Brief Engagement and Acceptance Coaching for Community and Hospice Settings (the BEACHeS Study): Protocol for the development and pilot testing of an evidence-based psychological intervention to enhance wellbeing and aid transition into palliative care
Abstract
Abstract: Background: Cancer affects millions of individuals globally, with a mortality rate of over eight million people annually. Although palliative care is often provided outside of specialist services, many people require, at some point in their illness journey, support from specialist palliative care services, for example, those provided in hospice settings. This transition can be a time of uncertainty and fear, and there is a need for effective interventions to meet the psychological and supportive care needs of people with cancer that cannot be cured. Whilst Acceptance and Commitment Therapy (ACT) has been shown to be effective across diverse health problems, robust evidence for its effectiveness in palliative cancer populations is not extensive. Method: This mixed-methods study uses a single-case experimental design with embedded qualitative interviews to pilot test a novel intervention for this patient group. Between 14 and 20 patients will be recruited from two hospices in England and Scotland. Participants will receive five face-to-face manualised sessions with a psychological therapist. Sessions are structured around teaching core ACT skills (openness, awareness and engagement) as a way to deal effectively with challenges of transition into specialist palliative care services. Outcome measures include cancer-specific quality of life (primary outcome) and distress (secondary outcome), which are assessed alongside measures of psychological flexibility. Daily diary outcome assessments will be taken for key measures, alongside more detailed weekly self-report, through baseline, intervention and 1-month follow-up phases. After follow-up, participants will be invited to take part in a qualitative interview to understand their experience of taking part and acceptability and perceived effectiveness of the intervention and its components. Discussion: This study is the first investigation of using ACT with terminally ill patients at the beginning of their transition into palliative treatment. Using in-depth single-case approaches, we will refine and manualise intervention content by the close of the study for use in follow-up research trials. Our long-term goal is then to test the intervention as delivered by non-psychologist specialist palliative care practitioners thus broadening the potential relevance of the approach. Trial registration: Open Science Framework, 46033. Registered 19 April 2018.Citation
Pilot and Feasibility Studies, volume 5, issue 1, page 104Publisher
BioMed CentralType
articleDescription
From Springer Nature via Jisc Publications RouterHistory: received 2018-11-23, registration 2019-08-12, accepted 2019-08-12, epub 2019-08-20, online 2019-08-20, collection 2019-12
Publication status: Published
Collections
Related items
Showing items related by title, author, creator and subject.
-
Introducing experiences from African pastoralist communities to cope with climate change risks, hazards and extremes: Fostering poverty reductionAbstract Pastoralist communities all over Africa have been facing a variety of social and economic problems, as well as climate risks and hazards for many years. They have also been suffering from climate change and extremes events, along with a variety of weather and climate threats, which pose many challenges to herders. On the one hand, pastoralist communities have little influence on policy decisions; however, on the other hand, they suffer to a significant extent from such policies, which limit their options for sustainable development and poverty alleviation. Also, the socio-cultural legacy of herders, and their role in food security and provision of ecosystem services, as well as their efforts towards climate change adaptation, are little documented, particularly in Eastern and Southern African countries. There is a perceived need for international studies on the risks and impacts of climate change and extreme events on the sustainability of pastoralist communities in Africa, especially in eastern and southern Africa. Based on the need to address this research gap, this paper describes the climate change risks and challenges that climate threats pose to the sustainability and livelihoods of pastoralist communities in eastern and southern Africa. Also, it discusses the extent to which such problems affect their well-being and income. Additionally, the paper reports on the socioeconomic vulnerability indices at country-level. Also, it identifies specific problems pastoralists face, and a variety of climate adaptation strategies to extreme events through field survey among pastoralist communities in a sample of five countries, namely Ethiopia, Kenya, Malawi, Uganda, and Zimbabwe. The study has shown that the long-term sustainability of the livelihoods of pastoral communities is currently endangered by climate change and the risks and hazards it brings about, which may worsen poverty among this social group. Also, the study suggests that a more systematic and structured approach is needed when assessing the climate vulnerability of individual pastoral communities, since this may help in designing suitable disaster risk reduction strategies. Moreover, the paper shows that it is also necessary to understand better the socio-ecological systems (SES) of the various communities, and how their livelihoods are influenced by the changing conditions imposed by a changing climate.
-
Validation of CIP2A as a Biomarker of Subsequent Disease Progression and Treatment Failure in Chronic Myeloid LeukaemiaBackground: It would be clinically useful to prospectively identify the risk of disease progression in chronic myeloid leukaemia (CML). Overexpression of cancerous inhibitor of protein phosphatase 2A (PP2A) (CIP2A) protein is an adverse prognostic indicator in many cancers. Methods: We examined CIP2A protein levels in diagnostic samples from the SPIRIT2 trial in 172 unselected patients, of whom 90 received imatinib and 82 dasatinib as first-line treatment. Results: High CIP2A levels correlated with inferior progression-free survival (p = 0.04) and with worse freedom from progression (p = 0.03), and these effects were confined to dasatinib recipients. High CIP2A levels were associated with a six-fold higher five-year treatment failure rate than low CIP2A levels (41% vs. 7.5%; p = 0.0002), in both imatinib (45% vs. 11%; p = 0.02) and dasatinib recipients (36% vs. 4%; p = 0.007). Imatinib recipients with low CIP2A levels had a greater risk of treatment failure (p = 0.0008). CIP2A levels were independent of Sokal, Hasford, EUTOS (EUropean Treatment and Outcome Study), or EUTOS long-term survival scores (ELTS) or the presence of major route cytogenetic abnormalities. No association was seen between CIP2A levels and time to molecular response or the levels of the CIP2A-related proteins PP2A, SET, SET binding protein 1 (SETBP1), or AKT. Conclusions: These data confirm that high diagnostic CIP2A levels correlate with subsequent disease progression and treatment failure. CIP2A is a simple diagnostic biomarker that may be useful in planning treatment strategies.
-
Prediction of One Repetition Maximum Using Reference Minimum Velocity Threshold Values in Young and Middle-Aged Resistance-Trained MalesBackground: This study determined the accuracy of different velocity-based methods when predicting one-repetition maximum (1RM) in young and middle-aged resistance-trained males. Methods: Two days after maximal strength testing, 20 young (age 21.0 ± 1.6 years) and 20 middle-aged (age 42.6 ± 6.7 years) resistance-trained males completed three repetitions of bench press, back squat, and bent-over-row at loads corresponding to 20–80% 1RM. Using reference minimum velocity threshold (MVT) values, the 1RM was estimated from the load-velocity relationships through multiple (20, 30, 40, 50, 60, 70, and 80% 1RM), two-point (20 and 80% 1RM), high-load (60 and 80% 1RM) and low-load (20 and 40% 1RM) methods for each group. Results: Despite most prediction methods demonstrating acceptable correlations (r = 0.55 to 0.96), the absolute errors for young and middle-aged groups were generally moderate to high for bench press (absolute errors = 8.2 to 14.2% and 8.6 to 20.4%, respectively) and bent-over-row (absolute error = 14.9 to 19.9% and 8.6 to 18.2%, respectively). For squats, the absolute errors were lower in the young group (5.7 to 13.4%) than the middle-aged group (13.2 to 17.0%) but still unacceptable. Conclusion: These findings suggest that reference MVTs cannot accurately predict the 1RM in these populations. Therefore, practitioners need to directly assess 1RM.
