Pilot evaluation of a self-help ACT intervention for palliative care patients

Abstract

This pilot study evaluates the feasibility and efficacy of a brief (four-week) predominantly self-help acceptance and commitment therapy (ACT) intervention (“Full Palliative Living”) in improving palliative patient primary outcomes (death attitudes, distress, pain, and quality of life) and a secondary outcome psychological flexibility (PF) within a palliative care (PC) setting. A quasi-experimental non-equivalent group design was used with pre- and post-intervention assessments with two groups: intervention (n = 52) and comparison (n = 54). Across three sets of analyses (mixed within/between ANCOVAs, intervention group t-tests and reliable change index), results demonstrated beneficial intervention effects for distress and PF at post-intervention. Mediation analyses showed that increases in PF mediated improvements in distress. Feasibility of delivering the intervention in a frontline PC service was supported by intervention acceptability and adherence ratings, intervention engagement, and participants’ perceptions of intervention helpfulness. The intervention effects on distress are noteworthy given the high prevalence of distress and the self-reported prioritisation of help-seeking for distress among PC patients. The Full Palliative Living program has the potential to make a significant contribution to a holistic approach to PC.