). A whole brain and psychophysical interaction connectivity approach was used. Parameter estimates from significant clusters were extracted and correlated with clinical symptoms. Whilst no group level differences in whole brain activation were demonstrated, significant group level functional connectivity differences emerged. WR participants showed increased connectivity between the bilateral occipital face area and the cingulate, precentral gyri, superior, middle, medial and inferior frontal gyri compared to AAN and HC when viewing happy valenced faces. Eating disorder symptoms and parameter estimates were positively correlated. Our findings characterise the neural basis of social-emotional processing in a large sample of individuals with AN.
    • Tears Evoke the Intention to Offer Social Support: A Systematic Investigation of the Interpersonal Effects of Emotional Crying Across 41 Countries

      Zickfeld, Janis H.; van de Ven, Niels; Pich, Olivia; Schubert, Thomas W.; Berkessel, Jana B.; Pizarro, José J.; Bhushan, Braj; Mateo, Nino Jose; Barbosa, Sergio; Sharman, Leah; et al. (Elsevier, 2021-04-13)
      Tearful crying is a ubiquitous and likely uniquely human phenomenon. Scholars have argued that emotional tears serve an attachment function: Tears are thought to act as a social glue by evoking social support intentions. Initial experimental studies supported this proposition across several methodologies, but these were conducted almost exclusively on participants from North America and Europe, resulting in limited generalizability. This project examined the tears-social support intentions effect and possible mediating and moderating variables in a fully pre-registered study across 7,007 participants (24,886 ratings) and 41 countries spanning all populated continents. Participants were presented with four pictures out of 100 possible targets with or without digitally-added tears. We confirmed the main prediction that seeing a tearful individual elicits the intention to support, d = .49 [.43, .55]. Our data suggest that this effect could be mediated by perceiving the crying target as warmer and more helpless, feeling more connected, as well as feeling more empathic concern for the crier, but not by an increase in personal distress of the observer. The effect was moderated by the situational valence, identifying the target as part of one’s group, and trait empathic concern. A neutral situation, high trait empathic concern, and low identification increased the effect. We observed high heterogeneity across countries that was, via split-half validation, best explained by country-level GDP per capita and subjective well-being with stronger effects for higher-scoring countries. These findings suggest that tears can function as social glue, providing one possible explanation why emotional crying persists into adulthood.
    • The challenge of relational referents in early word extensions: Evidence from noun-noun compounds

      Snape, Simon; Krott, Andrea; University of Chester; University of Birmingham
      Young children struggle more with mapping novel words onto relational referents (e.g., verbs) compared to non-relational referents (e.g., nouns). We present further evidence for this notion by investigating children’s extensions of noun-noun compounds, which map onto combinations of non-relational referents, i.e. objects (e.g., baby and bottle for baby bottle), and relations (e.g., a bottle FOR babies). We tested two- to five-year-olds’ and adults’ generalisations of novel compounds composed of novel (e.g., kig donka) or familiar (e.g., star hat) nouns that were combined by one of two relations (e.g., donka that has a kig attached (=attachment relation) versus donka that stores a kig (=function relation)). Participants chose between a relational (shared relation) and a non-relational (same colour) match. Results showed a developmental shift from encoding non-relational aspects (colour) towards relations of compound referents, supporting the challenge of relational word referents. Also, attachment relations were more frequently encoded than function relations.
    • Evaluating process and effectiveness of a low-intensity CBT intervention for women with gynaecological cancer (the EPELIT Trial)

      Hulbert-Williams, Nicholas J.; Hulbert-Williams, Lee; Flynn, Ryan J.; Pendrous, Rosina; MacDonald-Smith, Carey; Mullard, Anna; Swash, Brooke; Evans, Gemma; Price, Annabel; University of Chester; North Wales Cancer Treatment Centre; Ysbyty Gwynedd; Addenbrooke's Hospital Cambridge (F1000Research, 2021-03-29)
      Background: Improving survival from gynaecological cancers is creating an increasing clinical challenge for long-term distress management. Psychologist-led interventions for cancer survivors can be beneficial, but are often costly. The rise of the Psychological Wellbeing Practitioner (PWP) workforce in the UK might offer a cheaper, but equally effective, intervention delivery method that is more sustainable and accessible. We aimed to test the effectiveness of a PWP co-facilitated intervention for reducing depression and anxiety, quality of life and unmet needs. Methods: We planned this trial using a pragmatic, non-randomised controlled design, recruiting a comparator sample from a second clinical site. The intervention was delivered over six-weekly sessions; data were collected from participants at baseline, weekly during the intervention, and at one-week and three-month follow-up. Logistical challenges meant that we only recruited 8 participants to the intervention group, and 26 participants to the control group. Results: We did not find significant, between-group differences for depression, quality of life or unmet needs, though some differences at follow-up were found for anxiety (p<.001). Analysis of potential intervention mediator processes indicated the potential importance of self-management self-efficacy. Low uptake into the psychological intervention raises questions about (a) patient- driven needs for group-based support, and (b) the sustainability of this intervention programme. Conclusions: This study failed to recruit to target; the under-powered analysis likely explains the lack of significant effects reported, though some trends in the data are of interest. Retention in the intervention group, and low attrition in the control group indicate acceptability of the intervention content and trial design; however a small baseline population rendered this trial infeasible in its current design. Further work is required to answer our research questions, but also, importantly, to address low uptake for psychological interventions in this group of cancer survivors.
    • Evaluating the impact of COVID-19 on supportive care needs, psychological distress and 3 quality of life in UK cancer survivors and their support network.

      Hulbert-Williams, Nicholas J.; Leslie, Monica; Hulbert-Williams, Lee; Smith, Eilidh; Howells, Lesley; Pinato, David J; University of Chester; Maggie's Cancer Centres; Imperial College London
      Objectives: The COVID-19 pandemic is having considerable impact on cancer care, including restricted access to hospital-based care, treatment and psychosocial support. We investigated the impact on unmet needs and psychosocial wellbeing. Methods: 144 participants (77% female), including people with cancer and their support networks, were recruited. The most prevalent diagnosis was breast cancer. Forty-one participants recruited pre-pandemic were compared with 103 participants recruited during the COVID-19 pandemic. We measured participants’ unmet supportive care needs, psychological distress and quality of life. Results: Half of our patient respondents reported unexpected changes to treatment following pandemic onset, with widespread confusion about their longer-term consequences. Although overall need levels have not increased, specific needs have changed in prominence. People with cancer reported significantly reduced anxiety (p=.049) and improved quality of life (p=.032) following pandemic onset, but support network participants reported reduced quality of life (p=.009), and non-significantly elevated anxiety, stress and depression. Conclusion: Psychological wellbeing of people with cancer has not been detrimentally affected by pandemic onset. Reliance on home-based support to compensate for the lost availability of structured healthcare pathways may, however, explain significant and detrimental effects on the wellbeing and quality of life of people in their support and informal care networks.
    • Acceptance and Commitment Therapy (ACT) Enhanced Communication Skills: development and evaluation of a novel training programme

      Hulbert-Williams, Nicholas J; Hulbert-Williams, Lee; Patterson, Pandora; Suleman, Sahil; Howells, Lesley; University of Chester; Canteen Australia; University of Sydney; St George's University Hospitals NHS Foundation Trust; Maggie's Cancer Centres
      Background: Psychological suffering is ubiquitous with cancer and frequently presents as an unmet supportive care need. In clinical practice, distress-related needs are often addressed by nurses and non-psychologist allied healthcare professionals who may have limited training in psychological therapeutic frameworks, particularly more recently-developed interventions such as Acceptance and Commitment Therapy (ACT). Aims: We developed a single-day training programme for professionals working in supportive and palliative cancer care settings to change the nature of clinical communication about psychological distress and suffering towards an ACT-consistent approach. Method: We report on experiences of training delivery, and evaluation data about training satisfaction and intention to apply the training to clinical practice, from three training iterations in British and Australian, government-funded and charitable sectors. One hundred and sixteen cancer care professionals participated in the training. Evaluation data was collected from 53 participants (at either two-week or three-month follow-up, or both) using self-report survey including both quantitative and free-text questions. Results: At two-week follow-up, 73% of trainees rating our course as having relevance to their work, and at three-month follow up, 46% agreed that they were better placed to provide improved clinical services. Qualitative feedback supported the inclusion of experiential learning and theoretical explanations underpinning ACT techniques. Undertaking this training did not significantly increase trainees’ stress levels, nor did implementation of this new way of working negatively affect staff wellbeing. Positive, ACT-consistent, changes in communication behaviours and attitudes were reported, however there was a lack of significant change in psychological flexibility. Discussion: Acceptability and applicability of this training to supportive and palliative healthcare is positive. The lack of change in psychological flexibility suggests a potential need for more experiential content in the training programme. Logistical challenges in one training group suggests the need for more robust train-the-trainer models moving forward.
    • Concreteness of semantic interpretations of abstract and representational artworks

      Schepman, Astrid; Rodway, Paul; University of Chester
      The authors tested two contrasting theoretical predictions to establish whether semantic interpretations of abstract artworks had different lexical concreteness from those of representational artworks. In Experiment 1, 49 non-expert participants provided brief verbal interpretations of 20 abstract and 20 representational artworks. Frequentist and Bayesian Linear Mixed Models showed that the words’ concreteness levels were robustly higher for interpretations of abstract artworks than representational artworks. This difference was present regardless of the inclusion or exclusion of function words. Potential diluting or inflating impacts on the effect due to the multi-word responses were examined in Experiment 2, in which 72 new participants provided single-word interpretations for the same artworks. The effect replicated with a larger effect size. The findings suggest that non-expert viewers prioritise establishing what is depicted over seeking deeper meanings if the depicted is not readily established perceptually. The findings are incompatible with the theoretical stance that abstract art has abstract meaning. Instead, the findings are consistent with complex models of aesthetic processing in which meaning may emerge in stages. The effect of art type on the concreteness of meaning is an important, hitherto undiscovered basic finding in empirical aesthetics. Our novel methods enable further research in this field.
    • Setting an International Research Agenda for Fear of Cancer Recurrence: an online delphi consensus study

      Shaw, Joanne; Kamphuis, H; Sharpe, Louise; Lebel, Sophie; Smith, Allan Ben; Hulbert-Williams, Nicholas J; Dhillon, Haryana M; Butow, Phyllis; University of Sydney; University of Ottawa; University of New South Wales; University of Chester (Frontiers Media, 2021-02-22)
      Background: Fear of cancer recurrence (FCR) is common amongst cancer survivors. There is rapidly growing research interest in FCR but a need to prioritise research to address the most pressing clinical issues and reduce duplication and fragmentation of effort. This study aimed to establish international consensus among clinical and academic FCR experts regarding priorities for FCR research. Methods: Members of the International Psycho-oncology Society (IPOS) Fear of Cancer Recurrence Special Interest Group (FORwards) were invited to participate in an online Delphi study. Research domains identified in Round 1 were presented and discussed at a focus group (Round 2) to consolidate the domains and items prior to presentation in further survey rounds (Round 3) aimed at gaining consensus on research priorities of international significance. Results: Thirty four research items were identified in Round 1 and 33 of the items were consolidated into 6 overarching themes through a focus group discussion with FCR experts. The 33 research items were presented in subsequent rounds of the delphi technique. Twenty one participants contributed to delphi round 1, 16 in round 2 and 25 and 29 participants for subsequent delphi rounds. Consensus was reached for 27 items in round 3.1. A further 4 research items were identified by panellists and included in round 3.2. After round 3.2, 35 individual research items were ratified by the panellists. Given the high levels of consensus and stability between rounds no further rounds were conducted. Overall intervention research was considered the most important focus for FCR research. Panellists identified models of care that facilitate greater access to FCR treatment and evaluation of the effectiveness of FCR interventions in real world settings as the two research items of highest priority. Defining the mechanisms of action and active components across FCR/P interventions, was the third highest priority identified. Conclusions: The findings of this study outline a research agenda for international FCR research. Intervention research to identify models of care that increase access to treatment, are based on a flexible approach based on symptom severity and can be delivered within routine clinical care, were identified as research areas to prioritise. Greater understanding of the active components and mechanisms of action of existing FCR interventions will facilitate increased tailoring of interventions to meet patient need.