Living Well With Uncertainty in Advanced, Metastatic or Incurable Cancers: A Pragmatic Feasibility Study of the Adapting to Life With Cancer Cognitive ExisteNtial Therapy (ACCENT).
Cheryl Harris, Lauriane Giguère, Alanna Chu, Jani Lamarche, Tori Langmuir, Kerry Menelas, Nicole Rutkowski, Ghizlène Sehabi, Sophie Lebel
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Abstract
Background: New treatments are contributing to individuals living longer with advanced, metastatic, or incurable (AMI) cancers. The impact of these treatments is unpredictable, resulting in considerable uncertainty for these patients. Currently, there are no interventions that effectively address uncertainty in AMI cancers. To fill this gap, we designed the Adapting to life with Cancer Cognitive ExisteNtial Therapy (ACCENT) intervention.
Aim: To evaluate the feasibility, acceptability, and preliminary efficacy of ACCENT in AMI cancers.
Methods: ACCENT was delivered online for 6 consecutive weekly sessions of 1.5 hours to five groups of six to seven patients. Thirty-two patients were interested in participating, but 2 did not complete the assessments pre- or post-intervention. A pragmatic feasibility study was conducted using data collected in routine clinical practice. Participants completed the Intolerance of Uncertainty Scale-Short Form, the Generalized Anxiety Disorder scale, and the Impact of Events Scale before and after the intervention. Post-intervention, participants answered open-ended questions to assess acceptability, rated their perceptions of improvement and usefulness, and completed the Satisfaction with Therapy and Therapist Scale.
Results: ACCENT appears feasible with participants completing the intervention and all assessments between January 2022 and November 2023. It appears acceptable with an attrition rate of 12.5%, and a high degree of attendance and satisfaction. There was a non-significant decrease in intolerance of uncertainty, and a significant decrease in anxiety, and cancer-specific distress post-intervention.
Conclusion: A randomized controlled pilot study is warranted to further evaluate ACCENT in patients with AMI cancers.
期刊介绍：
Psycho-Oncology is concerned with the psychological, social, behavioral, and ethical aspects of cancer. This subspeciality addresses the two major psychological dimensions of cancer: the psychological responses of patients to cancer at all stages of the disease, and that of their families and caretakers; and the psychological, behavioral and social factors that may influence the disease process. Psycho-oncology is an area of multi-disciplinary interest and has boundaries with the major specialities in oncology: the clinical disciplines (surgery, medicine, pediatrics, radiotherapy), epidemiology, immunology, endocrinology, biology, pathology, bioethics, palliative care, rehabilitation medicine, clinical trials research and decision making, as well as psychiatry and psychology.
This international journal is published twelve times a year and will consider contributions to research of clinical and theoretical interest. Topics covered are wide-ranging and relate to the psychosocial aspects of cancer and AIDS-related tumors, including: epidemiology, quality of life, palliative and supportive care, psychiatry, psychology, sociology, social work, nursing and educational issues.
Special reviews are offered from time to time. There is a section reviewing recently published books. A society news section is available for the dissemination of information relating to meetings, conferences and other society-related topics. Summary proceedings of important national and international symposia falling within the aims of the journal are presented.
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